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Warren C, Nimmagadda SR, Gupta R, Levin M. The epidemiology of food allergy in adults. Ann Allergy Asthma Immunol 2023; 130:276-287. [PMID: 36509408 DOI: 10.1016/j.anai.2022.11.026] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/31/2022] [Accepted: 11/23/2022] [Indexed: 12/13/2022]
Abstract
The prevalence and awareness of food allergy (FA) among US adults is arguably at a historical high, both with respect to primary immunoglobulin E-mediated food hypersensitivity and other food-triggered conditions that operate through a variety of immunologic mechanisms (eg, pollen-FA syndrome, alpha-gal syndrome, food protein-induced enterocolitis syndrome, eosinophilic esophagitis). Worryingly, not only are many adults retaining childhood-onset food allergies as they age into adulthood, it seems that many adults are experiencing adult-onset allergies to previously tolerated foods, with correspondingly adverse physical, and psychological health impacts. Consequently, this review aims to summarize what is currently known about the epidemiology and population-level burden of FA among adult populations in North America and around the globe. This article also provides insights into the natural history of these conditions and what we need to know as we look to the future to support effective care and prevent FA.
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Affiliation(s)
- Christopher Warren
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Evanston, Illinois; Center for Food Allergy and Asthma Research, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Evanston, Illinois.
| | - Sai R Nimmagadda
- Center for Food Allergy and Asthma Research, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Evanston, Illinois; Division of Allergy and Immunology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Ruchi Gupta
- Center for Food Allergy and Asthma Research, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Evanston, Illinois; Ann and Robert H. Lurie Children's Hospital of Chicago, Department of Pediatrics, Chicago, Illinois
| | - Michael Levin
- Division Paediatric Allergology, University of Cape Town, Cape Town, South Africa
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Muamba Nkashama L, Kayembe Lubeji D, Mwanza Kasongo JC, Kadima Mutombo T, Nyembue Tshipukane D. Sensitization and Clinical Characteristics of Congolese Children with Vernal Keratoconjunctivitis in Kinshasa. Ocul Immunol Inflamm 2023; 31:15-20. [PMID: 34582304 DOI: 10.1080/09273948.2021.1976217] [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] [Indexed: 01/27/2023]
Abstract
BACKGROUND Data on the sensitization pattern and clinical characteristics of pediatric vernal keratoconjunctivitis (VKC) are scary in Central Africa. This chronic form of allergic conjunctivitis affects the quality of school life and work productivity. There is no study that shows the breadth of vernal keratoconjunctivitis in our setting. PURPOSE To describe the clinical characteristics of vernal keratoconjunctivitis in Kinshasa, to evaluate the sensitization profile and associated factors. METHODS A total of 400 children with vernal keratoconjunctivitis underwent a clinical examination and a skin prick test (SPT) for 10 allergens. Dermatophagoides pteronyssinus, Blomia tropicalis and cockroach were the most common allergens in 52, 1 %, 18, 8% and 13% respectively among sensitized children and 66, 4% showed polysensitization. RESULTS The main symptoms were itchy eyes 45%, brownish discoloration conjunctiva 17%, red eyes 12, 2%, eyelids rubbing 11, 5%, tearing 8, 7% and photophobia 5, 5%.The limbic form was predominant with 54%, followed by palpebral form 26% and mixed form 20%. The most common complications were superficial punctate keratitis 17, 2%, shield ulcer 1, 5%, corneal plaque 1, 3% and corneal erosion 1%. CONCLUSION This study outlines that 34, 5% of children attending the outpatient Ophthalmology Department in two hospitals of Kinshasa for vernal keratoconjunctivitis disease had a positive skin prick test to at least one allergen, in particular for Dermatophagoides pteronyssinus, Blomia tropicalis and cockroach.
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Affiliation(s)
- Léon Muamba Nkashama
- Ophthalmology Department, University Hospital of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - David Kayembe Lubeji
- Ophthalmology Department, University Hospital of Kinshasa, Kinshasa, Democratic Republic of Congo
| | | | - Théodore Kadima Mutombo
- Masina Ophthalmology Hospital, National Eye Care Program, Kinshasa, Democratic Republic of Congo
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AL-Iede M, Al-Ani A, Mafrachi B, Alkhulaifat D, Hassan K, Elhussieni M, Salah N, Al-Somadi H, Ali E, Al-Zayadneh E, Khreesha L. Sensitization to Inhaled Allergens in Atopic Children in Jordan Capital, Amman: A Cross-sectional Study. CURRENT RESPIRATORY MEDICINE REVIEWS 2021. [DOI: 10.2174/1573398x17666210301123802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
As the prevalence of allergic diseases is increasing all over the world, it is
vital to identify the specific allergens, which contribute to the development and persistence of such
conditions.
