adairАллергология и Иммунология в ПедиатрииAllergology and Immunology in Paediatrics2500-11752712-7958Ассоциация детских аллергологов и иммунологов России10.53529/2500-1175-2024-1-5-11adair-126Research ArticleОБЗОРREVIEWРоль неспецифических факторов риска при атопическом дерматитеRole of nonspecific risk factors in atopic dermatitishttps://orcid.org/0000-0001-5999-7085МачарадзеД. Ш.MacharadzeD. Sh.

Дали Шотаевна Мачарадзе, д. м. н., в. н. с.

клинический отдел

125212; ул. Адмирала Макарова, д. 10; Москва

Dali Sh. Macharadze, Doc. Sci., Leading Researcher

125212; 10 Admiral Makarov st.; Moscow

dalim_a@mail.ruhttps://orcid.org/0009-0005-5298-056XРассановаЕ. А.RassanovaE. A.

Екатерина Андреевна Рассанова, ассистент

кафедра педиатрии

610998; ул. К. Маркса, д. 112; Киров

Ekaterina A. Rassanova, assistant

Department of pediatrics

610998; 112 K. Marx st.; Kirov

ekaterinarassanova@yandex.ruhttps://orcid.org/0000-0002-6945-2019РуженцоваТ. А.RuzhentsovaT. A.

Татьяна Александровна Руженцова, д. м. н., зам. директора по клинической работе

125212; ул. Адмирала Макарова, д. 10; Москва

Tatyana A. Ruzhentsova, Doc. Sci., Deputy Director

125212; 10 Admiral Makarov st.; Moscow

ruzhencova@gmail.comhttps://orcid.org/0000-0003-1670-0506ГаланинаА. В.GalaninaA. V.

Алена Васильевна Галанина, д. м. н., профессор

кафедра пропедевтики детских болезней

117997; ул. Островитянова, д. 1; Москва

Alena V. Galanina, Doc. Sci., Professor of Department

117997; 1 Ostrovityanova st.; Moscow

alenagalanina@yandex.ruhttps://orcid.org/0009-0009-5351-4893МалышевВ. С.MalyshevV. S.

Владимир Сергеевич Малышев, д. б. н., зав. лабораторией

127106; Алтуфьевское ш., д. 9; Москва

Vladimir S. Malyshev, Doc. Sci. (Biol.), Head of the Lab Department

127106; 9 Altufyevskoe shosse;  Moscow

com.delafere@mail.ruФБУН МНИИЭМ им. Г. Н. Габричевского РоспотребнадзораРоссияResearch Institute of Epidemiology and Microbiology named after. G. N. Gabrichevsky RospotrebnadzorRussian FederationФГБОУ ВО Кировский ГМУ Минздрава РоссииРоссияFederal State Budgetary Educational Institution of Higher Education «Kirov State Medical University» of the Ministry of Healthcare of the Russian FederationRussian FederationФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава РоссииРоссияFederal State Autonomous Educational Institution of Higher Education «N. I. Pirogov Russian National Research Medical University» of the Ministry of Health of the Russian FederationRussian FederationООО «Фидес Лаб»Россия«FIDES Lab», Limited Liability CompanyRussian Federation20240505202401511Copyright © Мачарадзе Д.Ш., Рассанова Е.А., Руженцова Т.А., Галанина А.В., Малышев В.С., 20242024Мачарадзе Д.Ш., Рассанова Е.А., Руженцова Т.А., Галанина А.В., Малышев В.С.Macharadze D.S., Rassanova E.A., Ruzhentsova T.A., Galanina A.V., Malyshev V.S.This work is licensed under a Creative Commons Attribution 4.0 License.https://adair.elpub.ru/jour/article/view/126

   Увеличение распространенности атопического дерматита (АтД) за последние десятилетия свидетельствует о том, что факторы окружающей среды играют важную роль в этиологии и патогенезе заболевания. Неспецифические факторы относятся к внешним (или экспосомным) факторам и включают человеческие и природные факторы, влияющие на здоровье популяции: например, социально-экономический статус больного; климат, в том числе температуру воздуха, воздействие ультрафиолетового излучения, загрязнение воздуха; а также проживание в городе или сельской местности. Несмотря на то, что в исследованиях показано влияние этих факторов на течение АтД, в целом ни один из них достоверно не увеличивает или не снижает риск развития заболевания. В этом обзоре кратко обсуждаются исследования, посвященные роли неспецифических внешних факторов риска и их влиянию на развитие и течение АтД у детей и взрослых.

