Prevention of food allergy - 06/04/16
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Abstract |
The past few decades have witnessed an increase in the prevalence of IgE-mediated food allergy (FA). For prevention strategies to be effective, we need to understand the causative factors underpinning this rise. Genetic factors are clearly important in the development of FA, but given the dramatic increase in prevalence over a short period of human evolution, it is unlikely that FA arises through germline genetic changes alone. A plausible hypothesis is that 1 or more environmental exposures, or lack thereof, induce epigenetic changes that result in interruption of the default immunologic state of tolerance. Strategies for the prevention of FA might include primary prevention, which seeks to prevent the onset of IgE sensitization; secondary prevention, which seeks to interrupt the development of FA in IgE-sensitized children; and tertiary prevention, which seeks to reduce the expression of end-organ allergic disease in children with established FA. This review emphasizes the prevention of IgE-mediated FA through dietary manipulation, among other strategies; in particular, we focus on recent interventional studies in this field.
Le texte complet de cet article est disponible en PDF.Key Words : Food allergy, atopic dermatitis, peanut allergy, cow's milk allergy, egg allergy, oral food challenge, specific IgE
Abbreviations used : AD, aOR, CMA, CoFAR, EAT, FA, FLG, HEAP, ITT, LEAP, NNT, OFC, OR, PA, RR, sIgE, SPT, STAR, TEWL, UK
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Disclosure of potential conflict of interest: G. du Toit has received grants from the National Institute of Allergy and Infectious Diseases (NIAID)/National Institutes of Health (NIH), Food Allergy Research & Education (FARE), the Medical Research Council and Asthma UK Centre, and the UK Department of Health through NIH Research and has equity holding in FoodMaestro. G. Lack has received grants from the National Institute of Allergy and Infectious Diseases (NIAID)/National Institutes of Health (NIH), Food Allergy Research & Education (FARE), the Medical Research Council and Asthma UK Centre, the UK Department of Health through NIH Research, the National Peanut Board (NPB), the UK Food Standards Agency (FSA), and the Medical Research Council, and has equity holding in DBV Technologies. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 137 - N° 4
P. 998-1010 - avril 2016 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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