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Brewerton TD, Dennis K, Wiss DA. Dismantling the myth of "all foods fit" in eating disorder treatment. J Eat Disord 2024; 12:60. [PMID: 38760858 PMCID: PMC11102136 DOI: 10.1186/s40337-024-01017-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 05/09/2024] [Indexed: 05/19/2024] Open
Abstract
We call for a reevaluation of the long-standing dogmatic nutritional principle that "all foods fit" for all cases of eating disorders (EDs) and its corollary, "there are no bad foods" (for anyone ever) during ED treatment. Based on accumulated scientific research, we challenge these ideologies as outdated, confusing, and potentially harmful to many patients. We review the evidence that indicates the folly of these assumptions and show there are a variety of exceptions to these rules, including (1) food allergies, sensitivities, and intolerances, (2) religious and spiritual preferences or doctrines, and (3) the ubiquitous emergence and widespread availability of ultra-processed foods leading to the potential development of addiction-like eating and a higher prevalence of various medical and psychiatric comorbidities, as well as higher mortality. This evidence supports a nutritional psychiatry approach that should be integrated into (rather than dissociated from) ED treatment research and practice.
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Affiliation(s)
- Timothy D Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
| | - Kim Dennis
- SunCloud Health, Chicago, IL, USA
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago, IL, USA
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Winslow A, Mills C, Schwartz JT, Assa'ad A. Implementing Food Oral Immunotherapy Into Clinical Practice: Quality and Safety Perspectives From a US Academic Center. J Allergy Clin Immunol Pract 2024; 12:1159-1169. [PMID: 38423284 DOI: 10.1016/j.jaip.2024.02.032] [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] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 02/03/2024] [Accepted: 02/22/2024] [Indexed: 03/02/2024]
Abstract
Oral immunotherapy (OIT) is an accessible procedure for practicing allergy/immunology providers, yet rigorous safety standards are limited in the clinical setting. By exploring the transition from research to clinical practice OIT, we review relevant safety considerations necessary for the clinical provider. We offer a perspective on clinical benefits and considerations at the individual, collaboration, and policy levels from the vantage of a large academic OIT program, and we propose several practical start-up checklists and clerical considerations for practicing providers. Awareness of the local population and front-end planning is necessary to improve the accessibility of this procedure in clinical practice among racial and socioeconomic minority populations. Sharing and merging OIT protocols, procedural methods, and electronic medical record order sets may increase harmonization among OIT-providing institutions and further our abilities to pool safety and outcomes data, ultimately enhancing the safety and efficacy of clinical OIT.
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Affiliation(s)
- Andrew Winslow
- Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
| | - Christa Mills
- Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Justin T Schwartz
- Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Amal Assa'ad
- Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
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3
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Ozturk CS, Merter OS, Sengul ZK. The experiences of mothers of children with food allergy: A qualitative study. J Pediatr Nurs 2023; 73:113-119. [PMID: 37659339 DOI: 10.1016/j.pedn.2023.08.017] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/17/2023] [Accepted: 08/19/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND Food allergies adversely affect the quality of life of the child and family, as they require lifelong treatment and follow-up. This study aims to examine the experiences of mothers who have children with food allergies within the framework of the biopsychosocial-spiritual model. METHODS This study, using a qualitative research design, was carried out with mothers of children followed up with food allergy in the pediatric allergy outpatient clinic of a university hospital between December 15, 2022 and January 05, 2023. Purposive sampling method was used in the study and semi-structured interviews were conducted with 12 mothers. All interviews were audio recorded and transcribed. Inductive thematic analysis method was used. The study was written based on the COREQ checklist. FINDINGS Three themes, eight sub-themes, and 19 categories were identified: The effects of the disease on the physical health of the child and mother in the biological effects theme; psychosocial responses to disease, adaptation to treatment, future anxiety, coping strategies, and communication/interaction in the psychosocial effects theme; search for purpose-meaning in life and understanding belief/basic human values in the spiritual effects theme. DISCUSSION It has been concluded that food allergies affect maternal health extensively, especially in the psychosocial field, and that it affects family relationships, the time that mothers spare for themselves, and physical and spiritual health. APPLICATION TO PRACTICE The findings will be a guide for improving the quality of life of mothers followed up with food allergies and for the care and counseling support to be provided to mothers.
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Affiliation(s)
- Cigdem Sari Ozturk
- Gazi University, Nursing Faculty, Pediatric Nursing Department, Ankara, Turkey.
| | - Ozlem Selime Merter
- Firat University, Health Sciences Faculty, Nursing Department, Elazığ, Turkey
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Kordeva SA, Batashki I, Tchernev G. Netherton syndrome in a Bulgarian patient : Presentation of a case and an update of therapeutic options. Wien Med Wochenschr 2023; 173:276-286. [PMID: 36695942 DOI: 10.1007/s10354-022-00999-y] [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: 09/07/2022] [Accepted: 12/15/2022] [Indexed: 01/26/2023]
Abstract
Comel-Netherton syndrome, or Netherton syndrome (NS), is a rare chronic genetic skin condition affecting the daily life of patients, which often results in poorly developed social skills and anxiety. Genetic predisposition plays a key role alongside the clinical findings, and clinicians must be aware of it as it can mimic other well-known skin conditions. Diagnosis is challenging both clinically and histologically. Clinically, it can mimic a severe form of atopic dermatitis, psoriasiform dermatitis overlapping with atopic dermatitis, or erythrokeratodermia variabilis. The difficulties in making histological diagnosis are similar, and it is often necessary to take several biopsies in order to clarify the diagnosis. Although retinoids are used for both psoriasis, erythrokeratodermia variabilis, and other congenital forms of keratodermia, the recommended treatment doses are different. This often results in poor treatment outcome. We present a 16-year-old patient previously diagnosed as erythrokeratodermia variabilis and treated with little to no improvement. Systemic therapy with acitretin 10 mg daily, local pimecrolimus 1%, emollients, and bilastine 20 mg once daily was initiated. Due to the limited application of retinoids and the difficulties in achieving permanent remission, modern medicine is faced with the challenge of seeking innovative therapeutic solutions. New hopes are placed on targeted or anti-cytokine therapy, based on inhibiting the inflammatory component of the disease. This article is mainly focused on innovative therapeutic options, including modern medications such as dupilumab, infliximab, secukinumab, anakinra, omalizumab, and others.
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Affiliation(s)
- Simona Atanasova Kordeva
- Onkoderma-Clinic for Dermatology, Venereology and Dermatologic Surgery, General Skobelev 26, 1606, Sofia, Bulgaria.
| | - Ilia Batashki
- Medical Institute of Ministry of Interior, General Skobelev 79, 1606, Sofia, Bulgaria
| | - Georgi Tchernev
- Onkoderma-Clinic for Dermatology, Venereology and Dermatologic Surgery, General Skobelev 26, 1606, Sofia, Bulgaria
- Department of Dermatology and Venereology, Medical Institute of Ministry of Interior, General Skobelev 79, 1606, Sofia, Bulgaria
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Gosse L, Sterling B, Liabeuf V, Lehucher-Michel MP, Gaudy C, Richard MA. Allergy activity in the dermatology department of a French university hospital over a 2-year period: A retrospective study of 1813 patients. Ann Dermatol Venereol 2023; 150:213-214. [PMID: 37586899 DOI: 10.1016/j.annder.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/24/2023] [Accepted: 06/05/2023] [Indexed: 08/18/2023]
Affiliation(s)
- L Gosse
- AP-HM, Timone University, Department of Dermatology, Marseille, France.
| | - B Sterling
- AP-HM, Timone University, Department of Dermatology, Marseille, France
| | - V Liabeuf
- AP-HM, Timone University, Department of Dermatology, Marseille, France
| | - M-P Lehucher-Michel
- 21CEReSS-EA 3279, Research Centre in Health Services and Quality of Life of Aix Marseille University, Dermatology Department, University Hospital Timone, Assistance Publique Hôpitaux de Marseille, APHM, 13385 Marseille, France
| | - C Gaudy
- AP-HM, Timone University, Department of Dermatology, Marseille, France
| | - M-A Richard
- 21CEReSS-EA 3279, Research Centre in Health Services and Quality of Life of Aix Marseille University, Dermatology Department, University Hospital Timone, Assistance Publique Hôpitaux de Marseille, APHM, 13385 Marseille, France
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Miyazaki J, Ikehara S, Tanigawa K, Kimura T, Ueda K, Ozono K, Kimura T, Kobayashi Y, Yamazaki S, Kamijima M, Sobue T, Iso H. Prenatal exposure to selenium, mercury, and manganese during pregnancy and allergic diseases in early childhood: The Japan Environment and Children's study. Environ Int 2023; 179:108123. [PMID: 37595534 DOI: 10.1016/j.envint.2023.108123] [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] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/23/2023] [Accepted: 07/28/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND Prenatal exposure to metallic elements may adversely affect early childhood health. However, more evidence is needed as population-based cohort studies are currently limited. OBJECTIVES We aimed to examine the associations between prenatal metallic (mercury, selenium, and manganese) exposure and the risk of allergic diseases in early childhood until three years of age. METHODS The data from 94,794 mother-infant pairs, who participated in the Japan Environment and Children's study, were used in this study. Prenatal metallic element exposure was measured in maternal blood collected during mid-pregnancy. The incidence of atopic dermatitis, food allergies, asthma, and allergic rhinitis during the first three years of life was prospectively investigated using self-reports of physician-diagnosed allergies. A multivariable modified Poisson regression model was used to estimate the cumulative incidence ratio and their 95% confidence intervals of allergic diseases associated with prenatal exposure to mercury, selenium, and manganese. We further evaluated the interaction between mercury and selenium exposures in this association. RESULTS We confirmed 26,238 cases of childhood allergic diseases: atopic dermatitis, food allergies, asthma, and allergic rhinitis in 9,715 (10.3%), 10,897 (11.5%), and 9,857 (10.4%), 4,630 (4.9%), respectively. No association was found between prenatal mercury or manganese exposure and the risk of allergic diseases. Prenatal selenium exposure was inversely associated with atopic dermatitis, food allergies, allergic rhinitis, and any allergic diseases, but not with asthma. These inverse associations were more pronounced for lower mercury exposures than for higher exposures. CONCLUSIONS Our findings suggest that prenatal exposure to selenium may be beneficial for reducing the risk of atopic dermatitis, food allergies, allergic rhinitis, and any allergic diseases in early childhood, especially with lower prenatal mercury exposure.
