Asthma Health Outcomes Project
Overviews of Surveyed Asthma ProgramsSeptember 2005
International Programs: United Kingdom (cont’d)
Primary Prevention of Asthma and Atopy During Childhood by Allergen Avoidance in Infancy: A Randomised Controlled Study
St. Mary's Hospital
ST4 6QG United Kingdom
Dr. S. Hasan Arshad
44 1782 553 012
Primary Prevention of Asthma and Atopy During Childhood by Allergen Avoidance in Infancy: A Randomised Controlled Study was implemented from 1990 to 1999 in the United Kingdom. The study was designed as a 'proof of concept' study to find out whether there was 'a window of opportunity' in infancy when the avoidance of food and inhaled allergens protects against the development of allergic disorders in high-risk infants.
One-hundred and twenty infants with family history of atopy and high cord-blood concentrations of total IgE were allocated randomly to prophylactic and control groups. In the prophylactic group (n=58), lactating mothers avoided allergenic foods and avoided feeding their infants these and soya, wheat, and orange up to the age of 12 months. Formula fed infants were given a soya based protein hydrolysate. The infants' bedrooms and living rooms were treated with an acarididal powder and foam every 3 months, and concentrations of Der p 1 in dust samples were measured. Mattress covers were given as well. In the control group (n=62), the diet of mothers and infants was unrestricted; no acaricidal treatment was done and Der p 1 concentrations were measured at birth and at 9 months. A pediatric allergy specialist examined the children at 1, 2, 4 and 8 years of age. Questionnaire, medical examination and skin prick tests were carried out at all visits. At age 8 spirometry and methacholine and exercise challenges were performed and blood was taken for total IgE and inhalant screen.
Symptoms and bronchial hyper responsiveness significantly improved. It was concluded that strict allergen avoidance in infancy in high risk children reduces the development of allergic sensitization to house dust mites.
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