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Nguyen A, du Toit G, Lack G, Marrs T. Optimising the management of peanut allergy by targeting immune plasticity. Clin Exp Allergy 2024; 54:169-184. [PMID: 38423799 DOI: 10.1111/cea.14454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 11/03/2023] [Accepted: 11/23/2023] [Indexed: 03/02/2024]
Abstract
Randomised controlled trials investigating the efficacy of oral tolerance induction to peanut have enabled detailed comparison of their clinical and immunological success. They have demonstrated that the regular consumption of peanut for at least 2 years by babies who are not allergic enables protection from developing peanut allergy. The LEAP study intervention tested the impact of regular peanut consumption for 4 years and demonstrated a sustained protection against the development of peanut allergy even after 12 months of peanut avoidance from 5 to 6 years of age. The PreventADALL trial introduced multiple allergens into babies' diets from early infancy and reduced the prevalence of food allergy at 3 years, especially by protecting against peanut allergy. Immunological studies from the LEAP cohort demonstrated that regular peanut consumption was associated with a prompt induction of peanut-specific IgG4 and reduced manufacture of peanut and Ara h 2-specific IgE. Even after stopping peanut consumption for 5 years, there continued to be a significant fall in peanut-specific Ara h 2 IgE in the consumption group from 5 to 6 years of age (p < .01). Children who developed peanut allergy by 5 years started to develop increasing sensitisation to linear sequential peanut epitopes from 2.5 years of age, suggesting that putative disease-modifying interventions should commence before 3 years. Data comparing clinical outcomes between children undergoing peanut immunotherapy from infancy suggest that younger children can consume higher portions of peanut without reaction on challenge whilst taking immunotherapy, have fewer side effects and are more likely to enjoy remission of PA. Peanut oral immunotherapy modulates T-cell populations in order to bring about hypo-responsiveness of allergy effector cells. Studies are now needed to characterise and compare different states of immunological tolerance. This will accelerate the design of interventions which can promote primary, secondary and tertiary levels of PA prevention across a range of age groups.
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Affiliation(s)
- Alan Nguyen
- Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - George du Toit
- Paediatric Allergy, Department of Women and Children's Health, King's College London, Strand, UK
- Children's Allergies, Evelina London, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK
| | - Gideon Lack
- Paediatric Allergy, Department of Women and Children's Health, King's College London, Strand, UK
| | - Tom Marrs
- Paediatric Allergy, Department of Women and Children's Health, King's College London, Strand, UK
- Children's Allergies, Evelina London, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK
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2
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Xu Y, Zhang F, Mu G, Zhu X. Effect of lactic acid bacteria fermentation on cow milk allergenicity and antigenicity: A review. Compr Rev Food Sci Food Saf 2024; 23:e13257. [PMID: 38284611 DOI: 10.1111/1541-4337.13257] [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: 03/02/2023] [Revised: 09/22/2023] [Accepted: 10/02/2023] [Indexed: 01/30/2024]
Abstract
Cow milk is a major allergenic food. The potential prevention and treatment effects of lactic acid bacteria (LAB)-fermented dairy products on allergic symptoms have garnered considerable attention. Cow milk allergy (CMA) is mainly attributed to extracellular and/or cell envelope proteolytic enzymes with hydrolysis specificity. Numerous studies have demonstrated that LAB prevents the risk of allergies by modulating the development and regulation of the host immune system. Specifically, LAB and its effectors can enhance intestinal barrier function and affect immune cells by interfering with humoral and cellular immunity. Fermentation hydrolysis of allergenic epitopes is considered the main mechanism of reducing CMA. This article reviews the linear epitopes of allergens in cow milk and the effect of LAB on these allergens and provides insight into the means of predicting allergenic epitopes by conventional laboratory analysis methods combined with molecular simulation. Although LAB can reduce CMA in several ways, the mechanism of action remains partially clarified. Therefore, this review additionally attempts to summarize the main mechanism of LAB fermentation to provide guidance for establishing an effective preventive and treatment method for CMA and serve as a reference for the screening, research, and application of LAB-based intervention.
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Affiliation(s)
- Yunpeng Xu
- School of Food Science and Technology, Dalian Polytechnic University, Dalian, Liaoning, P. R. China
| | - Feifei Zhang
- Liaoning Ocean and Fisheries Science Research Institute, Dalian, Liaoning, P. R. China
| | - Guangqing Mu
- Dalian Key Laboratory of Functional Probiotics, Dalian, Liaoning, P. R. China
| | - Xuemei Zhu
- School of Food Science and Technology, Dalian Polytechnic University, Dalian, Liaoning, P. R. China
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3
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Abang Abdullah AF, Muhamad NA, Ab Ghani RM, Maamor NH, Leman FN, Too CL, Ismail IH, Mohd Zulkefli NA, Mohd Nazan AIN, Md Said S. The Effectiveness of Early Food Introduction in Preventing Childhood Allergic Diseases: Protocol for a Systematic Review and Meta-Analysis. JMIR Res Protoc 2023; 12:e46816. [PMID: 37358892 DOI: 10.2196/46816] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/20/2023] [Accepted: 04/20/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND Allergic diseases affect around 40% of the pediatric population worldwide. The coexistence of asthma, allergic rhinitis, eczema, and food allergy renders allergy treatment and prevention challenging. Infant feeding strategies recommend avoiding allergenic foods to prevent allergy development and anaphylaxis. However, recent evidence suggests that early consumption of food allergens during weaning in infants aged 4-6 months could result in food tolerance, thus reducing the risk of developing allergies. OBJECTIVE The aim of this study is to systematically review and carry out a meta-analysis of evidence on the outcome of early food introduction for preventing childhood allergic diseases. METHODS We will conduct a systematic review of interventions through a comprehensive search of various databases including PubMed, Embase, Scopus, CENTRAL, PsycINFO, CINAHL, and Google Scholar to identify potential studies. The search will be performed for any eligible articles from the earliest published articles up to the latest available studies in 2023. We will include randomized controlled trials (RCTs), cluster RCTs, non-RCTs, and other observational studies that assess the effect of early food introduction to prevent childhood allergic diseases. RESULTS Primary outcomes will include measures related to the effect of childhood allergic diseases (ie, asthma, allergic rhinitis, eczema, and food allergy). PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines will be followed for study selection. All data will be extracted using a standardized data extraction form and the quality of the studies will be assessed using the Cochrane Risk of Bias tool. A summary of findings table will be generated for the following outcomes: (1) total number of allergic diseases, (2) rate of sensitization, (3) total number of adverse events, (4) improvement of health-related quality of life, and (5) all-cause mortality. Descriptive and meta-analyses will be performed using a random-effects model in Review Manager (Cochrane). Heterogeneity among selected studies will be assessed using the I2 statistic and explored through meta-regression and subgroup analyses. Data collection is expected to start in June 2023. CONCLUSIONS The results acquired from this study will contribute to the existing literature and harmonize recommendations for infant feeding with regard to the prevention of childhood allergic diseases. TRIAL REGISTRATION PROSPERO CRD42021256776; https://tinyurl.com/4j272y8a. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/46816.
