The Importance of Allergen Avoidance in High Risk Infants and Sensitized Patients: A Meta-analysis Study.
10.4168/aair.2014.6.6.525
- Author:
Wu HUIYAN
1
;
Guo YUHE
;
Wang JUAN
;
Zhang JUNYAN
;
Wang SHAN
;
Zhang XIAOJUN
;
Tao AILIN
Author Information
1. Guangdong Provincial Key Laboratory of Allergy & Clinical Immunology, the State Key Laboratory of Respiratory Disease, the Second Affiliated Hospital of Guangzhou Medical University, Guangdong 510260, China. taoailin@gzhmu.edu.cn
- Publication Type:Meta-Analysis ; Original Article
- Keywords:
Meta-analysis;
allergen avoidance;
allergenic potential newborns;
previously sensitized patients;
allergic diseases
- MeSH:
Allergens;
Asthma;
Cough;
Eczema;
Forced Expiratory Volume;
Humans;
Hypersensitivity;
Incidence;
Infant*;
Infant, Newborn;
Lung;
Methods;
Odds Ratio;
Peak Expiratory Flow Rate;
Data Accuracy;
Respiratory Sounds;
Rhinitis;
Uncertainty
- From:Allergy, Asthma & Immunology Research
2014;6(6):525-534
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: At this time, there is uncertainty regarding whether allergen avoidance is the most appropriate strategy for managing or preventing allergies. The purpose of this study was to evaluate the effectiveness of allergen avoidance in the prevention of allergic symptoms in previously sensitized patients and newborns that have the potential to develop allergies. METHODS: We performed online searches of articles published from January 1980 to December 2012 in PubMed and The Cochrane Central Register of Controlled Trials, and selected articles involving randomized controlled trials (RCTs) and allergen avoidance. The parameters used to determine allergenic potential in newborns included the risk ratio (RR) of eczema, asthma, rhinitis, wheeze, and cough. The methods employed to evaluate previously sensitized patients were the standardized mean difference (SMD) of forced expiratory volume in 1 second (FEV1) and peak expiratory flow rate (PEFR). Data quality was assessed using the Jadad scale. RESULTS: A total of 14 RCTs were identified. Meta-analysis demonstrated that allergen avoidance for newborns did not reduce the subsequent incidence of allergic diseases (eczema, P=0.21; rhinitis, P=0.3; cough, P=0.1) but significantly reduced the incidence of asthma and wheezing in high-risk infants (asthma, P=0.03; wheeze, P=0.0004). However, previously sensitized patients who reduced their exposure to known allergens did not show improvement in their lung functions (FEV1, P=0.3; PEFR morning, P=0.53; PEFR evening, P=0.2; PEFR, P=0.29). CONCLUSIONS: Allergen avoidance may not always be successful in preventing allergic symptoms. However, rigorous methodological studies are required to confirm this hypothesis.
