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Nocerino R, Carucci L, Coppola S, Cecere G, Micillo M, Castaldo T, Russo S, Sandomenico M, Marino A, Gualano R, Ercolini P, Capasso A, Bedogni G, Berni Canani R. Epidemiology of Paediatric Italian Food Allergy: Results of the EPIFA study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2024; 3:100246. [PMID: 38655562 PMCID: PMC11035069 DOI: 10.1016/j.jacig.2024.100246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 01/14/2024] [Accepted: 01/27/2024] [Indexed: 04/26/2024]
Abstract
Background Updated epidemiologic data are important for defining effective public health strategies for pediatric food allergy (FA). Objective The Epidemiology of Paediatric Italian Food Allergy (EPIFA) study was designed to investigate the epidemiology of pediatric FA in one of the most heavily populated Italian regions. Methods A retrospective cohort study was performed in collaboration with family pediatricians aimed at investigating the epidemiology of Italian pediatric FA during 2009 to 2021. Family pediatricians in the Campania region were invited to use the Google Forms platform for online compilation of data forms. Data forms were reviewed by experienced pediatric allergists at the coordinating center. Results A total population of 105,151 subjects (aged 0-14 years) was screened during the study period. Data from 752 FA patients were evaluated. A progressive increase in FA incidence and prevalence was observed from 2009 to 2021, with a relative increase up to 34% and 113.6%, respectively, at the end of study period. The relative increase in FA prevalence was higher in the 0-3-year-old age group in the same study period (+120.8%). The most frequent allergens were cow's milk, hen's egg, and nuts. Conclusion The results of the EPIFA study showed an increase in pediatric FA incidence and prevalence from 2009 to 2021 in Italy. These results underline the necessity of new effective strategies for preventing and managing these conditions.
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Affiliation(s)
- Rita Nocerino
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Serena Coppola
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Gaetano Cecere
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Maria Micillo
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Tina Castaldo
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Stefania Russo
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Marialuisa Sandomenico
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Antonio Marino
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Renato Gualano
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Paola Ercolini
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Antonella Capasso
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Giorgio Bedogni
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
- Department of Internal Medicine, S Maria delle Croci Hospital, AUSL Romagna, Ravenna, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
- European Laboratory for the Investigation of Food-Induced Diseases, University of Naples Federico II, Naples, Italy
- Task Force for Microbiome Studies, University of Naples Federico II, Naples, Italy
| | - Italian Society of Pediatric Gastroenterology and Nutrition (SIGENP)
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
- European Laboratory for the Investigation of Food-Induced Diseases, University of Naples Federico II, Naples, Italy
- Task Force for Microbiome Studies, University of Naples Federico II, Naples, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
- Department of Internal Medicine, S Maria delle Croci Hospital, AUSL Romagna, Ravenna, Italy
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2
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Todoric K, Merrill S. Oral Immunotherapy: An Overview. Med Clin North Am 2024; 108:719-731. [PMID: 38816113 DOI: 10.1016/j.mcna.2023.08.011] [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] [Indexed: 06/01/2024]
Abstract
Oral immunotherapy (OIT) is an alternative treatment of IgE-mediated food allergy that has been shown to increase tolerance threshold to many of the top food allergens, although this effect may be dependent on age, dose, frequency, and duration. OIT has been shown to be effective and safe in infants, and early initiation can improve rates of desensitization even for those foods whose natural history favors loss of allergy. Studies looking at protocol modification to improve OIT success are ongoing as is the evaluation of clinical tools to help monitor OIT effects.
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Affiliation(s)
- Krista Todoric
- Medical Arts Allergy, 220 Wilson Street Suite 200, Carlisle, PA 17013, USA.
| | - Sarah Merrill
- Family Medicine Department, UC San Diego Health, 402 Dickinson Street, San Diego, CA 92103, USA
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3
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Conway AE, Golden DBK, Brough HA, Santos AF, Shaker MS. Serologic measurements for peanut allergy: Predicting clinical severity is complex. Ann Allergy Asthma Immunol 2024; 132:686-693. [PMID: 38272114 DOI: 10.1016/j.anai.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/14/2024] [Accepted: 01/15/2024] [Indexed: 01/27/2024]
Abstract
Allergist-immunologists use serologic peanut allergy testing to maximize test sensitivity and specificity while minimizing cost and inconvenience. Recent advances toward this goal include a better understanding of specific IgE (sIgE) and component testing, epitope-sIgE assays, and basophil activation testing. Predicting reaction severity with serologic testing is challenged by a range of co-factors that influence reaction severity, such as the amount and form of any allergen consumed and comorbid disease. In 2020, the Allergy Immunology Joint Task Force on Practice Parameters recommended Ara h 2-sIgE as the most cost-effective diagnostic test for peanut allergy because of its superior performance, when compared with skin prick testing and serum IgE. Basophil activation testing, a functional test of allergic response not evaluated in the Joint Task Force on Practice Parameters guideline, is a promising option for both allergy diagnosis and prognosis. Similarly, epitope-sIgE testing may improve prediction of reaction thresholds, but further validation is needed. Despite advances in food allergy testing, many of these tools remain limited by cost, accessibility, and feasibility. In addition, there is a need for further research on how atopic dermatitis may be modifying serologic food allergy severity assessments. Given these limitations, allergy test selection requires a shared decision-making approach so that a patient's values and preferences regarding financial impact, inconvenience, and psychological effects are considered in the context of clinician expertise on the timing and use of optimized testing.
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Affiliation(s)
| | - David B K Golden
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Helen A Brough
- Department of Women and Children's Health (Pediatric Allergy), School of Life Courses Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Children's Allergy Service and Children's Allergy Service, Evelina Children's Hospital, Guy's and St. Thomas's NHS Foundation Trust, London, United Kingdom
| | - Alexandra F Santos
- Department of Women and Children's Health (Pediatric Allergy), School of Life Courses Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Children's Allergy Service and Children's Allergy Service, Evelina Children's Hospital, Guy's and St. Thomas's NHS Foundation Trust, London, United Kingdom; Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Marcus S Shaker
- Dartmouth Geisel School of Medicine, Hanover, New Hampshire; Section of Allergy and Immunology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
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4
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Sakihara T. Regular consumption following early introduction of allergenic foods and aggressive treatment of eczema are necessary for preventing the development of food allergy in children. Curr Opin Allergy Clin Immunol 2024; 24:160-165. [PMID: 38538069 PMCID: PMC11062606 DOI: 10.1097/aci.0000000000000983] [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] [Indexed: 04/10/2024]
Abstract
PURPOSE OF REVIEW Over the past two decades, food allergy prevention strategies have shifted from 'delayed introduction' to 'no delayed introduction' to 'early introduction' of allergenic foods. This article reviews important research in this field published in the early 2020s to support future strategies for food allergy prevention. RECENT FINDINGS Recent randomized controlled trials (RCTs), systematic reviews, meta-analyses, and real-world studies have reported that early allergenic food introduction, especially peanut and egg, are effective for preventing food allergies. However, there are also reports that food-induced anaphylaxis admission rates in infants are increasing. SUMMARY Early allergenic food introduction by itself is not sufficient to prevent the development of food allergies. Recent RCTs (SPADE study and COMEET study) have demonstrated that continued regular cow's milk consumption after early introduction is important for preventing the onset of cow's milk allergy. Furthermore, an RCT (PACI study) reported that early and aggressive anti-inflammatory topical therapy for eczema can contribute to the prevention of egg allergy by suppressing percutaneous sensitization. Food allergies may be prevented through a combination of early food introduction, regular consumption, and active eczema treatment. Further research is needed to develop well tolerated, effective, and practical strategies to prevent food allergies.
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5
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Votto M, Peters R, Riggioni C, Eigenmann P. Editorial on the virtual issue "Food allergy". Pediatr Allergy Immunol 2024; 35:e14145. [PMID: 38753420 DOI: 10.1111/pai.14145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 05/05/2024] [Indexed: 05/18/2024]
Affiliation(s)
- Martina Votto
- Pediatric Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Rachel Peters
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Pediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Carmen Riggioni
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore City, Singapore
| | - Philippe Eigenmann
- Pediatric Allergy Unit, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
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Kuźniar J, Kozubek P, Gomułka K. Differences in the Course, Diagnosis, and Treatment of Food Allergies Depending on Age-Comparison of Children and Adults. Nutrients 2024; 16:1317. [PMID: 38732564 PMCID: PMC11085589 DOI: 10.3390/nu16091317] [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: 03/25/2024] [Revised: 04/23/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
Food allergy (FA) has become a common global public health issue, with a growing prevalence in the modern world and a significant impact on the lives of patients, their families, and caregivers. It affects every area of life and is associated with elevated costs. Food allergy is an adverse immune reaction that occurs in response to a given food. The symptoms vary from mild to severe and can lead to anaphylaxis. This is why it is important to focus on the factors influencing the occurrence of food allergies, specific diagnostic methods, effective therapies, and especially prevention. Recently, many guidelines have emphasized the impact of introducing specific foods into a child's diet at an early age in order to prevent food allergies. Childhood allergies vary with age. In infants, the most common allergy is to cow's milk. Later in life, peanut allergy is more frequently diagnosed. Numerous common childhood allergies can be outgrown by adulthood. Adults can also develop new IgE-mediated FA. The gold standard for diagnosis is the oral provocation test. Skin prick tests, specific IgE measurements, and component-resolved diagnostic techniques are helpful in the diagnosis. Multiple different approaches are being tried as possible treatments, such as immunotherapy or monoclonal antibodies. This article focuses on the prevention and quality of life of allergic patients. This article aims to systematize the latest knowledge and highlight the differences between food allergies in pediatric and adult populations.
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Affiliation(s)
- Julia Kuźniar
- Student Scientific Group of Internal Medicine and Allergology, Wroclaw Medical University, 50-369 Wroclaw, Poland;
| | - Patrycja Kozubek
- Student Scientific Group of Internal Medicine and Allergology, Wroclaw Medical University, 50-369 Wroclaw, Poland;
| | - Krzysztof Gomułka
- Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, 50-369 Wroclaw, Poland;
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7
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Valdelvira R, Costa J, Crespo JF, Cabanillas B. Major peanut allergens are quickly released from peanuts when seeds are hydrated under specific conditions. Food Chem 2024; 437:137901. [PMID: 37922800 DOI: 10.1016/j.foodchem.2023.137901] [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: 07/03/2023] [Revised: 10/20/2023] [Accepted: 10/27/2023] [Indexed: 11/07/2023]
Abstract
Allergens release from their biological source is a critical step in allergic sensitization. We sought to investigate in vitro the role of hydration at 1:10 w/v without stirring and 1:5 w/v with and without stirring on the release of major and minor allergens from peanut kernels. We hypothesized that hydration plays a pivotal role in peanut allergens release, affecting major allergens predominantly, and that peanut-water ratio and stirring influence allergen diffusion. We found that major peanut allergen Ara h 1 was quickly released during hydration leading to a decrease in its content in the seed particularly at hydration performed at 1:5 w/v with stirring. Ara h 2 remained more preserved in the hydrated seed, while Ara h 3 showed no content decrease despite its important release into the hydration water. Minor allergens Ara h 8 and Ara h 9 have lower abundance in peanut leading to a reduction of their content in the seed after their diffusion into the water during hydration. The results also demonstrated that a higher seed-to-water ratio (1:5 w/v) and stirring had a more pronounced impact on allergen release.
