Influence of early-life exposures on food sensitization and food allergy in an inner-city birth cohort

Emily C. McGowan, Gordon R. Bloomberg, Peter J. Gergen, Cynthia M. Visness, Katy F. Jaffee, Megan Sandel, George O'Connor, Meyer Kattan, James Gern, Robert A. Wood

Research output: Contribution to journalArticle

Abstract

Objective Previous data suggest that food allergy (FA) might be more common in inner-city children; however, these studies have not collected data on both sensitization and clinical reactivity or early-life exposures.

Methods Children in the Urban Environment and Childhood Asthma birth cohort were followed through age 5 years. Household exposures, diet, clinical history, and physical examinations were assessed yearly; levels of specific IgE to milk, egg, and peanut were measured at 1, 2, 3, and 5 years of age. On the basis of sensitization (IgE ≥0.35 kU/L) and clinical history over the 5-year period, children were classified as having FA or being possibly allergic, sensitized but tolerant, or not allergic/not sensitized.

Results Five hundred sixteen children were included. Overall, 55.4% were sensitized (milk, 46.7%; egg, 31.0%; and peanut, 20.9%), whereas 9.9% were categorized as having FA (peanut, 6.0%; egg, 4.3%; and milk, 2.7%; 2.5% to >1 food). The remaining children were categorized as possibly allergic (17.0%), sensitized but tolerant (28.5%), and not sensitized (44.6%). Eighteen (3.5%) reported reactions to foods for which IgE levels were not measured. Food-specific IgE levels were similar in children with FA versus sensitized but tolerant children, except for egg, levels of which were higher in patients with FA at ages 1 and 2 years. FA was associated with recurrent wheeze, eczema, aeroallergen sensitization, male sex, breast-feeding, and lower endotoxin exposure in year 1 but not with race/ethnicity, income, tobacco exposure, maternal stress, or early introduction of solid foods.

Conclusions Even given that this was designed to be a high-risk cohort, the cumulative incidence of FA is extremely high, especially considering the strict definition of FA that was applied and that only 3 common allergens were included.

Original languageEnglish (US)
Pages (from-to)171-178.e4
JournalJournal of Allergy and Clinical Immunology
Volume135
Issue number1
DOIs
StatePublished - Jan 1 2015

Keywords

  • Food allergy
  • Urban Environment and Childhood Asthma cohort
  • inner city
  • specific IgE

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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  • Cite this

    McGowan, E. C., Bloomberg, G. R., Gergen, P. J., Visness, C. M., Jaffee, K. F., Sandel, M., O'Connor, G., Kattan, M., Gern, J., & Wood, R. A. (2015). Influence of early-life exposures on food sensitization and food allergy in an inner-city birth cohort. Journal of Allergy and Clinical Immunology, 135(1), 171-178.e4. https://doi.org/10.1016/j.jaci.2014.06.033