Food allergy and the development of asthma symptoms

Food Sensitization Impact on Asthma Attacks in Children According to Age Group

Introduction: The progression of allergy disorders is termed “atopic march.” Having one allergic disorder increases the likelihood of acquiring others. Asthma and food allergies often coexist. There are no thresholds for specific IgE (sIgE) associated with the presence of clinical symptoms. Each allergen shows a particular trend with age. Objective: Our study and analysis aim to identify food sensitization in children with asthma and evaluate its impact on asthma attacks and clinical control. Material and methods: As a part of a bigger study, 56 children (mean age 11.07 years (5.3–17.5), 38 boys, and 18 girls) with bronchial asthma were tested for total IgE and sIgE against food and inhalator allergens. All children performed baseline and post-BD spirometry and were assessed for asthma control. Results: In the studied population of children, sIgE against several food allergens was positive in the same patient. A significant correlation was found between the positive sIgE for milk and soy (p < 0.0001), for milk and egg yolk (p = 0.01), compared to milk and peanuts (p = 0.004), compared to egg yolk and fish (p < 0.0001), compared to egg yolk and casein (p < 0.001), and soy (p < 0.0001). The children who are positive for sIgE antibodies in cats, dogs, Cladosporium, Aspergillus, wormwood from aeroallergens and soy from food allergens have a higher risk of hospitalization for exacerbation of bronchial asthma. (p < 0.05). In the studied population, sensitization to food allergens among asthmatics does not contribute to the number of asthma attacks. Conclusions: Food sensitivity is associated with eczema, while mite sensitization is strongly associated with rhinitis and asthma. Food sensitization is not a risk factor for asthma exacerbation in children older than five years old.

Eating fish and fruits are associated with lower prevalence of allergic diseases

BACKGROUND

Allergic diseases are recognized as a burden on the public health. They stand as one of the most common chronic diseases, especially in developed countries. Therefore, the objective of this study is to evaluate the association between the development of atopic allergy and the presence of food allergy in children, and food consumption.

METHODS

This multidisciplinary cross-observational epidemiological study was conducted among 1199 schoolchildren who were recruited in 4th grade and 5th grade (9-11 years old from Marseille). Data were collected by means of a standardized epidemiological questionnaire with a medical assessment focusing on allergic diseases, and questions on lifestyle and child nutrition (FFQ).

RESULTS

During the last 12 months, prevalence of allergic diseases were shown as follows: 41% of children presented allergic rhinitis symptoms, 24% reported having asthma related symptoms, while 28% suffered of eczema and 7% complained of food allergy. There was a significant association between food allergy and asthma symptoms (P-value<0.001, IC=[2.29-7.69]), eczema (P-value<0.001, IC=[2.37-8.32]) and allergic rhinitis (P-value<0.001, IC=[2.32-8.17]). Regarding dietary habits, the multivariate analysis shows that the consumption of vegetables (ORa=0.72 [0.64-0.74]) and fish (ORa=0.74 [0.50-1.09], ORa=0.66 [0.47-0.94] respectively) are associated decreased risk of developing asthma and allergic rhinitis symptoms, while fruit consumption (ORa=0.68 [0.45-1.03]) is associated with a decrease in eczema symptoms.

CONCLUSION

This study shows that the presence of a food allergy is strongly associated with allergic diseases. Indeed, the consumption of vegetables, fruits and fish seems to have a protective effect on the occurrence of these diseases.

Association of food allergy and decreased lung function in children and young adults with asthma

BACKGROUND

Food allergy (FA) appears early in the atopic march, a progression that may lead to the development of asthma. The association between FA and pulmonary function in children with and without asthma remains unknown.

OBJECTIVE

To investigate the association between FA and lung function in children with and without asthma.

METHODS

We enrolled 1,068 children as a part of a family-based FA cohort. We then categorized children as having FA by physician diagnosis, evidence of specific IgE, and typical symptoms within 2 hours of food ingestion. We categorized asthma by physician diagnosis. We used American Thoracic Society criteria for spirometry measurements. We assessed the effects of asthma classification and FA number on lung function using mixed-effect models.

RESULTS

We enrolled 1,068 children: 417 (39%) had asthma, 402 (38%) had at least 1 FA, and 162 (15%) had 2 or more FAs. Unstratified analyses found no significant association between FA number and lung function. In children with asthma, we detected statistically significant differences in predicted forced expiratory flow at 25% to 75% between children with 2 or more FAs compared with those with none (mean [SE] β = -7.5 [3.6]; P = .04). This effect lost significance after adjusting for aeroallergen sensitization. We detected no significant associations between FA number and predicted forced expiratory volume in 1 second, forced vital capacity, and ratio of forced expiratory volume in 1 second to forced vital capacity.

CONCLUSION

Having 2 or more FAs is a potential risk factor for greater small airway airflow obstruction among children with asthma, highlighting the need for close clinical follow-up and improved intervention strategies for these patients.

Does allergy explain why some children have severe asthma?

Asthma is a common disease in childhood with a minority of affected children having severe therapy-resistant asthma (STRA). Children with STRA can be differentiated from those with mild-moderate disease by greater allergic sensitization, increased eosinophilic airway inflammation, increased airway remodelling and reduced corticosteroid responsiveness. The aetiology of STRA in children is multifactorial but allergy seems to play a key role. Many children with asthma have coexisting allergic disease, and severe rhinitis seems to be an important driver of STRA in children. Allergies to foods, moulds, pollen and pets have also been associated with severe asthma exacerbations. Identifying allergens that are driving asthma symptoms in children with STRA may provide additional strategies for improving their disease control. Avoidance strategies may be possible. Additional monoclonal antibody therapy with Omalizumab or Mepolizumab may be helpful in children with clinically important polysensitization.

Habitual snoring in children with previous allergic sensitization

Previous studies have reported a high prevalence of allergy in children with Habitual Snoring (HS), but the relationship between allergy in the early years of life and the subsequent development of this Sleep Disordered Breathing (SDB) is yet to be elucidated. The purpose of the present study was to determine the role of early, under 36 months of age, allergic sensitization to food (with or without sensitization to airborne allergens) in determining the development of HS 8-10 years after. One hundred and forty-eight children (10-14 years, mean age 12 years) with a history of food allergy were selected. Under the age of 36 months, atopic status was assessed by skin prick test for a panel of airborne and food allergens. Questionnaires filled in by parents were used to collect information on children's snoring and associated symptoms. HS was defined as snoring three or more times per week. At 1-3 years of age 54 children were positive to food allergens alone, and 94 were positive also to airborne allergens. After 8-10 years of life, when patients were aged between 10 and 14 years, habitual snoring was reported in 37 children. Furthermore, among the 54 children under three years of age sensitized only to food, 8 became HS while of the 94 children sensitized to both food and inhalants allergens 29 developed HS. The difference between those two groups was statistically significant (p=0.04). We reported a significant risk of developing HS in children with early allergic sensitization. Specifically this risk was higher when food allergy was associated with inhalant allergy. The onset of upper airway inflammation due to allergic triggers in subjects under three years of age may be related to the subsequent development of SDB after 8-10 years.