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Demidova A, Drewitz KP, Kimkool P, Banjanin N, Barzylovich V, Botjes E, Capper I, Castor MAR, Comberiati P, Cook EE, Costa J, Chu DK, Epstein MM, Galvin AD, Giovannini M, Girard F, Golding MA, Greenhawt M, Ierodiakonou D, Jones CJ, Khaleva E, Knibb RC, Macit-Çelebi MS, Mack DP, Mafra I, Marchisotto MJ, Mijakoski D, Nekliudov N, Özdemir C, Patel N, Pazukhina E, Protudjer JLP, Rodríguez Del Rio P, Roomet J, Sammut P, Schoos AMM, Schopfer AF, Schultz F, Seylanova N, Skypala I, Sørensen M, Stoleski S, Stylianou E, Upton J, van de Veen W, Genuneit J, Boyle RJ, Apfelbacher C, Munblit D. Core Outcome Set for IgE-mediated food allergy clinical trials and observational studies of interventions: International Delphi consensus study 'COMFA'. Allergy 2024; 79:977-989. [PMID: 38433402 DOI: 10.1111/all.16023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/23/2023] [Accepted: 11/29/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND IgE-mediated food allergy (FA) is a global health concern with substantial individual and societal implications. While diverse intervention strategies have been researched, inconsistencies in reported outcomes limit evaluations of FA treatments. To streamline evaluations and promote consistent reporting, the Core Outcome Measures for Food Allergy (COMFA) initiative aimed to establish a Core Outcome Set (COS) for FA clinical trials and observational studies of interventions. METHODS The project involved a review of published clinical trials, trial protocols and qualitative literature. Outcomes found as a result of review were categorized and classified, informing a two-round online-modified Delphi process followed by hybrid consensus meeting to finalize the COS. RESULTS The literature review, taxonomy mapping and iterative discussions with diverse COMFA group yielded an initial list of 39 outcomes. The iterative online and in-person meetings reduced the list to 13 outcomes for voting in the formal Delphi process. One more outcome was added based on participant suggestions after the first Delphi round. A total of 778 participants from 52 countries participated, with 442 participating in both Delphi rounds. No outcome met a priori criteria for inclusion, and one was excluded as a result of the Delphi. Thirteen outcomes were brought to the hybrid consensus meeting as a result of Delphi and two outcomes, 'allergic symptoms' and 'quality of life' achieved consensus for inclusion as 'core' outcomes. CONCLUSION In addition to the mandatory reporting of adverse events for FA clinical trials or observational studies of interventions, allergic symptoms and quality of life should be measured as core outcomes. Future work by COMFA will define how best to measure these core outcomes.
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Affiliation(s)
| | - Karl Philipp Drewitz
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University, Magdeburg, Germany
| | - Parisut Kimkool
- Department of Pediatric Allergy, Imperial College Healthcare NHS Trust, London, UK
| | - Nikolina Banjanin
- Institute of Hygiene and Medical Ecology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vladyslava Barzylovich
- Department of Pediatrics, National Medical University named after O.O. Bogomolets, Kyiv, Ukraine
| | - Erna Botjes
- Dutch Food Allergy SVA, Nijkerk, The Netherlands
| | | | - Mary Anne R Castor
- Division of Allergy and Immunology, Department of Pediatrics, College of Medicine-Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Pasquale Comberiati
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Emma E Cook
- Modern Japanese Studies Program, Graduate School of Media and Communication, Hokkaido University, Sapporo, Japan
| | - Joana Costa
- REQUIMTE-LAQV, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
| | - Derek K Chu
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Michelle M Epstein
- Experimental Allergy Laboratory, Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | | | - Mattia Giovannini
- Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Michael A Golding
- The Children's Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Matthew Greenhawt
- Department of Pediatrics, Section of Allergy and Immunology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Despo Ierodiakonou
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | | | - Ekaterina Khaleva
- Clinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Rebecca C Knibb
- School of Psychology, Aston Institute of Health and Neurodevelopment, Aston University, Birmingham, UK
| | | | - Douglas P Mack
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Isabel Mafra
- REQUIMTE-LAQV, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
| | | | - Dragan Mijakoski
- Department for Allergic Diseases, Institute of Occupational Health of R.N. Macedonia, WHO Collaborating Center, Skopje, North Macedonia
- Department of Occupational Medicine, Faculty of Medicine, Ss. Cyril and Methodius, University in Skopje, Skopje, North Macedonia
| | - Nikita Nekliudov
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Cevdet Özdemir
- Department of Pediatric Basic Sciences, Institute of Child Health, Istanbul University, Istanbul, Turkey
| | - Nandinee Patel
- Department of Pediatric Allergy, Imperial College Healthcare NHS Trust, London, UK
| | | | - Jennifer L P Protudjer
- The Children's Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Jelena Roomet
- Centre for Allergology and Immunology, East Tallinn Central Hospital, Tallinn, Estonia
| | - Patrick Sammut
- Department of Paediatrics, Mater Dei Hospital, Msida, Malta
| | - Ann-Marie Malby Schoos
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen University Hospital-Herlev and Gentofte, Gentofte, Denmark
- Department of Pediatrics, Slagelse Sygehus, Slagelse, Denmark
| | | | - Fallon Schultz
- International FPIES Association (IFPIES), Point Pleasant Beach, New Jersey, USA
| | | | - Isabel Skypala
- Department of Inflammation and Repair, Imperial College London, London, UK
| | - Martin Sørensen
- Regional center for asthma, allergy and hypersensitivity, University Hospital of North Norway, Tromsø, Norway
| | - Sasho Stoleski
- Department for Allergic Diseases, Institute of Occupational Health of R.N. Macedonia, WHO Collaborating Center, Skopje, North Macedonia
- Department of Occupational Medicine, Faculty of Medicine, Ss. Cyril and Methodius, University in Skopje, Skopje, North Macedonia
| | - Eva Stylianou
- Department of Pulmonary Medicine, Regional Centre for Asthma, Allergy and Hypersensitivity, Oslo University Hospital, Oslo, Norway
| | - Julia Upton
- The Hospital for Sick Children, Divison of Immunology and Allergy, Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Willem van de Veen
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
| | - Jon Genuneit
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Robert J Boyle
- Department of Pediatric Allergy, Imperial College Healthcare NHS Trust, London, UK
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University, Magdeburg, Germany
| | - Daniel Munblit
- Care for Long Term Conditions Division, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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2
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Spolidoro GCI, Lisik D, Nyassi S, Ioannidou A, Ali MM, Amera YT, Rovner G, Khaleva E, Venter C, van Ree R, Worm M, Vlieg-Boerstra B, Sheikh A, Muraro A, Roberts G, Nwaru BI. Prevalence of tree nut allergy in Europe: A systematic review and meta-analysis. Allergy 2024; 79:302-323. [PMID: 37792850 DOI: 10.1111/all.15905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/31/2023] [Accepted: 09/18/2023] [Indexed: 10/06/2023]
Abstract
In 2014, the European Academy of Allergy and Clinical Immunology (EAACI) published the first systematic review that summarized the prevalence of food allergy (FA) and food sensitization in Europe for studies published 2000-2012. However, only summary estimates for tree nut allergy (TNA) were feasible in that work. In the current update of that systematic review, we summarized the prevalence of tree nut allergy/sensitization to individual tree nuts. Six databases were searched for relevant papers published 2012-2021 and 17 eligible studies were added to the 15 studies already identified between 2000 and 2012, giving a total of 32 studies. Of the investigated tree nuts, meta-analysis was possible for hazelnut, walnut, almond, and in few cases, for cashew, and Brazil nut. The lifetime self-reported prevalence was 0.8% (95% CI 0.5-1.1) for hazelnut and 0.4% (0.2-0.9) for walnut. The point self-reported prevalence was 4.0% (2.9-5.2) for hazelnut, 3.4% (2.0-4.9) for Brazil nut, 2.0% (1.1-2.9) for almond, and 1.8% (1.1-2.5) for walnut. Point prevalence of food challenge-confirmed TNA was 0.04% (0.0-0.1) for hazelnut and 0.02% (0.01-0.1) for walnut. Due to paucity of data, we could not identify any meaningful and consistent differences across age groups and European regions.
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Affiliation(s)
- Giulia C I Spolidoro
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Daniil Lisik
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - Sungkutu Nyassi
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - Athina Ioannidou
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - Mohamed Mustafa Ali
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Yohannes Tesfaye Amera
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Graciela Rovner
- ACT Institutet Sweden, Vejbystrand, Sweden
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Carina Venter
- Section of Allergy & Immunology, School of Medicine, University of Colorado Denver, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Ronald van Ree
- Department of Experimental Immunology and Department of Otorhinolaryngology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology, Allergy and Venerology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Berber Vlieg-Boerstra
- Department of Pediatrics, OLVG Hospital, Amsterdam, The Netherlands
- Department of Pediatrics, Rijnstate Hospital, Arnhem, The Netherlands
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Antonella Muraro
- Department of Mother and Child Health, The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region, University of Padua, Padua, Italy
| | - Graham Roberts
- Faculty of Medicine, University of Southampton, Southampton, UK
- David Hide Asthma and Allergy Centre, St Mary's Hospital, Isle of Wight, UK
| | - Bright I Nwaru
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
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3
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Alimani GS, Ananth S, Boccabella C, Khaleva E, Roberts G, Papadopoulos NG, Kosmidis C, Vestbo J, Papageorgiou E, Beloukas A, Mathioudakis AG. Prevalence and clinical implications of respiratory viruses in asthma during stable disease state and acute attacks: Protocol for a meta-analysis. PLoS One 2023; 18:e0294416. [PMID: 37967134 PMCID: PMC10651012 DOI: 10.1371/journal.pone.0294416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 10/31/2023] [Indexed: 11/17/2023] Open
Abstract
INTRODUCTION Viruses are detected in over 50% of acute asthma attacks and in a notable proportion of patients with asthma during stable disease state They are associated with worse outcomes. We will conduct a series of systematic reviews and meta-analyses to quantify the prevalence and clinical burden of various respiratory viruses in stable asthma and acute asthma attacks. In addition, we will assess the viral loads of respiratory viruses during stable and acute asthma, to explore whether viral load could differentiate attacks triggered by viruses versus those where viruses are present as "innocent bystanders". MATERIALS AND METHODS Based on a prospectively registered protocol (PROSPERO, ID: CRD42023375108) and following standard methodology recommended by Cochrane, we will systematically search Medline/PubMed, EMBASE, the Cochrane Library and relevant conference proceedings for studies assessing the prevalence or clinical burden of respiratory viruses in asthma. Methodological rigour of the included studies will be appraised using a tool specific for prevalence studies and the Newcastle-Ottawa Scale respectively. In anticipation of significant clinical and methodological heterogeneity, we will conduct random effect meta-analyses. For evaluating the prevalence of viruses, we will perform meta-analyses of proportions using the inverse variance method, and the Freeman-Tukey transformation. We will conduct meta-regression analyses for exploring heterogeneity. CONCLUSION We envisage that these systematic reviews and meta-analyses will quantify the prevalence and burden of respiratory viruses in stable and acute asthma and will drive future research and clinical practice.
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Affiliation(s)
| | - Sachin Ananth
- London North West University Healthcare Trust, London, United Kingdom
| | - Cristina Boccabella
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario "A Gemelli"—IRCCS, University of the Sacred Heart, Rome, Italy
| | - Ekaterina Khaleva
- Faculty of Medicine, Clinical and Experimental Sciences and Human Development in Health, University of Southampton, Southampton, United Kingdom
| | - Graham Roberts
- Faculty of Medicine, Clinical and Experimental Sciences and Human Development in Health, University of Southampton, Southampton, United Kingdom
- Paediatric Allergy and Respiratory Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Nikolaos G. Papadopoulos
- Division of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Chris Kosmidis
- Division of Evolution, Infection and Genomics, School of Biological Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Jørgen Vestbo
- Division of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
- The North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Effie Papageorgiou
- Department of Biomedical Sciences, University of West Attica, Athens, Greece
| | - Apostolos Beloukas
- Department of Biomedical Sciences, University of West Attica, Athens, Greece
- National AIDS Reference Centre of Southern Greece, University of West Attica, Athens, Greece
| | - Alexander G. Mathioudakis
- Division of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
- The North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
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4
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Spolidoro GCI, Ali MM, Amera YT, Nyassi S, Lisik D, Ioannidou A, Rovner G, Khaleva E, Venter C, van Ree R, Worm M, Vlieg-Boerstra B, Sheikh A, Muraro A, Roberts G, Nwaru BI. Prevalence estimates of eight big food allergies in Europe: Updated systematic review and meta-analysis. Allergy 2023; 78:2361-2417. [PMID: 37405695 DOI: 10.1111/all.15801] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 05/31/2023] [Accepted: 06/20/2023] [Indexed: 07/06/2023]
Abstract
In 2014, the European Academy of Allergy and Clinical Immunology published prevalence estimates for food allergy (FA) and food sensitization (FS) to the so-called eight big food allergens (i.e. cow's milk, egg, wheat, soy, peanut, tree nuts, fish and shellfish) in Europe for studies published between 2000 and 2012. The current work provides 10-year updated prevalence estimates for these food allergens. A protocol was registered on PROSPERO before starting the research (reference number CRD42021266657). Six databases were searched for studies published 2012-2021, added to studies published up to 2012, resulting in a total of 93 studies. Most studies were graded as at moderate risk of bias. The overall pooled estimates for all age groups of self-reported lifetime prevalence were as follows: cow's milk (5.7%, 95% confidence interval 4.4-6.9), egg (2.4%, 1.8-3.0), wheat (1.6%, 0.9-2.3), soy (0.5%, 0.3-0.7), peanut (1.5%, 1.0-2.1), tree nuts (0.9%, 0.6-1.2), fish (1.4%, 0.8-2.0) and shellfish (0.4%, 0.3-0.6). The point prevalence of food challenge-verified allergy were as follows: cow's milk (0.3%, 0.1-0.5), egg (0.8%, 0.5-1.2), wheat (0.1%, 0.01-0.2), soy (0.3%, 0.1-0.4), peanut (0.1%, 0.0-0.2), tree nuts (0.04%, 0.02-0.1), fish (0.02%, 0.0-0.1) and shellfish (0.1%, 0.0-0.2). With some exceptions, the prevalence of allergy to common foods did not substantially change during the last decade; variations by European regions were observed.
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Affiliation(s)
- Giulia C I Spolidoro
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Mohamed Mustafa Ali
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Yohannes Tesfaye Amera
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Sungkutu Nyassi
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - Daniil Lisik
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - Athina Ioannidou
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - Graciela Rovner
- ACT Institutet Sweden, Gothenburg, Sweden
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Carina Venter
- Section of Allergy & Immunology, School of Medicine, University of Colorado Denver, Children's Hospital Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Ronald van Ree
- Department of Experimental Immunology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Department of Otorhinolaryngology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology, Allergy and Venerology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Berber Vlieg-Boerstra
- Department of Pediatrics, OLVG Hospital, Amsterdam, The Netherlands
- Department of Pediatrics, Rijnstate Hospital, Arnhem, The Netherlands
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Antonella Muraro
- Department of Mother and Child Health, The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region, University of Padua, Padua, Italy
| | - Graham Roberts
- Faculty of Medicine, University of Southampton, Southampton, UK
- David Hide Asthma and Allergy Centre, St Mary's Hospital, Isle of Wight, UK
| | - Bright I Nwaru
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
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5
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Khaleva E, Rattu A, Brightling C, Bush A, Bourdin A, Bossios A, Chung KF, Chaudhuri R, Coleman C, Djukanovic R, Dahlén SE, Exley A, Fleming L, Fowler SJ, Gupta A, Hamelmann E, Koppelman GH, Melén E, Mahler V, Seddon P, Singer F, Porsbjerg C, Ramiconi V, Rusconi F, Yasinska V, Roberts G. Definitions of non-response and response to biological therapy for severe asthma: a systematic review. ERJ Open Res 2023; 9:00444-2022. [PMID: 37143849 PMCID: PMC10152254 DOI: 10.1183/23120541.00444-2022] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/06/2022] [Indexed: 01/27/2023] Open
Abstract
Background Biologics have proven efficacy for patients with severe asthma but there is lack of consensus on defining response. We systematically reviewed and appraised methodologically developed, defined and evaluated definitions of non-response and response to biologics for severe asthma. Methods We searched four bibliographic databases from inception to 15 March 2021. Two reviewers screened references, extracted data, and assessed methodological quality of development, measurement properties of outcome measures and definitions of response based on COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). A modified GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach and narrative synthesis were undertaken. Results 13 studies reported three composite outcome measures, three asthma symptoms measures, one asthma control measure and one quality of life measure. Only four measures were developed with patient input; none were composite measures. Studies utilised 17 definitions of response: 10 out of 17 (58.8%) were based on minimal clinically important difference (MCID) or minimal important difference (MID) and 16 out of 17 (94.1%) had high-quality evidence. Results were limited by poor methodology for the development process and incomplete reporting of psychometric properties. Most measures rated "very low" to "low" for quality of measurement properties and none met all quality standards. Conclusions This is the first review to synthesise evidence about definitions of response to biologics for severe asthma. While high-quality definitions are available, most are MCIDs or MIDs, which may be insufficient to justify continuation of biologics in terms of cost-effectiveness. There remains an unmet need for universally accepted, patient-centred, composite definitions to aid clinical decision making and comparability of responses to biologics.
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Affiliation(s)
- Ekaterina Khaleva
- Clinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Anna Rattu
- Clinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Chris Brightling
- Institute for Lung Health, Leicester NIHR BRC, University of Leicester, UK
| | - Andrew Bush
- Centre for Paediatrics and Child Health and National Heart and Lung Institute, Imperial College, Royal Brompton Hospital, London, UK
| | - Arnaud Bourdin
- PhyMedExp, University of Montpellier, Montpellier, France
| | - Apostolos Bossios
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital and Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kian Fan Chung
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Rekha Chaudhuri
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | | | - Ratko Djukanovic
- Clinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Sven-Erik Dahlén
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital and Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Louise Fleming
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Stephen J. Fowler
- Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Infection, Immunity and Respiratory Medicine, University of Manchester, NIHR Manchester Biomedical Research Unit, Manchester University NHS Foundation Trust, Manchester, UK
| | - Atul Gupta
- Department of Paediatric Respiratory Medicine, King's College Hospital, London, UK
| | - Eckard Hamelmann
- Children's Center Bethel, Department of Pediatrics, University Bielefeld, Bielefeld, Germany
| | - Gerard H. Koppelman
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Department of Pediatric Pulmonology and Pediatric Allergology, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands
| | - Erik Melén
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Vera Mahler
- Division of Allergology, Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany
| | - Paul Seddon
- Respiratory Care, Royal Alexandra Children's Hospital, Brighton, UK
| | - Florian Singer
- Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland
- Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Celeste Porsbjerg
- Department of Respiratory Medicine, Respiratory Research Unit, Bispebjerg Hospital, Copenhagen, Denmark
| | - Valeria Ramiconi
- European Federation of Allergy and Airways Diseases Patients’ Associations, Brussels, Belgium
| | - Franca Rusconi
- Department of Mother and Child Health, Azienda USL Toscana Nord Ovest, Pisa, Italy
| | - Valentyna Yasinska
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital and Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Graham Roberts
- Clinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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6
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Mathioudakis AG, Khaleva E, Fally M, Williamson PR, Jensen JU, Felton TW, Brightling C, Bush A, Winders T, Linnell J, Ramiconi V, Coleman C, Welte T, Roberts G, Vestbo J. Core outcome sets, developed collaboratively with patients, can improve the relevance and comparability of clinical trials. Eur Respir J 2023; 61:61/4/2202107. [PMID: 37012082 DOI: 10.1183/13993003.02107-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/16/2023] [Indexed: 04/05/2023]
Affiliation(s)
- Alexander G Mathioudakis
- Division of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, UK
- North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- A.G. Mathioudakis, E. Khaleva and M. Fally contributed equally to this work
| | - Ekaterina Khaleva
- Clinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- A.G. Mathioudakis, E. Khaleva and M. Fally contributed equally to this work
| | - Markus Fally
- Department of Respiratory Medicine and Infectious Diseases, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
- A.G. Mathioudakis, E. Khaleva and M. Fally contributed equally to this work
| | - Paula R Williamson
- Department of Health Data Science, University of Liverpool, MRC/NIHR Trials Methodology Research Partnership, Liverpool, UK
| | - Jens-Ulrik Jensen
- Department of Medicine, Section of Respiratory Medicine, Copenhagen University Hospital, Herlev and Gentofte, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tim W Felton
- Division of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, UK
- Acute Intensive Care Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Chris Brightling
- Institute for Lung Health, Leicester NIHR BRC, University of Leicester, Leicester, UK
| | - Andrew Bush
- Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK
- National Heart and Lung Institute, Imperial School of Medicine, Imperial College London, London, UK
| | - Tonya Winders
- Allergy and Asthma Network, Vienna, VA, USA
- Global Allergy and Airways Patient Platform, Vienna, VA, USA
| | - John Linnell
- European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - Valeria Ramiconi
- European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | | | - Tobias Welte
- Department of Respiratory Medicine and German Centre of Lung Research (DZL), Hannover Medical School, Hanover, Germany
| | - Graham Roberts
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Department of Respiratory Medicine and Infectious Diseases, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Jørgen Vestbo
- Division of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, UK
- North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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7
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Vazquez-Ortiz M, Khaleva E, Mukherjee S, Infante S, Meyer J, LeFew A, Yuan Q, Martinon-Torres F, Knibb RC. Challenges and unmet needs in FPIES from the parents and adult patients' perspective: An international survey. J Allergy Clin Immunol Pract 2023; 11:1306-1309.e2. [PMID: 36581071 DOI: 10.1016/j.jaip.2022.12.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 11/23/2022] [Accepted: 12/10/2022] [Indexed: 12/28/2022]
Affiliation(s)
- Marta Vazquez-Ortiz
- Section of Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, United Kingdom.
| | - Ekaterina Khaleva
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Shubhasree Mukherjee
- Paediatrics Department, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Sonsoles Infante
- Paediatric Allergy Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain
| | - Joy Meyer
- The FPIES Foundation, Stewartville, Minn
| | | | - Qian Yuan
- Food Allergy Center, Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
| | - Federico Martinon-Torres
- Translational Pediatrics and Infectious Diseases, Pediatrics Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Genetics, Vaccines and Infections Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago, University of Santiago de Compostela, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Rebecca C Knibb
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, United Kingdom
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8
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Bel Imam M, Stikas CV, Guha P, Chawes BL, Chu D, Greenhawt M, Khaleva E, Munblit D, Nekliudov N, van de Veen W, Schoos AMM. Outcomes reported in randomized controlled trials for mixed and non-IgE-mediated food allergy: Systematic review. Clin Exp Allergy 2023; 53:526-535. [PMID: 36880564 DOI: 10.1111/cea.14304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND Mixed and non-IgE-mediated food allergy is a subset of immune-mediated adverse food reactions that can impose a major burden on the quality of life of affected patients and their families. Clinical trials to study these diseases are reliant upon consistent and valid outcome measures that are relevant to both patients and clinicians, but the degree to which such stringent outcome reporting takes place is poorly studied. OBJECTIVE As part of the Core Outcome Measures for Food Allergy (COMFA) project, we identified outcomes reported in randomized clinical trials (RCT) of treatments for mixed or non-IgE-mediated food allergy. DESIGN In this systematic review, we searched the Ovid, MEDLINE and Embase databases for RCTs in children or adults investigating treatments for food protein-induced enterocolitis syndrome, food protein-induced allergic proctocolitis, food protein-induced enteropathy and eosinophilic gastrointestinal disorders including eosinophilic esophagitis [EoE], eosinophilic gastritis and eosinophilic colitis published until 14 October 2022. RESULTS Twenty-six eligible studies were identified, with 23 focused on EoE (88%). Most interventions were corticosteroids or monoclonal antibodies. All EoE studies assessed patient-reported dysphagia, usually using a non-validated questionnaire. Twenty-two of 23 EoE studies used peak tissue eosinophil count as the primary outcome, usually using a non-validated assessment method, and other immunological markers were only exploratory. Thirteen (57%) EoE studies reported endoscopic outcomes of which six used a validated scoring tool recently recommended as a core outcome for EoE trials. Funding source was not obviously associated with likelihood of an RCT reporting mechanistic versus patient-reported outcomes. Only 3 (12%) RCTs concerned forms of food allergy other than EoE, and they reported on fecal immunological markers and patient-reported outcomes. CONCLUSIONS Outcomes measured in clinical trials of EoE and non-IgE-mediated food allergy are heterogeneous and largely non-validated. Core outcomes for EoE have been developed and need to be used in future trials. For other forms of mixed or non-IgE-mediated food allergies, core outcome development is needed to support the development of effective treatments. SYSTEMATIC REVIEW REGISTRATION OSF public registry DOI:10.17605/OSF.IO/AZX8S.
