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Dehbozorgi S, Ramsey N, Lee ASE, Coleman A, Varshney P, Davis CM. Addressing Health Equity in Food Allergy. J Allergy Clin Immunol Pract 2024; 12:570-577. [PMID: 38280451 DOI: 10.1016/j.jaip.2024.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 01/29/2024]
Abstract
Social determinants of health can lead to poor health outcomes for food-allergic patients, including limited access to allergen-free foods and specialty care. Housing and transportation limitations can worsen social factors including food insecurity, poor early food introduction, increased reactivity to foods, lower tertiary/allergy care utilization, and increased emergency department utilization. A key component of addressing health equity involves valuing all people with sustained, focused efforts to address social determinants of health. In this clinical commentary, we discuss the current state of heath equity for food-allergic patients, highlighting the disparities in emergency care, food allergy prevention, and food insecurity. Solutions to improve health equity through clinical practice are proposed. Currently available funding opportunities through the National Institutes of Health for health equity initiatives are outlined. Gaps in health equity for food-allergic patients include the lack of documented successful implementation of effective solutions to food insecurity, poor early food introduction uptake, poor access to specialist care, and unequal distribution of educational resources. The availability of research funding and legislative policies supporting access to food and education bolster the impetus to move toward health equity for 20 million people in the United States with food allergy.
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Affiliation(s)
- Sara Dehbozorgi
- Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Nicole Ramsey
- Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ashley Sang Eun Lee
- Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Amaziah Coleman
- National Institutes of Health, National Institute of Allergy and Infectious Diseases, Rockville, Md
| | - Pooja Varshney
- Division of Allergy and Immunology, Department of Pediatrics, Dell Medical School at the University of Texas Austin, Dell Children's Medical Center, Austin, Texas
| | - Carla M Davis
- Division of Allergy, Immunology, and Retrovirology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.
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Jones SM, Anvari S, Coleman A, Pesek RD, Kloepfer KM, Perry TT, Jefferson AA, Doan D, Andres A, Doderer M, Hilbun A, Solomon R, Scurlock AM. Food insecurity and allergic diseases: A call to collective action. J Allergy Clin Immunol 2024; 153:359-367. [PMID: 37926122 DOI: 10.1016/j.jaci.2023.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/13/2023] [Accepted: 10/24/2023] [Indexed: 11/07/2023]
Abstract
Food security encompassess the concept of access by all people at all times to enough food for an active, healthy life. Conversely, food insecurity (FI) refers to household-level economic and social conditions of limited or uncertain access to adequate food. FI is a key social determinant of health that can negatively affect nutrition and health outcomes, as it is estimated that 10.2% of the US population meets criteria for FI. Recognizing the impact of FI on our patients and families is critical to promote health equity and optimize health outcomes. This review focuses on FI and allergic disease from the perspective of key multisector stakeholders within the field of allergy and immunology as well as from the larger health care arena, highlighting key resources and initiatives important to patients. Collectively, as specialists in allergy and immunology, and within the medical field more broadly, we must leverage our unique roles as we interface with patients and families and serve as committed advocates for change. Developing innovative strategies to promote health equity can provide a pathway forward for all children, adults, and families to gain access to healthy, nutritious food as part of their routine lifestyle. This is a call to action.
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Affiliation(s)
- Stacie M Jones
- University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children's Hospital, Little Rock, Ark.
| | - Sara Anvari
- Baylor College of Medicine and Texas Children's Hospital, Houston, Tex
| | - Amaziah Coleman
- National Institutes of Health, National Institute of Allergy and Infectious Diseases, Bethesda, Md
| | - Robert D Pesek
- University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children's Hospital, Little Rock, Ark
| | - Kirsten M Kloepfer
- Indiana University School of Medicine and Riley Children's Hospital at IU Health, Indianapolis, Ind
| | - Tamara T Perry
- University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children's Hospital, Little Rock, Ark
| | - Akilah A Jefferson
- University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children's Hospital, Little Rock, Ark
| | - Dieu Doan
- University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children's Hospital, Little Rock, Ark
| | - Aline Andres
- University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children's Nutrition Center, Little Rock, Ark
| | - Marcy Doderer
- Arkansas Children's Hospital, Little Rock, Ark; Arkansas Children's Health System, Little Rock, Ark
| | - Ashlie Hilbun
- Arkansas Children's Hospital, Little Rock, Ark; Arkansas Children's Health System, Little Rock, Ark
| | - Ryan Solomon
- Arkansas Children's Hospital, Little Rock, Ark; Arkansas Children's Health System, Little Rock, Ark
| | - Amy M Scurlock
- University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children's Hospital, Little Rock, Ark
