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Baghlaf MA, Eid NM, Enani S, Kokandi S, Alhussaini B, Waked MS. Prevalence and Risk Factors for IgE and IgG Cow's Milk Protein Allergies in Saudi Arabia. Cureus 2023; 15:e50812. [PMID: 38125695 PMCID: PMC10730981 DOI: 10.7759/cureus.50812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 12/23/2023] Open
Abstract
Cow's milk protein allergies (CMPAs) particularly occur in infancy and early childhood due to an immunological allergic reaction to milk proteins. This issue is increasing in Saudi Arabia and requires research to improve health status and provide alternatives. Our study aims to investigate the important aspects of immunoglobulin E (IgE) and IgG CMPA in Saudi Arabia regarding its prevalence and association with demographic and health-related factors in both adult and pediatric populations. A descriptive retrospective cross-sectional study was conducted on 376 patients, comprising 314 adults aged between 19 and 86 years, and 62 pediatric patients aged between one and 12 years. The study focused on individuals who attended a private medical center in Jeddah city over the past five years. Laboratory results for food allergy of IgE and IgG tests, including cow's milk proteins (CMPs), serum 25-hydroxyvitamin D (25OHD), specific IgE inhalant allergy results, and other health-related factors were collected from an electronic record system. Results have shown that casein was the most common sensitizing allergen of CMPs in adults, whereas α-lactalbumin was the most common sensitizing allergen in pediatrics. The most frequent sensitizing allergen in IgG CMP was cow's milk in 54/92 (58.7%) adults, followed by cow's sour milk products 41 (44.6%). Cow's milk was the most common sensitizing allergen in 20/20 (100%) children. The rate of CMPA was significantly higher in children younger than five years old (P =0.003), while children who interacted with pets had a marginal significantly reduced rate (P = 0.054). Thus, cow's milk is the most sensitizing allergen in IgG CMPs in adults and pediatrics.
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Affiliation(s)
- Mashail A Baghlaf
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, SAU
| | - Noura M Eid
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, SAU
- King Fahd Center for Medical Research, King Abdulaziz University, Jeddah, SAU
| | - Sumia Enani
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, SAU
- Food, Nutrition, and Lifestyle Unit, King Fahd Center for Medical Research, King Abdulaziz University, Jeddah, SAU
| | - Samia Kokandi
- Department of Nutrition, International Medical Center, Jeddah, SAU
| | - Bakr Alhussaini
- Department of Pediatric Gastroenterology, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
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Zhu T, Yang S, Mauro TM, Man MQ. Association of Epidermal Biophysical Properties with Obesity and Its Implications. Skin Pharmacol Physiol 2023; 36:165-173. [PMID: 37640014 DOI: 10.1159/000533587] [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: 06/26/2023] [Accepted: 08/04/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Obesity is a condition defined by an excess amount of body fat, with body mass index (BMI) of 30 and higher. It is associated with a number of other medical conditions, including insulin resistance, diabetes mellitus, and cardiovascular diseases, as well as dyslipidemia, and it is also associated with several cutaneous disorders such as atopic dermatitis, psoriasis, intertriginous dermatitis, acanthosis nigricans and skin infections. SUMMARY Evidence suggests a link between obesity and epidermal dysfunction. Generally, individuals with obesity display higher transepidermal water loss rate and lower stratum corneum hydration levels, although no association of obesity with epidermal dysfunction has been documented. Results of skin surface pH are controversial. But study demonstrated a positive correlation of BMI with skin surface pH on both the forearm and the shin in males, suggesting that the changes in epidermal function vary with gender in individuals with obesity. KEY MESSAGES This review summarizes the association between obesity and epidermal function, and discusses possible underlying mechanisms. Individuals with obesity exhibit poor epidermal permeability barrier and lower stratum corneum hydration levels. Because of the pathogenic role of compromised epidermal function in inflammation, which is also linked to obesity, improvement in epidermal function could benefit individuals with obesity, particularly those with abnormalities in epidermal function.
