Food allergy less common among children with cystic fibrosis
Key takeaways:
- Food allergy prevalence was lower in those with cystic fibrosis vs. the general pediatric population.
- The prevalence of food allergy significantly differed by sex and pancreatic enzyme replacement therapy.
SAN DIEGO — In a cohort of nearly 300 pediatric patients with cystic fibrosis, food allergy was found in less than 4% of the population, which was a lower proportion than the general pediatric population, according to a presentation here.
This retrospective cohort study was presented at the 2025 American Academy of Allergy, Asthma and Immunology/World Allergy Organization Joint Congress.
Stephanie Leeds, MD, MHS, assistant professor of pediatric allergy and immunology at Yale School of Medicine, and colleagues assessed 289 pediatric patients (median age, 12.4 years; 51.2% boys) with cystic fibrosis from three sources (the Cystic Fibrosis Foundation Registry, Yale University electronic medical records and Washington University in Saint Louis EMRs) to determine how prevalent food allergies are in this population, as well as whether there are certain demographic and clinical subgroups that have an increased food allergy prevalence.
“This study was developed after previous collaboration with researchers who found that in a large, unselected hospital population, patients with cystic fibrosis did not seem to have an IgE response to Arah2, the major peanut allergen,” Leeds told Healio. “Additionally, about 20% of patients with cystic fibrosis but less than 0.5% of control patients had ‘protective’ IgG against Arah2 in this unselected hospital population (unpublished data).
“All together, these findings raise the question: Could cystic fibrosis be protective against food allergy, and if so, what mechanisms might underlie this protective effect?” Leeds said.
Researchers sought out patients with a “convincing food allergy,” which factored in history, testing and management rather than just EMR documentation, and reported that only 3.8% (n = 11) had this allergy.
To put this finding into perspective, the abstract noted that 7.6% of the general U.S. pediatric patients surveyed in 2015 to 2016 had a food allergy, and this proportion was significantly higher (P < .0001) than that reported in the studied cystic fibrosis cohort.
After dividing the set of children with cystic fibrosis into various demographic groups, researchers found that four of the five studied characteristic groups (age, race, ethnicity and insurance type) did not significantly differ when evaluating the prevalence of food allergies within their subgroups. However, significantly more boys had a food allergy vs. girls (6.1% vs. 1.4%; P = .04).
A similar outcome was observed during the assessment of clinical characteristic groups, with most analyzed subgroups of these characteristics (for example, cystic fibrosis modulator and reflux therapy) having similar prevalences of food allergy. However, the prevalence of food allergy was significantly heightened among those without vs. with pancreatic enzyme replacement (9.1% vs. 2.3%; P = .02).
Additionally, Leeds said that “although not statistically significant, the distribution of cystic fibrosis mutation variants differed between those with and without food allergy.
“As we explore this topic in more detail, we may be able to understand food allergy development in a new way, which may eventually translate into novel understanding into prevention or therapeutics for food allergy,” Leeds told Healio. “This would be a long way off however, as these data are essentially exploratory at this point.”
Looking ahead, Leeds said an animal study exploring the relationship between cystic fibrosis and food allergy is in progress.
“One of our collaborators is now investigating peanut sensitization in a mouse model with homozygous CFTR mutations,” Leeds told Healio.
For more information:
Stephanie Leeds, MD, MHS, can be reached at stephanie.leeds@yale.edu.