- Section I 1800–1899
- Section II 1900–1949
- Section III 1950–1999
- Chapter 23 In praise of famous men: early cortisone studies
- Chapter 24 The relationship between mast cells and histamine
- Chapter 25 What goes round comes around: developing allergen immunotherapy
- Chapter 26 Burnet, clonal selection theory, and acquired immunological tolerance
- Chapter 27 Slow-reacting substance of anaphylaxis
- Chapter 28 Loveless and wasp-venom immunotherapy
- Chapter 29 Developing an understanding of mast cell biology
- Chapter 30 Disodium cromoglycate for allergic asthma
- Chapter 31 Ancient Egyptian soup for treating asthma: Cox and Intal
- Chapter 32 RAST: Iconic test for allergic sensitization
- Chapter 33 The discovery of IgE
- Chapter 34 Penicillin allergy: a model for practical clinical translational science
- Chapter 35 Unravelling the relationship between <i>Dermatophagoides pteronyssinus</i> and asthma
- Chapter 36 The Gell–Coombs classification
- Chapter 37 The dawn of molecular allergology
- Chapter 38 Immunotherapy can change the natural history of respiratory allergy
- Chapter 39 Anatomy of the asthmatic bronchi
- Chapter 40 Identifying a novel cause of occupational allergy
- Chapter 41 Delayed hypersensitivity to pollen allergens
- Chapter 42 Inhaled beclomethasone dipropionate: stepping-up asthma care
- Chapter 43 Challenging notions of the ‘atopic personality’
- Chapter 44 Establishing and investigating the relationship between food allergy and asthma
- Chapter 45 The histamine-inhalational test
- Chapter 46 Allergic reactions to colloid infusions—another chapter in the colloid debate
- Chapter 47 Total and specific IgE and allergic bronchopulmonary aspergillosis
- Chapter 48 Immunotherapy for venom allergy comes of age
- Chapter 49 Extending the evidence for immunotherapy to the management of children with house-dust-mite-triggered asthma
- Chapter 50 Insights from Xhosa children into environmental risk factors for the development of asthma
- Chapter 51 Viral infection, allergic sensitization, and asthma
- Chapter 52 Immune responses in atopic eczema
- Chapter 53 Understanding the relationship between atopic sensitization and airway hyper-responsiveness in asthma
- Chapter 54 Key insights into the relationship between food allergy and atopic dermatitis
- Chapter 55 From slow-reacting substance of anaphylaxis to anti-leukotrienes
- Chapter 56 Once more unto the breach: the role of the damaged bronchial epithelium in asthma
- Chapter 57 Management of anaphylactic shock
- Chapter 58 The hygiene hypothesis
- Chapter 59 In search of the elixir for childhood allergy and asthma prevention
- Chapter 60 A new way of considering ‘quality of life’
- Chapter 61 Food allergy and anaphylaxis
- Chapter 62 Allergen avoidance: the Isle of Wight study
- Chapter 63 Introducing sputum counts
- Chapter 64 Atopic asthma is a TH2-cell-mediated disease
- Chapter 65 Investigating the impact of hay fever on educational performance
- Chapter 66 Findings from an early peanut immunotherapy trial
- Chapter 67 Auto-immune mechanisms in chronic urticaria
- Chapter 68 Air pollution, mortality, and the need for public health policy
- Chapter 69 The geography of asthma and atopy: after the Berlin wall came down
- Chapter 70 The role of animal allergens in allergic disease
- Chapter 71 The natural history of wheezing: the Tucson cohort
- Chapter 72 Measuring food-specific IgE values
- Chapter 73 Tuberculosis exposure and atopy
- Chapter 74 The inner-city home environment and asthma
- Chapter 75 Mapping the burden of allergic disease in childhood: ISAAC
- Chapter 76 The relationship between obesity and asthma
- Chapter 77 The emergence of monoclonal antibodies
- Chapter 78 The renaissance in allergen immunotherapy
- Chapter 79 Pet exposure in early life and the development of allergy and asthma
- Section IV 2000–2012
- Section V Conclusions
(p. 204) Allergen avoidance: the Isle of Wight study
- Chapter:
- (p. 204) Allergen avoidance: the Isle of Wight study
- Author(s):
Sandra Kuiper
and Constant P van Schayck
- DOI:
- 10.1093/med/9780199651559.003.0062
There is much evidence that the development of allergic disorders may be related to early exposure of allergens, including those in breastmilk. We have tried to find out whether avoidance of food and inhaled allergens in infancy protects against the development of allergic disorders in high-risk infants. In a prenatally randomised, controlled study 120 infants with family history of atopy and high (>0·5 kU/I) cord-blood concentrations of total IgE were allocated randomly to prophylactic and control groups. In the prophylactic group (n = 58), lactating mothers avoided allergenic foods (milk, egg, fish, and nuts) and avoided feeding their infants these foods and soya, wheat, and orange up to the age of 12 months; the infants’ bedrooms and living rooms were treated with an acaricidal powder and foam every 3 months, and concentrations of Dermatophagoides pteronyssinus antigen (Der p I) in dust samples were measured by enzyme-linked immunosorbent assay. In the control group (n = 62), the diet of mothers and infants was unrestricted; no acaricidal treatment was done and Der p I concentrations were measured at birth and at 9 months. A paediatric allergy specialist unaware of group assignment examined the infants for allergic disorders at 10–12 months. Odds ratios were calculated by logistic regression analysis for various factors with control for other confounding variables. At 12 months, allergic disorders had developed in 25 (40%) control infants and in 8 (13%) of the prophylactic group (odds ratio 6·34, 95% confidence intervals 2·0–20·1). The prevalences at 12 months of asthma (4·13, 1·1–15·5) and eczema (3·6, 1·0–12·5) were also significantly greater in the control group. Parental smoking was a significant risk factor for total allergy at 12 months whether only one parent smoked (3·97, 1·2–13·6) or both parents smoked (4·72, 1·2–18·2). Reduced exposure of infants to allergens in food and in housedust lowered the frequency of allergic disorders in the first years of life. Passive smoking is an important risk factor that should be addressed in any prophylactic programme.
