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Kaur S, Rosenstreich D, Cleven KL, Spivack S, Grizzanti J, Reznik M, Jariwala SP. Severe asthma in adult, inner-city predominantly African-American and latinx population: demographic, clinical and phenotypic characteristics. J Asthma 2021; 59:2341-2351. [PMID: 34822312 DOI: 10.1080/02770903.2021.2010748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The burden of asthma morbidity with co-existing atopy among the racial/ethnic minorities in the socio-economically disadvantaged NYC borough of the Bronx is unusually high. The multidisciplinary Montefiore Asthma Center (MAC) provides guideline-based treatment to this high-risk population through the joint efforts of Allergists/Immunologists, Pulmonologists, and on-site health educators. METHODS The objective of this prospective, observational study was to define the demographic and clinical characteristics of severe asthma, evaluate improvement in asthma severity and lung function through the course of treatment at the MAC, and describe the asthma phenotypes of the patients managed at the MAC. Adults with severe asthma receiving treatment at the MAC were followed from their first to their last visit at the MAC. Patient demographics, along with asthma severity and co-existing allergies, were assessed. Possible phenotypes were defined (based on presence or absence of atopy, age at asthma onset, and blood eosinophil counts). RESULTS 227 patients were included in the final analysis, of which 55.5% were Hispanic and 33.9% identified as non-Hispanic Black. Ninety-one percent (91%) of our cohort was found to be atopic and allergic rhinoconjunctivitis (ARC) was the most commonly identified co-existing allergic condition (86.3%). Mean Asthma Control Test (ACT) scores improved from 11.1 (± 4.9) at the initial visit to 14.8 (± 6.1) at the last visit. The spirometric values did not improve despite treatment at MAC. CONCLUSION A multidisciplinary severe asthma center is an ideal setting to phenotype patients and offer personalized guideline-based management and education to adults with severe asthma.
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Affiliation(s)
- Savneet Kaur
- Department of Medicine, Division of Allergy/Immunology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - David Rosenstreich
- Department of Medicine, Division of Allergy/Immunology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Krystal L Cleven
- Department of Medicine, Division of Pulmonary Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Simon Spivack
- Department of Medicine, Division of Pulmonary Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Joseph Grizzanti
- Department of Medicine, Division of Pulmonary Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Marina Reznik
- Department of Pediatrics, Division of Academic General Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Sunit P Jariwala
- Department of Medicine, Division of Allergy/Immunology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
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Diaz-Cabrera NM, Sánchez-Borges MA, Ledford DK. Atopy: A Collection of Comorbid Conditions. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:3862-3866. [PMID: 34509674 DOI: 10.1016/j.jaip.2021.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 02/08/2023]
Abstract
The concept of atopy was initially developed in the first quarter of the 20th century on the basis of clinical observations without any knowledge of pathogenic mechanisms. Atopy involves a collection of comorbidities that share pathogenic features, and atopic comorbidities affect outcomes of concomitant conditions rather than existing synchronously. The clinical importance of understanding the relationship of these conditions is necessary because the treatment of one condition influences the others, and the development of one leads to or precedes the development of another. Environmental influences and multigenetic predispositions result in complex relationships among the atopic conditions sharing a type 2 pathogenesis. The specialty of Allergy and Immunology is devoted to managing the comorbidities of atopy, and better understanding of their connections can improve patient care.
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Affiliation(s)
- Natalie M Diaz-Cabrera
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Morsani College of Medicine and the James A. Haley Veterans' Hospital, Tampa, Fla.
| | - Mario A Sánchez-Borges
- Allergy and Clinical Immunology Department, Centro Médico Docente La Trinidad, Clinica El Avila, Caracas, Venezuela
| | - Dennis K Ledford
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Morsani College of Medicine and the James A. Haley Veterans' Hospital, Tampa, Fla
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Wai CYY, Leung NYH, Leung ASY, Wong GWK, Leung TF. Seafood Allergy in Asia: Geographical Specificity and Beyond. FRONTIERS IN ALLERGY 2021; 2:676903. [PMID: 35387013 PMCID: PMC8974776 DOI: 10.3389/falgy.2021.676903] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 06/17/2021] [Indexed: 11/13/2022] Open
Abstract
Asian countries have unique ways of food processing and dietary habits that may explain the observed differences in the prevalence, natural history, epidemiology and sensitization pattern of food allergic diseases when compared to western countries. Per capita consumption of seafood, including fish and shellfish, is well above the global average for many Asian countries because of their coastal geographical location and rich seafood supply. The wide availability and high abundance of seafood in Asian countries have shaped a diverse way of processing and eating this major food group. Such unique features have significant impact on the sensitization profile and allergenicity of Asians to fish and shellfish. For example, fish and shellfish are eaten raw in some countries that may promote sensitization to heat-labile allergens not otherwise seen in other regions. Fermented fish sauce is commonly used as a condiment in some countries which may promote fish sensitization. Shrimp head and shrimp roe are regarded as delicacies in some countries, but their allergen profiles are yet to be characterized. Freshwater fish and shellfish are a common food source in many Asian countries but the allergenicity of many such species remains unknown. In this review, we discuss factors that may contribute to differences in molecular profile and sensitization pattern for fish and shellfish that are observed in Asian populations and revisit the current status of seafood allergy in this part of the world. Acknowledging the similarities and differences of seafood allergy patterns between Asian and western populations can help us refine a better strategy for diagnosing and managing seafood allergy.