Objectives:
This study aims to assess the prevalence of aeroallergen sensitization and, to evaluate
the profile of skin prick test among atopic Jordanian children who are visiting Jordan University
Hospital (JUH).
Methods:
A retrospective analysis of all Skin Prick Test (SPT) and results of atopic children and
adolescents aged (1.5-18 years) who visited the pediatrics clinics at JUH from January 2018 until
December 2019.
Results:
Over two years, a total of 171 children (male: female ratio of 1.9) with a median age of
6.2 years (1.5-18) were subjected to SPT. One hundred and seven children (62.5%) were found to
be sensitized to at least one of the ten aeroallergen extracts tested. The most common sensitizations
were to olive pollen (45.6%), Mites Dermatophagoides Petronyssinus (42.0%), and Dog Dander
(38.6%). The highest sensitization rate was among the age group 2-4 years (28.1%). The sensitization
rates increased in conjunction with an increase in age in the first age groups (preschool and
school-age groups).
Conclusion:
The study’s findings provide an understanding of the locally prevalent aeroallergens,
yet a multi-center review would be more useful for creating an optimized SPT panel specific to the
Jordanian pediatric population.
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Affiliation(s)
| | | | - Baraa Mafrachi
- Faculty of Medicine, University of Jordan, Amman, Jordan
| | | | - Kamal Hassan
- Faculty of Medicine, University of Jordan, Amman, Jordan
| | | | - Neveen Salah
- Faculty of Medicine, University of Jordan, Amman, Jordan
| | | | - Elnagi Ali
- Faculty of Medicine, University of Jordan, Amman, Jordan
| | | | - Lubna Khreesha
- Ear, Nose, and Throat Department, Jordan University Hospital, Amman, Jordan
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Hossny E, Ebisawa M, El-Gamal Y, Arasi S, Dahdah L, El-Owaidy R, Galvan CA, Lee BW, Levin M, Martinez S, Pawankar R, Tang ML, Tham EH, Fiocchi A. Challenges of managing food allergy in the developing world. World Allergy Organ J 2019; 12:100089. [PMID: 31871534 PMCID: PMC6909084 DOI: 10.1016/j.waojou.2019.100089] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 10/30/2019] [Accepted: 10/30/2019] [Indexed: 02/07/2023] Open
Abstract
Food allergy (FA) is currently a significant health care problem in the developing world. Widely varying study populations and methodologies, the use of surrogate markers such as self report or hospitalization rates due to anaphylaxis rather than objective methods, limits robust estimation of FA prevalence in low income settings. Also, allergy is under-recognized as a clinical specialty in the developing world which compromises the chance for accurate diagnosis. In this review, most published data on food allergens from developing or low income countries are displayed. The diagnostic challenges and limitations of treatment options are discussed. It seems that FA is an under-appreciated health care issue in the developing world, and accurate determination of its burden in low-income settings represents an important unmet need. Multicenter surveillance studies, using standardized methodologies, are, therefore, needed to reveal the true extent of the problem and provide epidemiological clues for prevention. Preventive strategies should be tailored to fit local circumstances in different geographic regions. In addition, studying the gene environment interactions and impact of early life microbiota on the expression of FA in developing communities would be worthwhile. Efforts and resources should be directed toward public health education and training of health care providers dealing with food allergic patients.
