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Dietary prevention of allergic diseases in infants and small children
Authors:Antonella Muraro  Sten Dreborg  Susanne Halken  Arne Høst  Bodo Niggemann  Rob Aalberse  Syed H Arshad  rea von Berg  Kai- Hå kon Carlsen  Karel Duschén  Philippe Eigenmann  David Hill  Catherine Jones  Michael Mellon  Göran Oldeus  Arnold Oranje  Cristina Pascual  Susan Prescott  Hugh Sampson  Magnus Svartengren  Yvan Vandenplas  Ulrich Wahn  Jill A Warner  John O Warner  Magnus Wickman  Robert S Zeiger
Institution:Department of Pediatrics, University of Padua, Padua, Italy;, ESPACI Past President, Lerum, Sweden;, Department of Pediatrics, Sønderborg Hospital, Sønderborg, Denmark;, Department of Pediatrics, Odense University Hospital, Odense, Denmark;, Department of Pneumology and Immunology, University Children's Hospital Charité, Humboldt University, Berlin, Germany;, Department of Allergy CLB, Amsterdam, The Netherlands;, Clinical Allergy Research Unit, St Mary's Hospital, Newport, Isle of Wight, UK;, Marien-Hospital, Abt. für Kinderheilkunde, Wesel, Germany;, Voksentoppen National Centre of Asthma, Allergy and Chronic, Lung Diseases in Children, Oslo, Norway;, Department of Paediatrics, University Hospital Linköping, Linköping, Sweden;, Allergologie/Pediatrie, University of Geneve, Geneve, Switzerland;, Department of Allergy, Royal Children's Hospital, North Melbourne, Vic., Australia;, Child Health, Level G (803) Centre Block, Southampton General Hospital, Southampton, UK;, Kaiser Permanente San Diego, San Diego, CA, USA;, Department of Paediatrics, County Hospital Ryhov, Jönköping, Sweden;, Department of Dermatology and Venerology, University Hospital (Sophia) Rotterdam, Rotterdam, The Netherlands;, Servicio de Alergia, Hospital Infantil Universitario La Paz, Madrid, Spain;, Department of Paediatrics, University of Western Australia, Subiaco, WA, Australia;, Department of Pediatrics, Division of Allergy and Immunology, Mount Sinai School of Medicine, NY, USA;, Department of Public Health Sciences, Division of Occupational Medicine, Karolinska Hospital, Stockholm, Sweden;, A.Z.- Kinderen, Free University of Brussels, Brussels, Belgium;, Department of Environmental Health, Karolinska Hospital, Stockholm, Sweden
Abstract:The role of primary prevention of allergic diseases has been a matter of debate for the last 40 years. In order to shed some light into this issue, a group of experts of the Section of Pediatrics EAACI critically reviewed the existing literature on the subject. In this paper, the immunology of the fetus and newborn is reviewed as well as the post-natal development of the immune system. The influence of post-natal environment and breastfeeding on tolerance induction and sensitization are examined. Allergic diseases result from a strong relationship between genetic and environmental factors. Sensitization to food allergens occurs in the first year of life and cow's milk allergy is the first food allergy to appear in the susceptible infants. Hypoallergenicity of food formulas to be used is a critical issue both for treatment of cow's milk-allergic children and for prevention. Methods to document hypoallergenicity are discussed and evaluated in the preclinical and clinical steps.
Keywords:immune development  food allergy  cow's milk allergy  breast feeding  hypoallergenic formulae  review
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