51
|
Kaur N, Mehr S, Katelaris C, Wainstein B, Altavilla B, Saad R, Valerio C, Codarini M, Burton P, Perram F, Baumgart K, Barnes EH, Campbell DE. Added Diagnostic Value of Peanut Component Testing: A Cross-Sectional Study in Australian Children. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 9:245-253.e4. [PMID: 32942048 DOI: 10.1016/j.jaip.2020.08.060] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Peanut components are widely used in clinical practice; however, their utility to predict challenge outcome in the Australian children, outside of infants, is not well studied. OBJECTIVE Can peanut component testing predict outcome of challenge in peanut-allergic children. METHODS All children attending peanut challenges, regardless of previous allergic reactions to peanut or sensitization (skin prick test or peanut IgE) alone, were recruited. Serum collected before the challenge was analyzed for peanut IgE and Ara h 1, 2, 3, 6, 8, and 9 (ImmunoCap). RESULTS Of the 222 children recruited, 89 (40%) were allergic on oral food challenge. Ara h 2 and 6 performed similarly to peanut IgE and skin prick test in predicting challenge outcome (area under the curve, 0.84-0.87). No baseline clinical characteristics, including past history, predicted challenge outcome. By logistic regression, degree of polysensitization to Ara h 1, 2, or 3 increased the odds of allergic reaction at oral food challenge at 0.35 and 1.0 kUA/L cutoff levels (P < .001 for both). All 11 children sensitized (>0.35 kUA/L) to Ara h 1, 2, and 3 reacted to peanut challenge. Degree of polysensitization at more than 1.0 kUA/L was associated with a lower cumulative eliciting dose (P = .016) and with severity of allergic reaction on challenge (P = .007). CONCLUSIONS In our cohort, sensitization to the combination of Ara h 1, 2, and 3 was highly predictive of peanut allergy. Overall, only Ara h 2 as individual component most correlated with severity of reaction at challenge and adrenaline use. Ara h 8 and 9 were not useful in predicting challenge outcome.
Collapse
Affiliation(s)
- Narinder Kaur
- Department of Allergy and Immunology, The Children's Hospital at Westmead, SCHN, Sydney, NSW, Australia; Sydney Child Health Program, Sydney Children's Hospitals Network, Sydney, NSW, Australia
| | - Sam Mehr
- Department of Allergy and Immunology, The Children's Hospital at Westmead, SCHN, Sydney, NSW, Australia
| | - Constance Katelaris
- Camden and Campbelltown Hospital, Sydney, NSW, Australia; School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Brynn Wainstein
- Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia; School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Betina Altavilla
- Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia
| | - Rebecca Saad
- Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia
| | - Carolina Valerio
- Department of Allergy and Immunology, The Children's Hospital at Westmead, SCHN, Sydney, NSW, Australia
| | - Miriam Codarini
- Camden and Campbelltown Hospital, Sydney, NSW, Australia; School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Pamela Burton
- Camden and Campbelltown Hospital, Sydney, NSW, Australia
| | - Fiona Perram
- Camden and Campbelltown Hospital, Sydney, NSW, Australia
| | - Karl Baumgart
- Immunology, Douglass Hanly Moir Pathology, Sydney, NSW, Australia
| | - Elizabeth H Barnes
- NHMRC Clinical Trials Centre, Sydney Medical School, Sydney University, Sydney, NSW, Australia
| | - Dianne E Campbell
- Department of Allergy and Immunology, The Children's Hospital at Westmead, SCHN, Sydney, NSW, Australia; Faculty of Medicine and Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
| |
Collapse
|
52
|
DunnGalvin A, Roberts G, Schnadt S, Astley S, Austin M, Blom WM, Baumert J, Chan CH, Crevel RWR, Grimshaw KEC, Kruizinga AG, Regent L, Taylor S, Walker M, Mills ENC. Evidence-based approaches to the application of precautionary allergen labelling: Report from two iFAAM workshops. Clin Exp Allergy 2020; 49:1191-1200. [PMID: 31325393 DOI: 10.1111/cea.13464] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/27/2019] [Accepted: 07/05/2019] [Indexed: 12/11/2022]
Abstract
Food allergy is a major public health concern with avoidance of the trigger food(s) being central to management by the patient. Food information legislation mandates the declaration of allergenic ingredients; however, the labelling of the unintentional presence of allergens is less defined. Precautionary allergen labelling (PAL) was introduced by the food industry to help manage and communicate the risk of reaction from the unintended presence of allergens in foods. In its current form, PAL is counterproductive for consumers with food allergies as there is no standardized approach to applying PAL. Foods with a PAL often do not contain the identified food allergen while some products without a PAL contain quantities of common food allergens that are capable of inducing an allergic reaction. Integrated Approaches to Food Allergen and Allergy Risk Management (iFAAM) was an EU-funded project that aimed to improve the management of food allergens by the food industry for the benefit of people with food allergies. Within iFAAM, a clinically validated tiered risk assessment approach for food allergens was developed. Two cross-stakeholder iFAAM workshops were held on 13-14 December 2016 and 19-20 April 2018. One of the objectives of these workshops was to develop a proposal to make PAL effective for consumers. This paper describes the outcomes from these workshops. This provides the basis for the development of more informative and transparent labelling that will ultimately improve management and well-being in consumers with food allergy.
Collapse
Affiliation(s)
- Audrey DunnGalvin
- Applied Psychology and Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Graham Roberts
- University of Southampton Faculty of Medicine, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK
| | - Sabine Schnadt
- German Allergy and Asthma Association (DAAB), Mönchengladbach, Germany
| | | | | | - W Marty Blom
- The Netherlands Organisation for Applied Scientific Research (TNO), Zeist, The Netherlands
| | - Joseph Baumert
- Food Allergy Research and Resource Programme, University of Nebraska, Lincoln, NE, USA
| | - Chun-Han Chan
- Food Allergy and Intolerance Branch, Food Standards Agency, London, UK
| | | | | | - Astrid G Kruizinga
- The Netherlands Organisation for Applied Scientific Research (TNO), Zeist, The Netherlands
| | | | - Stephen Taylor
- Food Allergy Research and Resource Programme, University of Nebraska, Lincoln, NE, USA
| | - Michael Walker
- Laboratory of the Government Chemist, LGC, Teddington, UK
| | - E N Clare Mills
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Manchester Academic Health Science Centre, Manchester Institute of Biotechnology, The University of Manchester, Manchester, UK
| |
Collapse
|
53
|
Rossetto A, Morgan AJ, Hart LM, Kelly CM, Jorm AF. Frequency and quality of first aid offered by older adolescents: a cluster randomised crossover trial of school-based first aid courses. PeerJ 2020; 8:e9782. [PMID: 32874786 PMCID: PMC7439956 DOI: 10.7717/peerj.9782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/30/2020] [Indexed: 11/23/2022] Open
Abstract
Background Research indicates that school-based first aid programmes appear to improve students’ knowledge and skills. However, evidence for their effectiveness is limited by a lack of rigorously designed studies. This research used a cluster randomised crossover trial to assess the effects of two different types of first aid training on the frequency and appropriateness of older adolescents’ first aid behaviours towards their peers 12 months after training. Methods Schools eligible to participate were government funded and able to accommodate first aid training and survey time for two consecutive Year 10 student cohorts. Four Australian public schools were matched in two pairs and randomly assigned to receive either physical first aid (PFA) or teen mental health first aid (tMHFA) training for their Year 10 student cohort (mean age 16 years). In the second year, the new Year 10 cohort received the other intervention. Four cohorts were randomised to receive PFA and four were randomised to receive tMHFA. Online surveys were administered at baseline and 12 months after training, measuring whether students had encountered a peer needing PFA, whether they had provided PFA, what actions they performed and, if applicable, why they had been unable to help the person. Only research staff analysing the data could be blinded to measurement occasion, school identity and condition. Results Four cohorts received PFA and four received tMHFA. The results indicated that there were no differences between groups regarding the frequency of appropriate first aid actions performed 12 months after training. The most common types of PFA provided to a peer were sending for help and wound care. Students most commonly mentioned someone else attending to their peer or lacking skills or experience as reasons for not performing PFA actions. Conclusions More research that examines first aid behaviours using rigorous, longitudinal study designs is needed to establish the effectiveness of school-based first aid training for older adolescents.
Collapse
Affiliation(s)
- Alyssia Rossetto
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.,Mental Health First Aid Australia, Melbourne, VIC, Australia
| | - Amy J Morgan
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Laura M Hart
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Claire M Kelly
- Mental Health First Aid Australia, Melbourne, VIC, Australia
| | - Anthony F Jorm
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.,Mental Health First Aid Australia, Melbourne, VIC, Australia
| |
Collapse
|
54
|
Logan K, Du Toit G, Giovannini M, Turcanu V, Lack G. Pediatric Allergic Diseases, Food Allergy, and Oral Tolerance. Annu Rev Cell Dev Biol 2020; 36:511-528. [PMID: 32634325 DOI: 10.1146/annurev-cellbio-100818-125346] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Pediatric allergic disease is a significant health concern worldwide, and the prevalence of childhood eczema, asthma, allergic rhinitis, and food allergy continues to increase. Evidence to support specific interventions for the prevention of eczema, asthma, and allergic rhinitis is limited, and no consensus on prevention strategies has been reached. Randomized controlled trials investigating the prevention of food allergy via oral tolerance induction and the early introduction of allergenic foods have been successful in reducing peanut and egg allergy prevalence. Infant weaning guidelines in the United Sates were recently amended to actively encourage the introduction of peanut for prevention of peanut allergy.
Collapse
Affiliation(s)
- Kirsty Logan
- Paediatric Allergy Research Group, Department of Women and Children's Health, School of Life Course Sciences, King's College London, London SE1 7EH, United Kingdom;
| | - George Du Toit
- Paediatric Allergy Research Group, Department of Women and Children's Health, School of Life Course Sciences, King's College London, London SE1 7EH, United Kingdom;
| | - Mattia Giovannini
- Paediatric Allergy Research Group, Department of Women and Children's Health, School of Life Course Sciences, King's College London, London SE1 7EH, United Kingdom; .,Allergy Unit, Department of Pediatrics, Anna Meyer Children's University Hospital, 50139 Florence, Italy
| | - Victor Turcanu
- School of Immunology and Microbial Sciences and School of Life Course Sciences, King's College London, London WC2R 2LS, United Kingdom
| | - Gideon Lack
- Paediatric Allergy Research Group, Department of Women and Children's Health, School of Life Course Sciences, King's College London, London SE1 7EH, United Kingdom;
| |
Collapse
|
55
|
Hoyos-Bachiloglu R, Escobar JJ, Cifuentes C, Aguilera-Insunza R, Morales PS, Borzutzky A. Increasing food allergies in Chile, a developing country post-epidemiological transition. Pediatr Allergy Immunol 2020; 31:585-588. [PMID: 32045033 DOI: 10.1111/pai.13225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/27/2020] [Accepted: 02/04/2020] [Indexed: 01/21/2023]
Affiliation(s)
- Rodrigo Hoyos-Bachiloglu
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan J Escobar
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Camila Cifuentes
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Raquel Aguilera-Insunza
- Department of Clinical Immunology and Rheumatology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Arturo Borzutzky
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Millennium Institute on Immunology and Immunotherapy, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| |
Collapse
|
56
|
Frith K, Katelaris CH. Current perspectives on peanut allergy. Intern Med J 2020; 49:1480-1487. [PMID: 31808255 DOI: 10.1111/imj.14658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 09/11/2019] [Accepted: 09/15/2019] [Indexed: 12/18/2022]
Abstract
Peanut allergy is increasingly prevalent and for most patients is a life-long condition, with the potential to cause life-threatening reactions. Accurate diagnosis and appropriate management are essential to minimise risks due to accidental peanut exposure. Current management strategies focus on strict allergen avoidance and access to emergency medicines to treat potential reactions; however, active approaches are an area of intense research. Promising new methods of food allergen immunotherapy are set to change the approach to managing peanut allergic patients in the near future.
