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Ashique S, Mukherjee T, Mohanty S, Garg A, Mishra N, Kaushik M, Bhowmick M, Chattaraj B, Mohanto S, Srivastava S, Taghizadeh-Hesary F. Blueberries in focus: Exploring the phytochemical potentials and therapeutic applications. JOURNAL OF AGRICULTURE AND FOOD RESEARCH 2024; 18:101300. [DOI: 10.1016/j.jafr.2024.101300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/21/2024]
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Nesovic LD, Gonzalez Cruz PE, Rychener N, Wilks LR, Gill HS. Standardizing the skin tape stripping method for sensitization and using it to create a mouse model of peanut allergy. Int J Pharm 2024; 662:124479. [PMID: 39019298 DOI: 10.1016/j.ijpharm.2024.124479] [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: 03/30/2024] [Revised: 07/11/2024] [Accepted: 07/14/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Animal models for food allergies serve as crucial tools in understanding allergy mechanisms and assessing the efficacy of potential desensitization methods. The effectiveness of inducing allergies in mice through intragastric lavage sensitization varies. The intraperitoneal method can trigger systemic anaphylaxis, however it lacks anatomical relevance. Hence, a uniform and reliable allergy induction method in mice is required. Tape -stripping can mimic atopic dermatitis (AD), a precursor to lifelong peanut allergies in humans. Furthermore, skin damage triggers the upregulation of skin alarmins and the expansion of small-intestinal mast cells, both implicated in allergy development. METHODS We standardized a skin-based sensitization method in a mouse model of peanut allergy using skin tape-stripping followed by allergen application. We compared this method with intragastric sensitization. RESULTS Skin-based sensitization led to increased mast cells, goblet cells, and eosinophils in the small intestine, elevated systemic IgE levels, murine mast cell protease-1 (mMCP-1), histamine, and eosinophilic activity in peripheral blood. Moreover, it resulted in a significant hypothermic response, with nearly 30% mortality following an oral challenge one-month post-sensitization. CONCLUSION Our research offers a standardized and readily reproducible method for inducing peanut allergy in mice, which could also be adapted for other food allergens.
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Affiliation(s)
- Lazar D Nesovic
- Department of Chemical Engineering, Texas Tech University, 8th and Canton, Lubbock, TX 79409, USA
| | - Pedro E Gonzalez Cruz
- Department of Chemical Engineering, Texas Tech University, 8th and Canton, Lubbock, TX 79409, USA
| | - Natalie Rychener
- Department of Chemical Engineering, Texas Tech University, 8th and Canton, Lubbock, TX 79409, USA
| | - Logan R Wilks
- Department of Chemical Engineering, Texas Tech University, 8th and Canton, Lubbock, TX 79409, USA
| | - Harvinder S Gill
- Department of Chemical Engineering, Texas Tech University, 8th and Canton, Lubbock, TX 79409, USA; Department of Chemical and Biomolecular Engineering, North Carolina State University, Raleigh, NC 27695, USA.
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Oyama Y, Hamasaka T, Okada H, Nagashima Y, Morita M. Improved multi-food allergen analysis of processed foods using HRAM-LC-MS/MS with an ELISA-validated extraction solution and MS sample prep kit. Anal Bioanal Chem 2024; 416:5165-5175. [PMID: 39078454 DOI: 10.1007/s00216-024-05454-y] [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: 03/01/2024] [Revised: 07/05/2024] [Accepted: 07/08/2024] [Indexed: 07/31/2024]
Abstract
Food allergens in processed foods are affected by heating, processing, and the food matrix. To conduct highly reliable tests, extracting allergens into test solutions is necessary for appropriate detection. In addition to the commonly used enzyme-linked immunosorbent assay (ELISA), liquid chromatography-mass spectrometry (LC-MS), which has the advantage of simultaneously detecting multiple allergens in foods, is being increasingly used. When managing food allergens at food manufacturing sites, obtaining the same measured values is desirable, regardless of the analytical method used. Therefore, in this study, we focused on the importance of pretreatment steps for LC-MS when examining food allergens in processed foods, which can be difficult to analyze. The ELISA method uses food extracts optimized for analyzing allergens in processed foods. We developed a high-resolution accurate mass spectrometry (HRAM)-LC-MS/MS method using the same food extract used in the ELISA method and an MS sample preparation kit. Multiple food allergen analysis was performed using 1, 5, 10, and 20 ppm of allergen-incurred processed foods. Overall, a strong correlation was observed between the measured values of HRAM-LC-MS/MS and ELISA, demonstrating the applicability of multi-allergen analysis using LC-MS.
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Affiliation(s)
- Yuriko Oyama
- Morinaga BioScience, Inc., 2-1-1 Shimosueyoshi, Tsurumi-Ku, Yokohama, 230-8504, Japan
| | - Tomoko Hamasaka
- Thermo Fisher Scientific, 3-9 Moriya-Cho, Kanagawa-Ku, Yokohama, 221-0022, Japan
| | - Hideki Okada
- Morinaga & Co., Ltd., 1-13-16 Shibaura, Minato-Ku, Tokyo, 105-8309, Japan
| | - Yoshiki Nagashima
- Thermo Fisher Scientific, 3-9 Moriya-Cho, Kanagawa-Ku, Yokohama, 221-0022, Japan
| | - Minoru Morita
- Morinaga BioScience, Inc., 2-1-1 Shimosueyoshi, Tsurumi-Ku, Yokohama, 230-8504, Japan.
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Knibb RC. New insights into the incidence and prevalence of food allergy in England. Lancet Public Health 2024; 9:e640-e641. [PMID: 39214633 DOI: 10.1016/s2468-2667(24)00186-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Accepted: 08/02/2024] [Indexed: 09/04/2024]
Affiliation(s)
- R C Knibb
- Institute of Health and Neurodevelopment, Aston University, Birmingham B4 7ET, UK.
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Davis EC, Monaco CL, Insel R, Järvinen KM. Gut microbiome in the first 1000 days and risk for childhood food allergy. Ann Allergy Asthma Immunol 2024; 133:252-261. [PMID: 38494114 PMCID: PMC11344696 DOI: 10.1016/j.anai.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/11/2024] [Accepted: 03/11/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVE To summarize recent data on the association between gut microbiome composition and food allergy (FA) in early childhood and highlight potential host-microbiome interactions that reinforce or abrogate oral tolerance. DATA SOURCES PubMed search of English-language articles related to FA, other atopic disease, and the gut microbiome in pregnancy and early childhood. STUDY SELECTIONS Human studies published after 2015 assessing the relationship between the gut bacteriome and virome in the first 2 years of life and FA or food sensitization development in early childhood were prioritized. Additional human studies conducted on the prenatal gut microbiome or other atopic diseases and preclinical studies are also discussed. RESULTS Children who developed FA harbored lower abundances of Bifidobacterium and Clostridia species and had a less mature microbiome during infancy. The early bacterial microbiome protects against FA through production of anti-inflammatory metabolites and induction of T regulatory cells and may also affect FA risk through a role in trained immunity. Infant enteric phage communities are related to childhood asthma development, though no data are available for FA. Maternal gut microbiome during pregnancy is associated with childhood FA risk, potentially through transplacental delivery of maternal bacterial metabolites, though human studies are lacking. CONCLUSION The maternal and infant microbiomes throughout the first 1000 days of life influence FA risk through a number of proposed mechanisms. Further large, longitudinal cohort studies using taxonomic, functional, and metabolomic analysis of the bacterial and viral microbiomes are needed to provide further insight on the host-microbe interactions underlying FA pathogenesis in childhood.
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Affiliation(s)
- Erin C Davis
- Division of Allergy and Immunology, Center for Food Allergy, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Golisano Children's Hospital, Rochester, New York
| | - Cynthia L Monaco
- Division of Infectious Disease, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York; Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Richard Insel
- Division of Allergy and Immunology, Center for Food Allergy, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Golisano Children's Hospital, Rochester, New York
| | - Kirsi M Järvinen
- Division of Allergy and Immunology, Center for Food Allergy, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Golisano Children's Hospital, Rochester, New York; Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York; Division of Allergy, Immunology, and Rheumatology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York.
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6
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Turner PJ, Conrado AB, Kallis C, O'Rourke E, Haider S, Ullah A, Custovic D, Custovic A, Quint JK. Time trends in the epidemiology of food allergy in England: an observational analysis of Clinical Practice Research Datalink data. Lancet Public Health 2024; 9:e664-e673. [PMID: 39214635 DOI: 10.1016/s2468-2667(24)00163-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 07/10/2024] [Accepted: 07/11/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Estimates for the prevalence of food allergy vary widely, with a paucity of data for adults. The aim of this analysis was to report trends in the incidence and prevalence of food allergy in England, using a national primary care dataset. METHODS We analysed data from Clinical Practice Research Datalink between 1998 and 2018, with linked data to relevant hospital encounters in England. The main outcomes were incidence and prevalence of food allergy, according to three definitions of food allergy: possible food allergy, probable food allergy, and probable food allergy with adrenaline autoinjectors prescription. We also evaluated the difference in proportion of patients prescribed adrenaline autoinjectors by English Index of Multiple Deprivation (IMD), age, and by previous food anaphylaxis, and explored differences in patient encounters (general practice vs emergency department setting). FINDINGS 7 627 607 individuals in the dataset were eligible for inclusion, of whom 150 018 (median age 19 years [IQR 4-34]; 82 614 [55·1%] female and 67 404 [44·9%] male) had a possible food allergy. 121 706 met diagnostic criteria for probable food allergy, of whom 38 288 were prescribed adrenaline autoinjectors. Estimated incidence of probable food allergy doubled between 2008 and 2018, from 75·8 individuals per 100 000 person-years (95% CI 73·7-77·9) in 2008 to 159·5 (156·6-162·3) individuals per 100 000 person-years in 2018. Prevalence increased from 0·4% (23 399 of 6 432 383) to 1·1% (82 262 of 7 627 607) over the same period and was highest in children under 5 years (11 951 [4·0%] of 296 406 in 2018) with lower prevalence in school-aged children (from 11 353 [2·4%] of 473 597 in 2018 for children aged 5-9 years to 6896 [1·7%] of 404 525 for those aged 15-19 years) and adults (42 848 [0·7%] of 5 992 454 in 2018). In those with previous food anaphylaxis, only 2321 (58·3%) of 3980 (975 [64·0%] of 1524 children and young people and 1346 [54·8%] of 2456 adults) had a prescription for adrenaline autoinjector. Adrenaline autoinjectors prescription was less common in those resident in more deprived areas (according to IMD). In the analysis of health-care encounters, 488 604 (97·1%) of 503 198 visits recorded for food allergy occurred in primary care, with 115 655 (88·4%) of 130 832 patients managed exclusively in primary care. INTERPRETATION These estimates indicate an important and increasing burden of food allergy in England. Our findings that most patients with food allergy are managed outside the hospital system, with low rates of adrenaline autoinjector prescription in those with previous anaphylaxis, highlight a need to better support those working in primary care to ensure optimal management of patients with food allergy. FUNDING UK Food Standards Agency and UK Medical Research Council.
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Affiliation(s)
- Paul J Turner
- National Heart & Lung Institute, Imperial College London, London, UK.
| | | | | | - Eimear O'Rourke
- National Heart & Lung Institute, Imperial College London, London, UK
| | - Sadia Haider
- National Heart & Lung Institute, Imperial College London, London, UK
| | - Anhar Ullah
- National Heart & Lung Institute, Imperial College London, London, UK
| | - Darije Custovic
- National Heart & Lung Institute, Imperial College London, London, UK
| | - Adnan Custovic
- National Heart & Lung Institute, Imperial College London, London, UK
| | - Jennifer K Quint
- National Heart & Lung Institute, Imperial College London, London, UK
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Buta F, Paoletti G, Bragato MC, Giovannini M, Canonica GW, Heffler E. Real-world evidence of allergen immunotherapy. Curr Opin Allergy Clin Immunol 2024:00130832-990000000-00151. [PMID: 39212626 DOI: 10.1097/aci.0000000000001026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
PURPOSE OF REVIEW The full understanding of the long-term effectiveness and safety of allergen immunotherapy (AIT) for allergic respiratory diseases cannot be achieved through randomized controlled trials (RCTs) alone. However, real-world studies designed as registries can complement RCTs. RECENT FINDINGS The significance of registries is highlighted by their potential to reassess contraindications and collect data on adult and pediatric patients with multiple comorbidities who are often excluded from RCTs. SUMMARY AIT is the sole disease-modifying therapeutic approach capable of inducing tolerance and offering a long-term response to allergens. AIT has been shown to play a role in arresting the 'allergic march' in young people, which reduces the risk of developing asthmatic clinical manifestations. Although RCTs are considered the gold standard for evaluating the efficacy and safety of AIT, their duration is usually too short (seldom lasting more than 1 year) to assess the long-term effects of AIT. Several long-term studies show that AIT's effect depends strongly on its use duration.
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Affiliation(s)
- Federica Buta
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano
- Department of Clinical and Experimental Medicine, School and Operative Unit of Allergy and Clinical Immunology, University of Messina, Messina
| | - Giovanni Paoletti
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele
| | - Maria Chiara Bragato
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano
| | - Mattia Giovannini
- Allergy Unit, Meyer Children's Hospital IRCCS
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Giorgio Walter Canonica
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele
| | - Enrico Heffler
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele
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Hirano T, Koyanagi A, Ago H, Yamamoto M, Kitaura J, Kasai M, Okumura K. Allosteric inhibition of IgE-FcεRI interactions by simultaneous targeting of IgE F(ab')2 epitopes. Commun Biol 2024; 7:1042. [PMID: 39179708 PMCID: PMC11343869 DOI: 10.1038/s42003-024-06633-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/24/2024] [Indexed: 08/26/2024] Open
Abstract
Immunoglobulin E (IgE) plays pivotal roles in allergic diseases through interaction with a high-affinity receptor (FcεRI). We established that Fab fragments of anti-IgE antibodies (HMK-12 Fab) rapidly dissociate preformed IgE-FcεRI complexes in a temperature-dependent manner and inhibit IgE-mediated anaphylactic reactions, even after allergen challenge. X-ray crystallographic studies revealed that HMK-12 Fab interacts with each of two equivalent epitopes on the Cε2 homodimer domain involved in IgE F(ab')2. Consequently, HMK-12 Fab-mediated targeting of Cε2 reduced the binding affinity of Fc domains and resulted in rapid removal of IgE from the receptor complex. This unexpected finding of allosteric inhibition of IgE-FcεRI interactions by simultaneous targeting of two epitope sites on the Cε2 homodimer domain of IgE F(ab')2 may have implications for the development of novel therapies for allergic disease.
