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Grijincu M, Buzan MR, Zbîrcea LE, Păunescu V, Panaitescu C. Prenatal Factors in the Development of Allergic Diseases. Int J Mol Sci 2024; 25:6359. [PMID: 38928067 PMCID: PMC11204337 DOI: 10.3390/ijms25126359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
Allergic diseases are showing increasing prevalence in Western societies. They are characterized by a heightened reactivity towards otherwise harmless environmental stimuli. Allergic diseases showing a wide range of severity of symptoms have a significant impact on the quality of life of affected individuals. This study aims to highlight the mechanisms that induce these reactions, how they progress, and which prenatal factors influence their development. Most frequently, the reaction is mediated by immunoglobulin E (IgE) produced by B cells, which binds to the surface of mast cells and basophils and triggers an inflammatory response. The antibody response is triggered by a shift in T-cell immune response. The symptoms often start in early childhood with eczema or atopic dermatitis and progress to allergic asthma in adolescence. An important determinant of allergic diseases seems to be parental, especially maternal history of allergy. Around 30% of children of allergic mothers develop allergic sensitization in childhood. Genes involved in the regulation of the epithelial barrier function and the T-cell response were found to affect the predisposition to developing allergic disorders. Cord blood IgE was found to be a promising predictor of allergic disease development. Fetal B cells produce IgE starting at the 20th gestation week. These fetal B cells could be sensitized together with mast cells by maternal IgE and IgE-allergen complexes crossing the placental barrier via the low-affinity IgE receptor. Various factors were found to facilitate these sensitizations, including pesticides, drugs, exposure to cigarette smoke and maternal uncontrolled asthma. Prenatal exposure to microbial infections and maternal IgG appeared to play a role in the regulation of T-cell response, indicating a protective effect against allergy development. Additional preventive factors were dietary intake of vitamin D and omega 3 fatty acids as well as decreased maternal IgE levels. The effect of exposure to food allergens during pregnancy was inconclusive, with studies having found both sensitizing and protective effects. In conclusion, prenatal factors including genetics, epigenetics and fetal environmental factors have an important role in the development of allergic disorders in later life. Children with a genetic predisposition are at risk when exposed to cigarette smoke as well as increased maternal IgE in the prenatal period. Maternal diet during pregnancy and immunization against certain allergens could help in the prevention of allergy in predisposed children.
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Affiliation(s)
- Manuela Grijincu
- Center of Immuno-Physiology and Biotechnologies, Department of Functional Sciences, Victor Babeș University of Medicine and Pharmacy, 300041 Timișoara, Romania
- OncoGen Center, Pius Brînzeu County Clinical Emergency Hospital, 300723 Timișoara, Romania
| | - Maria-Roxana Buzan
- Center of Immuno-Physiology and Biotechnologies, Department of Functional Sciences, Victor Babeș University of Medicine and Pharmacy, 300041 Timișoara, Romania
- OncoGen Center, Pius Brînzeu County Clinical Emergency Hospital, 300723 Timișoara, Romania
| | - Lauriana-Eunice Zbîrcea
- Center of Immuno-Physiology and Biotechnologies, Department of Functional Sciences, Victor Babeș University of Medicine and Pharmacy, 300041 Timișoara, Romania
- OncoGen Center, Pius Brînzeu County Clinical Emergency Hospital, 300723 Timișoara, Romania
| | - Virgil Păunescu
- Center of Immuno-Physiology and Biotechnologies, Department of Functional Sciences, Victor Babeș University of Medicine and Pharmacy, 300041 Timișoara, Romania
- OncoGen Center, Pius Brînzeu County Clinical Emergency Hospital, 300723 Timișoara, Romania
| | - Carmen Panaitescu
- Center of Immuno-Physiology and Biotechnologies, Department of Functional Sciences, Victor Babeș University of Medicine and Pharmacy, 300041 Timișoara, Romania
- OncoGen Center, Pius Brînzeu County Clinical Emergency Hospital, 300723 Timișoara, Romania
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Boriboonhirunsarn D, Puttapratimonk S. Evaluation of Childhood Allergy Risk Among Pregnant Women in a Tertiary Care Hospital in Thailand. Cureus 2024; 16:e63322. [PMID: 39070479 PMCID: PMC11283371 DOI: 10.7759/cureus.63322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2024] [Indexed: 07/30/2024] Open
Abstract
OBJECTIVES This study aims to evaluate the prevalence of pregnant women whose children are at higher risk for childhood allergies and to assess knowledge of risk assessment and prevention strategies. METHODS A cross-sectional study was conducted on 310 pregnant women in an antenatal care clinic at a tertiary care hospital in Thailand. In addition to baseline demographic and obstetric characteristics, all participating pregnant women were asked to complete a questionnaire regarding risk evaluation and knowledge of childhood allergies on various topics. A childhood allergy risk assessment was evaluated based on the history of allergy disease in immediate family members. The questionnaire on knowledge was derived from a guideline issued by the Allergy, Asthma, and Immunology Association of Thailand, with possible scores of 0-30. RESULTS The mean maternal age was 30.6 years, and 139 (44.8%) were nulliparous. Overall, 86 couples (27.7%) were at high risk for childhood allergies. The mean total knowledge score was 15.2 out of 30, and only 24 women (7.7%) had an overall score of >20, and 40 women (12.9%) had an overall score of ≤10. The mean knowledge score for almost every subtopic was less than half of the possible points, except for the risk reduction strategies during pregnancy. Comparisons between those with higher and lower scores (≥16 vs. ≤15 points) showed that women with higher knowledge scores were significantly more likely to have had a previous child with an allergy (p=0.010). CONCLUSION The prevalence of pregnant women whose children were at higher risk for childhood allergies was 27.7% (86 of 310 couples). The women had limited knowledge of childhood allergies with regard to risk assessment, risk reduction strategies, and various interventions. The only factor associated with a higher knowledge score was having a previous child with an allergy.
