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Kallen EJJ, Revers A, Fernández-Rivas M, Asero R, Ballmer-Weber B, Barreales L, Belohlavkova S, de Blay F, Clausen M, Dubakiene R, Ebisawa M, Fernández-Perez C, Fritsche P, Fukutomi Y, Gislason D, Hoffmann-Sommergruber K, Jedrzejczak-Czechowicz M, Knulst AC, Kowalski ML, Kralimarkova T, Lidholm J, Metzler C, Mills ENC, Papadopoulos NG, Popov TA, Purohit A, Reig I, Seneviratne SL, Sinaniotis A, Takei M, Versteeg SA, Vassilopoulou AE, Vieths S, Welsing PMJ, Zwinderman AH, Le TM, Van Ree R. A European-Japanese study on peach allergy: IgE to Pru p 7 associates with severity. Allergy 2023; 78:2497-2509. [PMID: 37334557 DOI: 10.1111/all.15783] [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: 01/23/2023] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Pru p 3 and Pru p 7 have been implicated as risk factors for severe peach allergy. This study aimed to establish sensitization patterns to five peach components across Europe and in Japan, to explore their relation to pollen and foods and to predict symptom severity. METHODS In twelve European (EuroPrevall project) and one Japanese outpatient clinic, a standardized clinical evaluation was conducted in 1231 patients who reported symptoms to peach and/or were sensitized to peach. Specific IgE against Pru p 1, 2, 3, 4 and 7 and against Cup s 7 was measured in 474 of them. Univariable and multivariable Lasso regression was applied to identify combinations of parameters predicting severity. RESULTS Sensitization to Pru p 3 dominated in Southern Europe but was also quite common in Northern and Central Europe. Sensitization to Pru p 7 was low and variable in the European centers but very dominant in Japan. Severity could be predicted by a model combining age of onset of peach allergy, probable mugwort, Parietaria pollen and latex allergy, and sensitization to Japanese cedar pollen, Pru p 4 and Pru p 7 which resulted in an AUC of 0.73 (95% CI 0.73-0.74). Pru p 3 tended to be a risk factor in South Europe only. CONCLUSIONS Pru p 7 was confirmed as a significant risk factor for severe peach allergy in Europe and Japan. Combining outcomes from clinical and demographic background with serology resulted in a model that could better predict severity than CRD alone.
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Affiliation(s)
- E J J Kallen
- Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - A Revers
- Epidemiology and Data Science (EDS), Amsterdam University Medical Center location University of Amsterdam, Amsterdam, The Netherlands
| | - M Fernández-Rivas
- Department of Allergy, Hospital Clinico San Carlos, Universidad Complutense, IdISSC, ARADyAL, Madrid, Spain
| | - R Asero
- Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy
| | - B Ballmer-Weber
- Allergy Unit, Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland
- Faculty of Medicine, University of Zürich, Zürich, Switzerland
- Clinic for Dermatology and Allergology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - L Barreales
- Department of Allergy, Hospital Clinico San Carlos, Universidad Complutense, IdISSC, ARADyAL, Madrid, Spain
| | - S Belohlavkova
- Medical Faculty Pilsen, Charles University Prague, Prague, Czech Republic
| | - F de Blay
- Allergy Division, Chest Disease Department, Strasbourg University Hospital, Strasbourg, France
| | - M Clausen
- Landspitali University Hospital, University of Iceland, Faculty of Medicine, Reykjavik, Iceland
| | - R Dubakiene
- Clinic of Chest diseases, Allergology and Immunology Institute of Clinic al Medicine Medical Faculty Vilnius University, Vilnius, Lithuania
| | - M Ebisawa
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Kanagawa, Japan
| | - C Fernández-Perez
- Servicio de Medicina Preventiva, Area De Santiago de Compostela y Barbanza, Instituto de Investigación Sanitaria de Santiago (IDIS) A Coruña, Santiago, Spain
| | - P Fritsche
- Allergy Unit, Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland
| | - Y Fukutomi
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Kanagawa, Japan
| | - D Gislason
- Landspitali University Hospital, University of Iceland, Faculty of Medicine, Reykjavik, Iceland
| | - K Hoffmann-Sommergruber
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - M Jedrzejczak-Czechowicz
- Department of Immunology and Allergy, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - A C Knulst
- Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - M L Kowalski
- Department of Immunology and Allergy, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - T Kralimarkova
- Clinic of Occupational Diseases, University Hospital Sv. Ivan Rilski, Sofia, Bulgaria
| | - J Lidholm
- Thermo Fisher Scientific, Uppsala, Sweden
| | - C Metzler
- Allergy Unit, Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland
| | - E N C Mills
- Division of Infection, Immunity and Respiratory Medicine, Manchester Institute of Biotechnology & Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
| | - N G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | - T A Popov
- Clinic of Occupational Diseases, University Hospital Sv. Ivan Rilski, Sofia, Bulgaria
| | - A Purohit
- Allergy Division, Chest Disease Department, Strasbourg University Hospital, Strasbourg, France
| | - I Reig
- Allergist and Pediatrician, Nápoles y Sicilia Health Center, Valencia, Spain
| | - S L Seneviratne
- Institute of Immunity and Transplantation, University College London, London, UK
| | - A Sinaniotis
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | - M Takei
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Kanagawa, Japan
| | - S A Versteeg
- Department of Experimental Immunology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - A E Vassilopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - S Vieths
- Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany
| | - P M J Welsing
- Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - A H Zwinderman
- Epidemiology and Data Science (EDS), Amsterdam University Medical Center location University of Amsterdam, Amsterdam, The Netherlands
| | - T M Le
- Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - R Van Ree
- Departments of Experimental Immunology and of Otorhinolaryngology, Amsterdam University Medical Center, Amsterdam, The Netherlands
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Mahesh PA, Kaleem Ullah M, Parthasarathi A. Allergic sensitization to foods in India and other Low-Middle-income countries. Clin Exp Allergy 2023. [PMID: 36825760 DOI: 10.1111/cea.14300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 01/06/2023] [Accepted: 02/05/2023] [Indexed: 02/25/2023]
Abstract
Food allergy is an important cause of morbidity, significantly affecting the quality of life of the sufferer. Most food allergy research has been undertaken in high-income countries. Here, we summarize literature regarding food allergy in India and other low-middle-income countries (LMIC). We provide summaries of self-reported adverse food reactions and food sensitization in these regions by reviewing published community-based studies of prevalence, burden, and risk factors. We identified 2 community-based studies of food allergy prevalence in Karnataka, India, which estimate that food allergy affects just 0.14% of children and 1.2% of adults. The overall prevalence of allergic sensitization to 'any' food was 26.5% in adults and 19.1% in children by serum-specific IgE; but only 4.48% in children by skin prick test. We identified a further 28 studies in other LMICs, mainly from China but also Turkey, South Africa, Ghana, Mexico, Brazil, Thailand, Philippines, and Korea. The overall prevalence of allergic sensitization to 'any' food ranged from 0.11% to 16.8% in children using serum-specific IgE and 0.14% to 9.6% in children by skin prick test. The questionnaires and skin prick testing materials used and number of allergens tested varied significantly between studies. Other than Karnataka, there is no information on prevalence of food sensitization and probable food allergy in the community in India. Similar lack of information is noted among the majority of the 136 LMICs. Where community-based studies have been undertaken, there is wide variation in the prevalence and patterns of food sensitization across different LMICs, at least partly due to variations in study methodology. International collaboration is required in order to formally assess food allergy prevalence and burden across representative samples from multiple LMICs.
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Affiliation(s)
- Padukudru Anand Mahesh
- Department of Respiratory Medicine, Special Interest Group, Environment and Respiratory Diseases, JSS Medical College, JSSAHER, Mysore, Karnataka, India
| | - Mohammed Kaleem Ullah
- Centre for Excellence in Molecular Biology and Regenerative Medicine (A DST-FIST Supported Center), Department of Biochemistry (A DST-FIST Supported Department), JSS Medical College, JSSAHER, Karnataka, Mysore, India.,Division of Infectious Disease and Vaccinology, School of Public Health, University of California, Berkeley, California, USA
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3
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Wang J, Zhang L, Shi J, Vanga SK, Raghavan V. Effect of microwave processing on the nutritional properties and allergenic potential of kiwifruit. Food Chem 2023; 401:134189. [DOI: 10.1016/j.foodchem.2022.134189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 09/04/2022] [Accepted: 09/07/2022] [Indexed: 10/14/2022]
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4
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Wang J, Zhang L, Dong X, Wang J, Raghavan V. Effects of variety, maturity and storage conditions on the allergic potential of kiwifruit and its relationship with antioxidant activity. Food Chem X 2022; 16:100467. [PMID: 36263246 PMCID: PMC9574761 DOI: 10.1016/j.fochx.2022.100467] [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: 12/28/2021] [Revised: 09/01/2022] [Accepted: 10/08/2022] [Indexed: 11/06/2022] Open
Abstract
Allergenicity of kiwifruit strongly associated with its physiological attributes. 10-day storage of kiwifruit at 20 °C increased the Act d 2 content by 50 %. Act d 2 content in the seeds was 4-fold higher than that of peel. Act d 2 content showed a negative relationship with antioxidant activity.
This work aimed to study the influences of physiological characteristics (variety, maturity, and fruit components) and storage conditions on the allergenic potential of kiwifruit. The results found kiwifruit allergen (Act d 2) is only measured in the green kiwifruit rather than golden kiwifruit. The Act d 2 content of seed is 2-fold and 4-fold higher than that of pulp and peel, respectively. The highest Act d 2 allergen content was determined in ripe kiwifruit, followed by overripe fruit and unripe fruit. A 50 % of enhancement in Act d 2 content was observed after 10-day storage at 20 °C. Further, the Act d 2 content showed a negative relationship with the ascorbic acid content and total antioxidant activity at various conditions. Thus, antioxidants as important factors may involve the regulation of Act d 2 in kiwifruit. These findings could provide a deep understanding in the distribution of Act d 2.
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Affiliation(s)
- Jin Wang
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China
- Corresponding authors at: Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China (J. Wang).
| | - Lili Zhang
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China
| | - Xin Dong
- Department of Bioresource Engineering, Faculty of Agricultural and Environmental Sciences, McGill University, Sainte-Anne-de-Bellevue, QC H9X3V9, Canada
| | - Jun Wang
- College of Food Science and Engineering, Northwest A&F University, Yangling 712100, China
- Corresponding authors at: Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China (J. Wang).
| | - Vijaya Raghavan
- Department of Bioresource Engineering, Faculty of Agricultural and Environmental Sciences, McGill University, Sainte-Anne-de-Bellevue, QC H9X3V9, Canada
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5
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Development of an immunomagnetic nanoparticle-based lateral flow assay for detecting major kiwi allergen Act d1 in processed foods. Eur Food Res Technol 2022. [DOI: 10.1007/s00217-022-03988-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
Nuts are considered healthy foods due to their high content of nutritional compounds with functional properties. However, the list of the most allergenic foods includes tree nuts, and their presence must be indicated on food labels. Most nut allergens are seed storage proteins, pathogenesis-related (PR) proteins, profilins and lipid transfer proteins (LTP). Nut allergenic proteins are characterized by their resistance to denaturation and proteolysis. Food processing has been proposed as the method of choice to alter the allergenicity of foods to ensure their safety and improve their organoleptic properties. The effect of processing on allergenicity is variable by abolishing existing epitopes or generating neoallergens. The alterations depend on the intrinsic characteristics of the protein and the type and duration of treatment. Many studies have evaluated the molecular changes induced by processes such as thermal, pressure or enzymatic treatments. As some processing treatments have been shown to decrease the allergenicity of certain foods, food processing may play an important role in developing hypoallergenic foods and using them for food tolerance induction. This work provides an updated overview of the applications and influence of several processing techniques (thermal, pressure and enzymatic digestion) on nut allergenicity for nuts, namely, hazelnuts, cashews, pistachios, almonds and walnuts.
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7
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Abstract
PURPOSE OF REVIEW Food allergy remains a disease of global public health significance well known to impact social, emotional, and financial well being. This review aims to summarize the existing literature focused on the direct, indirect, and intangible costs of food allergy at the household and healthcare system levels, and begin to discuss how emerging treatment and prevention strategies may be leveraged to comprehensively care for the food allergic population with the efficient use of health resources. RECENT FINDINGS Food allergy imposes significant costs to multiple stakeholders and largely impact families at the household level. Recent studies elucidate the need to balance the household management of food allergy with the efficient use of health resources. Overall, it remains critical that safe foods and medications remain affordable while further exploring the cost-effectiveness of early introduction, emerging food allergy therapies, and the wider use of stock epinephrine to adequately meet the public health needs of the food-allergic community. SUMMARY Better understanding how the cost of food allergy impacts populations will help to inform more progressive policies aimed at lessening socioeconomic disparities and ultimately improve quality of life for children and adults with food allergies.
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8
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Cox AL, Eigenmann PA, Sicherer SH. Clinical Relevance of Cross-Reactivity in Food Allergy. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2021; 9:82-99. [PMID: 33429724 DOI: 10.1016/j.jaip.2020.09.030] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/23/2020] [Accepted: 09/23/2020] [Indexed: 02/07/2023]
Abstract
The diagnosis and management of food allergy is complicated by an abundance of homologous, cross-reactive proteins in edible foods and aeroallergens. This results in patients having allergic sensitization (positive tests) to many biologically related foods. However, many are sensitized to foods without exhibiting clinical reactivity. Although molecular diagnostics have improved our ability to identify clinically relevant cross-reactivity, the optimal approach to patients requires an understanding of the epidemiology of clinically relevant cross-reactivity, as well as the food-specific (degree of homology, protein stability, abundance) and patient-specific factors (immune response, augmentation factors) that determine clinical relevance. Examples of food families with high rates of cross-reactivity include mammalian milks, eggs, fish, and shellfish. Low rates are noted for grains (wheat, barley, rye), and rates of cross-reactivity are variable for most other foods. This review discusses clinically relevant cross-reactivity related to the aforementioned food groups as well as seeds, legumes (including peanut, soy, chickpea, lentil, and others), tree nuts, meats, fruits and vegetables (including the lipid transfer protein syndrome), and latex. The complicating factor of addressing co-allergy, for example, the risks of allergy to both peanut and tree nuts among atopic patients, is also discussed. Considerations for an approach to individual patient care are highlighted.
