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Toyokuni K, Yamamoto-Hanada K, Yang L, Hagino K, Harama D, Omori M, Matsumoto Y, Suzuki D, Umezawa K, Takada K, Shimada M, Hirai S, Ishikawa F, Hamaguchi S, Saito-Abe M, Sato M, Miyaji Y, Kabashima S, Fukuie T, Noguchi E, Suzuki K, Ohya Y. Influence of household pet ownership and filaggrin loss-of-function mutations on eczema prevalence in children: A birth cohort study. Allergol Int 2024:S1323-8930(24)00004-2. [PMID: 38302328 DOI: 10.1016/j.alit.2024.01.003] [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: 10/16/2023] [Revised: 12/05/2023] [Accepted: 01/04/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND The association between pet exposure in infancy, early childhood eczema, and FLG mutations remains unclear. METHODS This was a birth cohort study performed in Tokyo, Japan. The primary outcome was current eczema based on questionnaire responses collected repeatedly from birth to 5 years of age. Generalized estimating equations and generalized linear modeling were used to evaluate the association. RESULTS Data from 1448 participants were used for analyses. Household dog ownership during gestation, early infancy, and 18 months of age significantly reduced the risk of current eczema. Household cat ownership also reduced the risk of current eczema, albeit without statistical significance. The combined evaluation of children from households with pets, be it cats, dogs or both, the risk of current eczema at 1-5 years of age was lower in those with household pet exposure ownership during gestation (RR = 0.59, 95 % CI 0.45-0.77) and at 6 months (RR = 0.49, 95 % CI 0.36-0.68). , Reduced risks of eczema were also observed at 2-5 (RR = 0.52, 95 % CI 0.37-0.73) and 3-5 years of age (RR = 0.50 95 % CI 0.35-0.74) when the respective household pet ownership were evaluated at 18 months and 3 years of age. These protective associations of reduced risk of eczema were only observed in children without FLG mutations. CONCLUSIONS Household dog and pet (dog, cat, or both) ownership was protective against early childhood eczema in a birth cohort dataset. This protective association was observed only in children without FLG mutations, which should be confirmed in studies with larger cohorts.
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Affiliation(s)
- Kenji Toyokuni
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan; Department of Health and Psychosocial Medicine, Aichi Medical University School of Medicine, Aichi, Japan
| | | | - Limin Yang
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kouhei Hagino
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Daisuke Harama
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Marei Omori
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yasuaki Matsumoto
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Daichi Suzuki
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kotaro Umezawa
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kazuma Takada
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Mami Shimada
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Seiko Hirai
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Fumi Ishikawa
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan; Department of Health and Psychosocial Medicine, Aichi Medical University School of Medicine, Aichi, Japan
| | - Sayaka Hamaguchi
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Mayako Saito-Abe
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Miori Sato
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan; Department of Health and Psychosocial Medicine, Aichi Medical University School of Medicine, Aichi, Japan
| | - Yumiko Miyaji
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Shigenori Kabashima
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Tatsuki Fukuie
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Emiko Noguchi
- Department of Medical Genetics, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Kohta Suzuki
- Department of Health and Psychosocial Medicine, Aichi Medical University School of Medicine, Aichi, Japan
| | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
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Suzuki D, Saito-Abe M, Matsumoto Y, Umezawa K, Takada K, Toyokuni K, Ishikawa F, Hirai S, Sato M, Miyaji Y, Morita H, Hamaguchi S, Kabashima S, Fukuie T, Nomura I, Yamamoto-Hanada K, Ohya Y. [A CASE OF INDUCIBLE LARYNGEAL OBSTRUCTION UNSUCCESSFULLY TREATED AS SEVERE ASTHMA WAS WELL CONTROLLED AFTER APPROPRIATE DIAGNOSIS AND INSTRUCTION OF THERAPEUTIC BREATHING MANEUVERS]. Arerugi 2023; 72:44-48. [PMID: 36792160 DOI: 10.15036/arerugi.72.44] [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] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND Inducible laryngeal obstruction (ILO) refers to respiratory disorders caused by airflow limitation in the larynx, including vocal cord dysfunction, and may sometimes be misdiagnosed as bronchial asthma (BA). Here, we report the case of an 11-year-old boy diagnosed with BA in infancy. He was referred to our Allergy Center and was taking a high dose of inhaled corticosteroids (ICS) due to frequent coughing from the age of 10 years and persistent coughing following COVID-19 infection at the age of 11. However, the patient continued to experience frequent coughing attacks and repeated visits to the emergency department after inhalation of β2-stimulants failed to improve his cough. We admitted him to the allergy center for examinations to assess the BA severity. In the airway hypersensitiveness test, saline inhalation performed prior to methacholine inhalation caused expiratory stridor and respiratory distress in the larynx, which worsened with β2-stimulant inhalation. Based on these results, we ruled out BA and diagnosed ILO. We instructed him on breathing maneuvers, and he was able to respond appropriately when symptoms appeared. We then started reducing his ICS dose.
