Re: ABKM a očkování

Maargit, hele akorát vyšel nový Journal Watch... Dost zajímavé. Je to teda o dětech s atopem, ale zjevně kojení nekojení jak je genetická predispozice k alergiím, může se ledacos semlít.

Exclusive breast-feeding does not prevent atopic dermatitis.

The relevance of food allergies to atopic dermatitis (AD) is debated. To prevent food allergies, many mothers feed breast milk only. This reasonable approach may not work. Allergic food sensitization may occur through contact of food with dermatitic skin.
Researchers examined 619 exclusively breast-fed 3-month-old infants for AD, scored any AD for severity, and screened for common mutations of the filaggrin FLG gene (which encodes the epidermal barrier protein filaggrin). They also performed skin-prick testing for allergy to six foods (cow""s milk, egg, cod fish, wheat, sesame, and peanut).
About 25% had AD at examination. About 12% carried at least one FLG mutation (93% heterozygous, 7% either homozygous or compound heterozygous); in children with AD, the incidence of FLG mutation was 24%. Infants with FLG mutations were more likely than others to have AD at 3 months. Roughly 6% were sensitized to one or more of the six foods (egg 24/619, cow""s milk 10/619, peanuts 8/619, wheat 2/619, sesame and cod fish 0/619). FLG mutations were not associated with food sensitization, but having AD was strongly associated with having food allergy (P<0.001). More-severe AD was associated with increased food allergy incidence.
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Comment
Exclusive breast-feeding did not prevent atopic dermatitis. Food sensitization may occur through affected skin. The filaggrin gene FLG mutation does not predispose to food allergy unless AD is present. The results surprised me, until I remembered that food allergens are proteins too big to penetrate intact skin even if FLG mutations are present. They can, however, penetrate the damaged barrier in AD skin. It seems counterintuitive that inflamed skin of exclusively breast-fed babies would come into contact with food. Perhaps sensitization occurs to food allergens in breast milk, or perhaps, via transplacental transport in utero.
Lower exposure to food allergens may inadequately stimulate immunoregulatory networks, just as the hygiene hypothesis proposes that decreased bacterial exposure results in increased predisposition to infection. These investigators are now testing whether early introduction of allergenic foods might better protect against AD than breast-feeding alone (http://www.eatstudy.co.uk).