medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2018-17-182-186medsovet-2717Research ArticleДЕРМАТОЛОГИЯDERMATOLOGYФакторы риска развития атопического дерматита у грудных детей и первичная профилактика заболеванияAtopic dermatitis: risk factors for disease development in infants and primary prevention of the diseaseТамразоваО. Б.TamrazovaO. В.

Тамразова Ольга Борисовна – доктор медицинских наук, профессор кафедры дерматовенерологии ФГАОУ ВО «Российский университет дружбы народов» Министерства образования и науки РФ

Москва 

ФГАОУ ВО «Российский университет дружбы народов» Минобрнауки России; Детская городская клиническая больница им. З.А. Башляевой Департамента здравоохраненияРоссияRussian Peoples’ Friendship University of the Ministry of Education and Science of the Russian Federation; Bashlyaeva Children’s City Clinical Hospital of the Moscow City Health DepartmentRussian Federation201821102018017182187Copyright © Тамразова О.Б., 20182018Тамразова О.Б.Tamrazova O.В.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2717

Атопический дерматит – болезнь раннего детского возраста и первое проявление атопического марша. Терапия пациентов с атопическим дерматитом не влияет на причину и носит в основном патогенетический или симптоматический характер, что и определяет настоятельную необходимость профилактики заболевания у детей раннего детского возраста начиная с перинатального периода. В статье подробно рассматриваются факторы риска развития заболевания в современном обществе. Особое внимание уделено применению эмолентов в первичной профилактике атопического дерматита.

Atopic dermatitis is a disease of early childhood and the first manifestation of an atopic march. Therapy of patients with atopic dermatitis does not affect the cause of the desease and has mainly a pathogenetic or symptomatic character, which proves urgent need to prevent disease in early childhood, beginning the perinatal period. The article considers in detail the risk factors for the disease development in modern society. Particular attention is given to the use of emollients in the primary prevention of atopic dermatitis.

атопический дерматитпрофилактикафакторы рискаперинатальный периодэмолентыСтелатопиаatopic dermatitispreventionrisk factorsperinatal periodemollientsStelatopiaReferencesФедеральные клинические рекомендации по ведению больных атопическим дерматитом. РОДВК. Москва, 2015.Federal clinical guidelines for management of patients with atopic dermatitis. RODVK. Moscow, 2015.Spergel JM. From atopic dermatitis to asthma: the atopic march. Ann Allergy Asthma Immunol, 2010, 105(2): 99–106.Spergel JM. From atopic dermatitis to asthma: the atopic march. Ann Allergy Asthma Immunol, 2010, 105(2): 99–106.Nutten S. Atopic dermatitis: global epidemiology and risk factors. Ann Nutr Metab, 2015, 66(suppl 1): 8-16Nutten S. Atopic dermatitis: global epidemiology and risk factors. Ann Nutr Metab, 2015, 66(suppl 1): 8-16Weidinger S, Novak N. Atopic dermatitis. Lancet, 2016, 387(10023): 1109–22.Weidinger S, Novak N. Atopic dermatitis. Lancet, 2016, 387(10023): 1109–22.Odhiambo JA, Williams HC, Clayton TO, Robertson CF, Asher MI. Global variations in prevalence of eczema symptoms in children from ISAAC Phase Three. J Allergy Clin Immunol, 2009, 124: 1251-1258.Odhiambo JA, Williams HC, Clayton TO, Robertson CF, Asher MI. Global variations in prevalence of eczema symptoms in children from ISAAC Phase Three. J Allergy Clin Immunol, 2009, 124: 1251-1258.Mallol J, Crane J, von Mutius E, Odhiambo J, Keil U, Stewart A, ISAAC Phase Three Study Group: The Internatio nal Study of Asthma and Allergies in Childhood (ISAAC) Phase Three: a global synthesis. Allergol Immunopathol (Madr), 2013, 41: 73-85.Mallol J, Crane J, von Mutius E, Odhiambo J, Keil U, Stewart A, ISAAC Phase Three Study Group: The Internatio nal Study of Asthma and Allergies in Childhood (ISAAC) Phase Three: a global synthesis. Allergol Immunopathol (Madr), 2013, 41: 73-85.Hjern A, Haglund B, Hedlin G. Ethnicity, childhood environment and atopic disorder. Clin Exp Allergy, 2000, 30: 521–8.Hjern A, Haglund B, Hedlin G. Ethnicity, childhood environment and atopic disorder. Clin Exp Allergy, 2000, 30: 521–8.Waddington CH. The Epigenotpye. Endeavour, 1942: 18–20.Waddington CH. The Epigenotpye. Endeavour, 1942: 18–20.Смирнов В.В., Леонов Г.Е. Эпигенетика: теоретические аспекты и практическое значение. Лечащий врач, 2016, 12: 12-18.Smirnov VV, Leonov GE. Epigenetics: theoretical aspects and practical significance. Lechashchiy Vrach, 2016, 12: 12-18.Amarasekera M, Prescott SL, Palmer DJ. Nutrition in early life, immune-programming and allergies: the role of epigenetics. Asian Pac J Allergy Immunol, 2013, 31(3): 175–82.Amarasekera M, Prescott SL, Palmer DJ. Nutrition in early life, immune-programming and allergies: the role of epigenetics. Asian Pac J Allergy Immunol, 2013, 31(3): 175–82.Элис Д., Дженювейн Т., Рейнберг Д. Эпигенетика. М.: Техносфера, 2010.Allis D., Jenuwein T., Reinberg, D. Epigenetics. M.: Tekhnosfera, 2010.Begin P, Nadeau KC. Epigenetic regulation of asthma and allergic disease. Allergy Asthma Clin Immunol, 2014, May 28, 10 (1): 27.Begin P, Nadeau KC. Epigenetic regulation of asthma and allergic disease. Allergy Asthma Clin Immunol, 2014, May 28, 10 (1): 27.Martinez JA, Milagro FI, Claycombe KJ, Schalinske KL. Epigenetics in Adipose Tissue, Obesity, Weight Loss, and Diabetes. Advances in Nutrition, 2014, Jan 1, 5 (1): 71–81.Martinez JA, Milagro FI, Claycombe KJ, Schalinske KL. Epigenetics in Adipose Tissue, Obesity, Weight Loss, and Diabetes. Advances in Nutrition, 2014, Jan 1, 5 (1): 71–81.Strachan DP. Allergy and family size: a riddle worth solving. Clin Exp Allergy, 1997, 27: 235-6.Strachan DP. Allergy and family size: a riddle worth solving. Clin Exp Allergy, 1997, 27: 235-6.Lee SY, Kwon JW, Seo JH, et al. Prevalence of atopy and allergic diseases in Korean children: associations with a farming environment and rural lifestyle. Int Arch Allergy Immunol, 2012, 158: 168-74.Lee SY, Kwon JW, Seo JH, et al. Prevalence of atopy and allergic diseases in Korean children: associations with a farming environment and rural lifestyle. Int Arch Allergy Immunol, 2012, 158: 168-74.Kummeling I, Stelma FF, Dagnelie PC, Snijders BE, Penders J, Huber M, Van RR, van den Brandt PA, Thijs C. Early life exposure to antibiotics and the subsequent development of eczema, wheeze, and allergic sensitization in the first 2 years of life: The KOALA Birth Cohort Study. Pediatrics, 2007, 119: e225– e231.Kummeling I, Stelma FF, Dagnelie PC, Snijders BE, Penders J, Huber M, Van RR, van den Brandt PA, Thijs C. Early life exposure to antibiotics and the subsequent development of eczema, wheeze, and allergic sensitization in the first 2 years of life: The KOALA Birth Cohort Study. Pediatrics, 2007, 119: e225– e231.Gerrard JW, Geddes CA, Reggin PL, et al. Serum IgE levels in white and Metis communities in Saskatchewan. Ann Allergy, 1976, 37: 91-100.Gerrard JW, Geddes CA, Reggin PL, et al. Serum IgE levels in white and Metis communities in Saskatchewan. Ann Allergy, 1976, 37: 91-100.Braun-Fahrlander C, Riedler J, Herz U et