title: Allergy and asthma prevention 2014.
abstract: Asthma and allergic diseases have become one of the epidemics of the 21st century in developed countries. Much of the success of other areas of medicine, such as infectious diseases, lies on preventive measures. Thus, much effort is also being placed lately in the prevention of asthma and allergy. This manuscript reviews the current evidence, divided into four areas of activity. Interventions modifying environmental exposure to allergens have provided inconsistent results, with multifaceted interventions being more effective in the prevention of asthma. Regarding nutrition, the use of hydrolyzed formulas in high-risk infants reduces the incidence of atopic dermatitis, while there is for now not enough evidence to recommend other dietary modifications, prebiotics, probiotics, or other microbial products. Pharmacologic agents used until now for prevention have not proved useful, while there is hope that antiviral vaccines could be useful in the future. Allergen-specific immunotherapy is effective for the treatment of allergic patients with symptoms; the study of its value for primary and secondary prevention of asthma and allergy is in its very preliminary phases. The lack of success in the prevention of these disorders lies on their complexity, which involves many genetic, epigenetic, and environmental interactions. There is a need to identify target populations, involved mechanisms and interactions, and the best interventions. These must be effective, feasible, implementable, and affordable.
authors.affiliation: Pediatric Pulmonology and Allergy Unit, Children's Hospital La Fe, Instituto de Investigacion La Fe, Valencia, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Nieto
authors.forename: Ulrich
authors.initials: U
authors.lastname: Wahn
authors.forename: Albrecht
authors.initials: A
authors.lastname: Bufe
authors.forename: Philippe
authors.initials: P
authors.lastname: Eigenmann
authors.forename: Susanne
authors.initials: S
authors.lastname: Halken
authors.forename: Gunilla
authors.initials: G
authors.lastname: Hedlin
authors.forename: Arne
authors.initials: A
authors.lastname: Høst
authors.forename: Jonathan
authors.initials: J
authors.lastname: Hourihane
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Just
authors.forename: Gideon
authors.initials: G
authors.lastname: Lack
authors.forename: Susanne
authors.initials: S
authors.lastname: Lau
authors.forename: Paolo Maria
authors.initials: PM
authors.lastname: Matricardi
authors.forename: Antonella
authors.initials: A
authors.lastname: Muraro
authors.forename: Nikos
authors.initials: N
authors.lastname: Papadopoulos
authors.forename: Graham
authors.initials: G
authors.lastname: Roberts
authors.forename: Angela
authors.initials: A
authors.lastname: Simpson
authors.forename: Erkka
authors.initials: E
authors.lastname: Valovirta
authors.forename: Stephan
authors.initials: S
authors.lastname: Weidinger
authors.forename: Magnus
authors.initials: M
authors.lastname: Wickman
authors.forename: Angel
authors.initials: A
authors.lastname: Mazon
mesh_terms: D000485:Allergens / Q000276:immunology; D000818:Animals; D001249:Asthma / Q000276:immunology / Q000517:prevention & control*; D003888:Desensitization, Immunologic; D004781:Environmental Exposure / Q000009:adverse effects; D019317:Evidence-Based Medicine; D005247:Feeding Behavior; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology / Q000517:prevention & control*; D007223:Infant; D041943:Infant Formula; D019936:Probiotics
chemical_list: D000485:Allergens
keywords: Allergy; asthma; atopic dermatitis; avoidance; environment; food allergy; immunotherapy; nutrition; prebiotics; prevention; probiotics; risk factors