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Bartha I, Almulhem N, Santos AF. Feast for thought: A comprehensive review of food allergy 2021-2023. J Allergy Clin Immunol 2024; 153:576-594. [PMID: 38101757 PMCID: PMC11096837 DOI: 10.1016/j.jaci.2023.11.918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 11/19/2023] [Accepted: 11/27/2023] [Indexed: 12/17/2023]
Abstract
A review of the latest publications in food allergy over the past couple of years confirmed that food allergy is a major public health concern, affecting about 8% of children and 10% of adults in developed countries. The prevalence of food allergy varies around the world, with the increase being driven mainly by environmental factors, possibly together with genetic susceptibility to environmental changes. A precise diagnosis of food allergy is extremely important. Both new tests (eg, the basophil activation test) and improved optimization of information provided by existing tests (eg, the skin prick test and measurement of specific IgE level) can contribute to improving the accuracy and patients' comfort of food allergy diagnosis. Understanding the underlying immune mechanisms is fundamental to designing allergen-specific treatments that can be safe and effective in the long term. New discoveries of the immune response to food allergens, including T-cell and B-cell responses, have emerged. Novel therapeutic approaches are being trialed at various stages of development as attempts to allow for more active intervention to treat food allergy. Prevention is key to reducing the increase in prevalence. Early introduction of allergenic foods seems to be the most effective intervention, but others are being studied, and will, it is hoped, lead to modification of the epidemiologic trajectory of food allergy over time.
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Affiliation(s)
- Irene Bartha
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, United Kingdom; Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, School of Immunology and Microbial Sciences King's College London, London, United Kingdom
| | - Noorah Almulhem
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, United Kingdom; Department of Otolaryngology Head and Neck Surgery, King Fahad Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Alexandra F Santos
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, United Kingdom; Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, School of Immunology and Microbial Sciences King's College London, London, United Kingdom; Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences King's College London, London, United Kingdom.
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Ilmarinen P, Julkunen-Iivari A, Lundberg M, Luukkainen A, Nuutinen M, Karjalainen J, Huhtala H, Pekkanen J, Kankaanranta H, Toppila-Salmi S. Cluster Analysis of Finnish Population-Based Adult-Onset Asthma Patients. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:3086-3096. [PMID: 37268268 DOI: 10.1016/j.jaip.2023.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Phenotypes of adult asthma have been identified in previous studies but rarely in population-based settings. OBJECTIVE To identify clusters of adult-onset asthma in a Finnish population-based study on subjects born before 1967. METHODS We used population-based data from 1350 asthmatics with adult-onset asthma (Adult Asthma in Finland) from Finnish national registers. Twenty-eight covariates were selected based on literature. The number of covariates was reduced by using factor analysis before cluster analysis. RESULTS Five clusters (CLU1-CLU5) were identified, 3 clusters with late-onset adult asthma (onset ≥40 years) and 2 clusters with onset at earlier adulthood (<40 years). Subjects in CLU1 (n = 666) had late-onset asthma and were nonobese, symptomatic, and predominantly female with few respiratory infections during childhood. CLU2 (n = 36) consisted of subjects who had earlier-onset asthma, were predominantly female, obese with allergic asthma, and had recurrent respiratory infections. Subjects in CLU3 (n = 75) were nonobese, older, and predominantly men with late-onset asthma, smoking history, comorbidities, severe asthma, least allergic diseases, low education, many siblings, and childhood in rural areas. CLU4 (n = 218) was a late-onset cluster consisting of obese females with comorbidities, asthma symptoms, and low education level. Subjects in CLU5 (n = 260) had earlier onset asthma, were nonobese, and predominantly allergic females. CONCLUSIONS Our population-based adult-onset asthma clusters take into account several critical factors such as obesity and smoking, and identified clusters that partially overlap with clusters identified in clinical settings. Results give us a more profound understanding of adult-onset asthma phenotypes and support personalized management.
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Affiliation(s)
- Pinja Ilmarinen
- Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Anna Julkunen-Iivari
- Department of Allergy, Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Marie Lundberg
- Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Annika Luukkainen
- Inflammation Center, Department of Infectious Diseases, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Mikko Nuutinen
- Department of Allergy, Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Haartman Institute, Medicum, University of Helsinki, Helsinki, Finland
| | - Jussi Karjalainen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Allergy Centre, Tampere University Hospital, Tampere, Finland
| | - Heini Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Juha Pekkanen
- Department of Public Health, University of Helsinki, Helsinki, Finland; Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - Hannu Kankaanranta
- Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Sanna Toppila-Salmi
- Department of Allergy, Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Haartman Institute, Medicum, University of Helsinki, Helsinki, Finland; Department of Pulmonary Medicine, Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
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Giannetti A, Pession A, Bettini I, Ricci G, Giannì G, Caffarelli C. IgE Mediated Shellfish Allergy in Children-A Review. Nutrients 2023; 15:3112. [PMID: 37513530 PMCID: PMC10386692 DOI: 10.3390/nu15143112] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/08/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Shellfish is a leading cause of food allergy and anaphylaxis worldwide. Recent advances in molecular characterization have led to a better understanding of the allergen profile. High sequence homology between shellfish species and between shellfish and house dust mites leads to a high serological cross-reactivity, which does not accurately correlate with clinical cross-reactions. Clinical manifestations are immediate and the predominance of perioral symptoms is a typical feature of shellfish allergy. Diagnosis, as for other food allergies, is based on SPTs and specific IgE, while the gold standard is DBPCFC. Cross-reactivity between shellfish is common and therefore, it is mandatory to avoid all shellfish. New immunotherapeutic strategies based on hypoallergens and other innovative approaches represent the new frontiers for desensitization.
