Russian Journal of AllergyRussian Journal of AllergyРоссийский Аллергологический Журнал1810-88302686-682XPublishing House ABV Press1698410.36691/RJA16984ReviewsНаучные обзорыResearch ArticleThe role of exposome-specific risk factors in atopic dermatitisРоль экспосом-специфических факторов риска при атопическом дерматитеhttps://orcid.org/0000-0001-5999-70852399-5783MacharadzeDali Sh.МачарадзеДали Шотаевна
Russian Federation

MD, Dr. Sci. (Medicine)

д-р мед. наук

dalim_a@mail.ruhttps://orcid.org/0000-0002-6945-20193685-2618RuzhentsovaTatiana A.РуженцоваТатьяна Александровна
Russian Federation

MD, Dr. Sci. (Medicine)

д-р мед. наук

ruzhencova@gmail.comhttps://orcid.org/0000-0003-0140-23039419-5672JanaevaHeda A.ЯнаеваХеда Ахмедовна
Russian Federation

MD, Cand. Sci. (Medicine)

канд. мед. наук

heda-allergolog@mail.ruhttps://orcid.org/0000-0003-3904-71084337-6008MeshkovaNatalia A.МешковаНаталья Андреевна
Russian Federation

MD

врач-ординатор

nataliaandreevnamesh@gmail.comhttps://orcid.org/0009-0009-5351-4893MalyshevVladimir S.МалышевВладимир Сергеевич
Russian Federation

MD, Dr. Sci. (Biol.)

д-р биол. наук

com.delafere@mail.ruGabrichevsky Research Institute of Epidemiology and MicrobiologyМосковский научно-исследовательский институт эпидемиологии и микробиологии имени Г.Н. ГабричевскогоMoscow Medical University “Reaviz”Московский медицинский университет «Реавиз»Chechen State University named after A.A. KadyrovЧеченский государственный университет имени А.А. КадыроваRepublican Skin and Venereological Dispensary, GroznyРеспубликанский кожно-венерологический диспансер, ГрозныйThe Russian National Research Medical University named after N.I. PirogovРоссийский национальный исследовательский медицинский университет имени Н.И. Пирогова“Fides Lab”«Фидес Лаб»110220251004202522158662711202404022025Copyright ©; 2025, PH “ABV-Press”Copyright ©; 2025, ООО «ИД «АБВ-пресс»2025PH “ABV-Press”ООО «ИД «АБВ-пресс»https://creativecommons.org/licenses/by-nc-nd/4.0/https://rusalljournal.ru/raj/article/view/16984

The article provides an overview of the latest concepts regarding the role of specific exposomal factors in atopic dermatitis in children and adults. As is known, specific factors include: air pollutants (external, internal), air humidity, metals, water hardness, detergents, pollen and other allergen, diet, human lifestyle factors. In this work, the main attention is paid to all the above factors, except for the role of allergy in the etiopathogenesis of atopic dermatitis (a separate publication will be devoted to this issue). Based on the data of systematic reviews, meta-analyses and recent studies, the role of specific factors is analyzed: air pollutants (external and indoor), diet for pregnant women and during lactation; various dietary supplements, etc. — in the development of atopic dermatitis. It is shown that these (and other exposomal) factors can also participate in the worsening of clinical manifestations of atopic dermatitis (for example, detergents). However, the leading role of any specific factor (factors) in the etiopathogenesis of atopic dermatitis (including allergies) has not been reliably proven to date. This also applies to nutritional factors (for example, adherence to a hypoallergenic diet by the mother during pregnancy and lactation, use of vitamin D and probiotics in the pre- and postnatal periods, etc.). In all likelihood, the external exposome is involved as a risk factor in the development of atopic dermatitis and worsening of the severity of the disease. Nevertheless, measures aimed at improving environmental factors can only be useful, especially in combination with anti-inflammatory drugs.

