Changes in food sensitization with changing allergy practice in Ireland

Hurley, Sadhbh; Franklin, Ruth; Murray, Deirdre M.; Venter, Carina; Hourihane, Jonathan

doi:10.1111/cea.14288

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…We have previously reported how the lower peanut sensitization and allergy prevalence found in CORAL may be secondary to secular changes in allergy practice between the BASELINE and CORAL cohorts with CORAL researchers encouraging both the introduction and maintenance of common allergens into infants' diets 18 …”

Section: Discussionmentioning

confidence: 99%

Atopic outcomes at 2 years in the CORAL cohort, born in COVID‐19 lockdown

Hurley,

Franklin,

McCallion

et al. 2023

Pediatric Allergy Immunology

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IntroductionThe CORAL study is a cohort of infants born during the first weeks of the first SARS‐CoV‐2 (COVID‐19) lockdown. This cohort has had lower antibiotic exposure, higher breastfeeding rates and lower infection rates, especially in the first year of life. We hypothesized that the altered early‐life environment of infants born during lockdown would change the incidence of allergic conditions.MethodsThis longitudinal, observational study followed 365 infants born between March and May 2020 from enrolment to the age of 2 years. Infants attended three research appointments at 6‐, 12‐, and 24‐months and completed detailed questionnaires. At research appointments, children had skin prick testing, and atopic dermatitis (AD) assessment. Statistical analysis focused on changes within the group at different time points, the influence of specific environmental factors on allergic risk and compared the incidence of atopic conditions with a pre‐pandemic Irish infant cohort, BASELINE.ResultsAD was more common in CORAL group at both 12 (26.5% vs. 15.5%; p < .001) and 24 months (21.3% vs. 15.9%; p = .02) compared with pre‐pandemic BASELINE cohort. Within the CORAL group, those with AD at both 12‐ and 24‐month appointments had a more severe AD phenotype associated with a higher risk of allergic sensitization. There was less milk (0% vs. 1%; p = .09), peanut (0.6% vs. 1.8%; p = .3), and egg allergy (0% vs. 2.9%; p < .001) in the CORAL group at 24 months compared with the BASELINE cohort. Aeroallergen sensitization increased between 12 and 24 months in the CORAL cohort (1.5% vs. 8.9%; p < .001), as did parent‐reported wheezing episodes (9% vs. 24%; p < .001).ConclusionsDespite higher AD incidence in the CORAL cohort, the incidence of food sensitization and allergy are lower than expected pre‐pandemic rates possibly reflecting the early introduction and maintenance of dietary allergens enhanced by changes in infant infections, antibiotic use, and breastfeeding in the first 2 years of life in the group. These beneficial effects of the lockdown could be outweighing the expected risk of less early‐life microbial encounters outlined by the hygiene hypothesis.

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Section: Discussionmentioning

confidence: 99%

Atopic outcomes at 2 years in the CORAL cohort, born in COVID‐19 lockdown

Hurley,

Franklin,

McCallion

et al. 2023

Pediatric Allergy Immunology

Self Cite

View full text Add to dashboard Cite

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“…Studies have also examined the real-world effectiveness of early food introduction. [16 ]. When compared with the older BASELINE cohort, the newer CORAL cohort had a higher prevalence of atopic dermatitis, but lower prevalences of peanut and egg allergy.…”

Section: Early Introduction Of Allergenic Foods: Multiple Foods Peanu...mentioning

confidence: 88%

“…Studies have also examined the real-world effectiveness of early food introduction. Hurley et al compared the incidences of peanut and egg allergy between two cohorts of infants in Ireland: the Babies After Scope: Evaluating the Longitudinal Impact Using Neurological and Nutritional Endpoints (BASELINE) cohort (born in 2008–2011) and the Impact of Coronavirus Pandemic on Allergic and Autoimmune Dysregulation in Infants Born During Lockdown (CORAL) cohort (born in 2020) [ 16 ▪ ]. When compared with the older BASELINE cohort, the newer CORAL cohort had a higher prevalence of atopic dermatitis, but lower prevalences of peanut and egg allergy.…”

Section: Early Introduction Of Allergenic Foods: Multiple Foods Peanu...mentioning

confidence: 99%

Regular consumption following early introduction of allergenic foods and aggressive treatment of eczema are necessary for preventing the development of food allergy in children

Sakihara

2024

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of review Over the past two decades, food allergy prevention strategies have shifted from ‘delayed introduction’ to ‘no delayed introduction’ to ‘early introduction’ of allergenic foods. This article reviews important research in this field published in the early 2020s to support future strategies for food allergy prevention. Recent findings Recent randomized controlled trials (RCTs), systematic reviews, meta-analyses, and real-world studies have reported that early allergenic food introduction, especially peanut and egg, are effective for preventing food allergies. However, there are also reports that food-induced anaphylaxis admission rates in infants are increasing. Summary Early allergenic food introduction by itself is not sufficient to prevent the development of food allergies. Recent RCTs (SPADE study and COMEET study) have demonstrated that continued regular cow's milk consumption after early introduction is important for preventing the onset of cow's milk allergy. Furthermore, an RCT (PACI study) reported that early and aggressive anti-inflammatory topical therapy for eczema can contribute to the prevention of egg allergy by suppressing percutaneous sensitization. Food allergies may be prevented through a combination of early food introduction, regular consumption, and active eczema treatment. Further research is needed to develop well tolerated, effective, and practical strategies to prevent food allergies.

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