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Peters RL, Soriano VX, Lycett K, Flynn C, Idrose NS, Tang MLK, Wijesuriya R, Allen KJ, Ranganathan S, Lowe AJ, Perrett KP, Lodge CJ, Koplin JJ, Dharmage SC. Infant food allergy phenotypes and association with lung function deficits and asthma at age 6 years: a population-based, prospective cohort study in Australia. THE LANCET. CHILD & ADOLESCENT HEALTH 2023; 7:636-647. [PMID: 37506717 DOI: 10.1016/s2352-4642(23)00133-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Food allergy is considered a precursor to asthma in the context of the atopic march, but the relationship between infant food allergy phenotypes and lung function and asthma in childhood is unclear. We aimed to examine the association between food sensitisation and challenge-confirmed food allergy in infancy, as well as persistent and resolved food allergy up to age 6 years, and the risk of lung function deficits and asthma at age 6 years. METHODS The longitudinal, population-based HealthNuts cohort study in Melbourne, VIC, Australia, recruited 5276 infants children aged 1 year who attended council-run immunisation sessions between Sept 28, 2007, and Aug 5, 2011. At age 1 year, all children completed skin prick testing to four food allergens (egg, peanut, sesame, and either shrimp or cow's milk) and an oral food challenge (egg, peanut, and sesame) at the Royal Children's Hospital in Melbourne. Parents completed questionnaires about their infant's allergy history, demographic characteristics, and environmental exposures. At age 6 years, children were invited for a health assessment that included skin prick testing for ten foods (milk, egg, peanut, wheat, sesame, soy, shrimp, cashew, almond, and hazelnut) and eight aeroallergens (alternaria, cladasporum, house dust mite, cat hair, dog hair, bermuda grass, rye grass, and birch mix), oral food challenges, and lung function testing by spirometry. Questionnaires completed by parents (different to those completed at age 1 year) captured the child's allergy and respiratory history and demographics. We investigated associations between food allergy phenotypes (food-sensitised tolerance or food allergy; and ever, transient, persistent, or late-onset food allergy), lung function spirometry measures (forced expiratory volume in 1 sec [FEV1] and forced vital capacity [FVC] z-scores, FEV1/FVC ratio, forced expiratory flow at 25% and 75% of the pulmonary volume [FEF25-75%], and bronchodilator responsiveness), and asthma using regression methods. Only children with complete data on the exposure, outcome, and confounders were included in models. Infants without food sensitisation or food allergy at age 1 year and 6 years served as the reference group. FINDINGS Of 5276 participants, 3233 completed the health assessment at age 6 years and were included in this analysis. Food allergy, but not food-sensitised tolerance, at age 1 year was associated with reduced FEV1 and FVC (aβ -0·19 [95% CI -0·32 to -0·06] and -0·17 [-0·31 to -0·04], respectively) at age 6 years. Transient egg allergy was associated with reduced FEV1 and FVC compared with never having egg allergy (-0·18 [95% CI -0·33 to -0·03] and -0·15 [-0·31 to 0·00], respectively), whereas persistent egg allergy was not (FEV1 -0·09 [-0·48 to 0·31]; FVC -0·20 [-0·62 to 0·21]). Transient peanut allergy was associated with reduced FEV1 and FVC (FEV1 aβ -0·37 [-0·79 to 0·04] and FVC aβ -0·55 [-0·98 to -0·12]), in addition to persistent peanut allergy (FEV1 aβ -0·30 [-0·54 to -0·06] and FVC aβ-0·30 [-0·55 to -0·05]), and late-onset peanut allergy (FEV1 aβ -0·62 [-1·06 to -0·18] and FVC aβ-0·49 [-0·96 to -0·03]). Estimates suggested that food-sensitised tolerance and food allergy were associated with reduced FEF25-75%, although some estimates were imprecise. Food allergy phenotypes were not associated with an FEV1/FVC ratio. Late-onset peanut allergy was the only allergy phenotype that was possibly associated with increased risk of bronchodilator responsiveness (2·95 [95% CI 0·77 to 11·38]). 430 (13·7%) of 3135 children were diagnosed with asthma before age 6 years (95% CI 12·5-15·0). Both food-sensitised tolerance and food allergy at age 1 year were associated with increased asthma risk at age 6 years (adjusted odds ratio 1·97 [95% CI 1·23 to 3·15] and 3·69 [2·81 to 4·85], respectively). Persistent and late-onset peanut allergy were associated with higher asthma risk (3·87 [2·39 to 6·26] and 5·06 [2·15 to 11·90], respectively). INTERPRETATION Food allergy in infancy, whether it resolves or not, is associated with lung function deficits and asthma at age 6 years. Follow-up studies of interventions to prevent food allergy present an opportunity to examine whether preventing these food allergies improves respiratory health. FUNDING National Health & Medical Research Council of Australia, Ilhan Food Allergy Foundation, AnaphylaxiStop, the Charles and Sylvia Viertel Medical Research Foundation, the Victorian Government's Operational Infrastructure Support Program.