   The increasing prevalence of atopic dermatitis (AD) over recent decades suggests that environmental factors play an important role in the etiology and pathogenesis of the disease. Nonspecific factors refer to external (or exposomal) factors and include human and natural factors that influence the health of a population: for example, the socioeconomic status of the patient; climate, including air temperature, exposure to ultraviolet radiation, air pollution; and living in a city or rural area. Although studies have shown the influence of these factors on the course of AD, in general, none of them significantly increases or decreases the risk of developing the disease. This review briefly discusses studies on the role of nonspecific environmental risk factors and their impact on the course of AD in children and adults.

атопический дерматитнеспецифические факторы рискаклиматсоциально-экономические условиягородская/сельская средаatopic dermatitisnonspecific risk factorsclimatesocio-economic conditionsurban/rural environmentReferencesAkdis CA. Does the epithelial barrier hypothesis explain the increase in allergy, autoimmunity and other chronic conditions? Nat Rev Immunol. 2021; 21 (11): 739–751. doi: 10.1038/s41577-021-00538-7.Akdis CA. Does the epithelial barrier hypothesis explain the increase in allergy, autoimmunity and other chronic conditions? Nat Rev Immunol. 2021; 21 (11): 739–751. doi: 10.1038/s41577-021-00538-7.Sözener ZC, Cevhertas L, Nadeau K et al. Environmental factors in epithelial barrier dysfunction. J Allergy Clin Immunol. 2020; 145 (6): 1517–1528. doi: 10.1016/j.jaci.2020.04.024.Sözener ZC, Cevhertas L, Nadeau K et al. Environmental factors in epithelial barrier dysfunction. J Allergy Clin Immunol. 2020; 145 (6): 1517–1528. doi: 10.1016/j.jaci.2020.04.024.Narla S, Silverberg JI. The Role of Environmental Exposures in Atopic Dermatitis. Curr Allergy Asthma Rep. 2020; 20 (12): 74. doi: 10.1007/s11882-020-00971-z.Narla S, Silverberg JI. The Role of Environmental Exposures in Atopic Dermatitis. Curr Allergy Asthma Rep. 2020; 20 (12): 74. doi: 10.1007/s11882-020-00971-z.Leung D. Atopic dermatitis: age and race do matter! J Allergy Clin Immunol 2015; 136: 1265–1267. doi: 10.1016/j.jaci.2015.09.011Leung D. Atopic dermatitis: age and race do matter! J Allergy Clin Immunol 2015; 136: 1265–1267. doi: 10.1016/j.jaci.2015.09.011Bieber T. Atopic dermatitis: an expanding therapeutic pipeline for a complex disease. Nat Rev Drug Discov. 2022; 21 (1): 21–40. doi: 10.1038/s41573-021-00266-6.Bieber T. Atopic dermatitis: an expanding therapeutic pipeline for a complex disease. Nat Rev Drug Discov. 2022; 21 (1): 21–40. doi: 10.1038/s41573-021-00266-6.Carson C, Rasmussen M, Thyssen J et al. Clinical presentation of atopic dermatitis by filaggrin gene mutation status during the first 7 years of life in a prospective cohort study. PLoSOne. 2012; 7: e48678. doi: 10.1371/journal.pone.0048678.Carson C, Rasmussen M, Thyssen J et al. Clinical presentation of atopic dermatitis by filaggrin gene mutation status during the first 7 years of life in a prospective cohort study. PLoSOne. 2012; 7: e48678. doi: 10.1371/journal.pone.0048678.Wegienka G, Zoratti E, Cole Johnson C. The role of the early-life environment in the development of allergic disease. Immunol Allergy Clin North Am 2015; 35: 1–17. doi: 10.1016/j.iac.2014.09.002.Wegienka G, Zoratti E, Cole Johnson C. The role of the early-life environment in the development of allergic disease. Immunol Allergy Clin North Am 2015; 35: 1–17. doi: 10.1016/j.iac.2014.09.002.Kantor R, Silverberg JI. Environmental risk factors and their role in the management of atopic dermatitis. Expert Rev Clin Immunol. 