Influence of early-life exposures on food sensitization and food allergy in an inner-city birth cohort - 06/01/15
Abstract |
Objective |
Previous data suggest that food allergy (FA) might be more common in inner-city children; however, these studies have not collected data on both sensitization and clinical reactivity or early-life exposures.
Methods |
Children in the Urban Environment and Childhood Asthma birth cohort were followed through age 5 years. Household exposures, diet, clinical history, and physical examinations were assessed yearly; levels of specific IgE to milk, egg, and peanut were measured at 1, 2, 3, and 5 years of age. On the basis of sensitization (IgE ≥0.35 kU/L) and clinical history over the 5-year period, children were classified as having FA or being possibly allergic, sensitized but tolerant, or not allergic/not sensitized.
Results |
Five hundred sixteen children were included. Overall, 55.4% were sensitized (milk, 46.7%; egg, 31.0%; and peanut, 20.9%), whereas 9.9% were categorized as having FA (peanut, 6.0%; egg, 4.3%; and milk, 2.7%; 2.5% to >1 food). The remaining children were categorized as possibly allergic (17.0%), sensitized but tolerant (28.5%), and not sensitized (44.6%). Eighteen (3.5%) reported reactions to foods for which IgE levels were not measured. Food-specific IgE levels were similar in children with FA versus sensitized but tolerant children, except for egg, levels of which were higher in patients with FA at ages 1 and 2 years. FA was associated with recurrent wheeze, eczema, aeroallergen sensitization, male sex, breast-feeding, and lower endotoxin exposure in year 1 but not with race/ethnicity, income, tobacco exposure, maternal stress, or early introduction of solid foods.
Conclusions |
Even given that this was designed to be a high-risk cohort, the cumulative incidence of FA is extremely high, especially considering the strict definition of FA that was applied and that only 3 common allergens were included.
Le texte complet de cet article est disponible en PDF.Key words : Food allergy, inner city, Urban Environment and Childhood Asthma cohort, specific IgE
Abbreviations used : FA, IQR, OR, URECA
Plan
Supported in whole or in part with federal funds from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services, under contract nos. NO1-AI-25496, NO1-AI-25482, HHSN272200900052C, and HHSN272201000052I. Additional support was provided under grants RR00052, M01RR00533, 1UL1RR025771, M01RR00071, 1UL1RR024156, and 5UL1RR024992-02. |
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Disclosure of potential conflict of interest: E. C. McGowan, G. O'Connor, and M. Kattan have received research support from the National Institutes of Health (NIH). G. R. Bloomberg has received research support and travel support from the National Institutes of Health/National Institute of Allergy and Infectious Diseases (NIAID). C. M. Visness and K. F. Jaffee have received research support from the National Institutes of Health/National Institute of Allergy and Infectious Diseases. J. Gern has received research support from the National Institutes of Health, GlaxoSmithKline, and Merck and has received consultancy fees from GlaxoSmithKline, Johnson & Johnson, Merck, MedImmune, Boehringer Ingelheim, and Gilead. R. A. Wood has received research support from the National Institutes of Health, has received consultancy fees from the Asthma and Allergy Foundation of America, is employed by Johns Hopkins University, and has received royalties from UpToDate. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 135 - N° 1
P. 171 - janvier 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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