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Affiliation(s)
- Rachel L Peters
- Centre for Food and Allergy Research, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia.
| | - Victoria X Soriano
- Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Kate Lycett
- Murdoch Children's Research Institute, Parkville, VIC, Australia; Deakin University, Burwood, VIC, Australia
| | - Catherine Flynn
- Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Nur Sabrina Idrose
- Murdoch Children's Research Institute, Parkville, VIC, Australia; Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Mimi L K Tang
- Centre for Food and Allergy Research, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, VIC, Australia
| | - Rushani Wijesuriya
- Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Katrina J Allen
- Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Sarath Ranganathan
- Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Adrian J Lowe
- Centre for Food and Allergy Research, Parkville, VIC, Australia; Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Kirsten P Perrett
- Centre for Food and Allergy Research, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, VIC, Australia
| | - Caroline J Lodge
- Centre for Food and Allergy Research, Parkville, VIC, Australia; Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Jennifer J Koplin
- Centre for Food and Allergy Research, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia; Child Health Research Centre, University of Queensland, South Brisbane, QLD, Australia
| | - Shyamali C Dharmage
- Centre for Food and Allergy Research, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia; Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
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Alves M, Asbell P, Dogru M, Giannaccare G, Grau A, Gregory D, Kim DH, Marini MC, Ngo W, Nowinska A, Saldanha IJ, Villani E, Wakamatsu TH, Yu M, Stapleton F. TFOS Lifestyle Report: Impact of environmental conditions on the ocular surface. Ocul Surf 2023; 29:1-52. [PMID: 37062427 DOI: 10.1016/j.jtos.2023.04.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 04/18/2023]
Abstract
Environmental risk factors that have an impact on the ocular surface were reviewed and associations with age and sex, race/ethnicity, geographical area, seasonality, prevalence and possible interactions between risk factors are reviewed. Environmental factors can be (a) climate-related: temperature, humidity, wind speed, altitude, dew point, ultraviolet light, and allergen or (b) outdoor and indoor pollution: gases, particulate matter, and other sources of airborne pollutants. Temperature affects ocular surface homeostasis directly and indirectly, precipitating ocular surface diseases and/or symptoms, including trachoma. Humidity is negatively associated with dry eye disease. There is little data on wind speed and dewpoint. High altitude and ultraviolet light exposure are associated with pterygium, ocular surface degenerations and neoplastic disease. Pollution is associated with dry eye disease and conjunctivitis. Primary Sjögren syndrome is associated with exposure to chemical solvents. Living within a potential zone of active volcanic eruption is associated with eye irritation. Indoor pollution, "sick" building or house can also be associated with eye irritation. Most ocular surface conditions are multifactorial, and several environmental factors may contribute to specific diseases. A systematic review was conducted to answer the following research question: "What are the associations between outdoor environment pollution and signs or symptoms of dry eye disease in humans?" Dry eye disease is associated with air pollution (from NO2) and soil pollution (from chromium), but not from air pollution from CO or PM10. Future research should adequately account for confounders, follow up over time, and report results separately for ocular surface findings, including signs and symptoms.
