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Sheehan M, Lins de Holanda Coelho G, Kelleher M, Hourihane JOB, Byrne A, Dunn Galvin A. The impact of an evidence-based myth-busting information intervention on maternal food allergy-related quality of life, anxiety and self-efficacy. Clin Exp Allergy 2024; 54:631-633. [PMID: 38747120 DOI: 10.1111/cea.14494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/29/2024] [Accepted: 05/01/2024] [Indexed: 08/03/2024]
Affiliation(s)
- Mairead Sheehan
- Paediatric Allergy, Children's Health Ireland, Dublin, Ireland
| | | | - Maeve Kelleher
- Paediatric Allergy, Children's Health Ireland, Dublin, Ireland
| | - Jonathan O' B Hourihane
- Paediatric Allergy, Children's Health Ireland, Dublin, Ireland
- Paediatrics and Child Health, Royal College of Surgeons, Dublin, Ireland
| | - Aideen Byrne
- Paediatric Allergy, Children's Health Ireland, Dublin, Ireland
- Department of Paediatrics, School of Medicine, Trinity College Dublin, Dublin, Ireland
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Jones CJ, Tallentire H, Edgecumbe R, Sherlock G, Hale L. Online, group, low-intensity psychological intervention for adults, children, and parents with food allergy. Ann Allergy Asthma Immunol 2024:S1081-1206(24)00481-2. [PMID: 39069154 DOI: 10.1016/j.anai.2024.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 07/22/2024] [Accepted: 07/23/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Food allergy (FA) impairs psychological wellbeing because of constant vigilance, planning and preparation, dietary and social restrictions, and fear of accidental ingestion, though psychological interventions are sparse. OBJECTIVE To examine online, group, low-intensity psychological interventions for adults, children, young people (CYP), and parents with food allergies. METHODS The randomized controlled trials assessed the feasibility and signal of the efficacy of a psychological intervention for adults, CYP, and parents with FA. Participants were randomized to receive the psychological intervention or treatment as usual. The intervention consisted of two, 3-hour manualized online sessions spaced 1 week apart. All participants completed relevant Food Allergy Quality of Life Questionnaires (FAQLQ) and worry (Penn State Worry Questionnaires), in addition to exploratory outcomes, at baseline, 1 month, and 3 months. RESULTS A total of 129 participants (n = 44 adults, n = 52 CYP, and n = 33 parents) were recruited and randomized; 95 (74%) (n = 36 adults, n = 35 CYP, and n = 24 parents) were retained at 3 months. Owing to baseline differences, mean change was used for parent and CYP outcomes. The psychological intervention demonstrated large FAQLQ benefits across adults (g = -1.12, 95% CI -0.41 to -1.28), CYP (g = 1.23, 95% CI 0.51-1.95), and parents (g = 1.43, 95% CI 0.54-2.30) compared with controls at 3-months. CONCLUSION This study provides encouraging findings regarding the feasibility of online, group, low-intensity psychological interventions, in terms of recruitment and retention as well as a signal of efficacy on FAQLQ. A definitive trial including health economic analysis and FA-specific psychological measures with consideration of best routes to implementation, is warranted. TRIAL REGISTRATION Clinicaltrials.gov Identifiers: NCT04763889 (adults), NCT04770727 (CYP), and NCT04774796 (parents).
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Affiliation(s)
- Christina J Jones
- School of Psychology, Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom.
