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Vassilopoulou E, Rallis D, Milani GP, Agostoni C, Feketea G, Lithoxopoulou M, Stefanaki E, Ladomenou F, Douladiris N, Cronin C, Popescu CA, Pop RM, Bocsan IC, Tsabouri S. Nurturing Infants to Prevent Atopic Dermatitis and Food Allergies: A Longitudinal Study. Nutrients 2023; 16:21. [PMID: 38201851 PMCID: PMC10780847 DOI: 10.3390/nu16010021] [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: 11/18/2023] [Revised: 12/14/2023] [Accepted: 12/16/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Atopic dermatitis (AD) at a young age often precedes the development of food allergies. Although AD affects millions of infants worldwide, prenatal and postnatal risk factors, and their association with the development of food allergies later on, are not fully elucidated. This study seeks to investigate AD epidemiology in infancy and its risk factors, examining early-life factors (both prenatal and postnatal) that could contribute to the later development of food allergies. METHODS Between January 2019 and December 2019, 501 infants were included in this prospective cohort study. Longitudinal data collection was performed through maternal interviews, the first one conducted within three days after the delivery and the second within 24 to 36 months after the delivery, encompassing variables such as demographics, family history of atopy, maternal smoking, antibiotic use during pregnancy, the mode of delivery, breastfeeding history, food practices, and greenness exposure within 3 days from delivery, while they were still in the hospital. RESULTS Maternal smoking during pregnancy (p = 0.001) and an older sibling atopy history (p = 0.03) was significantly linked to AD incidence. Cesarean section delivery (p = 0.04) was associated with a higher risk of food allergies in infants with AD. Having a garden at home correlated with a higher likelihood of AD (p = 0.01), and food elimination without medical guidance (p = 0.02) due to AD correlated with an elevated risk of food allergies. CONCLUSIONS Encouraging timely allergenic food introduction while promoting dietary diversity, rich in plant-based foods, maternal smoking cessation, and professional dietary guidance may help minimize AD and food allergy risk. Future studies should address the role of greenness in the development of AD and food allergies.
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Affiliation(s)
- Emilia Vassilopoulou
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.P.M.); (C.A.)
| | - Dimitrios Rallis
- Neonatal Intensive Care Unit, Faculty of Medicine, University of Ioannina, 45500 Ioannina, Greece; (D.R.); (S.T.)
| | - Gregorio Paolo Milani
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.P.M.); (C.A.)
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Carlo Agostoni
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.P.M.); (C.A.)
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Gavriela Feketea
- Department of Pharmacology, Toxicology and Clinical Pharmacology, University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania; (G.F.); (R.M.P.); (I.C.B.)
- Pediatric Allergy Outpatient Clinic, Department of Pediatrics, “Karamandaneio” Children’s Hospital of Patra, 26331 Patras, Greece
| | - Maria Lithoxopoulou
- 2nd Department of Neonatology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, “Papageorgiou” General Hospital of Thessaloniki, 56403 Thessaloniki, Greece;
| | - Evangelia Stefanaki
- Pediatric Allergy Outpatient Clinic, Department of Pediatrics, Venizeleion General Hospital of Heraklion, 71409 Heraklion, Greece;
| | - Fani Ladomenou
- Pediatric Infectious Unit, Department of Pediatrics, University Hospital of Ioannina, 45500 Ioannina, Greece;
| | - Nikolaos Douladiris
- Allergy Unit, 2nd Pediatric Clinic, University of Athens, 11527 Athens, Greece;
| | - Caoimhe Cronin
- Department of Paediatrics and Child Health, University College Cork, T12 K8AF Cork, Ireland;
| | - Codruta Alina Popescu
- Department of Abilities Human Sciences, Iuliu Hatieganu University of Medicine and Pharmacy, 40012 Cluj-Napoca, Romania;
| | - Raluca Maria Pop
- Department of Pharmacology, Toxicology and Clinical Pharmacology, University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania; (G.F.); (R.M.P.); (I.C.B.)
| | - Ioana Corina Bocsan
- Department of Pharmacology, Toxicology and Clinical Pharmacology, University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania; (G.F.); (R.M.P.); (I.C.B.)
| | - Sophia Tsabouri
- Neonatal Intensive Care Unit, Faculty of Medicine, University of Ioannina, 45500 Ioannina, Greece; (D.R.); (S.T.)
