1
|
Gorzkiewicz M, Łoś-Rycharska E, Gawryjołek J, Gołębiewski M, Krogulska A, Grzybowski T. The methylation profile of IL4, IL5, IL10, IFNG and FOXP3 associated with environmental exposures differed between Polish infants with the food allergy and/or atopic dermatitis and without the disease. Front Immunol 2023; 14:1209190. [PMID: 37520545 PMCID: PMC10373304 DOI: 10.3389/fimmu.2023.1209190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
Objectives Epigenetic dynamics has been indicated to play a role in allergy development. The environmental stimuli have been shown to influence the methylation processes. This study investigated the differences in CpGs methylation rate of immune-attached genes between healthy and allergic infants. The research was aimed at finding evidence for the impact of environmental factors on methylation-based regulation of immunological processes in early childhood. Methods The analysis of methylation level of CpGs in the IL4, IL5, IL10, IFNG and FOXP3 genes was performed using high resolution melt real time PCR technology. DNA was isolated from whole blood of Polish healthy and allergic infants, with food allergy and/or atopic dermatitis, aged under six months. Results The significantly lower methylation level of FOXP3 among allergic infants compared to healthy ones was reported. Additional differences in methylation rates were found, when combining with environmental factors. In different studied groups, negative correlations between age and the IL10 and FOXP3 methylation were detected, and positive - in the case of IL4. Among infants with different allergy symptoms, the decrease in methylation level of IFNG, IL10, IL4 and FOXP3 associated with passive smoke exposure was observed. Complications during pregnancy were linked to different pattern of the IFNG, IL5, IL4 and IL10 methylation depending on allergy status. The IFNG and IL5 methylation rates were higher among exclusively breastfed infants with atopic dermatitis compared to the non-breastfed. A decrease in the IFNG methylation was noted among allergic patients fed exclusively with milk formula. In different study groups, a negative correlation between IFNG, IL5 methylation and maternal BMI or IL5 methylation and weight was noted. Some positive correlations between methylation rate of IL10 and child's weight were found. A higher methylation of IL4 was positively correlated with the number of family members with allergy. Conclusion The FOXP3 methylation in allergic infants was lower than in the healthy ones. The methylation profile of IL4, IL5, IL10, IFNG and FOXP3 associated with environmental exposures differed between the studied groups. The results offer insights into epigenetic regulation of immunological response in early childhood.
Collapse
Affiliation(s)
- Marta Gorzkiewicz
- Department of Forensic Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Ewa Łoś-Rycharska
- Department of Pediatrics, Allergology and Gastroenterology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Julia Gawryjołek
- Department of Pediatrics, Allergology and Gastroenterology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Marcin Gołębiewski
- Department of Plant Physiology and Biotechnology, Nicolaus Copernicus University in Toruń, Toruń, Poland
- Interdisciplinary Centre of Modern Technologies, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Aneta Krogulska
- Department of Pediatrics, Allergology and Gastroenterology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Tomasz Grzybowski
- Department of Forensic Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| |
Collapse
|
2
|
Tedner SG, Klevebro S, Bergström A, Kull I, Andersson N, Borres MP, Ballardini N, Westman M, Konradsen JR, van Hage M, Nilsson C, Melén E, Asarnoj A. Development of sensitization to peanut and storage proteins and relation to markers of airway and systemic inflammation: A 24-year follow-up. Allergy 2023; 78:488-499. [PMID: 36315061 PMCID: PMC10098493 DOI: 10.1111/all.15568] [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: 05/20/2022] [Revised: 09/01/2022] [Accepted: 09/16/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Long-time data of peanut allergy over time is sparse. We aimed to study the longitudinal development of sensitization to peanut extract and storage protein allergen molecules and associations with asthma status, airway and systemic inflammation markers. METHODS The Swedish birth cohort BAMSE followed 4089 participants with questionnaires, clinical investigations and blood sampling between 0 and 24 years. Information on (i) background factors at 2 months, (ii) peanut allergy symptoms and IgE data (ImmunoCAP) at 4, 8, 16, and 24 years, and (iii) IgE to storage proteins, lung function data including exhaled nitric oxide (FENO) as well as systemic inflammatory markers at 24 years of age were collected. RESULTS The prevalence of peanut extract sensitization, defined as IgE ≥ 0.35 kUA /L, was 5.4%, 8.0%, 7.5%, and 6.2% at 4, 8, 16, and 24 years of age, respectively. Between 8 and 24 years of age, (33/1565) participants developed IgE-ab to peanut extract (median 1,4, range 0.7-2.6 kUA /L), and among those 85% were also sensitized to birch. Only six individuals developed sensitization to Ara h 2 (≥0.1 kUA /L) between 8 and 24 years of age, of whom three had an IgE-ab level between 0.1-0.12 kUA /L. Storage protein sensitization was associated with elevated FENO, blood eosinophils and type 2 inflammation-related systemic proteins. CONCLUSION Sensitization to peanut extract after 4 years of age is mainly induced by birch cross-sensitization and IgE to Ara h 2 rarely emerges after eight years of age. Storage protein sensitization is associated with respiratory and systemic inflammation.
Collapse
Affiliation(s)
- Sandra G Tedner
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Susanna Klevebro
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Inger Kull
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Niklas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Magnus P Borres
- Department of Women's and Children's Health, Uppsala University and Thermo Fisher Scientific, Uppsala, Sweden
| | - Natalia Ballardini
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Marit Westman
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet and University Hospital, Stockholm, Sweden.,S:t Göran Asthma and Allergy Clinic, Praktikertjänst, Stockholm, Sweden
| | - Jon R Konradsen
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Marianne van Hage
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - Caroline Nilsson
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Erik Melén
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Anna Asarnoj
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
3
|
Takahashi K, Yanagida N, Itonaga T, Nishino M, Nagakura KI, Ogura K, Sato S, Ebisawa M. Phenotyping of immediate-type food allergies based on 10 years of research: A latent class analysis. Pediatr Allergy Immunol 2022; 33:e13873. [PMID: 36433852 DOI: 10.1111/pai.13873] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 09/30/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Food allergy is a disease with a diverse and variable natural history, and some patients may react to two or more food antigens. This study aimed to classify and characterize the long-term prognosis of infantile-onset, immediate-type food allergies, focusing on three major antigens in Japan: egg, milk, and wheat. METHODS All children who visited our hospital with food allergies, including suspected cases, were prospectively registered in our medical database. Among the children in this database, subjects registered by the age of 1 year with immediate-type symptoms or sensitization to the above three antigens were included. The course of the subjects up to the age of 6 years was analyzed. Cox regression analysis and repeated-measures latent class analysis (LCA) were performed to reveal risk factors and tolerance patterns for food allergies. RESULTS We included 915 patients with immediate-type food allergy symptoms and 276 sensitized asymptomatic patients in this study. The number of patients with immediate-type symptoms to egg, milk, and wheat was 609, 443, and 235, respectively. The number of patients with multiple food allergies was 302. The proportion of patients with tolerance to egg, milk, and wheat at 6 years of age was 74%, 69%, and 75%, respectively. LCA revealed 7 classes of prognosis for food allergies. The largest class was transient egg allergy alone (19.6%), and there were severe cases of multiple food allergies (6.5%). CONCLUSIONS This study demonstrated the prognosis of food allergy classes in Japan, including multiple food allergies, with 7 classes with its own characteristics.
