How food allergy risk changes as children grow
Food allergy is an important health concern in childhood, and knowing whether an allergy is likely to persist or disappear can affect medical decisions. Sensitization, however, is not the same as an allergy: specific IgE antibodies may be detectable without a child developing symptoms after eating the food in question.
This study in the Allergy journal sheds light on how the risk of food allergies evolves in children as they grow. Researchers from University Hospital St. Pölten analyzed blood samples from 500 mother-child pairs participating in the Canadian CHILD Study. At age 1, 25.3% of the children showed specific IgE sensitization to various foods, and this percentage increased to 40.4% by age 5.
The allergens that triggered sensitization changed over time; while egg and peanut were the primary food sensitizers at age 1, peanut and tree nuts became the main triggers by age 5.
Interestingly, sensitization to environmental allergens like cats, dogs, house dust mites, and grass pollen also rose in early childhood. Peanut and tree nut sensitization followed distinct patterns - around half of the children with peanut sensitization at 12 months continued to show it by age 5, while sensitization to cashew, hazelnut, walnut, and pistachio typically developed later.
However, not all sensitization was permanent; about one in four children lost sensitization to key 2S albumins during the four-year span. These 2S albumins are crucial markers for food allergies that can cause systemic reactions. The study's findings are particularly relevant as oral immunotherapy becomes more common in treating food allergies. This therapy appears to be most effective when initiated early in life.
Thus, understanding whether a sensitization is new, persistent, or disappearing can guide doctors and families in making informed decisions about treatment options. However, it's important to note that this study did not include oral food challenges to confirm actual food allergies, so these patterns only indicate sensitization and do not confirm the resolution of established food allergies in children.
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