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Oh J, Lee M, Park J, Kim HJ, Lee SW, Rahmati M, Koyanagi A, Smith L, Kim MS, López Sánchez GF, Dragioti E, Min C, Papadopoulos NG, Shin YH, Shin JI, Yon DK. Prenatal and postnatal exposure to antibiotics and risk of food allergy in the offspring: A nationwide birth cohort study in South Korea. Pediatr Allergy Immunol 2024; 35:e14114. [PMID: 38529692 DOI: 10.1111/pai.14114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 03/07/2024] [Accepted: 03/11/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND There are only preliminary studies examining the associations of postnatal antibiotic exposure with food allergy in childhood, and the effect of antibiotic exposure in utero has not been resolved. Thus, we aimed to investigate the effect of prenatal and postnatal antibiotic exposure on the risk of food allergy in childhood. METHODS Using the nationwide birth cohort in South Korea, all 3,163,206 infants (pairing mother; n = 2,322,735) born in South Korea between 2010 and 2017 were included in the analysis. The primary outcome was the diagnosis of food allergy, and the observation period was between January 1, 2009, and December 31, 2020. We implemented four different designs for the study, which consisted of a full unmatched cohort, 1:1 propensity-matched cohort, sibling comparison cohort, and health screening cohort along with multiple subgroup analyses. RESULTS During the follow-up period (median 6.92 years [IQR, 4.72-9.00]) of the 3,161,858 infants (52.6% male) in the birth cohort, 29,973 (1.9%) were diagnosed with food allergies. After a 1:1 propensity score matching, the use of antibiotics increased the risk of overall food allergy (prenatal [HR, 1.05; 95% CI, 1.04-1.09] and postnatal [HR, 1.05; 95% CI, 1.01-1.10] periods). The association was more significantly accentuated when antibiotic exposure was used in the short term, and the children were born preterm or with low birthweight; however, a trimester-specific effect was not observed. We observed more pronounced risks of food allergy in the health screening cohort (prenatal, 17%; postnatal, 15%), thus addressing the adverse effects of critical factors including maternal BMI, smoking status, and type of infant feeding. Similar trends were observed across all four differnt cohorts. CONCLUSION This study reported a moderate association between early-life antibiotic use and subsequent food allergy during childhood throughout four different designs of analyses. This study suggests that clinicians need to consider the risks and benefits of antibiotics when administering antibiotics to individuals in the prenatal and postnatal periods.
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Affiliation(s)
- Jiyeon Oh
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Myeongcheol Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Jaeyu Park
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Hyeon Jin Kim
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, South Korea
| | - Masoud Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khorramabad, Iran
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-e-Asr University of Rafsanjan, Rafsanjan, Iran
- CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Min Seo Kim
- Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Elena Dragioti
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Research Laboratory Psychology of Patients, Families, and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Chanyang Min
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Nikolaos G Papadopoulos
- Allergy Department, 2nd Paediatric Clinic, National Kapodistrian University of Athens, Athens, Greece
- Lydia Becker Institute of Immunology & Inflammation, University of Manchester, Manchester, UK
| | - Youn Ho Shin
- Department of Pediatrics, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, South Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
- Severance Underwood Meta-Research Center, Institute of Convergence Science, Yonsei University, Seoul, South Korea
| | - Dong Keon Yon
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, South Korea
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Yan Z, Zhang W, Sun K. TREM1 is involved in the mechanism between asthma and lung cancer by regulating the Toll‑like receptor signaling pathway. Oncol Lett 2024; 27:16. [PMID: 38028174 PMCID: PMC10664071 DOI: 10.3892/ol.2023.14149] [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] [Received: 09/08/2022] [Accepted: 06/09/2023] [Indexed: 12/01/2023] Open
Abstract
Lung cancer and asthma are both global health problems with significant economic consequences. Recent studies have demonstrated that asthma may be a risk factor for lung cancer. The present study aimed to explore the pathogenesis between these two diseases through a comprehensive analysis. Differentially expressed genes (DEGs) screened in the asthma-related GSE165934 dataset were analyzed to find relevant inflammatory pathways. Overlapping genes regulated by inflammatory pathways and lung cancer-DEGs from The Cancer Genome Atlas (TCGA) were obtained and subjected to survival and gene-wide mutation analyses, and nomogram construction to determine the hub gene. The hub gene was further analyzed through expression validation, immunoassays and functional experiments to investigate its role and mechanism in lung cancer. Functional enrichment analysis showed that 1,275 DEGs from GSE165934 were closely associated with the Toll-like receptor signaling pathway, and 8 overlapping genes were identified from 12 genes regulated by the Toll-like receptor signaling pathway and 3,134 TCGA-DEGs. After a series of bioinformatics analyses, it was found that triggering receptor expressed on myeloid cells 1 (TREM1) was the hub gene involved in the mechanism of asthma and lung cancer. TREM1 was also found to be a suppressor gene in lung cancer correlated with immune cells, immune checkpoint-related genes and tumor mutational burden score. Additionally, the results of Cell Counting Kit-8 and Transwell experiments demonstrated that overexpression of TREM1 could significantly inhibit the invasion, proliferation and migration of lung cancer cells. Reverse transcription-quantitative PCR and western blotting demonstrated that the overexpression of TREM1 could also significantly reduce the level of Toll-like receptor signaling pathway proteins. The present findings suggest that TREM1 is associated with the mechanism of asthma and lung cancer through its regulation of the Toll-like receptor signaling pathway. Furthermore, TREM1 may serve as a potential treatment target and prognostic indicator for patients with lung cancer.
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Affiliation(s)
- Zhulin Yan
- Department of Emergency Medicine, Minhang Hospital, Fudan University, Shanghai 201100, P.R. China
| | - Wei Zhang
- Department of Emergency Medicine, Minhang Hospital, Fudan University, Shanghai 201100, P.R. China
| | - Keyu Sun
- Department of Emergency Medicine, Minhang Hospital, Fudan University, Shanghai 201100, P.R. China
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El-Asheer OM, El-Gazzar AF, Zakaria CM, Hassanein FA, Mohamed KA. Frequency of gastrointestinal manifestations among infants with cow’s milk protein allergy, Egypt. EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE 2022. [DOI: 10.1186/s43054-022-00128-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Abstract
Background
Cow’s milk is known to be the most frequent food allergen in infants in the first years of life. Eliminating cow milk protein from diets and reintroducing it with a challenge test are the main methods for sure diagnosis. Cow’s Milk-related Symptom Score (CoMiSS) has been developed for primary health care providers to improve their knowledge about CMPA.
Objective
This study was conducted to prescribe clinical presentation of cow’s milk allergy among infants.
Methods
A cross-sectional study was conducted at Gastroenterology and Nutrition Unit, University Children Hospital, from the 1st of January 2020 to the 31st of December 2020. Forty infants, complaining of recurrent or persistent gastrointestinal manifestations, were included in our study (28 males and 12 females). Those infants were subjected to detailed medical and social patient history, comprehensive physical exam, and CoMiSS scoring as an awareness tool to suspect underlying cow milk allergy. Infants with a CoMiSS of more than 12 points and positive elimination rechallenge test were regarded as eligible to be part of our study.
Results
This study showed that the most frequently occurring gastrointestinal manifestations associated with CMPA were regurgitation (92%), diarrhea (80%), colic (75%), vomiting (67.5%), and lastly constipation which represents only (5%).
Conclusion
Regurgitation and diarrhea are the commonest presentations for infants proved to have cow milk allergy with CoMiSS score and elimination rechallenge test, where constipation is the least common presentation for those infants.
