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In 1990, 120 pregnant women, whose babies were at high risk of developing allergic disease because of their family history, were recruited into an interventional allergy prevention study. Sixty two mothers were in an observational control group and 58 mothers agreed to restrict their diet, omitting potentially allergenic foods while breast feeding, and allowed their homes to be treated with an acaricide to eliminate house dust mite allergen. The researchers considered this to be a ‘proof of concept’ study. The study was performed in a controlled environment, with a group of highly motivated mothers who were closely observed by the research physicians and dietician.
The children were followed up regularly during the first year of life and then at two, four and eight years of age. Review up to four years showed significant benefit in reducing allergic disorders and sensitisation to common allergens in the prophylactic group. At eight years, all 120 children were reviewed; there was still benefit from the intervention with less sensitisation to house dust mite and less asthma. It appears that the combined reduction in allergen exposure in the critical period of early infancy is effective in preventing asthma and atopy, possibly by the modulation of immune responses in high risk children.
Assessment at 17 years was thought to be crucial to determine whether the benefit from measures taken at birth would continue past adolescence. A successful grant application was made to the National Institute for Health Research (NIHR) and follow-up of the children was completed in 2010. The review consisted of a questionnaire, skin prick test, blood test, bronchial challenge and sputum induction.