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Affiliation(s)
- Aisha Fadhilah Abang Abdullah
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
- Department of Paediatrics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Nor Asiah Muhamad
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Rimah Melati Ab Ghani
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Nur Hasnah Maamor
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Fatin Norhasny Leman
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Chun Lai Too
- Immunogenetic Unit, Allergy and Immunology Research Center, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Intan Hakimah Ismail
- Department of Paediatrics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Nor Afiah Mohd Zulkefli
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | | | - Salmiah Md Said
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
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Sadiq Z, Safiabadi Tali SH, Hajimiri H, Al-Kassawneh M, Jahanshahi-Anbuhi S. Gold Nanoparticles-Based Colorimetric Assays for Environmental Monitoring and Food Safety Evaluation. Crit Rev Anal Chem 2023:1-36. [PMID: 36629748 DOI: 10.1080/10408347.2022.2162331] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Recent years have witnessed an exponential increase in the research on gold nanoparticles (AuNPs)-based colorimetric sensors to revolutionize point-of-use sensing devices. Hence, this review is compiled focused on current progress in the design and performance parameters of AuNPs-based sensors. The review begins with the characteristics of AuNPs, followed by a brief explanation of synthesis and functionalization methods. Then, the mechanisms of AuNPs-based sensors are comprehensively explained in two broad categories based on the surface plasmon resonance (SPR) characteristics of AuNPs and their peroxidase-like catalytic properties (nanozyme). SPR-based colorimetric sensors further categorize into aggregation, anti-aggregation, etching, growth-mediated, and accumulation-based methods depending on their sensing mechanisms. On the other hand, peroxidase activity-based colorimetric sensors are divided into two methods based on the expression or inhibition of peroxidase-like activity. Next, the analytes in environmental and food samples are classified as inorganic, organic, and biological pollutants, and recent progress in detection of these analytes are reviewed in detail. Finally, conclusions are provided, and future directions are highlighted. Improving the sensitivity, reproducibility, multiplexing capabilities, and cost-effectiveness for colorimetric detection of various analytes in environment and food matrices will have significant impact on fast testing of hazardous substances, hence reducing the pollution load in environment as well as rendering food contamination to ensure food safety.
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Affiliation(s)
- Zubi Sadiq
- Department of Chemical and Materials Engineering, Gina Cody School of Engineering and Computer Science, Concordia University, Montréal, Québec, Canada
| | - Seyed Hamid Safiabadi Tali
- Department of Chemical and Materials Engineering, Gina Cody School of Engineering and Computer Science, Concordia University, Montréal, Québec, Canada
| | - Hasti Hajimiri
- Department of Chemical and Materials Engineering, Gina Cody School of Engineering and Computer Science, Concordia University, Montréal, Québec, Canada
| | - Muna Al-Kassawneh
- Department of Chemical and Materials Engineering, Gina Cody School of Engineering and Computer Science, Concordia University, Montréal, Québec, Canada
| | - Sana Jahanshahi-Anbuhi
- Department of Chemical and Materials Engineering, Gina Cody School of Engineering and Computer Science, Concordia University, Montréal, Québec, Canada
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Kubo K, Takeda S, Uchida M, Maeda M, Endo N, Sugahara S, Suzuki H, Fukahori H. Lit-LAMP-DNA-vaccine for shrimp allergy prevents anaphylactic symptoms in a murine model. Int Immunopharmacol 2022; 113:109394. [DOI: 10.1016/j.intimp.2022.109394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/17/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
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Multi-Omic Profiles in Infants at Risk for Food Reactions. Genes (Basel) 2022; 13:genes13112024. [DOI: 10.3390/genes13112024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 10/29/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
Abstract
Food reactions (FR) are multifactorial and impacted by medical, demographic, environmental, and immunologic factors. We hypothesized that multi-omic analyses of host-microbial factors in saliva would enhance our understanding of FR development. This longitudinal cohort study included 164 infants followed from birth through two years. The infants were identified as FR (n = 34) or non-FR (n = 130) using the Infant Feeding Practice II survey and medical record confirmation. Saliva was collected at six months for the multi-omic assessment of cytokines, mRNAs, microRNAs, and the microbiome/virome. The levels of one miRNA (miR-203b-3p, adj. p = 0.043, V = 2913) and one viral phage (Proteus virus PM135, adj. p = 0.027, V = 2955) were lower among infants that developed FRs. The levels of one bacterial phylum (Cyanobacteria, adj. p = 0.048, V = 1515) were higher among infants that developed FR. Logistical regression models revealed that the addition of multi-omic features (miR-203b-3p, Cyanobacteria, and Proteus virus PM135) improved predictiveness for future FRs in infants (p = 0.005, X2 = 12.9), predicting FRs with 72% accuracy (AUC = 0.81, sensitivity = 72%, specificity = 72%). The multi-omic analysis of saliva may enhance the accurate identification of infants at risk of FRs and provide insights into the host/microbiome interactions that predispose certain infants to FRs.
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Zhu H, Tang K, Chen G, Liu Z. Biomarkers in oral immunotherapy. J Zhejiang Univ Sci B 2022; 23:705-731. [PMID: 36111569 PMCID: PMC9483607 DOI: 10.1631/jzus.b2200047] [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: 11/11/2022]
Abstract
Food allergy (FA) is a global health problem that affects a large population, and thus effective treatment is highly desirable. Oral immunotherapy (OIT) has been showing reasonable efficacy and favorable safety in most FA subjects. Dependable biomarkers are needed for treatment assessment and outcome prediction during OIT. Several immunological indicators have been used as biomarkers in OIT, such as skin prick tests, basophil and mast cell reactivity, T cell and B cell responses, allergen-specific antibody levels, and cytokines. Other novel indicators also could be potential biomarkers. In this review, we discuss and assess the application of various immunological indicators as biomarkers for OIT.
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Affiliation(s)
- Haitao Zhu
- Department of Pediatrics (No. 3 Ward), Northwest Women's and Children's Hospital, Xi'an 710061, China
| | - Kaifa Tang
- Department of Urology, the Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
| | - Guoqiang Chen
- Department of Pediatrics (No. 3 Ward), Northwest Women's and Children's Hospital, Xi'an 710061, China
| | - Zhongwei Liu
- Department of Cardiology, Shaanxi Provincial People's Hospital, Xi'an 710068, China.
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Advances in the Study of the Mechanism by Which Selenium and Selenoproteins Boost Immunity to Prevent Food Allergies. Nutrients 2022; 14:nu14153133. [PMID: 35956310 PMCID: PMC9370097 DOI: 10.3390/nu14153133] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 12/19/2022] Open
Abstract
Selenium (Se) is an essential micronutrient that functions in the body mainly in the form of selenoproteins. The selenoprotein contains 25 members in humans that exhibit a number of functions. Selenoproteins have immunomodulatory functions and can enhance the ability of immune system to regulate in a variety of ways, which can have a preventive effect on immune-related diseases. Food allergy is a specific immune response that has been increasing in number in recent years, significantly reducing the quality of life and posing a major threat to human health. In this review, we summarize the current understanding of the role of Se and selenoproteins in regulating the immune system and how dysregulation of these processes may lead to food allergies. Thus, we can explain the mechanism by which Se and selenoproteins boost immunity to prevent food allergies.