Представлен обзор последних данных о роли специфических экспосомных факторов при атопическом дерматите у детей и взрослых. Как известно, к специфическим факторам относят следующие: загрязнители воздуха (внешние, внутренние), влажность воздуха, металлы, жесткость воды, моющие средства, пыльцу и другие аллергены, диету, факторы образа жизни человека. В данной работе основное внимание уделено всем перечисленным факторам, кроме роли аллергии, в этиопатогенезе атопического дерматита (этому вопросу будет посвящена отдельная публикация). На основании данных систематических обзоров, метаанализов и последних исследований проанализирована роль специфических факторов: загрязнителей воздуха (внешних и внутри помещений), диеты для беременных и во время лактации, различных биодобавок и т. п. в развитии атопического дерматита. Показано, что эти и другие экспосомные факторы могут ухудшать клинические проявления атопического дерматита (например, моющие средства). Однако ведущая роль какого-либо специфического фактора (факторов) в этиопатогенезе атопического дерматита (в том числе и аллергии) на сегодняшний день достоверно не доказана. Это касается и нутритивных факторов (например, соблюдения гипоаллергенной диеты матерью во время беременности и лактации, использования витамина D и пробиотиков в пре- и постнатальном периодах и т. п.). По всей вероятности, внешний экспосом участвует как фактор риска в развитии атопического дерматита и ухудшении степени тяжести заболевания. Тем не менее меры, направленные на улучшение экологических факторов, могут быть только полезны, особенно в комплексе с противовоспалительными препаратами.