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Affiliation(s)
| | - Siraluck Puttapratimonk
- Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, THA
- Obstetrics and Gynaecology, Wat Raja O Ros School, Bangkok, THA
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Spolidoro GCI, Lisik D, Nyassi S, Ioannidou A, Ali MM, Amera YT, Rovner G, Khaleva E, Venter C, van Ree R, Worm M, Vlieg-Boerstra B, Sheikh A, Muraro A, Roberts G, Nwaru BI. Prevalence of tree nut allergy in Europe: A systematic review and meta-analysis. Allergy 2024; 79:302-323. [PMID: 37792850 DOI: 10.1111/all.15905] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/31/2023] [Accepted: 09/18/2023] [Indexed: 10/06/2023]
Abstract
In 2014, the European Academy of Allergy and Clinical Immunology (EAACI) published the first systematic review that summarized the prevalence of food allergy (FA) and food sensitization in Europe for studies published 2000-2012. However, only summary estimates for tree nut allergy (TNA) were feasible in that work. In the current update of that systematic review, we summarized the prevalence of tree nut allergy/sensitization to individual tree nuts. Six databases were searched for relevant papers published 2012-2021 and 17 eligible studies were added to the 15 studies already identified between 2000 and 2012, giving a total of 32 studies. Of the investigated tree nuts, meta-analysis was possible for hazelnut, walnut, almond, and in few cases, for cashew, and Brazil nut. The lifetime self-reported prevalence was 0.8% (95% CI 0.5-1.1) for hazelnut and 0.4% (0.2-0.9) for walnut. The point self-reported prevalence was 4.0% (2.9-5.2) for hazelnut, 3.4% (2.0-4.9) for Brazil nut, 2.0% (1.1-2.9) for almond, and 1.8% (1.1-2.5) for walnut. Point prevalence of food challenge-confirmed TNA was 0.04% (0.0-0.1) for hazelnut and 0.02% (0.01-0.1) for walnut. Due to paucity of data, we could not identify any meaningful and consistent differences across age groups and European regions.
