Prevalence of atopic diseases and the use of topical corticosteroids. Is there any connection?
The prevalence of atopic diseases (atopic dermatitis, bronchial asthma, allergic rhinitis) has considerably increased for the last 40 years. This tendency has coincided with the beginning of the epoch of the use of the topical corticosteroids, which have a potent immunomodulation action. This fact itself as well as a number of research results has allowed to formulate the following hypothesis: the use of topical corticosteroids in children of early age contributes to the increase of prevalence of atopic diseases in the developed countries. The offered hypothesis can explain lower prevalence of atopic diseases in rural areas and in children from families with the anthroposophic life style. In other side this hypothesis also capable to give explanation of increased level of atopic diseases among people with high socioeconomic level and in children from 1 child families. It is of a note that corticosteroids use in developing countries is limited due to economic reasons and active use of complementary medicine. If the proposed hypothesis is correct, a revision of the therapeutic approaches is necessary concerning the attitude towards application of topical corticosteroids in children suffering from various forms of eczema. The direct proof of this hypothesis can be found during prospective studies.
Pampura
Alexander N
AN
Department of Allergology and Clinical Immunology, Moscow Institute of Pediatrics and Child Surgery of the Ministry of Public Health, Taldomskaya Street 2, 125412 Moscow, Russian Federation. apampura@pedklin.ru
D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D001249:Asthma / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D003430:Cross-Sectional Studies; D003876:Dermatitis, Atopic / Q000453:epidemiology* / Q000209:etiology; D019049:Developed Countries / Q000706:statistics & numerical data; D003906:Developing Countries; D006801:Humans; D008954:Models, Biological; D015995:Prevalence; D012221:Rhinitis, Allergic, Perennial / Q000453:epidemiology* / Q000209:etiology; D012424:Rural Population; D012959:Socioeconomic Factors; D014505:Urban Population
D000305:Adrenal Cortex Hormones