Strategies to Prevent or Reduce Allergic Disease

Abstract

The need for allergy prevention strategies has never been greater. Surging rates of food allergy and eczema are now adding to the already substantial burden of asthma and respiratory allergic diseases. The parallel rise in many other immune diseases suggests that the developing immune system is highly vulnerable to modern environmental changes. These strong environmental pressures may be one reason why simple allergen avoidance strategies have not been successful. Another more recent strategy to curtail the allergy epidemic has been to identify factors associated with modern lifestyle that may be causally linked with allergic disease, in an attempt to restore more favourable conditions for immune tolerance during early development. More hygienic conditions and disruption of microbial exposure have prompted strategies to restore this balance using probiotic and prebiotic supplements. Modern dietary changes linked with allergic diseases have prompted supplementation studies to assess the preventive merits of specific immunomodulatory dietary nutrients such as polyunsaturated fatty acids. Other nutrients such as antioxidants, folate, and vitamin D are also currently under investigation. Modern environmental pollutants have also been associated with adverse effects on immune development and the risk of disease. While many of these avenues have provided some promise, they have not yet translated into specific recommendations. Current evidence-based guidelines for allergy prevention remain limited to avoidance of cigarette smoke, promotion of breastfeeding and the use of hydrolysed formula when breastfeeding is not possible. Allergen avoidance strategies have been largely removed from most guidelines. It is hoped that a number of ongoing studies will help provide clearer recommendations around the use of probiotics, prebiotics, specific dietary nutrients and the role of early introduction of allergenic foods for the promotion of tolerance. Despite the current uncertainties, prevention remains the best long-term strategy to reduce the growing burden of allergic disease.

Strategy of Food Tolerance Development in Children With Food Allergy

“…Интерпретация полученных результатов осложнена существенными различиями в дизайне исследований и использованием различных диагностических тестов для верификации диагноза. В статье, посвященной страте-гии снижения аллергических заболеваний, приведены результаты исследования, показавшие, что элиминация одного или более самых часто встречаемых пищевых аллергенов у беременных способствует выраженному протективному эффекту в отношении формирования син-дрома атопического дерматита/экземы у ребенка в тече-ние первых 12-18 мес жизни [21]. В противоположность этому утверждению в двух проспективных исследованиях [22,23], так же как и в исследовании, составленном на основе вопросника [24], не было получено каких-либо доказательств эффекта материнской диеты на развитие аллергии к арахису в течение беременности или лактации.…”

The Potential of Maternal Dietary Modification for Prevention of Food Allergy

“…With increasing evidence that allergic disease are associated with disruption of the microbial 'balance' , including altered early colonization and reduced diversity of intestinal flora, attempts have been made to prevent allergic disease by restoring a more optimal pattern of microflora through probiotic supplements during pregnancy and/or infancy [73]. The Food and Agricultural Organization of the United Nations and the World Health Organization [74], defines probiotics as 'living microorganisms, which when administered in adequate amounts confer health benefits on the host.…”

Immune biomarkers in the spectrum of childhood noncommunicable diseases

“…Non-communicable diseases (NCDs) are one of the major global challenges of the 21st century 1 . NCDs have been termed a "slow-motion disaster" 2 and a global crisis 3 as their prevalence increases in all countries, in all income groups, and at all ages.…”

“…oxidative or endoplasmic reticulum) stress 1,8 . This low-grade inflammation differs from classical inflammation, which occurs in response to a threat or injury and leads to tissue repair and restoration of the basal homeostatic state.…”