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Affiliation(s)
- Giulia C I Spolidoro
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Daniil Lisik
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - Sungkutu Nyassi
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - Athina Ioannidou
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - Mohamed Mustafa Ali
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Yohannes Tesfaye Amera
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Graciela Rovner
- ACT Institutet Sweden, Vejbystrand, Sweden
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Carina Venter
- Section of Allergy & Immunology, School of Medicine, University of Colorado Denver, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Ronald van Ree
- Department of Experimental Immunology and Department of Otorhinolaryngology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology, Allergy and Venerology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Berber Vlieg-Boerstra
- Department of Pediatrics, OLVG Hospital, Amsterdam, The Netherlands
- Department of Pediatrics, Rijnstate Hospital, Arnhem, The Netherlands
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Antonella Muraro
- Department of Mother and Child Health, The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region, University of Padua, Padua, Italy
| | - Graham Roberts
- Faculty of Medicine, University of Southampton, Southampton, UK
- David Hide Asthma and Allergy Centre, St Mary's Hospital, Isle of Wight, UK
| | - Bright I Nwaru
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
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Spolidoro GCI, Ali MM, Amera YT, Nyassi S, Lisik D, Ioannidou A, Rovner G, Khaleva E, Venter C, van Ree R, Worm M, Vlieg-Boerstra B, Sheikh A, Muraro A, Roberts G, Nwaru BI. Prevalence estimates of eight big food allergies in Europe: Updated systematic review and meta-analysis. Allergy 2023; 78:2361-2417. [PMID: 37405695 DOI: 10.1111/all.15801] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 05/31/2023] [Accepted: 06/20/2023] [Indexed: 07/06/2023]
Abstract
In 2014, the European Academy of Allergy and Clinical Immunology published prevalence estimates for food allergy (FA) and food sensitization (FS) to the so-called eight big food allergens (i.e. cow's milk, egg, wheat, soy, peanut, tree nuts, fish and shellfish) in Europe for studies published between 2000 and 2012. The current work provides 10-year updated prevalence estimates for these food allergens. A protocol was registered on PROSPERO before starting the research (reference number CRD42021266657). Six databases were searched for studies published 2012-2021, added to studies published up to 2012, resulting in a total of 93 studies. Most studies were graded as at moderate risk of bias. The overall pooled estimates for all age groups of self-reported lifetime prevalence were as follows: cow's milk (5.7%, 95% confidence interval 4.4-6.9), egg (2.4%, 1.8-3.0), wheat (1.6%, 0.9-2.3), soy (0.5%, 0.3-0.7), peanut (1.5%, 1.0-2.1), tree nuts (0.9%, 0.6-1.2), fish (1.4%, 0.8-2.0) and shellfish (0.4%, 0.3-0.6). The point prevalence of food challenge-verified allergy were as follows: cow's milk (0.3%, 0.1-0.5), egg (0.8%, 0.5-1.2), wheat (0.1%, 0.01-0.2), soy (0.3%, 0.1-0.4), peanut (0.1%, 0.0-0.2), tree nuts (0.04%, 0.02-0.1), fish (0.02%, 0.0-0.1) and shellfish (0.1%, 0.0-0.2). With some exceptions, the prevalence of allergy to common foods did not substantially change during the last decade; variations by European regions were observed.
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Affiliation(s)
- Giulia C I Spolidoro
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Mohamed Mustafa Ali
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Yohannes Tesfaye Amera
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Sungkutu Nyassi
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - Daniil Lisik
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - Athina Ioannidou
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - Graciela Rovner
- ACT Institutet Sweden, Gothenburg, Sweden
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Carina Venter
- Section of Allergy & Immunology, School of Medicine, University of Colorado Denver, Children's Hospital Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Ronald van Ree
- Department of Experimental Immunology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Department of Otorhinolaryngology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology, Allergy and Venerology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Berber Vlieg-Boerstra
- Department of Pediatrics, OLVG Hospital, Amsterdam, The Netherlands
- Department of Pediatrics, Rijnstate Hospital, Arnhem, The Netherlands
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Antonella Muraro
- Department of Mother and Child Health, The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region, University of Padua, Padua, Italy
| | - Graham Roberts
- Faculty of Medicine, University of Southampton, Southampton, UK
- David Hide Asthma and Allergy Centre, St Mary's Hospital, Isle of Wight, UK
| | - Bright I Nwaru
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
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5
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van Boven FE, Arends NJT, Sprikkelman AB, Emons JAM, Hendriks AI, van Splunter M, Schreurs MWJ, Terlouw S, Gerth van Wijk R, Wichers HJ, Savelkoul HFJ, van Neerven RJJ, Hettinga KA, de Jong NW. Tolerance Induction in Cow's Milk Allergic Children by Heated Cow's Milk Protein: The iAGE Follow-Up Study. Nutrients 2023; 15:nu15051181. [PMID: 36904179 PMCID: PMC10005260 DOI: 10.3390/nu15051181] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/10/2023] [Accepted: 02/21/2023] [Indexed: 03/03/2023] Open
Abstract
Accelerating the induction of tolerance to cow's milk (CM) reduces the burden of cow's milk allergy (CMA). In this randomised controlled intervention study, we aimed to investigate the tolerance induction of a novel heated cow milk protein, the iAGE product, in 18 children with CMA (diagnosed by a paedriatric allergist). Children who tolerated the iAGE product were included. The treatment group (TG: n = 11; mean age 12.8 months, SD = 4.7) consumed the iAGE product daily with their own diet, and the control group (CG: n = 7; mean age 17.6 months, SD = 3.2) used an eHF without any milk consumption. In each group, 2 children had multiple food allergies. The follow-up procedures consisted of a double-blind placebo-controlled food challenge (DBPCFC) with CM t = 0, t = 1 (8 months), t = 2 (16 months), and t = 3 (24 months). At t = 1, eight (73%) of 11 children in the TG had a negative DBPCFC, versus four out of seven (57%) in the CG (BayesFactor = 0.61). At t = 3, nine of the 11 (82%) children in the TG and five of seven (71%) in the CG were tolerant (BayesFactor = 0.51). SIgE for CM reduced from a mean of 3.41 kU/L (SD = 5.63) in the TG to 1.24 kU/L (SD = 2.08) at the end of intervention, respectively a mean of 2.58 (SD = 3.32) in the CG to 0.63 kU/L (SD = 1.06). Product-related AEs were not reported. CM was successfully introduced in all children with negative DBPCFC. We found a standardised, well-defined heated CM protein powder that is safe for daily OIT treatment in a selected group of children with CMA. However, the benefits of inducing tolerance were not observed.