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Affiliation(s)
- Tingting Zhu
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shuyun Yang
- Department of Dermatology, The People's Hospital of Baoshan, Baoshan, China
| | - Theodora M Mauro
- Department of Dermatology, Veterans Affairs Medical Center San Francisco, University of California San Francisco, San Francisco, California, USA
| | - Mao-Qiang Man
- Department of Dermatology, Veterans Affairs Medical Center San Francisco, University of California San Francisco, San Francisco, California, USA
- Dermatology Hospital, Southern Medical University, Guangzhou, China
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Baghlaf MA, Eid NMS. Prevalence, Risk Factors, Clinical Manifestation, Diagnosis Aspects and Nutrition Therapy in Relation to both IgE and IgG Cow’s Milk Protein Allergies among a Population of Saudi Arabia: A Literature Review. CURRENT RESEARCH IN NUTRITION AND FOOD SCIENCE JOURNAL 2021. [DOI: 10.12944/crnfsj.9.2.02] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Cow milk protein allergy (CMPA) becoming a major public health issue that has attracted the attention of health professionals and researchers. This paper aimed to review the important aspects of both IgE and IgG types of cow’s milk protein allergy in terms of prevalence, clinical manifestation, risk factors, other health-related issues and nutritional therapy proposed for such allergies in the adult and pediatric population in Saudi Arabia. A search on “cow’s milk allergy” was done using PubMed, Google Scholar and Scopus Engine for published papers between 1993 and 2020 to find studies yielding knowledge on that context. The prevalence of cow’s milk protein allergy (CMPA) among infants is now in the range of 2–3%. This type of allergy is also detected in adulthood but less frequently. CMPA is defined as an immunological reaction to specific proteins in milk. CMPA is classified based on its type as an immunoglobulin E (IgE)-mediated form and an immunoglobulin G (IgG)-mediated form, each type representing different immunological pathways. The presence of Genetic aspects, family history and short duration of breastfeeding in the infant are among the risk factors contributing to this form of allergy. Its manifestations mainly present as skin presentation, followed by the gastrointestinal and respiratory presentation in most cases in addition to a life-threatening anaphylactic reaction that may occur in 12% of cases. food allergy committees have developed strict diagnosis criteria, including blood testing for food-specific immunoglobulin E (sIgE), a skin prick test and double-blind placebo-controlled food challenges (DBPCFC) as the gold standard. A diet free of cow’s milk protein (CMP) allergen and including the appropriate alternative milk formula is the first line of prevention recommended by many organizations and food allergy experts. As for Saudi Arabia, more research and clinical trials are required to discuss the various aspects of adult and pediatric CMPA and to provide a better understanding along with good control strategies implementation.
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Affiliation(s)
- Mashail A Baghlaf
- 1Faculty of Applied Medical Sciences, Department of Medical Laboratory Technology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Noura M S Eid
- 2Faculty of Applied Medical Sciences, Department of Clinical Nutrition, King Abdulaziz University, Jeddah, Saudi Arabia
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Hong MR, Lei D, Yousaf M, Chavda R, Gabriel S, Janmohamed SR, Silverberg JI. A real-world study of the longitudinal course of adult atopic dermatitis severity in clinical practice. Ann Allergy Asthma Immunol 2020; 125:686-692.e3. [PMID: 32682980 DOI: 10.1016/j.anai.2020.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/03/2020] [Accepted: 07/10/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Little is known about the longitudinal course of adult atopic dermatitis (AD) lesional severity and extent in clinical practice. OBJECTIVE To determine the longitudinal course of AD in clinical practice. METHODS A prospective, dermatology practice-based study was performed (n = 400). Patients were assessed at baseline and approximately 6, 12, 18, and 24 months by eczema area and severity index (EASI) and objective-scoring atopic dermatitis (objective-SCORAD). Multivariable repeated measures linear regression models were constructed to evaluate AD severity over time. RESULTS Overall, 36.2% and 18.2% of patients had moderate (6.0-22.9) or severe (23.0-72.0) EASI scores at any visit, respectively. Similarly, 29.0% and 26.4% of patients had moderate (24.0-37.9) or severe (38.0-83.0) objective-SCORAD scores at