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Mitselou N, Andersson N, Bergström A, Kull I, Georgelis A, Hage M, Hedman AM, Almqvist C, Ludvigsson JF, Melén E. Preterm birth reduces the risk of IgE sensitization up to early adulthood: A population-based birth cohort study. Allergy 2022; 77:1570-1582. [PMID: 34486741 DOI: 10.1111/all.15077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 06/06/2021] [Accepted: 06/24/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Immunoglobulin E (IgE) sensitization is associated with asthma and allergic diseases. Gestational age influences early immune system development, thereby potentially affecting the process of tolerance induction to allergens. OBJECTIVE To study IgE sensitization to common allergens by gestational age from childhood up to early adulthood. METHODS Population-based birth cohort, data from the Swedish BAMSE study were used. Allergen-specific IgE antibodies to a mix of common food (fx5) and inhalant (Phadiatop) allergens were analysed at 4, 8, 16 and 24 years. Sensitization was defined as allergen-specific IgE ≥0.35 kUA /L to fx5 and/or Phadiatop at each time point. Using logistic regression and generalized estimated equations, adjusted odds ratios (aORs) for sensitization in relation to gestational age were calculated. Replication was sought within the Swedish twin study STOPPA. RESULTS In BAMSE, 3522 participants were screened for IgE antibodies during follow-up; of these, 197 (5.6%) were born preterm (<37 gestational weeks) and 330 (9.4%) post-term (≥42 weeks). Preterm birth reduced the risk of sensitization to common food and/or inhalant allergens up to early adulthood by 29% (overall aOR = 0.71; 95% CI: 0.52-0.98), and to food allergens specifically by 40% (overall aOR = 0.60; 95% CI: 0.38-0.93). No relation was found between post-term birth and IgE sensitization at any time point. Replication analyses in STOPPA (N = 675) showed similar risk estimates for sensitization to food and/or inhalant allergens (aOR = 0.72; 95% CI: 0.42-1.21), which resulted in a combined meta-analysis aOR = 0.71 (95% CI: 0.54-0.94). CONCLUSIONS Our study suggests an inverse association between preterm birth and long-term IgE sensitization.
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Affiliation(s)
- Niki Mitselou
- Department of Pediatrics Örebro University Hospital Örebro Sweden
| | - Niklas Andersson
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
| | - Anna Bergström
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
- Centre for Occupational and Environmental Medicine Region Stockholm Stockholm Sweden
| | - Inger Kull
- Department of Clinical Science and Education Södersjukhuset Stockholm Sweden
- Sachs' Children and Youth Hospital Södersjukhuset Stockholm Sweden
| | - Antonios Georgelis
- Centre for Occupational and Environmental Medicine Region Stockholm Stockholm Sweden
| | - Marianne Hage
- Division of Immunology and Allergy Department of Medicine Solna Karolinska Institutet and Karolinska University Hospital Stockholm Sweden
| | - Anna M. Hedman
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
- Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden
| | - Jonas F. Ludvigsson
- Department of Pediatrics Örebro University Hospital Örebro Sweden
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
- Division of Epidemiology and Public Health School of Medicine University of Nottingham Nottingham UK
- Department of Medicine Columbia University College of Physicians and Surgeons New York New York USA
| | - Erik Melén
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
- Department of Clinical Science and Education Södersjukhuset Stockholm Sweden
- Sachs' Children and Youth Hospital Södersjukhuset Stockholm Sweden
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Ali A, Hamzaid NH, Ismail NAS. The Interplay of Nutriepigenomics, Personalized Nutrition and Clinical Practice in Managing Food Allergy. Life (Basel) 2021; 11:1275. [PMID: 34833150 PMCID: PMC8623511 DOI: 10.3390/life11111275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/25/2021] [Accepted: 11/05/2021] [Indexed: 11/16/2022] Open
Abstract
Food allergy in children has been a common issue due to the challenges of prescribing personalized nutrition with a lack of nutriepigenomics data. This has indeed further influenced clinical practice for appropriate management. While allergen avoidance is still the main principle in food allergy management, we require more information to advance the science behind nutrition, genes, and the immune system. Many researchers have highlighted the importance of personalized nutrition but there is a lack of data on how the decision is made. Thus, this review highlights the relationship among these key players in identifying the solution to the clinical management of food allergy with current nutriepigenomics data. The discussion integrates various inputs, including clinical assessments, biomarkers, and epigenetic information pertaining to food allergy, to curate a holistic and personalized approach to food allergy management in particular.
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Affiliation(s)
- Adli Ali
- Department of Pediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
| | - Nur Hana Hamzaid
- Dietetic Program & Centre for Rehabilitation and Special Needs Studies (iCaRehab), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia;
| | - Noor Akmal Shareela Ismail
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
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Smith SS, Hilas O. Peanut ( Arachis hypogaea) Allergen Powder-dnfp: The First FDA-approved Oral Immunotherapy for Desensitization of Peanut Allergy in Children. J Pediatr Pharmacol Ther 2021; 26:669-674. [PMID: 34588930 PMCID: PMC8475804 DOI: 10.5863/1551-6776-26.7.669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/30/2021] [Indexed: 11/11/2022]
Abstract
Peanut (Arachis hypogaea) Allergen Powder-dnfp (Palforzia, Aimmune™ Therapeutics, Inc.; Brisbane, CA) is the first FDA-approved oral immunotherapy indicated for the mitigation of allergic reactions, including anaphylaxis, in patients with peanut allergy. It may be initiated in individuals 4 to 17 years of age and continued for maintenance in those 4 years of age and older. Initiation and dose titration require a stepwise approach and the supervision of a health care professional. Patients taking Peanut (Arachis hypogaea) Allergen Powder-dnfp should also follow a peanut-avoidant diet. In addition, patients should have an injectable epinephrine product in case of drug-related anaphylaxis. Commonly reported adverse reactions include gastrointestinal, respiratory, and dermatologic manifestations that are frequently associated with allergic reactions.
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12
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Krempski JW, Warren C, Han X, Zhang W, He Z, Lejeune S, Nadeau K. Food Allergies: An Example of Translational Research. Immunol Allergy Clin North Am 2021; 41:143-163. [PMID: 33863476 DOI: 10.1016/j.iac.2021.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Food allergies have been rising in prevalence since the 1990s, imposing substantial physical, psychosocial, and economic burdens on affected patients and their families. Until recently, the only therapy for food allergy was strict avoidance of the allergenic food. Recent advances in translational studies, however, have led to insights into allergic sensitization and tolerance. This article provides an overview of cutting-edge research into food allergy and immune tolerance mechanisms utilizing mouse models, human studies, and systems biology approaches. This research is being translated and implemented in the clinical setting to improve diagnosis and reduce food allergy's public health burden.