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Affiliation(s)
- Manal Bel Imam
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | | | - Payal Guha
- School of Medicine, Imperial College London, London, UK
| | - Bo L Chawes
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Derek Chu
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.,Department of Medicine, McMaster University, Hamilton, Ontario, Canada.,The Research Institute of St Joe's Hamilton, Hamilton, Ontario, Canada
| | - Matthew Greenhawt
- Department of Pediatrics, Section of Allergy and Immunology, Children's Hospital Colorado, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
| | - Ekaterina Khaleva
- Clinical and Experimental Sciences and Human Development, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Daniel Munblit
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Inflammation, Repair and Development Section, NHLI, Imperial College London, London, UK
| | - Nikita Nekliudov
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Willem van de Veen
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Ann-Marie M Schoos
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Pediatrics, Slagelse Hospital, Slagelse, Denmark
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9
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Spolidoro GCI, Amera YT, Ali MM, Nyassi S, Lisik D, Ioannidou A, Rovner G, Khaleva E, Venter C, van Ree R, Worm M, Vlieg-Boerstra B, Sheikh A, Muraro A, Roberts G, Nwaru BI. Frequency of food allergy in Europe: An updated systematic review and meta-analysis. Allergy 2023; 78:351-368. [PMID: 36271775 PMCID: PMC10099188 DOI: 10.1111/all.15560] [Citation(s) in RCA: 47] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 02/01/2023]
Abstract
Food allergy (FA) is increasingly reported in Europe, however, the latest prevalence estimates were based on studies published a decade ago. The present work provides the most updated estimates of the prevalence and trends of FA in Europe. Databases were searched for studies published between 2012 and 2021, added to studies published up to 2012. In total, 110 studies were included in this update. Most studies were graded as moderate risk of bias. Pooled lifetime and point prevalence of self-reported FA were 19.9% (95% CI 16.6-23.3) and 13.1% (95% CI 11.3-14.8), respectively. The point prevalence of sensitization based on specific IgE (slgE) was 16.6% (95% CI 12.3-20.8), skin prick test (SPT) 5.7% (95% CI 3.9-7.4), and positive food challenge 0.8% (95% CI 0.5-0.9). While lifetime prevalence of self-reported FA and food challenge positivity only slightly changed, the point prevalence of self-reported FA, sIgE and SPT positivity increased from previous estimates. This may reflect a real increase, increased awareness, increased number of foods assessed, or increased number of studies from countries with less data in the first review. Future studies require rigorous designs and implementation of standardized methodology in diagnosing FA, including use of double-blinded placebo-controlled food challenge to minimize potential biases.
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Affiliation(s)
- Giulia C I Spolidoro
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Yohannes Tesfaye Amera
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Mohamed Mustafa Ali
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Sungkutu Nyassi
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - Daniil Lisik
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - Athina Ioannidou
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - Graciela Rovner
- ACT Institutet Sweden, Gothenburg, Sweden.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Carina Venter
- Section of Allergy and Immunology, School of Medicine, University of Colorado Denver, Children's Hospital Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Ronald van Ree
- Department of Experimental Immunology and Department of Otorhinolaryngology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology, Allergy and Venerology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Berber Vlieg-Boerstra
- Department of Pediatrics, OLVG Hospital, Amsterdam, the Netherlands.,Department of Pediatrics, Rijnstate Hospital, Arnhem, the Netherlands
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Antonella Muraro
- Department of Mother and Child Health, The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region, University of Padua, Padua, Italy
| | - Graham Roberts
- Faculty of Medicine, University of Southampton, Southampton, UK.,David Hide Asthma and Allergy Centre, St Mary's Hospital, Isle of Wight, UK
| | - Bright I Nwaru
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
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10
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Coleman C, Khaleva E, Rattu A, Frankemölle B, Nielsen H, Roberts G, Williams C. Narrative review to capture patients' perceptions and opinions about non-response and response to biological therapy for severe asthma. Eur Respir J 2023; 61:13993003.00837-2022. [PMID: 36104293 PMCID: PMC9849704 DOI: 10.1183/13993003.00837-2022] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/15/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND There are now many biological therapies to treat severe asthma. To assess which work best for which patient, we need to develop definitions of response. This narrative review aims to capture severe asthma patients' perceptions about non-response and response to biological therapy. METHODS Four bibliographic databases were searched from inception to September 2021. Grey literature was searched with the involvement of patient representatives. A thematic approach was used for synthesis. No qualitative studies specifically explore patients' perspectives on response to biological therapy for severe asthma. Three papers and one published asthma patient interview were included. Relevant grey literature was included from online discussion forums, blogs and social media websites. RESULTS Adult patients framed positive response to biological therapy in terms of reduced burden of disease and treatment. Both were multifaceted. Some patients experienced reduced benefit from biological therapy over time. There was a group of patients who described a limited response or non-response to biological therapy. This was framed within the context of continuing hospitalisation and oral corticosteroid treatment. The speed of onset of benefit was felt to be important by some. CONCLUSIONS Definitions of non-response and response need to be patient-centred, yet there is a complete lack of qualitative research focused on this topic. By combining relevant published and grey literature we have provided a description of adult patients' perceptions of response to biological therapy in severe asthma. We now need to understand the views of children and adolescents with severe asthma and their carers, and diverse patient experiences in real-world settings.
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Affiliation(s)
| | - Ekaterina Khaleva
- Clinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Anna Rattu
- Clinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | | | - Hanna Nielsen
- Faculty of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Graham Roberts
- Clinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
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11
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Vazquez-Ortiz M, Gore C, Alviani C, Angier E, Blumchen K, Comberiati P, Duca B, DunnGalvin A, Garriga-Baraut T, Gowland MH, Egmose B, Knibb R, Khaleva E, Mortz CG, Pfaar O, Pite H, Podesta M, Santos AF, Sanchez-Garcia S, Timmermans F, Roberts G. A practical toolbox for the effective transition of adolescents and young adults with asthma and allergies: An EAACI position paper. Allergy 2023; 78:20-46. [PMID: 36176045 PMCID: PMC10091987 DOI: 10.1111/all.15533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/19/2022] [Accepted: 09/25/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Adolescence is a critical stage of rapid biological, emotional and social change and development. Adolescents and young adults (AYA) with asthma and allergies need to develop the knowledge and skills to self-manage their health independently. Healthcare professionals (HCP), parents and their wider network play an essential role in supporting AYA in this process. Previous work showed significant limitations in transition care across Europe. In 2020, the first evidence-based guideline on effective transition for AYA with asthma and allergies was published by EAACI. AIM We herein summarize practical resources to support this guideline's implementation in clinical practice. METHODS For this purpose, multi-stakeholder Task Force members searched for resources in peer review journals and grey literature. These resources were included if relevant and of good quality and were pragmatically rated for their evidence-basis and user friendliness. RESULTS Resources identified covered a range of topics and targeted healthcare professionals, AYA, parents/carers, schools, workplace and wider community. Most resources were in English, web-based and had limited evidence-basis. CONCLUSIONS This position paper provides a valuable selection of practical resources for all stakeholders to support effective transitional care for AYA with asthma and allergies. Future research should focus on developing validated, patient-centred tools to further assist evidence-based transition care.
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Affiliation(s)
- Marta Vazquez-Ortiz
- Section of Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK
- Department of Paediatrics, Imperial College Healthcare NHS Trust, London, UK
| | - Claudia Gore
- Section of Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK
- Department of Paediatrics, Imperial College Healthcare NHS Trust, London, UK
| | - Cherry Alviani
- Faculty of Medicine, University of Southampton, Southampton, UK
- The David Hide Asthma and Allergy Centre, St Mary's Hospital, Isle of Wight, UK
| | - Elizabeth Angier
- Primary Care, Population Science and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Katharina Blumchen
- Department of Paediatric and Adolescent Medicine, Paediatric Pneumology, Allergology and Cystic Fibrosis, University Hospital Frankfurt, Goethe-University, Frankfurt am Main, Germany
| | - Pasquale Comberiati
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy
| | - Bettina Duca
- Department of Child and Adolescent Health, Mater Dei Hospital, Malta
| | - Audrey DunnGalvin
- Applied Psychology and Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Teresa Garriga-Baraut
- Pediatric Allergy Unit. Vall d'Hebron University Hospital, Barcelona, Spain
- 'Growth and Development' Research Group. Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain
| | | | - Britt Egmose
- Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
| | - Rebecca Knibb
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, UK
| | | | - Charlotte G Mortz
- Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Helena Pite
- Allergy Center, CUF Descobertas Hospital and CUF Tejo Hospital; CEDOC, Cardiovascular and Metabolic Pharmacology, iNOVA4Health, NOVA
| | | | - Alexandra F Santos
- Department of Women and Children's Health (Paediatric Allergy, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
- Children's Allergy Service, Guy's and St Thomas' Hospital, London, UK
- Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | | | - Frans Timmermans
- Nederlands Anafylaxis Netwerk-European Anaphylaxis Taskforce, Dordrecht, The Netherlands
| | - Graham Roberts
- Faculty of Medicine, University of Southampton, Southampton, UK
- The David Hide Asthma and Allergy Centre, St Mary's Hospital, Isle of Wight, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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12
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Rattu A, Khaleva E, Brightling C, Dahlén SE, Bossios A, Fleming L, Chung KF, Melén E, Djukanovic R, Chaudhuri R, Exley A, Koppelman GH, Bourdin A, Rusconi F, Porsbjerg C, Coleman C, Williams C, Nielsen H, Davin E, Taverner P, Romagosa Vilarnau S, Roberts G. Identifying and appraising outcome measures for severe asthma: a systematic review. Eur Respir J 2022; 61:13993003.01231-2022. [PMID: 36549712 DOI: 10.1183/13993003.01231-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Valid outcome measures are imperative to evaluate treatment response, yet the suitability of existing endpoints for severe asthma is unclear. This review aimed to identify outcome measures for severe asthma and appraise the quality of their measurement properties. METHODS A literature search was performed to identify "candidate" outcome measures published between 2018-2020 (PROSPERO, CRD42020204437). A modified Delphi exercise was conducted to select "key" outcome measures within healthcare professional, patient, pharmaceutical, and regulatory stakeholder groups. Initial validation studies for "key" measures were rated against modified quality criteria from COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN). The evidence was discussed at multi-stakeholder meetings to ratify "priority" outcome measures. Subsequently, four bibliographic databases were searched from inception to identify development and validation studies for these endpoints. Two reviewers screened records, extracted data, assessed their methodological quality, and graded the evidence according to COSMIN. RESULTS 96 outcome measures were identified as "candidates", 55 as "key", and 24 as "priority" for severe asthma; including clinical, healthcare utilisation, quality of life, asthma control, and composite. 32 studies reported measurement properties of 17 "priority" endpoints from the latter three domains. Only SAQ and C-ACT were developed with input from severe asthma patients. The certainty of evidence was "low" to "very low" for most "priority" endpoints across all measurement properties, and none fulfilled all quality standards. CONCLUSION Only two outcome measures had robust developmental data for severe asthma. This review informed development of core outcome measures sets for severe asthma.
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Affiliation(s)
- Anna Rattu
- Clinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Ekaterina Khaleva
- Clinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Chris Brightling
- Institute for Lung Health, Leicester NIHR BRC, University of Leicester, UK
| | - Sven-Erik Dahlén
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Huddinge and Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Apostolos Bossios
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Huddinge and Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Louise Fleming
- National Heart and Lung Institute, Imperial College, London, UK
| | - Kian Fan Chung
- National Heart and Lung Institute, Imperial College, London, UK
| | - Erik Melén
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Ratko Djukanovic
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Sir Henry Wellcome Laboratories, Southampton, UK
| | - Rekha Chaudhuri
- Institute of Infection, Immunity & Inflammation, University of Glasgow, Glasgow, UK
| | - Andrew Exley
- Co-Director, Adept Biologica Consulting Limited, London, UK
| | - Gerard H Koppelman
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Department of Paediatric Pulmonology and Paediatric Allergology, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands
| | - Arnaud Bourdin
- PhyMedExp, University of Montpellier, Montpellier, France
| | - Franca Rusconi
- Department of Mother and Child Health, Azienda USL Toscana Nord Ovest, Pisa, Italy
| | - Celeste Porsbjerg
- Department of Mother and Child Health, Azienda USL Toscana Nord Ovest, Pisa, Italy
| | | | | | - Hanna Nielsen
- Faculty of Medicine, Karolinska Institutet Stockholm, Sweden; 3TR Patient Working Group
| | | | | | - Sofia Romagosa Vilarnau
- European Federation of Allergy and Airways Diseases Patients' Associations (EFA), Brussels, Belgium
| | - Graham Roberts
- Clinical and Experimental Sciences and Human Development, University of Southampton, University Road, Highfield, Southampton, UK. NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK. David Hide Asthma and Allergy Centre, St Mary's Hospital, Isle of Wight, UK
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13
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Khaleva E, Skypala I, Riggioni C. Editorial comments on: "Diagnosis and management of food allergy associated gastroesophageal reflux disease in young children - EAACI position paper". Pediatr Allergy Immunol 2022; 33:e13877. [PMID: 36433847 DOI: 10.1111/pai.13877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 10/23/2022] [Indexed: 11/22/2022]
Affiliation(s)
- Ekaterina Khaleva
- Clinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Isabel Skypala
- Department of Allergy & Clinical Immunology, Royal Brompton & Harefield Hospitals, Part of Guys & St Thomas NHS Foundation Trust, London, UK
| | - Carmen Riggioni
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
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14
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Khaleva E, Rattu A, Brightling C, Bush A, Bossios A, Bourdin A, Chung KF, Chaudhuri R, Coleman C, Dahlén SE, Djukanovic R, Deschildre A, Fleming L, Fowler SJ, Gupta A, Hamelmann E, Hashimoto S, Hedlin G, Koppelman GH, Melén E, Murray CS, Pilette C, Porsbjerg C, Pike KC, Rusconi F, Williams C, Ahrens B, Alter P, Anckers F, van den Berge M, Blumchen K, Brusselle G, Clarke GW, Cunoosamy D, Dahlén B, Dixey P, Exley A, Frey U, Gaillard EA, Giovannini-Chami L, Grigg J, Hartenstein D, Heaney LG, Karadag B, Kaul S, Kull I, Licari A, Maitland-van der Zee AH, Mahler V, Schoos AMM, Nagakumar P, Negus J, Nielsen H, Paton J, Pijnenburg M, Ramiconi V, Vilarnau SR, Principe S, Rutjes N, Saglani S, Seddon P, Singer F, Staudinger H, Turner S, Vijverberg S, Winders T, Yasinska V, Roberts G. Development of Core Outcome Measures sets for paediatric and adult Severe Asthma (COMSA). Eur Respir J 2022; 61:13993003.00606-2022. [PMID: 36229046 PMCID: PMC10069873 DOI: 10.1183/13993003.00606-2022] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/14/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Effectiveness studies with biological therapies for asthma lack standardised outcome measures. The COMSA (Core Outcome Measures sets for paediatric and adult Severe Asthma) working group sought to develop Core Outcome Measures (COM) sets to facilitate better synthesis of data and appraisal of biologics in paediatric and adult asthma clinical studies. METHODS COMSA utilised a multi-stakeholder consensus process among patients with severe asthma, adult, and paediatric clinicians, pharmaceutical representatives and health regulators from across Europe. Evidence included a systematic review of development, validity, and reliability of selected outcome measures plus a narrative review and a pan-European survey to better understand patients' and carers' views about outcome measures. It was discussed using a modified GRADE Evidence to Decision framework. Anonymous voting was conducted using predefined consensus criteria. RESULTS Both adult and paediatric COM sets include forced expiratory volume in 1 s (FEV1) as z scores, annual frequency of severe exacerbations and maintenance oral corticosteroid use. Additionally, the paediatric COM set includes the Paediatric Asthma Quality of Life Questionnaire, and Asthma Control Test (ACT) or Childhood-ACT while the adult COM includes the Severe Asthma Questionnaire and the Asthma Control Questionnaire-6 (symptoms and rescue medication use reported separately). CONCLUSIONS This patient-centred collaboration has produced two COM sets for paediatric and adult severe asthma. It is expected that they will inform the methodology of future clinical trials, enhance comparability of efficacy and effectiveness of biological therapies, and help assess their socioeconomic value. COMSA will inform definitions of non-response and response to biological therapy for severe asthma.
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Affiliation(s)
- Ekaterina Khaleva
- Clinical and Experimental Sciences and Human Development in Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Anna Rattu
- Clinical and Experimental Sciences and Human Development in Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Chris Brightling
- Institute for Lung Health, Leicester NIHR BRC, University of Leicester, UK
| | - Andrew Bush
- Centre for Paediatrics and Child Health and National Heart and Lung Institute, Imperial College; Royal Brompton Hospital, London, UK
| | - Apostolos Bossios
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Huddinge and Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Arnaud Bourdin
- PhyMedExp, University of Montpellier, Montpellier, France
| | - Kian Fan Chung
- National Heart & Lung Institute, Imperial College London, London, UK
| | - Rekha Chaudhuri
- Institute of Infection, Immunity & Inflammation, University of Glasgow, Glasgow, UK
| | | | - Sven-Erik Dahlén
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Huddinge and Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Ratko Djukanovic
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Sir Henry Wellcome Laboratories, Southampton, UK
| | - Antoine Deschildre
- CHU Lille, Unité de Pneumologie et Allergologie Pédiatrique, Hôpital Jeanne de Flandre, Lille, France.,Univ. Lille, U1019 - UMR 8204 - CIIL - Center for Infection and Immunity of Lille, Lille, France
| | - Louise Fleming
- National Heart & Lung Institute, Imperial College London, London, UK
| | - Stephen J Fowler
- Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Infection, Immunity & Respiratory Medicine, The University of Manchester, and NIHR Manchester Biomedical Research Unit and Manchester University NHS Foundation Trust, Manchester, UK
| | - Atul Gupta
- Department of Paediatric Respiratory Medicine, King's College Hospital, London, UK
| | - Eckard Hamelmann
- Children's Center Bethel, Department of Pediatrics, University Bielefeld, Bielefeld, Germany
| | - Simone Hashimoto
- Department of Pediatric Pulmonology, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, the Netherlands.,Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Gunilla Hedlin
- Department of Women's and Children's Health and Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
| | - Gerard H Koppelman
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Department of Pediatric Pulmonology and Pediatric Allergology, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands
| | - Erik Melén
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Clare S Murray
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Charles Pilette
- Department of Pulmonology, Cliniques universitaires Saint-Luc & pole of pulmonology, ENT and dermatology, Institute of experimental and clinical research (IREC), UCLouvain, Brussels, Belgium
| | - Celeste Porsbjerg
- Department of Respiratory Medicine, Respiratory Research Unit, Bispebjerg Hospital, Copenhagen, Denmark
| | - Katharine C Pike
- Department of Paediatric Respiratory Medicine, Bristol Royal Hospital for Children, Bristol, UK
| | - Franca Rusconi
- Department of Mother and Child Health, Azienda USL Toscana Nord Ovest, Pisa, Italy
| | | | - Birgit Ahrens
- Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Division of Allergology, Langen, Germany
| | - Peter Alter
- Department of Medicine, Pulmonary and Critical Care Medicine, Philipps University of Marburg (UMR), Marburg, Germany
| | | | - Maarten van den Berge
- University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands
| | - Katharina Blumchen
- Department of Children and Adolescent Medicine, Division of Pneumology, Allergology, Cystic fibrosis, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany
| | - Guy Brusselle
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Graham W Clarke
- Translational Science and Experimental Medicine, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals, R&D, AstraZeneca, Gothenburg, Sweden
| | - Danen Cunoosamy
- Global Medical Affairs Respiratory, Allergy & GI, Sanofi Genzyme, Cambridge, MA, USA
| | - Barbro Dahlén
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Huddinge and Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Piers Dixey
- National Heart & Lung Institute, Imperial College London, London, UK.,Royal Brompton Hospital, London, UK
| | | | - Urs Frey
- University Children's Hospital Basel, University of Basel, Switzerland
| | - Erol A Gaillard
- University of Leicester, Department of Respiratory Sciences, Leicester NIHR Biomedical Research Centre (Respiratory theme), Leicester, UK
| | - Lisa Giovannini-Chami
- Pediatric Pulmonology and Allergology Department, Hôpitaux pédiatriques de Nice CHU-Lenval, Nice, France.,Université Côte d'Azur, France
| | | | - Diana Hartenstein
- Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Division of Allergology, Langen, Germany
| | - Liam G Heaney
- Wellcome-Wolfson Centre for Experimental Medicine School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, UK
| | - Bülent Karadag
- Marmara University Faculty of Medicine, Division of Pediatric Pulmonology, Istanbul, Turkey
| | - Susanne Kaul
- Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Division of Allergology, Langen, Germany
| | - Inger Kull
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Amelia Licari
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Anke H Maitland-van der Zee
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Dept. of Paediatric Respiratory Medicine and Allergy, Emma's Children Hospital, AmsterdamUMC, University of Amsterdam, the Netherlands
| | - Vera Mahler
- Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Division of Allergology, Langen, Germany
| | - Ann-Marie M Schoos
- COpenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Pediatrics, Slagelse Sygehus, Slagelse, Denmark
| | - Prasad Nagakumar
- Department of Respiratory Medicine, Birmingham Children's Hospital, Birmingham, UK.,Institute of inflammation and Ageing, University of Birmingham
| | | | - Hanna Nielsen
- Patient and Public Involvement, Sweden.,Faculty of Medicine, Karolinska Institutet, Sweden
| | - James Paton
- School of Medicine, College of Medical, Veterinary, and Life Sciences, University of Glasgow, Glasgow, UK
| | - Mariëlle Pijnenburg
- Erasmus MC - Sophia Children's Hospital, University Medical Centre Rotterdam, Department of Paediatrics/ Paediatric Respiratory Medicine and Allergology, Rotterdam, The Netherlands
| | - Valeria Ramiconi
- European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - Sofia Romagosa Vilarnau
- European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - Stefania Principe
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Department of Pulmonary Medicine; AOUP "Policlinico Paolo Giaccone", University of Palermo, Palermo, Italy
| | - Niels Rutjes
- Department of Pediatric Pulmonology & Allergy. Amsterdam UMC, Emma Children's Hospital, Amsterdam, The Netherlands
| | - Sejal Saglani
- National Heart & Lung Institute, Imperial College London, London, UK
| | - Paul Seddon
- Respiratory Care, Royal Alexandra Children's Hospital, Brighton, UK
| | - Florian Singer
- Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland.,Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Austria
| | - Heribert Staudinger
- Therapeutic Area Immunology and Inflammation, Sanofi Genzyme, Bridgewater, USA
| | - Steve Turner
- Women and children division, NHS Grampian, Aberdeen, UK.,Child Health, University of Aberdeen, Aberdeen, UK
| | - Susanne Vijverberg
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Department of Pediatric Pulmonology, Emma's Children Hospital, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Tonya Winders
- Allergy & Asthma Network, Vienna, VA, USA.,Global Allergy & Airways Patient Platform, Vienna, AT
| | - Valentyna Yasinska
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Huddinge and Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Graham Roberts
- Clinical and Experimental Sciences and Human Development in Health, Faculty of Medicine, University of Southampton, Southampton, UK .,Paediatric Allergy and Respiratory Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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15
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Lisik D, Ioannidou A, Spolidoro G, Ali M, Nyassi S, Amera Y, Rovner G, Khaleva E, Venter C, van Ree R, Worm M, Vlieg-Boerstra B, Sheikh A, Muraro A, Roberts G, Nwaru BI. Prevalence of sensitization to molecular food allergens in Europe: A systematic review. Clin Transl Allergy 2022; 12:e12175. [PMID: 35821705 PMCID: PMC9260209 DOI: 10.1002/clt2.12175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 11/07/2022] Open
Abstract
Background Recent reports indicate that the prevalence of food allergy is increasing, but accurate estimates remain a challenge due to cross-reactivity and limited use of precise diagnostic methods. Molecular allergy diagnostics, in which sensitization to individual molecular allergens is measured, is emerging as a promising tool for evaluation of sensitization profiles. In this systematic review, we summarized estimates of prevalence of sensitization to molecular food allergens in the general population in Europe. Methods Following a protocol prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO; reference CRD42021266657), we searched seven databases with no restrictions on publication date or language. Two reviewers independently screened the literature, extracted data, and appraised the risk of bias in the included studies. The findings were synthesized narratively. Results From 4776 de-duplicated records, five studies, with low to moderate overall risk of bias, were included. Forty-six molecular allergens from 18 foods were investigated. Overall, the prevalence of sensitization was low, particularly for major allergens, and non-existent for 10 molecular allergens (0% [95% CI 0-0.8]). The highest prevalence was seen for PR-10 proteins, such as Cor a 1.04 (13.6% [95% CI 10.9-16.9]). Conclusions Available data, primarily from North-western Europe, indicate that sensitization to molecular food allergens is overall low. The highest estimates were found for cross-reactive PR-10 proteins. There were not enough studies to discern regional differences or perform meta-analysis, highlighting the need for more population-representative studies in order to elucidate patterns of sensitization to molecular food allergens in Europe.
