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D’Aiuto V, Mormile I, Granata F, Napolitano F, Lamagna L, Della Casa F, de Paulis A, Rossi FW. Worldwide Heterogeneity of Food Allergy: Focus on Peach Allergy in Southern Italy. J Clin Med 2024; 13:3259. [PMID: 38892968 PMCID: PMC11173152 DOI: 10.3390/jcm13113259] [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: 04/12/2024] [Revised: 05/25/2024] [Accepted: 05/30/2024] [Indexed: 06/21/2024] Open
Abstract
Food allergy (FA) has shown an increasing prevalence in the last decades, becoming a major public health problem. However, data on the prevalence of FA across the world are heterogeneous because they are influenced by several factors. Among IgE-mediated FA, an important role is played by FA related to plant-derived food which can result from the sensitization to a single protein (specific FA) or to homologous proteins present in different foods (cross-reactive FA) including non-specific lipid transfer proteins (nsLTPs), profilins, and pathogenesis-related class 10 (PR-10). In addition, the clinical presentation of FA is widely heterogeneous ranging from mild symptoms to severe reactions up to anaphylaxis, most frequently associated with nsLTP-related FA (LTP syndrome). Considering the potential life-threatening nature of nsLTP-related FA, the patient's geographical setting should always be taken into account; thereby, it is highly recommended to build a personalized approach for managing FA across the world in the precision medicine era. For this reason, in this review, we aim to provide an overview of the prevalence of nsLTP-mediated allergies in the Mediterranean area and to point out the potential reasons for the different geographical significance of LTP-driven allergies with a particular focus on the allergenic properties of food allergens and their cross reactivity.
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Affiliation(s)
- Valentina D’Aiuto
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (V.D.); (I.M.); (F.N.); (F.D.C.); (A.d.P.); (F.W.R.)
| | - Ilaria Mormile
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (V.D.); (I.M.); (F.N.); (F.D.C.); (A.d.P.); (F.W.R.)
| | - Francescopaolo Granata
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (V.D.); (I.M.); (F.N.); (F.D.C.); (A.d.P.); (F.W.R.)
| | - Filomena Napolitano
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (V.D.); (I.M.); (F.N.); (F.D.C.); (A.d.P.); (F.W.R.)
| | - Laura Lamagna
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy;
| | - Francesca Della Casa
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (V.D.); (I.M.); (F.N.); (F.D.C.); (A.d.P.); (F.W.R.)
| | - Amato de Paulis
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (V.D.); (I.M.); (F.N.); (F.D.C.); (A.d.P.); (F.W.R.)
- Center for Basic and Clinical Immunology Research (CISI), WAO Center of Excellence, University of Naples Federico II, 80131 Naples, Italy
| | - Francesca Wanda Rossi
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (V.D.); (I.M.); (F.N.); (F.D.C.); (A.d.P.); (F.W.R.)
- Center for Basic and Clinical Immunology Research (CISI), WAO Center of Excellence, University of Naples Federico II, 80131 Naples, Italy
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Vassilopoulou E, Feketea G, Pagkalos I, Rallis D, Milani GP, Agostoni C, Douladiris N, Lakoumentas J, Stefanaki E, Efthymiou Z, Tsabouri S. Complementary Feeding Practices: Recommendations of Pediatricians for Infants with and without Allergy Risk. Nutrients 2024; 16:239. [PMID: 38257132 PMCID: PMC10819658 DOI: 10.3390/nu16020239] [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: 11/30/2023] [Revised: 12/30/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
AIM To investigate the routine guidance provided by pediatricians concerning the timing of complementary feeding (CF) for both healthy infants and those at a heightened risk of allergies. METHODS A total of 233 pediatricians participated in an anonymous online survey that included questions about demographics and recommendations for CF. Specifically, they provided guidance on the types of foods, preparation methods, supplements, time intervals for introducing new foods to infants at low and high allergy risk, and delayed food introductions for high-risk cases. RESULTS The respondents advised introducing certain foods at specific ages: fruits, starchy non-gluten grains, vegetables, olive oil, and meat were appropriate at 6 months; gluten-rich grains at 7 months; yogurt, hard-boiled eggs, and legumes at 8 months; fish at 8.5 months; and nuts at 9 months. Pediatricians, especially those with less than 15 years of practice, often introduced egg, seafood, gluten-rich grains, legumes, and nuts earlier for high-risk infants. Parenthood and male gender were associated with the earlier introduction of eggs and grains. CONCLUSIONS Greek pediatricians follow a structured food introduction schedule for CF in infants. Interestingly, they tend to delay the introduction of common food allergens and recommend longer intervals between introducing new foods, particularly for high-risk infants. Key Notes: Despite recent evidence-based indications on healthy complementary feeding strategies for infants, discrepancies persist among pediatricians regarding food choices and the order and timing of food introduction, both for healthy infants and those at risk of allergy. Guidance on complementary feeding by pediatricians is influenced by their individual characteristics. Pediatricians tend to delay the introduction of common food allergens and recommend longer intervals between introducing new foods, particularly for high-risk infants.
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Affiliation(s)
- Emilia Vassilopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (E.V.); (I.P.); (J.L.); (Z.E.)
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.P.M.); (C.A.)
| | - Gavriela Feketea
- Department of Pediatrics, “Karamandaneio” Children’s Hospital of Patra, 26331 Patras, Greece
- Department of Pharmacology, “luliu Hatieganu” University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Ioannis Pagkalos
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (E.V.); (I.P.); (J.L.); (Z.E.)
| | - Dimitrios Rallis
- School of Health Sciences, University of Ioannina, 45110 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, 20157 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, 20157 Milan, Italy
| | - Nikolaos Douladiris
- Allergy Unit, 2nd Pediatric Clinic, University of Athens, 11527 Athens, Greece;
| | - John Lakoumentas
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (E.V.); (I.P.); (J.L.); (Z.E.)
| | - Evangelia Stefanaki
- Department of Pediatrics, General Hospital of Heraklion, Venizeleio and Pananio, 71409 Heraklion, Greece;
| | - Zenon Efthymiou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (E.V.); (I.P.); (J.L.); (Z.E.)
| | - Sophia Tsabouri
- School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (D.R.); (S.T.)
