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The natural history and clinical predictors of egg allergy in the first 2 years of life: A prospective, population-based cohort study

Background There is a paucity of data examining the natural history of and risk factors for egg allergy persistence, the most common IgE-mediated food allergy in infants. Objective We aimed to assess the natural history of egg allergy and identify clinical predictors for persistent egg allergy in a... Full description

Journal Title: Journal of allergy and clinical immunology 2013, Vol.133 (2), p.485-491.e6
Main Author: Peters, Rachel L., MPH
Other Authors: Dharmage, Shyamali C., MBBS, MSc, MD, PhD , Gurrin, Lyle C., PhD , Koplin, Jennifer J., PhD , Ponsonby, Anne-Louise, BMedSci, MBBS, PhD, FAFPHM, FRACP , Lowe, Adrian J., PhD , Tang, Mimi L.K., MBBS, FRACP, FRCPA, FAAAAI, PhD , Tey, Dean, MBBS, FRACP , Robinson, Marnie, MBBS, FRACP , Hill, David, MBBS, FRACP , Czech, Helen, BNurs, RN , Thiele, Leone, BA, RN, MNSc , Osborne, Nicholas J., PhD , Allen, Katrina J., BMedSc, MBBS, FRACP, FAAAAI, PhD
Format: Electronic Article Electronic Article
Language: English
Subjects:
Age
Quelle: Alma/SFX Local Collection
Publisher: New York, NY: Mosby, Inc
ID: ISSN: 0091-6749
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title: The natural history and clinical predictors of egg allergy in the first 2 years of life: A prospective, population-based cohort study
format: Article
creator:
  • Peters, Rachel L., MPH
  • Dharmage, Shyamali C., MBBS, MSc, MD, PhD
  • Gurrin, Lyle C., PhD
  • Koplin, Jennifer J., PhD
  • Ponsonby, Anne-Louise, BMedSci, MBBS, PhD, FAFPHM, FRACP
  • Lowe, Adrian J., PhD
  • Tang, Mimi L.K., MBBS, FRACP, FRCPA, FAAAAI, PhD
  • Tey, Dean, MBBS, FRACP
  • Robinson, Marnie, MBBS, FRACP
  • Hill, David, MBBS, FRACP
  • Czech, Helen, BNurs, RN
  • Thiele, Leone, BA, RN, MNSc
  • Osborne, Nicholas J., PhD
  • Allen, Katrina J., BMedSc, MBBS, FRACP, FAAAAI, PhD
subjects:
  • Abridged Index Medicus
  • Age
  • allergen-specific IgE
  • Allergic diseases
  • Allergies
  • Allergy and Immunology
  • baked egg
  • Biological and medical sciences
  • Child, Preschool
  • Digestive allergic diseases
  • Eczema
  • Egg allergy
  • Egg Hypersensitivity - diagnosis
  • Egg Hypersensitivity - epidemiology
  • Egg Hypersensitivity - immunology
  • Eggs - adverse effects
  • Families & family life
  • Family medical history
  • Female
  • filaggrin
  • Food
  • Food allergies
  • Food allergy
  • Fundamental and applied biological sciences. Psychology
  • Fundamental immunology
  • Humans
  • Immune Tolerance
  • Immunoglobulin E
  • Immunoglobulin E - blood
  • Immunopathology
  • Infant
  • Male
  • Medical colleges
  • Medical sciences
  • natural history
  • oral food challenge
  • Parents & parenting
  • Phenotype
  • Population
  • Prospective Studies
  • resolution
  • Risk Factors
  • Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
  • skin prick test
  • Skin Tests
  • Studies
ispartof: Journal of allergy and clinical immunology, 2013, Vol.133 (2), p.485-491.e6
description: Background There is a paucity of data examining the natural history of and risk factors for egg allergy persistence, the most common IgE-mediated food allergy in infants. Objective We aimed to assess the natural history of egg allergy and identify clinical predictors for persistent egg allergy in a population-based cohort. Methods The HealthNuts study is a prospective, population-based cohort study of 5276 infants who underwent skin prick tests to 4 allergens, including egg. Infants with a detectable wheal were offered hospital-based oral food challenges (OFCs) to egg, irrespective of skin prick test wheal sizes. Infants with challenge-confirmed raw egg allergy were offered baked egg OFCs at age 1 year and follow-up at age 2 years, with repeat OFCs to raw egg. Results One hundred forty infants with challenge-confirmed egg allergy at age 1 year participated in the follow-up. Egg allergy resolved in 66 (47%) infants (95% CI, 37% to 56%) by 2 years of age; however, resolution was lower in children with baked egg allergy at age 1 year compared with baked egg tolerance (13% and 56%, respectively; adjusted odds ratio, 5.27; 95% CI, 1.36-20.50; P  = .02). In the subgroup of infants who were tolerant to baked egg at age 1 year, frequent ingestion of baked egg (≥5 times per month) compared with infrequent ingestion (0-4 times per month) increased the likelihood of tolerance (adjusted odds ratio, 3.52; 95% CI, 1.38-8.98; P  = .009). Mutation in the filaggrin gene was not associated with the resolution of either egg allergy or egg sensitization at age 2 years. Conclusion Phenotyping of egg allergy (baked egg tolerant vs allergic) should be considered in the management of this allergy because it has prognostic implications and eases dietary restrictions. Randomized controlled trials for egg oral immunotherapy should consider stratifying at baseline by the baked egg subphenotype to account for the differential rate of tolerance development.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0091-6749
fulltext: fulltext
issn:
  • 0091-6749
  • 1097-6825
url: Link


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titleThe natural history and clinical predictors of egg allergy in the first 2 years of life: A prospective, population-based cohort study
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creatorPeters, Rachel L., MPH ; Dharmage, Shyamali C., MBBS, MSc, MD, PhD ; Gurrin, Lyle C., PhD ; Koplin, Jennifer J., PhD ; Ponsonby, Anne-Louise, BMedSci, MBBS, PhD, FAFPHM, FRACP ; Lowe, Adrian J., PhD ; Tang, Mimi L.K., MBBS, FRACP, FRCPA, FAAAAI, PhD ; Tey, Dean, MBBS, FRACP ; Robinson, Marnie, MBBS, FRACP ; Hill, David, MBBS, FRACP ; Czech, Helen, BNurs, RN ; Thiele, Leone, BA, RN, MNSc ; Osborne, Nicholas J., PhD ; Allen, Katrina J., BMedSc, MBBS, FRACP, FAAAAI, PhD
creatorcontribPeters, Rachel L., MPH ; Dharmage, Shyamali C., MBBS, MSc, MD, PhD ; Gurrin, Lyle C., PhD ; Koplin, Jennifer J., PhD ; Ponsonby, Anne-Louise, BMedSci, MBBS, PhD, FAFPHM, FRACP ; Lowe, Adrian J., PhD ; Tang, Mimi L.K., MBBS, FRACP, FRCPA, FAAAAI, PhD ; Tey, Dean, MBBS, FRACP ; Robinson, Marnie, MBBS, FRACP ; Hill, David, MBBS, FRACP ; Czech, Helen, BNurs, RN ; Thiele, Leone, BA, RN, MNSc ; Osborne, Nicholas J., PhD ; Allen, Katrina J., BMedSc, MBBS, FRACP, FAAAAI, PhD ; HealthNuts study
descriptionBackground There is a paucity of data examining the natural history of and risk factors for egg allergy persistence, the most common IgE-mediated food allergy in infants. Objective We aimed to assess the natural history of egg allergy and identify clinical predictors for persistent egg allergy in a population-based cohort. Methods The HealthNuts study is a prospective, population-based cohort study of 5276 infants who underwent skin prick tests to 4 allergens, including egg. Infants with a detectable wheal were offered hospital-based oral food challenges (OFCs) to egg, irrespective of skin prick test wheal sizes. Infants with challenge-confirmed raw egg allergy were offered baked egg OFCs at age 1 year and follow-up at age 2 years, with repeat OFCs to raw egg. Results One hundred forty infants with challenge-confirmed egg allergy at age 1 year participated in the follow-up. Egg allergy resolved in 66 (47%) infants (95% CI, 37% to 56%) by 2 years of age; however, resolution was lower in children with baked egg allergy at age 1 year compared with baked egg tolerance (13% and 56%, respectively; adjusted odds ratio, 5.27; 95% CI, 1.36-20.50; P  = .02). In the subgroup of infants who were tolerant to baked egg at age 1 year, frequent ingestion of baked egg (≥5 times per month) compared with infrequent ingestion (0-4 times per month) increased the likelihood of tolerance (adjusted odds ratio, 3.52; 95% CI, 1.38-8.98; P  = .009). Mutation in the filaggrin gene was not associated with the resolution of either egg allergy or egg sensitization at age 2 years. Conclusion Phenotyping of egg allergy (baked egg tolerant vs allergic) should be considered in the management of this allergy because it has prognostic implications and eases dietary restrictions. Randomized controlled trials for egg oral immunotherapy should consider stratifying at baseline by the baked egg subphenotype to account for the differential rate of tolerance development.
