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
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DOI：
10.1016/j.jaci.2006.12.621
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发表时间：
2007-02-01
影响因子：
14.2
通讯作者：
Matthews, Sharon M.
中科院分区：
文献类型：
--
作者：
Arshad, Syed Hasan;Bateman, Belinda;Matthews, Sharon M.
背景资料：早期过敏原暴露可能会增加儿童过敏的风险，但减少过敏原暴露的保护作用仍不确定。目的：评价减少婴儿期食物和屋尘螨（HDM）过敏原暴露对预防哮喘和过敏的作用。婴儿，在较高的风险，因为家庭倾向，产前招募和随机预防组（n = 58）和对照组（n = 62）。预防组婴儿要么母乳喂养，母亲低过敏原饮食或给予广泛水解的配方奶粉。通过使用杀螨剂和床垫罩，减少了对HDM的暴露。对照组遵循标准建议。结果：重复测量分析，调整所有相关的混杂变量，证实了对哮喘的预防作用：调整后的比值比（OR）为0.24; 95% CI为0.09-0.66; P = 0.005;特应性皮炎，OR，0.23; CI，0.08-0.64; P = 0.005;鼻炎，OR，0.42; CI，0.19-0.92; P = 0.03;和特应性，OR，0.13; CI，0.05-0.32; P <0.001。主要观察到的保护作用，在亚组的儿童持续性疾病（症状在所有访问），并在那些有证据的过敏sensitivity.Conclusion：过敏性疾病可以减少，至少在第一个8年的生活，结合食物和HDM过敏原避免在infanty.Clinical影响：严格的食物和HDM过敏原避免应考虑预防过敏的高危婴儿。
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; Cl, 0.08-0.64; P = .005; rhinitis, OR, 0.42; CI, 0.19-0.92; P = .03; and atopy, OR, 0.13; Cl, 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.