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Rossi G, Cesca J, Fong C, Wallace A, DComm PS, Osuagwu UL, Bailey J, Dutton T, De Alwis AC. Rural parents' adherence to infant feeding guidelines to prevent allergy: a cross sectional study in New South Wales. BMC Public Health 2023; 23:2458. [PMID: 38066470 PMCID: PMC10704778 DOI: 10.1186/s12889-023-17396-8] [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: 05/15/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Responding to international research showing that early introduction of common food allergens can reduce the chance of developing allergies, in 2016 the Australasian Society of Clinical Immunology and Allergy (ASCIA) revised allergen introduction guidelines, recommending earlier introduction of allergens to infants in their first year. Australia has high food allergy rates, and limited understanding of adherence to allergen introduction guidelines, especially in rural areas. This project explored rural parent adherence to ASCIA guidelines. METHODS This was a mixed method cross sectional study using an online survey including multiple-choice and qualitative short answer responses. The sample were 336 women from two rural health districts in New South Wales. All were aged 18 or over, and either pregnant or had delivered a baby since July 2018. Descriptive statistics were used to measure behavioural alignment with the recommended guidelines, thematic analysis was used to analyse attitudes and explanations. RESULTS In 84.3% of children, feeding adhered to all four guidelines studied, including no elimination of allergens during pregnancy (98%), age of introduction of solids (97.7%), continuation of breast milk/cow's milk formula during introduction of solids (95%), and age of introduction of allergens (92.9%). Adherence was not significantly correlated with the education (X2 = 17.9, P = .056), prior history of allergy [neither mother (X2 = 0.945,P = .623) nor previous children (X2 = 0.401,P = .818)], or primary care received during pregnancy. More than 90% of participants agreed or strongly agreed that the guidelines are realistic, trustworthy, and important for the health of their child. However, thematic analysis revealed that parents' perceptions of a child's individual progress, and medical conditions or other circumstances, such as challenges with breastfeeding, will often take precedence over adherence to specific guideline recommendations. CONCLUSIONS High rates of adherence with ASCIA guidelines found here are comparable with findings from metropolitan studies and encouraging for future population health. Participant comments on the guidelines imply to rural policymakers that there are multiple influences on parent decisions about infant feeding, often including parents' own intuition and experiences. Further studies to improve understanding of the role of information, carers, and other influences on parent decision-making concerning feeding attitudes and behaviours will be necessary to optimise adherence in rural areas.
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Affiliation(s)
- Gianni Rossi
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Sydney, Australia
| | - Jessica Cesca
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Sydney, Australia
| | - Charmie Fong
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Sydney, Australia
| | - Andrew Wallace
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Sydney, Australia
| | - Peter Simmons DComm
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Sydney, Australia
- School of Rural Medicine, Charles Sturt University, Bathurst, Australia
- Gulbali Research Institute, Charles Sturt University, Bathurst, Australia
| | - Uchechukwu Levi Osuagwu
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Sydney, Australia.
- Translational Health Research Institute (THRI), Western Sydney University, Sydney, Australia.
| | - Jannine Bailey
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | - Tegan Dutton
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Sydney, Australia
| | - Adambarage Chandima De Alwis
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Sydney, Australia
- Department of Paediatrics, Bathurst Base Hospital, Bathurst, NSW, 2795, Australia
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Prevalence and maternal determinants of early and late introduction of complementary foods: results from the Growing Up in New Zealand cohort study. Br J Nutr 2023; 129:491-502. [PMID: 35403582 PMCID: PMC9876814 DOI: 10.1017/s000711452200112x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A nationally generalisable cohort (n 5770) was used to determine the prevalence of non-timely (early/late) introduction of complementary food and core food groups and associations with maternal sociodemographic and health behaviours in New Zealand (NZ). Variables describing maternal characteristics and infant food introduction were sourced, respectively, from interviews completed antenatally and during late infancy. The NZ Infant Feeding Guidelines were used to define early (≤ 4 months) and late (≥ 7 months) introduction. Associations were examined using multivariable multinomial regression, presented as adjusted relative risk ratios and 95 % confidence intervals (RRR; 95% CI). Complementary food introduction was early for 40·2 % and late for 3·2 %. The prevalence of early food group introduction were fruit/vegetables (23·8 %), breads/cereals (36·3 %), iron-rich foods (34·1 %) and of late were meat/meat alternatives (45·9 %), dairy products (46·2 %) and fruits/vegetables (9·9 %). Compared with infants with timely food introduction, risk of early food introduction was increased for infants: breastfed < 6months (2·52; 2·19-2·90), whose mothers were < 30 years old (1·69; 1·46-1·94), had a diploma/trade certificate v. tertiary education (1·39; 1·1-1·70), of Māori v. European ethnicity (1·40; 1·12-1·75) or smoked during pregnancy (1·88; 1·44-2·46). Risk of late food introduction decreased for infants breastfed < 6 months (0·47; 0.27-0·80) and increased for infants whose mothers had secondary v. tertiary education (2·04; 1·16-3·60) were of Asian v. European ethnicity (2·22; 1·35, 3·63) or did not attend childbirth preparation classes (2·23; 1·24-4·01). Non-timely food introduction, specifically early food introduction, is prevalent in NZ. Interventions to improve food introduction timeliness should be ethnic-specific and support longer breast-feeding.