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Affiliation(s)
- Rafael Valdelvira
- Department of Allergy, Instituto de Investigación Biosanitaria Hospital 12 de Octubre (imas12), Avenida de Córdoba s/n, 28041 Madrid, Spain
| | - Joana Costa
- REQUIMTE-LAQV, Faculdade de Farmácia, Universidade do Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - Jesus F Crespo
- Department of Allergy, Instituto de Investigación Biosanitaria Hospital 12 de Octubre (imas12), Avenida de Córdoba s/n, 28041 Madrid, Spain
| | - Beatriz Cabanillas
- Department of Allergy, Instituto de Investigación Biosanitaria Hospital 12 de Octubre (imas12), Avenida de Córdoba s/n, 28041 Madrid, Spain.
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8
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Trinh THK, Duong CN, Pham THT, Au HDT, Tran LT, Nguyen CV, Nguyen HBG, Tran NM, Phan QQ, Le TNA, Nguyen N. Risk Factors for Severe Seafood Allergy Among Adults in an Urban City in Vietnam. J Asthma Allergy 2024; 17:167-179. [PMID: 38497090 PMCID: PMC10944135 DOI: 10.2147/jaa.s448565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/20/2024] [Indexed: 03/19/2024] Open
Abstract
Purpose Increasing seafood consumption is associated with more frequent reports of food allergy. Little is known about seafood allergy (SFA) among adults in Vietnam. We investigated the characteristics of individuals with SFA and the risk factors for severe SFA. Patients and methods A cross-sectional, web-based survey was conducted among individuals aged ≥ 18 years from universities in Ho Chi Minh City (Vietnam) between December 2021 and July 2022. The survey was based on a structured, validated questionnaire related to FA. Strict definitions of "convincing allergy" were used. Multivariate analysis was used to estimate the risk factors for severe SFA after adjusting for covariates. Data were analyzed using JASP (v.0.16.3) and SPSS (v.22.0). Results Totally, 1038 out of 2137 (48.57%) individuals completed the questionnaire, of whom 285 (27.46%) had reported SFA. Convincing SFA accounted for 20.13% (209/1038) of the cases, with convincing shellfish allergy being more common than fish allergy. Participants with comorbid shellfish and fish allergy had higher prevalence of atopic dermatitis, peanut/nut allergy, other food allergy, and cutaneous and upper airway symptoms compared to participants with shellfish allergy (p < 0.05). The spectrum of reactive seafood was diverse and characterized by local species. The age of symptom onset was most commonly during late childhood and adolescence, with most reactions persisting into adulthood. A history of anaphylaxis, comorbid peanut, and tree nut allergy, and ≥3 allergens were associated with severe SFA. Conclusion Features of causative, coexisting seafood allergy, and risk factors for severe SFA were demonstrated, which can provide a reference for future studies.
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Affiliation(s)
- Tu H K Trinh
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Chi N Duong
- University of Massachusetts Lowell, Lowell, MA, USA
| | - Tu H T Pham
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Hao D T Au
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Loc T Tran
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Cuong V Nguyen
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Han B G Nguyen
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Nguyen M Tran
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Quy Q Phan
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Thu N A Le
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Nga Nguyen
- Hasaki Clinic, Ho Chi Minh City, Vietnam
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9
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Licata J, Evatt M, Pasek T, Bilenski B. Empowering middle school students to save lives through increasing awareness of food allergies and anaphylaxis through virtual media: A quality improvement project. J Pediatr Nurs 2024; 75:221-223. [PMID: 38195373 DOI: 10.1016/j.pedn.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Affiliation(s)
- Jodi Licata
- Duquesne University School of Nursing, Duquesne University, 600 Forbes Avenue, Pittsburgh, PA 15282, United States of America.
| | - Manjulata Evatt
- Duquesne University, Pittsburgh, PA, United States of America
| | - Tracy Pasek
- University of Pittsburgh Medical Center Children's Hospital of Pittsburgh University of Pennsylvania School of Nursing, Philadelphia, PA, United States of America
| | - Bridgett Bilenski
- North Allegheny School District, Pittsburgh, PA, United States of America
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10
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Ge X, Ju G, Lv X, Sui X, Zhang Y, Liang L, Yang Q, Wu W, Lv L. Reducing the allergenicity of tropomyosin in shrimp by covalent conjugation with quercetin and chlorogenic acid. Int J Biol Macromol 2024; 262:130099. [PMID: 38342255 DOI: 10.1016/j.ijbiomac.2024.130099] [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: 07/06/2023] [Revised: 02/01/2024] [Accepted: 02/08/2024] [Indexed: 02/13/2024]
Abstract
The study aimed to assay the allergenicity of shrimp tropomyosin (TM) following covalent conjugation with quercetin (QR) and chlorogenic acid (CA). The structure of the TM-polyphenol covalent conjugates was examined by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), circular dichroism (CD), fluorescence, differential scanning calorimetry (DSC), and Fourier Transform infrared spectroscopy (FTIR). Potential allergenicity was evaluated using in vitro and in vivo methods. The results showed that QR and CA induced structural changes in TM through aggregation. RBL-2H3 cell results showed that TM-QR and TM-CA covalent conjugates reduced the release of β-hexosaminidase and histamine, respectively. In the mice model, TM-QR and TM-CA covalent conjugates reduced the level of IgE, IgG, IgG1, histamine, and mMCP-1 in sera. Furthermore, the allergenicity was reduced by suppressing Th2-related cytokines (IL-4, IL-5, IL-13) and promoting Th1-related cytokines (IFN-γ). These research findings demonstrate that the covalent binding of TM with QR and CA, modifies the allergenic epitopes of shrimp TM, thereby reducing its potential allergenicity. This approach holds practical applications in the production of low-allergenicity food within the food industry.
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Affiliation(s)
- Xinyu Ge
- School of Food Science and Engineering, Qingdao Agricultural University, Qingdao 266109, China
| | - Guangxiu Ju
- Qingdao Municipal Center For Disease Control & Prevention, 175 Shandong Road shibei District, Qingdao, Shandong Province 266033, China
| | - Xiaojing Lv
- Qingdao Municipal Center For Disease Control & Prevention, 175 Shandong Road shibei District, Qingdao, Shandong Province 266033, China
| | - Xiufen Sui
- Qingdao Municipal Center For Disease Control & Prevention, 175 Shandong Road shibei District, Qingdao, Shandong Province 266033, China
| | - Yalin Zhang
- School of Food Science and Engineering, Qingdao Agricultural University, Qingdao 266109, China
| | - Lifan Liang
- School of Food Science and Engineering, Qingdao Agricultural University, Qingdao 266109, China
| | - Qingli Yang
- School of Food Science and Engineering, Qingdao Agricultural University, Qingdao 266109, China
| | - Wei Wu
- School of Food Science and Engineering, Qingdao Agricultural University, Qingdao 266109, China
| | - Liangtao Lv
- School of Food Science and Engineering, Qingdao Agricultural University, Qingdao 266109, China.
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11
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Kim S, Ahn K, Kim J. Practical issues of oral immunotherapy for egg or milk allergy. Clin Exp Pediatr 2024; 67:140-148. [PMID: 37350169 PMCID: PMC10915454 DOI: 10.3345/cep.2023.00234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 06/24/2023] Open
Abstract
Oral immunotherapy (OIT) has been recommended to reduce parental burden related to strict allergen avoidance and induce desensitization and immune tolerance for patients with long-lasting allergies to hen's eggs (HE) or cow's milk (CM). OIT should be monitored by pediatric allergists specializing in OIT and oral food challenge tests to manage allergic reactions. Although a previous history of anaphylaxis or multiple food allergies is not a contraindication to OIT, it is contraindicated if the patient has uncontrolled asthma, a malignancy, active systemic autoimmune disorders, or diseases requiring treatment with beta-blockers. A variety of OIT protocols have been de veloped to ensure better outcomes and safe up-dosing, including adjunctive therapies with biologics. This review provides insight into the practical issues of various immunotherapy options for children with HE or CM allergies.
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Affiliation(s)
- Sukyung Kim
- Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hallym University School of Medicine, Hwaseong, Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology, Seoul, Korea
| | - Jihyun Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology, Seoul, Korea
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12
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Gravina A, Olivero F, Brindisi G, Comerci AF, Ranucci C, Fiorentini C, Sculco E, Figliozzi E, Tudini L, Matys V, De Canditiis D, Piccioni MG, Zicari AM, Anania C. Dietary Intervention during Weaning and Development of Food Allergy: What Is the State of the Art? Int J Mol Sci 2024; 25:2769. [PMID: 38474015 DOI: 10.3390/ijms25052769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/14/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
Food allergy (FA) affects approximately 6-8% of children worldwide causing a significant impact on the quality of life of children and their families. In past years, the possible role of weaning in the development of FA has been studied. According to recent studies, this is still controversial and influenced by several factors, such as the type of food, the age at food introduction and family history. In this narrative review, we aimed to collect the most recent evidence about weaning and its role in FA development, organizing the gathered data based on both the type of study and the food. As shown in most of the studies included in this review, early food introduction did not show a potential protective role against FA development, and we conclude that further evidence is needed from future clinical trials.
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Affiliation(s)
- Alessandro Gravina
- Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | | | - Giulia Brindisi
- Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Antonia Fortunata Comerci
- Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Chiara Ranucci
- Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Cinzia Fiorentini
- Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Eleonora Sculco
- Department of Translation and Precision Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Ethel Figliozzi
- Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Laura Tudini
- Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Viviana Matys
- Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | | | - Maria Grazia Piccioni
- Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Anna Maria Zicari
- Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Caterina Anania
- Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy
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Lee ASE, Ramsey N. Climate Change and Food Allergy. Immunol Allergy Clin North Am 2024; 44:75-83. [PMID: 37973261 DOI: 10.1016/j.iac.2023.07.003] [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] [Indexed: 11/19/2023]
Abstract
The role of environmental factors including climate change and consequent influences of air pollution on food allergy remains less explored compared with impacts on allergic rhinitis and asthma. In this review, we discuss the epithelial barrier hypothesis as a proposed mechanism of food allergy development that may be relevant in this context. We also discuss existing studies that provide insight into the intricate relationship between food allergy and climate-related environmental factors.
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Affiliation(s)
- Ashley Sang Eun Lee
- Division of Allergy and Immunology, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York 10029, USA; Department of Pediatrics, Jaffe Food Allergy Institute, 10540 Avenue K, Brooklyn, NY 11236-3018, USA.
| | - Nicole Ramsey
- Division of Allergy and Immunology, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York 10029, USA; Department of Pediatrics, Jaffe Food Allergy Institute, 10540 Avenue K, Brooklyn, NY 11236-3018, USA
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14
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Orhan Kiliç B, Kiliç S, Özmert E, Tavares A, Konuksever D, Kubat G, Köksal BT. Evaluation of vitamin B 12 values at time of diagnosis in 0- to 36-month-old children with food allergies. Nutrition 2024; 118:112270. [PMID: 38007994 DOI: 10.1016/j.nut.2023.112270] [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: 09/15/2023] [Revised: 10/13/2023] [Accepted: 10/18/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVES The relationship between food allergies and vitamin B12 deficiency in young children remains unclear despite extensive studies on the nutritional status of affected children. The aim of this study was to compare vitamin B12 levels in children with recently diagnosed food allergies and healthy children ages 0 to 36 mo. METHODS A retrospective study at Başkent University Hospital analyzed 773 patients ages 0 to 36 mo. Participants were divided into two groups: food allergy and healthy. Vitamin B12 deficiency (<300 ng/mL) was assessed using χ2 tests and regression analyses. RESULTS The sample comprised 773 children ages 0 to 36 mo, with a mean age of 16 ± 9 mo (range: 1-36). Among the participants, 399 (52%) were healthy children, whereas 374 (48%) had food allergies. The prevalence of vitamin B12 deficiency was higher in children with food allergies (38%) than in healthy children (21%; P < 0.001). According to both univariate and multivariate regression analyses, formula feeding showed a negative association with vitamin B12 deficiency (β = -0.54; 95% confidence interval [CI], 0.35-0.97; P = 0.038). On the other hand, having allergic diseases (β = 0.69; 95% CI, 0.30-0.83; P = 0.040) and breastfeeding for <6 mo (β = 1.35; 95% CI, 1.41-10.50-0.50; P = 0.009) exhibited a positive association with vitamin B12 deficiency. CONCLUSION Food-allergic children ages 0 to 36 mo were at higher risk for vitamin B12 deficiency. Formula feeding had a protective effect, whereas allergic diseases and breastfeeding for <6 mo were risk factors. Further investigation is needed to understand the underlying mechanisms. Monitoring B12 levels and interventions are crucial for the nutritional well-being of food-allergic children.