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Affiliation(s)
- Frank E. van Boven
- Department of Internal Medicine, Section of Allergology & Clinical Immunology, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Nicolette J. T. Arends
- Depertment of Peadiatric Allergology, Sophia Children Hospital, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Aline B. Sprikkelman
- Department of Peadiatric Pulmonology & Allergology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
- University Medical Center Groningen, GRIAC Research Institute, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Joyce A. M. Emons
- Depertment of Peadiatric Allergology, Sophia Children Hospital, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Astrid I. Hendriks
- Depertment of Peadiatric Allergology, Sophia Children Hospital, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Marloes van Splunter
- Cell Biology & Immunology, Wageningen University & Research, 6708 PB Wageningen, The Netherlands
| | - Marco W. J. Schreurs
- Department of Immunology, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Severina Terlouw
- Department of Internal Medicine, Section of Allergology & Clinical Immunology, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Roy Gerth van Wijk
- Department of Internal Medicine, Section of Allergology & Clinical Immunology, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Harry J. Wichers
- Food & Biobased Research, Wageningen University & Research, 6700 AA Wageningen, The Netherlands
| | - Huub F. J. Savelkoul
- Cell Biology & Immunology, Wageningen University & Research, 6708 PB Wageningen, The Netherlands
| | - R. J. Joost van Neerven
- Cell Biology & Immunology, Wageningen University & Research, 6708 PB Wageningen, The Netherlands
- FrieslandCampina, 3811 LP Amersfoort, The Netherlands
| | - Kasper A. Hettinga
- Dairy Science and Technology, Food Quality and Design Group, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, The Netherlands
| | - Nicolette W. de Jong
- Department of Internal Medicine, Section of Allergology & Clinical Immunology, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands
- Depertment of Peadiatric Allergology, Sophia Children Hospital, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands
- Correspondence: ; Tel.: +31-6-21697954
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6
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Spolidoro GCI, Amera YT, Ali MM, Nyassi S, Lisik D, Ioannidou A, Rovner G, Khaleva E, Venter C, van Ree R, Worm M, Vlieg-Boerstra B, Sheikh A, Muraro A, Roberts G, Nwaru BI. Frequency of food allergy in Europe: An updated systematic review and meta-analysis. Allergy 2023; 78:351-368. [PMID: 36271775 PMCID: PMC10099188 DOI: 10.1111/all.15560] [Citation(s) in RCA: 58] [Impact Index Per Article: 58.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 02/01/2023]
Abstract
Food allergy (FA) is increasingly reported in Europe, however, the latest prevalence estimates were based on studies published a decade ago. The present work provides the most updated estimates of the prevalence and trends of FA in Europe. Databases were searched for studies published between 2012 and 2021, added to studies published up to 2012. In total, 110 studies were included in this update. Most studies were graded as moderate risk of bias. Pooled lifetime and point prevalence of self-reported FA were 19.9% (95% CI 16.6-23.3) and 13.1% (95% CI 11.3-14.8), respectively. The point prevalence of sensitization based on specific IgE (slgE) was 16.6% (95% CI 12.3-20.8), skin prick test (SPT) 5.7% (95% CI 3.9-7.4), and positive food challenge 0.8% (95% CI 0.5-0.9). While lifetime prevalence of self-reported FA and food challenge positivity only slightly changed, the point prevalence of self-reported FA, sIgE and SPT positivity increased from previous estimates. This may reflect a real increase, increased awareness, increased number of foods assessed, or increased number of studies from countries with less data in the first review. Future studies require rigorous designs and implementation of standardized methodology in diagnosing FA, including use of double-blinded placebo-controlled food challenge to minimize potential biases.
