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Del Refugio Morfin Maciel BM, Álvarez Castelló M. [Risk factors for food allergy]. REVISTA ALERGIA MÉXICO 2023; 70:214-221. [PMID: 38506859 DOI: 10.29262/ram.v70i4.1329] [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: 08/01/2023] [Accepted: 10/29/2023] [Indexed: 03/21/2024] Open
Abstract
Allergy is the result of genetic and environmental interactions, including time, route, and dose of food exposure in susceptible patients. Risk factors can be: 1) genetic and 2) environmental, and these, in turn, are divided into prenatal, perinatal and postnatal. Food allergy appears frequently and depends on multiple risk factors (genetic and environmental), which in turn are divided into: prenatal, natal and postnatal factors; They participate in the expression of the disease and clinical intervention is not possible in all cases.
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Affiliation(s)
- Blanca María Del Refugio Morfin Maciel
- Alergóloga Pediatra, Instituto Nacional de Pediatría; Académico numerario de la Academia Mexicana de Pediatría; Maestría en Ciencias Mé-dicas, Universidad Nacional Autónoma de México Alergóloga, Hospital San Ángel Inn Chapultepec, Ciudad de
| | - Mirta Álvarez Castelló
- Doctor en Ciencias médicas, Especialista en Medicina General Integral y Alergología; Hospital Universitario General Calixto García; Investigadora Titular; Profesora auxiliar
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2
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González Díaz SN. [Epidemiology of food allergy]. REVISTA ALERGIA MÉXICO 2023; 70:211-213. [PMID: 38506858 DOI: 10.29262/ram.v70i4.1328] [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: 08/01/2023] [Accepted: 10/29/2023] [Indexed: 03/21/2024] Open
Abstract
Food allergy is very common throughout the world and has become a major public health problem, with 220 million people suffering from it. Food allergy has been disproportionately observed in people from industrialized or Western countries and was previously considered to predominate in the pediatric versus adult population. However, the current exponential growth of the adult population and older adults, especially in Western countries, and environmental and lifestyle changes, have profoundly changed the epidemiology of food allergy, with a growing increase even at advanced ages. The foods that represent the greatest severity and clinical impact are peanuts, walnuts, fish, shellfish, eggs, cow's milk protein, wheat, soy and seeds. Although some types of food allergies (cow's milk and egg) may disappear, peanut and tree nut allergies may persist into adulthood. The control or cure of cow's milk protein allergy is gradual throughout childhood and adolescence. Despite the predominance of allergy to fish, shellfish, peanuts, and tree nuts in most reactions in adults, the most common form of IgE-mediated food allergy is oral allergy syndrome or pollen allergy syndrome. food.
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Affiliation(s)
- Sandra Nora González Díaz
- Alergia e Inmunología Clínica, Jefe del Centro Regional de Alergia e Inmunología Clínica, Hospital Universitario, Facultad de Medicina, Universidad Autónoma de Nuevo León, México; Secretaria de Relaciones
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3
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Ansotegui Zubeldia IJ, Fiocchi A. [Introduction to food allergy]. REVISTA ALERGIA MÉXICO 2023; 70:208-210. [PMID: 38506857 DOI: 10.29262/ram.v70i4.1308] [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: 08/01/2023] [Accepted: 10/29/2023] [Indexed: 03/21/2024] Open
Abstract
Food allergy is a common chronic disorder that affects infants, children, adolescents, and adults. The prevalence of food allergy has increased in recent decades throughout the world, not limited to Western countries. Since there is no treatment, this focuses on avoiding allergens, in addition to educating patients and caregivers in the emergency treatment of acute reactions, for example: application of epinephrine. Studies suggest that accidental reactions occur in about 45% of children with food allergies each year, although most reactions are mild or moderate in severity. Hospital admissions for food anaphylaxis vary from 4 to 20 per 100,000 inhabitants; Deaths are rare, with an estimated incidence of 0.03 to 0.3 per million people with food allergy. Death from food anaphylaxis is rare and appears to have remained stable, possibly due to increases in food allergen labeling, diagnostic services, rates of intramuscular epinephrine prescription, and awareness of food allergies. Omalizumab is a drug approved for several disorders (chronic hives or difficult asthma) and may help reduce symptoms associated with food allergy. The relative importance of alternative technologies, management strategies and policies for food allergy varies from one region to another, due to differences in the epidemiology, education, socioeconomic well-being, and cultural preferences of the population.