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Jiao L, Su CW, Cao T, Zheng S, Walker WA, Shi HN. Maternal Influences and Intervention Strategies on the Development of Food Allergy in Offspring. Front Immunol 2022; 13:817062. [PMID: 35281070 PMCID: PMC8904425 DOI: 10.3389/fimmu.2022.817062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/01/2022] [Indexed: 11/24/2022] Open
Abstract
Food allergies and other immune-mediated diseases have become serious health concerns amongst infants and children in developed and developing countries. The absence of available cures limits disease management to allergen avoidance and symptomatic treatments. Research has suggested that the presence of maternal food allergies may expose the offspring to genetic predisposition, making them more susceptible to allergen sensitization. The following review has focused on epidemiologic studies regarding maternal influences of proneness to develop food allergy in offspring. The search strategy was "food allergy OR maternal effects OR offspring OR prevention". A systematically search from PubMed/MEDLINE, Science Direct and Google Scholar was conducted. Specifically, it discussed the effects of maternal immunity, microbiota, breastfeeding, genotype and allergy exposure on the development of food allergy in offspring. In addition, several commonly utilized prenatal and postpartum strategies to reduce food allergy proneness were presented, including early diagnosis of high-risk infants and various dietary interventions.
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Affiliation(s)
- Lefei Jiao
- School of Marine Sciences, Ningbo University, Ningbo, China
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Chien-Wen Su
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Tinglan Cao
- Laboratory for Lipid Medicine and Technology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Shasha Zheng
- Department of Nutrition, California Baptist University, Riverside, CA, United States
| | - W. Allan Walker
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Hai Ning Shi
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
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Huang WD, Lin YT, Tsai ZY, Chang LS, Liu SF, Lin YJ, Kuo HC. Association between maternal age and outcomes in Kawasaki disease patients. Pediatr Rheumatol Online J 2019; 17:46. [PMID: 31324255 PMCID: PMC6642512 DOI: 10.1186/s12969-019-0348-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 07/03/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The etiology of Kawasaki disease (KD) is still unknown; perinatal factors may have role with few studies. This study was aim to survey the perinatal factors and clinical outcome of KD, including coronary artery lesion (CAL) formation and intravenous immunoglobulin (IVIG) treatment response. METHODS We enrolled a total of 185 KD patient-caregiver dyads in this study using questionnaires. The questionnaire included two categories: children's characteristics, which consisted of age at disease onset, gender, gestational age at delivery, birth body weight, delivery methods, and breastfeeding status, and caregivers' characteristics, which consisted of parents or not, education levels, maternal age at giving birth, total number of offspring, and family income. We analyzed the association of these factors with CAL formation and IVIG treatment response of KD. RESULTS KD patients with CAL formation had a higher maternal age than non-CAL patients (32.49 ± 3.42 vs. 31.01 ± 3.92 years, p = 0.016). We also found that maternal age ≥ 32 years group had a higher rate of having KD patients with CAL (39/81 vs. 24/74, odds ratio 1.935, 95% confidence interval [1.007, 3.718], p = 0.047). The maternal age ≥ 35 years group had a higher rate of having KD patients with IVIG resistance (6/31 vs. 6/116, odds ratio 4.400, 95% confidence interval [1.309, 14.786], p = 0.01). There was no significant difference in either CAL formation or IVIG resistance in KD with regard to patient's age at disease onset, gestational age, birth body weight, delivery methods, breastfeeding, caregiver type, caregivers' education level, total number of offspring, or family income (p > 0.05). CONCLUSIONS This study is the first to report that maternal age is significantly associated with CAL formation and IVIG resistance in KD. We hypothesize that a maternal age less than 32 years would benefit KD offspring.
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Affiliation(s)
- Wei-Dong Huang
- 0000 0004 1790 3548grid.258164.cDepartment of Pediatrics, Baoan Maternal and Child Health Hospital, Jinan University, Shenzhen, 518102 China
| | - Yu-Ting Lin
- grid.413804.aDepartment of Medical Education, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Zi-Yu Tsai
- grid.413804.aDepartment of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan ,grid.145695.aChang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Ling-Sai Chang
- grid.413804.aDepartment of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan ,grid.145695.aChang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Shih-Feng Liu
- grid.413804.aDepartment of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan ,grid.145695.aDivision of Pulmonary & Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yi-Ju Lin
- grid.413804.aDepartment of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ho-Chang Kuo
- Department of Pediatrics, Baoan Maternal and Child Health Hospital, Jinan University, Shenzhen, 518102, China. .,Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan. .,Chang Gung University, College of Medicine, Taoyuan, Taiwan.
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Kalach N, Bellaïche M, Elias-Billon I, Dupont C. Family history of atopy in infants with cow's milk protein allergy: A French population-based study. Arch Pediatr 2019; 26:226-231. [PMID: 30885604 DOI: 10.1016/j.arcped.2019.02.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/07/2018] [Accepted: 02/16/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This French multicenter, cross-sectional, observational study aimed to describe the family history of atopy in infants with cow's milk protein allergy (CMPA), and the related diagnostic approaches used by specialists in a real-life ambulatory setting. PATIENTS AND METHODS In total, 1674 infants with suspected CMPA [median age 4.5 months (range: 0.1-18.0), males 54%] were enrolled in the study by 466 private physicians (pediatricians: 97%). Family history of atopy was defined as a known history of atopy in at least one first- (father, mother, and/or sibling) and/or second-degree relative (grandparents, uncles, and aunts), as reported by parents to physicians. RESULTS Atopy in a first-degree relative was more common among infants with documented or high probability of CMPA (in 84% and 80% of cases, respectively, vs. the other subgroups, P=0.005). Most infants experienced digestive (92%) and skin (61%) symptoms suggestive of CMPA. Delayed reactions were reported in 64% of infants. According to a post-classification based on the results of previous diagnostic tests and procedures, 1133 infants (68%) had highly probable (52%) or documented CMPA (16%). In these infants, a history of atopy was reported in first- and/or second-degree relative(s) in 86% of cases (81% in first-degree relatives). Whatever the family history of atopy, the characteristics of the infants were similar, except for fewer pets in the case of negative family atopy (14% vs. 25%, P<0.001). Atopy in a parent was more frequent in infants who presented with the first signs suggestive of CMPA within the first 6 months of life vs. those with later first symptoms (75% vs. 65%, P=0.063). CONCLUSION This French study confirms the high rate of family history of atopy in first-degree relatives of infants with probable or documented CMPA.
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Affiliation(s)
- N Kalach
- Clinique pédiatrique Saint-Antoine, hôpital Saint-Vincent-de-Paul, groupement des hôpitaux de l'institut catholique de Lille (GHICL), boulevard de Belfort, 59020 Lille cedex, France.
| | - M Bellaïche
- Service de gastroentérologie pédiatrique, hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | - I Elias-Billon
- Medical department, nutrition hygiène santé, 94150 Rungis, France
| | - C Dupont
- Service de gastroentérologie pédiatrique, université Paris V - René Descartes, hôpital Necker-Enfants-malades, AP-HP, 75015 Paris, France
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Torres-Arroyo A, Ruiz-Lara A, Castillo-Villanueva A, Méndez-Cruz ST, Espinosa-Padilla SE, Espinosa-Rosales FJ, Zarate-Mondragón F, Cervantes-Bustamante R, Bosch-Canto V, Vizzuett-López I, Ordaz-Fávila JC, Oria-Hernández J, Reyes-Vivas H. Proteomics: a tool to develop novel diagnostic methods and unravel molecular mechanisms of pediatric diseases. BOLETIN MEDICO DEL HOSPITAL INFANTIL DE MEXICO 2018; 74:233-240. [PMID: 29382492 DOI: 10.1016/j.bmhimx.2017.03.009] [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: 02/16/2017] [Accepted: 03/17/2017] [Indexed: 11/19/2022] Open
Abstract
Proteomics is the study of the expression of changes and post-translational modifications (PTM) of proteins along a metabolic condition either normal or pathological. In the field of health, proteomics allows obtaining valuable data for treatment, diagnosis or pathophysiological mechanisms of different illnesses. To illustrate the aforementioned, we describe two projects currently being performed at the Instituto Nacional de Pediatría: The immuno-proteomic study of cow milk allergy and the Proteomic study of childhood cataract. Cow's milk proteins (CMP) are the first antigens to which infants are exposed and generate allergy in some of them. In Mexico, the incidence of CMP allergy has been estimated at 5-7%. Clinical manifestations include both gastrointestinal and extra-gastrointestinal symptoms, making its diagnosis extremely difficult. An inappropriate diagnosis affects the development and growth of children. The goals of the study are to identify the main immune-reactive CMP in Mexican pediatric population and to design more accurate diagnostic tools for this disease. Childhood cataract is a major ocular disease representing one of the main causes of blindness in infants; in developing countries, this disease promotes up to 27% of cases related to visual loss. From this group, it has been estimated that close to 60% of children do not survive beyond two years after vision lost. PTM have been pointed out as the main cause of protein precipitation at the crystalline and, consequently, clouding of this tissue. The study of childhood cataract represents an outstanding opportunity to identify the PTM associated to the cataract-genesis process.