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Affiliation(s)
- Giulia C I Spolidoro
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Yohannes Tesfaye Amera
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Mohamed Mustafa Ali
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Sungkutu Nyassi
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - Daniil Lisik
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - Athina Ioannidou
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - Graciela Rovner
- ACT Institutet Sweden, Gothenburg, Sweden.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Carina Venter
- Section of Allergy and Immunology, School of Medicine, University of Colorado Denver, Children's Hospital Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Ronald van Ree
- Department of Experimental Immunology and Department of Otorhinolaryngology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology, Allergy and Venerology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Berber Vlieg-Boerstra
- Department of Pediatrics, OLVG Hospital, Amsterdam, the Netherlands.,Department of Pediatrics, Rijnstate Hospital, Arnhem, the Netherlands
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Antonella Muraro
- Department of Mother and Child Health, The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region, University of Padua, Padua, Italy
| | - Graham Roberts
- Faculty of Medicine, University of Southampton, Southampton, UK.,David Hide Asthma and Allergy Centre, St Mary's Hospital, Isle of Wight, UK
| | - Bright I Nwaru
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
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How a Family History of Allergic Diseases Influences Food Allergy in Children: The Japan Environment and Children's Study. Nutrients 2022; 14:nu14204323. [PMID: 36297007 PMCID: PMC9606927 DOI: 10.3390/nu14204323] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/05/2022] [Accepted: 10/12/2022] [Indexed: 11/05/2022] Open
Abstract
The influence of family allergic history on food allergy in offspring in Japan is unknown. We analyzed data from a nationwide birth cohort study using logistic regression models to examine the associations of maternal, paternal, and both parental histories of allergic diseases (food allergy, atopic dermatitis, asthma, and rhinitis) with their child’s food allergy at 1.5 and 3 years of age. This analysis included 69,379 singleton full-term mothers and 37,179 fathers and their children. All parental histories of allergic diseases showed significant positive associations with their child’s food allergy. When both parents had a history of allergic diseases, the adjusted odds ratio (aOR) tended to be higher than when either parent had allergic diseases (p for trend < 0.0001). The highest aOR was detected when both parents had food allergy (2.60; 95% confidential interval, 1.58−4.27), and the aOR was 1.71 when either parent had food allergy (95% confidential interval, 1.54−1.91). The aORs were attenuated but still had significant positive associations after adjusting for the child’s atopic dermatitis, a risk factor for allergy development. In conclusion, all parental allergic diseases were significantly positively associated with their child’s food allergy. The effect of family history showed a stepwise increase in risk from either parent to both parents, and the highest risk of allergic disease was a parental history of food allergy.
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de Jong NW, van Splunter ME, Emons JAM, Hettinga KA, Gerth van Wijk R, Wichers HJ, Savelkoul HFJ, Sprikkelman AB, van Neerven RJJ, Liu L, van der Meulen G, Herpertz I, Duijvestijn YCM, Breukels M, Brouwer MI, Schilperoord J, van Doorn O, Vlieg-Boerstra B, van den Berg J, Pellis L, Terlouw S, Hendriks AI, Schreurs MWJ, van Boven FE, Arends NJT. Introduction of Heated Cow's Milk Protein in Challenge-Proven Cow's Milk Allergic Children: The iAGE Study. Nutrients 2022; 14:nu14030629. [PMID: 35276990 PMCID: PMC8838309 DOI: 10.3390/nu14030629] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/13/2022] [Accepted: 01/27/2022] [Indexed: 02/07/2023] Open
Abstract
The introduction of baked milk products in cow’s milk (CM) allergic children has previously been shown to accelerate induction tolerance in a selected group of children. However, there is no standardized baked milk product on the market. Recently, a new standardized, heated and glycated cow’s milk protein (HP) product was developed. The aim of this study was to measure safety and tolerability of a new, well characterized heated CM protein (HP) product in cow’s milk allergic (CMA) children between the age of 3 and 36 months. The children were recruited from seven clinics throughout The Netherlands. The HP product was introduced in six incremental doses under clinical supervision. Symptoms were registered after introduction of the HP product. Several questionnaires were filled out by parents of the children. Skin prick tests were performed with CM and HP product, sIgE to CM and α-lactalbumin (Bos d4), β-lactoglobulin (Bos d5), serum albumin (Bos d 6), lactoferrin (Bos d7) and casein (Bos d8). Whereas 72% percent (18 out of 25) of the children tolerated the HP product, seven children experienced adverse events. Risk factors for intolerance to the HP product were higher skin prick test (SPT) histamine equivalent index (HEP) results with CM and the HP product, higher specific IgE levels against Bos d4 and Bos d8 levels and Bos d5 levels. In conclusion, the HP product was tolerated by 72% of the CM allergic children. Outcomes of SPT with CM and the HP product, as well as values of sIgE against caseins, α-lactalbumin, and β-lactoglobulin may predict the tolerability of the HP product. Larger studies are needed to confirm these conclusions.
