Factors influencing the natural history of non-IgE-mediated gastrointestinal food allergies in paediatric age: a prospective multicentre cohort study
Background We aimed at identifying the factors influencing the natural history of non-IgE-mediated gastrointestinal food allergies (non-IgE-GIFA), a group of common paediatric conditions including food protein–induced: enteropathy (FPE), allergic proctocolitis (FPIAP), enterocolitis syndrome (FPIES)...
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BMJ Publishing Group
2025-02-01
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| Series: | BMJ Paediatrics Open |
| Online Access: | https://bmjpaedsopen.bmj.com/content/9/1/e003203.full |
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| author | Giorgio Bedogni Roberto Berni Canani Laura Carucci Rita Nocerino Serena Coppola Pasqualina Capasso Veronica Giglio |
| author_facet | Giorgio Bedogni Roberto Berni Canani Laura Carucci Rita Nocerino Serena Coppola Pasqualina Capasso Veronica Giglio |
| author_sort | Giorgio Bedogni |
| collection | DOAJ |
| description | Background We aimed at identifying the factors influencing the natural history of non-IgE-mediated gastrointestinal food allergies (non-IgE-GIFA), a group of common paediatric conditions including food protein–induced: enteropathy (FPE), allergic proctocolitis (FPIAP), enterocolitis syndrome (FPIES), and motility disorders (FPIMD).Methods Prospective multicentre cohort study involving paediatric patients (both sexes, aged ≤14 y) with non-IgE-GIFA diagnosed and followed for 24 months at a Tertiary Centre for Paediatric Allergy, Gastroenterology and Nutrition. Anamnestic and clinical data were collected from all enrolled patients.Results 123 non-IgE-GIFA patients were enrolled (56% male, median age (IQR) 150 (60–300) days): FPE (39%), FPIES (17%), FPIAP (16%) and FPIMD (28%). 42% of patients had multiple food allergies (FAs) at baseline, and 64% had a positive family history of allergy. Male sex (OR = 2.24, 95% CI 1.07 to 4.71) and every 1 month of diagnostic delay (OR=1.09, 95% CI 1.01 to 1.18) were positively associated with the occurrence of multiple FAs. At 24-month follow-up, 54% of patients acquired immune tolerance. This rate was higher in FPIAP (75%), when compared with FPIMD (62%), FPE (54%) and FPIES (24%). The odds of 24-month immune tolerance acquisition rate was lower in children with family history of allergy (OR=0.41, 95% CI 0.19 to 0.89) and in those with multiple FAs at baseline (OR=0.24, 95% CI 0.11 to 0.51). At 24-month follow-up, the rate of patients with allergic march was 0.46 (95% CI 0.38 to 0.55, n=57/123), without differences comparing the four phenotypes. The presence of multiple FAs at baseline was associated with an increased risk of developing allergic march (OR=2.22, 95% CI 1.07 to 4.61) at 24-month follow-up.Conclusions The results of the study suggest the potential role of modifiable and non-modifiable risk factors influencing the natural history of paediatric patients affected by non-IgE-GIFA. |
| format | Article |
| id | doaj-art-81abf2e8388744babb1df51b0a3fbbad |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-02-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Paediatrics Open |
| spelling | doaj-art-81abf2e8388744babb1df51b0a3fbbad2025-02-08T17:05:13ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722025-02-019110.1136/bmjpo-2024-003203Factors influencing the natural history of non-IgE-mediated gastrointestinal food allergies in paediatric age: a prospective multicentre cohort studyGiorgio Bedogni0Roberto Berni Canani1Laura Carucci2Rita Nocerino3Serena Coppola4Pasqualina Capasso5Veronica Giglio6Department of Maternal and Pediatric Sciences, University of Milan, Fondazione IRCCS Ca`Granda Ospedale Maggiore Policlinico, Milan, ItalyDepartment of Pediatrics and European Laboratory for the Investigation of Food Induced Diseases, University of Naples “Federico