title: Does eczema lead to asthma?
abstract: The nature of the relationship between eczema, asthma, and allergic rhinitis has been controversial. It has been commonly held that these disorders, while sharing genetic and environmental risk factors, are unrelated disorders that may develop sequentially along an atopic pathway. Conversely, the link between eczema and these later-onset respiratory disorders may be causal. This review examines the relationship between eczema, asthma, and allergic rhinitis in the context of the atopic march, the skin barrier, and recent developments in eczema genetics; and we propose that the relationship is causal. We describe a plausible biological pathway with eczema as the first step in a progressive atopic march that over time leads to asthma and/or allergic rhinitis. Such a pathway has implications for our understanding of these disorders and steps that might be made to prevent the development of asthma in particular. We propose that intervention studies in eczema should be conducted to confirm or refute this causal relationship. Such studies may materially improve the quality of life of eczema patients and will have important public health benefits if the interventions lead to a reduction in the burden of asthma.
authors: Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, The University of Melbourne, Carlton, Victoria, Australia. j.burgess@pgrad.unimelb.edu.au
authors: John A
authors: JA
authors: Burgess
authors: Adrian J
authors: AJ
authors: Lowe
authors: Melanie C
authors: MC
authors: Matheson
authors: George
authors: G
authors: Varigos
authors: Michael J
authors: MJ
authors: Abramson
authors: Shyamali C
authors: SC
authors: Dharmage
mesh_terms: D001249:Asthma / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics; D015984:Causality; D003876:Dermatitis, Atopic / Q000150:complications* / Q000453:epidemiology / Q000235:genetics; D004777:Environment; D000091344:Filaggrin Proteins; D006801:Humans; D007381:Intermediate Filament Proteins; D015995:Prevalence; D011446:Prospective Studies; D012221:Rhinitis, Allergic, Perennial / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics; D006255:Rhinitis, Allergic, Seasonal / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics; D012307:Risk Factors; D012867:Skin
chemical_list: D000091344:Filaggrin Proteins; D007381:Intermediate Filament Proteins