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Affiliation(s)
- Daichi Suzuki
- Allergy Center, National Center for Child Health and Development
| | - Mayako Saito-Abe
- Allergy Center, National Center for Child Health and Development
| | | | - Kotaro Umezawa
- Allergy Center, National Center for Child Health and Development
| | - Kazuma Takada
- Allergy Center, National Center for Child Health and Development
| | - Kenji Toyokuni
- Allergy Center, National Center for Child Health and Development
| | - Fumi Ishikawa
- Allergy Center, National Center for Child Health and Development
| | - Seiko Hirai
- Allergy Center, National Center for Child Health and Development
| | - Miori Sato
- Allergy Center, National Center for Child Health and Development
| | - Yumiko Miyaji
- Allergy Center, National Center for Child Health and Development
| | - Hideaki Morita
- Allergy Center, National Center for Child Health and Development
| | - Sayaka Hamaguchi
- Allergy Center, National Center for Child Health and Development
| | | | - Tatsuki Fukuie
- Allergy Center, National Center for Child Health and Development
| | - Ichiro Nomura
- Allergy Center, National Center for Child Health and Development
| | | | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development
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Kumagai F, Yamamoto-Hanada K, Saito-Abe M, Sato M, Ishikawa F, Irahara M, Miyaji Y, Kabashima S, Ohya Y, Akiyama M, Kono M. FLG mutations, eczema control, and respiratory symptom at one-year-old in early-onset atopic dermatitis infants (PACI-ON cohort study). J Dermatol Sci 2023; 109:99-101. [PMID: 36737282 DOI: 10.1016/j.jdermsci.2023.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 01/27/2023]
Affiliation(s)
- Fumiko Kumagai
- Department of Dermatology and Plastic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | | | - Mayako Saito-Abe
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Miori Sato
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Fumi Ishikawa
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Makoto Irahara
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yumiko Miyaji
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Shigenori Kabashima
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yukihiro Ohya
- Department of Dermatology and Plastic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Masashi Akiyama
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Michihiro Kono
- Department of Dermatology and Plastic Surgery, Akita University Graduate School of Medicine, Akita, Japan.
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Hirai S, Yamamoto-Hanada K, Kabashima S, Fukuie T, Shoji K, Ozawa K, Sago H, Ohya Y. [ANTIMICROBIAL ALLERGY ASSESSMENT DURING PREGNANCY FOR APPROPRIATE ANTIMICROBIAL USE AT DELIVERY]. Arerugi 2023; 72:1223-1229. [PMID: 38092398 DOI: 10.15036/arerugi.72.1223] [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] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
BACKGROUND Avoidance of suspect drugs based solely on a history of drug allergy is detrimental to disease outcomes. Many antimicrobial allergy labels are not usually true allergy. Some studies have demonstrated that antimicrobial allergy assessments can be safely performed on pregnant women. The purpose of this study was to examine the usefulness of antibiotic allergy assessment during pregnancy in Japan. METHODS We reviewed pregnant women who reported antimicrobial allergies and were referred to the allergy center. Allergists conducted an interview and skin test and selected antibiotics that could be used at delivery. RESULTS Twenty-four pregnant women were referred to as having antimicrobial allergies. Most of the suspected antimicrobials were cephalosporin (13 cases, 52%) and penicillin (9 cases, 36%). Five women were ruled out only by our interviews. Of the remaining 20 cases, 10 were immediate type, 6 were non-immediate type, and 4 were unknown. All 21 pregnant women who needed antimicrobials were able to use the first-line drugs (β-lactam antimicrobials) at the time of delivery. No surgical site infections or allergic reactions were observed. CONCLUSION Pregnant women with antimicrobial allergy labels could be evaluated by antimicrobial allergy assessment during pregnancy, and first-line antimicrobials were safely and properly used at delivery.
