Allergic March

Year 2026, Volume: 12 Issue: 1, 120 - 129, 25.02.2026

Mehmet Fatih Karakuş

https://doi.org/10.19127/mbsjohs.1805968

https://izlik.org/JA35NC36SY

Abstract

Background: Atopy is defined as an individual or familial history of type 1 allergy, bronchial asthma, allergic rhinitis-conjunctivitis and/or atopic dermatitis and/or a tendency to overproduce IgE antibodies. Asthma, allergic rhinitis, food allergy and atopic dermatitis are typically considered allergic diseases. Allergic March - Atopic March is a concept that refers to the natural progression of allergic diseases that usually begin early in life. The order of disease progression in childhood is usually Atopic Dermatitis → Food Allergy → Allergic Rhinitis → Asthma. This progression, which continues as skin, gastrointestinal system, respiratory system, may change depending on genetic and environmental exposure, possibly through epigenetic mechanisms.

Review text: The main problem is inflammation caused by dysregulation of the immune response dependent on T helper 2 (Th2) cells. Possible mechanisms for the Allergic March are described as dysfunction of the skin barrier, alterations in the microbiome, epigenetic factors, social dysfunction of cells and molecules and the predicted interaction of other genes. Strategically, it is important to consider that breastfeeding for more than 6 months not only reduces the incidence of atopic dermatitis but also reduces the risk of developing other allergic diseases, that the use of Lactobacillus rhamnosus as a probiotic during the first 2 years of life can be effective, that the use of tobacco products at home or in the environment triggers the development of allergic sensitisation - asthma in children and that the prevention of exposure is strongly ensured.

Conclusion: According to the Allergic March theory, early recognition of children at risk of allergic diseases and prevention of the process will significantly improve the quality of life in a healthy adult. 

Keywords

asthma , rhinitis allergic , food allergies , atopic dermatitis , allergy

Alerjik Yürüyüş

https://izlik.org/JA35NC36SY

Abstract

Giriş: Atopi; tip 1 alerji, bronşiyal astım, alerjik rinit-konjonktivit ve/veya atopik dermatit yönünden bireysel veya ailesel öykü ve/veya aşırı IgE antikoru üretme eğilimi olarak tanımlanır. Astım, alerjik rinit, gıda alerjisi ve atopik dermatit genellikle alerjik hastalıklar olarak kabul edilir. Alerjik Yürüyüş (Atopik Yürüyüş), genellikle yaşamın erken dönemlerinde başlayan alerjik hastalıkların doğal ilerlemesini ifade eden bir kavramdır. Çocukluk döneminde hastalık ilerleme sırası genellikle Atopik Dermatit → Gıda Alerjisi → Alerjik Rinit → Astım şeklindedir. Deri, gastrointestinal sistem ve solunum sistemi olarak devam eden bu ilerleme; genetik ve çevresel maruziyete bağlı olarak, muhtemelen epigenetik mekanizmalar aracılığıyla değişebilir. Derleme Metni: Temel sorun, T yardımcı 2 (Th2) hücrelerine bağımlı immün yanıtın disregülasyonundan (bozulmasından) kaynaklanan inflamasyondur. Alerjik Yürüyüş için olası mekanizmalar; deri bariyerinin disfonksiyonu, mikrobiyomdaki değişiklikler, epigenetik faktörler, hücrelerin ve moleküllerin sosyal işlev bozukluğu ve diğer genlerin öngörülen etkileşimi olarak tanımlanmaktadır. Stratejik olarak; 6 aydan fazla emzirmenin sadece atopik dermatit insidansını azaltmakla kalmayıp diğer alerjik hastalıkların gelişme riskini de azalttığı, yaşamın ilk 2 yılında probiyotik olarak Lactobacillus rhamnosus kullanımının etkili olabileceği, evde veya çevrede tütün ürünleri kullanımının çocuklarda alerjik duyarlılaşma ve astım gelişimini tetiklediği ve bu maruziyetin önlenmesinin güçlü bir şekilde sağlanması gerektiği dikkate alınmalıdır. Sonuç: Alerjik Yürüyüş teorisine göre, alerjik hastalık riski taşıyan çocukların erken fark edilmesi ve sürecin önlenmesi, sağlıklı bir yetişkinin yaşam kalitesini önemli ölçüde artıracaktır.

