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Zhang X, Chen H, Liu S, Wang X, Guo B, Liu J, Feng S, Liu F. Allergen Sensitization in Children in Weifang, China: Differences Between Monosensitization and Polysensitization. J Asthma Allergy 2023; 16:397-410. [PMID: 37081905 PMCID: PMC10112473 DOI: 10.2147/jaa.s405549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/03/2023] [Indexed: 04/22/2023] Open
Abstract
Background Children are the age group with the highest prevalence of allergy diseases. There is currently a lack of knowledge regarding monosensitization and polysensitization characteristics in children. In this study, we investigated the characteristics and differences between monosensitization and polysensitization in children in Weifang, eastern China. Objective To demonstrate the basic features of monosensitization and polysensitization in children. To explore the inherent and clinical parameter differences between monosensitized and polysensitized children. Material and Methods A total of 6030 individuals with a physician-determined need for allergy testing were tested for 15 common allergens, including 9 aeroallergens and 6 food allergens. A total of 938 allergen-positive children aged 1 month to 18 years were eventually included in this analysis. Complete blood count results from the same time as the allergen test were derived from the computerized medical records. Intrinsic features such as age, gender, sIgE, T-IgE, and clinical parameters such as eosinophil percentage, eosinophil count, basophil percentage, and basophil count were compared. Results The results showed that dust mite-related allergens, mould-related allergens, and tree and grass pollen-related allergens were the most prevalent allergens among monosensitized children. Additionally, the results of the combined pattern of polysensitive childhood allergens indicate the most common two allergens that were present together included dust mites and mould-related allergens, dust mite and Artemisia pollens, and dust mite and Humulus scandens pollens. Polysensitization can result in higher sIgE, T-IgE and eosinophil levels. Conclusion In conclusion, we provide a basic overview of allergens in monosensitized and polysensitized children. These findings provide new insight into the management of allergic diseases, particularly from the standpoint of polysensitization.
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Affiliation(s)
- Xiyan Zhang
- School of Clinical Medicine, Weifang Medical University, Weifang, People’s Republic of China
- Department of Allergy, Weifang People's Hospital, Weifang, People’s Republic of China
| | - Hui Chen
- School of Clinical Medicine, Weifang Medical University, Weifang, People’s Republic of China
| | - Shengnan Liu
- Department of Blood Transfusion, Affiliated Hospital of Weifang Medical University, Weifang, People’s Republic of China
| | - Xijuan Wang
- Department of Allergy, Weifang People's Hospital, Weifang, People’s Republic of China
| | - Beibei Guo
- Department of Allergy, Weifang People's Hospital, Weifang, People’s Republic of China
| | - Jingjing Liu
- Department of Allergy, Weifang People's Hospital, Weifang, People’s Republic of China
| | - Shaojie Feng
- Department of Allergy, Weifang People's Hospital, Weifang, People’s Republic of China
- Correspondence: Shaojie Feng; Fengxia Liu, Email ;
| | - Fengxia Liu
- Department of Allergy, Weifang People's Hospital, Weifang, People’s Republic of China
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Investigation of Basophil Activation Test for Diagnosing Milk and Egg Allergy in Younger Children. J Clin Med 2020; 9:jcm9123942. [PMID: 33291359 PMCID: PMC7762017 DOI: 10.3390/jcm9123942] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/26/2020] [Accepted: 12/03/2020] [Indexed: 01/28/2023] Open
Abstract
In children with concomitant food allergy and atopic dermatitis (AD), uncovering the causative food allergen is more arduous. We evaluated the basophil activation test (BAT) for its diagnostic value in children, including those with AD, for milk or egg allergy. We simultaneously measured serum-specific immunoglobulin E (sIgE) levels and performed BATs for cow’s milk and egg white. We compared their overall diagnostic performance using the area under the receiver operating characteristic curve (AUC) with the Delong method and compared them in children with AD. Analyses were completed for 75 children for milk allergy and for 85 children for egg allergy. The sIgE and percentage of basophils with the expression of CD63 were correlated for both milk (r = 0.384, p < 0.001) and egg (r = 0.557, p < 0.001). The AUC of sIgE (0.701) for milk allergy was significantly increased when combined with the BAT (0.805; p = 0.029). In children with AD, the AUC of the BAT (0.924) for milk allergy was significantly larger than that of sIgE (0.701; p = 0.017). The BAT is a potentially useful diagnostic tool for milk allergy in children when combined with sIgE. Moreover, it may be a surrogate marker for milk allergy in children with AD.