| | - Holly Tallentire
- School of Psychology, Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom; Surrey & Borders National Health Sevice Partnership Trust, United Kingdom
| | - Rebecca Edgecumbe
- School of Psychology, Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom; Surrey & Borders National Health Sevice Partnership Trust, United Kingdom
| | - Gina Sherlock
- School of Psychology, Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom; Surrey & Borders National Health Sevice Partnership Trust, United Kingdom
| | - Lucy Hale
- School of Psychology, Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom
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Knibb RC, Jones CJ, Herbert LJ, Screti C. Psychological support needs for children with food allergy and their families: A systematic review. Pediatr Allergy Immunol 2024; 35:e14108. [PMID: 38528707 DOI: 10.1111/pai.14108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/23/2024] [Accepted: 02/28/2024] [Indexed: 03/27/2024]
Abstract
This systematic review aimed to review the evidence for psychological support for children with food allergies and their families, identify effective psychological interventions, and highlight the support needs for this group. A systematic search was undertaken across six databases (up to October 2023). Articles were checked by three reviewers for inclusion. Study data were extracted, and quality was assessed using the Mixed Methods Appraisal Tool. A narrative synthesis was undertaken. A total of 11 papers were included (n = 838 participants). Intervention types were based on cognitive behavioral therapy (CBT; n = 7); psycho-education (n = 1); peer mentoring (n = 1); self-regulation theory (n = 1); and coping (n = 1). Two interventions were for children only, three were for children and parents and six for parents only. Cognitive behavioral therapy-based interventions with highly anxious parents or children or those facilitated by a psychologist showed significant improvements with moderate-to-large effect sizes. The one self-help CBT-based online program showed no effects. Other intervention types reported mainly trends in improvement due to small sample sizes. Most interventions were aimed at supporting children or parents in day-to-day management of food allergy, measuring outcomes such as quality of life, self-efficacy, anxiety, worry, and depression. One intervention was designed to assist with oral immunotherapy outcomes. The majority of the studies had small sample sizes and were feasibility or proof-of-concept studies. Available research evidence points to effectiveness of facilitated CBT-based interventions for those that have high food allergy-related anxiety, but as many studies have small sample sizes and few report effect sizes, no firm conclusions can yet be drawn. A stepped care approach is likely to be useful for this population. Research using large interventional designs, particularly for children and adolescents, are needed.
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Affiliation(s)
- Rebecca C Knibb
- School of Psychology, College Health and Life Sciences, Aston University, Birmingham, UK
| | - Christina J Jones
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Linda J Herbert
- Division of Psychology & Behavorial Health, Children's National Hospital, Washington, District of Columbia, USA
- Department of Pediatrics, George Washington University School of Medicine, Washington, District of Columbia, USA
| | - Cassandra Screti
- School of Psychology, College Health and Life Sciences, Aston University, Birmingham, UK
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4
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Crealey M, de Holanda Coelho GL, Byrne A, Dunn Galvin A. Educational tool for mothers of young children with food allergy: Randomised controlled trial. Clin Exp Allergy 2023; 53:1219-1221. [PMID: 37641848 DOI: 10.1111/cea.14383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 07/07/2023] [Accepted: 08/01/2023] [Indexed: 08/31/2023]
Affiliation(s)
- Miranda Crealey
- Department of Paediatric Allergy, Children's Health Ireland, Dublin, Ireland
- Department of Paediatrics and Child Health, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Aideen Byrne
- Department of Paediatric Allergy, Children's Health Ireland, Dublin, Ireland
- School of Medicine, Department of Paediatrics, Trinity College Dublin, Dublin, Ireland
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Sanagavarapu P, Dadich A, Hussain W. Interventions to Promote Food Allergy Literacy in Childhood: A Systematic Scoping Review. THE JOURNAL OF SCHOOL HEALTH 2023. [PMID: 36861668 DOI: 10.1111/josh.13310] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/07/2022] [Accepted: 02/05/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND This article introduces the concept, food allergy literacy (FAL), which encompasses the knowledge, behaviors, and skills needed to manage a food allergy and is thus critical to child safety. Yet, there is limited clarity on how to promote FAL in children. METHODS Twelve academic databases were systematically searched to identify publications on interventions to promote FAL in children. Five publications met the inclusion criteria, which involved children (3 to 12 years), their parents, or educators and tested the efficacy of an intervention. FINDINGS Four interventions were for parents and educators, while 1 intervention was for parents with their children. The interventions were educational and focused on promoting participant knowledge and skills of food allergy, and/or psychosocial in nature, promoting coping, confidence, and self-efficacy in managing children's allergies. All interventions were deemed effective. Only 1 study used a control group, and none assessed the long-term benefits of the interventions. IMPLICATIONS FOR SCHOOL POLICY, PRACTICE, AND EQUITY The results can enable health service providers and educators to design evidence-based interventions to promote FAL. This might involve designing, implementing, and evaluating curricula and play-based activities, therein, that award greater attention to food allergy-its consequences, risks, skills to prevent risk, and managing food allergy in educational settings. CONCLUSIONS There is limited evidence on child-focused interventions that promote FAL. There is, therefore, considerable opportunity to co-design and test interventions with children.
