アトピー性皮膚炎　発症予防のエビデンス

抄録

Many studies of risk factors for atopic dermatitis (AD) onset have reported about skin barrier dysfunction such as filaggrin gene mutation and rise in transepidermal water loss in addition to family history and genetic background. There are also reports of the influence of risk factors given by westernized living environment such as change of intestinal microbiome, reduction of sunlight exposure, change of diet as immunological background, and it is thought that each factor interacts complicatedly. Various studies have been conducted to try to prevent the onset of AD, such as eliminating specific foods in mothers during pregnancy or lactation, or in infants undergoing weaning, and avoiding inhaled antigens such as house dust mites or pets in the environment. However, it has not been possible to demonstrate efficacy in many prevention studies using these allergen removal measures. Currently, moisturizing skin care from early infancy is expected to be most effective as a prophylactic method for AD. Furthermore, as a compromised skin barrier and the presence of dermatitis constitute percutaneous sensitization risk to food antigens, the possibility that skin cares aiming at active eczema control against atopic dermatitis decrease allergen sensitization and subsequent allergy march has been considered, however, at present, supporting evidence is scarce.