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Affiliation(s)
- Christine Y. Y. Wai
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Nicki Y. H. Leung
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Agnes S. Y. Leung
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Gary W. K. Wong
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Ting F. Leung
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
- *Correspondence: Ting F. Leung
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Xepapadaki P, Christopoulou G, Stavroulakis G, Freidl R, Linhart B, Zuidmeer L, Lakoumentas J, van Ree R, Valenta R, Papadopoulos NG. Natural History of IgE-Mediated Fish Allergy in Children. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:3147-3156.e5. [PMID: 33866031 DOI: 10.1016/j.jaip.2021.04.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Fish allergy is not uncommon, especially in countries with high fish consumption, it can frequently be severe and may affect dietetic and lifestyle choices. Nevertheless, data on its clinical course and natural history are scarce. OBJECTIVE To describe the natural history of immunoglobulin E-mediated fish allergy and the potential differential reactivity to various fish species and identify prognostic markers in children with confirmed disease. METHODS Clinical history, specific immunoglobulin E, and skin prick tests to various fish were recorded in 126 children with confirmed immunoglobulin E-mediated fish allergy. Immunoglobulin E reactivity was also evaluated by immunoblotting. Eligible participants proceeded to a series of food challenges to tuna, swordfish, and codfish. In total, 234 challenges were performed. RESULTS Fifty-eight children (9.7 ± 3.9 years) were included in the analysis. Age at first reaction was 0.5 to 5 years (median, 1.3 years). Thirteen children (22%) tolerated all fish tested, including cod, 1 to 14 years (mean, 8.2 ± 4.2 years) following their first reported reaction. Complete fish tolerance increased with age, ranging from 3.4% in preschool children to over 45% in adolescents (95% confidence interval, 26.3%-79.7%). Most children were able to tolerate swordfish (94%) and tuna (95%). Prechallenge specific immunoglobulin E to cod greater than 4.87 kUA/L was the best positive predictive marker for fish allergy persistence (94%), followed by skin prick tests to sardine greater than 6.5 mm (92%). CONCLUSIONS A considerable proportion of fish-allergic children develop tolerance around adolescence. Most fish-allergic children can consume tuna and swordfish, which, thus, provide safe alternatives for a balanced diet.
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Affiliation(s)
- Paraskevi Xepapadaki
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Christopoulou
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - George Stavroulakis
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Raphaela Freidl
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Birgit Linhart
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Laurian Zuidmeer
- Department of Experimental Immunology, Amsterdam University Medical Centers, location AMC, Amsterdam, The Netherlands
| | - John Lakoumentas
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Ronald van Ree
- Department of Experimental Immunology, Amsterdam University Medical Centers, location AMC, Amsterdam, The Netherlands; Department of Otorhinolaryngology, Amsterdam University Medical Centers, location AMC, Amsterdam, The Netherlands
| | - Rudolf Valenta
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria; NRC Institute of Immunology FMBA of Russia; Laboratory for Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First, Moscow State Medical University, Moscow, Russia; Laboratory for Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, Moscow, Russia; Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Nikolaos G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece; Division of Infection, Immunity, and Respiratory Medicine, The University of Manchester, Manchester, United Kingdom.
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Kumari MV, Amarasiri L, Rajindrajith S, Devanarayana NM. Functional abdominal pain disorders and asthma: two disorders, but similar pathophysiology? Expert Rev Gastroenterol Hepatol 2021; 15:9-24. [PMID: 32909837 DOI: 10.1080/17474124.2020.1821652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Functional abdominal pain disorders (FAPDs) and asthma are common ailments affecting both children and adults worldwide. Multiple studies have demonstrated an association between these two disorders. However, the exact reason for this observed association is not apparent. AREAS COVERED The current review has explored available literature and outlined multiple underlying pathophysiological mechanisms, common to both asthma and FAPDs, as possible reasons for this association. EXPERT OPINION Smooth muscle dysfunction, hypersensitivity and hyper-responsiveness, mucosal inflammation, and barrier dysfunction involving gastrointestinal and respiratory tracts are the main underlying pathophysiological mechanisms described for the generation of symptoms in FAPDs and asthma. In addition, alterations in neuroendocrine regulatory functions, immunological dysfunction, and microbial dysbiosis have been described in both disorders. We believe that the pathophysiological processes that were explored in this article would be able to expand the mechanisms of the association. The in-depth knowledge is needed to be converted to therapeutic and preventive strategies to improve the quality of care of children suffering from FAPDs and asthma.
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Affiliation(s)
- Manori Vijaya Kumari
- Department of Physiology, Faculty of Medicine & Allied Sciences, Rajarata University of Sri Lanka , Anuradhapura, Sri Lanka
| | - Lakmali Amarasiri
- Department of Physiology, Faculty of Medicine, University of Colombo , Colombo, Sri Lanka
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Pecoraro L, Tenero L, Pietrobelli A, Dalle Carbonare L, Czernin S, Widhalm K, Alvarez-Perea A, Piacentini G. Canned tuna tolerance in children with IgE-mediated fish allergy: an allergological and nutritional view. Minerva Pediatr 2020; 72:408-415. [PMID: 32686923 DOI: 10.23736/s0026-4946.20.05972-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Scientific research, diagnostic tools and clinical experience have shown that children suffering from IgE-mediated fish allergy do not need to follow a strict exclusion diet. In fact, they could tolerate some species of fish, which could be reintroduced in the diet by verifying their tolerance with an oral food challenge in a clinical setting. Consequently, it is possible to look a new insight on diagnosis and management of IgE-mediated fish allergy in children, considering the use of canned tuna in clinical settings. Authors performed a literature search through the Cochrane Library and Medline/PubMed databases. All quantitative and qualitative pediatric studies involving diagnosis and management of IgE-mediated fish allergy and the use of canned tuna in clinical settings were considered. Articles related to allergological and nutritional features of fish, and especially canned tuna, were selected. This research was conducted on May 2020. Canned tuna shows peculiar allergological and nutritional characteristics. Relating to allergy, canning process, characterized by cooking the fish under pressure for a time equal to about 7 hours, can lead a conformational change in parvalbumin, making it less allergenic. In terms of nutrition, canned tuna contains B, D and A vitamins and, above all, omega-3 fatty acids and shows a favourable and significantly sustainable nutritional profile. Lower allergenicity, adequate nutritional value and its rich availability in markets at reasonable costs, could make the use of canned tuna as a solution with an excellent risk/benefit ratio in the field of IgE-mediated fish allergy.