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Affiliation(s)
- Arianna Giannetti
- Paediatrics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.G.); (A.P.)
| | - Andrea Pession
- Paediatrics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.G.); (A.P.)
| | - Irene Bettini
- Paediatrics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.G.); (A.P.)
| | - Giampaolo Ricci
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy;
| | - Giuliana Giannì
- Clinica Pediatrica, Azienda Ospedaliero-Universitaria, Medicine and Surgery Department, Università di Parma, 43126 Parma, Italy;
| | - Carlo Caffarelli
- Clinica Pediatrica, Azienda Ospedaliero-Universitaria, Medicine and Surgery Department, Università di Parma, 43126 Parma, Italy;
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Madooh L, Allahou S, Alshallal H, Alkazemi F, Alyaseen D, Allahow F, Alsattam S, Al-Majran A, Ziyab AH. Food allergy knowledge, attitudes and beliefs of kindergarten teachers in Kuwait: a cross-sectional study. BMJ Paediatr Open 2023; 7:10.1136/bmjpo-2022-001795. [PMID: 36882233 PMCID: PMC10008333 DOI: 10.1136/bmjpo-2022-001795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/20/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Food allergy (FA) affects up to 10% of children globally, with clinical symptoms varying from mild to severe, and in rare instances, it is life-threatening. Approximately one in five children with FA experience a food-induced allergic reaction in school, leaving teachers as the first line of intervention. This study aimed to assess kindergarten teachers' knowledge, attitudes and beliefs regarding FA. METHODS This cross-sectional study enrolled kindergarten teachers in Kuwait using stratified cluster sampling. The Chicago Food Allergy Research Survey for the General Public was used to assess teachers' knowledge, attitudes and beliefs regarding FA. The overall FA knowledge score was calculated for each participant. The χ2 test was used to assess the differences in the distribution of categorical variables. RESULTS Responses were obtained from 882 public kindergarten teachers from 63 kindergartens. Most teachers (81.9%) encountered students with FA in their classrooms. Only 13.5% of the teachers reported receiving training in FA. Overall, participants scored an average of 52.2% on the FA knowledge assessment, with participants receiving prior training in FA scoring on average higher than those with no prior training in FA (55.9% vs 51.6%, p=0.005). A few teachers (10.7%) were aware that lactose intolerance was not equivalent to milk allergy. In terms of attitudes regarding FA, only 14.9% of the participants acknowledged that children with FA are teased/stigmatised due to their condition, and 33.7% recognised that avoidance of allergenic food is difficult. Moreover, only 9.9% of the teachers self-reported their ability to use an epinephrine autoinjector. CONCLUSIONS Improved knowledge and awareness of FA among public kindergarten teachers in Kuwait are needed to ensure the safety of children with FA in schools. Teachers should be trained to prevent, recognise and manage FA-related allergic reactions.
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Affiliation(s)
- Latifah Madooh
- Department of Community Medicine and Behavioral Sciences, Kuwait University, Kuwait, Kuwait
| | - Shaikhah Allahou
- Department of Community Medicine and Behavioral Sciences, Kuwait University, Kuwait, Kuwait
| | - Haya Alshallal
- Department of Community Medicine and Behavioral Sciences, Kuwait University, Kuwait, Kuwait
| | - Fatemah Alkazemi
- Department of Community Medicine and Behavioral Sciences, Kuwait University, Kuwait, Kuwait
| | - Dina Alyaseen
- Department of Community Medicine and Behavioral Sciences, Kuwait University, Kuwait, Kuwait
| | - Farah Allahow
- Department of Community Medicine and Behavioral Sciences, Kuwait University, Kuwait, Kuwait
| | - Shahad Alsattam
- Department of Community Medicine and Behavioral Sciences, Kuwait University, Kuwait, Kuwait
| | - Abdullah Al-Majran
- Department of Community Medicine and Behavioral Sciences, Kuwait University, Kuwait, Kuwait
| | - Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Kuwait University, Kuwait, Kuwait
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Muacevic A, Adler JR, Alsalmi S, Althomali M, Alsofyani R, Alkhudaydi F, Osman M. Prevalence of Parent-Reported Food Allergies and Associated Risk Predictors Among Children in Saudi Arabia. Cureus 2023; 15:e33974. [PMID: 36820112 PMCID: PMC9938726 DOI: 10.7759/cureus.33974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The worldwide prevalence of food allergies has been increasing recently. Due to limited data on food allergy (FA) in Saudi Arabia, this study was conducted to estimate the prevalence and risk factors of parent-reported food allergies and clinical manifestations in children in Taif, Saudi Arabia. METHODOLOGY A cross-sectional questionnaire-based observational study was conducted from July 2019 to December 2020. A total of 508 parents of school children (aged five to eight years) responded to the questions based on the child's health and food allergies. RESULTS FA (16.1%) was observed as the most common type of allergy among children. The prevalence of other atopic diseases was estimated at 30.5%. The most common allergy-causing foods were eggs (4.9%), peanuts (2.7%), and sesame (2.5%). Rash, itching without rash, and vomiting were the most common FA symptoms. The presence of childhood eczema (p< 0.0001), allergic rhinitis (p= 0.005), and the father's history of allergy (p= 0.005) were all significant and independent predictors/risk factors for FA among the studied children. CONCLUSION We noted substantial parents' concern with food allergies among children in Saudi Arabia, which necessitates the establishment of effective diagnosis and treatment strategies and primary prevention initiatives.
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Zhang X, Lu C, Li Y, Norbäck D, Murthy P, Sram RJ, Deng Q. Early-life exposure to air pollution associated with food allergy in children: Implications for 'one allergy' concept. ENVIRONMENTAL RESEARCH 2023; 216:114713. [PMID: 36347392 DOI: 10.1016/j.envres.2022.114713] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/23/2022] [Accepted: 10/30/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The rapid increase of food allergy (FA) has become the "second wave" of allergy epidemic and is now a major global public health concern. Mounting evidence indicates that early life exposure to air pollution is associated with the "first wave" of allergy epidemic (including asthma, allergic rhinitis and eczema) in children, but little is known about its association with FA. OBJECTIVES We hypothesize FA has triple exposure pathways, gut-skin-airway, and investigate the effects of airway exposure to outdoor and indoor air pollution on childhood FA. METHODS A cohort study of 2598 preschool children aged 3-6 years old was conducted in Changsha, China. The prevalence of FA was surveyed using a standard questionnaire by International Study of Asthma and Allergies in Childhood (ISAAC). Exposure to indoor air pollution was assessed by four indicators: new furniture, redecoration, mold or dampness, and window condensation. Exposure to outdoor air pollution was evaluated by the concentrations of PM10, SO2 and NO2, which were obtained from the monitored stations. Both prenatal and postnatal exposure windows were considered. The association between exposure to outdoor/indoor air pollution and childhood FA was estimated by multiple logistic regression models using odds ratio (OR) and a 95% confidence interval (CI). RESULTS A total of 14.9% children reported FA. The prevalence was significantly associated with exposure to indoor air pollution, OR (95% CI) = 1.93 (1.35-2.75) for prenatal exposure to mold/dampness and 1.49 (1.07-2.10) and 1.41 (1.04-1.89) respectively for postnatal exposure to new furniture and window condensation. The prevalence of FA was also associated with prenatal and postnatal exposure to outdoor air pollution, particularly the traffic-related air pollutant NO2, with adjusted ORs (95% Cls) respectively 1.24 (1.00-1.54) and 1.38 (1.03-1.85) per interquartile range (IQR) increase. Sensitivity analysis showed that the association between outdoor/indoor air pollution and childhood FA was significant only in young children aged 3-4 years. CONCLUSION Early-life exposure to high levels of outdoor and indoor air pollution in China due to the rapid economic growth and fast urbanization in the past decades may contribute to the rapid increase of food allergy (FA) in children. Our study indicates that, in addition to gut and skin, airway may be a new route of food sensitization. Air pollution leads to the first and second waves of allergy epidemics, suggesting a concept of 'one allergy' disease.
