Risk Factors for Hen's Egg Allergy in Europe: EuroPrevall Birth Cohort

One in 50 children present with egg allergy. This is an update of the BSACI guideline for the management of egg allergy. 1 It was prepared by an expert group of the Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI) and addresses the diagnosis and treatment of patients with egg allergy, for healthcare professionals working in secondary care. It includes guidance for families with egg-allergic children and adult egg-allergic patients. The guideline working group included paediatric and adult allergists, paediatric and adult allergy specialist dieticians and clinical psychologists working with egg-allergic patients. During development of this guideline, representatives from patient organizations (Allergy UK and Anaphylaxis Campaign) were part of the guideline writing group and involved in selection of topics, evidence, recommendations and draft reviews. Declarations of interest of the guideline lead and the writing group members are held at BSACI office and are available on request. None jeopardized unbiased guideline

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“…Egg allergy in children is associated with eczema and rhinitis 7 . Eczema is a significant risk factor for egg allergy 8 .…”

Section: Risk Factorsmentioning

confidence: 99%

BSACI 2021 guideline for the management of egg allergy

Leech

Ewan

Skypala

et al. 2021

Clin Experimental Allergy

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“…The strongest known risk factor for FA is probably eczema, particularly eczema that starts early in life and is more severe. 27,28 This finding has been noted consistently across studies in both population-based studies and allergy clinics for many years; however, the mechanism driving this association remains unclear. It has been hypothesized that a damaged skin barrier resulting from eczema may allow the absorption of food allergens through the skin leading to food sensitization and allergy, in the absence of pre-existing oral tolerance to those foods.…”

Section: Epidemi Ologymentioning

confidence: 70%

“…[22][23][24][25][26] More recent studies have shown that large differences in FA prevalence can exist even within individual countries, with some of this difference driven by a lower prevalence in rural areas compared with urban areas. 4,27,28 Reasons for these differences are largely speculative, with differences in the prevalence of the risk factors described below potentially playing a role.…”

Section: Epidemi Ologymentioning

confidence: 99%

Update on food allergy

Peters

Krawiec

Santos

2021

Pediatric Allergy Immunology

111

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Food allergy (FA) can be classified into IgE-and non-IgE-mediated depending on the involvement of IgE in its pathogenesis. In this review, we are focusing on IgE-mediated food allergy. FA affects about 8% of children in the Western countries and seems to be rising in other parts of the world such as in Vietnam and South Africa, and other parts of Asia and Africa, particularly in urban rather than rural areas. [1][2][3][4] The prevalence of FA has increased over the recent decades, as has the number of hospitalizations for food-induced anaphylaxis, following what seems to be the 'second wave of the allergy epidemic' after the rise in the prevalence of asthma and respiratory allergy in previous decades. [5][6][7] Pouessel et al 8 have shown that foods caused 37% of cases of ICU admissions for anaphylaxis and 79% of recurrent anaphylaxis. Self-reported FA is even more common with an often underappreciated impact. 1 Gupta et al 1 report that about 40% of food allergic children report multiple food allergies, often severe food allergies, and carry an adrenaline auto-injector. In Western countries, such as the USA and the UK, FA affects disproportionally children from ethnic minorities, such as children of Afro-Caribbean descent. 1,9,10 Whether this has to do with genetic predisposition in face of environmental factors related to the modern lifestyle

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“…Importantly, eczema is a well-known confounder and effect modifier of egg and peanut allergy, and participants with early introduction of egg were less likely to have a history of eczema at enrollment when compared to those without early introduction of egg. The lower prevalence of eczema at enrollment may be related to the lower incidence of IgE-mediated egg allergy within this group [ 1 , 2 , 3 , 14 , 42 , 43 , 44 , 45 , 46 ]. Additionally, while similar to previous studies, prevalence of likely egg allergy and prevalence of likely peanut allergy within our cohort (0.5% and 1%, respectively) were lower than previously reported estimates in other US-based studies of food allergy in childhood of 0.8–0.9% for egg [ 37 , 38 ], and 1.4–2.2% for peanut [ 37 , 38 , 40 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

Early Introduction of Food Allergens and Risk of Developing Food Allergy

et al. 2021

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There is increasing evidence that early introduction of allergenic foods may decrease the risk of developing IgE-mediated food allergy. Patterns of food introduction before the 2015 publication of the Learning Early about Peanut Allergy (LEAP) trial are not well-studied, but are important as a baseline for evaluating subsequent changes in infant feeding practices and potentially food allergy. We performed a retrospective longitudinal study using data from a multicenter cohort of infants hospitalized with bronchiolitis between 2011–2014. The primary outcomes were IgE-mediated egg or peanut allergy by age 3 years. Of 770 participants included in the analysis, 635 (82%) introduced egg, and 221 (27%) introduced peanut by age 12 months per parent report. Four participants had likely egg allergy, and eight participants had likely peanut allergy by age 3 years. Regular infant egg consumption was associated with less egg allergy. The association was suggestive for infant peanut consumption with zero peanut allergy cases. Overall, our results suggest that early introduction of peanut was uncommon before 2015. Although limited by the small number of allergy cases, our results suggest that early introduction of egg and peanut are associated with a decreased risk of developing food allergy, and support recent changes in practice guidelines.

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Risk Factors for Hen's Egg Allergy in Europe: EuroPrevall Birth Cohort

Cited by 34 publications

References 29 publications

BSACI 2021 guideline for the management of egg allergy

BSACI 2021 guideline for the management of egg allergy

Update on food allergy

Early Introduction of Food Allergens and Risk of Developing Food Allergy

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