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Nuyttens L, De Vlieger L, Diels M, Schrijvers R, Bullens DMA. The clinical and immunological basis of early food introduction in food allergy prevention. FRONTIERS IN ALLERGY 2023; 4:1111687. [PMID: 36756279 PMCID: PMC9899849 DOI: 10.3389/falgy.2023.1111687] [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: 11/29/2022] [Accepted: 01/04/2023] [Indexed: 01/24/2023] Open
Abstract
IgE-mediated food allergy has an estimated prevalence of 6%-10% in developed countries. Allergen avoidance has long been the main focus in the prevention of food allergy and late solid food introduction after 6-12 months of age was recommended in high-risk infants. However, the rising prevalence of food allergy despite delayed exposure to allergens and the observations that IgE-mediated sensitization to food products could even occur before the introduction of solid foods resulted in a shift towards early solid food introduction as an attempt to prevent IgE-mediated food allergy. Since then, many trials focused on the clinical outcome of early allergen introduction and overall seem to point to a protective effect on the development of IgE-mediated food allergies. For non-IgE-mediated diseases of food allergy, evidence of early food introduction seems less clear. Moreover, data on the underlying immunological processes in early food introduction is lacking. The goal of this review is to summarize the available data of immunological changes in early food introduction to prevent IgE and non-IgE mediated food allergy.
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Affiliation(s)
- L. Nuyttens
- Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology & Transplantation, KU Leuven, Leuven, Belgium,Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - L. De Vlieger
- Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology & Transplantation, KU Leuven, Leuven, Belgium
| | - M. Diels
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - R. Schrijvers
- Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology & Transplantation, KU Leuven, Leuven, Belgium,Department of General Internal Medicine, Division of Allergy and Clinical Immunology, University Hospitals Leuven, Leuven, Belgium
| | - D. M. A. Bullens
- Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology & Transplantation, KU Leuven, Leuven, Belgium,Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium,Correspondence: D. M. A Bullens
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How primary care providers can help prevent food allergies. Curr Opin Pediatr 2022; 34:430-437. [PMID: 35797492 DOI: 10.1097/mop.0000000000001145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW IgE-mediated food allergy rates have increased in recent decades, yet treatment options remain limited. Prevention strategies are thus essential. We will review recent research and consensus guidelines for food allergy prevention. RECENT FINDINGS Research has continued to support that early introduction of allergens via the gastrointestinal tract induces tolerance and prevents development of food allergy. In contrast, allergen sensitization may occur via transcutaneous allergen exposure. This is supported by research that shows a decreased risk of food allergy with aggressive treatment of atopic dermatitis. More recent research suggests that transcutaneous sensitization could also be facilitated by frequent emollient use in the absence of atopic dermatitis but definitive research is lacking. Murine models have shown a likely role of dysbiosis, or disruption of the body's normal healthy microbiome, in development of food allergy, yet human studies have yet to show a conclusive benefit of probiotics in the prevention of food allergy. SUMMARY Important approaches for food allergy prevention are: introduction of peanut and cooked egg at 4-6 months, early introduction of other allergenic foods, and early diagnosis and treatment of atopic dermatitis (because of a predisposition to food sensitization through the damaged skin barrier). More research is needed to clarify the role, if any, of emollient use and probiotics.
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Allergieprävention durch Ernährung. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01488-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Spolidoro GCI, Azzolino D, Cesari M, Agostoni C. Diet Diversity Through the Life-Course as an Opportunity Toward Food Allergy Prevention. FRONTIERS IN ALLERGY 2022; 2:711945. [PMID: 35386992 PMCID: PMC8974677 DOI: 10.3389/falgy.2021.711945] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 09/02/2021] [Indexed: 11/13/2022] Open
Abstract
The prevalence of food allergies (FA) is increasing worldwide. Generally, the onset of allergies, including FA, begins in early childhood and may persist and/or develop through the life-course. Even though epidemiological studies have focused mainly on children, allergies can also occur for the first-time during adulthood. Within the prolongation of life, it is expected that allergies will be encountered more often even in older people. Recent findings suggest that an early exposure to diverse food antigens may promote the development of immune tolerance. Accordingly, diet diversity during the first year of life or even earlier may have a positive impact on the prevention of allergies. The anti-inflammatory properties of some dietary nutrients may positively contribute to a tolerogenic immune environment too. Diet diversity is associated with a more favorable microbiome, and increasing evidence suggests a promising role of gut microbiota manipulation in inducing immune tolerance. Unjustified avoidance of allergenic foods may expose to intakes of some nutrients below recommended levels through the life-course, even more in cases of self-diagnosis and treatment of presumed forms of food intolerance. Nutritional strategies including the early exposure to a variety of food antigens are a promising area of research for preventive purposes through the life-course possibly extending positive outcomes to older stages. The aim of this paper is to highlight the role of diet diversity in preventing the development of FA starting in early life, as well as to provide an overview of the main strategies to prevent related nutritional issues throughout the life-course.
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Affiliation(s)
- Giulia C I Spolidoro
- Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Domenico Azzolino
- Department of Clinical and Community Sciences, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Matteo Cesari
- Department of Clinical and Community Sciences, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Carlo Agostoni
- Department of Clinical and Community Sciences, University of Milan, Milan, Italy.,Pediatric Intermediate Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Jiao L, Su CW, Cao T, Zheng S, Walker WA, Shi HN. Maternal Influences and Intervention Strategies on the Development of Food Allergy in Offspring. Front Immunol 2022; 13:817062. [PMID: 35281070 PMCID: PMC8904425 DOI: 10.3389/fimmu.2022.817062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/01/2022] [Indexed: 11/24/2022] Open
Abstract
Food allergies and other immune-mediated diseases have become serious health concerns amongst infants and children in developed and developing countries. The absence of available cures limits disease management to allergen avoidance and symptomatic treatments. Research has suggested that the presence of maternal food allergies may expose the offspring to genetic predisposition, making them more susceptible to allergen sensitization. The following review has focused on epidemiologic studies regarding maternal influences of proneness to develop food allergy in offspring. The search strategy was "food allergy OR maternal effects OR offspring OR prevention". A systematically search from PubMed/MEDLINE, Science Direct and Google Scholar was conducted. Specifically, it discussed the effects of maternal immunity, microbiota, breastfeeding, genotype and allergy exposure on the development of food allergy in offspring. In addition, several commonly utilized prenatal and postpartum strategies to reduce food allergy proneness were presented, including early diagnosis of high-risk infants and various dietary interventions.