Collapse
Affiliation(s)
- Kyohei Takahashi
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan.,Course of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Noriyuki Yanagida
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - Takaaki Itonaga
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan.,Course of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Makoto Nishino
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan.,Course of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ken-Ichi Nagakura
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - Kiyotake Ogura
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - Sakura Sato
- Course of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - Motohiro Ebisawa
- Course of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| |
Collapse
|
4
|
Volker E, Tessier C, Rodriguez N, Yager J, Kozyrskyj A. Pathways of atopic disease and neurodevelopmental impairment: assessing the evidence for infant antibiotics. Expert Rev Clin Immunol 2022; 18:901-922. [PMID: 35822921 DOI: 10.1080/1744666x.2022.2101450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Epidemiologic studies are starting to report associations between antibiotic use in early life and neurodevelopmental disorders. Through mechanisms within the gut microbiota-brain axis, indeed, it is plausible that infant antibiotic treatment plays a role in the development of atopic disease and neurodevelopmental disorders. AREAS COVERED This narrative review summarizes and interprets published evidence on infant antibiotic use in future outcomes of atopic disease, and neurodevelopmental delay and disorders, including attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). To this end, we critically assess study bias from 2 main confounding factors, maternal/infant infection and infant feeding status. We also discuss common mechanisms that link atopy and neurodevelopment, and propose hypotheses related to immune activation and the gut microbiome. EXPERT OPINION Atopic disease and neurodevelopmental disorders share many risk factors and biological pathways. Infant antibiotic use has been linked to both disorders and is likely a marker for prenatal or infant infection. The mediating role of breastfeeding can also not be discounted. The exploration of causal pathways along the gut-brain axis leading towards neurodevelopmental impairment is evolving and of future interest.
Collapse
|
5
|
Wärnberg Gerdin S, Lie A, Asarnoj A, Borres MP, Lødrup Carlsen KC, Färdig M, Konradsen JR, Monceyron Jonassen C, Olsson Mägi C, Rehbinder EM, Rudi K, Skjerven HO, Staff AC, Söderhäll C, Tedner SG, Hage M, Vettukattil R, Nordlund B. Impaired skin barrier and allergic sensitization in early infancy. Allergy 2022; 77:1464-1476. [PMID: 34738238 DOI: 10.1111/all.15170] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 05/18/2021] [Accepted: 10/15/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Factors predicting allergic sensitization in the first 6 months of life are poorly understood. We aimed to determine whether eczema, dry skin, and high transepidermal water loss (TEWL) at 3 months were associated with allergic sensitization at 6 months of age and, secondarily, to establish whether these characteristics predicted sensitization from 3 to 6 months of age. METHODS At 3 months of age, 1,994 infants from the population-based PreventADALL birth cohort in Norway and Sweden were assessed for eczema and dry skin on the cheeks and/or extensors; impaired skin barrier function, defined as TEWL in the upper quartile (>9.4 g/m2 /h), and allergen-specific IgE levels <0.1 kUA /L, available in 830. At 6 months, we assessed allergic sensitization to any food (egg, cow's milk, peanut, wheat, soy) or inhalant (birch, timothy grass, dog, and cat) allergen by a skin prick test wheal diameter ≥2 mm larger than negative control. RESULTS Any sensitization was found in 198 of the 1,994 infants (9.9%), the majority to food allergens (n = 177, 8.9%). Eczema, dry skin, and high TEWL at 3 months increased the risk of sensitization at 6 months; adjusted odds ratios 4.20 (95% CI 2.93-6.04), 2.09 (95% CI 1.51-2.90) and 3.67 (95% CI 2.58-5.22), respectively. Eczema predicted sensitization with 55.6% sensitivity and 68.1% specificity; dry skin with 65.3% sensitivity and 57.3% specificity; and high TEWL with 61.7% sensitivity and 78.1% specificity. CONCLUSION Eczema, dry skin, and high TEWL at 3 months predicted allergic sensitization at 6 months of age.
Collapse
Affiliation(s)
- Sabina Wärnberg Gerdin
- Astrid Lindgren Children’s Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden
| | - Anine Lie
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Anna Asarnoj
- Astrid Lindgren Children’s Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden
| | - Magnus P. Borres
- Department of Women’s and Children’s Health Uppsala University Uppsala Sweden
| | - Karin C. Lødrup Carlsen
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Martin Färdig
- Astrid Lindgren Children’s Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden
| | - Jon R. Konradsen
- Astrid Lindgren Children’s Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden
| | - Christine Monceyron Jonassen
- Genetic Unit Centre for Laboratory Medicine Østfold Hospital Trust Kalnes Norway
- Faculty of Chemistry, Biotechnology and Food Science Norwegian University of Life Sciences Ås Norway
| | - Caroline‐Aleksi Olsson Mägi
- Astrid Lindgren Children’s Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden
| | - Eva Maria Rehbinder
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Dermatology Oslo University Hospital Oslo Norway
| | - Knut Rudi
- Faculty of Chemistry, Biotechnology and Food Science Norwegian University of Life Sciences Ås Norway
| | - Håvard Ove Skjerven
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Anne Cathrine Staff
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Obstetrics and Gynaecology Oslo University Hospital Oslo Norway
| | - Cilla Söderhäll
- Astrid Lindgren Children’s Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden
| | - Sandra G. Tedner
- Astrid Lindgren Children’s Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden
| | - Marianne Hage
- Department of Medicine Solna Division of Immunology and Allergy Karolinska Institutet and Karolinska University Hospital Stockholm Sweden
| | - Riyas Vettukattil
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Björn Nordlund
- Astrid Lindgren Children’s Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden
| |
Collapse
|
6
|
Egg Allergy in Children and Weaning Diet. Nutrients 2022; 14:nu14081540. [PMID: 35458102 PMCID: PMC9025129 DOI: 10.3390/nu14081540] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/02/2022] [Accepted: 04/03/2022] [Indexed: 02/01/2023] Open
Abstract
Eggs are a fundamental food in the human diet, and together with cow’s milk, they are the most common food allergen. This work highlights the main nutritional characteristics of eggs to show how their absence from a child’s diet can constitute a serious deficiency. We then analyze the risk factors that facilitate the onset of egg allergy. The third part of the paper reports possible interventions to lower the appearance of food allergy that have been occurred in trials. The last part of the paper is a synthesis of this research study that has been taken from several of the latest guidelines or from position papers.
Collapse
|
7
|
Assessment of egg and milk allergies among Indians by revalidating a food allergy predictive model. World Allergy Organ J 2022; 15:100639. [PMID: 35399818 PMCID: PMC8956949 DOI: 10.1016/j.waojou.2022.100639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 12/10/2021] [Accepted: 02/21/2022] [Indexed: 12/24/2022] Open
|
8
|
Chang CL, Ali GB, Lodge CJ, Abramson MJ, Erbas B, Tang MLK, Svanes C, Bui DS, Dharmage SC, Lowe AJ. Associations between Body Mass Index Trajectories in the first two years of life and Allergic Rhinitis, Eczema and Food Allergy outcomes up to early adulthood. Pediatr Allergy Immunol 2022; 33:e13765. [PMID: 35338730 DOI: 10.1111/pai.13765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Early life body mass index (BMI) trajectories influence the risk of asthma at 18 years of age. However, it is unclear if these are also associated with other allergic diseases. OBJECTIVES We investigated the associations between BMI trajectories and subsequent allergic rhinitis, eczema and food sensitisation/allergies. METHODS Parent-reported anthropometric data were collected 18 times in the first two years of life from a cohort of 620 participants in a high-risk cohort. Group-based trajectory modelling was applied to develop BMI trajectories. Associations between trajectories and allergic rhinitis, eczema and food sensitisation at 6, 12 and 18 years of age were assessed using logistic regression models. Potential effect modifications by parental allergic disease, sex and allocated infant formula were assessed. RESULTS We identified five BMI trajectories: average, below average, persistently low, early low and catch up, and persistently high. None showed an association with allergic rhinitis. In participants with maternal allergic rhinitis, 'early-low and catch-up' (OR = 2.83;95%CI 1.34-5.96, Pint = 0.05) and 'below average' trajectories (OR = 2.39; 1.18-7.23, Pint = 0.02) were associated with allergic rhinitis at 18 years of age compared with the average trajectory. No associations were observed with eczema or food sensitisation. CONCLUSION Infants with early-low and catch-up, or below average BMI growth, were at increased risk of allergic rhinitis at 18 years if they had a mother with allergic rhinitis. These results require replication, but suggest that interactions between poor intrauterine growth, failure to thrive and maternal allergies may influence the risk of allergic rhinitis.