2017; 13 (1): 15–26. doi: 10.1080/1744666X.2016.1212660.Kantor R, Silverberg JI. Environmental risk factors and their role in the management of atopic dermatitis. Expert Rev Clin Immunol. 2017; 13 (1): 15–26. doi: 10.1080/1744666X.2016.1212660.Wan J, Oganisian A, Spieker A et al. Racial/Ethnic Variation in Use of Ambulatory and Emergency Care for Atopic Dermatitis among US Children. J Invest Dermatol. 2019; 139 (9): 1906–1913. doi: 10.1016/j.jid.2019.02.024.Wan J, Oganisian A, Spieker A et al. Racial/Ethnic Variation in Use of Ambulatory and Emergency Care for Atopic Dermatitis among US Children. J Invest Dermatol. 2019; 139 (9): 1906–1913. doi: 10.1016/j.jid.2019.02.024.Kopel LS, Phipatanakul W, Gaffin J. Social disadvantage and asthma control in children. Paediatr Respir Rev. 2014; 15 (3): 256–262; quiz 262-3. doi: 10.1016/j.prrv.2014.04.017.Kopel LS, Phipatanakul W, Gaffin J. Social disadvantage and asthma control in children. Paediatr Respir Rev. 2014; 15 (3): 256–262; quiz 262-3. doi: 10.1016/j.prrv.2014.04.017.McKenzie C, Silverberg JI. The prevalence and persistence of atopic dermatitis in urban United States children. Ann Allergy Asthma Immunol. 2019; 123 (2): 173–178. doi: 10.1016/j.anai.2019.05.014.McKenzie C, Silverberg JI. The prevalence and persistence of atopic dermatitis in urban United States children. Ann Allergy Asthma Immunol. 2019; 123 (2): 173–178. doi: 10.1016/j.anai.2019.05.014.Levin ME, Botha M, Basera W et al. Environmental factors associated with allergy in urban and rural children from the South African Food Allergy (SAFFA) cohort. J Allergy Clin Immunol. 2020; 145 (1): 415–426. doi: 10.1016/j.jaci.2019.07.048.Levin ME, Botha M, Basera W et al. Environmental factors associated with allergy in urban and rural children from the South African Food Allergy (SAFFA) cohort. J Allergy Clin Immunol. 2020; 145 (1): 415–426. doi: 10.1016/j.jaci.2019.07.048.Davis MF, Ludwig S, Brigham E et al. Effect of home exposure to Staphylococcus aureus on asthma in adolescents. J Аllergy Сlin immunol. 2018; 141 (1): 402–405. doi: 10.1016/j.jaci.2017.06.031.Davis MF, Ludwig S, Brigham E et al. Effect of home exposure to Staphylococcus aureus on asthma in adolescents. J Аllergy Сlin immunol. 2018; 141 (1): 402–405. doi: 10.1016/j.jaci.2017.06.031.Stefanovic N, Flohr C, Irvine AD. The exposome in atopic dermatitis. Allergy. 2020; 75 (1): 63–74. doi: 10.1111/all.13946.Stefanovic N, Flohr C, Irvine AD. The exposome in atopic dermatitis. Allergy. 2020; 75 (1): 63–74. doi: 10.1111/all.13946.Flohr C, Yeo L. Atopic dermatitis and the hygiene hypothesis revisited. Curr Probl Dermatol 2011; 41: 1–34. doi: 10.1159/000323290.Flohr C, Yeo L. Atopic dermatitis and the hygiene hypothesis revisited. Curr Probl Dermatol 2011; 41: 1–34. doi: 10.1159/000323290.Schram ME, Tedja AM, Spijker R. et al. Is there a rural/urban gradient in the prevalence of eczema? A systematic review. Br J Dermatol. 2010; 162 (5): 964–973. doi: 10.1111/j.1365-2133.2010.09689.x.Schram ME, Tedja AM, Spijker R. et al. Is there a rural/urban gradient in the prevalence of eczema? A systematic review. Br J Dermatol. 