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Yi KH. Where and when to use ultrasonography in botulinum neurotoxin, fillers, and threading procedures? J Cosmet Dermatol 2024; 23:773-776. [PMID: 37969045 DOI: 10.1111/jocd.16064] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/01/2023] [Accepted: 10/26/2023] [Indexed: 11/17/2023]
Affiliation(s)
- Kyu-Ho Yi
- Maylin Clinic (Apgujeong), Seoul, Korea
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, Yonsei University College of Dentistry, Seoul, Korea
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2
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Yi K, Kim S, Kim H. Ultrasonographic observations of the paradoxical mentalis bulging in regard to botulinum neurotoxin injection for mentalis muscle. Skin Res Technol 2023; 29:e13517. [PMID: 38009025 PMCID: PMC10616537 DOI: 10.1111/srt.13517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 10/21/2023] [Indexed: 11/28/2023]
Affiliation(s)
- Kyu‐Ho Yi
- Maylin Clinic (Apgujeong)SeoulSouth Korea
- Division in Anatomy and Developmental BiologyDepartment of Oral BiologyHuman Identification Research Institute, BK21 FOUR ProjectYonsei University College of DentistrySeoulRepublic of Korea
| | - Soo‐Bin Kim
- Division in Anatomy and Developmental BiologyDepartment of Oral BiologyHuman Identification Research Institute, BK21 FOUR ProjectYonsei University College of DentistrySeoulRepublic of Korea
| | - Hee‐Jin Kim
- Division in Anatomy and Developmental BiologyDepartment of Oral BiologyHuman Identification Research Institute, BK21 FOUR ProjectYonsei University College of DentistrySeoulRepublic of Korea
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3
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Fiocchi A, Monaci L, De Angelis E, Calandrelli V, Dahdah L, Valluzzi R, Urbani S, Mazzuca C, Arasi S, Cafarotti A, Riccardi C, Artesani MC, Putignani L, Pecora V, Marzano V, Fierro V. Reactivity to allergenic food contaminants: A study on products on the market. Clin Transl Allergy 2023; 13:e12301. [PMID: 37746792 PMCID: PMC10515704 DOI: 10.1002/clt2.12301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/17/2023] [Accepted: 08/29/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND The frequency and severity of reactions in food-allergic consumers exposed to unintentional food allergen contamination during production is unknown. To warn allergic consumers, it has been suggested for pre-packaged foods to be precautionary labelled when the food allergen contamination may exceed the amount to which 1%-5% of the population could react (ED01-ED05). ED01 for hazelnut and milk have been estimated at 0.1 and 0.2 mg, respectively, by the Voluntary Incidental Trace Allergen Labelling (VITAL) initiative. The respective reference doses recommended by the FAO/WHO Codex consultation are 3 and 2 mg. We evaluated the reactivity to potential traces of milk and hazelnut allergens in allergen-free pre-packaged products by children affected by severe allergies to milk and hazelnuts. METHODS Oral Food Challenges with commercially available hazelnut-free wafer biscuits and milk-free chocolate pralines were administered to patients with severe food allergies to hazelnut and cow's milk, respectively. Contamination levels of milk or hazelnut allergens were measured using chromatographic separation interfaced with triple quadrupole mass spectrometry. RESULTS No hazelnut allergic patient showed allergic reactions to exposure to biscuits, nor any milk allergic patient displayed allergic reactions to the dark chocolate praline. While no hazelnut trace was detected in biscuits, the praline was found to be contaminated by milk at concentrations ranging between 8 and 35 mg total protein/kg food. In our dose model, these amounts exceeded 1.5-10 times the VITAL ED01 and reached the threshold suggested by the FAO/WHO Codex consultation. CONCLUSIONS Upon the consumption of food products available on the market, many patients with severe food allergies tolerate significantly higher doses of allergen than reference doses indicated in the VITAL system used for precautionary allergen labelling. These doses support the safety of the FAO/WHO recommended reference doses.