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Affiliation(s)
- Nicolette W. de Jong
- Department of Internal Medicine, Section of Allergology & Clinical Immunology, Erasmus MC, University Medical Centre Rotterdam, 3015GD Rotterdam, The Netherlands; (M.E.v.S.); (R.G.v.W.); (S.T.); (F.E.v.B.)
- Depertment of Peadiatric Allergology, Sophia Children Hospital, Erasmus MC, University Medical Centre Rotterdam, 3015GD Rotterdam, The Netherlands; (J.A.M.E.); (A.I.H.); (N.J.T.A.)
- Correspondence: ; Tel.: +31-6-21697954
| | - Marloes E. van Splunter
- Department of Internal Medicine, Section of Allergology & Clinical Immunology, Erasmus MC, University Medical Centre Rotterdam, 3015GD Rotterdam, The Netherlands; (M.E.v.S.); (R.G.v.W.); (S.T.); (F.E.v.B.)
| | - Joyce A. M. Emons
- Depertment of Peadiatric Allergology, Sophia Children Hospital, Erasmus MC, University Medical Centre Rotterdam, 3015GD Rotterdam, The Netherlands; (J.A.M.E.); (A.I.H.); (N.J.T.A.)
| | - Kasper A. Hettinga
- Food Quality & Design Group, Wageningen University & Research Centre, 6708PB Wageningen, The Netherlands; (K.A.H.); (H.J.W.)
| | - Roy Gerth van Wijk
- Department of Internal Medicine, Section of Allergology & Clinical Immunology, Erasmus MC, University Medical Centre Rotterdam, 3015GD Rotterdam, The Netherlands; (M.E.v.S.); (R.G.v.W.); (S.T.); (F.E.v.B.)
| | - Harry J. Wichers
- Food Quality & Design Group, Wageningen University & Research Centre, 6708PB Wageningen, The Netherlands; (K.A.H.); (H.J.W.)
| | - Huub F. J. Savelkoul
- Cell Biology & Immunology Group, Wageningen University & Research Centre, 6708PB Wageningen, The Netherlands; (H.F.J.S.); (R.J.J.v.N.)
| | - Aline B. Sprikkelman
- Department of Peadiatric Pulmonology & Allergology, UMCG, University Medical Center Groningen, 9713GZ Groningen, The Netherlands;
- University Medical Center Groningen, GRIAC Research Institute, University of Groningen, 9713GZ Groningen, The Netherlands
| | - R. J. Joost van Neerven
- Cell Biology & Immunology Group, Wageningen University & Research Centre, 6708PB Wageningen, The Netherlands; (H.F.J.S.); (R.J.J.v.N.)
- FrieslandCampina, 3811LP Amersfoort, The Netherlands
| | - Liu Liu
- Department of Rheumatoloy, Leiden University, 2311BD Leiden, The Netherlands;
| | | | - Irene Herpertz
- Paediatric Allegology Center, VieCuri Medisch Centrum, 5912BL Venlo, The Netherlands;
| | | | - Mijke Breukels
- Deparment of Peadiatrics, Elkerliek, 5707HA Helmond, The Netherlands;
| | - Marianne I. Brouwer
- Department of Peadiatrics, Canisius Wilhelmina Ziekenhuis, 6532SZ Nijmegen, The Netherlands;
| | - Jaap Schilperoord
- Department of Peadiatrics, OLVG Hospital, 1091AC Amsterdam, The Netherlands; (J.S.); (O.v.D.); (B.V.-B.)
| | - Olga van Doorn
- Department of Peadiatrics, OLVG Hospital, 1091AC Amsterdam, The Netherlands; (J.S.); (O.v.D.); (B.V.-B.)
| | - Berber Vlieg-Boerstra
- Department of Peadiatrics, OLVG Hospital, 1091AC Amsterdam, The Netherlands; (J.S.); (O.v.D.); (B.V.-B.)
| | | | | | - Severina Terlouw
- Department of Internal Medicine, Section of Allergology & Clinical Immunology, Erasmus MC, University Medical Centre Rotterdam, 3015GD Rotterdam, The Netherlands; (M.E.v.S.); (R.G.v.W.); (S.T.); (F.E.v.B.)
| | - Astrid I. Hendriks
- Depertment of Peadiatric Allergology, Sophia Children Hospital, Erasmus MC, University Medical Centre Rotterdam, 3015GD Rotterdam, The Netherlands; (J.A.M.E.); (A.I.H.); (N.J.T.A.)
| | - Marco W. J. Schreurs
- Department of Immunology, Erasmus MC, University Medical Centre Rotterdam, 3015GD Rotterdam, The Netherlands;
| | - Frank E. van Boven
- Department of Internal Medicine, Section of Allergology & Clinical Immunology, Erasmus MC, University Medical Centre Rotterdam, 3015GD Rotterdam, The Netherlands; (M.E.v.S.); (R.G.v.W.); (S.T.); (F.E.v.B.)
| | - Nicolette J. T. Arends
- Depertment of Peadiatric Allergology, Sophia Children Hospital, Erasmus MC, University Medical Centre Rotterdam, 3015GD Rotterdam, The Netherlands; (J.A.M.E.); (A.I.H.); (N.J.T.A.)
