Keywords: Ovalbumin; breastfeeding; egg allergy; primary prevention.
Abstract:
There is an urgent need to delineate early-life factors protecting against food allergy, a rising epidemic affecting up to 10% of children. Prevention strategies now include early introduction of egg and peanut into infant diet to induce oral tolerance.1 However, recent studies demonstrate a significant proportion of infants already have egg sensitization and clinical reactivity (including anaphylaxis) at 4-6 months of age prior to the first introduction of egg in their solid food diet. This underscores the necessity to identify earlier and safer ways to promote oral tolerance development to food allergens in young infants. In seminal studies, we demonstrated that the presence of hen's egg-derived allergen ovalbumin (OVA) in breast milk induces oral tolerance and prevents allergic reactions in mice. Here, we addressed whether human data support this observation in a study of 88 breastfed infants at high risk for allergy, who were control participants of a larger double-blind randomized controlled trial (RCT), the Infant Fish Oil Supplementation Study, where all the mothers are allergic.