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Affiliation(s)
- Luca Pecoraro
- Department of Medicine, University of Verona, Verona, Italy - .,Clinic of Pediatric, ASST Mantova, Mantova, Italy -
| | - Laura Tenero
- , Division of Pediatric, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Angelo Pietrobelli
- , Division of Pediatric, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy.,Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | | | - Sarah Czernin
- Division of Nutrition and Metabolism, Department of Pediatrics, Austrian Academic Institute for Clinical Nutrition, Vienna, Austria
| | - Kurt Widhalm
- Division of Nutrition and Metabolism, Department of Pediatrics, Austrian Academic Institute for Clinical Nutrition, Vienna, Austria
| | | | - Giorgio Piacentini
- , Division of Pediatric, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
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Zhu Z, Hasegawa K, Camargo CA, Liang L. Investigating asthma heterogeneity through shared and distinct genetics: Insights from genome-wide cross-trait analysis. J Allergy Clin Immunol 2020; 147:796-807. [PMID: 32693092 PMCID: PMC7368660 DOI: 10.1016/j.jaci.2020.07.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 07/03/2020] [Accepted: 07/09/2020] [Indexed: 12/17/2022]
Abstract
Asthma is a heterogeneous respiratory disease reflecting distinct pathobiologic mechanisms. These mechanisms are based, at least partly, on different genetic factors shared by many other conditions, such as allergic diseases and obesity. Investigating the shared genetic effects enables better understanding of the mechanisms of phenotypic correlations and is less subject to confounding by environmental factors. The increasing availability of large-scale genome-wide association study (GWAS) for asthma has enabled researchers to examine the genetic contributions to the epidemiologic associations between asthma subtypes and those between coexisting diseases and/or traits and asthma. Studies have found not only shared but also distinct genetic components between asthma subtypes, indicating that the heterogeneity is related to distinct genetics. This review summarizes a recently compiled analytic approach-genome-wide cross-trait analysis-to determine shared and distinct genetic architecture. The genome-wide cross-trait analysis features in several analytic aspects: genetic correlation, cross-trait meta-analysis, Mendelian randomization, polygenic risk score, and functional analysis. In this article, we discuss in detail the scientific goals that can be achieved by these analyses, their advantages, and their limitations. We also make recommendations for future directions: (1) ethnicity-specific asthma GWASs and (2) application of cross-trait methods to multiomics data to dissect the heritability found in GWASs. Finally, these analytic approaches are also applicable to complex and heterogeneous traits beyond asthma.
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Affiliation(s)
- Zhaozhong Zhu
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass; Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Kohei Hasegawa
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
| | - Carlos A Camargo
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass; Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
| | - Liming Liang
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass.
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Odat H, Al-Qudah M. Food Elimination in the Management of Refractory Chronic Rhinosinusitis: A Pilot Study. EAR, NOSE & THROAT JOURNAL 2020; 100:NP424-NP428. [PMID: 32383988 DOI: 10.1177/0145561320924150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) is one of the most commonly reported chronic diseases. Refractory CRS represents a subgroup of patients who continue to be symptomatic even after adequate medical and surgical therapy. These patients started to form a significant portion of patients with CRS. Food elimination as a therapeutic method to control symptoms of different chronic diseases, such as eosinophilic esophagitis, asthma, and atopic dermatitis, has been described in the literature with variable success rates. OBJECTIVES To evaluate the effectiveness of food elimination therapy as adjuvant treatment in refractory patients having CRS with positive food sensitization. DESIGN Prospective open-label study. SETTING Tertiary academic center. METHODS Consecutive adult patients with refractory nonobstructive CRS (patients who had persistent sinonasal symptoms despite endoscopic sinus surgery and patent sinuses ostia with adequate medical treatment) with positive food sensitization were included. Subjects were asked to eliminate the sensitized food from their diet. Clinical outcome was assessed using the Lund-Kennedy symptom and Lund-Kennedy endoscopic appearance scores. RESULTS Twenty-two patients were initially enrolled in the study. Six patients were excluded; 4 were lost to follow-up, and 2 did not eliminate the causal food for the required period. The average age of the patients was 36 years old. There were 10 female and 6 male patients. Nasal discharge and facial pressure were the most common presenting symptoms. Shellfish, egg, and meat mix were the most common eliminated foods. There was a significant difference in the patients' Lund-Kennedy symptom and Lund-Kennedy endoscopic appearance scores at 6 and 12 weeks after food elimination therapy. CONCLUSIONS Food elimination in refractory CRS is an effective adjuvant treatment and should be considered in the treatment algorithm of patients with persistent symptoms after successfully performed sinus surgery.
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Affiliation(s)
- Haitham Odat
- Division of Otolaryngology, Department of Special Surgery, Jordan University of Science & Technology, Irbid, Jordan
| | - Mohannad Al-Qudah
- Division of Otolaryngology, Department of Special Surgery, Jordan University of Science & Technology, Irbid, Jordan
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Castan L, Cheminant MA, Colas L, Brouard S, Magnan A, Bouchaud G. Food allergen-sensitized CCR9 + lymphocytes enhance airways allergic inflammation in mice. Allergy 2018; 73:1505-1514. [PMID: 29315632 DOI: 10.1111/all.13386] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND The mechanisms of the atopic march, characterized by a natural progression from food and cutaneous allergies to rhinitis and asthma, are still unknown. However, as several organs can be involved, chemokines and their receptors might be implicated in this process and may be instrumental factors. OBJECTIVES We hypothesized that the T-cell gut-homing receptor CCR9 could be implicated in the evolution of allergic diseases. METHODS We characterized the immune response and the role of CCR9 in a murine model combining food allergy to wheat gliadin and a model of acute airways inflammation in response to house dust mite. RESULTS Compared with solely asthmatic-like mice, we demonstrated that the aggravation of pulmonary symptoms in consecutive food and respiratory allergies, characterized by an increase in pulmonary resistance and a higher Th17/Treg ratio, was abrogated in CCR9 knockout mice. Moreover, transfer of food-allergic CD4+ T cells from wild-type but not from CCR9-/- aggravated airways inflammation demonstrating that CCR9 is involved in food allergy-enhanced allergic airway inflammation to unrelated allergens. CONCLUSION Taken together, our results demonstrated a crucial role of the T-cell homing receptor CCR9 in this model and validated its potential for use in the development of therapeutic strategies for allergic diseases.
