Prevention of Food Allergy: early introduction of complementary food and oral immune tolerance

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  • Narita Masami
    Division of Allergy, Tokyo Metropolitan Children's Medical Center

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Other Title
  • 食物アレルギーの発症予防
  • ～離乳食早期摂取による経口免疫寛容～

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<p>Avoiding sensitization to food antigens and inducing oral immune tolerance are the main two strategies for preventing the onset of immediate food allergy. Recent researches have revealed that percutaneous sensitization occurs in infants with eczema due to skin barrier dysfunction, but the effective method for preventing food sensitization has not been reported. Even after the sensitization, however, oral immune tolerance induction may be enough for preventing food allergy. A meta-analysis of recent randomized controlled trials indicated that the introduction of peanut and hen' egg as early as age 4 to 6 months decreased the onset of allergy to these foods. During the past few decades in Japan, the timing of introducing hen's egg has become later, and the previous guideline (Heisei 19) accordingly recommended introducing egg into the diet of infants at age 7 or 8 months. Based on recent evidence this age has been revised to 5 to 6 months in the "Guideline for Supporting Breast Feeding and Weaning" (2019 revised edition). Early introduction of complementary food is a promising strategy for preventing food allergy though the induction of oral immune tolerance, although extreme caution is needed for allergic reactions in patients who have already developed food allergy.</p>

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