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Affiliation(s)
- James Walter Krempski
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, CA, USA.
| | - Christopher Warren
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, CA, USA
| | - Xiaorui Han
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, CA, USA
| | - Wenming Zhang
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, CA, USA
| | - Ziyuan He
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, CA, USA
| | - Stéphanie Lejeune
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, CA, USA
| | - Kari Nadeau
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, CA, USA
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Herman RA, Bauman PA, Goodwin L, Islamovic E, Ma EH, Serrano H, Silvanovich A, Simmons AR, Song P, Tetteh AO, Wang R. Mass spectrometric analysis of digesta does not improve the allergenicity assessment of GM crops. Transgenic Res 2021; 30:283-288. [PMID: 33864193 PMCID: PMC8169501 DOI: 10.1007/s11248-021-00254-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 04/05/2021] [Indexed: 11/23/2022]
Abstract
An investigation of the potential allergenicity of newly expressed proteins in genetically modified (GM) crops comprises part of the assessment of GM crop safety. However, allergenicity is not completely predictable from a definitive assay result or set of protein characteristics, and scientific opinions regarding the data that should be used to assess allergenicity are continuously evolving. Early studies supported a correlation between the stability of a protein exposed to digestive enzymes such as pepsin and the protein’s status as a potential allergen, but over time the conclusions of these earlier studies were not confirmed. Nonetheless, many regulatory authorities, including the European Food Safety Authority (EFSA), continue to require digestibility analyses as a component of GM crop risk assessments. Moreover, EFSA has recently investigated the use of mass spectrometry (MS), to make digestion assays more predictive of allergy risk, because it can detect and identify small undigested peptides. However, the utility of MS is questionable in this context, since known allergenic peptides are unlikely to exist in protein candidates intended for commercial development. These protein candidates are pre-screened by the same bioinformatics processes that are normally used to identify MS targets. Therefore, MS is not a standalone allergen identification method and also cannot be used to predict previously unknown allergenic epitopes. Thus, the suggested application of MS for analysis of digesta does not improve the poor predictive power of digestion assays in identifying allergenic risk.
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Affiliation(s)
| | | | | | | | - Eric H Ma
- Syngenta Crop Protection, LLC., Research Triangle Park, NC, USA
| | | | | | | | - Ping Song
- Corteva Agriscience, Indianapolis, IN, USA
| | | | - Rong Wang
- Bayer, Crop Science Division, Chesterfield, MO, USA
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Mori Y, Ugajin T, Okada K, Handa Y, Umemoto N, Iijima H, Igawa K, Yokozeki H. Epicutaneously sensitized food-induced anaphylaxis is ameliorated with "oral tolerance" to antigen. Exp Dermatol 2020; 30:367-376. [PMID: 33063903 DOI: 10.1111/exd.14216] [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: 03/19/2020] [Revised: 10/08/2020] [Accepted: 10/12/2020] [Indexed: 01/01/2023]
Abstract
Food allergy is an antigen-specific immunological adverse reaction after exposure to a given food. Multiple clinical studies showed that oral immunotherapy (OIT) is effective for the prevention and treatment for food allergy that is developed in infants and children. However, the effectiveness of OIT for epicutaneously sensitized food allergy remains unclear. Previously, we established a mouse model of epicutaneous-sensitized food allergy. In this model, systemic allergic reaction including intestinal and skin symptoms, such as anaphylaxis, was observed. We treated this model with OIT in two ways (OIT before sensitization or OIT during the sensitization phase) and evaluated the preventive effect of both methods. OIT before sensitization significantly ameliorated mast cell degranulation in sensitized skin, but there was no decrease in rectal temperatures or in mast cell degranulation in the jejunum. However, OIT administered during the sensitization phase significantly ameliorated the decrease in rectal temperature and mast cell degranulation in the skin and jejunum. OIT before sensitization increased the regulatory T cells in mesenteric lymph node (MLN), but not in the spleen, and it reduced antigen-specific IgG, but not IgE, production compared with the non-OIT control. However, OIT during sensitization caused a greater increase in regulatory T cells in both the MLN and spleen and reduced antigen-specific IgE and IgG generation compared with the non-OIT control group. Thus, OIT during the sensitization phase was effective for the prevention of epicutaneous-sensitized food allergy.
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Affiliation(s)
- Yukari Mori
- Department of Dermatology, Graduate School, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Tsukasa Ugajin
- Department of Dermatology, Graduate School, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Kouhei Okada
- Department of Dermatology, Graduate School, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Yutaro Handa
- Department of Dermatology, Graduate School, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Naoshi Umemoto
- Department of Dermatology, Graduate School, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Hazuki Iijima
- Department of Dermatology, Graduate School, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Ken Igawa
- Department of Dermatology, Graduate School, Tokyo Medical and Dental University, Bunkyo-ku, Japan.,Department of Dermatology, Dokkyo Medical University, Shimotsuga-gun, Japan
| | - Hiroo Yokozeki
- Department of Dermatology, Graduate School, Tokyo Medical and Dental University, Bunkyo-ku, Japan
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15
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Breslin M, Lack G. Food Allergy: Challenges with the New Guidelines. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 7:2499-2501.e9. [PMID: 31495437 DOI: 10.1016/j.jaip.2019.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 06/06/2019] [Accepted: 06/06/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Moira Breslin
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Duke University Medical Center, Durham, NC.
| | - Gideon Lack
- Paediatric Allergy Group, Department of Women and Children's Heath, School of Life Course Sciences, King's College London, London, United Kingdom; Paediatric Allergy Group, Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom; Children's Allergy Service, Guy's and St. Thomas's NHS Foundation Trust, London, United Kingdom
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16
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Early life microbial exposures and allergy risks: opportunities for prevention. Nat Rev Immunol 2020; 21:177-191. [PMID: 32918062 DOI: 10.1038/s41577-020-00420-y] [Citation(s) in RCA: 128] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2020] [Indexed: 02/07/2023]
Abstract
Allergies, including asthma, food allergy and atopic dermatitis, are increasing in prevalence, particularly in westernized countries. Although a detailed mechanistic explanation for this increase is lacking, recent evidence indicates that, in addition to genetic predisposition, lifestyle changes owing to modernization have an important role. Such changes include increased rates of birth by caesarean delivery, increased early use of antibiotics, a westernized diet and the associated development of obesity, and changes in indoor and outdoor lifestyle and activity patterns. Most of these factors directly and indirectly impact the formation of a diverse microbiota, which includes bacterial, viral and fungal components; the microbiota has a leading role in shaping (early) immune responses. This default programme is markedly disturbed under the influence of environmental and lifestyle risk factors. Here, we review the most important allergy risk factors associated with changes in our exposure to the microbial world and the application of this knowledge to allergy prevention strategies.
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17
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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.
