Immune Mechanisms--Observational Study of Food Allergy

描述(申请人提供)：食物过敏定义为对食物的不良反应 由免疫机制引起的蛋白质，目前估计影响1100多万美国人。这种疾病影响了大约6%的儿童，尽管努力通过饮食手段进行预防，但患病率似乎仍在增加。牛奶或鸡蛋过敏在婴幼儿中最为常见(-2.5%)，但很可能在5岁前消退(-50%-85%)。花生过敏现在影响0.8%的幼儿，通常是严重的，有时是致命的，与牛奶和鸡蛋过敏相反，花生过敏只在大约20%的患者中得到缓解。之前的研究表明，基因在花生过敏中起到了一定作用，但很明显，环境影响是美国幼儿发病率翻了一番的惊人原因，最近有证据表明。对食物过敏发展过程中涉及的机制只有有限的了解。尤其是花生过敏，目前尚不清楚为什么只有某些特应性患者才会患上这种过敏，也不知道是什么机制导致了这种过敏的永久性。为了有效地预防或逆转食物过敏的进展，将需要免疫干预。此外，成功的战略很可能需要 针对那些具有可识别风险的人(例如，具有与花生过敏发展相关的生物标记物的人)。这项观察性研究将调查花生、鸡蛋和牛奶过敏的发育免疫学。我们将招募400名3-12个月大的患有特应性皮炎和鸡蛋和/或牛奶过敏的儿童，并对他们进行为期4年的跟踪调查。在此期间，我们预测大约20%的人会出现临床花生过敏，25%-50%的人会经历鸡蛋或牛奶过敏的缓解。这一策略应该使我们能够描绘、比较和对比与花生过敏发展和鸡蛋和牛奶过敏丧失相关的生物标志物和免疫变化，同时评估重要的遗传和环境影响。这一结果应成为改进预防和治疗的基础。我们将解决与以下特定目标相关的假设：1)评估与花生过敏发生和临床结果相关的免疫参数(T细胞、体液)和遗传参数(Toll样受体多态)；2)评估可能影响花生过敏发生和临床结果的环境(饮食、卫生相关)和临床遗传因素。

DESCRIPTION (provided by applicant): Food allergy is defined as an adverse reaction to food proteins caused by immunologic mechanisms and is now estimated to affect over 11 million Americans. The disorder affects approximately 6% of children and appears to be increasing in prevalence despite efforts at prevention through dietary means. Milk or egg allergy in infants/young children are most common (-2.5%) but are likely to resolve (-50-85%) by age 5 years. Peanut allergy now affects 0.8% of young children, is often severe, sometimes fatal and in contrast to milk and egg allergy, peanut allergy resolves only in about 20% of patients. Previous studies have shown that genetics play a role in peanut allergy, but it is clear that environmental influences account for the startling, recently documented, doubling in incidence in young children in the US. There is only a limited understanding of the mechanisms involved in the developmental course of food allergies. For peanut allergy in particular, it is not known why only certain atopic individuals acquire this allergy, or what mechanisms are responsible for its permanence. To effectively prevent or reverse the progression of food allergy, immune interventions will be needed. Furthermore, it is likely that successful strategies will need to be directed to those persons at identifiable risk (e.g., who have biomarkers associated with development of peanut allergy). This observational study will investigate the developmental immunology of peanut, egg and milk allergy. We will enroll a cohort of 400 children age 3-12 months with atopic dermatitis and allergy to egg and/or milk and follow them over a 4-year period. During this time we predict that approximately 20% will develop clinical peanut allergy and 25-50% will experience resolution of egg or milk allergy. This strategy should enable us to delineate, compare and contrast biological markers and immunologic changes associated with the development of peanut allergy and loss of egg and milk allergy, while simultaneously evaluating important genetic and environmental influences. The results should form a basis for improved prevention and treatment. We will address hypotheses associated with the following specific aims: 1) To evaluate immune (T cell, humoral) and genetic (Toll-like receptor polymorphisms) parameters associated with the occurrence of peanut allergy and clinical outcomes; 2): To evaluate environmental (diet, hygiene-related) and clinical genetic (atopic dermatitis) factors that may influence occurrence of peanut allergy and clinical outcomes.