Can early introduction of egg prevent egg allergy in infants? A population-based study

Koplin, Jennifer J.; Osborne, Nicholas J.; Wake, Melissa; Martin, Pamela E.; Gurrin, Lyle C.; Robinson, Marnie; Tey, Dean; Slaa, M.; Thiele, Leone; Miles, L.; Anderson, Deborah J.; Tan, T.; Dang, Thanh; Hill, David; Lowe, Adrian J.; Matheson, Melanie C.; Ponsonby, Anne–Louise; Tang, Mimi L.K.; Dharmage, Shyamali C.; Allen, Katrina J.

doi:10.1016/j.jaci.2010.07.028

Cited by 364 publications

(288 citation statements)

References 28 publications

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“…Although the timing of this window to prevent allergies is not completely clear, current evidence suggests that this is most likely to be located between the 4th (around 17 weeks) and the 7th month of life (Prescott et al 2008). In this regard, Koplin et al (2010) have found that infants who were introduced to cooked egg at 4-7 months had the lowest risk of developing an allergy to eggs. The authors pointed to the new concept of a window during which exposure to potentially allergenic foods will promote the development of oral tolerance.…”

Section: Contributing Factors To Oral Tolerancementioning

confidence: 99%

Food Allergy and the Oral Immunotherapy Approach

Cabrera

Urra

2014

Arch. Immunol. Ther. Exp.

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Food allergy represents an increasing health problem, with children being the most affected population. The symptoms can appear within minutes or hours of ingesting the offending food, producing skin manifestations, respiratory, gastrointestinal and anaphylactic reactions in the severe forms. Food allergy is established by the loss of tolerance to food proteins, and is characterized by an altered balance of regulatory T (Treg) cells and the shift to Th2 type cytokines in the intestinal lamina propria. We have described the contribution of different factors in establishing oral tolerance, such as the antigenic exposition route, the gut microenvironment, and the timing of the food introduction. Apart from avoiding the food, immunotherapy is the only intervention which produces oral desensitization to food proteins. Among the underlying immunological mechanisms of oral immunotherapy (OIT) are the changes in humoral immunity (a decrease of allergen-specific IgE and an increase of allergen-specific IgG4) and cellular changes such as the increased number of FoxP3 ? Treg cells. At present, the experiences of OIT with various foods are offering promising results. OIT appears to be safe producing low adverse reactions, and effective in inducing desensitization in most subjects with food allergy.

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Section: Contributing Factors To Oral Tolerancementioning

confidence: 99%

Food Allergy and the Oral Immunotherapy Approach

Cabrera

Urra

2014

Arch. Immunol. Ther. Exp.

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“…The results of these recent publications seem to be more homogenous than the heterogeneous picture of past papers which did not show a beneficial effect of later food introduction or even an increased risk for atopic eczema in relation to the early introduction of solids or greater food diversity [15,16]. However, even some of these more recent studies did not consider possible reverse causation [12] and hence must be interpreted with caution. Some authors considered an adjustment for medical history of allergic diseases to be sufficient [8,10], while more cautiously performed analyses excluded children with early skin symptoms [5,6,9,14].…”

mentioning

confidence: 80%

“…In addition to findings from the DIPP and PASTURE/ EFRAIM cohort, a few more observational studies published during the past 5 years concluded that early introduction of solids reduces the risk of allergic diseases [12][13][14]. The results of these recent publications seem to be more homogenous than the heterogeneous picture of past papers which did not show a beneficial effect of later food introduction or even an increased risk for atopic eczema in relation to the early introduction of solids or greater food diversity [15,16].…”

mentioning

confidence: 97%

Timing and diversity of complementary food introduction for prevention of allergic diseases. How early and how much?

Heinrich

Koletzko

2014

Expert Review of Clinical Immunology

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“…The Australian Healthnuts cohort demonstrated that a delayed introduction of egg until 10-12 months and in infants older than 12 months were both associated with a significantly increased risk of egg allergy compared to those who were introduced to egg at 4-6 months of age. 38 This has further been supported by results from the Solids Timing for Allergy Reduction randomized control trial which looked at infants with moderate-to-severe eczema who were introduced to egg from 4 months of age in the form of pasteurized raw whole-egg powder (intervention group). 39 Although not statistically significant, when this group was compared to the control group who avoided egg (given rice powder instead), a lower proportion of infants in the intervention group (33%) had a diagnosis of IgE-mediated egg allergy compared to the control group (51%).…”

Section: Hen Egg Allergymentioning

confidence: 90%

Weaning and complementary feeding in preterm infants: management, timing and health outcome

Barachetti¹,

Villa²,

Barbarini³

2017

Pediatr Med Chir

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The introduction of solid food is necessary for any infant in order to provide adequate nutrition because when they grow up milk is insufficient for their nutritional needs. Infants born preterm have increased nutritional requirements. The high nutrient demands as well as the organ immaturity of preterm infants combine to render it difficult to achieve dietary intakes that will allow preterm infants to match their in utero growth rates. Current guidelines for the introduction of solid food to term infants cannot be directly translated to preterm infants. For preterm infants such guidelines are lacking. Based on the limited available evidence, it could be concluded that a corrected age of 3 months (13 weeks) may be an appropriate age to start introducing solid food for most preterm infants. About celiac disease (CD), gluten may be introduced into the infant’s diet anytime between 4 and 12 completed months of age. In children at high risk for CD, earlier introduction of gluten (4 vs 6 months or 6 vs 12 months) is associated with earlier development of CD autoimmunity (defined as positive serology) and CD, but the cumulative incidence of each in later childhood is similar. Relatively to weaning and allergies, the European Society of Pediatric Allergy and Clinical Immunology and the European Society for Paediatric Gastroenterology Hepatology and Nutrition have produced joint guidelines. They recommend exclusive breastfeeding for 4–6 months or use of hypoallergenic formulas if exclusive breastfeeding is not possible. In addition, The American Academy of Pediatrics recommendations now state that there is no evidence to recommend maternal dietary restrictions during pregnancy or breastfeeding. However, there is no evidence that delaying introduction of solids including allergenic foods after 4–6 months is protective.

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Can early introduction of egg prevent egg allergy in infants? A population-based study

Cited by 364 publications

References 28 publications

Food Allergy and the Oral Immunotherapy Approach

Food Allergy and the Oral Immunotherapy Approach

Timing and diversity of complementary food introduction for prevention of allergic diseases. How early and how much?

Weaning and complementary feeding in preterm infants: management, timing and health outcome

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