The prevalence and patterns of food allergy are highly variable in different parts of the world. Differences in food allergy epidemiology may be attributed to a complex interplay of genetic, epigenetic, and environmental factors, suggesting that mechanisms of food allergy may differ in various global populations. Genetic polymorphisms, migration, climate, and infant feeding practices all modulate food allergy risk, and possibly also the efficacy of interventions aimed at primary prevention of food allergy development. Approaches to diagnosis, treatment, and prevention of food allergy should thus be tailored carefully to each population's unique genetic and environmental make-up. Future research in the context of food allergy prevention should focus on elucidating factors determining differential responses between populations.
Climate ; Dermatitis, Atopic ; Diagnosis ; Epidemiology ; Epigenomics ; Food Hypersensitivity* ; Genetics ; Humans ; Infant ; Polymorphism, Genetic ; Prevalence ; Primary Prevention

Adolescent ; Antibiotic Prophylaxis ; Child ; Dermatitis, Atopic/prevention & control* ; Eczema/drug therapy* ; Humans

OBJECTIVETo determine whether lactic acid bacteria as probiotics is efficacious in the primary prevention of infantile eczema or atopic eczema.

METHODSFor this meta analysis of randomized controlled trials (RCT) describing the efficacy of probiotics in infants with eczema or atopic eczema at ages of ≤2 years, a comprehensive search in the databases was performed up to January 2010. Three reviewers independently evaluated the studies for methodological qualities. RevMan 5.0.2 software was used for meta analysis.

RESULTSTwelve RCTs on the preventive effects of lactic acid bacteria as probiotics on infantile eczema were included, and 7 of the 12 RCTs reported the preventive effect of lactic acid bacteria on atopic eczema. The meta analysis showed that there was an overall significant reduction in infantile eczema and atopic eczema favoring lactic acid bacteria compared with placebo. The relative risk (RR) ratios for eczema and atopic eczema were 0.80 (95%CI: 0.70-0.90; P<0.01) and 0.78 (95%CI: 0.64-0.97; P<0.01), respectively. Lactic acid bacteria combined with other probiotics decreased significantly the incidence of eczema, with a RR ratio of 0.79 (95%CI: 0.68-0.93; P<0.01). The use of lactic acid bacteria alone did not result in a reduction in the incidence of eczema, with a RR ratio of 0.85 (95%CI: 0.69-1.05; P>0.05).

CONCLUSIONSThe data from this meta analysis suggest that lactic acid probiotics combined with other probiotics play a role in the prevention of infantile eczema. There is insufficient evidence to recommend single use of lactic acid bacteria for prevention of eczema. Further studies are required to determine whether the findings are reproducible.

Child ; Child, Preschool ; Dermatitis, Atopic ; prevention & control ; Humans ; Lactobacillus ; Lactococcus ; Probiotics ; therapeutic use ; Randomized Controlled Trials as Topic ; Streptococcus thermophilus

Atopic dermatitis (AD) is among the most common skin disorders in humans. Although a variety of regimens are available for the treatment of AD, preventive approaches are limited. Recent studies have demonstrated that certain naturally-occurring herbal medicines are effective in preventing the development of AD via divergent mechanisms, such as inhibiting cytokine and chemokine expression, IgE production, inflammatory cell infiltration, histamine release, and/or enhancement of epidermal permeability barrier function. Yet, they exhibit few adverse effects. Since herbal medicines are widely available, inexpensive and generally safe, they could represent an ideal approach for preventing the development of AD, in both highly developed and developing countries.
Animals ; Chemokines ; metabolism ; Dermatitis, Atopic ; prevention & control ; Disease Models, Animal ; Herbal Medicine ; Humans ; Immunoglobulin E ; metabolism ; Inflammation ; pathology

There has been a dramatic increase in the prevalence of atopic dermatitis and asthma over the last few decades worldwide, including Korea. They are not only major public health problems with an enormous burden on health care resources but also the diseases adversely affect the quality of life of patients and their family. There are clear epidemiologic parallels in atopic dermatitis, wheezing, and asthma. Atopic dermatitis frequently is the first manifestation of atopic diathesis, which occurs in genetically predisposed individuals. Up to 80% of children with atopic dermatitis will eventually develop asthma and allergic rhinitis later in childhood. Also frequent wheezing in childhood will persist and can progress to asthma later. Therefore principal measures for primary prevention and early intervention for an infant with high risk should start as early as possible during early infancy.
Asthma* ; Child ; Delivery of Health Care ; Dermatitis, Atopic* ; Disease Susceptibility ; Early Intervention (Education) ; Humans ; Infant ; Korea ; Prevalence ; Primary Prevention ; Public Health ; Quality of Life ; Respiratory Sounds* ; Rhinitis