Collapse
Affiliation(s)
- Chia-Lun Chang
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Gulshan Bano Ali
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Caroline J Lodge
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Michael J Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Mimi L K Tang
- Allergy Immunology, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Allergy Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Cecilie Svanes
- Centre for International Health, University of Bergen, Bergen, Norway.,Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Dinh Son Bui
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Adrian J Lowe
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
| |
Collapse
|
9
|
Rodriguez N, Tessier CA, Mandhane PJ, Pei J, Simons E, Moraes TJ, Turvey SE, Subbarao P, Kozyrskyj AL. Sex-specific associations among infant food and atopic sensitizations and infant neurodevelopment. Front Pediatr 2022; 10:734428. [PMID: 36389362 PMCID: PMC9648178 DOI: 10.3389/fped.2022.734428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/02/2022] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Food sensitization is a first and strong indicator of immune deviation in the progression to other allergic conditions. Sensitization to food or other allergens and related inflammation during critical windows of infant development may adversely affect neurodevelopmental milestones. However, additional research is needed to test this association further. METHODS Associations between atopic (any food or aeroallergen) or food sensitization (specific to egg, soybean, peanut, and milk) at age 1 year and neurodevelopment up to 2 years of age were evaluated in the national CHILD Cohort Study, with a secondary aim examining whether these associations were sex-specific. Food and atopic sensitization were assessed by skin prick tests (SPT) in 1-year-old infants, with neurodevelopment assessed using the cognitive, language, motor, and social-emotional subscales of the Bayley Scales of Infant Development (BSID-III) administered at 1 and 2 years of age. RESULTS Atopic sensitization was present among 16.4% of infants, while 13.4% had food sensitizations. Only socioemotional scores reached statistical significance among the four BSID-III domains. Both atopic and food sensitization at 1 year of age was associated with lower social-emotional scores, independent of the infant's ethnicity. These findings were sex-specific and only observed among boys, among whom social-emotional scores were lowered by 5 points if atopic sensitization was present (-5.22 [95% CI: -9.96, -0.47], p = 0.03) or if food sensitization was present (-4.85 [95% CI: -9.82,0.11], p = 0.06). Similar results were observed using the standard SPT cut-off of ≥3 mm - for atopic sensitization (-5.17 [95% CI: -11.14, -0.80], p = 0.09) and for food sensitization (-4.61 [95% CI: -10.96, 1.74], p = 0.15). CONCLUSION In our study of term infants, we found an inverse, cross-sectional association between atopic and food sensitization status and social-emotional development scores in male children but not female children.
Collapse
Affiliation(s)
- Nicole Rodriguez
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Carmen A Tessier
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Piushkumar J Mandhane
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Jacqueline Pei
- Department of Educational Psychology, Faculty of Education, University of Alberta, Edmonton, AB, Canada
| | - Elinor Simons
- Department of Pediatrics and Child Health, University of Manitoba and Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Theo J Moraes
- Department of Pediatrics, Faculty of Medicine, University of Toronto and Hospital for Sick Children, Toronto, ON, Canada
| | - Stuart E Turvey
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Padmaja Subbarao
- Department of Pediatrics, Faculty of Medicine, University of Toronto and Hospital for Sick Children, Toronto, ON, Canada
| | - Anita L Kozyrskyj
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.,Department of Obstetrics and Gynecology, School of Public Health, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
10
|
Leech SC, Ewan PW, Skypala IJ, Brathwaite N, Erlewyn-Lajeunesse M, Heath S, Ball H, James P, Murphy K, Clark AT. BSACI 2021 guideline for the management of egg allergy. Clin Exp Allergy 2021; 51:1262-1278. [PMID: 34586690 DOI: 10.1111/cea.14009] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 08/09/2021] [Accepted: 08/15/2021] [Indexed: 12/19/2022]
Abstract
This guideline advises on the management of patients with egg allergy. Most commonly egg allergy presents in infancy, with a prevalence of approximately 2% in children and 0.1% in adults. A clear clinical history will confirm the diagnosis in most cases. Investigation by measuring egg-specific IgE (by skin prick testing or specific IgE assay) is useful in moderate-severe cases or where there is diagnostic uncertainty. Following an acute allergic reaction, egg avoidance advice should be provided. Egg allergy usually resolves, and reintroduction can be achieved at home if reactions have been mild and there is no asthma. Patients with a history of severe reactions or asthma should have reintroduction guided by a specialist. All children with egg allergy should receive the MMR vaccine. Most adults and children with egg allergy can receive the influenza vaccine in primary care, unless they have had anaphylaxis to egg requiring intensive care support. Yellow Fever vaccines should only be considered in egg-allergic patients under the guidance of an allergy specialist. This guideline was prepared by the Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI) and is intended for allergists and others with a special interest in allergy. The recommendations are evidence based. Where evidence was lacking, consensus was reached by the panel of specialists on the committee. The document encompasses epidemiology, risk factors, diagnosis, treatment, prognosis and co-morbid associations.
Collapse
Affiliation(s)
- Susan C Leech
- Department of Child Health, Kings College Hospital, London, UK
| | - Pamela W Ewan
- Allergy Clinic, NHS Foundation Trust, Cambridge University, Cambridge, UK
| | | | - Nicola Brathwaite
- Department of Child Health, Kings College Hospital, London, UK.,Department of Child Health, Kings College Hospital, London, UK
| | | | - Sarah Heath
- Department of Child Health, Kings College Hospital, London, UK
| | - Heidi Ball
- University Hospitals Leicester, Leicester, UK
| | - Polly James
- Evelina Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Karen Murphy
- Evelina Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Andrew T Clark
- Allergy Clinic, NHS Foundation Trust, Cambridge University, Cambridge, UK
| |
Collapse
|
11
|
Baghlaf MA, Eid NMS. Prevalence, Risk Factors, Clinical Manifestation, Diagnosis Aspects and Nutrition Therapy in Relation to both IgE and IgG Cow’s Milk Protein Allergies among a Population of Saudi Arabia: A Literature Review. CURRENT RESEARCH IN NUTRITION AND FOOD SCIENCE JOURNAL 2021. [DOI: 10.12944/crnfsj.9.2.02] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Cow milk protein allergy (CMPA) becoming a major public health issue that has attracted the attention of health professionals and researchers. This paper aimed to review the important aspects of both IgE and IgG types of cow’s milk protein allergy in terms of prevalence, clinical manifestation, risk factors, other health-related issues and nutritional therapy proposed for such allergies in the adult and pediatric population in Saudi Arabia. A search on “cow’s milk allergy” was done using PubMed, Google Scholar and Scopus Engine for published papers between 1993 and 2020 to find studies yielding knowledge on that context. The prevalence of cow’s milk protein allergy (CMPA) among infants is now in the range of 2–3%. This type of allergy is also detected in adulthood but less frequently. CMPA is defined as an immunological reaction to specific proteins in milk. CMPA is classified based on its type as an immunoglobulin E (IgE)-mediated form and an immunoglobulin G (IgG)-mediated form, each type representing different immunological pathways. The presence of Genetic aspects, family history and short duration of breastfeeding in the infant are among the risk factors contributing to this form of allergy. Its manifestations mainly present as skin presentation, followed by the gastrointestinal and respiratory presentation in most cases in addition to a life-threatening anaphylactic reaction that may occur in 12% of cases. food allergy committees have developed strict diagnosis criteria, including blood testing for food-specific immunoglobulin E (sIgE), a skin prick test and double-blind placebo-controlled food challenges (DBPCFC) as the gold standard. A diet free of cow’s milk protein (CMP) allergen and including the appropriate alternative milk formula is the first line of prevention recommended by many organizations and food allergy experts. As for Saudi Arabia, more research and clinical trials are required to discuss the various aspects of adult and pediatric CMPA and to provide a better understanding along with good control strategies implementation.