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Abstract
BACKGROUND Little is known about the impact of multimorbidity in childhood atopic dermatitis (AD). OBJECTIVE We sought to determine the likelihood and predictors of chronic disease multimorbidity in childhood AD. METHODS Data were examined for children (<18 years) in the 1996-2015 Medical Expenditure Panel Survey, an annual, representative sample of United States households. Multimorbidity was assessed using Charlson Comorbidity Index (CCI), Healthcare Utilization Project Chronic Comorbidity Indicator (HCUP-CCI) and frequency of atopic comorbidities. RESULTS Young children with mild-moderate and severe AD, and adolescents with mild-moderate AD had higher CCI scores. Similarly, young children and adolescents with mild-moderate and severe AD had increased HCUP-CCI scores. Children with AD and atopic disease had higher CCI and HCUP-CCI scores than children with either alone. Young children and adolescents with mild-moderate and severe AD had more atopic comorbidities. CONCLUSIONS Pediatric AD is associated with increased atopic and non-atopic multimorbidity. Comorbid atopic disease may identify a subset of children with AD who particularly benefit from enhanced screening and management of multimorbidity.
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Kahveci M, Koken G, Şahiner ÜM, Soyer Ö, Şekerel BE. Immunoglobulin E-Mediated Food Allergies Differ in East Mediterranean Children Aged 0-2 Years. Int Arch Allergy Immunol 2020; 181:365-374. [PMID: 32097952 DOI: 10.1159/000505996] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 01/17/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Precise diagnosis of allergy requires knowledge of the population's food allergy (FA) spectrum and predictors. METHODS Medical charts of Turkish children aged 0-2 years with FA and/or atopic dermatitis (AD) were reviewed. RESULTS A total of 1,389 patients, 912 with FA and 1,140 with AD, were included. In the FA group, the most frequently diagnosed FAs were egg white (75.9%), cow's milk (55.7%), tree nuts (31.5%) and sesame (20.6%). The detection of FA in 99% of children with any kind of FA necessitate testing with egg white, cow's milk, hazelnut, sesame, walnut, cashew, and pistachio. In the FA group, 72.7 and 56.8% had AD and multiple FA respectively. Multiple FA (56.8 vs. 49.8%) and hen's egg allergy (85.5 vs. 50.2%, p < 0.005) were more common and cow's milk allergy (51.4 vs. 67.1%, p < 0.005) less common in the AD subgroup of the FA group than in the non-AD subgroup. Multiple FA likelihood increases parallel to the severity of AD (p < 0.05). In the AD group, 58.2% had an immunoglobulin E-mediated FA. The risk of concomitant FA increased as the age at symptom onset of AD decreased (OR 0.800 [95% CI 0.731-0.875]; p < 0.001) and the severity of AD increased (OR 2.350 [95% CI 1.898-2.911]; p < 0.001). CONCLUSION Although severe and early-onset AD is a predictor of the presence and magnitude of FA in infancy, the spectrum of FA is a reflection of cultural characteristics. The clinical presentations of both AD and FA may in fact be an expression of the extent of the immune dysregulation underlying atopy and allergy.
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Affiliation(s)
- Melike Kahveci
- Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gizem Koken
- Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ümit Murat Şahiner
- Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Özge Soyer
- Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Bülent Enis Şekerel
- Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Turkey,
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Gonzales-González VA, Díaz AM, Fernández K, Rivera MF. Prevalence of food allergens sensitization and food allergies in a group of allergic Honduran children. Allergy Asthma Clin Immunol 2018; 14:23. [PMID: 29946340 PMCID: PMC6004676 DOI: 10.1186/s13223-018-0245-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 03/28/2018] [Indexed: 12/03/2022] Open
Abstract
Background Food allergy is a public health problem that has increased in the last decade. Despite the increasing rates in children, quality data on the burden of these diseases is lacking particularly in developing countries. Honduras has no studies in pediatric patients. Objectives The objective of this research was to identify the most common sensitization patterns to food through epicutaneous skin testing and food allergy rates in children and their correlation with common allergic diseases in a group of patients from Hospital of Pediatrics Maria. Methods Cross-sectional retrospective, descriptive study in which records and database of all allergic patients in the immunology outpatient clinic from Hospital of Pediatrics Maria were reviewed between the periods of January 2015 through June 2016. Results A total of 365 children were analyzed, the age of participants were in the range from 1 to 18 years, with an average of 9.8 years. Sensitization to food allergens were found in 23, and 58.3% were poly-sensitized. The most common food allergens that patients were sensitized to: milk 9.0%, eggs 6.9%, peanut 4.9% and pork meat 4.4%. Food allergy was confirmed via oral food challenged in 9.3% of the patients. The most frequent food allergies found were: cow’s milk allergy 6%, hen’s egg allergy 5.2% and wheat allergy 1.9%. Conclusions Milk and egg were the most common a food allergens found in the population studied. Most of the patients were found to be poly-sensitized. The frequent food allergies confirmed via oral food challenge were cow’s milk allergy, hen’s egg allergy and wheat allergy.