Keywords

astım , alerjik rinit , gıda alerjisi , atopik dermatit , alerji

References

• Ertam İ, Su Ö, Alper S, Sarıcaoğlu H, Karadağ AS, Odyakmaz Demirsoy E, et al. The Turkish guideline for the diagnosis and management of atopic dermatitis-2018. Turkderm-Turk Arch Dermatol Venereol. 2018;52(1): 6-23.
• Weidinger S, Novak N. Atopic dermatitis. Lancet. 2016;387(10023): 1109-1122.
• Turner S. Gene-Environment Interactions-What Can These Tell Us about the Relationship between Asthma and Allergy? Front Pediatr. 2017 May 22;5: 118. doi:10.3389/fped.2017.00118
• Martín-Orozco E, Norte-Muñoz M, Martínez-García J. Regulatory T Cells in Allergy and Asthma. Front Pediatr. 2017 May 23;5: 117. doi:10.3389/fped.2017.00117
• Spergel JM. Atopic march: link to upper airways. Curr Opin Allergy Clin Immunol. 2005;5(1): 17-21.
• von Kobyletzki LB, Bornehag CG, Hasselgren M, Larsson M, Lindström CB, Svensson Å. Eczema in early childhood is strongly associated with the development of asthma and rhinitis in a prospective cohort. BMC Dermatol. 2012 Jul 27;12: 11. doi:10.1186/1471-5945-12-11
• Yang L, Fu J, Zhou Y. Research Progress in Atopic March. Front Immunol. 2020 Aug 27;11: 1907. doi:10.3389/fimmu.2020.01907
• Torres T, Ferreira EO, Gonçalo M, Mendes-Bastos P, Selores M, Filipe P. Update on Atopic Dermatitis. Acta Med Port. 2019;32(9): 606-613.
• Knyziak-Medrzycka I, Majsiak E, Cukrowska B. Allergic March in Children: The Significance of Precision Allergy Molecular Diagnosis (PAMD@) in Predicting Atopy Development and Planning Allergen-Specific Immunotherapy. Nutrients. 2023 Feb 15;15(4): 978. doi:10.3390/nu15040978
• Sicherer SH, Sampson HA. Food allergy: epidemiology, pathogenesis, diagnosis, and treatment. J Allergy Clin Immunol. 2014;133(2): 291-307.
• Tran MM, Lefebvre DL, Dharma C, Dai D, Lou WYW, Subbarao P, et al. Canadian Healthy Infant Longitudinal Development Study investigators. Predicting the atopic march: Results from the Canadian Healthy Infant Longitudinal Development Study. J Allergy Clin Immunol. 2018;141(2): 601-607.e8.
• Schroeder A, Kumar R, Pongracic JA, Sullivan CL, Caruso DM, Costello J, et al. Food allergy is associated with an increased risk of asthma. Clin Exp Allergy. 2009;39(2): 261-270.
• Mohammad AA, Wu SZ, Ibrahim O, Bena J, Rizk M, Piliang M, et al. Prevalence of atopic comorbidities in eosinophilic esophagitis: a case control study of 449 patients. J Am Acad Dermatol. 2017;76(3): 559-560.
• Hirota T, Nakayama T, Sato S, Yanagida N, Matsui T, Sugiura S, et al. Association study of childhood food allergy with genome-wide association studies-discovered loci of atopic dermatitis and eosinophilic esophagitis. J Allergy Clin Immunol. 2017;140(6): 1713-1716.
• Hill DA, Spergel JM. Is eosinophilic esophagitis a member of the atopic march? Ann Allergy Asthma Immunol. 2018;120(2): 113-114.
• Hudson TJ. Skin barrier function and allergic risk. Nat Genet. 2006;38(4): 399-400.
• Noti M, Kim BS, Siracusa MC, Rak GD, Kubo M, Moghaddam AE, et al. Exposure to food allergens through inflamed skin promotes intestinal food allergy through the thymic stromal lymphopoietin-basophil axis. J Allergy Clin Immunol. 2014;133(5): 1390-1399 1399.e1–6.
