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Kubala SA, Young FD, Callier V, Rasooly MM, Dempsey C, Brittain E, Frischmeyer-Guerrerio PA. Key factors that influence quality of life in patients with IgE-mediated food allergy vary by age. Allergy 2024. [PMID: 39096008 DOI: 10.1111/all.16253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 06/18/2024] [Accepted: 07/13/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND While food allergy (FA) can be fatal, the greatest public health impact of FA arguably lies in its detrimental effect on quality of life (FAQOL). Understanding the factors that contribute to FAQOL at different ages is essential to develop personalized interventions that will improve FAQOL. OBJECTIVE To determine the most influential factors that impact FAQOL across ages in well-phenotyped participants with confirmed FA. METHODS One hundred and twenty-five individuals aged 2-28 years with IgE-mediated FA completed validated age-specific FAQOL questionnaires. The relationship between demographic/clinical variables and scores were analyzed to identify key predictors of FAQOL. RESULTS Poor FAQOL was associated with increasing age, strict avoidance practices, reactions to trace exposures, and more severe reactions as assessed by epinephrine use, anaphylaxis, and/or treatment in the emergency department; FAQOL improved with time from the event. FAQOL was worse in subjects avoiding >2 versus ≤2 foods and in those avoiding milk, egg, soy, sesame, or wheat. Number of foods avoided had greatest impact on children ages 2-7 years, while total number of allergic reactions strongly impacted FAQOL in teens and adults; FAQOL of subjects ages 8-12 years appeared less affected by these variables compared to other age groups. A decision tree analysis identified key predictors of overall FAQOL (age, number of food avoidances, and time since epinephrine use) that can be used to guide intervention strategies to improve FAQOL. CONCLUSION We directly compared FAQOL in extensively phenotyped children, teenagers, and adults with confirmed IgE-mediated FA. Age; timing, number, and severity of reactions; type and number of FA; and food avoidance practices influence FAQOL and should guide intervention strategies.
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Affiliation(s)
- Stephanie A Kubala
- Food Allergy Research Section, National Institute of Allergy and Infectious Diseases/National Institutes of Health, Bethesda, Maryland, USA
| | - Fernanda D Young
- Food Allergy Research Section, National Institute of Allergy and Infectious Diseases/National Institutes of Health, Bethesda, Maryland, USA
| | - Viviane Callier
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Marjohn M Rasooly
- Food Allergy Research Section, National Institute of Allergy and Infectious Diseases/National Institutes of Health, Bethesda, Maryland, USA
| | - Caeden Dempsey
- Food Allergy Research Section, National Institute of Allergy and Infectious Diseases/National Institutes of Health, Bethesda, Maryland, USA
| | - Erica Brittain
- Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases/National Institutes of Health, Bethesda, Maryland, USA
| | - Pamela A Frischmeyer-Guerrerio
- Food Allergy Research Section, National Institute of Allergy and Infectious Diseases/National Institutes of Health, Bethesda, Maryland, USA
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Kersh GJ, Salzer J, Jones ES, Binder AM, Armstrong PA, Choudhary SK, Commins GK, Amelio CL, Kato CY, Singleton J, Biggerstaff BJ, Beard CB, Petersen LR, Commins SP. Tick bite as a risk factor for alpha-gal specific IgE antibodies and development of alpha-gal syndrome. Ann Allergy Asthma Immunol 2022; 130:472-478. [PMID: 36574585 PMCID: PMC10148555 DOI: 10.1016/j.anai.2022.11.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The disaccharide galactose-α-1,3-galactose (alpha-gal) is expressed in mammals other than humans, apes, and old-world monkeys. In humans, elevated immunoglobulin-E (IgE) antibodies specific for alpha-gal can result in allergic hypersensitivity known as alpha-gal syndrome (AGS). Case reports and series suggest that tick bites can induce alpha-gal specific IgE antibodies. OBJECTIVE Evaluate tick exposure as a risk factor for AGS and elevated alpha-gal specific IgE (sIgE). METHODS We conducted a case-control study comparing AGS patients from a North Carolina allergy clinic with controls who were patients at a nearby internal medicine clinic. Cases and controls were administered a questionnaire to obtain information about demographics, home environment, outdoor activities, and recollection of tick bite. Serum samples taken at the time of enrollment were tested for total IgE, alpha-gal sIgE, and antibodies to other tickborne pathogens. RESULTS AGS patients were more likely to recall finding a tick on themselves (OR=11.20, 95% CI 4.97-25.15), live near wooded forest (OR=2.27, 95% CI 0.92-5.55), and spend 17 or more hours per week outdoors in wooded areas (OR=5.58, 95% CI 2.56-12.19). AGS patients were also more likely to report 4 or more tick bites (OR=33.05, 95% CI 9.92-155.12) and reactions at the site of tick bites (OR=7.93, 95% CI 3.74-16.80). Elevated alpha-gal sIgE was also observed in 33% of controls and was also associated with tick exposure in the controls (OR=4.25, 95% CI 2.21-8.18). CONCLUSION The results define tick bite as a risk factor for AGS and elevated alpha-gal sIgE.
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Affiliation(s)
- Gilbert J Kersh
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329.
| | - Johanna Salzer
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329
| | - Emma S Jones
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, 80521
| | - Alison M Binder
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329
| | - Paige A Armstrong
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329
| | - Shailesh K Choudhary
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Grace K Commins
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Claire L Amelio
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Cecilia Y Kato
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329
| | - Joseph Singleton
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329
| | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, 80521
| | - Charles B Beard
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, 80521
| | - Lyle R Petersen
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, 80521
| | - Scott P Commins
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
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Golding MA, Protudjer JLP. Lessons from the IMPAACT of coronavirus disease 2019 public health restrictions on food allergy-associated anxiety. Ann Allergy Asthma Immunol 2022; 129:134-135. [PMID: 35878957 PMCID: PMC9535254 DOI: 10.1016/j.anai.2022.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 05/17/2022] [Indexed: 10/25/2022]
Affiliation(s)
- Michael A Golding
- The Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
| | - Jennifer L P Protudjer
- The Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada; George and Fay Yee Centre for Healthcare Innovation, Winnipeg, Manitoba, Canada; Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Canada; Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden.
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Angel DM, Schatz M, Zeiger RS, Sicherer SH, Khan DA. Diversity, Equity, and Inclusion: What Can a Journal Do? THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:3853-3856. [PMID: 34563739 DOI: 10.1016/j.jaip.2021.09.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 09/17/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Dawn M Angel
- American Academy of Allergy and Clinical Immunology, Denver, Colo.
| | - Michael Schatz
- Department of Allergy, Kaiser Permanente Medical Care Program, San Diego, Calif
| | - Robert S Zeiger
- Kaiser Permanente Bernard J. Tyson School of Medicine, Department of Clinical Science, Pasadena, Calif
| | - Scott H Sicherer
- Division of Pediatric Allergy and Immunology, Jaffe Food Allergy Institute, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - David A Khan
- Division of Allergy and Immunology, Department of Internal Medicine, University of Texas Southwestern, Dallas, Texas
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