Endotoxin, Food Allergen Sensitization, and Food Allergy: A Complementary Epidemiologic and Experimental Study

Field: Medicine (Health Sciences)

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AAP Policy SupplementsSupplements Publish Supplement MultimediaVideo Abstracts Pediatrics On Call Podcast Subscribe Alerts Careers Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health Allergy Endotoxin, Food Allergen Sensitization, and Food Allergy: A Complementary Epidemiologic and Experimental Study Melissa Cardenas-Morales and Vivian Hernandez-Trujillo Pediatrics December 2020, 146 (Supplement 4) S328; DOI: https://doi.org/10.1542/peds.2020-023861M ArticleInfo & MetricsComments Download PDF A Tsuang, A Grishin, G Grishina. Allergy. 2020;75(3):625–635PURPOSE OF THE STUDY:The epidemiologic aspect of the study aimed to describe the association between exposure to house dust endotoxin and sensitization to food allergens, while the experimental component compared the measurement of cytokines secreted from peripheral blood mononuclear cells (PBMCs) after stimulation with endotoxin in allergic and nonallergic children.STUDY POPULATION:6963 participants, ages 1 to 84 years, from the 2005–2006 NHANES were included in the epidemiologic study. Twenty-one children (ages 1–19 years) from pediatric clinics at the Mount Sinai Health System with food allergy to either egg, milk or peanut, and healthy controls were included in the experimental study.METHODS:Dust endotoxin measurement in the household was obtained from the bedroom, with the amount of endotoxin units per sieved dust weight calculated. Serum-specific IgE levels of egg white, cow’s milk, and peanut were measured, with food allergen sensitization defined as a serum-specific IgE level ≥ 0.35 kUA/L. Clinical symptoms of food allergy were not reported in NHANES participants. Food allergen sensitization and log-10–transformed endotoxin level were compared using logistic regression models. The measurement of cytokines produced from PBMCs after endotoxin stimulation were obtained for children recruited from Mount Sinai with food allergy to either egg, milk or peanut (five patients per allergen) and 6 healthy controls, without clinical history of food allergy.RESULTS:The geometric mean household endotoxin level was 15.5 EU/mg, with the highest mean seen in children compared with adults among NHANES subjects. The endotoxin levels were found to be higher in those with a positive wheezing history in the past year. Of the study population, 13.5% were found to be sensitized to one or more foods, and this sensitization was more common in 1–5 year-old children. Milk sensitized participants had higher geometric mean endotoxin levels compared with those without milk sensitization (22.4 EU/mg vs 14.8 EU/mg), as did egg sensitized participants compared with those without egg sensitization (19.1 EU/mg vs 15.2 EU/mg). No significant difference in endotoxin levels when comparing peanut sensitized vs non-sensitized patients was seen. The experimental study found lower levels of secreted interferon γ from PBMCs stimulated by endotoxin in egg and milk sensitized patients compared with controls, but no significant difference in peanut sensitized patients.CONCLUSIONS:The odds of milk and egg sensitization are increased with exposure to higher house dust endotoxin levels. There is a decrease in Th1–specific cytokine response, specifically interferon γ secretion, in subject sensitized to egg and milk.REVIEWER COMMENTS:There have been mixed reports regarding the relationship between endotoxin exposure and risk of development of food allergy. This study highlights the need for further study of the role of endotoxin exposure and food allergy development. Additionally, the decreased secretion of the Th1 cytokine, interferon γ, in food sensitized patients underlines the skewing of the immune response toward a Th2 response in milk and egg sensitized patients. Due to the small sample size, further studies are needed to investigate the effects of age of exposure and specific food allergy, as this was not seen in peanut allergy patients. This may result in improved understanding of the role of the environment on the development of food allergy with the goal of prevention.Copyright © 2020 by the American Academy of Pediatrics PreviousNext Back to top Advertising Disclaimer » In this issue Pediatrics Vol. 146, Issue Supplement 4 1 Dec 2020 Table of ContentsIndex by author View this article with LENS PreviousNext Email Article Thank you for your interest in spreading the word on American Academy of Pediatrics.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Your Email * Your Name * Send To * Enter multiple addresses on separate lines or separate them with commas. 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Or Sign In to Email Alerts with your Email Address Email * Citation Tools Endotoxin, Food Allergen Sensitization, and Food Allergy: A Complementary Epidemiologic and Experimental Study Melissa Cardenas-Morales, Vivian Hernandez-Trujillo Pediatrics Dec 2020, 146 (Supplement 4) S328; DOI: 10.1542/peds.2020-023861M Citation Manager Formats BibTeXBookendsEasyBibEndNote (tagged)EndNote 8 (xml)MedlarsMendeleyPapersRefWorks TaggedRef ManagerRISZotero Share Endotoxin, Food Allergen Sensitization, and Food Allergy: A Complementary Epidemiologic and Experimental Study Melissa Cardenas-Morales, Vivian Hernandez-Trujillo Pediatrics Dec 2020, 146 (Supplement 4) S328; DOI: 10.1542/peds.2020-023861M Share This Article: Copy Print Download PDF Insight Alerts Table of Contents Jump to section ArticlePURPOSE OF THE STUDY:STUDY POPULATION:METHODS:RESULTS:CONCLUSIONS:REVIEWER COMMENTS:Info & MetricsComments Related ArticlesNo related articles found.Google Scholar Cited By...No citing articles found.Google Scholar More in this TOC SectionAllergy Postnatal Probiotics and Allergic Disease in Very Preterm Infants: Sub-study to the ProPrems Randomized Trial Non–β-Lactam Antibiotic Hypersensitivity Reactions Markers of Microbial Exposure Lower the Incidence of Atopic Dermatitis Show more Allergy Risk Factors and Prevention of Atopy Skin Care and Synbiotics for Prevention of Atopic Dermatitis or Food Allergy in Newborn Infants: A 2 X 2 Factorial, Randomized, Non-Treatment Controlled Trial Early-Life Exposure to Oral Antibiotics and Lung Function Into Early Adulthood Increased Moraxella and Streptococcus Species Abundance After Severe Bronchiolitis Is Associated With Recurrent Wheezing Show more Risk Factors and Prevention of Atopy Similar Articles Journal Info Editorial Board Editorial Policies Overview Licensing Information Authors/Reviewers Author Guidelines Submit My Manuscript Open Access Reviewer Guidelines Librarians Institutional Subscriptions Usage Stats Support Contact Us Subscribe Resources Media Kit About International Access Terms of Use Privacy Statement FAQ AAP.org shopAAP Follow American Academy of Pediatrics on Instagram Visit American Academy of Pediatrics on Facebook Follow American Academy of Pediatrics on Twitter Follow American Academy of Pediatrics on Youtube RSS © 2021 American Academy of Pediatrics