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Central European Journal of Immunology
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1-2/2006
vol. 31
 
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Clinical immunology
The effect of the diet of pregnant women on the development of allergy at their children

Barbara Wróblewska
,
Grażyna Duda
,
Ewa Wieczorek
,
Wanda Karwowska

(Centr Eur J Immunol 2006; 31 (1-2): 40-43)
Online publish date: 2006/10/12
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Introduction
Nutrition is one of the basic physiological functions of every living organism. Pregnancy is a time when serial metabolic changes in the mother are carefully regulated to provide optimum substrate to both mother and fetus. Taking into consideration the fact that during the first three months of pregnancy the growth of fetus is determined by protein content in mother’s diet, so the diet of mothers with food protein allergy history is of special concern. Many authors have shown that allergic reactions to food products ingested by the mother may take place as early as before the child’s birth [1, 2]. However, food allergy is the major problem of childhood. The development and phenotypic expression of atopic diseases depends on a complex interaction between genetic factors, environmental exposure to allergens, and non-specific adjuvant factors. The causal relationship between the ingested food product and the anomalous reaction in a given organ or body system and coexistent immune disturbances are the criteria for the diagnosis of allergic hypersensitivity [3]. The antigen content in the mother’s diet during pregnancy can increase the risk of developing allergy in the newborn. Nutrition standards for people in Poland recommend women in their second and third trimester should increase energy intake by 300 kcal/day, up to average daily intake 2500 kcal±700 kcal [4]. (It is estimated that in the second trimester more than 2/3 of energy from the diet is used by the mother and the rest by the child in the uterus). Approximately 60% of general amount of protein should be of animal origin e.g. meat, milk and diary products. Balanced animal protein is the source of valuable amino acids, however it can have allergen character. Maternal nutritional status affects maternal nutrition of the offspring and provides the signal in the capacity to reach the embryo, to be ‘read’ by it and to modify expression of the selected genes. Meat and milk protein allergens act on developing baby organism in uterus by dependent and independent mechanisms of IgE antibodies production [5]. The analysis of the role of various environmental factors triggering hypersensitivity reactions showed that the percentage of people allergic to food products was the greatest in the youngest age group [6]. Detailed enquiries concerning medical history of the mothers, including their diet during pregnancy were made to define the role of food factors in the development of allergy at the very earliest stage of human life. The aim of the study was to evaluate risk factors for the development of hypersensitivity to food products in the selected groups of infants from the families with and without atopy. In the research study conducted, the effect of family history of atopy and the selected environmental factors on the development of food allergy in infants were assessed.
Materials and methods
Nutrition questionnaire was filled in the presence of examined 67 women recruited at the Department of Obstetrics National Research Institute of Mother and Child in Warsaw. Questions had closed character and were concerned women’s dietetic habits. During follow-up visits, women filled in a questionnaire, whereas the infants were clinically examined. Determination of 67 newborn umbilical cord cellular response was measured by in vitro migration of leukocytes in the presence of various antigens [7]. Six ml of umbilical cord blood samples were mixed with preservative-free heparin and 2 ml of Plasmagel was allowed to sedimentation at 37°C for one hour. The WBC-rich supernatant was centrifuged and the cell pellet washed three times in Hank’s. The washed cells were resuspended in minimum essential medium (MEM) with 25 mM Hepes buffer. The leukocyte suspension was centrifuged at 350 x g for 10 minutes in microhaematocrit capillary tubes sealed at one end with non-toxic plasticine. The chamber was placed in an incubator at 37°C and the leukocytes were allowed to migrate for 20 hours. Total IgE in umbilical cord sera was estimated by enzyme linked immunosorbent assay ELISA [8]. The study was approved by Opinion of Bioethical Commission (No 41/2005) at National Research Institute of Mother and Child in Warsaw issued on 9th of August 2005.
Results