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Affiliation(s)
- Xin Zhang
- School of Energy Science and Engineering, Central South University, Changsha 410083, China
| | - Chan Lu
- XiangYa School of Public Health, Central South University, Changsha 410078, China
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Padmini Murthy
- Department of Public Health, School of Health Sciences and Practice, New York Medical College, Hawthorne NY 10532, USA
| | - Radim J Sram
- Department of Genetic Toxicology and Epigenetics, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - Qihong Deng
- School of Public Health, Zhengzhou University, Zhengzhou 450001, China.
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Ziyab AH, Holloway JW, Ali YM, Zhang H, Karmaus W. Eczema among adolescents in Kuwait: Prevalence, severity, sleep disturbance, antihistamine use, and risk factors. World Allergy Organ J 2022; 16:100731. [PMID: 36601260 PMCID: PMC9791032 DOI: 10.1016/j.waojou.2022.100731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/15/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Background Eczema (atopic dermatitis) is a common inflammatory skin disease that is more prevalent in children and adolescents than adults. In Kuwait, there is a lack of empirical knowledge on eczema epidemiology among adolescents. Therefore, this study aimed to estimate the prevalence of eczema symptoms and severity, assess the frequency of eczema-related nocturnal sleep disturbance and its relation to antihistamine use, and determine factors that are associated with eczema prevalence and eczema-related nocturnal sleep disturbance. Methods A school-based cross-sectional study enrolled adolescents (n = 3864) aged 11-14 years across Kuwait. Information on eczema symptoms and clinical history, use of antihistamines, parental history of eczema, mode of delivery, and childhood life-style factors and exposures were reported by parents. Current eczema was defined as chronic or chronically relapsing itchy dermatitis with characteristic morphology and distribution in the past 12 months. Among subjects reporting current itchy rash, frequency of nocturnal sleep disturbance due to itchy rash in the past 12 months was reported as: never, <1 night per week, and ≥1 nights per week. Associations were assessed by applying a modified Poisson regression to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI). Results The prevalence estimate of current (past 12 months) itchy rash was 20.5% (735/3593) and current eczema was 10.2% (388/3791), with 19.5% (736/3775) reporting history of ever doctor-diagnosed eczema. Among subjects with current itchy rash, nocturnal sleep disturbance due to itchy rash affected 21.7% (157/724) of participants for <1 night per week and affected 12.7% (92/724) of participants for ≥1 nights per week. Antihistamine use at least once per month increased as the frequency of nocturnal sleep disturbance due to itchy rash increased (Ptrend <0.001). Factors that demonstrated association with current eczema prevalence included underweight body mass index (aPR = 1.71, 95% CI: 1.16-2.53), Cesarean section delivery (1.29, 1.01-1.65), and maternal (1.72, 1.35-2.19) and paternal (1.83, 1.44-2.32) history of eczema. Frequent (≥1 nights per week) nocturnal sleep disturbance was associated with Cesarean section delivery (1.98, 1.37-2.85), exposure to household tobacco smoke (1.70, 1.18-2.47), and dog-keeping (1.93, 1.06-3.52). Conclusions Eczema symptoms are common among adolescents in Kuwait, with similar epidemiological patterns as those observed in western countries. A large proportion of affected adolescents reported nocturnal sleep disturbance due to itchy rash. Modifiable risk factors were associated increased prevalence of eczema and night awakenings.
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Affiliation(s)
- Ali H. Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait,Corresponding author. Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, P. O. Box 24923, Safat 13110, Kuwait
| | - John W. Holloway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Yaser M. Ali
- Department of Internal Medicine, Mubarak Al-Kabeer Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Hongmei Zhang
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | - Wilfried Karmaus
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
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Maillard Reaction Induced Changes in Allergenicity of Food. Foods 2022; 11:foods11040530. [PMID: 35206007 PMCID: PMC8870895 DOI: 10.3390/foods11040530] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/09/2022] [Accepted: 02/11/2022] [Indexed: 01/27/2023] Open
Abstract
Food allergy is increasing in prevalence, posing aheavier social and financial burden. At present, there is still no widely accepted treatment for it. Methods to reduce or eliminate the allergenicity of trigger foods are urgently needed. Technological processing contributes to producing some hypoallergenic foods. Among the processing methods, the Maillard reaction (MR) is popular because neither special chemical materials nor sophisticated equipment is needed. MR may affect the allergenicity of proteins by disrupting the conformational epitope, disclosing the hidden epitope, masking the linear epitope, and/or forming a new epitope. Changes in the allergenicity of foods after processing are affected by various factors, such as the characteristics of the allergen, the processing parameters, and the processing matrix, and they are therefore variable and difficult to predict. This paper reviews the effects of MR on the allergenicity of each allergen group from common allergenic foods.
