This synopsis book reports advances and key observations that will impact the care of children with allergic and immunologic diseases now and in the near future. Reviewers selected many articles that have clinical “pearls” and provide insights that are applicable for daily practice, as well as ones that challenge our previous notions and provide data that may lead to new approaches for diagnosis and treatment.Prevention of atopic disease requires identification of environmental factors that confer risk or provide protection. Studies reviewed here substantially support the “hygiene hypothesis” and suggest that pet exposure and having siblings are protective, whereas use of antibiotics during pregnancy is a risk factor for atopic disease. The Section on Allergy and Immunology–cosponsored Clinical Report on atopy prevention through diet1 continues to ring true with regard to having no restrictions on selection of complementary foods for an infant’s early diet if he or she is otherwise healthy. In fact, studies reviewed here suggest that exposure to a variety of foods, including allergenic ones, in the first year is not likely to induce allergy and may be protective. Vitamin D insufficiency remains a potential risk factor for atopy, presumably because of adverse effects on immune function and regulation, although studies reviewed here present conflicting evidence and randomized trials are needed to better identify the …
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