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Affiliation(s)
- Junji Miyazaki
- Division of Environmental Medicine and Population Sciences, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, 1-3, Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Department of Preventive Medicine and Public Health, School of Medicine, Keio University, 35, Shinano-cho, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Satoyo Ikehara
- Division of Environmental Medicine and Population Sciences, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, 1-3, Yamadaoka, Suita-shi, Osaka 565-0871, Japan
| | - Kanami Tanigawa
- Division of Environmental Medicine and Population Sciences, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, 1-3, Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Osaka Maternal and Child Health Information Center, Osaka Women's and Children's Hospital, 840, Murodo-cho, Izumi-shi, Osaka 594-1101, Japan
| | - Takashi Kimura
- Department of Public Health, Faculty of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo-shi, Hokkaido 060-8638, Japan
| | - Kimiko Ueda
- Division of Environmental Medicine and Population Sciences, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, 1-3, Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Faculty of Health and Well-being, Kansai University, 1-11-1 Kaorigaoka-cho, Sakai-ku, Sakai, Osaka, 590-8515, Japan
| | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan
| | - Yayoi Kobayashi
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, 16-2, Onogawa, Tsukuba-shi, Ibaraki 305-8506, Japan
| | - Shin Yamazaki
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, 16-2, Onogawa, Tsukuba-shi, Ibaraki 305-8506, Japan
| | - Michihiro Kamijima
- Department of Occupational and Environmental Health, Graduate School of Medical Sciences, Nagoya City University, 1, Kawasumi, Mizuho-Cho, Mizuho-ku, Nagoya 467-8601, Japan
| | - Tomotaka Sobue
- Division of Environmental Medicine and Population Sciences, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, 1-3, Yamadaoka, Suita-shi, Osaka 565-0871, Japan
| | - Hiroyasu Iso
- Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, 1-3, Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.
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Sampige R, Frankel LA. The relationship between children's food allergies and family mealtimes: A systematic review. J Child Health Care 2023:13674935231183491. [PMID: 37316486 DOI: 10.1177/13674935231183491] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Food allergy prevalence is increasing among children; however, it is not clear how children's food allergy status impacts family mealtimes. This study's purpose was to systematically synthesize research regarding the relationship between children's food allergies, parental meal-centered stress, and family mealtime dynamics. Data sources for this study include peer-reviewed, English language sources from CINAHL, MEDLINE, APA PsycInfo, Web of Science, and Google Scholar. Five keyword categories (child, food allergies, meal preparation, stress, and family) were utilized to identify sources regarding how food allergies of children (from birth-12 years) relate to family mealtime dynamics or parental meal-centered stress. All 13 identified studies determined that pediatric food allergies relate to either increased parental stress, meal preparation issues, mealtime problems, or changes to family meals. Studies also indicate that meal preparation takes longer, requires more vigilance, and is more stressful due to children's food allergies. Limitations include that most studies were cross-sectional and based on maternal self-report. Children's food allergies are associated with parental meal-centered stress and mealtime issues. However, there is a need for research to account for specific changes to family mealtime dynamics and parent feeding behaviors so that pediatric health care professionals can alleviate parental meal-centered stress and provide guidance towards optimal feeding behaviors.
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Affiliation(s)
- Ritu Sampige
- Honors Biomedical Sciences, University of Houston System, Houston, TX, USA
| | - Leslie Ann Frankel
- Department of Psychological, Health and Learning Sciences, University of Houston System, Houston, TX, USA
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Dubrovsky I, Bose M, Miller J, Kerrihard AL. Cow's milk allergy in children impacts parental or caregiver calcium intake. Nutr Res 2023; 110:66-73. [PMID: 36682229 DOI: 10.1016/j.nutres.2022.12.003] [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: 06/22/2022] [Revised: 12/14/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
Food allergies have become a global epidemic, affecting more than 10% of the population and 8% of children worldwide. Eliminating or limiting a food group from the diet can adversely impact micronutrient consumption. Milk allergies can impact the amount of calcium consumed in the diet, serving as a barrier to meeting daily calcium needs. Previous research evaluates the nutritional impact food allergies may have on children diagnosed with food allergies; however, there is a marked gap in literature that investigates the impact that children's allergy may have on their parent or caregiver. We hypothesized that milk elimination in a child's diet resulting from a milk allergy is associated with inadequate calcium intake among parents. Study participants (n = 55) lived in the United States and included parents or caregivers of a child with a diagnosed milk allergy (experimental group) and parents of a child without a milk allergy (control group). Calcium intake was estimated by using the validated Calcium Assessment Tool. Results demonstrated that the experimental group consumed significantly less calcium (273 mg/d) than the control group (520 mg/d; P < .01). Notably, both groups consumed inadequate calcium relative to the calcium Recommended Dietary Allowance for adults of 1000 mg/d, although calcium supplementation was not assessed in this study. Key findings from this study indicate widespread inadequate dietary calcium intake and suggest a need for increased calcium consumption in this population.
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Affiliation(s)
- Ilana Dubrovsky
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ 07043, USA.
| | - Mousumi Bose
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ 07043, USA
| | - Jamie Miller
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ 07043, USA
| | - Adrian L Kerrihard
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ 07043, USA
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El Baba A, Jeimy S, Soller L, Kim H, Begin P, Chan ES. Geographical discrepancy in oral food challenge utilization based on Canadian billing data. Allergy Asthma Clin Immunol 2023; 19:5. [PMID: 36650588 PMCID: PMC9843933 DOI: 10.1186/s13223-022-00751-6] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/08/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Oral food challenges (OFC) confer the highest sensitivity and specificity in diagnosis; however, uptake has been variable across clinical settings. Numerous barriers were identified in literature from inadequate training to resource access. OFC utilization patterns using billing data have not been previously studied. OBJECTIVE The objective of this study is to explore the geographic differences in utilization of OFCs across Ontario and Québec using anonymized billing data from 2013 to 2017. METHODS Anonymized OFC billing data were obtained between 2013 and 2017 from Ontario Health Insurance Plan (OHIP) and Régie de l'Assurance Maladie du Québec (RAMQ). The number of OFCs was extracted by location, billings, and physician demographics for clinic and hospital-based challenges. RESULTS Over the period studied, the number of OFCs increased by 92% and 85% in Ontario clinics and Québec hospitals, respectively. For Ontario hospitals, the number of OFCs increased by 194%. While Québec performed exclusively hospital-based OFCs, after controlling for the population, the number of OFCs per 100,000 residents annually were similar to Ontario at 50 and 49 OFCs, respectively. The number of OFCs varied across the regions studied with an annual rate reaching up to 156 OFCs per 100,000 residents in urban regions and as low as 0.1 in regions furthest from city centers. CONCLUSION OFC utilization has steadily increased over the last decade. There has been marked geographical discrepancies in OFC utilization which could be driven by the location of allergists and heterogeneity in their practices. More research is needed to identify barriers and propose solutions to them.
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Affiliation(s)
- Ala El Baba
- grid.39381.300000 0004 1936 8884Division of Internal Medicine, Department of Medicine, Western University, 1151 Richmond St, London, ON N6A 3K7 Canada
| | - Samira Jeimy
- grid.39381.300000 0004 1936 8884Division of Clinical Immunology and Allergy, Department of Medicine, Western University, London, ON Canada
| | - Lianne Soller
- grid.17091.3e0000 0001 2288 9830Division of Allergy and Immunology, Department of Pediatrics, University of British Columbia, Vancouver, BC Canada ,grid.414137.40000 0001 0684 7788BC Children’s Hospital Research Institute, Vancouver, BC Canada
| | - Harold Kim
- grid.39381.300000 0004 1936 8884Division of Clinical Immunology and Allergy, Department of Medicine, Western University, London, ON Canada ,grid.25073.330000 0004 1936 8227Division of Clinical Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, ON Canada
| | - Philippe Begin
- grid.411418.90000 0001 2173 6322Division of Allergy, Rheumatology and Immunology, Department of Pediatrics, CHU Sainte-Justine, Montréal, QC Canada ,grid.410559.c0000 0001 0743 2111Division of Allergy and Clinical Immunology, Department of Medicine, Centre Hospitalier de l’Université de Montréal, Montréal, QC Canada
| | - Edmond S. Chan
- grid.17091.3e0000 0001 2288 9830Division of Allergy and Immunology, Department of Pediatrics, University of British Columbia, Vancouver, BC Canada ,grid.414137.40000 0001 0684 7788BC Children’s Hospital Research Institute, Vancouver, BC Canada
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Hotta M, Ueda K, Ikehara S, Tanigawa K, Nakayama H, Wada K, Kimura T, Ozono K, Sobue T, Iso H. The Duration of Neonatal Phototherapy and Allergic Disorders: The Japan Environment and Children's Study. Int Arch Allergy Immunol 2023; 184:211-219. [PMID: 36470223 DOI: 10.1159/000527381] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 08/18/2022] [Accepted: 09/27/2022] [Indexed: 12/10/2022] Open
Abstract
INTRODUCTION Currently, the association between the duration of neonatal phototherapy and the risk of allergic disorders has not been reported. This observational cohort study aimed to examine the association between allergic disorders, including food allergies, that are present before 3 years of age and the duration of phototherapy using the nationwide birth cohort data. METHODS The Japan Environment and Children's Study was a nationwide birth cohort study. Data of 77,064 infants aged 1 year, 1.5 years, 2 years, and 3 years were analyzed. We divided the participants into three groups: no phototherapy, short phototherapy (1-24 h), and long phototherapy (>24 h) and evaluated the cumulative incidence of allergic disorders before 3 years of age, including asthma, atopic dermatitis, and food allergies. Logistic regression analysis was performed to assess the impact of phototherapy duration on the cumulative incidence of allergic disorders. RESULTS After adjustment for potential risk factors, long phototherapy was found to be positively associated with food allergies at age 2 years (OR: 1.16; 95% CI: 1.01-1.33) and all allergic disorders at age 3 years (OR: 1.12; 95% CI: 1.01-1.24), including food allergies (OR 1.18; 95% CI: 1.04-1.35). CONCLUSION A long duration of neonatal phototherapy was positively associated with the risk of allergic disorders, especially food allergies.
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Affiliation(s)
- Masashi Hotta
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Japan,
| | - Kimiko Ueda
- Maternal & Child Health Information Center, Osaka Women's and Children's Hospital, Izumi, Japan
| | - Satoyo Ikehara
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Osaka University, Suita, Japan.,Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, Suita, Japan
| | - Kanami Tanigawa
- Maternal & Child Health Information Center, Osaka Women's and Children's Hospital, Izumi, Japan.,Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Osaka University, Suita, Japan.,Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, Suita, Japan
| | - Hirofumi Nakayama
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Japan.,Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, Suita, Japan
| | - Kazuko Wada
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tomotaka Sobue
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Osaka University, Suita, Japan.,Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, Suita, Japan
| | - Hiroyasu Iso
- Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, Suita, Japan.,Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
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da S Correia JA, Antunes AA, Taborda-Barata L, Boechat JL, Sarinho ESC. Prevalence of reported food allergies in Brazilian preschoolers living in a small Brazilian city. Allergy Asthma Clin Immunol 2022; 18:74. [PMID: 35964111 PMCID: PMC9375345 DOI: 10.1186/s13223-022-00710-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 03/23/2022] [Accepted: 07/26/2022] [Indexed: 12/27/2022]
Abstract
Introduction Although the prevalence of allergic diseases, including food allergies, has increased over recent decades, relevant information on this topic is still lacking, particularly in younger children living in small cities. Objective To investigate the prevalence of reported food allergies in preschoolers in Limoeiro/Pernambuco, Brazil. Methods This was a cross-sectional study with preschoolers. Parents/guardians of all preschoolers enrolled at municipal schools between March and June 2019 (total of 619) were invited to complete a screening questionnaire (total of 619). Another 151 questionnaires were applied on the streets of the town. For positive responses, a second, more detailed and validated questionnaire was completed. Results A total of 412 questionnaires were returned, of which, 47 presented a positive response to food allergies and only 29 (7.04%) identified a particular food. The most frequently reported food items were shrimp, mollusks, pork, fruit and milk. Of the 29 who identified foods, 22 responded to the detailed questionnaire, resulting in only 4 (0.97%) positive responses. Of these, two were later discarded through clinical examinations and an open oral provocation test, resulting in a final prevalence of 0.48% of confirmed food allergies. Conclusion The prevalence of reported food allergies was lower than that described in previous studies. The most commonly mentioned foods were shrimp, mollusks and pork, with more reports of multiple food allergies, even in children who had never been previously exposed to these possible allergens, which highlights the relevance of perception in reported food allergy studies. Supplementary Information The online version contains supplementary material available at 10.1186/s13223-022-00710-1.
