Authors: Lowe, Adrian J.; Lodge, Caroline J.; Allen, Katrina J.; Abramson, Michael J.; Matheson, Melanie C.; Thomas, Paul S.; Barton, Christopher A.; Bennett, Catherine M.; Erbas, Bircan; Svanes, Cecilie; Wjst, Mathias; Real, Francisco Gomez; Perret, Jennifer L.; Russell, Melissa A.; Southey, Melissa C.; Hopper, John L.; Gurrin, Lyle C.; Axelrad, Christine J.; Hill, David J.; Dharmage, Shyamali C.
Brief summary of the paper: Why was the cohort set up?
The Melbourne Atopy Cohort Study (MACS) is a longitudinal study of a high-risk birth cohort, and their families, that focuses on the natural history, causes and consequences of allergic diseases (eczema, food allergy, asthma and allergic rhinitis). There is evidence that the prevalences of asthma, eczema and allergic rhinitis have risen rapidly since the 1960s and, although the evidence is less robust, there also appears to have been a later increase in the prevalence of food allergy. Australia has one of the highest rates of these diseases in the world. The rapid rise in prevalence suggests that shifts in environmental exposures are important in the induction of these diseases, as genetic influences alone cannot account for such swift changes.
For these reasons we established the MACS in 1990, by recruiting 620 unborn infants (probands) and their family members (1234 parents and 617 siblings). The MACS was originally designed to trial the effect of three infant formulae on the incidence of allergic disease. Before birth, infants were randomized to receive one of three formulae (cows’ milk, soy and a partially hydrolysed whey formula) at cessation or partial cessation of breastfeeding. Further details of this clinical trial are published elsewhere. Although the MACS was commenced as a clinical trial, the data have been subsequently used to address a wide range of questions relating to the natural history of allergic disease and risk factors for these conditions. Specific areas of focus are:
- oral and environmental risk factors for allergic disease and impaired lung function;
- use of early life biomarkers, particularly skin prick testing, to identify children at the greatest risk of developing allergic disease;
- and examination of the natural history and inter- relationships between the manifestations of allergic diseases, including wheeze sub-types.
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