Collapse
Affiliation(s)
- Katie Frith
- Department of Immunology and Infectious Diseases, Sydney Children's Hospital and University of New South Wales, Sydney, New South Wales, Australia
| | - Constance H Katelaris
- Department of Immunology, Campbelltown Hospital and Western Sydney University, Sydney, New South Wales, Australia
| |
Collapse
|
57
|
Krogulska A, Wood RA. Peanut allergy diagnosis: Moving from basic to more elegant testing. Pediatr Allergy Immunol 2020; 31:346-357. [PMID: 31945225 DOI: 10.1111/pai.13215] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/15/2019] [Accepted: 12/28/2019] [Indexed: 01/17/2023]
Abstract
Peanut allergy (PNA) is an IgE-mediated immune disorder, which merits particular attention due to its impact on the health and quality of life of millions of patients worldwide. PNA tends to develop in early life and resolves in only 20% of peanut-allergic children. It accounts for the majority of severe food-related allergic reactions. An accurate diagnosis of PNA is vital. In this review, we present the approach to the diagnosis of peanut allergy, starting from the history and proceeding to measures of overall sensitization and then to component-resolved diagnostics and oral food challenges as indicated. Additional testing in development includes basophil activation testing and determination of epitopes for peanut-allergic responses. Based on the literature, stepwise approaches and predictive models for diagnosing PNA are also presented.
Collapse
Affiliation(s)
- Aneta Krogulska
- Department of Pediatrics, Allergology and Gastroenterology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Robert A Wood
- Department of Pediatrics, Division of Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, USA
| |
Collapse
|
58
|
Abstract
Objectives: Although the factors driving emergency department demand have been extensively investigated, a comparatively minimal amount is known about the factors that are driving an increase in emergency ambulance demand. Methods: We conducted a retrospective observational study of consecutive cases attended by Ambulance Victoria in Melbourne, Australia from 2008 to 2015. Incidence rates were calculated, and adjusted time series regression analyses were performed to assess the driving factors of ambulance demand. Results: A total of 2,443,952 consecutive cases were included. Demand grew by 29.2% over the 8-year period. The age-specific incidence increased significantly over time for patients aged < 60 years, but not for patients aged ≥ 60 years. After adjustment for seasonality and population growth, demand increased by 1.4% per annum (incident rate ratio [IRR] = 1.014 [1.011-1.017]). The largest annual growth in demand was observed in patients with a history of mental health issues (IRR = 1.058 [1.054-1.062]), alcohol/drug abuse (IRR = 1.061 [1.056-1.066]), or a Charlson Comorbidity Index [CCI] score ≥ 4 (IRR = 1.045 [1.039-1.051]). Cases involving patients of relative socio-economic/educational disadvantage, younger age, or with no preexisting health conditions according to the CCI also grew faster than the overall patient population. Cases requiring transport to hospital increased by 1.2% annually (IRR = 1.012 [1.009-1.016]), although patients not requiring medical intervention from paramedics increased by 6.7% annually (IRR = 1.067 [1.063-1.072]). Conclusions: Increases in ambulance demand exceeded population growth. Emergency ambulances were increasingly utilized for transport of patients who did not require medical intervention from paramedics. Identifying the characteristics of patients driving ambulance demand will enable targeted demand management strategies.
Collapse
|
59
|
Hua T, Sambell R, Wallace R, Vale S, Devine A. Food allergy management in Early Childhood Education and Care Services in Australia. J Paediatr Child Health 2020; 56:394-399. [PMID: 31589366 DOI: 10.1111/jpc.14633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 07/07/2019] [Accepted: 09/01/2019] [Indexed: 11/29/2022]
Abstract
AIM To assess Australian Early Childhood Education and Care Services (ECEC) staff on their preparedness to manage children with food allergy (FA) and anaphylaxis. METHODS An online survey addressing training, knowledge, skills and staff confidence to manage FA and anaphylaxis was emailed to 5956 ECEC services nationally (excluding Western Australia, where this survey had been previously implemented); 494 surveys were completed and analysed. RESULTS One in 10 (9.5%) ECEC services did not require staff to undertake anaphylaxis training, indicating non-compliance with current legislation. Staff felt confident in managing FA and anaphylaxis, regardless of their level of training. Against recommendations, 37% of participating ECEC services stored adrenaline autoinjectors (AAI) in a locked location. Only 51.4% of ECEC services reported having an AAI trainer device. Victoria reported the highest level of anaphylaxis management training (P < 0.05), and staff were significantly less likely to store their AAI devices in a locked location compared to New South Wales and Queensland (P < 0.001). New South Wales and Queensland had a significantly lower proportion of services with AAI training devices than Victoria (P < 0.001). CONCLUSIONS ECEC staff self-reported high levels of training, knowledge, skills and confidence in FA and anaphylaxis management. However, we identified gaps in staff knowledge and skills, particularly in how to correctly store and administer an AAI device. Compliance with appropriate FA and anaphylaxis policies and emergency response plans need to be prioritised.
Collapse
Affiliation(s)
- Tonghuan Hua
- Public Health, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Ros Sambell
- Public Health, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Ruth Wallace
- Public Health, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Sandra Vale
- National Allergy Strategy, Sydney, New South Wales, Australia.,Australasian Society of Clinical Immunology and Allergy (ASCIA), Sydney, New South Wales, Australia
| | - Amanda Devine
- Public Health, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| |
Collapse
|
60
|
Abstract
PURPOSE OF REVIEW In recent decades, food allergy has become an increasing concern for families, clinicians, and policymakers. This review aims to summarize what is currently known about the epidemiology and population-level burden of IgE-mediated food allergy, including its effects on quality of life. RECENT FINDINGS Prevalence surveys, healthcare utilization data, and findings from longitudinal cohort studies across the globe indicate that food allergy imposes a growing societal burden. Worryingly, recent data indicate that food allergies may be more prevalent among adult populations than previously acknowledged, with many reported cases of adult-onset allergies. While it remains unclear how much of the current population-level burden of disease results from true, IgE-mediated allergy, as much epidemiological data does not incorporate clinical confirmation of disease prevalence-it is clear that affected individuals suffer impairments in their quality of life and incur substantial economic costs-beyond the physical health burden imposed by anaphylaxis.
Collapse
Affiliation(s)
- Christopher M Warren
- Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois, 60611, USA.,Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, California, USA
| | - Jialing Jiang
- Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois, 60611, USA
| | - Ruchi S Gupta
- Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois, 60611, USA. .,Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
| |
Collapse
|
61
|
Rasmussen E, Goddard AG, Bayer DK. Use of electronic learning modules can improve medical trainee knowledge regarding anaphylaxis diagnosis and treatment. Ann Allergy Asthma Immunol 2020; 124:295-296.e1. [PMID: 31911166 DOI: 10.1016/j.anai.2019.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/26/2019] [Accepted: 12/23/2019] [Indexed: 11/16/2022]
Affiliation(s)
- Erin Rasmussen
- University of Iowa Hospitals and Clinics, Iowa City, Iowa.
| | | | - Diana K Bayer
- University of Iowa Stead Family Children's Hospital, Iowa City, Iowa
| |
Collapse
|
62
|
McWilliam V, Peters RL, Allen KJ, Dharmage SC, Ponsonby AL, Tang ML, Smart J, Perrett K, Tey D, Robinson M, Taranto M, Koplin JJ, Gurrin LC, Dwyer T, Lowe A, Wake M, Robertson C, Sawyer S, Patton G, Douglass J, Vuillermin P. Skin Prick Test Predictive Values for the Outcome of Cashew Challenges in Children. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:141-148.e2. [DOI: 10.1016/j.jaip.2019.05.057] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 05/10/2019] [Accepted: 05/29/2019] [Indexed: 12/31/2022]
|
63
|
DunnGalvin A, Treneva M, Pampura A, Grebenko A, Makatsori M, Munblit D. Quality of life associated with maternal anxiety disorder in Russian children and adolescents with food allergy. Pediatr Allergy Immunol 2020; 31:78-84. [PMID: 31562786 DOI: 10.1111/pai.13130] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 09/05/2019] [Accepted: 09/18/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Food allergy negatively impacts the quality of life (QoL) and has been associated with increased maternal anxiety. There is currently a lack of data assessing QoL of food-allergic children and adolescents in Russia. We aimed to evaluate the performance of the Food Allergy Quality of Life Questionnaire (FAQLQ) measures in a Russian sample of children, adolescents, and mothers and to investigate association between child QoL and maternal general anxiety. METHODS FAQLQ and Food Allergy Independent Measures (FAIM) were translated to Russian to be completed by participants. Mothers also filled the General Anxiety Disorder (GAD-7) questionnaire. Reliability, construct, and discriminant validity of the FAQLQs and association between FAQLQ scores and general anxiety were assessed. RESULTS A total of 142 participants completed FAQLQ and FAIM. In total, 126 mothers completed GAD-7 questionnaire. All FAQLQs showed excellent internal consistency (α > 0.94). The means for the FAQLQ-PF, FAQLQ-CF, and FAQLQ-TF varied according to the number of foods avoided, severity of symptoms, and FAIM and GAD scores (ηp2 0.40 P < .001). One in 5 mothers had GAD-7 score indicative of moderate-to-severe anxiety. Association strength between GAD and FAQLQ increased with age. GAD score was associated with FAQLQ-PF score, controlling for multiple confounders. CONCLUSION The FAQLQ showed good reliability and validity in Russian. This study identified number of foods avoided and reported reaction severity being associated with greater QoL impairment in Russian children and adolescents affected by food allergy. The significant association found between general anxiety in parents and QoL in children and adolescents has practice, screening, and resource implications.
Collapse
Affiliation(s)
- Audrey DunnGalvin
- School of Applied Psychology, University College Cork, Cork City, Ireland.,Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Marina Treneva
- Veltischev Research and Clinical Institute for Pediatrics of the Pirogov Russian National Research Medical University, Moscow, Russia
| | - Alexander Pampura
- Veltischev Research and Clinical Institute for Pediatrics of the Pirogov Russian National Research Medical University, Moscow, Russia
| | | | - Melina Makatsori
- Specialist Allergy and Clinical Immunology Department, RNTNE Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - Daniel Munblit
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Department of Paediatrics, Imperial College London, London, UK.,The In-VIVO Global Network, an Affiliate of the World Universities Network (WUN), USA.,Solov'ev Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| |
Collapse
|
64
|
Estcourt MJ, Campbell DE, Gold MS, Richmond P, Allen KJ, Quinn HE, Marsh JA, Peters RL, Valerio C, Dai D, Waddington CS, Wood NJ, McIntyre PB, Holt PG, Snelling TL. Whole-Cell Pertussis Vaccination and Decreased Risk of IgE-Mediated Food Allergy: A Nested Case-Control Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 8:2004-2014. [PMID: 31891824 DOI: 10.1016/j.jaip.2019.12.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/25/2019] [Accepted: 12/10/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Rates of food allergy have increased markedly in Australia and other high- income countries in recent years. On the basis of ecological observations, and the known immunologic characteristics of whole-cell pertussis (wP) compared with acellular pertussis (aP) vaccines, we hypothesized that wP vaccination in infancy protects against the development of food allergy. OBJECTIVE To determine whether infants who receive wP in infancy were less likely to develop IgE-mediated food allergy than those who received aP. METHODS Retrospective cohort-nested case-control study of Australian children born in the period 1997 to 1999, the period of transition from using wP-containing to aP-containing vaccines. Children diagnosed with IgE-mediated food allergy were individually matched to 10 controls by date of birth, socioeconomic decile, and jurisdiction of birth. The odds ratio of vaccination with wP versus aP among cases and matched controls was calculated using conditional logistic regression. RESULTS The odds ratio of receiving the first dose as wP (rather than aP) among cases of food allergy compared with controls was 0.77 (95% CI, 0.62-0.95). The results of secondary analyses (any dose as wP vs aP-only, and wP-only vs aP-only) were broadly similar. CONCLUSIONS Australian infants who received wP vaccines were less likely to be diagnosed with food allergy in childhood than contemporaneous children who received aP vaccines. If a protective effect is confirmed in a randomized controlled trial, wP or mixed wP and aP vaccination schedules could form part of an effective strategy for combating the rise in food allergies.