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Affiliation(s)
- José A da S Correia
- Postgraduate Program in Child and Adolescent Health (PPGSCA), Universidade Federal de Pernambuco, Av. Prof. Morais Rego, 1235 - Cidade Universitária, Recife, PE, CEP: 50670-901, Brazil. .,Department of Medicine, Faculdade Integrada Tiradentes, Jaboatão dos Guararapes PE, Brazil.
| | | | - Luiz Taborda-Barata
- CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.,Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal
| | - José Laerte Boechat
- Clinical Immunology Service, Faculty of Medicine, Universidade Federal Fluminense, Niteroi, RJ, Brazil.,Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto and CINTESIS, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Emanuel Sávio Cavalcanti Sarinho
- Postgraduate Program in Child and Adolescent Health (PPGSCA), Universidade Federal de Pernambuco, Av. Prof. Morais Rego, 1235 - Cidade Universitária, Recife, PE, CEP: 50670-901, Brazil
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12
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Baeza-Velasco C, Lorente S, Tasa-Vinyals E, Guillaume S, Mora MS, Espinoza P. Gastrointestinal and eating problems in women with Ehlers-Danlos syndromes. Eat Weight Disord 2021; 26:2645-56. [PMID: 33582971 DOI: 10.1007/s40519-021-01146-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/01/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Ehlers-Danlos syndromes (EDS) are a group of heritable conditions in which abnormal collagen synthesis leads to features such as joint hypermobility, skin abnormalities, and tissue fragility. Gastrointestinal (GI) symptoms are common among those affected. These may negatively impact eating behaviors, leading to weight/nutritional problems. We aimed to compare GI symptoms, disordered eating, and body mass index (BMI) between EDS patients and healthy controls, and to explore the link between these variables in EDS patients. METHOD In this cross-sectional study, women with EDS and healthy controls responded to an online survey assessing GI symptoms (heartburn/regurgitations, early satiety, nausea/vomiting, bloating, abdominal pain, dysphagia), food allergies/intolerances, disordered eating, history of eating disorders (ED), and BMI. We performed intergroup comparisons as well as multivariate analyses to explore the associations between disordered eating, GI symptoms, and BMI in the EDS group. RESULTS Sixty-six women with EDS and 39 healthy controls were included in the study. The EDS patients showed significantly more GI symptoms and food allergies/intolerances, increased prevalence of ED history, higher risk of current ED, and lower BMI than the controls. In the EDS group, the risk for ED was associated with GI symptoms; restricted eating was associated with GI symptoms, food allergies/intolerances, and dysphagia; uncontrolled eating was associated with GI symptoms; and BMI was associated with GI symptoms and food allergies/intolerances. DISCUSSION Our results are concordant with that of previous reports highlighting the high level of GI problems and disordered eating in women with EDS. In addition, and for the first-time, the association between both is evidenced in this specific population. LEVEL OF EVIDENCE III Case-control analytic study.
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Dreier MJ, Wang SB, Nock MK, Hooley JM. Attentional biases towards food and body stimuli among individuals with disordered eating versus food allergies. J Behav Ther Exp Psychiatry 2021; 73:101657. [PMID: 34004497 DOI: 10.1016/j.jbtep.2021.101657] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 06/10/2020] [Revised: 03/18/2021] [Accepted: 04/30/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Individuals with disordered eating display heightened attentional biases towards food- and body-related stimuli. However, it is unknown whether these attentional biases reflect maladaptive thinking/eating pathology. We investigated the differences between maladaptive and adaptive ways of thinking about food by assessing food- and body-related attentional biases among individuals with disordered eating, participants with peanut allergies (i.e., individuals who think frequently about food in an adaptive manner), and healthy controls. We also examined the extent to which negative mood and rumination exacerbated attentional biases among those in these groups. METHOD Three hundred and twenty-one individuals with disordered eating (n = 139), peanut allergies (n = 60), and healthy controls (n = 122) completed food- and body-based Stroop tasks prior to and following a cognitive rumination task designed to increase negative mood. RESULTS Individuals with disordered eating and individuals with peanut allergies had significantly worse performance on the food and body Stroop tasks relative to healthy controls at baseline (ps < .001). However, there were no perceived differences in performance by group following rumination. LIMITATIONS The cognitive rumination task heightened negative mood for those in the disordered eating group but not for those in the peanut allergy or healthy control groups. CONCLUSIONS Findings suggest that frequent thoughts involving food are associated with attentional biases towards food and body stimuli. This appears to be the case regardless of whether these frequent thoughts are due to disordered eating or to fear of an allergic reaction.
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Affiliation(s)
- Melissa J Dreier
- Department of Psychology, Harvard University, Cambridge, MA, USA; Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA.
| | - Shirley B Wang
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Jill M Hooley
- Department of Psychology, Harvard University, Cambridge, MA, USA
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Abstract
"Food is relationships isn't it," Yamada san stated in 2017, neatly capturing the importance of food in social life. This article, drawing on the experiences of people with severe food allergies in Japan, illustrates the complexities of safely managing allergies when food-and the importance of sharing the same food-is so important to social life. In particular, I argue that individuals develop and practice skills of vigilance and situational awareness to mitigate physical and social risk which emerge through an affective imagination of what they feel could happen in the future, built on embodied memories of what has been experienced prior (e.g., severe allergic reactions and difficult social experiences with food). The development and enactment of these skills of vigilance happen through an 'education of attention' (Gibson in The ecological approach to visual perception, Psychology Press, New York, 1979; Ingold in The perception of the environment: essays on livelihood, dwelling and skill, Routledge, London, 2000) developed over time and in different social settings and constitute a somatic mode of attention (Csordas in Cult Anthropol 8:135-156, 1993) which shapes social interactions and aims to mitigate against any potential perceived social costs for not being able to eat everything.
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Affiliation(s)
- Emma E. Cook
- Modern Japanese Studies Program, Hokkaido University, Kita 15, Nishi 8, Kita Ku, Sapporo, 060-0815 Japan
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15
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Pandya SP. Adolescents Living with Food Allergies in Select Global Cities: Does a WhatsApp-Based Mindful Eating Intervention Promote Wellbeing and Enhance their Self-Concept? J Pediatr Nurs 2020; 55:83-94. [PMID: 32653830 DOI: 10.1016/j.pedn.2020.06.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/25/2020] [Accepted: 06/23/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE Food allergy prevalence in children and adolescents is increasing globally. Dietary restrictions are linked to the identities of food-allergic adolescents, which influences their wellbeing and self-concept. Mindful eating (ME) has been widely used to treat eating disorders. This study investigates whether WhatsApp-based mindful eating (ME) posts are effective for food-allergic adolescents in managing the condition, building self-concept and wellbeing. DESIGN AND METHODS A waitlist control design study was conducted with food-allergic adolescents (N pre-test = 244; N post-test = 215). Three measures were used to assess the outcomes pre- (T1) and post-test (T2): Mindful Eating Questionnaire (MEQ), Brief Psychological Wellbeing Scale for Adolescents (BPWBS-A), and Piers-Harris 2 Children's Self-Concept Scale (PH-2-CSCC). RESULTS The intervention was overall effective and more so for girls, middle class adolescents, with mothers as primary caregivers, whose primary caregivers had higher or postgraduate and professional qualifications, who were in turn also more likely to report no anaphylactic reaction and hospitalization emergency episodes at T2. Intervention compliance mediated the association between demographic predictors and outcome scores. Discriminant function analysis indicated stronger associations between certain predictors and subdomains of the self-concept outcome. CONCLUSIONS With adequate emphasis on intervention compliance and condition management, the WhatsApp-based ME posts would be effective for food-allergic adolescents. PRACTICAL IMPLICATIONS Pediatric nurses can recommend the intervention for community-dwelling food-allergic adolescents across contexts. Some refinements may be needed for boys, upper class adolescents, with father/kin as primary caregivers and less qualified parents.
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Abstract
The management of atopic diseases such as severe asthma, severe atopic dermatitis, and severe food allergy in childhood is challenging. In particular, there are safety concerns regarding the use of high-dose corticosteroids. The recent development of biologicals and their approval for the treatment of children offer a new, very promising, and more personalized therapy option. Omalizumab, mepolizumab, and dupilumab are currently approved as add-on treatments of severe asthma in children and have been shown to be effective in improvement of asthma control and reduction of exacerbations. Dupilumab is the only biological approved for the treatment of atopic dermatitis in adolescents so far. It has been demonstrated to significantly improve symptoms of atopic dermatitis.However, safety data for biologicals used in atopic diseases in children and adolescents are still very limited. Biologicals are generally considered to be safe in adults. These data are often extrapolated to children. Additionally, data for long-term use are lacking. Thus, the safety profiles of those biologicals cannot yet be conclusively assessed.
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Affiliation(s)
- Maike Vom Hove
- Hospital for Children and Adolescents, Leipzig University Medical Center, Leipzig, Germany
| | - Martina P Neininger
- Drug Safety Center, Institute of Pharmacy, Leipzig University, Leipzig, Germany
| | - Thilo Bertsche
- Drug Safety Center, Institute of Pharmacy, Leipzig University, Leipzig, Germany
| | - Freerk Prenzel
- Hospital for Children and Adolescents, Leipzig University Medical Center, Leipzig, Germany.
