Low Serum Adrenic Acid Levels in Infants and Subsequent Food-induced Anaphylaxis

Overview

Journal J Allergy Clin Immunol Glob

Specialty Allergy & Immunology

Date 2024 Jul 29

PMID 39071732

Authors

Mitsuyoshi Urashima

Ayu Kasamatsu

Hiroshi Tachimoto

Affiliations

Soon will be listed here.

Abstract

Background: The dietary fat hypothesis links increases in allergic diseases to reduced consumption of n-3 polyunsaturated fatty acids from fish, for example, eicosapentaenoic acid, and increased intake of n-6 polyunsaturated fatty acids from vegetable oils, for example, arachidonic acid.

Objective: Building upon the "fat hypothesis," we sought to investigate the association between 24 types of serum fatty acid levels in infants and the risk of subsequent food-induced anaphylaxis (FIA) by age 2 years as the primary outcome.

Methods: This study was conducted as a prespecified supplemental analysis within the ABC randomized clinical trial. We measured levels of 24 fatty acids in residual serum samples collected from 268 infants at age 5 to 6 months using gas chromatography-mass spectrometry.

Results: Among the 258 infants, 58 exhibited immediate-type food allergies, whereas 200 showed no food allergy. Of the 58 infants, 12 were diagnosed with FIA, whereas the remaining 46 had nonanaphylactic food allergy. Unexpectedly, among the 24 fatty acids, only adrenic acid, also known as docosatetraenoic acid, which is one of the n-6 polyunsaturated fatty acids, showed significantly lower levels in infants with FIA (median [interquartile range] (wt.%), 0.16 [0.14-0.17]), compared with those with no food allergy (0.19 [0.17-0.21]) ( = .0007). In contrast, adrenic acid levels in infants with nonanaphylactic food allergy were 0.19 [0.16-0.21] (wt.%), which did not differ significantly from those in infants with no food allergy ( = .69).

Conclusions: This study generated a hypothesis suggesting that infants with low serum adrenic acid levels might be at greater risk of subsequent FIA. This unexpected result warrants further investigation.

References

Brouwers H, Jonasdottir H, Kuipers M, Kwekkeboom J, Auger J, Gonzalez-Torres M . Anti-Inflammatory and Proresolving Effects of the Omega-6 Polyunsaturated Fatty Acid Adrenic Acid. J Immunol. 2020; 205(10):2840-2849. DOI: 10.4049/jimmunol.1801653. View

Sampson H, Mendelson L, Rosen J . Fatal and near-fatal anaphylactic reactions to food in children and adolescents. N Engl J Med. 1992; 327(6):380-4. DOI: 10.1056/NEJM199208063270603. View

Lack G . Epidemiologic risks for food allergy. J Allergy Clin Immunol. 2008; 121(6):1331-6. DOI: 10.1016/j.jaci.2008.04.032. View

Cianferoni A, Muraro A . Food-induced anaphylaxis. Immunol Allergy Clin North Am. 2012; 32(1):165-95. PMC: 3440177. DOI: 10.1016/j.iac.2011.10.002. View

Kasamatsu A, Tachimoto H, Urashima M . Impact of Maternal Fish Consumption on Serum Docosahexaenoic Acid (DHA) Levels in Breastfed Infants: A Cross-Sectional Study of a Randomized Clinical Trial in Japan. Nutrients. 2023; 15(20). PMC: 10609621. DOI: 10.3390/nu15204338. View

Beck M, Zelczak G, Lentze M . Abnormal fatty acid composition in umbilical cord blood of infants at high risk of atopic disease. Acta Paediatr. 2000; 89(3):279-84. View

Schindler T, Sinn J, Osborn D . Polyunsaturated fatty acid supplementation in infancy for the prevention of allergy. Cochrane Database Syst Rev. 2016; 10:CD010112. PMC: 6464137. DOI: 10.1002/14651858.CD010112.pub2. View

Egalini F, Guardamagna O, Gaggero G, Varaldo E, Giannone B, Beccuti G . The Effects of Omega 3 and Omega 6 Fatty Acids on Glucose Metabolism: An Updated Review. Nutrients. 2023; 15(12). PMC: 10301273. DOI: 10.3390/nu15122672. View

Duchen K, Casas R, Yu G, Bjorksten B . Human milk polyunsaturated long-chain fatty acids and secretory immunoglobulin A antibodies and early childhood allergy. Pediatr Allergy Immunol. 2000; 11(1):29-39. DOI: 10.1034/j.1399-3038.2000.00052.x. View

10.

