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Prevention of atopic disorders

  • Symposium on Pediatric Allergy-II
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Abstract

Prevention of sensitization, onset of disease and disease exacerbations is a very important aspect of holistic approach towards allergic disorders. The prevalence of allergic or atopic disorders has increased significantly in children over the last three decades. There are significant variations in prevalence between countries and also within many countries. Environmental factors obviously play a major role. Environmental allergens are responsible for sensitisation, disease and exacerbations of disease symptoms. Preventive strategies at each level are important : Primary prevention is to stop the process of sensitisation and secondary prevention to prevent re-exposures or prolonged exposure in those who have become sensitized while tertiary prevention is to reduce or minimise morbidity. Various allergen avoidance measures are discussed, with reference to India so that physicians can incorporate these in the management not only of atopic patients but also as preventive strategy in high risk families.

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References

  1. Strachan D, Sibbald B, Weiland Bet al. Worldwide variations in prevalence of symptoms of allergic rhinoconjunctivitis in children. The International Study of Asthma and Allergies in Children (ISAAC).Pediatr Allerg Immunol 1997; 8:161–176.

    Article  CAS  Google Scholar 

  2. ISAAC Steering Committee. Worldwide variation in the prevalence of asthma symptoms: ISAAC.Eur RespirJ 1998; 12:315–35.

    Article  Google Scholar 

  3. Steerenberg PA, Van Amsterdam JGC, Vandebrid BJet al. Environmental and life style factors may act in concert to increase the prevalence of respiratory allergy including asthma.Clin Exp Allerg 1999; 29: 1304–1308.

    Google Scholar 

  4. Grant EN, Wagner R, Weiss KW. Observation on emerging patterns of asthma in our society.J Allerg Clin Immunol 1999; 104: S1-S9.

    Article  CAS  Google Scholar 

  5. Bjorksten B, Holt BJ, Baron-Hay MJ, Munir AKM, Holt PG. Low-level exposure to house-dust mites stimulates T cell responses during early childhood independent of atopy.Clin Exp Allerg 1996; 26: 775–779.

    Article  CAS  Google Scholar 

  6. Jones CA, Holloway JA, Warner JO. Does atopic disease start in foetal life?Allerg 2000; 55: 2–10.

    Article  CAS  Google Scholar 

  7. Sporik RB, Holgate ST, Platts-Mills TAE, Cogswell J. Exposure to house dust mite allergen (Der p1) and the development of asthma in childhood: A prospective study.N Engl J Med 1990; 323 :502–507.

    Article  PubMed  CAS  Google Scholar 

  8. Suoniemi I, Bjorksten F, Haahtela T. Dependence of immediate hypersensitivity in the adolescent period on factors encountered in infancy.Allerg 1981; 36: 263–268.

    Article  CAS  Google Scholar 

  9. Holt PG. Environmental factors and primary T-cell sensitization to inhalant allergens: reappraisal of the role of infections and air pollution.Pediatr Allerg Immunol 1995; 6:1–10.

    Article  Google Scholar 

  10. Platts-Mills TAE, Thomas WR, Aalberse RC, Vervloet D, Chapman MD. Dust mite allergens and asthma: Report of a Second International Workshop.J Allerg Clin Immunol 1992; 89: 1046–1060.

    Article  CAS  Google Scholar 

  11. Platts-Mills TAE, Woodfolk JA, Sporik RB, Chapman MD, Heymann PW. Relevance of indoor allergen measurement and the use of avoidance measures on the treatment of allergic disease. Postgraduate course, 51st AAAI Annual Meeting. New York: AAAI; 1995; 111–125.

    Google Scholar 

  12. Woodfolk JA, Luezynska CM, de Blay F, Chapman MD, Platts-Mills TAE. Cat allergy (editorial).Ann Allerg 1992; 69: 273–275.

    PubMed  CAS  Google Scholar 

  13. Chapman MD. Cockroach allergens: a common cause of asthma in North American cities.Insights Allerg 1993; 8(6) : 1–8.

    Google Scholar 

  14. Peat JK, Salome CM, Woolcock AJ. Longitudinal changes in atopy during a 4 year period: relation to bronchial hyperresponsiveness and respiratory symptoms in a population sample of Australian schoolchildren.J Allerg Clin Immunol 1990; 85 : 65–74.

    Article  CAS  Google Scholar 

  15. Custovic A, Taggart SCO, Francis HC, Chapman MD, Woodcock A. Exposure to house dust mite allergens and the clinical activity of asthma.J Allerg Clin Immunol 1996; 98: 64–72.