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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;
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18
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Sampath V, Sindher SB, Alvarez Pinzon AM, Nadeau KC. Can food allergy be cured? What are the future prospects? Allergy 2020; 75:1316-1326. [PMID: 31733120 DOI: 10.1111/all.14116] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 10/15/2019] [Accepted: 10/17/2019] [Indexed: 12/31/2022]
Abstract
Food allergies have become a significant heath burden as prevalence continues to rise, affecting 6%-13% of the global population. In the absence of drugs approved by regulatory agencies, the current standard of care remains avoidance of allergenic foods and management of acute allergic reactions with antihistamines and epinephrine autoinjectors. Allergen immunotherapy has been shown to increase the threshold of reactivity in the majority of food-allergic individuals. However, challenges include long treatment periods, high rates of adverse reactions, and lack of permanence of desensitization and established protocols. To address these limitations, adjunctive allergen-specific immunotherapy, vaccines, and non-allergen-specific therapies (eg, monoclonal antibodies) are being explored. The future of food allergy treatment is promising with a number of clinical trials in progress. Currently, although desensitization can be achieved for the majority of individuals with food allergy through immunotherapy, continued ingestion of allergen is needed for most individuals to maintain desensitization. Further understanding of the mechanisms of food allergy and identification of biomarkers to distinguish between temporary and permanent resolution of allergies is needed before a cure, where reactivity to the allergen is permanently lost enabling the individual to consume the allergen in any amount at any time, can be envisioned.
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Affiliation(s)
- Vanitha Sampath
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University Stanford University Stanford CA USA
- Division of Pulmonary and Critical Care Medicine Stanford University Stanford CA USA
| | - Sayantani B. Sindher
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University Stanford University Stanford CA USA
- Division of Pulmonary and Critical Care Medicine Stanford University Stanford CA USA
| | - Andres M. Alvarez Pinzon
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University Stanford University Stanford CA USA
- Division of Pulmonary and Critical Care Medicine Stanford University Stanford CA USA
| | - Kari C. Nadeau
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University Stanford University Stanford CA USA
- Division of Pulmonary and Critical Care Medicine Stanford University Stanford CA USA
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19
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Herman RA, Roper JM, Zhang JXQ. Evidence runs contrary to digestive stability predicting protein allergenicity. Transgenic Res 2020; 29:105-107. [PMID: 31741205 PMCID: PMC7000492 DOI: 10.1007/s11248-019-00182-x] [Citation(s) in RCA: 4] [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: 10/28/2019] [Accepted: 11/07/2019] [Indexed: 02/07/2023]
Abstract
A dogma has persisted for over two decades that food allergens are more stable to digestion compared with non-allergenic proteins. This belief has become enshrined in regulations designed to assess the allergenic risk of novel food proteins. While the empirical evidence accumulated over the last 20+ years has largely failed to confirm a correlation between digestive stability and the allergenic status of proteins, even those who accept this finding often assert that this shortfall is the result of faulty assay design rather than lack of causality. Here, we outline why digestive stability may not in fact correlate with allergenic potential.
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Affiliation(s)
- Rod A Herman
- Corteva™ Agriscience, 9330 Zionsville Road, Indianapolis, IN, 47968, USA.
| | - Jason M Roper
- Corteva™ Agriscience, P.O. Box 30, Newark, DE, 19714, USA
| | - John X Q Zhang
- Corteva™ Agriscience, 8325 NW 62nd Avenue, Johnston, IA, 50131, USA
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20
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Giannetti A, Bernardini L, Cangemi J, Gallucci M, Masetti R, Ricci G. Role of Vitamin D in Prevention of Food Allergy in Infants. Front Pediatr 2020; 8:447. [PMID: 33014916 PMCID: PMC7461773 DOI: 10.3389/fped.2020.00447] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 06/29/2020] [Indexed: 01/04/2023] Open
Abstract
The prevalence of food allergy is increasing over the last decades. The role of vitamin D in the prevention of food allergy has been largely investigated. Its role on the physiology of calcium and bone is known, but calcitriol (active form of the vitamin D) also influences the epithelial cells, T cells, B cells, macrophages, and dendritic cells. Almost all cells of the adaptive immune system express the vitamin D receptor, making them also capable of being vitamin responsive. Specifically considering the potential role of vitamins in food allergy, vitamin D has been shown to affect several mechanisms that promote immunologic tolerance, including the T regulatory cell function and the induction of tolerogenic dendritic cells. The target of our review is to evaluate the role of vitamin D in the prevention of food allergy in children. There are contradictory data on the relationship among the vitamin D deficiency and the developing of food allergy. Some studies associate lower exposure to sunlight to food allergy; on the other hand, further research has found that higher vitamin D levels could increase the likelihood of allergic sensitization and food allergy. Therefore, there is an urgent need for well-planned randomized controlled trials on vitamin D supplementation, with particular regard to the prevention of food allergy. The role of vitamin D beyond bone and calcium metabolism is not fully understood.
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Affiliation(s)
- Arianna Giannetti
- Department of Paediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Luca Bernardini
- Department of Paediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Jessica Cangemi
- Department of Paediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Marcella Gallucci
- Department of Paediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Riccardo Masetti
- Department of Paediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Giampaolo Ricci
- Department of Paediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
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21
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Smeekens JM, Immormino RM, Balogh PA, Randell SH, Kulis MD, Moran TP. Indoor dust acts as an adjuvant to promote sensitization to peanut through the airway. Clin Exp Allergy 2019; 49:1500-1511. [PMID: 31444814 DOI: 10.1111/cea.13486] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/26/2019] [Accepted: 08/16/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND There is growing evidence that environmental peanut exposure through non-oral routes, including the skin and respiratory tract, can result in peanut sensitization. Environmental adjuvants in indoor dust can promote sensitization to inhaled antigens, but whether they contribute to peanut allergy development is unclear. OBJECTIVE We investigated whether indoor dust promotes airway sensitization to peanut and peanut allergy development in mice. METHODS Female and male C57BL/6J mice were exposed via the airways to peanut, indoor dust extract, or both for 2 weeks. Mice were then challenged with peanut and assessed for anaphylaxis. Peanut-specific immunoglobulins, peanut uptake by lung conventional dendritic cells (cDCs), lung innate cytokines, and T cell differentiation in lung-draining lymph nodes were quantified. Innate cytokine production by primary human bronchial epithelial cells exposed to indoor dust was also determined. RESULTS Inhalational exposure to low levels of peanut in combination with indoor dust, but neither alone, resulted in production of peanut-specific IgE and development of anaphylaxis upon peanut challenge. Indoor dust triggered production of innate cytokines in murine lungs and in primary human bronchial epithelial cells. Additionally, inhaled indoor dust stimulated maturation and migration of peanut-laden lung type 1 cDCs to draining lymph nodes. Inhalational exposure to peanut and indoor dust induced peanut-specific T helper 2 cell differentiation and accumulation of T follicular helper cells in draining lymph nodes, which were associated with increased B cell numbers and peanut-specific immunoglobulin production. CONCLUSIONS & CLINICAL RELEVANCE Indoor dust promotes airway sensitization to peanut and development of peanut allergy in mice. Our findings suggest that environmental adjuvants in indoor dust may be determinants of peanut allergy development in children.