Sartorio M, Pendezza E, Coppola S, Paparo L, DAuria E, Zuccotti G . Potential Role of Omega-3 Polyunsaturated Fatty Acids in Pediatric Food Allergy. Nutrients. 2022; 14(1). PMC: 8746967. DOI: 10.3390/nu14010152. View

11.

Black P, Sharpe S . Dietary fat and asthma: is there a connection?. Eur Respir J. 1997; 10(1):6-12. DOI: 10.1183/09031936.97.10010006. View

12.

Gunaratne A, Makrides M, Collins C . Maternal prenatal and/or postnatal n-3 long chain polyunsaturated fatty acids (LCPUFA) supplementation for preventing allergies in early childhood. Cochrane Database Syst Rev. 2015; (7):CD010085. PMC: 8783748. DOI: 10.1002/14651858.CD010085.pub2. View

13.

Roper R, Brown D, Phipps R . Prostaglandin E2 promotes B lymphocyte Ig isotype switching to IgE. J Immunol. 1995; 154(1):162-70. View

14.

Tachimoto H, Imanari E, Mezawa H, Okuyama M, Urashima T, Hirano D . Effect of Avoiding Cow's Milk Formula at Birth on Prevention of Asthma or Recurrent Wheeze Among Young Children: Extended Follow-up From the ABC Randomized Clinical Trial. JAMA Netw Open. 2020; 3(10):e2018534. PMC: 7532386. DOI: 10.1001/jamanetworkopen.2020.18534. View

15.

de Antueno R, de Bravo M, Toledo J, Mercuri O, de Tomas M . In vitro effect of eicosapentaenoic and docosahexaenoic acids on prostaglandin E2 synthesis in a human lung carcinoma. Biochem Int. 1989; 19(3):489-96. View

16.

De Caterina R . n-3 fatty acids in cardiovascular disease. N Engl J Med. 2011; 364(25):2439-50. DOI: 10.1056/NEJMra1008153. View

17.

Urashima M, Mezawa H, Okuyama M, Urashima T, Hirano D, Gocho N . Primary Prevention of Cow's Milk Sensitization and Food Allergy by Avoiding Supplementation With Cow's Milk Formula at Birth: A Randomized Clinical Trial. JAMA Pediatr. 2019; 173(12):1137-1145. PMC: 6806425. DOI: 10.1001/jamapediatrics.2019.3544. View

18.

Monge P, Garrido A, Rubio J, Magrioti V, Kokotos G, Balboa M . The Contribution of Cytosolic Group IVA and Calcium-Independent Group VIA Phospholipase As to Adrenic Acid Mobilization in Murine Macrophages. Biomolecules. 2020; 10(4). PMC: 7226511. DOI: 10.3390/biom10040542. View

19.

Bisgaard H, Stokholm J, Chawes B, Vissing N, Bjarnadottir E, Schoos A . Fish Oil-Derived Fatty Acids in Pregnancy and Wheeze and Asthma in Offspring. N Engl J Med. 2016; 375(26):2530-9. DOI: 10.1056/NEJMoa1503734. View

20.

Hamazaki K, Tsuchida A, Takamori A, Tanaka T, Ito M, Inadera H . Dietary intake of fish and ω-3 polyunsaturated fatty acids and physician-diagnosed allergy in Japanese population: The Japan Environment and Children's Study. Nutrition. 2019; 61:194-201. DOI: 10.1016/j.nut.2018.11.010. View