Box 1: Topics for future research
- Definitions of disease that are easy to apply, widely accepted and
clinically relevant
- Accurate estimates of the global epidemiologic burden of atopy
- Incorporate patient-relevant outcomes for food allergy and AD into
trial designs
- Earlier timing of interventions to address skin barrier dysfunction
(SBD)
- Randomized trials focusing on maternal and early life nutrition with
robust measurements of food, macro and micronutrient intake and
clearly defined study outcomes
- Current efforts should be broadened to more fully understand the
mechanisms underlying initiation, maintenance, loss, and redevelopment
of tolerance
- Fully characterize the molecular mechanisms underlying the phenotypes
of SBD that place some, but not all patients with AD at a
significantly increased risk for atopy, particularly food allergy
- Distinguish other SBD phenotypes, as seen in seborrheic dermatitis and
psoriasis from those in AD identifying potential targets to maintain
tolerance later in life
- Identify targeted treatment approaches to heal the SBD associated
specifically predisposing to atopy
- Ongoing evaluation of environmental exposures including irritants,
pollution, pollen, bacteria, viruses and fungi
- Begin to better understand the complex interaction of the commensal
microbiome of the gut and skin with potentially pathogenic bacteria
and fungi
- Focus the study of environmental and microbial factors on identifying
modifiable risks for manageable public health interventions benefiting
the majority of the global population