Considering 25 years of research on allergy prevention – have we let ourselves down?

Wahn, Ulrich

doi:10.1111/pai.12092

Cited by 15 publications

(11 citation statements)

References 24 publications

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“…As recently underlined, 29 several decades of intense clinical and basic research in allergy prevention led to little progress in identifying effective strategies to reduce the burden of allergic conditions. Despite some optimistic reports, 30 most of the concepts and proposals have failed to be effective, underlining the need for completely novel ideas and approaches.…”

Section: Discussionmentioning

confidence: 98%

“…Despite some optimistic reports, 30 most of the concepts and proposals have failed to be effective, underlining the need for completely novel ideas and approaches. 29 In a recent study tolerance principles were applied to boost resistance to primary allergic sensitization to inhalant allergens, but the protocol of sublingual administration of a mixture of soluble aeroallergens still did not provide any evidence of efficiency for allergy prophylaxis. 31 Identifying secondary prevention strategies to stop the atopic march remains a realistic means of investigation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Specific epicutaneous immunotherapy prevents sensitization to new allergens in a murine model

Mondoulet

Dioszeghy

Puteaux

et al. 2015

Journal of Allergy and Clinical Immunology

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Specific epicutaneous immunotherapy prevents sensitization to new allergens in a murine model

Mondoulet

Dioszeghy

Puteaux

et al. 2015

Journal of Allergy and Clinical Immunology

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“…Strategies and recommendations for prevention of allergies have typically been quite restrictive based on relatively poor scientific evidence. New data imply that most children do not benefit in longer term from avoidance diets or by taking extra precautions to avoid environmental allergen exposure . Therefore, the health of children is best served by giving similar recommendations to every child, that is, a balanced diet, physical activity, and a close connection with the natural environment, whether he/she is allergic or not .…”

Section: From Theory To Practicementioning

confidence: 99%

What is needed for allergic children?

Haahtela

2014

Pediatric Allergy Immunology

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“…Generally, alimentary strategies for primary prevention of allergic diseases through allergen avoidance have not yielded the expected drop in allergy prevalence (Wahn 2013) and are therefore reconsidered in the past decade (Longo et al 2013).…”

Section: Exclusion Diets Are Not An Effective Preventive Measurementioning

confidence: 99%

Importance of maternal diet in the training of the infant's immune system during gestation and lactation

Jeurink

Knipping

Wiens

et al. 2018

Critical Reviews in Food Science and Nutrition

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Latest forecasts predict that half of the European population will be allergic within the coming 15 years, with food allergies contributing substantially to the total burden; preventive measures are urgently needed. Unfortunately, all attempted alimentary strategies for primary prevention of allergic diseases through allergen avoidance so far have failed. This also holds true for the prevention of food allergies in breastfed infants by the common practice of excluding certain foods with allergenic potential from the maternal diet. As a preventive measure, therefore, exclusion diets should be discouraged. They can exhaust nursing mothers and negatively impact both their nutritional status as well as their motivation to breastfeed. A prolonged exclusion diet may be indicated solely in cases of doctor-diagnosed food allergy following rigid medical tests (e.g. double-blind placebo-controlled food challenges). Indicated cases usually involve exclusion of only a few food items. Continued breastfeeding is generally important for many aspects of the infant's health, including the training of the infant's immune responses to foreign compounds and avoidance of overshooting inflammatory responses. Recent studies suggest that the presence of maternal dietary proteins in amniotic fluid, cord blood, and human milk might support the induction of tolerance towards solid foods in infants. These are exactly the same species of proteins or remnants thereof that, in comparatively few cases, trigger allergic responses. However, the insight that the proteins of maternal dietary origin in human milk are more likely to be cure (or, more precise, directing prevention) than curse has still largely evaded the attention of health care professionals consulted by worried breastfeeding mothers. In this paper, we summarize recent literature on the importance of exposure to dietary proteins in the establishment of immunological tolerance and hence prevention of allergic disease. Multiple organizations have used the scientific knowledge to build (local) guidelines (e.g. AAAAI, EAACI, BSACI) that can support health care professionals to provide the best strategy to prevent the onset of allergic diseases. We thus hope to clarify existing confusion about the allergenic propensities of dietary proteins during early life, which has contributed to exaggerated fears around the diet of pregnant and breastfeeding mothers.

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Considering 25 years of research on allergy prevention – have we let ourselves down?

Cited by 15 publications

References 24 publications

Specific epicutaneous immunotherapy prevents sensitization to new allergens in a murine model

Specific epicutaneous immunotherapy prevents sensitization to new allergens in a murine model

What is needed for allergic children?

Importance of maternal diet in the training of the infant's immune system during gestation and lactation

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