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Affiliation(s)
- Daniil Lisik
- Krefting Research Centre University of Gothenburg Gothenburg Sweden
| | - Athina Ioannidou
- Krefting Research Centre University of Gothenburg Gothenburg Sweden
| | - Giulia Spolidoro
- Department of Clinical Science and Community Health University of Milan Milan Italy
| | - Mohamed Ali
- Krefting Research Centre University of Gothenburg Gothenburg Sweden
| | - Sungkutu Nyassi
- Krefting Research Centre University of Gothenburg Gothenburg Sweden
| | - Yohanes Amera
- Krefting Research Centre University of Gothenburg Gothenburg Sweden
| | - Graciela Rovner
- Division of Physiotherapy Department of Neurobiology, Care Sciences and Society Karolinska Institutet Stockholm Sweden.,ACT Institutet Sweden Gothenburg Sweden
| | | | - Carina Venter
- Section of Allergy & Immunology University of Colorado Denver School of Medicine and Children's Hospital Denver Colorado USA
| | - Ronald van Ree
- Department of Experimental Immunology and Department of Otorhinolaryngology Academic Medical Center Amsterdam The Netherlands
| | - Margitta Worm
- Division of Allergy and Immunology Department of Dermatology, Allergy and Venerology Charité Universitätsmedizin Berlin Berlin Germany
| | | | - Aziz Sheikh
- Usher Institute University of Edinburgh Edinburgh UK
| | - Antonella Muraro
- Department of Mother and Child Health University of Padua Padua Italy
| | - Graham Roberts
- Faculty of Medicine University of Southampton Southampton UK.,David Hide Asthma and Allergy Research Centre St Mary's Hospital Newport UK
| | - Bright I Nwaru
- Krefting Research Centre University of Gothenburg Gothenburg Sweden.,Wallenberg Centre for Molecular and Translational Medicine University of Gothenburg Gothenburg Sweden
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16
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Silva D, Rodríguez del Río P, Jong NW, Khaleva E, Singh C, Nowak‐Wegrzyn A, Muraro A, Begin P, Pajno G, Fiocchi A, Sanchez A, Jones C, Nilsson C, Bindslev‐Jensen C, Wong G, Sampson H, Beyer K, Marchisotto M, Fernandez Rivas M, Meyer R, Lau S, Nurmatov U, Roberts G. Allergen immunotherapy and/or biologicals for IgE-mediated food allergy: A systematic review and meta-analysis. Allergy 2022; 77:1852-1862. [PMID: 35001400 PMCID: PMC9303769 DOI: 10.1111/all.15211] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/07/2021] [Accepted: 12/19/2021] [Indexed: 02/06/2023]
Abstract
Background There is substantial interest in immunotherapy and biologicals in IgE‐mediated food allergy. Methods We searched six databases for randomized controlled trials about immunotherapy alone or with biologicals (to April 2021) or biological monotherapy (to September 2021) in food allergy confirmed by oral food challenge. We pooled the data using random‐effects meta‐analysis. Results We included 36 trials about immunotherapy with 2126 mainly child participants. Oral immunotherapy increased tolerance whilst on therapy for peanut (RR 9.9, 95% CI 4.5.–21.4, high certainty); cow's milk (RR 5.7, 1.9–16.7, moderate certainty) and hen's egg allergy (RR 8.9, 4.4–18, moderate certainty). The number needed to treat to increase tolerance to a single dose of 300 mg or 1000 mg peanut protein was 2. Oral immunotherapy did not increase adverse reactions (RR 1.1, 1.0–1.2, low certainty) or severe reactions in peanut allergy (RR 1,6, 0.7–3.5, low certainty), but may increase (mild) adverse reactions in cow's milk (RR 3.9, 2.1–7.5, low certainty) and hen's egg allergy (RR 7.0, 2.4–19.8, moderate certainty). Epicutaneous immunotherapy increased tolerance whilst on therapy for peanut (RR 2.6, 1.8–3.8, moderate certainty). Results were unclear for other allergies and administration routes. There were too few trials of biologicals alone (3) or with immunotherapy (1) to draw conclusions. Conclusions Oral immunotherapy improves tolerance whilst on therapy and is probably safe in peanut, cow's milk and hen's egg allergy. More research is needed about quality of life, cost and biologicals.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Giovanni Pajno
- Policlinico Hospital‐University of Messina Messina Italy
| | | | - Angel Sanchez
- AEPNAA Spanish Association for People with Food and Latex Allergy Madrid Spain
| | | | - Caroline Nilsson
- Karolinska Institutet and Sachs´ Children and Youth Hospital Stockholm Sweden
| | | | - Gary Wong
- Chinese University of Hong Kong Hong Kong Hong Kong
| | - Hugh Sampson
- Mount Sinai School of Medicine New York New York USA
| | | | | | | | | | - Susanne Lau
- Charité ‐ Universitätsmedizin Berlin Berlin Germany
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17
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Khaleva E, Knibb R, DunnGalvin A, Vazquez‐Ortiz M, Comberiati P, Alviani C, Garriga‐Baraut T, Gowland MH, Gore C, Angier E, Blumchen K, Duca B, Hox V, Jensen B, Mortz CG, Pite H, Pfaar O, Santos AF, Sanchez‐Garcia S, Timmermans F, Roberts G. Perceptions of adolescents and young adults with allergy and/or asthma and their parents on EAACI guideline recommendations about transitional care: A European survey. Allergy 2022; 77:1094-1104. [PMID: 34564855 DOI: 10.1111/all.15109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/08/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The European Academy of Allergy and Clinical Immunology has developed a guideline to provide evidence-based recommendations for healthcare professionals to support the transitional care of adolescents and young adults (AYA) with allergy and/or asthma. The goal of this work was to ensure that the draft recommendations are also important for patients. METHODS We surveyed patients aged 11-25 years with allergy and/or asthma and their parents across Europe between 17 February and 16 March 2020. The multilingual survey was distributed through national allergy and asthma patient organizations in Europe as well as through social media. RESULTS A total of 1210 responses from 24 European countries were collected. There were 415 (34.3%) AYA and 795 (65.7%) parents. The majority of AYA (72.3%) and parents (81.9%) were female. Patients had a history of asthma (61.1%), allergic rhinoconjunctivitis (54.1%), food allergy (53.8%), atopic eczema (42.6%) and anaphylaxis (28.8%). All recommendations achieved the median score of either 'important' or 'very important'. The least supported recommendations were the use of joint clinics with both paediatric and adult physicians attending and the use of web-based or mobile technologies for communication with the AYA. The most supported recommendation was checking that the AYA is knowledgeable and compliant with their prescribed medication. Qualitative analysis revealed conditional approval for some recommendations. CONCLUSIONS There was agreement from patients and parents on the importance of the draft recommendations on transitional care for AYA with allergy and/or asthma and their parents. The recommendations now need to be implemented into clinical practice across Europe.
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Affiliation(s)
| | - Rebecca Knibb
- School of Psychology College of Health and Life Sciences Aston University Birmingham UK
| | - Audrey DunnGalvin
- Applied Psychology and Paediatrics and Child Health University College Cork Cork Ireland
- Paediatrics and Child Infectious Diseases First Moscow State Medical University Moscow Russia
| | - Marta Vazquez‐Ortiz
- Section of Inflammation, Repair and Development National Heart and Lung Institute Imperial College London London UK
| | - Pasquale Comberiati
- Section of Paediatrics Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
- Department of Clinical Immunology and Allergology I.M. Sechenov First Moscow State Medical University Moscow Russia
| | - Cherry Alviani
- Faculty of Medicine University of Southampton Southampton UK
- The David Hide Asthma and Allergy Research Centre St Mary’s Hospital Isle of Wight UK
| | - Teresa Garriga‐Baraut
- Unitat d'Allergologia Pediàtrica Hospital Universitari Vall d'Hebron Barcelona Spain
- Grup d’Investigació “Creixement i Desenvolupament” Institut de Recerca de l’Hospital Universitari Vall d’Hebron (VHIR) Barcelona Spain
| | | | - Claudia Gore
- Section of Inflammation, Repair and Development National Heart and Lung Institute Imperial College London London UK
- Department of Paediatrics Imperial College Healthcare NHS Trust London UK
| | - Elizabeth Angier
- Primary Care and Population Sciences University of Southampton Southampton UK
| | - Katharina Blumchen
- Department of Paediatric and Adolescent Medicine Paediatric Pneumology, Allergology and Cystic Fibrosis University Hospital Frankfurt Frankfurt am Main Germany
| | - Bettina Duca
- Section of Inflammation, Repair and Development National Heart and Lung Institute Imperial College London London UK
- Department of Paediatrics Imperial College Healthcare NHS Trust London UK
| | - Valérie Hox
- Department of Otorhinolaryngology, Head and Neck Surgery University Hospitals Saint‐Luc Brussels Belgium
| | - Britt Jensen
- Department of Dermatology and Allergy Centre Odense Research Centre for Anaphylaxis (ORCA) Odense University Hospital Odense C Denmark
| | - Charlotte G. Mortz
- Department of Dermatology and Allergy Centre Odense Research Centre for Anaphylaxis (ORCA) Odense University Hospital Odense C Denmark
| | - Helena Pite
- Allergy Center CUF Descobertas Hospital and CUF Tejo Hospital Lisbon Portugal
- CEDOC, Chronic Diseases Research Center NOVA Medical School/Faculdade de Ciências Médicas Universidade Nova de Lisboa Lisbon Portugal
| | - Oliver Pfaar
- Section of Rhinology and Allergy Department of Otorhinolaryngology, Head and Neck Surgery University Hospital Marburg, Philipps‐Universität Marburg Marburg Germany
| | - Alexandra F. Santos
- Department of Women and Children’s Health (Paediatric Allergy) School of Life Course Sciences Faculty of Life Sciences and Medicine King’s College London London UK
- Peter Gorer Department of Immunobiology School of Immunology and Microbial Sciences King’s College London London UK
- Children’s Allergy Service Guy’s and St Thomas’ Hospital London UK
- Asthma UK Centre in Allergic Mechanisms of Asthma London UK
| | | | - Frans Timmermans
- Nederlands Anafylaxis Netwerk – European Anaphylaxis Taskforce Dordrecht The Netherlands
| | - Graham Roberts
- Faculty of Medicine University of Southampton Southampton UK
- The David Hide Asthma and Allergy Research Centre St Mary’s Hospital Isle of Wight UK
- NIHR Southampton Biomedical Research Centre University Hospital Southampton NHS Foundation Trust Southampton UK
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18
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Charles D, Shanley J, Temple SN, Rattu A, Khaleva E, Roberts G. Real-World Efficacy of Treatment with Benralizumab, Dupilumab, Mepolizumab and Reslizumab for Severe Asthma: A Systematic Review and Meta-analysis. Clin Exp Allergy 2022; 52:616-627. [PMID: 35174566 PMCID: PMC9311192 DOI: 10.1111/cea.14112] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/30/2022] [Accepted: 02/10/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Severe asthma is a major cause of morbidity. Some patients may benefit from biological therapies. Most evaluations of these treatments are derived from randomised controlled trials (RCTs), but few patients are eligible for these trials. Studies involving more diverse groups of participants exist but there is a lack of precise pooled estimates. OBJECTIVE This systematic review aims to evaluate the real-world efficacy of recently and nearly licensed biological therapies for severe asthma to assess the generalisability of the RCT data. METHODS Clinical outcomes including exacerbation rate, oral corticosteroid (OCS) usage, forced expiratory volume in 1 second (FEV1 ) and fractional exhaled nitric oxide (FeNO) were examined. Studies were assessed for risk of bias using the Critical Appraisal Skills Programme (CASP) checklist tool. The certainty of evidence was assessed using GRADE. RESULTS A total of 21 studies examining biologicals in real-world settings were identified, they mostly focused on benralizumab and mepolizumab. The introduction of biologicals reduced the annualised exacerbation rate significantly by -3.79 (95% CI -4.53, -3.04), -3.17 (95% CI -3.74, -2.59) and -6.72 (95% CI -8.47, -4.97) with benralizumab, mepolizumab and reslizumab respectively. Likewise, improvements were observed in FEV1 (0.17 L 95% CI 0.11, 0.24) and FeNO (-14.23 ppb 95% CI -19.71, -8.75) following treatment with mepolizumab. After treatment with benralizumab there was an increase in FEV1 (0.21 L 95% CI 0.08, 0.34). CONCLUSIONS These data demonstrate that anti-IL5 biologicals may improve the clinical outcomes of patients with severe asthma in a clinic environment with similar effect sizes to RCTs. The data were mainly retrospective and unadjusted, so estimated effect sizes may not be reliable. More data is needed to acquire accurate effect estimates in different subpopulations of patients.
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Affiliation(s)
- David Charles
- Academic Clinical Medicine, Southampton General Hospital, Tremona Road, Southampton, UK
| | - Jemma Shanley
- Child Health, Southampton General Hospital, Tremona Road, Southampton, UK
| | - Sasha-Nicole Temple
- Clinical Medicine, Royal London Hospital, Whitechapel Road, Whitechapel, London, UK
| | - Anna Rattu
- Clinical and Experimental Sciences and Human Development, Faculty of Medicine, University of Southampton, University Road, Highfield, Southampton, UK
| | - Ekaterina Khaleva
- Clinical and Experimental Sciences and Human Development, Faculty of Medicine, University of Southampton, University Road, Highfield, Southampton, UK
| | - Graham Roberts
- Clinical and Experimental Sciences and Human Development, University of Southampton, University Road, Highfield, Southampton, UK
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19
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Muraro A, Worm M, Alviani C, Cardona V, DunnGalvin A, Garvey LH, Riggioni C, Silva D, Angier E, Arasi S, Bellou A, Beyer K, Bijlhout D, Bilò MB, Bindslev‐Jensen C, Brockow K, Fernandez‐Rivas M, Halken S, Jensen B, Khaleva E, Michaelis LJ, Oude Elberink HNG, Regent L, Sanchez A, Vlieg‐Boerstra BJ, Roberts G. EAACI guidelines: Anaphylaxis (2021 update). Allergy 2022; 77:357-377. [PMID: 34343358 DOI: 10.1111/all.15032] [Citation(s) in RCA: 133] [Impact Index Per Article: 66.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 07/31/2021] [Indexed: 12/11/2022]
Abstract
Anaphylaxis is a clinical emergency which all healthcare professionals need to be able to recognize and manage. The European Academy of Allergy and Clinical Immunology Anaphylaxis multidisciplinary Task Force has updated the 2014 guideline. The guideline was developed using the AGREE II framework and the GRADE approach. The evidence was systematically reviewed and recommendations were created by weighing up benefits and harms. The guideline was peer-reviewed by external experts and reviewed in a public consultation. The use of clinical criteria to identify anaphylaxis is suggested with blood sampling for the later measurement of tryptase. The prompt use of intramuscular adrenaline as first-line management is recommended with the availability of adrenaline autoinjectors to patients in the community. Pharmacokinetic data should be provided for adrenaline autoinjector devices. Structured, comprehensive training for people at risk of anaphylaxis is recommended. Simulation training and visual prompts for healthcare professionals are suggested to improve the management of anaphylaxis. It is suggested that school policies reflect anaphylaxis guidelines. The evidence for the management of anaphylaxis remains mostly at a very low level. There is an urgent need to prioritize clinical trials with the potential to improve the management of patients at risk of anaphylaxis.
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Affiliation(s)
- Antonella Muraro
- Food Allergy Referral Centre Veneto Region Department of Women and Child Health Padua General University Hospital Padua Italy
| | - Margitta Worm
- Division of Allergy and Immunology Department of Dermatology, Venerology and Allergy Charité Universitätsmedizin Berlin Germany
| | - Cherry Alviani
- Clinical and Experimental Sciences and Human Development in Health Faculty of Medicine University of Southampton UK
| | - Victoria Cardona
- Allergy Section Department of Internal Medicine Hospital Vall d'Hebron & ARADyAL Research Network Barcelona Spain
| | - Audrey DunnGalvin
- University College Cork Cork Ireland
- Sechnov University Moscow Moscow Russia
| | - Lene Heise Garvey
- Allergy Clinic Department of Dermatology and allergy Copenhagen University Hospital Gentofte Copenhagen Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Carmen Riggioni
- Allergy, Immunology and Rheumatology Division Department of Pediatrics Yong Loo Lin School of MedicineNational University of Singapore Singapore City Singapore
| | | | - Elizabeth Angier
- Primary Care, Population Science and Medical Education Faculty of Medicine University of Southampton Southampton UK
| | - Stefania Arasi
- Allergy Unit ‐ Area of Translational Research in Pediatric Specialities Bambino Gesù Children's HospitalIRCCS Rome Italy
| | - Abdelouahab Bellou
- European Society for Emergency Medicine Brussels Belgium
- Department of Emergency Medicine Wayne State University School of Medicine Detroit Michigan USA
- University of Rennes 1 Rennes France
| | - Kirsten Beyer
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine Charité Universitätsmedizin Berlin Berlin Germany
| | - Diola Bijlhout
- Association for Teacher Education in Europe (ATEE Brussels Belgium
| | - Maria Beatrice Bilò
- Allergy Unit Department of Clinical and Molecular Sciences Polytechnic University of Marche Ancona Italy
- Department of Internal Medicine University Hospital of Ancona Ancona Italy
| | - Carsten Bindslev‐Jensen
- Department of Dermatology and Allergy Centre Odense Research Centre for Anaphylaxis (ORCA) Odense University Hospital Odense Denmark
| | - Knut Brockow
- Department of Dermatology and Allergy Biederstein Technical University of Munich Munich Germany
| | - Montserrat Fernandez‐Rivas
- Allergy Department Hospital Clinico San CarlosFacultad Medicina Universidad ComplutenseIdISSCARADyAL Madrid Spain
| | - Susanne Halken
- Hans Christian Andersen Children's HospitalOdense University Hospital Odense Denmark
| | - Britt Jensen
- Department of Dermatology and Allergy Centre Odense Research Centre for Anaphylaxis (ORCA) Odense University Hospital Odense Denmark
| | - Ekaterina Khaleva
- Clinical and Experimental Sciences and Human Development in Health Faculty of Medicine University of Southampton UK
| | - Louise J. Michaelis
- Department of Paediatric Immunology, Allergy, and Infectious Diseases Great North Children's Hospital Newcastle upon Tyne UK
- Faculty of Medical Sciences Population Health Sciences InstituteNewcastle University Newcastle upon Tyne UK
| | - Hanneke N. G. Oude Elberink
- Department of Allergology University Medical Center GroningenUniversity of Groningen, and Groningen Research Institute for Asthma and COPD Groningen The Netherlands
| | | | - Angel Sanchez
- AEPNAA Spanish Association for People with Food and Latex Allergy Madrid Spain
| | | | - Graham Roberts
- Clinical and Experimental Sciences and Human Development in Health Faculty of Medicine University of Southampton UK
- NIHR Southampton Biomedical Research Centre University Hospital Southampton NHS Foundation Trust Southampton UK
- The David Hide Asthma and Allergy Research CentreSt Mary's Hospital Isle of Wight UK
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20
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Halken S, Muraro A, de Silva D, Khaleva E, Angier E, Arasi S, Arshad H, Bahnson HT, Beyer K, Boyle R, du Toit G, Ebisawa M, Eigenmann P, Grimshaw K, Hoest A, Jones C, Lack G, Nadeau K, O'Mahony L, Szajewska H, Venter C, Verhasselt V, Wong GWK, Roberts G. EAACI guideline: Preventing the development of food allergy in infants and young children (2020 update). Pediatr Allergy Immunol 2021; 32:843-858. [PMID: 33710678 DOI: 10.1111/pai.13496] [Citation(s) in RCA: 163] [Impact Index Per Article: 54.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 02/27/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND This guideline from the European Academy of Allergy and Clinical Immunology (EAACI) recommends approaches to prevent the development of immediate-onset / IgE-mediated food allergy in infants and young children. It is an update of a 2014 EAACI guideline. METHODS The guideline was developed using the AGREE II framework and the GRADE approach. An international Task Force with representatives from 11 countries and different disciplinary and clinical backgrounds systematically reviewed research and considered expert opinion. Recommendations were created by weighing up benefits and harms, considering the certainty of evidence and examining values, preferences and resource implications. The guideline was peer-reviewed by external experts, and feedback was incorporated from public consultation. RESULTS All of the recommendations about preventing food allergy relate to infants (up to 1 year) and young children (up to 5 years), regardless of risk of allergy. There was insufficient evidence about preventing food allergy in other age groups. The EAACI Task Force suggests avoiding the use of regular cow's milk formula as supplementary feed for breastfed infants in the first week of life. The EAACI Task Force suggests introducing well-cooked, but not raw egg or uncooked pasteurized, egg into the infant diet as part of complementary feeding. In populations where there is a high prevalence of peanut allergy, the EAACI Task Force suggests introducing peanuts in an age-appropriate form as part of complementary feeding. According to the studies, it appears that the most effective age to introduce egg and peanut is from four to 6 months of life. The EAACI Task Force suggests against the following for preventing food allergy: (i) avoiding dietary food allergens during pregnancy or breastfeeding; and (ii) using soy protein formula in the first 6 months of life as a means of preventing food allergy. There is no recommendation for or against the following: use of vitamin supplements, fish oil, prebiotics, probiotics or synbiotics in pregnancy, when breastfeeding or in infancy; altering the duration of exclusive breastfeeding; and hydrolysed infant formulas, regular cow's milk-based infant formula after a week of age or use of emollients. CONCLUSIONS Key changes from the 2014 guideline include suggesting (i) the introduction of peanut and well-cooked egg as part of complementary feeding (moderate certainty of evidence) and (ii) avoiding supplementation with regular cow's milk formula in the first week of life (low certainty of evidence). There remains uncertainty in how to prevent food allergy, and further well-powered, multinational research using robust diagnostic criteria is needed.