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Affiliation(s)
- Monica Alves
- Department of Ophthalmology and Otorhinolaryngology, University of Campinas Campinas, Brazil.
| | - Penny Asbell
- Department of Bioengineering, University of Memphis, Memphis, USA
| | - Murat Dogru
- School of Optometry and Vision Science, UNSW, Sydney, NSW, Australia
| | - Giuseppe Giannaccare
- Department of Ophthalmology, University Magna Graecia of Catanzaro, Cantanzaro, Italy
| | - Arturo Grau
- Department of Ophthalmology, Pontifical Catholic University of Chile, Santiago, Chile
| | - Darren Gregory
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, USA
| | - Dong Hyun Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea
| | | | - William Ngo
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Anna Nowinska
- Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Ian J Saldanha
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Edoardo Villani
- Department of Clinical Sciences and Community Health, University of Milan, Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | - Tais Hitomi Wakamatsu
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, São Paulo Hospital, Federal University of São Paulo, Brazil
| | - Mitasha Yu
- Sensory Functions, Disability and Rehabilitation Unit, World Health Organization, Geneva, Switzerland
| | - Fiona Stapleton
- School of Optometry and Vision Science, UNSW, Sydney, NSW, Australia
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Akar HH, Nadir E, Beken B, Yeşil Y. Effect of early atopic sensitization in children aged 0-2 years on the development of asthma symptoms at 9-11 years of age. World J Pediatr 2022; 18:753-760. [PMID: 35790707 DOI: 10.1007/s12519-022-00579-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/31/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Personal genetic predisposition and early life environmental factors are important for the development of childhood asthma. We aimed to search whether egg, milk and mite sensitizations at 0-2 years old are risk factors for asthma symptoms at 9-11 years old. METHODS A total of 210 wheezer children who had specific immunoglobulin (Ig) E in 2010-2012 were included in the study (followed by pediatric allergy). Patients were divided into non-atopic (group 1, n = 157) and atopic patients [groups 2-7, n = 53 (5 patients were in both group 4 and group 5)] based on sensitizations. Using the International Study of Asthma and Allergy in Childhood questionnaire, current wheeze (CW, 2nd question), exercise wheezing (EW, 7th question), and dry cough (DC, 8th question) were surveyed. Also, parental allergies, eczema at 0-2 years, current eosinophil percentage and total IgE were recorded. RESULTS Eczema was observed as an important risk factor [CW: odds ratio (OR) = 2.83, 95% confidence interval (CI) = 1.54-5.23, P ≤ 0.001; EW: OR = 2.71, 95% CI = 1.33-5.54, P = 0.006; DC: OR = 3.03, 95% CI = 1.47-6.25, P = 0.003], whereas having no atopic sensitization at 0-2-year-old (group 1) was found as a significant protective factor for asthma at 9-11 years old (CW: OR = 0.32, 95% CI = 0.15-0.70, P = 0.004; EW: OR = 0.21, 95% CI 0.10-0.44, P ≤ 0.001; DC: OR = 0.25, 95% CI = 0.10-0.59, P = 0.002). CONCLUSION Early personal eczema is a significant risk factor for the development of asthma symptoms at 9-11 years old, whereas not having an allergic sensitization at 0-2 years old (group 1) is an important protective factor.
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Affiliation(s)
- Himmet Haluk Akar
- Division of Pediatric Immunology and Allergy, University of Istanbul Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
| | - Ebru Nadir
- Division of Pediatrics, University of Istanbul Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Burçin Beken
- Department of Pediatric Immunology and Allergy, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Yakup Yeşil
- Division of Pediatrics, University of Istanbul Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
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Piippo S, Viljanen M, Savilahti E, Kuitunen M. Allergic symptoms and sensitisation in adolescents with cows' milk allergy and atopic eczema in infancy. IMMUNITY INFLAMMATION AND DISEASE 2020; 8:423-433. [PMID: 32567223 PMCID: PMC7416017 DOI: 10.1002/iid3.324] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/03/2020] [Accepted: 06/05/2020] [Indexed: 01/26/2023]
Abstract
Background The association between atopic sensitisation, atopic eczema (AE) and asthma is known, but distinct roles of allergies on long‐term health are unestablished. Objective Evaluation of allergic symptoms and sensitisation in adolescents who in infancy had AE and verified cows' milk allergy (CMA) or AE and a negative CMA challenge, and controls. Methods Children with AE, with and without CMA, from a randomised controlled study in 1999‐2001 examining the effect of probiotics on AE severity at older than 12 months of age, attended a follow‐up visit at age 16 to 18, with age‐matched controls. Data came from a questionnaire (ISAAC questionnaire), analysis of serum antigen‐specific immunoglobulin Es (IgEs), and clinical evaluation. Group comparisons were carried out (χ2 tests and logistic regression). Results Fifty‐two patients with AE and CMA (AE/CMA+ group), 52 with AE and suspicion of CMA (AE/CMA− group), and 57 controls attended a study visit. IgE‐mediated sensitisation was significantly more prevalent in the AE/CMA+ group vs the controls, for horse, cat, dog, egg white and wheat (P < .024 for all). For birch, timothy and mugwort (P < .008 for all), sensitisation was more prevalent in both the AE/CMA+ group and the AE/CMA− group vs controls. On the basis of questionnaire data the AE/CMA + group reported a significantly higher lifetime prevalence of wheezing (64% vs 35% and 32%; P = .001), noninfectious rhinitis (85% vs 62% and 56%; P = .004), and hay fever (77% vs 52% and 33%; P < .001) vs the AE/CMA− group and the control group, respectively. Conclusion and Clinical Relevance Patients with AE and CMA in infancy, as opposed to patients with AE only, or controls, report more allergic symptoms and exhibit more allergic sensitisation in adolescence. This indicates that CMA in infancy is an independent risk factor of allergic disease in adolescence.