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Affiliation(s)
- Betul Orhan Kiliç
- Baskent University Faculty of Medicine, Department of Pediatrics, Ankara, Turkey.
| | - Serhat Kiliç
- Baskent University Faculty of Medicine, Department of Pediatrics, Ankara, Turkey
| | - Enis Özmert
- Baskent University Faculty of Medicine, Medical Student, Ankara, Turkey
| | - Alara Tavares
- Baskent University Faculty of Medicine, Medical Student, Ankara, Turkey
| | - Dilek Konuksever
- Ankara Bilkent City Hospital, Department of Pediatrics, Ankara, Turkey
| | - Gözde Kubat
- Baskent University Faculty of Medicine, Department of Medical Education, Ankara, Turkey
| | - Burcu Tahire Köksal
- Baskent University Faculty of Medicine, Department of Pediatric Allergy, Ankara, Turkey
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Izquierdo I, Casas L, Cabrera S, Fernandez A. How to handle off-label prescriptions of rupatadine, a second-generation antihistamine and PAF antagonist: a review. Drugs Context 2024; 13:2023-9-5. [PMID: 38264404 PMCID: PMC10803124 DOI: 10.7573/dic.2023-9-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/04/2023] [Indexed: 01/25/2024] Open
Abstract
The off-label use of second-generation antihistamines, used outside of the formal indications authorized by regulatory authorities, in different age groups, doses or in special populations, is very common for many allergic, autoimmune and dermatological diseases. The off-label use of rupatadine (a second-generation antihistamine with PAF antagonist activity) in these conditions is reviewed here, including in combination with immunotherapy in the treatment of food allergy or allergic rhinitis, at high doses in chronic urticaria, and with prescriptions of less common but challenging conditions such as skin pruritus or mast cell activation disorders like mastocytosis. Rupatadine use is reviewed herein to confirm if its off-label management is supported by well-designed clinical trials or by published real-world cases. This review will contribute to increasing compliance and achieving better results in clinical practice. Off-label use of rupatadine should be left to the discretion of the prescribing healthcare professional after careful clinical evaluation.
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Affiliation(s)
- Iñaki Izquierdo
- Medical Advice Department, BIOHORM S.L., Palau-Solità i Plegamans, Barcelona, Spain
| | - Laia Casas
- Clinical & Preclinical Development, Strategy and Innovation Department, BIOHORM S.L., Palau-Solità i Plegamans, Barcelona, Spain
| | - Susana Cabrera
- Pharmacovigilance Department, NOUCOR HEALTH, S.A., Palau-Solità i Plegamans, Barcelona, Spain
| | - Alberto Fernandez
- Pharmacovigilance Department, NOUCOR HEALTH, S.A., Palau-Solità i Plegamans, Barcelona, Spain
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16
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Kefford J, Marshall J, Packer RL, Ward EC. Feeding Characteristics in Children With Food Allergies: A Scoping Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:132-148. [PMID: 38040005 DOI: 10.1044/2023_jslhr-23-00303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
BACKGROUND Food allergy (FA) affects approximately 8% of children and may be immunoglobulin E (IgE)-mediated or non-IgE-mediated. It is recognized clinically that children with both subtypes of FA may present with features of pediatric feeding disorder (PFD); however, there is currently a limited detail of presenting characteristics. OBJECTIVE The objective of this study was to synthesize the current evidence regarding the feeding characteristics of children with FA, with a focus on the feeding skills and psychosocial domains of PFD. METHOD This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. Papers published between 2001 and 2022 describing feeding characteristics in the feeding skills and psychosocial domains in children with FA/history of FA were included. Papers that focused solely on characteristics from the medical or nutritional domains were excluded. Descriptive information regarding demographics, methodology, allergy profile and history, and the characteristics of PFD observed was extracted using a preconceived data extraction form. RESULTS Overall, 40 papers contained descriptions of feeding characteristics of children with non-IgE-mediated FA (n = 22) and IgE-mediated FA (n = 11), while four were nonspecific. In the psychosocial domain, food refusal/aversion, anxiety with eating, and poor intake were the most frequently reported, regardless of FA subtype. Less information was reported regarding feeding skills, although slowness in eating, immature diet, and delays in oral sensory-motor skills were described. CONCLUSIONS Children with FA/history of FA may present with a range of characteristics that map across the feeding skill and psychosocial domains of PFD. Systematic research is needed to fully describe the feeding characteristics of children with FA. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24562732.
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Affiliation(s)
- Jennifer Kefford
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Northern Sydney Local Health District, New South Wales Health, Sydney, Australia
| | - Jeanne Marshall
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Children's Health Queensland Hospital and Health Service, Queensland Children's Hospital, Brisbane, Australia
| | - Rebecca L Packer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Elizabeth C Ward
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Centre for Functioning and Health Research (CFAHR), Metro South Hospital and Health Service, Brisbane, Queensland, Australia
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17
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Huerta Hernández RE, Ortega Martell JA. [Treatment for living with food allergy]. REVISTA ALERGIA MÉXICO 2023; 70:280-283. [PMID: 38506872 DOI: 10.29262/ram.v70i4.1313] [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: 08/01/2023] [Accepted: 10/29/2023] [Indexed: 03/21/2024] Open
Abstract
The treatment of food allergy involves completely removing the allergenic food from the diet, careful label reading, and ingredient awareness. Family education is crucial, understanding alternative names for the allergen. An emergency action plan provided by the doctor, with clear instructions for epinephrine application and when to seek medical attention, is essential. For mild to moderate symptoms, oral antihistamines may be prescribed. Psychological support is necessary due to emotional repercussions. Collaboration with an allergy specialist is crucial for personalized treatment. Natural tolerance to the food may be achieved, especially in non-IgE-mediated allergies. However, some allergic manifestations persist, requiring treatment alternatives. Avoidance of the allergen and epinephrine application are key measures. Immunotherapy aims to desensitize immune cells, but its effectiveness varies. Bioterapeutic agents, such as monoclonal antibodies, are under investigation, although their clinical use still requires more studies.
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Affiliation(s)
| | - José Antonio Ortega Martell
- Pediatra, Alergólogo e Inmunólogo clínico; Profesor de Inmunología, Universidad Autónoma del Estado de Hidalgo, Pachuca
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18
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González Díaz SN. [Epidemiology of food allergy]. REVISTA ALERGIA MÉXICO 2023; 70:211-213. [PMID: 38506858 DOI: 10.29262/ram.v70i4.1328] [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: 08/01/2023] [Accepted: 10/29/2023] [Indexed: 03/21/2024] Open
Abstract
Food allergy is very common throughout the world and has become a major public health problem, with 220 million people suffering from it. Food allergy has been disproportionately observed in people from industrialized or Western countries and was previously considered to predominate in the pediatric versus adult population. However, the current exponential growth of the adult population and older adults, especially in Western countries, and environmental and lifestyle changes, have profoundly changed the epidemiology of food allergy, with a growing increase even at advanced ages. The foods that represent the greatest severity and clinical impact are peanuts, walnuts, fish, shellfish, eggs, cow's milk protein, wheat, soy and seeds. Although some types of food allergies (cow's milk and egg) may disappear, peanut and tree nut allergies may persist into adulthood. The control or cure of cow's milk protein allergy is gradual throughout childhood and adolescence. Despite the predominance of allergy to fish, shellfish, peanuts, and tree nuts in most reactions in adults, the most common form of IgE-mediated food allergy is oral allergy syndrome or pollen allergy syndrome. food.
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Affiliation(s)
- Sandra Nora González Díaz
- Alergia e Inmunología Clínica, Jefe del Centro Regional de Alergia e Inmunología Clínica, Hospital Universitario, Facultad de Medicina, Universidad Autónoma de Nuevo León, México; Secretaria de Relaciones
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19
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Ansotegui Zubeldia IJ, Fiocchi A. [Introduction to food allergy]. REVISTA ALERGIA MÉXICO 2023; 70:208-210. [PMID: 38506857 DOI: 10.29262/ram.v70i4.1308] [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: 08/01/2023] [Accepted: 10/29/2023] [Indexed: 03/21/2024] Open
Abstract
Food allergy is a common chronic disorder that affects infants, children, adolescents, and adults. The prevalence of food allergy has increased in recent decades throughout the world, not limited to Western countries. Since there is no treatment, this focuses on avoiding allergens, in addition to educating patients and caregivers in the emergency treatment of acute reactions, for example: application of epinephrine. Studies suggest that accidental reactions occur in about 45% of children with food allergies each year, although most reactions are mild or moderate in severity. Hospital admissions for food anaphylaxis vary from 4 to 20 per 100,000 inhabitants; Deaths are rare, with an estimated incidence of 0.03 to 0.3 per million people with food allergy. Death from food anaphylaxis is rare and appears to have remained stable, possibly due to increases in food allergen labeling, diagnostic services, rates of intramuscular epinephrine prescription, and awareness of food allergies. Omalizumab is a drug approved for several disorders (chronic hives or difficult asthma) and may help reduce symptoms associated with food allergy. The relative importance of alternative technologies, management strategies and policies for food allergy varies from one region to another, due to differences in the epidemiology, education, socioeconomic well-being, and cultural preferences of the population.
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Affiliation(s)
- Ignacio Javier Ansotegui Zubeldia
- Director Médico Ejecutivo, Expresidente de la Organización Mundial de Alergia (WAO). Jefe del Departamento de Alergia e Inmunología, Hospital Quironsalud, Bizkaia, Bilbao,
| | - Alessandro Fiocchi
- Director responsable de la S.C. de Pediatría, Hospital Materno Infantil Macedonio Melloni, Milán, Italia. Director del Departamento Materno Infantil, Hospital Fatebenefratelli-Ophthalmic de Milán, Italia. Profesor adjunto de la Escuela de Es-pecialización en Pediatría III, Universidad de Milán y Consejero de la Sociedad Italiana de Pediatría, Sección Lombarda. Pediatric Hospital Bambino Gesú IRCCS Allergy division, Roma, Italia
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20
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Olaya-Hernandez M, Vasquez LDM, Silva DL, Martinez-Betancur S, Guerra M, Arias O, Ramirez LF, Serrano CD. Food allergy spectrum in the tropic: clinical and epidemiological profiles in a colombian hospital. A cross-sectional study. Front Immunol 2023; 14:1291275. [PMID: 38193085 PMCID: PMC10773786 DOI: 10.3389/fimmu.2023.1291275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/29/2023] [Indexed: 01/10/2024] Open
Abstract
Introduction Food allergy affects 2-10% of the general population; it is more frequent among children than among adults, and it is one of the leading causes of anaphylaxis. Diagnosis of food allergy requires a detailed medical history, skin tests, specific immunoglobulin E (IgE) tests for the food involved, and an oral challenge as final confirmation. Objectives This study aimed to describe the clinical and epidemiological characteristics of patients who underwent oral food challenges for suspected food allergies in a reference center in Colombia. Methodology An observational, descriptive, cross-sectional and retrospective study was conducted. Data were retrospectively collected from patients who were evaluated in the allergology service and suspected of food allergy from 2011 to 2018. Quantitative variables are presented as means or medians depending on the normality of the distribution (assessed by the Shapiro-Wilk test), and categorical variables are presented as frequencies and percentages. Results A total of 215 controlled open challenges were performed on 176 patients, most of whom were children (69%). Thirty-one patients (17%) required another oral challenge with a second food, and 11 (6.25%) required another oral challenge with three foods. Twelve oral challenges (5.58%) were positive. Of these, five challenges were positive for cow's milk, 5 were positive for shrimp, and 2 were positive for legumes (peanuts and lentils). Conclusion The frequency of confirmed food allergies and the profile of food allergies in our population differs from that reported in other parts of the world.
