Childhood eczema and rhinitis linked to adult asthma
MedWire News: A combination of eczema and rhinitis in childhood is associated with a significantly increased risk for new-onset atopic asthma in middle age and persistence of childhood asthma to adult atopic asthma, research shows.
Writing in the Journal of Allergy and Immunology, Shyamali Dharmage (University of Melbourne, Victoria, Australia) and colleagues explain: "The evidence on whether the atopic march observed in childhood (ie, the progression from eczema to allergic rhinitis and asthma) extends to adulthood is sparse, and there is no evidence on whether the progression leads to a specific phenotype of asthma."
To investigate further, the team studied data on 1383 individuals who were recruited at the age of six to seven years in 1968 as part of the Tasmanian Longitudinal Health Study, and who were followed up at the age of 44 years.
In total, 261 (19.3%) participants had rhinitis, 250 (18.3%) had either infantile or flexural eczema, and 517 (37.7%) had asthma in childhood.
Of the 1320 individuals with complete data on childhood allergic diseases and adult asthma and atopy at the age of 44 years, 380 (27.5%) had current asthma, of whom 263 (69.2%) were atopic, as defined by a positive skin prick test response to at least one aeroallergen.
The researchers found that childhood eczema alone predicted the development of new-onset atopic asthma in adulthood, at an adjusted multinomial odds ratio (aMOR) of 4.1.
Childhood rhinitis alone predicted the persistence of childhood asthma to adult atopic asthma, at an aMOR of 2.7.
A combination of both childhood eczema and rhinitis predicted both new-onset atopic asthma (aMOR=6.3) and persistence of childhood asthma to adult atopic asthma (aMOR=11.7).
The researchers estimate that 29.7% of persistent atopic asthma cases and 18.1% of new-onset atopic asthma cases in their study could be attributed to childhood eczema and rhinitis.
They found no association between childhood eczema or rhinitis and nonatopic adult asthma.
Dharmage and team conclude: "Childhood eczema and rhinitis are strongly associated with the incidence and persistence of adult atopic asthma."
They add: "Our findings provide evidence for the origins of adult atopic asthma being found in childhood and might inform public health efforts to halt the progression of allergic diseases."
By Mark Cowen