BACKGROUND: Asthma is a chronic disease that often starts in childhood. The key risk factors are a child's environment and their genetic characteristics. The aim of this study was to evaluate the efficacy of environmental modification in the first 12 months of life on the prevalence of asthma in high-risk individuals. METHODS: Children (n=120) considered at high risk of allergic disorders (either dual heredity or single heredity and a high cord total IgE), were enrolled in a single-blinded, randomised controlled trial. Infants in the intervention arm were either breast fed with the mother on a low allergen diet or given an extensively hydrolysed formula. Exposure to house dust mite allergen was reduced. The control group followed standard advice. Children were assessed at ages 1, 2, 4, 8 and 18 years for the presence of asthma and atopy. RESULTS: At 18 years of age, there was a significantly lower prevalence of asthma in the prevention group compared with the control group (OR: 0.23, 95% CI 0.08 to 0.70, p=0.01), primarily due to asthma that developed during childhood but persisted until age 18 years. Repeated-measure analysis showed that there was an overall reduction in asthma prevalence from 1 to 18 years (OR: 0.51, CI 0.32 to 0.81, p=0.04). Prevalence of atopy was not significantly different between the two groups at age 18. CONCLUSION: Comprehensive allergen avoidance in the first year of life is effective in preventing asthma onset in individuals considered at high risk due to heredity. The effect occurs in the early years, but persists through to adulthood.
BACKGROUND: Asthma is a chronic disease that often starts in childhood. The key risk factors are a child's environment and their genetic characteristics. The aim of this study was to evaluate the efficacy of environmental modification in the first 12 months of life on the prevalence of asthma in high-risk individuals. METHODS: Children (n=120) considered at high risk of allergic disorders (either dual heredity or single heredity and a high cord total IgE), were enrolled in a single-blinded, randomised controlled trial. Infants in the intervention arm were either breast fed with the mother on a low allergen diet or given an extensively hydrolysed formula. Exposure to house dust mite allergen was reduced. The control group followed standard advice. Children were assessed at ages 1, 2, 4, 8 and 18 years for the presence of asthma and atopy. RESULTS: At 18 years of age, there was a significantly lower prevalence of asthma in the prevention group compared with the control group (OR: 0.23, 95% CI 0.08 to 0.70, p=0.01), primarily due to asthma that developed during childhood but persisted until age 18 years. Repeated-measure analysis showed that there was an overall reduction in asthma prevalence from 1 to 18 years (OR: 0.51, CI 0.32 to 0.81, p=0.04). Prevalence of atopy was not significantly different between the two groups at age 18. CONCLUSION: Comprehensive allergen avoidance in the first year of life is effective in preventing asthma onset in individuals considered at high risk due to heredity. The effect occurs in the early years, but persists through to adulthood.
Authors: Jay Portnoy; Jeffrey D Miller; P Brock Williams; Ginger L Chew; J David Miller; Fares Zaitoun; Wanda Phipatanakul; Kevin Kennedy; Charles Barnes; Carl Grimes; Désirée Larenas-Linnemann; James Sublett; David Bernstein; Joann Blessing-Moore; David Khan; David Lang; Richard Nicklas; John Oppenheimer; Christopher Randolph; Diane Schuller; Sheldon Spector; Stephen A Tilles; Dana Wallace Journal: Ann Allergy Asthma Immunol Date: 2013-12 Impact factor: 6.347
Authors: Manuel A R Ferreira; Riddhima Mathur; Judith M Vonk; Agnieszka Szwajda; Ben Brumpton; Raquel Granell; Bronwyn K Brew; Vilhelmina Ullemar; Yi Lu; Yunxuan Jiang; Patrik K E Magnusson; Robert Karlsson; David A Hinds; Lavinia Paternoster; Gerard H Koppelman; Catarina Almqvist Journal: Am J Hum Genet Date: 2019-03-28 Impact factor: 11.025
Authors: Erick Forno; Joanne Sordillo; John Brehm; Wei Chen; Takis Benos; Qi Yan; Lydiana Avila; Manuel Soto-Quirós; Michelle M Cloutier; Angel Colón-Semidey; Maria Alvarez; Edna Acosta-Pérez; Scott T Weiss; Augusto A Litonjua; Glorisa Canino; Juan C Celedón Journal: J Allergy Clin Immunol Date: 2017-02-04 Impact factor: 10.793