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Affiliation(s)
- L. Castan
- BIA; UR1268; INRA; Nantes France
- UNIV Nantes; Institut du thorax; INSERM CNRS; Nantes France
| | | | - L. Colas
- UNIV Nantes; Institut du thorax; INSERM CNRS; Nantes France
- Service de pneumologie; Centre Hospitalier Universitaire de Nantes; Nantes France
| | - S. Brouard
- Service de pneumologie; Centre Hospitalier Universitaire de Nantes; Nantes France
- Centre de Recherche en Transplantation et Immunologie UMR 1064; INSERM; Institut de Transplantation Urologie Néphrologie (ITUN); France.LabEx IGO Immunotherapy; Graft; Oncology; Nantes France
| | - A. Magnan
- UNIV Nantes; Institut du thorax; INSERM CNRS; Nantes France
- Service de pneumologie; Centre Hospitalier Universitaire de Nantes; Nantes France
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Food Allergy Is an Important Risk Factor for Childhood Asthma, Irrespective of Whether It Resolves. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2017; 6:1336-1341.e3. [PMID: 29153880 DOI: 10.1016/j.jaip.2017.10.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 10/04/2017] [Accepted: 10/10/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND The risk of developing asthma in those with early food allergy is unknown, particularly when early life food allergy has resolved. OBJECTIVE To understand whether challenge-proven food allergy in infancy increases the risk of asthma at age 4 years, using data from a population-based cohort. METHODS A total of 5,276 12-month-old infants were recruited using a population-based sampling frame. Infants underwent skin prick test to egg, peanut, and sesame and those with a detectable skin prick test result had oral food challenges. At age 4 years, food challenges were repeated to determine persistence or resolution of food allergy. The association between food allergy and doctor-diagnosed asthma was examined using binomial regression in 2,789 participants. RESULTS Children with food allergy at age 1 year had an increased risk of asthma (1 food allergy: relative risk [RR], 1.69; 95% CI, 1.29-2.21; 2 or more food allergies: RR, 2.76; 95% CI, 1.94-3.92). The risk of asthma was highest in children with food allergy and coexistent eczema in infancy (RR, 2.87; 95% CI, 2.22-3.70). Transient food allergy and persistent food allergy were both associated with an increased risk of asthma (transient egg allergy: RR, 1.92; 95% CI, 1.46-2.51; persistent egg allergy: RR, 2.60; 95% CI, 1.76-3.85). CONCLUSIONS Asthma at age 4 years is twice as common in those with challenge-proven food allergy at age 1 year, irrespective of whether the food allergy subsequently resolves. Children with 2 or more food allergies and those with coexistent eczema were almost 3 times as likely to develop asthma compared with those with no food allergies.
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Fernandes TJR, Costa J, Carrapatoso I, Oliveira MBPP, Mafra I. Advances on the molecular characterization, clinical relevance, and detection methods of Gadiform parvalbumin allergens. Crit Rev Food Sci Nutr 2017; 57:3281-3296. [DOI: 10.1080/10408398.2015.1113157] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - Joana Costa
- REQUIMTE-LAQV, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
| | - Isabel Carrapatoso
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | | | - Isabel Mafra
- REQUIMTE-LAQV, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
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Mejrhit N, Azdad O, Chda A, El Kabbaoui M, Bousfiha A, Bencheikh R, Tazi A, Aarab L. Evaluation of the sensitivity of Moroccans to shrimp tropomyosin and effect of heating and enzymatic treatments. FOOD AGR IMMUNOL 2017. [DOI: 10.1080/09540105.2017.1323187] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Najlae Mejrhit
- Faculty of Sciences & Techniques, Laboratory of Bioactive Molecules (LMBSF), University Sidi Mohamed Ben Abdellah, Fez, Morocco
| | - Ouarda Azdad
- Faculty of Sciences & Techniques, Laboratory of Bioactive Molecules (LMBSF), University Sidi Mohamed Ben Abdellah, Fez, Morocco
| | - Alae Chda
- Faculty of Sciences & Techniques, Laboratory of Bioactive Molecules (LMBSF), University Sidi Mohamed Ben Abdellah, Fez, Morocco
| | - Mohamed El Kabbaoui
- Faculty of Sciences & Techniques, Laboratory of Bioactive Molecules (LMBSF), University Sidi Mohamed Ben Abdellah, Fez, Morocco
| | - Amal Bousfiha
- Faculty of Sciences & Techniques, Laboratory of Bioactive Molecules (LMBSF), University Sidi Mohamed Ben Abdellah, Fez, Morocco
| | - Rachid Bencheikh
- Faculty of Sciences & Techniques, Laboratory of Bioactive Molecules (LMBSF), University Sidi Mohamed Ben Abdellah, Fez, Morocco
| | - Abdelali Tazi
- Faculty of Sciences & Techniques, Laboratory of Bioactive Molecules (LMBSF), University Sidi Mohamed Ben Abdellah, Fez, Morocco
| | - Lotfi Aarab
- Faculty of Sciences & Techniques, Laboratory of Bioactive Molecules (LMBSF), University Sidi Mohamed Ben Abdellah, Fez, Morocco
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Vega F, Panizo C, Dordal M, González M, Velázquez E, Valero A, Sánchez M, Rondón C, Montoro J, Matheu V, Lluch-Bernal M, González R, Fernández-Parra B, Del Cuvillo A, Dávila I, Colás C, Campo P, Antón E, Navarro A. Relationship between respiratory and food allergy and evaluation of preventive measures. Allergol Immunopathol (Madr) 2016; 44:263-75. [PMID: 26316421 DOI: 10.1016/j.aller.2015.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 05/02/2015] [Accepted: 05/07/2015] [Indexed: 01/24/2023]
Abstract
Food allergy and respiratory allergy are two frequently associated diseases and with an increasing prevalence. Several reports show the presence of respiratory symptoms in patients with food allergy, while certain foods may be related to the development or exacerbation of allergic rhinitis and asthma. The present update focuses on this relationship, revealing a pathogenic and clinical association between food and respiratory allergy. This association is even more intense when the food hypersensitivity is persistent or starts in the early years of life. Food allergy usually precedes respiratory allergy and may be a risk factor for allergic rhinitis and asthma, becoming a relevant clinical marker for severe atopic asthma. Furthermore, the presence of co-existing asthma may enhance life-threatening symptoms occurring during a food allergic reaction. Recommendations for dietary restrictions during pregnancy and breastfeeding to prevent the development of respiratory allergy are controversial and not supported by consistent scientific data. Current recommendations from medical societies propose exclusive breastfeeding during the first four months of life, with the introduction of solid food in the fourth to the seventh month period of life. A delayed introduction of solid food after this period may increase the risk of developing subsequent allergic conditions. Further studies are encouraged to avoid unjustified recommendations involving useless dietary restrictions.