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Affiliation(s)
- Sonja Piippo
- Department of Pediatrics, Children's Hospital, Pediatric Research Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Mirva Viljanen
- Department of Pediatrics, Children's Hospital, Pediatric Research Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Erkki Savilahti
- Department of Pediatrics, Children's Hospital, Pediatric Research Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Mikael Kuitunen
- Department of Pediatrics, Children's Hospital, Pediatric Research Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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Eigenmann P. Early life events influence asthma and food allergy, and how epitope binding can predict the outcome of oral immunotherapy. Pediatr Allergy Immunol 2019; 30:783-784. [PMID: 31823410 DOI: 10.1111/pai.13139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 10/12/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Philippe Eigenmann
- Department of Women-Children-Teenagers, University Hospital of Geneva, Geneva, Switzerland
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Eigenmann P. Fecal metabolites and early sensitization influence asthma, and how to prevent anaphylaxis in the community. Pediatr Allergy Immunol 2019; 30:679-680. [PMID: 31721312 DOI: 10.1111/pai.13123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 09/05/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Philippe Eigenmann
- Department of Women-Children-Teenagers, University Hospital of Geneva, Geneva, Switzerland
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Association between bisphenol A diglycidyl ether-specific IgG in serum and food sensitization in young children. Eur J Med Res 2018; 23:61. [PMID: 30587237 PMCID: PMC6306001 DOI: 10.1186/s40001-018-0358-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 12/20/2018] [Indexed: 12/22/2022] Open
Abstract
Background Recent studies have reported that endocrine-disrupting compound (EDC) exposure is related to food sensitization. Bisphenol A diglycidyl ether (BADGE) is one of the most widespread EDCs and its biological effects are considered to be greater on children than on adults. This study investigated the relationship between serum BADGE-specific immunoglobulin G (IgG) concentrations and food sensitization in young children by measuring food-specific IgE levels. Methods In total, 98 young children (59 boys and 39 girls; median age: 7 months; 25th and 75th percentile ages: 6 and 8 months, respectively) were enrolled. Blood samples were collected twice from all children (median sampling interval: 6 months; 25th and 75th percentile: 5 and 7 months). Food sensitization was evaluated based on food-specific IgE titers (egg white, milk, and wheat), which were determined using the capsulated hydrophilic carrier polymer-radioallergosorbent test. Furthermore, a dot-blotting assay for BADGE-specific IgG and quantitative reverse-transcriptase PCR for IL-6, IL-8, IL-10, and COX-2 mRNA expression were conducted. Results BADGE-specific IgG was detected in 20% of study subjects. A significant association was observed between the presence of BADGE-specific IgG and elevated wheat-specific IgE levels (OR = 3.56; 95% CI 1.13–11.2; P = 0.031). This relationship was particularly strong in girls (OR = 9.46; 95% CI 1.01–89.0; P = 0.049). A slight but non-significant association was noted between the presence of BADGE-specific IgG and elevated milk-specific IgE levels (OR = 2.77; 95% CI 0.93–8.22; P = 0.067). The expression of IL-6 mRNA among children with BADGE-specific IgG tended to increase, along with wheat-specific IgE levels. Conclusion BADGE exposure might enhance food sensitization in early childhood. Therefore, this should be strictly regulated, especially in younger children. Electronic supplementary material The online version of this article (10.1186/s40001-018-0358-1) contains supplementary material, which is available to authorized users.