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Prevalence of asthma and allergies among children in the United Arab Emirates: A cross-sectional study. World Allergy Organ J 2021; 14:100588. [PMID: 34703522 PMCID: PMC8503660 DOI: 10.1016/j.waojou.2021.100588] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 08/13/2021] [Accepted: 09/04/2021] [Indexed: 11/22/2022] Open
Abstract
Background Asthma, allergic rhinitis, and atopic dermatitis are the most common chronic inflammatory disorders in children worldwide. These conditions place a significant burden on the healthcare system due to their multiple related complications and the necessity of hospital visits. This study aimed to evaluate the prevalence and severity of asthma and allergic diseases among school children aged 6-7 years and 13-14 years in Dubai and the Northern Emirates, United Arab Emirates (UAE). Patients and methods This was a multicenter, cross-sectional study that recruited children from March to June 2019 via school class registers in Dubai and the Northern Emirates, UAE. The Arabic and English versions of the International Study of Asthma and Allergies in Childhood (ISAAC) core questionnaires on asthma, allergic rhinitis, and atopic dermatitis were completed by parents or legal guardians of children aged 6-7 years, and by the children themselves in those aged 13-14 years. Results In this study, we included 3436 children (1944 children aged 6-7 years and 1793 children aged 13-14 years). We estimated the prevalence of asthma (11.9%), wheezing (44.2%), allergic rhinitis (46.5%), hay fever (22.1%), and atopic dermatitis (12.9%) in the 6- to 7-year-old group. In the 13- to 14-year-old group, the prevalence was 9.8%, 33.1%, 51.3%, 19.9%, and 14.6%, respectively. The prevalence of any history of asthma was higher in boys than girls in the 6- to 7-year-old group (13.9% vs. 10%) and in the 13- to 14-year-old group (11.2% vs. 8.7%). In the 6- to 7-year-old group, the highest prevalence of asthma, sneezing, and atopic dermatitis was observed in Dubai, Ajman, and Umm Al Quwain, respectively. In the 13- to 14-year-old group, the highest prevalence of asthma was observed in Ras Al Khaimah, and the highest prevalence of sneezing and atopic dermatitis was observed in Sharjah. Conclusion We found that the prevalence of asthma, allergic rhinitis, and atopic dermatitis in the UAE is comparable to that in neighboring countries; the prevalence of asthma, wheezing, and hay fever was higher in the 6- to 7-year-old group, while in the 13- to 14-year-old group, the prevalence of allergic rhinitis and atopic dermatitis was higher. Overall, the prevalence of any history of asthma was highest in Ras Al Khaimah, followed by Dubai, and lowest in Ajman. Our findings suggest that allergic disorders represent a healthcare burden in the UAE and more efforts are needed to organize nationwide campaigns to detect undiagnosed children to overcome the burden caused by these conditions.
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Shehab K, Ziyab AH. Beliefs of parents in Kuwait about thirdhand smoke and its relation to home smoking rules: A cross-sectional study. Tob Induc Dis 2021; 19:66. [PMID: 34531710 PMCID: PMC8404267 DOI: 10.18332/tid/140090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/06/2021] [Accepted: 07/08/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Thirdhand smoke (THS) is the toxic residue of tobacco smoke that persists long after tobacco smoking on the clothing and hair of smokers and in the surrounding environment. This study aimed to assess parents' beliefs about THS in terms of harm and persistence in the environment and evaluate associations between parents' THS beliefs and home smoking rules. METHODS A sample of parents living in Kuwait were enrolled in a cross-sectional study. Parents reported home smoking rules (strict, partial, and no, home smoking ban) and completed the 9-item Beliefs About ThirdHand Smoke (BATHS) scale that assessed parents' overall, health, and persistence beliefs about THS. Associations between the quartiles of THS overall, health, and persistence beliefs scores and home smoking rules were evaluated using a modified Poisson regression, and adjusted prevalence ratios (APR) and 95% confidence intervals (CI) were estimated. RESULTS In total, 536 parents (404 females) were enrolled in the study, with 42.0% (n=225) and 43.6% (n=234) reporting a strict or partial home smoking ban, respectively. The prevalence of a strict home smoking ban was higher among never smokers than among ever smokers (49.1% vs 25.2%, p<0.001). The majority of participants indicated that THS exposure harms the health of children (67.2%) and adults (60.6%) and THS residue could remain for days in the environment (58.9%). The prevalence of a strict home smoking ban increased as THS overall (APRQ4 vs Q1 = 1.48; 95% CI: 1.12-1.96), health (APRQ4 vs Q1 = 1.22; 1.02-1.45), and persistence (APRQ4 vs Q1 = 1.55; 1.17-2.05) beliefs scores increased. CONCLUSIONS Parents' harm and persistence beliefs about THS were associated with enforcing a strict home smoking ban, which provides a safer environment for children and non-smokers. Therefore, tobacco prevention programs need to incorporate educational messages about the harm of THS in an attempt to promote smoke-free homes.
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Affiliation(s)
- Kawthar Shehab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
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Clinical Manifestations of Pediatric Food Allergy: a Contemporary Review. Clin Rev Allergy Immunol 2021; 62:180-199. [PMID: 34519995 DOI: 10.1007/s12016-021-08895-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2021] [Indexed: 12/12/2022]
Abstract
Food allergies (FAs) are an emerging health care issue, and a "second wave of the allergy epidemic" was named. There are extensive data that documented the prevalence rate as high as approximately 10%. FAs are immunological adverse reactions, including IgE-mediated mechanisms, cell-mediated mechanisms, or mixed IgE- and cell-mediated mechanisms. A diagnosis of FA is made by specific symptoms encounter with food, detailed past history, sensitization tests, and oral food challenges (OFCs) if necessary. The component-resolved diagnostics (CRD) test can distinguish true or cross-reaction. "Minimal elimination" from the results of CRD and OFC could avoid unnecessary food restriction. Strict food limitation is harsh and stressful on patients and their families. Children with FAs experience a higher rate of post-traumatic stress symptoms (PTSS) and bullying than others. In the last 20 years, oral immunotherapy (OIT), sublingual immunotherapy (SLIT), and epicutaneous immunotherapy (EPIT) are treatment strategies. OIT and EPIT are the most two encouraging treatments for FA. This review aims to introduce FAs in diverse clinical disorders, new perspectives, and their practical implications in diagnosing and treating FA.
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Toppila-Salmi S, Lemmetyinen R, Chanoine S, Karjalainen J, Pekkanen J, Bousquet J, Siroux V. Risk factors for severe adult-onset asthma: a multi-factor approach. BMC Pulm Med 2021; 21:214. [PMID: 34238263 PMCID: PMC8268541 DOI: 10.1186/s12890-021-01578-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 06/29/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The aim was to identify risk factors for severe adult-onset asthma. METHODS We used data from a population-based sample (Adult Asthma in Finland) of 1350 patients with adult-onset asthma (age range 31-93 years) from Finnish national registers. Severe asthma was defined as self-reported severe asthma and asthma symptoms causing much harm and regular impairment and ≥ 1 oral corticosteroid course/year or regular oral corticosteroids or waking up in the night due to asthma symptoms/wheezing ≥ a few times/month. Sixteen covariates covering several domains (personal characteristics, education, lifestyle, early-life factors, asthma characteristics and multiple morbidities) were selected based on the literature and were studied in association with severe asthma using logistic regressions. RESULTS The study population included 100 (7.4%) individuals with severe asthma. In a univariate analysis, severe asthma was associated with male sex, age, a low education level, no professional training, ever smoking, ≥ 2 siblings, ≥ 1 chronic comorbidity and non-steroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (NERD) (p < 0.05), and trends for association (p < 0.2) were observed for severe childhood infection, the presence of chronic rhinosinusitis with nasal polyps, and being the 1st child. The 10 variables (being a 1st child was removed due to multicollinearity) were thus entered in a multivariate regression model, and severe asthma was significantly associated with male sex (OR [95% CI] = 1.96 [1.16-3.30]), ever smoking (1.98 [1.11-3.52]), chronic comorbidities (2.68 [1.35-5.31]), NERD (3.29 [1.75-6.19]), and ≥ 2 siblings (2.51 [1.17-5.41]). There was a dose-response effect of the total sum of these five factors on severe asthma (OR [95% CI] = 2.30 [1.81-2.93] for each one-unit increase in the score). CONCLUSIONS Male sex, smoking, NERD, comorbidities, and ≥ 2 siblings were independent risk factors for self-reported severe asthma. The effects of these factors seem to be cumulative; each additional risk factor gradually increases the risk of severe asthma.