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Affiliation(s)
- Takao Hirano
- Department of Hematology, Juntendo University Nerima Hospital, Nerima-ku, Tokyo, Japan.
| | - Akemi Koyanagi
- Laboratory of Cell Biology, Biomedical Research Core Facilities, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Hideo Ago
- Advanced Photon Technology Division, RIKEN SPring-8 Center, Sayo, Hyogo, Japan
| | - Masaki Yamamoto
- Advanced Photon Technology Division, RIKEN SPring-8 Center, Sayo, Hyogo, Japan
| | - Jiro Kitaura
- Atopy Research Center, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Science of Allergy and Inflammation, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Masataka Kasai
- Atopy Research Center, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Ko Okumura
- Atopy Research Center, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
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Biagioni B, Scala E, Cecchi L. What molecular allergy teaches us about genetics and epidemiology of allergies. Curr Opin Allergy Clin Immunol 2024; 24:280-290. [PMID: 38640142 DOI: 10.1097/aci.0000000000000990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
PURPOSE OF REVIEW To delineate pertinent information regarding the application of molecular allergology within the realm of both genetic and epidemiological facets of allergic diseases. RECENT FINDINGS The emergence of molecular allergy has facilitated the comprehension of the biochemical characteristics of allergens originating from diverse sources. It has allowed for the exploration of sensitization trajectories and provided novel insights into the influence of genetics and environmental exposure on the initiation and development of allergic diseases. This review delves into the primary discoveries related to the genetics and epidemiology of allergies, facilitated by the application of molecular allergy. It also scrutinizes the impact of environmental exposure across varied geoclimatic, socioeconomic, and lifestyle contexts. Additionally, the review introduces specific models of molecular allergy within the realms of plants and animals. SUMMARY The utilization of molecular allergy in clinical practice holds crucially acknowledged diagnostic and therapeutic implications. From a research standpoint, there is a growing need for the widespread adoption of molecular diagnostic tools to achieve a more profound understanding of the epidemiology and natural progression of allergic diseases.
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Affiliation(s)
- Benedetta Biagioni
- Allergy and Clinical Immunology Unit, San Giovanni di Dio Hospital, Florence
| | - Enrico Scala
- Clinical and Laboratory Molecular Allergy Unit, IDI-IRCCS, Rome
| | - Lorenzo Cecchi
- SOSD Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
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10
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Rupar MJ, Hanson H, Rogers S, Botlick B, Trimmer S, Hickman JJ. Modelling the innate immune system in microphysiological systems. LAB ON A CHIP 2024; 24:3604-3625. [PMID: 38957150 PMCID: PMC11264333 DOI: 10.1039/d3lc00812f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 05/09/2024] [Indexed: 07/04/2024]
Abstract
This critical review aims to highlight how modeling of the immune response has adapted over time to utilize microphysiological systems. Topics covered here will discuss the integral components of the immune system in various human body systems, and how these interactions are modeled using these systems. Through the use of microphysiological systems, we have not only expanded on foundations of basic immune cell information, but have also gleaned insight on how immune cells work both independently and collaboratively within an entire human body system.
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Affiliation(s)
- Michael J Rupar
- Hesperos, Inc., 12501 Research Parkway, Suite 100, Orlando, FL 32826, USA.
| | - Hannah Hanson
- Hesperos, Inc., 12501 Research Parkway, Suite 100, Orlando, FL 32826, USA.
| | - Stephanie Rogers
- Hesperos, Inc., 12501 Research Parkway, Suite 100, Orlando, FL 32826, USA.
| | - Brianna Botlick
- Hesperos, Inc., 12501 Research Parkway, Suite 100, Orlando, FL 32826, USA.
| | - Steven Trimmer
- Hesperos, Inc., 12501 Research Parkway, Suite 100, Orlando, FL 32826, USA.
| | - James J Hickman
- Hesperos, Inc., 12501 Research Parkway, Suite 100, Orlando, FL 32826, USA.
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Messina NL, Gardiner K, Pittet LF, Forbes EK, Francis KL, Freyne B, Zufferey C, Abruzzo V, Morison C, Turner H, Allen KJ, Flanagan KL, Ponsonby AL, Robins-Browne R, Shann F, Vuillermin P, Donath S, Casalaz D, Curtis N. Neonatal BCG Vaccination for Prevention of Allergy in Infants: The MIS BAIR Randomised Controlled Trial. Clin Exp Allergy 2024. [PMID: 39004434 DOI: 10.1111/cea.14537] [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: 03/26/2024] [Revised: 06/27/2024] [Accepted: 06/29/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND The beneficial off-target effects of Bacille Calmette-Guérin (BCG) vaccination potentially include protection against allergy. OBJECTIVE In the MIS BAIR trial, we aimed to determine whether neonatal BCG vaccination reduces atopic sensitisation and clinical food allergy in infants. METHODS In this randomised controlled trial, 1272 neonates were allocated to BCG-Denmark vaccine (0.05 mL intradermal dose) or no BCG at birth. Randomisation was stratified by recruitment site, mode of delivery and plurality of birth. The primary outcome was the incidence of atopic sensitisation determined by skin prick test at 1 year of age. Food allergy was determined by 3-monthly online questionnaires and oral food challenges. Data were analysed by intention-to-treat using binary regression. CLINICALTRIALS gov (NCT01906853). RESULTS Atopic sensitisation during the first year of life was 22.9% among infants in the BCG group and 18.9% in the control group (adjusted risk difference (aRD) 3.8% (95% CI -1.5 to 9.1) after multiple imputation). Clinical food allergy was similar between infants in the BCG and control groups (9.8% vs. 9.6%; aRD 0.2, 95% CI -3.4 to 3.8). An interaction was observed between the primary outcome and maternal history of BCG vaccination. No interaction was observed for the additional prespecified potential effect modifiers tested (sex, delivery mode, family history of any allergy, season of birth, hepatitis B vaccination at randomisation, BCG scar and age at BCG administration). CONCLUSIONS AND CLINICAL RELEVANCE Neonatal BCG-Denmark vaccination does not protect against atopic sensitisation or clinical food allergy in the first year of life.
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Affiliation(s)
- Nicole L Messina
- Infectious Diseases, Clinical Epidemiology & Biostatistics Unit, Population Allergy, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Department of Microbiology & Immunology, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Kaya Gardiner
- Infectious Diseases, Clinical Epidemiology & Biostatistics Unit, Population Allergy, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of General Medicine, Department of Research Operations, Infectious Diseases Unit, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Laure F Pittet
- Infectious Diseases, Clinical Epidemiology & Biostatistics Unit, Population Allergy, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Department of Microbiology & Immunology, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
- Paediatric Immunology, Vaccinology, Rheumatology and Infectious Diseases Unit, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Emily K Forbes
- Infectious Diseases, Clinical Epidemiology & Biostatistics Unit, Population Allergy, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Kate L Francis
- Infectious Diseases, Clinical Epidemiology & Biostatistics Unit, Population Allergy, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Department of Microbiology & Immunology, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Bridget Freyne
- Infectious Diseases, Clinical Epidemiology & Biostatistics Unit, Population Allergy, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Department of Microbiology & Immunology, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
- School of Medicine, University College, Dublin, Ireland
- Department of Paediatric Infectious Diseases, Children's Health Ireland, Dublin, Ireland
| | - Christel Zufferey
- Infectious Diseases, Clinical Epidemiology & Biostatistics Unit, Population Allergy, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Veronica Abruzzo
- Infectious Diseases, Clinical Epidemiology & Biostatistics Unit, Population Allergy, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Clare Morison
- Infectious Diseases, Clinical Epidemiology & Biostatistics Unit, Population Allergy, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Hannah Turner
- Infectious Diseases, Clinical Epidemiology & Biostatistics Unit, Population Allergy, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Katrina J Allen
- Infectious Diseases, Clinical Epidemiology & Biostatistics Unit, Population Allergy, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Katie L Flanagan
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
- Tasmanian Vaccine Trial Centre, Clifford Craig Foundation, Launceston General Hospital, Launceston, Tasmania, Australia
- School of Health and Biomedical Science, RMIT University, Melbourne, Victoria, Australia
| | - Anne-Louise Ponsonby
- Infectious Diseases, Clinical Epidemiology & Biostatistics Unit, Population Allergy, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Department of Microbiology & Immunology, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Roy Robins-Browne
- Infectious Diseases, Clinical Epidemiology & Biostatistics Unit, Population Allergy, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Department of Microbiology & Immunology, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Frank Shann
- Department of Paediatrics, Department of Microbiology & Immunology, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Peter Vuillermin
- Infectious Diseases, Clinical Epidemiology & Biostatistics Unit, Population Allergy, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Institute of Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Victoria, Australia
- Child Health Research Unit, Barwon Health, Geelong, Victoria, Australia
| | - Susan Donath
- Infectious Diseases, Clinical Epidemiology & Biostatistics Unit, Population Allergy, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Department of Microbiology & Immunology, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Dan Casalaz
- Neonatal Intensive Care Unit, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Nigel Curtis
- Infectious Diseases, Clinical Epidemiology & Biostatistics Unit, Population Allergy, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Department of Microbiology & Immunology, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
- Department of General Medicine, Department of Research Operations, Infectious Diseases Unit, The Royal Children's Hospital, Parkville, Victoria, Australia
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Rowland AF, Nguyen TH, Cunha PP, Ezhuthachan I, Orenstein E, Kandaswamy S, Lee T. Implementing a clinical decision support tool to increase early peanut introduction guidance. J Allergy Clin Immunol 2024:S0091-6749(24)00712-7. [PMID: 38996876 DOI: 10.1016/j.jaci.2024.07.005] [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: 03/19/2024] [Revised: 06/15/2024] [Accepted: 07/09/2024] [Indexed: 07/14/2024]
Abstract
BACKGROUND General pediatric providers are the front line for early peanut introduction discussions, but many providers believe that they are ill-equipped to handle such discussions, as the guidelines have changed quickly. OBJECTIVE We hypothesized that a clinical decision support (CDS) tool could improve discussions of peanut introduction. METHODS CDS tools were designed by stakeholders, improved through usability testing, and integrated into the current note templates. On the basis of queries of electronic health records, we did a preperformance versus postperformance evaluation of conversations regarding peanut introduction, barriers to peanut introduction, and percentage of 12-month well-child checkups (WCCs) that resulted in successful introduction of peanut. Providers completed surveys before and after intervention to assess their awareness of early peanut introduction and comfort using the CDS tools. RESULTS Providers' awareness of early peanut introduction guidelines increased from 17.8% to 66.7% after the CDS tool was implemented; 79.1% of the providers were comfortable using the tool. The CDS tool improved peanut introduction conversations at the 4-month WCC from 2.4% to 81.2%, at the 6-month WCC from 3.0% to 84.2%, and at the 12-month WCC from 2.7% to 82.9%. In all, 56.6% of families had a plan to introduce peanut at the 4-month WCC. Of those who did not have a plan, the most common barrier was the family's unawareness of the benefits of early peanut introduction. At the 12-month WCC, 62.8% of families had introduced peanut without concerns. CONCLUSION A point-of-care CDS tool encouraged more discussions of early peanut introduction between general pediatric providers and all patients. CDS tools should be considered in quality improvement projects as an implementation method for the most up-to-date guidelines.
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Affiliation(s)
| | - Thinh H Nguyen
- Division of Immunology, Boston Children's Hospital, Boston, Mass
| | - Priscila P Cunha
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Ga
| | - Idil Ezhuthachan
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Ga
| | - Evan Orenstein
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Ga; Division of Hospital Medicine, Children's Healthcare of Atlanta, Atlanta, Ga
| | | | - Tricia Lee
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Ga; Children's Healthcare of Atlanta, Atlanta, Ga.
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13
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Nagafuji M, Fujiyama S, Ishii R, Shime M, Kitatsu T, Hoshino Y, Kanai Y, Arai J, Miyazono Y, Takada H. Effect of maturation at birth on the clinical features of neonatal cow's milk protein allergy: A retrospective study. J Pediatr Gastroenterol Nutr 2024; 79:48-53. [PMID: 38356291 DOI: 10.1002/jpn3.12157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/30/2023] [Accepted: 12/23/2023] [Indexed: 02/16/2024]
Abstract
Neonatal immune regulation transitions from fetal immunity and varies with maturation status, but its role in neonatal cow's milk protein allergy (CMPA) remains unknown. We studied the association between maturation status at birth and neonatal CMPA. Clinical and laboratory data of neonates presenting with CMPA symptoms were retrospectively collected from two tertiary hospitals. Patients were assessed according to gestational age at birth: preterm, late-preterm, and full-term. Fifty-five infants (26 females, 14 preterm, 15 late-preterm, and 26 full-term) were included; 44 were negative for milk-specific immunoglobulin E. Neonatal CMPA was common during moderately premature periods. Preterm infants exhibited longer latency from initial CM exposure to disease onset, lower incidence of bloody stool, and absence of elevated monocyte counts. However, immunoreactivity to CM antigens was retained in all infants. Neonatal CMPA features varied with infant maturation status at birth. Our results improve the understanding of intestinal immunity development, fetal/neonatal immune regulation, and CMPA pathogenesis.
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Affiliation(s)
- Motomichi Nagafuji
- Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Satoshi Fujiyama
- Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Ryota Ishii
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Michiru Shime
- Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Toshinori Kitatsu
- Department of Pediatric Allergy, Ibaraki Children's Hospital, Mito, Ibaraki, Japan
| | - Yusuke Hoshino
- Department of Neonatology, Ibaraki Children's Hospital, Mito, Ibaraki, Japan
| | - Yu Kanai
- Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
- Department of Child Health, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Junichi Arai
- Department of Neonatology, Ibaraki Children's Hospital, Mito, Ibaraki, Japan
| | - Yayoi Miyazono
- Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
- Department of Child Health, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hidetoshi Takada
- Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
- Department of Child Health, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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14
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Mendonca CE, Andreae DA. Food Allergy. Med Clin North Am 2024; 108:655-670. [PMID: 38816109 DOI: 10.1016/j.mcna.2023.08.003] [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] [Indexed: 06/01/2024]
Abstract
Food allergy is a growing health problem affecting both pediatric and adult patients. Food allergies are often immunoglobulin E (IgE) mediated but other food-induced non-IgE-mediated diseases exist. Diagnosis of food allergy relies on the combination of clinical and reaction history, skin and IgE testing as well as oral food challenges. Although oral immunotherapy has been able to achieve sustained unresponsiveness in some patients, no cure for food allergies has been found to date. Avoidance of the inciting food as well as availability of epinephrine autoinjectors remains the mainstay of treatment.