Collapse
Affiliation(s)
- Marie J Estcourt
- Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia; School of Population and Global Health, University of Western Australia, Crawley, WA, Australia
| | - Dianne E Campbell
- Department of Allergy and Immunology, The Children's Hospital at Westmead, Westmead, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Michael S Gold
- School of Medicine, University of Adelaide, Women's and Children's Health Network, North Adelaide, SA, Australia
| | - Peter Richmond
- Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia; Division of Paediatrics, School of Medicine, University of Western Australia and Immunology Department, Perth Children's Hospital, Nedlands, WA, Australia
| | - Katrina J Allen
- Centre for Food and Allergy Research, Murdoch Children's Research Institute, Melbourne, VIC, Australia; University of Melbourne Department of Paediatrics, Royal Children's Hospital Melbourne, Melbourne, VIC, Australia
| | - Helen E Quinn
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Westmead, NSW, Australia; Discipline of Child and Adolescent Health, The University of Sydney Children's Hospital, Westmead Clinical School, Westmead, NSW, Australia
| | - Julie A Marsh
- Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia; School of Population and Global Health, University of Western Australia, Crawley, WA, Australia
| | - Rachel L Peters
- Centre for Food and Allergy Research, Murdoch Children's Research Institute, Melbourne, VIC, Australia; University of Melbourne Department of Paediatrics, Royal Children's Hospital Melbourne, Melbourne, VIC, Australia
| | - Carolina Valerio
- Department of Allergy and Immunology, The Children's Hospital at Westmead, Westmead, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Danyi Dai
- Department of Allergy and Immunology, The Children's Hospital at Westmead, Westmead, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Claire S Waddington
- Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia; Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Nicholas J Wood
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Westmead, NSW, Australia; Discipline of Child and Adolescent Health, The University of Sydney Children's Hospital, Westmead Clinical School, Westmead, NSW, Australia
| | - Peter B McIntyre
- National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Westmead, NSW, Australia; Discipline of Child and Adolescent Health, The University of Sydney Children's Hospital, Westmead Clinical School, Westmead, NSW, Australia
| | - Patrick G Holt
- Human Immunology, Telethon Kids Institute, Perth Children's Hospital, Nedlands, WA, Australia
| | - Thomas L Snelling
- Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia; School of Public Health, Curtin University, Bentley, WA, Australia.
| |
Collapse
|
65
|
Li J, Ogorodova LM, Mahesh PA, Wang MH, Fedorova OS, Leung TF, Fernandez-Rivas M, Mills ENC, Potts J, Kummeling I, Versteeg SA, van Ree R, Yazdanbakhsh M, Burney PGJ, Wong GWK. Comparative Study of Food Allergies in Children from China, India, and Russia: The EuroPrevall-INCO Surveys. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 8:1349-1358.e16. [PMID: 31857266 DOI: 10.1016/j.jaip.2019.11.042] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 10/30/2019] [Accepted: 11/21/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND A clear understanding of the differences in the epidemiology of food allergy between rural and urban populations may provide insights into the causes of increasing prevalence of food allergy in the developed world. OBJECTIVE We used a standardized methodology to determine the prevalence and types of food-specific allergic sensitization and food allergies in schoolchildren from urban and rural regions of China, Russia, and India. METHODS The current study is a multicenter epidemiological survey of children recruited from 5 cities in China (Hong Kong and Guangzhou), Russia (Tomsk), and India (Bengaluru and Mysore) and 1 rural county in Southern China (Shaoguan). A total of 35,549 children aged 6 to 11 years from 3 countries participated in this survey. Random samples of children from 3 countries were first screened by the EuroPrevall screening questionnaire. Children with and without a history of adverse reactions to foods were then recruited for the subsequent case-control comparative studies. We determined the prevalence rates of food-specific IgE sensitization and food allergies using the predefined criteria. RESULTS The prevalence rates of food-specific IgE sensitization (≥0.7 kU/L) to at least 1 food were 16.6% in Hong Kong, 7.0% in Guangzhou, 16.8% in rural Shaoguan, 8.0% in Tomsk, and 19.1% in India. Using a definition of probable food allergy as reporting allergic symptoms within 2 hours of ingestion of a specific food plus the presence of allergic sensitization to the specific food (positive IgE and/or positive skin prick test result), the prevalence of food allergy was highest in Hong Kong (1.50%), intermediate in Russia (0.87%), and lowest in Guangzhou (0.21%), Shaoguan (0.69%), and India (0.14%). For children recruited from Hong Kong, both sensitization and food allergy were significantly higher in children who were born and raised in Hong Kong when compared with those who were born in mainland China and migrated to Hong Kong, highlighting the importance of early-life exposures in affecting the subsequent development of food sensitization and food allergy. CONCLUSIONS There are wide variations in the prevalence of food-specific IgE sensitization and food allergy in the 3 participating countries. Food allergy appears to be less common when compared with developed countries. The variations in the prevalence of food allergen sensitization cannot be explained by the differences in the degree of urbanization. Despite the high prevalence of food-specific IgE sensitization in India and rural China, food allergy is still extremely uncommon. In addition to IgE sensitization, other factors must play important roles resulting in the clinical manifestations of food allergies.
Collapse
Affiliation(s)
- Jing Li
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | | | - Padukudru Anand Mahesh
- Department of TB and Respiratory Medicine, JSS Medical College, JSS University and Allergy Asthma Associates, Mysore, India
| | - Maggie Haitian Wang
- School of Public Health, Chinese University of Hong Kong, Shatin, NT, Hong Kong, China
| | | | - Ting Fan Leung
- Department of Pediatrics, Chinese University of Hong Kong, Hong Kong, China
| | | | - E N Clare Mills
- School of Translational Medicine, Manchester Academic Health Science Centre and Manchester Interdisciplinary Biocentre, The University of Manchester, Manchester, United Kingdom
| | - James Potts
- Department of Respiratory Epidemiology and Public Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Ischa Kummeling
- Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands
| | - Serge A Versteeg
- Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands
| | - Ronald van Ree
- Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands; Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter G J Burney
- Department of Respiratory Epidemiology and Public Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Gary W K Wong
- Department of Pediatrics, Chinese University of Hong Kong, Hong Kong, China.
| |
Collapse
|
66
|
Global Trends in Anaphylaxis Epidemiology and Clinical Implications. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 8:1169-1176. [PMID: 31786255 PMCID: PMC7152797 DOI: 10.1016/j.jaip.2019.11.027] [Citation(s) in RCA: 116] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/18/2019] [Accepted: 11/18/2019] [Indexed: 12/20/2022]
Abstract
The true global scale of anaphylaxis remains elusive, because many episodes occur in the community without presentation to health care facilities, and most regions have not yet developed reliable systems with which to monitor severe allergic events. The most robust data sets currently available are based largely on hospital admissions, which are limited by inherent issues of misdiagnosis, misclassification, and generalizability. Despite this, there is convincing evidence of a global increase in rates of all-cause anaphylaxis, driven largely by medication- and food-related anaphylaxis. There is no evidence of parallel increases in global all-cause anaphylaxis mortality, with surprisingly similar estimates for case-fatality rates at approximately 0.5% to 1% of fatal outcomes for hospitalizations due to anaphylaxis across several regions. Studying regional patterns of anaphylaxis to certain triggers have provided valuable insights into susceptibility and sensitizing events: for example, the link between the mAb cetuximab and allergy to mammalian meat. Likewise, data from published fatality registers can identify potentially modifiable risk factors that can be used to inform clinical practice, such as prevention of delayed epinephrine administration, correct posturing during anaphylaxis, special attention to populations at risk (such as the elderly on multiple medications), and use of venom immunotherapy in individuals at risk of insect-related anaphylaxis.
Collapse
|
67
|
Sheridan MJ, Koeberl M, Hedges CE, Biros E, Ruethers T, Clarke D, Buddhadasa S, Kamath S, Lopata AL. Undeclared allergens in imported packaged food for retail in Australia. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2019; 37:183-192. [PMID: 31750787 DOI: 10.1080/19440049.2019.1679890] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The Australia New Zealand Food Standards Code (the Code) requires a declaration of the presence of 11 different allergens made through the label on a food product. Most food recalls in Australia are now due to undeclared allergens . This survey determined the extent of undeclared allergens in imported food products on the Asian retail market in Australia. A total of 50 imported packaged foods were selectively purchased from local Asian grocery retail stores in Melbourne and the presence of undeclared gluten, milk, peanut and egg determined. Analysis was performed using commercial enzyme-linked immunosorbent assay (ELISA) (R-Biopharm). Thirty-seven undeclared allergens (gluten n = 12, milk n = 12, peanut n = 6, and egg n = 7) were detected in 23 of the 50 products analysed (46%), with 18% containing multiple undeclared allergens. The high number of undeclared allergens is alarming and in line with the increasing number of food recalls and anaphylaxis recorded in Australia.
Collapse
Affiliation(s)
- Michael John Sheridan
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Martina Koeberl
- Food Allergen Laboratory, Analytical Services Branch, Department of Industry, Innovation and Science, National Measurement Institute, Melbourne, Australia
| | - Claire Elizabeth Hedges
- Food Allergen Laboratory, Analytical Services Branch, Department of Industry, Innovation and Science, National Measurement Institute, Melbourne, Australia
| | - Erik Biros
- College of Medicine and Dentistry, James Cook University, Townsville, Australia
| | - Thimo Ruethers
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Dean Clarke
- Food Allergen Laboratory, Analytical Services Branch, Department of Industry, Innovation and Science, National Measurement Institute, Melbourne, Australia
| | - Saman Buddhadasa
- Food Allergen Laboratory, Analytical Services Branch, Department of Industry, Innovation and Science, National Measurement Institute, Melbourne, Australia
| | - Sandip Kamath
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia.,Australian Institute for Tropical Health and Medicine, James Cook University, Townsville, Australia
| | - Andreas Ludwig Lopata
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia.,Australian Institute for Tropical Health and Medicine, James Cook University, Townsville, Australia
| |
Collapse
|
68
|
Tham EH, Leung ASY, Pacharn P, Lee S, Ebisawa M, Lee BW, Wong GWK. Anaphylaxis - Lessons learnt when East meets West. Pediatr Allergy Immunol 2019; 30:681-688. [PMID: 31220363 DOI: 10.1111/pai.13098] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/28/2019] [Accepted: 06/11/2019] [Indexed: 11/28/2022]
Abstract
The rapidly increasing prevalence of allergic disorders over the past 2 decades highlights the need to understand the epidemiology of anaphylaxis. In Europe, the United States, and Australia, the incidence of anaphylaxis is estimated to be between 60 and 950 cases per 100 000 population, with a lifetime prevalence of anaphylaxis of 0.05%-2%. The incidence appears to be increasing over time. Although the existing Asian literature is heterogeneous and limited by under-reporting, it also suggests a similar increasing trend in anaphylaxis incidence in Asia. Anaphylaxis triggers in Asia, such as the predominance of shellfish and wheat in older children and adolescents, differ from those seen in Western populations. Triggers unique to Asia such as traditional Chinese medications, galacto-oligosaccharides, and food delicacies have also been reported. Low usage of adrenaline as first-line treatment of anaphylaxis is evident across all countries and is particularly concerning. There is a need to establish prospective, standardized protocols for anaphylaxis data collection and reporting, to enhance the collective understanding of anaphylaxis and its burden, gaps in management and to identify areas for future research and intervention in each region. Understanding of the underlying reasons explaining the difference between East and West will facilitate future primary preventive strategies.