atopic dermatitisspecific exposome factorsair pollutantsdietair humiditywater hardness  атопический дерматитспецифические факторы экспосомазагрязнители воздухадиетавлажность воздухажесткость водыKantor 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.2016.1212660Kantor R., Silverberg JI. Environmental risk factors and their role in the management of atopic dermatitis // Expert Rev Clin Immunol. 2017. Vol. 13, N. 1. P. 15–26. doi: 10.1080/1744666X.2016.1212660Stefanovic N, Irvine A, Flohr C. The Role of the Environment and Exposome in Atopic Dermatitis. Curr Treat Options Allergy. 2021;8(3):222–241. doi: 10.1007/s40521-021-00289-9Stefanovic N., Irvine A., Flohr C. The Role of the Environment and Exposome in Atopic Dermatitis // Curr Treat Options Allergy. 2021. Vol. 8, N. 3. P. 222–241. doi: 10.1007/s40521-021-00289-9Grafanaki K, Antonatos C, Maniatis A, et al. Intrinsic Effects of Exposome in Atopic Dermatitis: Genomics, Epigenomics and Regulatory Layers. J Clin Med. 2023;12(12):4000. doi: 10.3390/jcm12124000Grafanaki K., Antonatos C., Maniatis A., et al. Intrinsic Effects of Exposome in Atopic Dermatitis: Genomics, Epigenomics and Regulatory Layers // J Clin Med. 2023. Vol. 12, N 12. P. 4000. doi: 10.3390/jcm12124000Bieber T. Atopic dermatitis: an expanding therapeutic pipeline for a complex disease. Nat Rev Drug Discov. 2022;21(1):21–40. doi: 10.1038/s41573-021-00266-6Bieber T. Atopic dermatitis: an expanding therapeutic pipeline for a complex disease // Nat Rev Drug Discov. 2022. Vol. 21, N 1. P. 21–40. doi: 10.1038/s41573-021-00266-6Macharadze DSh, Rassanova EA, Ruzhentsova TA, et al. Role of nonspecific risk factors in atopic dermatitis. Allergology and Immunology in Paediatrics. 2024(1):5–11. doi. 10.53529/2500-1175-2024-1-5-11Мачарадзе Д.Ш., Рассанова Е.А., Руженцова Т.А., и др. Роль неспецифических факторов риска при атопическом дерматите // Аллергология и иммунология в педиатрии. 2024. № 1. С. 5–11. doi: 10.53529/2500-1175-2024-1-5-11Fadadu R, Grimes B, Jewell N, et al. Association of Wildfire Air Pollution and Health Care Use for Atopic Dermatitis and Itch. JAMA Dermatol. 2021;157(6):658–666. doi: 10.1001/jamadermatol.2021.0179Fadadu R., Grimes B., Jewell N., et al. Association of Wildfire Air Pollution and Health Care Use for Atopic Dermatitis and Itch // JAMA Dermatol. 2021. Vol. 157, N 6. P. 658–666. doi: 10.1001/jamadermatol.2021.0179Ahn K. The role of air pollutants in atopic dermatitis. J Allergy Clin Immunol. 2014;134(5):993–999; discussion 1000. doi: 10.1016/j.jaci.2014.09.023Ahn K. The role of air pollutants in atopic dermatitis // J Allergy Clin Immunol. 2014. Vol. 134, N 5. P. 993–999; discussion 1000. doi: 10.1016/j.jaci.2014.09.023Alkotob SS, Cannedy C, Harter K, et al. Advances and novel developments in environmental influences on the development of atopic diseases. Allergy. 2020;75(2):3077–3086. doi: 10.1111/all.14624Alkotob S.S., Cannedy C., Harter K., et al. Advances and novel developments in envi-ronmental influences on the development of atopic diseases // Allergy. 2020. Vol. 75, N 2. P. 3077–3086. doi: 10.1111/all.14624Pan TL, Wang PW, Aljuffali I, et al. The impact of urban particulate pollution on skin barrier function and the subsequent drug absorption. J Dermatol Sci. 2015;78(1):51–60. doi: 10.1016/j.jdermsci.2015.01.011Pan T.L., Wang P.W., Aljuffali I., et al. The impact of urban particulate pollution on skin barrier function and the subsequent drug absorption // J Dermatol Sci. 2015. Vol. 78, N 1. P. 51–60. doi: 10.1016/j.jdermsci.2015.01.011Tang KT, Ku KC, Chen D, et al. Adult atopic dermatitis and exposure to air pollutantsa nationwide population-based study. Ann Allergy Asthma Immunol. 2017;118(3):351–355. doi: 10.1016/j.anai.2016.12.005Tang K.T., Ku K.C., Chen D., et al. Adult atopic dermatitis and exposure to air pollu-tants-a nationwide population-based study // Ann Allergy Asthma Immunol. 