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Caffarelli C, Garrubba M, Greco C, Mastrorilli C, Povesi Dascola C. Asthma and Food Allergy in Children: Is There a Connection or Interaction? Front Pediatr 2016; 4:34. [PMID: 27092299 PMCID: PMC4821099 DOI: 10.3389/fped.2016.00034] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 03/23/2016] [Indexed: 01/19/2023] Open
Abstract
This review explores the relationship between food allergy and asthma. They can share the same risk factors, such as parental allergy, atopic eczema, and allergen sensitization, and they often coincide in the same child. Coexistence may negatively influence the severity of both conditions. However, it remains to be determined whether food allergy may directly affect asthma control. An early food sensitization in the first year of life can predict the onset of asthma. Furthermore, asthmatic symptoms could rarely be caused by ingestion or inhalation of the offending food. Asthma caused by food allergy is severe and may be associated with anaphylactic symptoms. Therefore, an accurate identification of the offending foods is necessary in order to avoid exposure. Patients should be instructed to treat asthmatic symptoms quickly and to use self-injectable epinephrine.
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Affiliation(s)
- Carlo Caffarelli
- Clinica Pediatrica, Department of Clinica and Experimental Medicine, Azienda Ospedaliero-Universitaria di Parma, University of Parma , Parma , Italy
| | - Marilena Garrubba
- Clinica Pediatrica, Department of Clinica and Experimental Medicine, Azienda Ospedaliero-Universitaria di Parma, University of Parma , Parma , Italy
| | - Chiara Greco
- Clinica Pediatrica, Department of Clinica and Experimental Medicine, Azienda Ospedaliero-Universitaria di Parma, University of Parma , Parma , Italy
| | - Carla Mastrorilli
- Clinica Pediatrica, Department of Clinica and Experimental Medicine, Azienda Ospedaliero-Universitaria di Parma, University of Parma , Parma , Italy
| | - Carlotta Povesi Dascola
- Clinica Pediatrica, Department of Clinica and Experimental Medicine, Azienda Ospedaliero-Universitaria di Parma, University of Parma , Parma , Italy
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Arabkhazaeli A, Vijverberg SJH, van Erp FC, Raaijmakers JAM, van der Ent CK, Maitland van der Zee AH. Characteristics and severity of asthma in children with and without atopic conditions: a cross-sectional study. BMC Pediatr 2015; 15:172. [PMID: 26545978 PMCID: PMC4636786 DOI: 10.1186/s12887-015-0481-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 10/08/2015] [Indexed: 01/30/2023] Open
Abstract
Background Childhood allergic diseases have a major impact on a child’s quality of life, as well as that of their parents. We studied the coexistence of reported allergies in children who use asthma medication. Additionally, we tested the hypothesis that asthma severity is greater among children with certain combinations of co-morbid allergic conditions. Methods For this cross-sectional study, 703 children (ages 4 to 12 years) from the PACMAN cohort study were selected. All of the children were regular users of asthma medication. The study population was divided into nine subgroups according to parental-reported allergies of the child (hay fever, eczema, food allergy or combinations of these). In order to assess whether these subgroups differed clinically, the groups were compared for child characteristics (age, gender, family history of asthma), asthma exacerbations in the past year (oral corticosteroids (OCS) use; asthma-related emergency department (ED) visits), asthma control, fractional exhaled nitric oxide level (FeNO), and antihistaminic usage. Results In our study, 79.0 % of the parents reported that their child suffered from at least one atopic condition (hay fever, food allergy and eczema), and one quarter of the parents (25.6 %) reported that their child suffered from all three atopic conditions. Having more than one atopic condition was associated with an increased risk of OCS use (OR = 3.3, 95 % CI = 1.6 – 6.6), ED visits (OR = 2.3, 95 % CI = 1.2 – 4.6) in the past year and inadequate short term asthma control (OR = 1.9, 95 % CI = 1.3 – 2.8). Conclusions Children who use asthma medication often also have other allergic conditions. Parental reported allergies were associated with a higher risk of more severe asthma (more asthma complaints and more asthma exacerbations).
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Affiliation(s)
- Ali Arabkhazaeli
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, P.O. Box 80082, David de Wied Building, Universiteitsweg 99, Utrecht, 3508 TB, The Netherlands.
| | - Susanne J H Vijverberg
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, P.O. Box 80082, David de Wied Building, Universiteitsweg 99, Utrecht, 3508 TB, The Netherlands.
| | - Francine C van Erp
- Department of Pediatric Respiratory Medicine, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Lundlaan 6, Utrecht, 3584 EA, The Netherlands.
| | - Jan A M Raaijmakers
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, P.O. Box 80082, David de Wied Building, Universiteitsweg 99, Utrecht, 3508 TB, The Netherlands.
| | - Cornelis K van der Ent
- Department of Pediatric Respiratory Medicine, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Lundlaan 6, Utrecht, 3584 EA, The Netherlands.
| | - Anke H Maitland van der Zee
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, P.O. Box 80082, David de Wied Building, Universiteitsweg 99, Utrecht, 3508 TB, The Netherlands.
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Song Y, Li Z, Lin H, Du S, Hao Z, Lin H, Zhu Z. Effect of malondialdehyde treatment on the IgE binding capacity and conformational structure of shrimp tropomyosin. Food Chem 2015; 175:374-80. [DOI: 10.1016/j.foodchem.2014.12.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 11/03/2014] [Accepted: 12/01/2014] [Indexed: 11/28/2022]
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Abstract
Globally, the rising consumption of fish and its derivatives, due to its nutritional value and divergence of international cuisines, has led to an increase in reports of adverse reactions to fish. Reactions to fish are not only mediated by the immune system causing allergies, but are often caused by various toxins and parasites including ciguatera and Anisakis. Allergic reactions to fish can be serious and life threatening and children usually do not outgrow this type of food allergy. The route of exposure is not only restricted to ingestion but include manual handling and inhalation of cooking vapors in the domestic and occupational environment. Prevalence rates of self-reported fish allergy range from 0.2 to 2.29 % in the general population, but can reach up to 8 % among fish processing workers. Fish allergy seems to vary with geographical eating habits, type of fish processing, and fish species exposure. The major fish allergen characterized is parvalbumin in addition to several less well-known allergens. This contemporary review discusses interesting and new findings in the area of fish allergy including demographics, novel allergens identified, immunological mechanisms of sensitization, and innovative approaches in diagnosing and managing this life-long disease.
