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Eczema’s ‘key role’ in infant allergies

Friday July 19th, 2013

Eczema may play a key role in why some infants develop food allergies, a new study has suggested.

A link between eczema and food allergy has been known for some time and previous studies have shown that people with conditions such as eczema do not have adequate protection against environmental allergens.

But the latest findings turn previous theories on their head - suggesting that eczema may aggravate allergy, rather than being caused by it.

However, researchers from King's College London and the University of Dundee say their study, published in the Journal of Investigative Dermatology, adds to growing evidence that a breakdown of the skin barrier and inflammation in the skin have play a significant role.

The study, funded by the Food Standards Agency, Medical Research Council, and the National Institute for Health Research (NIHR), found that infants with an impaired skin barrier, especially if they also have eczema, are more than six times more likely than healthy infants to be sensitised to a variety of foods such as egg, cow's milk and peanut.

The researchers analysed more than 600 three-month-old babies from the EAT (Enquiring About Tolerance) Study, all of whom who were exclusively breastfed from birth.

They examined the infants for eczema, tested how much water the skin was able to retain, and screened for gene mutations associated with eczema.

Then the infants underwent skin prick tests to see if they were also sensitised to the six commonest allergenic foods. Egg white was the most common allergen, followed by cow's milk, and peanut.

The more severe the eczema, the stronger the correlation to food sensitivity, independent of genetic factors, but researchers cautioned that food sensitivity does not always lead to clinical allergy. A follow up of the EAT Study children is underway.

The researchers said as the babies involved in the study were exclusively breast-fed, and had not had any solid foods at the time they were examined, it suggested that active immune cells in the skin, rather than the gut, may play a crucial role in food sensitisation.

The breakdown of the skin barrier in eczema leaves active immune cells in the skin exposed to environmental allergens, in this case food proteins, which then triggers an allergic immune response.

Dr Carsten Flohr, NIHR Clinician scientist and senior lecturer at King's College London and consultant at St John's Institute of Dermatology at St Thomas' Hospital, said: “This is a very exciting study, providing further evidence that an impaired skin barrier and eczema could play a key role in triggering food sensitivity in babies, which could ultimately lead to the development of food allergies.

“It opens up the possibility that if we can repair the skin barrier and prevent eczema effectively then we might also be able to reduce the risk of food allergies.”

Tags: Allergies & Asthma | Child Health | Dermatology | Diet & Food | UK News

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