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Affiliation(s)
- Angélica Torres-Arroyo
- Laboratorio de Bioquímica-Genética, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, Mexico
| | - Arturo Ruiz-Lara
- Laboratorio de Bioquímica-Genética, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, Mexico
| | - Adriana Castillo-Villanueva
- Laboratorio de Bioquímica-Genética, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, Mexico
| | - Sara Teresa Méndez-Cruz
- Laboratorio de Bioquímica-Genética, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, Mexico
| | - Sara Elvia Espinosa-Padilla
- Unidad de Investigación en Inmunodeficiencias, Instituto Nacional de Pediatría Secretaría de Salud, Mexico City, Mexico
| | | | - Flora Zarate-Mondragón
- Departamento de Gastroenterología y Nutrición, Instituto Nacional de Pediatría Secretaría de Salud, Mexico City, Mexico
| | - Roberto Cervantes-Bustamante
- Departamento de Gastroenterología y Nutrición, Instituto Nacional de Pediatría Secretaría de Salud, Mexico City, Mexico
| | - Vanessa Bosch-Canto
- Departamento de Oftalmología, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, Mexico
| | - Iris Vizzuett-López
- Departamento de Oftalmología, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, Mexico
| | - Juan Carlos Ordaz-Fávila
- Departamento de Oftalmología, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, Mexico
| | - Jesús Oria-Hernández
- Laboratorio de Bioquímica-Genética, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, Mexico
| | - Horacio Reyes-Vivas
- Laboratorio de Bioquímica-Genética, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, Mexico.
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David Boothe W, Tarbox JA, Tarbox MB. Atopic Dermatitis: Pathophysiology. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1027:21-37. [PMID: 29063428 DOI: 10.1007/978-3-319-64804-0_3] [Citation(s) in RCA: 238] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The pathophysiology of atopic dermatitis is complex and multifactorial, involving elements of barrier dysfunction, alterations in cell mediated immune responses, IgE mediated hypersensitivity, and environmental factors. Loss of function mutations in filaggrin have been implicated in severe atopic dermatitis due to a potential increase in trans-epidermal water loss, pH alterations, and dehydration. Other genetic changes have also been identified which may alter the skin's barrier function, resulting in an atopic dermatitis phenotype. The imbalance of Th2 to Th1 cytokines observed in atopic dermatitis can create alterations in the cell mediated immune responses and can promote IgE mediated hypersensitivity, both of which appear to play a role in the development of atopic dermatitis. One must additionally take into consideration the role of the environment on the causation of atopic dermatitis and the impact of chemicals such as airborne formaldehyde, harsh detergents, fragrances, and preservatives. Use of harsh alkaline detergents in skin care products may also unfavorably alter the skin's pH causing downstream changes in enzyme activity and triggering inflammation. Environmental pollutants can trigger responses from both the innate and adaptive immune pathways. This chapter will discuss the multifaceted etiology of atopic dermatitis which will help us to elucidate potential therapeutic targets. We will also review existing treatment options and their interaction with the complex inflammatory and molecular triggers of atopic dermatitis.
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Affiliation(s)
- W David Boothe
- Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - James A Tarbox
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Michelle B Tarbox
- Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
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Errázuriz G, Lucero Y, Ceresa S, Gonzalez M, Rossel M, Vives A. Características clínicas y manejo de lactantes menores de 1 año con sospecha de alergia a proteína de leche de vaca. ACTA ACUST UNITED AC 2016; 87:449-454. [DOI: 10.1016/j.rchipe.2016.06.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 06/08/2016] [Accepted: 06/21/2016] [Indexed: 12/11/2022]
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10
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Liu T, Navarro S, Lopata AL. Current advances of murine models for food allergy. Mol Immunol 2016; 70:104-17. [DOI: 10.1016/j.molimm.2015.11.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 11/21/2015] [Accepted: 11/28/2015] [Indexed: 12/16/2022]
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Gonipeta B, Kim E, Gangur V. Mouse models of food allergy: how well do they simulate the human disorder? Crit Rev Food Sci Nutr 2016; 55:437-52. [PMID: 24915373 DOI: 10.1080/10408398.2012.657807] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Food allergy is a growing health problem with serious concerns due to high potential for fatality. Rapid advances in the knowledge on causes and mechanisms as well as in developing effective prevention/therapeutic strategies are needed. To meet these goals, mouse models that simulate the human disorder are highly desirable. During the past decade, several mouse models of food allergies have been reported. Here, we briefly reviewed the human disorder and then critically evaluated these models seeking answers to the following important questions: To what extent do they simulate the human disorder? What are the strengths and limitations of these models? What are the challenges facing this scientific area? Our analysis suggest that: (i) the mouse models, with inherent strengths and limitations, are available for many major food allergies; there is scope for additional model development and validation; (ii) models mostly simulate the severe forms of human disorder with similar immune and clinical features; (iii) the approaches used to develop some of the mouse models may be questionable; and (iv) the specific mechanisms of sensitization as wells as oral elicitation of fatal reactions in both humans and mice remains incompletely understood and therefore warrants further research.
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Affiliation(s)
- Babu Gonipeta
- a Food Allergy and Immunology Laboratory, Department of Food Science and Human Nutrition , Michigan State University , East Lansing , Michigan , USA
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Kim K. Influences of Environmental Chemicals on Atopic Dermatitis. Toxicol Res 2015; 31:89-96. [PMID: 26191377 PMCID: PMC4505354 DOI: 10.5487/tr.2015.31.2.089] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 06/12/2015] [Accepted: 06/22/2015] [Indexed: 12/12/2022] Open
Abstract
Atopic dermatitis is a chronic inflammatory skin condition including severe pruritus, xerosis, visible eczematous skin lesions that mainly begin early in life. Atopic dermatitis exerts a profound impact on the quality of life of patients and their families. The estimated lifetime prevalence of atopic dermatitis has increased 2~3 fold during over the past 30 years, especially in urban areas in industrialized countries, emphasizing the importance of life-style and environment in the pathogenesis of atopic diseases. While the interplay of individual genetic predisposition and environmental factors contribute to the development of atopic dermatitis, the recent increase in the prevalence of atopic dermatitis might be attributed to increased exposure to various environmental factors rather than alterations in human genome. In recent decades, there has been an increasing exposure to chemicals from a variety of sources. In this study, the effects of various environmental chemicals we face in everyday life - air pollutants, contact allergens and skin irritants, ingredients in cosmetics and personal care products, and food additives - on the prevalence and severity of atopic dermatitis are reviewed.
