Food allergy: what can be done to prevent progression to asthma?
OBJECTIVE
The primary objective of this review is to discuss risk factors for asthma development in food allergen-sensitized children. In the paper we discuss the possible measures to prevent progression to asthma by allergen and other adjuvant factor avoidance.


METHODS
A review from literature of articles on these topics was performed.


METHODS
Relevant publications on asthma risk factors and implementation of protective factors were critically evaluated.


RESULTS
Children with familiar history of atopy and sensitization to food proteins in early infancy are at high risk of subsequent respiratory allergic diseases and require specific prevention. Because early allergic sensitization is a significant risk factor for later development of asthma, prevention of asthma by early allergen avoidance is mandatory in high-risk children. Adjuvant factors such as tobacco smoke and mold exposure may act as nonspecific triggers for the development of atopy. The role of protective factors such as infections in early life, breast-feeding, a "healthy" diet needs to be evaluated in prospective studies. Pharmacologic intervention with antihistamines led to significant reduction in incidence of asthma in high-risk children, but confirmatory longitudinal studies in large populations are necessary.


CONCLUSIONS
There is now accumulating evidence that preventing exposure to house-dust mite may significantly reduce the prevalence of childhood asthma. However, allergen avoidance can not be recommended as the only strategy. Avoidance of adjuvant factors and implementation of potential protective factors aimed to reduce the risk to progression to asthma need to be evaluated in prospective studies.
Peroni
Diego G
DG
Department of Pediatrics, University of Verona, Verona, Italy.
Chatzimichail
Atanasio
A
Boner
Attilio L
AL
D000276:Adjuvants, Immunologic / Q000009:adverse effects; D016902:Air Pollution, Indoor / Q000009:adverse effects; D000485:Allergens / Q000009:adverse effects; D001249:Asthma / Q000209:etiology / Q000517:prevention & control*; D001942:Breast Feeding; D004032:Diet; D018450:Disease Progression; D004781:Environmental Exposure; D005231:Fatty Acids, Unsaturated / Q000378:metabolism; D005512:Food Hypersensitivity / Q000150:complications*; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D019570:Inhalation Exposure; D012307:Risk Factors; D014028:Tobacco Smoke Pollution / Q000009:adverse effects
D000276:Adjuvants, Immunologic; D000485:Allergens; D005231:Fatty Acids, Unsaturated; D006633:Histamine Antagonists; D014028:Tobacco Smoke Pollution