    Article  CAS  Google Scholar 

  16. Christiansen SC, Martin SB, Schleicher NC, Koziol JA, Hamilton RG, Zuraw BL. Exposure and sensitization to environmental allergen of predominantly Hispanic children with asthma in San Deigo, inner city.J Allerg Clin Immunol 1996; 98: 288–94.

    Article  CAS  Google Scholar 

  17. Warner JA, Miles EA, Jones AC, Quint DJ, Colwell BM, Warner JO. Is deficiency of interferon gamma production by allergen triggered cord blood cells a predictor of atopic eczema?Clin Exp Allerg 1994; 24: 423–430.

    Article  CAS  Google Scholar 

  18. Custovic A. Manchester Asthma and Allergy Study: Low-allergen environment can be achieved and maintained during pregnancy and in early life.J Allerg Clin Immunol 2000; 105: 252–258.

    Article  CAS  Google Scholar 

  19. Kramer MS. Maternal antigen avoidance during pregnancy for preventing atopic disease in infants of women at high risk. Cochrane Database Syst Rev {dy2000}; (2) : CD000133.

  20. Custovic A, Taggart SCO, Niven RMcL, Woodcock A. Monitoring exposure to house dust mite allergens.J Allerg Clin Immunol 1995; 96:134–135.

    Article  CAS  Google Scholar 

  21. Sporik R, Chapman M, Platts-Mills T. Airborne mite antigen.Lancet 1990; 336:1507–1508.

    Article  Google Scholar 

  22. deBlay F, Heymann PW, Chapman MD, Platts-Mills TAE. Airborne dust mite allergens: comparison of group II mite allergens with group I mite allergen and cat allergen Fel d 1.J Allerg Clin Immunol 1991; 88: 919–926.

    Article  CAS  Google Scholar 

  23. Custovic A, Green R, Fletcher Aet al. Aerodynamic properties of the major dog allergen, can f 1; distribution in homes, concentration and particle size of allergen in the air.Am J Respir Crit Care Med 1997; 155: 94–98.

    PubMed  CAS  Google Scholar 

  24. Platts-Mills TAE, Vervloet D, Thomas WR, Aalberse RC, Chapman MD. Indoor allergens and asthma: report of the Third International Workshop.J Allerg Clin Immunol 1997; 100: Sl-24.

    Google Scholar 

  25. Tovey ER, Chapman MD, Platts-Mills TAE. Mite faeces are a major source of house dust allergens.Nature 1981; 289: 592–593.

    Article  PubMed  CAS  Google Scholar 

  26. Maurya KR, Jamil Z. Factors affecting the distribution of house dust mites under domestic conditions.Ind J Med Res 1980; 72:284–292.

    CAS  Google Scholar 

  27. Bavdekar SB, Lahiri R, Menon J. Childhood asthma, Allergen skin test Paediatric Pulmonology.Update-Bulletin of Respiratory Chapter of Indian Academy of Paediatrics 1997; 9(2): 14–18.

    Google Scholar 

  28. Charpin D, Vervloet D. Epidemiology of allergic diseases. Its use for clinicians.Prog Allerg Clin Immunol 1991; 2: 238–241.

    Google Scholar 

  29. Owen S, Morganstern M, Hepworth J, Woodcock A. Control of house dust mite antigen in bedding.Lancet 1990; 336:396–397.

    Article  Google Scholar 

  30. Tan BB, Weald D, Strickland I, Friedman PS. Double-blind,controlled trial of effect of housedust mite avoidance on atopic dermatitis.Lancet 1996; 347:15–18.

    Article  PubMed  CAS  Google Scholar 

  31. McDonald LG, Tovey E. The role of water temperature and laundry procedures in reducing house dust mite populations and allergen content of bedding.J Allerg Clin Immunol 1992; 90: 599–608.

    Article  CAS  Google Scholar 

  32. McDonald LG, Tovey E. The effectiveness of benzyl benzoate and some essential oils as laundry additives for killing house dust mite.J Allerg Clin Immunol 1993; 92:771–2.

    Article  CAS  Google Scholar 

  33. Tovey ER, Woolcock AJ. Direct exposure of carpets to sunlight can kill all mites.J Allerg Clin Immunol 1994; 93:1072–1074.

    Article  CAS  Google Scholar 

  34. Le Mao J, Liebenberg B, Bischoff B, David B. Changes in mite allergen levels in homes using an acaricide combined with cleaning agents: a 3-year follow-up study.Indoor Enxnron 1992; 1 :212–218.

    Article  CAS  Google Scholar 

  35. Huss RW, Huss K, Squire ENet al. Mite allergen control with acaricide fails.J Allerg Clin Immunol 1994; 94: 27–31.

    Article  CAS  Google Scholar 

  36. Kalra S, Owen SJ, Hepworth J, Woodcock A. Airborne house dust mite antigen after vacuum cleaning.Lancet 1990; 336: 449.

