Первичная профилактика атопического дерматита у детей
Аннотация
Атопический дерматит является хроническим рецидивирующим заболеванием кожи, сопровождающимся зудом, сухостью кожи, экзематозным воспалением. У 5-10% пациентов отмечается непрерывно рецидивирующее течение болезни, что является причиной значительных материальных затрат на лечение, а также может привести к инвалидизации и резкому снижению качества жизни пациентов. В обзоре представлена информация о перспективных направлениях в профилактике развития атопического дерматита у детей и проанализирована возможность их применения в клинической практике.
Об авторах
Е. Е. ВарламовРоссия
к.м.н., с.н.с. отдела аллергологии и клинической иммунологии Научно-исследовательского клинического института педиатрии
А. Н. Пампура
Россия
д.м.н., зав. тем же отделом 125412 Москва, ул. Талдомская, д. 2
Список литературы
1. Williams Н., Flohr С. How epidemiology has challenged 3 prevailing concepts about atopic dermatitis. J Allergy Clin Immunol 2006; 118: 1: 209-213.
2. Novak N., Leung D.Y. Advances in atopic dermatitis. Curr Opin Immunol 2011; 23: 6: 778-783.
3. Тренева M.C., Пампура А.Н. Новорожденные Москвы: востребованность первичной диетопрофилатики аллергии. Рос аллергол журн 2013; 3: 25—29. (Treneva M.S., Pampura A.N. Newborns Moscow: relevance of primary prevention of allergy. Ros allergol zhurn 2013; 3: 25—29.)
4. Liao S.L., Lai S.H., Yeh K.W. Exclusive breastfeeding is associated with reduced cow's milk sensitization in early childhood. The PATCH (The Prediction of Allergy in Taiwanese Children) Cohort Study. Pediat Allergy Immunol 2014; 25: 5: 456-461.
5. Flohr C, Nagel G., Weinmayr G. et al. Lack of evidence for a protective effect of prolonged breastfeeding on childhood eczema: lessons from the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Two. Br J Dermatol 2011; 165:1280-1289.
6. Gdalevich M., Mimouni £>., David M. Breast-feeding and the onset of atopic dermatitis in childhood: a systematic review and meta-analysis of prospective studies. J Am Acad Dermatol 2001; 45: 520-527.
7. Yang Y.W., Tsai C.L., Lu C.Y. Exclusive breastfeeding and incident atopic dermatitis in childhood: a systematic review and metaanalysis of prospective cohort studies. Br J Dermatol 2009; 161: 373-383.
8. Clyne P.S., Kulczycki A.Jr. Human breast milk contains bovine IgG. Relationship to infant colic? Pediatrics 1991; 87: 439-444.
9. Vadas P., Wai Y, Burks W., Perelman B. Detection of peanut allergens in breast milk of lactating women. JAMA 2001; 285: 1746-1748.
10. Sicherer S., Wood R., Stablein D. Maternal consumption of peanut during pregnancy is associated with peanut sensitization in atopic infants. J Allergy Clin Immunol 2010; 126: 1191-1197.
11. American Academy of Pediatrics. Committee on Nutrition. Hypoallergenic infant formulas. Pediatrics 2000; 106: 346— 349.
12. Foisy M., Boyle R.J., Chalmers J.R. et al. Overview of reviews the prevention of eczema in infants and children: an overview of Cochrane and non-Cochrane reviews. Evid Based Child Health 2011; 6: 1322-1339.
13. Kramer M.S., Kakuma R. Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child. Cochrane Database Syst Rev 2012; 9: CD000133.
14. von Berg A., Filipiak-PittroffB., Kramer U. et al. Preventive effect of hydrolyzed infant formulas persists until age 6 years:
15. long-term results from the German Infant Nutritional Intervention Study (GINI). J Allergy Clin Immunol 2008; 121: 1442-1447.
16. von Berg A., Koletzko S., Filipiak-Pittroff B. et al. Certain hydrolyzed formulas reduce the incidence of atopic dermatitis but not that of asthma: three-year results of the German Infant Nutritional Intervention Study. J Allergy Clin Immunol 2007; 119:718-725.
17. Alexander D.D., Cabana M.D. Partially hydrolyzed 100% whey protein infant formula and reduced risk of atopic dermatitis: a meta-analysis. J Pediat Gastroenterol Nutr 2010; 50: 422-430.
18. Osborn D.A., Sinn J. Formulas containing hydrolysed protein for prevention of allergy and food intolerance in infants. Cochrane Database Syst Rev 2006; CD003664.
19. Lskedjian M., Szajewska H., SpieldennerJ. et al. Meta-analysis of a partially hydrolyzed 100%-whey infant formula vs. extensively hydrolyzed infant formulas in the prevention of atopic dermatitis. Curr Med Res Opin 2010; 26: 11: 2599-2606.
20. FlohrC, Mann J. New insights into the epidemiology of childhood atopic dermatitis. Allergy 2014; 69: 3—16.
21. Pfefferle P.Т., Prescott S.L., Kopp M. Microbial influence on tolerance and opportunities for intervention with prebiotics/ probiotics and bacterial lysates. J Allergy Clin Immunol 2013; 131: 1453-1463.
22. Enomoto Т., Sowa M., Nishimori К Effects of Bifidobacterial Supplementation to Pregnant Women and Infants in the Prevention of Allergy Development in Infants and on Fecal Mi-crobiota. Allergology International 2014; 63: 575—585.
23. Pelucchi C, Chatenoud L., Turati F. et al. Probiotics supplementation during pregnancy or infancy for the prevention of atopic dermatitis: a metaanalysis. Epidemiology 2012; 23: 402-414.
