Atopic sensitization is considered in the case of a person having IgE positivity or a prick test positivity to any common food- or air-borne allergen. Atopic conditions are considered: atopic dermatitis, allergic rhinitis (hay fever), allergic asthma, atopic keratoconjunctivitis. The likelihood of having asthma, rhinitis and atopic dermatitis together is 10 times higher than could be expected by chance. Atopy is more common among individuals with a number of different conditions, such as eosinophilic esophagitis and non-celiac gluten sensitivity.
Allergic reactions can range from sneezing and rhinorrhoea to anaphylaxis and even death.
In an allergic reaction, initial exposure to an otherwise harmless exogenous substance (known as an allergen) triggers the production of specific IgE antibodies by activated B cells. These IgE antibodies bind to the surface of mast cells via high-affinity IgE receptors, a step that is not itself associated with a clinical response. However, upon re-exposure, the allergen binds to membrane-bound IgE which activates the mast cells, releasing a variety of mediators. This type I hypersensitivity reaction is the basis of the symptoms of allergic reactions, which range from sneezing and rhinorrhoea to anaphylaxis. Allergens can be a number of different substances, for example pollen, dander, dust mites, and foods.
Environmental factors are also thought to play a role in the development of atopy, and the 'hygiene hypothesis' is one of the models that may explain the steep rise in the incidence of atopic diseases, though this hypothesis is incomplete and in some cases, contradictory to findings. This hypothesis proposes that excess 'cleanliness' in an infant's or child's environment can lead to a decline in the number of infectious stimuli that are necessary for the proper development of the immune system. The decrease in exposure to infectious stimuli may result in an imbalance between the infectious-response ("protective") elements and the allergic-response ("false alarm") elements within the immune system.
Some studies also suggest that the maternal diet during pregnancy may be a causal factor in atopic diseases (including asthma) in offspring, suggesting that consumption of antioxidants, certain lipids, and/or a Mediterranean diet may help to prevent atopic diseases.
A Swedish research study titled "Atopy In Children Of Families With An Anthroposophic Lifestyle" comparing the rate of bronchial asthma, allergies, dermatitis, and other atopic diseases among Steiner school pupils and pupils in public schools originally appeared in the May 1, 1999, edition of the British medical journal The Lancet. The findings indicated that Steiner school pupils were "at a significantly lower risk of atopy" than children attending public schools. The researchers investigated a variety of factors in the lives of the Steiner school pupils that might have contributed to this lower rate of atopy, which included breastfeeding, reduced immunization, avoidance of antibiotics and medications that reduce fevers, consumption of bio-dynamic and organic foods, and other physical aspects of the children's lives.
The multicenter PARSIFAL study in 2006, involving 6,630 children age 5 to 13 in 5 European countries, suggested that reduced use of antibiotics and antipyretics is associated with a reduced risk of allergic disease in children.
There is a strong genetic predisposition toward atopic allergies, especially on the maternal side. Because of the strong familial evidence, investigators have tried to map susceptibility genes for atopy. Genes for atopy (C11orf30, STAT6, SLC25A46, HLA-DQB1, IL1RL1/IL18R1, TLR1/TLR6/TLR10, LPP, MYC/PVT1, IL2/ADAD1, HLA-B/MICA) tend to be involved in allergic responses or other components of the immune system. The gene C11orf30 seems to be the most relevant for atopy as it may increase susceptibility to poly-sensitization.
Treatments for atopic disorders depend on the organ(s) involved. They can vary from local treatment options, often topical corticosteroids, to systemic treatment options with oral corticosteroids, biological treatments (e.g. omalizumab, mepolizumab) or allergen immunotherapy.