Collapse
Affiliation(s)
- Elizabeth H Tham
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Agnes S Y Leung
- Department of Pediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Sha Tin, Hong Kong, China
| | - Punchama Pacharn
- Department of Pediatrics, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sooyoung Lee
- Department of Pediatrics, Ajou University School of Medicine, Suwon, South Korea
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Sagamihara, Japan
| | - Bee Wah Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Gary W K Wong
- Department of Pediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Sha Tin, Hong Kong, China
| | | |
Collapse
|
69
|
DunnGalvin A, Roberts G, Regent L, Austin M, Kenna F, Schnadt S, Sanchez-Sanz A, Hernandez P, Hjorth B, Fernandez-Rivas M, Taylor S, Baumert J, Sheikh A, Astley S, Crevel R, Mills C. Understanding how consumers with food allergies make decisions based on precautionary labelling. Clin Exp Allergy 2019; 49:1446-1454. [PMID: 31400020 DOI: 10.1111/cea.13479] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/16/2019] [Accepted: 06/26/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Understanding consumer perceptions is crucial if effective food safety policy and risk communication are to be developed and implemented. We sought to understand how those living with food allergy assess risk with precautionary allergen labelling (PAL) and their preference in how risks are communicated within a quantitative risk assessment (QRA) framework. METHODS The Integrated Approaches to Food Allergen and Allergy Risk Management (iFAAM) labelling online survey was developed for adults and parents of children with food allergy and distributed across Germany, Ireland, Netherlands, Spain and UK via patient support groups. RESULTS There were 1560 complete responses. 'This product is not suitable for' was selected as first choice for PAL by 46% overall and 'May contain' was selected as the first choice by 44%. Seventy-three percent reported that it would improve their trust in a product if a QRA process had been used to make a decision about whether to include 'may contain'. Overall, 66% reported that a 'statement + symbol' on the label indicating a QRA, would help them to understand the risk assessment process that had been used by the food manufacturer. CONCLUSIONS Consumers want to know what process has actually taken place for the placing of a PAL and/or risk assessment statement on a particular food product. Our findings provide a basis for the development of more informative communication around food allergen risk and safety and support evidence-based policy-making in the context of the legislative requirements of the European Union's Food Information for Consumers Regulation.
Collapse
Affiliation(s)
- Audrey DunnGalvin
- Paediatrics and Child Health, University College, Cork, Ireland.,School of Applied Psychology, University College, Cork, Ireland.,Paediatrics and Child Infectious Diseases, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Graham Roberts
- Clinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK
| | | | | | | | - Sabine Schnadt
- Deutscher Allergie- und Asthmabunde.V., German Allergy and Asthma Association, Mönchengladbach, Germany
| | - Angel Sanchez-Sanz
- Asociación Española de Personas con Alergia a Alimentos y Látex, Madrid, Spain
| | - Pilar Hernandez
- Asociación Española de Personas con Alergia a Alimentos y Látex, Madrid, Spain
| | | | | | - Steve Taylor
- Food Allergy Research and Resource Program, University of Nebraska, Lincoln, NE, USA
| | - Joseph Baumert
- Food Allergy Research and Resource Program, University of Nebraska, Lincoln, NE, USA
| | - Aziz Sheikh
- Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | | | - Rene Crevel
- Unilever Safety and Environmental Assurance Centre, Bedford, UK.,René Crevel Consulting Limited, Bedford, UK
| | - Clare Mills
- Manchester Institute of Biotechnology, Division of Infection, Inflammation and Respiratory Medicine, School of Biological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| |
Collapse
|
70
|
|
71
|
Drug-Induced Anaphylaxis in Children. CURRENT TREATMENT OPTIONS IN ALLERGY 2019. [DOI: 10.1007/s40521-019-00209-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
72
|
Soriano VX, Peters RL, Ponsonby AL, Dharmage SC, Perrett KP, Field MJ, Knox A, Tey D, Odoi S, Gell G, Camesella Perez B, Allen KJ, Gurrin LC, Koplin JJ. Earlier ingestion of peanut after changes to infant feeding guidelines: The EarlyNuts study. J Allergy Clin Immunol 2019; 144:1327-1335.e5. [PMID: 31401287 DOI: 10.1016/j.jaci.2019.07.032] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 07/10/2019] [Accepted: 07/26/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Randomized controlled trials demonstrate that timely introduction of peanut to infants reduces the risk of peanut allergy. However, much debate remains regarding how to best achieve earlier peanut introduction at the population level. Our previous study in 2007-2011 (HealthNuts, n = 5300) indicated that few infants were consuming peanut in the first year. Australian infant feeding guidelines were updated in 2016 to recommend introducing peanut before 12 months for all infants. There were no data available on the subsequent effect on peanut introduction or peanut reactions. OBJECTIVE We sought to assess the consequences of a nonscreening approach to allergenic food introduction in a population-based sample of infants in their first year of life. METHODS EarlyNuts is a population-based, cross-sectional study of 12-month-old infants in Melbourne, Australia, recruited by using an identical sampling frame and methods to HealthNuts (72% response rate vs 73% response rate in HealthNuts). We report here on the first 860 participants recruited between November 2016 and October 2018. RESULTS Most infants (88.6%; 95% CI, 86.1% to 90.7%) had introduced peanut by 12 months (median age, 6 months), an increase from 28.4% (95% CI, 27.2% to 29.7%) in the HealthNuts study. By 12 months, the majority of these (76.4%) had consumed peanut more than 4 times, and 28% were eating peanut more than once per week. Preliminary results on parent-reported reactions show that 4.0% of those consuming peanut by 12 months had possible IgE-mediated reactions. CONCLUSIONS There has been a striking shift toward earlier peanut introduction, with a 3-fold increase in peanut introduction by age 1 year in 2018 compared with 2007-2011.
Collapse
Affiliation(s)
- Victoria X Soriano
- Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Rachel L Peters
- Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Anne-Louise Ponsonby
- School of Population and Global Health, University of Melbourne, Parkville, Australia; Neuroepidemiology Research Group, Florey Institute for Neuroscience and Mental Health, Parkville, Australia
| | - Shyamali C Dharmage
- School of Population and Global Health, University of Melbourne, Parkville, Australia
| | - Kirsten P Perrett
- Murdoch Children's Research Institute, Parkville, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia; School of Population and Global Health, University of Melbourne, Parkville, Australia
| | | | - Andrew Knox
- Murdoch Children's Research Institute, Parkville, Australia
| | - Dean Tey
- Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia; Melbourne Allergy Centre and Children's Specialists (MACCS) Medical Group, Royal Children's Hospital, Parkville, Australia
| | - Sasha Odoi
- Murdoch Children's Research Institute, Parkville, Australia
| | - Grace Gell
- Murdoch Children's Research Institute, Parkville, Australia
| | | | - Katrina J Allen
- Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia
| | - Lyle C Gurrin
- Murdoch Children's Research Institute, Parkville, Australia; School of Population and Global Health, University of Melbourne, Parkville, Australia
| | - Jennifer J Koplin
- Murdoch Children's Research Institute, Parkville, Australia; School of Population and Global Health, University of Melbourne, Parkville, Australia.
| |
Collapse
|
73
|
Wang Y, Allen KJ, Suaini NHA, McWilliam V, Peters RL, Koplin JJ. The global incidence and prevalence of anaphylaxis in children in the general population: A systematic review. Allergy 2019; 74:1063-1080. [PMID: 30688375 DOI: 10.1111/all.13732] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 12/15/2018] [Accepted: 01/20/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Despite an increasing number of publications from individual countries and regions, there is still no systematic review of the global epidemiology of anaphylaxis in the general paediatric population. METHODS We conducted a systematic review, using a protocol registered and published with the international prospective register of systematic reviews (PROSPERO). Results were reported following PRISMA guidelines. The search strategy was designed in Medline (ovid) and modified for Embase (ovid) and PubMed. Papers were screened by two independent reviewers following selection and exclusion criteria. Data extraction and risk of bias assessment were completed by the same two reviewers. Studies in adults only or those that did not report data in children separately were excluded. RESULTS A final total of 59 articles were included. Of these, 5 reported cumulative incidence, 39 reported incidence rate and 17 reported prevalence data. The incidence of anaphylaxis in children worldwide varied widely, ranging from 1 to 761 per 100 000 person-years for total anaphylaxis and 1 to 77 per 100 000 person-years for food-induced anaphylaxis. The definition of anaphylaxis from NIAID/FAAN was the most commonly used. Gender and ethnicity were demographic risk factors associated with anaphylaxis in children. Increasing total or food-induced anaphylaxis incidence over time was reported by 19 studies. CONCLUSION The reported incidence of anaphylaxis in children varied widely. Studies in developing countries are underrepresented. To accurately compare anaphylaxis incidence between countries and investigate the time trends, further studies using a standardized definition across different countries are required.
Collapse
Affiliation(s)
- Yichao Wang
- Murdoch Children's Research Institute; Parkville Victoria Australia
- Department of Paediatrics; University of Melbourne; Melbourne Victoria Australia
| | - Katrina J. Allen
- Murdoch Children's Research Institute; Parkville Victoria Australia
- Department of Paediatrics; University of Melbourne; Melbourne Victoria Australia
- The Department of Allergy and Immunology; Royal Children's Hospital; Melbourne Victoria Australia
| | - Noor H. A. Suaini
- Murdoch Children's Research Institute; Parkville Victoria Australia
- Department of Paediatrics; University of Melbourne; Melbourne Victoria Australia
| | - Vicki McWilliam
- Murdoch Children's Research Institute; Parkville Victoria Australia
- Department of Paediatrics; University of Melbourne; Melbourne Victoria Australia
- The Department of Allergy and Immunology; Royal Children's Hospital; Melbourne Victoria Australia
| | - Rachel L. Peters
- Murdoch Children's Research Institute; Parkville Victoria Australia
- Department of Paediatrics; University of Melbourne; Melbourne Victoria Australia
| | - Jennifer J. Koplin
- Murdoch Children's Research Institute; Parkville Victoria Australia
- The School of Population and Global Health; University of Melbourne; Melbourne Victoria Australia
| |
Collapse
|
74
|
Welch S, Johns R, Nicholls G, Bennett G, Kettle E, Duong M, Finckh A, Berry M, Woods N, Branch J, Tong W, Duffy M. Incorporation of a theme‐based research model into a pharmacy department research program. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2019. [DOI: 10.1002/jppr.1510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Susan Welch
- Pharmacy Department St Vincent's Hospital Sydney Australia
- Faculty of Pharmacy University of Sydney Sydney Australia
| | - Rachelle Johns
- Pharmacy Department St Vincent's Hospital Sydney Australia
| | - Gary Nicholls
- Emergency Department St Vincent's Hospital Sydney Australia
| | - Glenn Bennett
- Emergency Department St Vincent's Hospital Sydney Australia
| | - Emily Kettle
- Pharmacy Department St Vincent's Hospital Sydney Australia
| | - Minh‐Tu Duong
- Emergency Department St Vincent's Hospital Sydney Australia
| | - Andrew Finckh
- Emergency Department St Vincent's Hospital Sydney Australia
| | - Melinda Berry
- Don Harrison Patient Safety Simulation Centre St Vincent's Hospital Sydney Australia
| | - Nikki Woods
- Emergency Department St Vincent's Hospital Sydney Australia
| | - Judy Branch
- Anaesthetics Department St Vincent's Hospital Sydney Australia
| | - Winnie Tong
- HIV, Immunology and Infectious Diseases Department St Vincent's Centre for Applied Medical Research St Vincent's Hospital Sydney Australia
| | - Martin Duffy
- Emergency Department St Vincent's Hospital Sydney Australia
| |
Collapse
|
75
|
Ziyab AH. Prevalence of food allergy among schoolchildren in Kuwait and its association with the coexistence and severity of asthma, rhinitis, and eczema: A cross-sectional study. World Allergy Organ J 2019; 12:100024. [PMID: 30976380 PMCID: PMC6441753 DOI: 10.1016/j.waojou.2019.100024] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 12/25/2018] [Accepted: 03/11/2019] [Indexed: 11/09/2022] Open
Abstract
Background Food allergy (FA) is a common public health problem that affects both children and adults. Empirical knowledge of the burden of FA in Kuwait is limited. This study sought to estimate the prevalence of FA among schoolchildren in Kuwait and assess associations between FA and the coexistence and severity of asthma, rhinitis, and eczema. Methods Schoolchildren aged 11–14 years (n = 3,864) were enrolled in a cross-sectional study. Parents completed questionnaires regarding their children's early life exposures and clinical history of FA and allergic diseases. Study-defined FA was ascertained by a convincing clinical history. Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were estimated. Results The 12-month prevalence of study-defined FA was estimated to be 4.1% (154/3,738), with more girls being affected than boys (aPR = 1.44, 95% CI: 1.04–1.99). Egg (2.7%), fish (1.6%), shellfish (1.3%), peanut (1.3%), and tree nut (1.2%) were the most reported offending food allergens. Underweight and adiposity, cesarean section delivery, exposure to household dogs during infancy, and parental history of doctor-diagnosed FA were associated with an increased prevalence of study-defined FA. However, later birth order was associated with a reduced prevalence of study-defined FA. The prevalence of eczema only was higher in children with study-defined FA than in those without study-defined FA (aPR = 3.49, 95% CI: 2.37–5.14). In contrast, this association was not pronounced for children who had asthma only (aPR = 1.56, 95% CI: 0.94–2.57) or rhinitis only (aPR = 1.40, 95% CI: 0.86–2.28). Study-defined FA was associated with a 9.20-fold (95% CI: 4.50–18.78) higher prevalence of coexisting asthma, rhinitis, and eczema. Moreover, study-defined FA was associated with increased severity of symptoms of asthma, rhinitis, and eczema. Conclusions FA affects a considerable proportion of schoolchildren in Kuwait, and the most reported offending food allergens are similar to those reported in Western countries. Study-defined FA was associated with the coexistence and increased severity of asthma, rhinitis, and eczema, indicating that FA may link the comanifestations of allergic diseases and contribute to their chronicity and severity.