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2
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Shaw MA, Liu A. Nutritional Considerations for the First Year of Life. Pediatr Ann 2023; 52:e316-e321. [PMID: 37695279 DOI: 10.3928/19382359-20230720-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Feeding during the first year of life is a dynamic process with unique questions, concerns, and milestones emerging at every step. This article will review a small selection of specific questions and concerns related to feeding in the first 12 months of infancy. The aim of this article is to inform and support pediatric providers and parents during this crucial developmental period. [Pediatr Ann. 2023;52(9):e316-e321.].
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3
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Lander J, Bitzer EM, von Sommoggy J, Pawellek M, Altawil H, John C, Apfelbacher C, Dierks ML. How do parents access, appraise, and apply health information on early childhood allergy prevention? A focus group and interview study. Front Public Health 2023; 11:1123107. [PMID: 37139377 PMCID: PMC10149846 DOI: 10.3389/fpubh.2023.1123107] [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: 01/23/2023] [Accepted: 03/31/2023] [Indexed: 05/05/2023] Open
Abstract
Background When parents want to make health-related decisions for their child, they need to be able to handle health information from a potentially endless range of sources. Early childhood allergy prevention (ECAP) is a good example: recommendations have shifted from allergen avoidance to early introduction of allergenic foods. We investigated how parents of children under 3 years old access, appraise and apply health information about ECAP, and their respective needs and preferences. Methods We conducted 23 focus groups and 24 interviews with 114 parents of children with varied risk for allergies. The recruitment strategy and a topic guide were co-designed with the target group and professionals from public health, education, and medicine. Data were mostly collected via video calls, recorded and then transcribed verbatim. Content analysis according to Kuckartz was performed using MAXQDA and findings are presented as a descriptive overview. Results Parents most frequently referred to family members, friends, and other parents as sources of ECAP information, as well as healthcare professionals (HCPs), particularly pediatricians. Parents said that they exchanged experiences and practices with their peers, while relying on HCPs for guidance on decision-making. When searching for information online, they infrequently recalled the sources used and were rarely aware of providers of "good" health information. While parents often reported trying to identify the authors of information to appraise its reliability, they said they did not undertake more comprehensive information quality checks. The choice and presentation of ECAP information was frequently criticized by all parent groups; in particular, parents of at-risk children or with a manifested allergy were often dissatisfied with HCP consultations, and hence did not straightforwardly apply advice. Though many trusted their HCPs, parents often reported taking preventive measures based on their own intuition. Conclusion One suggestion to react upon the many criticisms expressed by parents regarding who and how provides ECAP information is to integrate central ECAP recommendations into regular child care counseling by HCPs-provided that feasible ways for doing so are identified. This would assist disease prevention, as parents without specific concerns are often unaware of the ECAP dimension of issues such as nutrition.