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Affiliation(s)
- Seiko Hirai
- Allergy Center, National Center for Child Health and Development
| | | | | | - Tatsuki Fukuie
- Allergy Center, National Center for Child Health and Development
| | - Kensuke Shoji
- Division of Infectious Diseases, National Center for Child Health and Development
| | - Katsusuke Ozawa
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development
| | - Haruhiko Sago
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development
| | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development
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Yamada S, Fujisawa T, Nagao M, Matsuzaki H, Motomura C, Odajima H, Nakamura T, Imai T, Nagakura KI, Yanagida N, Mitomori M, Ebisawa M, Kabashima S, Ohya Y, Habukawa C, Tomiita M, Hirayama M. Risk Factors for Lung Function Decline in Pediatric Asthma under Treatment: A Retrospective, Multicenter, Observational Study. Children (Basel) 2022; 9:children9101516. [PMID: 36291452 PMCID: PMC9600699 DOI: 10.3390/children9101516] [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] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/27/2022] [Accepted: 09/30/2022] [Indexed: 11/17/2022]
Abstract
Background: Childhood asthma is a major risk for low lung function in later adulthood, but what factors in asthma are associated with the poor lung function during childhood is not known. Objective: To identify clinical factors in children with asthma associated with low or declining lung function during the treatment. Methods: We enrolled children with asthma who had been treated throughout three age periods, i.e., 6−9, 10−12, and 13−15 years old, at seven specialized hospitals in Japan. Clinical information and lung function measurements were retrieved from the electronic chart systems. To characterize the lung function trajectories during each age period, we evaluated the forced expiratory volume 1 (FEV1) with % predicted values and individual changes by the slope (S) from linear regression. We defined four trajectory patterns: normal (Group N) and low (Group L), showing %FEV1 ≥80% or <80% throughout all three periods; upward (Group U) and downward (Group D), showing S ≥ 0 or S < 0%. Logistic regression analysis was performed to compare factors associated with the unfavorable (D/L) versus favorable (N/U) groups. Results: Among 273 eligible patients, 197 (72%) were classified into Group N (n = 150)/U (n = 47), while 76 (28%) were in Group D (n = 66)/L (n = 10). A history of poor asthma control, long-acting beta2 agonist use, and a lower height Z-score during 13−15 years were associated with an unfavorable outcome (Group D/L). Conversely, inhaled corticosteroid (ICS) use during 10−12 years and high-dose ICS use during 13−15 years were associated with a favorable outcome (Group N/U). Conclusion: We identified several factors that are associated with unfavorable lung function changes in pediatric asthma. Attention should be paid to the possible relationship between yearly changes in lung function and poor asthma control, use of ICS (and its dose) and use of LABA.