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Affiliation(s)
- Manuela Olaya-Hernandez
- Valle del Lili Foundation, Cali, Colombia
- Faculty of Health Sciences, ICESI University, Cali, Colombia
| | | | - Diana Lucia Silva
- Valle del Lili Foundation, Cali, Colombia
- Faculty of Health Sciences, ICESI University, Cali, Colombia
| | | | | | - Oriana Arias
- Valle del Lili Foundation, Cali, Colombia
- Faculty of Health Sciences, ICESI University, Cali, Colombia
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21
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Kou R, Wang J, Li A, Wang Y, Fan D, Zhang B, Fu W, Liu J, Fu H, Wang S. 2'-Fucosyllactose alleviates OVA-induced food allergy in mice by ameliorating intestinal microecology and regulating the imbalance of Th2/Th1 proportion. Food Funct 2023; 14:10924-10940. [PMID: 38009336 DOI: 10.1039/d3fo03272h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2023]
Abstract
Food allergy (FA) has become a prominent problem in public health. 2'-Fucosyllactose (2'-FL) was reported to alleviate FA symptoms; however, the regulatory mechanism is still unclear. This study evaluated the 2'-FL antiallergic potential in an ovalbumin (OVA)-sensitized mouse model and explored the systemic effects of 2'-FL on gut microecology and the intestinal immune barrier. The results showed that 2'-FL alleviated allergy symptoms, decreased serum allergic indicator levels, enhanced the intestinal barrier, and attenuated low-grade inflammation. The up-regulation of G protein-coupled receptors (GPRs) was associated with higher levels of short-chain fatty acids (SCFAs) in 2'-FL intervention mice. 2'-FL also improved the intestinal microbiota diversity and increased the abundance of Akkermansia, Lachnospiraceae UCG-006, and Ruminococcaceae while suppressing Muribaculaceae, Desulfovibrionaceae, and Erysipelotrichaceae. Additionally, 2'-FL ameliorated the imbalance of Th2/Th1, mainly by decreasing Th2-type immune response and enhanced CD4 + Foxp3 + Treg immunoreaction. These results suggest that 2'-FL restores intestinal barrier defects, gut microbiota disorder, and immune impairment while alleviating ovalbumin-induced allergic symptoms in FA mice.
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Affiliation(s)
- Ruixin Kou
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300071, China.
| | - Jin Wang
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300071, China.
| | - Ang Li
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300071, China.
| | - Yuanyifei Wang
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300071, China.
| | - Dancai Fan
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300071, China.
| | - Bowei Zhang
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300071, China.
| | - Wenhui Fu
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300071, China.
| | - Jingmin Liu
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300071, China.
| | - Hanyue Fu
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300071, China.
| | - Shuo Wang
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300071, China.
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22
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Robles‐Velasco K, Panchana‐Lascano M, Veintemilla‐Burgos F, Hinostroza R, Bernstein JA, Cherrez‐Ojeda I. Food allergy: What are people looking for? An infodemiology study. Clin Transl Allergy 2023; 13:e12322. [PMID: 38146802 PMCID: PMC10731990 DOI: 10.1002/clt2.12322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Affiliation(s)
- Karla Robles‐Velasco
- Universidad Espiritu SantoSamborondonEcuador
- Respiralab Research GroupGuayaquilEcuador
| | - Matias Panchana‐Lascano
- Respiralab Research GroupGuayaquilEcuador
- Universidad Catolica Santiago de GuayaquilGuayaquilEcuador
| | | | - Romina Hinostroza
- Universidad Espiritu SantoSamborondonEcuador
- Respiralab Research GroupGuayaquilEcuador
| | - Jonathan A. Bernstein
- Division of Immunology, Allergy SectionDepartment of Internal MedicineUniversity of Cincinnati College of MedicineCincinnatiOhioUSA
| | - Ivan Cherrez‐Ojeda
- Universidad Espiritu SantoSamborondonEcuador
- Respiralab Research GroupGuayaquilEcuador
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23
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Krzych-Fałta E, Białek S, Sybilski AJ, Tylewicz A, Samoliński B, Wojas O. Differential diagnostics of food allergy as based on provocation tests and laboratory diagnostic assays. Postepy Dermatol Alergol 2023; 40:709-715. [PMID: 38282888 PMCID: PMC10809836 DOI: 10.5114/ada.2023.132501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/27/2023] [Indexed: 01/30/2024] Open
Abstract
Due to the scale of the phenomenon, food allergy constitute a significant health problem and significantly impair the quality of life of patients. Differential diagnostics, including skin tests, sIgE detection tests, basophil and mast cell activation tests as well as double-blind placebo-controlled food challenge tests, is the gold standard in the diagnosis of food allergy. Recently, increasing attention has been paid to the potential use of nasal provocation test in the diagnosis of food allergy. Allergen dose, protocol standardization, assessment of subjective complaints and objectivization of test results are important factors determining the applicability of provocation tests.
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Affiliation(s)
- Edyta Krzych-Fałta
- Department of Basic Nursing, Medical University of Warsaw, Warsaw, Poland
| | - Sławomir Białek
- Department of Biochemistry and Pharmacogenomics, Medical University of Warsaw, Warsaw, Poland
| | - Adam J. Sybilski
- 2 Department of Paediatrics, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Aleksandra Tylewicz
- Department of Pediatrics and Allergology, The National Institute of Medicine of the Interior and Administration, Warsaw, Poland
| | - Bolesław Samoliński
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
| | - Oksana Wojas
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
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24
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Miller MA, McMurray JC, Watson NL, Mikita CP, Schwartz DJ. Clarification of food allergy diagnosis at a military medical center using oral food challenges. Ann Allergy Asthma Immunol 2023; 131:674-676. [PMID: 37495015 DOI: 10.1016/j.anai.2023.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/25/2023] [Accepted: 07/13/2023] [Indexed: 07/28/2023]
Affiliation(s)
- Mechelle A Miller
- Department of Allergy, Immunology, and Immunizations, Walter Reed National Military Medical Center, Bethesda, Maryland.
| | - Jeremy C McMurray
- Department of Allergy, Immunology, and Immunizations, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Nora L Watson
- Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Cecilia P Mikita
- Department of Allergy, Immunology, and Immunizations, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - David J Schwartz
- Department of Allergy, Immunology, and Immunizations, Walter Reed National Military Medical Center, Bethesda, Maryland
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25
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Li Y, Li L. A multicenter analysis on the changes of sIgE in China during the early period of COVID-19 pandemic. Immun Inflamm Dis 2023; 11:e1072. [PMID: 38018584 PMCID: PMC10629263 DOI: 10.1002/iid3.1072] [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: 05/15/2023] [Revised: 10/04/2023] [Accepted: 10/21/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVE This study aims to analyze the changes in allergen composition ratio during the early stages of the COVID-19 outbreak in China and analyze the underlying factors contributing to these alterations. METHODS A multicenter study approach was employed. A total of 618 male and female patients (0-89 years old) were recruited from the dermatology, pediatrics, and allergy departments of 17 hospitals across 15 Chinese cities between January 2020 and June 2021. Serum samples were collected and subjected to allergen-specific immunoglobulin E (sIgE) detection using the reversed enzyme allegro-sorbent test. The allergens included Dermatophagoides pteronyssinus (D. pteronyssinus), Dermatophagoides farina (D. farina), Ambrosia artemisiifolia (A. artemisiifolia), Salix babylonica (S. babylonica), dog dander, alternaria, cockroach, Artemisia argyi (A. argyi), cat dander, house dust, milk, hen's egg, mutton, cod, peanut, beef, soybean, shrimp, crab, and wheat. Each participant was required to exhibit at least one positive sIgE detection result (≥0.35 IU/mL). The chi-square test was used to analyze the differences between groups. RESULTS The positive sIgE proportion of inhalation allergens were significantly lower than that of ingestion allergens. As restrictions on outdoor activities and seafood imports persisted, the positive sIgE proportion of wheat and shrimp exhibited a significant decrease in the spring of 2021 compared to the corresponding period in 2020. Conversely, there was a substantial increase in the positive proportion of crab. The fluctuation in the ratio of D. pteronyssinus and D. farina appeared to be influenced more by seasonal factors rather than the COVID-19 pandemic. However, no noteworthy disparities were observed in the proportions of other allergens. CONCLUSION The alterations in allergen composition during the initial phase of the epidemic may be attributed to several factors, such as decreased travel, increased mask usage, reduced carbohydrate consumption, and changes in seafood consumption. However, factors such as season, cultural practices, and customs may also influence the composition of allergens.
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Affiliation(s)
- Yunzhu Li
- Department of Dermatology, Beijing Friendship HospitalCapital Medical UniversityBeijingChina
| | - Linfeng Li
- Department of Dermatology, Beijing Friendship HospitalCapital Medical UniversityBeijingChina
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26
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Koidl L, Gentile SA, Untersmayr E. Allergen Stability in Food Allergy: A Clinician's Perspective. Curr Allergy Asthma Rep 2023; 23:601-612. [PMID: 37665560 PMCID: PMC10506954 DOI: 10.1007/s11882-023-01107-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 09/05/2023]
Abstract
PURPOSE OF REVIEW The globally rising food allergy prevalence is associated with the urgent need for new disease prevention methods, efficient treatment, and reliable risk assessment methods for characterization of food allergens. Due to inter-individual variations in the digestive system, food allergens are degraded to a different extent in each person. Food processing also influences allergen digestion. RECENT FINDINGS In this review, we provide an overview of the digestive system with focus on relevance for food allergy. Main food proteins causing allergic reactions are evaluated, and the combined role of food processing and digestion for allergen stability is highlighted. Finally, clinical implications of this knowledge are discussed. Recent literature shows that allergen digestibility is dependent on food processing, digestive conditions, and food matrix. Digestion affects proteins allergenicity. It is currently not possible to predict the immunogenicity of allergens solely based on protein stability.
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Affiliation(s)
- Larissa Koidl
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Waehringer Guertel 18-20, E3Q, 1090, Vienna, Austria
| | - Salvatore Alessio Gentile
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Waehringer Guertel 18-20, E3Q, 1090, Vienna, Austria
| | - Eva Untersmayr
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Waehringer Guertel 18-20, E3Q, 1090, Vienna, Austria.