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1EISSN: 1097-6825
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3PMID: 24373356
4CODEN: JACIBY
languageeng
publisherNew York, NY: Mosby, Inc
subjectAbridged Index Medicus ; Age ; allergen-specific IgE ; Allergic diseases ; Allergies ; Allergy and Immunology ; baked egg ; Biological and medical sciences ; Child, Preschool ; Digestive allergic diseases ; Eczema ; Egg allergy ; Egg Hypersensitivity - diagnosis ; Egg Hypersensitivity - epidemiology ; Egg Hypersensitivity - immunology ; Eggs - adverse effects ; Families & family life ; Family medical history ; Female ; filaggrin ; Food ; Food allergies ; Food allergy ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Humans ; Immune Tolerance ; Immunoglobulin E ; Immunoglobulin E - blood ; Immunopathology ; Infant ; Male ; Medical colleges ; Medical sciences ; natural history ; oral food challenge ; Parents & parenting ; Phenotype ; Population ; Prospective Studies ; resolution ; Risk Factors ; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis ; skin prick test ; Skin Tests ; Studies
ispartofJournal of allergy and clinical immunology, 2013, Vol.133 (2), p.485-491.e6
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0American Academy of Allergy, Asthma & Immunology
12013 American Academy of Allergy, Asthma & Immunology
22015 INIST-CNRS
3Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.
4COPYRIGHT 2014 Elsevier B.V.
5Copyright Elsevier Limited Feb 2014
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0Peters, Rachel L., MPH
1Dharmage, Shyamali C., MBBS, MSc, MD, PhD
2Gurrin, Lyle C., PhD
3Koplin, Jennifer J., PhD
4Ponsonby, Anne-Louise, BMedSci, MBBS, PhD, FAFPHM, FRACP
5Lowe, Adrian J., PhD
6Tang, Mimi L.K., MBBS, FRACP, FRCPA, FAAAAI, PhD
7Tey, Dean, MBBS, FRACP
8Robinson, Marnie, MBBS, FRACP
9Hill, David, MBBS, FRACP
10Czech, Helen, BNurs, RN
11Thiele, Leone, BA, RN, MNSc
12Osborne, Nicholas J., PhD
13Allen, Katrina J., BMedSc, MBBS, FRACP, FAAAAI, PhD
14HealthNuts study
title
0The natural history and clinical predictors of egg allergy in the first 2 years of life: A prospective, population-based cohort study
1Journal of allergy and clinical immunology
addtitleJ Allergy Clin Immunol
descriptionBackground There is a paucity of data examining the natural history of and risk factors for egg allergy persistence, the most common IgE-mediated food allergy in infants. Objective We aimed to assess the natural history of egg allergy and identify clinical predictors for persistent egg allergy in a population-based cohort. Methods The HealthNuts study is a prospective, population-based cohort study of 5276 infants who underwent skin prick tests to 4 allergens, including egg. Infants with a detectable wheal were offered hospital-based oral food challenges (OFCs) to egg, irrespective of skin prick test wheal sizes. Infants with challenge-confirmed raw egg allergy were offered baked egg OFCs at age 1 year and follow-up at age 2 years, with repeat OFCs to raw egg. Results One hundred forty infants with challenge-confirmed egg allergy at age 1 year participated in the follow-up. Egg allergy resolved in 66 (47%) infants (95% CI, 37% to 56%) by 2 years of age; however, resolution was lower in children with baked egg allergy at age 1 year compared with baked egg tolerance (13% and 56%, respectively; adjusted odds ratio, 5.27; 95% CI, 1.36-20.50; P  = .02). In the subgroup of infants who were tolerant to baked egg at age 1 year, frequent ingestion of baked egg (≥5 times per month) compared with infrequent ingestion (0-4 times per month) increased the likelihood of tolerance (adjusted odds ratio, 3.52; 95% CI, 1.38-8.98; P  = .009). Mutation in the filaggrin gene was not associated with the resolution of either egg allergy or egg sensitization at age 2 years. Conclusion Phenotyping of egg allergy (baked egg tolerant vs allergic) should be considered in the management of this allergy because it has prognostic implications and eases dietary restrictions. Randomized controlled trials for egg oral immunotherapy should consider stratifying at baseline by the baked egg subphenotype to account for the differential rate of tolerance development.
