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Allergy march of Chinese children with infantile allergic symptoms: a prospective multi-center study
Qi Gao1, Yi-Xin Ren1, Yong-Ge Liu1
1Allergy Department, Beijing Children's Hospital, Capital Medical University, Beijing, China.
Insights
Many Chinese infants with food allergies develop respiratory issues like asthma and allergic rhinitis (AR). While most outgrow food sensitivities, they often develop new allergies to airborne triggers later.
Area of Science:
- Pediatric Allergy and Immunology
- Clinical Nutrition
- Epidemiology
Background:
- The allergy march describes the progression of allergic diseases from infancy to later childhood.
- Most evidence on the allergy march originates from European populations.
- This study investigates the allergy march in Chinese children with infantile food protein allergy (FPA).
Purpose of the Study:
- To examine the allergy march in Chinese infants diagnosed with FPA.
- To evaluate the impact of different formula interventions on the allergy march.
- To assess the development of respiratory allergies and allergen sensitization over time.
Main Methods:
- 153 infants with FPA were recruited and randomized to receive either amino-acid-based or soy-protein-based formula for 3 months.
- Long-term follow-up included questionnaires, physical examinations, and serum-specific IgE testing.
- Data collection occurred between 2008 and 2010, with follow-up in early school years.
Main Results:
- Physician-diagnosed allergic rhinitis (AR) and asthma prevalence were 43.75% and 23.21%, respectively, by early school age.
- Food sensitization decreased significantly, while aeroallergen sensitization increased from 0% in infancy to 65.57% upon follow-up (P=0.005).
- No significant difference was observed in the allergy march between infants receiving amino-acid-based versus soy-protein-based formula.
Conclusions:
- A significant proportion of Chinese infants with FPA develop respiratory allergies by early school age.
- While food allergies may resolve, sensitization to aeroallergens commonly emerges later.
- Neither amino-acid-based nor soy-protein-based formula demonstrated superiority in mitigating the allergy march.
Background:
Allergy march refers to progression of allergic diseases from infantile food allergy to the development of asthma and allergic rhinitis (AR). Evidence come mostly from studies in European countries. This study aimed to investigate allergy march in Chinese children with infantile food protein allergy (FPA) with a special focus on the effect of different formula interventions.
Methods:
From 2008 to 2010, 153 infants diagnosed with FPA were recruited in five tertiary hospitals across China. They were randomly treated with amino-acid-based formula or soy-protein-based formula for a period of 3 months. Long-term follow-up was performed when they reached early school age, using questionnaires, physical examinations, and serum-specific immunoglobulin E.
Results:
The overall follow-up rate was 73.20%. In patients who reached their early school years, the prevalence of physician-diagnosed AR and asthma were 43.75% and 23.21%, respectively. Only 40% of the subjects remained positive for food sensitizations upon follow-up. Twenty-six subjects receiving aeroallergen screening tests in infancy all proved negative, but upon follow-up, 65.57% were sensitized to aeroallergens (P=0.005). No significant difference between the effects of amino-acid-based formula and soy-protein-based formula on children's allergy march was observed.
Conclusions:
A high proportion (47.32%) of Chinese infants with early allergic symptoms developed respiratory allergies by their early school years. Most food-sensitized infants outgrew their condition several years later, but then aeroallergen sensitization often occurred. Amino-acid-based formula showed no advantages over soy protein-based formula with respect to arresting the allergy march.
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