Highlights from Guest Lecture by Dr. Katrina Allen
November 9, 2016
Katie Allen, MD, PhD is Theme Director of Population Health and Group Leader of Gastro and Food Allergy at Murdoch Childrens Research Institute in Australia. She is an inaugural Fellow of the Australian Academy of Health and Medical Science and Chief Investigator on five National Health and Medical Research Council funded studies all of which seek to understand factors, such as gene-environment interactions and epigenetic changes, that might explain the new allergy epidemic and the observed increases in allergies in the population. Dr. Allen is also Director of the NHMRC funded Australian Centre of Food & Allergy Research which aims to translate research findings into clinical practice and public health policy to ensure the best outcomes for children regarding food allergy.
Her research has illuminated the connection between vitamin D and food allergy, supported the role of early introduction of egg underpinning revised infant feeding guidelines in the US and Australia, identified an eczema gene that increases risk of food allergy, found that young siblings & pets may have a protective effect on infants in the development of allergies, helped establish guidelines for trace allergen labeling of food in Australia, and advanced diagnostic testing in peanut and egg allergies.
Her November 9, 2016 talk "The Rise in Food Allergy — Why is it Happening and Can We Prevent it?" included discussion about:
- Increasing food allergy burden on children under age 5 and the current epidemic in adolescents
- The design and results-to-date of the HealthNuts study of 5300 infants followed from age 1-10 years old — the world's first comprehensive population-based study of food allergy with objective measurement of true food allergy.
- Three current leading hypotheses of postnatal modifiable factors for the rise in food allergy — Skin barrier function and infant feeding (the Dual Allergen Exposure or Lack hypothesis); Vitamin D hypothesis; and Hygiene hypothesis (microbial diversity, migration and the modern lifestyle)
Key Points from Dr. Allen's research:
(excerpted from Allen and Koplin, JACI, 2016)
- Emerging evidence suggests that optimization of early life skin barrier function through a decrease in drying soaps and detergents and an increase in the use of nonallergenic moisturizers is a reasonable clinical recommendation.
- Current allergy recommendations are that infants should be introduced to solids around the age of 6 months but not before 4 months irrespective of family history risk, and that allergenic solids do not need to be avoided by infants when solids are introduced or by mothers when breastfeeding or lactating (See Australasian Society of Clinical Immunology and Allergy infant feeding guidelines here).
- It is universally agreed that human milk should be the first and most important source of nutrition for the infant as it contains a vast array of bioactive factors including hormones, growth factors, neuropeptides, anti-inflammatory, and immunomodulatory agents that influence many physiological systems and promote normal gut colonization. Its role in protection against food allergy risk remains unclear.
- The data suggest that recommendation of modified formula as a prevention measure for allergic disease may be premature, with the results of an updated Cochrane review expected to further inform infant feeding guidelines.
- There is insufficient data that probiotics or prebiotics protect against food allergy.
- At this point in time, there is insufficient evidence to support the use of vitamin D either as a prevention or treatment for food allergy.
Selection of Dr. Allen's recently published research on food allergy:
- Prospects for Prevention of Food Allergy.
Allen KJ, Koplin JJ. J Allergy Clin Immunol Pract. 2016 Mar-Apr;4(2):215-20. doi: 10.1016/j.jaip.2015.10.010. PMID: 26755097
- Cohort Profile: The HealthNuts Study: Population prevalence and environmental/genetic predictors of food allergy.
Koplin JJ, Wake M, Dharmage SC, Matheson M, Tang ML, Gurrin LC, Dwyer T, Peters RL, Prescott S, Ponsonby AL, Lowe AJ, Allen KJ; HealthNuts study group.Int J Epidemiol. 2015 Aug;44(4):1161-71. doi: 10.1093/ije/dyu261.
- Understanding the feasibility and implications of implementing early peanut introduction for prevention of peanut allergy.
Koplin JJ, Peters RL, Dharmage SC, Gurrin L, Tang ML, Ponsonby AL, Matheson M, Togias A, Lack G, Allen KJ; HealthNuts study investigators. J Allergy Clin Immunol. 2016 Oct;138(4):1131-1141.e2. doi: 10.1016/j.jaci.2016.04.011. PMID: 27260320