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Affiliation(s)
- Ignacio Javier Ansotegui Zubeldia
- Director Médico Ejecutivo, Expresidente de la Organización Mundial de Alergia (WAO). Jefe del Departamento de Alergia e Inmunología, Hospital Quironsalud, Bizkaia, Bilbao,
| | - Alessandro Fiocchi
- Director responsable de la S.C. de Pediatría, Hospital Materno Infantil Macedonio Melloni, Milán, Italia. Director del Departamento Materno Infantil, Hospital Fatebenefratelli-Ophthalmic de Milán, Italia. Profesor adjunto de la Escuela de Es-pecialización en Pediatría III, Universidad de Milán y Consejero de la Sociedad Italiana de Pediatría, Sección Lombarda. Pediatric Hospital Bambino Gesú IRCCS Allergy division, Roma, Italia
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Susanto NH, Lowe AJ, Salim A, Koplin JJ, Tang MLK, Suaini NHA, Ponsonby AL, Allen KJ, Dharmage SC, Erbas B. Associations between grass pollen exposures in utero and in early life with food allergy in 12-month-old infants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:712-722. [PMID: 32677468 DOI: 10.1080/09603123.2020.1793920] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/06/2020] [Indexed: 06/11/2023]
Abstract
Birth during pollen seasons may influence food allergy risk but no study has assessed pollen exposure. Using the HealthNuts population-based cohort of 5276 infants, we assessed grass pollen exposures, in utero and up to the first 6 months of life, on hen's egg, sesame and peanut allergy outcomes at 12 months. Cumulative pollen exposure in the first 7 days of life increased risk of peanut sensitization aMOR (adjusted multinomial odds ratio) = 1.21 (95% CI: 1.01-1.44). Exposure between first 4-6 months of life increased risk of hen's egg aMOR = 1.02 (95% CI: 1.004-1.04) and sensitization to all foods aMOR = 1.02 (95% CI: 1.003-1.04). Grass pollen exposure was associated with food challenge diagnosed food allergy, but only among infants with a maternal history of food allergy. Exposure to grass pollen in the intrauterine period and infancy may be important but more studies are needed to replicate these findings.
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Affiliation(s)
- Nugroho Harry Susanto
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia
| | - Adrian J Lowe
- Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Agus Salim
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia
| | - Jennifer J Koplin
- Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- The Murdoch Children's Research Institute, Parkville, Australia
| | - Mimi L K Tang
- The Murdoch Children's Research Institute, Parkville, Australia
- The Department of Paediatrics, University of Melbourne, Parkville, Australia
- The Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia
| | - Noor H A Suaini
- The Murdoch Children's Research Institute, Parkville, Australia
| | - Anne-Louise Ponsonby
- Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- The Murdoch Children's Research Institute, Parkville, Australia
| | - Katrina J Allen
- The Murdoch Children's Research Institute, Parkville, Australia
- The Department of Paediatrics, University of Melbourne, Parkville, Australia
- The Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia
- The Institute of Inflammation and Repair, University of Manchester, Manchester, UK
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
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5
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Feng H, Xiong X, Chen Z, Xu Q, Zhang Z, Feng J, Wu Y. Prevalence and factors for food allergy in different populations from different regions: A protocol for a systematic review and meta-analysis. PLoS One 2021; 16:e0261092. [PMID: 34905577 PMCID: PMC8670707 DOI: 10.1371/journal.pone.0261092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 11/22/2021] [Indexed: 11/25/2022] Open
Abstract
Background To determine the prevalence of food allergy (FA) and factors associated with these occurrences in different populations from different regions. Materials and methods The literature search will be conducted via Pubmed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Vip and Wanfang databases. Ratio rate (RR), odds ratio (OR) and 95% confidence intervals (CIs) will be adopted to evaluate prevalence and factors for FA in different populations from different regions. When the heterogeneity is small (I2<50%), the fixed effect model will be analyzed, otherwise, random effects model analysis will be performed. When the heterogeneity is large (I2≥50%), Meta regression will be used to explore the sources of inter-study heterogeneity. When the heterogeneity is large (I2≥50%) and the results are statistically significant (P<0.05), subgroup analysis will be analyzed based on age, gender, race/region, literature quality and other factors. Funnel plots will be used to