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Douros K, Tsabouri S, Feketea G, Grammeniatis V, Koliofoti EG, Papadopoulos M, Sardeli O, Triga M, Priftis KN. Retrospective study identified fish and milk as the main culprits in cases of food protein-induced enterocolitis syndrome. Acta Paediatr 2019; 108:1901-1904. [PMID: 30883926 DOI: 10.1111/apa.14779] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 01/20/2019] [Revised: 03/06/2019] [Accepted: 03/12/2019] [Indexed: 02/07/2023]
Abstract
AIM Food protein-induced enterocolitis syndrome (FPIES) is a non-immunoglobulin E (IgE)-mediated food allergy, which is confined to the gastrointestinal tract and occurs most frequently in the first year of life. Our aim was to examine the clinical features, causative agents and outcomes of Greek children with FPIES. METHODS This was a five-year (2013-2017) retrospective study, based on chart reviews of 78 children with FPIES from six Greek paediatric allergy centres. RESULTS Only five children needed an oral food challenge (OFC) for diagnosis, but 54 children (69%) had OFCs to monitor tolerance development. The most common problems were fish and milk, which affected affecting 42 (54%) and 25 (35%) of children, respectively. The median age of tolerance based on the results of the negative OFCs occurred by 34.0 (26.6-58.4) months. Fish and milk were tolerated by 24 (57%) and 13 (52%) of children by 43.8 and 24.3 months, respectively. Coexisting IgE sensitisation to the offending food was related to delayed tolerance. CONCLUSION Fish and milk were the most common food allergies in our series of Greek children with FPIES. Cases with IgE sensitisation to the food trigger took longer to resolve their allergies.
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Affiliation(s)
- Konstantinos Douros
- Allergology and Pulmonology Unit 3rd Paediatric Department Attikon Hospital National and Kapodistrian University of Athens Athens Greece
| | - Sophia Tsabouri
- Child Health Department University of Ioannina School of Medicine Ioannina Greece
| | | | - Vasilis Grammeniatis
- Allergology and Pulmonology Unit 3rd Paediatric Department Attikon Hospital National and Kapodistrian University of Athens Athens Greece
- Department of Paediatrics General Hospital of Ioannina Ioannina Greece
| | | | - Marios Papadopoulos
- Allergology and Pulmonology Unit 3rd Paediatric Department Attikon Hospital National and Kapodistrian University of Athens Athens Greece
- Iaso Children's Hospital Athens Greece
| | - Olympia Sardeli
- Allergology and Pulmonology Unit 3rd Paediatric Department Attikon Hospital National and Kapodistrian University of Athens Athens Greece
| | - Maria Triga
- Department of Paediatrics University General Hospital of Patras Patras Greece
| | - Kostas N. Priftis
- Allergology and Pulmonology Unit 3rd Paediatric Department Attikon Hospital National and Kapodistrian University of Athens Athens Greece
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Sirjani M, Shokouhi Shoormasti R, Sabetkish N, Ayazi M, Khodayari Namini N, Tayebi B, Pourpak Z. The potential anti-inflammatory role of adiponectin in food allergy: a case-control study on children. Br J Nutr 2018; 120:1117-21. [PMID: 30401008 DOI: 10.1017/S0007114518002659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
We aimed to assess the possible relationship between food allergy and two key adipokines - leptin and adiponectin - in children with food allergy. A total of forty patients with definite diagnosis of food allergy according to clinical history and specific IgE (sIgE) for food allergens (group I) were enrolled in this pilot study. The control group (group II) included thirty children with no evidence of allergic symptoms. Serum levels of leptin and adiponectin were measured by ELISA. Meanwhile, sIgE was measured for the eight most common food allergens by the immunoblot method in all participants. The median ages in groups I and II were 18·5 and 23·5 months, respectively. The respective Caesarean section rate was 64·9 and 16·7 % in groups I and II (P<0·001). Serum levels of adiponectin were significantly higher in the patient group compared with controls (24·11 (sd 12·14) v. 10·67 (sd 12·23) μg/ml, P<0·001), whereas no statistically meaningful difference was detected in serum leptin concentrations (P=0·92). There was a significant inverse relationship between age and adiponectin levels in group I (P=0·002, r -0·479) and group II (P=0·04, r -0·365), and it was more significant in group I. The most common allergens in the patient group were wheat (52·5 %), hazelnut (52·5 %), cow's milk (50 %) and egg white (30 %). The results of this study suggest an essential link between adiponectin and food allergy that is probably unlikely to be affected by obesity as a confounding factor.
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Humbert M, Bousquet J, Bachert C, Palomares O, Pfister P, Kottakis I, Jaumont X, Thomsen SF, Papadopoulos NG. IgE-Mediated Multimorbidities in Allergic Asthma and the Potential for Omalizumab Therapy. J Allergy Clin Immunol Pract 2019; 7:1418-1429. [PMID: 30928481 DOI: 10.1016/j.jaip.2019.02.030] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/27/2019] [Accepted: 02/28/2019] [Indexed: 12/15/2022]
Abstract
Allergic asthma often coexists with different pathological conditions, called multimorbidities, that are mostly of allergic nature and share a common underlying inflammatory pathophysiological mechanism. Multimorbidities of allergic asthma may influence asthma control, its severity, and patients' response to treatment, and contribute to the overall socioeconomic burden of the disease. Immunoglobulin E (IgE) is known to play a central role in the pathogenesis of various allergic diseases, including asthma. Thus, IgE-mediated immunologic pathways present an attractive target for intervention in asthma and multimorbidities. In this review, we discuss the most frequently reported IgE-mediated multimorbidities in allergic asthma, including allergic rhinitis, rhinoconjunctivitis, atopic dermatitis, vernal keratoconjunctivitis, chronic rhinosinusitis with nasal polyps, food allergies, and allergic bronchopulmonary aspergillosis. Omalizumab is a recombinant humanized monoclonal antibody against IgE and has been in use to treat allergic asthma for more than a decade. We comprehensively review the clinical evidence for omalizumab in the treatment of the aforementioned multimorbidities in allergic asthma.
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Affiliation(s)
- Marc Humbert
- Service de Pneumologie, Hôpital Bicêtre, Le Kremlin Bicêtre, France.
| | - Jean Bousquet
- MACVIA-France, Contre les Maladies Chroniques pour un Vieillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - Claus Bachert
- Upper Airways Research Laboratory and Department of Oto-Rhino-Laryngology, Ghent University and Ghent University Hospital, Ghent, Belgium
| | - Oscar Palomares
- Department of Biochemistry and Molecular Biology, School of Chemistry, Complutense University of Madrid, Madrid, Spain
| | | | | | | | - Simon Francis Thomsen
- Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark; Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nikolaos G Papadopoulos
- Division of Infection, Immunity & Respiratory Medicine, University of Manchester, Manchester, United Kingdom; Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
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Cavaliere C, Masieri S, Miranda V, Greco A, Ricottini L, Begvarfaj E, Minni A, Rosati D, Volterrani A. Clinical and immunological effects of a treatment with desentizating low-dose multicomponents in IgE mediated and non IgE mediated food allergies: observational retrospective pilot study. Clin Ter 2019; 170:e10-e15. [PMID: 30789192 DOI: 10.7417/ct.2019.2102] [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: 11/20/2022]
Abstract
BACKGROUND Alimentary allergy has high impact on the quality of life (Qol) of patients and their families: it represents an economic burden for individuals and National Health System. The disease, particularly frequent in pediatric age, recognizes different pathogenetic mechanisms and expresses itself through the production of IgE (IgE mediated form) antibodies or through cell-mediated immunune responses (non IgE mediated forms). The aim of this clinical observational retrospective study is to evaluate the effect of a long-term treatment with Low Dose Medicine (LDM) drugs in pediatric patients affected by IgE and non IgE mediated food allergy. OBJECTIVE The purpose of the study is to determine the efficacy of the treatment with Allergy Plex (Guna Laboratory, Milan, Italy) to induce clinical and/or immunological tolerance both to IgE mediated and non IgE mediated food allergy; the secondary endpoint is to investigate the treatment tolerability, the reduction of positivity to Skin Prick test and Patch test to food allergens and the decrease on the peripheral blood of the specific IgE to food allergens. The treatment efficacy was measured through a clinical score. METHODS In this study the immunomodulant activity of Allergy Plex 13, Allergy Plex 7 and Allergy Plex 10 (Guna S.p.A., Milano, Italy) was evaluated. In every patient the state of allergical clinical responses and the immuno-allergological state were evaluated by means of specific parameters letting know the regulatory response to the allergical Th fenotype. RESULTS Data about Clinical tolerance to food, Symptomatological clinical score, ECP, ACTH, Cortisol; IL-4, IL-10 was collected. There was evidence of improvement of clinical score, reduction of the diameter of cutaneous pomphus obtained through the Prick test and a decrease of IgE specifics values. CONCLUSIONS The data issued from this study seem to confirm the efficacy of treatment with Allergy Plex in allowing the restoration of immune tolerance and the definite reduction of the clinical score.
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Affiliation(s)
- C Cavaliere
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome
| | - S Masieri
- Department of Sense Organs Unit, Sapienza University of Rome
| | - V Miranda
- Clinical Research Unit Guna S.p.a, Milan
| | - A Greco
- Department of Sense Organs Unit, Sapienza University of Rome
| | | | - E Begvarfaj
- Department of Sense Organs Unit, Sapienza University of Rome
| | - A Minni
- Department of Sense Organs Unit, Sapienza University of Rome
| | - D Rosati
- Department of Sense Organs Unit, Sapienza University of Rome
| | - A Volterrani
- Department of Pediatric Allergology, Nuovo Regina Margherita Hospital, Rome, Italy
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Abstract
The purpose of our study was to determine the knowledge and practices regarding food allergies among food service workers operating in western Romania (Timiş, Arad, and Caraş-Severin counties). A self-administered, multiple-choice questionnaire was completed by 121 Romanian food service workers from 23 food service units from July to September 2016. The food service workers interviewed had a moderate level of knowledge and practices regarding food allergies. The results highlight knowledge gaps in the areas of cross-contact and control of anaphylaxis emergencies, indicating the need to retrain food service workers. Our study revealed positive results according to education level, better practices used by more experienced staff, and differences between job positions and eating places. Higher knowledge levels of trained employees coexisted with better practices reported by employees who attended specific courses on allergens. All of these findings (significant at the 5% level) support the hypothesis that training programs must be adapted to the participants' needs and characteristics (professional experience, field of activity, and food service education level) to be easily accessible and to lower costs.
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Affiliation(s)
- Călin Jianu
- 1 Faculty of Food Engineering, Banat's University of Agricultural Sciences and Veterinary Medicine "King Michael I of Romania" from Timişoara, Calea Aradului 119, 300645 Timişoara, Romania
| | - Ionuţ Goleţ
- 2 Faculty of Economics and Business Administration, West University of Timişoara, Blvd. V. Pârvan 4, 300223 Timişoara, Romania
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Österlund J, Winberg A, West CE. A 10-year review found increasing incidence trends of emergency egg allergy reactions and food-induced anaphylaxis in children. Acta Paediatr 2019; 108:314-320. [PMID: 29920760 DOI: 10.1111/apa.14464] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 02/18/2018] [Revised: 04/26/2018] [Accepted: 06/15/2018] [Indexed: 12/28/2022]
Abstract
AIM International reports have suggested that food allergies and food-induced anaphylaxis have increased in children. We investigated the incidence of emergency food reactions over a 10-year period. METHODS This study retrospectively reviewed the medical records of children presenting to Umeå University hospital, Sweden, with an emergency food reaction from January 1, 2006 to December 31, 2015. Cases were identified using discharge codes for allergies and anaphylaxis. Anaphylaxis cases were included if they fulfilled the international criteria. RESULTS We found emergency food allergy reactions in 519 children (58% boys) from 2006-2015 at a median age of 1.3 years. One-third were hospitalised (32%) including 71/99 cases of anaphylaxis. Milk and eggs were the most commonly identified triggers. Emergency reactions to eggs increased during the study period with a Spearman rank correlation coefficient of 0.770 (p < 0.01) and the figures for anaphylaxis were 0.745 (p = 0.013). The incidence of food-induced anaphylaxis increased and was 30 per 100 000 person-years for the study period. CONCLUSION Most of the emergency reactions, treated by secondary care paediatricians and emergency physicians, were to milk and eggs. Allergic reactions to eggs increased from 2006 to 2015, as did food-related anaphylaxis.