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Affiliation(s)
- Prathyusha Sanagavarapu
- School of Education, Western Sydney University, Locked Bag 1797, Sydney, NSW, 2751, Australia
| | - Ann Dadich
- School of Business, Western Sydney University, Locked Bag 1797, Sydney, NSW, 2751, Australia
| | - Wajiha Hussain
- School of Education, Western Sydney University, Locked Bag 1797, Sydney, NSW, 2751, Australia
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Cognitive-behavioral intervention for anxiety associated with food allergy in a clinical sample of children: Feasibility, acceptability, and proof-of-concept in children. Ann Allergy Asthma Immunol 2023; 130:100-105. [PMID: 36162619 DOI: 10.1016/j.anai.2022.09.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/22/2022] [Accepted: 09/19/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Multiple reviews have identified a lack of evidence-based treatments for excessive anxiety in the context of food allergy (FAA) as an unmet need. OBJECTIVE To evaluate the feasibility, acceptability, and proof of concept of Food Allergy Bravery (FAB), a brief, novel, manualized cognitive-behavioral-based intervention for anxiety in a clinical sample of children with FAA. METHODS A total of 3 cohorts of children (aged 8 to 12 years) with clinically impairing FAA and their parents were offered a course of FAB delivered in a group format. Ratings of anxiety severity and quality of life were collected at pretreatment, posttreatment, and 2- to 4-month follow-up. RESULTS All families offered treatment completed the full course of FAB, attended at least 5 of 6 active treatment sessions, and rated the intervention as highly satisfactory. All children were rated as very much improved or much improved on the Clinician Global Impression scale at posttreatment. Anxiety severity scores on the Scale of Food Allergy Anxiety and the Scale of Child Anxiety-Related Emotional Disorders significantly declined per both child and parent reports. Scores on the Food Allergy Quality of Life Questionnaire-Parent Form were significantly improved. Gains were maintained at follow-up. CONCLUSION This is the first study of an outpatient manualized psychosocial treatment for FAA in a clinically ascertained sample of children. Findings provide initial evidence of feasibility, acceptability, and proof of concept for the FAB intervention protocol. Randomized controlled trials are needed.
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Cheon J, Cho CM, Kim HJ, Kim DH. Effectiveness of educational interventions for quality of life of parents and children with food allergy: A systematic review. Medicine (Baltimore) 2022; 101:e30404. [PMID: 36086727 PMCID: PMC10980392 DOI: 10.1097/md.0000000000030404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/26/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Educational intervention along with medical treatment is important to improve the quality of life of children with food allergies and their parents. This systematic review was designed to investigate the effects of education programs for parents and children with food allergies to provide a direction for developing an intervention program to improve their quality of life. METHODS A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant studies published between January 2010 and August 2021 were identified through a systematic search of 5 databases (PubMed, EMBASE, CINAHL, Cochrane Central Register of Controlled Trial, and Psycho Info). RESULTS A total of 2351 articles were identified. Of these, 9 met the inclusion criteria after duplicates were removed. Among these, only 2 studies, using the support and handbook provided, showed significant results on quality of life. DISCUSSION There is a lack of educational interventions for children with food allergies and their parents. Educational intervention, an essential intervention, can maximize medical treatment and improve overall quality of life. Hence, these interventions should be actively developed and applied in the future.