Collapse
Affiliation(s)
- Mashail A Baghlaf
- 1Faculty of Applied Medical Sciences, Department of Medical Laboratory Technology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Noura M S Eid
- 2Faculty of Applied Medical Sciences, Department of Clinical Nutrition, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
12
|
Imran S, Neeland MR, Koplin J, Dharmage S, Tang MLK, Sawyer S, Dang T, McWilliam V, Peters R, Perrett KP, Novakovic B, Saffery R. Epigenetic programming underpins B-cell dysfunction in peanut and multi-food allergy. Clin Transl Immunology 2021; 10:e1324. [PMID: 34466226 PMCID: PMC8384135 DOI: 10.1002/cti2.1324] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/07/2021] [Accepted: 07/16/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Rates of IgE-mediated food allergy (FA) have increased over the last few decades, and mounting evidence implicates disruption of epigenetic profiles in various immune cell types in FA development. Recent data implicate B-cell dysfunction in FA; however, few studies have examined epigenetic changes within these cells. METHODS We assessed epigenetic and transcriptomic profiles in purified B cells from adolescents with FA, comparing single-food-allergic (peanut only), multi-food-allergic (peanut and ≥1 other food) and non-allergic (control) individuals. Adolescents represent a phenotype of persistent and severe FA indicative of a common immune deviation. RESULTS We identified 144 differentially methylated probes (DMPs) and 116 differentially expressed genes (DEGs) that distinguish B cells of individuals with FA from controls, including differential methylation of the PM20D1 promoter previously associated with allergic disorders. Subgroup comparisons found 729 DMPs specific to either single-food- or multi-food-allergic individuals, suggesting epigenetic distinctions between allergy groups. This included two regions with increased methylation near three S100 genes in multi-food-allergic individuals. Ontology results of DEGs specific to multi-food-allergic individuals revealed enrichment of terms associated with myeloid cell activation. Motif enrichment analysis of promoters associated with DMPs and DEGs showed differential enrichment for motifs recognised by transcription factors regulating B- and T-cell development, B-cell lineage determination and TGF-β signalling pathway between the multi-food-allergic and single-food-allergic groups. CONCLUSION Our data highlight epigenetic changes in B cells associated with peanut allergy, distinguishing features of the epigenome between single-food- and multi-food-allergic individuals and revealing differential developmental pathways potentially underpinning these distinct phenotypes.
Collapse
Affiliation(s)
- Samira Imran
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
| | - Melanie R Neeland
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
| | - Jennifer Koplin
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
| | - Shyamali Dharmage
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
- Allergy and Lung Health UnitMelbourne School of Population and Global HealthUniversity of MelbourneCarltonVICAustralia
| | - Mimi LK Tang
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
- Department of Allergy and ImmunologyRoyal Children's HospitalMelbourneVICAustralia
| | - Susan Sawyer
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
- Centre for Adolescent HealthRoyal Children's HospitalMelbourneVICAustralia
| | - Thanh Dang
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
| | - Vicki McWilliam
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
- Department of Allergy and ImmunologyRoyal Children's HospitalMelbourneVICAustralia
| | - Rachel Peters
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
| | - Kirsten P Perrett
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
- Department of Allergy and ImmunologyRoyal Children's HospitalMelbourneVICAustralia
| | - Boris Novakovic
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
| | - Richard Saffery
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
| |
Collapse
|
13
|
Piippo S, Viljanen M, Savilahti E, Kuitunen M. Allergic symptoms and sensitisation in adolescents with cows' milk allergy and atopic eczema in infancy. IMMUNITY INFLAMMATION AND DISEASE 2020; 8:423-433. [PMID: 32567223 PMCID: PMC7416017 DOI: 10.1002/iid3.324] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/03/2020] [Accepted: 06/05/2020] [Indexed: 01/26/2023]
Abstract
Background The association between atopic sensitisation, atopic eczema (AE) and asthma is known, but distinct roles of allergies on long‐term health are unestablished. Objective Evaluation of allergic symptoms and sensitisation in adolescents who in infancy had AE and verified cows' milk allergy (CMA) or AE and a negative CMA challenge, and controls. Methods Children with AE, with and without CMA, from a randomised controlled study in 1999‐2001 examining the effect of probiotics on AE severity at older than 12 months of age, attended a follow‐up visit at age 16 to 18, with age‐matched controls. Data came from a questionnaire (ISAAC questionnaire), analysis of serum antigen‐specific immunoglobulin Es (IgEs), and clinical evaluation. Group comparisons were carried out (χ2 tests and logistic regression). Results Fifty‐two patients with AE and CMA (AE/CMA+ group), 52 with AE and suspicion of CMA (AE/CMA− group), and 57 controls attended a study visit. IgE‐mediated sensitisation was significantly more prevalent in the AE/CMA+ group vs the controls, for horse, cat, dog, egg white and wheat (P < .024 for all). For birch, timothy and mugwort (P < .008 for all), sensitisation was more prevalent in both the AE/CMA+ group and the AE/CMA− group vs controls. On the basis of questionnaire data the AE/CMA + group reported a significantly higher lifetime prevalence of wheezing (64% vs 35% and 32%; P = .001), noninfectious rhinitis (85% vs 62% and 56%; P = .004), and hay fever (77% vs 52% and 33%; P < .001) vs the AE/CMA− group and the control group, respectively. Conclusion and Clinical Relevance Patients with AE and CMA in infancy, as opposed to patients with AE only, or controls, report more allergic symptoms and exhibit more allergic sensitisation in adolescence. This indicates that CMA in infancy is an independent risk factor of allergic disease in adolescence.
Collapse
Affiliation(s)
- Sonja Piippo
- Department of Pediatrics, Children's Hospital, Pediatric Research Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Mirva Viljanen
- Department of Pediatrics, Children's Hospital, Pediatric Research Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Erkki Savilahti
- Department of Pediatrics, Children's Hospital, Pediatric Research Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Mikael Kuitunen
- Department of Pediatrics, Children's Hospital, Pediatric Research Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| |
Collapse
|
14
|
Gray LEK, Ponsonby A, Collier F, O'Hely M, Sly PD, Ranganathan S, Tang MLK, Carlin JB, Saffery R, Vuillermin PJ, Burgner D, Allen KJ, Pezic A. Deserters on the atopic march: Risk factors, immune profile and clinical outcomes of food sensitized-tolerant infants. Allergy 2020; 75:1404-1413. [PMID: 31853983 DOI: 10.1111/all.14159] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 10/17/2019] [Accepted: 11/05/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND A few studies have investigated the antecedents and outcomes of infants who demonstrate IgE sensitization to foods that they clinically tolerate. Improved understanding of this sensitized-tolerant phenotype may inform strategies for the prevention of food allergy. METHODS In an Australian birth cohort (n = 1074), assembled using an unselected antenatal sampling frame, participants were categorized as nonsensitized (NS), sensitizedtolerant (ST), or food allergic (FA) based on skin prick testing and food challenge at 12 months of age. Environmental exposures were recorded throughout. Cord blood regulatory T-cell populations were measured at birth. Subsequent childhood allergic disease was assessed by parent report, clinical examination, and repeat skin prick testing. RESULTS The covariates of interest varied between NS (n = 698), ST (n = 27), and FA (n = 61) groups as follows, suggesting that across these measures, the ST group was more similar to the NS than the FA group: family history of eczema NS 44.6%, ST. 44.6%, FA 65.6%; pet ownership at 12 months: NS 71.5%, ST 81.5%, FA 45.8%; eczema during the first 12 months: NS 19%, ST 32%, FA 64%; and aeroallergen sensitization at 4 years: NS 19.1%, ST 28.6%, FA 44.4%. At birth, a higher proportion of activated regulatory T cells was associated with ST (OR = 2.89, 95% CI 1.03-8.16, P = .045). CONCLUSION Food-sensitized-tolerance in infancy appears to be associated with a similar pattern of exposures, immunity, and outcomes to nonsensitized infants. In addition, we found some evidence that an elevated proportion of activated regulatory T cells at birth was specific to the sensitized-tolerant infants, which may be relevant to suppression of clinical disease.
