INFORMATION FOR HEALTHCARE PROFESSIONALS ONLY. NOT TO BE DISTRIBUTED TO THE GENERAL PUBLIC.
ALLERGY IS ON THE RISE
Allergic diseases are no longer a rare health issue, they have become one of the most pressing global health concerns of our time. Today, up to 40% of the world’s population is living with an allergy1 and numbers are steadily climbing. By 2050, projections suggest as many as 4 billion people worldwide may be affected by an allergic disease.3,4
In infants and young children, food allergies are particularly concerning. Up to 8% of this age group is affected, with cow’s milk protein allergy (CMPA) being the leading cause.2 CMPA affects 2-5% children5 and 2-3% of infants5, making it one of the most common early-life food allergies.5-7
Its varied symptoms, impact growth8 and affect quality of life,1,9 making early recognition and diagnosis vital. This global rise in allergy has now become a crisis as experts are presented with more severe cases10 that persist into later childhood11 and are increasingly associated with hospitalizations.10
References:
1. Pawankar R, Canonica G, Holgate S, et al. World Allergy Organization (WAO) White Book on Allergy. Update 2013
2. Fiocchi A, Brozek J, Schünemann H, et al. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guidelines. World Allergy Organ J. 2010;3(4):57–161.
3. Akdis C. Global atlas of allergy. European Academy of Allergy and Clinical Immunology. 2014.
4. EAACI, Advocacy manifesto tackling the allergy crisis in Europe concerted policy action needed, 2015.
5.Schoemaker AA, Sprikkelman AB, Grimshaw KE, et al. Incidence and natural history of challenge-proven cow's milk allergy in European children--EuroPrevall birth cohort. Allergy. 2015;70(8):963–972.
6. Prescott SL, Pawankar R, Allen KJ, et al. A global survey of changing patterns of food allergy burden in children. World Allergy Organ J. 2013;6(1):21.
7. Rona RJ, Keil T, Summers C, et al. The prevalence of food allergy: a meta-analysis. J Allergy Clin Immunol. 2007; 120(3):638–646.
8. Robbins KA, Guerrerio AL, Hauck SA, et al. Growth and nutrition in children with food allergy requiring amino acid-based nutritional formulas. J Allery Clin Immunol. 2014;134(6):1463-1466.e5.
9. Dalgard FJ, Gieler U, Tomas-Aragones L, et al. The psychological burden of skin diseases: a cross-sectional multicenter study among dermatological out-patients in 13 European countries. J Invest Dermatol. 2015;135(4):984–991.
10. Nocerino R, Leone L, Cosenza L, Berni Canani R. Increasing rate of hospitalizations for food-induced anaphylaxis in Italian children: An analysis of the Italian Ministry of Health database. J Allergy Clin Immunol. 2015;135(3):833–5.e3.
11. Skripak JM, Matsui EC, Mudd K, Wood RA. The natural history of IgE-mediated cow's milk allergy. J Allergy Clin Immunol. 2007;120(5):1172–1177
WHY ARE ALLERGIES INCREASING?
Why are allergies on the rise? Experts point to a combination of environmental and lifestyle factors. Urbanization, pollution1-4, and changing diets all play a role, as do modern medical practices. Caesarean section deliveries5 and antibiotic use6, for example, are increasingly common, and both can disrupt the natural development of an infant’ s immune system.7-9
Allergies, including CMPA, are also part of what experts call the allergic march. Infants who develop CMPA early in life are at increased risk of later conditions such as asthma, eczema, or rhinitis. In addition, allergic children may face a higher risk of developing non-communicable diseases (NCDs) such as obesity, diabetes, hypertension, and heart disease later in life.10-13
1. Patel MM, et al. Environ Res. 2011;111(8):1222–1229.
2. Ryan PH, et al. J Allergy Clin Immunol. 2005;116(2):279–284.
3. Ryan PH et al. Am J Respir Crit Care Med. 2009;180(11):1068–1075.
4. SalimS, et al. Gut Microbes. 2013;5:2, 215–219.
5. Neu J, et al. Clin Perinatol. 2011;38(2):321–331.
6. Ahmadizar F, et al. Pediatr Allergy Immunol. 2017;28(5):430–437.
7. Canani RB, et al. ISME J. 2016;10(3):742–750.
8. Thompson-Chagoyan OC, et al. Pediatr Allergy Immunol. 2010;21(2p2):e394–e400.
9. Candy DCA, et al. Pediatr Res. 2018;83(3):677–686.
10. Pawankar R et al. World Allergy Organization (WAO) White Book on Allergy. Update 2013.
11. Prescott SL et al. J Allergy Clin Immunol. 2013;131(1):23–30.
12. West CE et al. J Allergy Clin Immunol. 2015;135(1):3–14.
13. Silverberg JI et al. J Allergy Clin Immunol. 2016;137(3):938–40.e1.
THE ROLE OF THE GUT IN ALLERGY DEVELOPMENT
Studies indicate that the GI tract plays an important part in allergy & most infants with allergies have an imbalance in gut microbiota.1-5
Recognizing and diagnosing CMPA is therefore about more than symptom relief. It is also about supporting healthy immune development during a critical window in early life.12-13
Infants with CMPA often have an altered Gut Micobiota compared to Healthy Breastfed Infants & are more susceptible to infections3-5
1.T akahashi I, Kiyono H. JPEN J Parenter Enteral Nutr. 1999;23(5 Suppl):S7–S12.
2. Macdonald TT, Monteleone G. Science. 2005;307(5717):1920–1925.
3. Canani RB, et al. ISME J. 2016;10(3):742–750.
4. Thompson-Chagoyan OC, et al. Pediatr Allergy Immunol. 2010;21(2 Pt 2):e394–e400.
5. Candy DCA, et al. Pediatr Res. 2018;83(3):677–686.
6. Prescott SL. J Allergy Clin Immunol. 2013;131(1):23– 30.
7 . Vighi G, et al. Clin Exp Immunol. 2008;153(Suppl 1):3–6.
8. Ahmadizar F, et al. Pediatr Allergy Immunol. 2017;28(5):430–437 .
9. Patel MM, et al. Environ Res. 2011;111(8):1222–1229.
10. Ryan PH, et al. J Allergy Clin Immunol. 2005;116(2):279–284.
11. Ryan PH, et al. Am J Respir Crit Care Med. 2009;180(11):1068–1075.
12. West CE, et al. J Allergy Clin Immunol. 2015;135(1):3–13.
13. Walker WA, et al. Pediatr Res.2015;77(1):220–228.
14. Scholtens PA, et al. Annu Rev Food Sci T echnol. 2012;3:425–447 .
15. Harmsen HJ, et al. J Pediatr Gastroenterol Nutr. 2000;30(1):61–67 .
FOR HEALTHCARE PROFESSIONALS ONLY, NOT TO BE DISTRIBUTED TO THE GENERAL PUBLIC.
IMPORTANT NOTICE: Breastfeeding is the best form of nutrition for infants and provides many benefits to babies and mothers. Combined breast and bottle-feeding in the first weeks of life may reduce the supply of breast milk, and reversing the decision not to breastfeed is difficult. The social and financial implications of not breastfeeding should be considered.
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