reflect reporting bias and the Begg’s test will be used to test the symmetry of the funnel plots. When publication bias occurs, “cut-and-fill” method will be adopted to adjust publication bias. And sensitivity analysis will be performed for all outcome indicators. Discussion This meta-analysis will evaluate the prevalence of FA and factors associated with these occurrences in different populations from different regions on the basis of existing evidences. Our study may be crucial to analyze similarities and differences regarding FA between different individuals from diverse regions and eventually define preventive or diagnostic approaches specifically tailored to certain populations and regions. Systematic review registration OSF registration number: 10.17605/OSF.IO/VQXU9
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Affiliation(s)
- Hua Feng
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, P.R. China
- School of Public Health, Nanchang University, Nanchang, P.R. China
| | - Xiujuan Xiong
- Department of Pathology, Basic Medical College of Nanchang University, Nanchang, P.R. China
| | - Zhuo Chen
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, P.R. China
| | - Qunying Xu
- School of Public Health, Nanchang University, Nanchang, P.R. China
| | - Zhongwei Zhang
- School of Public Health, Nanchang University, Nanchang, P.R. China
| | - Jiangao Feng
- School of Public Health, Nanchang University, Nanchang, P.R. China
| | - Yongning Wu
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, P.R. China
- NHC Key Laboratory of Food Safety Risk Assessment, Chinese Academy of Medical Science Research Unit (No. 2019RU014) (China National Center for Food Safety Risk Assessment), Beijing, P.R. China
- * E-mail:
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Motoyama Y, Morimoto T, Takeuchi J, Kusunoki T. Fall birth is associated with prolonged elimination in Japanese children with hen's egg allergy: A population-based study. Allergol Int 2021; 70:498-500. [PMID: 34162514 DOI: 10.1016/j.alit.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/25/2021] [Accepted: 06/01/2021] [Indexed: 11/28/2022] Open
Affiliation(s)
- Yuie Motoyama
- Laboratory of Child Health and Nutrition, Department of Food Science and Human Nutrition, Faculty of Agriculture, Ryukoku University, Shiga, Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan
| | - Jiro Takeuchi
- Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan
| | - Takashi Kusunoki
- Laboratory of Child Health and Nutrition, Department of Food Science and Human Nutrition, Faculty of Agriculture, Ryukoku University, Shiga, Japan; Department of Pediatrics, Shiga Medical Center for Children, Shiga, Japan.
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7
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Abstract
Gastrointestinal (GI) allergic disease is an umbrella term used to describe a variety of adverse, food antigen-driven, immune-mediated diseases. Although these diseases vary mechanistically, common elements include a breakdown of immunologic tolerance, a biased type 2 immune response, and an impaired mucosal barrier. These pathways are influenced by diverse factors such as diet, infections, exposure to antibiotics and chemicals, GI microbiome composition, and genetic and epigenetic elements. Early childhood has emerged as a critical period when these factors have a dramatic impact on shaping the immune system and therefore triggering or protecting against the onset of GI allergic diseases. In this Review, we will discuss the latest findings on the molecular and cellular mechanisms that govern GI allergic diseases and how these findings have set the stage for emerging preventative and treatment strategies.
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Abstract
The estimated prevalence of food allergy amongst children in the west is around 6-8% but there is paucity of data in the Indian population. There is a complex interplay of environmental influences and genetic factors in the immuno-pathogenesis and manifestations of food allergy. A reliable thorough clinical history, combined with positive skin prick tests or food-specific IgE, is essential for a more precise diagnosis of food allergy. Currently there is no cure for food allergy. The management of food allergy usually includes strict avoidance, patient education and provision of emergency medication (adrenaline-autoinjectors). Emerging therapies based on evolving research are focused on a more active approach to management which includes early introduction of potentially allergenic foods, anticipatory testing and desensitisation to food allergens. Lack of food labelling policy and non availability of adrenaline auto-injectors is a huge limiting factor for effective management of food allergy among children in India. The present review focuses on IgE mediated food allergy.
