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Prevention of asthma during the first 5 years of life: a randomized controlled trial.
J Allergy Clin Immunol. 2006 Jul; 118(1):53-61.JA

Abstract

BACKGROUND

Early life exposures may be important in the development of asthma and allergic disease.

OBJECTIVE

To test house dust mite (HDM) avoidance and dietary fatty acid modification, implemented throughout the first 5 years of life, as interventions to prevent asthma and allergic disease.

METHODS

We recruited newborns with a family history of asthma antenatally and randomized them, separately, to HDM avoidance or control and to dietary modification or control. At age 5 years, they were assessed for asthma and eczema and had skin prick tests for atopy.

RESULTS

Of 616 children randomized, 516 (84%) were evaluated at age 5 years. The HDM avoidance intervention resulted in a 61% reduction in HDM allergen concentrations (microg/g dust) in the child's bed but no difference in the prevalence of asthma, wheeze, or atopy (P > .1). The prevalence of eczema was higher in the active HDM avoidance group (26% vs 19%; P = .06). The ratio of omega-6 to omega-3 fatty acids in plasma was lower in the active diet group (5.8 vs 7.4; P < .0001). However, the prevalence of asthma, wheezing, eczema, or atopy did not differ between the diet groups (P > .1).

CONCLUSION

Further research is required to establish whether other interventions can be recommended for the prevention of asthma and allergic disease.

CLINICAL IMPLICATIONS

House dust mite avoidance measures and dietary fatty acid modification, as implemented in this trial during infancy and early childhood, did not prevent the onset of asthma, eczema, or atopy in high-risk children.

Authors+Show Affiliations

Woolcock Institute of Medical Research, Missenden Road Post Office, New South Wales 2050, Australia. g.marks@unsw.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16815138

Citation

Marks, Guy B., et al. "Prevention of Asthma During the First 5 Years of Life: a Randomized Controlled Trial." The Journal of Allergy and Clinical Immunology, vol. 118, no. 1, 2006, pp. 53-61.
Marks GB, Mihrshahi S, Kemp AS, et al. Prevention of asthma during the first 5 years of life: a randomized controlled trial. J Allergy Clin Immunol. 2006;118(1):53-61.
Marks, G. B., Mihrshahi, S., Kemp, A. S., Tovey, E. R., Webb, K., Almqvist, C., Ampon, R. D., Crisafulli, D., Belousova, E. G., Mellis, C. M., Peat, J. K., & Leeder, S. R. (2006). Prevention of asthma during the first 5 years of life: a randomized controlled trial. The Journal of Allergy and Clinical Immunology, 118(1), 53-61.
Marks GB, et al. Prevention of Asthma During the First 5 Years of Life: a Randomized Controlled Trial. J Allergy Clin Immunol. 2006;118(1):53-61. PubMed PMID: 16815138.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevention of asthma during the first 5 years of life: a randomized controlled trial. AU - Marks,Guy B, AU - Mihrshahi,Seema, AU - Kemp,Andrew S, AU - Tovey,Euan R, AU - Webb,Karen, AU - Almqvist,Catarina, AU - Ampon,Rosario D, AU - Crisafulli,Daniel, AU - Belousova,Elena G, AU - Mellis,Craig M, AU - Peat,Jennifer K, AU - Leeder,Stephen R, Y1 - 2006/05/30/ PY - 2005/11/30/received PY - 2006/04/03/revised PY - 2006/04/04/accepted PY - 2006/7/4/pubmed PY - 2006/8/10/medline PY - 2006/7/4/entrez SP - 53 EP - 61 JF - The Journal of allergy and clinical immunology JO - J. Allergy Clin. Immunol. VL - 118 IS - 1 N2 - BACKGROUND: Early life exposures may be important in the development of asthma and allergic disease. OBJECTIVE: To test house dust mite (HDM) avoidance and dietary fatty acid modification, implemented throughout the first 5 years of life, as interventions to prevent asthma and allergic disease. METHODS: We recruited newborns with a family history of asthma antenatally and randomized them, separately, to HDM avoidance or control and to dietary modification or control. At age 5 years, they were assessed for asthma and eczema and had skin prick tests for atopy. RESULTS: Of 616 children randomized, 516 (84%) were evaluated at age 5 years. The HDM avoidance intervention resulted in a 61% reduction in HDM allergen concentrations (microg/g dust) in the child's bed but no difference in the prevalence of asthma, wheeze, or atopy (P > .1). The prevalence of eczema was higher in the active HDM avoidance group (26% vs 19%; P = .06). The ratio of omega-6 to omega-3 fatty acids in plasma was lower in the active diet group (5.8 vs 7.4; P < .0001). However, the prevalence of asthma, wheezing, eczema, or atopy did not differ between the diet groups (P > .1). CONCLUSION: Further research is required to establish whether other interventions can be recommended for the prevention of asthma and allergic disease. CLINICAL IMPLICATIONS: House dust mite avoidance measures and dietary fatty acid modification, as implemented in this trial during infancy and early childhood, did not prevent the onset of asthma, eczema, or atopy in high-risk children. SN - 0091-6749 UR - https://www.unboundmedicine.com/medline/citation/16815138/Prevention_of_asthma_during_the_first_5_years_of_life:_a_randomized_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(06)00853-0 DB - PRIME DP - Unbound Medicine ER -