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Affiliation(s)
- Chelsea Elizabeth Mendonca
- Department of Family and Community Medicine, Baylor College of Medicine, 1100 West 34th Street, Houston, TX 77018, USA.
| | - Doerthe A Andreae
- Division of Allergy and Immunology, Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, UT 84132, USA
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15
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Knibb RC, Herbert LJ, Jones CJ, Protudjer JLP, Screti C, Roleston C, Brough HA, Warren C, Lombard L, Santos AF, Gupta R, Vickery BP, Marchisotto MJ. Global availability and uptake of psychological services for adults, caregivers and children with food allergy. Allergy 2024. [PMID: 39031702 DOI: 10.1111/all.16204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 04/24/2024] [Accepted: 05/12/2024] [Indexed: 07/22/2024]
Abstract
BACKGROUND Food allergy (FA) is associated with poor health-related quality of life and high levels of psychological distress. Psychological support is extremely important but not always available. As part of the Global Access to Psychological Services for Food Allergy (GAPS) study, we aimed to assess psychological distress and service use among adults, caregivers and children with FA in a global survey. METHODS Participants (n = 1329 adults with FA; n = 1907 caregivers of children with FA) from >20 countries were recruited through patient organisations, social media advertisements and online survey panels to complete an online survey. Surveys were available in six languages. RESULTS A total of 67.7% of adults and 77.2% of caregivers reported direct experience, and 51.6% of caregivers said their child had experienced FA-related psychological distress. The most commonly reported issue was anxiety about having an allergic reaction. Less than 20% had been assessed for FA-related psychological distress. There were significant differences across countries for levels of distress, screening for distress, seeing a mental health professional and being diagnosed with a FA-related mental health disorder (all p < .001). The United Kingdom, Australia and Brazil had the highest number of participants reporting distress. The most commonly reported barrier to seeing a mental health professional was cost. CONCLUSIONS FA-related distress is common across countries, but with substantial country-to-country variability. Allergy providers are encouraged to routinely assess families for psychological distress and provide access to appropriate mental health resources. Development and implementation of evidence-based, patient-informed accessible, affordable FA interventions in multiple languages is urgently needed.
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Affiliation(s)
- R C Knibb
- Aston Institute for Health and Neurodevelopment, Aston University, Birmingham, UK
| | - L J Herbert
- Children's National Health System, Washington, DC, USA
- George Washington University School of Medicine, Washington, DC, USA
| | - C J Jones
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - J L P Protudjer
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - C Screti
- Aston Institute for Health and Neurodevelopment, Aston University, Birmingham, UK
| | - C Roleston
- Aston Institute for Health and Neurodevelopment, Aston University, Birmingham, UK
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - H A Brough
- Children's Allergy Service, Evelina Children's Hospital, Guy's and St. Thomas's NHS Foundation Trust, London, UK
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - C Warren
- Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - L Lombard
- Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Private Practice, Chicago, Illinois, USA
| | - A F Santos
- Children's Allergy Service, Evelina Children's Hospital, Guy's and St. Thomas's NHS Foundation Trust, London, UK
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - R Gupta
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Institute for Public Health and Medicine, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
| | - B P Vickery
- Emory University School of Medicine, Atlanta, Georgia, USA
- Children's Healthcare of Atlanta, Atlanta, Georgia, USA
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16
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Sehgal S, Gupta N, Dadha P, Nagarajan S, Gupta R, Verma MJ, Ibrahim K, Bilaver LA, Warren C, Sachdev A, Nimmagadda SR, Gupta RS. Understanding the burden of food allergy among urban and rural school children from north India. World Allergy Organ J 2024; 17:100916. [PMID: 38974947 PMCID: PMC11227004 DOI: 10.1016/j.waojou.2024.100916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 05/08/2024] [Accepted: 05/14/2024] [Indexed: 07/09/2024] Open
Abstract
Background There is paucity of reliable epidemiological data regarding the burden of food allergy in most developing countries, including India. Objective To provide current estimates of the prevalence and distribution of food allergy among urban and rural school children aged 6-14 years in Delhi and the National Capital Region (NCR) of Khekra in India. Methods A cross-sectional study was conducted from January 2022 to February 2023 to enroll school children, 6-14 years, from select urban and rural schools in Delhi and NCR. A questionnaire consisting of questions focused on household environment, early life factors, and pediatric food allergy characteristics was administered by a trained medical researcher to collect parent-proxy data. Univariate statistics were used to describe frequencies, percentages, and 95% confidence intervals for survey items. Results The estimated prevalence of parent-reported food allergy was 0.8% (95% CI: 0.4-1.5; urban: 0.4%, 95% CI: 0.1-1.1; rural: 1.7%, 95% CI: 0.7-3.5). Fruits such as mango (0.3%, 95% CI: 0.1-0.9), strawberry (0.1%, 95% CI: 0.0-0.7), orange (0.1%, 95% CI: 0.0-0.7), and custard apple (0.1%, 95% CI: 0.0-0.7) were reported only by urban children, while rural children reported yogurt (0.6%, 95% CI: 0.1-1.8) and wheat (0.3%, 95% CI: 0.0-1.3). Both groups reported brinjal (also known as eggplant) and banana, 0.1% (95% CI: 0.0-0.7) of urban and 0.3% (95% CI: 0.0-1.3) of rural, respectively. Overall, commonly reported clinical symptoms were diarrhea and/or vomiting (100%, 95% CI: 76.2-100), abdominal pain (88.9%, 95% CI: 58.6-98.8), and rash/itchy skin (66.7%, 95% CI: 34.8-89.6). Among children with parent reported food allergy, 66.7% (95% CI: 34.8-89.6) of food allergies were physician diagnosed, of which 33.3% were diagnosed via history alone (95% CI:7.7-71.4) while 66.7% (95% CI: 28.6-92.3) were confirmed via skin prick test and/or blood test. Conclusion The overall prevalence of food allergy is very low in Delhi and Khekra, India. Future work should focus on elucidating the complex interplay of early-life, environmental, genetic, and lifestyle factors to understand the reasons for India's low food allergy burden and improve epidemiological clues to prevention for the nations with higher disease burden.
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Affiliation(s)
- Shruti Sehgal
- Center for Food Allergy and Asthma Research, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill, USA
| | - Neeraj Gupta
- Department of Pediatric Allergy and Pulmonology, Institute of Child Health, Sir Ganga Ram Hospital, Delhi, India
| | - Priyanka Dadha
- Center for Food Allergy and Asthma Research, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill, USA
| | | | - Ruma Gupta
- ADK Jain Eye Hospital, Khekra, Uttar Pradesh, India
| | | | - Khalid Ibrahim
- Center for Food Allergy and Asthma Research, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill, USA
| | - Lucy A. Bilaver
- Center for Food Allergy and Asthma Research, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Ill, USA
| | - Christopher Warren
- Center for Food Allergy and Asthma Research, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill, USA
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill, USA
| | - Anil Sachdev
- Department of Pediatric Allergy and Pulmonology, Institute of Child Health, Sir Ganga Ram Hospital, Delhi, India
| | - Sai R. Nimmagadda
- Center for Food Allergy and Asthma Research, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Ill, USA
- Division of Allergy and Immunology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill, USA
| | - Ruchi S. Gupta
- Center for Food Allergy and Asthma Research, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Ill, USA
- The Mary Ann & J. Milburn Smith Child Health Outcomes, Research and Evaluation Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill, USA
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17
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Chebar-Lozinsky A, De Koker C, Dziubak R, Rolnik DL, Godwin H, Dominguez-Ortega G, Skrapac AK, Gholmie Y, Reeve K, Shah N, Meyer R. Assessing Feeding Difficulties in Children Presenting with Non-IgE-Mediated Gastrointestinal Food Allergies-A Commonly Reported Problem. Nutrients 2024; 16:1563. [PMID: 38892497 PMCID: PMC11173616 DOI: 10.3390/nu16111563] [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: 04/04/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 06/21/2024] Open
Abstract
Many guidelines have been published to help diagnose food allergies, which have included feeding difficulties as a presenting symptom (particularly for non-IgE-mediated gastrointestinal allergies). This study aimed to investigate the prevalence of feeding difficulties in children with non-IgE-mediated gastrointestinal allergies and the association of such difficulties with symptoms and food elimination. An observational study was performed at Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. Children aged 4 weeks to 16 years without non-allergic co-morbidities who improved on an elimination diet using a previously published Likert scale symptom score were included. This study recruited 131 children, and 114 (87%) parents completed the questionnaire on feeding difficulties. Feeding difficulties were present in 61 (53.5%) of the 114 children. The most common feeding difficulties were regular meal refusals (26.9%), extended mealtimes (26.7%), and problems with gagging on textured foods (26.5%). Most children (40/61) had ≥2 reported feeding difficulties, and eight had ≥4. Children with feeding difficulties had higher rates of constipation and vomiting: 60.7% (37/61) vs. 35.8% (19/53), p = 0.008 and 63.9% (39/61) vs. 41.5% (22/53), p = 0.017, respectively. Logistic regression analysis demonstrated an association between having feeding difficulties, the age of the child, and the initial symptom score. Gender and the number of foods excluded in the elimination diet were not significantly associated with feeding difficulties. This study found that feeding difficulties are common in children with non-IgE-mediated gastrointestinal allergies, but there is a paucity of food allergy specific tools for establishing feeding difficulties, which requires further research in the long-term and consensus in the short term amongst healthcare professions as to which tool is the best for food allergic children.
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Affiliation(s)
- Adriana Chebar-Lozinsky
- Department of Allergy and Immune Disorders, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia;
| | - Claire De Koker
- Macassar Community Health Centre, Department of Health and Wellness, Western Cape Government, Elsenburg 7607, South Africa;
| | - Robert Dziubak
- Department of Gastroenterology, Great Ormond Street Hospital for Sick Children, London WC1N 3JH, UK
| | - Daniel Lorber Rolnik
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC 3800, Australia;
| | - Heather Godwin
- Department of Gastroenterology, Great Ormond Street Hospital for Sick Children, London WC1N 3JH, UK
| | - Gloria Dominguez-Ortega
- Department of Gastroenterology, Universidad Autonoma de Madrid, 28049 Madrid, Spain;
- Department Gastroenterology and Nutrition, Nino Jesus Univesity Children Hospital, 28009 Madrid, Spain
| | | | - Yara Gholmie
- Department of Nutrition, Simmons University, Boston, MA 02115, USA;
| | - Kate Reeve
- Royal Hospital for Children and Young People in Edinburgh, Edinburgh EH16 4TJ, UK;
| | - Neil Shah
- HCA Healthcare, London W1G 0PU, UK; (A.-K.S.); (N.S.)
| | - Rosan Meyer
- Department Dietetics, University of Winchester, Winchester SO22 4NR, UK
- Department of Medicine, KU Leuven, 3000 Leuven, Belgium
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18
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Leung ASY, Pawankar R, Pacharn P, Wong LSY, Le Pham D, Chan G, Rengganis I, Zhao J, Wang JY, Woo KCK, Ito K, Jeong K, Recto M, Lucas M, Nagao M, Lobo RCM, Munkhbayarlakh S, Sumadiono S, Huq SR, Ranasinghe T, Tang M. Perspectives and gaps in the management of food allergy and anaphylaxis in the Asia-Pacific Region. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2024; 3:100202. [PMID: 38283085 PMCID: PMC10818080 DOI: 10.1016/j.jacig.2023.100202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/03/2023] [Accepted: 10/08/2023] [Indexed: 01/30/2024]
Abstract
Background Food allergy (FA), which is a condition that has no effective cure and can result in severe life-threatening allergic reactions, remains a global public health concern; however, little is known about how FAs are currently managed in the Asia-Pacific region. Objective The main objective of this survey was to evaluate the epidemiology of FA, as well as the availability of resources and practices for management of FA and anaphylaxis by health care providers across Asia. Methods From June 2022 to September 2022, a questionnaire-based survey comprising 66 questions was electronically sent to member societies of the Asia Pacific Association of Allergy Asthma and Clinical Immunology by using Survey Monkey. Results A total of 20 responses were received from 15 member countries and territories. Compared with the pediatric data, there was a lack of prevalence data for FA in adults. Except for Australia and Japan, most regions had between 0.1 and 0.5 allergists per 100,000 population and some had fewer than 0.1 allergists per 100,000 population. The perceived rate of FA in regions with a short supply of allergists was high. Although specific IgE tests and oral food challenges were available in all regions, the median wait time for oral food challenges at government facilities was 37 days (interquartile range = 10.5-60 days). Seven regions still relied on prescriptions of ampules and syringes of injectable adrenaline, and adrenaline autoinjectors were not accessible in 4 regions. Oral immunotherapy as FA treatment was available in half of the surveyed countries and territories. Conclusions Our study offers a cross-sectional evaluation of the management practices for FA in each Asia Pacific Association of Allergy Asthma and Clinical Immunology member country or territory. Urgent actions are required to enhance allergy services, improve the accessibility and affordability of adrenaline autoinjectors, and conduct robust epidemiologic studies.
