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Çevik S, Altaş U, Özkars MY. The Skin Sebum and Moisture Levels of Children with Allergic Diseases: How Predictive Are They for House Dust Mite Allergy? Diagnostics (Basel) 2024; 14:1348. [PMID: 39001239 PMCID: PMC11240642 DOI: 10.3390/diagnostics14131348] [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: 05/13/2024] [Revised: 06/17/2024] [Accepted: 06/18/2024] [Indexed: 07/16/2024] Open
Abstract
The aim was to evaluate the prediction of house dust mite allergy in children diagnosed with allergic disease based on their skin moisture and sebum levels. This is a case-control study including children with asthma, allergic rhinitis (AR), and atopic dermatitis (AD) and a healthy control group. The participants' skin moisture and sebum levels were measured non-invasively using a digital device. A total of 421 patients and 143 healthy children were included. The median value of skin moisture percentage was statistically significantly lower in asthma, AR, and AD patients compared to the control group (p < 0.001 for each). The median value of skin sebum percentage was significantly lower in asthma and AD patients compared to the control group (p = 0.002 and p = 0.003, respectively). ROC analysis was performed to assess the predictive value of skin moisture percentage for house dust mite allergy in respiratory allergic diseases (asthma and AR) and AD separately. Using a cut-off point of 35.5% for skin moisture in asthma and AR patients, the sensitivity and specificity were 81.3% and 56.5%, respectively. Although the specificity is low, the high sensitivity value is promising. The non-invasive measurement of skin sebum and moisture could provide convenience to clinicians in the diagnosis and management of allergic diseases.
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Affiliation(s)
- Seda Çevik
- Umraniye Training and Research Hospital, Department of Pediatric Allergy and Immunology, University of Health Sciences, Umraniye, 34764 Istanbul, Türkiye; (U.A.); (M.Y.Ö.)
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Mediterranean Milk Ladder: Integrating a Healthy Eating Plan While Reintroducing Cow's Milk. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020234. [PMID: 36832362 PMCID: PMC9954599 DOI: 10.3390/children10020234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/21/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
The process of gradually reintroducing food allergens into an individual's diet is referred to as a food allergen "ladder", and the most recent edition of the original Milk Allergy in Primary (MAP) Care Guidelines, as well as the International Milk Allergy in Primary Care (IMAP), includes a shortened, improved, and international version with specific recipes, indicating the exact milk protein content, as well as the duration of heating and the temperature for each step of the ladder. Food allergen ladders are being used increasingly in clinical practice. The aim of this study was to develop a Mediterranean milk ladder based on the principles of the Mediterranean eating pattern. The protein content delivered in a portion of the final food product in each step of the ladder in the Mediterranean version corresponds to that provided in the IMAP ladder. Different recipes for the various steps were provided to increase acceptability and variety. Quantification of the total milk protein, casein content, and beta-lactoglobulin by Enzyme-linked immunosorbent assay (ELISA) could detect the gradual increase in concentrations, but the accuracy of the method was affected by the presence of the other ingredients in the mixtures. When developing the Mediterranean milk ladder, a key consideration was to reduce the amount of sugar by using limited amounts of brown sugar and substituting sugar with fresh fruit juice or honey for children aged older than one year. The proposed Mediterranean milk ladder includes principles of (a) healthy eating based on the Mediterranean diet and (b) the acceptability of foods across different age groups.
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Abstract
PURPOSE OF REVIEW To highlight the current evidence on food desensitization in children with food allergy. RECENT FINDINGS Food Allergen Specific Immunotherapy (FA-AIT) is currently recognised as a treatment option for treating children with allergy at least to the main common foods (i.e. milk, egg and peanut). The oral route of administration has been proven to be the most effective in achieving desensitisation. Efforts are devoted to overcome the current unmet needs mainly related to safety issues and long-term efficacy, as well as adherence to the treatment and improvement of health-related quality of life. In this perspective, alternative routes of administration and adjunctive treatments are under investigation. SUMMARY The future of food allergy management is a personalised approach based on a shared decision-making that takes into account the needs of patients and families. Health professionals will be able to offer multiple treatment options, including FA-AIT with adjunctive or alternative therapies. Thus, patients should be correctly identified, using validated predictive factors, in order to select appropriate candidates for these therapies.
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López JF, Bel Imam M, Satitsuksanoa P, Lems S, Yang M, Hwang YK, Losol P, Choi JP, Kim SH, Chang YS, Akdis M, Akdis CA, van de Veen W. Mechanisms and biomarkers of successful allergen-specific immunotherapy. Asia Pac Allergy 2022; 12:e45. [PMID: 36452016 PMCID: PMC9669467 DOI: 10.5415/apallergy.2022.12.e45] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 10/30/2022] [Indexed: 11/22/2023] Open
Abstract
Allergen-specific immunotherapy (AIT) is considered the only curative treatment for allergic diseases mediated by immunoglobulin E (IgE). Currently, the route of administration depends both on the different types of causal allergens and on its effectiveness and safety profile. Several studies have reported the mechanisms and changes in humoral and cellular response underlying AIT; however, the full picture remains unknown. Knowledge of who can benefit from this type of treatment is urgently needed due to the patient safety risks and costs of AIT. In vivo or in vitro biomarkers have become a strategy to predict clinical outcomes in precision medicine. There are currently no standardized biomarkers that allow determining successful responses to AIT, however, some studies have found differences between responders and nonresponders. In addition, different candidates have been postulated that may have the potential to become biomarkers. In this review, we aim to summarize the findings to date related to biomarkers in different IgE-mediated allergic diseases (respiratory, food, and venom allergy) with the potential to define who will benefit from AIT.
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Affiliation(s)
- Juan-Felipe López
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Manal Bel Imam
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | | | - Sophieke Lems
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Minglin Yang
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Yu-Kyoung Hwang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Purevsuren Losol
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul National University, Seoul, Korea
| | - Jun-Pyo Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sae-Hoon Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul National University, Seoul, Korea
| | - Yoon-Seok Chang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul National University, Seoul, Korea
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Willem van de Veen
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
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Matysiak J. Modern diagnostics in IgE-mediated cow’s milk allergy. JOURNAL OF MEDICAL SCIENCE 2022. [DOI: 10.20883/medical.e690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Cow's milk allergy (CMA) is the most common food allergy in infants and young children. Allergic reactions can vary from mild to severe, like an anaphylactic shock. In case of CMA diagnosis suspicion skin prick tests (SPT), immunoassays of specific IgE (sIgE) in blood serum (in vitro tests) and oral food challenge (OFC) tests can be performed. SPT wheal diameter and the level of serum specific IgE to milk do not correlate with severity of clinical symptoms, while procedure of OFC is often difficult or even imposible in practice. Therefore component resolved-diagnostics (CRD) tests are a new diagnostic tool, which allows for a better correlation of laboratory test results with the observed clinical symptoms and indicate the triggering allergens.
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