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Affiliation(s)
- Jooyoung Cheon
- College of Nursing, Sungshin Women’s University, Dobong-ro 76ga-gil, Gangbuk-gu, Seoul, Republic of Korea
| | - Chung Min Cho
- College of Nursing, Sungshin Women’s University, Dobong-ro 76ga-gil, Gangbuk-gu, Seoul, Republic of Korea
| | - Hyo Jin Kim
- College of Nursing, Seoul National University, 103, Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Dong Hee Kim
- College of Nursing, Sungshin Women’s University, Dobong-ro 76ga-gil, Gangbuk-gu, Seoul, Republic of Korea
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8
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Sugunasingha N, Jones FW, du Toit G, Jones CJ. Evaluating an online self-help intervention for parents of children with food allergies. Pediatr Allergy Immunol 2022; 33:e13731. [PMID: 35212055 PMCID: PMC9306710 DOI: 10.1111/pai.13731] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/12/2021] [Accepted: 01/07/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Parents of children with food allergies (CwFA) experience reduced quality of life (QoL) and may have reduced access to in-person interventions in the COVID-19 pandemic. This trial developed and evaluated an online, self-help, information provision website, aimed at improving QoL in parents of CwFA. METHODS In a single-blinded, randomised controlled trial (RCT), participants were randomised to either receive access to the website or a waiting-list control. At baseline, post-intervention (week 4) and follow-up (week 8), measures of parental food allergy-related QoL, depression, anxiety, stress, intolerance of uncertainty (IU) and self-efficacy were obtained. RESULTS A total of 205 participants were randomised; 97% were females, 91% white and 78% educated ≥ degree level, with a mean age of 38.95 years (SD = 6.89). 44.9% (n = 92) were retained at follow-up. The arms did not significantly differ on any outcome at any time point. For a sub-group of participants above the clinical cut-off for depression at baseline, the intervention may have improved QoL. Participants reported the website content as useful and accessible, but accessed it infrequently. In baseline data, IU and self-efficacy were significantly associated with QoL. CONCLUSION While the COVID-19 pandemic has encouraged greater provision of online interventions, our RCT suggests this particular website is not suitable for this population in general, although future research could examine its efficacy for depressed parents of CwFA, to increase confidence that the sub-group finding was not a Type 1 error. The baseline data suggest IU and self-efficacy remain potential proximal targets for intervention.
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Affiliation(s)
- Naomi Sugunasingha
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, UK
| | - Fergal W Jones
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, UK
| | - George du Toit
- Evelina Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
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Westwell-Roper C, To S, Andjelic G, Lu C, Lin B, Soller L, Chan ES, Stewart SE. Food-allergy-specific anxiety and distress in parents of children with food allergy: A systematic review. Pediatr Allergy Immunol 2022; 33:e13695. [PMID: 34779046 DOI: 10.1111/pai.13695] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 10/05/2021] [Accepted: 10/28/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Parenting a child with food allergy (FA) can lead to impaired quality of life and family functioning. Anxiety is a critical component of FA-associated distress and a potential target for therapeutic intervention. This systematic review aimed to clarify the concept of FA-specific anxiety (FAA) and its antecedents, consequences, and correlates and to determine the extent to which existing FA-specific outcome measures capture symptoms of parental distress and FAA. METHODS MEDLINE, EMBASE, PsycINFO, and CENTRAL were searched for qualitative and quantitative studies examining distress or anxiety in parents of children with FA through August 2020. This review was registered with PROSPERO (CRD42020208316) and conducted in accordance with PRISMA guidelines. RESULTS Ninety-eight studies were included in the final narrative synthesis. Most participants were mothers, and reporting of demographic data was limited. Parents identified anxiety as the most burdensome form of FA-specific emotional distress. Several allergy-related factors as well as medical and psychosocial interventions were associated with reduced parental anxiety and distress. However, affective, cognitive, and behavioral dimensions of FAA were only partially addressed by existing measures for general anxiety symptoms and FA-specific parental factors. CONCLUSIONS FAA contributes to distress and functional impairment among parents of children with FA. Current FA-specific parent measures fail to adequately capture dimensions of FAA, suggesting that further work is needed to improve the assessment and monitoring of FAA and its impacts. Characterization of this construct represents an initial step in developing standardized methods for assessing and monitoring FAA in clinical populations.