Collapse
Affiliation(s)
- Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| |
Collapse
|
76
|
Severe food allergies: can they be considered rare diseases? Curr Opin Allergy Clin Immunol 2019; 17:201-203. [PMID: 28379865 DOI: 10.1097/aci.0000000000000368] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
77
|
Berni Canani R, Paparo L, Nocerino R, Di Scala C, Della Gatta G, Maddalena Y, Buono A, Bruno C, Voto L, Ercolini D. Gut Microbiome as Target for Innovative Strategies Against Food Allergy. Front Immunol 2019; 10:191. [PMID: 30828329 PMCID: PMC6384262 DOI: 10.3389/fimmu.2019.00191] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 01/22/2019] [Indexed: 12/11/2022] Open
Abstract
The dramatic increase in food allergy prevalence and severity globally requires effective strategies. Food allergy derives from a defect in immune tolerance mechanisms. Immune tolerance is modulated by gut microbiota function and structure, and microbiome alterations (dysbiosis) have a pivotal role in the development of food allergy. Environmental factors, including a low-fiber/high-fat diet, cesarean delivery, antiseptic agents, lack of breastfeeding, and drugs can induce gut microbiome dysbiosis, and have been associated with food allergy. New experimental tools and technologies have provided information regarding the role of metabolites generated from dietary nutrients and selected probiotic strains that could act on immune tolerance mechanisms. The mechanisms are multiple and still not completely defined. Increasing evidence has provided useful information on optimal bacterial species/strains, dosage, and timing for intervention. The increased knowledge of the crucial role played by nutrients and gut microbiota-derived metabolites is opening the way to a post-biotic approach in the stimulation of immune tolerance through epigenetic regulation. This review focused on the potential role of gut microbiome as the target for innovative strategies against food allergy.
Collapse
Affiliation(s)
- Roberto Berni Canani
- Department of Translational Medical Science – Pediatric Section, University of Naples “Federico II”, Naples, Italy
- European Laboratory for the Investigation of Food-Induced Diseases, University of Naples “Federico II”, Naples, Italy
- ImmunoNutritionLab at CEINGE-Advanced Biotechnologies, University of Naples “Federico II”, Naples, Italy
- Task Force on Microbiome Studies, University of Naples “Federico II”, Naples, Italy
| | - Lorella Paparo
- Department of Translational Medical Science – Pediatric Section, University of Naples “Federico II”, Naples, Italy
- ImmunoNutritionLab at CEINGE-Advanced Biotechnologies, University of Naples “Federico II”, Naples, Italy
| | - Rita Nocerino
- Department of Translational Medical Science – Pediatric Section, University of Naples “Federico II”, Naples, Italy
- ImmunoNutritionLab at CEINGE-Advanced Biotechnologies, University of Naples “Federico II”, Naples, Italy
| | - Carmen Di Scala
- Department of Translational Medical Science – Pediatric Section, University of Naples “Federico II”, Naples, Italy
- ImmunoNutritionLab at CEINGE-Advanced Biotechnologies, University of Naples “Federico II”, Naples, Italy
| | - Giusy Della Gatta
- Department of Translational Medical Science – Pediatric Section, University of Naples “Federico II”, Naples, Italy
- ImmunoNutritionLab at CEINGE-Advanced Biotechnologies, University of Naples “Federico II”, Naples, Italy
| | - Ylenia Maddalena
- Department of Translational Medical Science – Pediatric Section, University of Naples “Federico II”, Naples, Italy
| | - Aniello Buono
- Department of Translational Medical Science – Pediatric Section, University of Naples “Federico II”, Naples, Italy
- ImmunoNutritionLab at CEINGE-Advanced Biotechnologies, University of Naples “Federico II”, Naples, Italy
| | - Cristina Bruno
- Department of Translational Medical Science – Pediatric Section, University of Naples “Federico II”, Naples, Italy
- ImmunoNutritionLab at CEINGE-Advanced Biotechnologies, University of Naples “Federico II”, Naples, Italy
| | - Luana Voto
- Department of Translational Medical Science – Pediatric Section, University of Naples “Federico II”, Naples, Italy
| | - Danilo Ercolini
- Task Force on Microbiome Studies, University of Naples “Federico II”, Naples, Italy
- Department of Agricultural Sciences, University of Naples “Federico II”, Naples, Italy
| |
Collapse
|
78
|
Sommerfield DL, Sommerfield A, Schilling A, Slevin L, Lucas M, von Ungern-Sternberg BS. Allergy alerts - The incidence of parentally reported allergies in children presenting for general anesthesia. Paediatr Anaesth 2019; 29:153-160. [PMID: 30414337 DOI: 10.1111/pan.13541] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 10/23/2018] [Accepted: 11/02/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIM Pediatric patients increasingly report allergies, including allergies to food and medications. We sought to determine the incidence and, nature of parent-reported allergies in children presenting for surgery and its significance for anesthetists. METHODS We prospectively collected data on admissions through our surgical admission unit over a 2-month period at a pediatric tertiary care teaching hospital. Data collected included patient demographics, history of atopy, with more comprehensive information collected if an allergy was reported. A clinical immunologist and an anesthetist reviewed the documentation of all patients reporting an allergy. RESULTS We reviewed 1001 pediatric patients, 158 (15.8%) patients with parent-reported allergies; to medications/drugs (n = 73), food (n = 66), environmental allergens (dust/grasses, n = 35), tapes/dressings (n = 27), latex (n = 4), and venom (eg, bee, wasp, n = 9). Forty-one patients reported antibiotic allergies, with Beta-lactam antibiotics being the most common, with the majority presenting with rash alone (57%). Ten patients reported allergies to nonsteroidal anti-inflammatory drugs and eight to opioids. Twenty-four patients reported egg and/or peanut allergy. Only 3/1001 (0.3%) patients were deemed to have evidence of likely IgE-mediated drug allergy. Of the reported allergies, only 60 (38.2%) had been investigated prior, most likely to be followed up were food (53%) and environmental allergies (44.4%). Only 4/73 (5.5%) reported medication allergies had further follow-up. Just four patients (0.4% of the entire cohort) had drug sensitivities/allergies that were likely to majorly alter anesthesia practice. CONCLUSION Only the minority of parent-reported allergies in pediatric surgical patients were specialist confirmed and likely to be clinically relevant. Self-reported food allergy is commonly specialist verified whereas reactions to medications were generally not. Over-reporting of allergies is increasingly common and limits clinician choice of medications. Better education of patients and their families and more timely verification or dismissal of parent-reported reactions is urgently needed.
Collapse
Affiliation(s)
- David L Sommerfield
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Perth, Australia.,School of Medicine, The University of Western Australia, Perth, Australia
| | - Aine Sommerfield
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Perth, Australia.,Telethon Kids Institute, Perth, Australia
| | - Alina Schilling
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Perth, Australia
| | - Lliana Slevin
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Perth, Australia.,Telethon Kids Institute, Perth, Australia
| | - Michaela Lucas
- School of Medicine, The University of Western Australia, Perth, Australia.,Department of Clinical Immunology, Perth Children's Hospital, Perth, Australia.,School of Biomedical Sciences Medicine, University of Western Australia, Perth, Australia.,Institute for Immunology and Infectious Diseases, Murdoch University, Perth, Australia.,PathWest Laboratory Medicine, Perth, Australia.,Department of Immunology, Sir Charles Gardiner Hospital, Perth, Australia
| | - Britta S von Ungern-Sternberg
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Perth, Australia.,School of Medicine, The University of Western Australia, Perth, Australia.,Telethon Kids Institute, Perth, Australia
| |
Collapse
|
79
|
Self-reported anaphylaxis to packaged foods in Australia. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 7:687-689. [DOI: 10.1016/j.jaip.2018.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/31/2018] [Accepted: 09/07/2018] [Indexed: 01/09/2023]
|
80
|
Vale S, Netting MJ, Ford LS, Tyquin B, McWilliam V, Campbell DE. Anaphylaxis management in Australian schools: Review of guidelines and adrenaline autoinjector use. J Paediatr Child Health 2019; 55:143-151. [PMID: 30523652 DOI: 10.1111/jpc.14307] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/21/2018] [Accepted: 10/23/2018] [Indexed: 12/15/2022]
Abstract
Food allergy and anaphylaxis is increasing in Australian children, and anaphylaxis is relatively common in Australian schools. This review aims to provide an overview of current policies and practices for anaphylaxis management in Australian schools, including approaches to risk mitigation and anaphylaxis training. We reviewed literature related to anaphylaxis training in the school setting published between 2010 and 2018. Current anaphylaxis policies/guidelines were obtained from Australian education and health departments, and reports of suspected anaphylaxis and adrenaline autoinjector (AAI) use for 2016-2017 were obtained from education departments where available. Our review of policies/guidelines across Australian jurisdictions indicates inconsistent approaches to anaphylaxis management training. Almost half of Australian school anaphylaxis events required a general-use AAI, administered to students not identified as at risk of anaphylaxis. Development of clear, evidence-based, consistent guidelines related to anaphylaxis management and training in the school setting is imperative to minimise risk.
Collapse
Affiliation(s)
- Sandra Vale
- National Allergy Strategy, Sydney, New South Wales, Australia.,Australasian Society of Clinical Immunology and Allergy, Sydney, New South Wales, Australia
| | - Merryn J Netting
- Australasian Society of Clinical Immunology and Allergy, Sydney, New South Wales, Australia.,Healthy Mothers Babies and Children's Theme, South Australian Health Medical Research Institute, Adelaide, South Australia, Australia.,Discipline of Paediatrics, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.,Nutrition Department, Women's and Children's Health Network, Adelaide, South Australia, Australia
| | - Lara S Ford
- Australasian Society of Clinical Immunology and Allergy, Sydney, New South Wales, Australia.,Department of Allergy and Immunology, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
| | - Briony Tyquin
- Department of Allergy and Immunology, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Vicki McWilliam
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Melbourne, Victoria, Australia.,Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Dianne E Campbell
- Department of Allergy and Immunology, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
81
|
Joshi PA, Smith J, Vale S, Campbell DE. The Australasian Society of Clinical Immunology and Allergy infant feeding for allergy prevention guidelines. Med J Aust 2019; 210:89-93. [DOI: 10.5694/mja2.12102] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Preeti A Joshi
- Australasian Society of Clinical Immunology and Allergy Sydney NSW
- The Children's Hospital at Westmead Sydney NSW
| | - Jill Smith
- Australasian Society of Clinical Immunology and Allergy Sydney NSW
| | - Sandra Vale
- Australasian Society of Clinical Immunology and Allergy Sydney NSW
| | | |
Collapse
|
82
|
The skin as a target for prevention of the atopic march. Ann Allergy Asthma Immunol 2019; 120:145-151. [PMID: 29413338 DOI: 10.1016/j.anai.2017.11.023] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 11/20/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Allergic diseases have increased dramatically in the developed world during the past few decades, yet the understanding of risk factors and effective prevention approaches remain limited. In this review, we summarize the evidence supporting the hypothesis that skin-barrier impairment and early-life atopic dermatitis (AD) could play a causal role in the development of sensitization and subsequent food allergies and allergic airways disease (allergic asthma and rhinitis). We further discuss the potential to target the skin barrier as a means to lower the incidence of allergic disease. DATA SOURCES Review of published literature. STUDY SELECTIONS Narrative. RESULTS There is a strong link between AD and sensitization, food allergy, asthma, and allergic rhinitis, particularly AD that is severe and commences in the first 6 months of life. There also is emerging evidence that regular use of prophylactic emollients can significantly decrease the expression of AD, at least while treatment continues. Studies are exploring whether decreased AD expression might modulate the allergic response at a more fundamental level and potentially alter the association between early-life AD and subsequent development of food allergy and allergic airways disease. CONCLUSION Although at this point there is only indirect evidence that early-life emollient use might prevent AD and food allergy, early studies are encouraging. The results of high-quality prevention trials that are in progress are eagerly anticipated. If found to be effective, then neonatal emollient use could be a simple public health measure to lower the incidence of AD, food allergies, and allergic airways disease in future generations.
