Modifiable risk factors for the development of allergy (#ACAAI19 Twitter summary)

Dr. Ellis @DrAnneEllis: Next up we have Dr. Syed Ashad - Risk factors for developing allergic disease - Lessons from the Isle of Wight.

The Isle of Wight cohort has 1536 parents and 495 children.

Modifiable risk factors for the development of atopy:
Obesity
Smoking
Pollution
Acetaminophen
Air Pollution
Breast feeding
Microbiome

Carina Venter PhD RD @VenterCarina Love this data from the Isle of Wight. - obesity trajectories and asthma risk
https://twitter.com/VenterCarina/status/1193536142337069056

Michael R. Rupp, MD @Docallergy: Obesity is a huge problem with some association with asthma. Time of influence is in the first few years of life. Maternal smoking and obesity seem to have the most increased risk for wheeze. Multigenerational smoking can increase DNA methylation and pass through generations to children increasing risk for wheeze even if child doesn’t smoke.

PARS is the best way to predict asthma
https://pars.research.cchmc.org/

Dr. Ellis @DrAnneEllis: Childhood obesity in the Isle of Wight study - if child is obese at the age of 4, highly likely to have persistent obesity.

Risk factors for childhood obesity - maternal obesity, maternal smoking - leads to a significant risk of asthma by age 18.

If both the mother and the grandmother were smokers, even more dramatic effect on the risk of asthma in the child.

Smoking by the grandmother induced epigenetic changes present in the index child.

Traffic related air pollution (TRAP) in the Isle of Wight study shown to lead to a number of epigenetic alterations affecting a number of tissues.

Microbiome analysis from children in the Isle of Wight cohort showed Enterobacteriaceae strongly associated at the family level with eczema, bacteroidetes predominated in 4 of 6 samples from infants without eczema.

Acetaminophen use in adolescence associated with an increased risk of wheezing/asthma in the IoW study. Breastfeeding for at least 4 months led to improved lung function at age 10 and 18yo.

Preschool wheeze is common. Only 1/3rd of these early wheezers will go on to develop asthma, however.

Family history of asthma, chest infections, positive allergy skin test and absence of nasal symptoms are major risk factors for wheezy infants to go onto develop asthma.