2017. Vol. 118, N 3. P. 351–355. doi: 10.1016/j.anai.2016.12.005David Boothe W, Tarbox J, Tarbox M. Atopic Dermatitis: Pathophysiology. Adv Exp Med Biol. 2017;1027:21–37. doi: 10.1007/978-3-319-64804-0_3David Boothe W., Tarbox J., Tarbox M. Atopic Dermatitis: Pathophysiology // Adv Exp Med Biol. 2017. Vol. 1027. P. 21–37. doi: 10.1007/978-3-319-64804-0_3Yang SI, Lee SH, Lee SY. Prenatal PM2.5 exposure and vitamin D-associated early persistent atopic dermatitis via placental methylation. Ann Allergy Asthma Immunol. 2020;125(6):665–673.e1. doi: 10.1016/j.anai.2020.09.008Yang S.I., Lee S.H., Lee S.Y. Prenatal PM2.5 exposure and vitamin D-associated early persistent atopic dermatitis via placental methylation // Ann Allergy Asthma Immunol. 2020. Vol. 125, N 6. P. 665–673.e1. doi: 10.1016/j.anai.2020.09.008Lee J-T, Cho Y-S, Son J-Y. Relationship between Ambient Ozone Concentrations and Daily Hospital Admissions for Childhood Asthma/Atopic Dermatitis in Two Cities of Korea during 2004–2005. Int J Environ Health Res. 2010;20:1–11. doi: 10.1080/09603120903254033Lee J.-T., Cho Y.-S., Son J.-Y. Relationship between Ambient Ozone Concentrations and Daily Hospital Admissions for Childhood Asthma /Atopic Dermatitis in Two Cities of Korea during 2004–2005 // Int J Environ Health Res. 2010. Vol. 20. Р. 1–11. doi: 10.1080/09603120903254033Yi O, Kwon HJ, Kim H, et al. Effect of Environmental Tobacco Smoke on Atopic Dermatitis among Children in Korea. Environ Res. 2012;113:40–45. doi: 10.1016/j.envres.2011.12.012Yi O., Kwon H.-J., Kim H., et al. Effect of Environmental Tobacco Smoke on Atopic Dermatitis among Children in Korea // Environ Res. 2012. Vol. 113. P. 40–45. doi: 10.1016/j.envres.2011.12.012Morgenstern V, Zutavern A, Cyrys J, et al., GINI Study Group, LISA Study Group. Atopic diseases, allergic sensitization, and exposure to traffic-related air pollution in children. Am J Respir Crit Care Med. 2008;177(12):1331–1337. doi: 10.1164/rccm.200701-036OCMorgenstern V., Zutavern A., Cyrys J., et al., GINI Study Group, LISA Study Group. Atopic diseases, allergic sensitization, and exposure to traffic-related air pollution in children // Am J Respir Crit Care Med. 2008. Vol. 177, N 12. P. 1331–1337. doi: 10.1164/rccm.200701-036OCMin K, Yi S, Kim H, et al. Association between exposure to traffic-related air pollution and pediatric allergic diseases based on modeled air pollution concentrations and traffic measures in Seoul, Korea: a comparative analysis. Environ Health. 2020;19:6. doi: 10.1186/s12940-020-0563-6Min K., Yi S., Kim H., et al. Association between exposure to traffic-related air pollu-tion and pediatric allergic diseases based on modeled air pollution concentrations and traffic measures in Seoul, Korea: a comparative analysis // Environ Health. 2020. Vol. 19. P. 6. doi: 10.1186/s12940-020-0563-6Lee J, Ryu S, Lee G, Bae GN. Indoor-to-outdoor particle concentration ratio model for human exposure analysis. Atmos Environ. 2016;127:100–106. doi: 10.1016/j.atmosenv.2015.12.020Lee J., Ryu S., Lee G., Bae G.N. Indoor-to-outdoor particle concentration ratio model for human exposure analysis // Atmos Environ. 2016. Vol. 127. P. 100–106. doi: 10.1016/j.atmosenv.2015.12.020Hendricks A, Eichenfield L, Shi VY. The impact of airborne pollution on atopic dermatitis: a literature review. Br J Dermatol. 2020;183(1):16–23. doi: 10.1111/bjd.18781Hendricks A., Eichenfield L., Shi VY. The impact of airborne pollution on atopic dermatitis: a literature review // Br J Dermatol. 