Filaggrin Mutations are Associated with an Increased Risk of Infantile Food Allergy and Sensitization

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Rationale

Filaggrin is central to skin barrier maintenance and filaggrin (FLG) mutations increase the risk of eczema, a condition associated with IgE-mediated food allergy. Recently, FLG mutations were shown to increase the risk of peanut allergy (Brown et al., 2011) although other foods were not assessed. We aimed to determine whether FLG mutations increase the risk of challenge-proven food allergy (egg, peanut and/ or sesame allergy) in a population cohort of one-year-old infants.

Methods

5302 one-year-old infants recruited from the population underwent skin prick tests (SPT) for egg, peanut and sesame and those sensitized underwent oral food challenge (OFC) to those foods. DNA from 627 Caucasian infants (n=308 with challenge-confirmed food allergy to peanut, egg and/or sesame; n=213 with positive SPT but negative OFC; and n=106 with negative SPT and negative OFC) were genotyped for five FLG mutations (R501X, 2282del4, R2447X, S3247X and 3702delG) using Sequenom MassARRAY.

Results

The presence of at least one of the above FLG mutations was associated with an increased risk of developing both food sensitization (OR=2.9; 95% CI=1.1-7.3) and challenge-confirmed food allergy (OR=2.8; 95% CI=1.1-7.4).

Conclusions

FLG mutations increase the risk of food allergy and food sensitization to egg, peanut and sesame in infants recruited from the general population. Further work elucidating the role of eczema in the association between FLG mutations and food sensitization/allergy is ongoing.

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