Food Allergy and Increased Asthma Morbidity in a School-Based Inner-City Asthma Study

Friedlander, James; Sheehan, William J.; Baxi, Sachin N.; Kopel, Lianne S.; Gaffin, Jonathan M.; Ozonoff, Al; Fu, Chunxia; Gold, Diane R.; Phipatanakul, Wanda

doi:10.1016/j.jaip.2013.06.007

Cited by 71 publications

(53 citation statements)

References 28 publications

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“…The prevalence of self-reported food allergies in our adolescent sample was 30%, a rate slightly higher than that of a previous report in younger children with asthma, 24% [10]. However, our food allergy rate is considerably higher than the prevalence of self-reported food sensitization, 17%, in the general population based on a large U.S. national survey [11].…”

Section: Discussioncontrasting

confidence: 79%

Common allergies in urban adolescents and their relationships with asthma control and healthcare utilization

Rhee

Love

Harrington

et al. 2018

Allergy Asthma Clin Immunol

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BackgroundUrban adolescents suffer a disproportionate burden of asthma morbidity, often in association with allergies. Literature is limited on comparing various types of allergies regarding prevalence and associations with asthma morbidity in urban dwelling adolescents. The purpose of this study was to examine the prevalence of common allergies reported by urban adolescents and to assess their relationships to healthcare utilization and asthma control.MethodsStudy participants included 313 urban adolescents (12–20 years of age) with persistent asthma who were recruited from three states in the United States. Self-report data were collected on nine indoor and outdoor allergies, healthcare utilization, and asthma exacerbation. Logistic regressions and zero-inflated Poisson regressions were conducted to examine the relationships between allergies and asthma morbidity.ResultsThe mean age of participants was 14.58 (± 1.97) and 52% were female, and 79% were black. Seventy-three percent (n = 229) reported one or more allergies. Dust mite and grass allergies were most common, each reported by 50%. The prevalence of pest allergies (cockroach and mouse) was 27.5% and 19%, respectively. Those with pest allergies were more likely to report ED visits (cockroach- Odds Ratio (OR) = 2.16, 95% CI 1.18–3.94, p = .01; mouse- OR = 2.13, 95% CI 1.09–4.07, p = .02), specialist visits (cockroach-OR = 2.69, 95% CI 1.60–4.54, p < .001; mouse- OR = 2.06, 95% CI 1.15–3.68, p = .01) and asthma exacerbation (cockroach-OR = 2.17, 95% CI 1.26–3.74, p < .001; mouse- OR = 2.30, 95% CI 1.26–4.18, p = .01). Cockroach allergies were associated with 2.2 times as many nights in the hospital (95% CI 1.053–3.398, p = 0.036) and 2.2 times as many specialist visits (95% CI 1.489–3.110, p < 0.001), and mouse allergy was associated with 1.6 times as many ED visits (95% CI 1.092–2.257, p = 0.015) compared to those without pest allergies.ConclusionsConcomitant occurrence of allergies is ubiquitous among urban adolescents with asthma. Only pest allergies, of those examined, appear to have implications for poorly controlled asthma, exacerbation and acute healthcare utilization. To reduce asthma burden in urban adolescents, identification and management of high-risk adolescents with pest allergen sensitization and exposure are warranted.

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Section: Discussioncontrasting

confidence: 79%

Common allergies in urban adolescents and their relationships with asthma control and healthcare utilization

Rhee

Love

Harrington

et al. 2018

Allergy Asthma Clin Immunol

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“…(6) Prior studies have identified an association between IgE-mediated food allergy and the development of comorbid atopic conditions including asthma and allergic rhinitis. (7, 8) However, the extent to which IgE-mediated food allergy is associated with eosinophilic esophagitis (EoE) is unknown.…”

Section: Introductionmentioning

confidence: 99%

The Prevalence of Eosinophilic Esophagitis in Pediatric Patients with IgE-Mediated Food Allergy

Hill

Dudley

Spergel

2017

The Journal of Allergy and Clinical Immunology: In Practice

105

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BACKGROUND Eosinophilic esophagitis (EoE) is an allergic inflammatory disease that is triggered by food allergens and characterized by progressive esophageal dysfunction. Recently, EoE has been identified in patients undergoing oral immunotherapy (OIT) for IgE-mediated food allergy, suggesting an association. OBJECTIVE We sought to ascertain whether significant associations exist between IgE-mediated food allergies and EoE. METHODS Utilizing analysis of EMR data and manual chart review, we examined our sub-specialty care network of 35,528 children and adolescents to identify and characterize patients with IgE-mediated, and EoE food allergy. The most common food allergens were defined, and the prevalence of EoE in patients with IgE-mediated food allergy was determined. Logistic regression was used to measure the extent to which IgE-mediated food allergy to specific foods is associated with EoE. RESULTS The most common causes of EoE were milk, grains, meats, peanut, tree nuts, egg, and soy, an allergen pattern that is distinct from that of IgE-mediated food allergy. The prevalence of EoE in patients with IgE-mediated food allergy was higher than that reported in the general population (4.7% vs 0.04%). The distribution of IgE-mediated food allergens in patients with EoE was similar to that of the general population, and IgE-mediated allergy to egg (2.27; 1.91–2.64), milk (4.19; 3.52–4.97), or shellfish (1.55; 1.24–1.92) was significantly associated with EoE diagnosis. CONCLUSIONS Our findings support a clinical association between these conditions that has implications for the management of children with food allergy, and particular relevance to patients undergoing OIT.

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“…(13) In particular, sensitization to multiple allergens and having a food allergy are risk factors for severe asthma exacerbations and death. (11, 16, 17)…”

Section: Introductionmentioning

confidence: 99%

Trends in allergy prevalence among children aged 0–17 years by asthma status, United States, 2001–2013

2016

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Objectives Children with asthma and allergies—particularly food and/or multiple allergies–are at risk for adverse asthma outcomes. This analysis describes allergy prevalence trends among US children by asthma status. Methods We analyzed 2001–2013 National Health Interview Survey data for children aged 0–17 years. We estimated trends for reported respiratory, food, and skin allergy and the percentage of children with one, two, or all three allergy types by asthma status. We estimated unadjusted trends, and among children with asthma, adjusted associations between demographic characteristics and allergy. Results Prevalence of any allergy increased by 0.3 percentage points annually among children without asthma but not among children with asthma. However, underlying patterns changed among children with asthma: food and skin allergy prevalence increased as did the percentage with all three allergy types. Among children with asthma, risk was higher among younger and non-Hispanic black children for reported skin allergy, among non-Hispanic white children for reported respiratory allergy, and among nonpoor children for food and respiratory allergies. Prevalence of having one allergy type decreased by 0.50 percentage points annually, while the percent with all three types increased 0.2 percentage points annually. Non-poor and non-Hispanic white children with asthma were more likely to have multiple allergy types. Conclusions While overall allergy prevalence among children with asthma remained stable, patterns in reported allergy type and number suggested a greater proportion may be at risk of adverse asthma outcomes associated with allergy: food allergy increased as did the percentage with all three allergy types.

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Food Allergy and Increased Asthma Morbidity in a School-Based Inner-City Asthma Study

Cited by 71 publications

References 28 publications

Common allergies in urban adolescents and their relationships with asthma control and healthcare utilization

Common allergies in urban adolescents and their relationships with asthma control and healthcare utilization

The Prevalence of Eosinophilic Esophagitis in Pediatric Patients with IgE-Mediated Food Allergy

Trends in allergy prevalence among children aged 0–17 years by asthma status, United States, 2001–2013

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