Preventing Atopic Dermatitis and ALLergies in Children—the PreventADALL study

Abstract

Reversing or aborting the increase in allergic and other immunerelated noncommunicable diseases (NCDs) in the Western world, first observed for allergic rhinitis from the 1890s, 1 requires priat, or in collaboration with (in Sweden), the 3 participating hospitals were eligible, provided sufficient language skills. Women carrying more than 2 fetuses, fetuses with severe malformations or disease and infants born prior to 35.0 weeks of GA, were excluded.All infants were randomized at birth to 1 of 4 similar sized groups: (1) no intervention; (2) skin care (oil-bath at least 5 days per week from 0.5 to 9 months of age); (3) consecutive introduction, between 3 and 4 months of age, of peanut, milk, wheat, and egg at least 4 days per week complementary to breastfeeding; or (4) both interventions. Weekly electronic diaries (2-26 weeks of age) recorded skin care, infant feeding, and symptoms of allergic diseases.Adverse events (0-12 months of age) elicited relevant investigations and treatment by direct access for the participants to the local pediatric department.Data collection (Figure 1, Table S1) includes electronic questionnaires with information of health and disease in the mother, child, and family; lifestyle; environment; stress; quality of life; diet in the mother and offspring; clinical investigations; fetal and child anthropometrics; lung function; skin barrier; allergy; and blood pressure

Solid Food Introduction and the Development of Food Allergies

“…The consumption of peanuts is directly related to the incidence of peanut allergy, and it greatly varies between countries and regions in the same country. In countries with a high peanut consumption (for example, North America; some countries in South America (Brazil); some European countries, especially the United Kingdom, the Netherlands and Sweden; South-East Asia and India [ 58 ]), American guidelines [ 50 ] recommend the early introduction of peanut at 4–6 months in infants with severe eczema and/or egg allergy, even if no convincing evidence was found from the LEAP study [ 28 ], and at around six months in infants with mild–moderate eczema. The method of peanut introduction depends on the results of IgE or SPT to the food ( Table 2 ).…”

“…The Preventing Atopic Dermatitis and Allergies in Children (PreventADALL) trial examines whether the introduction of four allergenic foods at 3–4 months and/or the use of oil-baths can prevent the development of FA in the general population [ 28 ]. We hope that the results of this trial are reported soon.…”

Dry skin and skin barrier in early infancy

“…Studies suggest that increased TEWL in infancy precedes AD development and allergic sensitization and that there is a regional and temporal immaturity in the skin barrier of infant cheeks . Future follow‐up investigations in the PreventADALL study may demonstrate if our findings of impaired skin barrier in infants with dry skin, especially when present concurrently on the cheeks and extensor surfaces, may point to a potential role for dry skin examination when selecting children for primary prevention, at risk for long‐life allergic diseases.…”

“…From the population‐based Preventing Atopic Dermatitis and Allergies in children (PreventADALL) study we found that 59% of the 1143 included 3‐month old infants had dry skin, defined as roughness and visible scaling without erythema, in at least one of 11 predefined anatomical skin areas. Most infants (47%) had ‘dry skin only’, while 40% had ‘unaffected skin’ and 13% had ‘possible AD’ (of these, 96% had dry skin), defined as doctor‐verified dermatitis, excluding differential diagnosis and including only a few infants fulfilling the diagnostic criteria for AD, as the majority were unable to itch at this early age.…”

Ефективність Антигістамінних Препаратів I Покоління При Лікуванні Алергічних Захворювань У Дітей

“…При этом была установлена сильная корреляция между распро-страненностью атопического дерматита и частотой аллергического ринита и бронхиальной астмы [22,24,26].…”