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Natural History of Perceived Food Hypersensitivity and IgE Sensitisation to Food Allergens in a Cohort of Adults
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
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2014 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 1, e85333- p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

No longitudinal studies exist on the natural history of food hypersensitivity and IgE sensitisation to food allergens in adults.

OBJECTIVE:

To examine the natural history of food hypersensitivity, the natural history of IgE sensitisation to food allergens and to investigate the risk factors for new onset food hypersensitivity.

METHODS:

Food hypersensitivity was questionnaire-assessed in 2307 individuals (aged 20-45 years) from Iceland and Sweden during the European Community Respiratory Health Survey both at baseline and follow-up 9 years later. IgE food and aeroallergen sensitisation were assessed in a subgroup of these individuals (n = 807). Values of 0.35 kU/L and above were regarded as positive sensitisation.

RESULTS:

Food hypersensitivity was reported by 21% of the subjects and this proportion remained unchanged at follow-up (p = 0.58). Fruits, nuts and vegetables were the three most common causes of food hypersensitivity, with a similar prevalence at baseline and follow-up. The prevalence IgE sensitisation to food allergens decreased in general by 56% (p<0.001) and IgE sensitisation to peanut decreased in particular by 67% (p = 0.003). The prevalence of timothy grass IgE sensitisation decreased by 15% (p = 0.003) while cat, mite and birch IgE sensitisation did not decrease significantly. Female sex, rhinitis, eczema and presence of IgE sensitisation to aeroallergens were independently associated with new onset food hypersensitivity.

CONCLUSION:

The prevalence of food hypersensitivity remained unchanged while the prevalence of IgE sensitisation to food allergens decreased in adults over a 9-year follow-up period. The decrease in prevalence of IgE sensitisation to food allergens was considerably larger than the change in prevalence of IgE sensitisation to aeroallergens.

Place, publisher, year, edition, pages
2014. Vol. 9, no 1, e85333- p.
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:uu:diva-215804DOI: 10.1371/journal.pone.0085333ISI: 000329868200042PubMedID: 24427301OAI: oai:DiVA.org:uu-215804DiVA: diva2:688458
Note

De sista två förtfattarna delar sista författarskapet.

Available from: 2014-01-16 Created: 2014-01-16 Last updated: 2017-12-06Bibliographically approved
In thesis
1. IgE sensitization against food allergens: Natural history, relation to airway inflammation and asthma
Open this publication in new window or tab >>IgE sensitization against food allergens: Natural history, relation to airway inflammation and asthma
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: According to recent studies in children, IgE sensitization not only against perennial allergens, but also against food allergens, is related to asthma risk and increased airway inflammation. During the last decade, a new technique for IgE determination based on allergen components has become available, but its use in epidemiological studies has been limited.

Aims: To investigate the relationship between the pattern of IgE sensitization to allergen components and the prevalence of asthma, airway inflammation and hyperresponsiveness in a population-based setting. To examine the relationship of IgE sensitization to allergen extract, and airway inflammation, airway hyperresponsiveness and blood eosinophilia in asthmatics. To examine the natural history of IgE sensitization to food allergens in adults. To compare extract-based and component-based IgE measurements in relation with new-onset respiratory disease and airway inflammation and hyperresponsiveness.

Methods: The present thesis is based on cross-sectional and longitudinal analyses of the adult, the population-based study ECRHS (European Community Health Survey) and a cross-sectional, observational study of young subjects with asthma. IgE sensitization was examined by means of both extract-based and component-based tests. Airway inflammation was assessed by exhaled NO and airway hyperresponsiveness with methacholine test.

Results: IgE sensitization to food allergens independently related to increased airway inflammation in both a population-based study and a study of asthmatics. Furthermore, a relation was found with increased blood eosinophils in asthmatics. The decrease in prevalence of IgE sensitization against food allergens during a 9-year follow-up was larger than the decrease of aeroallergens. Subjects with IgE sensitization to both cat extract and components showed more frequent airway inflammation, greater bronchial responsiveness and higher likelihood of developing asthma and rhinitis than subjects with IgE sensitization only to cat extract.

Conclusions: The presence of IgE antibodies against food allergens was independently associated with airway and systemic inflammation. Both aeroallergens and food allergens should be examined in order to understand the signaling of local and systemic inflammation in asthma. Prevalence of IgE sensitization to food decreased in adults to a larger extent than IgE sensitization against aeroallergens. Measurement of IgE sensitization to cat allergen components appears to have a higher clinical value than extract-based measurement

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2015. 66 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1107
Keyword
allergen components, extract-based, exhaled NO, airway hyperresponsiveness, blood eosinophil count, IgE sensitization, food hypersensitivity, food allergens, perennial allergens, natural history, markers of systemic inflammation, markers of local inflammation
National Category
Respiratory Medicine and Allergy
Research subject
Lung Medicine; Physiology; Immunology
Identifiers
urn:nbn:se:uu:diva-251396 (URN)978-91-554-9256-4 (ISBN)
Public defence
2015-06-02, Hedstrandssalen, Ing 70, Akademiska Sjukhuset, Uppsala, 13:15 (Swedish)
Opponent
Supervisors
Funder
Swedish Heart Lung FoundationVårdal FoundationSwedish Asthma and Allergy Association
Available from: 2015-05-12 Created: 2015-04-17 Last updated: 2015-07-07

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