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Affiliation(s)
- Kwangmi Kim
- College of Pharmacy, Dankook University, Cheonan, Korea
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Polloni L, Ferruzza E, Ronconi L, Lazzarotto F, Toniolo A, Bonaguro R, Muraro A. Perinatal stress and food allergy: a preliminary study on maternal reports. PSYCHOL HEALTH MED 2014; 20:732-41. [PMID: 25531062 DOI: 10.1080/13548506.2014.993406] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Maternal stress in fetal and early life has been associated with the development of respiratory allergies, but no studies exist about food allergy. Stressful events and the quality of caregiving provided, as they affect the emotional and physiologic regulation of the infant, could alter the hypothalamic-pituitary-adrenal and immune system, facilitating an increased allergic response. This study aimed to investigate the influence of perinatal stress, as perceived by mothers, on developing food allergy in childhood. A survey on pregnancy and the first three months after giving birth was submitted to 59 Italian mothers of at least one child suffering from severe food allergy and one completely healthy child, for a total of 118 children examined. The presence of stressful events and the quality of perinatal period for each child were assessed retrospectively. The food allergic children's data were compared to siblings' data through inferential statistics. The results showed a significantly higher number of stressful events occurred during patients' perinatal period, compared to siblings, in particular bereavements in pregnancy and parenting difficulties in postpartum. Mothers reported harder pregnancies and more stressful, harder, and, in general, worse postpartum when referring to their food-allergic children, in comparison with their siblings (p < .05). Psychological aspects are demonstrated to be involved in the development of allergic diseases. This study constitutes the first step to examine the role of early stress and perinatal psychosocial factors in the pathogenesis of food allergy; further studies are necessary to understand individual psychological impact and its relations with genetic and biological factors.
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Affiliation(s)
- L Polloni
- a Department of Women and Child Health, Referral Centre for Food Allergy Diagnosis and Treatment , Padua University Hospital , Padua , Italy
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Song Y, Liu C, Hui Y, Srivastava K, Zhou Z, Chen J, Miller RL, Finkelman FD, Li XM. Maternal allergy increases susceptibility to offspring allergy in association with TH2-biased epigenetic alterations in a mouse model of peanut allergy. J Allergy Clin Immunol 2014; 134:1339-1345.e7. [PMID: 25441650 DOI: 10.1016/j.jaci.2014.08.034] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 07/30/2014] [Accepted: 08/15/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Although maternal atopy is a risk factor for the development of peanut allergy, this phenomenon has not been well characterized experimentally, and the mechanisms underlying offspring risk are unclear. OBJECTIVE We sought to determine whether offspring of mothers with peanut allergy (O-PAM mice) are more susceptible to peanut allergy than offspring of naive mothers (O-NM mice) in a murine model and, if so, whether the susceptibility is linked to TH2-biased epigenetic alterations. METHODS Five-week-old O-PAM and O-NM mice were intragastrically sensitized to and challenged with peanut. Serum peanut-specific IgE levels, plasma histamine levels, anaphylactic reactions, and splenocyte and MLN cell cytokine production were measured. DNA methylation levels of the Il4 gene promoter from splenocytes and MLN cells from sensitized offspring and splenocytes from unsensitized neonatal offspring were determined by means of pyrosequencing. RESULTS O-PAM mice exhibited 3-fold higher peanut-specific IgE levels after peanut sensitization, as well as 5-fold higher histamine levels and significantly higher anaphylactic symptom scores after challenge than O-NM mice (P < .05-.01). Cultured splenocytes and MLNs from O-PAM mice produced significantly more TH2 cytokines than cells from O-NM mice (P < .05-.01). Cells from O-PAM mice exhibited significantly reduced DNA methylation at CpG sites of the Il4 gene promoter than cells from O-NM mice. DNA methylation levels were inversely correlated with IL-4 and IgE production. O-PAM neonatal splenocyte hypomethylation of the Il4 gene promoter was also present. CONCLUSION This study is the first to demonstrate that increased susceptibility to peanut allergy in O-PAM mice is associated with epigenetic alteration of the Il4 gene promoter. This finding might provide insight into preventing the development of early-life allergy.
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Affiliation(s)
- Ying Song
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Changda Liu
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Yiqun Hui
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Kamal Srivastava
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Zhenwen Zhou
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY; Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Jia Chen
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Rachel L Miller
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Columbia University, New York, NY; Division of Allergy and Immunology, Department of Pediatrics, Columbia University, New York, NY; Department of Environmental Health Sciences, Columbia University, New York, NY
| | - Fred D Finkelman
- Division of Immunology, Allergy and Rheumatology, University of Cincinnati College of Medicine, Cincinnati, Ohio; Department of Medicine, Cincinnati Veterans Affairs Medical Center, Cincinnati, Ohio; Division of Immunobiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Xiu-Min Li
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY.
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Nwaru BI, Takkinen HM, Kaila M, Erkkola M, Ahonen S, Pekkanen J, Simell O, Veijola R, Ilonen J, Hyöty H, Knip M, Virtanen SM. Food diversity in infancy and the risk of childhood asthma and allergies. J Allergy Clin Immunol 2014; 133:1084-91. [PMID: 24472626 DOI: 10.1016/j.jaci.2013.12.1069] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 12/05/2013] [Accepted: 12/10/2013] [Indexed: 01/23/2023]
Abstract
BACKGROUND Recently, the bacterial diversity of the intestinal flora and the diversity of various environmental factors during infancy have been linked to the development of allergies in childhood. Food is an important environmental exposure, but the role of food diversity in the development of asthma and allergies in childhood is poorly defined. OBJECTIVE We studied the associations between food diversity during the first year of life and the development of asthma and allergies by age 5 years. METHODS In a Finnish birth cohort we analyzed data on 3142 consecutively born children. We studied food diversity at 3, 4, 6, and 12 months of age. Asthma, wheeze, atopic eczema, and allergic rhinitis were measured by using the International Study of Asthma and Allergies in Childhood questionnaire at age 5 years. RESULTS By 3 and 4 months of age, food diversity was not associated with any of the allergic end points. By 6 months of age, less food diversity was associated with increased risk of allergic rhinitis but not with the other end points. By 12 months of age, less food diversity was associated with increased risk of any asthma, atopic asthma, wheeze, and allergic rhinitis. CONCLUSION Less food diversity during the first year of life might increase the risk of asthma and allergies in childhood. The mechanisms for this association are unclear, but increased dietary antigen exposure might contribute to this link.
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Affiliation(s)
- Bright I Nwaru
- School of Health Sciences, University of Tampere, Tampere, Finland; Allergy & Respiratory Research Group, Center for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom.
| | - Hanna-Mari Takkinen
- School of Health Sciences, University of Tampere, Tampere, Finland; Nutrition Unit, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland
| | - Minna Kaila
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland; Hjelt Institute, University of Helsinki, Helsinki, Finland
| | - Maijaliisa Erkkola
- Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Suvi Ahonen
- School of Health Sciences, University of Tampere, Tampere, Finland; Science Center of Pirkanmaa Hospital District, Tampere, Finland
| | - Juha Pekkanen
- Environmental Epidemiology Unit, National Institute for Health and Welfare, Kuopio, Finland; Unit of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Olli Simell
- Department of Pediatrics, University of Turku, Turku, Finland
| | - Riitta Veijola
- Department of Pediatrics, Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Jorma Ilonen
- Immunogenetics Laboratory, University of Turku, Turku, Finland; Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
| | - Heikki Hyöty
- Medical School, University of Tampere, Tampere, Finland; Fimlab Laboratories, Tampere, Finland
| | - Mikael Knip
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland; Folkhälsan Research Center, Helsinki, Finland; Children's Hospital, University of Helsinki, and Helsinki University Central Hospital, Helsinki, Finland; Diabetes and Obesity Research Program, University of Helsinki, Helsinki, Finland
| | - Suvi M Virtanen
- School of Health Sciences, University of Tampere, Tampere, Finland; Nutrition Unit, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland; Department of Pediatrics, Tampere University Hospital, Tampere, Finland; Science Center of Pirkanmaa Hospital District, Tampere, Finland
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Jacob CMA, Pastorino AC, Okay TS, Castro APBM, Gushken AKF, Watanabe LA, Frucchi VCZ, Oliveira LCD. Interleukin 10 (IL10) and transforming growth factor β1 (TGFβ1) gene polymorphisms in persistent IgE-mediated cow's milk allergy. Clinics (Sao Paulo) 2013; 68:1004-9. [PMID: 23917667 PMCID: PMC3714916 DOI: 10.6061/clinics/2013(07)19] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 03/30/2013] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES The aim of this cross-sectional study was to evaluate whether interleukin 10 (IL10) and transforming growth factor β1 (TGFβ1) gene polymorphisms were associated with persistent IgE-mediated cow's milk allergy in 50 Brazilian children. The diagnostic criteria were anaphylaxis triggered by cow's milk or a positive double-blind, placebo-controlled food challenge. Tolerance was defined as the absence of a clinical response to a double-blind, placebo-controlled food challenge or cow's milk exposure. METHOD The genomic DNA of the 50 patients and 224 healthy controls (HCs) was used to investigate five IL10 gene polymorphisms (-3575A/T, -2849A/G, -2763A/C, -1082G/A, -592C/A) and one TGFβ1 polymorphism (-509C/T). RESULTS Among the five IL10 polymorphisms analyzed, homozygosis for the G allele at the -1082 position was significantly higher in the patients compared with the healthy controls (p=0.027) and in the persistent cow's milk allergy group compared with the healthy controls (p=0.001). CONCLUSIONS Homozygosis for the G allele at the IL10 -1082G/A polymorphism is associated with the persistent form of cow's milk allergy.
