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Yamamoto-Hanada K, Ohya Y. Management of Infant Atopic Eczema to Prevent Severe Eczema and Food Allergy. Clin Exp Allergy 2024. [PMID: 38866599 DOI: 10.1111/cea.14515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 06/14/2024]
Abstract
Early intervention and active management of infant atopic eczema may play a crucial role in limiting eczema severity and preventing the onset of immediate-type food allergy. Eczema management involves education, skincare and medications targeting skin inflammation and barrier repair. Topical corticosteroids are the mainstay of anti-inflammatory therapy, with nonsteroidal options available for some infants. Proactive therapy, addressing subclinical inflammation, is useful for preventing eczema flares, especially in infants with recurrent eczema flares despite reactive therapy. In clinical practice, holistic consideration of overall infant and family health is essential. Providing advice on maternal stress management, nutritional guidance and recommendations for proper sleep and lifestyle is crucial for the well-being of children and their families, not limited to eczema treatment alone.
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Affiliation(s)
| | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
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Johnson H, Rao M, Yu J. Improved or not improved, that is the question: Patch testing outcomes from the Massachusetts General Hospital. Contact Dermatitis 2024; 90:324-327. [PMID: 38123166 DOI: 10.1111/cod.14483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/30/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Hadley Johnson
- University of Minnesota Medical School, Minneapolis, Minnesota, USA
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Medha Rao
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Cheng IH, Yii CY, Yong SB. Growth outcomes and food allergies in children: Study limitations. Ann Allergy Asthma Immunol 2024; 132:403. [PMID: 38432786 DOI: 10.1016/j.anai.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 03/05/2024]
Affiliation(s)
- I-Han Cheng
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
| | - Chin-Yuan Yii
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Landseed International Hospital, Taoyuan, Taiwan; Department of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan.
| | - Su-Boon Yong
- Center for Allergy, Immunology, and Microbiome (AIM.), China Medical University Hospital, Taichung, Taiwan; Department of Allergy, Immunology, and Rheumatology (AIR), China Medical University Children's Hospital, Taichung, Taiwan; Department of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
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4
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Mansur AH, Marsh J, Bahron A, Thomas M, Walters G, Busby J, Heaney LG, Krishna MT. Difficult-to-treat asthma patients from ethnic minority groups in central England are at an enhanced risk of house dust mite sensitisation. Clin Transl Allergy 2023; 13:e12303. [PMID: 37876034 PMCID: PMC10560749 DOI: 10.1002/clt2.12303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 08/15/2023] [Accepted: 09/13/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND House dust mite (HDM) is the most common sensitising allergen in asthma. Ethnic minority groups (EMGs) in the UK are more likely to live in deprived conditionings with a greater exposure to HDM and other aero-allergens. AIM To compare the ethnicity-based patterns of sensitisation to aero-allergens and the impact of ethnicity on clinical outcomes in patients with difficult-to-treat asthma (DTA). METHODS Data of patients with DTA were extracted from the registry of the Birmingham Regional Severe Asthma Service (BRSAS), which have a catchment population of 7.3million from Central England. Patients from White and EMG backgrounds were compared in terms of the prevalence of atopy, total serum immunoglobulin E (IgE), specific serum IgE (ssIgE) and asthma related clinical outcomes. Logistic regression analysis was conducted to explore ethnicity-based risk factors for HDM sensitisation. RESULTS A total of 1272 patients [White 1016 (79.9%), EMG 256 (20.1%) EMG] with a median age of 51 years (range 16-97) were included in the analysis. Patients from EMG were more likely (64%) to reside in the worst scale of index of multiple deprivation (IMD) than the White patients (25.5%), p < 0.0001. Positive HDM sensitisation was more prevalent in the EMG than in the White group [142/216 (66%) versus 375/842 (45%), p < 0.0001]. The median HDM ssIgE level was higher in the EMG than in the White group [3.0 KUA/L (IQR 0.06, 11.5) versus 0.1 (0.01, 3.0), p < 0.000001]. The odds ratio for positive sensitisation to HDM conveyed by the EMG status was 2.61 (95%CI, 1.8-3.8), p < 0.0001. Compared to the White group, the EMG had higher median total serum IgE [326 KU/L (115, 971) versus 114 (29.8, 434.8), p < 0.000001], higher blood eosinophil count (0.36 × 109 (0.18, 0.62) versus 0.23 (0.1,0.47), p < 0.000001), were marginally more atopic (79.2% vs. 75.6%, p = 0.098) and were less likely to being on maintenance oral corticosteroids (22% vs. 39.7%, p < 0.0001). CONCLUSION In this DTA cohort, positive HDM sensitisation was greater amongst the EMG than the White patients. The EMG status was a significant risk factor for HDM sensitisation.
