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In this Issue

In this Issue Over the last few years, there has been an ever increasing preoccupation with the influences of variations in nutrition on susceptibility to developing allergy. Of all the nutrients to be studied, polyunsaturated fatty acids have received the most concentrated attention. Indeed we have published several papers on this topic. Thus variation in breast milk fatty acids does effect outcomes ( 1 ). A prospective birth cohort study from Germany on over 2500 children followed up to 2 yr of age has shown that those with predominant margarine consumption have an increased risk of eczema and allergic sensitization compared with butter consumption. However a rather smaller retrospective cohort study from Italy did not find any effect of butter or margarine intakes on food, or inhalant‐allergic sensitization. However, frequent intake of fish during pregnancy did reduce the risk of food sensitization considerably. This, to a certain extent, is in conflict with the next study from the Slovak Republic. It involved a large birth cohort which identified that consumption of infant formula, eggs and fish was associated with an increased likelihood of eczema. However, this must be put into context. The Italian study was investigating the effect of fish intake during pregnancy, and the Slovak study fish intake of the infant. Finally we have a study of polyunsaturated fatty acid supplementation of mothers during breast‐feeding. There was no effect of the supplementation on the development of eczema, but amongst the eczematous children, there were lower levels of total serum immunoglobulin E (IgE) if they were supplemented. All these studies, while in some respects conflicting, do point to the fact that early life nutrition is important in relation to allergy outcomes. Very large prospective studies with controlled intervention will be required to disentangle epiphenomena from true cause and effect relationships. Over many years, people have investigated the value of measuring total IgE to predict the development of allergy. Certainly neonatal measurements have proved to be specific, but extremely insensitive. We now have a large cohort study from the UK which has shown that even at 12 months of age, total IgE used as a screening test for atopy has extremely poor predictive value. It remains to be seen whether focusing on other mediators of allergies, such as TH2 cytokines or surface markers of TH2 cells will provide greater predictive value. We have a study from Japan investigating such factors in groups of subjects of different ages. There clearly are age‐related changes, but unlike other previous published studies, there appear to be no differences in cord blood markers of those with a family history of allergic disease, compared with those with no family history. Prebiotics and probiotics, and fecal microflora in relation to allergy have been the subject of many previous papers in the Journal ( 2–4 ). We have two further papers on this topic. One has measured secretory immunoglobulin A (IgA) in feces of formula‐fed infants, either receiving a prebiotic or probiotic. There was a trend to have higher levels of secretory IgA in those in those receiving the prebiotic rather than the probiotic formula . Maybe for the future, we should concentrate on the use of prebiotics for prevention studies. However, studying fecal microflora has produced rather conflicting results in relation to outcomes. A study from Germany has suggested there is no evidence that the microflora have any effect in relation to the development of food allergy in children with atopic eczema. We have a paper on natural latex rubber allergens. There were remarkably different patterns of recognition of the various allergenic proteins between patients, in part dependent on their past history and evidence of associated fruit allergy. Finally we have a review of food‐dependent exercise‐induced anaphylaxis which has been written round a case report. We will be having more of these forms of educational case reports in a series to start shortly. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Pediatric Allergy and Immunology Wiley

In this Issue

Warner, J. O.
Pediatric Allergy and Immunology , Volume 17 (2) – Mar 1, 2006
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References (4)

Publisher
Wiley
Copyright
Copyright © 2006 Wiley Subscription Services, Inc., A Wiley Company
ISSN
0905-6157
eISSN
1399-3038
DOI
10.1111/j.1399-3038.2006.00401.x
Publisher site
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Abstract

Over the last few years, there has been an ever increasing preoccupation with the influences of variations in nutrition on susceptibility to developing allergy. Of all the nutrients to be studied, polyunsaturated fatty acids have received the most concentrated attention. Indeed we have published several papers on this topic. Thus variation in breast milk fatty acids does effect outcomes ( 1 ). A prospective birth cohort study from Germany on over 2500 children followed up to 2 yr of age has shown that those with predominant margarine consumption have an increased risk of eczema and allergic sensitization compared with butter consumption. However a rather smaller retrospective cohort study from Italy did not find any effect of butter or margarine intakes on food, or inhalant‐allergic sensitization. However, frequent intake of fish during pregnancy did reduce the risk of food sensitization considerably. This, to a certain extent, is in conflict with the next study from the Slovak Republic. It involved a large birth cohort which identified that consumption of infant formula, eggs and fish was associated with an increased likelihood of eczema. However, this must be put into context. The Italian study was investigating the effect of fish intake during pregnancy, and the Slovak study fish intake of the infant. Finally we have a study of polyunsaturated fatty acid supplementation of mothers during breast‐feeding. There was no effect of the supplementation on the development of eczema, but amongst the eczematous children, there were lower levels of total serum immunoglobulin E (IgE) if they were supplemented. All these studies, while in some respects conflicting, do point to the fact that early life nutrition is important in relation to allergy outcomes. Very large prospective studies with controlled intervention will be required to disentangle epiphenomena from true cause and effect relationships. Over many years, people have investigated the value of measuring total IgE to predict the development of allergy. Certainly neonatal measurements have proved to be specific, but extremely insensitive. We now have a large cohort study from the UK which has shown that even at 12 months of age, total IgE used as a screening test for atopy has extremely poor predictive value. It remains to be seen whether focusing on other mediators of allergies, such as TH2 cytokines or surface markers of TH2 cells will provide greater predictive value. We have a study from Japan investigating such factors in groups of subjects of different ages. There clearly are age‐related changes, but unlike other previous published studies, there appear to be no differences in cord blood markers of those with a family history of allergic disease, compared with those with no family history. Prebiotics and probiotics, and fecal microflora in relation to allergy have been the subject of many previous papers in the Journal ( 2–4 ). We have two further papers on this topic. One has measured secretory immunoglobulin A (IgA) in feces of formula‐fed infants, either receiving a prebiotic or probiotic. There was a trend to have higher levels of secretory IgA in those in those receiving the prebiotic rather than the probiotic formula . Maybe for the future, we should concentrate on the use of prebiotics for prevention studies. However, studying fecal microflora has produced rather conflicting results in relation to outcomes. A study from Germany has suggested there is no evidence that the microflora have any effect in relation to the development of food allergy in children with atopic eczema. We have a paper on natural latex rubber allergens. There were remarkably different patterns of recognition of the various allergenic proteins between patients, in part dependent on their past history and evidence of associated fruit allergy. Finally we have a review of food‐dependent exercise‐induced anaphylaxis which has been written round a case report. We will be having more of these forms of educational case reports in a series to start shortly.

Journal

Pediatric Allergy and Immunology – Wiley

Published: Mar 1, 2006

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