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Affiliation(s)
- Shingo Yamada
- Allergy Center, National Hospital Organization Mie National Hospital, Tsu 514-0125, Japan
| | - Takao Fujisawa
- Allergy Center, National Hospital Organization Mie National Hospital, 357 Ozato-kubota, Tsu 514-0125, Japan
- Correspondence: ; Tel.: +81-59-232-2531
| | - Mizuho Nagao
- Allergy Center, National Hospital Organization Mie National Hospital, Tsu 514-0125, Japan
| | - Hiroshi Matsuzaki
- Department of Pediatrics, National Hospital Organization Fukuoka National Hospital, Fukuoka 811-1394, Japan
| | - Chikako Motomura
- Department of Pediatrics, National Hospital Organization Fukuoka National Hospital, Fukuoka 811-1394, Japan
| | - Hiroshi Odajima
- Department of Pediatrics, National Hospital Organization Fukuoka National Hospital, Fukuoka 811-1394, Japan
| | - Toshinori Nakamura
- Department of Pediatrics, Showa University School of Medicine, Tokyo 142-8666, Japan
| | - Takanori Imai
- Department of Pediatrics, Showa University School of Medicine, Tokyo 142-8666, Japan
| | - Ken-ichi Nagakura
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Sagamihara 252-0392, Japan
| | - Noriyuki Yanagida
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Sagamihara 252-0392, Japan
| | - Masatoshi Mitomori
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Sagamihara 252-0392, Japan
| | - Motohiro Ebisawa
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Sagamihara 252-0392, Japan
| | - Shigenori Kabashima
- Allergy Center, National Center for Child Health and Development, Tokyo 157-8535, Japan
| | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development, Tokyo 157-8535, Japan
| | - Chizu Habukawa
- Department of Pediatric Allergy, National Hospital Organization Minami Wakayama Medical Center, Tanabe 656-8558, Japan
| | - Minako Tomiita
- Center of Pediatric Allergy and Rheumatology, National Hospital Organization Shimoshizu National Hospital, Yotsukaido 284-0003, Japan
| | - Masahiro Hirayama
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
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Yasudo H, Yamamoto-Hanada K, Yang L, Saito-Abe M, Sato M, Miyaji Y, Shimada M, Hirai S, Toyokuni K, Ishikawa F, Inuzuka Y, Kabashima S, Fukuie T, Ohya Y. Pollen Food Allergy Syndrome in Allergic March. Nutrients 2022; 14:nu14132658. [PMID: 35807837 PMCID: PMC9268136 DOI: 10.3390/nu14132658] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/07/2022] [Accepted: 06/24/2022] [Indexed: 11/20/2022] Open
Abstract
The association between pollen food allergy syndrome (PFAS) and allergic march remains unclear. In this prospective cohort study of the general population in Tokyo (T-Child Study), we found that sensitization to Cry j 1 and Fel d 1 at ages 5 and 9 years was associated with an increased risk of PFAS at 13 years old (at 5 years, Cry j 1: adjusted odds ratio aOR, 2.74; 95% confidence interval CI, 1.53–4.91; Fel d 1: aOR, 2.61; 95% CI, 1.31–5.19; at 9 years, Cry j 1: adjusted odds ratio aOR, 4.28; 95% confidence interval CI, 1.98–9.25; Fel d 1: aOR, 2.40; 95% CI, 1.33–4.32). In particular, sensitization to Bet v 1 at ages 5 and 9 years was associated with a strong risk of PFAS at the age of 13 years (at 5 years: aOR, 10.6; 95% CI, 2.64–42.5; at 9 years: aOR, 9.1; 95% CI, 4.71–17.6). PFAS risk by age 13 years was increased by any allergic symptom at 5 or 9 years, a combination of wheezing, eczema, and rhinitis, and Bet v 1 sensitization. Our findings suggest that PFAS may be associated with allergic march.