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Affiliation(s)
- Amanda L Cox
- Division of Allergy and Immunology, Department of Pediatrics, Elliot and Roslyn Jaffe Food Allergy Institute, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Philippe A Eigenmann
- The Department of Pediatrics Gynecology and Obstetrics, Medical School of the University of Geneva, University Hospitals of Geneva, Geneva, Switzerland
| | - Scott H Sicherer
- Division of Allergy and Immunology, Department of Pediatrics, Elliot and Roslyn Jaffe Food Allergy Institute, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY
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9
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Middelveld R, Gunnarsson NV, Ahlstedt S, Protudjer JLP. Associations between food allergy and perceived life status. Ann Allergy Asthma Immunol 2020; 125:703-705.e1. [PMID: 32717299 DOI: 10.1016/j.anai.2020.07.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 07/13/2020] [Accepted: 07/21/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Roelinde Middelveld
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Nina V Gunnarsson
- Department of Social Work, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Staffan Ahlstedt
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jennifer Lisa Penner Protudjer
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada; George and Fay Yee Centre for Healthcare Innovation, Winnipeg, Canada; The Children's Hospital Research Institute of Manitoba, Winnipeg, Canada; Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, Canada; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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10
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Vicente F, Sanchiz A, Rodríguez-Pérez R, Pedrosa M, Quirce S, Haddad J, Besombes C, Linacero R, Allaf K, Cuadrado C. Influence of Instant Controlled Pressure Drop (DIC) on Allergenic Potential of Tree Nuts. Molecules 2020; 25:molecules25071742. [PMID: 32290123 PMCID: PMC7180768 DOI: 10.3390/molecules25071742] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/01/2020] [Accepted: 04/09/2020] [Indexed: 01/12/2023] Open
Abstract
Pistachio and cashew contain allergenic proteins, which causes them to be removed from the diet of allergic people. Previous studies have demonstrated that food processing (thermal and non-thermal) can produce structural and/or conformational changes in proteins by altering their allergenic capacity. In this study, the influence of instant controlled pressure drop (DIC) on pistachio and cashew allergenic capacity has been studied. Western blot was carried out using IgG anti-11S and anti-2S and IgE antibodies from sera of patients sensitized to pistachio and cashew. DIC processing causes changes in the electrophoretic pattern, reducing the number and intensity of protein bands, as the pressure and temperature treatment increment, which results in a remarkable decrease in detection of potentially allergenic proteins. The harshest conditions of DIC (7 bar, 120 s) markedly reduce the immunodetection of allergenic proteins, not only by using IgG (anti 11S and anti 2S) but also when IgE sera from sensitized patients were used for Western blots. Such immunodetection is more affected in pistachio than in cashew nuts, but is not completely removed. Therefore, cashew proteins are possibly more resistant than pistachio proteins. According these findings, instant controlled pressure drop (DIC) can be considered a suitable technique in order to obtain hypoallergenic tree nut flour to be used in the food industry.
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Affiliation(s)
- Fatima Vicente
- Food Technology DepartmentSGIT-INIA, Ctra. La Coruña Km. 7.5, 28040 Madrid, Spain; (F.V.); (A.S.)
| | - Africa Sanchiz
- Food Technology DepartmentSGIT-INIA, Ctra. La Coruña Km. 7.5, 28040 Madrid, Spain; (F.V.); (A.S.)
| | - Rosa Rodríguez-Pérez
- Allergy Service, University Hospital La Paz, IdiPAZ, 28046 Madrid, Spain; (R.R.-P.); (M.P.); (S.Q.)
| | - Maria Pedrosa
- Allergy Service, University Hospital La Paz, IdiPAZ, 28046 Madrid, Spain; (R.R.-P.); (M.P.); (S.Q.)
| | - Santiago Quirce
- Allergy Service, University Hospital La Paz, IdiPAZ, 28046 Madrid, Spain; (R.R.-P.); (M.P.); (S.Q.)
| | - Joseph Haddad
- Laboratory Engineering Science for Environment (UMR 7356 CNRS), La Rochelle University, venue Michel Crepeau, 17042 La Rochelle, France; (J.H.); (C.B.); (K.A.)
| | - Colette Besombes
- Laboratory Engineering Science for Environment (UMR 7356 CNRS), La Rochelle University, venue Michel Crepeau, 17042 La Rochelle, France; (J.H.); (C.B.); (K.A.)
| | - Rosario Linacero
- Genetics, Physiology and Microbiology Department, Biology Faculty, Complutense University, 28040 Madrid, Spain, 28040 Madrid, Spain;
| | - Karim Allaf
- Laboratory Engineering Science for Environment (UMR 7356 CNRS), La Rochelle University, venue Michel Crepeau, 17042 La Rochelle, France; (J.H.); (C.B.); (K.A.)
| | - Carmen Cuadrado
- Food Technology DepartmentSGIT-INIA, Ctra. La Coruña Km. 7.5, 28040 Madrid, Spain; (F.V.); (A.S.)
- Correspondence: ; Tel.: +34-91-347-6925
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Immunoglobulin E (IgE)-Mediated Food Allergy in Children: Epidemiology, Pathogenesis, Diagnosis, Prevention, and Management. ACTA ACUST UNITED AC 2020; 56:medicina56030111. [PMID: 32143431 PMCID: PMC7142605 DOI: 10.3390/medicina56030111] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 02/25/2020] [Accepted: 02/28/2020] [Indexed: 12/13/2022]
Abstract
A food allergy is an immunoglobulin E (IgE)-mediated hypersensitive reaction to food, which consists in the appearance of allergic symptoms; it can vary from common urticaria to even fatal anaphylaxis. The prevalence of food allergies has been increasing in the past twenty years and it represents a major public health problem in industrialized countries. The mechanism that leads to food allergies is the lack of immunologic and clinical tolerance to food allergens. The diagnosis of IgE-mediated food allergies is based on the combined use of a detailed medical history, in-vivo, and in-vitro research of specific IgE, the elimination diet, and the double-blind placebo-controlled food challenge. The only currently available treatment for allergies is the strict elimination diet. This type of attitude, which we could define as “passive”, does not overcome the risk of accidental reactions due to involuntary intake of the culprit food. For food allergy management, an “active” approach is urgently needed, such as specific allergen immunotherapy, which is currently under development and only used for research purposes. This article aims to give an updated review of IgE-mediated food allergies in pediatric populations in terms of epidemiology, pathogenesis, prevention, diagnosis, and management.
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12
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Wang J, Vanga SK, Raghavan V. Structural responses of kiwifruit allergen Act d 2 to thermal and electric field stresses based on molecular dynamics simulations and experiments. Food Funct 2020; 11:1373-1384. [DOI: 10.1039/c9fo02427a] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Kiwifruit is considered to be the most common plant-based food causing allergic reactions, after peanuts, soybeans, and wheat.
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Affiliation(s)
- Jin Wang
- Department of Bioresource Engineering
- Faculty of Agricultural and Environmental Sciences
- McGill University
- Quebec
- Canada
| | - Sai Kranthi Vanga
- Department of Bioresource Engineering
- Faculty of Agricultural and Environmental Sciences
- McGill University
- Quebec
- Canada
| | - Vijaya Raghavan
- Department of Bioresource Engineering
- Faculty of Agricultural and Environmental Sciences
- McGill University
- Quebec
- Canada
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13
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14
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Li J, Ogorodova LM, Mahesh PA, Wang MH, Fedorova OS, Leung TF, Fernandez-Rivas M, Mills ENC, Potts J, Kummeling I, Versteeg SA, van Ree R, Yazdanbakhsh M, Burney PGJ, Wong GWK. Comparative Study of Food Allergies in Children from China, India, and Russia: The EuroPrevall-INCO Surveys. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 8:1349-1358.e16. [PMID: 31857266 DOI: 10.1016/j.jaip.2019.11.042] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 10/30/2019] [Accepted: 11/21/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND A clear understanding of the differences in the epidemiology of food allergy between rural and urban populations may provide insights into the causes of increasing prevalence of food allergy in the developed world. OBJECTIVE We used a standardized methodology to determine the prevalence and types of food-specific allergic sensitization and food allergies in schoolchildren from urban and rural regions of China, Russia, and India. METHODS The current study is a multicenter epidemiological survey of children recruited from 5 cities in China (Hong Kong and Guangzhou), Russia (Tomsk), and India (Bengaluru and Mysore) and 1 rural county in Southern China (Shaoguan). A total of 35,549 children aged 6 to 11 years from 3 countries participated in this survey. Random samples of children from 3 countries were first screened by the EuroPrevall screening questionnaire. Children with and without a history of adverse reactions to foods were then recruited for the subsequent case-control comparative studies. We determined the prevalence rates of food-specific IgE sensitization and food allergies using the predefined criteria. RESULTS The prevalence rates of food-specific IgE sensitization (≥0.7 kU/L) to at least 1 food were 16.6% in Hong Kong, 7.0% in Guangzhou, 16.8% in rural Shaoguan, 8.0% in Tomsk, and 19.1% in India. Using a definition of probable food allergy as reporting allergic symptoms within 2 hours of ingestion of a specific food plus the presence of allergic sensitization to the specific food (positive IgE and/or positive skin prick test result), the prevalence of food allergy was highest in Hong Kong (1.50%), intermediate in Russia (0.87%), and lowest in Guangzhou (0.21%), Shaoguan (0.69%), and India (0.14%). For children recruited from Hong Kong, both sensitization and food allergy were significantly higher in children who were born and raised in Hong Kong when compared with those who were born in mainland China and migrated to Hong Kong, highlighting the importance of early-life exposures in affecting the subsequent development of food sensitization and food allergy. CONCLUSIONS There are wide variations in the prevalence of food-specific IgE sensitization and food allergy in the 3 participating countries. Food allergy appears to be less common when compared with developed countries. The variations in the prevalence of food allergen sensitization cannot be explained by the differences in the degree of urbanization. Despite the high prevalence of food-specific IgE sensitization in India and rural China, food allergy is still extremely uncommon. In addition to IgE sensitization, other factors must play important roles resulting in the clinical manifestations of food allergies.
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Affiliation(s)
- Jing Li
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | | | - Padukudru Anand Mahesh
- Department of TB and Respiratory Medicine, JSS Medical College, JSS University and Allergy Asthma Associates, Mysore, India
| | - Maggie Haitian Wang
- School of Public Health, Chinese University of Hong Kong, Shatin, NT, Hong Kong, China
| | | | - Ting Fan Leung
- Department of Pediatrics, Chinese University of Hong Kong, Hong Kong, China
| | | | - E N Clare Mills
- School of Translational Medicine, Manchester Academic Health Science Centre and Manchester Interdisciplinary Biocentre, The University of Manchester, Manchester, United Kingdom
| | - James Potts
- Department of Respiratory Epidemiology and Public Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Ischa Kummeling
- Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands
| | - Serge A Versteeg
- Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands
| | - Ronald van Ree
- Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands; Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter G J Burney
- Department of Respiratory Epidemiology and Public Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Gary W K Wong
- Department of Pediatrics, Chinese University of Hong Kong, Hong Kong, China.
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15
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Palomares F, Ramos‐Soriano J, Gomez F, Mascaraque A, Bogas G, Perkins JR, Gonzalez M, Torres MJ, Diaz‐Perales A, Rojo J, Mayorga C. Pru p 3‐Glycodendropeptides Based on Mannoses Promote Changes in the Immunological Properties of Dendritic and T‐Cells from LTP‐Allergic Patients. Mol Nutr Food Res 2019; 63:e1900553. [DOI: 10.1002/mnfr.201900553] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/13/2019] [Indexed: 01/14/2023]
Affiliation(s)
- Francisca Palomares
- Research LaboratoryIBIMA‐Regional University Hospital of Malaga‐UMA 29009 Malaga Spain
| | - Javier Ramos‐Soriano
- Glycosystems LaboratoryInstitute for Chemical Research (IIQ)CSIC – University of Seville 41092 Seville Spain
| | - Francisca Gomez
- Allergy UnitIBIMA‐Regional University Hospital of Malaga‐UMA 29009 Malaga Spain
| | - Ainhoa Mascaraque
- Glycosystems LaboratoryInstitute for Chemical Research (IIQ)CSIC – University of Seville 41092 Seville Spain
| | - Gador Bogas
- Allergy UnitIBIMA‐Regional University Hospital of Malaga‐UMA 29009 Malaga Spain
| | - James Richard Perkins
- Research LaboratoryIBIMA‐Regional University Hospital of Malaga‐UMA 29009 Malaga Spain
| | - Miguel Gonzalez
- Research LaboratoryIBIMA‐Regional University Hospital of Malaga‐UMA 29009 Malaga Spain
| | - Maria Jose Torres
- Allergy UnitIBIMA‐Regional University Hospital of Malaga‐UMA 29009 Malaga Spain
| | | | - Javier Rojo
- Glycosystems LaboratoryInstitute for Chemical Research (IIQ)CSIC – University of Seville 41092 Seville Spain
| | - Cristobalina Mayorga
- Research LaboratoryIBIMA‐Regional University Hospital of Malaga‐UMA 29009 Malaga Spain
- Allergy UnitIBIMA‐Regional University Hospital of Malaga‐UMA 29009 Malaga Spain
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16
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Jorge A, Santos Silva M, Lozoya-Ibánez C, Lorente F, Sarinho E, Afonso RM, Pereira H, Taborda-Barata L. Development of a tool for screening adverse food reactions and food allergy in Portuguese children. Allergol Immunopathol (Madr) 2019; 47:342-349. [PMID: 30503673 DOI: 10.1016/j.aller.2018.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 09/04/2018] [Indexed: 12/30/2022]
Abstract
INTRODUCTION AND OBJECTIVES A standardised questionnaire may be an excellent tool for epidemiological studies aiming at screening children with suspected food allergies. Thus, the aim of the present study was to develop a screening questionnaire for assessing children with suspected food allergy and to analyse its reproducibility. MATERIALS AND METHODS A questionnaire of adverse food reactions was developed by literary review of similar questionnaires validated in other countries as well as less well defined, non-validated Portuguese questionnaires. Peer review of the questionnaire by a panel of specialists and subsequent exploratory analysis was carried out by applying the questionnaire in children with confirmed food allergy. Test-retest analysis was performed by giving a face-to-face questionnaire to 159 children with suspected adverse food reactions, aged between three and 11 years. Temporal stability using Spearman Rho correlation test and reproducibility was studied using Cohen's Kappa index. RESULTS 115 children confirmed adverse food reactions that occurred with one or more foods. Retest was given about three weeks after the test, to 50 of these children who were randomly selected. The questionnaire showed good temporal stability (Spearman correlation coefficient of 0.834), and good reproducibility (only two of the 27 items had a Kappa index <0.60). CONCLUSIONS This questionnaire showed good temporal stability and reproducibility. Its validation for screening children with suspected food allergy will allow a standardised approach to diagnosis and comparison of results obtained in different centres.