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Affiliation(s)
- Sanna Toppila-Salmi
- Haartman Institute, Medicum, University of Helsinki, Haartmaninkatu 3, PO Box 21, 00014 Helsinki, Finland
- Skin and Allergy Hospital, Hospital District of Helsinki and Uusimaa, Helsinki University Hospital and University of Helsinki (HUS), Meilahdentie 2, PO Box 160, 00029 Helsinki, Finland
| | - Riikka Lemmetyinen
- Haartman Institute, Medicum, University of Helsinki, Haartmaninkatu 3, PO Box 21, 00014 Helsinki, Finland
- Skin and Allergy Hospital, Hospital District of Helsinki and Uusimaa, Helsinki University Hospital and University of Helsinki (HUS), Meilahdentie 2, PO Box 160, 00029 Helsinki, Finland
| | - Sebastien Chanoine
- UGA/Inserm U 1209/CNRS UMR 5309 Joint Research Centre Team of Environmental Epidemiology Applied To Reproduction and Respiratory Health, Institute for Advanced Biosciences, Site Santé - Allée Des Alpes, 38700 La Tronche, France
- Pôle Pharmacie, CHU Grenoble Alpes, 38000 Grenoble, France
- Université Grenoble Alpes, 38000 Grenoble, France
| | - Jussi Karjalainen
- Allergy Centre, Tampere University Hospital, Teiskontie 35, PO Box 2000, 33521 Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere University, 33014 Tampere, Finland
| | - Juha Pekkanen
- Department of Public Health, University of Helsinki, Tukholmankatu 8 B, PO Box 20, 00014 Helsinki, Finland
- Environmental Health, National Institute for Health and Welfare, PO Box 95, 70701 Kuopio, Finland
| | - Jean Bousquet
- Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Charité, Universitätsmedizin Berlin, Berlin, Germany
- University Hospital Montpellier, MACVIA-France, Montpellier, France
| | - Valérie Siroux
- UGA/Inserm U 1209/CNRS UMR 5309 Joint Research Centre Team of Environmental Epidemiology Applied To Reproduction and Respiratory Health, Institute for Advanced Biosciences, Site Santé - Allée Des Alpes, 38700 La Tronche, France
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Wai CYY, Leung NYH, Leung ASY, Wong GWK, Leung TF. Seafood Allergy in Asia: Geographical Specificity and Beyond. FRONTIERS IN ALLERGY 2021; 2:676903. [PMID: 35387013 PMCID: PMC8974776 DOI: 10.3389/falgy.2021.676903] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 06/17/2021] [Indexed: 11/13/2022] Open
Abstract
Asian countries have unique ways of food processing and dietary habits that may explain the observed differences in the prevalence, natural history, epidemiology and sensitization pattern of food allergic diseases when compared to western countries. Per capita consumption of seafood, including fish and shellfish, is well above the global average for many Asian countries because of their coastal geographical location and rich seafood supply. The wide availability and high abundance of seafood in Asian countries have shaped a diverse way of processing and eating this major food group. Such unique features have significant impact on the sensitization profile and allergenicity of Asians to fish and shellfish. For example, fish and shellfish are eaten raw in some countries that may promote sensitization to heat-labile allergens not otherwise seen in other regions. Fermented fish sauce is commonly used as a condiment in some countries which may promote fish sensitization. Shrimp head and shrimp roe are regarded as delicacies in some countries, but their allergen profiles are yet to be characterized. Freshwater fish and shellfish are a common food source in many Asian countries but the allergenicity of many such species remains unknown. In this review, we discuss factors that may contribute to differences in molecular profile and sensitization pattern for fish and shellfish that are observed in Asian populations and revisit the current status of seafood allergy in this part of the world. Acknowledging the similarities and differences of seafood allergy patterns between Asian and western populations can help us refine a better strategy for diagnosing and managing seafood allergy.
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Affiliation(s)
- Christine Y. Y. Wai
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Nicki Y. H. Leung
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Agnes S. Y. Leung
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Gary W. K. Wong
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Ting F. Leung
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
- *Correspondence: Ting F. Leung
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Meng C, Gu L, Li Y, Li R, Cao Y, Li Z, Allen EG, Zhu D, Jin P. Ten-eleven translocation 2 modulates allergic inflammation by 5-hydroxymethylcytosine remodeling of immunologic pathways. Hum Mol Genet 2021; 30:1985-1995. [PMID: 34165552 DOI: 10.1093/hmg/ddab167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 02/02/2023] Open
Abstract
Allergic rhinitis (AR) is an allergen specific IgE-mediated inflammatory disease. Both genetic and environmental factors could play a role in the pathophysiology of AR. 5-methylcytosine (5-mC) can be converted to 5-hydroxymethylcytosine (5hmC) by the Ten-Eleven Translocation (TET) family of proteins as part of active DNA de-methylation pathway. 5hmC plays an important role in regulation of gene expression and differentiation in immune cells. Here we show that loss of ten-eleven translocation protein 2 (Tet2) could impact the severity of AR in the ovalbumin-induced mouse model. Genome-wide 5hmC profiling of both wildtype and Tet2 KO mice in response to AR revealed that the loss of Tet2 could lead to 5hmC alteration at specific immune response genes. Both partial loss and complete loss of Tet2 alters the 5hmC dynamic remodeling for the adaptive immune pathway, as well as cytokines. Thus, our results reveal a new role of Tet2 in immunology, and Tet2 may serve as a promising target in regulating the level of immune response.