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Kram Y, Sato M, Inuzuka Y, Kabashima S, Fukuie T, Uematsu S, Kudo T, Yamada Y, Ohtsuka Y, Matsumoto K, Yamamoto-Hanada K, Nomura I, Ohya Y. Development of an Action Plan for Acute Food Protein–Induced Enterocolitis Syndrome in Japan. J Allergy Clin Immunol 2022. [DOI: 10.1016/j.jaci.2021.12.684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kiguchi T, Yamamoto-Hanada K, Saito-Abe M, Sato M, Irahara M, Ogita H, Miyagi Y, Inuzuka Y, Toyokuni K, Nishimura K, Ishikawa F, Miyaji Y, Kabashima S, Fukuie T, Narita M, Ohya Y. Pollen-food allergy syndrome and component sensitization in adolescents: A Japanese population-based study. PLoS One 2021; 16:e0249649. [PMID: 33852622 PMCID: PMC8046202 DOI: 10.1371/journal.pone.0249649] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 12/22/2020] [Accepted: 03/22/2021] [Indexed: 11/18/2022] Open
Abstract
Allergic rhino-conjunctivitis with pollen allergy has been prevalent worldwide and Pollen-food allergy syndrome (PFAS) refers to individuals with pollen allergy who develop oral allergy syndrome (OAS) on consuming fruits and vegetables. The prevalence of PFAS varies by region and that in Japanese adolescents remains to be elucidated. In this cross-sectional study, we examined the epidemiological characteristics of PFAS in a general population of Japanese adolescents according to pollen allergy, OAS, and IgE component sensitization. Participants comprised adolescents, at age 13 years, from a prospective birth cohort study in Japan. We administered questionnaires to collect information from parents regarding pollen allergy, PFAS and OAS at each child’s age 13 years. ImmunoCAP ISAC was used to assess IgE component sensitization. Among 506 participants with a complete questionnaire and ISAC measurement results, 56.5% had a history of hay fever, 16.0% had a history of OAS, 51.0% had pollen allergy, and 11.7% had a history of PFAS; additionally, 72.7% were sensitized to one or more tree, grass, and/or weed allergens. The most common sensitization (95.7%) among adolescents with pollen allergy was to Japanese cedar (Cry j 1). The most common causal foods were kiwi and pineapple (both 39.0%). Knowledge levels about PFAS were poor among affected adolescents. We found a high prevalence of PFAS among adolescents in Japan. Although it affects approximately 1/10 adolescents in the general population, public awareness regarding PFAS is poor. Interventional strategies are needed to increase knowledge and to prevent PFAS in the general population.
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Affiliation(s)
- Tomoyuki Kiguchi
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | | | - Mayako Saito-Abe
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Miori Sato
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Makoto Irahara
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Hiroya Ogita
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yoshitsune Miyagi
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yusuke Inuzuka
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kenji Toyokuni
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Koji Nishimura
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Fumi Ishikawa
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yumiko Miyaji
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Shigenori Kabashima
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Tatsuki Fukuie
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Masami Narita
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
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Toyokuni K, Yamamoto-Hanada K, Yoshida A, Miyaji Y, Kabashima S, Fukuie T, Nomura I, Ohya Y. [ACUTE TREATMENT AND LONG-TERM PROGNOSIS OF SEVERE PROTEIN-LOSS IN ATOPIC DERMATITIS (SPLAD)]. Arerugi 2021; 70:1383-1390. [PMID: 34911891 DOI: 10.15036/arerugi.70.1383] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) in early infancy can lead to severe protein-loss in atopic dermatitis (SPLAD). The aim of this study was to elucidate the prognosis of SPLAD. METHODS This was a single-center, retrospective, observational study based on medical records. Participants comprised 61 children with SPLAD hospitalized at the Allergy Center, National Center for Child Health and Development, from 2002 to 2017. We examined patient characteristics, blood test results, and prognoses up to 3 years, including frequency of topical corticosteroid-(TCS) use and food intake status. RESULTS All participants improved hypoproteinemia and electrolyte abnormalities with AD treatment alone, without intravenous fluids. We performed proactive therapy to maintain remission by gradually decreasing the frequency of TCS-use. After 1, 2, and 3 years, 77%, 92%, and 95%, respectively, remission was maintained by using TCS 2 days a week or less, whereas 39% did not require TCS after 3 years. No participants received systemic therapy, including systemic steroids, immunosuppressants, or biologics. We observed that 29% of infants younger than 1 year at admission had eliminated one or more egg, milk, or wheat component after 3 years. CONCLUSIONS Even in patients with SPLAD, the most severe AD, TCS-use may be reduced to 2 days per week or less after 3 years with appropriate skin treatment.
