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The Relevance of Nutrition for Pediatric Allergy and Immunity
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The Relevance of Nutrition for Pediatric Allergy and Immunity

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Immunology".

Deadline for manuscript submissions: closed (31 October 2022) | Viewed by 45768

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editors

Prof. Dr. R.J. Joost van Neerven

E-Mail Website
Guest Editor
Cell Biology and Immunology Group, Wageningen University & Research, Wageningen, The Netherlands
Interests: mucosal immunology; allergy; asthma; food allergy; nutrition; dairy
Special Issues, Collections and Topics in MDPI journals
Dr. Janneke Ruinemans-Koerts

E-Mail Website
Guest Editor
Cell Biology and Immunology Group, Wageningen University & Research, Wageningen, The Netherlands
Interests: (food) allergy; nutrition; diary; diagnostics

Special Issue Information

Dear Colleagues,

The purpose of this Special Issue, “The Relevance of Nutrition for Pediatric Allergy and Immunity”, is to provide an overview of the role of the relevance of nutrition in early life to support immune development to prevent infections and the development of allergy.

The development of the immune system in early life is essential to shape an immune system that can provide immunity against infection, and that does not allow the development of allergies. The first three years (or 1000 days) seem to be crucial for the development of the immune system.

The prevalence of asthma, rhinitis and food allergy has increased tremendously in recent decades. The increase in food allergies and the chance of the development of other allergies with a negative impact on the quality of life have urged us to understand the way immune systems can be influenced at an early stage.

Different factors have been known to influence the development of the immune system of the newborn in order to respond to infection, but also to tolerate food allergens; these range from breast feeding and nutrient supplementation to the shaping of the microbiota and their metabolic activities. On the other hand, the early introduction of highly allergenic foods can also prevent food allergies and induce tolerance.

What are the immunomodulatory mechanisms of these nutritional factors? Can nutrition also play an active role in immunotherapy? Can nutrition help protect against gastrointestinal and respiratory tract infections in early life?

This Special Issue will touch upon the many aspects that relate to nutritional pediatric allergy and immunity, with a focus on three different questions:

  1. Can nutrition in early life help to prevent (food) allergies?
  2. Can early life nutrition help to support immune development and prevent infections?
  3. What is the role of the early introduction of food components in the prevention of food allergies?

The topics covered should range from epidemiology, breastfeeding and early life nutrition, to effects on microbiota, infection, allergy, asthma, and the mechanisms of immunomodulation by (the early introduction of) nutrition on infections and the development of (food) allergies.

Kind regards,

Prof. Dr. R.J. Joost van Neerven
Dr. Janneke Ruinemans-Koerts
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Allergy
  • Asthma
  • Breastfeeding
  • Early life nutrition
  • Epidemiology
  • Food allergy
  • Early food introduction
  • Food immunotherapy
  • Gastrointestinal infection
  • Immune development
  • Infant
  • Maternal diet
  • Mechanism
  • Microbiota, SCFA and other metabolites
  • Milk
  • Nutrition
  • Tolerance (oral)
  • Respiratory infection
  • Toddler

Published Papers (16 papers)

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Editorial

Jump to: Research, Review, Other

3 pages, 198 KiB  
Editorial
The Relevance of Nutrition for Pediatric Allergy and Immunity
by R. J. Joost van Neerven and Janneke Ruinemans-Koerts
Nutrients 2023, 15(8), 1881; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15081881 - 13 Apr 2023
Viewed by 1163
Abstract
The development of the immune system in early life is essential to shape an immune system [...] Full article
(This article belongs to the Special Issue The Relevance of Nutrition for Pediatric Allergy and Immunity)