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Affiliation(s)
- Jonas Lander
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School (MHH), Hannover, Germany
| | - Eva Maria Bitzer
- Department of Public Health and Health Education, University of Education Freiburg, Freiburg, Germany
| | - Julia von Sommoggy
- Medical Sociology, Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Maja Pawellek
- University Children's Hospital Regensburg (KUNO), University of Regensburg, Regensburg, Germany
| | - Hala Altawil
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School (MHH), Hannover, Germany
| | - Cosima John
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School (MHH), Hannover, Germany
| | - Christian Apfelbacher
- Institute for Social Medicine and Health Systems Research, Otto von Guericke University, Magdeburg, Germany
| | - Marie-Luise Dierks
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School (MHH), Hannover, Germany
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4
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Simultaneous quantification of six major allergens in commercial foods for children using a multiplex array on a digital versatile disc. Food Chem 2023; 404:134570. [DOI: 10.1016/j.foodchem.2022.134570] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/22/2022] [Accepted: 10/08/2022] [Indexed: 11/06/2022]
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5
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Muacevic A, Adler JR. Relationship Between Atopic Dermatitis and Food Allergy in Children. Cureus 2022; 14:e33160. [PMID: 36726939 PMCID: PMC9886409 DOI: 10.7759/cureus.33160] [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: 10/06/2022] [Accepted: 12/30/2022] [Indexed: 01/01/2023] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin condition characterized by a compromised skin barrier due to a variety of reasons, such as hereditary predisposition, immunological overactivity, and skin microbiome disruption. There is strong evidence linking food allergies (FA) with AD in some children, and many children with AD develop asymptomatic food sensitivity. FA and AD are two frequent childhood illnesses that are closely related. Food allergies affect 30% of kids suffering from moderate and severe eczema and can cause a variety of symptoms, including dry, cracked skin, rash, itchiness, oozing, and crusted skin. While preteens and teens with AD are commonly sensitive to environmental allergens including house dust mites, mold, pollen, or dander of animals, younger kids with AD typically exhibit sensitivity to food items like peanuts, milk, or eggs. A food challenge test (FC) should be used to confirm allergies before recommending a stringent diet that could be hazardous to the patient. While elimination diets continue to be the cornerstone of the management of FA, they should only be carried out under the guidance of a specialist. Topical treatments are crucial for all individuals with AD. Early skin care with emollients, topical steroid treatment, and early introduction of highly allergenic foods are promising methods of alleviating symptoms of AD.
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6
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Bhat R. Emerging trends and sustainability challenges in the global agri-food sector. FUTURE FOODS 2022. [DOI: 10.1016/b978-0-323-91001-9.00041-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Čelakovská J, Čermákova E, Vaňková R, Andrýs C, Krejsek J. ALEX2 multiplex examination – results of specific IgE to fish and shrimps in patients suffering from atopic dermatitis. FOOD AGR IMMUNOL 2021. [DOI: 10.1080/09540105.2021.2005546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- J. Čelakovská
- Department of Dermatology and Venereology Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - E. Čermákova
- Department of Medical Biophysic, Medical Faculty of Charles University, Hradec Králové, Czech republic
| | - R. Vaňková
- Department of Clinical Immunology and Allergy, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - C. Andrýs
- Department of Clinical Immunology and Allergy, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - J. Krejsek
- Department of Clinical Immunology and Allergy, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
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8
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Gastric Enzyme Supplementation Inhibits Food Allergy in a BALB/c Mouse Model. Nutrients 2021; 13:nu13030738. [PMID: 33652629 PMCID: PMC7996948 DOI: 10.3390/nu13030738] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/08/2021] [Accepted: 02/22/2021] [Indexed: 02/07/2023] Open
Abstract
Impaired gastric digestion due to suppressed gastric acidity enhances the risk for food allergy development. In the current study, we aimed to evaluate the impact of a supported gastric digestion via application of a pharmaceutical gastric enzyme solution (GES) on food allergy development and allergic reactions in a BALB/c mouse model. The ability of the GES to restore hypoacidic conditions was tested in mice treated with gastric acid suppression medication. To evaluate the impact on allergic symptoms, mice were orally sensitized with ovalbumin (OVA) under gastric acid suppression and subjected to oral challenges with or without GES. The immune response was evaluated by measurement of antibody titers, cytokine levels, mucosal allergy effector cell influx and regulatory T-cell counts. Clinical response was objectified by core body temperature measurements after oral OVA challenge. Supplementation of GES transiently restored physiological pH levels in the stomach after pharmaceutical gastric acid suppression. During oral sensitization, supplementation of gastric enzymes significantly reduced systemic IgE, IgG1 and IgG2a levels and allergic symptoms. In food allergic mice, clinical symptoms were reduced by co-administration of the gastric enzyme solution. Support of gastric digestion efficiently prevents food allergy induction and alleviates clinical symptoms in our food allergy model.