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Affiliation(s)
- Cristina Miuki Abe Jacob
- Allergy and Immunology Unit, Department of Pediatrics, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
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New Allergens of Relevance in Tropical Regions: The Impact of Ascaris lumbricoides Infections. World Allergy Organ J 2013; 4:77-84. [PMID: 23282442 PMCID: PMC3651106 DOI: 10.1097/wox.0b013e3182167e04] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
One of the many aspects of the relationships between parasite infections and allergic diseases is the possibility that allergens from parasites enhance the TH2 responses, especially IgE production, in allergic diseases such as asthma. In this review we discuss about the allergenic composition of the nematode Ascaris lumbricoides and their potential impact on allergy sensitization and asthma pathogenesis and prevalence in populations living in the tropics and naturally exposed to both, mite allergens and helminth infections.
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18
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Lin WH, Wu CR, Lee HZ, Kuo YH, Wen HS, Lin TY, Lee CY, Huang SY, Lin CY. Induced apoptosis of Th2 lymphocytes and inhibition of airway hyperresponsiveness and inflammation by combined lactic acid bacteria treatment. Int Immunopharmacol 2012; 15:703-11. [PMID: 23142092 DOI: 10.1016/j.intimp.2012.10.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Revised: 10/10/2012] [Accepted: 10/26/2012] [Indexed: 12/24/2022]
Abstract
Several lactic acid bacteria (LAB) demonstrably regulate the immune system and inhibit allergic disease. This study examined whether oral feeding of either Lactobacillus paracasei (L. paracasei) BB5 and/or Lactobacillus rhamnosus (L. rhamnosus) BB1 suppresses ovalbumin (OVA)-induced airway hyperresponsiveness (AHR) and inflammation in a murine model. OVA-specific immune responses, cell profile of bronchoalveolar lavage fluid (BALF), and airway AHR were assessed following OVA and methacholine challenge. We investigated whether LAB can enhance CD4(+)FoxP3(+) and CD8(+)FoxP3(+) regulatory T (Treg) cells in splenic cells and apoptosis of CD4(+)IL-4(+) T cells. Results found oral administration of combined LAB better than single L. paracasei or L. rhamnosus strain, improving Penh ratio after challenge with methacholine. High-dose combined LAB starkly decreased synthesis of OVA-specific IgE and IgG2a levels, as well as eosinophils infiltration in BALF. In addition, CD4(+)IL-4(+) T cells decreased while CD4(+)FoxP3(+) and CD8(+)FoxP3(+) Treg cells increased significantly in splenic mononuclear cells of high-dose combined LAB group. Findings indicate allergen-induced AHR and airway allergic inflammation suppressed by enhances CD4(+)FoxP3(+) and CD8(+)FoxP3(+) Treg populations as well as Th1 cell response after treating with combined LAB. This study may provide a basis for developing a novel therapeutic or protective method for airway allergic disease.
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Affiliation(s)
- Wen-Hsin Lin
- School of Pharmacy, China Medical University, Taichung, Taiwan
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19
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Feehley T, Stefka AT, Cao S, Nagler CR. Microbial regulation of allergic responses to food. Semin Immunopathol 2012; 34:671-88. [PMID: 22941410 PMCID: PMC3874145 DOI: 10.1007/s00281-012-0337-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 08/17/2012] [Indexed: 02/07/2023]
Abstract
The incidence of food allergy in developed countries is rising at a rate that cannot be attributed to genetic variation alone. In this review, we discuss the environmental factors that may contribute to the increasing prevalence of potentially fatal anaphylactic responses to food. Decreased exposure to enteric infections due to advances in vaccination and sanitation, along with the adoption of high-fat (Western) diets, antibiotic use, Cesarean birth, and formula feeding of infants, have all been implicated in altering the enteric microbiome away from its ancestral state. This collection of resident commensal microbes performs many important physiological functions and plays a central role in the development of the immune system. We hypothesize that alterations in the microbiome interfere with immune system maturation, resulting in impairment of IgA production, reduced abundance of regulatory T cells, and Th2-skewing of baseline immune responses which drive aberrant responses to innocuous (food) antigens.
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Affiliation(s)
- Taylor Feehley
- Committee on Immunology and Department of Pathology, University of Chicago, Chicago, IL, USA
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20
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Fuiano N, Incorvaia C. Dissecting the causes of atopic dermatitis in children: less foods, more mites. Allergol Int 2012; 61:231-43. [PMID: 22361514 DOI: 10.2332/allergolint.11-ra-0371] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 10/07/2011] [Indexed: 12/16/2022] Open
Abstract
Atopic dermatitis (AD) is a common, chronic or chronically relapsing, multifactorial skin disease that mainly occurs in children but affects also adults. AD usually begins early in life and often concerns people with a personal or family history of asthma and allergic rhinitis. AD is characterized by eczematous changes in the epidermis and originates from a late, T-cell mediated reaction associated to the formation and production of memory T-cell of TH2 type, occurrence of homing receptor at skin level and cutaneous lymphocyte-associated (CLA) antigens. Extrinsic or allergic AD, but not intrinsic AD, shows high total serum IgE levels and the presence of specific IgE for environmental and food allergens. A pivotal role in the pathogenesis of AD is played by filaggrin, a protein contained in the granular layer of the epidermis regulating the aggregation of keratin filaments. Mutation in the filaggrin gene causes decreased barrier function of the corny layers of the epidermis. This favours the enter through the skin of environmental allergens, especially the house dust mite, that further facilitates such entering by the proteolytic activity of its major allergen Der p 1. In fact, recent advances suggest that the dust mite, more than foods, is the major cause of allergic AD. As far as the causal diagnosis of AD is concerned, there is notable evidence supporting the capacity of the atopy patch test (APT) to reproduce the pathophysiologic events of AD. This makes APT a valuable diagnostic tool for AD.
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MESH Headings
- Animals
- Antigens, Dermatophagoides/adverse effects
- Antigens, Dermatophagoides/immunology
- Arthropod Proteins/adverse effects
- Arthropod Proteins/immunology
- Child
- Cysteine Endopeptidases/adverse effects
- Cysteine Endopeptidases/immunology
- Dermatitis, Atopic/diagnosis
- Dermatitis, Atopic/etiology
- Dermatitis, Atopic/genetics
- Dermatitis, Atopic/immunology
- Filaggrin Proteins
- Gene-Environment Interaction
- Humans
- Hypersensitivity, Delayed/diagnosis
- Hypersensitivity, Delayed/etiology
- Hypersensitivity, Delayed/genetics
- Hypersensitivity, Delayed/immunology
- Immunologic Memory
- Intermediate Filament Proteins/genetics
- Mutation
- Patch Tests
- Pyroglyphidae/immunology
- Skin/immunology
- Th2 Cells/immunology
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Affiliation(s)
- Nicola Fuiano
- Pediatric Allergy Service, ASL FG, Torremaggiore, Italy.