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Affiliation(s)
- A Jorge
- CICS - Health Sciences Research Centre, University of Beira Interior, Avenida Infante D. Henrique, 6200-506 Covilhã, Portugal; Department of Paediatrics, Cova da Beira Hospital Centre, Covilhã, Portugal
| | - M Santos Silva
- Quality Management Unit, Cova da Beira Hospital Centre, Covilhã, Portugal
| | - C Lozoya-Ibánez
- CICS - Health Sciences Research Centre, University of Beira Interior, Avenida Infante D. Henrique, 6200-506 Covilhã, Portugal; Allergy Department, Castelo Branco Local Health Unit, Castelo Branco, Portugal
| | - F Lorente
- Department of Pediatrics, Salamanca University Hospital, Spain
| | - E Sarinho
- Center for Research in Allergy and Clinical Immunology (HC/UFPE), Federal University of Pernambuco, Recife, Brazil
| | - R M Afonso
- Psychology and Education Department, University of Beira Interior, Covilhã, Portugal
| | - H Pereira
- Psychology and Education Department, University of Beira Interior, Covilhã, Portugal
| | - L Taborda-Barata
- CICS - Health Sciences Research Centre, University of Beira Interior, Avenida Infante D. Henrique, 6200-506 Covilhã, Portugal; Department of Allergy & Clinical Immunology, Cova da Beira Hospital Centre, Covilhã, Portugal.
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17
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Tian Y, Rao H, Fu W, Tao S, Xue WT. Effect of digestion on the immunoreactivity and proinflammatory properties of recombinant peanut allergen Ara h 1. FOOD AGR IMMUNOL 2019. [DOI: 10.1080/09540105.2019.1592123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Yang Tian
- Beijing Advanced Innovation Centre for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, People’s Republic of China
- College of Food Science and Nutritional Engineering, China Agriculture University, Beijing, People’s Republic of China
| | - Huan Rao
- Beijing Advanced Innovation Centre for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, People’s Republic of China
- College of Food Science and Nutritional Engineering, China Agriculture University, Beijing, People’s Republic of China
| | - Wenhui Fu
- Beijing Advanced Innovation Centre for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, People’s Republic of China
- College of Food Science and Nutritional Engineering, China Agriculture University, Beijing, People’s Republic of China
| | - Sha Tao
- College of Information and Electrical Engineering, China Agricultural University, Beijing, People’s Republic of China
| | - Wen-Tong Xue
- Beijing Advanced Innovation Centre for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, People’s Republic of China
- College of Food Science and Nutritional Engineering, China Agriculture University, Beijing, People’s Republic of China
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Humbert M, Bousquet J, Bachert C, Palomares O, Pfister P, Kottakis I, Jaumont X, Thomsen SF, Papadopoulos NG. IgE-Mediated Multimorbidities in Allergic Asthma and the Potential for Omalizumab Therapy. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 7:1418-1429. [PMID: 30928481 DOI: 10.1016/j.jaip.2019.02.030] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/27/2019] [Accepted: 02/28/2019] [Indexed: 12/15/2022]
Abstract
Allergic asthma often coexists with different pathological conditions, called multimorbidities, that are mostly of allergic nature and share a common underlying inflammatory pathophysiological mechanism. Multimorbidities of allergic asthma may influence asthma control, its severity, and patients' response to treatment, and contribute to the overall socioeconomic burden of the disease. Immunoglobulin E (IgE) is known to play a central role in the pathogenesis of various allergic diseases, including asthma. Thus, IgE-mediated immunologic pathways present an attractive target for intervention in asthma and multimorbidities. In this review, we discuss the most frequently reported IgE-mediated multimorbidities in allergic asthma, including allergic rhinitis, rhinoconjunctivitis, atopic dermatitis, vernal keratoconjunctivitis, chronic rhinosinusitis with nasal polyps, food allergies, and allergic bronchopulmonary aspergillosis. Omalizumab is a recombinant humanized monoclonal antibody against IgE and has been in use to treat allergic asthma for more than a decade. We comprehensively review the clinical evidence for omalizumab in the treatment of the aforementioned multimorbidities in allergic asthma.
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Affiliation(s)
- Marc Humbert
- Service de Pneumologie, Hôpital Bicêtre, Le Kremlin Bicêtre, France.
| | - Jean Bousquet
- MACVIA-France, Contre les Maladies Chroniques pour un Vieillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - Claus Bachert
- Upper Airways Research Laboratory and Department of Oto-Rhino-Laryngology, Ghent University and Ghent University Hospital, Ghent, Belgium
| | - Oscar Palomares
- Department of Biochemistry and Molecular Biology, School of Chemistry, Complutense University of Madrid, Madrid, Spain
| | | | | | | | - Simon Francis Thomsen
- Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark; Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nikolaos G Papadopoulos
- Division of Infection, Immunity & Respiratory Medicine, University of Manchester, Manchester, United Kingdom; Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
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Wang J, Vanga SK, McCusker C, Raghavan V. A Comprehensive Review on Kiwifruit Allergy: Pathogenesis, Diagnosis, Management, and Potential Modification of Allergens Through Processing. Compr Rev Food Sci Food Saf 2019; 18:500-513. [PMID: 33336949 DOI: 10.1111/1541-4337.12426] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 12/27/2018] [Accepted: 01/05/2019] [Indexed: 12/22/2022]
Abstract
Kiwifruit is rich in bioactive components including dietary fibers, carbohydrates, natural sugars, vitamins, minerals, omega-3 fatty acids, and antioxidants. These components are beneficial to boost the human immune system and prevent cancer and heart diseases. However, kiwifruit is emerging as one of the most common elicitors of food allergies worldwide. Kiwifruit allergy results from an abnormal immune response to kiwifruit proteins and occur after consuming this fruit. Symptoms range from the oral allergy syndrome (OAS) to the life-threatening anaphylaxis. Thirteen different allergens have been identified in green kiwifruit and, among these allergens, Act d 1, Act d 2, Act d 8, Act d 11, and Act d 12 are defined as the "major allergens." Act d 1 and Act d 2 are ripening-related allergens and are found in abundance in fully ripe kiwifruit. Structures of several kiwifruit allergens may be altered under high temperatures or strong acidic conditions. This review discusses the pathogenesis, clinical features, and diagnosis of kiwifruit allergy and evaluates food processing methods including thermal, ultrasound, and chemical processing which may be used to reduce the allergenicity of kiwifruit. Management and medical treatments for kiwifruit allergy are also summarized.
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Affiliation(s)
- Jin Wang
- Dept. of Bioresource Engineering, Faculty of Agricultural and Environmental Sciences, McGill Univ., Sainte-Anne-de-Bellevue, Quebec, Canada
| | - Sai Kranthi Vanga
- Dept. of Bioresource Engineering, Faculty of Agricultural and Environmental Sciences, McGill Univ., Sainte-Anne-de-Bellevue, Quebec, Canada
| | - Christine McCusker
- Meakins-Christie Laboratories, Research Inst. of the McGill Univ. Health Centre, Montreal, Quebec, Canada
| | - Vijaya Raghavan
- Dept. of Bioresource Engineering, Faculty of Agricultural and Environmental Sciences, McGill Univ., Sainte-Anne-de-Bellevue, Quebec, Canada
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20
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Nucera E, Ricci AG, Rizzi A, Mezzacappa S, Rienzo AD, Pecora V, Patriarca G, Buonomo A, Aruanno A, Schiavino D. Specific oral immunotherapy in food allergic patients: transient or persistent tolerance? Postepy Dermatol Alergol 2018; 35:392-396. [PMID: 30206453 PMCID: PMC6130139 DOI: 10.5114/ada.2018.77671] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 06/20/2017] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION The first therapeutic choice for food allergy is avoidance of the responsible food, but when this approach is not possible, specific oral desensitization could be considered as a good alternative. It is not clear yet whether the acquired tolerance is transient or persistent. AIM We report on a subset of 13 patients of a larger study, treated successfully with specific oral tolerance induction who experienced secondary loss of tolerance after a period of allergen avoidance. MATERIAL AND METHODS Thirteen patients affected by IgE-mediated food allergy: to cow milk (3 patients), to hen egg (3 patients), to cod fish (2 patients), to peanuts (1 patient) and to corn (1 patient) confirmed by a complete allergological workup and a double-blind placebo-controlled food challenge (DBPCFC), were treated with sublingual-oral desensitization. After the interruption of the maintenance phase, the laboratory tests were performed and 12 of 13 patients underwent DBPCFC. RESULTS Oral specific desensitization was completed successfully in all the 13 reported patients. At different times after the end of treatment, they decided, on their own initiative, to stop the ingestion of incriminated food. A new food allergen re-exposure caused adverse reactions in 12 of 13 patients. The detection of specific IgE and IgG4 during the period of allergen avoidance showed an increase in or a stable level of specific IgE and a decrease in specific IgG4 in 8 patients. CONCLUSIONS According to our experience, the tolerance obtained through the desensitizing treatment is transient and so the regular allergen intake is necessary for its maintenance.
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Affiliation(s)
- Eleonora Nucera
- Allergy Department, Catholic University, Policlinico A. Gemelli, Rome, Italy
| | - Anna Giulia Ricci
- Allergy Department, Catholic University, Policlinico A. Gemelli, Rome, Italy
| | - Angela Rizzi
- Allergy Department, Catholic University, Policlinico A. Gemelli, Rome, Italy
| | - Simona Mezzacappa
- Allergy Department, Catholic University, Policlinico A. Gemelli, Rome, Italy
| | - Alessia Di Rienzo
- Allergy Department, Catholic University, Policlinico A. Gemelli, Rome, Italy
| | - Valentina Pecora
- Allergy Department, Catholic University, Policlinico A. Gemelli, Rome, Italy
| | - Giampiero Patriarca
- Allergy Department, Catholic University, Policlinico A. Gemelli, Rome, Italy
| | - Alessandro Buonomo
- Allergy Department, Catholic University, Policlinico A. Gemelli, Rome, Italy
| | - Arianna Aruanno
- Allergy Department, Catholic University, Policlinico A. Gemelli, Rome, Italy
| | - Domenico Schiavino
- Allergy Department, Catholic University, Policlinico A. Gemelli, Rome, Italy
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21
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Datema MR, van Ree R, Asero R, Barreales L, Belohlavkova S, de Blay F, Clausen M, Dubakiene R, Fernández-Perez C, Fritsche P, Gislason D, Hoffmann-Sommergruber K, Jedrzejczak-Czechowicz M, Jongejan L, Knulst AC, Kowalski M, Kralimarkova TZ, Le TM, Lidholm J, Papadopoulos NG, Popov TA, del Prado N, Purohit A, Reig I, Seneviratne SL, Sinaniotis A, Versteeg SA, Vieths S, Zwinderman AH, Mills ENC, Fernández-Rivas M, Ballmer-Weber B. Component-resolved diagnosis and beyond: Multivariable regression models to predict severity of hazelnut allergy. Allergy 2018; 73:549-559. [PMID: 28986984 DOI: 10.1111/all.13328] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Component-resolved diagnosis (CRD) has revealed significant associations between IgE against individual allergens and severity of hazelnut allergy. Less attention has been given to combining them with clinical factors in predicting severity. AIM To analyze associations between severity and sensitization patterns, patient characteristics and clinical history, and to develop models to improve predictive accuracy. METHODS Patients reporting hazelnut allergy (n = 423) from 12 European cities were tested for IgE against individual hazelnut allergens. Symptoms (reported and during Double-blind placebo-controlled food challenge [DBPCFC]) were categorized in mild, moderate, and severe. Multiple regression models to predict severity were generated from clinical factors and sensitization patterns (CRD- and extract-based). Odds ratios (ORs) and areas under receiver-operating characteristic (ROC) curves (AUCs) were used to evaluate their predictive value. RESULTS Cor a 9 and 14 were positively (OR 10.5 and 10.1, respectively), and Cor a 1 negatively (OR 0.14) associated with severe symptoms during DBPCFC, with AUCs of 0.70-073. Combining Cor a 1 and 9 improved this to 0.76. A model using a combination of atopic dermatitis (risk), pollen allergy (protection), IgE against Cor a 14 (risk) and walnut (risk) increased the AUC to 0.91. At 92% sensitivity, the specificity was 76.3%, and the positive and negative predictive values 62.2% and 95.7%, respectively. For reported symptoms, associations and generated models proved to be almost identical but weaker. CONCLUSION A model combining CRD with clinical background and extract-based serology is superior to CRD alone in assessing the risk of severe reactions to hazelnut, particular in ruling out severe reactions.