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Affiliation(s)
- J Österlund
- Department of Clinical Sciences, Pediatrics; Umeå University; Umeå Sweden
| | - A Winberg
- Department of Clinical Sciences, Pediatrics; Umeå University; Umeå Sweden
| | - C E West
- Department of Clinical Sciences, Pediatrics; Umeå University; Umeå Sweden
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Hernandez M, Boj J, Espasa E, Planells P, Peretz B. Molar-Incisor Hypomineralization: Positive Correlation with Atopic Dermatitis and Food Allergies. J Clin Pediatr Dent 2018; 42:344-8. [PMID: 29763349 DOI: 10.17796/1053-4625-42.5.4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
AIM Molar-incisor hypomineralization is a disturbance in dental development that involves first permanent molars as well as permanent incisors with a prevalence that ranges from 2.5% to 40%. The objective of this study was to investigate the etiology of molar-incisor hypomineralization among school children from two randomly selected towns in the province of Barcelona, Spain. STUDY DESIGN A cross-sectional study was conducted with 705 children ranging in age from six years-old to 14 years and 11 months-old. Full mouth examinations were carried out in accordance with the European Academy of Paediatric Dentistry criteria for the diagnosis of molar-incisor hypomineralization, from April to July 2016. RESULTS A total of 56 cases of molar-incisor hypomineralization were found in 22 (39.3%) boys and 34 (60.7%) girls. MIH was significantly more prevalent among those who had atopic dermatitis (OR=90.9; 33.4-247.1 CI 95%), food allergies (OR=104.2; 12.2-887.5 CI 95%), bronchitis/asthma (OR=5.3; 2.7-10.1 CI 95%), varicella (OR=96.3; 41.9-221.1 CI 95%), otitis media (OR=12.2; 6.3-23.5 CI 95%), pneumonia (OR=276.7; 35.1-2183.7 CI 95%), and febrile syndrome (OR=7.8; 4.1-14.8 CI 95%). CONCLUSIONS The present research reveals for the first time a statistically significant relationship between atopic dermatitis and food allergies with the presence of molar-incisor hypomineralization.
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Remes S, Kulmala P. The interplay between risk and preventive factors explains why some children develop allergies to certain foods and others show tolerance. Acta Paediatr 2018; 107:1677-1683. [PMID: 29751365 DOI: 10.1111/apa.14391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 01/30/2018] [Revised: 03/26/2018] [Accepted: 05/03/2018] [Indexed: 01/02/2023]
Abstract
AIM A number of studies have clarified the tolerance mechanisms and risk factors for food allergies. Our aim was to explore food allergy symptoms by target organs, together with the risk factors and how to prevent food allergies and induce tolerance. METHODS We carried out a thorough review of studies on paediatric food allergies published in the last decade. RESULTS Food allergy symptoms may affect the skin, nasal and oral mucosa, conjunctivae, gastrointestinal tract or, in severe cases, the respiratory tract and cardiovascular organs. Immunoglobulin E (IgE)-mediated symptoms appear rapidly after exposure to the offending allergen, whereas non-IgE-mediated symptoms are typically delayed. The immunological processes involved in non-IgE-mediated allergic reactions are poorly understood, but T-cell activation is probably involved. There are several factors that influence the food sensitisation process: genetic predisposition, disruption of oral tolerance development, impaired skin barriers in atopic eczema and the influence of microbiomes. CONCLUSION The symptoms and intensity of reactions vary considerably with regard to food allergies, and these depend on the individual's concomitant immunological and regulatory mechanisms. There is strong evidence that dietary diversity is important for children, even when they come from families with high allergy risks.
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Affiliation(s)
- Sami Remes
- Department of Paediatrics; Kuopio University Hospital; Kuopio Finland
| | - Petri Kulmala
- PEDEGO Research Unit and Medical Research Center (MRC) Oulu; University of Oulu; Oulu University Hospital; Oulu Finland
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Urrutia-Pereira M, Mocellin L, de Oliveira R, Simon L, Lessa L, Solé D. Knowledge on asthma, food allergies, and anaphylaxis: Assessment of elementary school teachers, parents/caregivers of asthmatic children, and university students in Uruguaiana, in the state of Rio Grande do Sul, Brazil. Allergol Immunopathol (Madr) 2018; 46:421-430. [PMID: 29338962 DOI: 10.1016/j.aller.2017.09.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 09/14/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Allergic diseases have become an increasingly common reality in the last years, extending beyond the family context. OBJECTIVE Assessing the level of knowledge on asthma, food allergies and anaphylaxis of asthmatic children's parents/caregivers (PC), elementary school teachers (EST) and university students (US) in Uruguaiana, RS, Brazil. METHOD 577 individuals (PC - N=111; EST - N=177; US - N=299) took part in the study, answering the Newcastle Asthma Knowledge Questionnaire (validated for Portuguese) and another questionnaire on Food Allergy (FA) and anaphylaxis. RESULTS Although PC have asthmatic children, their asthma knowledge level was average, slightly above that of EST and EU. The lack of knowledge on passive smoking, use of medications and their side effects should be highlighted. US have shown to be better informed about FA and anaphylaxis. However, even though a significant proportion of respondents know the most common symptoms of FA and anaphylaxis, few named subcutaneous adrenaline as the drug of choice for treating anaphylaxis. Although a significant number of respondents know about the possibility of anaphylactic reactions happening at school or in activities outside the school, we were surprised by the absence of conditions in schools to provide emergency care to such students. CONCLUSION Despite the high prevalence of allergic diseases in childhood, asthmatic children's parents/caregivers, elementary school teachers and university students have inadequate levels of knowledge to monitor these patients.
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Palmu S, Heikkilä P, Uski V, Niitty S, Kurikka S, Korppi M. National allergy programme had little impact on parent-reported food allergies in children aged 6-7 years. Acta Paediatr 2018; 107:121-125. [PMID: 28925556 DOI: 10.1111/apa.14083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 07/27/2017] [Revised: 09/07/2017] [Accepted: 09/15/2017] [Indexed: 11/30/2022]
Abstract
AIM The ten-year Finnish national allergy programme was launched in 2008 to lessen the disease and psychological burden of allergy. This study assessed the prevalence of parent-reported food allergies requiring avoidance diets at primary school in children aged six and seven years. METHODS The cohort comprised 1937 children (51% boys) who started primary school in Tampere, Finland, in August 2016. School health nurses charted parent-reported, doctor-diagnosed food allergies requiring avoidance diets as part of the routine health examination. RESULTS We found that 127 (6.6%) children had parent-reported, doctor-diagnosed allergies to at least one food and 37 (1.9%) were allergic to basic foods, namely cows' milk, wheat and one other grain. All required an avoidance diet. The figure did not differ significantly from the 2.7% and 2.5% found by studies of this age group in 2009 and 2013, respectively. Allergies to fresh fruit and vegetables decreased from 5.8% in 2009 to 3.6% in 2016. CONCLUSION We studied the national allergy programme that started in 2008 and found that there was a nonsignificant overall decrease in the number of children aged six to seven years on avoidance diets for allergies between 2009 and 2016. The only allergies that showed significant decreases were fresh fruit and vegetables.
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Affiliation(s)
- Sauli Palmu
- Centre for Child Health Research; Tampere University and University Hospital; Tampere Finland
| | - Paula Heikkilä
- Centre for Child Health Research; Tampere University and University Hospital; Tampere Finland
| | - Virpi Uski
- Tampereen Voimia; Catering Enterprise; Tampere Finland
| | - Siina Niitty
- Health Services for Children and Youth; Tampere Finland
| | - Sari Kurikka
- Health Services for Children and Youth; Tampere Finland
| | - Matti Korppi
- Centre for Child Health Research; Tampere University and University Hospital; Tampere Finland
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Kalmarzi R, Ataee P, Homagostar G, Tagik M, Ghaderi E, Kooti W. Evaluation of the frequency of food allergens based on skin prick test in children in Kurdistan Province - Iran. Allergol Immunopathol (Madr) 2018; 46:45-57. [PMID: 28750899 DOI: 10.1016/j.aller.2017.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 01/09/2017] [Accepted: 02/18/2017] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Food allergy refers to abnormal reactions of the body caused by an immune system response to food. This study was conducted aiming to investigate allergy to food allergens in children with food allergies. MATERIALS AND METHODS This study was conducted as a cross-sectional one on 304 children aged six months to seven years with food allergies admitted to the tertiary referral hospital in Kurdistan Province - Iran, during 2014-2015. All the patients were examined for skin prick test using 49 allergens. Finally, the obtained data were analysed using SPSS15 and chi-square and t tests. RESULTS The highest percentage of occurrence of bump reaction (wheal) and redness (flare) was due to the consumption of fish, eggs, tomatoes, and cocoa. Moreover, the lowest rate of wheal and flare was caused by exposure to allergens like latex, tea, malt, and wheat flour. The reaction most created due to the consumption of foods was flare which was higher among under three-year-olds group (p<0.05), and between the sexes, girls showed the most common allergic reactions (p<0.05). CONCLUSION Since food allergy has a high prevalence in children, it should be considered with great interest. Considering that avoiding food allergens is the first step in the treatment of food allergies, the present study may be a useful guide in this regard.
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Affiliation(s)
- R Kalmarzi
- Cellular & Molecular Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - P Ataee
- Department of Pediatrics of Beast Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Gh Homagostar
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - M Tagik
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - E Ghaderi
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - W Kooti
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran.