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Sasaki M, Peters RL, Koplin JJ, Field MJ, McWilliam V, Sawyer SM, Vuillermin PJ, Pezic A, Gurrin LC, Douglass JA, Tang ML, Dharmage SC, Allen KJ. Risk Factors for Food Allergy in Early Adolescence: The SchoolNuts Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:496-505. [DOI: 10.1016/j.jaip.2017.12.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 12/08/2017] [Accepted: 12/09/2017] [Indexed: 11/17/2022]
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Kikkawa T, Yorifuji T, Fujii Y, Yashiro M, Okada A, Ikeda M, Doi H, Tsukahara H. Birth order and paediatric allergic disease: A nationwide longitudinal survey. Clin Exp Allergy 2018; 48:577-585. [PMID: 29368358 DOI: 10.1111/cea.13100] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 11/24/2017] [Accepted: 12/21/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND Environmental factors seem to be related to the incidence of allergic disease. Children with a later birth order are often exposed to environments, where pathogens and endotoxins can be found, and thus have a higher risk of developing infectious diseases. Therefore, birth order is regarded as an indicator that reflects post-natal environment. However, longitudinal studies are limited on this subject. This study sought to elucidate the relationships between birth order and allergic disease. METHODS From a nationwide longitudinal study that followed children born in 2001 (n = 47 015), we selected doctors' visits for 3 types of allergic disease-bronchial asthma, food allergy and atopic dermatitis-from infancy to 12 years of age and conducted binomial log-linear regression analysis to evaluate the associations between birth order and these diseases. We adjusted for the child and parental factors and estimated risk ratio (RR) and 95% confidence interval (CI) for each outcome. RESULTS The associations between birth order and bronchial asthma were diverse; later birth order increased the risk in early childhood, but decreased the risks during school age. For example, the adjusted RR comparing third-born or higher and first-born children was 1.19 (95% CI, 1.05-1.35) between 30 and 42 months of age, but was 0.76 (95% CI, 0.65-0.89) between 10 and 11 years. Later birth order was generally protective for food allergy but increased the risk of atopic dermatitis. CONCLUSION The influence of birth order depended on the type of allergic disease and the childhood period. Childhood is unique in terms of physical and immunological development, and the immune response to the post-natal environment in childhood appears to be heterogeneous.
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Affiliation(s)
- T Kikkawa
- Department of Pediatrics, Okayama University Hospital, Okayama, Japan.,Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - T Yorifuji
- Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science, Okayama, Japan
| | - Y Fujii
- Department of Pediatric Acute Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - M Yashiro
- Department of Pediatrics, Okayama University Hospital, Okayama, Japan
| | - A Okada
- Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - M Ikeda
- Department of Pediatric Acute Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - H Doi
- Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - H Tsukahara
- Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
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11
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Cingi C, Gevaert P, Mösges R, Rondon C, Hox V, Rudenko M, Muluk NB, Scadding G, Manole F, Hupin C, Fokkens WJ, Akdis C, Bachert C, Demoly P, Mullol J, Muraro A, Papadopoulos N, Pawankar R, Rombaux P, Toskala E, Kalogjera L, Prokopakis E, Hellings PW, Bousquet J. Multi-morbidities of allergic rhinitis in adults: European Academy of Allergy and Clinical Immunology Task Force Report. Clin Transl Allergy 2017; 7:17. [PMID: 28572918 PMCID: PMC5452333 DOI: 10.1186/s13601-017-0153-z] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 05/12/2017] [Indexed: 12/14/2022] Open
Abstract
This report has been prepared by the European Academy of Allergy and Clinical Immunology Task Force on Allergic Rhinitis (AR) comorbidities. The aim of this multidisciplinary European consensus document is to highlight the role of multimorbidities in the definition, classification, mechanisms, recommendations for diagnosis and treatment of AR, and to define the needs in this neglected area by a literature review. AR is a systemic allergic disease and is generally associated with numerous multi-morbid disorders, including asthma, eczema, food allergies, eosinophilic oesophagitis (EoE), conjunctivitis, chronic middle ear effusions, rhinosinusitis, adenoid hypertrophy, olfaction disorders, obstructive sleep apnea, disordered sleep and consequent behavioural and educational effects. This report provides up-to-date usable information to: (1) improve the knowledge and skills of allergists, so as to ultimately improve the overall quality of patient care; (2) to increase interest in this area; and (3) to present a unique contribution to the field of upper inflammatory disease.