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Affiliation(s)
- Susanne Halken
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Antonella Muraro
- Department of Women and Child Health, Food Allergy Referral Centre Veneto Region, Padua University Hospital, Padua, Italy
| | | | - Ekaterina Khaleva
- Clinical and Experimental Sciences and Human Development in Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Elizabeth Angier
- Primary Care, Population Science and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Stefania Arasi
- Allergy Unit - Area of Translational Research in Pediatric Specialities, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Hasan Arshad
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport, UK
| | - Henry T Bahnson
- Benaroya Research Institute and Immune Tolerance Network, Seattle, WA, USA
| | - Kirsten Beyer
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Robert Boyle
- National Heart and Lung Institute, Imperial College London, London, UK.,Centre for Evidence-based Dermatology, University of Nottingham, Nottingham, UK
| | - George du Toit
- Department of Paediatric Allergy, Division of Asthma, Allergy and Lung Biology, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Motohiro Ebisawa
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - Philippe Eigenmann
- Pediatric Allergy Unit, Department of Women-Children-Teenagers, University Hospitals of Geneva, Geneva, Switzerland
| | - Kate Grimshaw
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Department of Dietetics, Salford Royal NHS Foundation Trust, Salford, UK
| | - Arne Hoest
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | | | - Gideon Lack
- Paediatric Allergy Research Group, Department of Women and Children's Health, Faculty of Life Sciences and Medicine, School of Life Course Sciences, London, UK.,Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK.,Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK.,Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - Kari Nadeau
- Department of Paediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Liam O'Mahony
- Departments of Medicine and Microbiology, APC Microbiome Ireland, National University of Ireland, Cork, Ireland
| | - Hania Szajewska
- Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland
| | - Carina Venter
- Section of Allergy and Immunology, University of Colorado and Children's Hospital Colorado, Aurora, CO, USA
| | - Valérie Verhasselt
- School of Molecular Sciences, University of Western Australia, Perth, WA, Australia
| | - Gary W K Wong
- Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Graham Roberts
- Clinical and Experimental Sciences and Human Development in Health, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport, UK
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21
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de Silva D, Singh C, Muraro A, Worm M, Alviani C, Cardona V, DunnGlvin A, Garvey LH, Riggioni C, Angier E, Arasi S, Bellou A, Beyer K, Bijlhout D, Bilo MB, Brockow K, Fernandez‐Rivas M, Halken S, Jensen B, Khaleva E, Michaelis LJ, Oude Elberink H, Regent L, Sanchez A, Vlieg‐Boerstra B, Roberts G. Diagnosing, managing and preventing anaphylaxis: Systematic review. Allergy 2021; 76:1493-1506. [PMID: 32880997 DOI: 10.1111/all.14580] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/13/2020] [Accepted: 08/15/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND This systematic review used the GRADE approach to compile evidence to inform the European Academy of Allergy and Clinical Immunology's (EAACI) anaphylaxis guideline. METHODS We searched five bibliographic databases from 1946 to 20 April 2020 for studies about the diagnosis, management and prevention of anaphylaxis. We included 50 studies with 18 449 participants: 29 randomized controlled trials, seven controlled clinical trials, seven consecutive case series and seven case-control studies. Findings were summarized narratively because studies were too heterogeneous to conduct meta-analysis. RESULTS It is unclear whether the NIAID/FAAN criteria or Brighton case definition are valid for immediately diagnosing anaphylaxis due to the very low certainty of evidence. There was also insufficient evidence about the impact of most anaphylaxis management and prevention strategies. Adrenaline is regularly used for first-line emergency management of anaphylaxis but little robust research has assessed its effectiveness. Newer models of adrenaline autoinjectors may slightly increase the proportion of people correctly using the devices and reduce time to administration. Face-to-face training for laypeople may slightly improve anaphylaxis knowledge and competence in using autoinjectors. We searched for but found little or no comparative effectiveness evidence about strategies such as fluid replacement, oxygen, glucocorticosteroids, methylxanthines, bronchodilators, management plans, food labels, drug labels and similar. CONCLUSIONS Anaphylaxis is a potentially life-threatening condition but, due to practical and ethical challenges, there is a paucity of robust evidence about how to diagnose and manage it.
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Affiliation(s)
| | | | - Antonella Muraro
- Department of Women and Child Health Food Allergy Referral Centre Veneto Region Padua General University Hospital Padua Italy
| | - Margitta Worm
- Division of Allergy and Immunology Department of Dermatology, Venerology and Allergy Charité Universitätsmedizin Berlin Germany
| | - Cherry Alviani
- Faculty of Medicine Clinical and Experimental Sciences and Human Development in Health University of Southampton Southampton UK
| | - Victoria Cardona
- Department of Internal Medicine, Allergy Section Hospital Vall d’Hebron Barcelona Spain
- ARADyAL Research Network Cáceres Spain
| | - Audrey DunnGlvin
- University College Cork Cork UK
- Sechnov University Moscow Moscow Russia
| | - Lene Heise Garvey
- Department of Dermatology and Allergy Allergy Clinic Gentofte Hospital Hellerup Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Carmen Riggioni
- Paediatric Allergy and Clinical Immunology Department Hospital Sant Joan de Deu and Sant Joan de Deu Research Foundation Barcelona Spain
| | - Elizabeth Angier
- Primary Care and Population Sciences University of Southampton Southampton UK
| | - Stefania Arasi
- Predictive and Preventive Medicine Research Unit, Multifactorial and Systemic Diseases Research Area Bambino Gesù Hospital IRCCS Rome Italy
| | | | - Kirsten Beyer
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine Charite Universitatsmedizin Berlin Berlin Germany
| | - Diola Bijlhout
- Association for Teacher Education in Europe (ATEE) Brussels Belgium
| | - M. Beatrice Bilo
- Allergy Unit Department of Clinical and Molecular Sciences Polytechnic University of Marche Ancona Italy
- Department of Internal Medicine University Hospital of Ancona Ancona Italy
| | - Knut Brockow
- Department of Dermatology and Allergy Biederstein Technical University of Munich Munich Germany
| | - Montserrat Fernandez‐Rivas
- Allergy Department Hospital Clinico San Carlos Facultad Medicina Universidad ComplutenseIdISSCARADyAL Madrid Spain
| | - Susanne Halken
- Hans Christian Andersen Children’s HospitalOdense University Hospital Odense Denmark
| | - Britt Jensen
- Department of Dermatology and Allergy Centre Odense Research Centre for Anaphylaxis (ORCA) Odense University Hospital Odense Denmark
| | - Ekaterina Khaleva
- Faculty of Medicine Clinical and Experimental Sciences and Human Development in Health University of Southampton Southampton UK
| | - Louise J. Michaelis
- Paediatric Allergy Research Population Health Sciences Institute Newcastle University Newcastle upon Tyne UK
| | - Hanneke Oude Elberink
- Department of Allergology University Medical Center Groningen University of Groningen Groningen The Netherlands
- Groningen Research Institute for Asthma and COPD Groningen The Netherlands
| | | | - Angel Sanchez
- AEPNAA Spanish Association for People with Food and Latex Allergy Madrid Spain
| | - Berber Vlieg‐Boerstra
- Department of Paediatrics OLVG Amsterdam The Netherlands
- Department of Nutrition & Dietetics Hanze University of Applied Sciences Groningen The Netherlands
| | - Graham Roberts
- Faculty of Medicine Clinical and Experimental Sciences and Human Development in Health University of Southampton Southampton UK
- NIHR Southampton Biomedical Research Centre University Hospital Southampton NHS Foundation Trust Southampton UK
- The David Hide Asthma and Allergy Research CentreSt Mary’s HospitalIsle of Wight UK
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22
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Harnik E, Harper V, Khaleva E. Best of the Other Journals. Clin Exp Allergy 2021; 51:374-375. [PMID: 33617051 DOI: 10.1111/cea.13828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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23
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Roberts G, Vazquez‐Ortiz M, Khaleva E, DunnGalvin A, Gore C, Marchisotto MJ, Mortz CG, Pfaar O, Sánchez A. The need for improved transition and services for adolescent and young adult patients with allergy and asthma in all settings. Allergy 2020; 75:2731-2733. [PMID: 32484916 DOI: 10.1111/all.14427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/22/2020] [Accepted: 05/24/2020] [Indexed: 12/25/2022]
Affiliation(s)
- Graham Roberts
- Faculty of Medicine University of Southampton Southampton UK
- The David Hide Asthma and Allergy Research Centre St Mary's Hospital Isle of Wight UK
- NIHR Southampton Biomedical Research Centre University Hospital Southampton NHS Foundation Trust Southampton UK
| | - Marta Vazquez‐Ortiz
- Section of Inflammation, Repair and Development National Heart and Lung InstituteImperial College London London UK
| | | | - Audrey DunnGalvin
- Applied Psychology and Paediatrics and Child Health University College Cork Cork Ireland
- Paediatrics and Child Infectious Diseases First Moscow State Medical University Moscow Russia
| | - Claudia Gore
- Section of Inflammation, Repair and Development National Heart and Lung InstituteImperial College London London UK
- Department of Paediatrics Imperial College Healthcare NHS Trust London UK
| | - Mary Jane Marchisotto
- European Academy of Allergy and Clinical Immunology Patient Organisations Committee Point Pleasant NJ USA
| | - Charlotte G. Mortz
- Department of Dermatology and Allergy Centre Odense Research Centre for Anaphylaxis (ORCA) Odense University Hospital University of Southern Denmark Odense Denmark
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery Section of Rhinology and Allergy University Hospital Marburg Philipps‐Universität Marburg Marburg Germany
| | - Angel Sánchez
- Asociación Española de Personas con Alergia a Alimentos y Látex Madrid Spain
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24
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Roberts G, Vazquez‐Ortiz M, Knibb R, Khaleva E, Alviani C, Angier E, Blumchen K, Comberiati P, Duca B, DunnGalvin A, Garriga‐Baraut T, Gore C, Gowland MH, Hox V, Jensen B, Mortz CG, Pfaar O, Pite H, Santos AF, Sanchez‐Garcia S, Timmermans F. EAACI Guidelines on the effective transition of adolescents and young adults with allergy and asthma. Allergy 2020; 75:2734-2752. [PMID: 32558994 DOI: 10.1111/all.14459] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 06/11/2020] [Indexed: 12/11/2022]
Abstract
Adolescent and young adult (AYA) patients need additional support, while they experience the challenges associated with their age. They need specific training to learn the knowledge and skills required to confidently self-manage their allergies and/or asthma. Transitional care is a complex process, which should address the psychological, medical, educational and vocational needs of AYA in the developmentally appropriate way. The European Academy of Allergy and Clinical Immunology has developed a clinical practice guideline to provide evidence-based recommendations for healthcare professionals to support the transitional care of AYA with allergy and/or asthma. This guideline was developed by a multidisciplinary working panel of experts and patient representatives based on two recent systematic reviews. It sets out a series of general recommendations on operating a clinical service for AYA, which include the following: (a) starting transition early (11-13 years), (b) using a structured, multidisciplinary approach, (c) ensuring AYA fully understand their condition and have resources they can access, (d) active monitoring of adherence and (e) discussing any implications for further education and work. Specific allergy and asthma transition recommendations include (a) simplifying medication regimes and using reminders; (b) focusing on areas where AYA are not confident and involving peers in training AYA patients; (c) identifying and managing psychological and socio-economic issues impacting disease control and quality of life; (d) enrolling the family in assisting AYA to undertake self-management; and (e) encouraging AYA to let their friends know about their allergies and asthma. These recommendations may need to be adapted to fit into national healthcare systems.
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Affiliation(s)
- Graham Roberts
- Faculty of Medicine University of Southampton Southampton UK
- NIHR Southampton Biomedical Research Centre University Hospital Southampton NHS Foundation Trust Southampton UK
- The David Hide Asthma and Allergy Research Centre St Mary's Hospital Isle of Wight UK
| | - Marta Vazquez‐Ortiz
- Section of Inflammation, Repair and Development National Heart and Lung Institute Imperial College London London UK
| | - Rebecca Knibb
- Department of Psychology School of Life and Health Sciences Aston University Birmingham UK
| | | | - Cherry Alviani
- Faculty of Medicine University of Southampton Southampton UK
- The David Hide Asthma and Allergy Research Centre St Mary's Hospital Isle of Wight UK
| | - Elizabeth Angier
- Primary Care and Population Sciences University of Southampton Southampton UK
| | - Katharina Blumchen
- Department of Paediatric and Adolescent Medicine Paediatric Pneumology, Allergology and Cystic Fibrosis University Hospital Frankfurt Frankfurt am Main Germany
| | - Pasquale Comberiati
- Department of Clinical and Experimental Medicine Section of Paediatrics University of Pisa Pisa Italy
- Department of Clinical Immunology and Allergology I.M. Sechenov First Moscow State Medical University Moscow Russia
| | - Bettina Duca
- Section of Inflammation, Repair and Development National Heart and Lung Institute Imperial College London London UK
- Department of Paediatrics Imperial College Healthcare NHS Trust London UK
| | - Audrey DunnGalvin
- Applied Psychology and Paediatrics and Child Health University College Cork Cork Ireland
- Paediatrics and Child Infectious Diseases First Moscow State Medical University Moscow Russia
| | - Teresa Garriga‐Baraut
- Unitat d'Allergologia Pediàtrica Hospital Universitari Vall d'Hebron Barcelona Spain
- Grup d'Investigació “Creixement i Desenvolupament” Institut de Recerca de l'Hospital Universitari Vall d'Hebron (VHIR) Barcelona Spain
| | - Claudia Gore
- Section of Inflammation, Repair and Development National Heart and Lung Institute Imperial College London London UK
- Department of Paediatrics Imperial College Healthcare NHS Trust London UK
| | | | - Valérie Hox
- Department of Otorhinolaryngology, Head and Neck Surgery University Hospitals Saint‐Luc Brussels Belgium
| | - Britt Jensen
- Department of Dermatology and Allergy Centre Odense Research Centre for Anaphylaxis (ORCA) Odense University Hospital Odense C Denmark
| | - Charlotte G. Mortz
- Department of Dermatology and Allergy Centre Odense Research Centre for Anaphylaxis (ORCA) Odense University Hospital Odense C Denmark
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery Section of Rhinology and Allergy University Hospital Marburg Philipps‐Universität Marburg Marburg Germany
| | - Helena Pite
- Allergy Center CUF Descobertas Hospital and CUF Infante Santo Hospital CEDOC Chronic Diseases Research Center NOVA Medical School/Faculdade de Ciências Médicas Universidade Nova de Lisboa Lisbon Portugal
| | - Alexandra F. Santos
- Department of Women and Children's Health (Paediatric Allergy School of Life Course Sciences Faculty of Life Sciences and Medicine King's College London London UK
- Peter Gorer Department of Immunobiology School of Immunology and Microbial Sciences King's College London London UK
- Children's Allergy Service Guy's and St Thomas' Hospital London UK
- Asthma UK Centre in Allergic Mechanisms of Asthma London UK
| | | | - Frans Timmermans
- Nederlands Anafylaxis Netwerk—European Anaphylaxis Taskforce Dordrecht The Netherlands
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25
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Khaleva E, Vazquez-Ortiz M, Comberiati P, DunnGalvin A, Pite H, Blumchen K, Garriga-Baraut T, Hox V, Santos AF, Gore C, Knibb RC, Alviani C, Mortz CG, Angier E, Duca B, Jensen B, Sanchez-Garcia S, Gowland MH, Timmermans F, Pfaar O, Roberts G. Current transition management of adolescents and young adults with allergy and asthma: a European survey. Clin Transl Allergy 2020; 10:40. [PMID: 33042515 PMCID: PMC7542112 DOI: 10.1186/s13601-020-00340-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 05/30/2020] [Indexed: 12/30/2022] Open
Abstract
Background Transition from parent-delivered to self-management is a vulnerable time for adolescents and young adults (AYA) with allergy and asthma. There is currently no European guideline available for healthcare professionals (HCPs) on transition of these patients and local/national protocols are also mostly lacking. Methods European HCPs working with AYA with allergy and asthma were invited to complete an online survey assessing challenges of working with these patients, current transition practices and access to specific healthcare resources. Results A total of 1179 responses from 41 European countries were collected. Most HCPs (86%) reported a lack of a transition guideline and a lack of a transition process (20% paediatric HCPs, 50% of adult HCPs, 56% HCP seeing all ages). Nearly half (48%) acknowledged a lack of an established feedback system between paediatric and adult medical services. Many respondents never routinely asked about mental health issues such as self-harm or depression and are not confident in asking about self-harm (66.6%), sexuality (64%) and depression (43.6%). The majority of HCPs (76%) had not received specific training in the care of AYA although 87% agreed that transition was important for AYA with allergy and asthma. Conclusion Although there was agreement that transition is important for AYA with allergy and asthma, there are crucial limitations and variations in the current provision of transition services across Europe. Standardisation of AYA management and specific training are required. This should improve management and continuity of care during adolescence and into adulthood to achieve the best healthcare outcomes.![]()
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Affiliation(s)
| | - Marta Vazquez-Ortiz
- Section of Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK
| | - Pasquale Comberiati
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy.,Department of Clinical Immunology and Allergology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Audrey DunnGalvin
- Applied Psychology and Paediatrics and Child Health, University College Cork, Cork, Ireland.,Paediatrics and Child Infectious Diseases, First Moscow State Medical University, Moscow, Russia
| | - Helena Pite
- Allergy Center, CUF Descobertas Hospital and CUF Infante Santo Hospital, Lisbon, Portugal.,CEDOC, Chronic Diseases Research Center, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Katharina Blumchen
- Department of Paediatric and Adolescent Medicine, Paediatric Pneumology, Allergology and Cystic Fibrosis, University Hospital Frankfurt, Frankfurt Am Main, Germany
| | - Teresa Garriga-Baraut
- Unitat d'Allergologia Pediàtrica, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Grup d'Investigació "Creixement i Desenvolupament", Institut de Recerca de l'Hospital Universitari Vall d'Hebron (VHIR), Barcelona, Spain
| | - Valerie Hox
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Saint-Luc, Brussels, Belgium
| | - Alexandra F Santos
- Department of Women and Children's Health (Paediatric Allergy, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.,Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK.,Children's Allergy Service, Guy's and St Thomas' Hospital, London, UK.,Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - Claudia Gore
- Section of Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK.,Department of Paediatrics, Imperial College Healthcare NHS Trust, London, UK
| | - Rebecca C Knibb
- Department of Psychology, School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Cherry Alviani
- Faculty of Medicine, University of Southampton, Southampton, UK.,The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK
| | - Charlotte G Mortz
- Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
| | - Elizabeth Angier
- Primary Care and Population Sciences, University of Southampton, Southampton, UK
| | - Bettina Duca
- Section of Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK.,Department of Paediatrics, Imperial College Healthcare NHS Trust, London, UK
| | - Britt Jensen
- Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
| | | | | | - Frans Timmermans
- Nederlands Anafylaxis Netwerk - European Anaphylaxis Taskforce, Dordrecht, The Netherlands
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Graham Roberts
- Faculty of Medicine, University of Southampton, Southampton, UK.,The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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26
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de Silva D, Halken S, Singh C, Muraro A, Angier E, Arasi S, Arshad H, Beyer K, Boyle R, du Toit G, Eigenmann P, Grimshaw K, Hoest A, Jones C, Khaleva E, Lack G, Szajewska H, Venter C, Verhasselt V, Roberts G. Preventing food allergy in infancy and childhood: Systematic review of randomised controlled trials. Pediatr Allergy Immunol 2020; 31:813-826. [PMID: 32396244 DOI: 10.1111/pai.13273] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 04/01/2020] [Accepted: 05/05/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND This systematic review of ways to prevent immediate-onset/IgE-mediated food allergy will inform guidelines by the European Academy of Allergy and Immunology (EAACI). METHODS The GRADE approach was used. Eleven databases were searched from 1946 to October 2019 for randomized controlled trials (and large prospective cohort studies in the case of breastfeeding). The studies included heterogeneous interventions, populations, and outcomes and so were summarized narratively. RESULTS Forty-six studies examined interventions to reduce the risk of food allergy in infancy (up to 1 year) or early childhood. The following interventions for pregnant or breastfeeding women and/or infants may have little to no effect on preventing food allergy, but the evidence is very uncertain: dietary avoidance of food allergens, vitamin supplements, fish oil, probiotics, prebiotics, synbiotics, and emollients. Breastfeeding, hydrolyzed formulas, and avoiding cow's milk formula may not reduce the risk of cow's milk protein allergy; however, temporary supplementation with cow's milk formula in the first week of life may increase the risk of cow's milk allergy. Introducing well-cooked egg, but not pasteurized raw egg, from 4 to 6 months probably reduces the risk of hen's egg allergy. Introducing regular peanut consumption into the diet of an infant at increased risk beginning from 4 to 11 months probably results in a large reduction in peanut allergy in countries with a high prevalence. These conclusions about introducing peanut are based on moderate certainty evidence, from single trials in high-income countries. CONCLUSIONS Sixty percent of the included studies were published in the last 10 years, but much still remains to be understood about preventing food allergy. In particular, there is a need to validate the potential benefits of early introduction of food allergens in a wider range of populations.
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Affiliation(s)
| | - Susanne Halken
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | | | - Antonella Muraro
- Department of Women and Child Health, Food Allergy Referral Centre Veneto Region, Padua General University Hospital, Padua, Italy
| | - Elizabeth Angier
- Primary Care and Population Sciences, University of Southampton, Southampton, UK
| | - Stefania Arasi
- Pediatric Allergology Unit, Bambino Gesù Hospital (IRCCS), Rome, Italy
| | - Hasan Arshad
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK
| | - Kirsten Beyer
- Department of Pediatric Pneumology and Immunology, Charite Universitatsmedizin Berlin, Berlin, Germany
| | | | - George du Toit
- Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Philippe Eigenmann
- Pediatric Allergy Unit, Department of Pediatrics, University Hospitals of Geneva, Geneva, Switzerland
| | - Kate Grimshaw
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Department of Dietetics, Salford Royal NHS Foundation Trust, Salford, UK
| | - Arne Hoest
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | | | - Ekaterina Khaleva
- Clinical and Experimental Sciences and Human Development in Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Gideon Lack
- Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Hania Szajewska
- Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland
| | - Carina Venter
- Section of Allergy and Immunology, Children's Hospital Colorado, University of Colorado Aurora, Colorado, USA
| | | | - Graham Roberts
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK.,Clinical and Experimental Sciences and Human Development in Health, Faculty of Medicine, University of Southampton, Southampton, UK
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Santos AF, Du Toit G, O'Rourke C, Becares N, Couto-Francisco N, Radulovic S, Khaleva E, Basting M, Harris KM, Larson D, Sayre P, Plaut M, Roberts G, Bahnson HT, Lack G. Biomarkers of severity and threshold of allergic reactions during oral peanut challenges. J Allergy Clin Immunol 2020; 146:344-355. [PMID: 32311390 PMCID: PMC7417812 DOI: 10.1016/j.jaci.2020.03.035] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 02/10/2020] [Accepted: 03/20/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Oral food challenge (OFC) is the criterion standard to assess peanut allergy (PA), but it involves a risk of allergic reactions of unpredictable severity. OBJECTIVE Our aim was to identify biomarkers for risk of severe reactions or low dose threshold during OFC to peanut. METHODS We assessed Learning Early about Peanut Allergy study, Persistance of Oral Tolerance to Peanut study, and Peanut Allergy Sensitization study participants by administering the basophil activation test (BAT) and the skin prick test (SPT) and measuring the levels of peanut-specific IgE, Arachis hypogaea 2-specific IgE, and peanut-specific IgG4, and we analyzed the utility of the different biomarkers in relation to PA status, severity, and threshold dose of allergic reactions to peanut during OFC. RESULTS When a previously defined optimal cutoff was used, the BAT diagnosed PA with 98% specificity and 75% sensitivity. The BAT identified severe reactions with 97% specificity and 100% sensitivity. The SPT, level of Arachis hypogaea 2-specific IgE, level of peanut-specific IgE, and IgG4/IgE ratio also had 100% sensitivity but slightly lower specificity (92%, 93%, 90%, and 88%, respectively) to predict severity. Participants with lower thresholds of reactivity had higher basophil activation to peanut in vitro. The SPT and the BAT were the best individual predictors of threshold. Multivariate models were superior to individual biomarkers and were used to generate nomograms to calculate the probability of serious adverse events during OFC for individual patients. CONCLUSIONS The BAT diagnosed PA with high specificity and identified severe reactors and low threshold with high specificity and high sensitivity. The BAT was the best biomarker for severity, surpassed only by the SPT in predicting threshold. Nomograms can help estimate the likelihood of severe reactions and reactions to a low dose of allergen in individual patients with PA.
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Affiliation(s)
- Alexandra F Santos
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, London, United Kingdom; Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom; Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, United Kingdom; Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom.
| | - George Du Toit
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, London, United Kingdom; Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom; Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, United Kingdom
| | - Colin O'Rourke
- Immune Tolerance Network, Benaroya Research Institute, Seattle, Wash
| | - Natalia Becares
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, London, United Kingdom; Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom; Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom
| | - Natália Couto-Francisco
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, London, United Kingdom; Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom; Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom
| | - Suzana Radulovic
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, London, United Kingdom; Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom; Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, United Kingdom
| | - Ekaterina Khaleva
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, United Kingdom
| | - Monica Basting
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, London, United Kingdom; Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom
| | | | | | - Peter Sayre
- Division of Hematology-Oncology, Department of Medicine, University of California, San Francisco, Calif
| | - Marshall Plaut
- National Institute of Allergy and Infectious Diseases, Bethesda, Md
| | - Graham Roberts
- David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, Southampton, United Kingdom; National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Southampton, United Kingdom
| | - Henry T Bahnson
- Immune Tolerance Network, Benaroya Research Institute, Seattle, Wash
| | - Gideon Lack
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, London, United Kingdom; Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom; Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, United Kingdom; Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom.