any visit, respectively. Among patients with baseline moderate (6.0-22.9) or severe (23.0-72.0) EASI scores, 25.0% and 18.6% continued to have moderate or severe scores at 1 or more follow-up visits, respectively. Similarly, among patients with baseline moderate (24.0-37.9) or severe (38.0-83.0) objective-SCORAD scores, 22.6% and 24.5% continued to have moderate or severe scores at 1 or more follow-up visits, respectively. In longitudinal regression models, EASI was significantly associated with body surface area (adjusted β [95% confidence interval]: 0.16 [0.09-0.23]) and edema/papulation (2.31 [0.19-4.43]). In addition, objective-SCORAD was significantly associated with body surface area (0.12 [0.04-0.21]), edema/papulation (4.69 [2.05-7.32]), and scratch (3.34 [0.45-6.24]) over time. CONCLUSION AD lesional severity has a heterogeneous longitudinal course. Many patients had fluctuating lesional severity scores over time. A minority of patients had persistently moderate or severe lesions over time. Most patients with moderate-severe disease at baseline were unable to achieve persistent lesional clearance.
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Affiliation(s)
- Mindy R Hong
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Donald Lei
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Muhammad Yousaf
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Rajeev Chavda
- Prescription Strategy and Innovation Group, Galderma SA, La Tour-de-Peilz, Switzerland
| | - Sylvie Gabriel
- Prescription Strategy and Innovation Group, Galderma SA, La Tour-de-Peilz, Switzerland
| | - Sherief R Janmohamed
- Department of Dermatology, Universitair Ziekenhuis Brussel (UZB), Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Jette, Belgium
| | - Jonathan I Silverberg
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Dermatology, the George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
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Abstract
Atopic dermatitis is a heterogeneous, chronic, and inflammatory skin disease that is associated with a profound symptom burden. Recent studies have demonstrated associations between atopic dermatitis and a number of multi-organ and systemic disorders. The origin of these comorbid conditions is likely multifactorial, with combined effects of skin-barrier disruption, immune dysregulation, intense symptoms, and iatrogenic complications. Some of these comorbid conditions appear to be related to the underlying severity of atopic dermatitis and inadequate disease control. This review will summarize recent developments in the understanding of the comorbid health disorders associated with atopic dermatitis, particularly infections, sleep disturbances, and cardiovascular disease.
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Affiliation(s)
- Jonathan I Silverberg
- Departments of Dermatology, Preventive Medicine, and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Arkes building, 676 N Saint Clair St, Suite 1600, Chicago, IL, 60611, USA
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Kelishadi R, Roufarshbaf M, Soheili S, Payghambarzadeh F, Masjedi M. Association of Childhood Obesity and the Immune System: A Systematic Review of Reviews. Child Obes 2017; 13:332-346. [PMID: 28604080 DOI: 10.1089/chi.2016.0176] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The growing prevalence of childhood obesity has become a serious health problem over the past decades. As the immune system is greatly affected by excess weight, in this review of reviews, we discuss the findings of review articles about the relationship between childhood/maternal obesity and children's immune system. We searched English-language articles in PubMed, Scopus, ISI Thomson Reuters, and Google Scholar databases. All relevant reviews, either systematic or narrative, were retrieved. Then their quality was assessed by using the Assessment of Multiple Systematic Reviews and International Narrative Systematic Assessment tools, respectively. In the final step, 26 reviews were included. Our review suggests that childhood obesity is associated with extensive changes in the serum levels of inflammatory and anti-inflammatory cytokines and proteins, as well as the number of immune cells and their behavior. Therefore, it might cause or exacerbate diseases such as asthma, allergy, atopic dermatitis (AD), and obstructive sleep apnea syndrome. Moreover, childhood obesity may reduce the immune system responsiveness to vaccines and microorganisms. Furthermore, studies suggest that maternal obesity increases the risk of asthma in offspring. Future studies are needed to determine different associations of childhood obesity with allergy, atophic dermatitis, and autoimmune diseases.