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Affiliation(s)
- Kenji Toyokuni
- Allergy Center, National Center for Child Health and Development
| | | | - Akio Yoshida
- Allergy Center, National Center for Child Health and Development
| | - Yumiko Miyaji
- Allergy Center, National Center for Child Health and Development
| | | | - Tatsuki Fukuie
- Allergy Center, National Center for Child Health and Development
| | - Ichiro Nomura
- Allergy Center, National Center for Child Health and Development
| | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development
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10
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Miyagi Y, Yamamoto-Hanada K, Ogita H, Kiguchi T, Inuzuka Y, Toyokuni K, Nishimura K, Irahara M, Ishikawa F, Sato M, Saito-Abe M, Miyaji Y, Kabashima S, Fukuie T, Nomura I, Ohya Y. Avoidance of Hen's Egg Based on IgE Levels Should Be Avoided for Children With Hen's Egg Allergy. Front Pediatr 2020; 8:583224. [PMID: 33520887 PMCID: PMC7845740 DOI: 10.3389/fped.2020.583224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 12/18/2020] [Indexed: 11/29/2022] Open
Abstract
Background: Although hen's egg (HE) allergy was thought to be usually resolved by late childhood, majority of HE allergy patients with a high level of egg white (HEW)-specific IgE could not acquire tolerance for HE by age 8 years. Objective: The aim is to investigate whether the avoidance of HE until 6 years of age increased the risk of heated HE allergy at age 6 years. Methods: This was a retrospective case-control study. The HE tolerance children (n = 17) and children with low-dose HE reactor [a positive reaction to ≤ 4 g of heated HEW in oral food challenges (OFCs)] children (n = 26) were included based on the results of OFC at 6 years old. Multivariate logistic regression analysis was applied to examine the associations between HE avoidance until age 6 years and HE allergy status confirmed by OFC, adjusting the level of ovomucoid-specific IgE (OM-sIgE) during early infancy. Results: A lower proportion of strict avoidance of HE was observed in the HE tolerance group than in the low-dose HE reactor group (6 vs. 46%, p = 0.006). OM-sIgE levels in children younger than 2 years old were significantly higher in the low-dose HE reactor group than those in the HE tolerance group (median [interquartile], 26.7 UA/mL [11.9-53.4] vs. 7.9 UA/mL [0.35-23.4]; p =0.024). The avoidance of HE until 6 years of age increased the risk of heated HE allergy even after adjusting OM-sIgE levels. Conclusions: The long-term avoidance of HE from infancy increased the risk of heated HE allergy confirmed by OFC at age 6 years.
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Affiliation(s)
- Yoshitsune Miyagi
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan.,Department of Pediatrics, Nakagami Hospital, Okinawa, Japan
| | | | - Hiroya Ogita
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Tomoyuki Kiguchi
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yusuke Inuzuka
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kenji Toyokuni
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Koji Nishimura
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Makoto Irahara
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Fumi Ishikawa
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Miori Sato
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Mayako Saito-Abe
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yumiko Miyaji
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Shigenori Kabashima
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Tatsuki Fukuie
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Ichiro Nomura
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
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Kabashima S. Prevention of Hen’s Egg Allergy: Evidence for a New Direction. J JPN SOC FOOD SCI 2018. [DOI: 10.3136/nskkk.65.320] [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: 11/03/2022]
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Natsume O, Kabashima S, Nakazato J, Yamamoto-Hanada K, Narita M, Kondo M, Saito M, Kishino A, Takimoto T, Inoue E, Tang J, Kido H, Wong GWK, Matsumoto K, Saito H, Ohya Y. Two-step egg introduction for prevention of egg allergy in high-risk infants with eczema (PETIT): a randomised, double-blind, placebo-controlled trial. Lancet 2017; 389:276-286. [PMID: 27939035 DOI: 10.1016/s0140-6736(16)31418-0] [Citation(s) in RCA: 220] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 08/03/2016] [Accepted: 08/12/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Evidence is accumulating that early consumption is more beneficial than is delayed introduction as a strategy for primary prevention of food allergy. However, allergic reactions caused by early introduction of such solid foods have been a problematic issue. We investigated whether or not early stepwise introduction of eggs to infants with eczema combined with optimal eczema treatment would prevent egg allergy at 1 year of age. METHODS In this randomised, double-blind, placebo-controlled trial, we enrolled infants 4-5 months of age with eczema from two centres in Japan. Exclusion criteria were being born