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13Egg Hypersensitivity - epidemiology
14Egg Hypersensitivity - immunology
15Eggs - adverse effects
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17Family medical history
18Female
19filaggrin
20Food
21Food allergies
22Food allergy
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25Humans
26Immune Tolerance
27Immunoglobulin E
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29Immunopathology
30Infant
31Male
32Medical colleges
33Medical sciences
34natural history
35oral food challenge
36Parents & parenting
37Phenotype
38Population
39Prospective Studies
40resolution
41Risk Factors
42Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
43skin prick test
44Skin Tests
45Studies
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titleThe natural history and clinical predictors of egg allergy in the first 2 years of life: A prospective, population-based cohort study
authorPeters, Rachel L., MPH ; Dharmage, Shyamali C., MBBS, MSc, MD, PhD ; Gurrin, Lyle C., PhD ; Koplin, Jennifer J., PhD ; Ponsonby, Anne-Louise, BMedSci, MBBS, PhD, FAFPHM, FRACP ; Lowe, Adrian J., PhD ; Tang, Mimi L.K., MBBS, FRACP, FRCPA, FAAAAI, PhD ; Tey, Dean, MBBS, FRACP ; Robinson, Marnie, MBBS, FRACP ; Hill, David, MBBS, FRACP ; Czech, Helen, BNurs, RN ; Thiele, Leone, BA, RN, MNSc ; Osborne, Nicholas J., PhD ; Allen, Katrina J., BMedSc, MBBS, FRACP, FAAAAI, PhD
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6Tang, Mimi L.K., MBBS, FRACP, FRCPA, FAAAAI, PhD
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abstractBackground There is a paucity of data examining the natural history of and risk factors for egg allergy persistence, the most common IgE-mediated food allergy in infants. Objective We aimed to assess the natural history of egg allergy and identify clinical predictors for persistent egg allergy in a population-based cohort. Methods The HealthNuts study is a prospective, population-based cohort study of 5276 infants who underwent skin prick tests to 4 allergens, including egg. Infants with a detectable wheal were offered hospital-based oral food challenges (OFCs) to egg, irrespective of skin prick test wheal sizes. Infants with challenge-confirmed raw egg allergy were offered baked egg OFCs at age 1 year and follow-up at age 2 years, with repeat OFCs to raw egg. Results One hundred forty infants with challenge-confirmed egg allergy at age 1 year participated in the follow-up. Egg allergy resolved in 66 (47%) infants (95% CI, 37% to 56%) by 2 years of age; however, resolution was lower in children with baked egg allergy at age 1 year compared with baked egg tolerance (13% and 56%, respectively; adjusted odds ratio, 5.27; 95% CI, 1.36-20.50; P  = .02). In the subgroup of infants who were tolerant to baked egg at age 1 year, frequent ingestion of baked egg (≥5 times per month) compared with infrequent ingestion (0-4 times per month) increased the likelihood of tolerance (adjusted odds ratio, 3.52; 95% CI, 1.38-8.98; P  = .009). Mutation in the filaggrin gene was not associated with the resolution of either egg allergy or egg sensitization at age 2 years. Conclusion Phenotyping of egg allergy (baked egg tolerant vs allergic) should be considered in the management of this allergy because it has prognostic implications and eases dietary restrictions. Randomized controlled trials for egg oral immunotherapy should consider stratifying at baseline by the baked egg subphenotype to account for the differential rate of tolerance development.
copNew York, NY
pubMosby, Inc
pmid24373356
doi10.1016/j.jaci.2013.11.032