al. Environmental Exposure to Endotoxin and Its Relation to Asthma in School-Age Children. N Engl J Med, 2002 September 19, 347: 869–877.Braun-Fahrlander C, Riedler J, Herz U et al. Environmental Exposure to Endotoxin and Its Relation to Asthma in School-Age Children. N Engl J Med, 2002 September 19, 347: 869–877.Pelucchi C, Chatenoud L, Turati F, Galeone C, Moja L, Bach JF, La Vecchia C: Probiotics supplementation during pregnancy or infancy for the prevention of atopic dermatitis: a metaanalysis. Epidemiology, 2012, 23: 402-414.Pelucchi C, Chatenoud L, Turati F, Galeone C, Moja L, Bach JF, La Vecchia C: Probiotics supplementation during pregnancy or infancy for the prevention of atopic dermatitis: a metaanalysis. Epidemiology, 2012, 23: 402-414.Osborn DA, Sinn JK: Prebiotics in infants for prevention of allergy. Cochrane Database Syst Rev, 2013, 3: CD006474.Osborn DA, Sinn JK: Prebiotics in infants for prevention of allergy. Cochrane Database Syst Rev, 2013, 3: CD006474.Langan SM, Flohr C, Williams HC. The role of furry pets in eczema: a systematic review. Arch Dermatol, 2007, 143: 1570-1577.Langan SM, Flohr C, Williams HC. The role of furry pets in eczema: a systematic review. Arch Dermatol, 2007, 143: 1570-1577.Pelucchi C, Galeone C, Bach JF, La Vecchia C, Chatenoud L. Pet exposure and risk of atopic dermatitis at the pediatric age: a meta-analysis of birth cohort studies. J Allergy Clin Immunol, 2013, 132: 616-622.Pelucchi C, Galeone C, Bach JF, La Vecchia C, Chatenoud L. Pet exposure and risk of atopic dermatitis at the pediatric age: a meta-analysis of birth cohort studies. J Allergy Clin Immunol, 2013, 132: 616-622.Gaffin JM, Spergel M, Boguniewicz M, Eichenfield LF, Paller AS, Fowler JF, Dinulos JG, Tilles SA. Effect of cat and daycare exposures on the risk of asthma in children with atopic dermatitis. Allergy Asthma Proc, 2012 May-Jun, 33(3): 282–288.Gaffin JM, Spergel M, Boguniewicz M, Eichenfield LF, Paller AS, Fowler JF, Dinulos JG, Tilles SA. Effect of cat and daycare exposures on the risk of asthma in children with atopic dermatitis. Allergy Asthma Proc, 2012 May-Jun, 33(3): 282–288.Kremmyda LS, Vlachava M, Noakes PS, Diaper ND, Miles EA, Calder PC. Atopy Risk in Infants and Children in Relation to Early Exposure to Fish, Oily Fish, or Long-Chain Omega # Fatty Acids: A Systematic Review. Clin Rev Allergy Immunol, 2011, 41(1): 36-66.Kremmyda LS, Vlachava M, Noakes PS, Diaper ND, Miles EA, Calder PC. Atopy Risk in Infants and Children in Relation to Early Exposure to Fish, Oily Fish, or Long-Chain Omega # Fatty Acids: A Systematic Review. Clin Rev Allergy Immunol, 2011, 41(1): 36-66.Willers SM, Devereux G, Craig LCA, McNeill G, Wijga AH, Abou El‐Magd W, Turner SW, Helms PJ, Seaton A. Maternal food consumption during pregnancy and asthma, respiratory and atopic symptoms in 5‐year‐old children. Thorax, 2007 Sep, 62(9): 773–779.Willers SM, Devereux G, Craig LCA, McNeill G, Wijga AH, Abou El‐Magd W, Turner SW, Helms PJ, Seaton A. Maternal food consumption during pregnancy and asthma, respiratory and atopic symptoms in 5‐year‐old children. Thorax, 2007 Sep, 62(9): 773–779.Beckhaus AA, Garcia-Marcos L, Forno E, PachecoGonzalez RM, Celedon JC, Castro-Rodriguez JA. Maternal nutrition during pregnancy and risk of asthma, wheeze, and atopic diseases during childhood: a systematic review and meta-analysis. Allergy, 2015 Dec, 70(12): 1588-604.Beckhaus AA, Garcia-Marcos L, Forno E, PachecoGonzalez RM, Celedon JC, Castro-Rodriguez JA. Maternal nutrition during pregnancy and risk of asthma, wheeze, and atopic diseases