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Swartz J, Aronsson B, Lindblad F, Järnbert-Pettersson H, Scheynius A, Pershagen G, Alm J. Vaccination and Allergic Sensitization in Early Childhood - The ALADDIN Birth Cohort. EClinicalMedicine 2018; 4-5:92-98. [PMID: 31193660 PMCID: PMC6537579 DOI: 10.1016/j.eclinm.2018.10.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 08/24/2018] [Accepted: 10/15/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The increasing incidence of allergic diseases highlights the importance of finding underlying mechanisms. Early vaccination has been suggested as one influential factor. However, it is difficult to find a study group with a large variation between subjects concerning compliance to the official vaccination program. The anthroposophic lifestyle is of interest in this context. Moreover, cohort studies show that children of families with this lifestyle run a lower risk of allergic sensitization and allergy-related disease. METHODS From the prospective birth cohort ALADDIN we included one group from the anthroposophic community, with restrictive attitudes concerning vaccinations, and two other groups of age-matched children with more conventional parental lifestyles. In all, 466 children were followed from birth to five years of age. Detailed vaccination data and blood samples were collected at six months, one, two, and five years. Information was also obtained on risk factors for allergy. The outcome variable, allergic sensitization was defined as allergen-specific serum IgE levels ≥ 0.35 kUA/L. FINDINGS In a logistic regression model adjusted for socio-demographics and established allergy risk factors, vaccination at later age or having a lower number of injections or vaccines were associated with low OR for allergic sensitization during the first year of life. However, after adjustment for anthroposophic lifestyle, no statistically significant associations remained. The adjusted OR for sensitization at five years of age in children not receiving any vaccinations (n = 54) was 0.98 [95% CI 0.38-2.57]. INTERPRETATION We found no support for an association between early childhood vaccination and subsequent allergic sensitization. Our findings do not support scepticism towards early childhood vaccination motivated by allergy risk.
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Key Words
- ALADDIN
- ALADDIN, Assessment of Lifestyle and Allergic Diseases During INfancy
- Allergic sensitization
- Anthroposophic lifestyle
- DPPT, Diphtheria, Pertussis, Polio, Tetanus
- DTP, Diphtheria, Tetanus, Pertussis
- DTaP, Diphtheria, Tetanus, acellular Pertussis
- Early childhood
- MCHC, Maternal and Child Healthcare Centres
- MMR, Measles, Mumps, Rubella
- NIP, the National Swedish Immunization Program
- OR, odds ratio
- Pentavac™, Diphtheria, Tetanus, Pertussis, Polio, Haemophilus influenzae type b
- Tetravac™, Diphtheria, Tetanus, Pertussis, Polio
- Vaccination
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Affiliation(s)
- Jackie Swartz
- Vidarkliniken, Järna, Sweden
- Corresponding author at: Child and Adolescent Psychiatrist, GP, Vidarkliniken, SE-15391 Järna, Sweden.
| | - Bernice Aronsson
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Frank Lindblad
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Hans Järnbert-Pettersson
- Karolinska Institutet, Department of Clinical Science and Education Södersjukhuset, Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Annika Scheynius
- Karolinska Institutet, Department of Clinical Science and Education Södersjukhuset, Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
- Clinical Genomics, SciLifeLab, Stockholm, Sweden
| | - Göran Pershagen
- Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Sweden
| | - Johan Alm
- Karolinska Institutet, Department of Clinical Science and Education Södersjukhuset, Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
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Fedotova MM, Fedorova OS, Konovalova UV, Kamaltynova EM, Nagaeva TA, Ogorodova LM. Hen’s egg allergy: an update. BULLETIN OF SIBERIAN MEDICINE 2018. [DOI: 10.20538/1682-0363-2018-2-156-166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Hen’s egg allergy is one of the most common problems in pediatrics. This pathology is associated with severe clinical manifestations, often with a risk of anaphylactic reactions. This review presents current data on the epidemiology and clinical presentation, as well as aspects of the natural history and management of hen’s egg allergy. The paper will provide data on allergenic proteins of hen’s egg, including data on structure, physicochemical properties, IgE-binding capacity, and cross-reactivity. Finally, practical information about egg allergy and immunization will be presented.