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Affiliation(s)
- Lefei Jiao
- School of Marine Sciences, Ningbo University, Ningbo, China
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Chien-Wen Su
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Tinglan Cao
- Laboratory for Lipid Medicine and Technology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Shasha Zheng
- Department of Nutrition, California Baptist University, Riverside, CA, United States
| | - W. Allan Walker
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Hai Ning Shi
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
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Atopic Status in Children with Asthma and Respiratory Allergies—Comparative Analysis of Total IgE, ImmunoCAP Phadiatop/fx5 and Euroimmun Pediatric Immunoblot. SINUSITIS 2021. [DOI: 10.3390/sinusitis6010001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Introduction: An atopic status assessment (skin prick test or specific immunoglobulin (sIgE)) in asthmatic children is considered a milestone in identifying potential risk factors and triggers provoking loss of asthma control and asthma exacerbation. Objective: The study aims to perform a comparative analysis of different laboratory methods for a serological assessment of an atopic status in asthma and respiratory allergies in children. Material and methods: A total of 86 children were included, all of whom were diagnosed with bronchial asthma, aged from 5 to 17 years and screened for total IgE level using enzyme-linked immunosorbent assay (ELISA). In 48 randomly selected children, we performed a semi-quantitative serological in vitro assessment of the specific IgE antibodies against food and aeroallergen, using two different laboratory methods—Euroimmun Immunoblot and ImmunoCAP (Phadiatop/fx5). Results: In 70% of the children with a history of allergies, and 65.3% without clinically manifested allergies, multiscreen test ImmunoCAP Phadiatop/fx5 showed positivity and confirmed atopy. Our results showed a significant moderate to strong correlation between multiscreen ImmunoCAP Phadiatop/fx5, and Euroimmun specific IgE titers against aero-allergens—cats, mites, tree mix and food allergens—soy, wheat (р = 0.006), rice, р = 0.090), apple р = 0.007) and peanut. A sensitivity of 63% and specificity of 73.5% was observed for EUROIMMUN Pediatric (food allergens, IgE titer > 1) compared with the gold standard ImmunoCap/fx5. The mean value of total IgE is significantly higher in children with asthma and concomitant with allergic rhinitis compared to those without allergic rhinitis (mean 202.52 U/mL, IQR 102.50 (24.20–363.95) vs. 316.68, IQR 261.00 (109.20–552.50), p = 0.005). Conclusion: Establishing the spectrum of the most common respiratory and food allergens is an essential factor for maintaining asthma control, both through a strategy to avoid allergen exposure and by developing a recommendation plan. The immunoblotting technique is easily applicable in daily clinical and laboratory practice. It is also a cost-effective and reliable alternative to the “gold standard” ImmunoCAP Phadiatop/fx5 in diagnosing atopy in children.
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Ali A, Hamzaid NH, Ismail NAS. The Interplay of Nutriepigenomics, Personalized Nutrition and Clinical Practice in Managing Food Allergy. Life (Basel) 2021; 11:1275. [PMID: 34833150 PMCID: PMC8623511 DOI: 10.3390/life11111275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/25/2021] [Accepted: 11/05/2021] [Indexed: 11/16/2022] Open
Abstract
Food allergy in children has been a common issue due to the challenges of prescribing personalized nutrition with a lack of nutriepigenomics data. This has indeed further influenced clinical practice for appropriate management. While allergen avoidance is still the main principle in food allergy management, we require more information to advance the science behind nutrition, genes, and the immune system. Many researchers have highlighted the importance of personalized nutrition but there is a lack of data on how the decision is made. Thus, this review highlights the relationship among these key players in identifying the solution to the clinical management of food allergy with current nutriepigenomics data. The discussion integrates various inputs, including clinical assessments, biomarkers, and epigenetic information pertaining to food allergy, to curate a holistic and personalized approach to food allergy management in particular.
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Affiliation(s)
- Adli Ali
- Department of Pediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
| | - Nur Hana Hamzaid
- Dietetic Program & Centre for Rehabilitation and Special Needs Studies (iCaRehab), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia;
| | - Noor Akmal Shareela Ismail
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
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Sur LM, Armat I, Duca E, Sur G, Lupan I, Sur D, Samasca G, Lazea C, Lazar C. Food Allergy a Constant Concern to the Medical World and Healthcare Providers: Practical Aspects. Life (Basel) 2021; 11:life11111204. [PMID: 34833080 PMCID: PMC8620930 DOI: 10.3390/life11111204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/26/2021] [Accepted: 11/05/2021] [Indexed: 01/01/2023] Open
Abstract
Food allergy (FA) is a condition with a growing incidence and is a constant concern for the medical world and healthcare providers. With potential symptoms including anaphylaxis, in the event of an allergic reaction the patient’s life may well be endangered. The diagnosis of FA is a continuous challenge because mild cases tend to be ignored or diagnosed late and young children with allergies are cared for by parents, who are not always able to accurately interpret symptoms. It is very important to be able to differentiate FAs from food intolerance and toxic reactions to food. An accurate diagnosis is required to provide personalized management of an FA. More sophisticated and accurate diagnostic tests, including component diagnosis and epitope reactivity, allow the provision of a directed diagnosis, a more accurate therapeutic approach, and a useful prognostic evaluation. Tests used in current practice include the specific search for serum IgE, elimination diets, oral food challenges, single, blind, and double-blind (DBPCFC) tests, as well as skin tests. The risk of anaphylaxis can be assessed by molecular diagnostics/component-resolved diagnosis (CRD) and by conducting a basophilic activation test (BAT). These tests allow a planned, personalized treatment based on molecular and clinical profiles. CRD can determine the individual profile of allergic molecular reactivity and enable the formulation of a prognostic judgment. Our article highlights the importance of knowing the immune mechanisms, diagnostics, and immunotherapies in FAs. Starting from observing exposure to food allergens, to identifying allergic reactions, analysing the severity of clinical manifestations, noting the possibilities of diagnosis, and illustrating adequate management strategies.
