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Members Allergy does not develop before birth
Klaus Bønnelykke, M.D., Christian Bressen Pipper, M.Sc., Ph.D. and Hans Bisgaard, M.D.
How do you explain to the parents of a newly diagnosed peanut allergic infant how she developed the allergy after they tell you she has never had peanut? You of course ask about the maternal diet during pregnancy and breastfeeding, looking for the source of exposure. Just last year at the 2007 AAAAI Annual Meeting in San Diego a study was presented stating that early exposure to low levels of peanut in human breast milk or in utero may be a significant risk factor for the development of peanut allergy in infancy. However, the authors of a current study in the March JACI have turned the tables.
Whereas the study cited from last year was based on maternal questionnaires, the authors of this new study analyzed low levels of inhalant and food allergen-specific IgE, antibodies which play an important role in allergies, in cord blood. They found that such IgE was no longer detectable in the blood of infants at 6 months of age and seemed to be the result mothers passing antibodies on to their fetus rather than antibodies being produced by the fetus in the womb. This lead the researchers to question the hypothesis that specific allergies can develop already before birth.
Prenatal origins of allergic disease have been debated in the past and will likely continue to be an area of research. In the meantime, clinicians want to know what to tell the expectant mother about what she can do, or not do, to avoid allergies in her child. These authors conclude that current recommendations about avoidance of allergens during pregnancy are not supported by scientific evidence and should be withdrawn to avoid unnecessary restrictions of the diet of pregnant mothers. This study certainly challenges the concept of prenatal development of allergic disease and thereby, the rationale behind allergen avoidance during pregnancy.
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