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Ibáñez-Sandin MD, Rodríguez Del Río P, Alvarado MI, García BE, Garriga-Baraut T, Reche Frutos M, Escudero C, Ramirez A, Vila L, Lasa EM, Blasco C, Marchán-Martin E, Martorell A, Sanchez-García S, Rodríguez-Álvarez M, Infante S, Rodríguez Vazquez V, Olaguibel JM, Labrador-Horrillo M, Carrillo T. Onset of nut allergy in a pediatric cohort: clinical and molecular patterns. AFRUSEN study. J Investig Allergol Clin Immunol 2021; 32:270-281. [PMID: 33884956 DOI: 10.18176/jiaci.0696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Nut Allergy, Peanut, Walnut, Allergy Onset, Sensitization Profile, Component Resolved Diagnosis, Anaphylaxis, Food Allergy.
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Affiliation(s)
- M D Ibáñez-Sandin
- Allergy Department, Hospital Infantil Universitario Niño Jesus, Madrid, Spain.,Health Research Institute Princesa, Madrid; cARADyAL RD16/0006/0026, Spain
| | - P Rodríguez Del Río
- Allergy Department, Hospital Infantil Universitario Niño Jesus, Madrid, Spain.,Health Research Institute Princesa, Madrid; cARADyAL RD16/0006/0026, Spain
| | - M I Alvarado
- Servicio de Alergología, Complejo Hospitalario Universitario de Cáceres, Cáceres, Spain
| | - B E García
- Service of Alergology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - T Garriga-Baraut
- Unitat d´Al·lergologia Pediàtrica, Hospital Universitari Vall d´Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.,Grup d'Investigació "Creixement i Desenvolupament", Institut de Recerca de l'Hospital Universitari Vall d'Hebron (VHIR), Barcelona, Spain
| | - M Reche Frutos
- Servicio de Alergología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
| | - C Escudero
- Allergy Department, Hospital Infantil Universitario Niño Jesus, Madrid, Spain.,Health Research Institute Princesa, Madrid; cARADyAL RD16/0006/0026, Spain
| | - A Ramirez
- Unidad de Alergia alimentaria, Unidad de Alergología, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - L Vila
- Complexo Hospitalario Universitario A Coruña, Spain
| | - E M Lasa
- Unidad de Alergología Infantil, Servicio de Alergología, Hospital Universitario Donostia, Spain
| | - C Blasco
- Unidad de Alergología Pediátrica, Hospital Universitario Vall d´Hebron de Barcelona, Spain
| | - E Marchán-Martin
- Complejo Hospitalario Universitario de Toledo, Servicio de Alergología, Toledo, Spain
| | - A Martorell
- Allergy Service, University General Hospital, Valencia, Spain
| | - S Sanchez-García
- Allergy Department, Hospital Infantil Universitario Niño Jesus, Madrid, Spain.,Health Research Institute Princesa, Madrid; cARADyAL RD16/0006/0026, Spain
| | - M Rodríguez-Álvarez
- Allergy Department, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - S Infante
- Paediatric Allergy Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - J M Olaguibel
- Servicio de Alergología, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - M Labrador-Horrillo
- Sección de Alergia, Vall d'Hebron Hospital Universitari, Barcelona, Spain, Vall d'Hebron Institut de Recerca (VHIR), Barcelona Spain, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain, ARADyAL research network, Instituto de Salud Carlos III (ISCII
| | - T Carrillo
- Servicio de Alergología, Hospital Universitario de Gran Canaria Dr. Negrin, Spain
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Rodríguez del Río P, Díaz-Perales A, Sanchez-García S, Escudero C, do Santos P, Catarino M, Ibañez MD. Oral immunotherapy in children with IgE-mediated wheat allergy: outcome and molecular changes. J Investig Allergol Clin Immunol 2014; 24:240-248. [PMID: 25219106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND IgE-mediated wheat allergy affects around 0.5% of the population, and current management is based on avoidance. We propose an active intervention to promote tolerance in wheat-allergic children. OBJECTIVES To investigate the efficacy and safety of an oral immunotherapy (OIT) protocol with wheat to treat IgE-mediated wheat-allergic children. METHODS Six wheat allergic patients assessed in a double-blind, placebo-controlled food challenge (DBPCFC) underwent wheat OIT with an up-dosing phase until 100 g of wheat was tolerated, followed by a 6-month maintenance phase. Tolerance to rye and oat was evaluated, as were specific IgE (sIgE) to wheat and other cereals and sIgE, slgG4, and sIgG1 to a panel of wheat proteins (alpha-amylase and trypsin inhibitors, wheat lipid transfer proteins, gliadins, and glutenins). RESULTS Threshold doses in the wheat DBPCFC ranged from 6.6 g to 96.6 g. Five out of 6 (83%) patients successfully finished the up-dosing phase in 3 to 24 days; after a 6-month maintenance phase, all the patients maintained good tolerance of 100 g of wheat daily. Only 6.25% of doses in the up-dosing phase elicited mild adverse reactions. All 5 patients who successfully finished the up-dosing phase tolerated rye after OIT, and all but 1 tolerated oat as well. The median baseline wheat sIgE was 47.5 kU(A)/L, increasing to 84.55 kU(A)/L after up-dosing and decreasing to 28.75 kU(A)/L after 6 months of follow-up. None of the patients showed sIgE to 5-omega-gliadin, but alpha-amylase inhibitors were recognized by all patients. Specific IgG4 and sIgG1 increased in all patients. CONCLUSIONS Our wheat OIT protocol was safe, efficient, and rapid. In our population, alpha-amylase was the major allergen.
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