PURPOSE: As allergic diseases become common and their socio-economic burden increases, the government needs to develop measures to prevent and manage allergic diseases. Gyeonggi-do Atopy Asthma Education Information Center, funded by the Ministry of Health and Welfare, the Korean Center for Disease Control and Gyeonggi-do, was established in October 2011 to carry out the community-based programs for the patients with allergic diseases in Gyeonggi-do. We investigated the demand on learning, preferred topics and the way of learning about allergic diseases from the public health centers in Gyeonggi-do. METHODS: From March to May 2012, 54 administrators from 45 public health centers in Gyeonggi-do answered about their educational demand and preferred way of learning and having information. RESULTS: A total of 52 administrators (96%) from the public health centers answered that they wanted to participate in the education programs on allergic diseases from Gyeonggi-do Atopy Asthma Education Information Center. Forty eight percent of them had learned about allergic diseases at least once previously by lectures, followed by information brochures and by on-line searching. They wanted to learn about an overview of atopic eczema and how to care it, followed by overviews of asthma and allergic rhinitis. They preferred small group seminars with about 10 participants for learning and wanted to have video clips of lectures, followed by booklets for educational materials. CONCLUSION: This research on the educational demand from the public health centers will be useful in planning the future community-based allergy programs and enhancing communication with the administrators in Gyeonggi-do.
Administrative Personnel ; Asthma ; Centers for Disease Control and Prevention (U.S.) ; Dermatitis, Atopic ; Financial Management ; Humans ; Hypersensitivity ; Information Centers ; Learning ; Lectures ; Pamphlets ; Public Health ; Rhinitis ; Rhinitis, Allergic, Perennial

OBJECTIVETo explore the predictive value of cord blood 25(OH)D [25(OH)D] for infantile atopic dermatitis (AD), and to provide a reference for primary prevention of early infantile AD.

METHODSThe neonates born from July to September, 2015 were enrolled. The cord blood samples were collected at birth to measure the level of 25(OH)D. Outpatient follow-up was conducted for all the infants at 6 weeks, 3 months, and 6 months after birth. A survey was performed to investigate the incidence of AD.

RESULTSA total of 67 neonates completed a 6-month follow-up. The incidence of AD was 34% (23/67), and 91% (21/23) of these cases occurred in the first month after birth. The 23 AD children had a significantly lower cord 25(OH)D level than those without AD (P<0.05). The children with a cord 25(OH)D level <30 nmol/L showed a significantly higher incidence of AD than those with a cord 25(OH)D level ≥30 nmol/L (P<0.05). The receiver operating characteristic (ROC) analysis showed that the area under the ROC curve of cord 25(OH)D in predicting AD was 0.648 (standard error: 0.075; 95%CI: 0.502-0.795). Its sensitivity, specificity, positive predictive value, and negative predictive value were 52.2%, 79.5%, 57.1%, and 76.1%, respectively. Logistic regression analysis showed that low cord 25(OH)D level, preference for seafood during pregnancy, atopic family history, and mixed feeding were risk factors for infantile AD (P<0.05).

CONCLUSIONSCord 25(OH)D level is inversely associated with the risk of infantile AD, but it has a low diagnostic value for this disease.

Calcifediol ; blood ; Dermatitis, Atopic ; blood ; epidemiology ; etiology ; prevention & control ; Female ; Fetal Blood ; chemistry ; Humans ; Infant, Newborn ; Logistic Models ; Male ; Predictive Value of Tests ; ROC Curve ; Risk Factors

OBJECTIVETo assess the preventive effect of probiotics against pediatric allergic diseases.

METHODThe authors searched all randomized controlled trials on the preventive effect of probiotics on pediatric allergic diseases from 8 databases (Pubmed, Medline, Springer link, highwire, Cochrane, Vip, Wanfang Data and CNKI) up to September 2011. Two reviewers assessed the studies to see if they meet inclusion criteria, and extracted data. Meta-analysis for the result of homogenous studies was made with RevMan 4.2 and the co-effect was pooled by using fixed-effects model of relative risk (RR) ratios.