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Affiliation(s)
| | - Linda Monaci
- Institute of Sciences of Food ProductionCNR‐ISPABariItaly
| | | | | | - Lamia Dahdah
- Allergy DptBambino Gesù Children's HospitalIRCCSRomeItaly
| | - Rocco Valluzzi
- Allergy DptBambino Gesù Children's HospitalIRCCSRomeItaly
| | - Sara Urbani
- Allergy DptBambino Gesù Children's HospitalIRCCSRomeItaly
| | - Carmen Mazzuca
- Allergy DptBambino Gesù Children's HospitalIRCCSRomeItaly
| | - Stefania Arasi
- Allergy DptBambino Gesù Children's HospitalIRCCSRomeItaly
| | | | - Carla Riccardi
- Allergy DptBambino Gesù Children's HospitalIRCCSRomeItaly
| | | | - Lorenza Putignani
- Unit of Microbiology and Diagnostic ImmunologyBambino Gesù Children's HospitalIRCCSRomeItaly
- Unit of Human MicrobiomeDepartment of Diagnostics and Laboratory MedicineBambino Gesù Children's HospitalIRCCSRomeItaly
| | | | - Valeria Marzano
- Unit of Microbiology and Diagnostic ImmunologyBambino Gesù Children's HospitalIRCCSRomeItaly
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4
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Lloyd M, Loke P, Mack DP, Sicherer SH, Perkin MR, Boyle R, Yin Leung AS, Lee BW, Levin M, Blumchen K, Fiocchi A, Ebisawa M, Oliveira LCLD, Tang MLK. Varying Approaches to Management of IgE-Mediated Food Allergy in Children Around the World. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:1010-1027.e6. [PMID: 36805346 DOI: 10.1016/j.jaip.2023.01.049] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/17/2023]
Abstract
Food allergy is a chronic disease that affects individuals of all ages and is a significant public health problem globally. This narrative overview examines clinical management strategies for IgE-mediated food allergy in children around the world to understand variations in practice. Information was drawn from clinical practice guidelines, recent research, the websites of professional and governmental bodies with expertise in food allergy, and clinical experts from a broad cross-section of geographical regions. The structure and delivery of clinical services, allergen avoidance and food labeling, and resources to support the management of allergic reactions in the community are discussed in detail. The adoption of emerging food immunotherapies is also explored. Wide variations in clinical management of food allergy were apparent across the different countries. Common themes were continuing issues with access to specialist care and recognition of the need to balance risk reduction with dietary and social restrictions to avoid unnecessary detrimental impacts on the quality of life of food allergy sufferers. Findings highlight the need for standardized presentation of practice and priorities, and may assist clinicians and researchers when engaging with government and funding agencies to address gaps.
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Affiliation(s)
- Melanie Lloyd
- Allergy Immunology, Murdoch Children's Research Institute, Parkville, VIC, Australia; Centre for Medicine Use and Safety, Monash University, Parkville, VIC, Australia
| | - Paxton Loke
- Allergy Immunology, Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, Monash University, Clayton, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Douglas P Mack
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Scott H Sicherer
- Elliot and Roslyn Jaffe Food Allergy Institute, Division of Allergy and Immunology, Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Michael R Perkin
- Population Health Research Institute, St. George's, University of London, London, United Kingdom
| | - Robert Boyle
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Agnes Sze Yin Leung
- Department of Paediatrics, Prince of Wales Hospital, the Chinese University of Hong Kong, Shatin, Hong Kong; Hong Kong Hub of Paediatric Excellence, the Chinese University of Hong Kong, Shatin, Hong Kong
| | - Bee Wah Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michael Levin
- Division of Paediatric Allergology, University of Cape Town, Cape Town, South Africa
| | - Katharina Blumchen
- Department of Children and Adolescent Medicine, Division of Pneumology, Allergology and Cystic Fibrosis, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany
| | - Alessandro Fiocchi
- Translational Research in Paediatric Specialities Area, Allergy Division, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Sagamihara, Japan
| | - Lucila Camargo Lopes de Oliveira
- Department of Paediatrics, Division of Allergy, Clinical Immunology and Rheumatology, Federal University of São Paulo, São Paulo, Brazil
| | - Mimi L K Tang
- Allergy Immunology, Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, VIC, Australia.
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5
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Tang R, Lyu X, Liu Y, Zhu M, Yang X, Wu Z, Han B, Wu S, Sun J. Four clinical phenotypes of cow’s milk protein allergy based on dairy product specific IgE antibody types in North China. Front Immunol 2022; 13:949629. [PMID: 36275773 PMCID: PMC9585381 DOI: 10.3389/fimmu.2022.949629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Abstract
Background Cow’s milk protein allergy (CMPA) is a common allergy. Immunoglobulin E (IgE)-mediated cow’s milk allergy is associated with a high mortality risk and poor prognosis. The study aims to investigate whether there are different clinically CMPA phenotypes in China and to explore the association between CMPA phenotypes and specific IgE (sIgE) antibodies against different dairy products. Methods Serum sIgE against different animal milk and cow’s milk products and different milk components was measured by an allergen array. Four CMPA classifications were identified by the presence of serum sIgE: boiled milk-positive, yogurt-positive, buttermilk-positive, and raw milk-positive. Results Among the 234 participants included in the study, 9 were boiled milk sIgE-positive, 50 were yogurt sIgE-positive, 17 were buttermilk sIgE-positive, and 158 were only raw milk sIgE-positive. The boiled milk-positive group had the highest levels of raw milk sIgE and casein sIgE antibodies, followed sequentially by the yogurt-positive, buttermilk-positive, and raw milk-positive groups. The boiled milk group observed the highest levels of sIgE against raw milk, casein, α-lactalbumin, and β-lactoglobulin. These levels differed significantly from those in the other three groups. Allergic symptoms were distributed differently among the four study groups. The percentages of allergic patients with gastrointestinal tract symptoms in the above mentioned four groups ranged from high to low, and the percentages of patients with skin symptoms in the four groups ranged from low to high, respectively. Conclusion Based on dairy product sIgE antibody levels associated with different milk components and various clinical allergic symptom tendencies, we could distinguish four CMPA phenotypes.
