Food allergies often occur in early childhood with or without atopic dermatitis. Currently, a family history is taken to determine whether an infant is likely to develop a food allergy, but not all babies born into atopic families will develop a food allergy. Some children who do not have a family history of allergies may develop a food allergy. Therefore, family history cannot be considered an indicator of the development of food allergies.
Researchers are conducting research to identify people at risk for food allergies and develop a program to prevent the development of it and have identified early predictors of this condition in 2024. The study included 129 infants aged 2 months and did not have any signs of food allergy or atopic dermatitis. The study used skin tape sampling technique, which is noninvasive and gentle. The superficial proteins on the skin and the lipids bind to the tapes. The tapes were collected from the infants' forearms to study what is found on the skin. Then the children were clinically monitored for 24 months to see if food allergies and atopic dermatitis would develop.
Within this cohort, 9 of 129 infants had developed food allergy alone, 9 others had developed atopic dermatitis with food allergy, and 28 had developed atopic dermatitis alone. In the stratum corneum of children who developed food allergy and who developed both food allergy and atopic dermatitis had increased levels and proportions of unsaturated (N24:1)(C18-sphingosine) ceramide and (N26:1)(C18-sphingosine) ceramide compared with the children who only developed atopic dermatitis and the children who did not develop atopic dermatitis nor food allergy, indicating that these increases of those unsaturated non-hydroxy fatty acid sphingosine ceramides (NS-ceramides) are unique to food allergy. IL-33 level was moderately elevated in those children with food allergies but not in those with atopic dermatitis.
The children who developed food allergy additionally had increased levels of protein-bound omega-hydroxy fatty acid sphingosine ceramides (OS-ceramides) compared with the children who did not develop any food allergy or atopic dermatitis and with the children who developed atopic dermatitis.
The thymic stromal lymphopoietin was elevated in those with atopic dermatitis and with both food allergy and atopic dermatitis, but not in those with food allergy. Further, the children who developed atopic dermatitis had increased unsaturated sphingomyelin species with 24:1 and 26:1 fatty acid, but the children who developed food allergy or food allergy with atopic dermatitis did not have these increases.
The researchers concluded that unsaturated NS-ceramide species and protein-bound OS-ceramides are strong predictors for food allergy. Also, altered lipid profiles, IL-33 and TNF-alpha together substantially increased food allergy prediction possibilities, with an odds ratio greater than 100.
Additional studies including different ethnic groups in different regions of the world are needed to determine the universality of these molecular signatures.