Collapse
Affiliation(s)
- Lawrence E. K. Gray
- School of Medicine Deakin University Geelong Vic. Australia
- Barwon Health Geelong Vic. Australia
| | - Anne‐Louise Ponsonby
- The Murdoch Children's Research Institute Parkville Vic. Australia
- The University of Melbourne Parkville Vic. Australia
| | - Fiona Collier
- School of Medicine Deakin University Geelong Vic. Australia
- Barwon Health Geelong Vic. Australia
- The Murdoch Children's Research Institute Parkville Vic. Australia
| | - Martin O'Hely
- School of Medicine Deakin University Geelong Vic. Australia
- The Murdoch Children's Research Institute Parkville Vic. Australia
| | - Peter D. Sly
- The Murdoch Children's Research Institute Parkville Vic. Australia
- University of Queensland South Brisbane Qld Australia
| | - Sarath Ranganathan
- The Murdoch Children's Research Institute Parkville Vic. Australia
- The University of Melbourne Parkville Vic. Australia
- The Royal Children's Hospital Parkville Vic. Australia
| | - Mimi L. K. Tang
- The Murdoch Children's Research Institute Parkville Vic. Australia
- The University of Melbourne Parkville Vic. Australia
- The Royal Children's Hospital Parkville Vic. Australia
| | - John B. Carlin
- The Murdoch Children's Research Institute Parkville Vic. Australia
- The University of Melbourne Parkville Vic. Australia
- The Royal Children's Hospital Parkville Vic. Australia
| | - Richard Saffery
- The Murdoch Children's Research Institute Parkville Vic. Australia
- The University of Melbourne Parkville Vic. Australia
| | - Peter J. Vuillermin
- School of Medicine Deakin University Geelong Vic. Australia
- Barwon Health Geelong Vic. Australia
- The Murdoch Children's Research Institute Parkville Vic. Australia
| | | | | | | | | |
Collapse
|
15
|
High-Dose Vitamin D Supplementation Does Not Prevent Allergic Sensitization of Infants. J Pediatr 2019; 209:139-145.e1. [PMID: 30902420 DOI: 10.1016/j.jpeds.2019.02.021] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 02/05/2019] [Accepted: 02/12/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To investigate the effect of vitamin D supplementation dose on allergic sensitization and allergic diseases in infants, and to evaluate whether vitamin D status in pregnancy and at birth are associated with infant allergy outcomes. STUDY DESIGN Altogether, 975 infants participated in a randomized, controlled trial of daily vitamin D supplementation of 10 μg (400 IU) or 30 μg (1200 IU) from the age of 2 weeks. At 12 months of age, food and aeroallergen IgE antibodies were measured, and the occurrence of allergic diseases and wheezing were evaluated. RESULTS We found no differences between the vitamin D supplementation groups in food (OR, 0.98; 95% CI, 0.66-1.46) or aeroallergen sensitization at 12 months (OR, 0.76; 95% CI,0.34-1.71). Allergic diseases or wheezing did not differ between groups, except for milk allergy which occurred more often in infants administered 30 μg vitamin D compared with the 10 μg dose (OR, 2.23; 95% CI, 1.00-4.96). Infants with high cord blood 25-hydroxyvitamin D (≥100 nmol/L) had a higher risk of food allergen sensitization compared with those with lower 25(OH)D concentration (75-99.9 nmol/L; OR, 2.00; 95% CI, 1.19-3.39). CONCLUSIONS High-dose vitamin D supplementation did not prevent allergic sensitization, allergic diseases, or wheezing during the first year of life. In contrast, we observed an increased risk of milk allergy in infants randomized to higher vitamin D supplementation, and an increased risk of allergic sensitization in infants with high cord blood vitamin D status, indicating a possible adverse effect of high concentrations of vitamin D.
Collapse
|
16
|
Epidemiology of Cow's Milk Allergy. Nutrients 2019; 11:nu11051051. [PMID: 31083388 PMCID: PMC6566637 DOI: 10.3390/nu11051051] [Citation(s) in RCA: 160] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/06/2019] [Accepted: 05/06/2019] [Indexed: 02/07/2023] Open
Abstract
Immunoglobulin E (IgE)-mediated cow's milk allergy (CMA) is one of the most common food allergies in infants and young children. CMA can result in anaphylactic reactions, and has long term implications on growth and nutrition. There are several studies in diverse populations assessing the epidemiology of CMA. However, assessment is complicated by the presence of other immune-mediated reactions to cow's milk. These include non-IgE and mixed (IgE and non-IgE) reactions and common non-immune mediated reactions, such as lactose intolerance. Estimates of prevalence and population-level patterns are further complicated by the natural history of CMA (given its relatively high rate of resolution) and variation in phenotype (with a large proportion of patients able to tolerate baked cow's milk). Prevalence, natural history, demographic patterns, and long-term outcomes of CMA have been explored in several disparate populations over the past 30 to 40 years, with differences seen based on the method of outcome assessment, study population, time period, and geographic region. The primary aim of this review is to describe the epidemiology of CMA. The review also briefly discusses topics related to prevalence studies and specific implications of CMA, including severity, natural course, nutritional impact, and risk factors.
Collapse
|
17
|
Eigenmann P. On early metabolite exposure influencing asthma outcome, the risk of hymenoptera allergy in a birth cohort, and improvement of food allergy management at school. Pediatr Allergy Immunol 2019; 30:5-6. [PMID: 30697869 DOI: 10.1111/pai.13014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 12/18/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Philippe Eigenmann
- Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland
| |
Collapse
|
18
|
The skin as a target for prevention of the atopic march. Ann Allergy Asthma Immunol 2019; 120:145-151. [PMID: 29413338 DOI: 10.1016/j.anai.2017.11.023] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 11/20/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Allergic diseases have increased dramatically in the developed world during the past few decades, yet the understanding of risk factors and effective prevention approaches remain limited. In this review, we summarize the evidence supporting the hypothesis that skin-barrier impairment and early-life atopic dermatitis (AD) could play a causal role in the development of sensitization and subsequent food allergies and allergic airways disease (allergic asthma and rhinitis). We further discuss the potential to target the skin barrier as a means to lower the incidence of allergic disease. DATA SOURCES Review of published literature. STUDY SELECTIONS Narrative. RESULTS There is a strong link between AD and sensitization, food allergy, asthma, and allergic rhinitis, particularly AD that is severe and commences in the first 6 months of life. There also is emerging evidence that regular use of prophylactic emollients can significantly decrease the expression of AD, at least while treatment continues. Studies are exploring whether decreased AD expression might modulate the allergic response at a more fundamental level and potentially alter the association between early-life AD and subsequent development of food allergy and allergic airways disease. CONCLUSION Although at this point there is only indirect evidence that early-life emollient use might prevent AD and food allergy, early studies are encouraging. The results of high-quality prevention trials that are in progress are eagerly anticipated. If found to be effective, then neonatal emollient use could be a simple public health measure to lower the incidence of AD, food allergies, and allergic airways disease in future generations.