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Affiliation(s)
- Lucia M. Sur
- Department of Pediatric I, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (L.M.S.); (C.L.); (C.L.)
- Children Emergency Clinical Hospital, 400370 Cluj-Napoca, Romania; (I.A.); (E.D.); (G.S.)
| | - Ionel Armat
- Children Emergency Clinical Hospital, 400370 Cluj-Napoca, Romania; (I.A.); (E.D.); (G.S.)
| | - Emanuela Duca
- Children Emergency Clinical Hospital, 400370 Cluj-Napoca, Romania; (I.A.); (E.D.); (G.S.)
| | - Genel Sur
- Children Emergency Clinical Hospital, 400370 Cluj-Napoca, Romania; (I.A.); (E.D.); (G.S.)
| | - Iulia Lupan
- Molecular Biology Department, Babes Bolyai University, 400084 Cluj-Napoca, Romania;
| | - Daniel Sur
- The Oncology Institute “Prof. Dr. Ion Chiricuta”, 400015 Cluj-Napoca, Romania;
| | - Gabriel Samasca
- Children Emergency Clinical Hospital, 400370 Cluj-Napoca, Romania; (I.A.); (E.D.); (G.S.)
- Department of Allergology and Immunology, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
- Correspondence:
| | - Cecilia Lazea
- Department of Pediatric I, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (L.M.S.); (C.L.); (C.L.)
- Children Emergency Clinical Hospital, 400370 Cluj-Napoca, Romania; (I.A.); (E.D.); (G.S.)
| | - Calin Lazar
- Department of Pediatric I, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (L.M.S.); (C.L.); (C.L.)
- Children Emergency Clinical Hospital, 400370 Cluj-Napoca, Romania; (I.A.); (E.D.); (G.S.)
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13
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Dogra SK, Cheong Kwong C, Wang D, Sakwinska O, Colombo Mottaz S, Sprenger N. Nurturing the Early Life Gut Microbiome and Immune Maturation for Long Term Health. Microorganisms 2021; 9:2110. [PMID: 34683431 PMCID: PMC8537230 DOI: 10.3390/microorganisms9102110] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/04/2021] [Accepted: 10/04/2021] [Indexed: 12/21/2022] Open
Abstract
Early life is characterized by developmental milestones such as holding up the head, turning over, sitting up and walking that are typically achieved sequentially in specific time windows. Similarly, the early gut microbiome maturation can be characterized by specific temporal microorganism acquisition, colonization and selection with differential functional features over time. This orchestrated microbial sequence occurs from birth during the first years of age before the microbiome reaches an adult-like composition and function between 3 and 5 years of age. Increasingly, these different steps of microbiome development are recognized as crucial windows of opportunity for long term health, primarily linked to appropriate immune and metabolic development. For instance, microbiome disruptors such as preterm and Cesarean-section birth, malnutrition and antibiotic use are associated with increased risk to negatively affect long-term immune and metabolic health. Different age discriminant microbiome taxa and functionalities are used to describe age-appropriate microbiome development, and advanced modelling techniques enable an understanding and visualization of an optimal microbiome maturation trajectory. Specific microbiome features can be related to later health conditions, however, whether such features have a causal relationship is the topic of intense research. Early life nutrition is an important microbiome modulator, and 'Mother Nature' provides the model with breast milk as the sole source of nutrition for the early postnatal period, while dietary choices during the prenatal and weaning period are to a large extent guided by tradition and culture. Increasing evidence suggests prenatal maternal diet and infant and child nutrition impact the infant microbiome trajectory and immune competence development. The lack of a universal feeding reference for such phases represents a knowledge gap, but also a great opportunity to provide adequate nutritional guidance to maintain an age-appropriate microbiome for long term health. Here, we provide a narrative review and perspective on our current understanding of age-appropriate microbiome maturation, its relation to long term health and how nutrition shapes and influences this relationship.
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Affiliation(s)
| | | | | | | | | | - Norbert Sprenger
- Nestlé Institute of Health Sciences, Société des Produits Nestlé S.A., 1000 Lausanne 26, Switzerland; (S.K.D.); (K.C.C.); (D.W.); (O.S.); (S.C.M.)
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14
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Kaminskaite V, Ludman S. Does early egg introduction prevent egg allergy in children? Arch Dis Child 2021; 106:1024-1027. [PMID: 33931400 DOI: 10.1136/archdischild-2021-321968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 11/04/2022]
Affiliation(s)
| | - Sian Ludman
- Paediatrics, Royal Devon and Exeter Hospital, Exeter, Devon, UK
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15
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Tedner SG, Söderhäll C, Konradsen JR, Bains KES, Borres MP, Carlsen K, Carlsen KCL, Färdig M, Gerdin SW, Gudmundsdóttir HK, Haugen G, Hedlin G, Jonassen CM, Kreyberg I, Mägi CO, Nordhagen LS, Rehbinder EM, Rudi K, Skjerven HO, Staff AC, Vettukattil R, Hage M, Nordlund B, Asarnoj A. Extract and molecular-based early infant sensitization and associated factors-A PreventADALL study. Allergy 2021; 76:2730-2739. [PMID: 33751598 DOI: 10.1111/all.14805] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/15/2021] [Accepted: 01/21/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND More knowledge about sensitization patterns in early infancy, including impact of molecular allergology, is needed to help predict future allergy development more accurately. OBJECTIVE We aimed to determine the prevalence and patterns of allergic sensitization at 3 months of age, and explore possible associated factors. METHODS From the Scandinavian antenatally recruited PreventADALL mother-child cohort, we included 1110 3-month infants with available serum. Sensitization was defined as s-IgE of ≥0.1 kUA /L by Phadiatop Infant® (ThermoFisher Scientific) including birch, cat, grass, dog, milk, egg, peanut and wheat. Further ImmunoCAP analyses to ovomucoid, casein, Ara h 1-3, omega-5-gliadin were performed in food extract s-IgE-positive children. Maternal sensitization was defined as s-IgE ≥ 0.35 kUA /L to Phadiatop® (inhalant allergen mix) and/or Fx5 (food allergen mix) at 18-week pregnancy. RESULTS Overall 79 (7.3%) infants had specific sensitization, many with low s-IgE-levels (IQR 0.16-0.81 kUA /L), with 78 being sensitized to food extract allergens; 41 to egg, 27 to milk, 10 to peanut, and 25 to wheat. A total of 62/78 were further analysed, 18 (29%) had s-IgE to ovomucoid, casein, Ara h 1-3 and/or omega-5-gliadin. Eight infants (0.7%) were sensitized to inhalant allergens. Maternal sensitization to food allergens was associated with infant sensitization, odds ratio 3.64 (95% CI 1.53-8.68). CONCLUSION Already at 3 months of age, 7% were sensitized to food, mostly without detectable s-IgE to food allergen molecules, and <1% to inhalant allergens. Maternal food sensitization was associated with infants' sensitization.