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Affiliation(s)
- Michael F Sharp
- Molecular Immunology Group, Center of Biodiscovery and Molecular Development of Therapeutics, School of Pharmacy and Molecular Science, James Cook University, Townsville, Australia
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18
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Scientific Opinion on the evaluation of allergenic foods and food ingredients for labelling purposes. EFSA J 2014. [DOI: 10.2903/j.efsa.2014.3894] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Protein carbonylation during electron beam irradiation may be responsible for changes in IgE binding to turbot parvalbumin. Food Chem Toxicol 2014; 69:32-7. [DOI: 10.1016/j.fct.2014.03.039] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Revised: 03/17/2014] [Accepted: 03/28/2014] [Indexed: 01/27/2023]
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20
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Kuehn A, Metz-Favre C, Pauli G, Lehners-Weber C, Codreanu-Morel F, Hentges F, Auriol P, Bienvenu F, Braun C, Crepin C, Foessel A, Guenard L, Krieger P, Renaudin JM, Tuyeras JF, de Blay F, Morisset M, Hilger C. Étude comparative des phénotypes cliniques de l’allergie au poisson selon les profils de sensibilisation moléculaire à la parvalbumine, à l’énolase, à l’aldolase et à la gélatine de poisson. REVUE FRANCAISE D ALLERGOLOGIE 2014. [DOI: 10.1016/j.reval.2013.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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21
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Kuehn A, Hilger C, Lehners-Weber C, Codreanu-Morel F, Morisset M, Metz-Favre C, Pauli G, de Blay F, Revets D, Muller CP, Vogel L, Vieths S, Hentges F. Identification of enolases and aldolases as important fish allergens in cod, salmon and tuna: component resolved diagnosis using parvalbumin and the new allergens. Clin Exp Allergy 2014; 43:811-22. [PMID: 23786287 DOI: 10.1111/cea.12117] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 02/07/2013] [Accepted: 02/11/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND The majority of fish-allergic patients are sensitized to parvalbumin, known to be the cause of important IgE cross-reactivity among fish species. Little is known about the importance of fish allergens other than parvalbumin. OBJECTIVE The aim of this study was to characterize hitherto undefined fish allergens in three commonly consumed fish species, cod, salmon and tuna, and to evaluate their importance for in vitro IgE-diagnosis in addition to parvalbumin and fish gelatin. METHODS Sixty-two patients were diagnosed by clinical history, skin prick tests and specific IgE to fish extracts. Two new fish allergens from cod, salmon and tuna were identified by microsequencing. These proteins were characterized by immunoblot, ELISA and mediator release assay. Purified parvalbumin, enolase, aldolase and fish gelatin were used for quantification of specific IgE in ELISA. RESULTS Parvalbumin and two other allergens of 50 and 40 kDa were detected in IgE-immunoblots of cod, salmon and tuna extracts by most patient sera. The 50 and 40 kDa proteins were identified as beta-enolase and fructose-bisphosphate aldolase A respectively. Both purified enzymes showed allergenic activity in the mediator release assay. Indeed, 72.6% of the patients were sensitized to parvalbumin, 20% of these had specific IgE to salmon parvalbumin only. IgE to enolases were found in 62.9% (0.5-95.0 kUA /L), to aldolases in 50.0% (0.4-26.0 kUA /L) and to fish gelatin in 19.3% (0.4-20.0 kUA /L) of the patients. Inter-species cross-reactivity, even though limited, was found for enolases and aldolases by IgE-inhibition ELISA. CONCLUSIONS AND CLINICAL RELEVANCE Fish enolase and aldolase have been identified as important new fish allergens. In fish allergy diagnosis, IgE to enolase and aldolase are especially relevant when IgE to parvalbumin are absent.
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Affiliation(s)
- A Kuehn
- Laboratory of Immunogenetics and Allergology, CRP-Santé, L-1526 Luxembourg, Luxembourg.
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Rosmilah M, Shahnaz M, Meinir J, Masita A, Noormalin A, Jamaluddin M. Identification of parvalbumin and two new thermolabile major allergens of Thunnus tonggol using a proteomics approach. Int Arch Allergy Immunol 2013; 162:299-309. [PMID: 24193115 DOI: 10.1159/000354544] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 07/12/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The longtail tuna (Thunnus tonggol) is widely consumed in Asia. Parvalbumin, the main major allergen of fish, has been well identified in multiple fish species, yet little is known about the allergenic proteins in T. tonggol. Thus, the aim of this study was to characterize the major allergens of T. tonggol using a proteomics approach. METHODS Raw and boiled extracts of the fish were prepared. Fish proteins were separated by means of SDS-PAGE and two-dimensional (2-DE) electrophoresis. 1-DE immunoblotting of raw extract was performed with sera from fish-allergic patients. Ten sera were further analysed by 2-DE immunoblotting. Selected major allergenic protein spots were excised, trypsin digested and analysed by means of mass spectrometry. RESULTS SDS-PAGE of raw extract revealed 26 protein fractions, while boiled extract demonstrated fewer bands. The 2-DE gel profile of the raw extract further fractionated the protein bands to more than 100 distinct protein spots. 1-DE immunoblotting of raw extract exhibited two thermolabile protein fractions of 42 and 51 kDa as the major allergens, while the boiled extract only revealed a single IgE-binding band at 151 kDa. 2-DE immunoblotting of raw extract further detected numerous major IgE-reactive spots of 11-13, 42 and 51 kDa. Mass spectrometry analysis of the peptides generated from the 12, 42 and 51 kDa digested spots indicated that these spots were parvalbumin, creatine kinase and enolase, respectively. CONCLUSIONS In addition to parvalbumin, two new thermolabile allergens were identified as major allergenic proteins of T. tonggol. This study proved that both thermostable and thermolabile proteins are important in local tuna allergy and should be included in diagnostic strategies.