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Owora AH, Tepper RS, Ramsey CD, Chan-Yeung M, Watson WTA, Becker AB. Transitions between alternating childhood allergy sensitization and current asthma states: A retrospective cohort analysis. Pediatr Allergy Immunol 2022; 33:e13699. [PMID: 34799887 PMCID: PMC9300087 DOI: 10.1111/pai.13699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 01/27/2023]
Affiliation(s)
- Arthur H Owora
- Department of Epidemiology and Biostatistics, School of Public Health, Bloomington, Indiana, USA.,Department of Pediatrics and Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Robert S Tepper
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Clare D Ramsey
- Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Moira Chan-Yeung
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Wade T A Watson
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Allan B Becker
- Department of Pediatrics and Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
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10
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Cooper PJ, Ster IC, Chico ME, Vaca M, Barreto ML, Strachan DP. Patterns of allergic sensitization and factors associated with emergence of sensitization in the rural tropics early in the life course: findings of an Ecuadorian birth cohort. FRONTIERS IN ALLERGY 2021; 2:687073. [PMID: 34888545 PMCID: PMC7612078 DOI: 10.3389/falgy.2021.687073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction There are limited data on emergence of allergic sensitization (or atopy) during childhood in tropical regions. Methods We followed a birth cohort of 2404 newborns to 8 years in tropical Ecuador and collected: risk factor data by maternal questionnaires periodically from birth; atopy was measured by skin prick test reactivity (SPT) to aeroallergens in parents, and aeroallergens and food allergens in children at 2, 3, 5, and 8 years; and stool samples for soil-transmitted helminths (STH) from children periodically to 8 years and from parents and household members at the time of recruitment of cohort children. Data on risk factors were measured either at birth or repeatedly (time-varying) from birth to 8 years. Longitudinal repeated-measures analyses were done using generalized estimating equations to estimate an the age-dependent risk of positive SPT (SPT+) to any allergen or mite during early childhood to school age. Results SPT+ to any allergen was present in 29.0% of fathers and 24.8% of mothers, and in cohort children increased with age, initially to mite but later to cockroach, reaching 14.8% to any allergen (10.7% mite and 5.3% cockroach) at 8 years. Maternal SPT+, particularly presence of polysensitization (OR 2.04, 95% CI 1.49-2.77) significantly increased the risk of SPT+ during childhood, while household overcrowding at birth decreased the risk (OR 0.84, 95% CI 0.72-0.98). For mite sensitization, maternal polysensitization increased (OR 2.14, 95% CI 1.40-3.27) but rural residence (OR 0.69, 95% CI 0.50-0.94) and birth order (3rd -4th vs. 1st - 2nd: OR 0.71, 95% CI 0.52-0.98) decreased the risk. Time-varying exposures to agricultural activities (OR 0.77, 95% CI 0.60-0.98) and STH parasites (OR 0.70, 95% CI 0.64-0.91) during childhood decreased while anthelmintics increased the childhood risk (OR 1.47, 95% CI 1.05-2.05) of mite sensitization. Conclusion Our data showed the emergence of allergic sensitization, primarily to mite and cockroach allergens, during childhood in tropical Ecuador. A role for both antenatal and postnatal factors acting as potential determinants of SPT+ emergence was observed.