Ralston, Stuart H., Herausgeber. Penman, Ian D., Herausgeber. Strachan, Mark W. J., Herausgeber. Hobson, Richard P., Herausgeber. Britton, Robert, Illustrator. Davidson, Leybourne S. 1894-1981 Begründer des Werks. (2018-04-23). Davidson's principles and practice of medicine. Elsevier. ISBN 978-0-7020-7028-0. OCLC 1040673074.{{cite book}}: CS1 maint: multiple names: authors list (link) CS1 maint: numeric names: authors list (link) 978-0-7020-7028-0
Ralston, Stuart H., Herausgeber. Penman, Ian D., Herausgeber. Strachan, Mark W. J., Herausgeber. Hobson, Richard P., Herausgeber. Britton, Robert, Illustrator. Davidson, Leybourne S. 1894-1981 Begründer des Werks. (2018-04-23). Davidson's principles and practice of medicine. Elsevier. ISBN 978-0-7020-7028-0. OCLC 1040673074.{{cite book}}: CS1 maint: multiple names: authors list (link) CS1 maint: numeric names: authors list (link) 978-0-7020-7028-0
"Mosby's Medical Dictionary:atopy". Archived from the original on 2011-07-10. https://web.archive.org/web/20110710192530/http://www.elsevier.com/wps/find/bookdescription.cws_home/716563/description
Wright, Rosalind J; Enlow, Michelle Bosquet (2008-09-01). "Maternal stress and perinatal programming in the expression of atopy". Expert Review of Clinical Immunology. 4 (5): 535–538. doi:10.1586/1744666X.4.5.535. ISSN 1744-666X. PMC 2762209. PMID 19838310. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762209
Coca AF, Cooke RA. (1923) On the classification of the phenomenon of hypersensitiveness J Immunol http://www.jimmunol.org/cgi/content/abstract/8/3/163
Johannes Ring; Bernhard Przybilla; Thomas Ruzicka (2006). Handbook of atopic eczema. Birkhäuser. pp. 3–. ISBN 978-3-540-23133-2. Retrieved 4 May 2010. 978-3-540-23133-2
Ruby Pawankar; Stephen T. Holgate; Lanny J. Rosenwasser (7 April 2009). Allergy Frontiers: Classification and Pathomechanisms. Springer. pp. 33–. ISBN 978-4-431-88314-2. Retrieved 4 May 2010. 978-4-431-88314-2
"atopy". Online Etymology Dictionary. Douglas Harper. 2019. Retrieved 26 Sep 2019. https://www.etymonline.com/word/atopy
Simpson, Angela; Tan, Vincent Y. F.; Winn, John; Svensén, Markus; Bishop, Christopher M.; Heckerman, David E.; Buchan, Iain; Custovic, Adnan (June 2010). "Beyond Atopy" (PDF). American Journal of Respiratory and Critical Care Medicine. 181 (11): 1200–1206. doi:10.1164/rccm.200907-1101oc. ISSN 1073-449X. PMID 20167852. https://pure.manchester.ac.uk/ws/files/20022234/POST-PEER-REVIEW-NON-PUBLISHERS-DOCUMENT.PDF
Sun, Hai-Lun; Yeh, Chih-Jung; Ku, Min-Sho; Lue, Ko-Huang (2012-01-01). "Coexistence of allergic diseases: Patterns and frequencies". Allergy and Asthma Proceedings. 33 (1): e1-4. doi:10.2500/aap.2012.33.3506. ISSN 1088-5412. PMID 22370527. /wiki/Doi_(identifier)
Mansueto P, Seidita A, D'Alcamo A, Carroccio A (2014). "Non-celiac gluten sensitivity: literature review" (PDF). J Am Coll Nutr (Review). 33 (1): 39–54. doi:10.1080/07315724.2014.869996. hdl:10447/90208. PMID 24533607. S2CID 22521576. https://iris.unipa.it/bitstream/10447/90208/1/Journal%20of%20the%20Americal%20College%20of%20Nutrition%202014%2033%2039-54.pdf
González-Cervera J, Arias Á, Redondo-González O, Cano-Mollinedo MM, Terreehorst I, Lucendo AJ (2017). "Association between atopic manifestations and eosinophilic esophagitis: A systematic review and meta-analysis". Ann Allergy Asthma Immunol (Systematic Review and Meta-analysis). 118 (5): 582–590.e2. doi:10.1016/j.anai.2017.02.006. PMID 28366582. /wiki/Doi_(identifier)