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Affiliation(s)
- Misnan Rosmilah
- Department of Biology, Faculty of Science and Mathematics, Sultan Idris Education University, Tanjong Malim, Perak, Malaysia
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Zicari AM, Indinnimeo L, De Castro G, Zappalà D, Tancredi G, Bonci E, Celani C, Duse M. Food allergy and the development of asthma symptoms. Int J Immunopathol Pharmacol 2012; 25:731-40. [PMID: 23058023 DOI: 10.1177/039463201202500319] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Allergies are multifactorial diseases the onset of which depends also on genetic and environmental factors in early life. Thus, environmental factors can affect the immune response and modify lung development, thereby leading to asthma. The role of the factors used to date to predict asthma development is modest, and clinical criteria should always be considered in association with familiarity for atopy. The aim of this study is to evaluate the risk of asthma in a population with positive skin prick test (SPT) (which is a reliable marker of atopy) to food allergens, regardless of clinical manifestations in the early years of life. The cohort of children enrolled in our study who had a positive SPT to food in the first three years of life had a prevalence of asthma after 7-14 years, double that of the general pediatric population. This prevalence increased significantly in patients with SPT positivity for food and inhalant allergens. We identified a correlation between the sensitization profile in children under the age of 36 months and the development of asthma during a period of 7-14 years. This study confirms that early sensitization is an important risk factor for the development of asthma, particularly in association with sensitization to inhalants, and that the persistence of food sensitization in school-age children and adolescents is associated to more severe asthma.
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Affiliation(s)
- A M Zicari
- Department of Pediatrics, Sapienza University, Rome, Italy.
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Tsabouri S, Triga M, Makris M, Kalogeromitros D, Church MK, Priftis KN. Fish and shellfish allergy in children: review of a persistent food allergy. Pediatr Allergy Immunol 2012; 23:608-15. [PMID: 22554093 DOI: 10.1111/j.1399-3038.2012.01275.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The increased consumption of fish and shellfish has resulted in more frequent reports of adverse reactions to seafood, emphasizing the need for more specific diagnosis and treatment of this condition and exploring reasons for the persistence of this allergy. This review discusses interesting and new findings in the area of fish and shellfish allergy. New allergens and important potential cross-reacting allergens have been identified within the fish family and between shellfish, arachnids, and insects. The diagnostic approach may require prick to-prick tests using crude extracts of both raw and cooked forms of seafood for screening seafood sensitization before a food challenge or where food challenge is not feasible. Allergen-specific immunotherapy can be important; mutated less allergenic seafood proteins have been developed for this purpose. The persistence of allergy because of seafood proteins' resistance after rigorous treatment like cooking and extreme pH is well documented. Additionally, IgE antibodies from individuals with persistent allergy may be directed against different epitopes than those in patients with transient allergy. For a topic as important as this one, new areas of technological developments will likely have a significant impact, to provide more accurate methods of diagnosing useful information to patients about the likely course of their seafood allergy over the course of their childhood and beyond.
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Affiliation(s)
- Sophia Tsabouri
- Department of Paediatrics, University Hospital of Ioannina, Ioannina, Greece.
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25
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Abstract
PURPOSE OF REVIEW To consider the possible links between food allergy and asthma. RECENT FINDINGS Food allergy and asthma coexist in many children, and recent studies demonstrate that having these comorbid conditions increases the risk for morbidity. Children with food allergies and asthma are more likely to have near-fatal or fatal allergic reactions to food and more likely to have severe asthma. SUMMARY Although a causal link has not been determined, increased awareness of the heightened risks of having both of these common childhood conditions and good patient/parent education and management of both conditions can lead to improved outcomes.
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Malmberg LP, Saarinen KM, Pelkonen AS, Savilahti E, Mäkelä MJ. Cow's milk allergy as a predictor of bronchial hyperresponsiveness and airway inflammation at school age. Clin Exp Allergy 2011; 40:1491-7. [PMID: 20618346 DOI: 10.1111/j.1365-2222.2010.03567.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Cow's milk allergy (CMA) has been found to be associated with an increased incidence of asthma at school age. However, prospective population-based studies of CMA and the development of airway inflammation and bronchial hyperresponsivess (BHR) are lacking. OBJECTIVE The aims of this study was to evaluate CMA as a risk factor for BHR and airway inflammation presented later in childhood. METHODS We followed prospectively 118 children with CMA and invited them to a clinical visit at a mean age of 8.6 years including the measurement of exhaled nitric oxide (FE(NO) ) and bronchial challenge with histamine. Ninety-four patients and 80 control subjects from the same cohort participated. RESULTS At school age, children with a history of CMA had higher FE(NO) levels (P=0.0009) and more pronounced responsiveness to histamine (P=0.027) than their controls. Stratified analysis showed a significant difference only in IgE-positive CMA. Multinomial logistic regression analysis showed that IgE-positive CMA [odds ratio (OR) 3.51; 95% confidence intervals (CI) 1.56-7.90; P=0.002] and a history of wheeze during the first year of life (OR 2.81; 95% CI 1.16-6.84; P=0.023) were independent explanatory factors for increased FE(NO) , and IgE-positive CMA (OR 3.37; 95% CI 1.03-10.97; P=0.044) and parental smoking (OR 3.41; 95% CI 1.14-10.22; P=0.028) for increased BHR, whereas for IgE-negative CMA, no associations with FE(NO) or BHR were found. In the CMA group, those exposed to CM very early at the maternity hospital, had less BHR (P=0.002). CONCLUSIONS Compared with their controls, children with a history of IgE-positive CMA show signs of airway inflammation, expressed as higher FE(NO) , and more pronounced bronchial responsiveness to histamine at school age. In contrast to IgE-negative CMA, IgE-positive CMA is a significant predictor of increased FE(NO) and BHR at school age. Very early exposure to CM was associated with less BHR.
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Affiliation(s)
- L P Malmberg
- Department of Allergy, Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland.