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Affiliation(s)
- M. R. Datema
- Department of Experimental Immunology; Academic Medical Center; Amsterdam The Netherlands
| | - R. van Ree
- Department of Experimental Immunology; Academic Medical Center; Amsterdam The Netherlands
- Department of Otorhinolaryngology; Academic Medical Center; Amsterdam The Netherlands
| | - R. Asero
- Ambulatorio di Allergologia; Clinica San Carlo; Paderno Dugnano Italy
| | - L. Barreales
- Allergy Department; Hospital Clinico San Carlos, IdISSC; Madrid Spain
| | | | - F. de Blay
- Allergy Division; Chest Disease Department; Strasbourg University Hospital; Strasbourg France
| | - M. Clausen
- Faculty of Medicine; University of Iceland; Landspitali University Hospital; Reykjavik Iceland
| | - R. Dubakiene
- Medical Faculty; Vilnius University; Vilnius Lithuania
| | | | - P. Fritsche
- Allergy Unit; Department of Dermatology; University Hospital Zürich; Zürich Switzerland
| | - D. Gislason
- Faculty of Medicine; University of Iceland; Landspitali University Hospital; Reykjavik Iceland
| | - K. Hoffmann-Sommergruber
- Department of Pathophysiology and Allergy Research; Medical University of Vienna; Vienna Austria
| | - M. Jedrzejczak-Czechowicz
- Department of Immunology, Rheumatology and Allergy; Faculty of Medicine; Medical University of Lodz; Lodz Poland
| | - L. Jongejan
- Department of Experimental Immunology; Academic Medical Center; Amsterdam The Netherlands
| | - A. C. Knulst
- Department of Dermatology and Allergology; University Medical Center Utrecht; Utrecht The Netherlands
| | - M. Kowalski
- Department of Immunology, Rheumatology and Allergy; Faculty of Medicine; Medical University of Lodz; Lodz Poland
| | - T. Z. Kralimarkova
- Clinic of Allergy and Asthma; Medical University of Sofia; Sofia Bulgaria
| | - T.-M. Le
- Department of Dermatology and Allergology; University Medical Center Utrecht; Utrecht The Netherlands
| | - J. Lidholm
- Thermo Fisher Scientific; Uppsala Sweden
| | - N. G. Papadopoulos
- Allergy Department; 2nd Pediatric Clinic; University of Athens; Athens Greece
- Centre for Paediatrics and Child Health; Institute of Human Development; University of Manchester; Manchester UK
| | - T. A. Popov
- Clinic of Allergy and Asthma; Medical University of Sofia; Sofia Bulgaria
| | - N. del Prado
- Clinical epidemiology Unit; Preventive Medicine Department; Hospital Clinico San Carlos, IdISSC; Madrid Spain
| | - A. Purohit
- Allergy Division; Chest Disease Department; Strasbourg University Hospital; Strasbourg France
| | - I. Reig
- Allergy Department; Hospital Clinico San Carlos, IdISSC; Madrid Spain
| | - S. L. Seneviratne
- Institute of Immunity and Transplantation; University College London; London UK
| | - A. Sinaniotis
- Allergy Department; 2nd Pediatric Clinic; University of Athens; Athens Greece
| | - S. A. Versteeg
- Department of Experimental Immunology; Academic Medical Center; Amsterdam The Netherlands
| | - S. Vieths
- Division of Allergology; Paul-Ehrlich-Institut; Federal Institute for Vaccines and Biomedicines; Langen Germany
| | - A. H. Zwinderman
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics; Academic Medical Center; Amsterdam The Netherlands
| | - E. N. C. Mills
- Institute of Inflammation and Repair; Manchester Academic Health Science Centre; Manchester Institute of Biotechnology; The University of Manchester; Manchester UK
| | | | - B. Ballmer-Weber
- Allergy Unit; Department of Dermatology; University Hospital Zürich; Zürich Switzerland
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22
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Palomares F, Gomez F, Bogas G, Campo P, Perkins JR, Diaz-Perales A, Rodriguez MJ, Prieto A, Barber D, Torres MJ, Mayorga C. Immunological Changes Induced in Peach Allergy Patients with Systemic Reactions by Pru p 3 Sublingual Immunotherapy. Mol Nutr Food Res 2018; 62. [PMID: 29105313 DOI: 10.1002/mnfr.201700669] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 10/17/2017] [Indexed: 12/17/2022]
Abstract
SCOPE Sublingual immunotherapy using peach extract enriched in Pru p 3 (Pru p 3-enriched-SLIT) brings a new perspective to treating patients with allergy to lipid transfer proteins. We evaluate the immunological changes induced by Pru p 3-enriched-SLIT during one year. METHODS AND RESULTS Three groups are included: peach allergic patients who receive Pru p 3-enriched-SLIT, peach allergic untreated patients, and controls. Peripheral blood mononuclear cells are obtained before treatment and at different time-points. Monocyte-derived dendritic cells (moDCs) maturation and lymphocyte proliferation are assessed by flow cytometry. Data showed a significant reduction of moDCs maturation status during one year of treatment and an increase in PD-L1. Moreover, we observed a significant decrease of the Pru p 3-specific proliferation of effector cells and an increase in regulatory T (Treg) cells with higher PD-L1 expression and IL-10 production. These are observed in patients treated only. CONCLUSION Successful Pru p 3-enriched-SLIT is linked to an important immunosuppression of allergen-specific effector T cells, potentially due to an increase of allergen-specific Treg cells. These cellular changes are orchestrated by the activity of moDCs promoting the expression of PD-L1 that will participate in the regulatory response. These changes may serve as biomarkers during SLIT alongside other features such as IgE/IgG4 ratio.
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Affiliation(s)
- Francisca Palomares
- Research Laboratory, IBIMA-Regional University Hospital of Malaga-UMA, Malaga, Spain
| | - Francisca Gomez
- Allergy Unit, IBIMA-Regional University Hospital of Malaga-UMA, Malaga, Spain
| | - Gador Bogas
- Allergy Unit, IBIMA-Regional University Hospital of Malaga-UMA, Malaga, Spain
| | - Paloma Campo
- Allergy Unit, IBIMA-Regional University Hospital of Malaga-UMA, Malaga, Spain
| | - James Richard Perkins
- Research Laboratory, IBIMA-Regional University Hospital of Malaga-UMA, Malaga, Spain
| | - Araceli Diaz-Perales
- Centre for Plant Biotechnology and Genomics (UPM-INIA), Campus de Montegancedo, Pozuelo de Alarcón, Madrid, Spain
| | - Maria J Rodriguez
- Research Laboratory, IBIMA-Regional University Hospital of Malaga-UMA, Malaga, Spain
| | - Ana Prieto
- Pediatric Unit, Regional University Hospital of Malaga, Malaga, Spain
| | - Domingo Barber
- Institute for Applied Molecular Medicine (IMMA), School of Medicine, Universidad CEU San Pablo, Madrid, Spain
| | - María J Torres
- Allergy Unit, IBIMA-Regional University Hospital of Malaga-UMA, Malaga, Spain
| | - Cristobalina Mayorga
- Research Laboratory, IBIMA-Regional University Hospital of Malaga-UMA, Malaga, Spain.,Allergy Unit, IBIMA-Regional University Hospital of Malaga-UMA, Malaga, Spain
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Cortes A, Castillo A, Sciaraffia A. Food allergy: Children's symptom levels are associated with mothers' psycho-socio-economic variables. J Psychosom Res 2018; 104:48-54. [PMID: 29275785 DOI: 10.1016/j.jpsychores.2017.11.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 11/13/2017] [Accepted: 11/14/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Allergies affect children's health as well as their quality of life, stress levels, and family budget. The available literature suggests that family, social and psychological factors are affected by allergic pathologies such as rhinitis, asthma and atopic dermatitis. However, few studies have focused on quantifying such association in child food allergy. This study aims to enhance the understanding of the associations between caregiver variables and children's Food Allergy (FA). METHODS The study involved 206 participants: 103 mothers plus 103 children with IgE mediated FA. The analyses excluded two outliers comprising 101 subjects. For statistical analyses, each dyad -mother/child- was considered to be one subject unity. A between-subjects one-way ANOVA determined the association of children's cutaneous, gastric and respiratory symptoms with anxiety, depression, perceived social support and socioeconomic factors in the mothers. RESULTS There are significant associations between children's allergic symptoms (gastric and cutaneous) and mothers' psychological state (anxiety and depression); family budget; social interactions (with friends, family and partner); understanding of health care required by their child; and sleep disorders. Respiratory symptoms did not show any significant associations with the dependent variables. CONCLUSION FA is a process in which children's symptoms are significantly associated with socioeconomic and psychological variables of the mothers. The presence or absence of some specific symptoms is directly associated with specific impacts on the mothers. An understanding of such dynamics supports the consideration of a comprehensive and multidisciplinary therapeutic approach to offer more ecological healthcare for "families living with FA."
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Affiliation(s)
- Aaron Cortes
- Departamento de Traumatología, Hospital Clínico Universidad de Chile, Santiago, Chile.
| | - Angela Castillo
- Sección de Medicina, Hospital Carlos Van Buren, Valparaiso, Chile
| | - Alicia Sciaraffia
- Sección de Inmunología, VIH y Alergias, Hospital Clínico Universidad de Chile, Santiago, Chile
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Abstract
Understanding the epidemiology of food allergy is complicated by the difficulty of identifying it on a large scale. The prevalence of food allergy is higher in younger age groups and decreases with age. Allergy to peanut and egg seems to be more common in Northern Europe, the United States, Canada and Australia compared with Southern Europe, Eastern Europe and Asia, whereas shellfish and fish allergies may be more common in Asia. The rate of transient unrecognized food allergy may be high and variable recognition of food allergy may explain some of the differences seen in food allergy prevalence.
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Affiliation(s)
- Joan H Dunlop
- Division of Pediatric Allergy and Immunology, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, CMSC 1102, 600 North Wolfe Street, Baltimore, MD 21287, USA
| | - Corinne A Keet
- Division of Pediatric Allergy and Immunology, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, CMSC 1102, 600 North Wolfe Street, Baltimore, MD 21287, USA.
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25
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Lin HY, Huang CH, Park J, Pathania D, Castro CM, Fasano A, Weissleder R, Lee H. Integrated Magneto-Chemical Sensor For On-Site Food Allergen Detection. ACS NANO 2017; 11:10062-10069. [PMID: 28792732 DOI: 10.1021/acsnano.7b04318] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Adverse food reactions, including food allergies, food sensitivities, and autoimmune reaction (e.g., celiac disease) affect 5-15% of the population and remain a considerable public health problem requiring stringent food avoidance and epinephrine availability for emergency events. Avoiding problematic foods is practically difficult, given current reliance on prepared foods and out-of-home meals. In response, we developed a portable, point-of-use detection technology, termed integrated exogenous antigen testing (iEAT). The system consists of a disposable antigen extraction device coupled with an electronic keychain reader for rapid sensing and communication. We optimized the prototype iEAT system to detect five major food antigens in peanuts, hazelnuts, wheat, milk, and eggs. Antigen extraction and detection with iEAT requires <10 min and achieves high-detection sensitivities (e.g., 0.1 mg/kg for gluten, lower than regulatory limits of 20 mg/kg). When testing under restaurant conditions, we were able to detect hidden food antigens such as gluten within "gluten-free" food items. The small size and rapid, simple testing of the iEAT system should help not only consumers but also other key stakeholders such as clinicians, food industries, and regulators to enhance food safety.
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Affiliation(s)
| | | | | | | | | | | | - Ralph Weissleder
- Department of Systems Biology, Harvard Medical School , Boston, Massachusetts 02114, United States
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26
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Jorge A, Soares E, Sarinho E, Lorente F, Gama J, Taborda-Barata L. Prevalence and clinical features of adverse food reactions in Portuguese children. Allergy Asthma Clin Immunol 2017; 13:40. [PMID: 28878810 PMCID: PMC5585952 DOI: 10.1186/s13223-017-0212-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 08/16/2017] [Indexed: 01/13/2023] Open
Abstract
Background The prevalence of adverse food reactions (AFR) has been increasing in the western world. Clinical manifestations are diversified and it may not be possible to clinically discriminate between IgE and non-IgE mediated AFR. In Portugal, the prevalence of AFR and food allergies in children is not known. Thus, the objectives of this study were to determine the prevalence of AFR in central Portugal. Methods Point prevalence study in 3–11 year-old schoolchildren from Central Portugal. Food-related questionnaires, skin prick tests (SPT) with foods and determination of food-specific IgE levels were performed. Results Of 4045 schoolchildren, 2474 (61.2%) accepted to be included in the study. Global prevalence of AFR was 7.1% (95% CI 6.2–8.1), based upon the initial questionnaire, 4.6% (95% CI 3.9–5.5), based upon a confirmatory questionnaire and the prevalence of probable food allergy (IgE-associated AFR: positive history + positive SPT and/or positive specific IgE) was 1.4% (95% CI 0.9–1.9). Most frequently implicated foods were fresh fruits, fish and egg. A first episode at an earlier age, mucocutaneous and anaphylactic reactions were more frequent in IgE-associated AFR. Conclusions The prevalence of probable food allergy in 3–11 year old Portuguese children from central Portugal is low and parents over-report its frequency. Most frequently implicated foods were fresh fruit and fish. Immediate type, polysymptomatic, and more severe reactions may commence at an earlier age and be more frequent in IgE-associated than in non-IgE associated reactions. Electronic supplementary material The online version of this article (doi:10.1186/s13223-017-0212-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Arminda Jorge
- CICS-Health Sciences Research Centre, University of Beira Interior, Avenida Infante D. Henrique, Covilhã, 6200-506 Portugal.,Department of Paediatrics, Cova da Beira Hospital, Covilhã, Portugal
| | - Elisa Soares
- CICS-Health Sciences Research Centre, University of Beira Interior, Avenida Infante D. Henrique, Covilhã, 6200-506 Portugal
| | - Emanuel Sarinho
- UFPE Allergy & Clinical Immunology Research Centre, Pernambuco Federal University, Recife, Brazil
| | - Felix Lorente
- Department of Paediatrics, Salamanca University Hospital, Salamanca, Spain
| | - Jorge Gama
- Department of Mathematics, Faculty of Sciences, University of Beira Interior, Covilhã, Portugal
| | - Luís Taborda-Barata
- CICS-Health Sciences Research Centre, University of Beira Interior, Avenida Infante D. Henrique, Covilhã, 6200-506 Portugal.,Department of Allergy & Clinical Immunology, Cova da Beira Hospital, Covilhã, Portugal
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27
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Fedorova OS, Janse JJ, Ogorodova LM, Fedotova MM, Achterberg RA, Verweij JJ, Fernández-Rivas M, Versteeg SA, Potts J, Minelli C, van Ree R, Burney P, Yazdanbakhsh M. Opisthorchis felineus negatively associates with skin test reactivity in Russia-EuroPrevall-International Cooperation study. Allergy 2017; 72:1096-1104. [PMID: 28032359 DOI: 10.1111/all.13120] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND Most studies on the relationship between helminth infections and atopic disorders have been conducted in (sub)tropical developing countries where exposure to multiple parasites and lifestyle can confound the relationship. We aimed to study the relationship between infection with the fish-borne helminth Opishorchis felineus and specific IgE, skin prick testing, and atopic symptoms in Western Siberia, with lifestyle and hygiene standards of a developed country. METHODS Schoolchildren aged 7-11 years were sampled from one urban and two rural regions. Skin prick tests (SPT) and specific IgE (sIgE) against food and aeroallergens were measured, and data on allergic symptoms and on demographic and socioeconomic factors were collected by questionnaire. Diagnosis of opisthorchiasis was based on PCR performed on stool samples. RESULTS Of the 732 children included, 34.9% had opisthorchiasis. The sensitization to any allergen when estimated by positive SPT was 12.8%, while much higher, 24.0%, when measured by sIgE. Atopic symptoms in the past year (flexural eczema and/or rhinoconjunctivitis) were reported in 12.4% of the children. SPT was positively related to flexural eczema and rhinoconjunctivitis, but not to wheezing. Opisthorchiasis showed association with lower SPT response, as well as borderline association with low IgE reactivity to any allergen. However, the effect of opisthorchiasis on SPT response was not mediated by IgE, suggesting that opisthorchiasis influences SPT response through another mechanism. Opisthorchiasis also showed borderline association with lower atopic symptoms. CONCLUSIONS There is a negative association between a chronic helminth infection and skin prick test reactivity even in a developed country.