2010; 162 (5): 964–973. doi: 10.1111/j.1365-2133.2010.09689.x.Burbank AJ, Sood AK, Kesic M et al. Environmental determinants of allergy and asthma in early life. J Allergy Clin Immunol. 2017; 140 (1): 1–12. doi: 10.1016/j.jaci.2017.05.010.Burbank AJ, Sood AK, Kesic M et al. Environmental determinants of allergy and asthma in early life. J Allergy Clin Immunol. 2017; 140 (1): 1–12. doi: 10.1016/j.jaci.2017.05.010.Perkin MR, Strachan DP. Which aspects of the farming lifestyle explain the inverse association with childhood allergy? J Allergy Clin Immunol. 2006; 117 (6): 1374–1381. doi: 10.1016/j.jaci.2006.03.008.Perkin MR, Strachan DP. Which aspects of the farming lifestyle explain the inverse association with childhood allergy? J Allergy Clin Immunol. 2006; 117 (6): 1374–1381. doi: 10.1016/j.jaci.2006.03.008.Ruokolainen L, Paalanen L, Karkman A. Significant disparities in allergy prevalence and microbiota between the young people in Finnish and Russian Karelia. Clin Exp Allergy. 2017; 47 (5): 665–674. doi: 10.1111/cea.12895.Ruokolainen L, Paalanen L, Karkman A. Significant disparities in allergy prevalence and microbiota between the young people in Finnish and Russian Karelia. Clin Exp Allergy. 2017; 47 (5): 665–674. doi: 10.1111/cea.12895.Glatthardt T, van Tilburg Bernardes Е, Arrieta М-С. The mycobiome in atopic diseases: Inducers and triggers. J Allergy Clin Immunol. 2023; 152: 1368–1375. doi: 10.1016/j.jaci.2023.10.006.Glatthardt T, van Tilburg Bernardes Е, Arrieta М-С. The mycobiome in atopic diseases: Inducers and triggers. J Allergy Clin Immunol. 2023; 152: 1368–1375. doi: 10.1016/j.jaci.2023.10.006.Irvine A, Mina-Osorio P. Disease trajectories in childhood atopic dermatitis: an update and practitioner’s guide. Br J Dermatol. 2019; 181 (5): 895–906. doi: 10.1111/bjd.17766.Irvine A, Mina-Osorio P. Disease trajectories in childhood atopic dermatitis: an update and practitioner’s guide. Br J Dermatol. 2019; 181 (5): 895–906. doi: 10.1111/bjd.17766.Fleischer Jr AB. Atopic dermatitis: the relationship to temperature and seasonality in the United States. Int J Dermatol. 2019; 58: 465–471. doi: 10.1111/ijd.14289.Fleischer Jr AB. Atopic dermatitis: the relationship to temperature and seasonality in the United States. Int J Dermatol. 2019; 58: 465–471. doi: 10.1111/ijd.14289.Silverberg JI, Hanifin J, Simpson EL. Climatic factors are associated with childhood eczema prevalence in the United States. J Invest Dermatol. 2013; 133 (7): 1752–1759. doi: 10.1038/jid.2013.19.Silverberg JI, Hanifin J, Simpson EL. Climatic factors are associated with childhood eczema prevalence in the United States. J Invest Dermatol. 2013; 133 (7): 1752–1759. doi: 10.1038/jid.2013.19.Vocks E, Busch R, Fröhlich C et al. Influence of weather and climate on subjective symptom intensity in atopic eczema. Int J Biometeorol. 2001; 45 (1): 27–33. doi: 10.1007/s004840000077.Vocks E, Busch R, Fröhlich C et al. Influence of weather and climate on subjective symptom intensity in atopic eczema. Int J Biometeorol. 2001; 45 (1): 27–33. doi: 10.1007/s004840000077.Kim M, Kim YM, Lee J. Seasonal variation and monthly patterns of skin symptoms in Korean children with atopic eczema/dermatitis syndrome. Allergy and Asthma Proceedings. 2017; 38: 294–299. doi: 10.2500/aap.2017.38.4055.Kim M, Kim YM, Lee J. Seasonal variation and monthly patterns of skin symptoms in Korean children with atopic eczema/dermatitis syndrome. Allergy and Asthma Proceedings. 