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Tam JS, Izadi N, Yu JE. Editorial: Patient focused developments in food allergy. FRONTIERS IN ALLERGY 2023; 4:1287078. [PMID: 37822677 PMCID: PMC10563198 DOI: 10.3389/falgy.2023.1287078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 09/12/2023] [Indexed: 10/13/2023] Open
Affiliation(s)
- Jonathan S. Tam
- Division of Clinical Immunology and Allergy, Children’s Hospital of Los Angeles, Los Angeles, CA, United States
| | - Neema Izadi
- Division of Clinical Immunology and Allergy, Children’s Hospital of Los Angeles, Los Angeles, CA, United States
| | - Joyce E. Yu
- Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, United States
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Morinaga T, Yamamoto T, Sugimoto Y. A mouse model of food allergy permitting skin and nasal symptoms. Adv Med Sci 2023; 68:372-378. [PMID: 37797366 DOI: 10.1016/j.advms.2023.09.012] [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: 03/08/2023] [Revised: 06/26/2023] [Accepted: 09/26/2023] [Indexed: 10/07/2023]
Abstract
PURPOSE Developing experimental animal models that show clinical symptoms and methods for quantitative and objective evaluation are important for understanding food allergies. Therefore, this study aimed to develop an ovalbumin (OVA)-induced mouse model of food allergy and a useful method to evaluate the symptoms of food allergy. MATERIAL/METHODS Mice were sensitized via intraperitoneal injection of OVA. Subsequently, local sensitization was performed once weekly by oral administration of OVA. Itching and nasal symptoms were observed after oral administration of the antigen. First, we examined the dose-dependency of the antigen. Symptoms were checked weekly. In order to confirm food allergy symptoms, the effect of histamine H1 receptor antagonist was examined. Finally, we measured antigen-specific IgE antibody levels in the serum. RESULTS Scratching behavior, sneezing and nasal rubbing were increased. Both itching and rhinitis symptoms increased steadily, after which, the number of symptoms remained almost constant. No difference was observed between the results of 3- and 5-week-old mice. Cetirizine inhibited these symptoms in a dose-dependent manner. In addition, antigen-specific IgE antibodies were produced in both 3- and 5-week-old mice. CONCLUSIONS This method may be useful for evaluating the symptoms of skin and rhinitis that could not be assessed in the conventional food allergy model and could be induced with a low dose of antigen. In particular, the developed method, which measures the number of itching and nasal symptoms, may enable quantitative, objective, and noninvasive evaluation of food allergy severity.
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Affiliation(s)
- Takafumi Morinaga
- Laboratory of Inflammatory Pharmacology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kita-ku, Okayama, Japan
| | - Takuya Yamamoto
- Laboratory of Inflammatory Pharmacology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kita-ku, Okayama, Japan
| | - Yukio Sugimoto
- Laboratory of Inflammatory Pharmacology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kita-ku, Okayama, Japan.
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Morąg B, Kozubek P, Gomułka K. Obesity and Selected Allergic and Immunological Diseases-Etiopathogenesis, Course and Management. Nutrients 2023; 15:3813. [PMID: 37686844 PMCID: PMC10489982 DOI: 10.3390/nu15173813] [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: 07/28/2023] [Revised: 08/25/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Obesity is a global problem. It affects every age group and is associated with many negative health effects. As an example, there is a relationship between obesity and allergic and immunological diseases, such as asthma, psoriasis, food allergies, allergic rhinitis and atopic dermatitis. Obesity undeniably affects their development. In addition, it causes adverse changes in the course and response to therapy in relation to patients without excessive body weight. The treatment of diseases associated with obesity is difficult; drugs are less effective and must be used in higher doses, and their use in patients with obesity is often associated with higher risks. The main form of treatment of all obesity-related diseases is a change in eating habits and increased physical activity, which leads to a decrease in body fat mass. The positive effect of reducing BMI has been confirmed in many independent studies. This paper reviews various types of research documents published since 2019. It aims to systematize the latest knowledge and highlight the need for further research for effective and sustainable treatment options for obesity, its complications and obesity-related diseases.
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Affiliation(s)
- Bartłomiej Morąg
- Faculty of Dentistry, Wroclaw Medical University, 50-425 Wrocław, Poland;
| | - Patrycja Kozubek
- Student Scientific Group of Adult Allergology, Wroclaw Medical University, 50-369 Wrocław, Poland
| | - Krzysztof Gomułka
- Clinical Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, 50-369 Wrocław, Poland;
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Brasal-Prieto M, Fernández-Prades L, Dakhaoui H, Sobrino F, López-Enríquez S, Palomares F. Update on In Vitro Diagnostic Tools and Treatments for Food Allergies. Nutrients 2023; 15:3744. [PMID: 37686776 PMCID: PMC10489659 DOI: 10.3390/nu15173744] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/15/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
Food allergy (FA) is an adverse immunological reaction to a specific food that can trigger a wide range of symptoms from mild to life-threatening. This adverse reaction is caused by different immunological mechanisms, such as IgE-mediated, non-IgE-mediated and mixed IgE-mediated reactions. Its epidemiology has had a significant increase in the last decade, more so in developed countries. It is estimated that approximately 2 to 10% of the world's population has FA and this number appears to be increasing and also affecting more children. The diagnosis can be complex and requires the combination of different tests to establish an accurate diagnosis. However, the treatment of FA is based on avoiding the intake of the specific allergenic food, thus being very difficult at times and also controlling the symptoms in case of accidental exposure. Currently, there are other immunomodulatory treatments such as specific allergen immunotherapy or more innovative treatments that can induce a tolerance response. It is important to mention that research in this field is ongoing and clinical trials are underway to assess the safety and efficacy of these different immunotherapy approaches, new treatment pathways are being used to target and promote the tolerance response. In this review, we describe the new in vitro diagnostic tools and therapeutic treatments to show the latest advances in FA management. We conclude that although significant advances have been made to improve therapies and diagnostic tools for FA, there is an urgent need to standardize both so that, in their totality, they help to improve the management of FA.
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Arámburo-Gálvez JG, Figueroa-Salcido OG, Ramírez-Torres GI, Terán-Cabanillas E, Gracia-Valenzuela MH, Arvizu-Flores AA, Sánchez-Cárdenas CA, Mora-Melgem JA, Valdez-Zavala L, Cárdenas-Torres FI, Ontiveros N. Prevalence of Parent-Reported Food Allergy in a Mexican Pre-School Population. J Clin Med 2023; 12:5095. [PMID: 37568497 PMCID: PMC10420166 DOI: 10.3390/jcm12155095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
The magnitude and relevance of food allergies in the preschool population remain unknown in most regions of Mexico and Latin America. Thus, our aim was to estimate the parent-reported prevalence of food allergies in a Mexican preschool population and to characterize their clinical diagnosis and presentation. A cross-sectional survey was conducted in Culiacán City. A validated questionnaire was utilized. A total of 810 parents responded to the questionnaire (valid response rate, 40.7%). The estimated prevalence rates (95% CI) were: "physician-diagnosed Food Allergy (FA), ever" 5.30% (3.86-7.08); "immediate-type FA, ever" 2.96% (1.91-4.38); "immediate-type FA, current" 1.60% (0.86-2.73); and food-dependent anaphylaxis 1.11% (0.51-2.01). The main food allergens were milk (0.49%), strawberries (0.37%), egg, and soy (0.25% each). Atopic diseases and a family history of allergies were significantly associated with immediate-type FA. Among "immediate-type FA, current" cases, 76.9% required emergency room visits, but the prescription of epinephrine autoinjectors was reported in one case only. The food reactions occurred at home (92.35%), in a relative's house (38.5), and at restaurants (23%). Immediate-type FA reactions requiring emergency room visits are not uncommon among the studied population. Actions like proper anaphylaxis management and the prevention of cross-contamination of foods should be encouraged.
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Affiliation(s)
- Jesús Gilberto Arámburo-Gálvez
- Nutrition Sciences Postgraduate Program, Faculty of Nutrition Sciences, Autonomous University of Sinaloa, Culiacan 80010, Mexico; (J.G.A.-G.); (O.G.F.-S.); (E.T.-C.); (C.A.S.-C.); (J.A.M.-M.); (L.V.-Z.)
| | - Oscar Gerardo Figueroa-Salcido
- Nutrition Sciences Postgraduate Program, Faculty of Nutrition Sciences, Autonomous University of Sinaloa, Culiacan 80010, Mexico; (J.G.A.-G.); (O.G.F.-S.); (E.T.-C.); (C.A.S.-C.); (J.A.M.-M.); (L.V.-Z.)
- Integral Postgraduate Program in Biotechnology, Faculty of Chemical and Biological Sciences, Autonomous University of Sinaloa, Ciudad Universitaria, Culiacan 80010, Mexico
| | | | - Elí Terán-Cabanillas
- Nutrition Sciences Postgraduate Program, Faculty of Nutrition Sciences, Autonomous University of Sinaloa, Culiacan 80010, Mexico; (J.G.A.-G.); (O.G.F.-S.); (E.T.-C.); (C.A.S.-C.); (J.A.M.-M.); (L.V.-Z.)
| | - Martina Hilda Gracia-Valenzuela
- Department of Engineering, Technological National of Mexico, Technological Institute of the Yaqui Valley, Bacum 85276, Mexico;
| | - Aldo Alejandro Arvizu-Flores
- Postgraduate Program in Health Sciences, Faculty of Biological and Health Sciences, University of Sonora, Hermosillo 83000, Mexico;
| | - Cesar Antonio Sánchez-Cárdenas
- Nutrition Sciences Postgraduate Program, Faculty of Nutrition Sciences, Autonomous University of Sinaloa, Culiacan 80010, Mexico; (J.G.A.-G.); (O.G.F.-S.); (E.T.-C.); (C.A.S.-C.); (J.A.M.-M.); (L.V.-Z.)
| | - José Antonio Mora-Melgem
- Nutrition Sciences Postgraduate Program, Faculty of Nutrition Sciences, Autonomous University of Sinaloa, Culiacan 80010, Mexico; (J.G.A.-G.); (O.G.F.-S.); (E.T.-C.); (C.A.S.-C.); (J.A.M.-M.); (L.V.-Z.)
| | - Luisamaria Valdez-Zavala
- Nutrition Sciences Postgraduate Program, Faculty of Nutrition Sciences, Autonomous University of Sinaloa, Culiacan 80010, Mexico; (J.G.A.-G.); (O.G.F.-S.); (E.T.-C.); (C.A.S.-C.); (J.A.M.-M.); (L.V.-Z.)
| | - Feliznando Isidro Cárdenas-Torres
- Nutrition Sciences Postgraduate Program, Faculty of Nutrition Sciences, Autonomous University of Sinaloa, Culiacan 80010, Mexico; (J.G.A.-G.); (O.G.F.-S.); (E.T.-C.); (C.A.S.-C.); (J.A.M.-M.); (L.V.-Z.)
| | - Noé Ontiveros
- Clinical and Research Laboratory (LACIUS, U.N.), Department of Chemical, Biological, and Agricultural Sciences (DC-QB), Faculty of Biological and Health Sciences, University of Sonora, Navojoa 85880, Mexico
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Fowler J, Lieberman J. Update on clinical research for food allergy treatment. FRONTIERS IN ALLERGY 2023; 4:1154541. [PMID: 37520143 PMCID: PMC10379782 DOI: 10.3389/falgy.2023.1154541] [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] [Received: 01/30/2023] [Accepted: 06/20/2023] [Indexed: 08/01/2023] Open
Abstract
The incidence of IgE-mediated food allergy (FA) has continued to increase over the years which places substantial burden on patient health and quality of life. With no cure for this disease, the mainstay of management has been allergen avoidance. However, there have been advancements in FA treatment in recent years with multiple clinical trials utilizing novel and innovative therapeutic strategies. A landmark event came in 2020 with the first drug approval for food allergy with the approval of a product for peanut oral immunotherapy. In addition to oral immunotherapy, different delivery systems of immunotherapy (SLIT, EPIT) are being studied in addition to probiotics, biologic agents - used as monotherapy and as an adjunct, and modified allergens has taken place with the hope to further enhance existing therapeutic options. The hope through these continued developments is for therapies to emerge that will provide a more comprehensive benefit to this patient population.