during childhood: a systematic review and meta-analysis. Allergy, 2015 Dec, 70(12): 1588-604.Kim G, Bae JH. Vitamin D and atopic dermatitis: A systematic review and meta-analysis. Nutrition, 2016 Sep, 32(9): 913-20.Kim G, Bae JH. Vitamin D and atopic dermatitis: A systematic review and meta-analysis. Nutrition, 2016 Sep, 32(9): 913-20.Mutgi K, Koo J. Update on the Role of systemic vitamin D in atopic dermatitis. Pediatr Dermatol, 2013, 30: 303–307.Mutgi K, Koo J. Update on the Role of systemic vitamin D in atopic dermatitis. Pediatr Dermatol, 2013, 30: 303–307.Gronlund MM, Gueimonde M, Laitinen K, Kociubinski G, Gronroos T, Salminen S, Isolauri E. Maternal breast-milk and intestinal bifidobacteria guide the compositional development of the Bifidobacterium microbiota in infants at risk of allergic disease. Clin Exp Allergy, 2007, 37: 1764–1772.Gronlund MM, Gueimonde M, Laitinen K, Kociubinski G, Gronroos T, Salminen S, Isolauri E. Maternal breast-milk and intestinal bifidobacteria guide the compositional development of the Bifidobacterium microbiota in infants at risk of allergic disease. Clin Exp Allergy, 2007, 37: 1764–1772.Bergmann RL, Diepgen TL, Kuss O, Bergmann KE, Kujat J, Dudenhausen JW, Wahn U. Breastfeeding duration is a risk factor for atopic eczema. Clin Exp Allergy, 2002, 32: 205–209.Bergmann RL, Diepgen TL, Kuss O, Bergmann KE, Kujat J, Dudenhausen JW, Wahn U. Breastfeeding duration is a risk factor for atopic eczema. Clin Exp Allergy, 2002, 32: 205–209.Sandini U, Kukkonen AK, Poussa T, Sandini L, Savilahti E, Kuitunen M. Protective and risk factors for allergic diseases in high-risk children at the ages of two and five years. Int Arch Allergy Immunol, 2011, 1566 339–348.Sandini U, Kukkonen AK, Poussa T, Sandini L, Savilahti E, Kuitunen M. Protective and risk factors for allergic diseases in high-risk children at the ages of two and five years. Int Arch Allergy Immunol, 2011, 1566 339–348.Juto P, Bjorksten B. Serum IgE in infants and influence of type of feeding. Clin Allergy, 1980, 10: 593–600.Juto P, Bjorksten B. Serum IgE in infants and influence of type of feeding. Clin Allergy, 1980, 10: 593–600.Roduit C, Frei R, Loss G, Buchele G, Weber J, Depner M, Loeliger S, Dalphin ML, Roponen M, Hyvarinen A, Riedler J, Dalphin JC, Pekkanen J, von Mutius E, Braun-Fahrlander C, Lauener R: Develop ment of atopic dermatitis according to age of onset and association with early-life exposures. J Allergy Clin Immunol, 2012, 130: 130-136.Roduit C, Frei R, Loss G, Buchele G, Weber J, Depner M, Loeliger S, Dalphin ML, Roponen M, Hyvarinen A, Riedler J, Dalphin JC, Pekkanen J, von Mutius E, Braun-Fahrlander C, Lauener R: Develop ment of atopic dermatitis according to age of onset and association with early-life exposures. J Allergy Clin Immunol, 2012, 130: 130-136.Nwaru BI, Takkinen HM, Niemela O, Kaila M, Erkkola M, Ahonen S, Tuomi H, Haapala AM, Kenward MG, Pekkanen J et al. Introduction of complementary foods in infancy and atopic sensitization at the age of 5 years: Timing and food diversity in a Finnish birth cohort. Allergy, 2013, 68: 507–516.Nwaru BI, Takkinen HM, Niemela O, Kaila M, Erkkola M, Ahonen S, Tuomi H, Haapala AM, Kenward MG, Pekkanen J et al. Introduction of complementary foods in infancy and atopic sensitization at the age of 5 years: Timing and food diversity in a Finnish birth cohort. Allergy, 2013, 68: 507–516.Kim BJ, Hong SJ. Ambient air pollution and allergic diseases in children. Korean J Pedatr, 2012, 55: 185-92.Kim BJ, Hong SJ. Ambient air pollution and allergic diseases in children. Korean J Pedatr, 2012, 55: 185-92.Takizawa H. Impact of air pollution on allergic diseases. Korean J Intern Med, 2011, 26: 262-73.Takizawa H. Impact of air pollution on allergic diseases. Korean J Intern Med, 2011, 26: 262-73.Bieber T. Atopic dermatitis. N Eng J Med, 2008, 358: 1483–94.Bieber T. Atopic dermatitis. N Eng J Med, 2008, 358: 1483–94.