Collapse
|
83
|
Sackesen C, Altintas DU, Bingol A, Bingol G, Buyuktiryaki B, Demir E, Kansu A, Kuloglu Z, Tamay Z, Sekerel BE. Current Trends in Tolerance Induction in Cow's Milk Allergy: From Passive to Proactive Strategies. Front Pediatr 2019; 7:372. [PMID: 31620408 PMCID: PMC6760011 DOI: 10.3389/fped.2019.00372] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 08/30/2019] [Indexed: 12/15/2022] Open
Abstract
This review addresses the current strategies of inducing tolerance development in infant and childhood cow's milk protein allergy (CMPA). The change in prevention strategies for CMPA has been emphasized based on the lack of evidence to support the efficacy of food allergen avoidance in infancy and the concept of the dual-allergen-exposure hypothesis, which suggests that allergen exposure through the skin leads to sensitization, whereas early oral consumption of allergenic food protein induces oral tolerance. The new approach is based on the likelihood of early introduction of allergenic foods to the infant's diet to reduce the development of food allergies through oral tolerance induction. The latest treatment guidelines recommend the continuation of breast feeding and the elimination of cow's milk and products from the maternal diet in exclusively breast-fed infants with CMPA, the use of an extensively hydrolyzed infant formula (eHF) with proven efficacy in CMPA as the first elimination diet in formula-fed infants with CMPA and the use of amino acid-based formula (AAF) in severe cases, such as anaphylaxis, enteropathy, eosinophilic esophagitis, and food protein-induced enterocolitis syndrome (FPIES), as well as cases of multiple system involvement, multiple food allergies, and intolerance to extensively hydrolyzed formula (eHF). In conclusion, this paper presents the current knowledge on tolerance development in infants and children with CMPA to increase the awareness of the clinicians concerning the new approaches in CMPA treatment Tolerance development is considered a relatively new concept in CMPA, inducing a shift in interventions in CMPA from a passive (avoidance of responsible allergen) toward a proactive (tolerance induction) strategy.
Collapse
Affiliation(s)
- Cansin Sackesen
- Division of Pediatric Allergy, Department of Pediatrics, Koc University School of Medicine, Istanbul, Turkey
| | - Derya Ufuk Altintas
- Division of Pediatric Allergy, Department of Pediatrics, Cukurova University School of Medicine, Adana, Turkey
| | - Aysen Bingol
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Gulbin Bingol
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Acibadem University School of Medicine, Istanbul, Turkey
| | - Betul Buyuktiryaki
- Division of Pediatric Allergy and Asthma, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Esen Demir
- Division of Pediatric Allergy, Department of Pediatrics, Ege University School of Medicine, Izmir, Turkey
| | - Aydan Kansu
- Division of Pediatric Gastroenterology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Zarife Kuloglu
- Division of Pediatric Gastroenterology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Zeynep Tamay
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Istanbul University Istanbul School of Medicine, Istanbul, Turkey
| | - Bulent Enis Sekerel
- Division of Pediatric Allergy and Asthma, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
84
|
Paparo L, Nocerino R, Di Scala C, Della Gatta G, Di Costanzo M, Buono A, Bruno C, Berni Canani R. Targeting Food Allergy with Probiotics. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1125:57-68. [DOI: 10.1007/5584_2018_316] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
85
|
Yan N, Xu J, Zhao C, Wu Y, Gao F, Li C, Zhou W, Xiao T, Zhou X, Shao Q, Xia S. Human umbilical cord-derived mesenchymal stem cells ameliorate the enteropathy of food allergies in mice. Exp Ther Med 2018; 16:4445-4456. [PMID: 30546392 PMCID: PMC6256969 DOI: 10.3892/etm.2018.6763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 08/09/2018] [Indexed: 12/13/2022] Open
Abstract
Food allergy prevalence has steadily increased worldwide over the past decades and immunotherapeutic treatment strategies are gaining attention. Human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) exhibit similar immune regulatory properties to bone marrow-derived MSCs. hUC-MCSs can be prepared with fewer ethical constraints and are potential candidates for allergic disorder therapies. The current study aimed to investigate potential antiallergic properties of hUC-MSCs in mice with ovalbumin (OVA)-induced food allergy. Administration of hUC-MSCs cells intraperitoneally combined with oral gavage of the culture medium significantly alleviated OVA-induced diarrhea symptoms. Additionally, this treatment significantly decreased IgE levels and the percentage of T helper 2 cells in the blood, which were increased in mice with OVA-induced food allergy. The mRNA levels of the inflammatory cytokines interleukin-4 and tumor necrosis factor-α, and inflammatory cell infiltration in mouse colons were significantly decreased in hUC-MSCs-treated animals compared with mice with OVA-induced food allergy. Goblet cells were detected in colons of allergy-induced mice and their numbers were reduced following treatment with hUC-MSCs. In addition, treatment with hUC-MSCs reestablished the gut flora. The results revealed that hUC-MSCs may have a potential application in food allergy therapy.
Collapse
Affiliation(s)
- Nannan Yan
- Department of Immunology, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China.,Institute of Clinic Laboratory Diagnostic, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Jie Xu
- Department of Immunology, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China.,Institute of Clinic Laboratory Diagnostic, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Chuanxiang Zhao
- Department of Immunology, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China.,Institute of Clinic Laboratory Diagnostic, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Yi Wu
- Department of Immunology, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China.,Institute of Clinic Laboratory Diagnostic, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Fengwei Gao
- Department of Immunology, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China.,Institute of Clinic Laboratory Diagnostic, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Ci Li
- Department of Immunology, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China.,Institute of Clinic Laboratory Diagnostic, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Wenhui Zhou
- Department of Immunology, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China.,Institute of Clinic Laboratory Diagnostic, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Tengfei Xiao
- Department of Immunology, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China.,Institute of Clinic Laboratory Diagnostic, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Xiaoming Zhou
- Department of Pathology, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Qixiang Shao
- Department of Immunology, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China.,Institute of Clinic Laboratory Diagnostic, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Sheng Xia
- Department of Immunology, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China.,Institute of Clinic Laboratory Diagnostic, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| |
Collapse
|
86
|
Psychosocial Mediators of Change and Patient Selection Factors in Oral Immunotherapy Trials. Clin Rev Allergy Immunol 2018; 55:217-236. [PMID: 30284193 DOI: 10.1007/s12016-018-8700-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Health-related quality of life (HRQL) is influenced by physiological, psychological, and environmental variables and can be best understood by considering the interactions of factors that cut across multiple levels. One of the most important issues relating to treatment in food allergy is to identify, describe, and define predictors that may contribute to modify HRQL outcomes. The research presented demonstrates that measures of HRQL are able to distinguish key features of known groups (e.g. relating to reaction severity, treatment, allergen type/number, expectation of outcome) and delineate impact on hitherto unknown groups (e.g. relating to personality types and coping styles). This heterogeneity may explain why HRQL or other patient-related outcomes may differ in individuals during, or following any treatment or intervention. Patient-reported outcomes are relatively poorly defined to date. Since HRQL has only been studied in relatively few oral immunotherapy trials to date, primarily looking at caregiver HRQL, it is unclear which factors, measures, or subscales are most predictive of short- and/or long-term treatment outcomes for which type of patient, and which time points for measurement are most informative. A standardised protocol that incorporates HRQL and other relevant patient-related outcome measures and agreed definitions of outcomes would allow for the comparison of efficacy of food allergy treatments between centres, trials, or countries. Further evidence-based research aimed at exploring the effects of interventions on outcomes in food allergy is needed, including the influence of patient and parent factors on protocol design. To this end, it is vital that patient-related outcomes such as improved HRQL are seen as a primary outcome and are measured at multiple intervals during the trial duration and beyond. The creative use of methods and designs (both qualitative and quantitative) to better understand the role of HRQL in immunotherapy treatment trials will enable improved modelling of the costs, risks, and benefits of any treatment. Systematic analysis and modelling of antecedent factors, mediators, and outcomes will be important to boost intervention effects and to maximise the overall benefits of treatment.
Collapse
|
87
|
The Epidemiology of Food Allergy in the Global Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15092043. [PMID: 30231558 PMCID: PMC6163515 DOI: 10.3390/ijerph15092043] [Citation(s) in RCA: 248] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 09/06/2018] [Accepted: 09/13/2018] [Indexed: 01/27/2023]
Abstract
There is a lack of high-quality evidence based on the gold standard of oral food challenges to determine food allergy prevalence. Nevertheless, studies using surrogate measures of food allergy, such as health service utilization and clinical history, together with allergen-specific immunoglobulin E (sIgE), provide compelling data that the prevalence of food allergy is increasing in both Western and developing countries. In Western countries, challenge-diagnosed food allergy has been reported to be as high as 10%, with the greatest prevalence noted among younger children. There is also growing evidence of increasing prevalence in developing countries, with rates of challenge-diagnosed food allergy in China and Africa reported to be similar to that in Western countries. An interesting observation is that children of East Asian or African descent born in a Western environment are at higher risk of food allergy compared to Caucasian children; this intriguing finding emphasizes the importance of genome-environment interactions and forecasts future increases in food allergy in Asia and Africa as economic growth continues in these regions. While cow’s milk and egg allergy are two of the most common food allergies in most countries, diverse patterns of food allergy can be observed in individual geographic regions determined by each country’s feeding patterns. More robust studies investigating food allergy prevalence, particularly in Asia and the developing world, are necessary to understand the extent of the food allergy problem and identify preventive strategies to cope with the potential increase in these regions.
Collapse
|
88
|
Rueter K, Ta B, Bear N, Lucas M, Borland ML, Prescott SL. Increased Use of Adrenaline in the Management of Childhood Anaphylaxis Over the Last Decade. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:1545-1552. [DOI: 10.1016/j.jaip.2017.11.038] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 11/13/2017] [Accepted: 11/15/2017] [Indexed: 10/18/2022]
|
89
|
Wang Y, Allen KJ, Suaini NHA, Peters RL, Ponsonby AL, Koplin JJ. Asian children living in Australia have a different profile of allergy and anaphylaxis than Australian-born children: A State-wide survey. Clin Exp Allergy 2018; 48:1317-1324. [PMID: 30025179 DOI: 10.1111/cea.13235] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 05/31/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Asian children born in Australia have higher rates of eczema and nut allergy than non-Asian children. However, it is not known whether this country of birth differential exists for other allergies or anaphylaxis risk. OBJECTIVE We investigated the influence of maternal and child's country of birth on the prevalence of parent-reported eczema, asthma, food allergy and being diagnosed by a doctor as being "at risk of anaphylaxis." METHODS We assessed the relationship between mother and child country of birth and allergies using the 2010 School Entrant Health Questionnaire, completed for 57 005 5-year old children (85.8% response rate) in Victoria, Australia. Analyses were conducted using logistic regression with results presented as odds ratios (OR) with 95% confidence intervals (CIs). RESULTS Children born in Australia to Asian-born mothers were more likely to have parent-reported food allergy (OR 2.33, 95%CI 1.96-2.77) and eczema (OR 2.04, 95%CI 1.73-2.41), but not more likely to have asthma (OR 0.87, 95% CI 0.74-1.02) than non-Asian children. By contrast, children born in Asia who subsequently migrated to Australia had a lower risk of food allergy (OR 0.33, 95%CI 0.20-0.55), eczema (OR 0.37, 95%CI 0.24-0.57) and asthma (OR 0.29, 95% CI 0.21-0.40). Patterns of anaphylaxis risk differed depending on the trigger. Compared with Australian-born non-Asian children, Australian-born Asian children were more likely to be diagnosed as being at risk of both food-induced and non-food-induced anaphylaxis. For children born in Asia, risk was lower for anaphylaxis to milk, peanut and tree nuts compared to non-Asian children, but higher for soy, wheat and non-food triggers. CONCLUSIONS AND CLINICAL RELEVANCE Patterns of allergy/anaphylaxis risk and their triggers differed according to both ethnicity and country of birth, suggesting a gene-environment factor is in play. The difference in patterns for asthma compared with other atopic diseases is surprising and warrants further exploration.
