EARLY INTERVENTION FOR THE PREVENTION OF ATOPIC-DERMATITIS

Based on a lecture given to the European Society for Pediatric Allergy and Clinical Immunology. Diseases associated with atopy are increasin g throughout the world. Individuals appear to have a genetic predispos ition to atopy which is then provoked by environmental influences. Ing ested or inhaled allergens provoke an antibody response and a state of sensitization. In many but not all sensitized individuals subsequent exposure to allergen will provoke a release of histamine and other med iators from sensitized mast cells and produce clinical signs of an all ergic reaction in the target organ or throughout the body. At the pres ent time one approach to the prevention or reduction of such reactions appears to be the identification of the high-risk infant and then pre venting or limiting exposure to the potentially allergenic protein mat erials in the child's diet or immediate environment. This paper outlin es the problems of identifying high-risk infants and comments on the s uccess claimed in the intervention studies that have been undertaken. The possible hazards to mothers and infants of dietary exclusion are e mphasized and the provision of appropriate medical and dietetic suppor t are regarded as of paramount importance. Although more studies are n eeded, the Isle of Wight intervention programme offers hope to familie s at high-risk of atopy that the problem can be reduced for the next g eneration.