The use of hydrolysates in allergy prevention programmes.
The beneficial effect of a prevention programme regarding the frequency and severity of manifestations suggestive of atopic disease is difficult to prove since the genesis of atopy is multifactorial, including genetic and environmental factors. Twin studies indicate that genetic and environmental factors may each account for about 50% of the phenotype expression of allergic disease (Schultz-Larsen, Holm & Henningsen, 1986). Family studies suggest a heterogenic inheritance (Lee, Geha & Leung, 1988). In order to increase the scientific persuasive impact, as many as possible of these influencing factors should be controlled. However, the more all these factors are controlled, the less persuasive the results will be in daily practice, when dealing with a 'population' instead of a highly motivated selected study cohort. Results of most of the 'atopy prevention trials' starting at birth suggest that prevention is antigen-specific: elimination of cow's milk protein from feeding of high-risk infants, selected because of a family history of atopy, results in a life-long decreased incidence of cow's milk protein allergy. We present here five-year follow-up data of a prevention program using a partial hydrolysate. It is unclear if the introduction of 'tolerance' to cow's milk proteins early in life is relevant or not, since the natural history of allergy to cow's milk protein is transient in a majority of infants. It is also unclear if a high-degree hydrolysate would result in a more efficient prevention than a partial-degree hydrolysate, or that a partial-degree hydrolysate would result in a better development of tolerance than a high-degree hydrolysate.
Vandenplas
Y
Y
Academic Children's Hospital Free University of Brussels, Belgium.
D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007225:Infant Food / Q000032:analysis; D007231:Infant, Newborn; D016269:Milk Hypersensitivity / Q000178:diet therapy* / Q000235:genetics / Q000517:prevention & control; D011322:Primary Prevention / Q000379:methods*; D011492:Protein Hydrolysates / Q000032:analysis / Q000627:therapeutic use*
D011492:Protein Hydrolysates