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Mahdavinia M, Fyolek JP, Jiang J, Thivalapill N, Bilaver LA, Warren C, Fox S, Nimmagadda SR, Newmark PJ, Sharma H, Assa'ad A, Seed PC, Gupta RS. Gut microbiome is associated with asthma and race in children with food allergy. J Allergy Clin Immunol 2023; 152:1541-1549.e1. [PMID: 37714436 PMCID: PMC10872992 DOI: 10.1016/j.jaci.2023.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/30/2023] [Accepted: 07/27/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND The composition of the gut microbiome has been associated with development of atopic conditions such as food allergy (FA) and asthma. African American or Black children with FA have higher rate of asthma compared to their White counterparts. OBJECTIVE We sought to investigate whether the diversity and relative abundance (RA) of gut microbiota is different between children with FA from different racial backgrounds living in the same cities. Furthermore, we aimed to understand whether the difference in the gut microbiota is associated with asthma in children with FA. METHODS We analyzed and compared the stool microbiome of a cohort of Black and White children with FA by shotgun genomic sequencing. RESULTS A total of 152 children with IgE-mediated FA enrolled onto FORWARD (Food Allergy Outcomes Related to White and African American Racial Differences); 30 Black and 122 White children were included. The RA of several bacteria was associated with race and asthma. Most notably the RA of Bacteroides thetaiotaomicron, Chlamydia thrachomatis, Parabacteroides goldsteinii, and Bacteroides eggerthii were significantly higher, while the RA of Bifidobacterium sp CAG:754, Parabacterium johnsonii, Bacteroides intestinalis, and Bifidobacterium breve were significantly lower in stool samples of Black children compared to White children. Asthma was associated with lower RA of B breve, Bifidobacterium catenulatum, Prevotella copri, Veilloella sp CAG:933, and Bacteroides plebius, and higher RA of 3 Bacteroides species. CONCLUSIONS The observed variations in the gut microbiota of Black and White children such as differences in the Bacteroides and Bifidobacterium species along with their association to history of asthma in our cohort is indicative of their potential role in the higher rate of asthma observed among Black children with FA.
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Affiliation(s)
- Mahboobeh Mahdavinia
- Division of Allergy and Immunology, Department of Medicine and Department of Pediatrics, Rush University Medical Center, Chicago, Ill.
| | - John P Fyolek
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Jialing Jiang
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Neil Thivalapill
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Lucy A Bilaver
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Christopher Warren
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Susan Fox
- Division of Allergy and Immunology, Department of Medicine and Department of Pediatrics, Rush University Medical Center, Chicago, Ill
| | - Sai R Nimmagadda
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill; Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
| | - Pamela J Newmark
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Hemant Sharma
- Division of Allergy and Immunology, Children's National Health Systems, Washington, DC
| | - Amal Assa'ad
- Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, and the University of Cincinnati, Cincinnati, Ohio
| | - Patrick C Seed
- Division of Infectious Disease, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
| | - Ruchi S Gupta
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
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Cook EE. Anthropological and sociological perspectives on food allergy. Clin Exp Allergy 2023; 53:989-1003. [PMID: 37649424 DOI: 10.1111/cea.14387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 08/17/2023] [Accepted: 08/19/2023] [Indexed: 09/01/2023]
Abstract
This review explores the anthropological and sociological literature on food allergy and identifies four primary areas of research to date. The first explores the relationality and management of risk, uncertainty and stigma among parents and sufferers of food allergies. The second analyses the influence of intersectionality, specifically the effects of class, gender, race/ethnicity and disability on experiences of food allergy. The third discusses diagnostic difficulties and the impact these have on legitimacy and believability, both in the context of clinician-patient relations and in managing food allergies in public spaces. The fourth explores the ethics and uncertainties in food allergy treatments and how scientific knowledge of emerging treatments is constructed. This body of research illustrates that although an individual disease, food allergy experiences are significantly affected by socio-cultural structures, institutions, ideologies and discourses. The review concludes with four primary recommendations. First, there should be more incorporation of anthropological or sociological methodologies and perspectives into studies of food allergy. Second, studies are needed from more countries exploring lived experience of food allergy. Third, research on food allergy needs to incorporate an analysis of intersectional factors such as gender, class and race/ethnicity, and should explore the experiences of minority populations. Fourth, more research is needed on the interactions between biomedicine and local systems of knowledge, as well as the factors that shape what treatments become available, for whom it becomes available, experiences of treatment and aspects (including biases) that influence patient-clinician interactions.