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Li XM. Treatment of asthma and food allergy with herbal interventions from traditional chinese medicine. ACTA ACUST UNITED AC 2012; 78:697-716. [PMID: 21913200 DOI: 10.1002/msj.20294] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Prevalence of asthma and allergy has increased over the past 2-3 decades in Westernized countries. Despite increased understanding of the pathogenesis of asthma and allergic diseases, control of severe asthma is still difficult. Asthma is also associated with a high prevalence of anxiety, particularly in adolescents. There is no effective treatment for food allergy. Food allergy is often associated with severe and recalcitrant eczema. Novel approaches for treatment of asthma and food allergy and comorbid conditions are urgently needed. Traditional Chinese medicine, used in Asia for centuries, is beginning to play a role in Western healthcare. There is increasing scientific evidence supporting the use of traditional Chinese medicine for asthma treatment. Since 2005, several controlled clinical studies of "antiasthma" herbal remedies have been published. Among the herbal medicines, antiasthma herbal medicine intervention is the only antiasthma traditional Chinese medicine product that is a Food and Drug Administration investigational new drug that has entered clinical trials in the United States. Research into the effects and mechanisms of action of antiasthma herbal medicine intervention in animal models is actively being pursued. Research on traditional Chinese medicine herbal medicines for treating food allergy is rare. The herbal intervention Food Allergy Herbal Formula-2 is the only Food and Drug Administration botanical investigational new drug under investigation as a multiple food allergy therapy. This review article discusses promising traditional Chinese medicine interventions for asthma, food allergy, and comorbid conditions, and explores their possible mechanisms of action.
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Affiliation(s)
- Xiu-Min Li
- Department of Pediatric Allergy and Immunology, Mount Sinai School of Medicine, New York, NY, USA.
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Kim J, Chang E, Han Y, Ahn K, Lee SI. The incidence and risk factors of immediate type food allergy during the first year of life in Korean infants: a birth cohort study. Pediatr Allergy Immunol 2011; 22:715-9. [PMID: 21539613 DOI: 10.1111/j.1399-3038.2011.01163.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We conducted this study to determine the incidence of food allergy (FA) in Korean infants and identify the risk factors of FAs during the first year of life in a birth cohort study. METHODS Pregnant women ≥34 weeks of gestation were enrolled in this study. Participants were asked to complete questionnaires describing basic demographic information including family history of allergic diseases. Since birth, all the babies were regularly followed up for FA symptoms through telephone interviews at 4, 8, and 12 months of age. FA was defined as a repetitive convincing history of immediate allergic reactions following the ingestion of offending food. RESULTS & CONCLUSIONS A total of 1177 infants and their parents completed this study. The prevalence of FA was 5.3% in infants. The three leading food allergens were hen's eggs (33/62), cow's milk (20/62) and peanut/nuts (8/62). Children with a history of maternal AD showed a significantly higher prevalence of FA (P = 0.012) [aRR = 3.17]. In addition, children who were born during autumn had a higher prevalence than those born during spring (p = 0.005) [aRR = 3.48]. In conclusion, we identified several characteristics that may influence the development of FA in the next generation, including maternal AD and autumn birth.
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Affiliation(s)
- Jihyun Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Natural history of IgE-dependent food allergy diagnosed in children during the first three years of life. Adv Med Sci 2011; 56:48-55. [PMID: 21550944 DOI: 10.2478/v10039-011-0008-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The aim of the study was to analyze: the course of allergy diagnosed during first three years of life, frequency of food tolerance development and impact of factors which have potential meaning in that process. MATERIAL AND METHODS The study was performed in 115 children with IgE-dependent allergy, diagnosed during first three years of life, treated in 2nd Department of Pediatrics and Allergology of Polish Mothers Health Center in Lodz. All children were invited to our clinic in order to analyze course of the allergy after period of minimum 5 years since diagnosis. RESULTS The results of the study revealed that food tolerance was acquired by high percentage of examined children (87.9%) among 83 children with food allergy. However among 32 children with initial inhalant allergy there were still no food sensitizations. The frequency of this process increased with age of examined children. The study revealed that such factors as lack of family history of atopy, clinical manifestation limited to one system, lack of inhalant allergy, type of allergen, good social conditions, have positive impact on tolerance development. CONCLUSIONS High percentage of children with food allergy is able to develop the status of food immunotolerance. Factors which predispose to development of food allergy have also negative impact on ability to acquiring tolerance to harmful food. The study indicates the need of constant and wide education about decreasing exposure to allergy predisposing factors which could increase chance of food tolerance development.
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Costa AJF, Sarinho ESC, Motta MEFA, Gomes PN, de Oliveira de Melo SM, da Silva GAP. Allergy to cow's milk proteins: what contribution does hypersensitivity in skin tests have to this diagnosis? Pediatr Allergy Immunol 2011; 22:e133-8. [PMID: 21342278 DOI: 10.1111/j.1399-3038.2010.00988.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Food allergy is an immunologically mediated adverse reaction to food protein. Cow's milk protein allergy (CMPA) is the most frequent type and is the one that is most difficult to diagnose. This study had the objective of analyzing the accuracy of hypersensitivity and specific IgE skin tests among children with CMPA and predominantly gastrointestinal clinical manifestations. The participants in this study were 192 children aged one and five (median of 2 yr). Among these, 122 underwent open oral challenge to the suspected food. After evaluating the sensitivity, specificity and positive and negative predictive values (respectively, PPV and NPV) of skin and specific IgE tests in relation to the gold standard (open oral challenge); all the children underwent the skin prick test (SPT), specific IgE test and atopy patch test (APT) for cow's milk, eggs, wheat and peanuts and the open oral challenge for the food to which the child was sensitive or had suspected sensitivity. Presence of food allergy was confirmed for 50 children (40.9%). Among these cases, 44/50 (88%) were of allergy to cow's milk protein. Children who presented a positive response to an oral challenge to cow's milk protein were considered to be cases, while the controls were children with negative response. Twenty-two of the 44 cases (50.0%) presented symptoms within the first 4 h after the challenge. The SPT presented 31.8% sensitivity, 90.3% specificity, 66.7% PPV and 68.4% NPV. The APT presented 25.0% sensitivity, 81.9% specificity, 45.8% PPV and 64.1% NPV. The specific IgE test presented, respectively, 20.5%, 88.9%, 52.9% and 64.6%. Despite the operational difficulty and the possible exposure risk, oral challenge is the best method for diagnosing CMPA, because of the low sensitivity and PPV of skin and specific IgE tests.
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Abstract
PURPOSE OF REVIEW Food allergy, a growing clinical and public health problem in the United States and worldwide, is likely determined by multiple environmental and genetic factors. The purpose of this review is to summarize recent advances in food allergy genetic research. RECENT FINDINGS There is compelling evidence that genetic factors may play a role in food allergy. However, the specific genetic loci that may modulate individual risk of food allergy remain to be identified. To date, only a limited number of candidate gene association studies of food allergy have been reported. Polymorphism(s) in nine genes have been associated with the incidence of food allergy or food allergy severity in at least one study. But most of these findings remain to be replicated in independent populations. In contrast, there are considerable advances in genetics of other allergic diseases such as asthma and atopic dermatitis. Although asthma and atopic dermatitis often coexist with food allergy, the relevance of their candidate genes to food allergy remains to be evaluated. SUMMARY Genetics in food allergy is a promising research area but is still in its infancy. More studies are needed to dissect susceptible genes of food allergy. A genome-wide association approach may serve as a powerful tool to identify novel genes related to food allergy. Furthermore, the role of gene-environment interaction, gene-gene interaction, and epigenetics in food allergy remains largely unexplored. Given the complex nature of food allergy, future studies need to integrate environment, genomics, and epigenomics in order to better understand the multifaceted etiology and biological mechanisms of food allergy.