before 37 weeks of gestational age, experience of ingestion of hen's eggs or egg products, history of immediate allergic reaction to hen's eggs, history of non-immediate allergic reaction to a particular type of food, and complications of any severe disease. Infants were randomly assigned (block size of four; stratified by institution and sex) to early introduction of egg or placebo (1:1). Participants in the egg group consumed orally 50 mg of heated egg powder per day from 6 months to 9 months of age and 250 mg per day thereafter until 12 months of age. We aggressively treated participants' eczema at entry and maintained control without exacerbations throughout the intervention period. Participants and physicians were masked to assignment, and allocation was concealed. The primary outcome was the proportion of participants with hen's egg allergy confirmed by open oral food challenges at 12 months of age, assessed blindly by standardised methods, in all randomly allocated participants who received the intervention. This trial is registered with the University Hospital Medical Information Network Clinical Trials Registry, number UMIN000008673. FINDINGS Between Sept 18, 2012, and Feb 13, 2015, we randomly allocated 147 participants (73 [50%] to the egg group and 74 [50%] to the placebo group). This trial was terminated on the basis of the results of the scheduled interim analysis of 100 participants, which showed a significant difference between the two groups (four [9%] of 47 participants had an egg allergy in the egg group vs 18 [38%] of 47 in the placebo group; risk ratio 0·222 [95% CI 0·081-0·607]; p=0·0012). In the primary analysis population, five (8%) of 60 participants had an egg allergy in the egg group compared with 23 (38%) of 61 in the placebo group (risk ratio 0·221 [0·090-0·543]; p=0·0001). The only difference in adverse events between groups was admissions to hospital (six [10%] of 60 in the egg group vs none in the placebo group; p=0·022). 19 acute events occurred in nine (15%) participants in the egg group versus 14 events in 11 (18%) participants in the placebo group after intake of the trial powder. INTERPRETATION Introduction of heated egg in a stepwise manner along with aggressive eczema treatment is a safe and efficacious way to prevent hen's egg allergy in high-risk infants. In this study, we developed a practical approach to overcome the second wave of the allergic epidemic caused by food allergy. FUNDING Ministry of Health, Labour and Welfare, and National Centre for Child Health and Development, Japan.
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Affiliation(s)
- Osamu Natsume
- Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development; Okura, Setagaya-Ku, Tokyo, Japan; Division of Pediatrics, Hamamatsu University School of Medicine; Handayama, Higashiku, Hamamatsu, Shizuoka, Japan
| | - Shigenori Kabashima
- Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development; Okura, Setagaya-Ku, Tokyo, Japan; Division of Pediatrics, Tachikawa Sougo General Hospital; Nishiki-Cho, Tachikawa, Tokyo, Japan
| | - Junko Nakazato
- Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development; Okura, Setagaya-Ku, Tokyo, Japan; Division of Pediatrics, Kanemura Ladies Clinic; Minami-Iriso, Hazama, Saitama, Japan
| | - Kiwako Yamamoto-Hanada
- Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development; Okura, Setagaya-Ku, Tokyo, Japan
| | - Masami Narita
- Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development; Okura, Setagaya-Ku, Tokyo, Japan
| | - Mai Kondo
- Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development; Okura, Setagaya-Ku, Tokyo, Japan; Division of Pediatrics, Oume Municipal General Hospital; Higashi-Oume, Oume, Tokyo, Japan
| | - Mayako Saito
- Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development; Okura, Setagaya-Ku, Tokyo, Japan
| | - Ai Kishino
- Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development; Okura, Setagaya-Ku, Tokyo, Japan; Division of Pediatrics, Tokyo Bay UrayasuIchikawa Medical Center, Pediatrics, Toudaizima, Urayasu, Chiba, Japan
| | - Tetsuya Takimoto
- Center for Clinical Research and Development, National Center for Child Health and Development, Okura, Setagaya, Tokyo, Japan
| | - Eisuke Inoue
- Center for Clinical Research and Development, National Center for Child Health and Development, Okura, Setagaya, Tokyo, Japan
| | - Julian Tang
- Center for Clinical Research and Development, National Center for Child Health and Development, Okura, Setagaya, Tokyo, Japan
| | - Hiroshi Kido
- Division of Enzyme Chemistry, Institute for Enzyme Research, Tokushima University, Tokushima, Japan
| | - Gary W K Wong
- Department of Pediatrics and School of Public Health, Prince of Wales Hospital, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Kenji Matsumoto
- Department of Allergy and Clinical Immunology, National Research Institute for Child Health and Development, Okura, Setagaya, Tokyo, Japan
| | - Hirohisa Saito
- Department of Allergy and Clinical Immunology, National Research Institute for Child Health and Development, Okura, Setagaya, Tokyo, Japan
| | - Yukihiro Ohya
- Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development; Okura, Setagaya-Ku, Tokyo, Japan.