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Affiliation(s)
- Johanna M Smeekens
- Department of Pediatrics, UNC School of Medicine, Chapel Hill, NC.,UNC Food Allergy Initiative, Chapel Hill, NC
| | | | - Peter A Balogh
- Department of Pediatrics, UNC School of Medicine, Chapel Hill, NC
| | - Scott H Randell
- Department of Cell Biology and Physiology, UNC School of Medicine, Chapel Hill, NC
| | - Michael D Kulis
- Department of Pediatrics, UNC School of Medicine, Chapel Hill, NC.,UNC Food Allergy Initiative, Chapel Hill, NC
| | - Timothy P Moran
- Department of Pediatrics, UNC School of Medicine, Chapel Hill, NC
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22
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Zhu YQ, Wang DQ, Liu B, Hu Y, Shen YY, Xu JH, Tang H. Wheat-dependent exercise-induced anaphylaxis in Chinese people: a clinical research on 33 cases with antigenic analysis of wheat proteins. Clin Exp Dermatol 2019; 45:56-62. [PMID: 31267575 DOI: 10.1111/ced.14035] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a severe allergic condition in which wheat ingestion together followed by physical exercise induces anaphylaxis. For patients with WDEIA, omega-5 gliadin is considered to be one of the major allergens. AIM To analyse the clinical features and allergen spectrum of WDEIA and to investigate the relationship between WDEIA and serum levels of platelet-activating factor (PAF), interleukin (IL)-9 and IL-33. METHODS Medical histories and conditions of WDEIA cases were collected and summarized, with allergen tests of wheat proteins measured at the same visit. Of the 33 patients enrolled, 13 also had serum levels of PAF, IL-9 and IL-33 measured. The healthy control (HC) group consisted of 13 healthy individuals, who also underwent both the wheat-protein allergen tests and the inflammatory-mediator tests. RESULTS All patients experienced severe allergic reaction during exercise after wheat ingestion. Manifestations of WDEIA included facial oedema, generalized urticaria and respiratory symptoms. Unconsciousness was also observed in 21 cases. In the patient group, 57.6% were confirmed as hypersensitive to glyceraldehyde-3-phosphate dehydrogenase (GAPDH), while 54.5% were allergic to omega-5 gliadin. PAF concentration was significantly higher in patients with WDEIA compared with HCs, whereas there was no significant difference in IL-9 or IL-33 between the two groups. CONCLUSIONS WDEIA is a rare type of anaphylaxis. GAPDH and omega-5 gliadin may be the most common allergy-causing wheat proteins for Chinese people. PAF may be associated with the onset and development of WDEIA.
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Affiliation(s)
- Y-Q Zhu
- Department of Dermatology, Huashan Hospital affiliated to Fudan University, No. 12, Wulumuqi Zhong Rd, Shanghai, 200040, China
| | - D-Q Wang
- Department of Dermatology, Huashan Hospital affiliated to Fudan University, No. 12, Wulumuqi Zhong Rd, Shanghai, 200040, China
| | - B Liu
- Department of Dermatology, The Fifth People's Hospital of Shanghai affiliated to Fudan University, No. 128, Ruili Rd, Shanghai, 200040, China
| | - Y Hu
- Department of Dermatology, Huashan Hospital affiliated to Fudan University, No. 12, Wulumuqi Zhong Rd, Shanghai, 200040, China
| | - Y-Y Shen
- Department of Dermatology, Huashan Hospital affiliated to Fudan University, No. 12, Wulumuqi Zhong Rd, Shanghai, 200040, China
| | - J-H Xu
- Department of Dermatology, Huashan Hospital affiliated to Fudan University, No. 12, Wulumuqi Zhong Rd, Shanghai, 200040, China
| | - H Tang
- Department of Dermatology, Huashan Hospital affiliated to Fudan University, No. 12, Wulumuqi Zhong Rd, Shanghai, 200040, China
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23
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Dhondalay GK, Rael E, Acharya S, Zhang W, Sampath V, Galli SJ, Tibshirani R, Boyd SD, Maecker H, Nadeau KC, Andorf S. Food allergy and omics. J Allergy Clin Immunol 2019; 141:20-29. [PMID: 29307411 DOI: 10.1016/j.jaci.2017.11.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 11/09/2017] [Accepted: 11/14/2017] [Indexed: 01/06/2023]
Abstract
Food allergy (FA) prevalence has been increasing over the last few decades and is now a global health concern. Current diagnostic methods for FA result in a high number of false-positive results, and the standard of care is either allergen avoidance or use of epinephrine on accidental exposure, although currently with no other approved treatments. The increasing prevalence of FA, lack of robust biomarkers, and inadequate treatments warrants further research into the mechanism underlying food allergies. Recent technological advances have made it possible to move beyond traditional biological techniques to more sophisticated high-throughput approaches. These technologies have created the burgeoning field of omics sciences, which permit a more systematic investigation of biological problems. Omics sciences, such as genomics, epigenomics, transcriptomics, proteomics, metabolomics, microbiomics, and exposomics, have enabled the construction of regulatory networks and biological pathway models. Parallel advances in bioinformatics and computational techniques have enabled the integration, analysis, and interpretation of these exponentially growing data sets and opens the possibility of personalized or precision medicine for FA.
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Affiliation(s)
- Gopal Krishna Dhondalay
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, Calif; Institute for Immunity, Transplantation, and Infection, Stanford University School of Medicine, Stanford, Calif
| | - Efren Rael
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, Calif; Institute for Immunity, Transplantation, and Infection, Stanford University School of Medicine, Stanford, Calif
| | - Swati Acharya
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, Calif; Institute for Immunity, Transplantation, and Infection, Stanford University School of Medicine, Stanford, Calif
| | - Wenming Zhang
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, Calif; Institute for Immunity, Transplantation, and Infection, Stanford University School of Medicine, Stanford, Calif
| | - Vanitha Sampath
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, Calif; Institute for Immunity, Transplantation, and Infection, Stanford University School of Medicine, Stanford, Calif
| | - Stephen J Galli
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, Calif; Department of Pathology, Stanford University School of Medicine, Stanford, Calif; Department of Microbiology & Immunology, Stanford University School of Medicine, Stanford, Calif
| | - Robert Tibshirani
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, Calif; Department of Biomedical Data Sciences, Stanford University School of Medicine, Stanford, Calif
| | - Scott D Boyd
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, Calif; Department of Pathology, Stanford University School of Medicine, Stanford, Calif; Institute for Immunity, Transplantation, and Infection, Stanford University School of Medicine, Stanford, Calif
| | - Holden Maecker
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, Calif; Department of Microbiology & Immunology, Stanford University School of Medicine, Stanford, Calif; Institute for Immunity, Transplantation, and Infection, Stanford University School of Medicine, Stanford, Calif
| | - Kari Christine Nadeau
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, Calif; Institute for Immunity, Transplantation, and Infection, Stanford University School of Medicine, Stanford, Calif.
