Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Early Introduction of Multi-Allergen Mixture for Prevention of Food Allergy

Version 1 : Received: 8 December 2021 / Approved: 15 December 2021 / Online: 15 December 2021 (15:02:28 CET)

How to cite: Quake, A.Z.; Liu, T.A.; D’Souza, R.; Jackson, K.G.; Woch, M.; Tetteh, A.; Sampath, V.; Nadeau, K.C.; Sindher, S.; Chinthrajah, R.S.; Cao, S. Early Introduction of Multi-Allergen Mixture for Prevention of Food Allergy. Preprints 2021, 2021120257 (doi: 10.20944/preprints202112.0257.v1). Quake, A.Z.; Liu, T.A.; D’Souza, R.; Jackson, K.G.; Woch, M.; Tetteh, A.; Sampath, V.; Nadeau, K.C.; Sindher, S.; Chinthrajah, R.S.; Cao, S. Early Introduction of Multi-Allergen Mixture for Prevention of Food Allergy. Preprints 2021, 2021120257 (doi: 10.20944/preprints202112.0257.v1).

Abstract

The incidence and prevalence of food allergy (FA) are increasing. While several studies have established the safety and efficacy of early introduction of single allergens in infants for the prevention of FA, the exact dose, frequency, and number of allergens that can be safely introduced to infants particularly in those at high or low risk of atopy are still unclear. This 1-year study evaluated the safety of early introduction of single foods (milk, egg, or peanut), vs. two foods (milk/egg, egg/peanut, milk/peanut), vs. multiple foods (milk/egg/peanut/cashew/almond/shrimp/walnut/wheat/fish/soy at low, medium, or high doses) vs no early introduction in infants between 4-6 months of age. At the end of the study, they were evaluated for plasma biomarkers associated with food reactivity with standardized blood tests. Two to four years after the start of the study, participants were evaluated by standardized food challenges. The serving sizes for the single, double, and low dose mixtures were 300 mg total protein per day. The serving sizes for the medium and high dose mixture was 900 mg and 3000 mg total protein, respectively. Equal parts of each protein were used for double or mixture foods. All infants were breastfed until at least 6 months of age. Results demonstrate that infants at either high or low risk for atopy were able to tolerate early introduction of multiple allergenic foods with no increases in any safety issues, including eczema, FA, or food protein induced enterocolitis. The mixtures of foods at either low, medium, or high doses demonstrated trends for improvement in food challenge reactivity and plasma biomarkers compared to single and double food introductions. The results of this study suggest that early introduction of foods, particularly simultaneous mixtures of many allergenic foods is efficacious for preventing FA and can occur safely.

Keywords

Multi-allergen; early introduction; food allergy; efficacy; safety; prevention

Subject

MEDICINE & PHARMACOLOGY, Pediatrics

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