2020. Vol. 183, N 1. P. 16–23. doi: 10.1111/bjd.18781Narla 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-zNarla S., Silverberg J.I. The Role of Environmental Exposures in Atopic Dermatitis // Curr Allergy Asthma Rep. 2020. Vol. 20, N 12. P. 74. doi: 10.1007/s11882-020-00971-zBhuda M, Wichmann J, Shirinde J. Association between Outdoor and Indoor Air Pollution Sources and Atopic Eczema among Preschool Children in South Africa. Int J Environ Res Public Health. 2024;21(3):326. doi: 10.3390/ijerph21030326Bhuda M., Wichmann J., Shirinde J. Association between Outdoor and Indoor Air Pollution Sources and Atopic Eczema among Preschool Children in South Africa // Int J Environ Res Public Health. 2024. Vol. 21, N 3. P. 326. doi: 10.3390/ijerph21030326Winter M, Thürmann L, Gu Z, et al. The benzene metabolite 1,4-benzoquinone reduces regulatory T-cell function: A potential mechanism for tobacco smoke-associated atopic dermatitis. J Allergy Clin Immunol. 2017;140(2):603–605. doi: 10.1016/j.jaci.2017.01.034Winter M., Thürmann L., Gu Z., et al. The benzene metabolite 1,4-benzoquinone reduc-es regulatory T-cell function: A potential mechanism for tobacco smoke-associated atopic dermatitis // J Allergy Clin Immunol. 2017. Vol. 140, N 2. P. 603–605. doi: 10.1016/j.jaci.2017.01.034Кantor R, Kim A, Thyssen JP, Silverberg JI. Association of Atopic Dermatitis with Smoking: A Systematic Review and Meta-Analysis. J Am Acad Dermatol. 2016;75:1119–1125.e1. doi: 10.1016/j.jaad.2016.07.017Кantor R., Kim A., Thyssen J.P., Silverberg J.I. Association of Atopic Dermatitis with Smoking: A Systematic Review and Meta-Analysis // J Am Acad Dermatol. 2016. Vol. 75. P. 1119–1125.e1. doi: 10.1016/j.jaad.2016.07.017Lau H, Lee J, Yap Q, et al. Smoke exposure and childhood atopic eczema and food allergy: A systematic review and meta-analysis. Pediatr Allergy Immunol. 2023;34(8):14010. doi: 10.1111/pai.14010Lau H., Lee J., Yap Q., et al. Smoke exposure and childhood atopic eczema and food al-lergy: A systematic review and meta-analysis // Pediatr Allergy Immunol. 2023. Vol. 34, N. 8. P. 14010. doi: 10.1111/pai.14010Pilz AC, Schielein MC, Schuster B, et al. Atopic Dermatitis: Disease Characteristics and Comorbidities in Smoking and Non-smoking Patients from the TREATgermany Registry. Acad Derm Venereol. 2022;36:413–421. doi: 10.1111/jdv.17789Pilz A.C., Schielein M.C., Schuster B., et al. Atopic Dermatitis: Disease Characteristics and Comorbidities in Smoking and Non-smoking Patients from the TREATgermany Registry // Acad Derm Venereol. 2022. Vol. 36. P. 413–421. doi: 10.1111/jdv.17789Morra D, Cho E, Li T, et al. Smoking and Risk of Adult-Onset Atopic Dermatitis in US Women. J Am Acad Dermatol. 2021;84:561–563. doi: 10.1016/j.jaad.2020.07.077Morra D., Cho E., Li T., et al. Smoking and Risk of Adult-Onset Atopic Dermatitis in US Women // J Am Acad Dermatol. 2021. Vol. 84. Р. 561–563. doi: 10.1016/j.jaad.2020.07.077Pilz AC, Durner V, Schielein M, et al. Addictions in Patients with Atopic Dermatitis: A Cross-sectional Pilot Study in Germany. J Eur Acad Derm Venereol. 2022;36:84–90. doi: 10.1111/jdv.17708Pilz A.C., Durner V., Schielein M., et al. Addictions in Patients with Atopic Dermatitis: A Cross-sectional Pilot Study in Germany // J Eur Acad Derm Venereol. 2022. Vol. 36. P. 84–90. doi: 10.1111/jdv.17708Arafune J, Tsujiguchi H, Hara A, et al. Increased Prevalence of Atopic Dermatitis in Children Aged 0–3 Years Highly Exposed to Parabens. Int J Environ Res Public Health. 2021;18:11657. doi: 10.3390/ijerph182111657Arafune J., Tsujiguchi H., Hara A., et al. Increased Prevalence of Atopic Dermatitis in Children Aged 0–3 Years Highly Exposed to Parabens // Int J Environ Res Public Health. 2021. Vol. 18. P. 11657. doi: 10.3390/ijerph182111657von Holst H, Nayak P, Dembek Z, et al. Perfluoroalkyl Substances Exposure and Immunity, Allergic Response, Infection, and Asthma in Children: Review of Epidemiologic Studies. Heliyon. 