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9
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Knoop KA, McDonald KG, Coughlin PE, Kulkarni DH, Gustafsson JK, Rusconi B, John V, Ndao IM, Beigelman A, Good M, Warner BB, Elson CO, Hsieh CS, Hogan SP, Tarr PI, Newberry RD. Synchronization of mothers and offspring promotes tolerance and limits allergy. JCI Insight 2020; 5:137943. [PMID: 32759496 DOI: 10.1172/jci.insight.137943] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 06/24/2020] [Indexed: 12/24/2022] Open
Abstract
Allergic disorders, characterized by Th2 immune responses to environmental substances, are increasingly common in children in Western societies. Multiple studies indicate that breastfeeding, early complementary introduction of food allergens, and antibiotic avoidance in the first year of life reduces allergic outcomes in at-risk children. Why the benefit of these practices is restricted to early life is largely unknown. We identified a preweaning interval during which dietary antigens are assimilated by the colonic immune system. This interval is under maternal control via temporal changes in breast milk, coincides with an influx of naive T cells into the colon, and is followed by the development of a long-lived population of colonic peripherally derived Tregs (pTregs) that can be specific for dietary antigens encountered during this interval. Desynchronization of mothers and offspring produced durable deficits in these pTregs, impaired tolerance to dietary antigens introduced during and after this preweaning interval, and resulted in spontaneous Th2 responses. These effects could be rescued by pTregs from the periweaning colon or by Tregs generated in vitro using periweaning colonic antigen-presenting cells. These findings demonstrate that mothers and their offspring are synchronized for the development of a balanced immune system.
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Affiliation(s)
| | | | | | | | | | - Brigida Rusconi
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | | | - I Malick Ndao
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Avraham Beigelman
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA.,The Kipper Institute of Allergy and Immunology, Schneider Children's Medical Center of Israel, Tel Aviv University, Israel
| | - Misty Good
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Barbara B Warner
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Charles O Elson
- Department of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Simon P Hogan
- Mary H. Weiser Food Allergy Center, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Phillip I Tarr
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri, USA
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10
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Abrams EM, Simons E, Gerdts J, Nazarko O, Povolo B, Protudjer JLP. "I want to really crack this nut": an analysis of parent-perceived policy needs surrounding food allergy. BMC Public Health 2020; 20:1194. [PMID: 32738893 PMCID: PMC7395383 DOI: 10.1186/s12889-020-09309-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 07/28/2020] [Indexed: 11/13/2022] Open
Abstract
Background In Canada, anaphylaxis-level food allergy constitutes a legal disability. Yet, no nationwide policies exist to support families. We sought to understand what parents of children with food allergy perceive as the most pressing food allergy-related policy concerns in Canada. Methods Between March–June 2019, we interviewed 23 families whose food allergic children (N = 28mean age 7.9 years) attending an allergy clinic in Winnipeg, Canada. Interviews were audio-recorded, transcribed and analyzed using content analysis. Results Over 40% of children had multiple food allergies, representing most of Health Canada’s priority allergens. We identified four themes: (1) High prevalence. High priority?. (2) Food labels can be misleading, (3) Costs and creative ideas, and (4) Do we have to just deal with the status quo around allergies? Conclusion Food allergy ought to be a national policy priority, to improve the process for precautionary labelling, to improve funding, educational tools access to care, and knowledge of current allergy guidelines.