Collapse
|
19
|
Bedolla-Barajas M, Morales-Romero J, Gaxiola-Arredondo BY, Alcalá-Padilla G, Romero-Velarde E. Prolonged breastfeeding and delayed introduction of whole cow's milk into the diet are factors associated with egg sensitization: A matched case-control study. Allergol Immunopathol (Madr) 2018; 46:539-545. [PMID: 29739686 DOI: 10.1016/j.aller.2018.01.006] [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: 10/14/2017] [Revised: 12/27/2017] [Accepted: 01/03/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Both breastfeeding and the moment at which introduction to solid food occurs have been associated with food allergy. OBJECTIVE To evaluate whether prolonged breastfeeding and the delayed introduction of whole cow's milk into an infant's diet are factors that can be associated with egg sensitization. METHODS This was a hospital-based case-control study, matched by age and sex: each study group comprised 97 atopic children. Additionally, logistic regression was used to identify the factors associated with egg protein sensitization. RESULTS The most common type of allergic disease among both groups was allergic rhinitis. After adjusting for possible confounding variables, a delayed introduction to whole cow's milk decreased the odds of egg protein sensitization; OR=0.16 (95% CI: 0.07-0.36, p<0.0001). Notably, breastfeeding during the first six months of life, regardless of whether it was the only milk an infant drank, increased the risk for sensitization to chicken eggs; OR=5.54 (95% CI: 2.41-12.7, p<0.0001). CONCLUSION Prolonged breastfeeding, regardless of whether it was the only milk an infant drank, greatly increased the risk of egg sensitization. Interestingly, a delayed introduction to whole cow's milk was associated with a reduced possibility of becoming sensitized to eggs. Further studies are required to elucidate these findings.
Collapse
Affiliation(s)
- M Bedolla-Barajas
- Servicio de Alergia e Inmunología Clínica, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Salvador de Quevedo y Zubieta No. 750, Colonia La Perla, C. P. 44340, Guadalajara, Jalisco, Mexico.
| | - J Morales-Romero
- Instituto de Salud Pública, Universidad Veracruzana, Av. Luis Castelazo Ayala s/n., Colonia Industrial Ánimas, C. P. 91190, Xalapa, Veracruz, Mexico
| | - B Y Gaxiola-Arredondo
- Servicio de Alergología e Inmunología Clínica, Hospital Civil de Guadalajara "Fray Antonio Alcalde", Coronel Calderón No. 777, Colonia El Retiro, C. P. 44280, Guadalajara, Jalisco, Mexico
| | - G Alcalá-Padilla
- Servicio de Alergología e Inmunología Clínica, Hospital Civil de Guadalajara "Fray Antonio Alcalde", Coronel Calderón No. 777, Colonia El Retiro, C. P. 44280, Guadalajara, Jalisco, Mexico
| | - E Romero-Velarde
- División de Pediatría, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Salvador de Quevedo y Zubieta No. 750, Colonia La Perla, C. P. 44340, Guadalajara, Jalisco, Mexico
| |
Collapse
|
20
|
Peters RL, Koplin JJ, Allen KJ, Lowe AJ, Lodge CJ, Tang ML, Wake M, Ponsonby AL, Erbas B, Abramson MJ, Hill D, Gurrin LC, Dharmage SC. The Prevalence of Food Sensitization Appears Not to Have Changed between 2 Melbourne Cohorts of High-Risk Infants Recruited 15 Years Apart. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:440-448.e2. [DOI: 10.1016/j.jaip.2017.11.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 10/20/2017] [Accepted: 11/14/2017] [Indexed: 12/01/2022]
|
21
|
Mastrorilli C, Caffarelli C, Hoffmann-Sommergruber K. Food allergy and atopic dermatitis: Prediction, progression, and prevention. Pediatr Allergy Immunol 2017; 28:831-840. [PMID: 29117431 DOI: 10.1111/pai.12831] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2017] [Indexed: 12/29/2022]
Abstract
The rising burden of allergic diseases in childhood requires a compelling need to identify individuals at risk for atopy very early in life or even predict the onset of food allergy and atopic dermatitis since pregnancy. The development and clinical phenotypes of atopic diseases in childhood depend on a complex interaction between genetic and environmental factors, such as allergen exposure, air pollution, and infections. Preventive strategies may include avoidance measures, diet supplements, and early complementary food introduction. Overall, the management of allergic diseases has been improving to date toward a patient's tailored approach. This review will cover the current understanding of risk factors, prediction, and management of food allergy and atopic dermatitis in childhood and discuss how these may contribute to the modification of the natural history of food allergy and atopic dermatitis.
Collapse
Affiliation(s)
- Carla Mastrorilli
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, Parma, Italy.,Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Carlo Caffarelli
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | | |
Collapse
|
22
|
Prenatal and early-life triclosan and paraben exposure and allergic outcomes. J Allergy Clin Immunol 2017; 142:269-278.e15. [PMID: 29111213 DOI: 10.1016/j.jaci.2017.09.029] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 07/19/2017] [Accepted: 09/07/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND In cross-sectional studies triclosan and parabens, ubiquitous ingredients in personal care and other products, are associated with allergic disease. OBJECTIVES We investigated the association between prenatal and early-life triclosan and paraben exposure and childhood allergic disease in a prospective longitudinal study. METHODS Subjects were enrollees in the Vitamin D Antenatal Asthma Reduction Trial. Triclosan, methyl paraben, and propyl paraben concentrations were quantified in maternal plasma samples pooled from the first and third trimesters and urine samples from children at age 3 or 4 years. Outcomes were parental report of physician-diagnosed asthma or recurrent wheezing and allergic sensitization to food or environmental antigens based on serum specific IgE levels at age 3 years in high-risk children. RESULTS The analysis included 467 mother-child pairs. Overall, there were no statistically significant associations of maternal plasma or child urine triclosan or paraben concentrations with asthma or recurrent wheeze or food or environmental sensitization at age 3 years. A trend toward an inverse association between triclosan and paraben exposure and allergic sensitization was observed. There was evidence of effect measure modification by sex, with higher odds of environmental sensitization associated with increasing paraben concentrations in male compared with female subjects. CONCLUSIONS We did not identify a consistent association between prenatal and early-life triclosan or paraben concentrations and childhood asthma, recurrent wheeze, or allergic sensitization in the overall study population. The differential effects of triclosan or paraben exposure on allergic sensitization by sex observed in this study warrant further exploration.
Collapse
|
23
|
Moghtaderi M, Hosseini Teshnizi S, Farjadian S. Sensitization to common allergens among patients with allergies in major Iranian cities: a systematic review and meta-analysis. Epidemiol Health 2017; 39:e2017007. [PMID: 28171712 PMCID: PMC5434227 DOI: 10.4178/epih.e2017007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Accepted: 02/05/2017] [Indexed: 12/20/2022] Open
Abstract
Various allergens are implicated in the pathogenesis of allergic diseases in different regions. This study attempted to identify the most common allergens among patients with allergies based on the results of skin prick tests in different parts of Iran. Relevant studies conducted from 2000 to 2016 were identified from the MEDLINE database. Six common groups of allergen types, including animal, cockroach, food, fungus, house dust mite, and pollen were considered. Subgroup analysis was performed to determine the prevalence of each type of allergen. The Egger test was used to assess publication bias. We included 44 studies in this meta-analysis. The overall prevalence of positive skin test results for at least one allergen was estimated to be 59% in patients with allergies in various parts of Iran. The number of patients was 11,646 (56% male and 44% female), with a mean age of 17.46±11.12 years. The most common allergen sources were pollen (47.0%), mites (35.2%), and food (15.3%). The prevalence of sensitization to food and cockroach allergens among children was greater than among adults. Pollen is the most common allergen sensitization in cities of Iran with a warm and dry climate; however, sensitization to house dust mites is predominant in northern and southern coastal areas of Iran.