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Cunha N, Andrade V, Ruivo P, Pinto P. Effects of Insect Consumption on Human Health: A Systematic Review of Human Studies. Nutrients 2023; 15:3076. [PMID: 37513494 PMCID: PMC10386438 DOI: 10.3390/nu15143076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 06/28/2023] [Accepted: 07/04/2023] [Indexed: 07/30/2023] Open
Abstract
Insects have been consumed as food in diverse cultures worldwide, gaining recognition as a sustainable and nutritious food source. This systematic review aims to update information on the impact of insect consumption on human health based on human randomized controlled trials (RCTs) and allergenicity assessment studies. Following PRISMA guidelines, studies published in the last 10 years were analyzed. From one-thousand and sixty-three retrieved references, nine RCTs and five allergenicity studies were analyzed. Post-prandial amino acid levels increased after insect protein consumption. In comparison with other protein sources, insect protein showed no significant differences in the area under the curve (AUC) values for essential amino acids but tended to have lower peaks and peak later. In terms of muscle protein synthesis, there were no significant differences between insect protein and other protein sources. Glucose levels did not differ; however, insulin levels were lower after the consumption of insect-based products. The effects on inflammatory markers and microbiota composition were inconclusive and the studies did not show significant effects on appetite regulation. Allergenicity assessments revealed a sensitisation and cross-reactivity between insect allergens and known allergens. A partial reduction of cross-allergenicity was observed via thermal processing. Insect protein is an adequate protein source with promising health benefits; however, further research is needed to fully understand its potential and optimise its inclusion into the human diet.
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Affiliation(s)
- Nair Cunha
- Escola Superior Agraria, Instituto Politécnico de Santarém, 2001-904 Santarém, Portugal
- Life Quality Research Centre (CIEQV), IPSantarem/IPLeiria, 2040-413 Rio Maior, Portugal
| | - Vanda Andrade
- Escola Superior Agraria, Instituto Politécnico de Santarém, 2001-904 Santarém, Portugal
- Life Quality Research Centre (CIEQV), IPSantarem/IPLeiria, 2040-413 Rio Maior, Portugal
| | - Paula Ruivo
- Escola Superior Agraria, Instituto Politécnico de Santarém, 2001-904 Santarém, Portugal
- Life Quality Research Centre (CIEQV), IPSantarem/IPLeiria, 2040-413 Rio Maior, Portugal
| | - Paula Pinto
- Escola Superior Agraria, Instituto Politécnico de Santarém, 2001-904 Santarém, Portugal
- Life Quality Research Centre (CIEQV), IPSantarem/IPLeiria, 2040-413 Rio Maior, Portugal
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Bartha I, Rodríguez Del Río P. Clinical outcomes of efficacy in food allergen immunotherapy trials. Curr Opin Allergy Clin Immunol 2023; 23:239-245. [PMID: 37185829 DOI: 10.1097/aci.0000000000000905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
PURPOSE OF REVIEW With food allergy affecting millions of children worldwide, the consolidation of food allergen immunotherapy represents an encouraging therapeutic option, that might expand in the next few years to reach greater number of candidates. This review aims at providing a critical overview of the efficacy outcomes employed in food allergen immunotherapy trials (AIT). RECENT FINDINGS Understanding efficacy endpoints rely on identifying what and how these are being measured. Desensitization, as the efficacy of the therapy to increase the patient's reactivity threshold to the food during therapy, and Sustained Unresponsiveness, withholding such efficacy even if the therapy is withdrawn, are nowadays considered the main parameters of efficacy evaluation. Quality of life is a promising variable to capture food AIT impact from the patient's perspective.There is a relevant degree of heterogeneity across studies in outcomes definitions and also in oral food challenges design, the tool that is more spread to assess results, hampering study comparison. SUMMARY Interpreting the results of a clinical trial, and comparing data from different studies is an important task, both for the researcher and the clinician, that should be done after a careful analysis of the outcomes and the evaluation tools used.
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Affiliation(s)
- Irene Bartha
- Department of Women and Children's Health (Paediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Pablo Rodríguez Del Río
- Allergy Department, Hospital Infantil Universitario Niño Jesús
- FibHNJ, ARADyAL-RETICs RD16/RD16/0006/0026 Instituto de Salud Carlos III
- IIS La Princesa, Madrid, Spain
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Ma RX, Hu JQ, Fu W, Zhong J, Cao C, Wang CC, Qi SQ, Zhang XL, Liu GH, Gao YD. Intermittent fasting protects against food allergy in a murine model via regulating gut microbiota. Front Immunol 2023; 14:1167562. [PMID: 37228621 PMCID: PMC10205017 DOI: 10.3389/fimmu.2023.1167562] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/14/2023] [Indexed: 05/27/2023] Open
Abstract
Background The prevalence of food allergy (FA) is increasing. Decreases in the diversity of gut microbiota may contribute to the pathogenesis of FA by regulating IgE production of B cells. Intermittent fasting (IF) is a popular diet with the potential to regulate glucose metabolism, boosting immune memory and optimizing gut microbiota. The potential effect of long-term IF on the prevention and treatment of FA is still unknown. Methods Two IF protocols (16 h fasting/8 h feeding and 24 h fasting/24 h feeding) were conducted on mice for 56 days, while the control mice were free to intake food (free diet group, FrD). To construct the FA model, all mice were sensitized and intragastrical challenged with ovalbumin (OVA) during the second half of IF (day 28 to day 56). Rectal temperature reduction and diarrhea were recorded to evaluate the symptoms of FA. Levels of serum IgE, IgG1, Th1/Th2 cytokines, mRNA expression of spleen T cell related transcriptional factors, and cytokines were examined. H&E, immunofluorescence, and toluidine blue staining were used to assess the structural changes of ileum villi. The composition and abundance of gut microbiota were analyzed by 16srRNA sequencing in cecum feces. Results The diarrhea score and rectal temperature reduction were lower in the two fasting groups compared to the FrD groups. Fasting was associated with lower levels of serum OVA-sIgE, OVA-sIgG1, interleukin (IL)-4 and IL-5, and mRNA expression of IL-4, IL-5, and IL-10 in the spleen. While no significant association was observed in interferon (IFN)-γ, tumor necrosis factor (TNF)-α, IL-6, IL-2 levels. Less mast cell infiltration in ileum was observed in the 16h/8h fasting group compared to the FrD group. ZO-1 expression in the ileum of the two fasting groups was higher in IF mice. The 24h/24h fasting reshaped the gut microbiota, with a higher abundance of Alistipes and Rikenellaceae strains compared to the other groups. Conclusion In an OVA-induced mice FA model, long-term IF may attenuate FA by reducing Th2 inflammation, maintaining the integrity of the intestinal epithelial barrier, and preventing gut dysbiosis.
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Affiliation(s)
- Ru-xue Ma
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jia-qian Hu
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Wei Fu
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jian Zhong
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Can Cao
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Chang-chang Wang
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Shi-quan Qi
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiao-Lian Zhang
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China
- Department of Immunology, School of Basic Medical Sciences, Wuhan University, Wuhan, China
- Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, China
| | - Guang-hui Liu
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ya-dong Gao
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China
- Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, China
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Boustany L, Faye M, Brocart C, Sabouraud-Leclerc D. L’importance de l’ETP pour une induction de tolérance orale alimentaire réussie. REVUE FRANÇAISE D'ALLERGOLOGIE 2023. [DOI: 10.1016/j.reval.2023.103320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Hörold M, Apfelbacher C, Gerhardinger K, Rohr M, Schimmelpfennig M, Weigt J, Brandstetter S. Parents' and Health Care Professionals' Perspectives on Prevention and Prediction of Food Allergies in Children: Protocol for a Qualitative Study. JMIR Res Protoc 2023; 12:e41436. [PMID: 36947117 PMCID: PMC10131891 DOI: 10.2196/41436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Food allergy in children is increasing in prevalence in the western world and appears to become an important health problem. Parents of children at risk of food allergy live with the fear of allergic reaction, especially when the children are very young. The paradigm shift in allergy prevention in the last decade-away from allergen avoidance toward a tolerance induction approach-challenges both parents and health care professionals, as they have to deal with changing information and new evidence that often contradicts previous assumptions. Yet, research on health information-seeking behavior and needs of parents on primary prevention of food allergy in children as well as on prediction and prevention strategies of German health care professionals is lacking. OBJECTIVE The aim of the study is to explore and understand parents' and health care professionals' perspectives on the prediction and prevention of food allergies. We are particularly interested in information needs, information seeking, and health care usage and place a special focus on families' experiences when their child is at risk or diagnosed with food allergies. Furthermore, food allergy prediction and prevention strategies of health care professionals will be explored. METHODS This study is part of the NAMIBIO (food allergy biomarker) app consortium, which aims to identify early predictors for the development of food allergy in children and develop apps to guide health care professionals and parents of children with a high risk of food allergy toward prevention and timely tolerance induction. The study uses a qualitative approach with topic-guided interviews and focus groups with parents of children (0-3 years) and health care professionals. Data collection will continue until theoretical saturation is reached. The qualitative content analysis will be used according to Kuckartz to identify overarching themes toward information needs and seeking behavior as well as usage of health care and health care professionals' predictive and preventive strategies. In addition, a constructivist grounded theory approach will be used to explore and understand parents' experiences, interactions, and social processes in families in daily life. RESULTS Recruitment and data collection started in February 2022 and is still ongoing. CONCLUSIONS The qualitative study will provide insight into parents' information-seeking behavior and needs regarding the prevention of food allergy in children, parents' use of pediatric primary care, and health care professionals strategies for the prediction and prevention of food allergies in children. We assume that our results will highlight the challenges associated with the paradigm shift in allergy prevention for both parents and health care professionals. The results will be used to make practical recommendations from the user's perspective and inform the development of the NAMIBIO apps. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/41436.
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Affiliation(s)
- Madlen Hörold
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Katharina Gerhardinger
- University Children's Hospital Regensburg (KUNO), Hospital St Hedwig of the Order of St John, University of Regensburg, Regensburg, Germany
| | - Magdalena Rohr
- University Children's Hospital Regensburg (KUNO), Hospital St Hedwig of the Order of St John, University of Regensburg, Regensburg, Germany
| | - Maria Schimmelpfennig
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Julia Weigt
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Susanne Brandstetter
- University Children's Hospital Regensburg (KUNO), Hospital St Hedwig of the Order of St John, University of Regensburg, Regensburg, Germany
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Epstein-Rigbi N, Levy MB, Nachshon L, Koren Y, Katz Y, Goldberg MR, Elizur A. Efficacy and safety of food allergy oral immunotherapy in adults. Allergy 2023; 78:803-811. [PMID: 36190349 DOI: 10.1111/all.15537] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/18/2022] [Accepted: 08/24/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Oral immunotherapy (OIT) is an emerging method for treating food allergy in children. However, data regarding adults undergoing this process are lacking. METHODS We retrospectively analyzed the medical records of patients with food allergy aged ≥17 years who completed OIT treatment between April 2010 and December 2020 at Shamir Medical Center. Data were compared with that of children aged 4 to <11 years and adolescents aged ≥11 to 17 treated during the same time period. RESULTS A total of 96 adults at a median age of 22.3 years who underwent OIT for milk (n = 53), peanut (n = 18), sesame (n = 7), egg (n = 5), and tree nuts (n = 13) were analyzed and compared with 1299 children and 309 adolescents. Adults experienced more adverse reactions requiring injectable epinephrine, both during in-clinic up-dosing (49% vs. 15.9% and 26.5% for children and adolescents, respectively, p < 0.0001) and during home treatment (22.9% vs. 12.4%, p = 0.007 for children, and 17.5%, p = 0.23 for adolescents). Most adults (61.5%) were fully desensitized, but the rates of full desensitization were significantly lower than children (73.4%, p = 0.013). Significantly more adults (28.3%) undergoing milk OIT failed treatment than children (14.3%, p = 0.015) and adolescents (14.1%, p = 0.022), while failure rates in adults undergoing OIT for other foods were low (9.3%) and comparable with children and adolescents. CONCLUSIONS OIT is successful in desensitizing most adults with IgE-mediated food allergy. Adults undergoing milk OIT are at increased risk for severe reactions and for OIT failure while failure rates in adults undergoing OIT for other foods are low.