• Savinko T, Matikainen S, Saarialho-Kere U, Lehto M, Wang G, Lehtimaki S, et al. IL-33 and ST2 in atopic dermatitis: expression profiles and modulation by triggering factors. J Invest Dermatol. 2012;132(5): 1392-1400.
• Hill DA, Spergel JM. The atopic march: critical evidence and clinical relevance. Ann Allergy Asthma Immunol. 2018;120(2): 131-137.
• Penders J, Thijs C, van den Brandt PA, Kummeling I, Snijders B, Stelma F, et al. Gut microbiota composition and development of atopic manifestations in infancy: the KOALA Birth Cohort Study. Gut. 2007;56(5): 661-667.
• Xu CJ, Soderhall C, Bustamante M, Baiz N, Gruzieva O, Gehring U, et al. DNA methylation in childhood asthma: an epigenome-wide meta-analysis. Lancet Respir Med. 2018;6(5): 379-388.
• Peng C, Van Meel ER, Cardenas A, Rifas-Shiman SL, Sonawane AR, Glass KR, et al. Epigenome-wide association study reveals methylation pathways associated with childhood allergic sensitization. Epigenetics. 2019;14(5): 445-466.
• Luo J, Li Y, Gong R. The mechanism of atopic march may be the ’social’ event of cells and molecules (Review). Int J Mol Med. 2010;26(6): 779-785.
• Marenholz I, Esparza-Gordillo J, Ruschendorf F, Bauerfeind A, Strachan DP, Spycher BD, et al. Meta-analysis identifies seven susceptibility loci involved in the atopic march. Nat Commun. 2015 Nov 6;6:8804. doi:10.1038/ncomms9804
• Paller AS, Spergel JM, Mina-Osorio P, Irvine AD. The atopic march and atopic multimorbidity: many trajectories, many pathways. J Allergy Clin Immunol. 2019;143(1): 46-55.
• Abo-Zaid G, Sharpe RA, Fleming LE, Depledge M, Osborne NJ. Association of infant eczema with childhood and adult asthma: analysis of data from the 1958 birth cohort study. Int J Environ Res Public Health. 2018;15(7): 1415.
• Soller L, Ben-Shoshan M, Harrington DW, Fragapane J, Joseph L, St Pierre Y, et al. Overall prevalence of self-reported food allergy in Canada. J Allergy Clin Immunol. 2012;130(4): 986-988.
• Kull I, Bohme M, Wahlgren CF, Nordvall L, Pershagen G, Wickman M. Breast-feeding reduces the risk for childhood eczema. J Allergy Clin Immunol. 2005;116(3): 657-661.
• Wickens K, Black PN, Stanley TV, Mitchell E, Fitzharris P, Tannock GW, et al. A differential effect of 2 probiotics in the prevention of eczema and atopy: a double-blind, randomized, placebo-controlled trial. J Allergy Clin Immunol. 2008;122(4): 788-794.
• Lannero E, Wickman M, van Hage M, Bergstrom A, Pershagen G, Nordvall L. Exposure to environmental tobacco smoke and sensitisation in children. Thorax. 2008;63(2): 172-176.
• Dick S, Friend A, Dynes K, AlKandari F, Doust E, Cowie H, et al. A systematic review of associations between environmental exposures and development of asthma in children aged up to 9 years. BMJ Open. 2014 Nov 24;4(11): e006554. doi:10.1136/bmjopen-2014-006554
• Barnes PJ. Glucocorticoids. Chem Immunol Allergy. 2014;100: 311-316.
• Jacobsen L, Wahn U, Bilo MB. Allergen-specific immunotherapy provides immediate, long-term and preventive clinical effects in children and adults: the effects of immunotherapy can be categorised by level of benefit - the centenary of allergen specific subcutaneous immunotherapy. Clin Transl Allergy. 2012;2: 8.