The Effect of Early Food Introduction and Skin Emollients on Pollen Sensitization: A Randomized Trial (PreventADALL)...

Area of Science:

• Allergy and Immunology
• Dermatology
• Pediatrics

Background:

• Pollen sensitization can be linked to proteins found in common food allergens.
• Understanding cross-reactivity is crucial for allergy prevention strategies.

Purpose of the Study:

• To investigate if early introduction of foods and skin emollients prevent birch and grass sensitization by age 3.
• To determine if skin barrier function mediates these effects or if season of birth modifies them.

Main Methods:

• A population-based randomized controlled trial involving 2,066 children.
• Interventions included early food introduction (tastes of common allergens) and skin emollients (oil baths, cream).
• Sensitization assessed via specific IgE and skin prick tests; mediation analysis used transepidermal water loss.

Main Results:

• Early food introduction showed no effect on pollen sensitization.
• Skin intervention was associated with an increased risk of birch sensitization (OR 2.38, 95% CI 1.43-3.95).
• A significant indirect effect of skin intervention on sensitization via transepidermal water loss was observed.

Conclusions:

• Early dietary interventions do not prevent pollen sensitization.
• Skin barrier impairment in infancy, potentially exacerbated by emollients, is linked to increased birch sensitization risk.
• No significant modification of effects by season of birth was found.