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Atopic March Research Paper

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Atopic March is a process of progression from AD to allergic rhinitis and asthma. AD starts early in first few years of life and many studies have suggested that the previous expression of AD is a prerequisite for the development of allergic rhinitis and asthma. Van der Hulst et al examined that there is increased risk of development of asthma in young children with AD through 13 prospective cohort studies.5

ETIOPATHOGENESIS
Earlier the disease was considered a dysfunction of keratinocytes, but the emergence of new concepts have demonstrated immunologic and inflammatory dysfunctions, besides the importance of environmental factors also.13 Patients of Atopic Dermatitis can have both ,the permeability barrier defects and antimicrobial barrier defects of stratum corneum. 23
1.Role of Genetics Genetic predisposition is a very important factor in the pathogenesis of AD. It is a highly heritable disease in which phenotype-specific genes
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25 Atopic dermatitis has strong tendency to run in families. It has been seen that without family history only 10-15 % of patients develop atopic dermatitis whereas in 25-30% and 50-75% of cases single and both parental history is present respectively. There are more chances of disease in children if mother is suffering from atopic dermatitis.26 About 46 genes till mid 2009 have demonstrated at least one positive association with AD .Of these, the gene encoding filaggrin (FLG) has been most consistently replicated. It has been seen that genes located on chromosome 1q21 which control epidermal differentiation are strongly associated with atopic dermatitis.25 The filaggrin gene, FLG, is situated in the epidermal differentiation complex 1q21. In European population ,8.8% of the general population carry one or more FLG null alleles, whereas 42% of the AD cohort carry one or more of these FLG
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