2021;7(10):e08160. doi: 10.1016/j.heliyon.2021.e08160von Holst H., Nayak P., Dembek Z., et al. Perfluoroalkyl Substances Exposure and Im-munity, Allergic Response, Infection, and Asthma in Children: Review of Epidemiologic Studies // Heliyon. 2021. Vol. 7. P. 08160. doi: 10.1016/j.heliyon.2021.e08160Tsai T-L, Wang S-L, Hsieh C-J, et al. TMICS Study Group Association between Prenatal Exposure to Metals and Atopic Dermatitis Among Children Aged 4 Years in Taiwan. JAMA Netw Open. 2021;4:e2131327. doi: 10.1001/jamanetworkopen.2021.31327Tsai T.-L., Wang S.-L., Hsieh C.-J., et al. TMICS Study Group Association between Prenatal Exposure to Metals and Atopic Dermatitis Among Children Aged 4 Years in Taiwan // JAMA Netw Open. 2021. Vol. 4. P. e2131327. doi: 10.1001/jamanetworkopen.2021.31327Kathuria P, Silverberg JI. Association of Pollution and Climate with Atopic Eczema in US Children. Pediatr Allergy Immunol. 2016;27:478–485. doi: 10.1111/pai.12543Kathuria P., Silverberg J.I. Association of Pollution and Climate with Atopic Eczema in US Children // Pediatr Allergy Immunol. 2016. Vol. 27. Р. 478–485. doi: 10.1111/pai.12543Lee S, Park S, Park H, et al. Joint Association of Prenatal Bisphenol-A and Phthalates Exposure with Risk of Atopic Dermatitis in 6-Month-Old Infants. Sci Total Environ. 2021;789:147953. doi: 10.1016/j.scitotenv.2021.147953Lee S., Park S., Park H., et al. Joint Association of Prenatal Bisphenol-A and Phthalates Exposure with Risk of Atopic Dermatitis in 6-Month-Old Infants // Sci.Total Environ. 2021. Vol. 789. Р. 147953. doi: 10.1016/j.scitotenv.2021.147953Xian M, Wawrzyniak P, Rückert B, et al. Anionic surfactants and commercial detergents decrease tight junction barrier integrity in human keratinocytes. J Allergy Clin Immunol. 2016;138:890–893.e899. doi: 10.1016/j.jaci.2016.07.003Xian M., Wawrzyniak P., Rückert B., et al. Anionic surfactants and commercial deter-gents decrease tight junction barrier integrity in human keratinocytes // J Allergy Clin Immunol. 2016. Vol. 138. P. 890–893.e899. doi: 10.1016/j.jaci.2016.07.003Kim Y, Kim J, Han Y, et al. Short-term effects of weather and air pollution on atopic dermatitis symptoms in children: A panel study in Korea. PLoS One. 2017;12(4):e0175229. doi: 10.1371/journal.pone.0175229Kim Y., Kim J., Han Y., et al. Short-term effects of weather and air pollution on atopic dermatitis symptoms in children: A panel study in Korea // PLoS One. 2017. Vol. 12, N 4. P. e0175229. doi: 10.1371/journal.pone.0175229Hamann C, Andersen Y, Engebretsen K, et al. The effects of season and weather on healthcare utilization among patients with atopic dermatitis. J Eur Acad Dermatology Venereol. 2018;32:1745–1753. doi: 10.1111/jdv.15023Hamann C., Andersen Y., Engebretsen K., et al. The effects of season and weather on healthcare utilization among patients with atopic dermatitis // J Eur Acad Dermatology Venereol. 2018. Vol. 32. P. 1745–1753. doi: 10.1111/jdv.15023Jabbar-Lopez ZK, Craven J, Logan K, et al. Longitudinal analysis of the effect of water hardness on atopic eczema: evidence for gene–environment interaction. Br J Dermatol. 2020;183:285–293. doi: 10.1111/bjd.18597Jabbar-Lopez Z.K., Craven J., Logan K., et al. Longitudinal analysis of the effect of water hardness on atopic eczema: evidence for gene-environment interaction // Br J Dermatol. 