Research

Jump to: Editorial, Review, Other

17 pages, 3248 KiB  
Article
Milk Allergen Micro-Array (MAMA) for Refined Detection of Cow’s-Milk-Specific IgE Sensitization
by Victoria Garib, Daria Trifonova, Raphaela Freidl, Birgit Linhart, Thomas Schlederer, Nikolaos Douladiris, Alexander Pampura, Daria Dolotova, Tatiana Lepeshkova, Maia Gotua, Evgeniy Varlamov, Evgeny Beltyukov, Veronika Naumova, Styliani Taka, Alina Kiyamova, Stefani Katsamaki, Alexander Karaulov and Rudolf Valenta
Nutrients 2023, 15(10), 2401; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15102401 - 21 May 2023
Cited by 5 | Viewed by 1669
Abstract
Background: Immunoglobulin-E(IgE)-mediated hypersensitivity to cow’s milk allergens is a frequent cause of severe and life-threatening anaphylactic reactions. Besides case histories and controlled food challenges, the detection of the IgE antibodies specific to cow’s milk allergens is important for the diagnosis of cow-milk-specific IgE [...] Read more.
Background: Immunoglobulin-E(IgE)-mediated hypersensitivity to cow’s milk allergens is a frequent cause of severe and life-threatening anaphylactic reactions. Besides case histories and controlled food challenges, the detection of the IgE antibodies specific to cow’s milk allergens is important for the diagnosis of cow-milk-specific IgE sensitization. Cow´s milk allergen molecules provide useful information for the refined detection of cow-milk-specific IgE sensitization. Methods: A micro-array based on ImmunoCAP ISAC technology was developed and designated milk allergen micro-array (MAMA), containing a complete panel of purified natural and recombinant cow’s milk allergens (caseins, α-lactalbumin, β-lactoglobulin, bovine serum albumin-BSA and lactoferrin), recombinant BSA fragments, and α-casein-, α-lactalbumin- and β-lactoglobulin-derived synthetic peptides. Sera from 80 children with confirmed symptoms related to cow’s milk intake (without anaphylaxis: n = 39; anaphylaxis with a Sampson grade of 1–3: n = 21; and anaphylaxis with a Sampson grade of 4–5: n = 20) were studied. The alterations in the specific IgE levels were analyzed in a subgroup of eleven patients, i.e., five who did not and six who did acquire natural tolerance. Results: The use of MAMA allowed a component-resolved diagnosis of IgE sensitization in each of the children suffering from cow’s-milk-related anaphylaxis according to Sampson grades 1–5 requiring only 20–30 microliters of serum. IgE sensitization to caseins and casein-derived peptides was found in each of the children with Sampson grades of 4–5. Among the grade 1–3 patients, nine patients showed negative reactivity to caseins but showed IgE reactivity to alpha-lactalbumin (n = 7) or beta-lactoglobulin (n = 2). For certain children, an IgE sensitization to cryptic peptide epitopes without detectable allergen-specific IgE was found. Twenty-four children with cow-milk-specific anaphylaxis showed additional IgE sensitizations to BSA, but they were all sensitized to either caseins, alpha-lactalbumin, or beta-lactoglobulin. A total of 17 of the 39 children without anaphylaxis lacked specific IgE reactivity to any of the tested components. The children developing tolerance showed a reduction in allergen and/or peptide-specific IgE levels, whereas those remaining sensitive did not. Conclusions: The use of MAMA allows for the detection, using only a few microliters of serum, of IgE sensitization to multiple cow’s milk allergens and allergen-derived peptides in cow-milk-allergic children with cow-milk-related anaphylaxis. Full article
(This article belongs to the Special Issue The Relevance of Nutrition for Pediatric Allergy and Immunity)
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12 pages, 962 KiB  
Article
Proposal to Screen for Zinc and Selenium in Patients with IgA Deficiency
by Soraya Regina Abu Jamra, Camila Gomes Komatsu, Fernando Barbosa, Jr., Persio Roxo-Junior and Anderson Marliere Navarro
Nutrients 2023, 15(9), 2145; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15092145 - 29 Apr 2023
Viewed by 1850
Abstract
The increase in life expectancy can be a consequence of the world’s socioeconomic, sanitary and nutritional conditions. Some studies have demonstrated that individuals with a satisfactory diet variety score present a lower risk of malnutrition and better health status. Zinc and selenium are [...] Read more.