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Affiliation(s)
- O. S. Fedorova
- Department of Faculty Pediatrics; Siberian State Medical University; Tomsk Russian Federation
| | - J. J. Janse
- Department of Parasitology; Leiden University Medical Center; Leiden The Netherlands
| | - L. M. Ogorodova
- Department of Faculty Pediatrics; Siberian State Medical University; Tomsk Russian Federation
| | - M. M. Fedotova
- Department of Faculty Pediatrics; Siberian State Medical University; Tomsk Russian Federation
| | - R. A. Achterberg
- Department of Parasitology; Leiden University Medical Center; Leiden The Netherlands
| | - J. J. Verweij
- Department of Parasitology; Leiden University Medical Center; Leiden The Netherlands
| | | | - S. A. Versteeg
- Department of Experimental Immunology; Academic Medical Center; Amsterdam The Netherlands
| | - J. Potts
- Department of Respiratory Epidemiology and Public Health; National Heart and Lung Institute; Imperial College London; London UK
| | - C. Minelli
- Department of Respiratory Epidemiology and Public Health; National Heart and Lung Institute; Imperial College London; London UK
| | - R. van Ree
- Department of Experimental Immunology; Academic Medical Center; Amsterdam The Netherlands
- Department of Otorhinolaryngology; Academic Medical Center; Amsterdam The Netherlands
| | - P. Burney
- Department of Respiratory Epidemiology and Public Health; National Heart and Lung Institute; Imperial College London; London UK
| | - M. Yazdanbakhsh
- Department of Parasitology; Leiden University Medical Center; Leiden The Netherlands
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van Bilsen JHM, Sienkiewicz-Szłapka E, Lozano-Ojalvo D, Willemsen LEM, Antunes CM, Molina E, Smit JJ, Wróblewska B, Wichers HJ, Knol EF, Ladics GS, Pieters RHH, Denery-Papini S, Vissers YM, Bavaro SL, Larré C, Verhoeckx KCM, Roggen EL. Application of the adverse outcome pathway (AOP) concept to structure the available in vivo and in vitro mechanistic data for allergic sensitization to food proteins. Clin Transl Allergy 2017; 7:13. [PMID: 28507730 PMCID: PMC5429547 DOI: 10.1186/s13601-017-0152-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 05/03/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The introduction of whole new foods in a population may lead to sensitization and food allergy. This constitutes a potential public health problem and a challenge to risk assessors and managers as the existing understanding of the pathophysiological processes and the currently available biological tools for prediction of the risk for food allergy development and the severity of the reaction are not sufficient. There is a substantial body of in vivo and in vitro data describing molecular and cellular events potentially involved in food sensitization. However, these events have not been organized in a sequence of related events that is plausible to result in sensitization, and useful to challenge current hypotheses. The aim of this manuscript was to collect and structure the current mechanistic understanding of sensitization induction to food proteins by applying the concept of adverse outcome pathway (AOP). MAIN BODY The proposed AOP for food sensitization is based on information on molecular and cellular mechanisms and pathways evidenced to be involved in sensitization by food and food proteins and uses the AOPs for chemical skin sensitization and respiratory sensitization induction as templates. Available mechanistic data on protein respiratory sensitization were included to fill out gaps in the understanding of how proteins may affect cells, cell-cell interactions and tissue homeostasis. Analysis revealed several key events (KE) and biomarkers that may have potential use in testing and assessment of proteins for their sensitizing potential. CONCLUSION The application of the AOP concept to structure mechanistic in vivo and in vitro knowledge has made it possible to identify a number of methods, each addressing a specific KE, that provide information about the food allergenic potential of new proteins. When applied in the context of an integrated strategy these methods may reduce, if not replace, current animal testing approaches. The proposed AOP will be shared at the www.aopwiki.org platform to expand the mechanistic data, improve the confidence in each of the proposed KE and key event relations (KERs), and allow for the identification of new, or refinement of established KE and KERs.
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Affiliation(s)
| | | | | | | | | | - Elena Molina
- Instituto de Investigación en Ciencias de la Alimentación, Madrid, Spain
| | | | - Barbara Wróblewska
- Institute of Animal Reproduction and Food Research of Polish Academy of Sciences, Olsztyn, Poland
| | - Harry J Wichers
- Wageningen University and Research, Wageningen, The Netherlands
| | - Edward F Knol
- University Medical Center Utrecht, Utrecht, The Netherlands
| | | | | | | | | | - Simona L Bavaro
- Institute of Sciences of Food Production, National Research Council, Bari, Italy
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Ricci A, Chemaly M, Davies R, Fernández Escámez PS, Girones R, Herman L, Lindqvist R, Nørrung B, Robertson L, Ru G, Simmons M, Skandamis P, Snary E, Speybroeck N, Ter Kuile B, Threlfall J, Wahlström H, Allende A, Barregård L, Jacxsens L, Koutsoumanis K, Sanaa M, Varzakas T, Baert K, Hempen M, Rizzi V, Van der Stede Y, Bolton D. Hazard analysis approaches for certain small retail establishments in view of the application of their food safety management systems. EFSA J 2017; 15:e04697. [PMID: 32625423 PMCID: PMC7010028 DOI: 10.2903/j.efsa.2017.4697] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Under current European hygiene legislation, food businesses are obliged to develop and implement food safety management systems (FSMS) including prerequisite programme (PRP) activities and hazard analysis and critical control point principles. This requirement is especially challenging for small food retail establishments, where a lack of expertise and other resources may limit the development and implementation of effective FSMS. In this opinion, a simplified approach to food safety management is developed and presented based on a fundamental understanding of processing stages (flow diagram) and the activities contributing to increased occurrence of the hazards (biological, chemical (including allergens) or physical) that may occur. The need to understand and apply hazard or risk ranking within the hazard analysis is removed and control is achieved using PRP activities as recently described in the European Commission Notice 2016/C278, but with the addition of a PRP activity covering ‘product information and customer awareness’. Where required, critical limits, monitoring and record keeping are also included. Examples of the simplified approach are presented for five types of retail establishments: butcher, grocery, bakery, fish and ice cream shop.
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Inam M, Shafique RH, Roohi N, Irfan M, Abbas S, Ismail M. Prevalence of sensitization to food allergens and challenge proven food allergy in patients visiting allergy centers in Rawalpindi and Islamabad, Pakistan. SPRINGERPLUS 2016; 5:1330. [PMID: 27563525 PMCID: PMC4980862 DOI: 10.1186/s40064-016-2980-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 08/01/2016] [Indexed: 11/19/2022]
Abstract
In this study, we estimated the prevalence of food allergy in the adult allergic patients of Rawalpindi and Islamabad , Pakistan, based on self-report, skin prick test (SPT) and oral food challenge test (OFC). SPT was used for the estimation of sensitization to wheat, egg, milk, beef, chicken, mutton, fish, corn, lentils, rice, soya, peanut and banana. Among 689 patients, 39.19 % showed sensitivity to one or more foods, where, sensitization to wheat (156; 22.6 %) was highest, followed by egg (148; 21.48 %) and milk (138; 20.03 %). Sensitization to various proteins ranged between 15.53–15.97 %, while lentils, corn, rice, soya and peanut sensitization was 15.4, 16, 12.5, 12 and 11.5 % respectively. Only 7.1 % patients were SPT positive for banana allergen. SPT was performed in patients with self-reported food allergy (341/689) and also with no self-reported history of food allergy (348/689). SPT results were positive in 69.8 % of the self-report group, whereas, in the patients with no self-reported food allergy 9.2 % were found sensitized to one or more tested food allergens. 101 patients were recruited for OFC, 61 % of these were confirmed of food allergy. The prevalence of food allergy in the study population was 9 %. Food specific OFC results show that wheat allergy is affecting 1.6 % (95 % CI 0.9–2.84 %) of the total allergy patients, followed by egg allergy 1.31 % (95 % CI 0.70–2.47 %). Furthermore, corn allergy, rice allergy and peanut allergy were 1.02, 0.87 and 0.73 %, respectively. In conclusion, wheat allergy is the most prevalent, followed by egg, chicken, beef and fish allergy, respectively.
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Affiliation(s)
- Muhammad Inam
- Physiology/Endocrinology Lab, Department of Zoology, University of the Punjab, Quaid-i-Azam Campus, Lahore, 54590 Pakistan
| | - Rubaba Hamid Shafique
- Department of Zoology, University of Arid Agriculture Rawalpindi (PMAS-UAAR), Rawalpindi, Pakistan
| | - Nabila Roohi
- Physiology/Endocrinology Lab, Department of Zoology, University of the Punjab, Quaid-i-Azam Campus, Lahore, 54590 Pakistan
| | - Muhammad Irfan
- Department of Zoology, University of Arid Agriculture Rawalpindi (PMAS-UAAR), Rawalpindi, Pakistan
| | - Shahid Abbas
- Allergy Asthma and Immunology Centre, Khyber Plaza Fazal-e-Haq Road, Blue Area, Islamabad, Pakistan
| | - Muhammad Ismail
- Institute of Biomedical and Genetic Engineering (IBGE), Islamabad, Pakistan
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Mahesh PA, Wong GWK, Ogorodova L, Potts J, Leung TF, Fedorova O, Holla AD, Fernandez-Rivas M, Clare Mills EN, Kummeling I, Versteeg SA, van Ree R, Yazdanbakhsh M, Burney P. Prevalence of food sensitization and probable food allergy among adults in India: the EuroPrevall INCO study. Allergy 2016; 71:1010-9. [PMID: 27297800 DOI: 10.1111/all.12868] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2016] [Indexed: 01/21/2023]
Abstract
BACKGROUND Data are lacking regarding the prevalence of food sensitization and probable food allergy among general population in India. We report the prevalence of sensitization and probable food allergy to 24 common foods among adults from general population in Karnataka, South India. METHODOLOGY The study was conducted in two stages: a screening study and a case-control study. A total of 11 791 adults in age group 20-54 were randomly sampled from general population in South India and answered a screening questionnaire. A total of 588 subjects (236 cases and 352 controls) participated in the case-control study involving a detailed questionnaire and specific IgE estimation for 24 common foods. RESULTS A high level of sensitization (26.5%) was observed for most of the foods in the general population, higher than that observed among adults in Europe, except for those foods that cross-react with birch pollen. Most of the sensitization was observed in subjects who had total IgE above the median IgE level. A high level of cross-reactivity was observed among different pollens and foods and among foods. The prevalence of probable food allergy (self-reports of adverse symptoms after the consumption of food and specific IgE to the same food) was 1.2%, which was mainly accounted for cow's milk (0.5%) and apple (0.5%). CONCLUSION Very high levels of sensitization were observed for most foods, including those not commonly consumed in the general population. For the levels of sensitization, the prevalence of probable food allergy was low. This disassociation needs to be further explored in future studies.
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Affiliation(s)
- P. A. Mahesh
- Department of Allergy; Allergy Asthma Associates; Mysore Karnataka India
- Department of TB and Respiratory Medicine; JSS Medical College and Hospital; JSS University, Mysore Karnataka India
| | - Gary W. K. Wong
- Department of Pediatrics and School of Public Health; Chinese University of Hong Kong; Shatin, NT Hong Kong China
| | - L. Ogorodova
- Department of Faculty Pediatrics; Siberian State Medical University; Tomsk Russia
| | - J. Potts
- Department of Respiratory Epidemiology and Public Health; National Heart and Lung Institute; Imperial College London London UK
| | - T. F. Leung
- Department of Pediatrics and School of Public Health; Chinese University of Hong Kong; Shatin, NT Hong Kong China
| | - O. Fedorova
- Department of Faculty Pediatrics; Siberian State Medical University; Tomsk Russia
| | - Amrutha D. Holla
- Department of Allergy; Allergy Asthma Associates; Mysore Karnataka India
| | | | - E. N. Clare Mills
- Respiratory and Allergy Centre; Institute of Inflammation and Repair; Manchester Institute of Biotechnology; The University of Manchester Manchester UK
| | - I. Kummeling
- Department of Respiratory Epidemiology and Public Health; National Heart and Lung Institute; Imperial College London London UK
| | - S. A. Versteeg
- Department of Experimental Immunology and Department of Otorhinolaryngology; Academic Medical Center; Amsterdam the Netherlands
| | - R. van Ree
- Department of Experimental Immunology and Department of Otorhinolaryngology; Academic Medical Center; Amsterdam the Netherlands
| | - M. Yazdanbakhsh
- Department of Parasitology; Leiden University Medical Center; Leiden the Netherlands
| | - P. Burney
- Department of Respiratory Epidemiology and Public Health; National Heart and Lung Institute; Imperial College London London UK
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Morou Z, Lyrakos GN, Papadopoulos NG, Douladiris N, Tatsioni A, Dimoliatis ID. Translation, Adaptation and Initial Validation of Food Allergy Quality of Life Questionnaire: Child form in Greek. Health Psychol Res 2016; 4:4624. [PMID: 27403459 PMCID: PMC4926025 DOI: 10.4081/hpr.2016.4624] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Revised: 11/12/2015] [Accepted: 02/05/2016] [Indexed: 11/23/2022] Open
Abstract
The aim of the study is to determine the reliability and validity of the Greek version of the Food Allergy Quality of life Questionnaire-Child Form (FAQLQ-CF). After linguistic validation, the Greek FAQLQ-CF, Food Allergy Independent Measure (FAIM) and Pediatric Quality of Life Inventory (PedsQL™) were used by a physician to interview children diagnosed with food allergy and aged 8-12 via telephone. Cronbach's alpha was used to evaluate reliability, and factor analysis to assess construct validity. The correlation between FAQLQ-CF and FAIM was moderate (rho=0.509, P<0.001) and internal consistency was strong (Cronbach's alpha 0.905). FAQLQ-CF discriminated well each question's contribution to children's quality of life deterioration (32-80%), each child's quality of life (17-89%), children differing in doing things with others (total score 3.55 vs 2.57, difference =0.98 > minimal clinical importance difference = 0.5; P<0.001), but not children differing in reporting anaphylaxis. The total FAQLQ-CF score correlated with the total PedsQL™ score and with the score of one of PedsQL™ subscales, demonstrating convergent validity. Factor analysis uncovered an underlying structure of four factors, explaining 50% of the variance. We can conclude that Greek FAQLQ-CF is a reliable, valid, discriminant tool for interviewing food allergic children aged 8-12, detecting those in need for immediate care.
