Early Introduction of Multi-Allergen Mixture for Prevention of Food Allergy: Pilot Study

The incidence and prevalence of food allergy (FA) is increasing. While several studies have established the safety and efficacy of early introduction of single allergens in infants for the prevention of FA, the exact dose, frequency, and number of allergens that can be safely introduced to infants,...

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Veröffentlicht in:	Nutrients Jg. 14; H. 4; S. 737
Hauptverfasser:	Quake, Antonia Zoe, Liu, Taryn Audrey, D’Souza, Rachel, Jackson, Katherine G., Woch, Margaret, Tetteh, Afua, Sampath, Vanitha, Nadeau, Kari C., Sindher, Sayantani, Chinthrajah, R. Sharon, Cao, Shu
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	Switzerland MDPI AG 09.02.2022 MDPI
Schlagworte:	allergenicity Allergens Allergy desensitization almonds Arachis Asthma atopy biomarkers breast feeding dietary protein eczema Eggs Enrollments enterocolitis Food allergies Food allergy Food Hypersensitivity - epidemiology Food Hypersensitivity - prevention & control Good Manufacturing Practice hazelnuts Health aspects Humans Hypersensitivity, Immediate Infant Infants Manufacturers Methods Milk peanuts Pediatric research Physiological aspects Pilot Projects Prevention protein content Proteins risk salmon shrimp walnuts wheat United States United States > US multi-allergen early introduction food allergy safety efficacy prevention
ISSN:	2072-6643, 2072-6643
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Abstract	The incidence and prevalence of food allergy (FA) is increasing. While several studies have established the safety and efficacy of early introduction of single allergens in infants for the prevention of FA, the exact dose, frequency, and number of allergens that can be safely introduced to infants, particularly in those at high or low risk of atopy, are still unclear. This 1-year pilot study evaluated the safety of the early introduction of single foods (milk, egg, or peanut) vs. two foods (milk/egg, egg/peanut, milk/peanut) vs. multiple foods (milk/egg/peanut/cashew/almond/shrimp/walnut/wheat/salmon/hazelnut at low, medium, or high doses) vs. no early introduction in 180 infants between 4–6 months of age. At the end of the study, they were evaluated for plasma biomarkers associated with food reactivity via standardized blood tests. Two to four years after the start of the study, participants were evaluated by standardized food challenges. The serving sizes for the single, double, and low dose mixtures were 300 mg total protein per day. The serving sizes for the medium and high dose mixtures were 900 mg and 3000 mg total protein, respectively. Equal parts of each protein were used for double or mixture foods. All infants were breastfed until at least six months of age. The results demonstrate that infants at either high or low risk for atopy were able to tolerate the early introduction of multiple allergenic foods with no increases in any safety issues, including eczema, FA, or food protein induced enterocolitis. The mixtures of foods at either low, medium, or high doses demonstrated trends for improvement in food challenge reactivity and plasma biomarkers compared to single and double food introductions. The results of this study suggest that the early introduction of foods, particularly simultaneous mixtures of many allergenic foods, may be safe and efficacious for preventing FA and can occur safely. These results need to be confirmed by larger randomized controlled studies.
AbstractList	The incidence and prevalence of food allergy (FA) is increasing. While several studies have established the safety and efficacy of early introduction of single allergens in infants for the prevention of FA, the exact dose, frequency, and number of allergens that can be safely introduced to infants, particularly in those at high or low risk of atopy, are still unclear. This 1-year pilot study evaluated the safety of the early introduction of single foods (milk, egg, or peanut) vs. two foods (milk/egg, egg/peanut, milk/peanut) vs. multiple foods (milk/egg/peanut/cashew/almond/shrimp/walnut/wheat/salmon/hazelnut at low, medium, or high doses) vs. no early introduction in 180 infants between 4-6 months of age. At the end of the study, they were evaluated for plasma biomarkers associated with food reactivity via standardized blood tests. Two to four years after the start of the study, participants were evaluated by standardized food challenges. The serving sizes for the single, double, and low dose mixtures were 300 mg total protein per day. The serving sizes for the medium and high dose mixtures were 900 mg and 3000 mg total protein, respectively. Equal parts of each protein were used for double or mixture foods. All infants were breastfed until at least six months of age. The results demonstrate that infants at either high or low risk for atopy were able to tolerate the early introduction of multiple allergenic foods with no increases in any safety issues, including eczema, FA, or food protein induced enterocolitis. The mixtures of foods at either low, medium, or high doses demonstrated trends for improvement in food challenge reactivity and plasma biomarkers compared to single and double food introductions. The results of this study suggest that the early introduction of foods, particularly simultaneous mixtures of many allergenic foods, may be safe and efficacious for preventing FA and can occur safely. These results need to be confirmed by larger randomized controlled studies.The incidence and prevalence of food allergy (FA) is increasing. While several studies have established the safety and efficacy of early introduction of single allergens in infants for the prevention