2020. Vol. 183. Р. 285–293. doi: 10.1111/bjd.18597Miyake Y, Yokoyama T, Yura A, et al. Ecological association of water hardness with prevalence of childhood atopic dermatitis in a Japanese urban area. Environ Res. 2004;94(1):33–37. doi: 10.1016/s0013-9351(03)00068-9Miyake Y., Yokoyama T., Yura A., et al. Ecological association of water hardness with prevalence of childhood atopic dermatitis in a Japanese urban area // Environ Res. 2004. Vol. 94. N 1. P. 33–37. doi: 10.1016/s0013-9351(03)00068-9Chaumont A, Voisin C, Sardella A, Bernard A. Interactions between domestic water hardness, infant swimming and atopy in the development of childhood eczema. Environ Res. 2012;116:52–57. doi: 10.1016/j.envres.2012.04.013Chaumont A., Voisin C., Sardella A., Bernard A. Interactions between domestic water hardness, infant swimming and atopy in the development of childhood eczema // Envi-ron Res. 2012. Vol. 116. Р. 52–57. doi: 10.1016/j.envres.2012.04.013Thomas K, Dean T, O’Leary C, et al. A randomised controlled trial of ion-exchange water softeners for the treatment of eczema in children. PLoS Med. 2011;8:e1000395. doi: 10.1371/journal.pmed.1000395Thomas K., Dean T., O’Leary C., et al. A randomised controlled trial of ion-exchange water softeners for the treatment of eczema in children // PLoS Med. 2011. Vol. 8. P. e1000395. doi: 10.1371/journal.pmed.1000395Kramer M, Kakuma R. Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child. Evid Based Child Health. 2014;9:447–483. doi: 10.1002/ebch.1972Kramer M., Kakuma R. Maternal dietary antigen avoidance during pregnancy or lacta-tion, or both, for preventing or treating atopic disease in the child // Evid Based Child Health. 2014. Vol. 9. Р. 447–483. doi: 10.1002/ebch.1972Venter C, Agostoni C, Arshad S, et al. Dietary factors during pregnancy and atopic outcomes in childhood: a systematic review from the European Academy of Allergy and Clinical Immunology. Pediatr Allergy Immunol. 2020;31:889–912. doi: 10.1111/pai.13303Venter C., Agostoni C., Arshad S., et al. Dietary factors during pregnancy and atopic outcomes in childhood: a systematic review from the European Academy of Allergy and Clinical Immunology // Pediatr Allergy Immunol. 2020. Vol. 31. Р. 889–912. doi: 10.1111/pai.13303Trikamjee T, Comberiati P, D’Auria E, et al. Nutritional Factors in the Prevention of Atopic Dermatitis in Children. Front Pediatr. 2021;8:577413. doi: 10.3389/fped.2020.577413Trikamjee T., Comberiati P., D’Auria E., et al. Nutritional Factors in the Prevention of Atopic Dermatitis in Children // Front Pediatr. 2021. Vol. 8. P. 577413. doi: 10.3389/fped.2020.577413Donovan S, Dewey K, Novotny R, et al. Maternal Diet during Pregnancy and Lactation and Risk of Child Food Allergies and Atopic Allergic Diseases: A Systematic Review [Internet]. Alexandria (VA): USDA Nutrition Evidence Systematic Review. 2020. PMID: 35289989. doi: 10.52570/NESR.DGAC2020.SR0207Donovan S., Dewey K., Novotny R., et al. Maternal Diet during Pregnancy and Lactation and Risk of Child Food Allergies and Atopic Allergic Diseases: A Systematic Review [Internet] // Alexandria (VA): USDA Nutrition Evidence Systematic Review. 2020. PMID: 35289989. doi: 10.52570/NESR.DGAC2020.SR0207Thyssen JP, Zirwas MJ, Elias PM. Potential Role of Reduced Environmental UV Exposure as a Driver of the Current Epidemic of Atopic Dermatitis. J Allergy Clin Immunol. 2015;136:1163–1169. doi: 10.1016/j.jaci.2015.06.042Thyssen J.P., Zirwas M.J., Elias P.M. Potential Role of Reduced Environmental UV Ex-posure as a Driver of the Current Epidemic of Atopic Dermatitis // J Allergy Clin Immunol. 2015. Vol. 136. P. 1163–1169. doi: 10.1016/j.jaci.2015.06.042Hyppönen E, Sovio U, Wjst M, et al. Infant vitamin d supplementation and allergic conditions in adulthood: northern Finland birth cohort 1966. Ann N Y Acad Sci. 2004;1037:84–95. doi: 10.1196/annals.1337.013Hyppönen E., Sovio U., Wjst M., et al. Infant vitamin d supplementation and allergic conditions in adulthood: northern Finland birth cohort 1966 // Ann N Y Acad Sci. 2004. Vol. 1037. P. 84–95. doi: 10.1196/annals.1337.013Bäck O, Blomquist H, Hernell O, Stenberg B. Does vitamin D intake during infancy promote the development of atopic allergy? Acta Derm Venereol. 2009;89(1):28–32. doi: 10.2340/00015555-0541Bäck O., Blomquist H., Hernell O., Stenberg B. Does vitamin D intake during infancy promote the development of atopic allergy? // Acta Derm Venereol. 