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Forero Molina MA, Garcia E, Gonzalez-Devia D, García-Duperly R, Vera A. A 17-year-old male with a Small Bowel Neuroendocrine Tumor: flushing differential diagnosis. World Allergy Organ J 2017; 10:30. [PMID: 28904734 PMCID: PMC5582400 DOI: 10.1186/s40413-017-0161-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 04/19/2017] [Accepted: 07/05/2017] [Indexed: 12/11/2022] Open
Abstract
Background Neuroendocrine tumors (NETs) are heterogeneous neoplasms that originate from cells with a secretory function. Small bowel NETs (SB-NETs) are related to serotonin hypersecretion which causes: flushing, diarrhea, abdominal pain, bronchoconstriction and heart involvement, also known as carcinoid syndrome (CS). CS can be confused with an allergic reaction and thus should be considered as a differential diagnosis in the allergy consult. We present the case of a pediatric patient initially referred under the suspicion of food allergies. Case presentation We present the case of a 17-year-old male with evanescent non-pruriginous erythematous lesions- flushing that appeared with food consumption, associated with conjunctival injection, warmth and diaphoresis after the lesions disappeared. He denied abdominal pain, diarrhea, cough or wheezing. The 24-h urinary 5-hydroxyindoleacetic acid (5-HIAA) excretion was elevated. The CT scan showed thickening of the distal ileum and multiple lesions on both hepatic lobules and the colonoscopy revealed a tumor in the ileocecal valve. Hepatic and intestinal biopsies reported a well-differentiated NET of the ileocecal valve with hepatic metastasis. He was started on octreotide and underwent a wide hepatectomy and right hemicolectomy with improvement of symptoms. Conclusions NETs can present as carcinoid syndrome (flushing, diarrhea, abdominal pain, wheezing), which constitutes vague symptomatology and represents a challenging diagnosis for physicians. They can be confused with an allergic reaction and the allergist should consider it as a differential diagnosis. Accurate diagnostic tests will help to diagnose NETs earlier and potentially prevent carcinoid heart disease, bowel obstruction, and improve quality of life and mortality in these patients.
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Affiliation(s)
- Maria Alejandra Forero Molina
- Faculty of Medicine, Universidad de los Andes, Bogotá, Colombia.,Hospital Universitario Fundación Santa Fe de Bogotá, Av 9 N° 116-20, oficina 213, Bogotá, D.C, Colombia
| | - Elizabeth Garcia
- Faculty of Medicine, Universidad de los Andes, Bogotá, Colombia.,Allergy Section, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Deyanira Gonzalez-Devia
- Faculty of Medicine, Universidad de los Andes, Bogotá, Colombia.,Department of Internal Medicine-Endocrinology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Rafael García-Duperly
- Faculty of Medicine, Universidad de los Andes, Bogotá, Colombia.,Department of Surgery, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Alonso Vera
- Faculty of Medicine, Universidad de los Andes, Bogotá, Colombia.,Department of Surgery, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
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Srivastava KD, Song Y, Yang N, Liu C, Goldberg IE, Nowak-Węgrzyn A, Sampson HA, Li XM. B-FAHF-2 plus oral immunotherapy (OIT) is safer and more effective than OIT alone in a murine model of concurrent peanut/tree nut allergy. Clin Exp Allergy 2017; 47:1038-1049. [PMID: 28397379 PMCID: PMC5533629 DOI: 10.1111/cea.12936] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 10/28/2016] [Revised: 03/21/2017] [Accepted: 03/26/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Concurrent sensitization to peanut (PN) and tree nuts (TN), the most dangerous food allergies, is common. Current oral immunotherapy (OIT) is not fully satisfactory. OBJECTIVE To determine whether the herbal formula B-FAHF-2 (BF2) ameliorates PN/TN OIT adverse reactions and enhances persistence of a tolerant state. METHODS Concurrently sensitized PN-, walnut- (WN) and cashew (CSH)-allergic mice received 1-day PN/WN/CSH rush OIT plus 3 weeks of maintenance dosing, with or without 3 weeks prior and 3 weeks BF2 co-treatment. Anaphylactic symptom scores, core body temperatures, plasma histamine levels, basophil numbers, antigen-specific IgE, cytokine levels, and IL-4, INF-γ and Foxp3 gene promoter DNA methylation status, and their correlation with final challenge symptom scores were determined. RESULTS BF2+OIT-treated mice experienced significantly fewer and less severe adverse reactions than OIT-only-treated mice (P<.01) during the 1-day rush OIT build-up dose phase. Both OIT-only and BF2+OIT mice showed significant desensitization (P<.01 and .001, respectively) at 1 week post-therapy challenge, being greater in BF2+OIT mice. All sham-treated and 91% of OIT-treated mice experienced anaphylaxis whereas only 21% of BF2+OIT-treated mice exhibited reactions during 5-6 weeks of dose escalation single PN and TN challenges. Greater and more persistent protection in BF2+OIT mice was associated with significantly lower plasma histamine and IgE levels, increased IFN-γ/IL-4 and IL-10/IL-4 ratios, DNA remethylation at the IL-4 promoter and demethylation at IFN-γ and Foxp3 promoters. Final challenge symptom scores were inversely correlated with IL-4 DNA methylation levels (P<.0002) and positively correlated with IFN-γ and Foxp3 gene promoter methylation levels (P<.0011) (P<.0165). CONCLUSIONS AND CLINICAL RELEVANCE Combined BF2/OIT therapy was safer and produced longer post-treatment protection and more tolerance-prone immunological and epigenetic modifications than OIT alone. BF2/OIT may provide an additional OIT option for patients with concurrent PN/TN and other food allergies.
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Affiliation(s)
- K D Srivastava
- Department of Pediatrics, Jaffe Food Allergy Institute, Center for Integrative Medicine for Immunology and Wellness, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Y Song
- Department of Pediatrics, Jaffe Food Allergy Institute, Center for Integrative Medicine for Immunology and Wellness, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - N Yang
- Department of Pediatrics, Jaffe Food Allergy Institute, Center for Integrative Medicine for Immunology and Wellness, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - C Liu
- Department of Pediatrics, Jaffe Food Allergy Institute, Center for Integrative Medicine for Immunology and Wellness, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - I E Goldberg
- Department of Pediatrics, Jaffe Food Allergy Institute, Center for Integrative Medicine for Immunology and Wellness, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - A Nowak-Węgrzyn
- Department of Pediatrics, Jaffe Food Allergy Institute, Center for Integrative Medicine for Immunology and Wellness, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - H A Sampson
- Department of Pediatrics, Jaffe Food Allergy Institute, Center for Integrative Medicine for Immunology and Wellness, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - X-M Li
- Department of Pediatrics, Jaffe Food Allergy Institute, Center for Integrative Medicine for Immunology and Wellness, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Graham MT, Andorf S, Spergel JM, Chatila TA, Nadeau KC. Temporal Regulation by Innate Type 2 Cytokines in Food Allergies. Curr Allergy Asthma Rep 2016; 16:75. [PMID: 27771884 DOI: 10.1007/s11882-016-0656-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW Food allergies (FAs) are a growing epidemic in western countries with poorly defined etiology. Defined as an adverse immune response to common food allergens, FAs present heterogeneously as a single- or multi-organ response that ranges in severity from localized hives and angioedema to systemic anaphylaxis. RECENT FINDINGS Current research focusing on epithelial-derived cytokines contends that temporal regulation by these factors impact initial sensitization and persistence of FA responses upon repeated food allergen exposure. Mechanistic understanding of FA draws insight from a myriad of atopic conditions studied in humans and modeled in mice. In this review, we will highlight how epithelial-derived cytokines initiate and then potentiate FAs. We will also review existing evidence of the contribution of other atopic diseases to FA pathogenesis and whether FA symptoms overlap with other atopic diseases.
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31
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Tuokkola J, Luukkainen P, Nevalainen J, Ahonen S, Toppari J, Ilonen J, Veijola R, Knip M, Virtanen SM, Kaila M. Eliminating cows' milk, but not wheat, barley or rye, increases the risk of growth deceleration and nutritional inadequacies. Acta Paediatr 2017; 106:1142-1149. [PMID: 28345135 DOI: 10.1111/apa.13846] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 11/26/2016] [Revised: 01/22/2017] [Accepted: 03/21/2017] [Indexed: 12/23/2022]
Abstract
AIM Our study examined the growth and nutritional intake of children on milk and/or wheat, barley or rye elimination diets. METHODS This was a nested case-control study within the Finnish Type 1 Diabetes Prediction and Prevention Study. It investigated 295 children born in the Tampere University Hospital area between 1997 and 2004 on a diet without cows' milk and/or wheat, barley or rye due to food allergies and 265 matched controls. Nutritional intake was recorded with three-day food records at the ages of one, two and three years. Serial growth measurements were recorded annually up to the age of five years. RESULTS Despite consuming a balanced diet with sufficient energy and protein, the children on milk elimination diets grew slower than the control children (p = 0.009). Wheat, barley or rye elimination was not associated with growth. The intakes of protein and calcium were lower in children in the milk elimination group than the controls, at p < 0.05 for all. However, children on elimination diets consumed less saturated fats and sugar and more vitamin C and iron than the control children. CONCLUSION Children on elimination diets faced an increased risk of growth deceleration and suboptimal intake of several micronutrients.
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Affiliation(s)
- Jetta Tuokkola
- Children's Hospital; University of Helsinki and Helsinki University Hospital; Helsinki Finland
- Nutrition Unit; National Institute for Health and Welfare; Helsinki Finland
| | - Päivi Luukkainen
- Children's Hospital; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | | | - Suvi Ahonen
- Nutrition Unit; National Institute for Health and Welfare; Helsinki Finland
- School of Health Sciences; University of Tampere; Tampere Finland
- Science Centre; Tampere University Hospital; Tampere Finland
| | - Jorma Toppari
- Department of Pediatrics; University of Turku; Turku Finland
| | - Jorma Ilonen
- Department of Clinical Microbiology; University of Eastern Finland; Kuopio Finland
- Immunogenetics Laboratory; University of Turku; Turku Finland
| | - Riitta Veijola
- Department of Pediatrics; PEDEGO Research Unit; Medical Research Center; Oulu University Hospital and University of Oulu; Oulu Finland
| | - Mikael Knip
- Children's Hospital; University of Helsinki and Helsinki University Hospital; Helsinki Finland
- Research Programs Unit; Diabetes and Obesity; University of Helsinki; Helsinki Finland
- Folkhälsan Research Institute; Helsinki Finland
- Department of Pediatrics; Tampere University Hospital; Tampere Finland
| | - Suvi M. Virtanen
- Nutrition Unit; National Institute for Health and Welfare; Helsinki Finland
- School of Health Sciences; University of Tampere; Tampere Finland
- Science Centre; Tampere University Hospital; Tampere Finland
- Center for Child Health Research; University of Tampere and Tampere University Hospital; Tampere Finland
| | - Minna Kaila
- Department of Pediatrics; Tampere University Hospital; Tampere Finland
- Public Health Medicine; University of Helsinki and Helsinki University Hospital; Helsinki Finland
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Cingi C, Gevaert P, Mösges R, Rondon C, Hox V, Rudenko M, Muluk NB, Scadding G, Manole F, Hupin C, Fokkens WJ, Akdis C, Bachert C, Demoly P, Mullol J, Muraro A, Papadopoulos N, Pawankar R, Rombaux P, Toskala E, Kalogjera L, Prokopakis E, Hellings PW, Bousquet J. Multi-morbidities of allergic rhinitis in adults: European Academy of Allergy and Clinical Immunology Task Force Report. Clin Transl Allergy 2017; 7:17. [PMID: 28572918 PMCID: PMC5452333 DOI: 10.1186/s13601-017-0153-z] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [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: 02/01/2017] [Accepted: 05/12/2017] [Indexed: 12/14/2022] Open
Abstract
This report has been prepared by the European Academy of Allergy and Clinical Immunology Task Force on Allergic Rhinitis (AR) comorbidities. The aim of this multidisciplinary European consensus document is to highlight the role of multimorbidities in the definition, classification, mechanisms, recommendations for diagnosis and treatment of AR, and to define the needs in this neglected area by a literature review. AR is a systemic allergic disease and is generally associated with numerous multi-morbid disorders, including asthma, eczema, food allergies, eosinophilic oesophagitis (EoE), conjunctivitis, chronic middle ear effusions, rhinosinusitis, adenoid hypertrophy, olfaction disorders, obstructive sleep apnea, disordered sleep and consequent behavioural and educational effects. This report provides up-to-date usable information to: (1) improve the knowledge and skills of allergists, so as to ultimately improve the overall quality of patient care; (2) to increase interest in this area; and (3) to present a unique contribution to the field of upper inflammatory disease.