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Affiliation(s)
- C. Cingi
- Department of Otorhinolaryngology, Eskisehir Osmangazi University School of Medicine, Eskisehir, Turkey
| | - P. Gevaert
- Upper Airway Research Laboratory, Ghent University Hospital, Ghent, Belgium
| | - R. Mösges
- Institute of Medical Statistics, Informatics, and Epidemiology, Medical Faculty, University of Köln, Cologne, Germany
| | - C. Rondon
- Allergy Unit, IBIMA, Regional University Hospital of Malaga, UMA, Malaga, Spain
| | - V. Hox
- Clinical division of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Louvain, Belgium
| | - M. Rudenko
- London Allergy and Immunology Centre, London, UK
| | - N. B. Muluk
- ENT Department, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey
| | - G. Scadding
- Royal National Throat, Nose and Ear Hospital, London, UK
| | - F. Manole
- Faculty of Medicine, ENT Department, University of Oradea, Oradea, Romania
| | - C. Hupin
- Institut de Recherche Expérimentale et Clinique (IREC), Pole de Pneumologie, ORL & Dermatologie, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - W. J. Fokkens
- Department of Otorhinolaryngology, Head and Neck Surgery, Academic Medical Centre (AMC), Amsterdam, The Netherlands
| | - C. Akdis
- Christine Kuhne-Center for Allergy Research and Education, Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland
| | - C. Bachert
- Upper Airway Research Laboratory, Ghent University Hospital, Ghent, Belgium
| | - P. Demoly
- Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France
| | - J. Mullol
- Unitat de Rinologia i Clinica de l’Olfacte, Servei d’Otorinolaringologia, Hospital Clínic, Barcelona, Catalonia Spain
| | - A. Muraro
- The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region, Department of Mother and Child Health, University of Padua, Padua, Italy
| | - N. Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | | | - P. Rombaux
- Service d’ORL, Cliniques Universitaires St-Luc, Brussels, Belgium
| | - E. Toskala
- Department of Otorhinolaryngology-Head and Neck Surgery, Temple University, Philadelphia, PA USA
| | - L. Kalogjera
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Sestre milosrdnice, Zagreb, Croatia
| | - E. Prokopakis
- Department of Otorhinolaryngology, University Hospital of Crete, Crete, Greece
| | - P. W. Hellings
- Clinical division of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Louvain, Belgium
| | - J. Bousquet
- Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France
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12
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Grieger JA, Clifton VL, Tuck AR, Wooldridge AL, Robertson SA, Gatford KL. In utero Programming of Allergic Susceptibility. Int Arch Allergy Immunol 2016; 169:80-92. [PMID: 27044002 DOI: 10.1159/000443961] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Around 30-40% of the world's population will experience allergy, the most common and earliest-onset noncommunicable disease. With a steady rise in the incidence of allergic disease over recent decades, up to 18% of children will suffer a respiratory, food or skin allergy before their 18th birthday. There is compelling evidence that the risk of developing allergy is influenced by early life events and particularly in utero exposures. METHODS A comprehensive literature review was undertaken which outlines prenatal risk factors and potential mechanisms underlying the development of allergy in childhood. RESULTS Exposures including maternal cigarette smoking, preterm birth and Caesarean delivery are implicated in predisposing infants to the later development of allergy. In contrast, restricted growth in utero, a healthy maternal diet and a larger family size are protective, but the mechanisms here are unclear and require further investigation. CONCLUSION To ameliorate the allergy pandemic in young children, we must define prenatal mechanisms that alter the programming of the fetal immune system and also identify specific targets for antenatal interventions.