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Affiliation(s)
- Agnes Sze Yin Leung
- Department of Paediatrics, Prince of Wales Hospital, Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
| | - Ruby Pawankar
- Division of Allergy, Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Punchama Pacharn
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Lydia Su Yin Wong
- Department of Paediatrics, Yong Loo Lin School of Medicine and Khoo Teck Puat-National University Children’s Medical Institute, National University of Singapore, Singapore, Singapore
| | - Duy Le Pham
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Grace Chan
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Iris Rengganis
- Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
| | - Jing Zhao
- Capital Institute of Pediatrics in China, Beijing, China
| | - Jiu Yao Wang
- Division of Allergy and Clinical Immunology, Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | | | - Komei Ito
- Allergy and Immunology Center, Aichi Children's Health And Medical Center, Aichi, Japan
| | | | - Marysia Recto
- Division of Adult and Pediatric Allergy and Immunology, University of the Philippines College of Medicine, Philippine General Hospital, Manila, Philippines
| | - Michaela Lucas
- WA Health and University of Western Australia, Perth, Australia
| | - Mizuho Nagao
- National Hospital Organization Mie National Hospital, Tsu, Japan
| | | | - Sonomjamts Munkhbayarlakh
- Department of Pulmonology and Allergology, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Sumadiono Sumadiono
- Department of Child Health, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Syed Rezaul Huq
- National Institute of the Chest Disease and Hospital NIDCH Mohakhali, Dhaka, Bangladesh
| | - Thushali Ranasinghe
- Allergy, Immunology and Cell Biology Unit, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Mimi Tang
- Allergy Immunology, Murdoch Children's Research Institute, Department of Allergy and Immunology, The Royal Children's Hospital Melbourne, Melbourne, Australia
| | - Asia Pacific Association of Allergy Asthma and Clinical Immunology food allergy and anaphylaxis and junior member committees
- Department of Paediatrics, Prince of Wales Hospital, Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
- Division of Allergy, Department of Pediatrics, Nippon Medical School, Tokyo, Japan
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Department of Paediatrics, Yong Loo Lin School of Medicine and Khoo Teck Puat-National University Children’s Medical Institute, National University of Singapore, Singapore, Singapore
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore
- Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
- Capital Institute of Pediatrics in China, Beijing, China
- Division of Allergy and Clinical Immunology, Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Gleneagles Hospital, Kuala Lumpur, Malaysia
- Allergy and Immunology Center, Aichi Children's Health And Medical Center, Aichi, Japan
- Ajou University School of Medicine, Suwon, Korea
- Division of Adult and Pediatric Allergy and Immunology, University of the Philippines College of Medicine, Philippine General Hospital, Manila, Philippines
- WA Health and University of Western Australia, Perth, Australia
- National Hospital Organization Mie National Hospital, Tsu, Japan
- Fe del Mundo Medical Center, Metro Manila, Manila, Philippines
- Department of Pulmonology and Allergology, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
- Department of Child Health, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
- National Institute of the Chest Disease and Hospital NIDCH Mohakhali, Dhaka, Bangladesh
- Allergy, Immunology and Cell Biology Unit, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
- Allergy Immunology, Murdoch Children's Research Institute, Department of Allergy and Immunology, The Royal Children's Hospital Melbourne, Melbourne, Australia
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19
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Li Y, Gao Y, Wang Y, Duan Y, Fu Y, Yang H, Xi J. Localization of an IgE epitope of glycinin A2 peptide chain. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2024; 104:3697-3704. [PMID: 38160247 DOI: 10.1002/jsfa.13254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION One of the main allergens in soybeans is glycinin, which seriously impacts the normal lives of allergic people. Previous studies have confirmed that thermal processing and thermal processing combined with ultrahigh-pressure processing could significantly reduce the antigenicity of glycinin. The dominant antigen region of acidic peptide chain A2 of G2 subunit was located by phage display experiment. METHODS In this paper, overlapping peptides and alanine substitution techniques were used to explore the key amino acids that significantly affect the antigenicity of A2 peptide chain. The purity of peptide 1, peptide 2 and peptide 3 was identified by mass spectrometry and high-performance liquid chromatography, and the results showed that the purity of the synthesized overlapping peptide was more than 90%. SDS-PAGE showed that the peptide was successfully coupled with bovine serum albumin. The antigenicity of the coupling peptide was tested by ELISA and Dot-Blot, and the allergenicity was detected by reacting with the serum of patients with soybean globulin allergy. CONCLUSION The results showed that peptide 3 has stronger antigenicity and sensitization. Alanine substitution technology allowed one to perform site-directed mutagenesis on peptide 3. Dot-Blot and ELISA tests showed that D259, E260, E261, Q263 and C266 may be the key amino acids that significantly affect the antigenicity of peptide 3. The research presented is of great significance for correctly guiding the production of safe food and preventing the occurrence of food allergic diseases. © 2023 Society of Chemical Industry.
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Affiliation(s)
- Yingying Li
- College of Food Science and Engineering, Henan University of Technology, Zhengzhou, China
| | - Yida Gao
- College of Food Science and Engineering, Henan University of Technology, Zhengzhou, China
| | - Yichao Wang
- College of Food Science and Engineering, Henan University of Technology, Zhengzhou, China
| | - Yuying Duan
- College of Food Science and Engineering, Henan University of Technology, Zhengzhou, China
| | - Yang Fu
- College of Food Science and Engineering, Henan University of Technology, Zhengzhou, China
| | - Huanhuan Yang
- College of Food Science and Engineering, Henan University of Technology, Zhengzhou, China
| | - Jun Xi
- College of Food Science and Engineering, Henan University of Technology, Zhengzhou, China
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Capra ME, Decarolis NM, Monopoli D, Laudisio SR, Giudice A, Stanyevic B, Esposito S, Biasucci G. Complementary Feeding: Tradition, Innovation and Pitfalls. Nutrients 2024; 16:737. [PMID: 38474864 DOI: 10.3390/nu16050737] [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: 02/03/2024] [Revised: 02/26/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
According to WHO, "complementary feeding (CF) is the process starting when breast milk alone or infant formula alone is no longer sufficient to meet the nutritional requirements of infants, and therefore, other foods and liquids are needed, along with breast human milk or a breastmilk substitute". CF is one of the most important "critical and sensitive periods" in human life: indeed, timing and approaches to solid foods introduction in an infant's nutrition are of utmost importance as potential epigenetic factors from infancy to adulthood. CF is also deeply influenced by each country and single-family traditions, culture, and beliefs. The aim of our narrative review is to analyze traditional CF practices, including innovative and alternative ones that emerged in the last decades, such as baby-led weaning or plant-based weaning, and to evaluate their effects on the risk of developing non-communicable diseases. Moreover, we will discuss pitfalls and misunderstandings that pediatricians frequently have to face when dealing with complementary feeding. Health care professionals must not have prejudices against parents' wishes or traditions about CF; rather, they should support and educate them in case of any alternative CF choice, always pursuing the infant's adequate growth, neuro- and taste development, and the achievement of correct eating behavior as the primary goal.
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Affiliation(s)
- Maria Elena Capra
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Italian Society of Pediatric Nutrition (SINUPE), 20126 Milan, Italy
| | - Nicola Mattia Decarolis
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Delia Monopoli
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Serena Rosa Laudisio
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Antonella Giudice
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Brigida Stanyevic
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Giacomo Biasucci
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Italian Society of Pediatric Nutrition (SINUPE), 20126 Milan, Italy
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
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21
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Liu J, Guo S, Wang Y, Huang N, Li W, Ma D, Yang Y, Yang L, Chen H, Zhu R. A survey on prevalence and parents' perceptions of food allergy in 3- to 16-year-old children in Wuhan, China. World Allergy Organ J 2024; 17:100883. [PMID: 38435726 PMCID: PMC10906528 DOI: 10.1016/j.waojou.2024.100883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 01/27/2024] [Accepted: 02/13/2024] [Indexed: 03/05/2024] Open
Abstract
Background The prevalence of food allergy (FA) has risen in recent decades, yet there is limited data on the cognition and beliefs of FA among the parents of FA children. Objective To investigate the prevalence of FA and assess the knowledge and perception of FA among parents of FA children in Wuhan, China. Methods Online questionnaires were conducted for the parents of 3- to 16-year-old children. They reported symptoms of suspected FA in the screening questionnaire were interviewed for further diagnostic evaluation. All the parents of the suspected FA children completed the subsequent assessments of the knowledge and perception on FA as well as their attitude towards the current online platforms. Results A total of 1963 children were recruited. The prevalence of self-reported FA was 10.2% (95% CI: 8.1-12.4%) and the physician-diagnosed FA was 6.2% (95% CI: 5.1-7.2%) in 3- to 16-year-olds in Wuhan. And the children with family history (57.9%) were predisposed to developing FA (P<0.001). The total Brief Illness Perception Questionnaire (B-IPQ) score was 41.3 ± 10.0 among the parents. The B-IPQ scores correlated with symptom onset, but not with family history or other atopic comorbidities. The parents who never sought treatments obtained lower B-IPQ scores on most items compared to those who received treatments. The accuracy rate of the FA knowledge questionnaire was 56.7%. 11.6% of participants reported that children's FA had an impact on their lives. 67.2% of participants had searched information of FA online, among whom 80% expected to obtain professional suggestions on management and prevention strategies of FA from online platform. Conclusion In 3- to 16-year-old children in Wuhan, the prevalence of self-reported and physician-diagnosed FA was 10.2% and 6.2% respectively. Parents' knowledge of FA was insufficient and only a small proportion of parents perceived that their lives and careers have been affected considerably by FA of their children. Patient education and current online platforms should be improved among parents of FA children.
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Affiliation(s)
- Jin Liu
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuyan Guo
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yin Wang
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nan Huang
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenjing Li
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dongxia Ma
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yaqi Yang
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lin Yang
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Chen
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rongfei Zhu
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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22
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Jung M, Kim S, Yoo HW, Kim HY, Kim M, Lee JY, Park B, Kim J, Ahn K, Kyung Y, Kim J. Validity and Reliability of the Korean Versions of the Food Allergy Quality of Life Questionnaire-Child Form and Teenager Form. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2024; 16:202-210. [PMID: 38528387 DOI: 10.4168/aair.2024.16.2.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/27/2023] [Accepted: 12/25/2023] [Indexed: 03/27/2024]
Abstract
We aimed to assess the validity and reliability of the Korean versions of the Food Allergy Quality of Life Questionnaire-Child Form (K-FAQLQ-CF) and the Food Allergy Quality of Life Questionnaire-Teenager Form (K-FAQLQ-TF). Patients aged 8-17 years with food allergy (FA) were enrolled and completed the Korean versions of the questionnaires, including the K-FAQLQ-CF, the Food Allergy Independent Measure-Child Form (K-FAIM-CF), and the Pediatric Quality of Life Inventory™ (K-PedsQL™ 4.0) for children and the K-FAQLQ-TF, the Food Allergy Independent Measure-Teenager Form (K-FAIM-TF), and the K-PedsQL™ 4.0 for adolescents. We enrolled 56 children and 23 adolescents in this study. The K-FAQLQ-CF showed a good internal consistency (Cronbach's α coefficient = 0.969) and an excellent test-retest reliability (intraclass correlation coefficient = 0.914, P = 0.011). There was a moderate correlation between the K-FAQLQ-CF and K-FAIM-CF scores (β = 0.736, P < 0.001), indicating construct validity. The K-FAQLQ-CF score was weakly associated with the K-PedsQL™ 4.0 score (β = -0.289, P = 0.031), verifying convergent and discriminant validities. The K-FAQLQ-TF also showed a good internal consistency (Cronbach's α coefficient = 0.966) and test-retest reliability (intraclass correlation coefficient = 0.974, P = 0.005). Construct validity was also established by a moderate correlation with the K-FAIM-TF (β = 0.699, P < 0.001). Our results suggest that the K-FAQLQ-CF and K-FAQLQ-TF are valid and reliable tools to evaluate the quality of life of children and adolescents with FA in Korea.
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Affiliation(s)
- Minyoung Jung
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University School of Medicine, Busan, Korea
| | - Sukyung Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Won Yoo
- Department of Pediatrics, Pusan National University School of Medicine, Busan, Korea
| | - Hye-Young Kim
- Integrated and Respiratory Care Center for Children, Seoul National University Hospital, Seoul, Korea
| | - Minji Kim
- Department of Pediatrics, Chungnam National University Sejong Hospital, Chungnam National University College of Medicine, Sejong, Korea
| | - Ji Young Lee
- Department of Pediatrics, Hallym University Chuncheon Sacred Heart Hospital, Hallym University School of Medicine, Chuncheon, Korea
| | - Boram Park
- Biomedical Statistics Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Jiwon Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology, Seoul, Korea
| | - Yechan Kyung
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
| | - Jihyun Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology, Seoul, Korea.
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23
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Maldonado-Puebla M, Akenroye A, Busby J, Cardet JC, Louisias M. Pharmacoequity in Allergy-Immunology: Disparities in Access to Medications for Allergic Diseases and Proposed Solutions in the United States and Globally. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:272-280. [PMID: 37951413 PMCID: PMC10922722 DOI: 10.1016/j.jaip.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/27/2023] [Accepted: 11/01/2023] [Indexed: 11/14/2023]
Abstract
Pharmacoequity is the principle that individuals should have access to high-quality medications regardless of race and ethnicity, socioeconomic status, or availability of resources. In this review, we summarize access to therapeutics for allergic diseases in the United States and other selected countries. We focus on domains of health care access (health insurance coverage, medication availability, and specialist access) as well as system-level factors and clinician- and patient-level factors such as interpersonal racism and cultural beliefs, and how they can affect timely access to appropriate therapy for allergic diseases. Finally, we propose how pharmacoequity in allergy-immunology can be achieved by highlighting solutions to factors limiting access to medications for allergic diseases, and identify potential future research directions.
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Affiliation(s)
- Martin Maldonado-Puebla
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, Fla
| | - Ayobami Akenroye
- Division of Allergy and Clinical Immunology, Department of Medicine, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Harvard Medical School, Boston, Mass; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Mass
| | - John Busby
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom, (f)Department of Immunology, Boston Children's Hospital, Boston, Mass
| | - Juan Carlos Cardet
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, Fla
| | - Margee Louisias
- Division of Allergy and Clinical Immunology, Department of Medicine, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Harvard Medical School, Boston, Mass.
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24
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Cabanos C, Finkina E. Editorial: Current perspectives on the role of lipids in allergic reaction. Front Mol Biosci 2024; 11:1364003. [PMID: 38293600 PMCID: PMC10822935 DOI: 10.3389/fmolb.2024.1364003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 01/04/2024] [Indexed: 02/01/2024] Open
Affiliation(s)
- Cerrone Cabanos
- Laboratory of Food Quality Design and Development, Graduate School of Agriculture, Kyoto University, Uji, Kyoto, Japan
| | - Ekaterina Finkina
- Science-Educational Center, M. M. Shemyakin and Yu A. Ovchinnikov Institute of Bioorganic Chemistry, The Russian Academy of Sciences, Moscow, Russia
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25
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Moya B, Dieguez MC, Crespo JF, Cabanillas B. Food Allergens of Plant and Animal Origin: Classification, Characteristics, and Properties. Methods Mol Biol 2024; 2717:1-14. [PMID: 37737974 DOI: 10.1007/978-1-0716-3453-0_1] [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] [Indexed: 09/23/2023]
Abstract
Food allergy is an adverse immune response to specific foods that can be either IgE-mediated or non-IgE mediated. The causes of IgE-mediated food allergy are multifactorial and involve genetic, dietary, and environmental factors. The prevalence of food allergy has increased over the last few decades, especially in urbanized, industrialized, and Westernized countries, and the epithelial barrier hypothesis has been recently suggested as a possible explanation for this increase. Food allergens of plant and animal origin are classified into a few families and superfamilies that are widely distributed and conserved. While it is known that food allergens share common properties, such as stability to enzymes and solubility, they also exhibit differential properties, and exceptions to the common characteristics exist. In recent years, novel characteristics of food allergens have been proposed based on their immunological properties and their ability to act as adjuvants or enhancers of the immune system.This chapter provides an overview of the current knowledge of food allergy, covering their prevalence, classification of food allergens from plant and animal origins, and recent advancements in the characterization of the properties of these allergens.
