This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Food allergy is defined as an adverse reaction to food proteins caused by immunologic mechanisms, and is now estimated to affect over 11 million Americans. The disorder affects approximately 6% of children and 3.5% of adults in the United States and appears to be increasing in prevalence despite efforts at prevention through dietary means. Peanut allergy now affects 0.8% of young children, is often severe, sometimes fatal and, in contrast to milk and egg allergy, is more likely to persist. Previous studies have shown that peanut allergy is a hereditary disorder, but it is clear that environmental influences account for the startling, recently documented, doubling in the incidence of peanut allergy in young children in the US and the UK. The hallmark of food-allergic disease is the production of food-specific IgE antibodies that represent an end result of a Th2 influenced immune response. There is only a limited understanding of the mechanisms involved in the developmental course of food allergies. To effectively prevent or reverse the progression of food allergy, immune interventions will be needed. Furthermore, it is likely that successful strategies will need to be directed to those persons at identifiable risk (e.g., who have biomarkers associated with development of peanut allergy). This observational study will investigate the developmental immunology of peanut, egg and milk allergy in a cohort of milk or egg allergic children who are at risk for peanut allergy. During this time we predict that approximately 20% will develop clinical peanut allergy and 25-50% will experience resolution of egg or milk allergy. This strategy should enable us to delineate, compare and contrast biological markers and immunologic changes associated with the development of peanut allergy and loss of egg and milk allergy while simultaneously evaluating important clinical and environmental influences likely to account for the recent alarming rise in these allergies (e.g., the hygiene hypothesis). The results of this observational study, in combination with discoveries in the associated projects of the Consortium of Food Allergy Research, should form a basis for improved prevention and treatment strategies.
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