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Affiliation(s)
- Philip J Cooper
- Institute of Infection and Immunity, St George's University of London, London, UK.,Escuela de Medicina, Universidad Internacional del Ecuador, Quito, Ecuador.,Fundacion Ecuatoriana Para Investigacion en Salud, Quito, Ecuador
| | - Irina Chis Ster
- Institute of Infection and Immunity, St George's University of London, London, UK
| | - Martha E Chico
- Fundacion Ecuatoriana Para Investigacion en Salud, Quito, Ecuador
| | - Maritza Vaca
- Fundacion Ecuatoriana Para Investigacion en Salud, Quito, Ecuador
| | - Mauricio L Barreto
- Center for Data and Knowledge Integration for Health (CIDACS)-FIOCRUZ, Salvador, Brazil
| | - David P Strachan
- Population Health Research Institute, St George's University of London, London, UK
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11
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Roff AJ, Morrison JL, Tai A, Clifton VL, Gatford KL. Maternal asthma during pregnancy and risks of allergy and asthma in progeny: a systematic review protocol. JBI Evid Synth 2021; 19:2007-2013. [PMID: 33795583 DOI: 10.11124/jbies-20-00328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The primary objective of this systematic review is to synthesize the best available evidence on the relationship between in utero exposure to maternal asthma and postnatal allergy. Secondary objectives are to investigate the impact of asthma loss of control, asthma exacerbation, and asthma severity during pregnancy on risks of allergy and asthma in progeny. INTRODUCTION Maternal asthma is a well-known risk factor for childhood asthma, with recent evidence suggesting that children of asthmatic mothers are also at increased risk of allergic diseases. Importantly, these do not appear to be purely genetic associations, since maternal asthma is more strongly associated with childhood asthma than paternal asthma. In addition, experimentally induced allergic asthma during pregnancy increases allergic responses to sensitization in mice. The strength of the relationships between exposure to maternal asthma or severity of maternal asthma, and progeny asthma and allergy are unknown. INCLUSION CRITERIA This review will include primary studies that report incidence of physician-diagnosed asthma or allergic disease in human progeny who were exposed in utero to maternal asthma, in comparison to progeny not exposed to maternal asthma. METHODS Initial search terms include (pregnan∗ OR gestat∗) AND asthma∗ AND allerg∗. We will search the following electronic databases for published and unpublished evidence: PubMed, Embase, MEDLINE (Ovid), Web of Science, Cochrane Library, CINAHL, Scopus, Informit Health, MedNar, ProQuest, and Trove. There will be no restrictions on publication date. Only studies available as a full-text English publication will be considered for inclusion. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020201538.
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Affiliation(s)
- Andrea J Roff
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia.,Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Janna L Morrison
- Early Origins of Adult Health Research Group, Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Andrew Tai
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia.,Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia.,Respiratory and Sleep Medicine, Women's and Children's Hospital, Adelaide, SA, Australia
| | - Vicki L Clifton
- Mater Medical Research Institute, University of Queensland, Brisbane, QLD, Australia
| | - Kathryn L Gatford
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia.,Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
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12
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Mustonen N, Siljander H, Niemelä O, Ilonen J, Haahtela T, Knip M. Allergy-Related Symptoms Are Poorly Predicted by IgE and Skin Prick Testing in Early Life. Int Arch Allergy Immunol 2021; 182:574-584. [PMID: 33550294 DOI: 10.1159/000512109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 10/07/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION In childhood, the so-called allergic march involves progression from IgE sensitization to allergy-related symptoms. Both IgE sensitization and relevant clinical symptoms are required for the diagnosis of allergy, but concordance between test results and clinical symptoms varies greatly, creating challenges for the diagnostics and for the prediction of outcomes. We assessed the prevalence of IgE sensitization and allergy symptoms, concordance between 2 IgE sensitization testing methods, and predictive value of these tests in relation to clinical symptoms in young Finnish children. METHODS The current study included 2 series of children: a birth cohort, in which the participants were followed prospectively from birth up to 3 years, and a young children cohort observed from 3 to 5 years of age. They were regularly monitored for sensitization by measuring serum allergen-specific IgEs (sIgEs) and performing skin prick tests (SPTs). The emergence of atopic dermatitis, wheezing, and symptoms associated with food allergies was recorded. RESULTS Over the first 5 years of life, the prevalence of sIgE sensitization was 46%, while it was 36% for positive SPTs. Disease prevalence was 26% for atopic dermatitis, 25% for wheezing, and 19% for symptoms associated with food allergies. Concordance between sIgE and SPT results was good for aeroallergens, but poor for dietary allergens. The association between clinical symptoms and sensitization was stronger at 5 years than at 3 years of age. The proportion of children with concordant combinations of allergy symptoms and sensitization markers in contrast to those with discordant combinations increased from 3 to 5 years. CONCLUSION In early childhood, testing for IgE sensitization predicts allergy-related symptoms in an age-dependent manner, but not particularly well. Tests predict symptoms caused by aeroallergens clearly better than those caused by dietary allergens. The clinical relevance of sensitization testing in early life is therefore limited in the prediction of true allergy.
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Affiliation(s)
- Neea Mustonen
- Pediatric Research Center, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Heli Siljander
- Pediatric Research Center, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and University of Tampere, Seinäjoki, Finland
| | - Jorma Ilonen
- Immunogenetics Laboratory, Institute of Biomedicine, University of Turku, Turku, Finland.,Clinical Microbiology, Turku University Hospital, Turku, Finland
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - Mikael Knip
- Pediatric Research Center, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland, .,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland, .,Folkhälsan Research Center, Helsinki, Finland, .,Tampere Center for Child Health Research, Tampere University Hospital, Tampere, Finland,
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