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Affiliation(s)
- Rui Tang
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Allergy Department, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaohong Lyu
- Eight-year program of clinical medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yi Liu
- Hangzhou Zheda Dixun Biological Gene Engineering Co., Ltd., Hangzhou, China
| | - Mingzhi Zhu
- Hangzhou Zheda Dixun Biological Gene Engineering Co., Ltd., Hangzhou, China
| | - Xukai Yang
- Hangzhou Zheda Dixun Biological Gene Engineering Co., Ltd., Hangzhou, China
| | - Zhoujie Wu
- Hangzhou Zheda Dixun Biological Gene Engineering Co., Ltd., Hangzhou, China
| | - Bingnan Han
- Zheda Dixun Anti-Allergy Functional Molecular Laboratory, Department of Development Technology of Marine Resources, College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou, China
- *Correspondence: Jinlyu Sun, ; Shandong Wu, ; Bingnan Han,
| | - Shandong Wu
- Hangzhou Zheda Dixun Biological Gene Engineering Co., Ltd., Hangzhou, China
- *Correspondence: Jinlyu Sun, ; Shandong Wu, ; Bingnan Han,
| | - Jinlyu Sun
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Allergy Department, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Jinlyu Sun, ; Shandong Wu, ; Bingnan Han,
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Valluzzi RL, Riccardi C, Arasi S, Piscitelli AL, Calandrelli V, Dahdah L, Fierro V, Mennini M, Fiocchi A. Cow's milk and egg protein threshold dose distributions in children tolerant to beef, baked milk, and baked egg. Allergy 2022; 77:3052-3060. [PMID: 35652800 PMCID: PMC9796240 DOI: 10.1111/all.15397] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 04/21/2022] [Accepted: 05/10/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND The use of eliciting doses (EDs) for food allergens is necessary to inform individual dietary advice and food allergen risk-management. The Eliciting Dose 01 (ED01) for milk and egg, calculated from populations of allergic subjects undergoing oral food challenges (OFCs), are 0.2 mg total protein. The respective Eliciting Dose 05 (ED05) is 2.4 mg for milk and 2.3 mg for egg. As about 70% children allergic to such foods may tolerate them when baked, we sought to verify the EDs of that subpopulation of milk and egg-allergic children. METHODS We retrospectively assessed consecutive OFC for fresh milk and egg between January 2018 and December 2020 in a population of baked food-tolerant children. RESULTS Among 288 children (median age 56 - IQR 36-92.5 months, 67.1% male) included, 87 (30.2%) returned positive OFC results, 38 with milk and 49 with egg. The most conservative ED01 was 0.3 mg total protein (IQR 0.03-2.9) for milk and 14.4 mg total protein (IQR 3.6-56.9) for egg. The respective ED05 was 4.2 (IQR 0.9-19.6) mg for milk and 87.7 (IQR 43-179) mg for egg. Such thresholds are, respectively, 1.5 (milk ED01), 1.75 (milk ED05), 72 (egg ED01), and 38.35 (egg ED05) times higher than the currently used thresholds. CONCLUSIONS The subpopulation of children allergic to milk and egg, but tolerant to baked proteins, displays higher reactivity thresholds than the general population of children allergic to milk and egg. Their risk stratification, in both individual and population terms, should consider this difference. In baked milk-tolerant children, milk causes reactions at lower doses than egg in our group of egg-tolerant children. This could be associated with the relative harmlessness of egg compared with milk in the determinism of fatal anaphylactic reactions in children.