II”, Naples, ItalyImmunoNutritionLab, CEINGE Advanced Biotechnologies, Napoli, Campania, ItalyDepartment of Translational Medical Science, University of Naples Federico II, Napoli, Campania, ItalyDepartment of Translational Medical Science, University of Naples Federico II, Napoli, Campania, ItalyDepartment of Translational Medical Science, University of Naples Federico II, Napoli, Campania, ItalyDepartment of Translational Medical Science, University of Naples Federico II, Napoli, Campania, ItalyBackground We aimed at identifying the factors influencing the natural history of non-IgE-mediated gastrointestinal food allergies (non-IgE-GIFA), a group of common paediatric conditions including food protein–induced: enteropathy (FPE), allergic proctocolitis (FPIAP), enterocolitis syndrome (FPIES), and motility disorders (FPIMD).Methods Prospective multicentre cohort study involving paediatric patients (both sexes, aged ≤14 y) with non-IgE-GIFA diagnosed and followed for 24 months at a Tertiary Centre for Paediatric Allergy, Gastroenterology and Nutrition. Anamnestic and clinical data were collected from all enrolled patients.Results 123 non-IgE-GIFA patients were enrolled (56% male, median age (IQR) 150 (60–300) days): FPE (39%), FPIES (17%), FPIAP (16%) and FPIMD (28%). 42% of patients had multiple food allergies (FAs) at baseline, and 64% had a positive family history of allergy. Male sex (OR = 2.24, 95% CI 1.07 to 4.71) and every 1 month of diagnostic delay (OR=1.09, 95% CI 1.01 to 1.18) were positively associated with the occurrence of multiple FAs. At 24-month follow-up, 54% of patients acquired immune tolerance. This rate was higher in FPIAP (75%), when compared with FPIMD (62%), FPE (54%) and FPIES (24%). The odds of 24-month immune tolerance acquisition rate was lower in children with family history of allergy (OR=0.41, 95% CI 0.19 to 0.89) and in those with multiple FAs at baseline (OR=0.24, 95% CI 0.11 to 0.51). At 24-month follow-up, the rate of patients with allergic march was 0.46 (95% CI 0.38 to 0.55, n=57/123), without differences comparing the four phenotypes. The presence of multiple FAs at baseline was associated with an increased risk of developing allergic march (OR=2.22, 95% CI 1.07 to 4.61) at 24-month follow-up.Conclusions The results of the study suggest the potential role of modifiable and non-modifiable risk factors influencing the natural history of paediatric patients affected by non-IgE-GIFA.https://bmjpaedsopen.bmj.com/content/9/1/e003203.full |
| spellingShingle | Giorgio Bedogni Roberto Berni Canani Laura Carucci Rita Nocerino Serena Coppola Pasqualina Capasso Veronica Giglio Factors influencing the natural history of non-IgE-mediated gastrointestinal food allergies in paediatric age: a prospective multicentre cohort study BMJ Paediatrics Open |
| title | Factors influencing the natural history of non-IgE-mediated gastrointestinal food allergies in paediatric age: a prospective multicentre cohort study |
| title_full | Factors influencing the natural history of non-IgE-mediated gastrointestinal food allergies in paediatric age: a prospective multicentre cohort study |
| title_fullStr | Factors influencing the natural history of non-IgE-mediated gastrointestinal food allergies in paediatric age: a prospective multicentre cohort study |
| title_full_unstemmed | Factors influencing the natural history of non-IgE-mediated gastrointestinal food allergies in paediatric age: a prospective multicentre cohort study |
| title_short | Factors influencing the natural history of non-IgE-mediated gastrointestinal food allergies in paediatric age: a prospective multicentre cohort study |
| title_sort | factors influencing the natural history of non ige mediated gastrointestinal food allergies in paediatric age a prospective multicentre cohort study |
| url | https://bmjpaedsopen.bmj.com/content/9/1/e003203.full |
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