Theme 1: Epidemiology of Food Allergy Across Europe
Leader: Peter Burney
Overall Aim:
The first objective of this Theme was to obtain authoritative estimates of the prevalence of food allergy across the different areas of Europe and to provide a qualitative assessment of the variation of this prevalence. The research in Theme 1 has been conducted through community based surveys, cross-sectional studies of severe allergies and a birth cohort Theme 1. These studies investigated sensitisation towards 25 foods across the different climatic and cultural regions of Europe including new member states where no previous studies had been conducted. It is also through the studies of Theme 1 that the population of biological samples required for the research in other project themes was generated.
1. Birth cohort (Leader: Kirsten Beyer)
The EuroPrevall birth cohort study is the most comprehensive investigation of food allergies in the first years of life with over 11,000 participants from 9 different countries. The birth cohort studies have been used to
- Investigate the effect of maternal diet during pregnancy on the development of food allergies during infancy.
- Investigate the use of early food sensitizations (such as to egg white) as predictors of future progress of allergic disease.
- Facilitate the study of inheritance of genetic markers for food allergy through Theme 2 activities (WP2.1.4) by providing blood samples of both parents and children for genetic studies.
- Provide information on how the temporal development of food allergy in infants may differ across Europe and any relationship there may be with patterns of allergen sensitization using component resolved diagnostic methods, particularly those developed through Theme 3, WP3.2.
- Develop international diagnostic decision points for food allergen-specific serum IgE concentration for several foods, reducing the requirement for oral food challenges in the future.
- Provide biological material for WP2.2 [placenta biopsies] and WP3.2 [serum for testing new diagnostic tools].
- In addition to these specific activities, the setting up of the EuroPrevall cohort will build an important pan-European platform for future studies into the development of food allergy for many years to come.
- Diagnostic decision points based on IgE to certain foods (peanut, egg, and cow’s milk) have been described which can help to reduce the need for DBPCFC in a number of patients. However, these diagnostic decision points vary widely between different studies populations in various countries. The study in this WP will provide diagnostic decision points across the major cultural and climatic regions in Europe for children with first manifestation of food allergy and for children during the natural course of the disease.
2. Community based surveys and cross-sectional studies of severe allergies (Leader: Peter Burney)
Community based panels are required to provide unbiased estimates of the association between self-reported food intolerance, sensitisation to different groups of allergenic foods and risk factors.
A multi-centre cross-sectional survey undertaken in school-age children and adults will be undertaken in ten centres across Europe. The questionnaires collected information on: sensitivity to other related allergenic substances (pollen, dust etc), indicators of past infections likely to influence development of allergy and other risk factors known to influence sensitisation / expression of allergy, e.g. limited information on exposure to particular foods. All subjects involved in these studies will also be asked to provide serum for analysis of antibodies, including chronic infections, and whole blood for extraction and storage of DNA for future analysis of genetic factors involved in food allergy proposed in Theme 2 . Selected patients from cohorts will also be used through Theme 4 to investigate the socioeconomic impact of food allergy.
3. Serum Bank (Leader: Montserrat Fernandez-Rivas)
The clinical studies in the heart of this project will enable effective characterisation of those individuals with the severest food allergies which find their way into expert allergy centres, and will therefore facilitate the assembly of a highly complementary set of data and samples to those collected through the epidemiological studies of Theme 1.
One aim of this WP is the establishment of a serum bank which is essential to activities in Theme 3 looking at:
- Establish the IgE-reactivity of the allergen library as part of its authentication and to characterise novel allergens.
- The validation of novel diagnostic methods.
- Investigation into the effect of the food matrix and other metabolic (including digestive) processes on the allergenicity of foods.
- Establishing clinical studies in tropical (China), sub-tropical (India) and sub-arctic (Russia), linking these where possible other environmental allergies (such as pollen)