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Affiliation(s)
| | - Adolfo Martin Díaz
- Division of Pediatric Allergy and Immunology, Hospital María de Especialidades Pediátricas, Tegucigalpa, Francisco Morazán, Honduras
| | - Karla Fernández
- Division of Pediatric Allergy and Immunology, Hospital María de Especialidades Pediátricas, Tegucigalpa, Francisco Morazán, Honduras
| | - María Félix Rivera
- 3Division of Epidemiology, Facultad de Ciencias Medicas, Universidad Nacional Autonoma de Honduras, Tegucigalpa, Francisco Morazán, Honduras
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Thøstesen LM, Kjaer HF, Pihl GT, Nissen TN, Birk NM, Kjaergaard J, Jensen AKG, Aaby P, Olesen AW, Stensballe LG, Jeppesen DL, Benn CS, Kofoed PE. Neonatal BCG has no effect on allergic sensitization and suspected food allergy until 13 months. Pediatr Allergy Immunol 2017; 28:588-596. [PMID: 28660649 DOI: 10.1111/pai.12748] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/25/2017] [Indexed: 02/01/2023]
Abstract
BACKGROUND Vaccination with Bacillus Calmette-Guérin (BCG) is used in many countries as protection against tuberculosis. Studies have suggested that BCG may also have non-specific effects, reducing non-tuberculosis mortality, morbidity, and atopic manifestations. In this study, we evaluated the effect of neonatal BCG vaccination on allergic sensitization and suspected food allergy at 13 months of age. METHODS The Danish Calmette Study was conducted from 2012 to 2015 at three Danish hospitals. Within 7 days of birth, the 4262 newborns of 4184 included mothers were randomized 1:1 to BCG or to a no-intervention control group. Exclusion criteria were gestational age <32 weeks, birth weight <1000 g, known immunodeficiency, or no Danish-speaking parent. Follow-up information was collected through telephone interviews at 3 and 13 months of age. Subgroups of participants were offered blood sampling at 13 months of age. RESULTS By 13 months of age, the parents and/or general practitioners of 5.6% (117/2089) of the children in the BCG group and 6.1% (126/2061) of the control group suspected food allergy, resulting in a risk ratio comparing BCG-vaccinated children with control children of 0.91 (95% CI 0.71-1.16). Among 1370 blood samples, sensitization (Phadiatop Infant >0.35 kUA/L) was found in 55 of 743 (7.4%) children in the BCG group and 50 of 627 (8.0%) of the control group (risk ratio 0.94 [0.65-1.36]). CONCLUSION In this randomized clinical trial, neonatal BCG had no significant effect on suspected food allergy or on sensitization at 13 months of age.
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Affiliation(s)
- Lisbeth Marianne Thøstesen
- Department of Pediatrics, Kolding Hospital, Kolding, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Henrik Fomsgaard Kjaer
- Allergy Centre and Department of Dermatology, Odense University Hospital, Odense C, Denmark
| | - Gitte Thybo Pihl
- Department of Pediatrics, Kolding Hospital, Kolding, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | | | - Nina Marie Birk
- Department of Pediatrics, 460, Copenhagen University Hospital, Hvidovre, Denmark
| | - Jesper Kjaergaard
- Research Unit Women's and Childrens' Health, The Department of Pediatrics and Adolescent Medicine, Juliane Marie Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen Ø, Denmark
| | - Aksel Karl Georg Jensen
- Research Centre for Vitamins and Vaccines (CVIVA), Bandim Health Project, Statens Serum Institut, Copenhagen S, Denmark.,Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Peter Aaby
- Bandim Health Project, Statens Serum Institut, Copenhagen S, Denmark
| | - Annette Wind Olesen
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense C, Denmark
| | - Lone Graff Stensballe
- The Department of Pediatrics and Adolescent Medicine, Juliane Marie Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen Ø, Denmark
| | | | - Christine Stabell Benn
- Research Centre for Vitamins and Vaccines (CVIVA), Statens Serum Institut, Copenhagen S, Denmark.,OPEN, Institute of Clinical Research, University of Southern Denmark/Odense University Hospital, Odense, Denmark
| | - Poul-Erik Kofoed
- Department of Pediatrics, Kolding Hospital, Kolding, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.,OPEN, Institute of Clinical Research, University of Southern Denmark/Odense University Hospital, Odense, Denmark
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