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Affiliation(s)
- C Cingi
- Department of Otorhinolaryngology, Eskisehir Osmangazi University School of Medicine, Eskisehir, Turkey
| | - P Gevaert
- Upper Airway Research Laboratory, Ghent University Hospital, Ghent, Belgium
| | - R Mösges
- Institute of Medical Statistics, Informatics, and Epidemiology, Medical Faculty, University of Köln, Cologne, Germany
| | - C Rondon
- Allergy Unit, IBIMA, Regional University Hospital of Malaga, UMA, Malaga, Spain
| | - V Hox
- Clinical division of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Louvain, Belgium
| | - M Rudenko
- London Allergy and Immunology Centre, London, UK
| | - N B Muluk
- ENT Department, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey
| | - G Scadding
- Royal National Throat, Nose and Ear Hospital, London, UK
| | - F Manole
- Faculty of Medicine, ENT Department, University of Oradea, Oradea, Romania
| | - C Hupin
- Institut de Recherche Expérimentale et Clinique (IREC), Pole de Pneumologie, ORL & Dermatologie, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - W J Fokkens
- Department of Otorhinolaryngology, Head and Neck Surgery, Academic Medical Centre (AMC), Amsterdam, The Netherlands
| | - C Akdis
- Christine Kuhne-Center for Allergy Research and Education, Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland
| | - C Bachert
- Upper Airway Research Laboratory, Ghent University Hospital, Ghent, Belgium
| | - P Demoly
- Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France
| | - J Mullol
- Unitat de Rinologia i Clinica de l'Olfacte, Servei d'Otorinolaringologia, Hospital Clínic, Barcelona, Catalonia Spain
| | - A Muraro
- The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region, Department of Mother and Child Health, University of Padua, Padua, Italy
| | - N Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | | | - P Rombaux
- Service d'ORL, Cliniques Universitaires St-Luc, Brussels, Belgium
| | - E Toskala
- Department of Otorhinolaryngology-Head and Neck Surgery, Temple University, Philadelphia, PA USA
| | - L Kalogjera
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Sestre milosrdnice, Zagreb, Croatia
| | - E Prokopakis
- Department of Otorhinolaryngology, University Hospital of Crete, Crete, Greece
| | - P W Hellings
- Clinical division of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Louvain, Belgium
| | - J Bousquet
- Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France
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Abstract
Food allergies are common and seem to be increasing in prevalence. Preventive measures have become far more evident in the public arena (schools, camps, sports venues, and so forth). Evaluation and management of food allergies has evolved such that primary care practitioners may choose to provide initial diagnostic and treatment care or refer to allergists for similar care. Food allergies, once considered incurable, are now being diminished in intensity by new strategies.
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Affiliation(s)
- Samuel N Grief
- Department of Family Medicine, University of Illinois at Chicago, 1919 West Taylor Street, Suite 143, Chicago, IL 60612, USA.
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Abstract
Food allergies can newly arise in adulthood or persist following a food allergy occurring in childhood. The prevalence of primary food allergy is basically higher in children than in adults; however, in the routine practice food allergies in adulthood appear to be increasing and after all a prevalence in Germany of 3.7 % has been published. The clinical spectrum of manifestations of food allergies in adulthood is broad. Allergy symptoms of the immediate type can be observed as well as symptoms occurring after a delay, such as indigestion, triggering of hematogenous contact eczema or flares of atopic dermatitis. The same principles for diagnostics apply in this group as in childhood. In addition to the anamnesis, skin tests and in vitro tests, as a rule elimination diets and in particular provocation tests are employed. Molecular allergy diagnostics represent a major step forward, which allow a better assessment of the risk of systemic reactions to certain foodstuffs (e.g. peanuts) and detection of cross-reactions in cases of apparently multiple sensitivities. Current German and European guidelines from 2015 are available for the practical approach to clarification of food allergies. The most frequent food allergies in adults are nuts, fruit and vegetables, which can cross-react with pollen as well as wheat, shellfish and crustaceans. The therapy of allergies involves a consistent avoidance of the allogen. Detailed dietary plans are available with avoidance strategies and instructions for suitable food substitutes. A detailed counseling of affected patients by specially trained personnel is necessary especially in order to avoid nutritional deficiencies and to enable patients to enjoy a good quality of life.
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Affiliation(s)
- Thomas Werfel
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
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Venter C, Maslin K, Dean T, Arshad SH. Does concurrent breastfeeding alongside the introduction of solid food prevent the development of food allergy? J Nutr Sci 2016; 5:e40. [PMID: 27752307 DOI: 10.1017/jns.2016.31] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 06/21/2016] [Accepted: 07/20/2016] [Indexed: 11/21/2022] Open
Abstract
The timing of introduction of solid food on the subsequent development of food allergy is under debate and the role of concurrent breastfeeding is unclear. The aim of the present study was to investigate the role of solid food introduction whilst concurrently breastfeeding on food allergy outcome, with a specific focus on cows’ milk allergy. Prospectively collected infant feeding data from a birth cohort were analysed. Participants with histories suggestive of food allergy underwent diagnostic food challenges. Children with food allergy were matched to control participants for age and sex. Mann–Whitney U tests, χ2, Fisher exact tests and logistic regression calculations were undertaken. A total of thirty-nine food-allergic children and seventy-eight matched controls were identified, including twenty-two cows’ milk-allergic children and forty-four matched controls. The control group introduced solid food earlier than the food-allergic group (P < 0·05). There was no effect of concurrent breastfeeding alongside cows’ milk introduction or other food allergens on the development of food allergy. Due to small numbers, it was not possible to explore differences for food allergy phenotype. We have therefore found no evidence that introducing solids, or food allergens, whilst breastfeeding has an allergy-preventative effect; however, the results should be interpreted with caution due to sample size. Recommendations regarding infant feeding and food allergy should be carefully considered. Although breastfeeding should be promoted for many health reasons, larger studies looking at the introduction of food allergens on the development of food allergy are needed to make a final conclusion.
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Radke TJ, Brown LG, Hoover ER, Faw BV, Reimann D, Wong MR, Nicholas D, Barkley J, Ripley D. Food Allergy Knowledge and Attitudes of Restaurant Managers and Staff: An EHS-Net Study. J Food Prot 2016; 79:1588-1598. [PMID: 28221943 PMCID: PMC5321626 DOI: 10.4315/0362-028x.jfp-16-085] [Citation(s) in RCA: 34] [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] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Dining outside of the home can be difficult for persons with food allergies who must rely on restaurant staff to properly prepare allergen-free meals. The purpose of this study was to understand and identify factors associated with food allergy knowledge and attitudes among restaurant managers, food workers, and servers. This study was conducted by the Environmental Health Specialists Network (EHS-Net), a collaborative forum of federal, state, and local environmental health specialists working to understand the environmental factors associated with food safety issues. EHS-Net personnel collected data from 278 randomly selected restaurants through interviews with restaurant managers, food workers, and servers. Results indicated that managers, food workers, and servers were generally knowledgeable and had positive attitudes about accommodating customers' food allergies. However, we identified important gaps, such as more than 10% of managers and staff believed that a person with a food allergy can safely consume a small amount of that allergen. Managers and staff also had lower confidence in their restaurant's ability to properly respond to a food allergy emergency. The knowledge and attitudes of all groups were higher at restaurants that had a specific person to answer food allergy questions and requests or a plan for answering questions from food allergic customers. However, food allergy training was not associated with knowledge in any of the groups but was associated with manager and server attitudes. Based on these findings, we encourage restaurants to be proactive by training staff about food allergies and creating plans and procedures to reduce the risk of a customer having a food allergic reaction.
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Affiliation(s)
- Taylor J Radke
- Centers for Disease Control and Prevention, National Center for Environmental Health, 4770 Buford Highway, Mailstop F58, Atlanta, Georgia 30341
| | - Laura G Brown
- Centers for Disease Control and Prevention, National Center for Environmental Health, 4770 Buford Highway, Mailstop F58, Atlanta, Georgia 30341
| | - E Rickamer Hoover
- Centers for Disease Control and Prevention, National Center for Environmental Health, 4770 Buford Highway, Mailstop F58, Atlanta, Georgia 30341
| | - Brenda V Faw
- California Department of Public Health, Sacramento, California 95899
| | - David Reimann
- Minnesota Department of Health, Mankato, Minnesota 56001
| | - Melissa R Wong
- New York City Department of Health and Mental Hygiene, New York, New York 11101
| | - David Nicholas
- New York State Department of Health, Albany, New York 12237
| | - Jonathan Barkley
- Rhode Island Department of Health, Providence, Rhode Island 02908
| | - Danny Ripley
- Metro Nashville/Davidson County Public Health Department, Nashville, Tennessee 37209, USA
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Buser MC, Scinicariello F. Perfluoroalkyl substances and food allergies in adolescents. Environ Int 2016; 88:74-79. [PMID: 26722671 PMCID: PMC8132312 DOI: 10.1016/j.envint.2015.12.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 12/11/2015] [Accepted: 12/16/2015] [Indexed: 05/21/2023]
Abstract
Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are a class of organic compounds that are persistent in the environment due to their stable carbon-fluorine backbone, which is not susceptible to degradation. Research suggests these chemicals may exert an immunotoxic effect. The aim of this study is to investigate the associations between four PFASs - perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorohexane sulfonic acid (PFHxS) - with food sensitization and food allergies in adolescent participants (ages 12-19years) in the National Health and Nutrition Examination Survey (NHANES) 2005-2006 and 2007-2010, respectively. We performed multivariate logistic regression to analyze the association between individual PFASs with food sensitization (defined as having at least 1 food-specific IgE level≥0.35kU/L) in NHANES 2005-2006 and food allergies (self-reported) in NHANES 2007-2010. Serum PFOA, PFOS, and PFHxS were statistically significantly associated with higher odds to have self-reported food allergies in NHANES 2007-2010. When using IgE levels as a marker of food sensitization, we found that serum PFNA was inversely associated with food sensitization (NHANES 2005-2006). In conclusion, we found that serum levels of PFASs were associated with higher odds to have self-reported food allergies. Conversely, adolescents with higher serum PFNA were less likely to be sensitized to food allergens. These results, along with previous studies, warrant further investigation, such as well-designed longitudinal studies.