Collapse
Affiliation(s)
- Mozhgan Moghtaderi
- Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Allergy Clinic of Ali-Asghar Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeed Hosseini Teshnizi
- Clinical Research Development Center of Children Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Shirin Farjadian
- Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Immunology, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
24
|
Alduraywish SA, Standl M, Lodge CJ, Abramson MJ, Allen KJ, Erbas B, von Berg A, Heinrich J, Lowe AJ, Dharmage SC. Is there a march from early food sensitization to later childhood allergic airway disease? Results from two prospective birth cohort studies. Pediatr Allergy Immunol 2017; 28:30-37. [PMID: 27590890 DOI: 10.1111/pai.12651] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/01/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND The march from early aeroallergen sensitization to subsequent respiratory allergy is well established, but it is unclear whether early life food sensitization precedes and further increases risk of allergic airway disease. OBJECTIVE To assess the association between food sensitization in the first 2 years of life and subsequent asthma and allergic rhinitis by age 10-12 years. METHODS We used data from two independent cohorts: the high-risk Melbourne Atopic Cohort Study (MACS) (n = 620) and the population-based LISAplus (n = 3094). Food sensitization was assessed at 6, 12, and 24 months in MACS and 24 months in LISAplus. Multiple logistic regressions were used to estimate associations between sensitization to food only, aeroallergen only, or both and allergic airway disease. RESULTS When compared to non-sensitized children, sensitization to food only at 12 months in MACS and 24 months in LISAplus was associated with increased risk of current asthma (aOR = 2.2; 95% CI 1.1, 4.6 in MACS and aOR = 4.9; 2.4, 10.1 in LISAplus). Similar results were seen for allergic rhinitis. Additionally, cosensitization to food and aeroallergen in both cohorts at any tested point was a stronger predictor of asthma (at 24 months, aOR = 8.3; 3.7, 18.8 in MACS and aOR = 14.4; 5.0, 41.6 in LISAplus) and allergic rhinitis (at 24 months, aOR = 3.9; 1.9, 8.1 in MACS and aOR = 7.6; 3.0, 19.6 in LISAplus). CONCLUSIONS In both cohorts, food sensitization (with or without aeroallergen sensitization) in the first two years of life increased the risk of subsequent asthma and allergic rhinitis. These findings support the role of early life food sensitization in the atopic march and suggest trials to prevent early onset have the potential to reduce the development of allergic airways disease.
Collapse
Affiliation(s)
- Shatha A Alduraywish
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.,Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Marie Standl
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Caroline J Lodge
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - Michael J Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Vic., Australia
| | - Katrina J Allen
- Murdoch Children's Research Institute, Department of Paediatrics, University of Melbourne, Royal Childrens' Hospital, Melbourne, Vic., Australia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, Vic., Australia
| | - Andrea von Berg
- Marien-Hospital Wesel, Department of Pediatrics, Research Institute, Wesel, Germany
| | - Joachim Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine Unit, Paediatric Environmental Epidemiology, WHO Collaboration Centre for Occupational Health, University Hospital Munich, Munich, Germany
| | - Adrian J Lowe
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.,Murdoch Children's Research Institute, Department of Paediatrics, University of Melbourne, Royal Childrens' Hospital, Melbourne, Vic., Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.,Murdoch Children's Research Institute, Department of Paediatrics, University of Melbourne, Royal Childrens' Hospital, Melbourne, Vic., Australia
| |
Collapse
|
25
|
Foong RX, du Toit G, Fox AT. Asthma, Food Allergy, and How They Relate to Each Other. Front Pediatr 2017; 5:89. [PMID: 28536690 PMCID: PMC5422552 DOI: 10.3389/fped.2017.00089] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 04/10/2017] [Indexed: 11/17/2022] Open
Abstract
The association between atopic diseases is well known, and previous research has shown that having one atopic disease can predispose to having another. The link between asthma and food allergy has been well researched, but the exact relationship between the two atopic conditions is not fully understood. Food allergic infants are at increased risk for the development of asthma and are at risk of food-induced asthmatic episodes and also anaphylaxis. Having a diagnosis of both food allergy and asthma has also been shown to have an effect on the severity of a patient's disease including being at greater risk of severe asthmatic episodes. Therefore, understanding the relationship between these two conditions in order to treat and manage these children safely is crucial to clinicians.
Collapse
Affiliation(s)
- Ru-Xin Foong
- Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy, King's College London, Guy's and St. Thomas' Hospitals NHS Foundation Trust, London, UK.,Institute of Child Health, University College of London, London, UK
| | - George du Toit
- Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy, King's College London, Guy's and St. Thomas' Hospitals NHS Foundation Trust, London, UK
| | - Adam T Fox
- Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy, King's College London, Guy's and St. Thomas' Hospitals NHS Foundation Trust, London, UK
| |
Collapse
|
26
|
Protudjer JLP, Vetander M, Kull I, Hedlin G, van Hage M, Wickman M, Bergström A. Food-Related Symptoms and Food Allergy in Swedish Children from Early Life to Adolescence. PLoS One 2016; 11:e0166347. [PMID: 27846286 PMCID: PMC5112902 DOI: 10.1371/journal.pone.0166347] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 10/27/2016] [Indexed: 12/03/2022] Open
Abstract
Background Risk factors for persistence of food-related symptoms (FRS) and food allergy (FA) from early life to adolescence are incompletely understood. The aim of this study was to identify risk factors for FRS and FA in adolescence amongst children with FRS or FA in the first four years of life (early life). Methods In children enrolled in a Swedish birth cohort and followed to 16 years (n = 2572), we defined children with early life FRS in the absence of FA, and FA. Corresponding phenotypes were defined at 16 years. Associations between potential risk factors at 4 years and FRS and FA at 16 years were investigated using logistic regression. Results Early life FRS and FA prevalences were 12.2% and 6.8%, respectively. Amongst children with early life FRS, 35.7% had FRS or FA at 16 years, whereas 74.3% of the children with early life FA had FA at 16 years. For each of the early life phenotypes, parental allergy, early life allergic multimorbidity, early life reactions to peanuts/tree nuts and IgE reactivity at 4 years were statistically significantly associated with FRS or FA at 16 years. In contrast, male sex was associated with an increased risk of FA at 16 years among children with early life FA only. Conclusions In early life, food-related symptoms are twice as common as food allergy. Unlike food allergy, food-related symptoms often remit by adolescence. Yet, these phenotypes have many common risk factors for persistence to adolescence.
Collapse
Affiliation(s)
- Jennifer L. P. Protudjer
- Institute of Environmental Medicine and Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Mirja Vetander
- Institute of Environmental Medicine and Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
- Sachs’ Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Inger Kull
- Institute of Environmental Medicine and Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
- Sachs’ Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
- Department of Clinical Science and Education and Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
| | - Gunilla Hedlin
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
- Department of Women’s and Children’s Health and Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
| | - Marianne van Hage
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
- Department of Medicine Solna, Immunology and Allergy Unit, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden
| | - Magnus Wickman
- Institute of Environmental Medicine and Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
- Sachs’ Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Anna Bergström
- Institute of Environmental Medicine and Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
27
|
Wright BL, Kulis M, Orgel KA, Burks AW, Dawson P, Henning AK, Jones SM, Wood RA, Sicherer SH, Lindblad RW, Stablein D, Leung DYM, Vickery BP, Sampson HA. Component-resolved analysis of IgA, IgE, and IgG4 during egg OIT identifies markers associated with sustained unresponsiveness. Allergy 2016; 71:1552-1560. [PMID: 27015954 DOI: 10.1111/all.12895] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND In a previously reported CoFAR study, 55 subjects with egg allergy underwent randomized, placebo-controlled egg oral immunotherapy (eOIT). Active treatment induced desensitization in most and sustained unresponsiveness (SU) in a smaller subset. We hypothesized that component-resolved analysis of IgE, IgG4, IgA, IgA1, and IgA2 may identify potential biomarkers of SU in OIT subjects. METHODS Longitudinal samples for 51 egg-allergic subjects (37 active and 14 placebo) were available. Egg white (EW)-, ovalbumin (OVA)-, and ovomucoid (OVM)-specific levels of IgA, IgA1, and IgA2 were quantified by ELISA. IgE and IgG4 to these antigens were quantified using ImmunoCAP® . Clinical responders achieved SU to egg; all others were considered nonresponders. Between-group comparisons were made among active and placebo, as well as responders and nonresponders. RESULTS No placebo subjects achieved responder status. Through month 48, among the 37 active subjects, baseline IgE-OVM was lower in responders (median 3.97 kU/l, n = 19) than in nonresponders (10.9 kU/l, n = 18, P = 0.010). Logistic regression analysis revealed that lower baseline IgE-EW (P = 0.038), IgE-OVM (P = 0.032), and a higher IgG4/IgE-OVM ratio (P = 0.013) were associated with clinical response. Relative increases in IgG4-EW, IgA-EW, and IgA2-EW were observed in responders (P = 0.024, 0.024, and 0.029, respectively). IgG4/IgE, IgA/IgE, and IgA2/IgE ratios for EW and IgA/IgE ratio for OVA were found to be significantly elevated among responders (P = 0.004, 0.009, 0.028, and 0.008, respectively). CONCLUSIONS Increased IgG4-EW, IgA-EW, and IgA2-EW during eOIT are associated with clinical response to eOIT. Lower pretreatment IgE-EW and IgE-OVM are also associated with SU. Future studies are needed to evaluate and validate these potential biomarkers.