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Khaleva E, Franz A, Garvey LH, Jay N, Ylescupidez A, Bahnson HT, du Toit G. Perioperative anaphylaxis in children: Etiology, time sequence, and patterns of clinical reactivity. Pediatr Allergy Immunol 2020; 31:85-94. [PMID: 31518461 DOI: 10.1111/pai.13124] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 09/02/2019] [Accepted: 09/05/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Perioperative anaphylaxis (PA) in children is an uncommon but potentially life-threatening complication associated with anesthesia. Early identification and management of PA is essential to optimize clinical outcomes. METHODS We performed a retrospective study of anesthesia records from pediatric patients with PA from centers in the United Kingdom, France, and the United States over a period of 10 years. Time sequence of clinical signs and physiological variables during PA were collected, along with results of allergy testing. RESULTS Twenty-nine children with PA were included. Median age was 11 years. Based on the modified Ring and Messmer Grading Scale, severe reactions were seen in 25 (86%) members of this cohort, with 4 (14%) experiencing cardiac arrest. Life-threatening hypotension was the first clinical sign of PA in 59% of cases, followed by tachycardia and bronchospasm. In 16 (55%) cases, the initial signs of PA involved multiple organ systems. When the initial signs of PA were cardiovascular and/or respiratory, more epinephrine doses were administered. Average time from initial sign of PA to treatment with epinephrine was 6 minutes (SD: 6, range: 1-25). The causative allergen was identified in 15 patients. CONCLUSION Severe hypotension is the most common presenting sign of PA in children. Initial cardiovascular and/or respiratory signs are associated with the need for increased epinephrine doses. Further studies should optimize the prediction, identification, and early management of PA in children.
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Affiliation(s)
- Ekaterina Khaleva
- Department of Paediatric Allergy, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Faculty of Medicine, MSc Allergy, University of Southampton, Southampton, UK.,inVIVO Planetary Health, Group of the Worldwide Universities, West New York, NJ, USA
| | - Amber Franz
- Seattle Children's Hospital, Seattle, WA, USA
| | - Lene Heise Garvey
- Danish Anaesthesia Allergy Centre, Allergy Clinic Gentofte Hospital and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Nicola Jay
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Alyssa Ylescupidez
- Benaroya Research Institute and The Immune Tolerance Network, Seattle, WA, USA
| | - Henry T Bahnson
- Benaroya Research Institute and The Immune Tolerance Network, Seattle, WA, USA
| | - George du Toit
- Department of Paediatric Allergy, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Department of Paediatric Allergy, King's Health Partners, King's College London, London, UK
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Boix-Amorós A, Collado MC, Van't Land B, Calvert A, Le Doare K, Garssen J, Hanna H, Khaleva E, Peroni DG, Geddes DT, Kozyrskyj AL, Warner JO, Munblit D. Reviewing the evidence on breast milk composition and immunological outcomes. Nutr Rev 2019; 77:541-556. [PMID: 31111150 DOI: 10.1093/nutrit/nuz019] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
A large number of biologically active components have been found in human milk (HM), and in both human and animal models, studies have provided some evidence suggesting that HM composition can be altered by maternal exposures, subsequently influencing health outcomes for the breastfed child. Evidence varies from the research studies on whether breastfeeding protects the offspring from noncommunicable diseases, including those associated with immunological dysfunction. It has been hypothesized that the conflicting evidence results from HM composition variations, which contain many immune active molecules, oligosaccharides, lactoferrin, and lysozyme in differing concentrations, along with a diverse microbiome. Determining the components that influence infant health outcomes in terms of both short- and long-term sequelae is complicated by a lack of understanding of the environmental factors that modify HM constituents and thereby offspring outcomes. Variations in HM immune and microbial composition (and the differing infantile responses) may in part explain the controversies that are evidenced in studies that aim to evaluate the prevalence of allergy by prolonged and exclusive breastfeeding. HM is a "mixture" of immune active factors, oligosaccharides, and microbes, which all may influence early immunological outcomes. This comprehensive review provides an in-depth overview of existing evidence on the studied relationships between maternal exposures, HM composition, vaccine responses, and immunological outcomes.
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Affiliation(s)
- Alba Boix-Amorós
- Institute of Agrochemistry and Food Technology, National Research Council (IATA-CSIC), Valencia, Spain
- In-VIVO Global Network, an affiliate of the World Universities Network (WUN), New York, New York, United States
| | - Maria Carmen Collado
- Institute of Agrochemistry and Food Technology, National Research Council (IATA-CSIC), Valencia, Spain
- In-VIVO Global Network, an affiliate of the World Universities Network (WUN), New York, New York, United States
| | - Belinda Van't Land
- Department of Immunology, Danone Nutricia Research, Utrecht, the Netherlands
- Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Anna Calvert
- Paediatric Infectious Diseases Research Group, St George's University of London, London, United Kingdom
| | - Kirsty Le Doare
- Paediatric Infectious Diseases Research Group, St George's University of London, London, United Kingdom
- Imperial College London, London, United Kingdom
- Public Health England, Porton Down, United Kingdom, and the MRC Unit, Fajara, Gambia
| | - Johan Garssen
- Department of Immunology, Danone Nutricia Research, Utrecht, the Netherlands
- Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
| | | | - Ekaterina Khaleva
- In-VIVO Global Network, an affiliate of the World Universities Network (WUN), New York, New York, United States
- University of Southampton, Southampton, UK
| | - Diego G Peroni
- In-VIVO Global Network, an affiliate of the World Universities Network (WUN), New York, New York, United States
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy
| | - Donna T Geddes
- In-VIVO Global Network, an affiliate of the World Universities Network (WUN), New York, New York, United States
- School of Molecular Sciences, the University of Western Australia, Perth, Australia
| | - Anita L Kozyrskyj
- In-VIVO Global Network, an affiliate of the World Universities Network (WUN), New York, New York, United States
- Department of Pediatrics, Department of Obstetrics & Gynecology, Faculty of Medicine & Dentistry, School of Public Health, University of Alberta, Alberta, Canada
| | - John O Warner
- In-VIVO Global Network, an affiliate of the World Universities Network (WUN), New York, New York, United States
- Imperial College London, London, United Kingdom
- National Institute for Health Research, Collaboration for Leadership in Applied Health Research and Care for NW London, London, United Kingdom
| | - Daniel Munblit
- In-VIVO Global Network, an affiliate of the World Universities Network (WUN), New York, New York, United States
- Imperial College London, London, United Kingdom
- Department of Pediatrics, Sechenov University, Moscow, Russia, and the Solov'ev Research and Clinical Center for Neuropsychiatry, Moscow, Russia
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30
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Khaleva E, Gridneva Z, Geddes DT, Oddy WH, Colicino S, Blyuss O, Boyle RJ, Warner JO, Munblit D. Transforming growth factor beta in human milk and allergic outcomes in children: A systematic review. Clin Exp Allergy 2019; 49:1201-1213. [PMID: 31058363 DOI: 10.1111/cea.13409] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/25/2019] [Accepted: 04/20/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Human milk (HM) transforming growth factor beta (TGF-β) is critical for inflammation regulation and oral tolerance promotion. Previous reports suggested that variations in HM TGF-β levels are associated with allergic outcomes. OBJECTIVE We undertook a systematic review (PROSPERO 2017 CRD42017069920) to reassess the evidence on the relationships between HM TGF-β and allergic outcomes in children. METHODS Electronic bibliographic databases (MEDLINE, EMBASE and Cochrane Library) were systematically searched. Two independent reviewers screened reference lists, extracted the data and assessed risk of bias using the National Institute for Clinical Excellence methodological checklist. RESULTS A total of 21 studies were identified. Sixteen studies assessed relationships between HM TGF-β and risk of eczema; 14, allergic sensitization; nine, wheezing/asthma; six, food allergy; three, allergic rhinitis/conjunctivitis. Five cohorts (5/18, 28%) reported a protective effect of TGF-β1, while 3 (3/10, 30%) suggested increased risk of allergic outcomes development and 1 (1/10, 10%), a protective effect of TGF-β2 on eczema. Meta-analysis was not possible due to significant heterogeneity in methodology, age of outcome assessment and differing statistical approaches. 71% (15/21) of studies carried a high risk of bias. CONCLUSION AND CLINICAL RELEVANCE In contrast with previous findings, we did not find strong evidence of associations between HM TGF-β and allergic outcomes. Differences in studies' methodology and outcomes do not allow unconditional rejection or acceptance of the hypothesis that HM TGF-β influences the risk of allergy development. Future studies on diverse populations employing standardized methods, accurate phenotyping of outcomes and evaluation of the effect of TGF-β in combination with other HM immune markers, microbiome and oligosaccharides are required.
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Affiliation(s)
- Ekaterina Khaleva
- University of Southampton, Southampton, UK.,inVIVO Planetary Health, Research Group of the Worldwide Universities Network, West New York, New Jersey
| | - Zoya Gridneva
- inVIVO Planetary Health, Research Group of the Worldwide Universities Network, West New York, New Jersey.,School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Donna T Geddes
- inVIVO Planetary Health, Research Group of the Worldwide Universities Network, West New York, New Jersey.,School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Wendy H Oddy
- Nutritional Epidemiology, Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Silvia Colicino
- The National Heart and Lung Institute, Imperial College London, London, UK
| | - Oleg Blyuss
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.,Department of Applied Mathematics, Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Russia.,Department of Pediatrics, Faculty of Pediatrics, Sechenov University, Moscow, Russia
| | - Robert J Boyle
- inVIVO Planetary Health, Research Group of the Worldwide Universities Network, West New York, New Jersey.,Department of Paediatrics, Imperial College London, London, UK.,Centre of Evidence-based Dermatology, University of Nottingham, Nottingham, UK
| | - John O Warner
- inVIVO Planetary Health, Research Group of the Worldwide Universities Network, West New York, New Jersey.,Department of Paediatrics, Imperial College London, London, UK.,Paediatrics and NIHR Collaboration for Leadership in Applied Health Research and Care for NW London, London, UK
| | - Daniel Munblit
- inVIVO Planetary Health, Research Group of the Worldwide Universities Network, West New York, New Jersey.,Department of Pediatrics, Faculty of Pediatrics, Sechenov University, Moscow, Russia.,Department of Paediatrics, Imperial College London, London, UK.,Healthcare Department of Moscow, Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
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Munblit D, Abrol P, Sheth S, Chow LY, Khaleva E, Asmanov A, Lauriola S, Padovani EM, Comberiati P, Boner AL, Warner JO, Boyle RJ, Peroni DG. Levels of Growth Factors and IgA in the Colostrum of Women from Burundi and Italy. Nutrients 2018; 10:E1216. [PMID: 30177587 PMCID: PMC6164593 DOI: 10.3390/nu10091216] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 08/24/2018] [Accepted: 08/27/2018] [Indexed: 12/26/2022] Open
Abstract
Colostrum is produced in the first days postpartum. It is a known source of immune mediators for a newborn within the first week of life. Although it is still unclear if colostrum composition varies between populations, recent data suggest differences. Hepatocyte growth factor (HGF); transforming growth factor-β (TGF-β) 1, 2, and 3; and immunoglobulin A (IgA) are key immunological components of colostrum that stimulate neonatal gastrointestinal and immune system development. We aimed to investigate the differences in the concentration between immune markers in the colostrum of mothers living in Burundi and Italy, and to identify the factors associated with differences. In this cross-sectional birth cohort study, a total of 99 colostrum samples from Burundian (n = 23) and Italian (n = 76) women were collected at 0 to 6 days postpartum. A clinical chemistry analyser was used for IgA quantification and electro-chemiluminescence, for HGF and TGFβ1-3 assessment. A univariate analysis and multivariate linear regression model were used for statistical testing. The concentrations of TGF-β2 (p = 0.01) and IgA (p < 0.01) were significantly higher in the colostrum from the women residing in Burundi than in Italy, both in a univariate analysis and upon the adjustment for confounding factors. A similar trend is seen for HGF, reaching statistical significance upon a multivariate analysis. We found a moderate to strong positive correlation between the TGF-β isoforms and IgA concentration in both countries (p < 0.01), with stronger concentration in the colostrum from Burundi. The results of this study are in support of previous data, suggesting that concentration of the immune active molecules is higher in the human milk of women residing in developing countries. However, with a small sample size, caution must be applied, as the findings require further confirmation. Future work should also be focused on other factors (e.g., lipid and microbial composition), as well as the investigation into colostrum and between populations comparison, adjusting for potential confounders.
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Affiliation(s)
- Daniel Munblit
- Department of Paediatrics, Imperial College London, London W2 1NY, UK.
- Faculty of Pediatrics, Sechenov University, 119991 Moscow, Russia.
- inVIVO Planetary Health, Group of the Worldwide Universities Network (WUN), 6010 Park Ave, West New York, NJ 07093, USA.
| | - Priya Abrol
- Department of Paediatrics, Imperial College London, London W2 1NY, UK.
| | - Shreya Sheth
- Department of Paediatrics, Imperial College London, London W2 1NY, UK.
| | - Li Yan Chow
- Department of Paediatrics, Imperial College London, London W2 1NY, UK.
| | - Ekaterina Khaleva
- inVIVO Planetary Health, Group of the Worldwide Universities Network (WUN), 6010 Park Ave, West New York, NJ 07093, USA.
- Department of Paediatrics, Saint-Petersburg State Paediatric Medical University, 194353 Saint-Petersburg, Russia.
| | - Alan Asmanov
- The Research and Clinical Institute for Pediatrics named after Academician Yuri Veltischev of the Pirogov Russian National Research Medical University, 125412 Moscow, Russia.
| | - Silvana Lauriola
- Department of Life and Reproduction Sciences, Section of Paediatrics, University of Verona, 37124 Verona, Italy.
| | - Ezio M Padovani
- Department of Life and Reproduction Sciences, Section of Paediatrics, University of Verona, 37124 Verona, Italy.
| | - Pasquale Comberiati
- Department of Life and Reproduction Sciences, Section of Paediatrics, University of Verona, 37124 Verona, Italy.
| | - Attilio L Boner
- Department of Life and Reproduction Sciences, Section of Paediatrics, University of Verona, 37124 Verona, Italy.
| | - John O Warner
- Department of Paediatrics, Imperial College London, London W2 1NY, UK.
- inVIVO Planetary Health, Group of the Worldwide Universities Network (WUN), 6010 Park Ave, West New York, NJ 07093, USA.
| | - Robert J Boyle
- Department of Paediatrics, Imperial College London, London W2 1NY, UK.
- inVIVO Planetary Health, Group of the Worldwide Universities Network (WUN), 6010 Park Ave, West New York, NJ 07093, USA.
| | - Diego G Peroni
- inVIVO Planetary Health, Group of the Worldwide Universities Network (WUN), 6010 Park Ave, West New York, NJ 07093, USA.
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, 56126 Pisa, Italy.
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Biggs KV, Hurrell K, Matthews E, Khaleva E, Munblit D, Boyle RJ. Formula Milk Supplementation on the Postnatal Ward: A Cross-Sectional Analytical Study. Nutrients 2018; 10:E608. [PMID: 29757936 PMCID: PMC5986488 DOI: 10.3390/nu10050608] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 04/26/2018] [Accepted: 05/09/2018] [Indexed: 12/29/2022] Open
Abstract
Breastfeeding rates are low in the UK, where approximately one quarter of infants receive a breastmilk substitute (BMS) in the first week of life. We investigated the reasons for early BMS use in two large maternity units in the UK, in order to understand the reasons for the high rate of early BMS use in this setting. Data were collected through infant feeding records, as well as maternal and midwife surveys in 2016. During 2016, 28% of infants received a BMS supplement prior to discharge from the hospital maternity units with only 10% supplementation being clinically indicated. There was wide variation in BMS initiation rates between different midwives, which was associated with ward environment and midwife educational level. Specific management factors associated with non-clinically indicated initiation of BMS were the absence of skin-to-skin contact within an hour of delivery (p = 0.01), and no attendance at an antenatal breastfeeding discussion (p = 0.01). These findings suggest that risk of initiating a BMS during postnatal hospital stay is largely modifiable. Concordance with UNICEF Baby Friendly 10 steps, attention to specific features of the postnatal ward working environment, and the targeting of midwives and mothers with poor educational status may all lead to improved exclusive breastfeeding rates at hospital discharge.
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Affiliation(s)
- Kirsty V Biggs
- Brighton and Sussex Medical School, Brighton BN2 5BE, UK.
| | | | - Eleanor Matthews
- Department of Paediatrics, Imperial College Healthcare NHS Trust, London W2 1NY, UK.
| | - Ekaterina Khaleva
- Department of Paediatrics, Saint-Petersburg State Paediatric Medical University, 194353 Saint-Petersburg, Russia.
- inVIVO Planetary Health, Group of the Worldwide Universities Network (WUN), 6010 Park Ave, West New York, NJ 07093, USA.
| | - Daniel Munblit
- Department of Paediatrics, Imperial College Healthcare NHS Trust, London W2 1NY, UK.
- inVIVO Planetary Health, Group of the Worldwide Universities Network (WUN), 6010 Park Ave, West New York, NJ 07093, USA.
- Faculty of Pediatrics, I. M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia.
| | - Robert J Boyle
- Department of Paediatrics, Imperial College Healthcare NHS Trust, London W2 1NY, UK.
- inVIVO Planetary Health, Group of the Worldwide Universities Network (WUN), 6010 Park Ave, West New York, NJ 07093, USA.