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- Section I 1800–1899
- Section II 1900–1949
- Section III 1950–1999
- Chapter 23 In praise of famous men: early cortisone studies
- Chapter 24 The relationship between mast cells and histamine
- Chapter 25 What goes round comes around: developing allergen immunotherapy
- Chapter 26 Burnet, clonal selection theory, and acquired immunological tolerance
- Chapter 27 Slow-reacting substance of anaphylaxis
- Chapter 28 Loveless and wasp-venom immunotherapy
- Chapter 29 Developing an understanding of mast cell biology
- Chapter 30 Disodium cromoglycate for allergic asthma
- Chapter 31 Ancient Egyptian soup for treating asthma: Cox and Intal
- Chapter 32 RAST: Iconic test for allergic sensitization
- Chapter 33 The discovery of IgE
- Chapter 34 Penicillin allergy: a model for practical clinical translational science
- Chapter 35 Unravelling the relationship between <i>Dermatophagoides pteronyssinus</i> and asthma
- Chapter 36 The Gell–Coombs classification
- Chapter 37 The dawn of molecular allergology
- Chapter 38 Immunotherapy can change the natural history of respiratory allergy
- Chapter 39 Anatomy of the asthmatic bronchi
- Chapter 40 Identifying a novel cause of occupational allergy
- Chapter 41 Delayed hypersensitivity to pollen allergens
- Chapter 42 Inhaled beclomethasone dipropionate: stepping-up asthma care
- Chapter 43 Challenging notions of the ‘atopic personality’
- Chapter 44 Establishing and investigating the relationship between food allergy and asthma
- Chapter 45 The histamine-inhalational test
- Chapter 46 Allergic reactions to colloid infusions—another chapter in the colloid debate
- Chapter 47 Total and specific IgE and allergic bronchopulmonary aspergillosis
- Chapter 48 Immunotherapy for venom allergy comes of age
- Chapter 49 Extending the evidence for immunotherapy to the management of children with house-dust-mite-triggered asthma
- Chapter 50 Insights from Xhosa children into environmental risk factors for the development of asthma
- Chapter 51 Viral infection, allergic sensitization, and asthma
- Chapter 52 Immune responses in atopic eczema
- Chapter 53 Understanding the relationship between atopic sensitization and airway hyper-responsiveness in asthma
- Chapter 54 Key insights into the relationship between food allergy and atopic dermatitis
- Chapter 55 From slow-reacting substance of anaphylaxis to anti-leukotrienes
- Chapter 56 Once more unto the breach: the role of the damaged bronchial epithelium in asthma
- Chapter 57 Management of anaphylactic shock
- Chapter 58 The hygiene hypothesis
- Chapter 59 In search of the elixir for childhood allergy and asthma prevention
- Chapter 60 A new way of considering ‘quality of life’
- Chapter 61 Food allergy and anaphylaxis
- Chapter 62 Allergen avoidance: the Isle of Wight study
- Chapter 63 Introducing sputum counts
- Chapter 64 Atopic asthma is a TH2-cell-mediated disease
- Chapter 65 Investigating the impact of hay fever on educational performance
- Chapter 66 Findings from an early peanut immunotherapy trial
- Chapter 67 Auto-immune mechanisms in chronic urticaria
- Chapter 68 Air pollution, mortality, and the need for public health policy
- Chapter 69 The geography of asthma and atopy: after the Berlin wall came down
- Chapter 70 The role of animal allergens in allergic disease
- Chapter 71 The natural history of wheezing: the Tucson cohort
- Chapter 72 Measuring food-specific IgE values
- Chapter 73 Tuberculosis exposure and atopy
- Chapter 74 The inner-city home environment and asthma
- Chapter 75 Mapping the burden of allergic disease in childhood: ISAAC
- Chapter 76 The relationship between obesity and asthma
- Chapter 77 The emergence of monoclonal antibodies
- Chapter 78 The renaissance in allergen immunotherapy
- Chapter 79 Pet exposure in early life and the development of allergy and asthma
- Section IV 2000–2012
- Section V Conclusions