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Association of frequent moisturizer use in early infancy with the development of food allergy

Perkin, MR; Logan, K; Marrs, T; Radulovic, S; Craven, J; Boyle, RJ; Chalmers, JR; Williams, HC; Versteeg, SA; van Ree, R; et al. Perkin, MR; Logan, K; Marrs, T; Radulovic, S; Craven, J; Boyle, RJ; Chalmers, JR; Williams, HC; Versteeg, SA; van Ree, R; Lack, G; Flohr, C; EAT Study Team (2021) Association of frequent moisturizer use in early infancy with the development of food allergy. Journal of Allergy and Clinical Immunology, 147 (3). 967-976.e1. ISSN 0091-6749 https://doi.org/10.1016/j.jaci.2020.10.044
SGUL Authors: Perkin, Michael Richard

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Abstract

Background Food allergy is thought to develop through transcutaneous sensitization, especially in the presence of skin barrier impairment and inflammation. Regular moisturizer application to infant skin could potentially promote transcutaneous sensitization and the development of food allergy. Objectives We tested this hypothesis in the Enquiring About Tolerance (EAT) study population. Methods The EAT study was a population-based randomized clinical trial conducted from January 15, 2008, to August 31, 2015, and recruited 1303 exclusively breastfed 3-month-old infants and their families from England and Wales. At enrollment at 3 months, families completed a questionnaire that included questions about frequency and type of moisturizer applied, use of corticosteroid creams, and parental report of dry skin or eczema. Infants were examined for visible eczema at the enrollment visit. Results A statistically significant dose-response relationship was observed between parent-reported moisturization frequency at 3 months of age and the subsequent development of food allergy. Each additional moisturization per week was associated with an adjusted odds ratio of 1.20 (95% CI, 1.13-1.27; P < .0005) for developing food allergy. For infants with no visible eczema at the enrollment visit, the corresponding adjusted odds ratio was 1.18 (95% CI, 1.07-1.30; P = .001) and for those with eczema at the enrollment visit, 1.20 (95% CI, 1.11-1.31; P < .0005). Moisturizer frequency showed similar dose-response relationships with the development of both food and aeroallergen sensitization at 36 months. Conclusions These findings support the notion that regular application of moisturizers to the skin of young infants may promote the development of food allergy through transcutaneous sensitization.

Item Type: Article
Additional Information: © 2020 The Authors. Published by Elsevier Inc. on behalf of the American Academy ofAllergy, Asthma & Immunology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: Journal of Allergy and Clinical Immunology
ISSN: 0091-6749
Dates:
DateEvent
4 March 2021Published
27 October 2020Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
Projects:
Project IDFunderFunder ID
T07051Food Standards Agencyhttp://dx.doi.org/10.13039/501100000354
MC_G1001205Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
NIHRCS/01/2008/00National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
URI: https://openaccess.sgul.ac.uk/id/eprint/112520
Publisher's version: https://doi.org/10.1016/j.jaci.2020.10.044

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