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Pouessel G, Claverie C, Labreuche J, Renaudin JM, Dorkenoo A, Eb M, Moneret-Vautrin A, Deschildre A, Leteurtre S, Grabenhenrich L, Worm M, Dölle S, Scherer K, Hutteger I, Christensen M, Bindslev-Jensen C, Mortz C, Eller E, Kjaer HF, Carneiro-Leão L, Badas J, Coimbra A, Levy DP, Ben-Shoshan M, Rimon A, Benor S, Arends NJT, Edelbroek N, de Groot H, Emons JAM, Brand HKA, Verhoeven D, van Veen LN, de Jong NW, Noh G, Jang EH, Pascal M, Dominguez O, Piquer M, Alvaro M, Jimenez-Feijoo R, Lozano J, Machinena A, del Mar Folqué M, Giner MT, Plaza AM, Turner P, Patel N, Vazquez-Ortiz M, Lindsley S, Walker L, Rosenberg S, Mari A, Alessandri C, Giangrieco I, Tuppo L, Rafaiani C, Mitterer G, Ciancamerla M, Ferrara R, Bernardi ML, Zennaro D, Tamburrini M, Ciardiello MA, Harwanegg C, Fernandez A, Selb R, Egenmann P, Epstein M, Hoffmann-Sommergruber K, Koning F, Lovik M, Clare Mills EN, Moreno J, van Loveren H, Wal JM, Diesner S, Bergmayr C, Pfitzner B, Assmann VE, Starkl P, Endesfelder D, Eiwegger T, Szepfalusi Z, Fehrenbach H, Jensen-Jarolim E, Hartmann A, Pali-Schöll I, Untersmayr E, Wille S, Meyer P, Klingebiel C, Lidholm J, Ehrenberg A, Östling J, Cleach I, Mège JL, Vitte J, Aina R, Dubiela P, Pfeifer S, Bublin M, Radauer C, Humeniuk P, Kabasser S, Asero R, Bogas G, Gomez F, Campo P, Salas M, Doña I, Barrionuevo E, Guerrero MA, Mayorga C, Prieto A, Barber D, Torres MJ, Jamin A, Wangorsch A, Ballmer B, Vieths S, Scheurer S, Apostolovic D, Mihailovic J, Krstic M, Starkhammar M, Velickovic TC, Hamsten C, van Hage M, van Erp FC, Knol EF, Kansen HM, Pontoppidan B, Meijer Y, van der Ent CK, Knulst AC, Sayers R, Brown H, Custovic A, Simpson A, Mills C, Schulz J, Akkerdaas J, Totis M, Capt A, Herouet-Guicheney C, van Ree R, Banerjee T, Banerjee A, Claude M, Bouchaud G, Lupi R, Castan L, Tranquet O, Denery-Papini S, Bodinier M, Brossard C, De Poi R, Gritti E, De Dominicis E, Popping B, de Laureto PP, Palosuo K, Kukkonen AK, Pelkonen A, Mäkelä M, Lee NA, Rost J, Muralidharan S, Campbell D, Mehr S, Nock C, Baumert J, Taylor S, Mastrorilli C, Tripodi S, Caffarelli C, Perna S, Di Rienzo Businco A, Sfika I, Dondi A, Bianchi A, Dascola CP, Ricci G, Cipriani F, Maiello N, del Giudice MM, Frediani T, Frediani S, Macrì F, Pistoletti C, Iacono ID, Patria MF, Varin E, Peroni D, Comberiati P, Chini L, Moschese V, Lucarelli S, Bernardini R, Pingitore G, Pelosi U, Olcese R, Moretti M, Cirisano A, Faggian D, Travaglini A, Plebani M, Verga MC, Calvani M, Giordani P, Matricardi PM, Ontiveros N, Cabrera-Chavez F, Galand J, Beaudouin E, Pineau F, Sakai S, Matsunaga K, Teshima R, Larré C, Denery S, Tschirner S, Trendelenburg V, Schulz G, Niggemann B, Beyer K, Bouferkas Y, Belabbas Y, Saidi D, Kheroua O, Mecherfi KEE, Guendouz M, Haddi A, Kaddouri H, Amaral L, Pereira A, Rodrigues S, Datema M, Jongejan L, Clausen M, Knulst A, Papadopoulos N, Kowalski M, de Blay F, Zwinderman A, Hoffman-Sommergruber K, Ballmer-Weber B, Fernandez-Rivas M, Deng S, Yin J, Eisenmann C, Nassiri M, Reinert R, van der Valk JPM, van Wijk RG, Vergouwe Y, Steyerberg EW, Reitsma M, Wichers HJ, Savelkoul HFJ, Vlieg-Boerstra B, Dubois AEJ, de Jong NW, Carolino F, Rodolfo A, Cernadas J, Roa-Medellín D, Rodriguez-Fernandez A, Navarro J, Albendiz V, Baeza ML, Intente-Herrero S, Mikkelsen A, Mehlig K, Lissner L, Verrill L, Luccioli S, van Bilsen J, Kuper F, Wolterbeek A, Rankouhi TR, Verschuren L, Cnossen H, Jeurink P, Garssen J, Knippels L, Garthoff J, Houben G, Leeman W, Eleonore Pettersson M, Schins AMM, Koppelman GH, Kollen BJ, Zubchenko S, Kuntz S, Mérida P, Álvaro M, Piquer M, Riggioni C, Castellanos JH, Jimenez R, Cap M, Drumez E, Lejeune S, Thumerelle C, Mordacq C, Nève V, Ricò S, Varini M, Nocerino R, Cosenza L, Amoroso A, Di Costanzo M, Di Scala C, Bedogni G, Canani RB, Turner PJ, Poza-Guedes P, González-Pérez R, Sánchez-Machín I, Matheu-Delgado V, Wambre E, Ballegaard AS, Madsen C, Gregersen J, Bøgh KL, Aubert P, Neunlist M, Magnan A, Lozano-Ojalvo D, Pablos-Tanarro A, Pérez-Rodríguez L, Molina E, López-Fandiño R, Rekima A, Macchiaverni P, Turfkruyer M, Holvoet S, Dupuis L, Baiz N, Annesi-Maesano I, Mercenier A, Nutten S, Verhasselt V, Mrakovcic-Sutic I, Banac S, Sutic I, Baricev-Novakovic Z, Sutic I, Pavisic V, Muñoz-Cano R, Jiménez-Rodríguez T, Corbacho D, Roca-Ferrer J, Bartra J, Bulog A, Micovic V, Markiewicz L, Szymkiewicz A, Szyc A, Wróblewska B, Harvey BM, Harthoorn LF, Wesley Burks A, Rentzos G, Björk ALB, Bengtsson U, Barber C, Kalicinsky C, Breynaert C, Coorevits L, Jansen C, Van Hoeyveld E, Verbeke K, Kochuyt AM, Schrijvers R, Deleanu D, Muntean A, Konstantakopoulou M, Pasioti M, Papadopoulou A, Iliopoulou A, Mikos N, Kompoti E, de Castro ED, Bartalomé B, Ue KL, Griffiths E, Till S, Grimshaw K, Roberts G, Selby A, Butiene I, Larco JI, Dubakiene R, Fiandor A, Fiocchi A, Papadopoulos N, Sigurdardottir S, Sprikkelman A, Schoemaker AF, Xepapadaki P, Keil T, Cojocariu Z, Barbado BS, Iancu V, Arroabarren E, Esarte MG, Arteaga M, Andrade MC, Borges D, Kalil J, Bianchi PG, Agondi RC, Gupta RK, Sharma A, Gupta K, Das M, Dwivedi P, Karseladze R, Jorjoliani L, Saginadze L, Tskhakaia M, Basello K, Piuri G, Speciani AF, Speciani MC, Camerotto C, Zinno F, Pakholchuk O, Nedelska S, Pattini S, Costantino MT, Peveri S, Villalta D, Savi E, Costanzi A, Revyakina VA, Kiseleva MA, Kuvshinova ED, Larkova IA, Shekhetov AA, Silva D, Moreira A, Plácido J, van der Kleij H, van Twuijver E, Sutorius R, de Kam PJ, van Odijk J, Lindqvist H, Lustig E, Jácome AAA, Aguilar KLB, Domínguez MG, Hernández DAM, Caruso C, Casale C, Rapaccini GL, Romano A, De Vitis I, Cocco RR, Aranda C, Mallozi MC, Motta JF, Moraes L, Pastorino A, Rosario N, Goudouris E, Porto A, Wandalsen NF, Sarinho E, Sano F, Solé D, Pitsios C, Petrodimopoulou M, Papadopoulou E, Passioti M, Kontogianni M, Adamia N, Khaleva E, del Prado AP, Du Toit G, Krzych E, Samolinska-Zawisza U, Furmanczyk K, Tomaszewska A, Raciborski F, Lipiec A, Samel-Kowalik P, Walkiewicz A, Borowicz J, Samolinski B, Nano AL, Recto M, Somoza ML, López NB, Alzate DP, Ruano FJ, Garcimartín MI, Haroun E, de la Torre MV, Rojas A, Onieva ML, Canto G, Rodrigues A, Forno A, Cabral AJ, Gonçalves R, Vorozhko I, Sentsova T, Chernyak O, Denisova S, Ilènko L, Muhortnich V, Zimmermann C, Rohrbach A, Bakhsh FR, Boudewijn K, Oomkes-Pilon AM, Van Ginkle D, Šilar M, Jeverica A, Vesel T, Avčin T, Korošec P, van der Valk J, Berends I, Arends N, van Maaren M, Wichers H, Emons J, Dubois A, de Jong N, Matsyura O, Besh L, Huang CH, Jan TR, Stiefel G, Tratt J, Kirk K, Carolino F, Arasi S, Caminiti L, Crisafulli G, Fiamingo C, Fresta J, Pajno G, Remington B, Kruizinga A, Marty Blom W, Westerhout J, Bijlsma S, Baumert J, Blankestijn M, Otten H, Klemans R, Michelsen-Huisman AD, van Os-Medendorp H, Kruizinga AG, Versluis A, van Duijn G, de Zeeuw-Brouwer HML, Castenmiller JJM, Noteborn HPJM, Houben GF, Bravin K, Luyt D, Javed B, Couch P, Munro C, Padfield P, Sperrin M, Byrne A, Oosthuizen L, Kelleher C, Ward F, Brosnan N, King G, Corbet E, Guzmán JAH, García MB, Asensio O, Navarrete LV, Larramona H, Miró XD, Pyrz K, Austin M, Boloh Y, Couch P, Galloway D, Hernandez P, Hourihane JO, Kenna F, Majkowska-Wojciechowska B, Regent L, Themisb M, Schnadt S, Semic-Jusufagic A, Galvin AD, Kauppila T, Kuitunen M, Kitsioulis NA, Douladiris N, Kostoudi S, Manolaraki I, Mitsias D, Manousakis E, Papadopoulos NG, Knibb R, Hammond J, Cooke R, Yrjänä J, Hanni AM, Vähäsarja P, Mustonen O, Dunder T, Kulmala P, Lasa E, D’Amelio C, Martínez S, Joral A, Gastaminza G, Goikoetxea MJ, Candy DCA, Van Ampting MTJ, Oude Nijhuis MM, Butt AM, Peroni DG, Fox AT, Knol J, Michaelis LJ, Padua I, Padrao P, Moreira P, Barros R, Sharif H, Ahmed M, Gomaa N, Mens J, Smit K, Timmermans F, Poredoš T, Jeverica AK, Sedmak M, Benedik E, Accetto M, Zupančič M, Yonamine G, Soldateli G, Aquilante B, Pastorino AC, de Moraes Beck CL, Gushken AK, de Barros Dorna M, dos Santos CN, Castro APM, Al-Qahtani A, Arnaout R, Khaliq AR, Amin R, Sheikh F, Alvarez J, Anda M, Palacios M, De Prada M, Ponce C, Balbino B, Sibilano R, Marichal T, Gaudenzio N, Karasuyama H, Bruhns P, Tsai M, Reber LL, Galli SJ, Ferreira AR, Cernadas JR, del Campo García A, Fernández SP, Carrera NS, Sánchez-Cruz FB, Lorenzo JRF, Claus S, Pföhler C, Ruëff F, Treudler R, Jaume ME, Madroñero A, Perez MTG, Julia JC, Plovdiv CH, Gethings L, Langridge J, Adel-Patient K, Bernard H, Barcievic-Jones I, Sokolova R, Yankova R, Ivanovska M, Murdjeva M, Popova T, Dermendzhiev S, Karjalainen M, Lehnigk U, Brown D, Locklear JC, Locklear J, Maris I, Hourihane J, Ornelas C, Caiado J, Ferreira MB, Pereira-Barbosa M, Puente Y, Daza JC, Monteseirin FJ, Ukleja-Sokolowska N, Gawronska-Ukleja E, Zbikowska-Gotz M, Bartuzi Z, Sokolowski L, Adams A, Mahon B, English K, Gourdon-Dubois N, Sellam L, Pereira B, Michaud E, Messaoudi K, Evrard B, Fauquert JL, Palomares F, Gomez G, Rodriguez MJ, Galindo L, Molina A, Paparo L, Mennini M, Aitoro R, Wawrzeńczyk A, Przybyszewski M, Wawrzeńczyk A, Sarıcoban HE, Ugras M, Yalvac Z, Flokstra-de Blok BMJ, van der Velde JL, Vereda A, Ippolito C, Traversa A, Adriano D, Bianchi DM, Gallina S, Decastelli L, Makatsori M, Miles A, Devetak SP, Devetak I, Tabet SA, Trandbohus JF, Winther P, Malling HJ, Hansen KS, Garvey LH, Wang CC, Cheng YH, Tung CW, Dietrich M, Marenholz I, Kalb B, Grosche S, Blümchen K, Schlags R, Price M, Rietz S, Esparza-Gordillo J, Lau S, Lee YA, Almontasheri A, Bahkali MA, Elshorbagi S, Alfhaid A, Altamimi M, Madbouly E, Al-Dhekri H, Arnaout RK, Basagaña M, Miquel S, Bartolomé B, Brix B, Rohwer S, Brandhoff S, Berger A, Suer W, Weimann A, Bueno C, Martín-Pedraza L, Abián S, Segundo-Acosta PS, López-Rodríguez JC, Barderas R, Batanero E, Cuesta-Herranz J, Villalba MT, Correia M, Benito-Garcia F, Arêde C, Piedade S, Morais-Almeida M, Hindley J, Yarham R, Kuklinska-Pijanka A, Gillick D, Patient K, Chapman MD, Bøgh KL, Miranda A, Matos E, Sokolova A, Rao H, Baricevic-Jones I, Smith F, Xue W, Magnusdottir H, Vidarsdottir AG, Lund S, Jensen AB, Ludviksson BR, Simon R, Elfont R, Bennett S, Voyksner R, de Lurdes Torre M, Yürek S, Faber MA, Bastiaensen A, Mangodt E, van Gasse A, Decuyper I, Sabato V, Hagendorens MM, Bridts CH, De Clerck LS, Ebo D, Schwarz S, Ziegert M, Albroscheit S, Schwager C, Kull S, Behrends J, Röckendorf N, Schocker F, Frey A, Homann A, Becker WM, Jappe U, Zaabat N, Osscini S, Agabriel C, Sterling B, Carsin A, Liabeuf V, Maćków M, Zbróg A, Bronkowska M, Courtois J, Gadisseur R, Bertholet C, Lukas P, Cavalier E, Delahaut P, Quinting B, Gertmo MB, Hasseus ET, Barzylovych V, Oliveira J, Ensina LF, Aranda CS, Dopazo L, Lopez R, Perez R, Santos-Diez L, Bilbao A, Garcia JM, Núñez IG, Mármol MÁA, Villarejo MJB, Martos JAB, Vergara MS, García JMI, Michalska A, Sergiejko G, Zacniewski R, Ghiordanescu IM, Deaconu C, Popescu M, Bumbacea RS, Ibranji A, Nikolla E, Loloci G, Juel-Berg N, Larsen LF, Poulsen LK, Marcelino J, Prata R, Costa AC, Duarte F, Neto M, Santos J, Pestana LC, Sampaio D, Minale P, Dignetti P, Bignardi D, Nedelea I, Popescu FD, Vieru M, Secureanu FA, Ganea CS, Vieira M, Silva JPM, Watts T, Watts S, Lomikovska M, Peredelskaya M, Nenasheva N, Filipovic I, Zivkovic Z, Filipovic D, Higgs J, Warner A, Jones C. Abstracts from the Food Allergy and Anaphylaxis Meeting 2016. Clin Transl Allergy 2017. [PMCID: PMC5384531 DOI: 10.1186/s13601-017-0142-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Yavuz ST, Koc O, Gungor A, Gok F, Hawley J, O’Brien C, Thomas M, Brodlie M, Michaelis L, Mota I, Gaspar Â, Piedade S, Sampaio G, Dias JG, Paiva M, Morais-Almeida M, Madureira C, Lopes T, Lopes S, Almeida F, Sequeira A, Carvalho F, Oliveira J, Gay-Crosier F, Nenciu IV, Nita AF, Ulmeanu A, Oraseanu D, Zapucioiu C, Machinena A, Sánchez OD, Lozano MA, Feijoo RJ, Blasco JL, Gibert MP, Muñoz MTG, da Costa MD, Martín AMP, Yilmaz EA, Cavkaytar Ö, Buyuktiryaki B, Soyer O, Sackesen C, Netting M, El-Merhibi A, Gold M, Quinn P, Penttila I, Makrides M, Giavi S, Muraro A, Lauener R, Mercenier A, Bersuch E, Montagner IM, Passioti M, Celegato N, Summermatter S, Nutten S, Bourdeau T, Vissers YM, Papadopoulos NG, van der Kleij H, Warmenhoven H, van Ree R, Pieters R, Opstelten DJ, van Schijndel H, Smit J, Fitzsimons R, Timms V, Du Toit G, Kaya G, Gulec M, Saldir M, Sener O, Hassan N, Shaaban H, El-Hariri H, Mahfouz AKIE, Gabor P, Gabor B, Csaba K, Chawes B, Bønnelykke K, Stokholm J, Heickendorff L, Brix S, Rasmussen M, Bisgaard H, Hallas HW, Arianto L, Pincus M, Keil T, Reich A, Wahn U, Lau S, Grabenhenrich L, Fagerstedt S, Hesla HM, Johansson E, Rosenlund H, Mie A, Scheynius A, Alm J, Esparza-Gordillo J, Matanovic A, Marenholz I, Bauerfeind A, Rohde K, Nemat K, Lee-Kirsch MA, Nordenskjöld M, Winge MC, Krüger R, Beyer K, Kalb B, Niggemann B, Hübner N, Cordell HJ, Bradley M, Lee YA, Gough H, Schramm D, Beschorner J, Schuster A, Bauer CP, Forster J, Zepp F, Bergmann R, Bergmann K, Garcia FB, Santos N, Pité H, Papadopoulou A, Mermiri D, Xatziagorou E, Tsanakas I, Lampidi S, Priftis K, Fuertes E, Markevych I, Bowatte G, Gruzieva O, Gehring U, Becker A, Berdel D, Brauer M, Carlsten C, Hoffmann B, Kozyrskyj A, Lodge C, Pershagen G, Wijga A, Joachim H, Zivkovic Z, Djuric-Filipovic I, Jocić-Stevanovic J, Zivanovic S, Taka S, Kokkinou D, Papakonstantinou A, Stefanopoulou P, Georgountzou A, Maggina P, Stamataki S, Papaevanggelou V, Andreakos E, Gibert MP, Spera AM, Deliu M, Belgrave D, Simpson A, Custovic A, Marques JG, Carreiro-Martins P, Belo J, Serranho S, Peralta I, Neuparth N, Leiria-Pinto P, Vazquez-Ortiz M, Pascal M, Plaza AM, Juan M, Paparo L, Nocerino R, Aitoro R, Langella I, Amoroso A, Amoroso A, Di Scala C, Berni Canani R, Maity S, Rotiroti G, Gandhi M, Jonsson K, Ljung A, Hesselmar B, Adlerbert I, Brekke H, Johansen S, Wold A, Sandberg AS, Nordlund B, Lundholm C, Ullemar V, van Hage M, Örtqvist A, Almqvist C, Selby A, Grimshaw K, Clausen M, Dubakiene R, Fiocchi A, Kowalski M, Papadopoulos N, Reche M, Sigurdardottir S, Sprikkleman A, Xepapadaki P, Mills C, Roberts G, Neto HJC, Wandalsen GF, Bianca ACD, Aranda C, Rosário NA, Solé D, Mallol J, Marcos LG, Banic I, Rijavec M, Plavec D, Korosec P, Turkalj M, Bozicevic A, De Mieri M, Hamburger M, Holley S, Morris R, Mitchell F, Knibb R, Latter S, Liossi C, Hassan MMM, Barman M, Sandin A, Posa D, Perna S, Hoffmann U, Chen KW, Resch Y, Vrtala S, Valenta R, Matricardi PM, Tsilochristou O, Rohrbach A, Cappella A, Hofmaier S, Hatzler L, D’Amelio R, Björkander S, Johansson MA, Lasaviciute G, Sverremark-Ekström E, Rüschendorf F, Strachan DP, Spycher BD, Baurecht H, Margaritte-Jeannin P, Sääf A, Kerkhof M, Ege M, Baltic S, Matheson MC, Li J, Michel S, Ang WQ, McArdle W, Arnold A, Homuth G, Demenais F, Bouzigon E, Söderhäll C, de Jongste JC, Postma DS, Braun-Fahrländer C, Horak E, Ogorodova LM, Puzyrev VP, Bragina EY, Hudson TJ, Morin C, Duffy DL, Marks GB, Robertson CF, Montgomery GW, Musk B, Thompson PJ, Martin NG, James A, Sleiman P, Toskala E, Rodriguez E, Fölster-Holst R, Franke A, Lieb W, Gieger C, Heinzmann A, Rietschel E, Cichon S, Nöthen MM, Pennell CE, Sly PD, Schmidt CO, Schneider V, Heinig M, Holt PG, Kabesch M, Weidinger S, Hakonarson H, Ferreira MAR, Laprise C, Freidin MB, Genuneit J, Koppelman GH, Melén E, Dizier MH, John Henderson A, Lee YA, González-Delgado P, Caparrós E, Clemente F, Cueva B, Moreno VM, Carretero JL, Fernández J, Swan K, Gopi M, Smith T, Ramesh E, Sadasivam A, Arêde C, Borrego LM, Pires G, Santa-Marta C, Brand S, Stein K, Heine H, Kauth M, Rolfsjord LB, Bakkeheim E, Skjerven HO, Carlsen KH, Hunderi JO, Berents TL, Mowinckel P, Lødrup Carlsen KC, Munzel U, Berger W, Valiente R, Vozmediano V, Lukas JC, Rodríguez M, Guarnaccia S, Vitale L, Pluda A, D’Agata E, Colombo D, Felici S, Gretter V, Facchetti S, Pecorelli G, Quecchia C, Guibas G, Spandou E, Megremis S, West P, Papadopoulos N, Rufo JC, Madureira J, Paciência I, Aguiar L, Padrão P, Pinto M, Delgado L, Moreira P, Teixeira JP, Fernandes EO, Moreira A, Dominguez AI, Valero A, Mullol J, Del Cuvillo A, Montoro J, Jauregui I, Bartra J, Davila I, Ferrer M, Sastre J, Martins C, Lima J, Leandro MJ, Nunes G, Branco JC, Trindade H, Borrego LM, Conkar S, Kilic M, Aygun C, Sancak R, Tagalaki E, Banos L, Vlachou A, Giannoula F, Pavlakou M, Kryoni M, Makris K, Lazova S, Petrova G, Miteva D, Perenovska P, Klyucharova A, Skorohodkina O, Koumaki D, Manousaki A, Agrapidi M, Iatridou L, Eruk O, Myridakis K, Manousakis E, Koumaki V, Dimou M, Ingemansson M, Hedlin G, Pastor N, de Boissieu D, Vanderhoof J, Moore N, Maditz K, Mehdi A, Elhassan S, Beck C, Al-Hammadi A, Maris I, O’Sullivan R, Hourihane J, Raptis G, DunnGalvin A, Greenhawt M, Venter C, O’Regan E, Cronin D, O’Reilly A, Abdelaziz F, Khelifi-Touhami D, Selim N, Khelifi-Touhami T, Merida P, Plaza AM, Castellanos JH, Lozano J, Dominguez O, Piquer M, Jimenez R, Giner MT, Kakleas K, Joishy M, Maskele W, Jenkins HR, Escarrer M, Madroñero A, Guerra MT, Julia JC, Cerda JC, Contreras J, Tauler E, Vidorreta MJ, Rojo A, Del Valle S, Flynn N, Foley G, Harmon C, Fitzsimons J, Baynova K, Del Robledo ÁM, Marina L, Cortes A, Sciaraffia A, Castillo A, Juel-Berg N, Hansen KS, Poulsen LK, Lazar A, Aguiar R, Lopes A, Paes MJ, Santos AS, Pereira-Barbosa MA, Eke Gungor H, Uytun S, Sahiner UM, Altuner Torun Y, Zivanovic M, Atanasković-Marković M, Vesel T, Nahtigal M, Obermayer-Temlin A, Križnik EŠ, Maslar M, Bizjak R, Tomšič-Matic M, Posega-Devetak S, Skerbinjek-Kavalar M, Predalič M, Avčin T, Pouessel G, Beaudouin E, Moneret-Vautrin AM, Deschildre A, Viñas M, Borja B, Hernández N, Castillo MJ, Izquierdo A, Ibero M, Kocabas CN, Heming C, Garrett E, Blackstock A, Chodhari R, Belohlavkova S, Kopelentova E, Visek P, Setinova I, Svarcova I, Sjölander S, Nilsson N, Berthold M, Ekoff H, Borres M, Nilsson C, González Domínguez L, Muñoz Archidona C, Moreira Jorge A, Quevedo Teruel S, Bracamonte Bermejo T, Castillo Fernández M, Pineda de la Losa F, Echeverría Zudaire LÁ, Vrani O, Mavroudi A, Fotoulaki M, Emporiadou M, Spiroglou K, Xinias I, Sadreddini HA, Warnes M, Traves D, Kostić G, Filipovic Đ, Sittisomwong S, Sittisomwong S, Podolec Z, Hartel M, Panek D, Podolec-Rubiś M, Banasik T, Abbasi E, Moghtaderi M, Sanneerappa P, Deliu A, Kutty M, Ramesh N, Sherkat R, Sabri MR, Dehghan B, Bigdelian H, Raeesi N, Afshar M, Rahimi H, Klein C, Al-Jebouri M, Svitich OA, Zubacheva DO, Potemkin DA, Gankovskaya LV, Zverev VV, OB Doyle E, Gallagher P, Dewlett S, Man K, Pocock J, Gerrardhughes A, Wasilewska J, Kaczmarski M, Lebensztejn D, Thuraisingham C, Sinniah D, Chen Y, Mei X, Ozdogan S, Karadeniz P, Ayyildiz-Emecen D, Oncul U, Sari G, Cavdar S, Farzan N, Vijverberg SJ, Palmer CJ, Tantisira KG, Maitland-van der Zee AH, Yavuzyilmaz F, Urganci N, Usta M, Hoxha M, Basho M, Wandalsen GF, Monteiro F, Lame B, Mesonjesi E, Sherri A, Ibranji A, Gjati L, Loloci G, Bardhi A, Moghtaderi B, Farjadian S, Eghtedari D, Olaya M, Del Mar Vasquez L, Ramirez LF, Serrano CD, Usta Guc B, Asilsoy S, Ozer F, Shopova S, Papochieva V, Loekmanwidjaja J, Mallozi M, Ratner P, Soteres D, Novák Z, Yáñez A, Ildikó K, Kuna P, Tortajada M, Valiente R, Feuerhahn J, Blome C, Hadler M, Karagiannis E, Langenbruch A, Augustin M, Roux M, Kakudo S, Zeldin RK, Sokolova A, Silva TM, Zivanovic SS, Cvetkovic V, Nikolic I, Zivanovic SJ, Saranac L, Nesterenko Z, Radic S, Milenkovic B, Smiljanic S, Micic-Stanijevic M, Calovic O, Hofbauer AMB, Agertoft L, Everson L, Kearney J, Coppel J, Braithwaite S, Christiansen ES, Kjaer HF, Eller E, Mørtz CG, Halken S, Román India C, Jiménez Jiménez J, Echeverría Zudaire L, O’Connor C, Kanti V, Lünnemann L, Malise G, Ludriksone L, Stroux A, Henrich W, Abu-Dakn M, Blume-Peytavi U, Garcia Bartels N, Schario M, Stanley T, Brandenbarg N, Boardman A, McGreevy G, Rodger E, Knight K, Taylor T, Scanlan G, Christoph G, van Stuivenberg M, Mosca F, Moro G, Chirico G, Braegger CP, Riedler J, Yavuz Y, Boehm G, Arasi S, Crisafulli G, Caminiti L, Porcaro F, Pajno GB, Tanaka A, Togawa Y, Oida K, Kambe N, Arkwright P, Amagai Y, Shimojo N, Sato Y, Mochizuki H, Jang H, Ishizaka S, Matsuda H, Barlianto W, Olivianto E, Chandra Kusuma HMS, Mollica M, Trinchese G, Alfano E, Amato F, Pirozzi C, Calignano A, Meli R, Rossberg S, Gerhold K, Zimmermann K, Zaino M, Geske T, Hamelmann E, Bogovic S, van den Berg J, Janssen C, Claver A, Martin-Muñoz MF, Martorell C, Belver MT, Alonso Lebrero E, Zapatero L, Fuentes V, Piqué M, Plaza A, Muñoz C, Blasco C, Villa B, Gómez C, Nevot S, García JM, Echeverria L, DeWitt B, Holloway J, Hodge D, Ludman S, Jafari-Mamaghani M, Ebling R, Fox AT, Lack G, Lovén Björkman S, Ballardini N, Basu S, Hallet J, Srinivas J, Stringer H, Jay N, Fonseca P, Vieira C, Mastrorilli C, Caffarelli C, Asero R, Tripodi S, Dondi A, Ricci G, Povesi Dascola C, Calamelli E, Cipriani F, Di Rienzo Businco A, Bianchi A, Candelotti P, Frediani T, Verga C, Korovessi P, Tiliakou S, Tavoulari E, Moraiti KM, Tee WJ, Deiratany S, Seedhoo R, McNamara R, Okafor I, Khaleva E, Novic G, Bychkova N, Abd Al-Aziz A, Fatouh A, Motawie A, Bostany EE, Ibrahim A, Andonova S, Savov A, Zoto M, Kyriakakou M, Vassilopoulou M, Balaska A, Kostaridou S, Wartna J, Bohnen AM, Elshout G, Pols DHJ, Bindels PJE, Seys SF, Dilissen E, Van der Eycken S, Schelpe AS, Marijsse G, Troosters T, Vanbelle V, Aertgeerts S, Ceuppens JL, Dupont LJ, Peers K, Bullens DM, Lokas SB, Zivkovic J, Nogalo B, Kobal IM, Oliveira G, Pike K, Melo A, Amélia T, Cidrais Rodrigues JC, Serrano C, Lopes dos Santos JM, Lopes C, Schauer U, Bergmann KC, Moral L, Toral T, Marco N, Avilés BG, Fuentes MJ, Garde J, Montahud C, Perona J, Forniés MJ, Arroabarren E, Anda M, Sanz ML, Lizaso MT, Arregui C, May S, Hartz M, Joshi A, Park MA, Posega Devetak S, Koren Jeverica A, Castro L, Gouveia C, Marques AC, Cabral AJ, Amaral L, Carolino F, Castro E, Passos M, Cernadas JR, Amaral L, Dias de Castro E, Pineda F, Gomes A, Brough H, Röhmel J, Schwarz C, Mehl A, Stock P, Staab D, Seib C, Critchlow A, Barber A, Delavalle B, Garriga T, Vilá B, Astolfi A, Di Chiara C, Neri I, Patrizi A, Neskorodova K, Kudryavtseva A, Alvarez J, Palacios M, Martinez-Merino M, Vaquero I. 4th Pediatric Allergy and Asthma Meeting (PAAM). Clin Transl Allergy 2016. [PMCID: PMC5123301 DOI: 10.1186/s13601-016-0117-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