The increase in life expectancy can be a consequence of the world’s socioeconomic, sanitary and nutritional conditions. Some studies have demonstrated that individuals with a satisfactory diet variety score present a lower risk of malnutrition and better health status. Zinc and selenium are important micronutrients that play a role in many biochemical and physiological processes of the immune system. Deficient individuals can present both innate and adaptive immunity abnormalities and increased susceptibility to infections. Primary immunodeficiency diseases, also known as inborn errors of immunity, are genetic disorders classically characterized by an increased susceptibility to infection and/or dysregulation of a specific immunologic pathway. IgA deficiency (IgAD) is the most common primary antibody deficiency. This disease is defined as serum IgA levels lower than 7 mg/dL and normal IgG and IgM levels in individuals older than four years. Although many patients are asymptomatic, selected patients suffer from different clinical complications, such as pulmonary infections, allergies, autoimmune diseases, gastrointestinal disorders and malignancy. Knowing the nutritional status as well as the risk of zinc and selenium deficiency could be helpful for the management of IgAD patients. Objectives: to investigate the anthropometric, biochemical, and nutritional profiles and the status of zinc and selenium in patients with IgAD. Methods: in this descriptive study, we screened 16 IgAD patients for anthropometric and dietary data, biochemical evaluation and determination of plasma and erythrocyte levels of zinc and selenium. Results: dietary intake of zinc and selenium was adequate in 75% and 86% of the patients, respectively. These results were consistent with the plasma levels (adequate levels of zinc in all patients and selenium in 50% of children, 25% of adolescents and 100% of adults). However, erythrocyte levels were low for both micronutrients (deficiency for both in 100% of children, 75% of adolescents and 25% of adults). Conclusion: our results highlight the elevated prevalence of erythrocyte zinc and selenium deficiency in patients with IgAD, and the need for investigation of these micronutrients in their follow-up. Full article
(This article belongs to the Special Issue The Relevance of Nutrition for Pediatric Allergy and Immunity)
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19 pages, 2661 KiB  
Article
Extensively Hydrolyzed Hypoallergenic Infant Formula with Retained T Cell Reactivity
by Raphaela Freidl, Victoria Garib, Birgit Linhart, Elisabeth M. Haberl, Isabelle Mader, Zsolt Szépfalusi, Klara Schmidthaler, Nikos Douladiris, Alexander Pampura, Evgeniy Varlamov, Tatiana Lepeshkova, Evgeny Beltyukov, Veronika Naumova, Styliani Taka, Dina Nosova, Olga Guliashko, Michael Kundi, Alina Kiyamova, Stefani Katsamaki and Rudolf Valenta
Nutrients 2023, 15(1), 111; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15010111 - 26 Dec 2022
Cited by 4 | Viewed by 2999
Abstract
Background: Immunoglobulin E (IgE)-mediated cow’s milk allergy (CMA) can be life-threatening and affects up to 3% of children. Hypoallergenic infant formulas based on hydrolyzed cow’s milk protein are increasingly considered for therapy and prevention of cow’s milk allergy. The aim of this study [...] Read more.
Background: Immunoglobulin E (IgE)-mediated cow’s milk allergy (CMA) can be life-threatening and affects up to 3% of children. Hypoallergenic infant formulas based on hydrolyzed cow’s milk protein are increasingly considered for therapy and prevention of cow’s milk allergy. The aim of this study was to investigate the allergenic activity and ability to induce T cell and cytokine responses of an infant formula based on extensively hydrolyzed cow’s milk protein (whey) (eHF, extensively hydrolyzed formula) supplemented with Galactooligosaccharides (GOS) and Limosilactobacillus fermentum CECT5716 (LF) to determine its suitability for treatment and prevention of CMA. Methods: eHF and standard protein formula based on intact cow’s milk proteins (iPF) with or without Galactooligosaccharide (GOS) and Limosilactobacillus fermentum CECT5716 (LF) were investigated with allergen-specific antibodies and tested for IgE reactivity and allergenic activity in basophil degranulation assays with sera from cow’s milk (CM)-allergic infants/children. Their ability to stimulate T cell proliferation and cytokine secretion in cultured peripheral blood mononuclear cells (PBMC) from