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Affiliation(s)
- Elissa M Abrams
- Section of Allergy and Immunology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Elinor Simons
- Section of Allergy and Immunology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | | | - Orla Nazarko
- Participant Advisory Committee to J Protudjer, Winnipeg, MB, Canada
| | - Beatrice Povolo
- Advocacy and Media Relations, Food Allergy Canada, Toronto, ON, Canada
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11
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Čelakovská J, Josef B, Vaneckova J, Krcmova I, Komorousová M, Cetkovská P, Vankova R, Krejsek J. Food Hypersensitivity Reactions to Seafish in Atopic Dermatitis Patients Older than 14 Year of Age - The Evaluation of Association with Other Allergic Diseases and Parameters. Indian J Dermatol 2020; 65:97-104. [PMID: 32180594 PMCID: PMC7059474 DOI: 10.4103/ijd.ijd_403_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Seafood allergy is among one of the common food allergies. Decrease in consumption of omega-3 polyunsaturated fatty acids (PUFAs), prevalent especially in oily fish, has been proposed to contribute to the increased prevalence of allergic diseases. Aim The aim of this study was to evaluate, in atopic dermatitis (AD) patients, the relation between the occurrence of food hypersensitivity reaction (FHR) to seafish and the occurrence of other atopic diseases and parameters. Methods Complete dermatological and allergological examination was performed in patients included in the study; 332 patients were examined, with the average age 26.8 years (SD 9.2 years). Results The FHR to seafish was confirmed in 11% of patients. Patients suffering from FHR to seafish suffered significantly more from sensitization to fungi (in 46%), from reactions to celery (in 34%), and from persistent eczematic lesions (in 82%). Conclusion FHRs to seafish in AD patients are associated with persistent eczematic lesions and with the higher occurrence of sensitization to fungi and reactions to celery. The occurrence of bronchial asthma, rhinitis, positive family history, and onset of AD under 5 years of age is higher in patients with reactions to seafish, but the difference is not statistically significant.
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Affiliation(s)
- Jarmila Čelakovská
- Department of Dermatology and Venereology, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - Bukač Josef
- Medical Biophysic, Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - Jaroslava Vaneckova
- Department of Dermatology and Venereology, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - Irena Krcmova
- Clinical Immunology and Allergy, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - Michaela Komorousová
- Department of Dermatovenereology, Faculty of Medicine in Pilsen, Charles University, Czech Republic
| | - Petra Cetkovská
- Department of Dermatovenereology, Faculty of Medicine in Pilsen, Charles University, Czech Republic
| | - Radka Vankova
- Clinical Immunology and Allergy, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - Jan Krejsek
- Clinical Immunology and Allergy, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
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12
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Costa C, Coimbra A, Vítor A, Aguiar R, Ferreira AL, Todo-Bom A. Food allergy-From food avoidance to active treatment. Scand J Immunol 2019; 91:e12824. [PMID: 31486118 DOI: 10.1111/sji.12824] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 07/14/2019] [Accepted: 08/29/2019] [Indexed: 12/31/2022]
Abstract
The prevalence of food allergy (FA) has increased too rapidly, possibly due to environmental factors. The guidelines recommend strict allergen avoidance, but FA is still the main cause of anaphylaxis in all age groups. Immunotherapy is the only treatment able to change the course of allergic disease, and oral immunotherapy (OIT) is the more effective route in FA. However, it carries the risk of adverse reactions, including anaphylaxis. To improve OIT safety, adjuvant therapy with the immunoglobulin E (IgE) monoclonal antibody omalizumab has been extensively used. Results suggest particular benefit in patients with high risk of fatal anaphylaxis. An alternative approach is to use omalizumab instead of OIT to prevent severe allergic reactions upon accidental exposure. This paper reviews current evidence regarding IgE-mediated FA, focusing on natural tolerance and food sensitization acquisition, and on avoidance measures and their limitations.
