Food Allergy Is an Important Risk Factor for Childhood Asthma, Irrespective of Whether It Resolves
Food Allergy Is an Important Risk Factor for Childhood Asthma, Irrespective of Whether It Resolves
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DOI：
10.1016/j.jaip.2017.10.019
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发表时间：
2018-07-01
影响因子：
9.4
通讯作者：
Allen, Katrina J.
中科院分区：
文献类型：
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作者：
Vermeulen, Evelien M.;Koplin, Jennifer J.;Allen, Katrina J.
背景：早期食物过敏患者患哮喘的风险尚不清楚，特别是当生命早期食物过敏已经解决时。 目的：利用基于人群的队列数据，了解婴儿期经挑战证实的食物过敏是否会增加 4 岁时患哮喘的风险。方法：使用基于人群的抽样框架招募了总共 5,276 名 12 个月大的婴儿。婴儿接受了鸡蛋、花生和芝麻的皮肤点刺测试，而那些皮肤点刺测试结果可检测到的婴儿则面临着口服食物的挑战。 4 岁时，重复进行食物挑战以确定食物过敏的持续情况或缓解情况。使用二项式回归对 2,789 名参与者检查食物过敏与医生诊断的哮喘之间的关联。 结果：1 岁时患有食物过敏的儿童患哮喘的风险增加（1 种食物过敏：相对风险 [RR]，1.69；95% CI，1.29-2.21；2 种或多种食物过敏：RR，2.76；95% CI， 1.94-3.92）。婴儿期有食物过敏和湿疹共存的儿童患哮喘的风险最高（RR，2.87；95% CI，2.22-3.70）。短暂性食物过敏和持续性食物过敏均与哮喘风险增加相关（短暂性鸡蛋过敏：RR，1.92；95% CI，1.46-2.51；持续性鸡蛋过敏：RR，2.60；95% CI，1.76-3.85）。结论：4 岁时哮喘的发病率是 1 岁时经挑战证实食物过敏的患者的两倍年， 无论食物过敏随后是否消失。患有 2 种或以上食物过敏以及同时患有湿疹的儿童患哮喘的可能性几乎是没有食物过敏的儿童的 3 倍。 (C) 2017 年美国过敏、哮喘和免疫学学会
BACKGROUND: The risk of developing asthma in those with early food allergy is unknown, particularly when early life food allergy has resolved.OBJECTIVE: To understand whether challenge-proven food allergy in infancy increases the risk of asthma at age 4 years, using data from a population-based cohort.METHODS: A total of 5,276 12-month-old infants were recruited using a population-based sampling frame. Infants underwent skin prick test to egg, peanut, and sesame and those with a detectable skin prick test result had oral food challenges. At age 4 years, food challenges were repeated to determine persistence or resolution of food allergy. The association between food allergy and doctor-diagnosed asthma was examined using binomial regression in 2,789 participants.RESULTS: Children with food allergy at age 1 year had an increased risk of asthma (1 food allergy: relative risk [RR], 1.69; 95% CI, 1.29-2.21; 2 or more food allergies: RR, 2.76; 95% CI, 1.94-3.92). The risk of asthma was highest in children with food allergy and coexistent eczema in infancy (RR, 2.87; 95% CI, 2.22-3.70). Transient food allergy and persistent food allergy were both associated with an increased risk of asthma (transient egg allergy: RR, 1.92; 95% CI, 1.46-2.51; persistent egg allergy: RR, 2.60; 95% CI, 1.76-3.85).CONCLUSIONS: Asthma at age 4 years is twice as common in those with challenge-proven food allergy at age 1 year, irrespective of whether the food allergy subsequently resolves. Children with 2 or more food allergies and those with coexistent eczema were almost 3 times as likely to develop asthma compared with those with no food allergies. (C) 2017 American Academy of Allergy, Asthma & Immunology