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Best KP, Sullivan TR, Palmer DJ, Gold M, Martin J, Kennedy D, Makrides M. Prenatal omega-3 LCPUFA and symptoms of allergic disease and sensitization throughout early childhood - a longitudinal analysis of long-term follow-up of a randomized controlled trial. World Allergy Organ J 2018; 11:10. [PMID: 29977437 PMCID: PMC6003086 DOI: 10.1186/s40413-018-0190-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 05/18/2018] [Indexed: 11/10/2022] Open
Abstract
Background Randomized controlled trials of prenatal omega (ω-3) long chain polyunsaturated fatty acid (LCPUFA) supplementation are suggestive of some protective effects on allergic sensitization and symptoms of allergic disease in childhood. Due to the nature of the atopic march, investigation of any effects of this prenatal intervention may be most informative when consistently assessed longitudinally during childhood. Methods Follow-up of children (n = 706) with familial risk of allergy from the Docosahexaenoic Acid to Optimize Mother Infant Outcome (DOMInO) trial. The intervention group received fish oil capsules (900 mg of ω-3 LCPUFA) daily from <21 weeks' gestation until birth; the control group received vegetable oil capsules without ω-3 LCPUFA. This new longitudinal analysis reports previously unpublished data collected at 1 and 3 years of age. The allergic disease symptom data at 1, 3 and 6 years of age were consistently reported by parents using the "International Study of Asthma and Allergies in Childhood" (ISAAC) questionnaire. Sensitization was determined by skin prick test to age specific, common allergen extracts. Results Changes over time in symptoms of allergic disease with sensitization (IgE-mediated) and sensitization did not differ between the groups; interaction p = 0.49, p = 0.10, respectively. Averaged across the 1, 3 and 6-year assessments, there were no significant effects of prenatal ω-3 LCPUFA supplementation on IgE-mediated allergic disease symptoms (adjusted relative risk 0.88 (95% CI 0.69, 1.12), p = 0.29) or sensitization (adjusted relative risk 0.97 (95% CI 0.82, 1.15), p = 0.76). Sensitization patterns to common allergens were consistent with the atopic march, with egg sensitization at 1 year strongly associated with house dust mite sensitization at 6 years, (p < 0.0001). Discussion Although there is some evidence to suggest that maternal supplementation with 900mg ω-3 LCPUFA has a protective effect on early symptoms of allergic disease and sensitization in the offspring, we did not observe any differences in the progression of disease over time in this longitudinal analysis. Further investigation into the dose and timing of ω-3 LCPUFA supplementation, including long-term follow up of children using consistent outcome reporting, is essential to determine whether this intervention may be of benefit as a primary prevention strategy for allergic disease. Conclusion Maternal supplementation with 900 mg of ω-3 LCPUFA did not change the progression of IgE-mediated allergic disease symptoms or sensitization throughout childhood from 1 to 6 years. Trial registration Australian New Zealand Clinical Trials Registry (ACTRN); DOMInO trial ACTRN12605000569606, early childhood allergy follow up ACTRN12610000735055 and 6-year allergy follow up ACTRN12615000498594.
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Affiliation(s)
- K P Best
- 1Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, South Australia Australia.,2School of Medicine, University of Adelaide, Adelaide, South Australia Australia.,7South Australian Health and Medical Research Institute, 72 King William Road, North Adelaide, South Australia 5006 Australia
| | - T R Sullivan
- 3School of Public Health, University of Adelaide, Adelaide, South Australia Australia
| | - D J Palmer
- 4School of Medicine, University of Western Australia, Nedlands, Western Australia 6009 Australia.,Telethon Kids Institute, University of Western Australia, Subiaco, Western Australia 6008 Australia
| | - M Gold
- 2School of Medicine, University of Adelaide, Adelaide, South Australia Australia
| | - J Martin
- 6Department of Respiratory and Sleep Medicine, Women's & Children's Hospital, North Adelaide, South Australia Australia
| | - D Kennedy
- 2School of Medicine, University of Adelaide, Adelaide, South Australia Australia.,6Department of Respiratory and Sleep Medicine, Women's & Children's Hospital, North Adelaide, South Australia Australia
| | - M Makrides
- 1Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, South Australia Australia.,2School of Medicine, University of Adelaide, Adelaide, South Australia Australia
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