Collapse
Affiliation(s)
- B. L. Wright
- University of North Carolina School of Medicine; Chapel Hill NC USA
- Duke University Medical Center; Durham NC USA
| | - M. Kulis
- University of North Carolina School of Medicine; Chapel Hill NC USA
| | - K. A. Orgel
- University of North Carolina School of Medicine; Chapel Hill NC USA
| | - A. W. Burks
- University of North Carolina School of Medicine; Chapel Hill NC USA
| | - P. Dawson
- The EMMES Corporation; Rockville MD USA
| | | | - S. M. Jones
- University of Arkansas for Medical Sciences and Arkansas Children's Hospital; Little Rock AR USA
| | - R. A. Wood
- Johns Hopkins University School of Medicine; Baltimore MD USA
| | | | | | | | | | - B. P. Vickery
- University of North Carolina School of Medicine; Chapel Hill NC USA
| | - H. A. Sampson
- Icahn School of Medicine at Mt. Sinai; New York NY USA
| | | |
Collapse
|
28
|
Predictors of allergen sensitization in Singapore children from birth to 3 years. Allergy Asthma Clin Immunol 2016; 12:56. [PMID: 27799959 PMCID: PMC5078880 DOI: 10.1186/s13223-016-0161-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 10/06/2016] [Indexed: 11/18/2022] Open
Abstract
Background Immune responses in allergic diseases begin with allergen sensitization, which usually occurs in childhood. Allergen sensitization involves a complex interplay of genetic and environmental factors, and sensitization patterns may change with age. Objective To determine the predictors of allergen sensitization in the first 3 years of life in the growing up in Singapore towards healthy outcomes (GUSTO) prospective birth cohort study. Methods Interviewers collected information on demographics, family history of allergy, social and lifestyle factors, and the child’s health. We analyzed data from 849 children who completed skin prick testing (SPT) to inhalant allergens (house dust mites: Dermatophagoides pteronyssinus, Dermatophagoides farinae, and Blomia tropicalis) and food allergens (egg, peanut and cow’s milk) to assess risk factors for allergen sensitization at 18 months. To ensure that clinical phenotypes preceded allergen sensitization, we also analyzed data from 649 children who had a negative skin prick test at 18 months and completed skin prick testing at 36 months. Results We observed a significant association between eczema reported before 18 months and a positive SPT at 18 months [aOR 4.5 (1.9–10.7)]. Ninety-five (14.6 %) children with negative SPTs at 18 months developed positive tests at 36 months. Onset of eczema before 18 months was associated with an increased risk of new allergen sensitization at 36 months among children non-sensitized at 18 months [aOR 3.4 (1.2–9.3)]. An association was seen between wheeze reported before 18 months and new allergen sensitization at 36 months [aOR 3.2 (1.1–9.1)]. We found no significant association, however, between rhinitis reported before 18 months and new allergen sensitization at 36 months. Conclusions Early onset of eczema and wheeze are risk factors for later allergen sensitization, suggesting a possible increased susceptibility to allergen exposure through an impaired skin barrier or defective airway epithelium. Trial registration NCT01174875 Registered 1 July 2010, retrospectively registered
Collapse
|
29
|
IgE reactivity to hen egg white allergens in dogs with cutaneous adverse food reactions. Vet Immunol Immunopathol 2016; 177:52-7. [DOI: 10.1016/j.vetimm.2016.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 05/24/2016] [Accepted: 06/15/2016] [Indexed: 01/19/2023]
|
30
|
Foong RX, Roberts G, Fox AT, du Toit G. Pilot study: assessing the clinical diagnosis of allergy in atopic children using a microarray assay in addition to skin prick testing and serum specific IgE. Clin Mol Allergy 2016; 14:8. [PMID: 27547124 PMCID: PMC4991090 DOI: 10.1186/s12948-016-0046-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 08/08/2016] [Indexed: 11/10/2022] Open
Abstract
Background Children with atopic dermatitis (AD) are at risk of developing allergy. Alongside clinical history, testing modalities include skin prick tests (SPT), specific immunoglobulin-E (sp-IgE) and recently, microarray assays. The aim of this pilot study was to assess current tests and the ISAC sIgE-112 system in the diagnosis of food and aeroallergen allergy. Methods Children aged 0–11 years with moderate to severe AD were included. An initial allergy assessment including clinical history, SPT and sp-IgE was performed to determine food and aeroallergen sensitization. A second independent clinical assessment using the same information given to the first assessor and ISAC test results for food and aeroallergen sensitization was also made for each participant. The results from both were compared. Results 30 children [mean age 3.91 years (SD 3.3)] were included; 53.3 and 46.7 % had moderate and severe AD, respectively. Sp-IgE tests had a higher percentage of positive results compared to SPT and ISAC tests for common allergens. There was a significant difference between the three tests in detecting aeroallergen sensitization (p = 0.038), especially between sp-IgE and ISAC tests, but no significant difference between the tests for food allergen sensitization. There was good agreement between the two assessors; 70 % of the children had a change in diagnosis, with 60 % having at least one diagnosis added and 40 % having at least one diagnosis removed. Conclusions There is a role for the use of ISAC testing in diagnosing sensitization and allergy in children with AD as it leads to a change in diagnosis for many patients. Further work is required to assess its clinical and cost effectiveness. Electronic supplementary material The online version of this article (doi:10.1186/s12948-016-0046-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Ru-Xin Foong
- Division of Asthma, Allergy and Lung Biology, Guy's and St. Thomas' NHS Foundation Trust, London, SE1 7EH UK ; Institute of Child Health, University College of London, London, UK
| | - Graham Roberts
- University of Southampton and National Institute for Health Research Respiratory Biomedical Research Unit, Southampton and David Hide Centre, Southampton, UK
| | - Adam Tobias Fox
- Division of Asthma, Allergy and Lung Biology, Guy's and St. Thomas' NHS Foundation Trust, London, SE1 7EH UK
| | - George du Toit
- Division of Asthma, Allergy and Lung Biology, Guy's and St. Thomas' NHS Foundation Trust, London, SE1 7EH UK
| |
Collapse
|
31
|
[Modern allergy diagnostic procedures and their clinical application]. Hautarzt 2015; 67:27-32. [PMID: 26530489 DOI: 10.1007/s00105-015-3722-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Due to the increasing incidence of allergies, the importance of allergy diagnostic procedures is growing. In addition to a patient's history and prick, intracutaneous and patch testing, serological testing is an important diagnostic procedure. In recent years, tremendous advances have been made in the area of in vitro allergy tests. In particular, it is possible to predict severity and risk management of food allergies with component-based IgE diagnostic procedures. Even new allergy syndromes have been elucidated at the molecular level.
Collapse
|