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Gestational Diabetes is Associated with Food Allergen Sensitization in an Inner-City Population
S268 Abstracts
of the Budesonide- and in 88.9% of the Placebo-patients. No SAE’s occurred. The course of symptoms reflected fairly well the activity of the inflammation. Endoscopically, white exudates and red furrows disappeared in parallel with the eosinophilic infiltration, whereas corrugated rings persisted. CONCLUSIONS: A 15-day course with Budesonide is highly effective in inducing a remission in adults with active EoE. Symptoms reflect the degree of inflammation. White exudates and red furrows are associated with active inflammation.
1039
Gestational Diabetes is Associated with Food Allergen Sensitization in an Inner-City Population R. Kumar1, X. Hong2, R. E. Story1, Y. Yu2, J. A. Pongracic1, X. Wang2; 1 Division of Allergy and Immunology, Children’s Memorial Hospital, Chicago, IL, 2Mary-Ann and J Milburn Smith Child Health Research Core, Children’s Memorial Hospital, Chicago, IL. RATIONALE: Obesity and metabolic syndrome are prevalent in innercity populations, as is food allergen sensitization. We sought to determine whether an early life metabolic exposure, gestational diabetes (GDM), modified the risk of food allergen sensitization. METHODS: Term newborns from the Boston Birth Cohort (n 5 748) were prospectively followed from birth to a mean age of 2.8 6 2.2 years. GDM was determined by standardized review of maternal pre- and perinatal medical records. The primary outcome was food allergen sensitization (sIgE 0.35 kUA/L, Phadia Immunocap) to any one of 9 food allergens (egg white, sesame, peanut, soy, milk, shrimp, walnut, cod fish, and wheat). Multivariate stepwise logistic regression models evaluated the association of GDM with the development of food allergen sensitization, adjusting for infant age, gender, c-section, maternal race, family history of atopy, and pets in the home. RESULTS: This is a predominantly low income, minority population. Of 748 term births, 34 (4.5%) were complicated by GDM in-utero and 152 (20%) developed sensitization to food allergens postnatally. The children exposed to GDM in-utero had a 2.3 times increased risk of developing sensitization to food allergens (OR, 95%CI 5 2.3, 1.1-4.6; p 5 0.02). When the analysis was limited to those children with Immunocap measured after 2 years of age, the association was even stronger (OR, 95%CI 5 3.8, 1.211.3; p 5 0.02). The association was consistent across ethnicity. CONCLUSIONS: In this inner-city birth cohort, GDM was independently associated with early childhood sensitization to food. Studies beyond the hygiene hypothesis are needed to further explore early life pathways such as in-utero metabolic disturbances to the development of allergy.
1040
TUESDAY
Protective Effect of Early Fresh Fruit Ingestion on the Development of Food Allergy J. S. Kim1, L. M. Arguelles2, R. Kumar1, J. A. Pongracic1, X. Wang2; 1Division of Allergy & Immunology, Children’s Memorial Hospital, Chicago, IL, 2The Mary Ann and J Milburn Smith Child Health Research Program, Children’s Memorial Hospital and Children’s Memorial Research Center, Chicago, IL. RATIONALE: Food allergy (FA) is increasing in prevalence in Westernized countries but knowledge regarding early life factors remains limited. We sought to evaluate the role of diet on FA development. METHODS: This is part of a family-based study in Chicago, including 286 children with FA and 276 without FA (controls). FA was determined by objective symptoms developing within 2 hours of ingestion to one of 9 foods (cow milk, soybean, egg, wheat, peanut, walnut, codfish, shrimp, sesame), corroborated by positive skin prick test (Multi-Test II, [Decatur, IL]) or ImmunoCAP >0.1 kUA/L (Phadia [Sweden]). Information on introduction of solid food in early childhood was obtained by parental questionnaire interview. Multivariate logistic regressions were performed with adjustment for child’s age, gender, C-section delivery, and breastfeeding for 4 months along with maternal education, family income, parental atopy, and correlations between siblings. RESULTS: The mean age of this sample was 3.6 years (range 0.5-7.0). When examined collectively, solid food introduction before 6 months [OR 0.90 (0.64, 1.29)] was not significantly associated with FA.
J ALLERGY CLIN IMMUNOL FEBRUARY 2009
However, when specific types of food were examined, introduction of fresh fruit before 6 months was highly protective [OR 0.28 (0.11, 0.72)] against FA development. Introduction of jarred fruits [OR 0.92 (0.55, 1.52)] or green/orange vegetables [OR 0.84 (0.42, 1.68)] before 6 months was not protective. CONCLUSIONS: Introduction of fresh fruit prior to 6 months appears to have an independent, protective effect against FA development. Further studies are needed on baby food processing and early food intake, including antioxidant micronutrients, in the development of FA.