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Affiliation(s)
- Emma E Cook
- Modern Japanese Studies, Hokkaido University, Sapporo, Japan
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Dileep A, Warren C, Bilaver LA, Gupta RS, Mahdavinia M. Understanding how socioeconomic determinants affect the development of allergy to common foods in children. Ann Allergy Asthma Immunol 2023; 131:393-395. [PMID: 37343825 PMCID: PMC10527777 DOI: 10.1016/j.anai.2023.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/10/2023] [Accepted: 06/14/2023] [Indexed: 06/23/2023]
Affiliation(s)
- Anandu Dileep
- Division of Allergy/Immunology, Rush University Medical Center, Chicago, Illinois
| | - Christopher Warren
- Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Lucy A Bilaver
- Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Ruchi S Gupta
- Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Mahboobeh Mahdavinia
- Division of Allergy/Immunology, Rush University Medical Center, Chicago, Illinois.
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Devonshire A, Gautam Y, Johansson E, Mersha TB. Multi-omics profiling approach in food allergy. World Allergy Organ J 2023; 16:100777. [PMID: 37214173 PMCID: PMC10199264 DOI: 10.1016/j.waojou.2023.100777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 04/05/2023] [Accepted: 04/05/2023] [Indexed: 05/24/2023] Open
Abstract
The prevalence of food allergy (FA) among children is increasing, affecting nearly 8% of children, and FA is the most common cause of anaphylaxis and anaphylaxis-related emergency department visits in children. Importantly, FA is a complex, multi-system, multifactorial disease mediated by food-specific immunoglobulin E (IgE) and type 2 immune responses and involving environmental and genetic factors and gene-environment interactions. Early exposure to external and internal environmental factors largely influences the development of immune responses to allergens. Genetic factors and gene-environment interactions have established roles in the FA pathophysiology. To improve diagnosis and identification of FA therapeutic targets, high-throughput omics approaches have emerged and been applied over the past decades to screen for potential FA biomarkers, such as genes, transcripts, proteins, and metabolites. In this article, we provide an overview of the current status of FA omics studies, namely genomic, transcriptomic, epigenomic, proteomic, exposomic, and metabolomic. The current development of multi-omics integration of FA studies is also briefly discussed. As individual omics technologies only provide limited information on the multi-system biological processes of FA, integration of population-based multi-omics data and clinical data may lead to robust biomarker discovery that could translate into advances in disease management and clinical care and ultimately lead to precision medicine approaches.
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Affiliation(s)
- Ashley Devonshire
- Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Yadu Gautam
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Elisabet Johansson
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Tesfaye B. Mersha
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Dileep A, Warren C, Bilaver LA, Stephen E, Andy-Nweye AB, Fox S, Jiang J, Newmark PJ, Chura A, Abdikarim I, Nimmagadda SR, Sharma HP, Tobin MC, Assa'ad AH, Gupta RS, Mahdavinia M. Assessing Disparities in the Prevalence of Atopic Comorbidities Among Food-Allergic Children. J Allergy Clin Immunol Pract 2023; 11:1169-1176. [PMID: 36720389 PMCID: PMC10085831 DOI: 10.1016/j.jaip.2023.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/23/2022] [Accepted: 01/17/2023] [Indexed: 01/30/2023]
Abstract
BACKGROUND Previous studies have reported that Black children with food allergy (FA) have higher risk of atopic comorbidities than White children. OBJECTIVE Our study sought to understand if disparities in the prevalence of atopic comorbidities among children with FA are driven by individual and community-level socioeconomic status (SES). METHODS We analyzed data from a prospective, multicenter cohort investigating the natural history of pediatric atopy: the Food Allergy Outcomes Related to White and African American Racial Differences (FORWARD) study. A validated, multicomponent area deprivation index (ADI) percentile score was tabulated by the census block group for each subject's home address. The association of ADI with atopic comorbidities in FA was assessed via multivariable regression analysis. RESULTS Of the 700 children in this study, the mean ADI was 37.7 (95% confidence interval: 35.6-39.7). The mean ADI was higher in children with asthma (43.3) compared with those without asthma (31.8), which remained significant after adjusting for race (P < .0001). Children with allergic rhinitis (AR) had a higher mean ADI (39.1) compared with those without (33.4) (P = .008). ADI was associated with secondhand smoking, parents' education, and household income. Black children had a higher risk for asthma after adjusting for ADI and SES-related factors. CONCLUSION The independent association of ADI with asthma and AR, regardless of race, suggests a role of neighborhood-level socioeconomic deprivation in the development of these conditions among children with FA. Black children with FA remained at higher risk for asthma after adjusting for SES-related variables, which can indicate an independent risk for asthma in these children.
