Atopy is a marker for asthma that persists beyond early childhood

Most wheezing illness in early childhood resolves by 6 years of age. Early transient wheezing is associated with abnormal lung function in infancy and maternal smoking, but not maternal asthma or atopy. Small airway calibre is thought to predispose to virus induced wheezing in infancy that resolves in later childhood as airways increase in size.

Atopy is strongly associated with asthma that persists beyond the first 6 years of life. Allergic sensitisation to food allergens in the first 2 years of life and/or inhalant allergens at 7 yrs are associated with asthma at 7 yrs and 22 yrs.^{10, 11} The presence of other allergic disorders (eczema or allergic rhinitis) or parental history of atopy are risk factors for persistent asthma at 6 years.¹²

Atopy is also a risk factor for hospitalisation in asthma, as are frequent respiratory symptoms, airway hyperresponsiveness and reduced lung function.¹³

It should be noted that the absence of associated atopy or other allergic disorders does NOT preclude a diagnosis of asthma, particularly in early childhood.

Atopic individuals commonly suffer from several allergic disorders throughout their life. The manifestation of allergic disorders typically follows a characteristic sequence that is described as the Allergic (or Atopic) March.^14-18 Atopic eczema and food allergies tend to commence in infancy or early childhood. These are often followed by the development of asthma and perennial allergic rhinitis in the preschool years. In teenage years symptoms of perennial rhinitis may persist and increase and hay fever (seasonal allergic rhinitis and conjunctivitis) may develop for the first time.