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Affiliation(s)
- Zoe Morou
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Georgios N. Lyrakos
- Second Department of Anesthesiology, University of Athens Medical School, Athens, Greece
| | | | | | - Athina Tatsioni
- Tufts University School of Medicine, Boston, MA, USA
- Department of Internal Medicine, University of Ioannina Medical School, loannina Greece
| | - Ioannis D.K. Dimoliatis
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
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Epidemiology of food allergy and food-induced anaphylaxis: is there really a Western world epidemic? Curr Opin Allergy Clin Immunol 2016; 15:409-16. [PMID: 26258921 DOI: 10.1097/aci.0000000000000196] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Food-induced anaphylaxis continues to be an important cause of hospital admissions, particularly in children. This review outlines recent advances in understanding the epidemiology of IgE-mediated food allergy and potential mechanisms for its rise in prevalence. RECENT FINDINGS The rise in food allergy prevalence in Western countries has happened more quickly than changes to the genome can occur; thus, environmental changes are likely to be important. Recent studies, however, suggest that genetic risk determines responses to environmental risk factors. Environmental peanut exposure has been associated with increased peanut allergy risk in individuals with filaggrin null mutations, consistently with sensitization occurring through a damaged skin barrier. Reduced microbial and vitamin D exposure is also leading candidates for risk factors for food allergy in the context of genetic susceptibility. In addition, HLA-DR and HLA-DQ gene region variants appear to play a role in peanut allergy, although no studies have yet assessed their susceptibility to environmental cues. Finally, findings from observational cohorts and the first large-scale intervention trials for food allergy prevention support early oral allergen exposure to reduce the prevalence of specific food allergies, which is informing changes in public health guidelines at the population level. Further research will be required to assess the impact of these guideline changes on the population prevalence of food allergy. SUMMARY New studies are providing important insights into the prevalence, causes, and mechanisms of food allergy. Recent findings are informing changes to population health guidelines in developed countries, which have the potential to halt or reverse the increase in food allergy prevalence. By contrast, food allergy in the developing world remains understudied.
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Epidemiologische Daten zur Nahrungsmittelallergie in Europa. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 59:745-54. [DOI: 10.1007/s00103-016-2358-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Cheng F, Wu J, Zhang J, Pan A, Quan S, Zhang D, Kim H, Li X, Zhou S, Yang L. Development and inter-laboratory transfer of a decaplex polymerase chain reaction assay combined with capillary electrophoresis for the simultaneous detection of ten food allergens. Food Chem 2016; 199:799-808. [DOI: 10.1016/j.foodchem.2015.12.058] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 11/25/2015] [Accepted: 12/11/2015] [Indexed: 01/10/2023]
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36
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Teodorowicz M, Terlouw RJ, Jansen A, Savelkoul HFJ, Ruinemans-Koerts J. Immunological Characterization of Dutch Sesame Seed-Allergic Patients. Int Arch Allergy Immunol 2016; 169:13-22. [PMID: 26954556 DOI: 10.1159/000443641] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 12/22/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Sesame seed is an allergen of growing importance worldwide. However, knowledge of the clinically relevant sesame allergen and its cross-reactivity with homologous allergens is limited. The aim of this study was the immunological characterization of Dutch sesame seed-allergic patients and evaluation of cross-reactivity between sesame seed, tree nut and pollen allergens using different sources of allergen extracts. METHODS Six patients with a medical history of sesame seed allergy were included, i.e. 5 with an anaphylactic reaction and 1 with an oral allergy syndrome (OAS). The immunological background of the sesame seed and tree nut IgE sensitization was characterized with Western blotting and a basophil activation test (BAT). The major sesame allergen was identified by nanoLC-MS/MS. Cross-reactivity was measured using an immuno-inhibition assay with the Phadia ImmunoCAP system. RESULTS Oleosin was identified as the major allergen for the 5 patients with an anaphylactic reaction to sesame seed, but no cross-reactivity between sesame and tree nut proteins was observed. For the patient with OAS, IgE specific to oleosin was not detected but cross-reactivity between sesame seed and tree nut proteins was observed. The BAT and ImmunoCAP inhibition test added value to the clinical and immunological characterization of sesame seed-sensitized patients, distinguishing relevant and non-relevant sensitizations. CONCLUSIONS Our immunological approach enabled us to fully characterize the sensitization pattern of 6 sesame seed-allergic patients. The different protein composition of commercially available allergen extracts influences the outcomes of the immunological assays and thus also the diagnosis to a large extent.
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Affiliation(s)
- Malgorzata Teodorowicz
- Department of Cell Biology and Immunology, Wageningen University, Wageningen, The Netherlands
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Sánchez-García S, Cipriani F, Ricci G. Food Allergy in childhood: phenotypes, prevention and treatment. Pediatr Allergy Immunol 2015; 26:711-20. [PMID: 26595763 DOI: 10.1111/pai.12514] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2015] [Indexed: 12/30/2022]
Abstract
The prevalence of food allergy in childhood increased in the last decades, especially in Westernized countries where this phenomenon has been indicated as a second wave of the allergic epidemic. In parallel, scientific interest also increased with the effort to explain the reasons of this sudden rise and to identify potential protective and risk factors. A great attention has been focused on early exposures to allergenic foods, as well as on other nutritional factors or supplements that may influence the immune system in a positive direction. Both interventions on maternal diet before birth or during breastfeeding and then directly on infant nutrition have been investigated. Furthermore, the natural history of food allergy also seems to be changing over time; IgE-mediated cow's milk allergy and egg allergy seem to be more frequently a persistent rather than a transient disease in childhood, as described in the last years. Food avoidance and the emergency drugs in case of an adverse event, such as epinephrine self-injector, are currently the first-line treatment in patients with food allergies, with a resulting impairment in the quality of life and social behaviour. During the last decade, oral immunotherapy emerged as an optional treatment with remarkable results, offering a novel perspective in the treatment for and management of food allergy.
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Affiliation(s)
| | - Francesca Cipriani
- Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giampaolo Ricci
- Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Kiwifruit Allergy in Children: Characterization of Main Allergens and Patterns of Recognition. CHILDREN-BASEL 2015; 2:424-38. [PMID: 27417374 PMCID: PMC4928771 DOI: 10.3390/children2040424] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 09/24/2015] [Accepted: 10/02/2015] [Indexed: 11/17/2022]
Abstract
Kiwifruit allergy has been described mostly in the adult population, but immunoglobulin (Ig)E-mediated allergic reactions to kiwifruit appear to be occurring more frequently in children. To date, 13 allergens from kiwifruit have been identified. Our aim was to identify kiwifruit allergens in a kiwifruit allergic-pediatric population, describing clinical manifestations and patterns of recognition. Twenty-four children were included. Diagnosis of kiwifruit allergy was based on compatible clinical manifestations and demonstration of specific IgE by skin prick test (SPT) and/or serum-specific IgE determination. SDS-PAGE and immunoblotting were performed with kiwifruit extract, and proteins of interest were further analyzed by mass spectrometry/mass spectrometry. For component-resolved in vitro diagnosis, sera of kiwifruit-allergic patients were analyzed by an allergen microarray assay. Act d 1 and Act d 2 were bound by IgE from 15 of 24 children. Two children with systemic manifestations recognized a protein of 15 kDa, homologous to Act d 5. Act d 1 was the allergen with the highest frequency of recognition on microarray chip, followed by Act d 2 and Act d 8. Kiwifruit allergic children develop systemic reactions most frequently following ingestion compared to adults. Act d 1 and Act d 2 are major allergens in the pediatric age group.
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Schoemaker AA, Sprikkelman AB, Grimshaw KE, Roberts G, Grabenhenrich L, Rosenfeld L, Siegert S, Dubakiene R, Rudzeviciene O, Reche M, Fiandor A, Papadopoulos NG, Malamitsi-Puchner A, Fiocchi A, Dahdah L, Sigurdardottir ST, Clausen M, Stańczyk-Przyłuska A, Zeman K, Mills ENC, McBride D, Keil T, Beyer K. Incidence and natural history of challenge-proven cow's milk allergy in European children--EuroPrevall birth cohort. Allergy 2015; 70:963-72. [PMID: 25864712 DOI: 10.1111/all.12630] [Citation(s) in RCA: 284] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND Cow's milk allergy (CMA) is one of the most commonly reported childhood food problems. Community-based incidence and prevalence estimates vary widely, due to possible misinterpretations of presumed reactions to milk and differences in study design, particularly diagnostic criteria. METHODS Children from the EuroPrevall birth cohort in 9 European countries with symptoms possibly related to CMA were invited for clinical evaluation including cows' milk-specific IgE antibodies (IgE), skin prick test (SPT) reactivity and double-blind, placebo-controlled food challenge. RESULTS Across Europe, 12 049 children were enrolled, and 9336 (77.5%) were followed up to 2 years of age. CMA was suspected in 358 children and confirmed in 55 resulting in an overall incidence of challenge-proven CMA of 0.54% (95% CI 0.41-0.70). National incidences ranged from 1% (in the Netherlands and UK) to <0.3% (in Lithuania, Germany and Greece). Of all children with CMA, 23.6% had no cow's milk-specific IgE in serum, especially those from UK, the Netherlands, Poland and Italy. Of children with CMA who were re-evaluated one year after diagnosis, 69% (22/32) tolerated cow's milk, including all children with non-IgE-associated CMA and 57% of those children with IgE-associated CMA. CONCLUSIONS This unique pan-European birth cohort study using the gold standard diagnostic procedure for food allergies confirmed challenge-proven CMA in <1% of children up to age 2. Affected infants without detectable specific antibodies to cow's milk were very likely to tolerate cow's milk one year after diagnosis, whereas only half of those with specific antibodies in serum 'outgrew' their disease so soon.
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Affiliation(s)
- A. A. Schoemaker
- Department of Pediatric Respiratory Medicine and Allergy; Emma Children's Hospital; Academic Medical Centre; Amsterdam The Netherlands
| | - A. B. Sprikkelman
- Department of Pediatric Respiratory Medicine and Allergy; Emma Children's Hospital; Academic Medical Centre; Amsterdam The Netherlands
| | - K. E. Grimshaw
- Clinical and Experimental Sciences Academic Unit; Faculty of Medicine; University of Southampton; Southampton UK
| | - G. Roberts
- Clinical and Experimental Sciences Academic Unit; Faculty of Medicine; University of Southampton; Southampton UK
- NIHR Respiratory Biomedical Research Unit; University Hospital Southampton NHS Foundation Trust; Southampton UK
| | - L. Grabenhenrich
- Institute of Social Medicine; Epidemiology and Health Economics; Charité University Medical Centre; Berlin Germany
| | - L. Rosenfeld
- Department of Paediatric Pneumology and Immunology; Charité University Medical Centre; Berlin Germany
| | - S. Siegert
- Department of Paediatric Pneumology and Immunology; Charité University Medical Centre; Berlin Germany
- German Agency for Quality in Medicine; Berlin Germany
| | - R. Dubakiene
- Faculty of Medicine; Vilnius University; Vilnius Lithuania
| | | | - M. Reche
- Sofia Children's University Hospital; Madrid Spain
| | - A. Fiandor
- University Hospital La Paz; Madrid Spain
| | - N. G. Papadopoulos
- Department of Allergy; Second Paediatric Clinic; University of Athens; Athens Greece
| | - A. Malamitsi-Puchner
- Neonatal Division; Second Department of Obstetrics and Gynaecology; University of Athens; Athens Greece
| | - A. Fiocchi
- Division of Allergy; Department of Pediatrics; Pediatric Hospital Bambino Gesù; Rome Italy
| | - L. Dahdah
- Division of Allergy; Department of Pediatrics; Pediatric Hospital Bambino Gesù; Rome Italy
| | - S. Th. Sigurdardottir
- Department of Immunology; Landspitali-The National University Hospital of Iceland; Reykjavik Iceland
| | - M. Clausen
- Children's Hospital; Landspitali-The National University Hospital of Iceland; Reykjavik Iceland
| | - A. Stańczyk-Przyłuska
- Department of Pediatrics, Preventive Cardiology and Immunology; Medical University of Łódź; Łódź Poland
| | - K. Zeman
- Department of Pediatrics, Preventive Cardiology and Immunology; Medical University of Łódź; Łódź Poland
- Department of Pediatrics, Immunology and Nephrology; Department of Pediatrics, Clinical Immunology and Cardiology; Polish Mother's Health Centre Research Institute Łódź; Medical University of Łódź; Łódź Poland
| | - E. N. C. Mills
- Institute of Inflammation and Repair; Manchester Academic Health Science Centre; Manchester Institute of Biotechnology; University of Manchester; Manchester UK
| | - D. McBride
- Institute of Social Medicine; Epidemiology and Health Economics; Charité University Medical Centre; Berlin Germany
| | - T. Keil
- Institute of Social Medicine; Epidemiology and Health Economics; Charité University Medical Centre; Berlin Germany
- Institute of Clinical Epidemiology and Biometry; University of Würzburg; Würzburg Germany
| | - K. Beyer
- Department of Paediatric Pneumology and Immunology; Charité University Medical Centre; Berlin Germany
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Umetsu DT, Rachid R, Schneider LC. Oral immunotherapy and anti-IgE antibody treatment for food allergy. World Allergy Organ J 2015; 8:20. [PMID: 26185589 PMCID: PMC4491881 DOI: 10.1186/s40413-015-0070-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 05/11/2015] [Indexed: 01/30/2023] Open
Abstract
Food allergy is a major public health problem affecting nearly 10 % of children in most industrialized countries. Unfortunately, there are no effective therapies for food allergy, relegating patients to simply avoid the offending foods and treat reactions that occur on accidental exposure. Recently however, studies suggest that food immunotherapy may provide a promising new approach to food allergy, particularly using the oral form of immunotherapy (OIT). Enthusiasm for this approach though must be tempered because of the significant allergic reactions that often occur with OIT that tends to limit its use to patients with less severe disease. On the other hand, recent studies suggest that concomitant treatment of patients with omalizumab (anti-IgE monoclonal antibody) during the updosing phase of OIT may greatly reduce the allergic reactions associated with OIT, even in high-risk patients. This combined method may provide a novel approach to successfully and rapidly treat a large fraction of patients with high-risk food allergy.