2009. Vol. 89, N 1. P. 28–32. doi: 10.2340/00015555-0541Wang S, Yin P, Yu L, et al. Effects of Early Diet on the Prevalence of Allergic Disease in Children: A Systematic Review and Meta-Analysis. Adv Nutr. 2024;15(1):100128. doi: 10.1016/j.advnut.2023.10.001Wang S., Yin P., Yu L., et al. Effects of Early Diet on the Prevalence of Allergic Disease in Children: A Systematic Review and Meta-Analysis // Adv Nutr. 2024. Vol. 15, N 1. P. 100128. doi: 10.1016/j.advnut.2023.10.001Makrgeorgou A, Leonardi-Bee J, Bath-Hextall F, et al. Probiotics for treating eczema. Cochrane Database Syst Rev. 2018;11CD006135. doi: 10.1002/14651858.CD006135.pub3Makrgeorgou A., Leonardi-Bee J., Bath-Hextall F., et al. Probiotics for treating eczema // Cochrane Database Syst Rev. 2018 Nov 21;11(11):CD006135. doi: 10.1002/14651858.CD006135.pub3Amalia N, Orchard D, Francis KL, King E. Systematic Review and Meta-analysis on the Use of Probiotic Supplementation in Pregnant Mother, Breastfeeding Mother and Infant for the Prevention of Atopic Dermatitis in Children. Australas J Derm. 2020;61:628–643. doi: 10.1111/ajd.13186Amalia N., Orchard D., Francis K.L., King E. Systematic Review and Meta-analysis on the Use of Probiotic Supplementation in Pregnant Mother, Breastfeeding Mother and Infant for the Prevention of Atopic Dermatitis in Children // Australas J Derm. 2020. Vol. 61. Р. 628–643. doi: 10.1111/ajd.13186Richards M, Ferber J, Chen H, et al. Caesarean delivery and the risk of atopic dermatitis in children. Clin Exp Allergy. 2020;50(7):805–814. doi: 10.1111/cea.13668Richards M., Ferber J., Chen H., et al. Caesarean delivery and the risk of atopic dermatitis in children // Clin Exp Allergy. 2020. Vol. 50, N 7. P. 805–814. doi: 10.1111/cea.13668Flohr C, Nagel G, Weinmayr G, et al. Lack of evidence for a protective effect of prolonged breastfeeding on childhood eczema: lessons from the international study of asthma and allergies in childhood (ISAAC) phase two. Br J Dermatol. 2011;165:1280–1289. doi: 10.1111/j.1365-2133.2011.10588.xFlohr C., Nagel G., Weinmayr G., et al. Lack of evidence for a protective effect of pro-longed breastfeeding on childhood eczema: lessons from the international study of asthma and allergies in childhood (ISAAC) phase two // Br J Dermatol. 2011. Vol. 165. Р. 1280–1289. doi: 10.1111/j.1365-2133.2011.10588.xOsborn DA, Sinn JK, Jones LJ. Infant formulas containing hydrolysed protein for prevention of allergic disease. Cochrane Database Syst Rev. Oct 19;10(10):CD003664. doi: 10.1002/14651858.CD003664.pub6Osborn D.A., Sinn J.K., Jones L.J. Infant formulas containing hydrolysed protein for prevention of allergic disease // Cochrane Database Syst Rev. 2018. 10CD003664. doi: 10.1002/14651858.CD003664.pub6Boyle RJ, Tang ML, Chiang WC., et al. Prebiotic-supplemented partially hydrolysed cow’s milk formula for the prevention of eczema in high-risk infants: a randomized controlled trial. Allergy. 2016;71(5):701–110. doi. 10.1111/all.12848Boyle R.J., Tang M.L., Chiang W.C., et al. Prebiotic-supplemented partially hydrolysed cow’s milk formula for the prevention of eczema in high-risk infants: a randomized controlled trial // Allergy. 2016. Vol. 71. N 5. P. 701–110. doi. 10.1111/all.12848Park S, Choi HS, Bae JH. Instant noodles, processed food intake, and dietary pattern are associated with atopic dermatitis in an adult population (KNHANES 2009–2011). Asia Pac J Clin Nutr. 2016;25(3):602–613. doi: 10.6133/apjcn.092015.23Park S., Choi H.S., Bae J.H. Instant noodles, processed food intake, and dietary pattern are associated with atopic dermatitis in an adult population (KNHANES 2009–2011) // Asia Pac J Clin Nutr. 2016. Vol. 25. N. 3. P. 602–613. doi: 10.6133/apjcn.092015.23