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Affiliation(s)
- Beatriz Moya
- Department of Allergy, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Maria Carmen Dieguez
- Department of Allergy, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Jesus F Crespo
- Department of Allergy, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Beatriz Cabanillas
- Department of Allergy, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.
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26
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Burman A, Bhaloo N. Cochrane corner: Skin care interventions in infants for preventing eczema and food allergy. Clin Exp Allergy 2024; 54:7-10. [PMID: 38180122 DOI: 10.1111/cea.14446] [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: 12/02/2023] [Revised: 12/18/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024]
Affiliation(s)
- Alisha Burman
- University College Hospitals London Foundation Trust, London, UK
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27
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Del Refugio Morfin Maciel BM, Álvarez Castelló M. [Risk factors for food allergy]. REVISTA ALERGIA MÉXICO 2023; 70:214-221. [PMID: 38506859 DOI: 10.29262/ram.v70i4.1329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/29/2023] [Indexed: 03/21/2024] Open
Abstract
Allergy is the result of genetic and environmental interactions, including time, route, and dose of food exposure in susceptible patients. Risk factors can be: 1) genetic and 2) environmental, and these, in turn, are divided into prenatal, perinatal and postnatal. Food allergy appears frequently and depends on multiple risk factors (genetic and environmental), which in turn are divided into: prenatal, natal and postnatal factors; They participate in the expression of the disease and clinical intervention is not possible in all cases.
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Affiliation(s)
- Blanca María Del Refugio Morfin Maciel
- Alergóloga Pediatra, Instituto Nacional de Pediatría; Académico numerario de la Academia Mexicana de Pediatría; Maestría en Ciencias Mé-dicas, Universidad Nacional Autónoma de México Alergóloga, Hospital San Ángel Inn Chapultepec, Ciudad de
| | - Mirta Álvarez Castelló
- Doctor en Ciencias médicas, Especialista en Medicina General Integral y Alergología; Hospital Universitario General Calixto García; Investigadora Titular; Profesora auxiliar
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28
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Ansotegui Zubeldia IJ, Fiocchi A. [Introduction to food allergy]. REVISTA ALERGIA MÉXICO 2023; 70:208-210. [PMID: 38506857 DOI: 10.29262/ram.v70i4.1308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/29/2023] [Indexed: 03/21/2024] Open
Abstract
Food allergy is a common chronic disorder that affects infants, children, adolescents, and adults. The prevalence of food allergy has increased in recent decades throughout the world, not limited to Western countries. Since there is no treatment, this focuses on avoiding allergens, in addition to educating patients and caregivers in the emergency treatment of acute reactions, for example: application of epinephrine. Studies suggest that accidental reactions occur in about 45% of children with food allergies each year, although most reactions are mild or moderate in severity. Hospital admissions for food anaphylaxis vary from 4 to 20 per 100,000 inhabitants; Deaths are rare, with an estimated incidence of 0.03 to 0.3 per million people with food allergy. Death from food anaphylaxis is rare and appears to have remained stable, possibly due to increases in food allergen labeling, diagnostic services, rates of intramuscular epinephrine prescription, and awareness of food allergies. Omalizumab is a drug approved for several disorders (chronic hives or difficult asthma) and may help reduce symptoms associated with food allergy. The relative importance of alternative technologies, management strategies and policies for food allergy varies from one region to another, due to differences in the epidemiology, education, socioeconomic well-being, and cultural preferences of the population.
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Affiliation(s)
- Ignacio Javier Ansotegui Zubeldia
- Director Médico Ejecutivo, Expresidente de la Organización Mundial de Alergia (WAO). Jefe del Departamento de Alergia e Inmunología, Hospital Quironsalud, Bizkaia, Bilbao,
| | - Alessandro Fiocchi
- Director responsable de la S.C. de Pediatría, Hospital Materno Infantil Macedonio Melloni, Milán, Italia. Director del Departamento Materno Infantil, Hospital Fatebenefratelli-Ophthalmic de Milán, Italia. Profesor adjunto de la Escuela de Es-pecialización en Pediatría III, Universidad de Milán y Consejero de la Sociedad Italiana de Pediatría, Sección Lombarda. Pediatric Hospital Bambino Gesú IRCCS Allergy division, Roma, Italia
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29
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Poredoš T, Vesel Tajnšek T, Koren Jeverica A, Zajc Avramovič M, Markelj G, Emeršič N, Avčin T. Comprehensive Care and Education Can Improve Nutritional and Growth Outcomes in Children with Persistent Cow's Milk, Egg, or Peanut Allergies: A Five-Year Follow-Up Study of Nutritional Status. Nutrients 2023; 16:48. [PMID: 38201880 PMCID: PMC10780307 DOI: 10.3390/nu16010048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Data suggest that food allergies greatly impact a child's health and growth due to inadequate nutrient intake. Our study aimed to establish the long-term outcome of children with food allergies compared to a control group. METHODS This study was a retrospective cohort study with longitudinal follow-up with a mean period of 4.85 years from the diagnosis to the last study visit. The patients' nutritional intake was assessed using a three-day food diary and analysed by a dietitian. Patients (61 boys and 33 girls, mean age 6.9 years) had a single food allergy including 21 patients with cow's milk, 34 with egg, and 39 with peanut allergies. The control group included 36 children (19 boys and 17 girls, mean age 8.03 years). Blood analysis was performed on all participants. RESULTS Data from our study showed that patients with cow's milk, egg or peanut allergies had normal growth and achieved catch-up growth from the diagnosis until the last study visit. In the cow's milk allergy group, the allergy was shown to affect calcium intake (p < 0.05), while egg and peanut allergies did not impact the dietary intake of nutrients. None of the investigated food allergies affected blood results (p < 0.05). CONCLUSIONS In the present study, we showed that single food allergies do not compromise growth in children if they are provided with appropriate support and that the affected children reach catch-up growth from the diagnosis.
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Affiliation(s)
- Tomaž Poredoš
- Department of Hospital Nutrition and Dietetics, University Children’s Hospital, University Medical Center Ljubljana, Bohoričeva 20, 1000 Ljubljana, Slovenia
| | - Tina Vesel Tajnšek
- Department of Allergology, Rheumatology and Clinical Immunology, University Children’s Hospital, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia (A.K.J.); (M.Z.A.); (G.M.); (N.E.); (T.A.)
| | - Anja Koren Jeverica
- Department of Allergology, Rheumatology and Clinical Immunology, University Children’s Hospital, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia (A.K.J.); (M.Z.A.); (G.M.); (N.E.); (T.A.)
| | - Mojca Zajc Avramovič
- Department of Allergology, Rheumatology and Clinical Immunology, University Children’s Hospital, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia (A.K.J.); (M.Z.A.); (G.M.); (N.E.); (T.A.)
| | - Gašper Markelj
- Department of Allergology, Rheumatology and Clinical Immunology, University Children’s Hospital, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia (A.K.J.); (M.Z.A.); (G.M.); (N.E.); (T.A.)
| | - Nina Emeršič
- Department of Allergology, Rheumatology and Clinical Immunology, University Children’s Hospital, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia (A.K.J.); (M.Z.A.); (G.M.); (N.E.); (T.A.)
| | - Tadej Avčin
- Department of Allergology, Rheumatology and Clinical Immunology, University Children’s Hospital, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia (A.K.J.); (M.Z.A.); (G.M.); (N.E.); (T.A.)
- Department of Paediatrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
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30
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Wang C, Wang Y, Wang F, Zhang J, Sun Z, Zhang H, Fu L. High intestinal isoleucine is a potential risk factor for food allergy by regulating the mTOR/AKT pathway in dendritic cells. Clin Immunol 2023; 257:109818. [PMID: 37918466 DOI: 10.1016/j.clim.2023.109818] [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: 07/06/2023] [Revised: 09/30/2023] [Accepted: 10/19/2023] [Indexed: 11/04/2023]
Abstract
Food allergy is a global food safety problem with a growing prevalence. People in industrial regions are more susceptible to allergy, but the mechanisms behind this are not fully understood. In this study, the probiotic Lactobacillus casei Zhang (LcZ) was administered to allergic individuals and the impact on allergy-related factors were determined. LcZ alleviated allergenic responses, and there was a significant correlation between the intestinal isoleucine content and IgE concentration. Metagenomics results suggest that the metabolism of the gut microbiota is a source of isoleucine. In a mouse model of food allergy, a high isoleucine diet exacerbated allergic responses and increased the activity of allergenic dendritic cell. In a dendritic cell model, a protein array revealed that the mTOR/AKT pathway mediated the function of isoleucine, and molecular docking suggested that Sestrin2 could be the potential receptor. Overall, this study revealed the role of isoleucine in promoting food allergy, elucidated the underlying mechanisms, and suggested that a high intake of isoleucine could be a potential risk factor for food allergy.
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Affiliation(s)
- Chong Wang
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou 310018, China
| | - Yanbo Wang
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou 310018, China
| | - Fangting Wang
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou 310018, China
| | - Jiachao Zhang
- College of Food Science and Engineering, Key Laboratory of Food Nutrition and Functional Food of Hainan Province, Hainan University, Haikou 570228, China
| | - Zhihong Sun
- Key Laboratory of Dairy Biotechnology and Engineering Ministry of Education, and Key Laboratory of Dairy Products Processing Ministry of Agriculture, Inner Mongolia Agricultural University, Huhhot 010018, China
| | - Heping Zhang
- Key Laboratory of Dairy Biotechnology and Engineering Ministry of Education, and Key Laboratory of Dairy Products Processing Ministry of Agriculture, Inner Mongolia Agricultural University, Huhhot 010018, China
| | - Linglin Fu
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou 310018, China.
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Gan H, Huang Z, Zhu H, Li A, Chen T, Yin Z, Sun B. Study of Allergy and Sensitization Relationship in Children and Parents in Southern China. Int Arch Allergy Immunol 2023; 185:142-151. [PMID: 37926086 DOI: 10.1159/000533896] [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: 06/17/2023] [Accepted: 08/29/2023] [Indexed: 11/07/2023] Open
Abstract
INTRODUCTION The incidence of allergic diseases has increased globally, with genetics playing an essential role in these conditions' development. However, there is still a gap in understanding of how parental allergy status affects children's allergies. METHODS An electronic questionnaire was used to assess allergy-related symptoms in kindergarten children and their parents, with a clinical diagnosis and concurrent serum allergen-specific immunoglobulin E (IgE), total IgE, and blood cell counts obtained. RESULTS 88 family groups were enrolled, with allergy prevalence of 85.2% in children, 50% in fathers, and 42% in mothers. Allergic rhinoconjunctivitis was the most common allergic disease. When the mother had an allergy, the children's allergy diagnosis rate was 91.3%; 86.67% when the father had an allergy; and 85.71% when both parents had allergies. The child sensitization rate was 78.26% when the father had sensitization, 59.09% just as the mother had sensitization, and 84.21% when both parents had sensitization. Paternal allergies affected children's quality of life due to allergic rhinitis but not their rhinitis symptoms. Maternal allergies or sensitization did not significantly affect children's symptoms or quality-of-life scores. CONCLUSION The study found a positive correlation between childhood and parental allergies, and further studies are needed to confirm the findings.
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Affiliation(s)
- Hui Gan
- Department of Clinical Laboratory, The Key Laboratory of Advanced Interdisciplinary Studies Center, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou, China,
| | - Zhifeng Huang
- Department of Clinical Laboratory, The Key Laboratory of Advanced Interdisciplinary Studies Center, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou, China
| | - Huiqing Zhu
- Department of Clinical Laboratory, The Key Laboratory of Advanced Interdisciplinary Studies Center, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou, China
| | - Aoli Li
- Department of Clinical Laboratory, The Key Laboratory of Advanced Interdisciplinary Studies Center, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou, China
| | - Tong Chen
- Department of Clinical Laboratory, The Key Laboratory of Advanced Interdisciplinary Studies Center, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou, China
| | - Ziyu Yin
- Department of Clinical Laboratory, The Key Laboratory of Advanced Interdisciplinary Studies Center, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou, China
| | - Baoqing Sun
- Department of Clinical Laboratory, The Key Laboratory of Advanced Interdisciplinary Studies Center, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou, China
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Teramoto Y, Akagawa S, Hori SI, Tsuji S, Higasa K, Kaneko K. Dysbiosis of the gut microbiota as a susceptibility factor for Kawasaki disease. Front Immunol 2023; 14:1268453. [PMID: 38022552 PMCID: PMC10644744 DOI: 10.3389/fimmu.2023.1268453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Gut microbial imbalance (dysbiosis) has been reported in patients with acute Kawasaki disease (KD). However, no studies have analyzed the gut microbiota while focusing on susceptibility to KD. This study aimed to evaluate whether dysbiosis elevates susceptibility to KD by assessing children with a history of KD. Methods Fecal DNA was extracted from 26 children with a history of KD approximately 1 year prior (KD group, 12 boys; median age, 32.5 months; median time from onset, 11.5 months) and 57 age-matched healthy controls (HC group, 35 boys; median age, 36.0 months). 16S rRNA gene analysis was conducted with the Illumina Miseq instrument. Sequence reads were analyzed using QIIME2. Results For alpha diversity, Faith's phylogenetic diversity was significantly higher in the KD group. Regarding beta diversity, the two groups formed significantly different clusters based on Bray-Curtis dissimilarity. Comparing microbial composition at the genus level, the KD and HC groups were significantly different in the abundance of two genera with abundance over 1% after Benjamini-Hochberg false discovery rate correction for multiple comparisons. Compared with the HC group, the KD group had higher relative abundance of Ruminococcus gnavus group and lower relative abundance of Blautia. Discussion and conclusion Ruminococcus gnavus group reportedly includes pro-inflammatory bacteria. In contrast, Blautia suppresses inflammation via butyrate production. In the predictive functional analysis, the proportion of gut microbiota involved in several pathways was lower in the KD group. Therefore, dysbiosis characterized by distinct microbial diversity and decreased abundance of Blautia in parallel with increased abundance of Ruminococcus gnavus group might be a susceptibility factor for KD.
