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J Allergy Clin Immunol Pract. 2018 Jul - Aug;6(4):1336-1341.e3. doi: 10.1016/j.jaip.2017.10.019. Epub 2017 Nov 15.

Food Allergy Is an Important Risk Factor for Childhood Asthma, Irrespective of Whether It Resolves.

Author information

1
Murdoch Children's Research Institute, Parkville, Victoria, Australia.
2
Murdoch Children's Research Institute, Parkville, Victoria, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia.
3
Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria Australia.
4
Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria Australia; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Victoria, Australia.
5
Murdoch Children's Research Institute, Parkville, Victoria, Australia; George Institute for Global Health, Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom.
6
Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria Australia; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Victoria, Australia; Institute of Inflammation and Repair, University of Manchester, Manchester, United Kingdom. Electronic address: katrina.allen@mcri.edu.au.

Abstract

BACKGROUND:

The risk of developing asthma in those with early food allergy is unknown, particularly when early life food allergy has resolved.

OBJECTIVE:

To understand whether challenge-proven food allergy in infancy increases the risk of asthma at age 4 years, using data from a population-based cohort.

METHODS:

A total of 5,276 12-month-old infants were recruited using a population-based sampling frame. Infants underwent skin prick test to egg, peanut, and sesame and those with a detectable skin prick test result had oral food challenges. At age 4 years, food challenges were repeated to determine persistence or resolution of food allergy. The association between food allergy and doctor-diagnosed asthma was examined using binomial regression in 2,789 participants.

RESULTS:

Children with food allergy at age 1 year had an increased risk of asthma (1 food allergy: relative risk [RR], 1.69; 95% CI, 1.29-2.21; 2 or more food allergies: RR, 2.76; 95% CI, 1.94-3.92). The risk of asthma was highest in children with food allergy and coexistent eczema in infancy (RR, 2.87; 95% CI, 2.22-3.70). Transient food allergy and persistent food allergy were both associated with an increased risk of asthma (transient egg allergy: RR, 1.92; 95% CI, 1.46-2.51; persistent egg allergy: RR, 2.60; 95% CI, 1.76-3.85).

CONCLUSIONS:

Asthma at age 4 years is twice as common in those with challenge-proven food allergy at age 1 year, irrespective of whether the food allergy subsequently resolves. Children with 2 or more food allergies and those with coexistent eczema were almost 3 times as likely to develop asthma compared with those with no food allergies.

KEYWORDS:

Asthma; Eczema; Food allergy; Infants; Oral food challenge; Wheeze

PMID:
29153880
DOI:
10.1016/j.jaip.2017.10.019

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