Trust, but verify: a new potential association between food allergy and asthma in children

HealthNuts is a longitudinal, population-based paediatric cohort study of the origins and development of allergic diseases. Established in Melbourne, VIC, Australia, in 2007, HealthNuts has been tracking oral food challenge-based prevalence of egg, peanut, and sesame allergy; natural history of disease; phenotypes; risk factors; and remission rates. 1 Osborne NJ Koplin JJ Martin PE et al. Prevalence of challenge-proven IgE-mediated food allergy using population-based sampling and predetermined challenge criteria in infants. J Allergy Clin Immunol. 2011; 127 (76.e1–2): 668 Summary Full Text Full Text PDF PubMed Scopus (789) Google Scholar With longitudinal data to age 6 years, Rachel L Peters and colleagues 2 Peters RL Soriano VX Lycett K et al. Infant food allergy phenotypes and association with lung function deficits and asthma at age 6 years: a population-based, prospective cohort study in Australia. Lancet Child Adol Health. 2023; (online July 25.)https://doi.org/10.1016/S2352-4642(23)00133-5 Google Scholar now highlight a novel relationship between both food allergy and food sensitisation (eg, positive food allergy testing in individuals still tolerant to the food) and objective lung function deficits. A relationship between lung function and food sensitisation, independent of aeroallergen sensitisation, has been previously noted, 3 Teague WG Food allergen sensitization as a determinant of disturbed airway function in young infants: first step on the path to persistent asthma?. J Allergy Clin Immunol. 2008; 122: 766-767 Summary Full Text Full Text PDF PubMed Scopus (9) Google Scholar , 4 Tepper RS Llapur CJ Jones MH et al. Expired nitric oxide and airway reactivity in infants at risk for asthma. J Allergy Clin Immunol. 2008; 122: 760-765 Summary Full Text Full Text PDF PubMed Scopus (42) Google Scholar but this is the first cohort to reveal such associations in children whose food allergy has been objectively defined using the gold standard for diagnosis: the oral challenge. Oral challenge is typically supervised feeding of a patient with titrated doses of their suspected food allergen to objectively provoke a reaction or prove tolerance, in a setting where potential reactions can be treated. Infant food allergy phenotypes and association with lung function deficits and asthma at age 6 years: a population-based, prospective cohort study in AustraliaFood allergy in infancy, whether it resolves or not, is associated with lung function deficits and asthma at age 6 years. Follow-up studies of interventions to prevent food allergy present an opportunity to examine whether preventing these food allergies improves respiratory health. Full-Text PDF