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Affiliation(s)
- Jessica A Grieger
- Robinson Research Institute and School of Medicine, University ofAdelaide, Adelaide, S.A., Australia
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13
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Kim YH, Lee SY, Lee E, Cho HJ, Kim HB, Kwon JW, Yang SI, Kim EJ, Lee JK, Hong SJ. The change in food allergy prevalence of elementary school children in Seoul since the last 20 years and the risk factor analysis. ALLERGY ASTHMA & RESPIRATORY DISEASE 2016. [DOI: 10.4168/aard.2016.4.4.276] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Yeong-Ho Kim
- Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - So-Yeon Lee
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Eun Lee
- Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Hyun-Ju Cho
- Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyo-Bin Kim
- Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Ji-Won Kwon
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Song-I Yang
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Eun-Jin Kim
- Division of Allergy and Respiratory Diseases, National Institute of Health, Korea Center for Disease Control and Prevention, Cheongju, Korea
| | - Jeom-Kyu Lee
- Division of Allergy and Respiratory Diseases, National Institute of Health, Korea Center for Disease Control and Prevention, Cheongju, Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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14
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Abstract
The prevalence of food allergy is rising for unclear reasons, with prevalence estimates in the developed world approaching 10%. Knowledge regarding the natural course of food allergies is important because it can aid the clinician in diagnosing food allergies and in determining when to consider evaluation for food allergy resolution. Many food allergies with onset in early childhood are outgrown later in childhood, although a minority of food allergy persists into adolescence and even adulthood. More research is needed to improve food allergy diagnosis, treatment, and prevention.
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Affiliation(s)
- Jessica Savage
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Harvard Medical School, 1 Jimmy Fund Way, Smith Building, Room 516c, Boston, MA 02115, USA; Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Harvard Medical School, 1 Jimmy Fund Way, Smith Building, Room 626, Boston, MA 02215, USA.
| | - Christina B Johns
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Harvard Medical School, 1 Jimmy Fund Way, Smith Building, Room 516c, Boston, MA 02115, USA
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15
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Cipriani F, Dondi A, Ricci G. Recent advances in epidemiology and prevention of atopic eczema. Pediatr Allergy Immunol 2014; 25:630-8. [PMID: 25406640 DOI: 10.1111/pai.12309] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/14/2014] [Indexed: 12/22/2022]
Abstract
Atopic dermatitis (AD), named also atopic eczema, is a chronic relapsing inflammatory skin disease with a considerable social and economic burden. The primum movens of AD is in most cases a genetic and/or immune-supported defect of the skin barrier, facilitating penetration and sensitization to food or airborne allergens, as well as infections by Staphylococcus aureus, herpes simplex virus, or other microbes. New pathogenetic concepts have generated new approaches to prevention and therapy of AD. In particular, the daily use of emollients in newborns at high risk of AD has shown interesting results, with a reduction in the cumulative incidence of AD ranging from 32% to 50% of the treated infants. On the other hand, the AD preventive efficacy of food and/or inhalant allergen avoidance has been questioned, and supplementation strategies (vitamin D, probiotics, or other compounds) need to be further investigated.
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Affiliation(s)
- Francesca Cipriani
- Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Byberg KK, Ogland B, Eide GE, Oymar K. Birth after preeclamptic pregnancies: association with allergic sensitization and allergic rhinoconjunctivitis in late childhood; a historically matched cohort study. BMC Pediatr 2014; 14:101. [PMID: 24725676 PMCID: PMC3995723 DOI: 10.1186/1471-2431-14-101] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 04/10/2014] [Indexed: 11/19/2022] Open
Abstract
Background The development of allergic sensitization and allergic disease may be related to factors during intrauterine life, but the role of maternal preeclampsia is not known. We studied if maternal preeclampsia is associated with long-term allergic sensitization, allergic rhinoconjunctivitis, atopic dermatitis, asthma and with altered lung function in late childhood. Methods 617 children participated in a 1:2 matched and controlled historical cohort study; 230 born after preeclamptic pregnancies and 387 born after normotensive pregnancies. Specific IgE in serum and lung function were measured at the age of 12.8 years and questionnaires on maternal and adolescent data were completed at the ages of 10.8 years (girls) and 11.8 years (boys), and at 12.8 years (both genders). The association between birth after preeclampsia and the main outcome measures allergic sensitization, allergic rhinoconjunctivitis, atopic dermatitis, asthma and lung function in late childhood were analysed with multiple regression analyses, including possible confounders. Results Severe maternal preeclampsia was associated with high level allergic sensitization (sum of specific IgE in serum ≥ 3.9 kU/l; the 25 percentile for all children being sensitized); odds ratio (OR): 3.79; 95% confidence interval (CI): (1.54, 9.32); p = 0.015 and with allergic rhinoconjunctivitis in offspring; OR: 2.22, 95% CI: (1.19, 4.14), p = 0.047. Preeclampsia was not associated with atopic dermatitis, asthma or altered lung function in late childhood. Conclusion Maternal preeclampsia was associated with allergic sensitization and allergic rhinoconjunctivitis in offspring in late childhood, but not with other atopic diseases.
