Efficacy of the Enquiring About Tolerance (EAT) study among infants at high risk of developing food allergy

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:144

Article

Perkin, Michael R.¹  Logan, Kirsty²  Bahnson, Henry T.³  Marrs, Tom²  Radulovic, Suzana²  Craven, Joanna²  Flohr, Carsten⁴  Mills, E. N.⁵  Versteeg, Serge A.⁶  van Ree, Ronald^6,7  Lack, Gideon² 

[1] St Georges Univ London, Populat Hlth Res Inst, London, England

[2] Kings Coll London, Sch Life Course Sci, Dept Women & Childrens Hlth, Paediat Allergy Res Grp, London, England

[3] Benaroya Res Inst, Seattle, WA USA

[4] Kings Coll London, Fac Life Sci & Med, Unit Populat Based Dermatol Res, Sch Basic & Med Biosci,St Johns Inst Dermatol, London, England

[5] Univ Manchester, Manchester Inst Biotechnol, Manchester Acad Hlth Sci Ctr, Sch Biol Sci,Div Infect Immun & Resp Med, Manchester, Lancs, England

[6] Acad Med Ctr, Dept Expt Immunol, Amsterdam, Netherlands

[7] Acad Med Ctr, Dept Otorhinolaryngol, Amsterdam, Netherlands

关键词: Food allergy;    diet;    allergens;    infancy;    breastfeeding;    randomized controlled trial;    adherence;   

DOI  :  10.1016/j.jaci.2019.06.045

来源: Elsevier

【 摘 要 】

Background: The Enquiring About Tolerance (EAT) study was a randomized trial of the early introduction of allergenic solids into the infant diet from 3 months of age. The intervention effect did not reach statistical significance in the intention-to-treat analysis of the primary outcome. Objective: We sought to determine whether infants at high risk of developing a food allergy benefited from early introduction. Methods: A secondary intention-to-treat analysis was performed of 3 groups: nonwhite infants; infants with visible eczema at enrollment, with severity determined by SCORAD; and infants with enrollment food sensitization (specific IgE >= 0.1 kU/L). Results: Among infants with sensitization to 1 or more foods at enrollment (>= 0.1 kU/L), early introduction group (EIG) infants developed significantly less food allergy to 1 or more foods than standard introduction group (SIG) infants (SIG, 34.2%; EIG, 19.2%; P = .03), and among infants with sensitization to egg at enrollment, EIG infants developed less egg allergy (SIG, 48.6%; EIG, 20.0%; P = .01). Similarly, among infants with moderate SCORAD (15-<40) at enrollment, EIG infants developed significantly less food allergy to 1 or more foods (SIG, 46.7%; EIG, 22.6%; P = .048) and less egg allergy (SIG, 43.3%; EIG, 16.1%; P = .02). Conclusion: Early introduction was effective in preventing the development of food allergy in specific groups of infants at high risk of developing food allergy: those sensitized to egg or to any food at enrollment and those with eczema of increasing severity at enrollment. This efficacy occurred despite low adherence to the early introduction regimen. This has significant implications for the new national infant feeding recommendations that are emerging around the world.

【 授权许可】

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