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Affiliation(s)
- Elham Hossny
- Pediatric Allergy and Immunology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Kanagawa, Japan
| | - Yehia El-Gamal
- Pediatric Allergy and Immunology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | | | - Lamia Dahdah
- Pediatric Hospital Bambino Gesù, Vatican City, Italy
| | - Rasha El-Owaidy
- Pediatric Allergy and Immunology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - Cesar A. Galvan
- Centro Nacional de Referencia de Alergia Asma e Inmunología (CERNAAI), Instituto Nacional de Salud del Niño, Lima-Perú, Peru
| | - Bee Wah Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michael Levin
- Division Paediatric Allergology, University of Cape Town, Red Cross Children's Hospital, Cape Town, South Africa
| | - Santiago Martinez
- Arnold Palmer Hospital for Children, Florida State University College of Medicine, Florida, United States
| | - Ruby Pawankar
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Mimi L.K. Tang
- Department of Allergy and Immunology, The Royal Children's Hospital, Melbourne, Australia
- Murdoch Children's Research Institute, Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia
| | - Elizabeth H. Tham
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Kakobo PK, Kalala HK, Tshibola MM, Kelekele JK, Nyembue DT, Hellings PW. Pattern of uncontrolled allergic rhinitis in a hospital setting of Kinshasa, Democratic Republic of Congo. IMMUNITY INFLAMMATION AND DISEASE 2019; 7:286-291. [PMID: 31532078 PMCID: PMC6842815 DOI: 10.1002/iid3.272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 08/27/2019] [Accepted: 09/02/2019] [Indexed: 11/13/2022]
Abstract
Aim To determine the clinical and allergic features of uncontrolled allergic rhinitis (UCAR) in the Democratic Republic of Congo (DRC). Methods Observational cross‐sectional study of 311 patients with UCAR. Allergic rhinitis was diagnosed clinically with sensitization to inhalant allergens and then confirmed by skin prick test. Severity was assessed using the Visual Analog Scale (VAS), with VAS scores greater than or equal to 5 used as cut off to determine uncontrolled status. Results The mean age of UCAR patients was 30.7 ± 15.1 years and 66.9% of the patients were females. Three out of four patients had persistent UCAR while the remainder had intermittent symptoms. UCAR was associated with rhinosinusitis and asthma in 18.6% and 18% of the patients, respectively. Among UCAR patients, 95.2% were polysensitized. The allergens most frequently involved were mites (82%), cat (27.3%), and dog (26.7%). The most frequent symptoms were nasal congestion, sneezing, and runny nose. There were 44.4% of the patients treated with nasal corticosteroids and 33.1% with oral antihistamine (anti‐H1). Conclusions This study reports on the clinical phenotype of UCAR in the DRC. The findings contribute to our understanding of UCAR in this population and may be used to implement strategies to reduce the prevalence and burden of UCAR in this setting.
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Affiliation(s)
- Patricia K Kakobo
- ENT Service, Kinshasa University Hospital, Kinshasa, Democratic Republic of Congo
| | - Hilaire K Kalala
- ENT Service, Kinshasa University Hospital, Kinshasa, Democratic Republic of Congo
| | - Maguy M Tshibola
- ENT Service, Kinshasa University Hospital, Kinshasa, Democratic Republic of Congo
| | - Joseph K Kelekele
- Ophtalmology Service, Kinshasa University Hospital, Kinshasa, Democratic Republic of Congo
| | - Dieudonné T Nyembue
- ENT Service, Kinshasa University Hospital, Kinshasa, Democratic Republic of Congo
| | - Peter W Hellings
- Department of Otorhinolaryngology and Head and Nose Surgery, University Hospital of Leuven, Leuven, Belgium.,Department of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Upper Airways Research Laboratory, University of Ghent, Ghent, Belgium
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Valero A, Quirce S, Dávila I, Delgado J, Domínguez-Ortega J. Allergic respiratory disease: Different allergens, different symptoms. Allergy 2017; 72:1306-1316. [PMID: 28208220 DOI: 10.1111/all.13141] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND Spanish population is rather homogeneous in its genetic and sociocultural characteristics, but allergen sensitization shows wide geographical variations. We aimed at assessing whether sensitization to different allergens in the diverse geographical areas induced different clinical and quality-of-life characteristics in adult patients with a first-time diagnosis of rhinitis and/or asthma. METHODS Two sequential, identically designed studies were carried out to evaluate such associations (PERFILAR I and II). PERFILAR II was an extension of PERFILAR I with additional allergens being included. Both phases were epidemiological, descriptive, cross-sectional, nonintervention multicenter studies. Participants were required to have lived for at least the last 2 years in the geographical zone. Asthma control assessment was based on ACQ-5. Health-related quality of life was evaluated with validated scales for rhinitis (ESPRINT-15) and asthma (Mini-AQLQ). Skin prick tests were used to identify sensitization to involved allergens. RESULTS A total of 301 physicians recruited 2711 patients for PERFILAR I+II. Sensitization to allergens was significantly different in patients with rhinitis with/without asthma. Seasonal allergens were associated with rhinitis, a longer time to asthma development, and more severe and commonly intermittent rhinitis. HDM were associated with more common rhinitis, and Alternaria was associated with asthma. The study confirms an association of geographical areas with relevant allergens and allergic clinical picture. CONCLUSION Different types of aeroallergens and specific sensitization profiles are associated with different allergic clinical pictures (rhinitis with/without asthma), different clinical symptoms, and different levels of severity. This could have implications to predict later clinical course and to select appropriate management approaches.