of FA, the exact dose, frequency, and number of allergens that can be safely introduced to infants, particularly in those at high or low risk of atopy, are still unclear. This 1-year pilot study evaluated the safety of the early introduction of single foods (milk, egg, or peanut) vs. two foods (milk/egg, egg/peanut, milk/peanut) vs. multiple foods (milk/egg/peanut/cashew/almond/shrimp/walnut/wheat/salmon/hazelnut at low, medium, or high doses) vs. no early introduction in 180 infants between 4-6 months of age. At the end of the study, they were evaluated for plasma biomarkers associated with food reactivity via standardized blood tests. Two to four years after the start of the study, participants were evaluated by standardized food challenges. The serving sizes for the single, double, and low dose mixtures were 300 mg total protein per day. The serving sizes for the medium and high dose mixtures were 900 mg and 3000 mg total protein, respectively. Equal parts of each protein were used for double or mixture foods. All infants were breastfed until at least six months of age. The results demonstrate that infants at either high or low risk for atopy were able to tolerate the early introduction of multiple allergenic foods with no increases in any safety issues, including eczema, FA, or food protein induced enterocolitis. The mixtures of foods at either low, medium, or high doses demonstrated trends for improvement in food challenge reactivity and plasma biomarkers compared to single and double food introductions. The results of this study suggest that the early introduction of foods, particularly simultaneous mixtures of many allergenic foods, may be safe and efficacious for preventing FA and can occur safely. These results need to be confirmed by larger randomized controlled studies. The incidence and prevalence of food allergy (FA) is increasing. While several studies have established the safety and efficacy of early introduction of single allergens in infants for the prevention of FA, the exact dose, frequency, and number of allergens that can be safely introduced to infants, particularly in those at high or low risk of atopy, are still unclear. This 1-year pilot study evaluated the safety of the early introduction of single foods (milk, egg, or peanut) vs. two foods (milk/egg, egg/peanut, milk/peanut) vs. multiple foods (milk/egg/peanut/cashew/almond/shrimp/walnut/wheat/salmon/hazelnut at low, medium, or high doses) vs. no early introduction in 180 infants between 4–6 months of age. At the end of the study, they were evaluated for plasma biomarkers associated with food reactivity via standardized blood tests. Two to four years after the start of the study, participants were evaluated by standardized food challenges. The serving sizes for the single, double, and low dose mixtures were 300 mg total protein per day. The serving sizes for the medium and high dose mixtures were 900 mg and 3000 mg total protein, respectively. Equal parts of each protein were used for double or mixture foods. All infants were breastfed until at least six months of age. The results demonstrate that infants at either high or low risk for atopy were able to tolerate the early introduction of multiple allergenic foods with no increases in any safety issues, including eczema, FA, or food protein induced enterocolitis. The mixtures of foods at either low, medium, or high doses demonstrated trends for improvement in food challenge reactivity and plasma biomarkers compared to single and double food introductions. The results of this study suggest that the early introduction of foods, particularly simultaneous mixtures of many allergenic foods, may be safe and efficacious for preventing FA and can occur safely. These results need to be confirmed by larger randomized controlled studies.
Audience	Academic
Author	D’Souza, Rachel Liu, Taryn Audrey Sampath, Vanitha Chinthrajah, R. Sharon Quake, Antonia Zoe Woch, Margaret Nadeau, Kari C. Cao, Shu Jackson, Katherine G. Tetteh, Afua Sindher, Sayantani
AuthorAffiliation	Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA 94304, USA; zoeq@stanford.edu (A.Z.Q.); tliu2236@gmail.com (T.A.L.); rdsouza@zis.ch (R.D.); kjawesomeness3@gmail.com (K.G.J.); mwoch@stanford.edu (M.W.); okobea@gmail.com (A.T.); vsampath@stanford.edu (V.S.); tina.sindher@stanford.edu (S.S.); schinths@stanford.edu (R.S.C.); shucao@stanford.edu (S.C.)
AuthorAffiliation_xml	– name: Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, CA 94304, USA; zoeq@stanford.edu (A.Z.Q.); tliu2236@gmail.com (T.A.L.); rdsouza@zis.ch (R.D.); kjawesomeness3@gmail.com (K.G.J.); mwoch@stanford.edu (M.W.); okobea@gmail.com (A.T.); vsampath@stanford.edu (V.S.); tina.sindher@stanford.edu (S.S.); schinths@stanford.edu (R.S.C.); shucao@stanford.edu (S.C.)
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Snippet	The incidence and prevalence of food allergy (FA) is increasing. While several studies have established the safety and efficacy of early introduction of single...
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SubjectTerms	allergenicity Allergens Allergy desensitization almonds Arachis Asthma atopy biomarkers breast feeding dietary protein eczema Eggs Enrollments enterocolitis Food allergies Food allergy Food Hypersensitivity - epidemiology Food Hypersensitivity - prevention & control Good Manufacturing Practice hazelnuts Health aspects Humans Hypersensitivity, Immediate Infant Infants Manufacturers Methods Milk peanuts Pediatric research Physiological aspects Pilot Projects Prevention protein content Proteins risk salmon shrimp walnuts wheat
Title	Early Introduction of Multi-Allergen Mixture for Prevention of Food Allergy: Pilot Study
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