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Affiliation(s)
- Yoshiki Teramoto
- Department of Pediatrics, Kansai Medical University, Hirakata, Osaka, Japan
| | - Shohei Akagawa
- Department of Pediatrics, Kansai Medical University, Hirakata, Osaka, Japan
| | - Shin-ichiro Hori
- Department of Pediatrics, Kansai Medical University, Hirakata, Osaka, Japan
| | - Shoji Tsuji
- Department of Pediatrics, Kansai Medical University, Hirakata, Osaka, Japan
| | - Koichiro Higasa
- Department of Genome Analysis, Institute of Biomedical Science, Kansai Medical University, Hirakata, Osaka, Japan
| | - Kazunari Kaneko
- Department of Pediatrics, Kansai Medical University, Hirakata, Osaka, Japan
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Kaczmarczyk R, Lasser T, Biedermann T, Ring J, Zink A. Revealing clinically relevant specific IgE sensitization patterns in Hymenoptera venom allergy with dimension reduction and clustering. World Allergy Organ J 2023; 16:100820. [PMID: 37822702 PMCID: PMC10562856 DOI: 10.1016/j.waojou.2023.100820] [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: 06/16/2023] [Revised: 09/05/2023] [Accepted: 09/11/2023] [Indexed: 10/13/2023] Open
Abstract
Background Immunoglobulin E (IgE) blood tests are used to detect sensitizations and potential allergies. Recent studies suggest that specific IgE sensitization patterns due to molecular interactions affect an individual's risk of developing allergic symptoms. Objective The aim of this study was to reveal specific IgE sensitization patterns and investigate their clinical implications in Hymenoptera venom allergy. Methods In this cross-sectional study, 257 hunters or fishers with self-filled surveys on previous Hymenoptera stings were analyzed. Blood samples were taken to determine Hymenoptera IgE sensitization levels. Using dimensionality reduction and clustering, specific IgE for 10 Hymenoptera venom allergens were evaluated for clinical relevance. Results Three clusters were unmasked using novel dimensionality reduction and clustering methods solely based on specific IgE levels to Hymenoptera venom allergens. These clusters show different characteristics regarding previous systemic reactions to Hymenoptera stings. Conclusion Our study was able to unmask non-linear sensitization patterns for specific IgE tests in Hymenoptera venom allergy. We were able to derive risk clusters for anaphylactic reactions following hymenoptera stings and pinpoint relevant allergens (rApi m 10, rVes v 1, whole bee, and wasp venom) for clustering.
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Affiliation(s)
- Robert Kaczmarczyk
- Technical University of Munich, School of Medicine, Department of Dermatology and Allergy, Munich, Germany
| | - Tobias Lasser
- Technical University of Munich, School of Computation, Information and Technology, Department of Informatics, Munich Institute of Biomedical Engineering, Munich, Germany
| | - Tilo Biedermann
- Technical University of Munich, School of Medicine, Department of Dermatology and Allergy, Munich, Germany
| | - Johannes Ring
- Technical University of Munich, School of Medicine, Department of Dermatology and Allergy, Munich, Germany
| | - Alexander Zink
- Technical University of Munich, School of Medicine, Department of Dermatology and Allergy, Munich, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, 17176, Stockholm, Sweden
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Tanno LK, Caminati M, Pouessel G, Senna G, Demoly P. Epidemiology of anaphylaxis: is the trend still going up? Curr Opin Allergy Clin Immunol 2023; 23:349-356. [PMID: 37548324 DOI: 10.1097/aci.0000000000000933] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
PURPOSE OF REVIEW To understand the current global scale of anaphylaxis and identify possible strategies to increase the accuracy of epidemiological data. RECENT FINDINGS Anaphylaxis mortality and morbidity statistics may gain new perspectives with the global implementation of the ICD-11. Improving the quality of epidemiological data related to anaphylaxis should clarify some areas of uncertainty about risk factors, leading to better targeting of strategies to protect those patients at risk, and support decision-making to facilitate health care planning and implementation of public health measures to prevent anaphylaxis. SUMMARY The true rate of anaphylaxis is unknown due to a number of factors, such as misdiagnosis, miscoding and undernotification. Moreover, there is lack of information about anaphylaxis epidemiology in many countries. Difficulties on collecting accurate and comparable data should be acknowledged and anaphylaxis data can vary widely. Currently, most robust data are derived from hospitalization datasets and national mortality databases. Anaphylaxis accounts for up to 0.26% of overall hospital admissions. It is suggested that the number of hospital admissions for anaphylaxis is increasing in many countries, both with respect to all-causes of anaphylaxis and by trigger, but the mortality rate remains low. However, there are still great challenges in capturing quality anaphylaxis mortality and morbidity statistics. Better understanding of anaphylaxis trends should clarify some areas of uncertainty about risk factors and prospect effective prevention strategies. As the knowledge derived from populations is key information for more realistic decision-making, the construction of the new section addressed to anaphylaxis in the ICD-11 will allow the collection of more accurate epidemiological data to support high quality management of patients, and to better facilitate health care planning to implement public health measures, reduce the morbidity and mortality attributable to anaphylaxis.
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Affiliation(s)
- Luciana Kase Tanno
- Division of Allergy, Department of Pulmonology, Allergy and Thoracic Oncology, University Hospital of Montpellier, Montpellier
- Desbrest Institute of Epidemiology and Public Health, UMR UA11 University of Montpellier - INSERM
- WHO Collaborating Centre on Scientific Classification Support, Montpellier, France
| | - Marco Caminati
- Asthma Center and Allergy Unit, University of Verona, Verona, Italy
| | - Guillaume Pouessel
- Department of Paediatrics, CH Roubaix
- Paediatric Pneumology and Allergology Unit, CHRU Lille, France
| | - Gianenrico Senna
- Asthma Center and Allergy Unit, University of Verona, Verona, Italy
- Department of Medicine, University of Verona, Verona, Italy
| | - Pascal Demoly
- Division of Allergy, Department of Pulmonology, Allergy and Thoracic Oncology, University Hospital of Montpellier, Montpellier
- Desbrest Institute of Epidemiology and Public Health, UMR UA11 University of Montpellier - INSERM
- WHO Collaborating Centre on Scientific Classification Support, Montpellier, France
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Cook EE. Anthropological and sociological perspectives on food allergy. Clin Exp Allergy 2023; 53:989-1003. [PMID: 37649424 DOI: 10.1111/cea.14387] [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: 04/02/2023] [Revised: 08/17/2023] [Accepted: 08/19/2023] [Indexed: 09/01/2023]
Abstract
This review explores the anthropological and sociological literature on food allergy and identifies four primary areas of research to date. The first explores the relationality and management of risk, uncertainty and stigma among parents and sufferers of food allergies. The second analyses the influence of intersectionality, specifically the effects of class, gender, race/ethnicity and disability on experiences of food allergy. The third discusses diagnostic difficulties and the impact these have on legitimacy and believability, both in the context of clinician-patient relations and in managing food allergies in public spaces. The fourth explores the ethics and uncertainties in food allergy treatments and how scientific knowledge of emerging treatments is constructed. This body of research illustrates that although an individual disease, food allergy experiences are significantly affected by socio-cultural structures, institutions, ideologies and discourses. The review concludes with four primary recommendations. First, there should be more incorporation of anthropological or sociological methodologies and perspectives into studies of food allergy. Second, studies are needed from more countries exploring lived experience of food allergy. Third, research on food allergy needs to incorporate an analysis of intersectional factors such as gender, class and race/ethnicity, and should explore the experiences of minority populations. Fourth, more research is needed on the interactions between biomedicine and local systems of knowledge, as well as the factors that shape what treatments become available, for whom it becomes available, experiences of treatment and aspects (including biases) that influence patient-clinician interactions.
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Affiliation(s)
- Emma E Cook
- Modern Japanese Studies, Hokkaido University, Sapporo, Japan
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36
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Nguyen TH, Cunha PP, Rowland AF, Orenstein E, Lee T, Kandaswamy S. User-Centered Design and Evaluation of Clinical Decision Support to Improve Early Peanut Introduction: Formative Study. JMIR Form Res 2023; 7:e47574. [PMID: 37606983 PMCID: PMC10481213 DOI: 10.2196/47574] [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: 03/24/2023] [Revised: 06/15/2023] [Accepted: 07/21/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Peanut allergy has recently become more prevalent. Peanut introduction recommendations have evolved from suggesting peanut avoidance until the age of 3 years to more recent guidelines encouraging early peanut introduction after the Learning Early about Peanut Allergy (LEAP) study in 2015. Guideline adherence is poor, leading to missed care opportunities. OBJECTIVE In this study, we aimed to develop a user-centered clinical decision support (CDS) tool to improve implementation of the most recent early peanut introduction guidelines in the primary care clinic setting. METHODS We edited the note template of the well-child check (WCC) visits at ages 4 and 6 months with CDS prompts and point-of-care education. Formative and summative usability testing were completed with pediatric residents in a simulated electronic health record (EHR). We estimated task completion rates and perceived usefulness of the CDS in summative testing, comparing a test EHR with and without the CDS. RESULTS Formative usability testing with the residents provided qualitative data that led to improvements in the build for both the 4-month and 6-month WCC note templates. During summative usability testing, the CDS tool significantly improved discussion of early peanut introduction at the 4-month WCC visit compared to scenarios without the CDS tool (9/15, 60% with CDS and 0/15, 0% without CDS). All providers except one at the 4-month WCC scenario gave at least an adequate score for the ease of use of the CDS tool for the history of present illness and assessment and plan sections. During the summative usability testing with the 6-month WCC new build note template, providers more commonly provided comprehensive care once obtaining a patient history concerning for an immunoglobulin E-mediated peanut reaction by placing a referral to allergy/immunology (P=.48), prescribing an epinephrine auto-injector (P=.07), instructing on how to avoid peanut products (P<.001), and providing an emergency treatment plan (P=.003) with CDS guidance. All providers gave at least an adequate score for ease of use of the CDS tool in the after-visit summary. CONCLUSIONS User-centered CDS improved application of early peanut introduction recommendations and comprehensive care for patients who have symptoms concerning for peanut allergy in a simulation.
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Affiliation(s)
- Thinh Hoang Nguyen
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
- Division of Immunology, Boston Children's Hospital, Boston, MA, United States
| | - Priscila Pereira Cunha
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
| | | | - Evan Orenstein
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
- Division of Hospital Medicine, Children's Healthcare of Atlanta, Atlanta, GA, United States
| | - Tricia Lee
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
- Department of Allergy and Immunology, Children's Healthcare of Atlanta, Atlanta, GA, United States
| | - Swaminathan Kandaswamy
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
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Rajput S, Vininski MS, Lehmann LA, Hobbs NJ, Dolence JJ. Androgen receptor signaling protects male mice from the development of immune response to peanut. AMERICAN JOURNAL OF CLINICAL AND EXPERIMENTAL IMMUNOLOGY 2023; 12:60-71. [PMID: 37736075 PMCID: PMC10509486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/09/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVES Peanut (PN) allergy is a major public health concern. Recent research has brought clarity about how individuals become sensitized to PN allergen with routes known through the skin, as well as the airway. Still unclear, however, is the role of sex hormones on the development of allergic immune responses to PN. This study examines the role of androgen receptor (AR) signaling in regulating PN-specific immune responses. METHODS We utilized a 4-week inhalation mouse model of PN allergy that is known to drive the production of PN-specific antibodies and elicit systemic anaphylaxis following PN challenge. Wildtype (WT) male, female, and androgen receptor-deficient testicular feminization mutant (ARTfm) male mice were examined using this model to document sex differences in PN allergy. To determine if sex differences also existed in the cellular immune response, this study utilized a 3-day inhalation mouse model of PN to examine the response of group 2 innate lymphoid cells (ILC2s). WT male and female mice were examined using this model to document sex differences in ILC2 response within the lungs. RESULTS AR use is critical in regulating PN-specific antibody levels. We found that ARTfm males have a higher antibody response and significantly worse anaphylactic response following PN challenge relative to WT males. WT males also exhibit a less severe anaphylactic response compared to ARTfm male and female mice. Lastly, we discovered that lung ILC2s from female mice respond more robustly to PN compared to ILC2s within WT male mice. CONCLUSIONS Taken together, this study suggests that male sex hormones, namely androgens, negatively regulate allergic immune responses to PN.