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Affiliation(s)
- Clara Westwell-Roper
- British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Division of Clinical and Behavioural Neurosciences, Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sharon To
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Gordan Andjelic
- British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Cynthia Lu
- British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Boyee Lin
- British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Lianne Soller
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Edmond S Chan
- British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - S Evelyn Stewart
- British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Division of Clinical and Behavioural Neurosciences, Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,British Columbia Mental Health and Substance Use Research Institute, Vancouver, British Columbia, Canada
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10
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Ramos A, Cooke F, Miller E, Herbert L. The Food Allergy Parent Mentoring Program: A Pilot Intervention. J Pediatr Psychol 2021; 46:856-865. [PMID: 33706373 DOI: 10.1093/jpepsy/jsab019] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Parents of young children with newly diagnosed food allergy (FA) are at risk for poor psychosocial outcomes due to FA's life-threatening nature and demanding management routines. Presently, there are no interventions to support FA parents during this adjustment phase. This single-arm pilot study explores the feasibility, acceptability, and preliminary efficacy of a novel intervention using peer mentorship to improve psychosocial functioning in parents of young children with newly diagnosed FA. METHODS Parent mentors were trained in mentorship and ethics and then matched with a mentee for a 6-month intervention period. Mentees, parents of children (under age 5 years) diagnosed with FA within 1 year, completed baseline and follow-up questionnaires to assess demographic and medical characteristics, FA knowledge, quality of life, self-efficacy, and social support and a program evaluation. Follow-up focus groups with mentors and individual interviews with mentees were conducted. RESULTS Participants were 8 mentors and 10 mentees (Mage = 36.60 years, 80% Caucasian) of children ages 0-3 years (Mage = 16.15 months; 60% male). Mentees reported high acceptability for the intervention in program evaluation and interviews, noting improvements in their social support, FA-related stress, confidence in FA management, and positive changes in FA parenting behaviors. CONCLUSION This study supports the use of a peer mentorship program to support parents of children with newly diagnosed FA. Future research is needed to determine how to scale this intervention to meet the needs of a large medical division.
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Affiliation(s)
- Ashley Ramos
- Division of Allergy and Immunology, Children's National Hospital.,Division of Allergy and Immunology, Children's National Health System and Department of Psychiatry and Behavioral Sciences at George Washington University School of Medicine and Health Sciences
| | - Frances Cooke
- Division of Allergy and Immunology, Children's National Hospital
| | - Emily Miller
- Division of Allergy and Immunology, Children's National Hospital
| | - Linda Herbert
- Division of Allergy and Immunology, Children's National Hospital.,Division of Allergy and Immunology, Children's National Health System and Department of Psychiatry and Behavioral Sciences at George Washington University School of Medicine and Health Sciences
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Vreeken-Ross SC, Cartwright-Hatton S, Harris SA, Hanna P, Jones CJ. Feasibility of an online CBT group intervention for parents of children with food allergy. Clin Exp Allergy 2021; 52:171-175. [PMID: 34143528 DOI: 10.1111/cea.13970] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/09/2021] [Accepted: 06/15/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Stefanie C Vreeken-Ross
- Faculty of Health & Medical Sciences, School of Psychology, University of Surrey, Guildford, UK
| | | | - Sally A Harris
- Royal Alexandra Children's Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Paul Hanna
- Faculty of Health & Medical Sciences, School of Psychology, University of Surrey, Guildford, UK
| | - Christina J Jones
- Faculty of Health & Medical Sciences, School of Psychology, University of Surrey, Guildford, UK
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12