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Affiliation(s)
- Cuida Meng
- Department of Otolaryngology Head and Neck Surgery, China-Japan Union of Jilin University, Changchun, China.,Jilin provincial Key Laboratory of Precise Diagnosis and Treatment of Upper Airway Allergic Diseases, China
| | - Lei Gu
- Affiliated First hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yujing Li
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Ronghua Li
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Yiqu Cao
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Ziyi Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Emily G Allen
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Dongdong Zhu
- Department of Otolaryngology Head and Neck Surgery, China-Japan Union of Jilin University, Changchun, China.,Jilin provincial Key Laboratory of Precise Diagnosis and Treatment of Upper Airway Allergic Diseases, China
| | - Peng Jin
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA
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Lieberman JA, Gupta RS, Knibb RC, Haselkorn T, Tilles S, Mack DP, Pouessel G. The global burden of illness of peanut allergy: A comprehensive literature review. Allergy 2021; 76:1367-1384. [PMID: 33216994 PMCID: PMC8247890 DOI: 10.1111/all.14666] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 10/30/2020] [Accepted: 11/14/2020] [Indexed: 01/05/2023]
Abstract
Peanut allergy (PA) currently affects approximately 2% of the general population of Western nations and may be increasing in prevalence. Patients with PA and their families/caregivers bear a considerable burden of self‐management to avoid accidental peanut exposure and to administer emergency medication (adrenaline) if needed. Compared with other food allergies, PA is associated with higher rates of accidental exposure, severe reactions and potentially fatal anaphylaxis. Approximately 7%–14% of patients with PA experience accidental peanut exposure annually, and one‐third to one‐half may experience anaphylaxis, although fatalities are rare. These risks impose considerably high healthcare utilization and economic costs for patients with PA and restrictions on daily activities. Measures to accommodate patients with PA are often inadequate, with inconsistent standards for food labelling and inadequate safety policies in public establishments such as restaurants and schools. Children with PA are often bullied, resulting in sadness, humiliation and anxiety. These factors cumulatively contribute to significantly reduced health‐related quality of life for patients with PA and families/caregivers. Such factors also provide essential context for risk/benefit assessments of new PA therapies. This narrative review comprehensively assessed the various factors comprising the burden of PA.
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Affiliation(s)
- Jay A. Lieberman
- University of Tennessee Health Science Center/Le Bonheur Children’s Hospital Memphis TN USA
| | - Ruchi S Gupta
- Institute for Public Health and Medicine Ann & Robert H. Lurie Children's Hospital of ChicagoNorthwestern School of Medicine Chicago IL USA
| | | | | | | | - Douglas P. Mack
- Department of Pediatrics McMaster University Hamilton ON Canada
| | - Guillaume Pouessel
- Pneumology and Allergology Unit Children's HospitalLille University Hospital Jeanne de Flandre France
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Darougar S, Mansouri M, Hassani S, Sohrabi MR, Hashemitari P. The effect of a cow's milk-free diet on asthma control in children: a quasi-experimental study. AMERICAN JOURNAL OF CLINICAL AND EXPERIMENTAL IMMUNOLOGY 2021; 10:8-16. [PMID: 33815958 PMCID: PMC8012302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 01/26/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Food allergy which usually develops in the first year of life is a risk factor for persistent asthma in young children. Cow's milk has been demonstrated to be the most commonly identified food allergen in children. Considering the central role of non-IgE-mediated food allergies in the development of hidden gastroesophageal reflux and consequently asthma, we evaluated the effect of eliminating food allergens to better control asthma. METHOD A total of eighty infants and children up to the age of 12 referred to the Asthma Clinic of Mofid Children Hospital for a period of one year were enrolled in this study. In those patients whose asthma remained uncontrolled (Childhood Asthma Control Test ≤19) despite a 2-week period of treatment, we advocated a 2-week-diet based on eliminating cow's milk in conjunction with asthma conventional therapy. For breast-fed infants, mothers were requested to eliminate these products from their daily intake regimens and for formula-fed infants, the elemental based formula was started. RESULTS Three of the patients were lost in follow-up and six of them were excluded from the study because of non-compliance. The Asthma Control Test score which was less than or equal to 19 in the entire study population, increased to 20 or more after we began a diet based on the elimination of cow's milk in all but 13 participants. CONCLUSION To conclude, the results were promising, demonstrating that a cow's milk protein elimination diet is a prudent approach in the management of patients with recalcitrant asthma, and can be considered as the missing link in asthma treatment.
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Affiliation(s)
- Sepideh Darougar
- Department of Pediatrics, Tehran Medical Sciences Branch, Islamic Azad UniversityTehran, Iran
| | - Mahboubeh Mansouri
- Department of Allergy and Clinical Immunology, Mofid Children Hospital, Shahid Beheshti University of Medical SciencesTehran, Iran
| | - Solmaz Hassani
- Mofid Children Hospital, Shahid Beheshti University of Medical SciencesTehran, Iran
| | - Mohammad Reza Sohrabi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical SciencesTehran, Iran
- Community Medicine Department, School of Medicine, Shahid Beheshti University of Medical SciencesTehran, Iran
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Dasanayaka BP, Li Z, Pramod SN, Chen Y, Khan MU, Lin H. A review on food processing and preparation methods for altering fish allergenicity. Crit Rev Food Sci Nutr 2020; 62:1951-1970. [PMID: 33307772 DOI: 10.1080/10408398.2020.1848791] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
People eat many varieties of food to satiate their hunger. Among them, a few numbers of food cause overreaction of the body's immune system, and fish holds a permanent position on that list. Processing methods, including one treatment or a combination, can have different effects on the allergenic potential of food proteins. An important point to note, however, is that not all of these methods can eliminate the potential for protein allergy. Thus, it is essential to understand the risk involved with the consumption of processed fish and its derivatives. Fish could be prepared in various ways before come to the dining plate. It has shown some of these methods can effectively manipulate the allergenicity owing to the alterations occurred in the protein conformation. This article provides an overview of the impact of fish processing methods (thermal and non-thermal) on the allergenic potential of fish along with possible causative structural modification provokes allergen stability. The article begins with current trends related to fish consumption, proceeds with the prevalence and underlying mechanism of fish allergy. Properties of clinically relevant fish proteins, projected IgE epitopes of PV, cross-reactivity of fish allergens are also addressed in this context to understand and compare the behavioral patterns of PV profiles of different species on processing methods.
