TY - JOUR
T1 - Association Between Folate Metabolites and the Development of Food Allergy in Children
AU - McGowan, Emily C.
AU - Hong, Xiumei
AU - Selhub, Jacob
AU - Paul, Ligi
AU - Wood, Robert A.
AU - Matsui, Elizabeth C.
AU - Keet, Corinne A.
AU - Wang, Xiaobin
N1 - Funding Information:
This work was funded by the National Institutes of Health (NIH) through the following grants: 1KL2TR001077, K23AI123596, R01ES026170, R01ES023447, K24AI114769, and by the American Academy of Allergy Asthma and Immunology (AAAAI)/Food Allergy Research and Education (FARE)/Howard Gittis Junior Faculty Research Award. The Boston Birth Cohort (the parent study) was supported in part by grants from the Bunning Family and their family foundations, FARE, and the National Institute of Allergy and Infectious Diseases (U01AI090727 from the Consortium of Food Allergy Research, and R21AI088609).Conflicts of interest: E. C. McGowan has received grants from the NIH, the AAAAI, and FARE, and served as a consultant for Shire, Inc. X. Hong, J. Selhub, L. Paul, and X. Wang have received grant support from the NIH. R. A. Wood has received grants from the NIH, DBV, Aimmune, Astella, and HAL-Allergy; has consultant arrangements with Stallergenes; is employed by Johns Hopkins University; and receives royalties from UpToDate. E. C. Matsui receives grant support from the NIH; serves as a consultant for Environmental Defense Fund, Church, & Dwight, LLC; and has received payment for lectures from Indoor Biotechnologies. C. A. Keet receives grant support from the NIH and is the co-owner of Skybrude Consulting, LLC.
Publisher Copyright:
© 2019 American Academy of Allergy, Asthma & Immunology
PY - 2020/1
Y1 - 2020/1
N2 - Background: Studies on the association between folate/folic acid exposure and the development of allergic disease have yielded inconsistent results, which may be due, in part, to lack of data distinguishing folate from folic acid exposure. Objective: To examine the association between total folate, 5-methyltetrahydrofolate (5-MTHF), and unmetabolized folic acid (UMFA) concentrations at birth and in early childhood and the development of food sensitization (FS) and food allergy (FA). Methods: A nested case control study was performed in the Boston Birth Cohort (BBC). Total folate, 5-MTHF, and UMFA were measured at birth and in early childhood. Based on food-specific IgE (sIgE) levels, diet, and clinical history, children were classified as FS (sIgE ≥0.35 kU/L), FA, or non-FS/FA (controls). Folate concentrations were divided into quartiles, and multiple logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: Of a total of 1394 children, 507 children with FS and 78 with FA were identified. Although mean total folate concentrations at birth were lower among those who developed FA (30.2 vs 35.3 nmol/L; P = .02), mean concentrations of the synthetic folic acid derivative, UMFA, were higher (1.7 vs 1.3 nmol/L, P = .001). Higher quartiles of UMFA at birth were associated more strongly with FA (OR 8.50; 95% CI 1.7-42.8; test for trend P = .001). Neither early childhood concentrations of 5-MTHF nor UMFA were associated with the development of FS or FA. Conclusion: Among children in the BBC, higher concentrations of UMFA at birth were associated with the development of FA, which may be due to increased exposure to synthetic folic acid in utero or underlying genetic differences in synthetic folic acid metabolism.
AB - Background: Studies on the association between folate/folic acid exposure and the development of allergic disease have yielded inconsistent results, which may be due, in part, to lack of data distinguishing folate from folic acid exposure. Objective: To examine the association between total folate, 5-methyltetrahydrofolate (5-MTHF), and unmetabolized folic acid (UMFA) concentrations at birth and in early childhood and the development of food sensitization (FS) and food allergy (FA). Methods: A nested case control study was performed in the Boston Birth Cohort (BBC). Total folate, 5-MTHF, and UMFA were measured at birth and in early childhood. Based on food-specific IgE (sIgE) levels, diet, and clinical history, children were classified as FS (sIgE ≥0.35 kU/L), FA, or non-FS/FA (controls). Folate concentrations were divided into quartiles, and multiple logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: Of a total of 1394 children, 507 children with FS and 78 with FA were identified. Although mean total folate concentrations at birth were lower among those who developed FA (30.2 vs 35.3 nmol/L; P = .02), mean concentrations of the synthetic folic acid derivative, UMFA, were higher (1.7 vs 1.3 nmol/L, P = .001). Higher quartiles of UMFA at birth were associated more strongly with FA (OR 8.50; 95% CI 1.7-42.8; test for trend P = .001). Neither early childhood concentrations of 5-MTHF nor UMFA were associated with the development of FS or FA. Conclusion: Among children in the BBC, higher concentrations of UMFA at birth were associated with the development of FA, which may be due to increased exposure to synthetic folic acid in utero or underlying genetic differences in synthetic folic acid metabolism.
KW - 5-Methyltetrahydrofolate
KW - Folate
KW - Folic acid
KW - Food allergy
KW - Unmetabolized folic acid
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U2 - 10.1016/j.jaip.2019.06.017
DO - 10.1016/j.jaip.2019.06.017
M3 - Article
C2 - 31252026
AN - SCOPUS:85069612762
SN - 2213-2198
VL - 8
SP - 132-140.e5
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
IS - 1
ER -