| | - Sandra Andorf
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, Calif; Institute for Immunity, Transplantation, and Infection, Stanford University School of Medicine, Stanford, Calif
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24
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Comberiati P, Costagliola G, D'Elios S, Peroni D. Prevention of Food Allergy: The Significance of Early Introduction. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E323. [PMID: 31261990 PMCID: PMC6681183 DOI: 10.3390/medicina55070323] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/25/2019] [Accepted: 06/27/2019] [Indexed: 12/25/2022]
Abstract
Over the last two decades, the prevalence of food allergies has registered a significant increase in Westernized societies, potentially due to changes in environmental exposure and lifestyle. The pathogenesis of food allergies is complex and includes genetic, epigenetic and environmental factors. New evidence has highlighted the role of the intestinal microbiome in the maintenance of the immune tolerance to foods and the potential pathogenic role of early percutaneous exposure to allergens. The recent increase in food allergy rates has led to a reconsideration of prevention strategies for atopic diseases, mainly targeting the timing of the introduction of solid foods into infants' diet. Early recommendation for high atopy risk infants to delay the introduction of potential food allergens, such as cow's milk, egg, and peanut, until after the first year of life, has been rescinded, as emerging evidence has shown that these approaches are not effective in preventing food allergies. More recently, high-quality clinical trials have suggested an opposite approach, which promotes early introduction of potential food allergens into infants' diet as a means to prevent food allergies. This evidence has led to the production of new guidelines recommending early introduction of peanut as a preventive strategy for peanut allergy. However, clinical trials investigating whether this preventive dietary approach could also apply to other types of food allergens have reported ambiguous results. This review focuses on the latest high-quality evidence from randomized controlled clinical trials examining the timing of solid food introduction as a strategy to prevent food allergies and also discusses the possible implications of early complementary feeding on both the benefits and the total duration of breastfeeding.
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Affiliation(s)
- Pasquale Comberiati
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, 56126 Pisa, Italy
| | - Giorgio Costagliola
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, 56126 Pisa, Italy
| | - Sofia D'Elios
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, 56126 Pisa, Italy
| | - Diego Peroni
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, 56126 Pisa, Italy.
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25
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26
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Sheehan WJ, Taylor SL, Phipatanakul W, Brough HA. Environmental Food Exposure: What Is the Risk of Clinical Reactivity From Cross-Contact and What Is the Risk of Sensitization. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2018; 6:1825-1832. [PMID: 30390900 PMCID: PMC6324195 DOI: 10.1016/j.jaip.2018.08.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 08/03/2018] [Accepted: 08/06/2018] [Indexed: 01/23/2023]
Abstract
For food-allergic individuals, the typical exposure to food proteins happens during ingestion; however, individuals may be exposed to foods in other ways. In addition to ingestion reactions, allergic patients may have reactions from cutaneous or mucosal exposures to food proteins, with the classic example being a peanut-allergic child touching a counter with peanut butter and then rubbing their eyes. Similar to hands, saliva can also act as a carrier for food proteins. Finally, there is a wealth of new research regarding the presence of food proteins in the environment, for example, within household floor dust. This review will focus on (1) cross-contact of food proteins and (2) environmental food protein exposures. Cross-contact occurs when one type of food comes into contact with another type of food resulting in the mixture of proteins. For food allergies, cross-contact is important when an allergen is inadvertently transferred to a food/meal that is thought to not contain that specific allergen. We will discuss the current literature regarding the presence of detectable food proteins in different locations, how and if these proteins are transferred or eliminated, and the clinical implications of exposures to food proteins under these different scenarios.
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Affiliation(s)
- William J Sheehan
- The Division of Allergy and Immunology, Children's National Medical Center, Washington, DC; George Washington University School of Medicine and Health Sciences, Washington, DC; The Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass.
| | - Steve L Taylor
- Food Allergy Research and Resource Program, Department of Food Science and Technology, University of Nebraska, Lincoln, Neb
| | - Wanda Phipatanakul
- The Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Helen A Brough
- Paediatric Allergy Group, Department of Women and Children's Health, School of Life Course Sciences, King's College London, Guy's Hospital, London, United Kingdom; Paediatric Allergy Group, School of Immunology & Microbial Sciences, King's College London, Guy's Hospital, London, United Kingdom; Children's Allergy Service, Evelina London, St Thomas' Hospital, London, United Kingdom
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27
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Mitselou N, Hallberg J, Stephansson O, Almqvist C, Melén E, Ludvigsson JF. Cesarean delivery, preterm birth, and risk of food allergy: Nationwide Swedish cohort study of more than 1 million children. J Allergy Clin Immunol 2018; 142:1510-1514.e2. [PMID: 30213656 DOI: 10.1016/j.jaci.2018.06.044] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/10/2018] [Accepted: 06/22/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Little is known about early-life risk factors for food allergy in children. OBJECTIVES We examined the association between perinatal characteristics and future risk of food allergy in offspring. METHODS This nationwide Swedish cohort study of 1,086,378 children born in Sweden in 2001-2012 used prospectively recorded data from health care registers. Using Cox regression, we estimated hazard ratios (HRs) with 95% CIs for the association between perinatal characteristics (eg, cesarean delivery and preterm birth) and food allergy as defined by diagnoses in the National Patient Register, adjusting for infant sex and maternal factors (age at delivery, country of birth, parity, smoking, body mass index, and asthma/pulmonary disease). RESULTS During the 13-year follow-up, 26,732 (2.5%) children were given a diagnosis of food allergy. Food allergy was positively associated with cesarean delivery (HR, 1.21; 95% CI, 1.18-1.25), large for gestational age (HR, 1.15; 95% CI, 1.10-1.19), and low 5-minute Apgar score (HR, 1.22; 95% CI, 1.10-1.36) but negatively associated with very preterm birth (<32 weeks of gestation: HR, 0.74; 95% CI, 0.56-0.98). No association was found between food allergy and moderately preterm birth, low birth weight, or small for gestational age. Risk estimates were similar when the outcome was restricted to 2 records of diagnosed food allergy. In 1,000 children undergoing cesarean delivery, an extra 5 developed food allergy compared with the reference group, suggesting that 17% of food allergy in children born by means of cesarean delivery can be explained by this exposure (attributable fraction). CONCLUSIONS Cesarean delivery was associated with increased risk of food allergy, whereas very preterm birth decreased risk.