WORKSHOP 4: Challenging clinical scenarios (CS01–CS06) CS01 Bullous lesions in two children: solitary mastocytoma S. Tolga Yavuz, Ozan Koc, Ali Gungor, Faysal Gok CS02 Multi-System Allergy (MSA) of cystic fibrosis: our institutional experience Jessica Hawley, Christopher O’Brien, Matthew Thomas, Malcolm Brodlie, Louise Michaelis CS03 Cold urticaria in pediatric age: an invisible cause for severe reactions Inês Mota, Ângela Gaspar, Susana Piedade, Graça Sampaio, José Geraldo Dias, Miguel Paiva, Mário Morais-Almeida CS04 Angioedema with C1 inhibitor deficiency in a girl: a challenge diagnosis Cristina Madureira, Tânia Lopes, Susana Lopes, Filipa Almeida, Alexandra Sequeira, Fernanda Carvalho, José Oliveira CS05 A child with unusual multiple organ allergy disease: what is the primer? Fabienne Gay-Crosier CS06 A case of uncontrolled asthma in a 6-year-old patient Ioana-Valentina Nenciu, Andreia Florina Nita, Alexandru Ulmeanu, Dumitru Oraseanu, Carmen Zapucioiu ORAL ABSTRACT SESSION 1: Food allergy (OP01–OP06) OP01 Food protein-induced enterocolitis syndrome: oral food challenge outcomes for tolerance evaluation in a Pediatric Hospital Adrianna Machinena, Olga Domínguez Sánchez, Montserrat Alvaro Lozano, Rosa Jimenez Feijoo, Jaime Lozano Blasco, Mònica Piquer Gibert, Mª Teresa Giner Muñoz, Marcia Dias da Costa, Ana Maria Plaza Martín OP02 Characteristics of infants with food protein-induced enterocolitis syndrome and allergic proctocolitis Ebru Arik Yilmaz, Özlem Cavkaytar, Betul Buyuktiryaki, Ozge Soyer, Cansin Sackesen OP03 The clinical and immunological outcomes after consumption of baked egg by 1–5 year old egg allergic children: results of a randomised controlled trial MerrynNetting, Adaweyah El-Merhibi, Michael Gold, PatrickQuinn, IrmeliPenttila, Maria Makrides OP04 Oral immunotherapy for treatment of egg allergy using low allergenic, hydrolysed egg Stavroula Giavi, Antonella Muraro, Roger Lauener, Annick Mercenier, Eugen Bersuch, Isabella M. Montagner, Maria Passioti, Nicolò Celegato, Selina Summermatter, Sophie Nutten, Tristan Bourdeau, Yvonne M. Vissers, Nikolaos G. Papadopoulos OP05 Chemical modification of a peanut extract results in an increased safety profile while maintaining efficacy Hanneke van der Kleij, Hans Warmenhoven, Ronald van Ree, Raymond Pieters, Dirk Jan Opstelten, Hans van Schijndel, Joost Smit OP06 Administration of the yellow fever vaccine in egg allergic children Roisin Fitzsimons, Victoria Timms, George Du Toit ORAL ABSTRACT SESSION 2: Asthma (OP07–OP12) OP07 Previous exacerbation is the most important risk factor for future exacerbations in school-age children with asthma S. Tolga Yavuz, Guven Kaya, Mustafa Gulec, Mehmet Saldir, Osman Sener, Faysal Gok OP08 Comparative study of degree of severity and laboratory changes between asthmatic children using different acupuncture modalities Nagwa Hassan, Hala Shaaban, Hazem El-Hariri, Ahmed Kamel Inas E. Mahfouz OP09 The concentration of exhaled carbon monoxide in asthmatic children with different controlled stadium Papp Gabor, Biro Gabor, Kovacs Csaba OP10 Effect of vitamin D3 supplementation during pregnancy on risk of persistent wheeze in the offspring: a randomised clinical trial Bo Chawes, Klaus Bønnelykke, Jakob Stokholm, Lene Heickendorff, Susanne Brix, Morten Rasmussen, Hans Bisgaard OP11 Lung function development in childhood Henrik Wegener Hallas, Bo Chawes, Lambang Arianto, Hans Bisgaard OP12 Is the effect of maternal and paternal asthma different in female and male children before puberty? Maike Pincus, Thomas Keil, Andreas Reich, Ulrich Wahn, Susanne Lau, Linus Grabenhenrich ORAL ABSTRACT SESSION 3: Epidemiology—genetics (OP13–OP18) OP13 Lifestyle is associated with incidence and category of allergen sensitisation: the ALADDIN birth cohort Sara Fagerstedt, Helena Marell Hesla, Emelie Johansson, Helen Rosenlund, Axel Mie, Annika Scheynius, Johan Alm OP15 Maternal filaggrin mutations increase the risk of atopic dermatitis in children: an effect independent of mutation inheritance Jorge Esparza-Gordillo, Anja Matanovic, Ingo Marenholz, Anja Bauerfeind, Klaus Rohde, Katja Nemat, Min-Ae Lee-Kirsch, Magnus Nordenskjöld, Marten C. G. Winge, Thomas Keil, Renate Krüger, Susanne Lau, Kirsten Beyer, Birgit Kalb, Bodo Niggemann, Norbert Hübner, Heather J. Cordell, Maria Bradley, Young-Ae Lee OP16 Allergic multimorbidity of asthma, rhinitis and eczema in the first 2 decades of the German MAS birth cohort Thomas Keil, Hannah Gough, Linus Grabenhenrich, Dirk Schramm, Andreas Reich, John Beschorner, Antje Schuster, Carl-Peter Bauer, Johannes Forster, Fred Zepp, Young-Ae Lee, Renate Bergmann, Karl Bergmann, Ulrich Wahn, Susanne Lau OP17 Childhood anaphylaxis: a growing concern Filipe Benito Garcia, Inês Mota, Susana Piedade, Ângela Gaspar, Natacha Santos, Helena Pité, Mário Morais-Almeida OP18 Indoor exposure to molds and dampness in infancy and its association to persistent atopic dermatitis in school age. Results from the Greek ISAAC II study Athina Papadopoulou, Despina Mermiri, Elpida Xatziagorou, Ioannis Tsanakas, Stavroula Lampidi, Kostas Priftis ORAL ABSTRACT SESSION 4: Pediatric rhinitis—immunotherapy (OP19–OP24) OP19 Associations between residential greenness and childhood allergic rhinitis and aeroallergen sensitisation in seven birth cohorts Elaine Fuertes, Iana Markevych, Gayan Bowatte, Olena Gruzieva, Ulrike Gehring, Allan Becker, Dietrich Berdel, Michael Brauer, Chris Carlsten, Barbara Hoffmann, Anita Kozyrskyj, Caroline Lodge, Göran Pershagen, Alet Wijga, Heinrich Joachim OP20 Full symptom control in pediatric patients with allergic rhinitis and asthma: results of a 2-year sublingual allergen immunotherapy study Zorica Zivkovic, Ivana Djuric-Filipovic, Jasmina Jocić-Stevanovic, Snežana Zivanovic OP21 Nasal epithelium of different ages of atopic subjects present increased levels of oxidative stress and increased cell cytotoxicity upon rhinovirus infection Styliani Taka, Dimitra Kokkinou, Aliki Papakonstantinou, Panagiota Stefanopoulou, Anastasia Georgountzou, Paraskevi Maggina, Sofia Stamataki, Vassiliki Papaevanggelou, Evangelos Andreakos, Nikolaos G. Papadopoulos OP22 Cluster subcutaneous immunotherapy schedule: tolerability profile in children Monica Piquer Gibert, Montserrat Alvaro Lozano, Jaime Lozano Blasco, Olga Domínguez Sánchez, Rosa Jiménez Feijoo, Marcia Dias da Costa, Mª Teresa Giner Muñoz, Adriana Machinena Spera, Ana Maria Plaza Martín OP23 Rhinitis as a risk factor for asthma severity in 11-year old children: population-based cohort study Matea Deliu, Danielle Belgrave, Angela Simpson, Adnan Custovic OP24 The Global Lung Function Initiative equations in airway obstruction evaluation of asthmatic children João Gaspar Marques, Pedro Carreiro-Martins, Joana Belo, Sara Serranho, Isabel Peralta, Nuno Neuparth, Paula Leiria-Pinto POSTER DISCUSSION SESSION 1: Food allergy (PD01–PD05) PD01 Allergen-specific humoral and cellular responses in children who fail egg oral immunotherapy due to allergic reactions Marta Vazquez-Ortiz, Mariona Pascal, Ana Maria Plaza, Manel Juan PD02 FoxP3 epigenetic features in children with cow milk allergy Lorella Paparo, Rita Nocerino, Rosita Aitoro, Ilaria Langella, Antonio Amoroso, Alessia Amoroso, Carmen Di Scala, Roberto Berni Canani PD04 Combined milk and egg allergy in early childhood: let them eat cake? Santanu Maity, Giuseppina Rotiroti, Minal Gandhi PD05 Introduction of complementary foods in relation to allergy and gut microbiota in farm and non-farm children Karin Jonsson, Annika Ljung, Bill Hesselmar, Ingegerd Adlerbert, Hilde Brekke, Susanne Johansen, Agnes Wold, Ann-Sofie Sandberg POSTER DISCUSSION SESSION 2: Asthma and wheeze (PD06–PD16) PD06 The association between asthma and exhaled nitric oxide is influenced by genetics and sensitisation Björn Nordlund, Cecilia Lundholm, Villhelmina Ullemar, Marianne van Hage, Anne Örtqvist, Catarina Almqvist PD09 Prevalence patterns of infant wheeze across Europe Anna Selby, Kate Grimshaw, Thomas Keil, Linus Grabenhenrich, Michael Clausen, Ruta Dubakiene, Alessandro Fiocchi, Marek Kowalski, Nikos Papadopoulos, Marta Reche, Sigurveig Sigurdardottir, Aline Sprikkleman, Paraskevi Xepapadaki, Clare Mills, Kirsten Beyer, Graham Roberts PD10 Epidemiologic changes in recurrent wheezing infants Herberto Jose Chong Neto, Gustavo Falbo Wandalsen, Ana Carolina Dela Bianca, Carolina Aranda, Nelson Augusto Rosário, Dirceu Solé, Javier Mallol, Luis García Marcos PD13 A single nucleotide polymorphism in the GLCCI1 gene is associated with response to asthma treatment in children IvanaBanic, Matija Rijavec, Davor Plavec, Peter Korosec, Mirjana Turkalj PD14 Pollen induced asthma: Could small molecules in pollen exacerbate the protein-mediated allergic response? Alen Bozicevic, Maria De Mieri, Matthias Hamburger PD15 A qualitative study to understand how we can empower teenagers to better self-manage their asthma Simone Holley, Ruth Morris, Frances Mitchell, Rebecca Knibb, Susan Latter, Christina Liossi, Graham Roberts PD16 Polymorphism of endothelial nitric oxide synthase (eNOS) gene among Egyptian children with bronchial asthma Mostafa M. M. Hassan POSTER DISCUSSION SESSION 3: Mechanisms—Epidemiology (PD17–PD21) PD17 Pregnancy outcomes in relation to development of allergy in a Swedish birth cohort Malin Barman, Anna Sandin, Agnes Wold, Ann-Sofie Sandberg PD18 Evolution of the IgE response to house dust mite molecules in childhood Daniela Posa, Serena Perna, Carl-Peter Bauer, Ute Hoffmann, Johannes Forster, Fred Zepp, Antje Schuster, Ulrich Wahn, Thomas Keil, Susanne Lau, Kuan-Wei Chen, Yvonne Resch, Susanne Vrtala, Rudolf Valenta, Paolo Maria Matricardi PD19 Antibody recognition of nsLTP-molecules as antigens but not as allergens in the German-MAS birth cohort Olympia Tsilochristou, Alexander Rohrbach, Antonio Cappella, Stephanie Hofmaier, Laura Hatzler, Carl-Peter Bauer, Ute Hoffmann, Johannes Forster, Fred Zepp, Antje Schuster, RaffaeleD’Amelio, Ulrich Wahn, Thomas Keil, Susanne Lau, Paolo Maria Matricardi PD20 Early life colonization with Lactobacilli and Staphylococcus aureus oppositely associates with the maturation and activation of FOXP3+ CD4 T-cells Sophia Björkander, Maria A. Johansson, Gintare Lasaviciute, Eva Sverremark-Ekström PD21 Genome-wide meta-analysis identifies 7 susceptibility loci involved in the atopic march Ingo Marenholz, Jorge Esparza-Gordillo, Franz Rüschendorf, Anja Bauerfeind, David P. Strachan, Ben D. Spycher, Hansjörg Baurecht, Patricia Margaritte-Jeannin, Annika Sääf, Marjan Kerkhof, Markus Ege, Svetlana Baltic, Melanie C Matheson, Jin Li, Sven Michel, Wei Q. Ang, Wendy McArdle, Andreas Arnold, Georg Homuth, Florence Demenais, Emmanuelle Bouzigon, Cilla Söderhäll, Göran Pershagen, Johan C. de Jongste, Dirkje S Postma, Charlotte Braun-Fahrländer, Elisabeth Horak, Ludmila M. Ogorodova, Valery P. Puzyrev, Elena Yu Bragina, Thomas J Hudson, Charles Morin, David L Duffy, Guy B Marks, Colin F Robertson, Grant W Montgomery, Bill Musk, Philip J Thompson, Nicholas G. Martin, Alan James, Patrick Sleiman, Elina Toskala, Elke Rodriguez, Regina Fölster-Holst, Andre Franke, Wolfgang Lieb, Christian Gieger, Andrea Heinzmann, Ernst Rietschel, Thomas Keil, Sven Cichon, Markus M Nöthen, Craig E Pennell, Peter D Sly, Carsten O Schmidt, Anja Matanovic, Valentin Schneider, Matthias Heinig, Norbert Hübner, Patrick G. Holt, Susanne Lau, Michael Kabesch, Stefan Weidinger, Hakon Hakonarson, Manuel AR Ferreira, Catherine Laprise, Maxim B. Freidin, Jon Genuneit, Gerard H Koppelman, Erik Melén, Marie-Hélène Dizier, A. John Henderson, Young Ae Lee POSTER DISCUSSION SESSION 4: Food allergy—Anaphylaxis (PD22–PD26) PD22 Atopy patch test in food protein induced enterocolitis caused by solid food Purificacion González-Delgado, Esther Caparrós, Fernando Clemente, Begoña Cueva, Victoria M. Moreno, Jose Luis Carretero, Javier Fernández PD23 Watermelon allergy: a novel presentation Kate Swan, George Du Toit PD24 A pilot study evaluating the usefulness of a guideline template for managing milk allergy in primary care Mudiyur Gopi, Tim Smith, Edara Ramesh, Arun Sadasivam PD26 Efficacy and safety of cow’s milk oral immunotherapy protocol Inês Mota, Filipe Benito Garcia, Susana Piedade, Angela Gaspar, Graça Sampaio, Cristina Arêde, Luís Miguel Borrego, Graça Pires, Cristina Santa-Marta, Mário Morais-Almeida POSTER DISCUSSION SESSION 5: Prevention and treatment—Allergy (PD27–PD36) PD27 Allergy-protection by the lactic acid bacterium Lactococcus lactis G121: mode-of-action as revealed in a murine model of experimental allergy Stephanie Brand, Karina Stein, Holger Heine, Marion Kauth PD29 The relationship between quality of life and morning salivary cortisol after acute bronchiolitis in infancy Leif Bjarte Rolfsjord, Egil Bakkeheim, Johan Alm, Håvard Ove Skjerven, Kai-Håkon Carlsen, Jon Olav Hunderi, Teresa Løvold Berents, Petter Mowinckel, Karin C. Lødrup Carlsen PD30 Randomised trial of the efficacy of MP29-02* compared with fluticasone propionate nasal spray in children aged ≥6 years to <12 years with allergic rhinitis Ulrich Wahn, Ullrich Munzel, William Berger PD31 10 mg of oral bilastine in 2 to 11 years old children has similar exposure to the adult therapeutic dose (20 mg) Ulrich Wahn, Román Valiente, Valvanera Vozmediano, John C. Lukas, Mónica Rodríguez PD33 Daily symptoms, nocturnal symptoms, activity limitations and reliever therapies during the three steps of IOEASMA programme: a comparison Sebastiano Guarnaccia, Luigi Vitale, Ada Pluda, Emanuele D’Agata, Denise Colombo, Stefano Felici, Valeria Gretter, Susanna Facchetti, Gaia Pecorelli, Cristina Quecchia PD34 Sensitisation to an inert aeroallergen in weaning rats and longstanding disease, in a sensitisation-tolerant and easily tolerisable rodent strain George Guibas, Evangelia Spandou, Spyridon Megremis, Peter West, Nikolaos Papadopoulos PD35 Bacterial and fungi exposure in school and allergic sensitisation in children João Cavaleiro Rufo, Joana Madureira, Inês Paciência, Lívia Aguiar, Patrícia Padrão, Mariana Pinto, Luís Delgado, Pedro Moreira, João Paulo Teixeira, Eduardo Oliveira Fernandes, André Moreira PD36 Comparative study of allergy rhinitis between two populations: children vs. adults Adriana Izquierdo Dominguez, Antonio Valero, Joaquim Mullol, Alfonso Del Cuvillo, Javier Montoro, Ignacio Jauregui, Joan Bartra, Ignacio Davila, Marta Ferrer, Joaquin Sastre POSTER VIEWING SESSION 1: Inflammation—Genetics—Immunology—Dermatology (PP01–PP09) PP01 Immune profile in late pregnancy: immunological markers in atopic asthmaticwomen as risk factors for atopy in the progeny Catarina Martins, Jorge Lima, Maria José Leandro, Glória Nunes, Jorge Cunha Branco, Hélder Trindade, Luis Miguel Borrego PP02 The impact of neonatal sepsis on development of allergic diseases Secil Conkar, Mehtap Kilic, Canan Aygun, Recep Sancak PP03 Clinical overview of selective IgE deficiency in childhood Athina Papadopoulou, Eleni Tagalaki, Lambros Banos, Anna Vlachou, Fotini Giannoula, Despina Mermiri PP04 Inverse relationship between serum 25(ΟΗ) vitamin D3 and total IgE in children and adolescence Athina Papadopoulou, Stavroula Lampidi, Marina Pavlakou, Maria Kryoni, Kostas Makris PP05 PP06 PP07 Asthma control questionnaire and specific IgE in children Snezhina Lazova, Guergana Petrova, Dimitrinka Miteva, Penka Perenovska PP08 Features of chronic urticaria of adolescents Aliya Klyucharova, Olesya Skorohodkina PP09 Cutaneous mastocytosis in children: a clinical analysis of 8 cases in Greece Dimitra Koumaki, Alkisti Manousaki, Maria Agrapidi, Lida Iatridou, Omima Eruk, Konstantinos Myridakis, Emmanouil Manousakis, Vasiliki Koumaki POSTER VIEWING SESSION 2: Food allergy—Anaphylaxis (PP10–PP47) PP10 Prognostic factors in egg allergy Maria Dimou, Maria Ingemansson, Gunilla Hedlin PP11 Evaluation of the efficacy of an amino acid-based formula in infants who are intolerant to extensively hydrolysed protein formula Nitida Pastor, Delphine de Boissieu, Jon Vanderhoof, Nancy Moore, Kaitlin Maditz PP12 Anaphylaxis and epinephrine auto-injector use: a survey of pediatric trainees Adeli Mehdi, Shaza Elhassan, Carolin Beck, Ahmed Al-Hammadi PP13 Anaphylaxis in children: acute management in the Emergency Department Ioana Maris, Ronan O’Sullivan, Jonathan Hourihane, PP14 Understanding Cumbrian schools preparedness in managing children at risk of anaphylaxis in order to provide training and support which will create healthy and safe environments for children with allergies George Raptis, Louise Michaelis PP15 A new valid and reliable parent and child questionnaire to measure the impact of food protein enterocolitis syndrome on children: the FPIES Quality of Life Questionnaire (FPIESQL), Parent and Child Short Form Audrey DunnGalvin, Matthew Greenhawt, Carina Venter, Jonathan Hourihane PP16 An in-depth case study investigation of the experiences of teenagers and young adults in growing up and living with food allergy with emphasis on coping, management and risk, support, and social and self-identity Evelyn O’Regan, Duncan Cronin, Jonathan Hourihane, Anna O’Reilly, Audrey DunnGalvin PP17 Cow’s milk protein allergy in Constantine. A retrospective study of 62 cases between 1996 and 2013 Foued Abdelaziz, Dounia Khelifi-Touhami, Nihad Selim, Tahar Khelifi-Touhami PP18 PP19 Cow’s milk and egg oral immunotherapy in children older than 5 years Pablo Merida, Ana Mª Plaza, Juan Heber Castellanos, Adrianna Machinena, Montserrat Alvaro Lozano, Jaime Lozano, Olga Dominguez, Monica Piquer, Rosa Jimenez, Mª Teresa Giner PP20 Professionals’ awareness of management of Cow’s Milk Protein Allergy (CMPA) in North Wales Hospitals Konstantinos Kakleas, Manohar Joishy, Wendmu Maskele, Huw R. Jenkins PP21 PP22 Anaphylaxis: the great unknown for teachers. Presentation of a protocol for schools Mercedes Escarrer, Agustín Madroñero, Maria Teresa Guerra, Juan Carlos Julia, Juan Carlos Cerda, Javier Contreras, Eulalia Tauler, Maria Jesus Vidorreta, Ana Rojo, Silvia Del Valle PP23 Challenges facing children with food allergies and their parents in out of school activity sectors Niamh Flynn PP24 A review of food challenges at a Regional Irish Centre Gary Foley, Carol Harmon, John Fitzsimons PP25 The use of epinephrine in infants with anaphylaxis Krasimira Baynova, Ávila Maria Del Robledo, Labella Marina PP26 PP27 PP28 Mother’s psychological state predicts the expression of symptoms in food allergic children Aaron Cortes, Alicia Sciaraffia, Angela Castillo PP29 The correlation between sIgE towards tree nuts and birch pollen in a Danish Pediatric Allergy Clinic Nanna Juel-Berg, Kirsten Skamstrup Hansen, Lars Kærgaard Poulsen PP30 Food allergy in children: evaluation of parents’ use of online social media Andreia Florina Nita, Ioana Valentina Nenciu, Adina Lazar, Dumitru Oraseanu PP31 The impact of food allergy on quality of life: FAQLQ questionnaire Rita Aguiar, Anabela Lopes, Maria J. Paes, Amélia S. Santos, M. A. Pereira-Barbosa PP32 An unexpected cause of anaphylaxis: potato Hatice Eke Gungor, Salih Uytun, Umit Murat Sahiner, Yasemin Altuner Torun PP33 Is it clinical phenotype of allergic diseases determined by sensitisation to food? Mirjana Zivanovic, Marina Atanasković-Marković PP34 PP35 Prescribing adrenaline auto-injectors in children in 2014: the data from regional pediatricians Tina Vesel, Mihaela Nahtigal, Andreja Obermayer-Temlin, Eva Šoster Križnik, Mirjana Maslar, Ruben Bizjak, Marjeta Tomšič-Matic, Sonja Posega-Devetak, Maja Skerbinjek-Kavalar, Mateja Predalič, Tadej Avčin PP36 Who should have an adrenaline autoinjector? Adherence to the European and French guidelines among 121 allergists from the Allergy Vigilance Network Guillaume Pouessel, Etienne