Collapse
Affiliation(s)
- Yichao Wang
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Katrina J Allen
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Noor H A Suaini
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Rachel L Peters
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Anne-Louise Ponsonby
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Jennifer J Koplin
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,The School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
90
|
Robinson M, Koplin JJ, Field MJ, Sasaki M, Peters RL, McWilliam V, Sawyer SM, Patton GC, Vuillermin PJ, Douglass J, Gurrin LC, Tang MLK, Dharmage SC, Allen KJ. Patterns of Carriage of Prescribed Adrenaline Autoinjectors in 10- to 14-Year-Old Food-Allergic Students: A Population-Based Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 7:437-443. [PMID: 30031901 DOI: 10.1016/j.jaip.2018.06.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/11/2018] [Accepted: 06/07/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Adolescence is well recognized as a period of increased risk for severe and fatal food-induced anaphylaxis. Current Australian adrenaline autoinjector (AAI) prescription guidelines therefore suggest that consideration be given to AAI prescription in all adolescents with a food allergy. To date, however, few studies have assessed the AAI carriage behavior of adolescents prescribed AAI devices. OBJECTIVE To determine the carriage behavior of prescribed AAI devices in a population-based sample of young Australian adolescents. METHODS Students aged 10 to 14 years (and their parents) from randomly selected schools in metropolitan Melbourne completed self-administered questionnaires regarding the history and management of food allergy, including prescription and carriage of AAI device in different domains of school and social life. RESULTS A total of 9816 students completed the questionnaire (46% response): 620 students were assessed to have likely IgE-mediated food allergy and 234 (38%) of these had been prescribed an AAI. Most students (93%; 95% CI, 89%-96%) who were prescribed AAIs reported that they provided their AAI and anaphylaxis action plan to their school. Adherence to AAI carriage in other domains of social life was poor, with 49% (95% CI, 42%-56%) never carrying their AAI in 1 or more locations. Carriage of the AAI device was particularly poor when students were independent of parental supervision: 32% (95% CI, 25%-39%) never carried it when they were by themselves, 28% (95% CI, 22%-36%) never carried it while out with friends, and 36% (95% CI, 30%-43%) never carried their AAI to sporting activities. CONCLUSIONS Carriage of AAI devices is suboptimal in young adolescents prescribed AAIs, particularly when young adolescents are independent of parental supervision.
Collapse
Affiliation(s)
- Marnie Robinson
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; Royal Children's Hospital, Parkville, Victoria, Australia; Department of Clinical Immunology and Allergy, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Jennifer J Koplin
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Michael J Field
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Mari Sasaki
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Rachel L Peters
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Vicki McWilliam
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; Royal Children's Hospital, Parkville, Victoria, Australia
| | - Susan M Sawyer
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; Royal Children's Hospital, Parkville, Victoria, Australia; Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - George C Patton
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Peter J Vuillermin
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; Child Health Research Unit, Barwon Health, Geelong, Victoria, Australia; School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Jo Douglass
- Department of Clinical Immunology and Allergy, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Lyle C Gurrin
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Mimi L K Tang
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; Royal Children's Hospital, Parkville, Victoria, Australia; Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Shyamali C Dharmage
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Katrina J Allen
- Murdoch Children's Research Institute, Parkville, Victoria, Australia; Royal Children's Hospital, Parkville, Victoria, Australia; Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia.
| | | |
Collapse
|
91
|
Jeong K, Lee JD, Kang DR, Lee S. A population-based epidemiological study of anaphylaxis using national big data in Korea: trends in age-specific prevalence and epinephrine use in 2010-2014. Allergy Asthma Clin Immunol 2018; 14:31. [PMID: 29988631 PMCID: PMC6027562 DOI: 10.1186/s13223-018-0251-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 04/05/2018] [Indexed: 12/22/2022] Open
Abstract
Background Previous reports on anaphylaxis in Asia are limited to relatively small-scale studies. We performed this study to identify the nationwide prevalence of anaphylaxis and epinephrine prescription rates by age groups. Methods The total number of patients, yearly and overall prevalence, percentage of emergency department visits, and epinephrine prescription rates were calculated for patients diagnosed with anaphylaxis based on the Korean National Health Insurance database from 2010 to 2014. Results The mean prevalence of anaphylaxis in Korea was 26.23 (95% confidence interval, CI 25.78-26.68) per 100,000 person-years during the 5 years. It increased from 20.55 (95% CI 20.15-20.10) in 2010 to 35.33 (95% CI 34.81-35.85) per 100,000 person-years in 2014. The average prevalence was > 35 per 100,000 person-years among 50-69 year-olds, and the mean crude prevalence in children was 22.3 (0-2 years), 17.3 (3-6 years), 12.1 (7-12 years), and 14.9 (13-17 years) per 100,000 person-years, respectively. The overall prevalence increased 1.7-fold, with the highest rate of increase in 0-2 years of age. The overall percentage of emergent anaphylaxis patients was 88.4%, and the prevalence of emergent anaphylaxis increased from 18.63 (95% CI 18.25-19.01) to 31.28 (95% CI 30.79-31.77) per 100,000 person-years. In-hospital epinephrine prescription rate increased from 31.5 to 39.7%. Conclusions The mean prevalence of anaphylaxis in Korea was 26.2 per 100,000 person-years during the study period. The total number of anaphylaxis patients increased 1.7-fold from 2010 to 2014, with the most noticeable increment being in young children.
Collapse
Affiliation(s)
- Kyunguk Jeong
- 1Department of Pediatrics, Ajou University School of Medicine, Worldcup-ro 164, Yeongtong-gu, Suwon, 16499 Republic of Korea
| | - Jung-Dong Lee
- 2Office of Biostatistics, Ajou University School of Medicine, Worldcup-ro 164, Yeongtong-gu, Suwon, 16499 Republic of Korea
| | - Dae Ryong Kang
- 2Office of Biostatistics, Ajou University School of Medicine, Worldcup-ro 164, Yeongtong-gu, Suwon, 16499 Republic of Korea
| | - Sooyoung Lee
- 1Department of Pediatrics, Ajou University School of Medicine, Worldcup-ro 164, Yeongtong-gu, Suwon, 16499 Republic of Korea
| |
Collapse
|
92
|
Liu QM, Xie CL, Gao YY, Liu B, Lin WX, Liu H, Cao MJ, Su WJ, Yang XW, Liu GM. Deep-Sea-Derived Butyrolactone I Suppresses Ovalbumin-Induced Anaphylaxis by Regulating Mast Cell Function in a Murine Model. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2018; 66:5581-5592. [PMID: 29763312 DOI: 10.1021/acs.jafc.8b01674] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Deep-sea-derived butyrolactone I (BTL-I), which was identified as a type of butanolide, was isolated from Aspergillus sp. Ovalbumin (OVA)-induced BALB/c anaphylaxis was established to explore the antifood allergic activity of BTL-I. As a result, BTL-I was able to alleviate OVA-induced allergy symptoms, reduce the levels of histamine and mouse mast cell proteinases, inhibit OVA-specific IgE, and decrease the population of mast cells in the spleen and mesenteric lymph nodes. BTL-I also significantly suppressed mast-dependent passive cutaneous anaphylaxis. Additionally, the maturation of bone marrow-derived mast cells (BMMCs) declined as BTL-I caused down-regulation of c-KIT receptors. Furthermore, molecular docking analyses revealed that BTL-I interacted with the inhibitory receptor, FcγRIIB. In conclusion, the reduction of mast cell function by deep-sea-derived BTL-I as well as its interactions with the inhibitory receptor, FcγRIIB, may contribute to BTL-I-related protection against food anaphylaxis.
Collapse
Affiliation(s)
- Qing-Mei Liu
- College of Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources , Jimei University , 43 Yindou Road , Xiamen , 361021 Fujian , P.R. China
| | - Chun-Lan Xie
- Key Laboratory of Marine Biogenetic Resources, South China Sea Bio-Resource Exploitation and Utilization Collaborative Innovation Center , Third Institute of Oceanography, State Oceanic Administration , 184 Daxue Road , Xiamen , 361005 Fujian , P.R. China
| | - Yuan-Yuan Gao
- College of Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources , Jimei University , 43 Yindou Road , Xiamen , 361021 Fujian , P.R. China
| | - Bo Liu
- College of Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources , Jimei University , 43 Yindou Road , Xiamen , 361021 Fujian , P.R. China
| | - Wei-Xiang Lin
- Key Laboratory of Marine Biogenetic Resources, South China Sea Bio-Resource Exploitation and Utilization Collaborative Innovation Center , Third Institute of Oceanography, State Oceanic Administration , 184 Daxue Road , Xiamen , 361005 Fujian , P.R. China
| | - Hong Liu
- College of Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources , Jimei University , 43 Yindou Road , Xiamen , 361021 Fujian , P.R. China
| | - Min-Jie Cao
- College of Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources , Jimei University , 43 Yindou Road , Xiamen , 361021 Fujian , P.R. China
| | - Wen-Jin Su
- College of Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources , Jimei University , 43 Yindou Road , Xiamen , 361021 Fujian , P.R. China
| | - Xian-Wen Yang
- Key Laboratory of Marine Biogenetic Resources, South China Sea Bio-Resource Exploitation and Utilization Collaborative Innovation Center , Third Institute of Oceanography, State Oceanic Administration , 184 Daxue Road , Xiamen , 361005 Fujian , P.R. China
| | - Guang-Ming Liu
- College of Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources , Jimei University , 43 Yindou Road , Xiamen , 361021 Fujian , P.R. China
| |
Collapse
|
93
|
Zurzolo GA, Allen KJ, Peters RL, Tang ML, Dharmage S, de Courten M, Mathai ML, Campbell DE. Anaphylaxis to packaged foods in Australasia. J Paediatr Child Health 2018; 54:551-555. [PMID: 29363215 DOI: 10.1111/jpc.13823] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 08/31/2017] [Accepted: 10/05/2017] [Indexed: 12/28/2022]
Abstract
AIMS To examine reports of anaphylaxis in Australasia from consumption of packaged food products with or without precautionary allergen labelling (PAL), where the known allergen triggers were not a listed ingredient. METHODS A questionnaire was sent to all members of the Australasian Society of Clinical Immunology and Allergy (n = 548). Participants were asked to complete a survey reporting whether they have had seen any patients over the last 3 months reporting anaphylaxis following ingestion of a packaged food where the suspected food allergen was not a listed ingredient. RESULTS Of the n = 548 members approached, n = 198 responded (response rate 36.1%).There were 14 reports of anaphylaxis to packaged foods (where the suspected allergen was not a listed ingredient), which met the case definition from a total of 198 respondents over the 9-month period. Of those reactions, 50.0% (confidence interval 95% 21-78) were reported from foods that did not have a PAL statement, and 50.0% (confidence interval 95% 21-78) were due to peanuts. CONCLUSION Anaphylaxis to undeclared allergens was not rare and did not appear to depend on whether the product was labelled with precautionary advice. There is currently no reliable labelling system that can inform food-allergic consumers of safer food choices. Improvements in the regulation of food labelling with PAL are required.