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Affiliation(s)
- Kristine Kjer Byberg
- Paediatric Department, Stavanger University Hospital, Post box 8100, N-4068 Stavanger, Norway.
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Sicherer SH, Sampson HA. Food allergy: Epidemiology, pathogenesis, diagnosis, and treatment. J Allergy Clin Immunol 2013; 133:291-307; quiz 308. [PMID: 24388012 DOI: 10.1016/j.jaci.2013.11.020] [Citation(s) in RCA: 850] [Impact Index Per Article: 77.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 11/25/2013] [Accepted: 11/25/2013] [Indexed: 01/04/2023]
Abstract
This review focuses on advances and updates in the epidemiology, pathogenesis, diagnosis, and treatment of food allergy over the past 3 years since our last comprehensive review. On the basis of numerous studies, food allergy likely affects nearly 5% of adults and 8% of children, with growing evidence of an increase in prevalence. Potentially rectifiable risk factors include vitamin D insufficiency, unhealthful dietary fat, obesity, increased hygiene, and the timing of exposure to foods, but genetics and other lifestyle issues play a role as well. Interesting clinical insights into pathogenesis include discoveries regarding gene-environment interactions and an increasing understanding of the role of nonoral sensitizing exposures causing food allergy, such as delayed allergic reactions to carbohydrate moieties in mammalian meats caused by sensitization from homologous substances transferred during tick bites. Component-resolved diagnosis is being rapidly incorporated into clinical use, and sophisticated diagnostic tests that indicate severity and prognosis are on the horizon. Current management relies heavily on avoidance and emergency preparedness, and recent studies, guidelines, and resources provide insight into improving the safety and well-being of patients and their families. Incorporation of extensively heated (heat-denatured) forms of milk and egg into the diets of children who tolerate these foods, rather than strict avoidance, represents a significant shift in clinical approach. Recommendations about the prevention of food allergy and atopic disease through diet have changed radically, with rescinding of many recommendations about extensive and prolonged allergen avoidance. Numerous therapies have reached clinical trials, with some showing promise to dramatically alter treatment. Ongoing studies will elucidate improved prevention, diagnosis, and treatment.
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Affiliation(s)
- Scott H Sicherer
- Elliot and Roslyn Jaffe Food Allergy Institute, Division of Allergy and Immunology, Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Hugh A Sampson
- Elliot and Roslyn Jaffe Food Allergy Institute, Division of Allergy and Immunology, Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
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Hakimeh D, Tripodi S. Recent advances on diagnosis and management of childhood asthma and food allergies. Ital J Pediatr 2013; 39:80. [PMID: 24373684 PMCID: PMC3891976 DOI: 10.1186/1824-7288-39-80] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 12/16/2013] [Indexed: 11/10/2022] Open
Abstract
The epidemic of childhood allergic disorders has been associated to the decline of infectious disease. However, exposure to many triggers (airborne viruses, tobacco smoke, pollution, indoor allergens, etc.) contribute to the disease. Breast feeding practices, nutrition, dietary and obesity also play a multifaceted role in shaping the observed worldwide trends of childhood allergies. Guidelines for treatment are available, but their implementation is suboptimal. Then developed countries are slowing learning integrating the development of suitable guidelines with implementation plans. Awareness, psychosocial and family factors strongly influence asthma and food allergy control. Moreover, monitoring tools are necessary to facilitate self-management. By taking into consideration these and many other pragmatic aspects, national public health programs to control the allergic epidemic have been successful in reducing its impact and trace the need for future research in the area.
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Affiliation(s)
| | - Salvatore Tripodi
- Department of Paediatrics and Allergology Unit, Sandro Pertini Hospital, Via dei Monti Tiburtini, 389, 00157 Rome, Italy.