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Affiliation(s)
- Rocco Luigi Valluzzi
- Translational Research in Paediatric Specialities Area, Allergy Unit, Bambino Gesù Children's HospitalIRCCSRomeItaly
| | - Carla Riccardi
- Translational Research in Paediatric Specialities Area, Allergy Unit, Bambino Gesù Children's HospitalIRCCSRomeItaly
| | - Stefania Arasi
- Translational Research in Paediatric Specialities Area, Allergy Unit, Bambino Gesù Children's HospitalIRCCSRomeItaly
| | - Anna Lucia Piscitelli
- Translational Research in Paediatric Specialities Area, Allergy Unit, Bambino Gesù Children's HospitalIRCCSRomeItaly
| | - Veronica Calandrelli
- Translational Research in Paediatric Specialities Area, Allergy Unit, Bambino Gesù Children's HospitalIRCCSRomeItaly
| | - Lamia Dahdah
- Translational Research in Paediatric Specialities Area, Allergy Unit, Bambino Gesù Children's HospitalIRCCSRomeItaly
| | - Vincenzo Fierro
- Translational Research in Paediatric Specialities Area, Allergy Unit, Bambino Gesù Children's HospitalIRCCSRomeItaly
| | - Maurizio Mennini
- Translational Research in Paediatric Specialities Area, Allergy Unit, Bambino Gesù Children's HospitalIRCCSRomeItaly
| | - Alessandro Fiocchi
- Translational Research in Paediatric Specialities Area, Allergy Unit, Bambino Gesù Children's HospitalIRCCSRomeItaly
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7
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De Angelis E, Di Bona D, Pilolli R, Loiodice R, Luparelli A, Giliberti L, D’Uggento AM, Rossi MP, Macchia L, Monaci L. In Vivo and In Vitro Assessment and Proteomic Analysis of the Effectiveness of Physical Treatments in Reducing Allergenicity of Hazelnut Proteins. Nutrients 2022; 14:nu14040874. [PMID: 35215523 PMCID: PMC8875159 DOI: 10.3390/nu14040874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/07/2022] [Accepted: 02/17/2022] [Indexed: 12/10/2022] Open
Abstract
Hazelnut is a widespread nut species, especially present in Europe, that can be consumed raw or roasted thanks to its pleasant taste and nutritional properties. In addition to renowned beneficial properties hazelnuts contain several proteins capable of inducing food allergy in sensitized individuals, including Cor a 2 (a profilin), Cor a 8 (a lipid transfer protein), Cor a 9 (an 11S seed storage globulin, legumin-like), and Cor a 11 (a 7S seed storage globulin, vicilin-like). In the present paper we investigated the effectiveness of autoclave-based treatments in decreasing the allergic potential of hazelnut as assessed by submitting the treated material to an in vivo skin prick test and an in vitro immunoblot analysis, with sera of allergic individuals exposed to the treated food material. This preliminary analysis showed that autoclave treatment preceded by hydration and/or followed by drying seems to be a promising approach and appears to be effective in reducing the allergenicity of hazelnuts in most patients, probably due to the denaturation of most major and minor allergenic proteins. This work opens up the opportunity to produce hypoallergenic hazelnut derivatives that can be tolerated by allergic subjects.
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Affiliation(s)
- Elisabetta De Angelis
- Institute of Sciences of Food Production—National Research Council of Italy (ISPA-CNR), 70126 Bari, Italy; (E.D.A.); (R.P.); (A.L.)
| | - Danilo Di Bona
- Department of Emergency and Organ Transplantation (DETO), School and Chair of Allergology and Clinical Immunology, University of Bari Aldo Moro, 70124 Bari, Italy; (D.D.B.); (R.L.); (L.G.); (M.P.R.); (L.M.)
| | - Rosa Pilolli
- Institute of Sciences of Food Production—National Research Council of Italy (ISPA-CNR), 70126 Bari, Italy; (E.D.A.); (R.P.); (A.L.)
| | - Roberto Loiodice
- Department of Emergency and Organ Transplantation (DETO), School and Chair of Allergology and Clinical Immunology, University of Bari Aldo Moro, 70124 Bari, Italy; (D.D.B.); (R.L.); (L.G.); (M.P.R.); (L.M.)
| | - Anna Luparelli
- Institute of Sciences of Food Production—National Research Council of Italy (ISPA-CNR), 70126 Bari, Italy; (E.D.A.); (R.P.); (A.L.)
| | - Lucia Giliberti
- Department of Emergency and Organ Transplantation (DETO), School and Chair of Allergology and Clinical Immunology, University of Bari Aldo Moro, 70124 Bari, Italy; (D.D.B.); (R.L.); (L.G.); (M.P.R.); (L.M.)
| | - Angela M. D’Uggento
- Department of Economics and Finance, University of Bari Aldo Moro, 70124 Bari, Italy;
| | - Maria Pia Rossi
- Department of Emergency and Organ Transplantation (DETO), School and Chair of Allergology and Clinical Immunology, University of Bari Aldo Moro, 70124 Bari, Italy; (D.D.B.); (R.L.); (L.G.); (M.P.R.); (L.M.)
| | - Luigi Macchia
- Department of Emergency and Organ Transplantation (DETO), School and Chair of Allergology and Clinical Immunology, University of Bari Aldo Moro, 70124 Bari, Italy; (D.D.B.); (R.L.); (L.G.); (M.P.R.); (L.M.)
| | - Linda Monaci
- Institute of Sciences of Food Production—National Research Council of Italy (ISPA-CNR), 70126 Bari, Italy; (E.D.A.); (R.P.); (A.L.)
- Correspondence:
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