    Article  PubMed  CAS  Google Scholar 

  37. Reisman RE, Mauriello PM, Davis GB, Georgitis JW, DeMasi JM. A double-blind study of the effectiveness of a high-efficiency particulate air (HEPA) filter in the treatment of patients with perennial allergic rhinitis and asthma.J Allerg Clin Immunol 1990; 85: 1050–1057.

    Article  CAS  Google Scholar 

  38. Korsgard J. Preventive measures in mite asthma. A controlled trial.Allerg 1983; 38: 93–102.

    Article  Google Scholar 

  39. Chapman MD, Vailes LD, Hayden ML, Platts-Mills TAE, Arruda LK. Cockroach allergens and their role in asthma. In: Kay AB, ed.Allerg and Allergic Disease, Oxford (UK): Blackwell Science Ltd; 1996; 942–951.

    Google Scholar 

  40. Rosenstreich DL, Eggleston PA, Kattan M, Baker D, Slavin RG, Gregen Pet al. The role of cockroach allergy and exposure to cockroach allergen in causing morbidity among inner-city children with asthma.N Eng J Med 1997; 336: 1356–13562.

    Article  CAS  Google Scholar 

  41. Sarpong SB, Wood RA, Eggleston PA. Short term effects of extermination and cleaning on cockroach allergen Bla g 2 in settled dust.Ann Allerg Asthma Immunol 1996; 76(3): 257–260.

    Article  CAS  Google Scholar 

  42. Eggleston PA, Wood RA, Rand C, Nixon WJ, Chen PH, Lukk P. Removal of cockroach allergen from inner-city homes.J Allerg Clin Immunol 1999; 104: 842–846.

    Article  CAS  Google Scholar 

  43. de Blay F, Chapman MD, Platts-Mills TAE. Airborne cat allergen (Fel d 1). Environmental conrol with the cat in situ.Am Rev Respir Dis 1991; 143: 1334–1339.

    PubMed  Google Scholar 

  44. Van Der Brempt X, Charpin D, Haddi E, Da Mata P, Vervloet D. Cat removal and Fel d 1 levels in mattresses.J Allerg Clin Immunol 1991; 87: 595–596.

    Article  Google Scholar 

  45. Gilnert R, Wilson P, Wedner HJ. Fel d 1 is markedly reduced following sequential washing of cat (abstract).J Allerg Clin Immunol 1990; 85: 327.

    Google Scholar 

  46. Ad Hoc Working group on Environmental allergens and asthma. Position statement: Environmental allergen avoidance in allergic asthma.J Allerg Clin Immunol 1999; 103 ; 203–205.

    Article  Google Scholar 

  47. Bjorksten F, Suoniemi I. Time and intensity of first pollen contacts and risk of subsequent pollen allergies.Acta Med Scand 1981; 209: 299–303.

    Article  PubMed  CAS  Google Scholar 

  48. Tariq SM, Mathews SM, Hakim EAet al. The prevalence of and risk factor for atopy in early childhood: a whole population birth cohort study.J Allerg Clin Immunol 1998; 101: 587–593.

    Article  CAS  Google Scholar 

  49. Guillet G, Guillet MH. Natural history of sensitisation in atopic dermatitis: a three year follow-up study in 250 children — food allergy and high risk of respiratory symptoms.Arch Dermatol 1992; 128: 187–192.

    Article  PubMed  CAS  Google Scholar 

  50. Vandenplas Y. Strategies for prevention.Clin Rev Allerg Immunol 1995; 13: 361–371.

    CAS  Google Scholar 

  51. Halken S, Jacobsen HP, Host A, Holmenlund D. The effect of hypoallergenic formulas in infants at risk of allergic disease.Euro Clin Nutr 1995; 49(Suppl 1): 13–18.

    Google Scholar 

  52. Businco L, Dreborg S, Einarssen R, Giampietro PG, Host A, Keller KMet al. Hydrolyzed cow’s milk formulae. Allergenicity and use in treatment and prevention. An ESPACI position paper.Pediatr Allerg Immunol 1993; 4: 101–111.

    Article  CAS  Google Scholar 

  53. ESPGHAN Committee on Nutrition. Aggett PJ, Haschke F, Heine W, Herwell O, Koletzko B, Rey Jet al. Comment on antigen-reduced infant formulae.Acta Paeditr Scand 1993; 83: 314–319.

    Google Scholar 

  54. Vandenplas Y. Myths and facts about breastfeeding: does it prevent later atopic disease?Acta Paediatr 1997; 86:1283–1287.