CM-allergic infants and children was studied with a FACS-based carboxyfluorescein diacetate succinimidyl ester (CFSE) dilution assay and xMAP Luminex fluorescent bead-based technology, respectively. Results: An eHF supplemented with GOS and LF exhibiting almost no IgE reactivity and allergenic activity was identified. This eHF induced significantly lower inflammatory cytokine secretion as compared to an intact protein-based infant formula but retained T cell reactivity. Conclusions: Due to strongly reduced allergenic activity and induction of inflammatory cytokine secretion but retained T cell reactivity, the identified eHF may be used for treatment and prevention of CMA by induction of specific T cell tolerance. Full article
(This article belongs to the Special Issue The Relevance of Nutrition for Pediatric Allergy and Immunity)
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17 pages, 1911 KiB  
Article
Direct Binding of Bovine IgG-Containing Immune Complexes to Human Monocytes and Their Putative Role in Innate Immune Training
by Mojtaba Porbahaie, Huub F. J. Savelkoul, Cornelis A. M. de Haan, Malgorzata Teodorowicz and R. J. Joost van Neerven
Nutrients 2022, 14(21), 4452; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14214452 - 22 Oct 2022
Cited by 1 | Viewed by 2024
Abstract
Bovine milk IgG (bIgG) was shown to bind to and neutralize the human respiratory synovial virus (RSV). In animal models, adding bIgG prevented experimental RSV infection and increased the number of activated T cells. This enhanced activation of RSV-specific T cells may be [...] Read more.
Bovine milk IgG (bIgG) was shown to bind to and neutralize the human respiratory synovial virus (RSV). In animal models, adding bIgG prevented experimental RSV infection and increased the number of activated T cells. This enhanced activation of RSV-specific T cells may be explained by receptor-mediated uptake and antigen presentation after binding of bIgG-RSV immune complexes (ICs) with FcγRs (primarily CD32) on human immune cells. This indirect effect of bIgG ICs on activation of RSV-specific T cells was confirmed previously in human T cell cultures. However, the direct binding of ICs to antigen-presenting cells has not been addressed. As bovine IgG can induce innate immune training, we hypothesized that this effect could be caused more efficiently by ICs. Therefore, we characterized the expression of CD16, CD32, and CD64 on (peripheral blood mononuclear cells (PBMCs), determined the optimal conditions to form ICs of bIgG with the RSV preF protein, and demonstrated the direct binding of these ICs to human CD14+ monocytes. Similarly, bIgG complexed with a murine anti-bIgG mAb also bound efficiently to the monocytes. To evaluate whether the ICs could induce innate immune training more efficiently than bIgG itself, the resulted ICs, as well as bIgG, were used in an in vitro innate immune training model. Training with the ICs containing bIgG and RSV preF protein—but not the bIgG alone—induced significantly higher TNF-α production upon LPS and R848 stimulation. However, the preF protein itself nonsignificantly increased cytokine production as well. This may be explained by its tropism to the insulin-like growth factor receptor 1 (IGFR1), as IGF has been reported to induce innate immune training. Even so, these data suggest a role for IgG-containing ICs in inducing innate immune training after re-exposure to pathogens. However, as ICs of bIgG with a mouse anti-bIgG mAb did not induce this effect, further research is needed to confirm the putative role of bIgG ICs in enhancing innate immune responses in vivo. Full article
(This article belongs to the Special Issue The Relevance of Nutrition for Pediatric Allergy and Immunity)
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10 pages, 808 KiB  
Article
Association of Exclusive Breastfeeding with Asthma Risk among Preschool Children: An Analysis of National Health and Nutrition Examination Survey Data, 1999 to 2014
by Chi-Nien Chen, Yu-Chen Lin, Shau-Ru Ho, Chun-Min Fu, An-Kuo Chou and Yao-Hsu Yang
Nutrients 2022, 14(20), 4250; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14204250 - 12 Oct 2022
Cited by 5 | Viewed by 1821
Abstract
Breastmilk contains many important nutrients, anti-inflammatory agents, and immunomodulators. It is the preferred nutrition source for infants. However, the association of the duration of exclusive breastmilk feeding (BMF) with asthma development is unclear. Data on children from the United States who participated in [...] Read more.