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Affiliation(s)
- Sunanda Rajput
- Department of Biology, University of Nebraska at Kearney Kearney, NE, USA
| | - McKenna S Vininski
- Department of Biology, University of Nebraska at Kearney Kearney, NE, USA
| | - Leigh-Anne Lehmann
- Department of Biology, University of Nebraska at Kearney Kearney, NE, USA
| | - Nicholas J Hobbs
- Department of Biology, University of Nebraska at Kearney Kearney, NE, USA
| | - Joseph J Dolence
- Department of Biology, University of Nebraska at Kearney Kearney, NE, USA
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Patel D, Munhoz J, Goruk S, Richard C, Field CJ. The Programming Effect of Plant-Based DHA, Along with Equivalent AA, on Immune System and Oral Tolerance Development in Six-Week Allergy Prone BALB/c Pups. J Nutr 2023; 153:2482-2496. [PMID: 37276938 DOI: 10.1016/j.tjnut.2023.06.002] [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: 12/19/2022] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Docosahexaenoic acid (DHA) and arachidonic acid (AA) on oral tolerance (OT) development in allergy-prone infants is less known. OBJECTIVES We aim to determine the effects of early life DHA supplementation (1% of total fat, from novel canola oil), along with AA, on OT toward ovalbumin (ova, egg protein) in allergy-prone BALB/c pups at 6-wk. METHODS Breastfeeding dams (n ≥ 10/diet) were fed DHA+AA (1% DHA, 1% AA wt/wt of total fat) or control (0% DHA, 0% AA) suckling period diet (SPD) during which pups consumed dam's milk. At 3-wk, pups from each SPD group were assigned to either the control or DHA+AA weaning diet. For OT, pups from each diet group were either orally fed ova or placebo daily from 21-25 d. Systemic immunization to ova was induced through intraperitoneal injections before euthanizing 6-wk pups. Ova-specific immunoglobulin (ova-Ig) and splenocytes ex-vivo cytokine response to different stimuli were analyzed using a 3-factor analysis of variance. RESULTS OT-induced suppression was seen in ova-stimulated splenocyte ex-vivo response, where ova-tolerized pups showed significantly lower total immunoglobulin (Ig)G, IgG1, interleukin (IL)-2 and IL-6 production than sucrose (placebo) pups. DHA+AA SPD was associated with 3 times lower plasma concentrations of ova-IgE (P = 0.03) than controls. DHA+AA weaning diet resulted in lower T helper type-2 cytokines (IL-4 and IL-6) with ova stimulation than controls, which may benefit OT. DHA+AA SPD resulted in significantly higher T cell cytokine response [IL-2, interferon-gamma, (IFNγ) and IL-1β] to anti-CD3/CD28 stimulation than controls. The splenocytes stimulated with lipopolysaccharide produced lower inflammatory cytokines (IFNγ, tumor necrosis factor-alpha, IL-6, and C-X-C motif ligand 1), which may be because of lower CD11b+CD68+ splenocytes proportion in pups from DHA+AA SPD than control (all P < 0.05). CONCLUSIONS DHA and AA in early life may influence OT in allergy-prone BALB/c mouse offspring, as they effectively promote T helper type-1 immune responses.
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Affiliation(s)
- Dhruvesh Patel
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Jaqueline Munhoz
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Susan Goruk
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Caroline Richard
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Catherine J Field
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.
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Stjerna ML, Brady G. Inter-embodied parental vigilance; the case of child food allergy. FRONTIERS IN SOCIOLOGY 2023; 8:1213769. [PMID: 37577126 PMCID: PMC10415010 DOI: 10.3389/fsoc.2023.1213769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/04/2023] [Indexed: 08/15/2023]
Abstract
There is developing interest in issues of embodiment in studies of children, health and illness. We take our point of departure in the parent-child-health/illness triad to explore the embodied aspects of parental vigilance in parenting children who have a food allergy, utilizing the concept of inter-embodiment. Drawing on a focus group study with parents in Sweden the analysis reveals that this vigilance can be seen as the embodied manifestation of concern for children's bodies in perpetual liminality, when constantly exposed to allergens and the risk of becoming ill. We argue that the lens of inter-embodiment, with a focus on bodies in relation, captures how parents lived experience of managing food allergy intertwines with that of their children in the parent-child-health/illness triad. The analysis uncovers a form of embodied knowledge that is often not verbalized, offering potential for new understandings of parent-child relations that center on chronic child health conditions.
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Affiliation(s)
- Marie-Louise Stjerna
- Department of Special Education, Faculty of Social Sciences, Stockholm University, Stockholm, Sweden
| | - Geraldine Brady
- Department of Social Work, Care and Community, School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
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Košćina S, Miletić Gospić A, Banić I, Sabljak D, Lipej M, Birkić T, Plavec D, Marjanović T, Sokolić D, Turkalj M. Protocol Development of a Personalized Balanced Nutrition Concept for Preschool Children, Primarily Those with Food Allergies, Using an IT Platform. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1367. [PMID: 37629657 PMCID: PMC10456309 DOI: 10.3390/medicina59081367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/12/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023]
Abstract
Children with food allergies are at higher risk for severe anaphylactic reactions and for key nutrient deficiency. In order to address these concerns, enable early detection, and improve the monitoring of children with food allergies, an innovative IT platform will be developed by IT experts (IN2 Ltd. Zagreb, Croatia, part of Constellation Software Inc. (Toronto, ON, Canada)) and Srebrnjak Children's Hospital, Zagreb, Croatia (SCH) for the effective implementation of personalized balanced nutrition in preschool institutions in Croatia. Additionally, the data obtained through this research, including epidemiological data on allergic diseases, clinical data (diagnostic allergy tests and others), anthropometry, and physical activity status, will be used to create a national Allergy registry. Other than being a tool for personalized and balanced nutrition for children, especially those with special dietary requirements (including food allergy and intolerance), the IT platform developed in this study will enable the continuous monitoring of these children as a part of their clinical management plan and earlier detection of food allergies, intolerance, and other conditions, even outside of the healthcare system. This research also aims at optimizing current and developing novel personalized therapeutic regimes, detecting novel early biomarkers in children with food allergies and intolerances, and involving all key stakeholders (caregivers, preschool institutions, etc.) in the shared-care approach in the management of food allergies in children.
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Affiliation(s)
- Siniša Košćina
- Healthcare and Public Sector, IN2 Group, HR-10000 Zagreb, Croatia
| | | | - Ivana Banić
- Department for Translational Medicine, Srebrnjak Children’s Hospital, HR-10000 Zagreb, Croatia
| | - Domagoj Sabljak
- Research Department, Srebrnjak Children’s Hospital, HR-10000 Zagreb, Croatia
| | - Marcel Lipej
- IT Department, Srebrnjak Children’s Hospital, HR-10000 Zagreb, Croatia;
| | - Tamara Birkić
- Healthcare and Public Sector, IN2 Group, HR-10000 Zagreb, Croatia
| | - Davor Plavec
- Department of Pediatrics, Faculty of Medicine, J.J. Strossmayer University of Osijek, HR-31000 Osijek, Croatia (M.T.)
| | | | - Darja Sokolić
- Croatian Agency for Agriculture and Food, HR-31000 Osijek, Croatia;
| | - Mirjana Turkalj
- Department of Pediatrics, Faculty of Medicine, J.J. Strossmayer University of Osijek, HR-31000 Osijek, Croatia (M.T.)
- School of Medicine, Catholic University of Croatia, HR-10000 Zagreb, Croatia
- Department for Allergology and Pulmonology, Srebrnjak Children’s Hospital, HR-10000 Zagreb, Croatia
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Santos MJL, Merrill KA, Ben-Shoshan M, Gerdts JD, Giesbrecht D, Lavine E, Prentice S, Upton J, Protudjer JLP. Food Allergy Education and Management in Early Learning and Childcare Centres: A Scoping Review on Current Practices and Gaps. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1175. [PMID: 37508672 PMCID: PMC10377763 DOI: 10.3390/children10071175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/05/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023]
Abstract
Anaphylaxis has occurred in preschools/schools yet there are no consistent food allergy (FA) management practices in early learning and childcare centres (ELCC) across jurisdictions. Presently, there are no reviews that have synthesized FA-related knowledge and management practices within ELCC. We aimed to perform a scoping review of FA management in ELCC, and report on perceived gaps or barriers. A PRISMA-ScR-guided search was conducted for North American, European and Australian articles in English/French in the OVID-MedLine, Scopus, and PsycInfo databases. Two independent reviewers screened the titles/abstracts of 2010 articles and full-text screened 77 articles; 15 of which were specifically related to ELCC. If the two reviewers could not agree to the relevance of a given study, a third reviewer provided guidance. This third reviewer also screened French articles. Thematic and descriptive reports of the studies were presented. We reported solely on pre-Coronavirus Disease pandemic ELCC studies. We included ten articles in this review, which provide evidence that ELCC staff have variable baseline knowledge, comprehension, experience, and practices in place to manage FA. ELCC staff also have limited FA-related training and experience regarding administration of epinephrine auto-injectors (EAI). Emergency Anaphylaxis Plans (EAP) were described in four studies. One study reported the parental influence on the site's food purchasing and FA management. Three studies provided educational interventions, which demonstrated increased and sustained FA-related knowledge and confidence post-intervention. Participants deemed the training beneficial and desired annual training and more FA resources to be available. Across jurisdictions, ELCC staff have provided care and administered EAI in emergencies, but training remained variable. Communication and care planning amongst ELCC staff, and parents, is crucial. Annual education, available EAI and EAPs are tools necessary for effectively managing emergencies.
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Affiliation(s)
- Mae Jhelene L Santos
- Department of Food and Human Nutritional Sciences, Faculty of Agriculture, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
- The Children's Hospital Research Institute of Manitoba, Winnipeg, MB R3E 3P4, Canada
| | - Kaitlyn A Merrill
- The Children's Hospital Research Institute of Manitoba, Winnipeg, MB R3E 3P4, Canada
- Department of Biochemistry, Faculty of Science, University of Winnipeg, Winnipeg, MB R3B 2E9, Canada
| | - Moshe Ben-Shoshan
- Division of Pediatric Allergy and Clinical Immunology, Department of Pediatrics, McGill University Health Center, Montreal, QC H4A 3J1, Canada
| | | | - Don Giesbrecht
- Canadian Child Care Federation, Ottawa, ON K1G 0Y9, Canada
| | - Elana Lavine
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, ON M5G 1X8, Canada
- Vaughn Pediatric Clinic, Woodbridge, Vaughan, ON L4L 8E2, Canada
| | - Susan Prentice
- Department of Sociology, Faculty of Arts, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Julia Upton
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, ON M5G 1X8, Canada
- Division of Immunology and Allergy, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Jennifer L P Protudjer
- Department of Food and Human Nutritional Sciences, Faculty of Agriculture, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
- The Children's Hospital Research Institute of Manitoba, Winnipeg, MB R3E 3P4, Canada
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3A 1S1, Canada
- George and Fay Yee Centre for Healthcare Innovation, Winnipeg, MB R3E 0T6, Canada
- Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
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Katidi A, Xanthopoulou S, Vlassopoulos A, Noutsos S, Priftis K, Kapsokefalou M. Food Allergens in Ultra-Processed Foods According to the NOVA Classification System: A Greek Branded Food Level Analysis. Nutrients 2023; 15:2767. [PMID: 37375674 DOI: 10.3390/nu15122767] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
Ultra-processed foods' (UPFs') consumption has been positively linked to the presence of allergic symptoms, but it is yet unknown whether this is linked to their nutritional composition or allergen load. This study used the ingredient lists available in the Greek Branded Food Composition Database, HelTH, to classify foods (n = 4587) into four grades of food processing (NOVA1-4) according to the NOVA System. Associations between NOVA grades and the presence of allergens (as an ingredient or trace) were studied. Overall, UPFs (NOVA4) were more likely to contain allergens than unprocessed foods, NOVA1 (76.1% vs. 58.0%). However, nested analyses among similar foods showed that in >90% of cases, processing degree was not linked to allergens' presence. Recipe/matrix complexity was more strongly linked to allergens' presence with NOVA4 foods declaring 1.3 allergenic ingredients vs. 0.4 allergenic ingredients in NOVA1 foods (p < 0.01). Exposure to trace allergens was more common for NOVA4 than NOVA1 foods (45.4% vs. 28.7%), but the extent of contamination was similar (2.3 vs. 2.8 trace allergens). Overall, UPFs are more complex mixtures with higher numbers of allergens per food and are more prone to cross-contamination. However, indicating a food's degree of processing is not sufficient to help identify allergen-free choices within the same subcategory.
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Affiliation(s)
- Alexandra Katidi
- Laboratory of Chemistry and Food Analysis, Department of Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece
| | - Stefania Xanthopoulou
- Laboratory of Chemistry and Food Analysis, Department of Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece
| | - Antonis Vlassopoulos
- Laboratory of Chemistry and Food Analysis, Department of Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece
| | - Stamoulis Noutsos
- Laboratory of Chemistry and Food Analysis, Department of Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece
| | - Kostas Priftis
- Allergology and Pulmonology Unit, 3rd Pediatric Department, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Maria Kapsokefalou
- Laboratory of Chemistry and Food Analysis, Department of Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece
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Lisik D, Ermis SSÖ, Ioannidou A, Milani GP, Nyassi S, Spolidoro GCI, Kankaanranta H, Goksör E, Wennergren G, Nwaru BI. Birth order, sibship size, and risk of atopic dermatitis, food allergy, and atopy: A systematic review and meta-analysis. Clin Transl Allergy 2023; 13:e12270. [PMID: 37357553 DOI: 10.1002/clt2.12270] [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: 03/20/2023] [Accepted: 05/31/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND Atopic dermatitis and food allergy are two frequently concomitant manifestations of the presence of atopy. A substantial number of studies have been published on the association of birth order and sibship size (number of siblings) with atopic dermatitis, food allergy, and atopy. The present work is the first systematic synthesis of the existing literature on this topic. METHODS Fifteen databases were searched. Screening, data extraction, and quality assessment were performed by independent pairs. Comparable numerical data were statistically synthesized using random-effects robust variance estimation. RESULTS In total, 114 studies were included out of 8819 papers obtained from database searches. Birth order ≥2 versus 1 was associated with lower risk of ever atopic dermatitis (pooled risk ratio [RR] 0.91, 95% CI 0.84-0.98), current food allergy (RR 0.77, 95% CI 0.66-0.90), and positive skin prick test (SPT) to common aeroallergens (RR 0.86, 95% CI 0.77-0.97). Sibship size ≥2 versus 1 was associated with decreased risk of current atopic dermatitis (RR 0.90, 95% CI 0.83-0.98), ever atopic dermatitis (RR 0.92, 95% CI 0.86-0.97), and positive SPT to common aeroallergens (RR 0.88, 95% CI 0.83-0.92). No putative associations were seen regarding atopy assessed through allergen-specific immunoglobulin E with common allergens. CONCLUSION The presence of siblings and being second-born or later may decrease the lifetime risk of atopic dermatitis and food allergy, albeit marginally. Similar association was seen with SPT sensitization. However, significant protection was not found for IgE sensitization.