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Affiliation(s)
- Célia Costa
- Immunoallergology Department, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte (CHLN), EPE, Lisbon, Portugal
| | - Alice Coimbra
- Immunoallergology Department, Hospital de S. João EPE, Centro Hospitalar de São João (CHSJ), Porto, Portugal
| | - Artur Vítor
- Pediatrics Department, Hospital de S. João EPE, Centro Hospitalar de São João (CHSJ), Porto, Portugal
| | - Rita Aguiar
- Immunoallergology Department, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte (CHLN), EPE, Lisbon, Portugal
| | - Ana Luísa Ferreira
- Immunoallergology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho (CHVNGE), Vila Nova de Gaia, Portugal
| | - Ana Todo-Bom
- Immunoallergology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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13
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Mathias JG, Zhang H, Soto-Ramirez N, Karmaus W. The association of infant feeding patterns with food allergy symptoms and food allergy in early childhood. Int Breastfeed J 2019; 14:43. [PMID: 31666803 PMCID: PMC6813109 DOI: 10.1186/s13006-019-0241-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 10/10/2019] [Indexed: 12/12/2022] Open
Abstract
Background The role of infant feeding for food allergy in children is unclear and studies have not addressed simultaneous exposures to different foods. The goal of this study was to analyze existing data on feeding practices that represent realistic exposure and assess the risk of food allergy symptoms and food allergy in children. Methods The Infant Feeding Practices Study II conducted by the CDC and US-FDA enrolled pregnant women and collected infant feeding information using nine repeated surveys. Participants were re-contacted after 6 years. Food allergy data were collected at 4, 9, 12, and 72 months. In total, 1387 participants had complete infant feeding pattern data for 6 months and information on food allergy symptoms and doctors’ diagnosed food allergy. Feeding patterns constituted six groups: 3-months of feeding at breast followed by mixed feeding, 3-months of breast milk and bottled milk followed by mixed feeding, 1-month of feeding at breast followed by mixed feeding, 6-months of mixed feeding i.e., concurrent feeding of breast milk, bottled milk and formula, 2–3 months of formula followed by formula and solid food, and formula and solid food since the first month. To estimate risks of food allergy, we used linear mixed models, controlling for potential confounders. Results Of the 328 children with food allergy symptoms in infancy and at 6 years, 52 had persistent symptoms from infancy. Children exposed to mixed feeding had a higher risk of food allergy symptoms (Risk Ratio [RR] 1.54; 95% Confidence Interval [CI] 1.04, 2.29) compared to 3-months of feeding at breast adjusted for confounding. No statistically significant risk of infant feeding patterns was found for doctors’ diagnosed food allergy. Paternal allergy posed a higher risk for food allergy symptoms (RR 1.36; 95% CI 1.01, 1.83). Prenatal maternal smoking increased the risk for doctors’ diagnosed food allergy (RR 2.97; 95% CI 1.53, 5.79). Conclusions Analysis of this prospective birth cohort suggest that introduction of multiple feeding source may lead to food allergy symptoms. Future efforts are needed to determine acceptable approaches to improve the ascertainment of food allergy in children and the role of infant feeding.
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Affiliation(s)
- Joacy G Mathias
- 1Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, The University of Memphis, Memphis, TN USA
| | - Hongmei Zhang
- 1Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, The University of Memphis, Memphis, TN USA
| | | | - Wilfried Karmaus
- 1Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, The University of Memphis, Memphis, TN USA
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14
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Čelakovská J, Bukač J, Ettler K, Vaneckova J, Ettlerova K. Allergy to Peanuts in Atopic Dermatitis Patients 14 Year or Older and the Association with Food Hypersensitivity, Inhalant Allergens, Asthma Bronchiale and Rhinitis. Indian J Dermatol 2018; 63:317-322. [PMID: 30078876 PMCID: PMC6052752 DOI: 10.4103/ijd.ijd_576_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND In adult patients suffering from atopic dermatitis (AD), studies investigating the co-prevalence of AD and food allergy are still scarce, and exact data are not available. AIMS AND OBJECTIVES To evaluate the occurrence of food allergy to peanuts in significant relation to food hypersensitivity, inhalant allergy and to asthma bronchial and rhinitis. MATERIALS AND METHODS Altogether 332 patients of AD 14 year or older were included in the study. The complete dermatological and allergological examinations were performed in all included patients (including examination of specific immunoglobulin E, skin prick test to different food and inhalant allergens, anamnestic data about food reactions, evaluation of allergic rhinitis, and allergic asthma bronchiale). We evaluated whether there was some relation between the food allergy to peanuts and followed parameters. Pairs of these categories were entered in the contingency tables, and the Chi-square test for the relationship of these variables was performed with the level of significance set to 5%. RESULTS Altogether 332 persons suffering from AD were included in the study of which 120 were male and 212 were female; the average age was 27.2 year. The significant relation between the allergy to peanuts and the occurrence of food hypersensitivity (FH) reactions to tomatoes, kiwi, apples, oranges, carrot and to the sensitization to grass, trees, mites, and the occurrence of rhinitis was found. CONCLUSION The significant relation between the allergy to peanuts and the occurrence of FH reactions and the sensitization to inhalant allergens and rhinitis was found. The future studies may show if the decrease in food allergy to peanuts can lead to the decrease of the occurrence of other FH reactions and sensitization to inhalant allergens and rhinitis in AD patients.