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Ebisawa M, Nishima S, Ohnishi H, Kondo N. Pediatric allergy and immunology in Japan. Pediatr Allergy Immunol 2013; 24:704-14. [PMID: 24112430 DOI: 10.1111/pai.12117] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/15/2013] [Indexed: 12/22/2022]
Abstract
The Japanese Society of Pediatric Allergy and Clinical Immunology (JSPACI) was started in 1966 and currently has 3613 members as of August 1, 2012. The number of pediatricians specializing in allergies who have been certified by the Japanese Society of Allergology is 817. Among these, there are 125 training directors and training facilities for allergy and clinical immunology. The JSPACI first published an asthma guideline specific for children in 2000, and this has been revised every 3 yrs, contributing to better control of pediatric asthma. Food allergy management guidelines were first developed in 2005, which have helped to improve the care of food allergy patients. Among 514 pediatric training programs by the Japanese Society of Pediatrics, there are 312 facilities routinely performing oral food challenges. Among these, there were already 53 facilities performing oral immunotherapy at the end of 2011, treating 1400 cases of food allergy. The prevalence of pediatric allergic diseases has increased in Japan over the past 50 yrs. A number of International Study of Asthma and Allergies in Childhood surveys have been conducted in the past at specific times. The prevalence of wheezing among children aged 13-14 yrs in 2002 was 13.0%. Multi-year surveys found a 1.5- to 2-fold increase every 10 yrs until 2002. However, according to the latest data in 2012, asthma prevalence seems to have slightly decreased in Japan. Food allergy mainly associated with infantile atopic eczema among infants younger than 1 yr of age is the most common form as with other developed countries. The estimated food allergy prevalence based on data from several surveys is 5-10% among infants (0-6 yrs) and 1-2% among schoolchildren (6-15 yrs). A variety of patients suffering from primary deficiency syndrome have been actively analyzed. Previously, antibody defects and well-defined syndromes with immunodeficiency were analyzed, but recent research is focusing on not only acquired immune disorders but also on innate immune disorders. In contrast to the widespread use of oral immunotherapy, one immediate issue is to develop and reassess subcutaneous and sublingual immunotherapies for mite and Japanese cedar pollen antigens that have been disused in Japan since the 1990s.
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Affiliation(s)
- Motohiro Ebisawa
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Sagamihara, Kanagawa, Japan
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Current World Literature. Curr Opin Allergy Clin Immunol 2013. [DOI: 10.1097/aci.0b013e3283619e49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ogura K, Ebisawa M. [The cutting-edge of medicine; pathogenesis and tolerance acquisition of food allergy]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 2013; 102:724-730. [PMID: 23777167 DOI: 10.2169/naika.102.724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Kiyotake Ogura
- Department of Pediatrics, Sagamihara National Hospital, Japan
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Kawada T. Prevalence of asthma and atopic dermatitis in children with special emphasis on birth order. Pediatr Allergy Immunol 2012; 23:795; author reply 796. [PMID: 22957737 DOI: 10.1111/j.1399-3038.2012.01314.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
This review highlights the progress made in food allergy (FA) and anaphylaxis research in pediatrics published in the journal Pediatric Allergy and Immunology since 2010. Putative risk factors for FA are as follows: a family history of allergic disease, particularly in the mother, low birth order, season of birth, and severe atopic eczema. Obstetric practices, antibiotic use, and home environment are factors deserving further research. Diagnostic decision levels and component-specific IgE are useful in the diagnosis of FA; however, oral food challenges remain the gold standard and may also be a means to reduce parental anxiety and to improve education. Oral immunotherapy studies show promise in increasing the threshold of reactivity of allergic patients and therefore improving their quality of life. In single-nut-allergic patients, introduction of other nuts allows broadening the diet and thus reducing the psychological impact of allergen avoidance. Nutritional deficiencies are not uncommon in food-allergic children and should be specifically assessed. The prescription of injectable adrenaline is still insufficient and not consistent among practitioners, requiring improved training and implementation of guidelines. Current research into the epidemiology and immunological mechanisms of FA and tolerance will enable us to devise strategies to both prevent and treat food allergies.
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Affiliation(s)
- Alexandra F Santos
- Department of Pediatric Allergy, Division of Asthma, Allergy & Lung Biology, King's College London, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK.
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