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Affiliation(s)
| | - Zhenxing Li
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province, P.R. China
| | | | - Yan Chen
- NHC Key Laboratory of Food Safety Risk Assessment, Chinese Academy of Medical Science Research Unit, China National Center for Food Safety Risk Assessment, Beijing, P.R. China
| | - Mati Ullah Khan
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province, P.R. China
| | - Hong Lin
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province, P.R. China
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Liu JQ, Hu TY, Diao KY, Yu D, Song YN, Mo LH, Yang G, Liu ZQ, Liu ZG, Yang PC. Cold stress promotes IL-33 expression in intestinal epithelial cells to facilitate food allergy development. Cytokine 2020; 136:155295. [PMID: 32977238 DOI: 10.1016/j.cyto.2020.155295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/23/2020] [Accepted: 09/08/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND The causative factors and pathogenesis of food allergy (FA) is not fully understood yet. Cold stress (CS) occurs frequently in human life that influences physiological activities in the body. In this study, we aimed to investigate the chronic CS (CS) effects on promoting the expression of IL-33 in intestinal epithelial cells. METHODS CS was carried out by placing mice at 4 °C for 1 h daily for 7 consecutive days. We developed a mouse model used to test the effects of CS on the FA development. RESULTS We found that, similar to conventional FA mouse model, CS induced the core body temperature to drop markedly in mice, increased intestinal epithelial barrier permeability and facilitated FA development. CS promoted interleukin (IL)-33 expression in intestinal epithelial cells through the adrenocorticotropic hormone (ACTH)/cortisol axis and via inducing the Il33 promoter methylation. CS facilitated the FA development in mice, that could be blocked by depletion of IL-33 expression in intestinal epithelial cells. CONCLUSIONS CS induces IL-33 expression in intestinal epithelial cells to promote Th2 polarization in the intestinal tissues and facilitates FA development.
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Affiliation(s)
- Jiang-Qi Liu
- Department of Allergy, Longgang ENT Hospital and Shenzhen ENT Institute, Shenzhen, China; Research Center of Allergy & Immunology, Shenzhen University School of Medicine, Shenzhen, China
| | - Tian-Yong Hu
- Department of Allergy, Longgang ENT Hospital and Shenzhen ENT Institute, Shenzhen, China; Research Center of Allergy & Immunology, Shenzhen University School of Medicine, Shenzhen, China
| | - Kai-Yuan Diao
- Department of Pediatric Otolaryngology, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Dian Yu
- Department of Allergy, Longgang ENT Hospital and Shenzhen ENT Institute, Shenzhen, China
| | - Yan-Nan Song
- Department of Allergy, Longgang ENT Hospital and Shenzhen ENT Institute, Shenzhen, China
| | - Li-Hua Mo
- Department of Allergy, Longgang ENT Hospital and Shenzhen ENT Institute, Shenzhen, China; Department of Pediatric Otolaryngology, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Gui Yang
- Department of Otolaryngology, Longgagn Central Hospital, Shenzhen, China
| | - Zhi-Qiang Liu
- Department of Allergy, Longgang ENT Hospital and Shenzhen ENT Institute, Shenzhen, China; Research Center of Allergy & Immunology, Shenzhen University School of Medicine, Shenzhen, China.
| | - Zhi-Gang Liu
- Department of Allergy, Longgang ENT Hospital and Shenzhen ENT Institute, Shenzhen, China.
| | - Ping-Chang Yang
- Department of Allergy, Longgang ENT Hospital and Shenzhen ENT Institute, Shenzhen, China; Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Shenzhen, China.
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Ziyab AH, Karmaus W, AlShatti KA, Al-Kandari M, Hussein SH, Ali YM. Psoriasis Among Adolescents in Kuwait and the Role of Siblings, Breastfeeding, and Household Cat and Secondhand Smoke Exposure: A Cross-Sectional Study. Dermatol Ther (Heidelb) 2020; 10:1137-1153. [PMID: 32844373 PMCID: PMC7477028 DOI: 10.1007/s13555-020-00437-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Indexed: 10/29/2022] Open
Abstract
INTRODUCTION Globally, the epidemiology of psoriasis is poorly understood, and most countries lack essential epidemiologic data regarding disease burden and its determinants. This study sought to estimate the prevalence of psoriasis among adolescents in Kuwait and assess its association with different risk factors, including obesity, sibship size, breastfeeding, and exposure to household secondhand smoke (SHS) and pets. METHODS Schoolchildren aged 11-14 years (n = 3864) were enrolled in a cross-sectional study. Lifetime and current (past 12 months) prevalence of psoriasis were ascertained according to ever having a history of doctor-diagnosis plus current active lesion(s) and/or current use of treatment of psoriasis. Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) were estimated. RESULTS The lifetime and current prevalence of psoriasis were estimated to be 3.6% (136/3806) and 1.1% (42/3806), respectively. Commonly reported anatomical sites affected by psoriasis included scalp (47.6%) and the extensor surface of the knees (50%) and elbows (38.1%). Household SHS exposure was associated with increased lifetime psoriasis (aPR = 1.41, 95% CI 1.07-1.98), and showed a trend for association with current psoriasis (1.77, 0.89-3.53). Similarly, cat-keeping during infancy was associated with lifetime psoriasis (1.96, 1.14-3.37), and demonstrated a trend for association with current psoriasis (1.49, 0.52-1.98). In contrast, breastfeeding was associated with a decreased lifetime psoriasis (0.62, 0.44-0.89), but was not associated with current psoriasis. Trend analyses showed that the prevalence of lifetime and current psoriasis increased with increasing numbers of total, older, and younger siblings. CONCLUSIONS Psoriasis affects a considerable proportion of schoolchildren in Kuwait. Interestingly, psoriasis prevalence was related to risk factors also found in allergic diseases, such as exposure to SHS, cat-keeping in infancy, breastfeeding, and sibship size, possibly suggesting a role of immune dysregulation.
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Affiliation(s)
- Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.