Breastmilk contains many important nutrients, anti-inflammatory agents, and immunomodulators. It is the preferred nutrition source for infants. However, the association of the duration of exclusive breastmilk feeding (BMF) with asthma development is unclear. Data on children from the United States who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014 were obtained. We examined the association between the duration of exclusive BMF and asthma in 6000 children (3 to 6 years old). After calculating the duration of exclusive breastfeeding according to answers to NHANES questionnaires, the estimated duration of exclusive BMF was divided into five categories: never breastfed or BMF for 0 to 2 months after birth; BMF for 2 to 4 months after birth; BMF for 4 to 6 months after birth; and BMF for ≥6 months after birth. The overall prevalence of asthma in children aged 3 to 6 years was approximately 13.9%. The risk of asthma was lower in children with an exclusive BMF duration of 4 to 6 months (aOR, 0.69; 95% CI, 0.48–0.98), after adjustment for potentially confounding factors. Subgroup analysis revealed that children of younger ages (3 to 4 years old) benefited most from the protective effects of exclusive BMF for 4 to 6 months (aOR, 0.47; 95% CI, 0.27, 0.8). We found that exclusive BMF, especially BMF for 4 to 6 months, is associated with a decreased risk of asthma in preschool-age children. The protective effect appeared to be diminished in older children. The potential mechanism needs further investigation. Full article
(This article belongs to the Special Issue The Relevance of Nutrition for Pediatric Allergy and Immunity)
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9 pages, 927 KiB  
Article
House Dust Mite Exposure through Human Milk and Dust: What Matters for Child Allergy Risk?
by Patricia Macchiaverni, Ulrike Gehring, Akila Rekima, Alet H. Wijga and Valerie Verhasselt
Nutrients 2022, 14(10), 2095; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14102095 - 17 May 2022
Cited by 1 | Viewed by 2484
Abstract
Allergies are major noncommunicable diseases associated with significant morbidity, reduced quality of life, and high healthcare costs. Despite decades of research, it is still unknown if early-life exposure to indoor allergens plays a role in the development of IgE-mediated allergy and asthma. The [...] Read more.
Allergies are major noncommunicable diseases associated with significant morbidity, reduced quality of life, and high healthcare costs. Despite decades of research, it is still unknown if early-life exposure to indoor allergens plays a role in the development of IgE-mediated allergy and asthma. The objective of this study is to contribute to the identification of early-life risk factors for developing allergy. We addressed whether two different sources of house dust mite Der p 1 allergen exposure during early life, i.e., human milk and dust, have different relationships with IgE levels and asthma outcomes in children. We performed longitudinal analyses in 249 mother–child pairs using data from the PIAMA birth cohort. Asthma symptoms and serum total and specific IgE levels in children were available for the first 16 years of life. Der p 1 levels were measured in human milk and dust samples from infant mattresses. We observed that infant exposure to Der p 1 through human milk was associated with an increased risk of having high levels of serum IgE (top tertile > 150 kU/mL) in childhood as compared to infants exposed to human milk with undetectable Der p 1 [adjusted OR (95% CI) 1.83 (1.05–3.20) p = 0.0294]. The Der p 1 content in infant mattress dust was not associated with increased IgE levels in childhood. The risk of asthma and Der p 1 sensitization was neither associated with Der p 1 in human milk nor with Der p 1 in dust. In conclusion, high levels of IgE in childhood were associated with Der p 1 exposure through human milk but not exposure from mattress dust. This observation suggests that human milk is a source of Der p 1 exposure that is relevant to allergy development and fosters the need for research on the determinants of Der p 1 levels in human milk. Full article
(This article belongs to the Special Issue The Relevance of Nutrition for Pediatric Allergy and Immunity)
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Graphical abstract