1041
Distribution of Intact Peanut Protein and DigestionResistant Ara h 2 Peptide in Human Serum and Saliva J. L. Baumert1, R. K. Bush2, M. B. Levy3, S. J. Koppelman4, J. A. Nordlee1, S. L. Hefle1, S. L. Taylor1; 1Food Allergy Research & Resource Program, University of Nebraska, Lincoln, NE, 2University of Wisconsin Hospital and Clinics, Madison, WI, 3Medical College of Wisconsin, Milwaukee, WI, 4HAL Allergy, Leiden, Netherlands. RATIONALE: Ara h 2 is comparatively resistant to digestion and a digestion-resistant peptide (DRP-Ara h 2) is released in model digestion experiments. The presence of intact peanut protein and/or DRP-Ara h 2 in serum and saliva of humans after ingestion of peanut might help in assessing the risk of an allergic reaction to saliva from kissing or use of shared utensils. METHODS: Ten healthy, non-allergic volunteers (ages 19-50) consumed capsules containing a total of 25 gm of roasted peanut flour (12.75 gm protein). Two additional volunteers, serving as negative controls, consumed capsules containing 25 gm of powdered sugar. Blood and saliva samples were collected at baseline and at various time points up to 24 hours after ingestion. Levels of intact peanut proteins were measured over time using a commercial peanut ELISA. Levels of DRP-Ara h 2 in similar fluids were measured using a uniquely developed inhibition ELISA. RESULTS: DRP-Ara h 2 was detected in the serum of 9 of 10 volunteers (maximum of 248 ng DRP-Ara h 2/ml serum) and in the saliva of 7 of 10 volunteers (maximum of 4890 ng DRP-Ara h 2/ml saliva) for up to 24 hours after ingestion. Intact peanut protein was not detected in either serum or saliva throughout all collection time points. CONCLUSIONS: Demonstration of the stability and distribution of digestion resistant peanut allergens in human body fluids over an extended period of time may provide insight into potential risks posed by exposure to allergenic proteins in saliva.
of the Budesonide- and in 88.9% of the Placebo-patients. No SAE’s occurred. The course of symptoms reflected fairly well the activity of the inflammation. Endoscopically, white exudates and red furrows disappeared in parallel with the eosinophilic infiltration, whereas corrugated rings persisted. CONCLUSIONS: A 15-day course with Budesonide is highly effective in inducing a remission in adults with active EoE. Symptoms reflect the degree of inflammation. White exudates and red furrows are associated with active inflammation.
1039
Gestational Diabetes is Associated with Food Allergen Sensitization in an Inner-City Population R. Kumar1, X. Hong2, R. E. Story1, Y. Yu2, J. A. Pongracic1, X. Wang2; 1 Division of Allergy and Immunology, Children’s Memorial Hospital, Chicago, IL, 2Mary-Ann and J Milburn Smith Child Health Research Core, Children’s Memorial Hospital, Chicago, IL. RATIONALE: Obesity and metabolic syndrome are prevalent in innercity populations, as is food allergen sensitization. We sought to determine whether an early life metabolic exposure, gestational diabetes (GDM), modified the risk of food allergen sensitization. METHODS: Term newborns from the Boston Birth Cohort (n 5 748) were prospectively followed from birth to a mean age of 2.8 6 2.2 years. GDM was determined by standardized review of maternal pre- and perinatal medical records. The primary outcome was food allergen sensitization (sIgE 0.35 kUA/L, Phadia Immunocap) to any one of 9 food allergens (egg white, sesame, peanut, soy, milk, shrimp, walnut, cod fish, and wheat). Multivariate stepwise logistic regression models evaluated the association of GDM with the development of food allergen sensitization, adjusting for infant age, gender, c-section, maternal race, family history of atopy, and pets in the home. RESULTS: This is a predominantly low income, minority population. Of 748 term births, 34 (4.5%) were complicated by GDM in-utero and 152 (20%) developed sensitization to food allergens postnatally. The children exposed to GDM in-utero had a 2.3 times increased risk of developing sensitization to food allergens (OR, 95%CI 5 2.3, 1.1-4.6; p 5 0.02). When the analysis was limited to those children with Immunocap measured after 2 years of age, the association was even stronger (OR, 95%CI 5 3.8, 1.211.3; p 5 0.02). The association was consistent across ethnicity. CONCLUSIONS: In this inner-city birth cohort, GDM was independently associated with early childhood sensitization to food. Studies beyond the hygiene hypothesis are needed to further explore early life pathways such as in-utero metabolic disturbances to the development of allergy.