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Affiliation(s)
- Jarmila Čelakovská
- From the Department of Dermatology and Venereology, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - Josef Bukač
- Department of Medical Biophysics, Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - Karel Ettler
- From the Department of Dermatology and Venereology, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - Jaroslava Vaneckova
- From the Department of Dermatology and Venereology, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - Kvetuse Ettlerova
- Department of Allergy and Clinical Immunology, Outpatient Clinic, Hradec Králové, Czech Republic
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15
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Azad MB, Vehling L, Lu Z, Dai D, Subbarao P, Becker AB, Mandhane PJ, Turvey SE, Lefebvre DL, Sears MR. Breastfeeding, maternal asthma and wheezing in the first year of life: a longitudinal birth cohort study. Eur Respir J 2017; 49:49/5/1602019. [PMID: 28461293 DOI: 10.1183/13993003.02019-2016] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 12/19/2016] [Indexed: 01/08/2023]
Abstract
The impact of breastfeeding on respiratory health is uncertain, particularly when the mother has asthma. We examined the association of breastfeeding and wheezing in the first year of life.We studied 2773 infants from the Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort. Caregivers reported on infant feeding and wheezing episodes at 3, 6 and 12 months. Breastfeeding was classified as exclusive, partial (supplemented with formula or complementary foods) or none.Overall, 21% of mothers had asthma, 46% breastfed for at least 12 months and 21% of infants experienced wheezing. Among mothers with asthma, breastfeeding was inversely associated with infant wheezing, independent of maternal smoking, education and other risk factors (adjusted rate ratio (aRR) 0.52; 95% CI 0.35-0.77 for ≥12 versus <6 months breastfeeding). Compared with no breastfeeding at 6 months, wheezing was reduced by 62% with exclusive breastfeeding (aRR 0.38; 95% CI 0.20-0.71) and by 37% with partial breastfeeding supplemented with complementary foods (aRR 0.63; 95% CI 0.43-0.93); however, breastfeeding was not significantly protective when supplemented with formula (aRR 0.89; 95% CI 0.61-1.30). Associations were not significant in the absence of maternal asthma (p-value for interaction <0.01).Breastfeeding appears to confer protection against wheezing in a dose-dependent manner among infants born to mothers with asthma.