"Davidson's Principles and Practice of Medicine, IE Edition, 20th Ed: Medicine—Clinical Medicine". Journal of Endocrinology, Metabolism and Diabetes of South Africa. 13 (2): 75. July 2008. doi:10.1080/22201009.2008.10872174. ISSN 1608-9677. S2CID 220276722. https://doi.org/10.1080%2F22201009.2008.10872174
"Davidson's Principles and Practice of Medicine, IE Edition, 20th Ed: Medicine—Clinical Medicine". Journal of Endocrinology, Metabolism and Diabetes of South Africa. 13 (2): 75. July 2008. doi:10.1080/22201009.2008.10872174. ISSN 1608-9677. S2CID 220276722. https://doi.org/10.1080%2F22201009.2008.10872174
"Davidson's Principles and Practice of Medicine, IE Edition, 20th Ed: Medicine—Clinical Medicine". Journal of Endocrinology, Metabolism and Diabetes of South Africa. 13 (2): 75. July 2008. doi:10.1080/22201009.2008.10872174. ISSN 1608-9677. S2CID 220276722. https://doi.org/10.1080%2F22201009.2008.10872174
"Davidson's Principles and Practice of Medicine, IE Edition, 20th Ed: Medicine—Clinical Medicine". Journal of Endocrinology, Metabolism and Diabetes of South Africa. 13 (2): 75. July 2008. doi:10.1080/22201009.2008.10872174. ISSN 1608-9677. S2CID 220276722. https://doi.org/10.1080%2F22201009.2008.10872174
"Davidson's Principles and Practice of Medicine, IE Edition, 20th Ed: Medicine—Clinical Medicine". Journal of Endocrinology, Metabolism and Diabetes of South Africa. 13 (2): 75. July 2008. doi:10.1080/22201009.2008.10872174. ISSN 1608-9677. S2CID 220276722. https://doi.org/10.1080%2F22201009.2008.10872174
Küster, W.; Petersen, M.; Christophers, E.; Goos, M.; Sterry, W. (December 12, 2004). "A family study of atopic dermatitis". Archives of Dermatological Research. 282 (2 / January, 1990): 98–102. doi:10.1007/BF00493466. PMID 2353830. S2CID 9396200. /wiki/Doi_(identifier)
Wright, Rosalind J; Enlow, Michelle Bosquet (2008-09-01). "Maternal stress and perinatal programming in the expression of atopy". Expert Review of Clinical Immunology. 4 (5): 535–538. doi:10.1586/1744666X.4.5.535. ISSN 1744-666X. PMC 2762209. PMID 19838310. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762209
Wright, Rosalind J; Enlow, Michelle Bosquet (2008-09-01). "Maternal stress and perinatal programming in the expression of atopy". Expert Review of Clinical Immunology. 4 (5): 535–538. doi:10.1586/1744666X.4.5.535. ISSN 1744-666X. PMC 2762209. PMID 19838310. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762209
Grammatikos AP (2008). "The genetic and environmental basis of atopic diseases". Ann. Med. 40 (7): 482–95. doi:10.1080/07853890802082096. PMID 18608118. S2CID 188280. https://doi.org/10.1080%2F07853890802082096
Alm, Johan S; Swartz, Jackie; Lilja, Gunnar; Scheynius, Annika; Pershagen, Göran (May 1999). "Atopy in children of families with an anthroposophic lifestyle". The Lancet. 353 (9163): 1485–1488. CiteSeerX 10.1.1.586.4628. doi:10.1016/S0140-6736(98)09344-1. PMID 10232315. S2CID 27540120. /wiki/CiteSeerX_(identifier)
