title: Childhood eczema and rhinitis predict atopic but not nonatopic adult asthma: a prospective cohort study over 4 decades.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  We sought to assess whether childhood eczema and rhinitis are risk factors for specific phenotypes of adult asthma.
  
  
  METHODS
  Participants of the Tasmanian Longitudinal Health Study recruited in 1968 (age range, 6.0-7.0 years) were followed up at age 44 years. The risk of current atopic or nonatopic asthma in middle age characterized by sensitization to aeroallergens given childhood eczema, rhinitis, or both was calculated by using multinomial logistic regression.
  
  
  RESULTS
  No association was found between childhood eczema or rhinitis and nonatopic adult asthma. In contrast, childhood eczema and rhinitis in combination predicted both new-onset atopic asthma by middle age (adjusted multinomial odds ratio [aMOR], 6.3; 95% CI, 1.7-23.2) and the persistence of childhood asthma to adult atopic asthma (aMOR, 11.7; 95% CI, 3.6-37.9). Participants with childhood eczema alone were at increased risk of new-onset atopic asthma (aMOR, 4.1; 95% CI, 1.9-8.8), whereas rhinitis alone predicted the persistence of childhood asthma to atopic asthma (aMOR, 2.7; 95% CI, 1.3-5.6). Of all asthma, 29.7% of persistent atopic asthma and 18.1% of new-onset atopic asthma could be attributed to having childhood eczema and rhinitis.
  
  
  CONCLUSIONS
  Childhood eczema and rhinitis are strongly associated with the incidence and persistence of adult atopic asthma.
authors: Murdoch Childrens Research Institute, Parkville, Australia.
authors: Pamela E
authors: PE
authors: Martin
authors: Melanie C
authors: MC
authors: Matheson
authors: Lyle
authors: L
authors: Gurrin
authors: John A
authors: JA
authors: Burgess
authors: Nicholas
authors: N
authors: Osborne
authors: Adrian J
authors: AJ
authors: Lowe
authors: Stephen
authors: S
authors: Morrison
authors: Désirée
authors: D
authors: Mészáros
authors: Graham G
authors: GG
authors: Giles
authors: Michael J
authors: MJ
authors: Abramson
authors: E Haydn
authors: EH
authors: Walters
authors: Katrina J
authors: KJ
authors: Allen
authors: Shyamali C
authors: SC
authors: Dharmage
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology; D002648:Child; D015331:Cohort Studies; D004198:Disease Susceptibility; D004485:Eczema / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012220:Rhinitis / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D012307:Risk Factors; D012882:Skin Tests; D011795:Surveys and Questionnaires; D013648:Tasmania / Q000453:epidemiology; D055815:Young Adult