Collapse
Affiliation(s)
- Giovanni A Zurzolo
- Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, Melbourne, Victoria, Australia.,Centre for Food and Allergy Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Katrina J Allen
- Centre for Food and Allergy Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia.,Institute of Inflammation and Repair, University of Manchester, Manchester, United Kingdom
| | - Rachel L Peters
- Centre for Food and Allergy Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Mimi Lk Tang
- Centre for Food and Allergy Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Shyamali Dharmage
- Centre for Food and Allergy Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Maximilian de Courten
- Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, Melbourne, Victoria, Australia
| | - Michael L Mathai
- Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, Melbourne, Victoria, Australia.,Centre for Food and Allergy Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Dianne E Campbell
- Centre for Food and Allergy Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Allergy and Immunology, Children's Hospital at Westmead, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
94
|
Wang Y, Koplin JJ, Ho MHK, Wong WHS, Allen KJ. Increasing hospital presentations for anaphylaxis in the pediatric population in Hong Kong. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:1050-1052.e2. [DOI: 10.1016/j.jaip.2017.09.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 09/08/2017] [Indexed: 11/17/2022]
|
95
|
Tanno LK, Bierrenbach AL, Simons FER, Cardona V, Thong BYH, Molinari N, Calderon MA, Worm M, Chang YS, Papadopoulos NG, Casale T, Demoly P. Critical view of anaphylaxis epidemiology: open questions and new perspectives. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2018; 14:12. [PMID: 29632547 PMCID: PMC5883526 DOI: 10.1186/s13223-018-0234-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 02/01/2018] [Indexed: 11/18/2022]
Abstract
In contrast to the majority of allergic or hypersensitivity conditions, worldwide anaphylaxis epidemiological data remain sparse with low accuracy, which hampers comparable morbidity statistics. Data can differ widely depending on a number of variables. In the current document we reviewed the forms on which anaphylaxis has been defined and classified; and how it can affect epidemiological data. With regards to the methods used to capture morbidity statistics, we observed the impact of the anaphylaxis coding utilizing the World Health Organization's International Classification of Diseases. As an outcome and depending on the anaphylaxis definition, we extracted the cumulative incidence, which may not reflect the real number of new cases. The new ICD-11 anaphylaxis subsection developments and critical view of morbidity statistics data are discussed in order to reach new perspectives on anaphylaxis epidemiology.
Collapse
Affiliation(s)
- Luciana Kase Tanno
- Hospital Sírio Libanês, São Paulo, Brazil
- University Hospital of Montpellier, Montpellier, France
- Sorbonne Université, INSERM, IPLESP, 75013 Paris, France
- Division of Allergy, Department of Pulmonology, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, 371, av. du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
| | - Ana Luiza Bierrenbach
- Sanas Epidemiology and Research, São Paulo, Brazil
- Teaching Research Institute (IEP), Hospital Sírio Libanês, São Paulo, Brazil
| | - F. Estelle R. Simons
- Section of Allergy & Clinical Immunology, Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Canada
| | - Victoria Cardona
- Allergy Section, Department of Internal Medicine, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Bernard Yu-Hor Thong
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore
| | | | - Moises A. Calderon
- Section of Allergy and Clinical Immunology, Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital, London, UK
| | - Margitta Worm
- Allergie-Centrum-Charité, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Yoon-Seok Chang
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Gyeonggi-do South Korea
| | - Nikolaos G. Papadopoulos
- Centre for Paediatrics and Child Health Institute of Human Development, University of Manchester, Manchester, UK
- Department of Allergy, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | - Thomas Casale
- American Academy of Allergy Asthma and Immunology, and Morsani College of Medicine, University of South Florida, Tampa, FL USA
| | - Pascal Demoly
- University Hospital of Montpellier, Montpellier, France
- Sorbonne Université, INSERM, IPLESP, 75013 Paris, France
| | - on behalf the Joint Allergy Academies
- Hospital Sírio Libanês, São Paulo, Brazil
- University Hospital of Montpellier, Montpellier, France
- Sorbonne Université, INSERM, IPLESP, 75013 Paris, France
- Sanas Epidemiology and Research, São Paulo, Brazil
- Teaching Research Institute (IEP), Hospital Sírio Libanês, São Paulo, Brazil
- Section of Allergy & Clinical Immunology, Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Canada
- Allergy Section, Department of Internal Medicine, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore
- IMAG, UMR 5149, DIM CHRU de Montpellier, Montpellier, France
- Section of Allergy and Clinical Immunology, Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital, London, UK
- Allergie-Centrum-Charité, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Gyeonggi-do South Korea
- Centre for Paediatrics and Child Health Institute of Human Development, University of Manchester, Manchester, UK
- Department of Allergy, 2nd Pediatric Clinic, University of Athens, Athens, Greece
- American Academy of Allergy Asthma and Immunology, and Morsani College of Medicine, University of South Florida, Tampa, FL USA
- Division of Allergy, Department of Pulmonology, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, 371, av. du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
| |
Collapse
|
96
|
Mullins RJ, Turner PJ, Barnes EH, Campbell DE. Allergic gastroenteritis hospital admission time trends in Australia and New Zealand. J Paediatr Child Health 2018; 54:398-400. [PMID: 29090503 DOI: 10.1111/jpc.13767] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 08/16/2017] [Accepted: 09/18/2017] [Indexed: 01/01/2023]
Abstract
AIM Recent epidemiological studies indicate increases in hospital food allergy-related anaphylaxis admission rates in Australian and New Zealand. The aim of the study was to examine whether non-IgE-mediated food allergy might have increased in parallel. METHODS We analysed childhood hospital admissions rates by ICD 10 codes for allergic gastroenteritis (AG) and infective gastroenteritis in Australia and New Zealand between June 1998 and July 2014. RESULTS In Australia, most AG-related admissions (73%) occurred in those aged <1 year and increased by 7.3%/year (95% confidence interval (CI) 5.5-9.3, P < 0.0001) from 6.8 to 26.5/105 population. Similar trends were observed for New Zealand; 81% of admissions occurred in those aged <1 year and increased by 9.4%/year (95% CI 5.5-9.3, P < 0.0001) from 7.2 to 30.7/105 population. By contrast there were no significant changes in AG-related admission rates in the older patients and infective gastroenteritis admissions fell in both countries in those aged <1 year; Australia by 4.4%/year (95% CI 4.3-4.6, P < 0.0001) and in New Zealand by 5.8%/year (95% CI 5.4-6.2, P < 0.0001). CONCLUSION We observed a fourfold increase in AG-related admission rates in two countries with known high rates of IgE-mediated food allergy/anaphylaxis. If confirmed by other studies, it will be of interest to determine if factors thought to contribute to the increase in IgE-mediated food allergy might also play a role in non-IgE-mediated gastroenterological food allergy syndromes.
Collapse
Affiliation(s)
- Raymond J Mullins
- John James Medical Centre, University of Sydney, Canberra, Australian Capital Territory, Australia.,Medical School, Australian National University, University of Sydney, Canberra, Australian Capital Territory, Australia
| | - Paul J Turner
- Section of Paediatrics, Imperial College London, London, United Kingdom.,Immunisation, Hepatitis and Blood Safety Department, Public Health England, London, United Kingdom.,Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
| | - Elizabeth H Barnes
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Dianne E Campbell
- Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia.,Department of Allergy and Clinical Immunology, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| |
Collapse
|
97
|
Sasaki M, Peters RL, Koplin JJ, Field MJ, McWilliam V, Sawyer SM, Vuillermin PJ, Pezic A, Gurrin LC, Douglass JA, Tang ML, Dharmage SC, Allen KJ. Risk Factors for Food Allergy in Early Adolescence: The SchoolNuts Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:496-505. [DOI: 10.1016/j.jaip.2017.12.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 12/08/2017] [Accepted: 12/09/2017] [Indexed: 11/17/2022]
|
98
|
Peters RL, Koplin JJ, Allen KJ, Lowe AJ, Lodge CJ, Tang ML, Wake M, Ponsonby AL, Erbas B, Abramson MJ, Hill D, Gurrin LC, Dharmage SC. The Prevalence of Food Sensitization Appears Not to Have Changed between 2 Melbourne Cohorts of High-Risk Infants Recruited 15 Years Apart. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:440-448.e2. [DOI: 10.1016/j.jaip.2017.11.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 10/20/2017] [Accepted: 11/14/2017] [Indexed: 12/01/2022]
|
99
|
Dunn Galvin A, McMahon S, Ponsonby AL, Hsiao KC, Tang MLK. The longitudinal impact of probiotic and peanut oral immunotherapy on health-related quality of life. Allergy 2018; 73:560-568. [PMID: 29052245 DOI: 10.1111/all.13330] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND We previously reported that probiotic and peanut oral immunotherapy (PPOIT) was effective at inducing sustained unresponsiveness compared with placebo in a double-blind, placebo-controlled randomized trial. This study evaluated the impact of PPOIT on health-related quality of life (HRQL). METHOD Fifty-one participants (PPOIT 24; placebo 27) from the PPOIT trial completed Food Allergy Quality of Life Questionnaire (FAQLQ-PF) and Food Allergy Independent Measure (FAIM) at pre-treatment, end-of-treatment and 3 months after end-of-treatment. A total of 42 participants (20 PPOIT; 22 placebo) completed measures at 12 months post-treatment. Changes over time in PPOIT and placebo groups were examined by repeated-measures analysis of variance and paired t tests. RESULTS Probiotic and peanut oral immunotherapy was associated with significant improvement in FAQLQ-PF (F = 3.63, P = .02), with mean difference 0.8 at 3 months post-treatment (P = .05) and 1.3 at 12 months post-treatment (P = .005), exceeding the 0.5 minimal clinically important difference for FAQLQ-PF. For FAIM, mean difference was 0.5 (P = .03) at 3 months and 0.4 (P = .04) at 12 months post-treatment. In placebo group, post-treatment FAQLQ and FAIM remained unchanged from pretreatment. Improvement in FAQLQ-PF and FAIM scores related specifically to acquisition of sustained unresponsiveness rather than to receiving PPOIT treatment or participation in the trial. CONCLUSIONS Probiotic and peanut oral immunotherapy has a sustained beneficial effect on psychosocial impact of food allergy at 3 and 12 months after end-of-treatment. Treatment was not associated with reduced HRQL relative to baseline in either PPOIT or placebo groups, indicating that PPOIT was well tolerated and psychological well-being was not negatively impacted. Improved HRQL was specifically associated with acquisition of sustained unresponsiveness.
Collapse
Affiliation(s)
- A. Dunn Galvin
- School of Applied Psychology; University College Cork; Cork Ireland
- Cork University Hospital; University College Cork; Cork Ireland
| | - S. McMahon
- School of Applied Psychology; University College Cork; Cork Ireland
| | - A.-L. Ponsonby
- Murdoch Children's Research Institute; Melbourne Vic. Australia
| | - K.-C. Hsiao
- Murdoch Children's Research Institute; Melbourne Vic. Australia
- The Royal Children's Hospital; Melbourne Vic. Australia
- The University of Melbourne; Melbourne Vic. Australia
| | - M. L. K. Tang
- Murdoch Children's Research Institute; Melbourne Vic. Australia
- The Royal Children's Hospital; Melbourne Vic. Australia
- The University of Melbourne; Melbourne Vic. Australia
| | | |
Collapse
|
100
|
DunnGalvin A, Polloni L, Le Bovidge J, Muraro A, Greenhawt M, Taylor S, Baumert J, Burks W, Trace A, DunnGalvin G, Forristal L, McGrath L, White J, Vasquez M, Allen K, Sheikh A, Hourihane J, Tang ML. Preliminary Development of the Food Allergy Coping and Emotions Questionnaires for Children, Adolescents, and Young People: Qualitative Analysis of Data on IgE-Mediated Food Allergy from Five Countries. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018. [DOI: 10.1016/j.jaip.2017.11.044] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|