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Affiliation(s)
- Roya Kelishadi
- 1 Child Growth and Development Research Center, Research Institute for Primordial Prevention of Noncommunicable Disease, Isfahan University of Medical Sciences , Isfahan, IR Iran
| | - Mohammad Roufarshbaf
- 2 Pharmacy Students' Research Committee, School of Pharmacy, Isfahan University of Medical Sciences , Isfahan, IR Iran
| | - Sina Soheili
- 2 Pharmacy Students' Research Committee, School of Pharmacy, Isfahan University of Medical Sciences , Isfahan, IR Iran
| | - Farzaneh Payghambarzadeh
- 3 Department of Immunology, Faculty of Medicine, Isfahan University of Medical Sciences , Isfahan, IR Iran
| | - Mohsen Masjedi
- 3 Department of Immunology, Faculty of Medicine, Isfahan University of Medical Sciences , Isfahan, IR Iran
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Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disorder with significant morbidity and quality-of-life impairment. The epidemiology of AD is complex and challenging to study. The 1-year US prevalence of AD was 12.98% in children in 2007-2008 and 7.2%-10.2% in adults in 2010-2012. There is considerable statewide and countrywide variation of AD prevalence and severity. The prevalence of childhood AD dramatically increased over the past few decades but may be leveling off in developed nations. AD is associated with increased direct and indirect costs to payers and patients, thereby contributing toward a considerable public health burden.
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Affiliation(s)
- Jonathan I Silverberg
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 North Street Clair Street, Suite 1600, Chicago, IL 60611, USA; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
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Zhang A, Silverberg JI. Association of atopic dermatitis with being overweight and obese: a systematic review and metaanalysis. J Am Acad Dermatol 2015; 72:606-16.e4. [PMID: 25773409 DOI: 10.1016/j.jaad.2014.12.013] [Citation(s) in RCA: 187] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 11/30/2014] [Accepted: 12/06/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Previous studies found conflicting results about whether atopic dermatitis (AD) is associated with overweight/obesity. OBJECTIVE We sought to examine the relationship between AD and overweight/obesity by performing a systematic review and metaanalysis. METHODS Observational studies of the relationship between AD and overweight/obesity were selected from PubMed, Embase, and the Cochrane Library. The quality of evidence was assessed using the Newcastle-Ottawa Scale. Fixed and random effects metaanalyses were performed to estimate pooled odds ratios (ORs). Sensitivity analyses were performed that compared results by location of study, study quality, and between studies in children and adults. RESULTS In total, 30 studies were included for review. Patients who were overweight (Cochrane-Mantel-Haenszel [CMH] OR, 1.27 [95% confidence interval {CI}: 1.19-1.36]; random effects OR, 1.23 [95% CI: 1.11-1.41]), obese (CMH OR, 1.68 [95% CI: 1.54-1.84]; random effects OR, 1.47 [95% CI: 1.21-1.79]), or overweight/obese (CMH OR, 1.42 [95% CI: 1.34-1.50]; random effects OR, 1.31 [95% CI: 1.16-1.48]) had higher odds of AD than normal weight patients. In sensitivity analyses, children who were overweight (random effects OR, 1.24 [95% CI: 1.08-1.43]), obese (random effects OR, 1.44 [95% CI: 1.12-1.86]), or overweight/obese (random effects OR, 1.32 [95% CI: 1.15-1.51]) and adults who were obese (random effects OR, 1.56 [95% CI: 1.24-1.95]) or overweight/obese (random effects OR, 1.29 [95% CI: 1.05-1.59]) had higher odds of AD. The association remained significant in North America and Asia but not Europe. LIMITATIONS Most studies were cross-sectional. CONCLUSIONS Overweight/obesity in North America and Asia is associated with an increased prevalence of AD.
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Affiliation(s)
- April Zhang
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jonathan I Silverberg
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
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