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Parvataneni S, Birmingham NP, Gonipeta B, Gangur V. Dominant, non-MHC genetic control of food allergy in an adjuvant-free mouse model. Int J Immunogenet 2009; 36:261-7. [PMID: 19624800 DOI: 10.1111/j.1744-313x.2009.00860.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Food allergy is a potentially fatal immune-mediated disorder with incompletely understood mechanisms. We studied the genetic control of food allergy using major histocompatibility complex-identical mice (H2(s)) and an adjuvant-free method of sensitization. Whereas, transdermal exposure to hazelnut - a model allergenic food, elicited robust IgG1 response in both strains, an IgE response was evident only in A.SW mice. Following oral challenge, only A.SW but not SJL mice exhibited signs of systemic anaphylaxis and hypothermia. In addition, (A.SW x SJL) F1 hybrids exhibited IgE responsiveness, systemic anaphylaxis and hypothermia similar to A.SW, indicating dominant inheritance of these traits. Furthermore, whereas A.SW and F1 mice but not SJL elicited robust interleukin (IL)-4 response, all three strains elicited IL-5 and IL-13 responses by spleen cells. These data demonstrate for the first time, dominant non-MHC genetic control of food allergy and a critical role of IL-4 but not IL-5 or IL-13 in this model.
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Affiliation(s)
- S Parvataneni
- Food Allergy and Immunology Laboratory, Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA
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Disease outcomes as a consequence of environmental influences on the development of the immune system. Curr Opin Allergy Clin Immunol 2009; 9:185-9. [DOI: 10.1097/aci.0b013e32832abfc2] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Glynn A, Thuvander A, Aune M, Johannisson A, Darnerud PO, Ronquist G, Cnattingius S. Immune cell counts and risks of respiratory infections among infants exposed pre- and postnatally to organochlorine compounds: a prospective study. Environ Health 2008; 7:62. [PMID: 19055819 PMCID: PMC2637846 DOI: 10.1186/1476-069x-7-62] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2008] [Accepted: 12/04/2008] [Indexed: 05/02/2023]
Abstract
BACKGROUND Early-life chemical exposure may influence immune system development, subsequently affecting child health. We investigated immunomodulatory potentials of polychlorinated biphenyls (PCBs) and p,p'-DDE in infants. METHODS Prenatal exposure to PCBs and p,p'-DDE was estimated from maternal serum concentrations during pregnancy. Postnatal exposure was calculated from concentrations of the compounds in mother's milk, total number of nursing days, and percentage of full nursing each week during the 3 month nursing period. Number and types of infections among infants were registered by the mothers (N = 190). White blood cell counts (N = 86) and lymphocyte subsets (N = 52) were analyzed in a subgroup of infants at 3 months of age. RESULTS Infants with the highest prenatal exposure to PCB congeners CB-28, CB-52 and CB-101 had an increased risk of respiratory infection during the study period. In contrast, the infection odds ratios (ORs) were highest among infants with the lowest prenatal mono-ortho PCB (CB-105, CB-118, CB-156, CB-167) and di-ortho PCB (CB-138, CB-153, CB-180) exposure, and postnatal mono- and di-ortho PCB, and p,p'-DDE exposure. Similar results were found for pre- and postnatal CB-153 exposure, a good marker for total PCB exposure. Altogether, a negative relationship was indicated between infections and total organochlorine compound exposure during the whole pre- and postnatal period. Prenatal exposure to CB-28, CB-52 and CB-101 was positively associated with numbers of lymphocytes and monocytes in infants 3 months after delivery. Prenatal exposure to p,p'-DDE was negatively associated with the percentage of eosinophils. No significant associations were found between PCB and p,p'-DDE exposure and numbers/percentages of lymphocyte subsets, after adjustment for potential confounders. CONCLUSION This hypothesis generating study suggests that background exposure to PCBs and p,p'-DDE early in life modulate immune system development. Strong correlations between mono- and di-ortho PCBs, and p,p'-DDE exposures make it difficult to identify the most important contributor to the suggested immunomodulation, and to separate effects due to pre- and postnatal exposure. The suggested PCB and p,p'-DDE modulation of infection risks may have consequences for the health development during childhood, since respiratory infections early in life may be risk factors for asthma and middle ear infections.
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Affiliation(s)
- Anders Glynn
- National Food Administration, Research and Development Department, PO Box 622, SE-751 26 Uppsala, Sweden
| | - Ann Thuvander
- National Food Administration, Research and Development Department, PO Box 622, SE-751 26 Uppsala, Sweden
- The National Board of Health and Welfare, SE-106 30 Stockholm, Sweden
| | - Marie Aune
- National Food Administration, Research and Development Department, PO Box 622, SE-751 26 Uppsala, Sweden
| | - Anders Johannisson
- Department of Anatomy and Physiology, Swedish University of Agricultural Sciences, PO Box 7070, SE- 750 07 Uppsala, Sweden
| | - Per Ola Darnerud
- National Food Administration, Research and Development Department, PO Box 622, SE-751 26 Uppsala, Sweden
| | - Gunnar Ronquist
- Department of Medical Sciences, Clinical Chemistry, University Hospital of Uppsala, SE- 751 85, Uppsala, Sweden
| | - Sven Cnattingius
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden
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Talley NJ. Gut eosinophilia in food allergy and systemic and autoimmune diseases. Gastroenterol Clin North Am 2008; 37:307-32, v. [PMID: 18499022 DOI: 10.1016/j.gtc.2008.02.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Eosinophilic gastroenteritis is a rare disease characterized by striking tissue eosinophilia in any layer of the gut wall; however, many diseases can cause increased gut eosinophilia. Allergic reactions to food are an important cause of gut eosinophilia. Not all adverse reactions to food are IgE mediated, and most cases of IgE-mediated food allergy do not have eosinophilic gastroenteritis. Parasitic, bacterial, and viral pathogens as well as certain systemic diseases such as vasculitis can cause gut eosinophilia. These heterogeneous conditions are reviewed in this article.
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Affiliation(s)
- Nicholas J Talley
- Division of Gastroenterology and Hepatology, Mayo Clinic Campus, Mayo Clinic, Jacksonville, FL 32224, USA.
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Flanagan JL, Lynch SV, Wiener-Kronish J. Molecular Approaches to Detection of Bacteria in Critical Care Patients. Intensive Care Med 2007. [DOI: 10.1007/978-0-387-49518-7_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Vandenplas Y, Koletzko S, Isolauri E, Hill D, Oranje AP, Brueton M, Staiano A, Dupont C. Guidelines for the diagnosis and management of cow's milk protein allergy in infants. Arch Dis Child 2007; 92:902-8. [PMID: 17895338 PMCID: PMC2083222 DOI: 10.1136/adc.2006.110999] [Citation(s) in RCA: 230] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Our aim was to develop guidance for general paediatricians and primary care physicians in diagnosing and managing cow's milk protein allergy in infants. The guidelines were developed by discussion based on existing national recommendations and standards, clinical experience and, whenever possible, evidence from the literature. Separate algorithms cover breast-fed and formula-fed infants. The recommendations emphasise the importance of comprehensive history taking and careful physical examination. Patients with severe symptoms need to be referred to a specialist. Elimination of cow's milk protein from the infant's or mother's diet and challenges are the gold standard for diagnosis. This guidance is intended as a basis for local discussion, implementation and prospective evaluation. The algorithms should be regularly assessed using clinical audit standards. Once validated, the diagnostic framework could provide a standardised approach in epidemiological and therapeutic studies.
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Affiliation(s)
- Yvan Vandenplas
- Department of Paediatrics, Universitair Ziekenhuis Brussel Kinderen, Vrije Universiteit Brussel, Brussels, Belgium.
