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Prevention of allergic disease during childhood by allergen avoidance: the Isle of Wight prevention study

Prevention of allergic disease during childhood by allergen avoidance: the Isle of Wight prevention study
Prevention of allergic disease during childhood by allergen avoidance: the Isle of Wight prevention study
BACKGROUND: Early life allergen exposure may increase the risk of childhood allergy, but the protective effect of reduction in allergen exposure remains uncertain. OBJECTIVE: To evaluate the effect of reduction in food and house dust mite (HDM) allergen exposure in infancy in preventing asthma and allergy. METHODS: Infants, at higher risk because of family predisposition, were recruited prenatally and randomized to prophylactic (n = 58) and control (n = 62) groups. Prophylactic group infants were either breast-fed with mother on a low allergen diet or given an extensively hydrolyzed formula. Exposure to HDM was reduced by the use of an acaricide and mattress covers. The control group followed standard advice. Development of allergic diseases and sensitization to common allergens (atopy) was assessed blindly at ages 1, 2, 4, and 8 years in all 120 children. RESULTS: Repeated measurement analysis, adjusted for all relevant confounding variables, confirmed a preventive effect on asthma: adjusted odds ratio (OR), 0.24; 95% CI, 0.09-0.66; P = .005; atopic dermatitis, OR, 0.23; CI, 0.08-0.64; P = .005; rhinitis, OR, 0.42; CI, 0.19-0.92; P = .03; and atopy, OR, 0.13; CI, 0.05-0.32; P < .001. The protective effect was primarily observed in the subgroup of children with persistent disease (symptoms at all visits) and in those with evidence of allergic sensitization. CONCLUSION: Allergic diseases can be reduced, for at least the first 8 years of life, by combined food and HDM allergen avoidance in infancy. CLINICAL IMPLICATIONS: Strict food and HDM allergen avoidance should be considered for prevention of allergy in high-risk infants.
atopy, allergy, asthma, rhinitis, atopic dermatitis, food allergy, prevention, diet, house dust mite, randomized controlled trial
0091-6749
307-313
Arshad, Syed Hasan
917e246d-2e60-472f-8d30-94b01ef28958
Bateman, Belinda
517b9b40-9557-4e30-ba2f-26a4f25ddab3
Sadeghnejad, Alireza
e2b0fa73-429f-4818-9f24-127f36c57752
Gant, Carole
fc45ebb0-27ab-4b32-b094-d80719d69c6f
Matthews, Sharon M.
8286afa1-179a-4392-9603-0dab6da298ea
Arshad, Syed Hasan
917e246d-2e60-472f-8d30-94b01ef28958
Bateman, Belinda
517b9b40-9557-4e30-ba2f-26a4f25ddab3
Sadeghnejad, Alireza
e2b0fa73-429f-4818-9f24-127f36c57752
Gant, Carole
fc45ebb0-27ab-4b32-b094-d80719d69c6f
Matthews, Sharon M.
8286afa1-179a-4392-9603-0dab6da298ea

Arshad, Syed Hasan, Bateman, Belinda, Sadeghnejad, Alireza, Gant, Carole and Matthews, Sharon M. (2007) Prevention of allergic disease during childhood by allergen avoidance: the Isle of Wight prevention study. Journal of Allergy and Clinical Immunology, 119 (2), 307-313. (doi:10.1016/j.jaci.2006.12.621).

Record type: Article

Abstract

BACKGROUND: Early life allergen exposure may increase the risk of childhood allergy, but the protective effect of reduction in allergen exposure remains uncertain. OBJECTIVE: To evaluate the effect of reduction in food and house dust mite (HDM) allergen exposure in infancy in preventing asthma and allergy. METHODS: Infants, at higher risk because of family predisposition, were recruited prenatally and randomized to prophylactic (n = 58) and control (n = 62) groups. Prophylactic group infants were either breast-fed with mother on a low allergen diet or given an extensively hydrolyzed formula. Exposure to HDM was reduced by the use of an acaricide and mattress covers. The control group followed standard advice. Development of allergic diseases and sensitization to common allergens (atopy) was assessed blindly at ages 1, 2, 4, and 8 years in all 120 children. RESULTS: Repeated measurement analysis, adjusted for all relevant confounding variables, confirmed a preventive effect on asthma: adjusted odds ratio (OR), 0.24; 95% CI, 0.09-0.66; P = .005; atopic dermatitis, OR, 0.23; CI, 0.08-0.64; P = .005; rhinitis, OR, 0.42; CI, 0.19-0.92; P = .03; and atopy, OR, 0.13; CI, 0.05-0.32; P < .001. The protective effect was primarily observed in the subgroup of children with persistent disease (symptoms at all visits) and in those with evidence of allergic sensitization. CONCLUSION: Allergic diseases can be reduced, for at least the first 8 years of life, by combined food and HDM allergen avoidance in infancy. CLINICAL IMPLICATIONS: Strict food and HDM allergen avoidance should be considered for prevention of allergy in high-risk infants.

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More information

Published date: 2007
Keywords: atopy, allergy, asthma, rhinitis, atopic dermatitis, food allergy, prevention, diet, house dust mite, randomized controlled trial

Identifiers

Local EPrints ID: 44633
URI: https://eprints.soton.ac.uk/id/eprint/44633
ISSN: 0091-6749
PURE UUID: 42e47e39-8808-45d8-90ad-2823b4e8fc11

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Date deposited: 05 Mar 2007
Last modified: 13 Mar 2019 21:06

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Contributors

Author: Belinda Bateman
Author: Alireza Sadeghnejad
Author: Carole Gant
Author: Sharon M. Matthews

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