title: Food Allergy in Infants With Atopic Dermatitis: Limitations of Food-Specific IgE Measurements.
abstract: OBJECTIVE
  Children with atopic dermatitis (AD) have a higher risk for development of food allergies. The objective of this study was to examine incidence of food allergy development in infants with AD and the predictive value of food-antigen-specific immunoglobulin E measurements.
  
  
  METHODS
  This trial examined the long-term safety and efficacy of pimecrolimus cream 1% in >1000 infants (3-18 months) with mild-to-severe AD without a history of food allergy. Food allergy development was followed throughout a 36-month randomized double-blind phase followed by an open-label (OL) phase up to 33 months. Additionally, sIgE for cow's milk, egg white, peanut, wheat, seafood mix, and soybean was measured by ImmunoCAP at baseline, end of the double-blind phase, and end of OL phase.
  
  
  RESULTS
  By the end of the OL phase, 15.9% of infants with AD developed at least 1 food allergy; allergy to peanut was most common (6.6%), followed by cow's milk (4.3%) and egg white (3.9%). Seafood, soybean, and wheat allergies were rare. Levels of sIgE for milk, egg, and peanut increased with severity of AD, as determined by Investigator's Global Assessment score. We assigned sIgE decision points for the 6 foods and tested their ability to predict definite food allergy in this population. Positive predictive values for published and newly developed sIgE decision points were low (<0.6 for all values tested).
  
  
  CONCLUSIONS
  In a large cohort of infants at risk for development of food allergy, sIgE levels were not clinically useful for predicting food allergy development.
authors.affiliation: The Children's Hospital of Philadelphia, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania; spergel@email.chop.edu.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Spergel
authors.affiliation: National Jewish Health and University of Colorado School of Medicine, Denver, Colorado;
authors.forename: Mark
authors.initials: M
authors.lastname: Boguniewicz
authors.affiliation: Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts;
authors.forename: Lynda
authors.initials: L
authors.lastname: Schneider
authors.affiliation: Oregon Health and Science University, Portland, Oregon;
authors.forename: Jon M
authors.initials: JM
authors.lastname: Hanifin
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois; and.
authors.forename: Amy S
authors.initials: AS
authors.lastname: Paller
authors.affiliation: Rady Children's Hospital, San Diego, University of California San Diego, San Diego, California.
authors.forename: Lawrence F
authors.initials: LF
authors.lastname: Eichenfield
mesh_terms: D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000150:complications*; D004311:Double-Blind Method; D005260:Female; D005512:Food Hypersensitivity / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D007223:Infant; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D012372:ROC Curve
chemical_list: D015415:Biomarkers; D007073:Immunoglobulin E