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Affiliation(s)
- A. Valero
- Pneumology and Allergy Department; Clinical and Experimental Respiratory Immunoallergy; IDIBAPS; CIBERES; Hospital Clinic; Barcelona Spain
| | - S. Quirce
- Department of Allergy; Healthcare Research Institute IdiPAZ; CIBER de Enfermedades Respiratorias; CIBERES; Hospital Universitario La Paz; Madrid Spain
| | - I. Dávila
- Immunoallergy Department; IBSAL-Hospital Universitario de Salamanca; Salamanca Spain
| | - J. Delgado
- Allergy Department; Hospital Virgen Macarena; Sevilla Spain
| | - J. Domínguez-Ortega
- Department of Allergy; Healthcare Research Institute IdiPAZ; CIBER de Enfermedades Respiratorias; CIBERES; Hospital Universitario La Paz; Madrid Spain
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Kariya S, Okano M, Nishizaki K. Relationship between chronic rhinosinusitis and lower airway diseases: An extensive review. World J Otorhinolaryngol 2015; 5:44-52. [DOI: 10.5319/wjo.v5.i2.44] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Revised: 12/04/2014] [Accepted: 03/05/2015] [Indexed: 02/06/2023] Open
Abstract
Significant links between allergic rhinitis and asthma have been reported, and the united airway disease hypothesis is supported by numerous findings in epidemiologic, physiologic, pathologic, and immunologic studies. The impact of allergic rhinitis on asthma has been established. On the other hand, the relationship between chronic rhinosinusitis and lung diseases has been under investigation. Chronic rhinosinusitis is a common disease, and the high prevalence of chronic rhinosinusitis in some kinds of lung diseases has been reported. Recent studies suggest that the treatment of chronic rhinosinusitis has beneficial effects in the management of asthma. Here, we present an overview of the current research on the relationship between chronic rhinosinusitis and lower airway diseases including asthma, chronic obstructive pulmonary disease, cystic fibrosis, diffuse panbronchiolitis, primary ciliary dyskinesia, idiopathic bronchiectasis, and allergic bronchopulmonary aspergillosis.
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Abstract
Food allergy has been traditionally perceived as being rare in Africa. However, the prevalence of other allergic manifestations such as asthma and atopic dermatitis continue to rise in the higher-income African countries. Since the food allergy epidemic in westernized countries has lagged behind that of allergic respiratory conditions, we hypothesize that food allergy is increasing in Africa. This article systematically reviews the evidence for food allergy in Africa, obtained through searching databases including PubMed, Medline, MD Consult, and scholarly Google. Articles are divided into categories based on strength of methodological diagnosis of food allergy. Information was found for 11 African countries: Botswana, Democratic Republic of Congo, Ghana, Kenya, Morocco, Mozambique, Nigeria, South Africa, Tanzania, Tunisia, and Zimbabwe. Most studies reflect sensitization to food or self-reported symptoms. However, a few studies had more stringent diagnostic testing that is convincing for food allergy, mostly conducted in South Africa. Apart from the foods that commonly cause allergy in westernized countries, other regionally significant or novel food allergens may include pineapple (Ghana), okra (Nigeria), and mopane worm (Botswana). Food allergy is definitely an emerging disease in Africa and resources need to be diverted to study, diagnose, treat, and prevent this important disease.
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Affiliation(s)
- Shiang-Ju Kung
- Department of Paediatrics, University of Botswana, P O Box AC163, ACH, Riverwalk, Gaborone, Botswana,
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