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Affiliation(s)
- Niki Mitselou
- Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.
| | - Jenny Hallberg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden; Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Olof Stephansson
- Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Erik Melén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Jonas F Ludvigsson
- Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom; Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY
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28
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Kiewiet MBG, Faas MM, de Vos P. Immunomodulatory Protein Hydrolysates and Their Application. Nutrients 2018; 10:E904. [PMID: 30011891 PMCID: PMC6073538 DOI: 10.3390/nu10070904] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 07/11/2018] [Accepted: 07/12/2018] [Indexed: 02/07/2023] Open
Abstract
Immunomodulatory protein hydrolysate consumption may delay or prevent western immune-related diseases. In order to purposively develop protein hydrolysates with an optimal and reproducible immunomodulatory effect, knowledge is needed on which components in protein hydrolysates are responsible for the immune effects. Important advances have been made on this aspect. Also, knowledge on mechanisms underlying the immune modulating effects is indispensable. In this review, we discuss the most promising application possibilities for immunomodulatory protein hydrolysates. In order to do so, an overview is provided on reported in vivo immune effects of protein hydrolysates in both local intestinal and systemic organs, and the current insights in the underlying mechanisms of these effects. Furthermore, we discuss current knowledge and physicochemical approaches to identify the immune active protein sequence(s). We conclude that multiple hydrolysate compositions show specific immune effects. This knowledge can improve the efficacy of existing hydrolysate-containing products such as sports nutrition, clinical nutrition, and infant formula. We also provide arguments for why immunomodulatory protein hydrolysates could be applied to manage the immune response in the increasing number of individuals with a higher risk of immune dysfunction due to, for example, increasing age or stress.
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Affiliation(s)
- Mensiena B G Kiewiet
- Immunoendocrinology, Division of Medical Biology, Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands.
| | - Marijke M Faas
- Immunoendocrinology, Division of Medical Biology, Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands.
| | - Paul de Vos
- Immunoendocrinology, Division of Medical Biology, Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands.
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Yrjänä JMS, Koski T, Törölä H, Valkama M, Kulmala P. Very early introduction of semisolid foods in preterm infants does not increase food allergies or atopic dermatitis. Ann Allergy Asthma Immunol 2018; 121:353-359. [PMID: 29981439 DOI: 10.1016/j.anai.2018.06.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 06/21/2018] [Accepted: 06/28/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND The optimal age for the introduction of solid foods for infants has long been a controversial issue. OBJECTIVE To determine whether the early introduction of semisolid foods influences the incidence of food allergy or atopic dermatitis among preterm infants. METHODS Retrospective data from 464 preterm infants born in Oulu University Hospital between 2008 and 2012 were analyzed. Age- and sex-matched full-term control children from the general population were identified. The primary outcome of the study was the difference in timing of the introduction of complementary feeding between preterm and full-term infants. The secondary outcomes were the incidences of food allergies and atopic dermatitis by the ages of 1 and 2 years. RESULTS Semisolid food was introduced at the median corrected age of 1.4 months for all preterm infants, at 1.9 months for late preterm, at 0.9 months for very preterm, and at 0.1 months for extremely preterm infants. The cumulative incidence, either of food allergies or of atopic dermatitis, did not differ significantly between preterm infants and controls by the ages of 1 and 2 years. CONCLUSION The very early introduction of complementary foods into the diet of preterm babies did not increase the incidence of food allergies or atopic dermatitis even among the most preterm infants. This finding supports the hypothesis that the gut-associated lymphoid tissue of preterm infants is ready to encounter food proteins and to begin the maturation process within 3 to 6 months of birth, regardless of gestational age.
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Affiliation(s)
- Jaakko M S Yrjänä
- PEDEGO Research Unit and MRC Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.
| | - Teppo Koski
- PEDEGO Research Unit and MRC Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Helena Törölä
- PEDEGO Research Unit and MRC Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Marita Valkama
- PEDEGO Research Unit and MRC Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Petri Kulmala
- PEDEGO Research Unit and MRC Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland; Biomedicine Research Unit, Medical Microbiology and Immunology, University of Oulu, Oulu, Finland
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30
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Sokolowska M, Akdis CA. Highlights in immune response, microbiome and precision medicine in allergic disease and asthma. Curr Opin Immunol 2018; 48:iv-ix. [PMID: 29127996 DOI: 10.1016/j.coi.2017.10.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Several recent key findings in immunology of allergic diseases that have led to a need of reassessment of our current thinking are reviewed in this issue of the journal. Recently developed strong evidence on the role of hygiene hypothesis in protection from allergic disease and its immune mechanisms is reviewed by Ober et al. The authors pointed out immunologic mechanisms of lower prevalence of asthma and allergic sensitization observed among Amish children living on traditional farms with higher endotoxin levels as compared to Hutterite children living on industrialized farms. Barcik et al. reviewed that biologically active histamine in humans is produced by certain bacteria in the gut in addition to several cells, and has broad immunoregulatory functions. Turcanu et al. reviewed immune mechanisms of a revolutionary change to protect from food allergy. The immunologic window of opportunity in the infants can be used to enable oral tolerance in severe allergy predisposed children. Accordingly, van de Veen et al. reviewed general mechanisms of allergen tolerance highlighting recent findings. Extensive usage of precision medicine due to emerging biologics is knocking the doors of allergic diseases and asthma. Boyd et al. reviewed the existing and future "immune monitoring" approaches in the multiple omics perspective with the hope of identifying better correlates of disease status, predictors of therapeutic outcomes, and potential side-effects of treatment. Paul et al. reviewed newly uncovered innate and adaptive immunologic mechanisms that contribute to the pathogenesis of eosinophilic esophagitis. Further highlighting newly developing disease subgroups and precision medicine, Guttman-Yassky & Kruger reviewed clinical subtypes of atopic dermatitis and psoriasis, which may potentially benefit from newly developing highly efficient biologicals. Complementing this paper, Kabashima & Nomura reviewed similarities and distinctions in mouse models of atopic dermatitis and psoriasis.
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Affiliation(s)
- Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland, Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland, Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.
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Herman RA, Ladics GS. Allergenic sensitization versus elicitation risk criteria for novel food proteins. Regul Toxicol Pharmacol 2018; 94:283-285. [PMID: 29481837 DOI: 10.1016/j.yrtph.2018.02.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 02/20/2018] [Accepted: 02/22/2018] [Indexed: 01/16/2023]
Abstract
The value of criteria used in the weight-of-evidence assessment of allergenic risk of genetically modified (GM) crops has been debated. This debate may originate, in part, from not specifying if the criteria are intended to contribute to the assessment of sensitization risk or elicitation risk. Here, this distinction is explicitly discussed in the context of exposure and hazard. GM crops with structural relationships with known allergens or sourced from an organism known to cause allergy (hazard) are screened for IgE-antibody reactivity using serum from sensitized individuals. If IgE reactivity is observed, the GM crop is not developed. While digestive and heat stability impact exposure and thus the elicitation risk to sensitized individuals, these attributes are not interpretable relative to sensitization risk. For novel food proteins with no identified hazard, heat stability cannot be validly assessed because relevant IgE antibodies are not available. Likewise, the uncertain and sometime non-monotonic dose relationship between oral exposure to allergens and sensitization makes digestive stability a poor predictor of sensitization risk. It is hoped that by explicitly distinguishing between sensitization risk and elicitation risk, some of the debate surrounding the weight-of evidence criteria for predicting the allergenic risk of GM crops can be resolved.
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Affiliation(s)
- Rod A Herman
- Dow AgroSciences LLC, 9330 Zionsville Road, Indianapolis, IN 46268, United States.
| | - Gregory S Ladics
- DuPont Haskell Global Centers for Health and Environmental Sciences, 1090 Elkton Road, Newark, DE 19711, United States
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