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Affiliation(s)
- Dale T Umetsu
- Genetech, One DNA Way, MS 453b, South San Francisco, California 94080 USA
| | - Rima Rachid
- Division of Immunology and Allergy, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115 USA
| | - Lynda C Schneider
- Division of Immunology and Allergy, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115 USA
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Authentication of closely related scombrid, catfish and tilapia species by PCR-based analysis and isoelectric focusing of parvalbumin. Eur Food Res Technol 2015. [DOI: 10.1007/s00217-015-2479-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Harrington DW, Dean J, Wilson K, Qamar Z. "We don't have such a thing, that you may be allergic": Newcomers' understandings of food allergies in Canada. Chronic Illn 2015; 11:126-39. [PMID: 25085906 DOI: 10.1177/1742395314546136] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 07/14/2014] [Indexed: 11/17/2022]
Abstract
Food allergies are emerging as important public health risks in Canada, affecting 3-4% of adults and 6-7% of children. Despite much lower prevalence rates among recent immigrants (i.e. in the country less than 10 years), evidence has shown this population to be more concerned about the risks of food allergies than the general population and have unique experiences around purchasing foods for allergen-free environments. As a substantial and growing segment of the Canadian population, it is important to understand newcomers' perceptions and knowledge of food allergies and related policies developed to protect allergic children (e.g. nut-free schools and or classrooms). This paper draws upon the results of focus groups conducted with newcomers from food allergic households (i.e. directly affected), as well as those with school-aged children who have to prepare or buy foods for allergen-controlled classrooms or schools (i.e. indirectly affected) living in Mississauga, Ontario. Results indicate unique challenges and understandings of food allergies as a new and unfamiliar risk for most newcomers, particularly as the indirectly affected participants negotiate the policy landscape. The directly affected group highlights the supportive environment in Canada resulting from the same policies and increased awareness in the general population.
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Affiliation(s)
| | - Jennifer Dean
- School of Planning, University of Waterloo, Waterloo, ON, Canada
| | - Kathi Wilson
- Department of Geography, University of Toronto Mississauga, Mississauga, ON, Canada
| | - Zafar Qamar
- Department of Geography, University of Toronto Mississauga, Mississauga, ON, Canada
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Fernández-Rivas M, Barreales L, Mackie AR, Fritsche P, Vázquez-Cortés S, Jedrzejczak-Czechowicz M, Kowalski ML, Clausen M, Gislason D, Sinaniotis A, Kompoti E, Le TM, Knulst AC, Purohit A, de Blay F, Kralimarkova T, Popov T, Asero R, Belohlavkova S, Seneviratne SL, Dubakiene R, Lidholm J, Hoffmann-Sommergruber K, Burney P, Crevel R, Brill M, Fernández-Pérez C, Vieths S, Clare Mills EN, van Ree R, Ballmer-Weber BK. The EuroPrevall outpatient clinic study on food allergy: background and methodology. Allergy 2015; 70:576-84. [PMID: 25640688 DOI: 10.1111/all.12585] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND The EuroPrevall project aimed to develop effective management strategies in food allergy through a suite of interconnected studies and a multidisciplinary integrated approach. To address some of the gaps in food allergy diagnosis, allergen risk management and socio-economic impact and to complement the EuroPrevall population-based surveys, a cross-sectional study in 12 outpatient clinics across Europe was conducted. We describe the study protocol. METHODS Patients referred for immediate food adverse reactions underwent a consistent and standardized allergy work-up that comprised collection of medical history; assessment of sensitization to 24 foods, 14 inhalant allergens and 55 allergenic molecules; and confirmation of clinical reactivity and food thresholds by standardized double-blind placebo-controlled food challenges (DBPCFCs) to milk, egg, fish, shrimp, peanut, hazelnut, celeriac, apple and peach. RESULTS A standardized methodology for a comprehensive evaluation of food allergy was developed and implemented in 12 outpatient clinics across Europe. A total of 2121 patients (22.6% <14 years) reporting 8257 reactions to foods were studied, and 516 DBPCFCs were performed. CONCLUSIONS This is the largest multicentre European case series in food allergy, in which subjects underwent a comprehensive, uniform and standardized evaluation including DBPCFC, by a methodology which is made available for further studies in food allergy. The analysis of this population will provide information on the different phenotypes of food allergy across Europe, will allow to validate novel in vitro diagnostic tests, to establish threshold values for major allergenic foods and to analyse the socio-economic impact of food allergy.
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Affiliation(s)
| | - L. Barreales
- Clinical Epidemilogy Unit; Preventive Medicine Department; Hospital Clínico San Carlos; IdISSC; Madrid Spain
| | - A. R. Mackie
- Institute of Food Research; Norwich Research Park; Colney Norwich UK
| | - P. Fritsche
- Allergy Unit; Department of Dermatology; University Hospital Zürich; Zürich Switzerland
| | - S. Vázquez-Cortés
- Allergy Department; Hospital Clínico San Carlos; IdISSC; Madrid Spain
| | | | - M. L. Kowalski
- Department of Immunology, Rheumatology and Allergy; Medical University of Lodz; Lodz Poland
| | - M. Clausen
- Department of Allergy, Respiratory Medicine and Sleep; Landspitali University Hospital; Reykjavik Iceland
| | - D. Gislason
- Department of Allergy, Respiratory Medicine and Sleep; Landspitali University Hospital; Reykjavik Iceland
| | - A. Sinaniotis
- Allergy Department; Laiko General Hospital; Athens Greece
| | - E. Kompoti
- Allergy Department; Laiko General Hospital; Athens Greece
| | - T.-M. Le
- Department of Dermatology/Allergology; University Medical Center Utrecht; Utrecht The Netherlands
| | - A. C. Knulst
- Department of Dermatology/Allergology; University Medical Center Utrecht; Utrecht The Netherlands
| | - A. Purohit
- Division of Asthma and Allergy; Department of Chest Diseases; University Hospital; Strasbourg France
| | - F. de Blay
- Division of Asthma and Allergy; Department of Chest Diseases; University Hospital; Strasbourg France
| | - T. Kralimarkova
- Clinical Centre of Allergology and Asthma; Medical University Sofia; Sofia Bulgaria
| | - T. Popov
- Clinical Centre of Allergology and Asthma; Medical University Sofia; Sofia Bulgaria
| | - R. Asero
- Ambulatorio di Allergologia; Clinica San Carlo; Paderno Dugnano Milano Italy
| | - S. Belohlavkova
- Department of Pediatrics; Faculty Hospital Bulovka; Charles University; Prague Czech Republic
| | - S. L. Seneviratne
- Department of Clinical Immunology and Allergy; Central Manchester and Manchester Children's University Hospitals NHS Trust; Manchester UK
| | - R. Dubakiene
- Allergy Centre; Vilnius University; Vilnius Lithuania
| | - J. Lidholm
- Thermo Fisher Scientific; Uppsala Sweden
| | - K. Hoffmann-Sommergruber
- Department of Pathophysiology and Allergy Research; Medical University of Vienna; Vienna Austria
| | - P. Burney
- Department of Respiratory Epidemiology and Public Health; National Heart and Lung Institute; Imperial College London; London UK
| | - R. Crevel
- Unilever Safety and Environmental Assurance Centre; Colworth Science Park; Sharnbrook Bedfordshire UK
| | - M. Brill
- Thermo Fisher Scientific; Uppsala Sweden
- VBC Genomics Biosciences Research GmbH; Vienna Austria
| | - C. Fernández-Pérez
- Clinical Epidemilogy Unit; Preventive Medicine Department; Hospital Clínico San Carlos; IdISSC; Madrid Spain
| | - S. Vieths
- Division of Allergologie; Paul Ehrlich Institute; Langen Germany
| | - E. N. Clare Mills
- Institute of Food Research; Norwich Research Park; Colney Norwich UK
- Institute of Inflammation and Repair; Manchester Academic Health Science Centre; Manchester Institute of Biotechnology; The University of Manchester; Manchester UK
| | - R. van Ree
- Department of Experimental Immunology; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
- Department of Otorhinolaryngology; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | - B. K. Ballmer-Weber
- Allergy Unit; Department of Dermatology; University Hospital Zürich; Zürich Switzerland
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Hristomanova Mitkovska S, Trajkov D, Petlichkovski A, Efinska-Mladenovska O, Spiroski M. Total IgE Distribution in Food Allergy Suspected Patients in Republic of Macedonia (2001-2011). Open Access Maced J Med Sci 2015; 3:202-8. [PMID: 27275222 PMCID: PMC4877854 DOI: 10.3889/oamjms.2015.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 03/21/2015] [Accepted: 04/12/2015] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: IgE may be considered the hallmark of allergic disorders. It is easily detected in serum and can be measured as total IgE and as allergen-specific IgE. In fact, the serum IgE assay is used to diagnose an allergy.AIM: The aim of this study is to evaluate, investigate and present the distribution of total serum IgE levels, determined with UniCap system, in food-allergy suspected patients in a Republic of Macedonia.MATERIAL AND METHODS: In this study we analyzed retrospectively 8898 consecutive patients that were admitted for allergy testing at the Institute of Immunobiology and Human Genetics during the ten year period between 01.01.2001 and 01.01.2011. Total IgE levels in patient sera were detected with the in vitro system UniCAP100 (Pharmacia, Uppsala, Sweden).RESULTS: When we analyzed the number of patients according to the total IgE groups, we noted that most of the patients have normal levels of total IgE in serum. However, we also discovered a group of patients with elevated levels of total IgE that are greater than 200 kU/L. The average concentration of total serum IgE is higher in women in the age group 6 (6-7 years), followed by a steep decrease in the age group 9 (9-10 years), and after that the average concentrations of total IgE were mostly constant with the exception of a partial increase in the age group 21 (65-69 years). For men, the average serum concentrations of total IgE were highest in the age group of 6 (6-7 years), which was significantly higher than the average concentrations of total IgE in all other age groups.CONCLUSION: The large number of enrolled patients, a particular strength of this study, revealed that average concentrations of total IgE in men are higher than in women and that total IgE did not decrease with age. On the contrary, increased total IgE levels were found in patients aged 65 and 69 of both genders. We continue our work with analyses of the specific IgE antibodies values toward food and the correlation with total IgE values.
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Ballmer-Weber BK, Fernandez-Rivas M, Beyer K, Defernez M, Sperrin M, Mackie AR, Salt LJ, Hourihane JO, Asero R, Belohlavkova S, Kowalski M, de Blay F, Papadopoulos NG, Clausen M, Knulst AC, Roberts G, Popov T, Sprikkelman AB, Dubakiene R, Vieths S, van Ree R, Crevel R, Mills EC. How much is too much? Threshold dose distributions for 5 food allergens. J Allergy Clin Immunol 2015; 135:964-971. [DOI: 10.1016/j.jaci.2014.10.047] [Citation(s) in RCA: 125] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 10/07/2014] [Accepted: 10/15/2014] [Indexed: 11/29/2022]
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Ballmer-Weber BK, Lidholm J, Fernández-Rivas M, Seneviratne S, Hanschmann KM, Vogel L, Bures P, Fritsche P, Summers C, Knulst AC, Le TM, Reig I, Papadopoulos NG, Sinaniotis A, Belohlavkova S, Popov T, Kralimarkova T, de Blay F, Purohit A, Clausen M, Jedrzejczak-Czechowcz M, Kowalski ML, Asero R, Dubakiene R, Barreales L, Clare Mills EN, van Ree R, Vieths S. IgE recognition patterns in peanut allergy are age dependent: perspectives of the EuroPrevall study. Allergy 2015; 70:391-407. [PMID: 25620497 DOI: 10.1111/all.12574] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND We tested the hypothesis that specific molecular sensitization patterns correlate with the clinical data/manifestation in a European peanut-allergic population characterized under a common protocol. METHODS Sixty-eight peanut-allergic subjects and 82 tolerant controls from 11 European countries were included. Allergy to peanut and lowest symptom-eliciting dose was established by double-blind placebo-controlled food challenge in all but anaphylactic subjects. Information of early or late (before or after 14 years of age) onset of peanut allergy was obtained from standardized questionnaires. IgE to peanut allergens rAra h 1-3, 6, 8-9, profilin and CCD was determined using ImmunoCAP. RESULTS Seventy-eight percent of peanut allergics were sensitized to peanut extract and 90% to at least one peanut component. rAra h 2 was the sole major allergen for the peanut-allergic population. Geographical differences were observed for rAra h 8 and rAra h 9, which were major allergens for central/western and southern Europeans, respectively. Sensitization to rAra h 1 and 2 was exclusively observed in early-onset peanut allergy. Peanut-tolerant subjects were frequently sensitized to rAra h 8 or 9 but not to storage proteins. Sensitization to Ara h 2 ≥ 1.0 kUA /l conferred a 97% probability for a systemic reaction (P = 0.0002). Logistic regression revealed a significant influence of peanut extract sensitization and region on the occurrence of systemic reactions (P = 0.0185 and P = 0.0436, respectively). CONCLUSION Sensitization to Ara h 1, 2 and 3 is usually acquired in childhood. IgE to Ara h 2 ≥ 1.0 kUA /l is significantly associated with the development of systemic reactions to peanut.