Flöistrup H, Swartz J, Bergström A; et al. (January 2006). "Allergic disease and sensitization in Steiner school children" (PDF). J. Allergy Clin. Immunol. 117 (1): 59–66. doi:10.1016/j.jaci.2005.09.039. PMID 16387585. Archived from the original (PDF) on 2007-09-27. Retrieved 2007-07-18.{{cite journal}}: CS1 maint: multiple names: authors list (link) https://web.archive.org/web/20070927025458/http://www.louisbolk.nl/downloads/mhuber/0601allergic.pdf
Blumenthal MN (2005). "The Role of Genetics in the Development of Asthma and Atopy". Curr Opin Allergy Clin Immunol. 5 (141–5): 141–5. doi:10.1097/01.all.0000162306.12728.c2. PMID 15764904. S2CID 30698973. /wiki/Doi_(identifier)
Hoffjan S, Nicolae D, Ober C (2003). "Association Studies for Asthma and Atopic Diseases: A Comprehensive Review of the Literature". Respir Res. 4 (14): 14748924. doi:10.1186/1465-9921-4-14. PMC 314398. PMID 14748924. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC314398
Bønnelykke, Klaus; Matheson, Melanie C; Pers, Tune H; Granell, Raquel; Strachan, David P; Alves, Alexessander Couto; Linneberg, Allan; Curtin, John A; Warrington, Nicole M; Standl, Marie; Kerkhof, Marjan; Jonsdottir, Ingileif; Bukvic, Blazenka K; Kaakinen, Marika; Sleimann, Patrick; Thorleifsson, Gudmar; Thorsteinsdottir, Unnur; Schramm, Katharina; Baltic, Svetlana; Kreiner-Møller, Eskil; Simpson, Angela; Pourcain, Beate St; Coin, Lachlan; Hui, Jennie; Walters, Eugene H; Tiesler, Carla M T; Duffy, David L; Jones, Graham; Ring, Susan M; McArdle, Wendy L; Price, Loren; Robertson, Colin F; Pekkanen, Juha; Tang, Clara S; Thiering, Elisabeth; Montgomery, Grant W; Hartikainen, Anna-Liisa; Dharmage, Shyamali C; Husemoen, Lise L; Herder, Christian; Kemp, John P; Elliot, Paul; James, Alan; Waldenberger, Melanie; Abramson, Michael J; Fairfax, Benjamin P; Knight, Julian C; Gupta, Ramneek; Thompson, Philip J; Holt, Patrick; Sly, Peter; Hirschhorn, Joel N; Blekic, Mario; Weidinger, Stephan; Hakonarsson, Hakon; Stefansson, Kari; Heinrich, Joachim; Postma, Dirkje S; Custovic, Adnan; Pennell, Craig E; Jarvelin, Marjo-Riitta; Koppelman, Gerard H; Timpson, Nicholas; Ferreira, Manuel A; Bisgaard, Hans; Henderson, A John (30 June 2013). "Meta-analysis of genome-wide association studies identifies ten loci influencing allergic sensitization". Nature Genetics. 45 (8): 902–906. doi:10.1038/ng.2694. PMC 4922420. PMID 23817571. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4922420
Amaral, André F. S.; Minelli, Cosetta; Guerra, Stefano; Wjst, Matthias; Probst-Hensch, Nicole; Pin, Isabelle; Svanes, Cecilie; Janson, Christer; Heinrich, Joachim; Jarvis, Deborah L. (December 2014). "The locus increases susceptibility to poly-sensitisation" (PDF). Allergy. 70 (3): 328–333. doi:10.1111/all.12557. hdl:10044/1/21574. PMID 25546184. S2CID 25960081. http://spiral.imperial.ac.uk/bitstream/10044/1/21574/6/Amaral_Allergy_revised_unmarked_forSPIRAL_11-3-2015.pdf
Nguyen, T.; Zuniga, R. (2013). "Skin conditions: New drugs for managing skin disorders". FP Essentials. 407: 11–16. PMID 23600334. /wiki/PMID_(identifier)
Lee, S. W.; Cheong, S. H.; Byun, J. Y.; Choi, Y. W.; Choi, H. Y. (2013). "Occupational hand eczema among nursing staffs in Korea: Self-reported hand eczema and contact sensitization of hospital nursing staffs". The Journal of Dermatology. 40 (3): 182–187. doi:10.1111/1346-8138.12036. PMID 23294332. S2CID 33771711. /wiki/Doi_(identifier)