22 pages, 3396 KiB  
Article
Early Introduction of Multi-Allergen Mixture for Prevention of Food Allergy: Pilot Study
by Antonia Zoe Quake, Taryn Audrey Liu, Rachel D’Souza, Katherine G. Jackson, Margaret Woch, Afua Tetteh, Vanitha Sampath, Kari C. Nadeau, Sayantani Sindher, R. Sharon Chinthrajah and Shu Cao
Nutrients 2022, 14(4), 737; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14040737 - 09 Feb 2022
Cited by 17 | Viewed by 4663 | Correction
Abstract
The incidence and prevalence of food allergy (FA) is increasing. While several studies have established the safety and efficacy of early introduction of single allergens in infants for the prevention of FA, the exact dose, frequency, and number of allergens that can be [...] Read more.
The incidence and prevalence of food allergy (FA) is increasing. While several studies have established the safety and efficacy of early introduction of single allergens in infants for the prevention of FA, the exact dose, frequency, and number of allergens that can be safely introduced to infants, particularly in those at high or low risk of atopy, are still unclear. This 1-year pilot study evaluated the safety of the early introduction of single foods (milk, egg, or peanut) vs. two foods (milk/egg, egg/peanut, milk/peanut) vs. multiple foods (milk/egg/peanut/cashew/almond/shrimp/walnut/wheat/salmon/hazelnut at low, medium, or high doses) vs. no early introduction in 180 infants between 4–6 months of age. At the end of the study, they were evaluated for plasma biomarkers associated with food reactivity via standardized blood tests. Two to four years after the start of the study, participants were evaluated by standardized food challenges. The serving sizes for the single, double, and low dose mixtures were 300 mg total protein per day. The serving sizes for the medium and high dose mixtures were 900 mg and 3000 mg total protein, respectively. Equal parts of each protein were used for double or mixture foods. All infants were breastfed until at least six months of age. The results demonstrate that infants at either high or low risk for atopy were able to tolerate the early introduction of multiple allergenic foods with no increases in any safety issues, including eczema, FA, or food protein induced enterocolitis. The mixtures of foods at either low, medium, or high doses demonstrated trends for improvement in food challenge reactivity and plasma biomarkers compared to single and double food introductions. The results of this study suggest that the early introduction of foods, particularly simultaneous mixtures of many allergenic foods, may be safe and efficacious for preventing FA and can occur safely. These results need to be confirmed by larger randomized controlled studies. Full article
(This article belongs to the Special Issue The Relevance of Nutrition for Pediatric Allergy and Immunity)
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17 pages, 1614 KiB  
Article
Proportions of Polyunsaturated Fatty Acids in Umbilical Cord Blood at Birth Are Related to Atopic Eczema Development in the First Year of Life
by Malin Barman, Mia Stråvik, Karin Broberg, Anna Sandin, Agnes E. Wold and Ann-Sofie Sandberg
Nutrients 2021, 13(11), 3779; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13113779 - 25 Oct 2021
Cited by 8 | Viewed by 2417
Abstract
Atopic eczema, the most common atopic disease in infants, may pave the way for sensitization and allergy later in childhood. Fatty acids have immune-regulating properties and may regulate skin permeability. Here we examine whether the proportions of fatty acids among the infant and [...] Read more.
Atopic eczema, the most common atopic disease in infants, may pave the way for sensitization and allergy later in childhood. Fatty acids have immune-regulating properties and may regulate skin permeability. Here we examine whether the proportions of fatty acids among the infant and maternal plasma phospholipids at birth were associated with maternal dietary intake during pregnancy and development of atopic eczema during the first year of age in the Nutritional impact on Immunological maturation during Childhood in relation to the Environment (NICE) birth cohort. Dietary data were collected with a semi-quantitative food frequency questionnaire, fatty acids were measured with GC-MS and atopic eczema was diagnosed by a pediatric allergologist at 12 months of age. We found that higher proportions of n-6 PUFAs (including arachidonic acid) but lower proportions of n-3 PUFAs (including DPA) in the infant’s phospholipids at birth were associated with an increased risk of atopic eczema at 12 months of age. The n-6 and n-3 PUFAs were related to maternal intake of meat and fish, respectively. Our results suggest that prenatal exposure to unsaturated fatty acids is associated with eczema development in the infant. Maternal diet during pregnancy may partly explain the fatty acid profiles in utero. Full article
(This article belongs to the Special Issue The Relevance of Nutrition for Pediatric Allergy and Immunity)
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Review

