Early life acute infections and risk for cow's milk protein allergy or atopic dermatitis at 6 months of age in high risk for allergy infants

BackgroundEarly life infections (ELIs), encompassing both viral and bacterial types, occur within the first six months of life. Influenced by genetic host factors and environmental conditions, the relationship between ELIs and subsequent allergic manifestations, particularly cow's milk protein...

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Main Authors: Rouzha Pancheva, Zoi Illiodromiti, George Moschonis, Eva Kontopodi, Eleni Karapati, Nicolaos Nicolaou, Eva Karaglani, Mikaela Sekkidou, Simoneta Popova, Nataliya Usheva, Miglena Marinova, Paraskevi Xepapadaki, Olympia Sardeli, Anastasia Kapetanaki, Nicoletta Iacovidou, Theodora Boutsikou, Evangelia Papathoma, Yannis Manios
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2024.1424331/full
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author Rouzha Pancheva
Rouzha Pancheva
Zoi Illiodromiti
George Moschonis
Eva Kontopodi
Eleni Karapati
Nicolaos Nicolaou
Nicolaos Nicolaou
Eva Karaglani
Mikaela Sekkidou
Mikaela Sekkidou
Simoneta Popova
Nataliya Usheva
Nataliya Usheva
Miglena Marinova
Paraskevi Xepapadaki
Olympia Sardeli
Anastasia Kapetanaki
Nicoletta Iacovidou
Theodora Boutsikou
Evangelia Papathoma
Yannis Manios
Yannis Manios
author_facet Rouzha Pancheva
Rouzha Pancheva
Zoi Illiodromiti
George Moschonis
Eva Kontopodi
Eleni Karapati
Nicolaos Nicolaou
Nicolaos Nicolaou
Eva Karaglani
Mikaela Sekkidou
Mikaela Sekkidou
Simoneta Popova
Nataliya Usheva
Nataliya Usheva
Miglena Marinova
Paraskevi Xepapadaki
Olympia Sardeli
Anastasia Kapetanaki
Nicoletta Iacovidou
Theodora Boutsikou
Evangelia Papathoma
Yannis Manios
Yannis Manios
author_sort Rouzha Pancheva
collection DOAJ
description BackgroundEarly life infections (ELIs), encompassing both viral and bacterial types, occur within the first six months of life. Influenced by genetic host factors and environmental conditions, the relationship between ELIs and subsequent allergic manifestations, particularly cow's milk protein allergy (CMPA) and atopic dermatitis (AD), is complex and not fully understood.ObjectiveThe aim of the current study was to examine the potential interplay between nutrition, infections, and allergic manifestations in the first six months of life in infants with a family history of allergies, who were either exclusively breastfed (EBF) or fed a combination of breast milk and standard (SF) or partially hydrolyzed infant formula (pHF).MethodsThe Allergy Reduction Trial (ART) is a multicenter, randomized controlled trial involving 551 participants. From birth, these participants were divided into three groups: Exclusive Breastfeeding (EBF), Partially Hydrolyzed Formula (pHF), and Standard Formula (SF). ELIs, defined as viral and bacterial infections occurring during the first 6 months, and outcomes (AD, CMPA) were recorded through questionnaires (i.e., SCORAD and CоMiSS) and clinical assessments.ResultsThe relative risk (RR) for CMPA in infants with ELIs was 0.20 (95% CI: 0.07–0.58), highlighting a protective effect of ELIs against CMPA development. Notably, the incidence of CMPA was significantly lower in infants who experienced ELIs compared to those without (3% vs. 13.4%, p = 0.001), with no cases of CMPA observed at 6 months in exclusively breastfed (EBF) infants with ELIs. For AD, a trend was observed where the incidence was lower in infants with ELIs who were fed with pHF at 6.5%, compared to those fed with SF at 18.2% (p = 0.092), suggesting a potential protective effect of ELIs in the pHF group against AD development.ConclusionThe study highlights a potential protective role of ELIs in reducing the risk of CMPA, particularly in EBF infants. Furthermore, it suggests a trend towards lower AD incidence in infants fed with pHF, highlighting the complex interplay between early microbial exposures, feeding practices, and immune development. Further research is warranted to unravel this challenging relationship and appropriately inform early life allergy prevention strategies
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spelling doaj-art-7ec36ab120af42fca96ecec68fe2e0be2024-12-20T16:58:26ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602024-12-011210.3389/fped.2024.14243311424331Early life acute infections and risk for cow's milk protein allergy or atopic dermatitis at 6 months of age in high risk for allergy infantsRouzha Pancheva0Rouzha Pancheva1Zoi Illiodromiti2George Moschonis3Eva Kontopodi4Eleni Karapati5Nicolaos Nicolaou6Nicolaos Nicolaou7Eva Karaglani8Mikaela Sekkidou9Mikaela Sekkidou10Simoneta Popova11Nataliya Usheva12Nataliya Usheva13Miglena Marinova14Paraskevi Xepapadaki15Olympia Sardeli16Anastasia Kapetanaki17Nicoletta Iacovidou18Theodora Boutsikou19Evangelia Papathoma20Yannis Manios21Yannis Manios22Department of Hygiene and Epidemiology, Faculty of Public Health, “Prof. Dr. Paraskev Stoyanov” Medical University—Varna, Varna, BulgariaResearch Group NutriLect, Department of Neuroscience, Research Institute, Medical University “Prof. Dr. Paraskev Stoyanov”—Varna, Varna, BulgariaNeonatal Department, Medical School, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, GreeceDiscipline of Food, Nutrition and Dietetics, Department of Sport, Exercise and Nutrition Sciences, School Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, AustraliaFrieslandCampina, Amersfoort, NetherlandsNeonatal Department, Medical School, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, GreeceUniversity of Nicosia Medical School, Nicosia, CyprusAsthma and Allergy Center, Limassol, CyprusDepartment of Nutrition & Dietetics, School of Health Science & Education, Harokopio University, Athens, GreeceUniversity of Nicosia Medical School, Nicosia, CyprusAsthma and Allergy Center, Limassol, CyprusDepartment of Hygiene and Epidemiology, Faculty of Public Health, “Prof. Dr. Paraskev Stoyanov” Medical University—Varna, Varna, BulgariaResearch Group NutriLect, Department of Neuroscience, Research Institute, Medical University “Prof. Dr. Paraskev Stoyanov”—Varna, Varna, BulgariaDepartment of Social Medicine and Healthcare Organization, Faculty of Public Health, “Prof. Dr. Paraskev Stoyanov” Medical University—Varna, Varna, BulgariaDepartment of Hygiene and Epidemiology, Faculty of Public Health, “Prof. Dr. Paraskev Stoyanov” Medical University—Varna, Varna, Bulgaria0Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece1Third Department of Pediatrics, National and Kapodistrian University of Athens, Attikon General University Hospital, Athens, Greece2Neonatology Department, Helena Venizelou Hospital, Athens, Greece3Neonatal Department, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece3Neonatal Department, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece4Neonatal Intensive Care Unit, Alexandra University and State Maternity Hospital, Athens, GreeceDepartment of Nutrition & Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece5Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, GreeceBackgroundEarly life infections (ELIs), encompassing both viral and bacterial types, occur within the first six months of life. Influenced by genetic host factors and environmental conditions, the relationship between ELIs and subsequent allergic manifestations, particularly cow's milk protein allergy (CMPA) and atopic dermatitis (AD), is complex and not fully understood.ObjectiveThe aim of the current study was to examine the potential interplay between nutrition, infections, and allergic manifestations in the first six months of life in infants with a family history of allergies, who were either exclusively breastfed (EBF) or fed a combination of breast milk and standard (SF) or partially hydrolyzed infant formula (pHF).MethodsThe Allergy Reduction Trial (ART) is a multicenter, randomized controlled trial involving 551 participants. From birth, these participants were divided into three groups: Exclusive Breastfeeding (EBF), Partially Hydrolyzed Formula (pHF), and Standard Formula (SF). ELIs, defined as viral and bacterial infections occurring during the first 6 months, and outcomes (AD, CMPA) were recorded through questionnaires (i.e., SCORAD and CоMiSS) and clinical assessments.ResultsThe relative risk (RR) for CMPA in infants with ELIs was 0.20 (95% CI: 0.07–0.58), highlighting a protective effect of ELIs against CMPA development. Notably, the incidence of CMPA was significantly lower in infants who experienced ELIs compared to those without (3% vs. 13.4%, p = 0.001), with no cases of CMPA observed at 6 months in exclusively breastfed (EBF) infants with ELIs. For AD, a trend was observed where the incidence was lower in infants with ELIs who were fed with pHF at 6.5%, compared to those fed with SF at 18.2% (p = 0.092), suggesting a potential protective effect of ELIs in the pHF group against AD development.ConclusionThe study highlights a potential protective role of ELIs in reducing the risk of CMPA, particularly in EBF infants. Furthermore, it suggests a trend towards lower AD incidence in infants fed with pHF, highlighting the complex interplay between early microbial exposures, feeding practices, and immune development. Further research is warranted to unravel this challenging relationship and appropriately inform early life allergy prevention strategieshttps://www.frontiersin.org/articles/10.3389/fped.2024.1424331/fullearly life infectionscow's milk protein allergyatopic dermatitisinfant feedingallergy preventionallergy reduction trial
spellingShingle Rouzha Pancheva
Rouzha Pancheva
Zoi Illiodromiti
George Moschonis
Eva Kontopodi
Eleni Karapati
Nicolaos Nicolaou
Nicolaos Nicolaou
Eva Karaglani
Mikaela Sekkidou
Mikaela Sekkidou
Simoneta Popova
Nataliya Usheva
Nataliya Usheva
Miglena Marinova
Paraskevi Xepapadaki
Olympia Sardeli
Anastasia Kapetanaki
Nicoletta Iacovidou
Theodora Boutsikou
Evangelia Papathoma
Yannis Manios
Yannis Manios
Early life acute infections and risk for cow's milk protein allergy or atopic dermatitis at 6 months of age in high risk for allergy infants
Frontiers in Pediatrics
early life infections
cow's milk protein allergy
atopic dermatitis
infant feeding
allergy prevention
allergy reduction trial
title Early life acute infections and risk for cow's milk protein allergy or atopic dermatitis at 6 months of age in high risk for allergy infants
title_full Early life acute infections and risk for cow's milk protein allergy or atopic dermatitis at 6 months of age in high risk for allergy infants
title_fullStr Early life acute infections and risk for cow's milk protein allergy or atopic dermatitis at 6 months of age in high risk for allergy infants
title_full_unstemmed Early life acute infections and risk for cow's milk protein allergy or atopic dermatitis at 6 months of age in high risk for allergy infants
title_short Early life acute infections and risk for cow's milk protein allergy or atopic dermatitis at 6 months of age in high risk for allergy infants
title_sort early life acute infections and risk for cow s milk protein allergy or atopic dermatitis at 6 months of age in high risk for allergy infants
topic early life infections
cow's milk protein allergy
atopic dermatitis
infant feeding
allergy prevention
allergy reduction trial
url https://www.frontiersin.org/articles/10.3389/fped.2024.1424331/full
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