24. Gruber C, van Stuijvenberg M., Mosca F. et al. Reduced occurrence of early atopic dermatitis because of immunoactive prebiotics among low-atopy-risk infants. J Allergy Clin Immunol 2010; 126: 791-797.
25. van derAa L.B., Heymans H.S., van Aalderen W.M. et al. Probiotics and prebiotics in atopic dermatitis: review of the theoretical background and clinical evidance. Pediatr Allergy Immunol 2010; 21: e355-367.
26. Osborn D.A., Sinn J.K Prebiotics in infants for prevention of allergy. Cochrane Database Syst Rev 2013; 3: CD006474.
27. Oren E., Banerji A., Camargo C.A. Jr. Vitamin D and atopic disorders in an obese population screened for vitamin D deficiency. J Allergy Clin Immunol 2008; 121: 533-534.
28. Solvoll K, Soyland E., Sandstad B. et al. Dietary habits among patients with atopic dermatitis. Eur J Clin Nutr 2000; 54: 93-97.
29. Peroni D.G., Piacentini G.L., Cametti E. et al. Correlation between serum 25-hydroxyvitamin D levels and severity of atopic dermatitis in children. Br J Dermatol. 2011; 164: 1078-1082.
30. Back О., Blomquist H.K., Hernell О. et al. Does vitamin D intake during infancy promote the development of atopic allergy? Acta Derm Venereol 2009; 89: 28-32.
31. MilnerJ.D., Stein DM., McCarterR. et al. Early infant multi-vitamin supplementation is associated with increased risk for food allergy and asthma. Pediatrics 2004; 114: 27—32.
32. Hypponen E., Sovio U., Wjst M. et al. Infant vitamin d supplementation and allergic conditions in adulthood: northern Finland birth cohort 1966. AnnN YAcad Sci2004; 1037: 84-95.
33. Gale C.R., Robinson S.M., Harvey N.C. et al. Maternal vitamin D status during pregnancy and child outcomes. Eur J Clin Nutr2008; 62: 68-77.
34. Weidinger S., Illig Т., Baurecht H. et al. Loss-of-function variations within the filaggrin gene predispose for atopic dermatitis with allergic sensitizations. J Allergy Clin Immunol 2006; 118:1:214-219.
35. Nomura Т., Sandilands A., Akiyama M. et al. Unique mutations in the filaggrin gene in Japanese patients with ichthyosis vulgaris and atopic dermatitis. J Allergy Clin Immunol 2007; 119: 2: 434-440.
36. Nemoto-Hasebe I, Akiyama M., Nomura T. et al. Clinical Severity Correlates with Impaired Barrier in Filaggrin-Related Eczema. Journal of Investigative Dermatology 2009; 129: 3: 682-689.
37. Киндеева Е.Т., Варламов Е.Е., Пампура А.Н. Функциональное состояние кожного барьера у детей с атопи-ческим дерматитом. Рос аллергол журн 2013; 1: 52—57. (Kindeeva E.T., Varlamov E.E., Pampura A.N. The functional state of the skin barrier in children with atopic dermatitis. Ros allergolzhurn2013; 1: 52-57.)
38. Palmer C.N, Irvine A.D., Terron-Kwiatkowski A. et al. Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis. Nat Genet 2006; 38: 4: 441-446.
39. Irvine A.D. Fleshing Out Filaggrin Phenotypes. Journal of Investigative Dermatology 2007; 127: 3: 504-507.
40. Bisgaard H., Simpson A., Colin NA. et al. Gene-Environment Interaction in the Onset of Eczema in Infancy: Filaggrin Loss-of-Function Mutations Enhanced by Neonatal Cat Exposure. PLoS Medicine 2008; 5: 131.
41. Henderson J., Northstone K., Lee S. et al. The burden of disease associated with filaggrin mutations: A population-based, longitudinal birth cohort study. J Allergy Clin Immunol 2008; 121: 872-877.
42. Варламов Е.Е., Тагирова М.К., Комова E.I. и др. Клиническое значение мутаций гена FLG у детей с ато-пическим дерматитом. Рос вестн перинатол и педиат 2015; 60: 2: 87-91. (Varlamov E.E., Tagirova M.K., Komo-va E.G. et al. The clinical significance of FLG mutations in children with atopic dermatitis. Ros vestn perinatol i pediat 2015; 60: 2: 87-91.)
43. Van Ginkel CD., Flokstra-de Blok B.M., Kollen B.J.et al. Loss-of-function variants of the filaggrin gene are associated with clinical reactivity to foods. Allergy 2015; 70: 4: 461-464.
44. Arroyave W.D., Rabito F.A., Carlson J.C. et al. Impermeable dust mite covers in the primary and tertiary prevention of allergic disease: a meta-analysis. Arch Dermatol 2007; 143: 12: 1570-1577.
45. Langan S.M., FlohrC, Williams H. С. The role of furry pets in eczema: a systematic review. Ann Allergy Asthma Immunol 2014; 112: 3:237-248.
46. Harris J.M., WilliamsH.C, WhiteC. etal. Early allergen exposure and atopic eczema. Br J Dermatol 2007; 156: 698—704.
47. Simpson E.L., Chalmers J.R., Hanifln J.M. et al. Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention. J Allergy Clin Immunol 2014; 134: 818-823.
48. Horimukai K., Morita K, Narita M. et al. Application of moisturizer to neonates prevents development of atopic dermatitis. Allergy 2014; 69: 56-61.
Рецензия
Для цитирования:
Варламов Е.Е., Пампура А.Н. Первичная профилактика атопического дерматита у детей. Российский вестник перинатологии и педиатрии. 2015;60(5):21-25.
For citation:
Varlamov E.E., Pampura A.N. Primary prevention of atopic dermatitis in children. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics). 2015;60(5):21-25. (In Russ.)