| | - Wilfried Karmaus
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | | | - Manal Al-Kandari
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Shaimaa H Hussein
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Yaser M Ali
- Department of Internal Medicine, Mubarak Al-Kabeer Hospital, Ministry of Health, Kuwait City, Kuwait
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Ziyab AH, Almari M, Al-Taiar A. Exposure to household secondhand smoke among adolescents in Kuwait: Results from two school-based cross-sectional studies. Tob Induc Dis 2020; 18:32. [PMID: 32336970 PMCID: PMC7177388 DOI: 10.18332/tid/119116] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/06/2020] [Accepted: 03/16/2020] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Detrimental effects of secondhand smoke (SHS) exposure are well established; however, data on SHS exposure among adolescents in Kuwait are lacking. Hence, this study sought to estimate the prevalence of household SHS exposure among two samples of adolescents in Kuwait and assess its variation by socioeconomic status and parental education level. METHODS Data from two large school-based cross-sectional studies were analyzed. Adolescents attending public middle (n=3864; aged 11–14 years) and high (n=1959; aged 14–19 years) schools throughout Kuwait were enrolled in 2016-2017, and parental self-reported household SHS exposure was ascertained. Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (APRs) and 95% confidence intervals (CIs) were estimated. RESULTS Overall, 45.8% (1755/3836; 95% CI: 44.2–47.3%) of the enrolled middle school students and 51.6% (998/1936; 95% CI: 49.3–53.8%) of the enrolled high school students were exposed to household SHS. Among middle and high school students, the prevalence of household SHS exposure increased as maternal/paternal education level and family income decreased. Among middle school students, paternal educational attainment of middle school or less compared to bachelor’s degree or higher was associated with 1.60 times (95% CI: 1.44–1.79) higher household SHS exposure. Similarly, in the sample of middle school students, the prevalence of household SHS exposure significantly increased from 35.8% among children from families reporting the highest household income to 50.5% among children from families with the lowest reported household income (p-trend<0.001). CONCLUSIONS Household SHS exposure is substantially high among adolescents in Kuwait. Enrolled adolescents from families with low socioeconomic status or with low parental education level have the highest household SHS exposure. These findings highlight the need for national comprehensive tobacco control policies and increasing parental awareness of the impact of SHS exposure on children.
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Affiliation(s)
- Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Mohammad Almari
- Department of Health Policy and Management, Faculty of Public Health, Kuwait University, Kuwait City, Kuwait
| | - Abdullah Al-Taiar
- School of Community and Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, United States
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AlShatti KA, Ziyab AH. Pet-Keeping in Relation to Asthma, Rhinitis, and Eczema Symptoms Among Adolescents in Kuwait: A Cross-Sectional Study. Front Pediatr 2020; 8:331. [PMID: 32656169 PMCID: PMC7324793 DOI: 10.3389/fped.2020.00331] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 05/20/2020] [Indexed: 11/30/2022] Open
Abstract
Background: Findings on the associations between household pet-keeping and allergic diseases, including asthma, rhinitis, and eczema, have been contradictory, with investigations reporting positive, negative, and null associations. This study sought to estimate the prevalence of pet-keeping among families in Kuwait and to assess the associations between pet-keeping and symptoms of allergic diseases among adolescents. Methods: Schoolchildren aged 11-14 years (n = 3,864) were enrolled in this cross-sectional study. The children's parents completed questionnaires regarding their child's environmental exposures, including pet-keeping in the past 12 months, and clinical history and symptoms of allergic diseases. Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (aPRs) and their 95% confidence intervals (CIs) were estimated. Results: Pet-keeping in the past 12 months was reported by 42.8% of the participating families. Birds, cats, rabbits, fish, and dogs were kept by 28.3, 13.2, 7.8, 3.9, and 3.1% of all households, respectively. Current cat ownership was significantly associated with current wheezing (aPR 1.29, 95% CI 1.05-1.58), current rhinitis symptoms (aPR 1.18, 95% CI 1.02-1.36), and ever doctor-diagnosed eczema (aPR 1.25, 95% CI 1.03-1.50). Current rabbit-keeping was positively associated with multiple symptoms of asthma (e.g., study-defined current asthma: aPR 1.38, 95% CI 1.04-1.82) and eczema (e.g., severe eczema: aPR 1.94, 95% CI 1.02-3.71). Similarly, current bird-keeping was associated with study-defined current rhinitis (aPR 1.19, 95% CI 1.05-1.41) and current itchy rash (aPR 1.27, 95% CI 1.10-1.46). Conclusions: Household pet-keeping is very common and diverse in Kuwait and was found to be positively associated with symptoms of allergic diseases among adolescents. The findings of associations between rabbit-keeping and symptoms of asthma and eczema add to the existing literature and further highlight the importance of considering the pet type when assessing such associations.
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Affiliation(s)
| | - Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
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22
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Rhinoconjunctivitis among Adolescents in Kuwait and Associated Risk Factors: A Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2019; 2019:3981064. [PMID: 31815136 PMCID: PMC6878814 DOI: 10.1155/2019/3981064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 10/13/2019] [Accepted: 10/21/2019] [Indexed: 01/01/2023]
Abstract
Rhinoconjunctivitis is a public health problem that causes major illness and disability worldwide. Epidemiological studies intended to determine the burden of rhinoconjunctivitis in Kuwait are limited. Hence, this study sought to estimate the prevalence of rhinoconjunctivitis among adolescents in Kuwait and explore its association with different risk factors. Schoolchildren aged 11–14 years (n = 3,864) were enrolled in a cross-sectional study. Parents completed questionnaires regarding their children's clinical history and symptoms of rhinoconjunctivitis and relevant exposures. Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were estimated. The 12-month (current) prevalence estimates of rhinitis, rhinoconjunctivitis, and severe rhinoconjunctivitis were 28.6% (1,040/3,643), 13.5% (497/3,689), and 1.2% (44/3,689), respectively. The prevalence of current rhinoconjunctivitis symptoms was higher in boys compared to girls (aPR = 1.19, 95% CI: 1.01–1.41). Parental history of rhinitis and asthma showed positive associations with rhinoconjunctivitis in offspring. Trend analyses showed that rhinoconjunctivitis prevalence decreased with increasing numbers of total siblings (aPR = 0.92, Ptrend < 0.001) and older siblings (aPR = 0.90, Ptrend < 0.001). Rhinoconjunctivitis is common among adolescents in Kuwait and its epidemiology is similar to that found in western countries.
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23
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Diet and Food Allergy as Risk Factors for Asthma in the Arabian Gulf Region: Current Evidence and Future Research Needs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203852. [PMID: 31614710 PMCID: PMC6843839 DOI: 10.3390/ijerph16203852] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 09/30/2019] [Accepted: 10/10/2019] [Indexed: 12/13/2022]
Abstract
Asthma is a chronic respiratory disease which is associated with higher levels of systemic inflammation. The causes of asthma remain poorly understood. Unhealthy diet and food allergy are potential risk factors for developing asthma. The prevalence of asthma in the Arabian Gulf region (AGR), and Kuwait, Saudi Arabia and Qatar in particular, is higher than in other Eastern Mediterranean countries. In the AGR, diets tend to be of low nutritional value due to high levels of total energy, cholesterol, sodium, added sugars and saturated fat, and low levels of fiber, fruit and vegetables. A few studies that include children and adults in the AGR have suggested a potential link between unhealthy diets/specific food allergens and increased risk of asthma, however, the association of food allergy with asthma is still a controversial issue. The aim of this commentary is to consider the evidence from the AGR regarding the effects of diet/food allergy on asthma risk that may be used to make recommendations for future research.
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