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27
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van der Ventel ML, Nieuwenhuizen NE, Kirstein F, Hikuam C, Jeebhay MF, Swoboda I, Brombacher F, Lopata AL. Differential responses to natural and recombinant allergens in a murine model of fish allergy. Mol Immunol 2011; 48:637-46. [DOI: 10.1016/j.molimm.2010.11.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Revised: 11/01/2010] [Accepted: 11/02/2010] [Indexed: 02/06/2023]
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Krogulska A, Dynowski J, Wasowska-Królikowska K. Bronchial reactivity in schoolchildren allergic to food. Ann Allergy Asthma Immunol 2010; 105:31-8. [PMID: 20642201 DOI: 10.1016/j.anai.2010.05.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Food allergy (FA) is associated with an increased risk of asthma. OBJECTIVE To evaluate whether bronchial hyperreactivity (BHR) occurs in children with FA depending on the presence of respiratory symptoms. METHODS Fifty-four children with FA and 62 without FA were studied for BHR, defined as a provocation concentration of methacholine that caused a decrease in forced expiratory volume in 1 second of 20% (PC20). The diagnosis of FA was established using questionnaires, clinical criteria, skin prick tests, serum specific IgE antibodies, and a double-blind placebo-controlled food challenge. RESULTS Among nonasthmatic children, BHR was diagnosed in 15 (47%) with FA and in 7 (17%) without FA (P < .005); BHR was demonstrated in 7 children (41%) with FA alone. All the patients with asthma with or without FA had BHR. The mean (SD) PC20 in children with FA alone was 2.8 [1.38] mg/mL and was significantly higher than that in children with asthma alone (0.88 [1.01] mg/mL) or with asthma and FA (0.96 [0.83] mg/mL) (P < .001). BHR was detected in 5 children (36%) with a mild anaphylactic reaction provoked by food, in 23 (74%) with a moderate reaction, and in all the children with a severe reaction. CONCLUSIONS Children with FA had increased BHR independent of respiratory symptoms. Although BHR occurs in asymptomatic children with FA, its course is milder than that in children with FA and asthma. Factors that determine BHR prevalence in children with FA are similar to those in children without FA.
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Affiliation(s)
- Aneta Krogulska
- Department of Pediatric Allergology, Gastroenterology, and Nutrition, Medical University of Lodz, Lodz, Poland.
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Abstract
Food allergy is a potentially severe immune response to a food or food additive. Although a majority of children will outgrow their food allergies, some may have lifelong issues. Food allergies and other atopic conditions, such as asthma, are increasing in prevalence in Western countries. As such, it is not uncommon to note the co-existence of food allergy and asthma in the same patient. As part of the atopic march, many food allergic patients may develop asthma later in life. Each can adversely affect the other. Food allergic patients with asthma have a higher risk of developing life-threatening food-induced reactions. Although food allergy is not typically an etiology of asthma, an asthmatic patient with food allergy may have higher rates of morbidity and mortality associated with the asthma. Asthma is rarely a manifestation of food allergy alone, but the symptoms can be seen with allergic reactions to foods. There may be evidence to suggest that early childhood environmental factors, such as the mother's and child's diets, factor in the development of asthma; however, the evidence continues to be conflicting. All food allergic patients and their families should be counseled on the management of food allergy and the risk of developing co-morbid asthma.
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Affiliation(s)
- Anupama Kewalramani
- Department of Pediatrics, Division of Pediatric Allergy/Pulmonology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Mary E Bollinger
- Department of Pediatrics, Division of Pediatric Allergy/Pulmonology, University of Maryland School of Medicine, Baltimore, MD, USA
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Ben-Shoshan M, Harrington DW, Soller L, Fragapane J, Joseph L, St Pierre Y, Godefroy SB, Elliot SJ, Clarke AE. A population-based study on peanut, tree nut, fish, shellfish, and sesame allergy prevalence in Canada. J Allergy Clin Immunol 2010; 125:1327-35. [DOI: 10.1016/j.jaci.2010.03.015] [Citation(s) in RCA: 172] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Revised: 03/11/2010] [Accepted: 03/19/2010] [Indexed: 11/26/2022]
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Current world literature. Curr Opin Pulm Med 2010; 16:77-82. [PMID: 19996898 DOI: 10.1097/mcp.0b013e328334fe23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Davis CM. Food allergies: clinical manifestations, diagnosis, and management. Curr Probl Pediatr Adolesc Health Care 2009; 39:236-54. [PMID: 19913754 DOI: 10.1016/j.cppeds.2009.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Abstract
PURPOSE OF REVIEW Seafood plays an important role in human nutrition worldwide, sustained by international trade of a variety of new seafood products. Increased production and consumption have resulted in more frequent reports of adverse reactions, highlighting the need for more specific diagnosis and treatment of seafood allergy. This review discusses recent literature in this field. RECENT FINDINGS The most recent prevalence data from Asia highlight seafood as a significant sensitizer in up to 40% of children and 33% of adults. Furthermore, the demonstration of species-specific sensitization to salt-water and fresh-water prawns and processed prawn extract should improve diagnosis. Studies on humans demonstrated for the first time that biologically active fish allergens can be detected in serum samples as early as 10 min after ingestion. These studies highlight that minute amounts of ingested seafood allergens can quickly trigger allergic symptoms; also, inhaled airborne allergens seem to induce sensitization and reactions. In the past 2 years, over 10 additional seafood allergens have been characterized. Allergen-specific detection assays in food products are available for crustacean tropomyosin; however, many specific mollusk and some fish allergens are not readily identified. SUMMARY Although cross-reactivity between crustacean and mollusks as well as mites is demonstrated, the often poor correlation of IgE reactivity and clinical symptoms calls for more detailed investigations. The recent development of hypoallergenic parvalbumin from carp could form the basis for safer vaccination products for treatment of fish allergy. Molecular characterization of more universal marker allergens for the three major seafood groups will improve current component-resolved clinical diagnosis and have a significant impact on the management of allergic patients, on food labeling and on future immunotherapy for seafood allergy.
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Affiliation(s)
- Andreas L Lopata
- RMIT University, Bundoora West Campus, Melbourne, Victoria, Australia.
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34
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Current World Literature. Curr Opin Allergy Clin Immunol 2009; 9:284-90. [DOI: 10.1097/aci.0b013e32832c00ee] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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