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Affiliation(s)
- Melanie C Buser
- Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, GA, 30341, USA
| | - Franco Scinicariello
- Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, GA, 30341, USA.
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Riggle KM, Wahbeh G, Williams EM, Riehle KJ. Perforated duodenal ulcer: An unusual manifestation of allergic eosinophilic gastroenteritis. World J Gastroenterol 2015; 21:12709-12712. [PMID: 26640348 PMCID: PMC4658626 DOI: 10.3748/wjg.v21.i44.12709] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 06/04/2015] [Accepted: 09/02/2015] [Indexed: 02/06/2023] Open
Abstract
Spontaneous perforation of a duodenal ulcer secondary to allergic eosinophilic gastroenteritis (EGE) has not been previously reported. We present such a case in a teenager who presented with peritonitis. After exploration and operative repair of his ulcer, he continued to experience intermittent abdominal pain, and further evaluation revealed eosinophilic gastroenteritis in the setting of multiple food allergies. His EGE resolved after adhering to a restrictive diet. Both duodenal ulcers and EGE are very rarely seen in pediatric patients. EGE has a variable presentation depending on the layer(s) of bowel wall affected and the segment of the gastrointestinal tract that is involved. Once diagnosed, it may respond to dietary changes in patients with recognized food allergies, or to steroids in patients in whom an underlying cause is not identified. Our case highlights the need to keep EGE in the differential diagnosis when treating pediatric patients with duodenal ulcers. The epidemiology, pathophysiology, and treatment of EGE are also discussed, along with a review of the current literature.
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Akintunde ME, Rose M, Krakowiak P, Heuer L, Ashwood P, Hansen R, Hertz-Picciotto I, Van de Water J. Increased production of IL-17 in children with autism spectrum disorders and co-morbid asthma. J Neuroimmunol 2015; 286:33-41. [PMID: 26298322 DOI: 10.1016/j.jneuroim.2015.07.003] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 06/18/2015] [Accepted: 07/01/2015] [Indexed: 01/08/2023]
Abstract
Inflammation and asthma have both been reported in some children with autism spectrum disorder (ASD). To further assess this connection, peripheral immune cells isolated from young children with ASD and typically developing (TD) controls and the production of cytokines IL-17, -13, and -4 assessed following ex vivo mitogen stimulation. Notably, IL-17 production was significantly higher following stimulation in ASD children compared to controls. Moreover, IL-17 was increased in ASD children with co-morbid asthma compared to controls with the same condition. In conclusion, children with ASD exhibited a differential response to T cell stimulation with elevated IL-17 production compared to controls.
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Quake C, Nadeau KC. The role of epigenetic mediation and the future of food allergy research. Semin Cell Dev Biol 2015; 43:125-30. [PMID: 26150170 DOI: 10.1016/j.semcdb.2015.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Revised: 06/29/2015] [Accepted: 07/01/2015] [Indexed: 11/22/2022]
Abstract
IgE-mediated food allergy is a developing global health problem with prevalence rising at alarmingly fast rates. In this review, we discuss the interplay between genetics, epigenetics, and environmental exposures in the pathogenesis of food allergies. We aim to highlight the most recent evidence that suggests how epigenetic control may mediate genetic susceptibility of food allergies. We also examine how epigenetic modifications may be the key in explaining how environmental factors modulate and modify gene expression, leading to the dysregulation of immune tolerance and consequently, the development of food allergies. The emerging epigenetic paradigm in food allergies is likely to provide new mechanistic insight into food allergy risk and development as well as shape our therapeutic and preventive strategies.
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Mora CA, Herzog AF, Raso RA, Stark WJ. Programmable living material containing reporter micro-organisms permits quantitative detection of oligosaccharides. Biomaterials 2015; 61:1-9. [PMID: 25988843 DOI: 10.1016/j.biomaterials.2015.04.054] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 01/19/2015] [Revised: 04/21/2015] [Accepted: 04/30/2015] [Indexed: 10/23/2022]
Abstract
The increasing molecular understanding of many diseases today permits the development of new diagnostic methods. However, few easy-to-handle and inexpensive tools exist for common diseases such as food disorders. Here we present a living material based analytical sensor (LiMBAS) containing genetically modified bacteria (Escherichia coli) immobilized and protected in a thin layer between a nanoporous and support polymer membrane for a facile quantification of disease-relevant oligosaccharides. The bacteria were engineered to fluoresce in response to the analyte to reveal its diffusion behavior when using a blue-light source and optical filter. We demonstrated that the diffusion zone diameter was related semi-logarithmically to the analyte concentration. LiMBAS could accurately quantify lactose or galactose in undiluted food samples and was able to measure food intolerance relevant concentrations in the range of 1-1000 mM requiring a sample volume of 1-10 μL. LiMBAS was storable for at least seven days without losing functionality at 4 °C. A wide range of genetic tools for E. coli are readily available thus allowing the reprogramming of the material to serve as biosensor for other molecules. In combination with smartphones, an automated diagnostic analysis becomes feasible which would also allow untrained people to use LiMBAS.
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Affiliation(s)
- Carlos A Mora
- Institute for Chemical- and Bioengineering, Department of Chemistry and Applied Biosciences, ETH Zurich, Vladimir-Prelog-Weg 1, 8093 Zurich, Switzerland
| | - Antoine F Herzog
- Institute for Chemical- and Bioengineering, Department of Chemistry and Applied Biosciences, ETH Zurich, Vladimir-Prelog-Weg 1, 8093 Zurich, Switzerland
| | - Renzo A Raso
- Institute for Chemical- and Bioengineering, Department of Chemistry and Applied Biosciences, ETH Zurich, Vladimir-Prelog-Weg 1, 8093 Zurich, Switzerland
| | - Wendelin J Stark
- Institute for Chemical- and Bioengineering, Department of Chemistry and Applied Biosciences, ETH Zurich, Vladimir-Prelog-Weg 1, 8093 Zurich, Switzerland.
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Abstract
Immunoglobulin E-mediated allergic responses to food and environmental allergens can cause symptoms ranging from mild allergic rhinitis and rashes to gastrointestinal distress and, most seriously, anaphylaxis. The diagnosis can be difficult, as it relies on complex interplay between patient history and diagnostic tests with low specificity. Adding to the difficulty in confirming the diagnosis is an increased public interest in food intolerances, which can be inappropriately attributed to an allergic response. Treatment of allergic diseases with avoidance strategies and pharmacologic treatments can improve quality of life and control of other chronic conditions, such as asthma and eczema.
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Kotlyar DS, Shum M, Hsieh J, Blonski W, Greenwald DA. Non-pulmonary allergic diseases and inflammatory bowel disease: A qualitative review. World J Gastroenterol 2014; 20:11023-11032. [PMID: 25170192 PMCID: PMC4145746 DOI: 10.3748/wjg.v20.i32.11023] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 01/06/2014] [Accepted: 04/16/2014] [Indexed: 02/06/2023] Open
Abstract
While the etiological underpinnings of inflammatory bowel disease (IBD) are highly complex, it has been noted that both clinical and pathophysiological similarities exist between IBD and both asthma and non-pulmonary allergic phenomena. In this review, several key points on common biomarkers, pathophysiology, clinical manifestations and nutritional and probiotic interventions for both IBD and non-pulmonary allergic diseases are discussed. Histamine and mast cell activity show common behaviors in both IBD and in certain allergic disorders. IgE also represents a key immunoglobulin involved in both IBD and in certain allergic pathologies, though these links require further study. Probiotics remain a critically important intervention for both IBD subtypes as well as multiple allergic phenomena. Linked clinical phenomena, especially sinonasal disease and IBD, are discussed. In addition, nutritional interventions remain an underutilized and promising therapy for modification of both allergic disorders and IBD. Recommending new mothers breastfeed their infants, and increasing the duration of breastfeeding may also help prevent both IBD and allergic diseases, but requires more investigation. While much remains to be discovered, it is clear that non-pulmonary allergic phenomena are connected to IBD in a myriad number of ways and that the discovery of common immunological pathways may usher in an era of vastly improved treatments for patients.
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Abstract
Asthma has many triggers including rhinosinusitis; allergy; irritants; medications (aspirin in aspirin-exacerbated respiratory disease); and obesity. Paradoxic vocal fold dysfunction mimics asthma and may be present along with asthma. This article reviews each of these triggers, outlining methods of recognizing the trigger and then its management. In many patients more than one trigger may be present. Full appreciation of the complexity of these relationships and targeted therapy to the trigger is needed to best care for the patient with asthma.
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Affiliation(s)
- Justin C. McCarty
- Lake Erie of Osteopathic Medicine, 5000 Lakewood Ranch Boulevard, Bradenton, FL 34211–4909, USA
| | - Berrylin J. Ferguson
- UPMC Mercy, University of Pittsburgh School of Medicine, 1400 Locust Street, Suite B11500, Pittsburgh, PA 15219, USA
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Banla M, Maneh N, Vonor K, Vonor B, Nonon Saa KB, Agba A, Gantin RG, Balo KP, Soboslay PT, Bakondé B. [Tropical endemic limbo-conjunctivitis (TELC) and allergic management: a preliminary study in Togolese children]. J Fr Ophtalmol 2013; 36:677-82. [PMID: 23906546 DOI: 10.1016/j.jfo.2013.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 12/13/2012] [Revised: 02/24/2013] [Accepted: 03/05/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To study the impact of certain allergens on the manifestations of tropical endemic limbo-conjunctivitis (TELC) in Togolese children. METHODS This is a 3-year prospective study of 36 Togolese children with acute recurrences of TELC after 1 to 5 months of remission. Skin prick tests were conducted with five perennial respiratory allergens (dust mites, paper mites, roaches, dog and cat, grass pollen) and three food allergens (egg, peanut, shrimp). The reactions were compared to a negative control (saline solution) and a positive control (histamine or codeine sulfate). Length of remissions between acute exacerbations before and after allergy testing were noted. RESULTS Thirty-five children were polysensitive. Individual allergens were: dust mites (83.3%), followed by cockroach (72.2%), shrimp (61.1%), peanuts (55.6%), eggs (44.4%), the cat and/or dog dander (38.9%), and grass pollen (22.2%). The rate of remission prior to allergy testing was 77.8% within 2 months after treatment of an exacerbation; with allergy management, 55.5% of patients experienced remission beyond 1 year. DISCUSSION The literature reports that TELC is caused by multiple antigens. The clear predominance of respiratory and food allergens may lead to a new pathway for managing TELC in Togolese children. CONCLUSION Allergy testing is of great importance for patients with frequent acute exacerbations of TELC.
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Affiliation(s)
- M Banla
- Centre hospitalier et universitaire de Lomé (CHU Campus), 05 BP 25 Agbalépédogan, Lomé, Togo; International Onchocerciasis Research Laboratory, CHR, BP 178, Sokodé, Togo.
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