4.5 Article

The role of short-term grass pollen exposure in food skin-prick test reactivity, food allergy, and eczema flares in children

Journal

PEDIATRIC ALLERGY AND IMMUNOLOGY
Volume 33, Issue 10, Pages -

Publisher

WILEY
DOI: 10.1111/pai.13862

Keywords

eczema; food allergy; food sensitization; grass; pediatrics; pollen

Funding

  1. AnaphylaxiStop
  2. Charles and Sylvia Viertel Medical Research Foundation
  3. Ilhan Food Allergy Foundation
  4. National Health and Medical Research Council [1006215, 491233]
  5. Royal Children's Hospital Foundation [2018-984]
  6. University of Melbourne Developing Research Momentum
  7. Victorian Government's Operational Infrastructure Support Program
  8. Royal Melbourne Hospital

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This study investigated the impact of pollen exposure on food allergy and eczema flares. The study found that increasing grass pollen concentration was associated with an increased risk of food allergy and eczema flares in children.
BackgroundWhile the relationship between pollen and respiratory allergies is well-documented, the role of short-term pollen exposure in food allergy and eczema flares has not previously been explored. We aimed to investigate these associations in a population-based sample of children. MethodsWe investigated 1- (n = 1108) and 6-year-old (n = 675) children in the grass pollen season from the HealthNuts cohort. Grass pollen concentrations were considered on the day of testing (lag 0), up to three days before (lag 1-lag 3) and cumulatively (lag 0-3). Associations between grass pollen and food skin-prick test reactivity (SPT & GE; 2 mm at age 1 year and & GE; 3 mm at age 6 years), eczema flares, challenge-confirmed food allergy, reaction threshold to oral food challenges (OFC), and serum food-specific IgE levels were analyzed using either logistic or quantile regression models. Atopy and family history of allergic disease were considered as potent effect modifiers. ResultsGrass pollen at lag 0-3 (every 20 grains/m(3) increase) was associated with an up to 1.2-fold increased odds of food SPT reactivity and eczema flares in 6-year-olds. In 1-year-olds, the associations were only observed for peanut in those with a family history of food allergy. Increasing grass pollen concentrations were associated with a lower reaction threshold to OFC and higher serum IgE levels in peanut-allergic 1-year-olds only. ConclusionIncreasing grass pollen concentration was associated with increased risk of food SPT reactivity and eczema flares in children. The associations in peanut-allergic infants may be related to immune activation and/or peanut and grass pollen cross-reactivity leading to a lower reaction threshold.

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