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Affiliation(s)
- B. K. Ballmer-Weber
- Allergy Unit; Department of Dermatology; University Hospital; Zürich Switzerland
| | - J. Lidholm
- Thermo Fisher Scientific; Uppsala Sweden
| | | | - S. Seneviratne
- Department of Clinical Immunology; Royal Free Hospital and University College; London UK
| | - K.-M. Hanschmann
- Division of Biostatistics; Paul-Ehrlich-Institut; Langen Germany
| | - L. Vogel
- Division of Allergology; Paul-Ehrlich-Institut; Langen Germany
| | - P. Bures
- Allergy Unit; Department of Dermatology; University Hospital; Zürich Switzerland
| | - P. Fritsche
- Allergy Unit; Department of Dermatology; University Hospital; Zürich Switzerland
| | - C. Summers
- Manchester Royal Infirmary; Manchester UK
| | - A. C. Knulst
- Department of Dermatology/Allergology; University Medical Center; Utrecht The Netherlands
| | - T.-M. Le
- Department of Dermatology/Allergology; University Medical Center; Utrecht The Netherlands
| | - I. Reig
- Allergy Department; Hospital Clinico San Carlos; IdISSC; Madrid Spain
| | - N. G. Papadopoulos
- Allergy Department; 2nd Pediatric Clinic; University of Athens; Athens Greece
- Centre for Paediatrics and Child Health; Institute of Human Development; University of Manchester; Manchester UK
| | - A. Sinaniotis
- Allergy Department; 2nd Pediatric Clinic; University of Athens; Athens Greece
| | - S. Belohlavkova
- Pediatric Department; Faculty Hospital Bulovka; Prague Czech Republic
| | - T. Popov
- Clinic of Allergy & Asthma; Medical University of Sofia; Sofia Bulgaria
| | - T. Kralimarkova
- Clinic of Allergy & Asthma; Medical University of Sofia; Sofia Bulgaria
| | - F. de Blay
- Allergy division; Chest disease department; University Hospital of Strasbourg; Strasbourg France
| | - A. Purohit
- Allergy division; Chest disease department; University Hospital of Strasbourg; Strasbourg France
| | - M. Clausen
- Department of Allergy; Respiratory Medicine and Sleep; Landspitali University Hospital; Reykjavík Iceland
| | - M. Jedrzejczak-Czechowcz
- Department of Immunology, Rheumatology and Allergy; Faculty of Medicine; Medical University of Lodz; Lodz Poland
| | - M. L. Kowalski
- Department of Immunology, Rheumatology and Allergy; Faculty of Medicine; Medical University of Lodz; Lodz Poland
| | - R. Asero
- Ambulatorio di Allergologia; Clinica San Carlo; Paderno Dugnano Italy
| | - R. Dubakiene
- Medical Faculty Vilnius University; Vilnius Lithuania
| | - L. Barreales
- Clinical Epidemiology Unit; Preventive Medicine Department; Hospital Clinico San Carlos; IdISSC; Madrid Spain
| | - E. N. Clare Mills
- Institute of Inflammation and Repair and Manchester Institute of Biotechnology; Manchester Academic Health Sciences Centre; The University of Manchester; Manchester UK
| | - R. van Ree
- Department of Experimental Immunology and Department of Otorhinolaryngology; Academic Medical Center of the University of Amsterdam; Amsterdam The Netherlands
| | - S. Vieths
- Division of Allergology; Paul-Ehrlich-Institut; Langen Germany
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Datema MR, Zuidmeer-Jongejan L, Asero R, Barreales L, Belohlavkova S, de Blay F, Bures P, Clausen M, Dubakiene R, Gislason D, Jedrzejczak-Czechowicz M, Kowalski ML, Knulst AC, Kralimarkova T, Le TM, Lovegrove A, Marsh J, Papadopoulos NG, Popov T, Del Prado N, Purohit A, Reese G, Reig I, Seneviratne SL, Sinaniotis A, Versteeg SA, Vieths S, Zwinderman AH, Mills C, Lidholm J, Hoffmann-Sommergruber K, Fernández-Rivas M, Ballmer-Weber B, van Ree R. Hazelnut allergy across Europe dissected molecularly: A EuroPrevall outpatient clinic survey. J Allergy Clin Immunol 2015; 136:382-91. [PMID: 25772593 DOI: 10.1016/j.jaci.2014.12.1949] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 11/25/2014] [Accepted: 12/04/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Hazelnut allergy is birch pollen-driven in Northern/Western Europe and lipid transfer protein-driven in Spain and Italy. Little is known about other regions and other allergens. OBJECTIVE Establishing a molecular map of hazelnut allergy across Europe. METHODS In 12 European cities, subjects reporting reactions to hazelnut (n = 731) were evaluated and sensitization to 24 foods, 12 respiratory allergen sources, and latex was tested by using skin prick test and ImmunoCAP. A subset (124 of 731) underwent a double-blind placebo-controlled food challenge to hazelnut. Sera of 423 of 731 subjects were analyzed for IgE against 7 hazelnut allergens and cross-reactive carbohydrate determinants by ImmunoCAP. RESULTS Hazelnut allergy was confirmed in 70% of those undergoing double-blind placebo-controlled food challenges. Birch pollen-driven hazelnut sensitization (Cor a 1) dominated in most cities, except in Reykjavik, Sofia, Athens, and Madrid, where reporting of hazelnut allergy was less frequent anyhow. In Athens, IgE against Cor a 8 dominated and strongly correlated with IgE against walnut, peach, and apple and against Chenopodium, plane tree, and mugwort pollen. Sensitization to seed storage proteins was observed in less than 10%, mainly in children, and correlated with IgE to nuts, seeds, and legumes. IgE to Cor a 12, observed in all cities (10% to 25%), correlated with IgE to nuts, seeds, and pollen. CONCLUSIONS In adulthood, the importance of hazelnut sensitization to storage proteins, oleosin (Cor a 12), and Cor a 8 is diluted by the increased role of birch pollen cross-reactivity with Cor a 1. Cor a 8 sensitization in the Mediterranean is probably driven by diet in combination with pollen exposure. Hazelnut oleosin sensitization is prevalent across Europe; however, the clinical relevance remains to be established.
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Affiliation(s)
- Mareen R Datema
- Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands
| | | | - Riccardo Asero
- Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy
| | - Laura Barreales
- Clinical Epidemiology Unit, Preventive Medicine Department, Hospital Clinico San Carlos, IdISSC, Madrid, Spain
| | | | - Frédéric de Blay
- Allergy Division, Chest Disease Department, University Hospital of Strasbourg, Strasbourg, France
| | - Peter Bures
- Allergy Unit, Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
| | - Michael Clausen
- Faculty of Medicine, University of Iceland, Landspitali University Hospital, Reykjavik, Iceland
| | | | - David Gislason
- Faculty of Medicine, University of Iceland, Landspitali University Hospital, Reykjavik, Iceland
| | | | - Marek L Kowalski
- Department of Immunology, Rheumatology and Allergy, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - André C Knulst
- Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Tanya Kralimarkova
- Clinic of Allergy and Asthma, Medical University of Sofia, Sofia, Bulgaria
| | - Thuy-My Le
- Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Alison Lovegrove
- Department of Plant Biology and Crop Science, Rothamsted Research, Harpenden, United Kingdom
| | - Justin Marsh
- Institute of Inflammation and Repair, Manchester Institute of Biotechnology, University of Manchester, Manchester, United Kingdom
| | - Nikolaos G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece; Centre for Paediatrics and Child Health, Institute of Human Development, University of Manchester, Manchester, United Kingdom
| | - Todor Popov
- Division of Allergology, Paul-Ehrlich-Insitut, Federal Institute for Vaccines and Biomedicines, Langen, Germany
| | - Náyade Del Prado
- Clinical Epidemiology Unit, Preventive Medicine Department, Hospital Clinico San Carlos, IdISSC, Madrid, Spain
| | - Ashok Purohit
- Allergy Division, Chest Disease Department, University Hospital of Strasbourg, Strasbourg, France
| | - Gerald Reese
- Division of Allergology, Paul-Ehrlich-Insitut, Federal Institute for Vaccines and Biomedicines, Langen, Germany
| | - Isabel Reig
- Allergy Department, Hospital Clinico San Carlos, IdISSC, Madrid, Spain
| | - Suranjith L Seneviratne
- Department of Clinical Immunology, St Mary's Hospital, and Imperial College London, London, United Kingdom
| | | | - Serge A Versteeg
- Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands
| | - Stefan Vieths
- Division of Allergology, Paul-Ehrlich-Insitut, Federal Institute for Vaccines and Biomedicines, Langen, Germany
| | - Aeilko H Zwinderman
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam, The Netherlands
| | - Clare Mills
- Institute of Inflammation and Repair, Manchester Institute of Biotechnology, University of Manchester, Manchester, United Kingdom
| | | | | | | | - Barbara Ballmer-Weber
- Allergy Unit, Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
| | - Ronald van Ree
- Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands; Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands.
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48
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Costa J, Mafra I, Carrapatoso I, Oliveira MBPP. Hazelnut Allergens: Molecular Characterization, Detection, and Clinical Relevance. Crit Rev Food Sci Nutr 2015; 56:2579-2605. [DOI: 10.1080/10408398.2013.826173] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Toro Monjaraz EM, Ramírez Mayans JA, Cervantes Bustamante R, Gómez Morales E, Molina Rosales A, Montijo Barrios E, Zárate Mondragón F, Cadena León J, Cazares Méndez M, López-Ugalde M. Perinatal factors associated with the development of cow's milk protein allergy. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2015; 80:27-31. [PMID: 25724742 DOI: 10.1016/j.rgmx.2015.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 12/09/2014] [Accepted: 01/12/2015] [Indexed: 12/17/2022]
Abstract
UNLABELLED The prevalence of cow's milk protein allergy (CMPA) has increased in recent years, and is associated with antimicrobial use during the perinatal period, prematurity, the type of childbirth, and the decrease in breastfeeding. The aim of this study was to analyze whether there is any association between these factors and the development of CMPA. MATERIAL AND METHODS A retrospective, comparative, cross-sectional, observational study was conducted by reviewing the case records of 101 children diagnosed with CMPA and seen at the Department of Gastroenterology and Nutrition of the Instituto Nacional de Pediatría within the time frame of January 2012 and August 2013. The following variables were included: age, sex, weeks of gestation, history of maternal infection and antimicrobial use during the pregnancy, type of delivery, and feeding with human milk, and its duration. Likewise, the case records of 90 children were reviewed as a control group on not having CMPA or any other allergy. The chi-square test was used for proportions, and the Mann-Whitney U test was used for comparing means in the statistical analysis. RESULTS The factors associated with CMPA were the use of antimicrobials during gestation and breastfeeding duration in months. Both factors were statistically significant (P<.001). No association was found between CMPA and gestational age or type of delivery. CONCLUSIONS The statistically significant associated factors were breastfeeding duration and the use of antimicrobials during the gestational stage. These results underline the necessity for prospective studies.
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Affiliation(s)
- E M Toro Monjaraz
- Departamento de Gastroenterología y Nutrición Pediátrica, Instituto Nacional de Pediatría, México, D.F., México.
| | - J A Ramírez Mayans
- Departamento de Gastroenterología y Nutrición Pediátrica, Instituto Nacional de Pediatría, México, D.F., México
| | - R Cervantes Bustamante
- Departamento de Gastroenterología y Nutrición Pediátrica, Instituto Nacional de Pediatría, México, D.F., México
| | - E Gómez Morales
- Departamento de Gastroenterología y Nutrición Pediátrica, Instituto Nacional de Pediatría, México, D.F., México
| | - A Molina Rosales
- Departamento de Gastroenterología y Nutrición Pediátrica, Instituto Nacional de Pediatría, México, D.F., México
| | - E Montijo Barrios
- Departamento de Gastroenterología y Nutrición Pediátrica, Instituto Nacional de Pediatría, México, D.F., México
| | - F Zárate Mondragón
- Departamento de Gastroenterología y Nutrición Pediátrica, Instituto Nacional de Pediatría, México, D.F., México
| | - J Cadena León
- Departamento de Gastroenterología y Nutrición Pediátrica, Instituto Nacional de Pediatría, México, D.F., México
| | - M Cazares Méndez
- Departamento de Gastroenterología y Nutrición Pediátrica, Instituto Nacional de Pediatría, México, D.F., México
| | - M López-Ugalde
- Departamento de Gastroenterología y Nutrición Pediátrica, Instituto Nacional de Pediatría, México, D.F., México
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Le TM, van Hoffen E, Kummeling I, Potts J, Ballmer-Weber BK, Bruijnzeel-Koomen CA, Lebens AF, Lidholm J, Lindner TM, Mackie A, Mills EC, van Ree R, Vieths S, Fernández-Rivas M, Burney PG, Knulst AC. Food allergy in the Netherlands: differences in clinical severity, causative foods, sensitization and DBPCFC between community and outpatients. Clin Transl Allergy 2015; 5:8. [PMID: 25774288 PMCID: PMC4359480 DOI: 10.1186/s13601-015-0051-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 01/30/2015] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND It is unknown whether food allergy (FA) in an unselected population is comparable to those from an outpatient clinic population. OBJECTIVE To discover if FA in a random sample from the Dutch community is comparable to that of outpatients. METHODS This study was part of the Europrevall-project. A random sample of 6600 adults received a questionnaire. Those with symptoms to one of 24 defined priority foods were tested for sIgE. Participants with a positive case history and elevated sIgE were evaluated by double-blind placebo-controlled food challenge (DBPCFC). Outpatients with a suspicion of FA were evaluated by questionnaire, sIgE and DBPCFC. RESULTS In the community, severe symptoms were reported less often than in outpatients (39.3% vs. 54.3%). Participants in the community were less commonly sensitized to any of the foods. When selecting only those with a probable FA (i.e. symptoms of priority food and elevation of sIgE to the respective food), no major differences were observed with respect to severity, causative foods, sensitization and DBPCFC between the groups. CONCLUSION In the Netherlands, there are large differences in self-reported FA between community and outpatients. However, Dutch community and outpatients with a probable FA do not differ with respect to severity, causative foods, sensitization and DBPCFC-outcome.
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Affiliation(s)
- Thuy-My Le
- Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - Els van Hoffen
- Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands ; Current affiliation: NIZO food research, Ede, The Netherlands
| | - Ischa Kummeling
- Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands ; Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK
| | - James Potts
- Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Carla Afm Bruijnzeel-Koomen
- Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - Ans Fm Lebens
- Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | | | - Titia M Lindner
- Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - Alan Mackie
- Institute of Food Research, Norwich Research Park, Colney, Norwich, NR4 7UA UK
| | - En Clare Mills
- Institute of Inflammation and Repair, Manchester Academic Health Sciences Centre, Manchester Institute of Biotechnology, The University of Manchester, Manchester, UK
| | - Ronald van Ree
- Department of Experimental Immunology and Department of Otorhinolaryngology, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands
| | - Stefan Vieths
- Division of Allergology, Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany
| | | | - Peter G Burney
- Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK
| | - André C Knulst
- Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands
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