Beaudouin, Anne M. Moneret-Vautrin, Antoine Deschildre, Allergy Vigilance Network PP37 Anaphylaxis by Anacardium Occidentale Marta Viñas, Bartolomé Borja, Nora Hernández, Mª José Castillo, Adriana Izquierdo, Marcel Ibero PP38 Anaphylaxis with honey in a child S. Tolga Yavuz, Ali Gungor, Betul Buyuktiryaki, Ozan Koc, Can Naci Kocabas, Faysal Gok PP39 Evaluation of courses adopted to children on prevention, recognition and management of anaphylaxis Tina Vesel, Mihaela Nahtigal PP40 Symptomatic dust mites and shrimp allergy: three pediatric case reports Filipa Almeida, Susana Lopes, Cristina Madureira, Tânia Lopes, Fernanda Carvalho PP41 Poor identification rates of nuts by high risk individuals: a call for improved education and support for families Camille Heming, Emily Garrett, Adam Blackstock, Santanu Maity, Rahul Chodhari PP42 DAFALL: database of food allergies in the Czech Republic Simona Belohlavkova, Eliska Kopelentova, Petr Visek, Ivana Setinova, Ivana Svarcova PP43 Serological cross-reactivity between grass and wheat is not only caused by profilins and CCDs Sigrid Sjölander, Nora Nilsson, Malin Berthold, Helena Ekoff, Gunilla Hedlin, Magnus Borres, Caroline Nilsson PP44 Oil body associated proteins in children with nuts allergy. Allergens to consider in IgE-mediated nuts allergy Loreto González Domínguez, Cristina Muñoz Archidona, Ana Moreira Jorge, Sergio Quevedo Teruel, Teresa Bracamonte Bermejo, Miriam Castillo Fernández, Fernando Pineda de la Losa, Luis Ángel Echeverría Zudaire PP45 PP46 Protective effect of helicobacter pylori infection against food allergy in children Olga Vrani, Antigone Mavroudi, Maria Fotoulaki, Maria Emporiadou, Kleomenis Spiroglou, Ioannis Xinias PP47 Anaphylaxis pathway: A road tryp-tase to success? Helyeh A. Sadreddini, Mia Warnes, Donna Traves POSTER VIEWING SESSION 3: Miscellaneous (PP48–PP58) PP48 Surveillance study on safety of SLIT in pediatric population Ivana Djuric-Filipovic, Zorica Zivkovic, Snežana Zivanovic, Gordana Kostić, Đorđe Filipovic PP49 Efficacy and safety of mixed mite subcutaneous immunotherapy among allergic rhinitis patients in the Northeastern Thailand Sawapon Sittisomwong, Siripong Sittisomwong PP50 Effect of inhaled beclomethasone or placebo on brain stem activity in a patient chronically treated with steroids: preliminary report Zygmunt Podolec, Marcin Hartel, Daria Panek, Magdalena Podolec-Rubiś, Tomasz Banasik PP51 Sensitisation to aeroallergens in patients with allergic rhinitis, asthma and atopic dermatitis in Shiraz, Southwestern Iran Elham Abbasi, Mozhgan Moghtaderi PP52 Referring a child for allergy test: how appropriate are we? Phani Sanneerappa, Alina Deliu, Moosa Kutty, Nagabathula Ramesh PP53 EBV lymphoproliferative disease and cardiac lymphoma in a STK4 deficient patient Roya Sherkat, Mohammad Reza Sabri, Bahar Dehghan, Hamid Bigdelian, Nahid Raeesi, Mino Afshar, Hamid Rahimi, Christoph Klein PP54 A case study: the effect of massive honeybees attack on various body parameters atopic girl including allergy Mohemid Al-Jebouri PP55 The role of TLR9, NLRP3 and proIL-1β in activation of antiviral innate immunity Oxana A. Svitich, Daria O. Zubacheva, Dmitrii A. Potemkin, Ludmila V. Gankovskaya, Vitalii V. Zverev PP56 Overnight pulse oximetry, as a screening tool to diagnose obstructive sleep apnoea. How effective is it? Phani Sanneerappa, Elaine OB Doyle, Paul Gallagher, Nagabathula Ramesh PP57 The presentation and management of acute urticaria and allergic reactions in children in a multi-ethnic, inner city Emergency Department (ED) Sherine Dewlett, Kin Man, Minal Gandhi, James Pocock, Anna Gerrardhughes PP58 Food allergens responsible for delayed-type sensitisation in atopy patch test in children diagnosed with autism spectrum disorder Jolanta Wasilewska, Maciej Kaczmarski, Dariusz Lebensztejn POSTER VIEWING SESSION 4: Asthma—Rhinitis (PP59–PP87) PP59 Systematic review of incense as a trigger factor for asthma Chandramani Thuraisingham, Davendralingam Sinniah PP60 Increased risks of mood and anxiety disorders in children with asthma Yue Chen, Xiaomei Mei PP61 PP62 Asthma Control Test (ACT) and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) association in children Sebnem Ozdogan, Pinar Karadeniz, Durdugul Ayyildiz-Emecen, Ummuhan Oncul PP63 Seasonal and gender variations in vitamin D levels in children with asthma and its association with pulmonary function tests Sebnem Ozdogan, Gizem Sari, Sabanur Cavdar PP64 Defining treatment response in childhood asthma: rationale and design of the Pharmacogenomics in the Childhood Asthma (PiCA) consortium Niloufar Farzan, Susanne J. Vijverberg, Colin J. Palmer, Kelan G. Tantisira, Anke-Hilseon Maitland-van der Zee behalf of the PiCA consortium PP65 Prevalence of asthma and allergic disease in patients with inflammatory disease compared to celiac disease Fatma Yavuzyilmaz, Sebnem Ozdogan, Nafiye Urganci, Merve Usta PP66 A severe case with cystic fibrosis (CF) asthma Mehmet Hoxha, Maksim Basho PP67 Severe asthma exacerbation complicated with pneumothorax in a child with uncontrolled asthma due to poor treatment compliance Ioana Valentina Nenciu, Andreia Florina Nita, Adina Lazar, Alexandru Ulmeanu, Carmen Zapucioiu, Dumitru Oraseanu PP68 Evaluation of the Pediatric Quality of Life inventory (PedsQL) asthma module among low income asthmatic children and adolescents in Sao Paolo, Brazil Gustavo F. Wandalsen, Fernanda Monteiro, Dirceu Solé PP69 Early initiation of specific immunotherapy in asthma patients leads to higher benefits Blerta Lame, Eris Mesonjesi, Arjeta Sherri PP70 Treatment resistant asthma and rhinosinusitis with recurrent pulmonary infections. Is it primary ciliary dyskinesia? Alkerta Ibranji, Laert Gjati, Gjustina Loloci, Ardii Bardhi PP71 The comparison of sensitisation to animal allergens in children- and adult- onset patients with asthma Behnam Moghtaderi, Shirin Farjadian, Dorna Eghtedari PP72 Characterisation of children less than five years with wheezing episodes in Cali, Colombia Manuela Olaya, Laura Del Mar Vasquez, Luis Fernando Ramirez, Carlos Daniel Serrano PP73 Evaluation of the patients with recurrent croup Belgin Usta Guc, Suna Asilsoy, Fulya Ozer PP74 Obesity in adolescence compromising the asthma control Guergana Petrova, Sylvia Shopova, Vera Papochieva, Snezhina Lazova, Dimitrinka Miteva, Penka Perenovska PP75 Sleep behavior in children with persistent allergic rhinitis Gustavo F. Wandalsen, Jessica Loekmanwidjaja, Márcia Mallozi, Dirceu Solé PP76 Randomised trial of the safety of MP29-02* compared with fluticasone propionate nasal spray in children aged ≥4 years to <12 years with allergic rhinitis William Berger, Ulrich Wahn, Paul Ratner, Daniel Soteres PP77 Safety and tolerability evaluation of bilastine 10 mg in children from 2 to 11 years of age with allergic rhinoconjunctivitis or urticaria Zoltán Novák, Anahí Yáñez, Kiss Ildikó, Piotr Kuna, Miguel Tortajada, Román Valiente, the Bilastine Pediatric Safety Study Group PP78 Sensitisation to Alternaria alternata: Is it a risk factor for severe rhinitis? Susana Lopes, Filipa Almeida, Tânia Lopes, Cristina Madureira, José Oliveira, Fernanda Carvalho PP79 Validation of the Patient Benefit Index (PBI) for the assessment of patient-related outcomes in allergic rhinitis in children Julia Feuerhahn, Christine Blome, Meike Hadler, Efstrathios Karagiannis, Anna Langenbruch, Matthias Augustin PP80 Efficacy of sublingual tablet of house dust mite allergen extracts in adolescents with house dust mite-associated allergic rhinitis Michel Roux, Shinji Kakudo, Efstrathios Karagiannis, Robert K. Zeldin PP81 Lung function improvement in a child treated with omalizumab for bronchial asthma Anna Sokolova, Tiago Milheiro Silva PP82 How to treat a child suffering from asthma, allergic rhinitis, allergy to peanuts and diabetes at the same time? Snezana S. Zivanovic, Vesna Cvetkovic, Ivana Nikolic, Sonja J. Zivanovic PP83 Nitric oxide in exhaled air in the relationship of the degree of sensitisation to aeroallergens Snezana S. Zivanovic, Ljiljana Saranac, Ivana Nikolic, Sonja J. Zivanovic, Zorica Zivkovic PP84 Clinical basis of diagnostic errors in pediatric asthma Zoia Nesterenko PP85 PP86 Childhood asthma control in Serbia and organised Asthma Educational Intervention (AEI) Snezana Radic, Branislava Milenkovic, Spomenka Smiljanic, Milka Micic-Stanijevic, Olivera Calovic PP87 Experience from a group of adolescents with severe allergic asthma treated with Omalizumab Anne Marie Bro Hofbauer, Lone Agertoft THEMATIC POSTER SESSION 1: Prevention and Treatment—Epidemiology (TP01–TP18) TP01 A cost effective primary school asthma education program: pilot study from inner London schools Lucy Everson, Jessica Kearney, Jonny Coppel, Simon Braithwaite, Rahul Chodhari TP02 The prevalence of allergic diseases among 14–15 years old adolescents in two Danish birth cohorts 14 years apart Elisabeth S. Christiansen, Henrik Fomsgaard Kjaer, Esben Eller, Charlotte G. Mørtz, Susanne Halken TP03 Does pattern of sensitisation to phleum pratense change with age? Is it different in children with allergic rhinitis or asthma? Cristina Román India, Ana Moreira Jorge, Loreto González Domínguez, Cristina Muñoz Archidona, Sergio Quevedo Teruel, Teresa Bracamonte Bermejo, Juana Jiménez Jiménez, Luis Echeverría Zudaire TP04 Practicalities of prevention of peanut allergy: modelling a national response to LEAP Cathal O’Connor, Jonathan Hourihane TP05 Comparison of the influence of sunflower seed oil and skin care lotion on the skin barrier function of newborns: a randomised controlled trial Varvara Kanti, Lena Lünnemann, Günther Malise, Laine Ludriksone, Andrea Stroux, Wolfgang Henrich, Michael Abu-Dakn, Ulrike Blume-Peytavi, Natalie Garcia Bartels TP06 The effect of daily skin care on skin barrier properties in infants with dry skin and risk for atopic dermatitis Varvara Kanti, Lena Lünnemann, Laine Ludriksone, Marianne Schario, Andrea Stroux, Ulrike Blume-Peytavi, Natalie Garcia Bartels TP07 Change in sum total aeroallergen skin prick test wheal diameters at 6 months predicts which children will respond to subcutaneous immunotherapy by three years Thorsten Stanley, Nicolien Brandenbarg TP08 Are mobile apps regarding adrenaline auto-injectors accessed by adolescents for support and education in the community? Alia Boardman, Gary McGreevy, Emily Rodger, Katherine Knight, Victoria Timms, Trisha Taylor, Gemma Scanlan, Roisin Fitzsimons TP09 TP10 Prevention of early atopic dermatitis among low-atopy-risk infants by immunoactive prebiotics is not sustained after the first year of life Grüber Christoph, Ulrich Wahn, Margriet van Stuivenberg, Fabio Mosca, Guido Moro, Gaetano Chirico, Christian P. Braegger, Joseph Riedler, Yalcin Yavuz, Günther Boehm TP11 TP12 TP13 Treatment with Omalizumab in a 16-year-old Caucasian girl with refractory solar urticaria Stefania Arasi, Giuseppe Crisafulli, Lucia Caminiti, Federica Porcaro, Giovanni Battista Pajno TP14 Ultra-pure soft water ameliorates skin conditions of adult and child patients with atopic dermatitis Akane Tanaka, Yaei Togawa, Kumiko Oida, Naotomo Kambe, Peter Arkwright, Yosuke Amagai, Naoki Shimojo, Yasunori Sato, Hiroyuki Mochizuki, Hyosun Jang, Saori Ishizaka, Hiroshi Matsuda TP15 Potential adjuvant effect of immunomodulator to improve specific immunotherapy in asthmatic child Wisnu Barlianto, Ery Olivianto, H. M. S. Chandra Kusuma TP16 How can Component Resolved Diagnosis (CRD) influence in Specific Immunotherapy (SIT) prescription, in a Spanish children population Ana Moreira Jorge, Cristina Román India, Loreto González Domínguez, Cristina Muñoz Archidona, Juana Jiménez Jiménez, Teresa Bracamonte Bermejo, Sergio Quevedo Teruel, Luis Echeverría Zudaire TP17 Mitochondrial dysfunction in food allergy: effects of L. rhamnosus GG in a mice model of peanut allergy Rosita Aitoro, Mariapia Mollica, Roberto Berni Canani, Giovanna Trinchese, Elena Alfano, Antonio Amoroso, Lorella Paparo, Francesco Amato, Claudio Pirozzi, Antonio Calignano, Rosaria Meli TP18 Prediction of atopic diseases in childhood: elevated blood eosinophils in infancy in a high risk birth cohort Siri Rossberg, Kerstin Gerhold, Kurt Zimmermann, Mohammad Zaino, Thomas Geske, Eckard Hamelmann, Susanne Lau THEMATIC POSTER SESSION 2: Food allergy—Anaphylaxis (TP19–TP38) TP19 TP20 TP21 Double-blind provocation tests in non-IgE mediated cow’s milk allergy and the occurrence of placebo reactions Sarah Bogovic, Jochem van den Berg, Chantal Janssen TP22 Gradual introduction of baked egg (BE) in egg allergic patients under 2 years old Angela Claver TP23 Randomised controlled trial of SOTI with raw hen’s egg in children with persistent egg allergy I: safety and efficacy of daily vs. weekly protocols of induction Mª Flor Martin-Muñoz, C. Martorell, M. T. Belver, E. Alonso Lebrero, L. Zapatero, V. Fuentes, M. Piqué, A. Plaza, C. Muñoz, A. Martorell, Cristina Blasco, B. Villa, C. Gómez, S. Nevot, J. M. García, L. Echeverria TP24 Randomised controlled trial of SOTI with raw hen’s egg in children with persistent egg allergy II: a randomised controlled trial to study a safer, more effective and easy to perform maintenance (daily vs. every two days) pattern of egg SOTI Mª Flor Martin-Muñoz, C. Martorell, M. T. Belver, E. Alonso Lebrero, L. Zapatero, V. Fuentes, M. Piqué, A. Plaza, C. Muñoz, A. Martorell, Cristina Blasco, B. Villa, C. Gómez, S. Nevot, J. M. García, L. Echeverria TP25 Determining the safety of baked egg home reintroduction for children with mild egg allergy Brenda DeWitt, Judith Holloway, Donald Hodge TP26 Demographics, investigations and patterns of sensitisation in children with oral allergy syndrome in a London Teaching Hospital Sian Ludman, Merhdad Jafari-Mamaghani, Rosemary Ebling, Adam T. Fox, Gideon Lack, George Du Toit TP27 Airborne peanut challenge in children: allergic reactions are rare Sofia Lovén Björkman, Caroline Nilsson, Natalia Ballardini TP28 The nutty question on Pediatric Wards: to be or “nut” to be? Supriyo Basu, Jenny Hallet, Jyothi Srinivas TP29 TP30 TP31 Allergy education in nursery schools Hazel Stringer, Nicola Jay TP32 Food allergy in the first year of life Tânia Lopes, Cristina Madureira, Filipa Almeida, Susana Lopes, Paula Fonseca, Clara Vieira, Fernanda Carvalho TP33 Prevalence and geographic distribution of oral allergy syndrome in Italian children: a multicenter study Carla Mastrorilli, Carlo Caffarelli, Riccardo Asero, Salvatore Tripodi, Arianna Dondi, Gianpaolo Ricci, Carlotta Povesi Dascola, Elisabetta Calamelli, Francesca Cipriani, Andrea Di Rienzo Businco, Annamaria Bianchi, Paolo Candelotti, Tullio Frediani, Carmen Verga, Paolo Maria Matricardi TP34 Are common standardised allergen extracts used in skin test enough in the diagnosis of nuts allergy? Cristina Muñoz Archidona, Loreto González Domínguez, Ana Moreira Jorge, Sergio Quevedo Teruel, Teresa Bracamonte Bermejo, Miriam Castillo Fernández, Fernando Pineda de la Losa, Luis Ángel Echeverría Zudaire TP35 Evaluation of IgE sensitisation in children with allergic proctocolitis and its relationship to atopic dermatitis Despina Mermiri, Paraskevi Korovessi, Skevi Tiliakou, Evaggelia Tavoulari, Kalliopi-Maria Moraiti, Fotini Giannoula, Athina Papadopoulou TP36 Food allergy in children: are we managing them appropriately in the Emergency Department? Wan Jean Tee, Samir Deiratany, Raymond Seedhoo, Roisin McNamara, Ike Okafor TP37 Importance of oil body associated allergenic proteins in nuts suspected allergy children Loreto González Domínguez, Ana Moreira Jorge, Cristina Muñoz Archidona, Teresa Bracamonte Bermejo, Sergio Quevedo Teruel, Fernando Pineda de la Losa, Miriam Castillo Fernández, Luis Ángel Echeverría Zudaire TP38 Practical application of basophil activation test in children with food allergy Ekaterina Khaleva, Gennady Novic, Natalia Bychkova THEMATIC POSTER SESSION 3: Asthma (TP39–TP57) TP39 Effect of corticosteroid therapy upon serum magnesium level in chronic asthmatic children Amany Abd Al-Aziz, Amany Fatouh, Ayat Motawie, Eman El Bostany, Amr Ibrahim TP40 ADAM33 in Bulgarian children with asthma Guergana Petrova, Dimitrinka Miteva, Snezhina Lazova, Penka Perenovska, Sylvia Andonova, Alexey Savov TP41 TP42 The impact of vitamin D serum levels in asthma and allergic rhinitis Maria Zoto, Marialena Kyriakakou, Paraskevi Xepapadaki, Nikolaos G. Papadopoulos TP43 Life-threatening, first reported, paradoxical bronchospasm after nebulised Salbutamol in a 10 year old child Paraskevi Korovessi, Mariza Vassilopoulou, Athina Balaska, Lambros Banos, Stavroula Kostaridou, Despina Mermiri TP44 TP45 Asthma symptoms in children with treatment for allergic rhinoconjunctivitis Jorien Wartna, Arthur M. Bohnen, Gijs Elshout, David H. J. Pols, Patrick J. E. Bindels Erasmus MC, Rotterdam, The Netherlands TP46 Atopy increased the risk of developing exercise-induced bronchoconstriction in young athletes Sven F. Seys; Ellen Dilissen, Sarah Van der Eycken, An-Sofie Schelpe, Gudrun Marijsse, Thierry Troosters, Vincent Vanbelle, Sven Aertgeerts, Jan L. Ceuppens, Lieven J. Dupont, Koen Peers, Dominique M. Bullens TP47 The effect of higher BMI on risk for asthma and treatment outcome in overweight and obese children Ivana Banic, Sandra Bulat Lokas, Jelena Zivkovic, Boro Nogalo, Iva Mrkic Kobal, Davor Plavec, Mirjana Turkalj TP48 TP49 TP50 TP51 TP52 The impact of a multidisciplinary project intended to change the culture of nebulisers towards pressurised metered dose inhalers Georgeta Oliveira, Katharine Pike, Alda Melo, Tomás Amélia, José Carlos Cidrais Rodrigues, Cristina Serrano, José Manuel Lopes dos Santos, Carla Lopes TP53 TP54 TP55 TP56 Increased asthma control in patients with severe persistent allergic asthma after 12 month of nightly temperature controlled laminar airflow (TLA) Eckard Hamelmann, Uwe Schauer, Karl-Christian Bergmann TP57 THEMATIC POSTER SESSION 4: Drug allergy—Dermatology (TP58–TP77) TP58 Should we proceed directly to provocation challenges to diagnose drug allergy? Our experience says yes Luis Moral, Teresa Toral, Nuria Marco, Beléns García Avilés, Mª Jesús Fuentes, Jesús Garde, Cristina Montahud, Javier Perona, Mª José Forniés TP59 Anaphylaxis to 13-valent pneumococcal vaccine Esozia Arroabarren, Marta Anda, Maria Luisa Sanz, Maria Teresa Lizaso, Candida Arregui TP60 Intrapartum antibiotic exposure for treatment of group B streptococcus was not associated with the development of penicillin allergy in children Sara May, Martha Hartz, Avni Joshi, Miguel A. Park TP61 Evaluation of suspected drug hypersensitivity reactions in 169 children referred to the General Hospital Sonja Posega Devetak, Tina Vesel, Anja Koren Jeverica, Tadej Avčin TP62 Drug provocation testing: experience of a tertiary hospital Leonor Castro, Carolina Gouveia, Ana Carvalho Marques, Antonio Jorge Cabral TP63 Perioperative anaphylaxis: a growing concern in pediatric population Luis Amaral, Fabrícia Carolino, Eunice Castro, Madalena Passos, Josefina R. Cernadas TP64 Raising awareness of hypersensitivity to non-steroidal anti-inflammatory drugs in the pediatric age Fabrícia Carolino, Luís Amaral, Eunice Dias de Castro, Josefina R. Cernadas TP65 Perioperative anaphylaxis in young children: how to confirm the suspicion Josefina R. Cernadas, Fabrícia Carolino, Luís Amaral, Fernando Pineda, Armanda Gomes TP66 A case study of a child suspected to be penicillin allergic-digging deeper Katherine Knight, Roisin Fitzsimons, Helen Brough TP67 Prevalence, characteristics and risk factors of hypersensitivity reactions to antibiotics in patients with cystic fibrosis Jobst Röhmel, Carsten Schwarz, Anne Mehl, Philippe Stock, Doris Staab TP68 Antibiotic drug hypersensitivity in cystic fibrosis: A pilot study using cellular allergy tests for diagnostics Jobst Röhmel, Carsten Schwarz, Christine Seib, Doris Staab, Philippe Stock TP69 Oral antibiotics challenges in children Anita Critchlow, Alyson Barber, Nicola Jay TP70 Hypersensitivity reaction to vancomycin: a new successful desensitization protocol Belen Delavalle, Teresa Garriga, Blanca Vilá, Cristina Blasco TP71 TP72 Clinical phenotypes according to FLG gene loss of function mutations in children with atopic dermatitis Francesca Cipriani, Annalisa Astolfi, Costanza Di Chiara, Elisabetta Calamelli, Iria Neri, Annalisa Patrizi, Gianpaolo Ricci TP73 TP74 Urticaria in children: clinical and epidemiological features Katerina Neskorodova, Asya Kudryavtseva TP75 TP76 Acute urticaria at the Pediatrics Emergency Department: is it allergy? Esozia Arroabarren, Jorge Alvarez, Marta Anda, Miriam Palacios, Marta Martinez-Merino, Ibone Vaquero TP77
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Khaleva E, Bychkova N, Novic G. Should the basophil activation test be the gold standard in the diagnosis of food allergies? BMC Proc 2015. [PMCID: PMC4306088 DOI: 10.1186/1753-6561-9-s1-a61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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