In 2532 Children we Report the Developmental Factors Influencing the Development of Atopic Diseases

Allergic asthma and rhinitis, atopic dermatitis (AD), urticaria and gastrointestinal allergy, are common diseases of infants and children. It was recently estimated that 14% of children suffer from AD, 8% from food allergy, and 12% from asthma [1,2]. The cumulated incidence of these diseases in adolescents has been estimated between 25-35%, while the prevalence is about 20% [3]. The phenotypic expression of these illnesses varies extensively, being very mild in some cases, severe in many, and even life threatening in others. Specific IgE antibodies to foods and positive challenge tests to a number of food allergens are frequently present in children with these disorders. Cow’s milk (CM) appears to be the most common offending food both in gastrointestinal (vomiting, diarrhea, etc) and in cutaneous manifestations (urticaria and AD). About 0.5-7% of infants suffer from more or less adverse reactions to CM [4]. Babies particularly of atopic parents are at high risk of developing atopic diseases, therefore they are defined as at-risk babies [5-7]. Atopy can interfere with a child’s life at any age level, with varying severity. Intractable diarrhea due to CM allergy (CMA) and AD are the most frequent in infants, where the clinical manifestations are more severe than in older children. Respiratory allergy and bronchial asthma can be serious illnesses in younger as well as in older children. The desire to understand the multifaceted problem of atopy has stimulated the clinicians’ and academicians’ imagination for decades. Therefore interest has been focused on methods for the prediction and prevention of atopy [5-9]. Prevention of IgE-mediated diseases relies on the skill necessary to overcome the natural forces unceasingly working to sensitize humans to produce IgE antibodies. The phenotypic expression of allergic disease ensues from an elaborate interrelationship between the atopy-prone genetic constitution of a child and the experienced environment that surrounds it. Prevention of atopy could potentially be met by selectively interfering with the genetic and environmental factors that appear to be responsible in concert for the final phenotypic expression of atopy. Human milk has been for centuries the only way of feeding human neonates. Since the beginning of this century CM formulas have become a common breast milk substitute when mother’s milk was not available. During this century and especially in the last decade other formulas have been developed in order to reduce the antigen load and therefore the risk of sensitization. In this paper we will briefly summarize recent data on the environmental factors triggering atopy. In addition, we will report recent knowledge on atopy prevention, also reviewing the so-called hypoallergenic formulas. Abbreviations: AD: Atopic Dermatitis; CM: Cow’s Milk; CMA: CM Allergy Glob J Otolaryngol 2(5): GJO.MS.ID.555598 (2016) 00