RESULTFifteen studies published between April 2001 and September 2011 including 3604 cases were included. All included studies were graded on randomization, allocation concealment, blinding, baseline and loss to follow-up. Meta-analysis based on included studies showed that prenatal and postnatal probiotic supplementation had preventive effect on pediatric atopic eczema by reducing the RR to 0.78 (95%CI: 0.70 - 0.88, P < 0.0001), and 3 studies in which probiotic was given only after birth, the RR was further reduced to 0.75 (95%CI: 0.66 - 0.86, P < 0.0001). Meta analysis for the effect of lactobacilus alone and combined with other bacteria showed that both decreased the RR ratios of 0.57 (95%CI: 0.44 - 0.73, P < 0.0001) and 0.79 (95%CI: 0.64 - 0.97, P = 0.02), respectively.

CONCLUSIONPresent evidences show that prenatal and postnatal probiotic supplementation will prevent pediatric atopic eczema, but not other allergic diseases such as sensitization, food allergy and asthma.

Asthma ; epidemiology ; prevention & control ; Child ; Child, Preschool ; Dermatitis, Atopic ; epidemiology ; prevention & control ; Female ; Humans ; Hypersensitivity ; epidemiology ; prevention & control ; Immunoglobulin E ; blood ; Infant ; Intestines ; microbiology ; Male ; Pregnancy ; Probiotics ; administration & dosage ; therapeutic use ; Randomized Controlled Trials as Topic ; Skin Tests

This short-term, prospective study was aimed to assess the effects of partially hydrolyzed formula (PHF) on the prevention of the development of atopic dermatitis in infants at high risk. The infants of parents with allergy symptoms and serum total IgE over 200 kU/L were divided into 3 groups by their feeding patterns: PHF group (n=15), standard formula (SF) group (n=32), and breast milk (BM) group (n=22). No allergenic food was given during the study period of 6 months, and breastfeeding mothers avoided egg ingestion. Their atopic symptoms were monitored every 2 months. The cumulative incidence and prevalence of atopic dermatitis at the age of 6 months were significantly less in the PHF group than in the SF group (47% vs.78%, p<0.05; 20% vs. 59%, p<0.05). Those rates of the PHF group were also less than those of the BM group, but they were not statistically significant. There was no difference in the onset age and disease severity. These results suggest that early feeding of PHF to infants at high risk has a short-term preventive effect on the development of atopic dermatitis during the first 6 months of life. Long-term preventive effects should be evaluated.
Breast Feeding ; Dermatitis, Atopic/*etiology/*prevention & control ; Electrophoresis, Polyacrylamide Gel ; Female ; Food Hypersensitivity ; Human ; Hydrolysis ; Hypersensitivity ; Immunoglobulin E/blood ; Infant ; *Infant Food ; Infant, Newborn ; Male ; Milk, Human ; Prospective Studies ; Protein Hydrolysates/*therapeutic use ; Risk ; Time Factors

Food allergies and atopic diseases are on the rise worldwide. There have been several published practice guidelines on the primary prevention of these diseases. One aspect of these guidelines is the recommendations on infant nutrition, as food allergen exposure and other nutritional factors may influence allergen sensitization. This article aims to review the current international recommendations on infant diet and weaning practices in the primary allergy prevention of infants. The conclusions drawn are as follows: (1) Breastfeeding is considered the gold standard for infant nutrition, especially since exclusive breastfeeding confers some protection against the development of allergic diseases. However, large cohort studies have not been carried out in Asian populations. (2) Maternal avoidance of allergenic food substances during pregnancy and lactation has not been proven to reduce the risk of allergies and is not recommended as a primary prevention strategy. (3) Hydrolyzed formulas have not been shown to have an advantage over breastfeeding, although they have some protective value against atopic eczema in at risk infants when compared to regular cows milk based infant formula. (4) Soy formula is also not recommended for prevention of atopic diseases. (5) Weaning to semisolids should be undertaken between the ages of 4 to 6 months as weaning before the age of 4 months is associated with increased of allergy symptoms. (6) The age for introduction of certain highly allergenic foods have been arrived at empirically and included in some guidelines. These comprise the initiation of dairy products at 12 months, eggs at 24 months, and peanuts, nuts and fish at 36 months.
Arachis ; Asian Continental Ancestry Group ; Breast Feeding ; Cohort Studies ; Dairy Products ; Dermatitis, Atopic ; Diet ; Eggs ; Female ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Imidazoles ; Infant ; Infant Formula ; Lactation ; Milk ; Nitro Compounds ; Nuts ; Ovum ; Pregnancy ; Primary Prevention ; Weaning