Тамразова О.Б., Молочков А.В. Ксероз кожиосновной патогенетический фактор развития атопического дерматита. Consilium Medicum. Дерматовенерология, 2014, 4: 48-54Tamra zova OB, Molochkov AV. Xeroderma: the main pathogenetic factor in atopic dermatitis. Con si lium Medicum. Dermatovenereologiya, 2014, 4: 48-54.Silverberg JI, Hanifin J, Simpson EL. Climatic factors are associated with childhood eczema prevalence in US. J Invest Dermatol, 2013 Jul, 133(7): 1752–1759.Silverberg JI, Hanifin J, Simpson EL. Climatic factors are associated with childhood eczema prevalence in US. J Invest Dermatol, 2013 Jul, 133(7): 1752–1759.Danby S and Cork MJ. The skin barrier in atopic dermatitis. In: A. Irvine, P. Hoeger, A. Yan (Eds.) Harper’s textbook of pediatric dermatology. Blackwell Publishing, Hoboken (NJ), 2011.Danby S and Cork MJ. The skin barrier in atopic dermatitis. In: A. Irvine, P. Hoeger, A. Yan (Eds.) Harper’s textbook of pediatric dermatology. Blackwell Publishing, Hoboken (NJ), 2011.Perkin MR, Craven J, Logan K, Strachan D, Marrs T, BM BS, Radulovic S, Campbell LE, MacCallum StF, McLean WHI, Lack G, Flohr C. Association between domestic water hardness, chlorine, and atopic dermatitis risk in early life: A populationbased cross-sectional study. J Clin Al Immun, 2016, 138(2): 509-516.Perkin MR, Craven J, Logan K, Strachan D, Marrs T, BM BS, Radulovic S, Campbell LE, MacCallum StF, McLean WHI, Lack G, Flohr C. Association between domestic water hardness, chlorine, and atopic dermatitis risk in early life: A populationbased cross-sectional study. J Clin Al Immun, 2016, 138(2): 509-516.Horimukai K, Morita K, Narita M et al. Application of moisturizer to neonates prevents development of atopic dermatitis. J Allergy Clin Immunol, 2014, 134: 824–830.Horimukai K, Morita K, Narita M et al. Application of moisturizer to neonates prevents development of atopic dermatitis. J Allergy Clin Immunol, 2014, 134: 824–830.Leitch CS, Chu R, Ray R, Holme SA. Preventing atopic eczema from birth using emollients. J Allergy Clin Immunology, 2015, 135(Issue 6): 1663–1664.Leitch CS, Chu R, Ray R, Holme SA. Preventing atopic eczema from birth using emollients. J Allergy Clin Immunology, 2015, 135(Issue 6): 1663–1664.Glatz M, Jo J-H, Kennedy EA, Polley EC, Segre JA, Simpson EL, Kong HH. Emollient use alters skin barrier and microbes in infants at risk for developing atopic dermatitis. PloS one, 2018, 13(2): e0192443.Glatz M, Jo J-H, Kennedy EA, Polley EC, Segre JA, Simpson EL, Kong HH. Emollient use alters skin barrier and microbes in infants at risk for developing atopic dermatitis. PloS one, 2018, 13(2): e0192443.Inoue Y, Nakagawara R, Kambara T, Tanaka K, Seki K, Enomoto H, et al. Prevalence of atopic dermatitis in Japanese infants treated with moisturizer since birth and its relation to FLG mutations. European journal of dermatology: EJD, 2013, 23(2): 288–9. pmid: 23518593.Inoue Y, Nakagawara R, Kambara T, Tanaka K, Seki K, Enomoto H, et al. Prevalence of atopic dermatitis in Japanese infants treated with moisturizer since birth and its relation to FLG mutations. European journal of dermatology: EJD, 2013, 23(2): 288–9. pmid: 23518593.

The authors declare that there are no conflicts of interest present.