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Fiocchi A, Vickery BP, Wood RA. The use of biologics in food allergy. Clin Exp Allergy 2021; 51:1006-1018. [PMID: 33966304 DOI: 10.1111/cea.13897] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/29/2021] [Accepted: 04/30/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Food allergy continues to pose problems due to its increased frequency and its increasingly high severity. In this context, alongside the traditional avoidance strategies of allergenic foods and desensitization through the cautious progression of exposure to foods in the context of oral immunotherapy (OIT), alternative strategies have made their way in the last decades. We review the possibilities of intervention in food allergy with the use of biological drugs capable of interfering with the synthesis of IgE, with their mechanisms of action, or with complex biological mechanisms that lead to the establishment of a food allergy. METHODS Repeated Entrez PubMed searches using the template algorithm "Food allergy" and "biologics" or "Omalizumab" or "Dupilumab" or "milk desensitization" or "oral tolerance induction" or "oral immunotherapy" or "Etokimab" or "Tezepelumab" or "Quilizumab" or "Ligelizumab" or "Tralokinumab" or "Nemolizumab" or "Mepolizumab" or "Reslizumab" or "Benralizumab". The authors' clinical experience in paediatric allergy units of University hospitals was also drawn upon. RESULTS The landscape in this context has changed dramatically over the past 10 years. We have acquired knowledge mainly on the effect of different types of anti-IgE treatments in poliallergic patients with food allergy, and in patients treated with OIT. However, other mediators are being targeted by specific biologic treatments. Among them, the alarmins Il-33 and TSLP, IL-4 and IL-13, eosinophil-related molecules as IL-6, IL-8, IL-10, IL-12, and mostly IL-5, and integrins involved in the pathogenesis of eosinophilic gastrointestinal diseases (EGIDs), as SIGLEC-8. CONCLUSIONS The ever-better knowledge of the mechanisms of food allergy allowing these developments will improve not only the perspective of patients with the most serious immediate food allergies such as anaphylaxis, but also those of patients with related diseases such as atopic dermatitis, eosinophilic esophagitis, and EGIDs. Biologics are also intended to complement OIT strategies that have developed over the years.
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Affiliation(s)
| | | | - Robert A Wood
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
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13
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Vreeken-Ross SC, Smith HE, Jones CJ. A review of freely available online support for food allergy-related emotional well-being. Clin Exp Allergy 2021; 51:942-946. [PMID: 33763914 DOI: 10.1111/cea.13868] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 12/26/2022]
Affiliation(s)
| | - Helen E Smith
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Christina J Jones
- School of Psychology, Faculty of Health & Medical Sciences, University of Surrey, Guildford, UK
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14
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Rubeiz CJ, Ernst MM. Psychosocial Aspects of Food Allergy: Resiliency, Challenges and Opportunities. Immunol Allergy Clin North Am 2021; 41:177-188. [PMID: 33863478 DOI: 10.1016/j.iac.2021.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Food allergy is a public health concern and has been found to be increasing in prevalence; however, psychosocial factors differentiate challenges related to management throughout the lifespan. Resilience has been found to improve quality of life in other chronic diseases, but little has been published regarding increasing resilience in food allergy. The psychosocial impacts of food allergy vary by age group and developmental stage. This article reviews developmental milestones within the context of food allergy in infancy, school-age children, adolescents, and adults. Recommendations for promoting resilience in patients with food allergy are provided.
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Affiliation(s)
- Christine J Rubeiz
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
| | - Michelle M Ernst
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
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Herbert L, DunnGalvin A. Psychotherapeutic Treatment for Psychosocial Concerns Related to Food Allergy: Current Treatment Approaches and Unmet Needs. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:101-108. [DOI: 10.1016/j.jaip.2020.10.037] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 12/18/2022]
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