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Affiliation(s)
- Sandra G. Tedner
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Cilla Söderhäll
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Jon R. Konradsen
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Karen E. S. Bains
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
| | - Magnus P. Borres
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Kai‐Håkon Carlsen
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
| | - Karin C. L. Carlsen
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
| | - Martin Färdig
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Sabina W. Gerdin
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Hrefna K. Gudmundsdóttir
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
| | - Guttorm Haugen
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
- Division of Obstetrics and Gynaecology Oslo University Hospital Oslo Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Christine M. Jonassen
- Genetic Unit Centre for Laboratory Medicine Østfold Hospital Trust Kalnes Norway
- Faculty of Chemistry, Biotechnology and Food Science Norwegian University of Life Sciences Ås Norway
| | - Ina Kreyberg
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
| | - Caroline‐Aleksi O. Mägi
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Live S. Nordhagen
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
- VID Specialized University Oslo Norway
| | - Eva M. Rehbinder
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
- Department of Dermatology Oslo University Hospital Oslo Norway
| | - Knut Rudi
- Faculty of Chemistry, Biotechnology and Food Science Norwegian University of Life Sciences Ås Norway
| | - Håvard O. Skjerven
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
| | - Anne C. Staff
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
- Division of Obstetrics and Gynaecology Oslo University Hospital Oslo Norway
| | - Riyas Vettukattil
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Faculty of Medicine University of Oslo, Institute of Clinical Medicine Oslo Norway
| | - Marianne Hage
- Department of Medicine Solna Division of Immunology and Allergy Karolinska Institutet and University Hospital Stockholm Sweden
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Anna Asarnoj
- Astrid Lindgren Children's Hospital, Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
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16
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Complementary Feeding in Italy: From Tradition to Innovation. CHILDREN 2021; 8:children8080638. [PMID: 34438529 PMCID: PMC8391452 DOI: 10.3390/children8080638] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 07/15/2021] [Accepted: 07/22/2021] [Indexed: 11/17/2022]
Abstract
Complementary feeding (CF) is a pivotal phase of the individual’s growth, during which children develops their future dietary habits. To date, only few studies investigated and compared weaning modalities between different geographical areas. The aim of this article is to describe the current Italian practice for CF in healthy term infants among different areas (North, Center, South) of Italy. Two different multiple-choice questionnaires were produced and sent to 665 Italian primary care pediatricians (PCP) and 2023 families with children under 1 year of age. As emerged from our investigation, in Italy CF is usually started between the 5th and 6th month of life. The preferred approach (chosen by 77% of families) involves the use of home-cooked liquid or semi-liquid ailments, or industrial baby foods. A new CF modality is emerging, consisting of traditional complementary foods with adult food tastings (10% of families). Approximately 91% of pediatricians give written dietary suggestions, and 83% of families follow their advice. We found significantly divergent weaning habits among different areas of Italy. PCP have a key role in guiding parents during the introduction of new foods in their infant’s diet and should take this as an opportunity to educate the whole family to healthy dietary habits.
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17
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Early Introduction of Food Allergens and Risk of Developing Food Allergy. Nutrients 2021; 13:nu13072318. [PMID: 34371828 PMCID: PMC8308770 DOI: 10.3390/nu13072318] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/23/2021] [Accepted: 07/02/2021] [Indexed: 12/27/2022] Open
Abstract
There is increasing evidence that early introduction of allergenic foods may decrease the risk of developing IgE-mediated food allergy. Patterns of food introduction before the 2015 publication of the Learning Early about Peanut Allergy (LEAP) trial are not well-studied, but are important as a baseline for evaluating subsequent changes in infant feeding practices and potentially food allergy. We performed a retrospective longitudinal study using data from a multicenter cohort of infants hospitalized with bronchiolitis between 2011–2014. The primary outcomes were IgE-mediated egg or peanut allergy by age 3 years. Of 770 participants included in the analysis, 635 (82%) introduced egg, and 221 (27%) introduced peanut by age 12 months per parent report. Four participants had likely egg allergy, and eight participants had likely peanut allergy by age 3 years. Regular infant egg consumption was associated with less egg allergy. The association was suggestive for infant peanut consumption with zero peanut allergy cases. Overall, our results suggest that early introduction of peanut was uncommon before 2015. Although limited by the small number of allergy cases, our results suggest that early introduction of egg and peanut are associated with a decreased risk of developing food allergy, and support recent changes in practice guidelines.