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Affiliation(s)
- Meghan B Azad
- Dept of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada .,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Lorena Vehling
- Dept of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.,Dept of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Zihang Lu
- Dept of Pediatrics and Physiology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - David Dai
- Dept of Medicine, McMaster University, Hamilton, ON, Canada
| | - Padmaja Subbarao
- Dept of Pediatrics and Physiology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Allan B Becker
- Dept of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | | | - Stuart E Turvey
- Dept of Pediatrics, Child and Family Research Institute and BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada
| | | | - Malcolm R Sears
- Dept of Medicine, McMaster University, Hamilton, ON, Canada.,Canadian Healthy Infant Longitudinal Development Study (investigators listed in acknowledgements)
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16
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Venter C, Maslin K, Dean T, Arshad SH. Does concurrent breastfeeding alongside the introduction of solid food prevent the development of food allergy? J Nutr Sci 2016; 5:e40. [PMID: 27752307 PMCID: PMC5048184 DOI: 10.1017/jns.2016.31] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 06/21/2016] [Accepted: 07/20/2016] [Indexed: 11/21/2022] Open
Abstract
The timing of introduction of solid food on the subsequent development of food allergy is under debate and the role of concurrent breastfeeding is unclear. The aim of the present study was to investigate the role of solid food introduction whilst concurrently breastfeeding on food allergy outcome, with a specific focus on cows' milk allergy. Prospectively collected infant feeding data from a birth cohort were analysed. Participants with histories suggestive of food allergy underwent diagnostic food challenges. Children with food allergy were matched to control participants for age and sex. Mann-Whitney U tests, χ2, Fisher exact tests and logistic regression calculations were undertaken. A total of thirty-nine food-allergic children and seventy-eight matched controls were identified, including twenty-two cows' milk-allergic children and forty-four matched controls. The control group introduced solid food earlier than the food-allergic group (P < 0·05). There was no effect of concurrent breastfeeding alongside cows' milk introduction or other food allergens on the development of food allergy. Due to small numbers, it was not possible to explore differences for food allergy phenotype. We have therefore found no evidence that introducing solids, or food allergens, whilst breastfeeding has an allergy-preventative effect; however, the results should be interpreted with caution due to sample size. Recommendations regarding infant feeding and food allergy should be carefully considered. Although breastfeeding should be promoted for many health reasons, larger studies looking at the introduction of food allergens on the development of food allergy are needed to make a final conclusion.
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Affiliation(s)
- Carina Venter
- School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK
- David Hide Asthma and Allergy Research Centre, Newport, Isle of Wight, UK
| | - Kate Maslin
- School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK
- David Hide Asthma and Allergy Research Centre, Newport, Isle of Wight, UK
| | - Taraneh Dean
- School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK
- David Hide Asthma and Allergy Research Centre, Newport, Isle of Wight, UK
| | - Syed Hasan Arshad
- David Hide Asthma and Allergy Research Centre, Newport, Isle of Wight, UK
- Clinical and Experimental Sciences, University of Southampton, Southampton, UK
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17
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Comerford KB, Ayoob KT, Murray RD, Atkinson SA. The Role of Avocados in Complementary and Transitional Feeding. Nutrients 2016; 8:E316. [PMID: 27213450 PMCID: PMC4882728 DOI: 10.3390/nu8050316] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 03/17/2016] [Accepted: 03/29/2016] [Indexed: 12/11/2022] Open
Abstract
Infant dietary patterns tend to be insufficient sources of fruits, vegetables, and fiber, as well as excessive in salt, added sugars, and overall energy. Despite the serious long-term health risks associated with suboptimal fruit and vegetable intake, a large percentage of infants and toddlers in the U.S. do not consume any fruits or vegetables on a daily basis. Since not all fruits and vegetables are nutritionally similar, guidance on the optimal selection of fruits and vegetables should emphasize those with the greatest potential for nutrition and health benefits. A challenge is that the most popularly consumed fruits for this age group (i.e., apples, pears, bananas, grapes, strawberries) do not closely fit the current general recommendations since they tend to be overly sweet and/or high in sugar. Unsaturated oil-containing fruits such as avocados are nutritionally unique among fruits in that they are lower in sugar and higher in fiber and monounsaturated fatty acids than most other fruits, and they also have the proper consistency and texture for first foods with a neutral flavor spectrum. Taken together, avocados show promise for helping to meet the dietary needs of infants and toddlers, and should be considered for inclusion in future dietary recommendations for complementary and transitional feeding.
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Affiliation(s)
- Kevin B Comerford
- Department of Nutrition, University of California at Davis, Davis, CA 95616, USA.
| | - Keith T Ayoob
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
| | - Robert D Murray
- Department of Human Sciences, The Ohio State University, Columbus, OH 43210, USA.
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