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Natsume O, Kabashima S, Nakasato J, Yamamoto-Hanada K, Narita M, Kondo M, Saito M, Kishino A, Inoue E, Shinahara W, Kido H, Saito H, Ohya Y. Early Introduction of Egg for Infants with Atopic Dermatitis to Prevent Egg Allergy: A Double-Blind Placebo-Controlled Randomized Clinical Trial. J Allergy Clin Immunol 2016. [DOI: 10.1016/j.jaci.2015.12.445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Horimukai K, Morita K, Narita M, Kondo M, Kabashima S, Inoue E, Sasaki T, Niizeki H, Saito H, Matsumoto K, Ohya Y. Transepidermal water loss measurement during infancy can predict the subsequent development of atopic dermatitis regardless of filaggrin mutations. Allergol Int 2016; 65:103-8. [PMID: 26666481 DOI: 10.1016/j.alit.2015.09.004] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 09/24/2015] [Accepted: 09/27/2015] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Atopic dermatitis (AD) is characterized by skin barrier dysfunction. Few studies have used noninvasive techniques to measure epidermis function in asymptomatic neonates. METHODS Data of 116 infants from our previous randomized controlled study were analyzed. Skin barrier function was measured through transepidermal water loss (TEWL), stratum corneum hydration (SCH), and pH. The association between skin barrier function and time to AD development was evaluated. Patients were classified with high or low TEWL, and SCH and pH were assessed. The survival function of the time to AD development and hazard ratios were estimated. Allergic sensitization to egg white and ovomucoid at 32 weeks was assessed. RESULTS Regardless of a filaggrin mutation, TEWL (optimal cutoff, 6.5 g/m(2)/h) of the forehead within the first week of life showed a lower p-value than TEWL of the leg, and the SCH and pH measurements. Baseline TEWL of the forehead was not different between groups, except for the mean gestational age, and it was not affected by humidity. We found a significant difference in the cumulative AD incidence between the high and low TEWL groups for the forehead only (p < 0.05). The probability without AD was lower in the high TEWL group than in the low TEWL group. For only the high TEWL group, AD development decreased significantly with daily emollient use. The high TEWL group exhibited a higher rate of sensitization to ovomucoid (p = 0.07). CONCLUSIONS TEWL of the forehead during the first week of life is associated with AD development.
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Urata M, Maeda H, Nakayama S, Yoneda E, Oda Y, Kumano T, Aoki N, Tomisaki T, Kabashima S. Stabilization of a Nb3Sn persistent current switch. Fusion Engineering and Design 1993. [DOI: 10.1016/0920-3796(93)90072-p] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Nakamura Y, Hosokawa Y, Yano H, Nakashima N, Nakashima T, Komatsu Y, Nakashima H, Fukuda S, Kuyama M, Hashimoto T, Nagasue N, Aiko Y, Kabashima S. Primary causes of perinatal death. An autopsy study of 1000 cases in Japanese infants. Hum Pathol 1982; 13:54-61. [PMID: 7076195 DOI: 10.1016/s0046-8177(82)80139-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Abstract
The autopsy cases of thanatophoric dysplasia of identical female twins were reported. These babies showed short limbs, long and narrow thoraxes, and depressed nasal roots. Disorganization of endochondral ossification and hypertrophic periosteum were recognized histologically at the epiphyseal plate of femur. The cause of death was respiratory distress caused by hypoplastic and atelectatic lungs. Their mother had no complaints except hydramnios. Female identical twins of this disease are very rare. It could be considered that the disease would be induced by some genetic disorders occurring at the earliest developmental stage.
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