    PubMed  CAS  Google Scholar 

  55. Burr ML. Does infant feeding affect the risk of allergy?Arch Dis Child 1983; 58: 561–565.

    Article  PubMed  CAS  Google Scholar 

  56. Walker WA. Development of intestinal host mechanisms and the passive protective role of human milk.Mead Johnson Symp Perinat Dev Med 1977; 2: 111–113.

    Google Scholar 

  57. Sarfati M, Vanderbeeken Y, Rubio-Trujillo M. Presence of IgE suppressor factors in human colostrum.J Immunol 1986; 16: 1005–1008.

    Article  CAS  Google Scholar 

  58. Kalliomaki L, Ouwenhand A, Arvilommi H, Kero P, Isolauri E. Transforming growth factor-ß. A potential regulator of atopic disease at an early age.J Allerg Clin Immunol 1999; 104(6): 1251–1257.

    Article  CAS  Google Scholar 

  59. Saarinen UM, Kajosaari M. Prophylaxis of atopic disease by six months total solid food elimination: Prospective follow-up study until 17 years old.Lancet 1995; 346: 1065–1069.

    Article  PubMed  CAS  Google Scholar 

  60. Kalliomaki M, Salminen S, Arvilommi H, Pentti K, Koskinen P, Isolauri E. Probiotics in primary prevention in atopic disease: a randomised placebo controlled trial.Lancet 2001; 357: 1076–1079.

    Article  PubMed  CAS  Google Scholar 

  61. Falth-Magnusson K, Oman H, Kjellman NI. Maternal abstention from cow milk and egg in allergy risk pregnancies. Effect on antibody production in the mother and the newborn.Allerg 1987; 42: 64–73.

    Article  CAS  Google Scholar 

  62. Lovegroove JA, Morgan JB, Hampton SM. Dietary factors influencing levels of food antibodies and antigens in breast milk.Acta Paediatr 1996; 85: 778–784.

    Google Scholar 

  63. Sigur SN, Hattevig G, Kjellman B. Maternal avoidance of eggs, cow’s milk and fish during lactation: effect on allergic manifestations, skin-prick tests and specific IgE antibodies in children at the age 4 years.Pediatrics 1992; 89: 735–739.

    Google Scholar 

  64. Arshad SH, Matthews S, Gant C, Hide DW. Effect of allergen avoidance on development of allergic disorders in infancy.Lancet 1992; 339: 1493–1497.

    Article  PubMed  CAS  Google Scholar 

  65. Tager IB, Hanrahan JP, Tosteson TD, Castile RD, Brown RW, Weiss STet al. Lung function, prenatal and postnatal smoke exposure, and wheezing in the first year of life.Am Rev Respir Dis 1993; 147: 811–817.

    PubMed  CAS  Google Scholar 

  66. Magnusson CGM. Maternal smoking influences cord serum IgE and IgD levels and increases the risk for subsequent infant allergy.J Allerg Clin Immunol 1986; 78: 898–904.

    Article  CAS  Google Scholar 

  67. Kelly YJ, Brabin BJ, Milligan P, Heaf DP, Reid J, Pearson MG. Maternal asthma, premature birth, and the risk of morbidity in schoolchildren in Merseyside.Thorax 1995; 50: 525–530.

    PubMed  CAS  Google Scholar 

  68. Conrer V, Cortinovis I, Rogari P, Riva L. Weight growth in infants born to mothers who smoked during pregnancy.BM J 1995; 310: 768–771.

    Google Scholar 

  69. Chan KN, Elliman A, Bryan E, Silverman M. Respiratory symptoms in children of low birthweight.Arch Dis Child 1989; 64: 1294–1304.

    PubMed  CAS  Google Scholar 

  70. Sears MR, Holdaway DM, Flannery EM, Herbison GP, Silva PA. Parental and neonatal risk factors of atopy, airway hyperresponsiveness and asthma.Arch Dis Child 1996; 75(5): 392–398.

    PubMed  CAS  Google Scholar 

  71. Von Mutius E. The environmental predictors of allergic disease.J Allerg Clin Immunol 2000; 105: 9–19.

    Article  Google Scholar 

  72. Chilmonczyk BAet al. Association between exposure to environmental tobacco smoke and exacerbations of asthma in children.N Eng J Med 1993; 328: 1665–1669.

    Article  CAS  Google Scholar 

  73. Strachan DP, Cook DG. Health effects of passive smoking. Parental smoking and chidhood asthma: Longitudinal and case-control studies.Thorax 1998; 53: 204–212.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Lata Kumar.

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Kumar, L., Surana, P. Prevention of atopic disorders. Indian J Pediatr 69, 257–262 (2002). https://doi.org/10.1007/BF02734236

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