Prevention of Asthma and Allergic Diseases During Childhood

Abstract

Allergic diseases, including atopic dermatitis, food allergy, allergic rhinitis, and asthma, often begin in childhood. The atopic march refers to the development of allergic disease in a typical progressive order starting with atopic dermatitis, followed by food allergy, then allergic rhinoconjunctivitis, and, finally, asthma. Over the past 40 years, there has been an increased incidence of allergic disease with up to a third of newborns considered to be at risk. Strong family histories of allergic disease support a role for genetic predisposition; however the increase in incidence cannot be accounted for by intergenerational changes alone. Numerous environmental exposures, including maternal and infant diet, microbial colonization, and toxin exposures, have been investigated for possible association with the development of allergic disease. In this chapter, we will review the existing data on environmental factors that may influence the development of asthma and allergic diseases in predisposed children. These studies provide insight into the mechanism of atopy as well as highlight potential preventive measures during pregnancy and early childhood.