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Prescott SL, Björkstén B. Probiotics for the prevention or treatment of allergic diseases. J Allergy Clin Immunol 2007; 120:255-62. [PMID: 17544096 DOI: 10.1016/j.jaci.2007.04.027] [Citation(s) in RCA: 134] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2007] [Revised: 04/20/2007] [Accepted: 04/23/2007] [Indexed: 11/30/2022]
Abstract
This review addresses the effects of probiotic bacteria on immune development and the role in the treatment and prevention of allergic disease. Although there is a sound theoretical basis for anticipating benefits, there are currently insufficient data to recommend probiotics as a part of standard therapy in any allergic conditions. Furthermore, although there have been several studies to show a benefit in prevention of atopic eczema, other studies have failed to support this. None of the studies has shown any clear preventive effect on sensitization, nor any allergic disease other than eczema. The term "probiotic" is often used loosely to include bacterial strains with little documented immunomodulatory capacity or controlled studies to support the claims. It is not known whether effects in experimental systems have any clinical relevance. Finally, very little is known about this large, complex internal ecosystem. Explanations for the varied results between studies include host factors (including genetic differences in microbial responses and allergic predisposition) and other environmental factors, such as general microbial burden, individual microbiota, diet (including consumption of prebiotic substances), and treatment with antibiotics. As more studies are completed, these factors are likely to make robust meta-analyses problematic to perform.
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Affiliation(s)
- Susan L Prescott
- School of Paediatrics and Child Health Research, University of Western Australia, PO Box D184, Princess Margaret Hospital, Perth WA 6001, Australia.
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Serra M, Brazís P, Fondati A, Puigdemont A. Assessment of IgE binding to native and hydrolyzed soy protein in serum obtained from dogs with experimentally induced soy protein hypersensitivity. Am J Vet Res 2006; 67:1895-900. [PMID: 17078752 DOI: 10.2460/ajvr.67.11.1895] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess binding of IgE to native, whole hydrolyzed, and separated hydrolyzed fractions of soy protein in serum obtained from dogs with experimentally induced soy protein hypersensitivity. ANIMALS 8 naïve Beagles (6 experimentally sensitized to native soy protein and 2 control dogs). PROCEDURES 6 dogs were sensitized against soy protein by administration of allergens during a 90-day period. After the sensitization protocol was completed, serum concentrations of soy-specific IgE were measured and intradermal skin tests were performed in all 6 dogs to confirm that the dogs were sensitized against soy protein. Serum samples from each sensitized and control dog underwent western blot analysis to assess the molecular mass band pattern of the different allergenic soy fractions and evaluate reactivities to native and hydrolyzed soy protein. RESULTS In sera from sensitized dogs, a characteristic band pattern with 2 major bands (approx 75 and 50 kd) and 2 minor bands (approx 31 and 20 kd) was detected, whereas only a diffuse band pattern associated with whole hydrolyzed soy protein was detected in the most reactive dog. Reactivity was evident only for the higher molecular mass peptide fraction. In control dogs, no IgE reaction to native or hydrolyzed soy protein was detected. CONCLUSIONS AND CLINICAL RELEVANCE Data suggest that the binding of soy-specific IgE to the hydrolyzed soy protein used in the study was significantly reduced, compared with binding of soy-specific IgE to the native soy protein, in dogs with experimentally induced soy hypersensitivity.
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Abstract
Allergic reactions to foods are an important medical problem throughout the industrialized world. The occurrence of food allergy appears to be strongly influenced by genetics, but the basis of the genetic predisposition to food allergy has not been differentiated from that for atopy in general. In addition, genetic susceptibility alone does not explain the prevalence of food allergy satisfactorily, leaving ample room to consider the importance of environmental influences (external, maternal, and gastrointestinal environment) and interactions between the host and the environment. Several features of food allergy are highlighted in this review: 1) patients with severe food allergies are overwhelmingly atopic, but food allergy occurs only in approximately 10% of patients with other atopic diseases; 2) most patients are clinically reactive to a single food, and although a substantial minority have multiple food allergies, the variety of bone fide food allergies in a given individual is limited; 3) foods contain multiple proteins whereas only a small subset are allergenic; 4) there is likely an important contribution of the environment, becoming manifest in genetically susceptible individuals.
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Affiliation(s)
- Stephen C Dreskin
- Division of Allergy and Clinical Immunology, Department of Medicine, University of Colorado Health Sciences Center, Campus Box B164, 4200 E. Ninth Avenue, Denver, CO 80262, USA.
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Dreskin SC. Do HLA genes play a role in the genetics of peanut allergy? Ann Allergy Asthma Immunol 2006; 96:766-8. [PMID: 16802762 DOI: 10.1016/s1081-1206(10)61337-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Bibliography. Current world literature. Outcome measures. Curr Opin Allergy Clin Immunol 2006; 6:241-4. [PMID: 16670521 DOI: 10.1097/01.all.0000225167.72842.fd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
PURPOSE OF REVIEW The default response to protein antigens in the intestine is the induction of systemic and local hyporesponsiveness, ensuring the prevention of coeliac disease and food allergies. Interest is increasing in the role of dietary manipulation and probiotics in treating allergic and other diseases, but less is known about how these regimens might influence systemic and local immune responses. This paper addresses the mechanisms at the interface of innate and adaptive immunity that determine how the body responds to orally administered proteins and how local bacteria modify these. RECENT FINDINGS This paper discusses evidence that dendritic cells in the intestinal mucosa are the critical cells that take up dietary proteins and migrate to the draining mesenteric lymph node, where they induce regulatory CD4 T-cell differentiation. The properties of tolerized T cells are discussed and it is proposed that the gut microenvironment maintains homeostasis by conditioning dendritic cells to remain in a quiescent state. Inhibitory signalling by commensal bacteria possibly contributes to this process. SUMMARY A regulatory network controls how dietary antigens are taken up and presented to T lymphocytes by specialized antigen-presenting cells. Elucidating their nature and how they are influenced by external factors such as probiotics may help develop novel therapies for allergy and help understand diseases such as coeliac disease.
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Affiliation(s)
- Stephan Strobel
- Peninsula Postgraduate Health Institute, Peninsula Medical School, Plymouth, UK.
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Poole JA, Barriga K, Leung DYM, Hoffman M, Eisenbarth GS, Rewers M, Norris JM. Timing of initial exposure to cereal grains and the risk of wheat allergy. Pediatrics 2006; 117:2175-82. [PMID: 16740862 DOI: 10.1542/peds.2005-1803] [Citation(s) in RCA: 212] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Early exposure to solid foods in infancy has been associated with the development of allergy. The aim of this study was to examine the association between cereal-grain exposures (wheat, barley, rye, oats) in the infant diet and development of wheat allergy. METHODS A total of 1612 children were enrolled at birth and followed to the mean age of 4.7 years. Questionnaire data and dietary exposures were obtained at 3, 6, 9, 15, and 24 months and annually thereafter. The main outcome measure was parent report of wheat allergy. Children with celiac disease autoimmunity detected by tissue transglutaminase autoantibodies were excluded. Wheat-specific immunoglobulin E levels on children reported to have wheat allergy were obtained. RESULTS Sixteen children (1%) reported wheat allergy. Children who were first exposed to cereals after 6 months of age had an increased risk of wheat allergy compared with children first exposed to cereals before 6 months of age (after controlling for confounders including a family history of allergic disorders and history of food allergy before 6 months of age). All 4 children with detectable wheat-specific immunoglobulin E were first exposed to cereal grains after 6 months. A first-degree relative with asthma, eczema, or hives was also independently associated with an increased risk of wheat-allergy development. CONCLUSIONS Delaying initial exposure to cereal grains until after 6 months may increase the risk of developing wheat allergy. These results do not support delaying introduction of cereal grains for the protection of food allergy.
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Affiliation(s)
- Jill A Poole
- Division of Allergy and Clinical Immunology, Department of Medicine and Pediatrics, National Jewish Medical and Research Center, Denver, Colorado, USA.
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