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Affiliation(s)
- Na'ama Epstein-Rigbi
- Institute of Allergy, Immunology and Pediatric Pulmonology, Shamir (former Assaf Harofeh) Medical Center, Zerifin, Israel.,Department of Pediatrics, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michael B Levy
- Institute of Allergy, Immunology and Pediatric Pulmonology, Shamir (former Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Liat Nachshon
- Institute of Allergy, Immunology and Pediatric Pulmonology, Shamir (former Assaf Harofeh) Medical Center, Zerifin, Israel.,Department of Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Koren
- Institute of Allergy, Immunology and Pediatric Pulmonology, Shamir (former Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Yitzhak Katz
- Department of Pediatrics, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michael R Goldberg
- Institute of Allergy, Immunology and Pediatric Pulmonology, Shamir (former Assaf Harofeh) Medical Center, Zerifin, Israel.,Department of Pediatrics, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Arnon Elizur
- Institute of Allergy, Immunology and Pediatric Pulmonology, Shamir (former Assaf Harofeh) Medical Center, Zerifin, Israel.,Department of Pediatrics, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Oral Immunotherapy. Prim Care 2023; 50:269-281. [PMID: 37105606 DOI: 10.1016/j.pop.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Oral immunotherapy (OIT) is an alternative treatment of IgE-mediated food allergy that has been shown to increase tolerance threshold to many of the top food allergens, although this effect may be dependent on age, dose, frequency, and duration. OIT has been shown to be effective and safe in infants, and early initiation can improve rates of desensitization even for those foods whose natural history favors loss of allergy. Studies looking at protocol modification to improve OIT success are ongoing as is the evaluation of clinical tools to help monitor OIT effects.
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40
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Da Silva Cardoso J, Ashworth J, Pinto D, Teixeira F, Araújo AR. Food Allergy in Preschoolers: Parents' Perception and Self-Reported Prevalence. Cureus 2023; 15:e35146. [PMID: 36960254 PMCID: PMC10030048 DOI: 10.7759/cureus.35146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2023] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND Food allergy is a potentially fatal condition (in the case of anaphylaxis, for example) and is characterized by an increasing prevalence. The main purpose of this study is to identify preschool children with parent-reported food allergies and characterize this population and type of allergy. METHODS This is a cross-sectional study, based on questionnaires to parents/legal guardians. All children who attend daycare or preschool in an area of the city of Porto, Portugal, were included. RESULTS A total of 740 questionnaires were distributed to nine schools, and responses were obtained from 363 (49.1%). Self-reported food reaction and/or allergy was related in 11.2% of children. The median age of the first reaction was 12 months and the most registered foods were milk, dry seed, and peanut. Cutaneous (48.7%) and gastrointestinal (35.9%) symptoms were the main manifestations. History of parents' and siblings' food allergies had statistically significant associations with food reactions and/or allergies of the child, with OR 3.05 (p=0.04, 95% CI 1.01-8.81) and OR 8.69 (p<0.01, 95% CI 2.11-35.79), respectively. Besides that, children's atopic dermatitis also had a statistically significant association with self-reported food reactions and/or allergies, with OR 2.30 (p<0.05, 95% CI 1.01-5.21). CONCLUSION Food reactions and/or allergies were reported in 11.2% of children. The history of parents' and siblings' food allergies and children's atopic dermatitis had statistically significant associations with food reactions and/or allergies, which shows that it may be an important factor to consider.
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Affiliation(s)
- Juliana Da Silva Cardoso
- Department of Pediatrics, Centro Materno-Infantil do Norte Albino Aroso, Centro Hospitalar Universitário do Porto, Porto, PRT
| | - Joanna Ashworth
- Department of Pediatrics, Centro Materno-Infantil do Norte Albino Aroso, Centro Hospitalar Universitário do Porto, Porto, PRT
| | - Diana Pinto
- Department of Pediatrics/Pediatric Allergology Unit, Centro Materno-Infantil do Norte Albino Aroso, Centro Hospitalar Universitário do Porto, Porto, PRT
| | - Fernanda Teixeira
- Department of Pediatrics/Pediatric Allergology Unit, Centro Materno-Infantil do Norte Albino Aroso, Centro Hospitalar Universitário do Porto, Porto, PRT
| | - Ana Rita Araújo
- Department of Pediatrics/Pediatric Allergology Unit, Centro Materno-Infantil do Norte Albino Aroso, Centro Hospitalar Universitário do Porto, Porto, PRT
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41
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Management of Adult Patients with Gastrointestinal Symptoms from Food Hypersensitivity-Narrative Review. J Clin Med 2022; 11:jcm11247326. [PMID: 36555942 PMCID: PMC9784954 DOI: 10.3390/jcm11247326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/29/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
The incidence of food hypersensitivity has increased dramatically over the years not only among children but also in adults. Adult patients are usually less suspected of food hypersensitivity symptoms since food allergies are more typical for small children, with a tendency to outgrow the condition. The aim of this article is to increase awareness of hypersensitivity to food symptoms and their diagnosis and treatment possibilities among gastroenterologists and other health care professionals dealing with this type of patient. Symptoms of many gastrointestinal disorders, especially functional, may be driven by different types of mechanisms, and food intolerance or allergy should be considered as a potential cause. This article presents the current understanding of the epidemiology, diagnosis and treatment of immune- and non-immune-mediated food-induced diseases. Diagnosis of food hypersensitivity is based mainly on medical history, different types of sensitivity tests, e.g., hydrogen breath test, specific IgE (sIgE) serum concentration, tissue eosinophil count, skin tests and oral food challenges considered as a "gold standard" for food allergy. Elimination diet and pharmacologic treatment for allergy symptoms are first-line therapies. Eosinophilic gastrointestinal diseases are often caused by non-IgE-mediated food allergies, require endoscopic biopsy samples to confirm diagnosis and proper elimination diet often combined with steroids or proton pump inhibitor agents for treatment. Mast cell activation syndrome (MCAS) derives from pathologic reaction of mast cells with increased tryptase serum level as a marker. Symptoms may occur in the digestive, respiratory, skin, neurologic and cardiovascular system. Treatment is based on histamine type 1, type 2 (H1, H2) receptor antagonists and other mast cell stabilizing agents. Carbohydrate intolerances are the most common type of food hypersensitivity in adult patients, and an elimination diet is effective for reducing symptoms. Food additives hypersensitivity remains difficult to diagnose, but use of a diet low in chemical substances alleviates symptoms and helps to diagnose the triggering factors.
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42
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Issa M, Rivière G, Houdeau E, Adel-Patient K. Perinatal exposure to foodborne inorganic nanoparticles: A role in the susceptibility to food allergy? FRONTIERS IN ALLERGY 2022; 3:1067281. [PMID: 36545344 PMCID: PMC9760876 DOI: 10.3389/falgy.2022.1067281] [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] [Received: 10/11/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022] Open
Abstract
Food allergy (FA) is an inappropriate immune response against dietary antigens. Various environmental factors during perinatal life may alter the establishment of intestinal homeostasis, thereby predisposing individuals to the development of such immune-related diseases. Among these factors, recent studies have emphasized the chronic dietary exposure of the mother to foodborne inorganic nanoparticles (NP) such as nano-sized silicon dioxide (SiO2), titanium dioxide (TiO2) or silver (Ag). Indeed, there is growing evidence that these inorganic agents, used as food additives in various products, as processing aids during food manufacturing or in food contact materials, can cross the placental barrier and reach the developing fetus. Excretion in milk is also suggested, hence continuing to expose the neonate during a critical window of susceptibility. Due to their immunotoxical and biocidal properties, such exposure may disrupt the host-intestinal microbiota's beneficial exchanges and may interfere with intestinal barrier and gut-associated immune system development in fetuses then the neonates. The resulting dysregulated intestinal homeostasis in the infant may significantly impede the induction of oral tolerance, a crucial process of immune unresponsiveness to food antigens. The current review focuses on the possible impacts of perinatal exposure to foodborne NP during pregnancy and early life on the susceptibility to developing FA.
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Affiliation(s)
- Mohammad Issa
- Département Médicaments et Technologies Pour la Santé (MTS), SPI/Laboratoire d’Immuno-Allergie Alimentaire, Université Paris-Saclay, CEA, INRAE, Gif-sur-Yvette, France
| | - Gilles Rivière
- French Agency for Food, Environmental and Occupational Health & Safety (ANSES, Agence Nationale De Sécurité Sanitaire De l’alimentation, De l’environnement et du Travail), Direction de l’Evaluation des Risques, Maisons-Alfort, France
| | - Eric Houdeau
- Toxalim UMR1331 (Research Centre in Food Toxicology), Toulouse University, INRAE, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Karine Adel-Patient
- Département Médicaments et Technologies Pour la Santé (MTS), SPI/Laboratoire d’Immuno-Allergie Alimentaire, Université Paris-Saclay, CEA, INRAE, Gif-sur-Yvette, France,Correspondence: Karine Adel-Patient
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43
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Tong S, Beggs PJ, Davies JM, Jiang F, Kinney PL, Liu S, Yin Y, Ebi KL. Compound impacts of climate change, urbanization and biodiversity loss on allergic disease. Int J Epidemiol 2022:6760684. [PMID: 36228124 DOI: 10.1093/ije/dyac197] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 10/10/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- Shilu Tong
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Paul J Beggs
- School of Natural Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, New South Wales, Australia
| | - Janet M Davies
- School of Biomedical Sciences, Centre Immunology and Infection Control, Queensland University of Technology, Brisbane, Australia
| | - Fan Jiang
- Department of Child Health, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Patrick L Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, USA
| | - Shijian Liu
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yong Yin
- Department of Respiratory Disease, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Kristie L Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, USA
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44
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Suprun M, Kearney P, Hayward C, Butler H, Getts R, Sicherer SH, Turner PJ, Campbell DE, Sampson HA. Predicting probability of tolerating discrete amounts of peanut protein in allergic children using epitope-specific IgE antibody profiling. Allergy 2022; 77:3061-3069. [PMID: 35960650 DOI: 10.1111/all.15477] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND IgE-epitope profiling can accurately diagnose clinical peanut allergy. OBJECTIVE We sought to determine whether sequential (linear) epitope-specific IgE (ses-IgE) profiling can provide probabilities of tolerating discrete doses of peanut protein in allergic subjects undergoing double-blind, placebo-controlled food challenges utilizing PRACTALL dosing. METHODS Sixty four ses-IgE antibodies were quantified in blood samples using a bead-based epitope assay. A pair of ses-IgEs that predicts Cumulative Tolerated Dose (CTD) was determined using regression in 75 subjects from the discovery cohort. This epitope-based predictor was validated on 331 subjects from five independent cohorts (ages 4-25 years). Subjects were grouped based on their predicted values and probabilities of reactions at each CTD threshold were calculated. RESULTS In discovery, an algorithm using two ses-IgE antibodies was correlated with CTDs (rho = 0.61, p < .05); this correlation was 0.51 (p < .05) in validation. Using the ses-IgE-based predictor, subjects were assigned into "high," "moderate," or "low" dose-reactivity groups. On average, subjects in the "high" group were four times more likely to tolerate a specific dose, compared with the "low" group. For example, predicted probabilities of tolerating 4, 14, 44, and 144 or 444 mg in the "low" group were 92%, 77%, 53%, 29%, and 10% compared with 98%, 95%, 94%, 88%, and 73% in the "high" group. CONCLUSIONS Accurate predictions of food challenge thresholds are complex due to factors including limited responder sample sizes at each dose and variations in study-specific challenge protocols. Despite these limitations, an epitope-based predictor was able to accurately identify CTDs and may provide a useful surrogate for peanut challenges.