About 60% of the infants with allergies had a family history of allergies. Their risk for developing allergies is influenced by the antigens in the mother’s diet during pregnancy. It results from analysis of three day questionnaire filled in by pregnant women that energy intake from their daily rations was 2416 + 639,05 kcal. The results of statistic analysis of energy and various nutrients intake are showed in the table 1. Detailed enquiries concerning atopic history of the mothers, including their diet during pregnancy were made to define the role of food factors in the development of allergy at the very earliest stage of human life. It was concluded that the women who were conscious of allergy threat usually eliminated milk and dairy products from their diet. The percentage of women on the milk-free diet was higher in atopic as compared to non-atopic families, but this difference was not statistically significant. Neither was there a significant difference concerning the time period when milk and dairy products were eliminated from the diet of pregnant women. Women tended to be on the elimination diet in the third trimester of pregnancy and in the majority of cases it proved ineffective in the prevention of hypersensitivity reactions in infants. Only few women during pregnancy, whose children were threatened by atopy disease, eliminated beef from their diets (3%) (table 2). It was found that food antigens: a-casein and b-lactoglobulin added to leukocytes culture isolated from umbilical cord blood showed ability to stop their migration. Leukocytes from umbilical cord blood of infants threatened by atopy, migrated slower than leukocytes from umbilical cord blood of infants not threatened by atopy. After adding b-lactoglobulin to leukocytes culture isolated from umbilical cord blood of infants not threatened by atopy, significantly higher value of average index inhibition migration of leukocytes was observed (0.9±0.1). Supply of bovine serum albumin (BSA) in the culture, inhibited migration of leukocytes culture isolated from umbilical cord blood of infants not threatened by atopy and threatened by atopy with the same strength. Average index data of inhibiting migration of leukocytes from umbilical cord blood by animal food antigens are shown in table 3. Variety of nutrients in mothers’ diets during the pregnancy had an influence on emerging nutritional allergy by infants. This analysis proved strong relationship between the diet of mother from atopy families and IgE umbilical cord levels in newborn. The combination of atopic heredity and elevated cord blood IgE resulted in the best predictive discrimination as regards development of allergic disease. The optimal high-risk group was defined by either double parental atopic predisposition or single atopic predisposition, the latter combined with a cord blood IgE> or = 0.3 kU/1. Percentage of infants threatened by emerging the disease from families without atopy was smaller. Observed differences were statistically important (p>0.05). Among infants from atopy families, who had allergy, 85% was exposed to milk allergens of cow milk from their mother’s diet (table 4).
Discussion
The role of primary prevention of allergic diseases has been a matter of debate for the last 40 years. The complex mechanism and etiology of hypersensitivity reactions to some food products encourage the investigators to search for pathogenetic factors of the disease. The causal relationship between the ingested food product and the anomalous reaction in a given organ or body system and coexistent immune disturbances are the criteria for the diagnosis of allergic hypersensitivity [8, 10]. The aim of the study was to evaluate risk factors for the development of hypersensitivity to food products in a selected group of infants from the families with and without atopy. Our results suggest that allergen-specific transplacental transfer is unlikely to be a major mechanism of allergen-specific immunity in infancy. The process of allergic sensitization needs an understanding of the role environmental factors play in its development. As it has been proven by Hermann [11], presence of antibodies for b-lactoglobulin in amniotic fluid contributes to the conclusion that immunologic answer to this allergen is already formed in fetus life. Detailed enquiries concerning medical history of the mothers, including their diet during pregnancy were made to define the role of food factors in the development of allergy at the very earliest stage of human life. It was concluded that the women who were conscious of allergy threaten usually eliminated milk and dairy products from their diet [12]. Elevated values of immunoglobulin E (IgE) concentrations in cord blood may indicate the hereditary or acquired susceptibility to allergy during prenatal period. The analysis of cord blood showed that newborns from atopic families displayed considerably higher IgE levels when compared with the newborns of non-atopic parents. The percentage of women on the milk-free diet was higher in atopic versus non-atopic families, but this difference was not statistically significant. Neither was there a significant difference concerning the period of time when milk and dairy products were eliminated from the diet of pregnant women. Women tended to be on the elimination diet in the third trimester of pregnancy and in the majority of cases it proved ineffective in the prevention of hypersensitivity reactions in infants.
References
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Copyright: © 2006 Polish Society of Experimental and Clinical Immunology This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (http://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
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