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Affiliation(s)
- Adel H. Mansur
- Birmingham Regional Severe Asthma ServiceBirmingham Heartland HospitalUniversity Hospitals Birmingham NHS Foundation TrustBirminghamUK
- Institute of Inflammation and AgeingUniversity of BirminghamBirminghamUK
| | - Julie Marsh
- Birmingham Regional Severe Asthma ServiceBirmingham Heartland HospitalUniversity Hospitals Birmingham NHS Foundation TrustBirminghamUK
| | - Ali Bahron
- Birmingham Regional Severe Asthma ServiceBirmingham Heartland HospitalUniversity Hospitals Birmingham NHS Foundation TrustBirminghamUK
| | - Maximillian Thomas
- Birmingham Regional Severe Asthma ServiceBirmingham Heartland HospitalUniversity Hospitals Birmingham NHS Foundation TrustBirminghamUK
| | - Gareth Walters
- Birmingham Regional Severe Asthma ServiceBirmingham Heartland HospitalUniversity Hospitals Birmingham NHS Foundation TrustBirminghamUK
| | - John Busby
- Centre for Public HealthSchool of MedicineDentistry and Biomedical SciencesQueens University BelfastBelfastUK
| | - Liam G. Heaney
- Wellcome‐Wolfson Centre for Experimental MedicineSchool of MedicineDentistry and Biomedical SciencesQueen's University BelfastBelfastUK
| | - Mamidipudi Thirumala Krishna
- Institute of Immunology and ImmunotherapyUniversity of Birminghamand University Hospitals Birmingham NHS Foundation TrustBirminghamUK
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Pedersen ES, Kuehni CE. Heat-related hospitalisations for asthma - challenges for research. Thorax 2023; 78:850-851. [PMID: 37380356 DOI: 10.1136/thorax-2023-220326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 06/30/2023]
Affiliation(s)
- Eva Sl Pedersen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Lunjani N, Akdis CA, O'Mahony L. Importance of examining atopic dermatitis disease mechanisms in African populations. Allergy 2023; 78:329-330. [PMID: 36576006 DOI: 10.1111/all.15559] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/11/2022] [Accepted: 10/19/2022] [Indexed: 12/29/2022]
Affiliation(s)
- Nonhlanhla Lunjani
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,University of Cape Town, Cape Town, South Africa
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.,Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland
| | - Liam O'Mahony
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland.,School of Microbiology, University College Cork, Cork, Ireland
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Cafarotti A, Giovannini M, Begìn P, Brough HA, Arasi S. Management of IgE-mediated food allergy in the 21st century. Clin Exp Allergy 2023; 53:25-38. [PMID: 36200952 PMCID: PMC10092460 DOI: 10.1111/cea.14241] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/15/2022] [Accepted: 09/26/2022] [Indexed: 01/24/2023]
Abstract
The 21st century has seen the propulsion of research in the field of food allergy, which has driven real changes in the clinical approach. Allergen immunotherapy has been recommended for the active management of food allergy. Data have shown promising additional methods of treatment, including biologics. Efforts have been devoted to the risk stratification of food allergy and the standardization of the assessment of food-allergic severity. Alternative routes of administration of epinephrine are under investigation to minimize any mechanical issue and the fear of injections. Evidence-based guidelines have been published by the main international societies in the field of anaphylaxis and food allergy management and new updates are in preparation. In the coming years, treatment options that are currently in pre-clinical or early clinical evaluation will hopefully lead to safe and effective disease-modifying therapies for food allergy in clinical practice. The identification of reliable biomarkers and the standardization of definitions and measurement approaches, alongside a shared decision-making with patients and families, will be key for the development of personalized care and to help minimize the substantial burden of food allergy.
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Affiliation(s)
- Arianna Cafarotti
- Allergy Unit - Area of Translational Research in Pediatric Specialities, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Mattia Giovannini
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Philippe Begìn
- Allergy, Immunology and Rheumatology Division, Department of Pediatrics, CHU Sainte-Justine, Montreal, Quebec, Canada.,Allergy and Clinical Immunology Division, Department of Medicine, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Helen A Brough
- Children's Allergy Service, Evelina Children's Hospital, Guy's and St. Thomas' NHS Foundation Hospital, London, UK.,Paediatric Allergy Group, Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Stefania Arasi
- Allergy Unit - Area of Translational Research in Pediatric Specialities, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Social inequalities in multimorbidity patterns in Europe: A multilevel latent class analysis using the European Social Survey (ESS). SSM Popul Health 2022; 20:101268. [DOI: 10.1016/j.ssmph.2022.101268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/16/2022] [Accepted: 10/11/2022] [Indexed: 11/07/2022] Open
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Shah M, Alsabri M, Al-Qadasi F, Malik S, McClean C, Ahmad K, Springer C, Viswanathan K, Kupferman FE. Asthma Outcome Measures Before and After the COVID-19 Outbreak Among the Pediatric Population in a Community Hospital. Cureus 2022; 14:e25621. [PMID: 35795497 PMCID: PMC9250694 DOI: 10.7759/cureus.25621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2022] [Indexed: 12/03/2022] Open
Abstract
Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is a global health threat that has affected patient care enormously. Moderate to severe asthma was listed as a risk factor for severe SARS-CoV-2 disease by the Centers for Disease Control. Little is known about the impact of the pandemic on asthma control in children, particularly African American children. Objective The present study sought to determine how changes during the coronavirus disease 2019 (COVID-19) pandemic affected asthma metrics in a majority African American pediatric population at a pediatric pulmonology clinic in a community hospital in New York. Methods This is a retrospective, pre-post, comparative cross-sectional study that included children three to 18 years of age with a known diagnosis of asthma followed in a pulmonary clinic. Data were gathered from electronic medical records. Subjects were selected if they presented to a pulmonology clinic within a certain time window both before and after the outbreak of the COVID-19 pandemic. Outcome variables included asthma medication statistics and healthcare utilization statistics. Results Inclusion criteria were met by 104 pediatric patients. The majority were African American. Emergency department visits, primary physician visits, and hospitalizations significantly decreased in the post-COVID study group compared to the pre-COVID control group. Conclusion Among a majority African American pediatric population, there were significant improvements in asthma outcomes after COVID-19 societal changes when compared to before COVID-19 based on outcome variables.
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