1040
TUESDAY
Protective Effect of Early Fresh Fruit Ingestion on the Development of Food Allergy J. S. Kim1, L. M. Arguelles2, R. Kumar1, J. A. Pongracic1, X. Wang2; 1Division of Allergy & Immunology, Children’s Memorial Hospital, Chicago, IL, 2The Mary Ann and J Milburn Smith Child Health Research Program, Children’s Memorial Hospital and Children’s Memorial Research Center, Chicago, IL. RATIONALE: Food allergy (FA) is increasing in prevalence in Westernized countries but knowledge regarding early life factors remains limited. We sought to evaluate the role of diet on FA development. METHODS: This is part of a family-based study in Chicago, including 286 children with FA and 276 without FA (controls). FA was determined by objective symptoms developing within 2 hours of ingestion to one of 9 foods (cow milk, soybean, egg, wheat, peanut, walnut, codfish, shrimp, sesame), corroborated by positive skin prick test (Multi-Test II, [Decatur, IL]) or ImmunoCAP >0.1 kUA/L (Phadia [Sweden]). Information on introduction of solid food in early childhood was obtained by parental questionnaire interview. Multivariate logistic regressions were performed with adjustment for child’s age, gender, C-section delivery, and breastfeeding for 4 months along with maternal education, family income, parental atopy, and correlations between siblings. RESULTS: The mean age of this sample was 3.6 years (range 0.5-7.0). When examined collectively, solid food introduction before 6 months [OR 0.90 (0.64, 1.29)] was not significantly associated with FA.
J ALLERGY CLIN IMMUNOL FEBRUARY 2009
However, when specific types of food were examined, introduction of fresh fruit before 6 months was highly protective [OR 0.28 (0.11, 0.72)] against FA development. Introduction of jarred fruits [OR 0.92 (0.55, 1.52)] or green/orange vegetables [OR 0.84 (0.42, 1.68)] before 6 months was not protective. CONCLUSIONS: Introduction of fresh fruit prior to 6 months appears to have an independent, protective effect against FA development. Further studies are needed on baby food processing and early food intake, including antioxidant micronutrients, in the development of FA.
1041
Distribution of Intact Peanut Protein and DigestionResistant Ara h 2 Peptide in Human Serum and Saliva J. L. Baumert1, R. K. Bush2, M. B. Levy3, S. J. Koppelman4, J. A. Nordlee1, S. L. Hefle1, S. L. Taylor1; 1Food Allergy Research & Resource Program, University of Nebraska, Lincoln, NE, 2University of Wisconsin Hospital and Clinics, Madison, WI, 3Medical College of Wisconsin, Milwaukee, WI, 4HAL Allergy, Leiden, Netherlands. RATIONALE: Ara h 2 is comparatively resistant to digestion and a digestion-resistant peptide (DRP-Ara h 2) is released in model digestion experiments. The presence of intact peanut protein and/or DRP-Ara h 2 in serum and saliva of humans after ingestion of peanut might help in assessing the risk of an allergic reaction to saliva from kissing or use of shared utensils. METHODS: Ten healthy, non-allergic volunteers (ages 19-50) consumed capsules containing a total of 25 gm of roasted peanut flour (12.75 gm protein). Two additional volunteers, serving as negative controls, consumed capsules containing 25 gm of powdered sugar. Blood and saliva samples were collected at baseline and at various time points up to 24 hours after ingestion. Levels of intact peanut proteins were measured over time using a commercial peanut ELISA. Levels of DRP-Ara h 2 in similar fluids were measured using a uniquely developed inhibition ELISA. RESULTS: DRP-Ara h 2 was detected in the serum of 9 of 10 volunteers (maximum of 248 ng DRP-Ara h 2/ml serum) and in the saliva of 7 of 10 volunteers (maximum of 4890 ng DRP-Ara h 2/ml saliva) for up to 24 hours after ingestion. Intact peanut protein was not detected in either serum or saliva throughout all collection time points. CONCLUSIONS: Demonstration of the stability and distribution of digestion resistant peanut allergens in human body fluids over an extended period of time may provide insight into potential risks posed by exposure to allergenic proteins in saliva.