Related Experiment Video
Updated: Mar 31, 2026
Basophil Activation Test for Allergy Diagnosis
Published on: May 31, 2021
Allergic manifestation 15 years after early intervention with hydrolyzed formulas--the GINI Study
A von Berg1, B Filipiak-Pittroff1, H Schulz2,3
1Department of Pediatrics, Marien-Hospital Wesel, Research Institute, Wesel, Germany.
Insights
Extensive casein hydrolysate formula (eHF-C) reduced asthma and allergic rhinitis in high-risk children. Partial whey hydrolysate (pHF-W) and eHF-C also lowered eczema incidence and prevalence up to adolescence.
Area of Science:
- Pediatric Allergy and Immunology
- Nutritional Science
- Public Health
Background:
- Long-term data on hydrolyzed formulas' impact on childhood allergies remain limited.
- Early life nutrition plays a crucial role in immune system development and allergy prevention.
- Identifying effective interventions for high-risk infants is essential for reducing allergic disease burden.
Purpose of the Study:
- To evaluate the long-term association between early infant feeding with different hydrolyzed formulas and allergic outcomes.
- To assess the preventative effects of partial whey hydrolysate (pHF-W), extensive whey hydrolysate (eHF-W), and extensive casein hydrolysate (eHF-C) compared to standard cow's milk formula (CMF).
- To examine outcomes including asthma, allergic rhinitis (AR), and eczema up to adolescence.
Main Methods:
- The GINI study involved 2252 high-risk infants receiving one of four formulas (pHF-W, eHF-W, eHF-C, or CMF) in the first four months.
- Parent-reported physician-diagnosed asthma, AR, and eczema were assessed.
- Spirometry and sensitization tests were conducted, with analyses using generalized linear models.
Main Results:
- Extensive casein hydrolysate (eHF-C) significantly reduced asthma prevalence (OR 0.49) and allergic rhinitis cumulative incidence (RR 0.77) and prevalence (OR 0.59).
- Partial whey hydrolysate (pHF-W) and eHF-C reduced eczema cumulative incidence (RR 0.75 and 0.60, respectively) and prevalence (eHF-C OR 0.42).
- No significant effects were observed for eHF-W on any allergic manifestation or for any formula on sensitization.
Conclusions:
- Early intervention with specific hydrolyzed formulas shows variable long-term preventative effects on allergic diseases in high-risk children.
- Extensive casein hydrolysate appears most effective in reducing asthma, allergic rhinitis, and eczema.
- Further research is needed to optimize hydrolyzed formula use for allergy prevention.
Background:
Data on the long-term impact of hydrolyzed formulas on allergies are scarce.
Objective:
To assess the association between early intervention with hydrolyzed formulas in high-risk children and allergic outcomes in adolescence.
Methods:
GINI trial participants (n = 2252) received one of four formulas in the first four months of life as breastmilk substitute if necessary: partial or extensive whey hydrolyzate (pHF-W, eHF-W), extensive casein hydrolyzate (eHF-C) or standard cow's milk formula (CMF) as reference. Associations between these formulas and the cumulative incidence and prevalence of parent-reported physician-diagnosed asthma, allergic rhinitis (AR) and eczema, as well as spirometric indices and sensitization, were examined using generalized linear models.
Results:
Between 11 and 15 years, the prevalence of asthma was reduced in the eHF-C group compared to CMF (odds ratio (OR) 0.49, 95% confidence interval (CI) 0.26-0.89), which is consistent with the spirometric results. The cumulative incidence of AR was lower in eHF-C (risk ratio (RR) 0.77, 95% CI 0.59-0.99]) and the AR prevalence in pHF-W (OR 0.67, 95% CI 0.47-0.95) and eHF-C (OR 0.59, 95% CI 0.41-0.84). The cumulative incidence of eczema was reduced in pHF-W (RR 0.75, 95% CI 0.59-0.96) and eHF-C (RR 0.60, 95% CI 0.46-0.77), as was the eczema prevalence between 11 and 15 years in eHF-C (OR 0.42, 95% CI 0.23-0.79). No significant effects were found in the eHF-W group on any manifestation,nor was there an effect on sensitization with any formula.
Conclusion:
In high-risk children, early intervention using different hydrolyzed formulas has variable preventative effects on asthma, allergic rhinitis and eczema up to adolescence.
Related Concept Videos
02:06Allergic Reactions
01:30Drug Toxicity: Allergic Reactions
01:30Hypersensitivities
Types of Hypersensitivities
Hypersensitivity reactions are categorized into four types: Type 1, Type 2, Type 3, and Type 4. Each type has a distinct mechanism...
01:30Allergic Reactions: Anaphylaxis
01:27Allergic Drug Reactions
01:29Hypersensitivity Reactions: Delayed Hypersensitivity Reactions