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12 pages, 505 KiB  
Review
Breastfeeding and Allergy Effect Modified by Genetic, Environmental, Dietary, and Immunological Factors
by Hanna Danielewicz
Nutrients 2022, 14(15), 3011; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14153011 - 22 Jul 2022
Cited by 10 | Viewed by 2278
Abstract
Breastfeeding (BF) is the most natural mode of nutrition. Its beneficial effect has been revealed in terms of both the neonatal period and those of lifelong effects. However, as for protection against allergy, there is not enough data. In the current narrative review, [...] Read more.
Breastfeeding (BF) is the most natural mode of nutrition. Its beneficial effect has been revealed in terms of both the neonatal period and those of lifelong effects. However, as for protection against allergy, there is not enough data. In the current narrative review, the literature within the last five years from clinical trials and population-based studies on breastfeeding and allergy from different aspects was explored. The aim of this review was to explain how different factors could contribute to the overall effect of BF. Special consideration was given to accompanying exposure to cow milk, supplement use, the introduction of solid foods, microbiota changes, and the epigenetic function of BF. Those factors seem to be modifying the impact of BF. We also identified studies regarding BF in atopic mothers, with SCFA as a main player explaining differences according to this status. Conclusion: Based on the population-based studies, breastfeeding could be protective against some allergic phenotypes, but the results differ within different study groups. According to the new research in that matter, the effect of BF could be modified by different genetic (HMO composition), environmental (cesarean section, allergen exposure), dietary (SCFA, introduction of solid food), and immunologic factors (IgG, IgE), thus partially explaining the variance. Full article
(This article belongs to the Special Issue The Relevance of Nutrition for Pediatric Allergy and Immunity)
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18 pages, 307 KiB  
Review
Relevance of Early Introduction of Cow’s Milk Proteins for Prevention of Cow’s Milk Allergy
by Laurien Ulfman, Angela Tsuang, Aline B. Sprikkelman, Anne Goh and R. J. Joost van Neerven
Nutrients 2022, 14(13), 2659; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14132659 - 27 Jun 2022
Cited by 10 | Viewed by 2892
Abstract
Food allergy incidence has increased worldwide over the last 20 years. For prevention of food allergy, current guidelines do not recommend delaying the introduction of allergenic foods. Several groundbreaking studies, such as the Learning Early About Peanut Allergy study, showed that the relatively [...] Read more.
Food allergy incidence has increased worldwide over the last 20 years. For prevention of food allergy, current guidelines do not recommend delaying the introduction of allergenic foods. Several groundbreaking studies, such as the Learning Early About Peanut Allergy study, showed that the relatively early introduction of this allergenic food between 4–6 months of age reduces the risk of peanut allergy. However, less is known about the introduction of cow’s milk, as many children already receive cow’s-milk-based formula much earlier in life. This can be regular cow’s milk formula with intact milk proteins or hydrolyzed formulas. Several recent studies have investigated the effects of early introduction of cow’s-milk-based formulas with intact milk proteins on the development of cow’s milk allergy while breastfeeding. These studies suggest that depending on the time of introduction and the duration of administration of cow’s milk, the risk of cow’s milk allergy can be reduced (early introduction) or increased (very early introduction followed by discontinuation). The aim of this narrative review is to summarize these studies and to discuss the impact of early introduction of intact cow’s milk protein—as well as hydrolyzed milk protein formulas—and the development of tolerance versus allergy towards cow’s milk proteins. Full article
(This article belongs to the Special Issue The Relevance of Nutrition for Pediatric Allergy and Immunity)
10 pages, 836 KiB  
Review
Early Introduction of Allergenic Foods and the Prevention of Food Allergy
by Brit Trogen, Samantha Jacobs and Anna Nowak-Wegrzyn
Nutrients 2022, 14(13), 2565; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14132565 - 21 Jun 2022
Cited by 18 | Viewed by 4762
Abstract
The increasing prevalence of food allergies is a growing public health problem. For children considered high risk of developing food allergy (particularly due to the presence of other food allergies or severe eczema), the evidence for the early introduction of allergenic foods, and [...] Read more.
The increasing prevalence of food allergies is a growing public health problem. For children considered high risk of developing food allergy (particularly due to the presence of other food allergies or severe eczema), the evidence for the early introduction of allergenic foods, and in particular peanut and egg, is robust. In such cases, the consensus is clear that not only should such foods not be delayed, but that they should be introduced at approximately 4 to 6 months of age in order to minimize the risk of food allergy development. The early introduction of allergenic foods appears to be an effective strategy for minimizing the public health burden of food allergy, though further studies on the generalizability of this approach in low-risk populations is needed. Full article
(This article belongs to the Special Issue The Relevance of Nutrition for Pediatric Allergy and Immunity)
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14 pages, 1031 KiB  
Review
The Foetal Origins of Allergy and Potential Nutritional Interventions to Prevent Disease
by John O. Warner and Jill Amanda Warner
Nutrients 2022, 14(8), 1590; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14081590 - 12 Apr 2022
Cited by 10 | Viewed by 3310
Abstract
The first nine months from conception to birth involves greater changes than at any other time in life, affecting organogenesis, endocrine, metabolic and immune programming. It has led to the concept that the “first 1000 days” from conception to the second birthday are [...] Read more.
