The atopic march

The atopic march refers to the natural history of allergic diseases as they develop during infancy and childhood. Introduced by the American allergists A. F. Coca and R. A. Cooke in 1923, the term atopy became closely associated with the IgE molecule after its identification as the carrier of hypersensitivity.1 However, in the context of the atopic march, IgE is a pathophysiologic mediator of some, but not all, atopic diseases. As such, it is better to consider the atopic march as a progression of allergic conditions that have common genetic and environmental predisposing factors, share the immunologic feature of one or more allergen-specific TH2 responses, and are characterized by a type 2 effector phase that can include generation of specific IgE, activation of granulocytes, and other innate features such as mucous production and edema.

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