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Affiliation(s)
- Maria Suprun
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | | | | | - Scott H Sicherer
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Paul J Turner
- National Heart & Lung Institute, Imperial College London, England, UK
| | | | - Hugh A Sampson
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
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45
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Cheon J, Cho CM, Kim HJ, Kim DH. Effectiveness of educational interventions for quality of life of parents and children with food allergy: A systematic review. Medicine (Baltimore) 2022; 101:e30404. [PMID: 36086727 PMCID: PMC10980392 DOI: 10.1097/md.0000000000030404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/26/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Educational intervention along with medical treatment is important to improve the quality of life of children with food allergies and their parents. This systematic review was designed to investigate the effects of education programs for parents and children with food allergies to provide a direction for developing an intervention program to improve their quality of life. METHODS A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant studies published between January 2010 and August 2021 were identified through a systematic search of 5 databases (PubMed, EMBASE, CINAHL, Cochrane Central Register of Controlled Trial, and Psycho Info). RESULTS A total of 2351 articles were identified. Of these, 9 met the inclusion criteria after duplicates were removed. Among these, only 2 studies, using the support and handbook provided, showed significant results on quality of life. DISCUSSION There is a lack of educational interventions for children with food allergies and their parents. Educational intervention, an essential intervention, can maximize medical treatment and improve overall quality of life. Hence, these interventions should be actively developed and applied in the future.
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Affiliation(s)
- Jooyoung Cheon
- College of Nursing, Sungshin Women’s University, Dobong-ro 76ga-gil, Gangbuk-gu, Seoul, Republic of Korea
| | - Chung Min Cho
- College of Nursing, Sungshin Women’s University, Dobong-ro 76ga-gil, Gangbuk-gu, Seoul, Republic of Korea
| | - Hyo Jin Kim
- College of Nursing, Seoul National University, 103, Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Dong Hee Kim
- College of Nursing, Sungshin Women’s University, Dobong-ro 76ga-gil, Gangbuk-gu, Seoul, Republic of Korea
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46
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Han B, Ma Y, Liu Y. Fucoxanthin Prevents the Ovalbumin-Induced Food Allergic Response by Enhancing the Intestinal Epithelial Barrier and Regulating the Intestinal Flora. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2022; 70:10229-10238. [PMID: 35947424 DOI: 10.1021/acs.jafc.2c04685] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study aimed to determine whether fucoxanthin alleviated ovalbumin (OVA)-induced food allergy (FA) and explored the possible mechanisms. The results indicated that supplementation with fucoxanthin at 10.0-20.0 mg/kg per day for 7 weeks inhibited food anaphylaxis and the production of immunoglobulin (Ig) E, IgG, histamine, and related cytokines while alleviating allergic symptoms in sensitized mice. Fucoxanthin enhanced the intestinal epithelial barrier by up-regulating tight junction (TJ) protein expression and promoting regenerating islet-derived protein III-gamma (RegIIIγ) and secretory IgA (sIgA) secretion. In addition, fucoxanthin induced the secretion of anti-inflammatory factors (interleukin (IL)-10 and transforming growth factor β (TGF-β)) by regulatory T (Treg) cells and decreased the pro-inflammatory factor levels (IL-4, tumor necrosis factor-α (TNF-α), IL-17, and IL-1β), ameliorating intestinal inflammation. Compared with the model group, beneficial bacteria, such as Lactobacillaceae, increased in the intestinal flora, while pathogenic bacteria like Helicobacteraceae, Desulfovibrionaceae, and Streptococcaceae decreased. Therefore, fucoxanthin may effectively prevent FA by enhancing the intestinal epithelial barrier and reshaping the intestinal flora.
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Affiliation(s)
- Bing Han
- College of Ocean Food and Biological Engineering, Jimei University, Xiamen, Fujian 361021, China
| | - Yu Ma
- College of Ocean Food and Biological Engineering, Jimei University, Xiamen, Fujian 361021, China
| | - Yixiang Liu
- College of Ocean Food and Biological Engineering, Jimei University, Xiamen, Fujian 361021, China
- Collaborative Innovation Center of Provincial and Ministerial Co-construction for Marine Food Deep Processing, Dalian Polytechnic University, Dalian 116034, China
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47
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王 丹, 吴 雪, 阎 诗, 周 甜, 黄 亚, 李 洁, 罗 晓. Risk factors for food sensitization in children with atopic dermatitis: a single-center cross-sectional study. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2022; 24:887-893. [PMID: 36036127 PMCID: PMC9425859 DOI: 10.7499/j.issn.1008-8830.2202098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To study the risk factors for food sensitization and the influence of food sensitization on quality of life and clinical signs in children with atopic dermatitis (AD). METHODS A retrospective analysis was performed on the medical data of 241 children with AD, including demographic features, age of onset, severity of AD, quality of life, physical examination results, skin prick test (SPT) results, serum total IgE levels, and eosinophil count. According to the results of SPT, the children were divided into a food sensitization group (n=127) and a non-food sensitization group (n=114). The multivariate logistic regression analysis was used to identify the risk factors for food sensitization in children with AD. RESULTS The prevalence rate of food sensitization was 52.7% (127/241) in the children with AD. The multivariate logistic regression analysis showed that birth in autumn or winter, age of onset of AD<12 months, severe AD, and total IgE>150 IU/mL were risk factors for food sensitization (P<0.05). Compared with the non-food sensitization group, the food sensitization group had a significantly poorer quality of life (P=0.008) and significantly higher prevalence rates of non-specific hand/foot dermatitis and palmar hyperlinearity (P<0.05). Compared with the single food sensitization group, the multiple food sensitization group had more severe AD and a significantly higher proportion of children with exclusive breastfeeding or total IgE>150 IU/mL (P<0.05). CONCLUSIONS The AD children born in autumn or winter, or those with early onset (<12 months), severe AD or total IgE>150 IU/mL have a higher risk of food sensitization. The AD children with food sensitization have a poorer quality of life and are more likely to develop non-specific hand/foot dermatitis and palmar hyperlinearity.
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Martínez-Pineda M, Yagüe-Ruiz C. The Risk of Undeclared Allergens on Food Labels for Pediatric Patients in the European Union. Nutrients 2022; 14:nu14081571. [PMID: 35458133 PMCID: PMC9026746 DOI: 10.3390/nu14081571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 12/27/2022] Open
Abstract
The dietary avoidance of allergens has been widely recognized as the key intervention in the management of food allergies, but the presence of undeclared allergens makes compliance difficult. The aim of this study was to analyze the presence of undeclared allergens in food labeling through RASFF notifications in the European Union, focusing on those allergens that frequently affect the pediatric population and the implicated products, so as to provide useful information for its risk evaluation and the development of educational materials for patients. The results showed milk (20.5%), gluten (14.8%), and nuts (10.9%) to be the pediatric allergens with higher presences. In 80% of the notifications concerning milk and milk derivatives, the specific compound present (lactose or lactoprotein) was not identified. They were mainly present in cereal and bakery products, prepared dishes and snacks, and cacao and confectionery products, all of which are frequently consumed by the pediatric population. The large quantity (7.6%) of undeclared allergens in “free-from-allergen” products was also remarkable, especially in regard to the supposedly not-present allergens. Undeclared allergens in food products pose an evident risk for allergic patients and knowledge of them should take a relevant role in a patient’s nutritional education. It is also necessary to raise awareness among manufacturers and safety authorities.
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Matsui T, Naito M, Kitamura K, Makino A, Takasato Y, Sugiura S, Izumi H, Ito K. Putative allergic reactivity of casein phosphopeptide in severe cow's milk allergy patients. Pediatr Allergy Immunol 2022; 33:e13752. [PMID: 35338736 DOI: 10.1111/pai.13752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 02/11/2022] [Accepted: 02/16/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Teruaki Matsui
- Department of Allergy, Allergy and Immunology Center, Aichi Children's Health and Medical Center, 7-426 Morioka, Obu-City, Aichi, 474-8710, Japan
| | - Michihiro Naito
- Department of Nutritional Sciences, Nagoya University of Arts and Sciences, 57 Takenoyama, Nisshin, Aichi, 470-0196, Japan
| | - Katsumasa Kitamura
- Department of Allergy, Allergy and Immunology Center, Aichi Children's Health and Medical Center, 7-426 Morioka, Obu-City, Aichi, 474-8710, Japan
| | - Atsushi Makino
- Department of Allergy, Allergy and Immunology Center, Aichi Children's Health and Medical Center, 7-426 Morioka, Obu-City, Aichi, 474-8710, Japan
| | - Yoshihiro Takasato
- Department of Allergy, Allergy and Immunology Center, Aichi Children's Health and Medical Center, 7-426 Morioka, Obu-City, Aichi, 474-8710, Japan
| | - Shiro Sugiura
- Department of Allergy, Allergy and Immunology Center, Aichi Children's Health and Medical Center, 7-426 Morioka, Obu-City, Aichi, 474-8710, Japan
| | - Hidehiko Izumi
- Department of Nutritional Sciences, Nagoya University of Arts and Sciences, 57 Takenoyama, Nisshin, Aichi, 470-0196, Japan
| | - Komei Ito
- Department of Allergy, Allergy and Immunology Center, Aichi Children's Health and Medical Center, 7-426 Morioka, Obu-City, Aichi, 474-8710, Japan
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50
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Suleyman A, Tamay Z, Güler N. Risk Factors for the Development of IgE-Mediated Food Allergy in Preschool Children with Asthma. J Trop Pediatr 2022; 68:6533389. [PMID: 35188210 DOI: 10.1093/tropej/fmac008] [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] [Indexed: 11/14/2022]
Abstract
BACKGROUND Food allergy is a component of the atopic march and may have effects on asthma. This study aimed to evaluate the risk factors for confirmed immunoglobulin E-mediated food allergies and their impact on the clinical picture in preschool children with asthma. METHODS Clinical history and allergic assessment results were obtained from medical records and analyzed retrospectively. Preschool children with asthma were included in the study and the characteristics of food allergy and asthma were evaluated. The patients were grouped as those with food allergy (Group I, n = 60) and those without (Group II, n = 98). RESULTS In patients with food allergy and asthma, the number of episodes requiring systemic steroids in the last year (p = 0.002), atopic dermatitis (p = 0.001), parental atopic disease (p = 0.009) and aeroallergen sensitivity rates (p < 0.001) was higher than patients without food allergies. The use of medium or high doses of inhaled steroids to achieve asthma control was more frequent in patients with food allergies (p = 0.014). Parental history of atopic disease [p = 0.007, odds ratio (OR): 3.27, 95% confidence interval (CI) 1.37-7.77)], atopic dermatitis (p = 0.017, OR: 2.80, 95% CI: 1.19-6.57), starting complementary food after 6 months (p = 0.004, OR: 3.9, 95% CI: 1.5-10.0) and having aeroallergen sensitivity (p < 0.001, OR: 6.01, 95% CI: 2.21-16.29) were identified as significant risk factors for food allergy. CONCLUSION Asthmatic preschool children with food allergies are more likely to have a parental atopic disease, atopic dermatitis, aeroallergen sensitivity and starting complementary food after 6 months. These patients experience more asthma attacks and need higher doses of steroids.
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Affiliation(s)
- Ayse Suleyman
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Zeynep Tamay
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Nermin Güler
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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