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18
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Bivi D, Di Chio T, Geri F, Morganti R, Goggi S, Baroni L, Mumolo MG, de Bortoli N, Peroni DG, Marchi S, Bellini M. Raising Children on a Vegan Diet: Parents' Opinion on Problems in Everyday Life. Nutrients 2021; 13:nu13061796. [PMID: 34070399 PMCID: PMC8226937 DOI: 10.3390/nu13061796] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/14/2021] [Accepted: 05/23/2021] [Indexed: 01/29/2023] Open
Abstract
A growing number of Italian families are adopting a vegan diet (VD) for their offspring from infancy for various reasons, with health benefits and ethics being the most common reasons. Barriers to effective communication with primary care pediatricians (PCPs) are perceived by many parents and, depending on the actors involved and the environment, a VD may affect social interactions in everyday life. A national cross-sectional survey was conducted between July and September 2020. Parents of children following a VD completed an online questionnaire. Data from 176 Italian parents were collected. About 72% (71.8%) of the children included in this study had been on a VD since weaning. Parents did not inform their primary care pediatricians (PCP) about the VD in 36.2% of the cases. In 70.8% of the cases, PCPs were perceived as skeptical or against a VD. About 70% (71.2%) of the parents relied on medical dietitians, and 28.2% on nutritionists/dietitians for dietary counseling. Parents administered an individual B12 supplement in 87.2% of the cases. To the best of our knowledge, this survey is the first which explores the relationship between vegan parents and their PCPs, the parental management of their children's diet and problems regarding the implementation of a VD in everyday life.
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Affiliation(s)
- Daisy Bivi
- Gastrointestinal Unit, Department of Translational Sciences and New Technology in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy; (D.B.); (F.G.); (M.G.M.); (N.d.B.); (S.M.); (M.B.)
| | - Teresa Di Chio
- Pediatric Institute of Southern Switzerland, Ospedale Regionale di Bellinzona e Valli, Via Ospedale 12, 6500 Bellinzona, Switzerland
- Correspondence: ; Tel.: +41-77-953-70-77
| | - Francesca Geri
- Gastrointestinal Unit, Department of Translational Sciences and New Technology in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy; (D.B.); (F.G.); (M.G.M.); (N.d.B.); (S.M.); (M.B.)
| | - Riccardo Morganti
- Section of Statistics, University Hospital of Pisa, 56100 Pisa, Italy;
| | - Silvia Goggi
- Scientific Society for Vegetarian Nutrition, Scientific Committee, Via Verdi 10/9, 30171 Mestre (VE), Italy; (S.G.); (L.B.)
| | - Luciana Baroni
- Scientific Society for Vegetarian Nutrition, Scientific Committee, Via Verdi 10/9, 30171 Mestre (VE), Italy; (S.G.); (L.B.)
| | - Maria Gloria Mumolo
- Gastrointestinal Unit, Department of Translational Sciences and New Technology in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy; (D.B.); (F.G.); (M.G.M.); (N.d.B.); (S.M.); (M.B.)
| | - Nicola de Bortoli
- Gastrointestinal Unit, Department of Translational Sciences and New Technology in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy; (D.B.); (F.G.); (M.G.M.); (N.d.B.); (S.M.); (M.B.)
| | - Diego Giampietro Peroni
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, 56126 Pisa, Italy;
| | - Santino Marchi
- Gastrointestinal Unit, Department of Translational Sciences and New Technology in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy; (D.B.); (F.G.); (M.G.M.); (N.d.B.); (S.M.); (M.B.)
| | - Massimo Bellini
- Gastrointestinal Unit, Department of Translational Sciences and New Technology in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy; (D.B.); (F.G.); (M.G.M.); (N.d.B.); (S.M.); (M.B.)
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19
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Bertmann F, Dunn CG, Racine EF, Fleischhacker S. The Risk of Homemade Infant Formulas: Historical and Contemporary Considerations. J Acad Nutr Diet 2021; 122:697-708. [PMID: 34016563 DOI: 10.1016/j.jand.2021.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 03/09/2021] [Accepted: 03/09/2021] [Indexed: 11/28/2022]
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20
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Savarino G, Corsello A, Corsello G. Macronutrient balance and micronutrient amounts through growth and development. Ital J Pediatr 2021; 47:109. [PMID: 33964956 PMCID: PMC8106138 DOI: 10.1186/s13052-021-01061-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/27/2021] [Indexed: 11/23/2022] Open
Abstract
Nutrition is essential for human growth, particularly in newborns and children. An optimal growth needs a correct diet, in order to ensure an adequate intake of macronutrients and micronutrients. Macronutrients are the compounds that humans consume in largest quantities, mainly classified in carbohydrates, proteins and fats. Micronutrients are instead introduced in small quantities, but they are required for an adequate growth in the pediatric age, especially zinc, iron, vitamin D and folic acid. In this manuscript we describe the most important macro and micronutrients for children's growth.
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Affiliation(s)
- Giovanni Savarino
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University Hospital "P.Giaccone", Palermo, Italy.
| | - Antonio Corsello
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- University of Milan, Milan, Italy
| | - Giovanni Corsello
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University Hospital "P.Giaccone", Palermo, Italy
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21
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Lamminsalo A, Lundqvist A, Virta LJ, Gissler M, Kaila M, Metsälä J, Virtanen SM. Cow's milk allergy in infancy and later development of type 1 diabetes-nationwide case-cohort study. Pediatr Diabetes 2021; 22:400-406. [PMID: 33470004 DOI: 10.1111/pedi.13181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/09/2020] [Accepted: 12/15/2020] [Indexed: 12/15/2022] Open
Abstract
BAKGROUND It is suggested that early intake of cow's milk could be a risk factor for type 1 diabetes (T1DM). Further, the different immunological background, gives a suggestion of an inverse relationship for the occurrence of these diseases. The aim of this study was to explore the association between cow's milk allergy (CMA) and the risk of T1DM in a register-based case-cohort study. METHODS Data were obtained from Finnish nationwide health registers. The study included all children born in Finland between January 01, 1986 and December 31, 2008 and diagnosed with T1DM before the age of 16 years (n = 7754). A 10% random sample from each birth year cohort was selected as a reference cohort (n = 137,798). T1DM, CMA, and asthma were defined based on valid special reimbursements for the costs of drugs/special formulas needed in the treatment of the diseases. Child's sex, birth decade, asthma, maternal diabetes and asthma, smoking during pregnancy, and previous deliveries were considered as confounding factors. Time-dependent, weighted Cox regression was applied for statistical analyses. RESULTS Children with CMA had an increased risk of developing T1DM in fully adjusted model (HR = 1.17; 95% CI 1.02-1.34), but the association was no longer observed when including the use of special infant formulas in the definition of CMA in the sensitivity analysis (HR = 1.11; 95% CI 0.92-1.32). CMA was associated with an increased risk of T1DM in children without asthma (HR = 1.27; 95%CI 1.10-1.47), but not in children with asthma (HR = 0.80; 95% CI 0.92-1.27). CONCLUSION Children with CMA may have an increased risk of T1DM.