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Affiliation(s)
- Daniil Lisik
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Saliha Selin Özuygur Ermis
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Athina Ioannidou
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Gregorio Paolo Milani
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Sungkutu Nyassi
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | | | - Hannu Kankaanranta
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Tampere University Respiratory Research Group, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Emma Goksör
- Department of Pediatrics, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Göran Wennergren
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Pediatrics, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Bright Ibeabughichi Nwaru
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
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Smith PK, Venter C, O’Mahony L, Canani RB, Lesslar OJL. Do advanced glycation end products contribute to food allergy? FRONTIERS IN ALLERGY 2023; 4:1148181. [PMID: 37081999 PMCID: PMC10111965 DOI: 10.3389/falgy.2023.1148181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/06/2023] [Indexed: 04/07/2023] Open
Abstract
Sugars can bind non-enzymatically to proteins, nucleic acids or lipids and form compounds called Advanced Glycation End Products (AGEs). Although AGEs can form in vivo, factors in the Western diet such as high amounts of added sugars, processing methods such as dehydration of proteins, high temperature sterilisation to extend shelf life, and cooking methods such as frying and microwaving (and reheating), can lead to inordinate levels of dietary AGEs. Dietary AGEs (dAGEs) have the capacity to bind to the Receptor for Advanced Glycation End Products (RAGE) which is part of the endogenous threat detection network. There are persuasive epidemiological and biochemical arguments that correlate the rise in food allergy in several Western countries with increases in dAGEs. The increased consumption of dAGEs is enmeshed in current theories of the aetiology of food allergy which will be discussed.
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Affiliation(s)
- P. K. Smith
- Clinical Medicine and Menzies School of Research, Griffith University, Gold Coast, QLD, Australia
- Correspondence: P. K. Smith
| | - C. Venter
- Children’s Hospital Colorado, University of Colorado, Aurora, CO, United States
| | - L. O’Mahony
- Department of Medicine, School of Microbiology, APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - R. Berni Canani
- Department of Translational Medical Science and ImmunoNutritionLab at CEINGE-Advanced Biotechnologies, University of Naples “Federico II”, Naples, Italy
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45
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Xi J, Li Y, Cheng H, Wang Y. Identification of allergenic epitopes destroyed by two processing technologies of glycinin A2 from soybean. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2023; 103:2700-2708. [PMID: 36335553 DOI: 10.1002/jsfa.12320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/25/2022] [Accepted: 11/06/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Glycinin is one of the most highly allergenic proteins in soybeans, and G2 is one of the five allergenic subunits of glycinin. Compared with the alkaline chain, the acidic chain A2 of the G2 subunit has strong allergenicity. However, the precise epitopes of A2 and the epitopes destroyed during processing are still unknown. RESULTS In the present study, preparation of two specific antibodies damaged by processing and phage display techniques were applied to locate the antigenic epitopes of glycinin A2 polypeptide chains disrupted by two processing techniques (thermal processing and ultra-high pressure combined thermal processing). Bioinformatics methods were used to predict the possible epitopes of the A2 chain. The A2 chain and its overlapping segments were introduced into T7 phages and expressed on phage shell by phage display. An indirect enzyme-linked immunosorbent assay was used to screen for antigenic epitopes that had been disrupted by the two processing technologies. The results showed that the dominant antigenic region disrupted by processing was located mainly in the A2-3-B fragment. The reacting experiment with the serum of allergic patients showed that the A2-3-B fragment protein was not only an antigenic region, but also an allergenic region. The two processing technologies destroyed the allergenic epitopes of A2 chain, thereby reducing the allergenicity of protein. The amino acids where the dominant allergenic region disrupted by processing was located were: 233 AIVTVKGGLRVTAPAMRKPQQEEDDDDEEEQPQCVE268 . CONCLUSION Precise epitopes of the acidic chain A2 in glycinin were identified and epitopes destroyed in two common processing methods were also obtained. The application products of rapid detection of de-allergenicity effect of processed food can be developed according to the location of processed destruction allergenic region, which is of great significance with respect to preventing the occurrence of soybean allergenic diseases. © 2022 Society of Chemical Industry.
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Affiliation(s)
- Jun Xi
- College of Food Science and Engineering, Henan University of Technology, Zhengzhou, China
| | - Yingying Li
- College of Food Science and Engineering, Henan University of Technology, Zhengzhou, China
| | - Huibin Cheng
- College of Food Science and Engineering, Henan University of Technology, Zhengzhou, China
| | - Yichao Wang
- College of Food Science and Engineering, Henan University of Technology, Zhengzhou, China
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Yamamoto-Hanada K, Sato M, Toyokuni K, Irahara M, Hiraide-Kotaki E, Harima-Mizusawa N, Morita H, Matsumoto K, Ohya Y. Combination of heat-killed Lactiplantibacillus plantarum YIT 0132 (LP0132) and oral immunotherapy in cow's milk allergy: a randomised controlled trial. Benef Microbes 2023; 14:17-30. [PMID: 36815492 DOI: 10.3920/bm2022.0064] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Safer and more effective cow milk (CM)-oral immunotherapy that does not induce allergic reactions has not yet been standardised. We sought to explore the efficacy and feasibility of a combination of heat-killed Lactiplantibacillus plantarum YIT 0132 (LP0132) and oral immunotherapy for treating IgE-mediated cow milk allergy (CMA). We conducted a 24-week, double-blind, randomised (1:1), two-arm, parallel-group, placebo-controlled, phase 2 trial of LP0132 intervention for treating IgE-mediated CMA in children aged 1-18 years (n=60) from January 29, 2018 to July 12, 2019 in Tokyo, Japan. Participants were randomly assigned to the LP0132 group receiving citrus juice fermented with LP0132 or to the control group receiving citrus juice without. Both groups received low-dose slow oral immunotherapy with CM. The primary outcome was improved tolerance to CM, proven by the CM challenge test at 24 weeks. Secondary outcomes were changes in serum biomarkers of serum-specific β-lactoglobulin-IgE (sIgE) and β-lactoglobulin-IgG4 (sIgG4). Exploratory outcomes included changes in serum cytokine levels and gut microbiota composition. A total of 61 participants were included. Finally, 31 children were assigned to the LP0132 group and 30 to the control group, respectively. After the intervention, 41.4 and 37.9% of the participants in the LP0132 and control groups, respectively, showed improved tolerance to CM. In serum biomarkers after the intervention, the sIgG4 level was significantly higher, and interleukin (IL)-5 and IL-9 were significantly lower, in the LP0132 group than in the control group. In the gut microbiome, the α-diversity and Lachnospiraceae increased significantly in the LP0132 group, and Lachnospiraceae after the intervention was significantly higher in the LP0132 group than in the control group. In conclusion, low-dose oral immunotherapy with modulating gut microbiota might be a safer and more effective approach for treating cow's milk allergy.
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Affiliation(s)
- K Yamamoto-Hanada
- Allergy Center, National Center for Child Health and Development, 2-10-1 Okura, 1578535 Tokyo, Japan
| | - M Sato
- Allergy Center, National Center for Child Health and Development, 2-10-1 Okura, 1578535 Tokyo, Japan
| | - K Toyokuni
- Allergy Center, National Center for Child Health and Development, 2-10-1 Okura, 1578535 Tokyo, Japan
| | - M Irahara
- Allergy Center, National Center for Child Health and Development, 2-10-1 Okura, 1578535 Tokyo, Japan
| | - E Hiraide-Kotaki
- Yakult Central Institute for Microbiological Research, 5-11 Izumi, Kunitachi, Tokyo 186-8650, Japan
| | - N Harima-Mizusawa
- Yakult Central Institute for Microbiological Research, 5-11 Izumi, Kunitachi, Tokyo 186-8650, Japan
| | - H Morita
- Department of Allergy and Clinical Immunology, National Research Institute for Child Health and Development, 2-10-1 Okura, 1578535 Tokyo, Japan
| | - K Matsumoto
- Department of Allergy and Clinical Immunology, National Research Institute for Child Health and Development, 2-10-1 Okura, 1578535 Tokyo, Japan
| | - Y Ohya
- Allergy Center, National Center for Child Health and Development, 2-10-1 Okura, 1578535 Tokyo, Japan
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Özdemir PG, Sato S, Yanagida N, Ebisawa M. Oral Immunotherapy in Food Allergy: Where Are We Now? ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2023; 15:125-144. [PMID: 37021501 PMCID: PMC10079524 DOI: 10.4168/aair.2023.15.2.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 03/01/2023] [Accepted: 03/14/2023] [Indexed: 04/07/2023]
Abstract
Food allergy (FA) has become more prevalent and problematic in the last 2 decades, and it poses important individual, social, and economic burdens. Besides treating reactions induced by accidental exposure and periodic evaluation for acquiring natural tolerance, the primary management approach is still allergen avoidance as a global standard. However, an active therapeutic approach that can raise the reaction threshold or accelerate tolerance is needed. This review aimed to provide an overview and the latest evidence of oral immunotherapy (OIT), which has recently been used in the active treatment of FA. FA immunotherapy, particularly OIT, is gaining considerable interest, and substantial effort has been made to integrate this active treatment into clinical practice. Consequently, growing evidence has been obtained regarding the efficacy and safety of OIT, particularly for allergens such as peanuts, eggs, and milk. However, several issues need to be addressed regarding the availability, safety, and long-term effects of this intervention. In this review, we summarize currently available information regarding tolerance-inducing immune mechanisms of OIT, data on efficacy and safety, gaps in current evidence, and ongoing research to develop new therapeutic molecules in order to enhance safety.
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Affiliation(s)
- Pınar Gökmirza Özdemir
- Department of Pediatric Allergy and Immunology, Trakya University School of Medicine, Edirne, Turkey
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Sakura Sato
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Noriyuki Yanagida
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Motohiro Ebisawa
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.
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Abstract
Food allergy is a growing health problem affecting both pediatric and adult patients. Food allergies are often immunoglobulin E (IgE) mediated but other food-induced non-IgE-mediated diseases exist. Diagnosis of food allergy relies on the combination of clinical and reaction history, skin and IgE testing as well as oral food challenges. Although oral immunotherapy has been able to achieve sustained unresponsiveness in some patients, no cure for food allergies has been found to date. Avoidance of the inciting food as well as availability of epinephrine autoinjectors remains the mainstay of treatment.
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Madooh L, Allahou S, Alshallal H, Alkazemi F, Alyaseen D, Allahow F, Alsattam S, Al-Majran A, Ziyab AH. Food allergy knowledge, attitudes and beliefs of kindergarten teachers in Kuwait: a cross-sectional study. BMJ Paediatr Open 2023; 7:10.1136/bmjpo-2022-001795. [PMID: 36882233 PMCID: PMC10008333 DOI: 10.1136/bmjpo-2022-001795] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/20/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Food allergy (FA) affects up to 10% of children globally, with clinical symptoms varying from mild to severe, and in rare instances, it is life-threatening. Approximately one in five children with FA experience a food-induced allergic reaction in school, leaving teachers as the first line of intervention. This study aimed to assess kindergarten teachers' knowledge, attitudes and beliefs regarding FA. METHODS This cross-sectional study enrolled kindergarten teachers in Kuwait using stratified cluster sampling. The Chicago Food Allergy Research Survey for the General Public was used to assess teachers' knowledge, attitudes and beliefs regarding FA. The overall FA knowledge score was calculated for each participant. The χ2 test was used to assess the differences in the distribution of categorical variables. RESULTS Responses were obtained from 882 public kindergarten teachers from 63 kindergartens. Most teachers (81.9%) encountered students with FA in their classrooms. Only 13.5% of the teachers reported receiving training in FA. Overall, participants scored an average of 52.2% on the FA knowledge assessment, with participants receiving prior training in FA scoring on average higher than those with no prior training in FA (55.9% vs 51.6%, p=0.005). A few teachers (10.7%) were aware that lactose intolerance was not equivalent to milk allergy. In terms of attitudes regarding FA, only 14.9% of the participants acknowledged that children with FA are teased/stigmatised due to their condition, and 33.7% recognised that avoidance of allergenic food is difficult. Moreover, only 9.9% of the teachers self-reported their ability to use an epinephrine autoinjector. CONCLUSIONS Improved knowledge and awareness of FA among public kindergarten teachers in Kuwait are needed to ensure the safety of children with FA in schools. Teachers should be trained to prevent, recognise and manage FA-related allergic reactions.
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Affiliation(s)
- Latifah Madooh
- Department of Community Medicine and Behavioral Sciences, Kuwait University, Kuwait, Kuwait
| | - Shaikhah Allahou
- Department of Community Medicine and Behavioral Sciences, Kuwait University, Kuwait, Kuwait
| | - Haya Alshallal
- Department of Community Medicine and Behavioral Sciences, Kuwait University, Kuwait, Kuwait
| | - Fatemah Alkazemi
- Department of Community Medicine and Behavioral Sciences, Kuwait University, Kuwait, Kuwait
| | - Dina Alyaseen
- Department of Community Medicine and Behavioral Sciences, Kuwait University, Kuwait, Kuwait
| | - Farah Allahow
- Department of Community Medicine and Behavioral Sciences, Kuwait University, Kuwait, Kuwait
| | - Shahad Alsattam
- Department of Community Medicine and Behavioral Sciences, Kuwait University, Kuwait, Kuwait
| | - Abdullah Al-Majran
- Department of Community Medicine and Behavioral Sciences, Kuwait University, Kuwait, Kuwait
| | - Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Kuwait University, Kuwait, Kuwait
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Prevalence of nut allergen sensitization among children in central Poland. Postepy Dermatol Alergol 2023; 40:40-46. [PMID: 36909898 PMCID: PMC9993204 DOI: 10.5114/ada.2022.124730] [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: 03/15/2022] [Accepted: 04/28/2022] [Indexed: 03/03/2023] Open
Abstract
Introduction The diagnostics of plant-derived food allergy may be challenging. However, the recognition of sensitization patterns in defined populations, especially in children, is clinically relevant as it enables the use of secondary prophylaxis to prevent life-threatening complications. Aim To investigate the rates and sensitization patterns to nut allergens in children from central Poland. Material and methods The retrospective assessment concerned data of 598 children diagnosed in a single centre due to suspected food allergy. The analysis included the results of component-based multiparametric assay Allergy Explorer2 (ALEX2). Results The sensitization to particular nut allergens varied among patients, depending on their age and nut type. The sensitization to any nut was found in 67% of children, whereas sensitization to hazelnut and peanut was the most common (56% and 55% of all children, respectively). Hazelnut sensitization was predominant in every age, and its prevalence increased with age, while peanut sensitization was detected in more than half of individuals from all groups, except for teenagers (44% of cases). Among hazelnut molecules sensitization to Cor a 1.04 was the most prevalent (74% of sensitized children), and for peanut allergens - Ara h 1 (65% of sensitized patients). The simultaneous sensitization to hazelnut, peanut and walnut (two or all of them) was found in almost half of the entire group. Conclusions Component-based diagnostics enables differentiation between primary and cross-reactive sensitization to nut allergens and detects co-sensitization. The clinical relevance of the latter observation is remarkable as co-sensitization increases the risk of life-threatening reactions even in trace nut contamination.
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