2017; 38: 294–299. doi: 10.2500/aap.2017.38.4055.Kathuria P, Silverberg JI. Association of pollution and climate with atopic eczema in US children. Pediatr Allergy Immunol. 2016; 27 (5): 478–485. doi: 10.1111/pai.12543.Kathuria P, Silverberg JI. Association of pollution and climate with atopic eczema in US children. Pediatr Allergy Immunol. 2016; 27 (5): 478–485. doi: 10.1111/pai.12543.Sargen MR, Hoffstad O, Margolis DJ. Warm, humid, and high sun exposure climates are associated with poorly controlled eczema: PEER (Pediatric Eczema Elective Registry) cohort, 2004–2012. J Invest Dermatol. 2014; 134 (1): 51–57. doi: 10.1038/jid.2013.274.Sargen MR, Hoffstad O, Margolis DJ. Warm, humid, and high sun exposure climates are associated with poorly controlled eczema: PEER (Pediatric Eczema Elective Registry) cohort, 2004–2012. J Invest Dermatol. 2014; 134 (1): 51–57. doi: 10.1038/jid.2013.274.Coates SJ, Enbiale W, Davis MDP, Andersen LK. The effects of climate change on human health in Africa, a dermatologic perspective: a report from the International Society of Dermatology Climate Change Committee. Int J Dermatol. 2020; 59 (3): 265–278. doi: 10.1111/ijd.14759.Coates SJ, Enbiale W, Davis MDP, Andersen LK. The effects of climate change on human health in Africa, a dermatologic perspective: a report from the International Society of Dermatology Climate Change Committee. Int J Dermatol. 2020; 59 (3): 265–278. doi: 10.1111/ijd.14759.Maglie R, Souza Monteiro de Araujo D. et al. The role of TRPA1 in skin physiology and pathology. Int J Mol Sci. 2021; 22 (6): 3065. doi: 10.3390/ijms22063065.Maglie R, Souza Monteiro de Araujo D. et al. The role of TRPA1 in skin physiology and pathology. Int J Mol Sci. 2021; 22 (6): 3065. doi: 10.3390/ijms22063065.Krämer U, Weidinger S, Darsow U et al. Seasonality in symptom severity influenced by temperature or grass pollen: results of a panel study in children with eczema. J Invest Dermatol. 2005; 124 (3): 514–523. doi: 10.1111/j.0022-202X.2005.23625.x.Krämer U, Weidinger S, Darsow U et al. Seasonality in symptom severity influenced by temperature or grass pollen: results of a panel study in children with eczema. J Invest Dermatol. 2005; 124 (3): 514–523. doi: 10.1111/j.0022-202X.2005.23625.x.Byremo G, Rød G, Carlsen KH. Effect of climatic change in children with atopic eczema. Allergy. 2006; 61 (12): 1403–1410. doi: 10.1111/j.1398-9995.2006.01209.x.Byremo G, Rød G, Carlsen KH. Effect of climatic change in children with atopic eczema. Allergy. 2006; 61 (12): 1403–1410. doi: 10.1111/j.1398-9995.2006.01209.x.Chen NT, Chen MJ, Wu CD, Guo YL. Emergency room visits for childhood atopic dermatitis are associated with floods? Sci Total Environ. 2021; 773: 145435. doi: 10.1016/j.scitotenv.2021.145435.Chen NT, Chen MJ, Wu CD, Guo YL. Emergency room visits for childhood atopic dermatitis are associated with floods? Sci Total Environ. 2021; 773: 145435. doi: 10.1016/j.scitotenv.2021.145435.El Kelish A, Zhao F, Heller W et al. Ragweed (Ambrosia artemisiifolia) pollen allergenicity: SuperSAGE transcriptomic analysis upon elevated CO<sub>2</sub> and drought stress. BMC Plant Biol. 2014; 14: 176. doi: 10.1186/1471-2229-14-176.El Kelish A, Zhao F, Heller W et al. Ragweed (Ambrosia artemisiifolia) pollen allergenicity: SuperSAGE transcriptomic analysis upon elevated CO<sub>2</sub> and drought stress. BMC Plant Biol. 2014; 14: 176. doi: 10.1186/1471-2229-14-176.

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