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Affiliation(s)
- Anni Lamminsalo
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland.,Research, Development, and Innovation Center, Tampere University Hospital, Tampere, Finland
| | - Annamari Lundqvist
- Public Health Solutions Department, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Lauri J Virta
- Research Department, Social Insurance Institution, Turku, Finland
| | - Mika Gissler
- Information Services Department, Finnish Institute for Health and Welfare, Helsinki, Finland.,Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Minna Kaila
- Public Health Medicine, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.,Department of Paediatrics, Tampere University Hospital, Tampere, Finland
| | - Johanna Metsälä
- Public Health Solutions Department, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Suvi M Virtanen
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland.,Research, Development, and Innovation Center, Tampere University Hospital, Tampere, Finland.,Public Health Solutions Department, Finnish Institute for Health and Welfare, Helsinki, Finland.,Center for Child Health Research, Tampere University, Tampere University Hospital, Tampere, Finland
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22
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Pouessel G, Jean-Bart C, Deschildre A, Van der Brempt X, Tanno LK, Beaumont P, Dumond P, Sabouraud-Leclerc D, Beaudouin E, Ramdane N, Liabeuf V, Renaudin JM. Food-induced anaphylaxis in infancy compared to preschool age: A retrospective analysis. Clin Exp Allergy 2019; 50:74-81. [PMID: 31651059 DOI: 10.1111/cea.13519] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/17/2019] [Accepted: 09/17/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Little is known regarding food anaphylaxis in infancy. We aimed to describe specificities of food anaphylaxis in infants (≤12 months) as compared to preschool children (1-6 years). METHODS We conducted a retrospective study of all food anaphylaxis cases recorded by the Allergy Vigilance Network from 2002 to 2018, in preschool children focusing on infants. RESULTS Of 1951 food anaphylaxis reactions, 61 (3%) occurred in infants and 386 (20%) in preschool children. Two infants had two anaphylaxis reactions; thus, we analyzed data among 59 infants (male: 51%; mean age: 6 months [SD: 2.9]); 31% had a history of atopic dermatitis, 11% of previous food allergy. The main food allergens were cow's milk (59%), hen's egg (20%), wheat (7%) and peanut (3%) in infants as compared with peanut (27%) and cashew (23%) in preschool children. Anaphylaxis occurred in 28/61 (46%) cases at the first cow's milk intake after breastfeeding discontinuation. Clinical manifestations were mainly mucocutaneous (79%), gastrointestinal (49%), respiratory (48%) and cardiovascular (21%); 25% of infants received adrenaline. Hives, hypotension and neurologic symptoms were more likely to be reported in infants than in preschool children (P = .02; P = .004; P = .002, respectively). Antihistamines and corticosteroids were more often prescribed in preschool children than in infants (P = .005; P = .025, respectively). CONCLUSION Our study found that in infants presenting with their first food allergy, in a setting with a high rate of infant formula use, the most predominant trigger was cow's milk. As compared to older preschool children, hives, hypotonia and hypotension were more likely to be reported in infants. We believe that this represents a distinct food anaphylaxis phenotype that can further support developing the clinical anaphylaxis criteria in infants.
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Affiliation(s)
- Guillaume Pouessel
- Department of Pediatrics, Children's Hospital, Roubaix, France.,Pediatric Pulmonology and Allergy Department, CHU Lille, Lille, France.,Allergy Vigilance Network, Vandoeuvre-lès-Nancy, France
| | | | - Antoine Deschildre
- Pediatric Pulmonology and Allergy Department, CHU Lille, Lille, France.,Allergy Vigilance Network, Vandoeuvre-lès-Nancy, France
| | - Xavier Van der Brempt
- Allergy Vigilance Network, Vandoeuvre-lès-Nancy, France.,Allergopôle, Clinique Saint-Luc, Bouge, Belgium
| | - Luciana Kase Tanno
- Allergy Vigilance Network, Vandoeuvre-lès-Nancy, France.,University Hospital, Montpellier, France.,INSERM UMR-S 1136, IPLESP, Equipe EPAR, Sorbonne Université, Paris, France.,Hospital Sírio Libanês, São Paulo, Brazil
| | - Pascale Beaumont
- Allergy Vigilance Network, Vandoeuvre-lès-Nancy, France.,Medical office, Saint-Maur des Fossés, France
| | - Pascale Dumond
- Allergy Vigilance Network, Vandoeuvre-lès-Nancy, France.,Pediatric Allergology Department, Children's hospital, University Hospital Nancy, Vandoeuvre-lès-Nancy, France
| | - Dominique Sabouraud-Leclerc
- Allergy Vigilance Network, Vandoeuvre-lès-Nancy, France.,Pediatric Department, American Memorial Hospital, Reims, France
| | - Etienne Beaudouin
- Department of Allergology and Clinical Immunology, Mercy Hospital, Metz-Thionville, France
| | - Nassima Ramdane
- EA 2694, Public health epidemiology and quality of care, University of Lille, Lille, France
| | - Valérie Liabeuf
- Department of Dermatology, La Timone Hospital, Aix-Marseille University, Marseille, France
| | - Jean-Marie Renaudin
- Allergy Vigilance Network, Vandoeuvre-lès-Nancy, France.,Pediatric Allergy Care Unit University Hospital, Vandoeuvre-lès-Nancy, France
| | -
- Allergy Vigilance Network, Vandoeuvre-lès-Nancy, France
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