Food Allergies Linked to Reduced Small Airway Function in Children With Asthma

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Children with food allergies are at greater risk for asthma-related morbidity and mortalities compared with children without food allergies.
Children with food allergies are at greater risk for asthma-related morbidity and mortalities compared with children without food allergies.

Children and young adults with asthma and more than 2 food allergies are at risk for decreased small airway lung function compared with children who have a single food allergy, according to a study published in Annals of Allergy, Asthma, & Immunology.

Investigators conducted a cohort analysis to understand the correlation between lung function and food allergies in children and young adults. They hypothesized that food allergies would decrease lung function independently from asthma status and that such allergies were linked to worsening lung function in individuals with asthma.

The primary outcome measured was forced expiratory flow 25% to 75% of predicted (FEF25-75). Secondary outcomes were percent-predicted values for forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1: FVC.

A skin prick test was used to identify 9 food allergens (cow milk, egg white, soybean, wheat, peanut, English walnut, sesame seed, fish, and shellfish) and 5 aeroallergens (Alternaria alternata, house dust mites, cat hair, dog epithelia, and cockroach).

A total of 1068 individuals aged 0 to 21 years with and without asthma who were enrolled in the Chicago Food Allergy Study were included in the analysis. Of the cohort, 665 children and young adults had no food allergies, 240 had 1 food allergy, 163 had at least 2 food allergies, and 417 were diagnosed with asthma (current or outgrown).

Significant decreases in FEF25-75 were observed in individuals with at least 2 food allergies compared with those who had no food allergies; no statistical significance was observed in individuals with 1 allergy compared with those with no food allergies.

In addition, percent-predicted values for FEV1, FVC, and FEV1: FVC did not significantly vary between patients with asthma with either 1, 2, or more food allergies and patients with asthma with no food allergies. Adjusting for aeroallergens removed all statistically significant values.

The investigators reported that multiple food allergies only affect lung function in children and young adults with asthma.

“We suggest that further studies should investigate the temporal relationship of multiple food allergy diagnoses with pediatric lung function trajectory,” concluded the authors. “Future studies should further confirm the relationship between aeroallergen sensitization, multiple food allergies, and asthma.”

Disclosure: This study was funded by the Food Allergy Initiative, the Blowitz-Ridgeway Foundation/Respiratory Health Association of Chicago, and the Thrasher Research Fund.

Reference

Sherenian MG, Singh AM, Arguelles L, et al. Food allergy is an independent risk factor for decreased lung function in children with asthma [published online August 3, 2018]. Annals of Allergy, Asthma, & Immunol. doi: 10.1016/j.anai.2018.07.037

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