The first nine months from conception to birth involves greater changes than at any other time in life, affecting organogenesis, endocrine, metabolic and immune programming. It has led to the concept that the “first 1000 days” from conception to the second birthday are critical in establishing long term health or susceptibility to disease. Immune ontogeny is predominantly complete within that time and is influenced by the maternal genome, health, diet and environment pre-conception and during pregnancy and lactation. Components of the immunological protection of the pregnancy is the generation of Th-2 and T-regulatory cytokines with the consequence that neonatal adaptive responses are also biased towards Th-2 (allergy promoting) and T-regulatory (tolerance promoting) responses. Normally after birth Th-1 activity increases while Th-2 down-regulates and the evolving normal human microbiome likely plays a key role. This in turn will have been affected by maternal health, diet, exposure to antibiotics, mode of delivery, and breast or cow milk formula feeding. Complex gene/environment interactions affect outcomes. Many individual nutrients affect immune mechanisms and variations in levels have been associated with susceptibility to allergic disease. However, intervention trials employing single nutrient supplementation to prevent allergic disease have not achieved the expected outcomes suggested by observational studies. Investigation of overall dietary practices including fresh fruit and vegetables, fish, olive oil, lower meat intake and home cooked foods as seen in the Mediterranean and other healthy diets have been associated with reduced prevalence of allergic disease. This suggests that the “soup” of overall nutrition is more important than individual nutrients and requires further investigation both during pregnancy and after the infant has been weaned. Amongst all the potential factors affecting allergy outcomes, modification of maternal and infant nutrition and the microbiome are easier to employ than changing other aspects of the environment but require large controlled trials before recommending changes to current practice. Full article
(This article belongs to the Special Issue The Relevance of Nutrition for Pediatric Allergy and Immunity)
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2 pages, 733 KiB  
Correction
Correction: Quake et al. Early Introduction of Multi-Allergen Mixture for Prevention of Food Allergy: Pilot Study. Nutrients 2022, 14, 737
by Antonia Zoe Quake, Taryn Audrey Liu, Rachel D’Souza, Katherine G. Jackson, Margaret Woch, Afua Tetteh, Vanitha Sampath, Kari C. Nadeau, Sayantani Sindher, R. Sharon Chinthrajah and Shu Cao
Nutrients 2023, 15(1), 135; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15010135 - 28 Dec 2022
Cited by 3 | Viewed by 1688
Abstract
In the original publication [...] Full article
(This article belongs to the Special Issue The Relevance of Nutrition for Pediatric Allergy and Immunity)
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12 pages, 916 KiB  
Systematic Review
Do Probiotics in Pregnancy Reduce Allergies and Asthma in Infancy and Childhood? A Systematic Review
by Alexander S. Colquitt, Elizabeth A. Miles and Philip C. Calder
Nutrients 2022, 14(9), 1852; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14091852 - 28 Apr 2022
Cited by 14 | Viewed by 4477
Abstract
The maternal immune system is very important in the development of the foetal immune system. Probiotics have been shown to help regulate immune responses. Therefore, it is possible that the administration of probiotics to pregnant women could influence the development of the foetal [...] Read more.
The maternal immune system is very important in the development of the foetal immune system. Probiotics have been shown to help regulate immune responses. Therefore, it is possible that the administration of probiotics to pregnant women could influence the development of the foetal immune system, reducing the likelihood of infants and children developing an allergic condition. The aim of this research was to conduct a systematic review to determine whether administering probiotics to pregnant women can reduce the incidence of allergic disease in their children. Medline, CINAHL and Embase databases were searched for randomised controlled trials (RCTs) that compared supplementation of probiotics to pregnant women to a placebo control and recorded the presentation of allergic conditions in their children. Data extracted from the study reports included their characteristics and findings. Study quality and risk of bias were assessed. From a total of 850 articles identified in the search, 6 were eligible for inclusion in this review. Two studies found no effect of maternal probiotics on the outcomes measured, two studies found that the incidence of eczema or atopic dermatitis (AD) was reduced by maternal probiotics, one study found no effect on the overall incidence of atopic sensitisation, but a reduction in a subgroup of children at high hereditary risk of allergic disease, and one study found no effect in an intention to treat analysis, but a reduction in AD in complete case analysis. The results of these studies are inconsistent but demonstrate that probiotics may have the potential to reduce infant allergies when administered prenatally, particularly in children at high risk of allergy development. There is a need for further larger-scale studies to be performed in order to provide a more definitive answer. Such studies should focus on at-risk groups. Full article
(This article belongs to the Special Issue The Relevance of Nutrition for Pediatric Allergy and Immunity)
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6 pages, 232 KiB  
Opinion
Partial Hydrolyzed Protein as a Protein Source for Infant Feeding: Do or Don’t?
by Yvan Vandenplas, Janusz Ksiażyk, Manuel Sanchez Luna, Natalia Migacheva, Jean-Charles Picaud, Luca A. Ramenghi, Atul Singhal and Martin Wabitsch
Nutrients 2022, 14(9), 1720; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14091720 - 21 Apr 2022
Cited by 6 | Viewed by 3464
Abstract
Exclusive breastfeeding until the age of six months is the recommended feeding method for all infants. However, this is not possible for every infant. Therefore, a second choice of feeding, as close as possible to the gold standard, is needed. For historical reasons, [...] Read more.
Exclusive breastfeeding until the age of six months is the recommended feeding method for all infants. However, this is not possible for every infant. Therefore, a second choice of feeding, as close as possible to the gold standard, is needed. For historical reasons, this has been cow’s-milk-based feeding. This paper discusses if this second-choice feeding method should contain intact protein or partially hydrolyzed proteins. The limited data available indicates that mother’s milk is relatively rich in bioactive peptides. Whether partially hydrolyzed protein might be a protein source closer to human milk protein content than intact cow’s milk needs further research. However, more research on protein and bioactive peptides in mother’s milk should be a priority for future scientific development in this field. Results of such research will also provide an answer to the question of which option would be the best second choice for infant feeding if sufficient breast milk is not available. Full article
(This article belongs to the Special Issue The Relevance of Nutrition for Pediatric Allergy and Immunity)
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