This article is part of Pulmonology Advisor‘s coverage of the American Academy of Allergy, Asthma & Immunology, taking place in Orlando, Florida. Our staff will report on medical research related to asthma and other respiratory conditions, conducted by experts in the field. Check back regularly for more news from AAAAI/WAO 2018.

ORLANDO — Higher levels of unmetabolized folic acid (UMFA) at birth is associated with the development of food allergies, which may be the result of increased exposure to synthetic folic acid in utero or underlying genetic differences, according to research presented at the 2018 Joint Congress of the American Academy of Allergy, Asthma &Immunology/World Allergy Organization (AAAAI/WAO) in Orlando, Florida.

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The research team, led by Emily C. McGowan, MD, from the University of Virginia School of Medicine, conducted a nested case control study in the Boston Birth Cohort. Total folate and 5-methyltetrahydrofolate (5-MTHF)/UMFA were measured at birth and in early life by a chemiluminescent assay and liquid chromatography-mass spectrometry/mass spectrometry, respectively. Diet, clinical history, and specific immunoglobin E (IgE) to common food allergens were assessed in early life. Based on specific IgE and clinical history, children were classified as having food allergy or not having food allergy. Folate levels were then divided into quartiles.

A total of 1394 children were included in this study: 507 (36%) had food sensitization (sIgE ≥0.35 ku/L) and 78 (5.6%) had food allergy. A subgroup had 5-MTHF and UMFA measured at birth (n=502) and early life (n=362). Mean total folate levels at birth were lower in children in whom food allergy developed (30.2 vs 35.3 nmol/L; P =.02), but mean levels of the synthetic folic acid derivative, UMFA, were higher (1.7 vs 1.3 nmol/L; P =.001). Higher quartiles of UMFA were associated more strongly with food allergy (odds ratio, 9.4; P =.007; P test for trend =.001). There was no association between early life total folate, 5-MTHF, or UMFA levels and the development of food allergy.

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McGowan EC, Hong X, Selhub J, et al. The association between folate/folic acid metabolites and the development of food allergy (FA) in children. Presented at: 2018 American Academy of Allergy, Asthma & Immunology/World Allergy Organization Joint Congress; March 2-5, 2018; Orlando, FL. Abstract 275.