O'Regan GM, Sandilands A, McLean WH, Irvine AD (2008). "Filaggrin in Atopic Dermatitis". J Allergy Clin Immunol. 122 (4): 689–93. doi:10.1016/j.jaci.2008.08.002. PMID 18774165. /wiki/Doi_(identifier)
Breuer K, Kapp A, Werfel T (2001). "Bacterial Infections and Atopic Dermatitis". Allergy. 56 (11): 1034–41. doi:10.1034/j.1398-9995.2001.00146.x. PMID 11703215. S2CID 28897487.{{cite journal}}: CS1 maint: multiple names: authors list (link) /wiki/Alexander_Kapp_(dermatologist_and_allergist)
Abramson JS, Dahl MV, Walsh G, Blumenthal MN, Douglas SD, Quie PG (1982). "Antistaphylococcal IgE in Patients with Atopic Dermatitis". J Am Acad Dermatol. 7 (1): 105–110. doi:10.1016/s0190-9622(82)80017-0. PMID 7107990. /wiki/Doi_(identifier)
Parish WE, Welbourn E, Champion RH (1976). "Hypersensitivity to Bacteria in Eczema. Ii. Titre and Immunoglobulin Class of Antibodies to Staphylococci and Micrococci". Br J Dermatol. 95 (3): 285–93. doi:10.1111/j.1365-2133.1976.tb07016.x. PMID 974019. S2CID 5842899. /wiki/Doi_(identifier)
Motala C, Potter PC, Weinberg EG, Malherbe D, Hughes J (1986). "Anti-Staphylococcus aureus-Specific IgE in Atopic Dermatitis". J Allergy Clin Immunol. 78 (4 Pt 1): 583–9. doi:10.1016/0091-6749(86)90075-8. PMID 3771950. /wiki/Doi_(identifier)
Amaral, André F.S.; Newson, Roger B.; Abramson, Michael J.; Antó, Josep M.; Bono, Roberto; Corsico, Angelo G.; de Marco, Roberto; Demoly, Pascal; Forsberg, Bertil; Gislason, Thorarinn; Heinrich, Joachim; Huerta, Ismael; Janson, Christer; Jõgi, Rain; Kim, Jeong-Lim; Maldonado, José; Martinez-Moratalla Rovira, Jesús; Neukirch, Catherine; Nowak, Dennis; Pin, Isabelle; Probst-Hensch, Nicole; Raherison-Semjen, Chantal; Svanes, Cecilie; Urrutia Landa, Isabel; van Ree, Ronald; Versteeg, Serge A.; Weyler, Joost; Zock, Jan-Paul; Burney, Peter G.J.; Jarvis, Deborah L. (November 2015). "Changes in IgE sensitization and total IgE levels over 20 years of follow-up". Journal of Allergy and Clinical Immunology. 137 (6): 1788–1795.e9. doi:10.1016/j.jaci.2015.09.037. PMC 4889785. PMID 26586040. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4889785
Wollenberg, A.; Barbarot, S.; Bieber, T.; Christen-Zaech, S.; Deleuran, M.; Fink-Wagner, A.; Gieler, U.; Girolomoni, G.; Lau, S.; Muraro, A.; Czarnecka-Operacz, M. (May 2018). "Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I". Journal of the European Academy of Dermatology and Venereology. 32 (5): 657–682. doi:10.1111/jdv.14891. PMID 29676534. https://doi.org/10.1111%2Fjdv.14891
Reddel, Helen K.; Bateman, Eric D.; Becker, Allan; Boulet, Louis-Philippe; Cruz, Alvaro A.; Drazen, Jeffrey M.; Haahtela, Tari; Hurd, Suzanne S.; Inoue, Hiromasa; de Jongste, Johan C.; Lemanske, Robert F. (September 2015). "A summary of the new GINA strategy: a roadmap to asthma control". European Respiratory Journal. 46 (3): 622–639. doi:10.1183/13993003.00853-2015. ISSN 0903-1936. PMC 4554554. PMID 26206872. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4554554
Klimek, Ludger; Bachert, Claus; Pfaar, Oliver; Becker, Sven; Bieber, Thomas; Brehler, Randolf; Buhl, Roland; Casper, Ingrid; Chaker, Adam; Czech, Wolfgang; Fischer, Jörg (2020-02-12). "Correction to "ARIA guideline 2019: treatment of allergic rhinitis in the German health system"". Allergo Journal International. 29 (2): 63–65. doi:10.1007/s40629-019-00115-4. ISSN 2197-0378. S2CID 211089322. /wiki/Doi_(identifier)