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Affiliation(s)
- Anandu Dileep
- Division of Allergy and Immunology, Rush University Medical Center, Chicago, Ill
| | - Christopher Warren
- Division of Allergy and Immunology, Northwestern University Feinberg School of Medicine, Chicago, Ill; Division of Allergy and Immunology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
| | - Lucy A Bilaver
- Division of Allergy and Immunology, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Ellen Stephen
- Division of Allergy and Immunology, Rush University Medical Center, Chicago, Ill
| | - Aame B Andy-Nweye
- Division of Allergy and Immunology, Rush University Medical Center, Chicago, Ill
| | - Susan Fox
- Division of Allergy and Immunology, Rush University Medical Center, Chicago, Ill
| | - Jialing Jiang
- Division of Allergy and Immunology, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Pamela J Newmark
- Division of Allergy and Immunology, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Annika Chura
- Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Iman Abdikarim
- Division of Allergy and Immunology, Children's National Health Systems, Washington DC
| | - Sai R Nimmagadda
- Division of Allergy and Immunology, Northwestern University Feinberg School of Medicine, Chicago, Ill; Division of Allergy and Immunology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
| | - Hemant P Sharma
- Division of Allergy and Immunology, Children's National Health Systems, Washington DC
| | - Mary C Tobin
- Division of Allergy and Immunology, Rush University Medical Center, Chicago, Ill
| | - Amal H Assa'ad
- Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Ruchi S Gupta
- Division of Allergy and Immunology, Northwestern University Feinberg School of Medicine, Chicago, Ill; Division of Allergy and Immunology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
| | - Mahboobeh Mahdavinia
- Division of Allergy and Immunology, Rush University Medical Center, Chicago, Ill.
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8
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Herbert LJ, Cooke F, Ramos A, Miller E, Padgett S, Green TD. A Qualitative Study to Inform Development of a Behavioral Intervention to Promote Food Allergy Self-Management and Adjustment among Early Adolescents. Clin Pract Pediatr Psychol 2023; 11:6-16. [PMID: 37007844 PMCID: PMC10065466 DOI: 10.1037/cpp0000433] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Objective Adolescence is a high-risk period for patients with food allergy (FA) as management responsibilities shift to the youth. This study used qualitative methods to explore FA experiences among a diverse pediatric FA population and inform behavioral intervention development. Methods A total of 26 adolescents ages 9-14 years with IgE-mediated FA (M age = 11.92 years; 62% male; 42% Black, 31% White, 12% Hispanic/Latinx) and 25 primary caregivers (M age = 42.57 years; 32% annual income > $100,000) were recruited from FA clinics to complete separate qualitative interviews about FA-related experiences. Interviews were audio-recorded, transcribed, and entered into Dedoose, a qualitative software program. A grounded theory qualitative analytic approach was used to analyze data. Results Emergent themes include: 1) FA is a chronic burden that affects daily life, 2) Families experience anxiety about FA, 3) Families find it challenging to transition FA management from parent to child, 4) FA families feel the need to be prepared, 5) FA families frequently advocate for their needs, and 6) Social experiences affect the FA experience. Conclusions Adolescents with FA and their caregivers experience daily stress related to their chronic illness. A behavioral intervention that provides FA education, bolsters stress/anxiety management, assists parents in transitioning FA management responsibility to the youth, teaches executive functioning and advocacy skills, and fosters peer support could help adolescents successfully cope with and manage FA in their daily lives.
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Affiliation(s)
- Linda Jones Herbert
- Children's National Hospital, Washington, DC
- George Washington University School of Medicine, Washington, DC
| | | | - Ashley Ramos
- Children's National Hospital, Washington, DC
- George Washington University School of Medicine, Washington, DC
| | | | - Shaylar Padgett
- Allergy and Asthma Center of NC, Cone Health Medical Group, Greensboro, NC
| | - Todd D Green
- DBV Technologies, Montrouge, France
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA
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9
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Dramburg S, Hilger C, Santos AF, de Las Vecillas L, Aalberse RC, Acevedo N, Aglas L, Altmann F, Arruda KL, Asero R, Ballmer-Weber B, Barber D, Beyer K, Biedermann T, Bilo MB, Blank S, Bosshard PP, Breiteneder H, Brough HA, Bublin M, Campbell D, Caraballo L, Caubet JC, Celi G, Chapman MD, Chruszcz M, Custovic A, Czolk R, Davies J, Douladiris N, Eberlein B, Ebisawa M, Ehlers A, Eigenmann P, Gadermaier G, Giovannini M, Gomez F, Grohman R, Guillet C, Hafner C, Hamilton RG, Hauser M, Hawranek T, Hoffmann HJ, Holzhauser T, Iizuka T, Jacquet A, Jakob T, Janssen-Weets B, Jappe U, Jutel M, Kalic T, Kamath S, Kespohl S, Kleine-Tebbe J, Knol E, Knulst A, Konradsen JR, Korošec P, Kuehn A, Lack G, Le TM, Lopata A, Luengo O, Mäkelä M, Marra AM, Mills C, Morisset M, Muraro A, Nowak-Wegrzyn A, Nugraha R, Ollert M, Palosuo K, Pastorello EA, Patil SU, Platts-Mills T, Pomés A, Poncet P, Potapova E, Poulsen LK, Radauer C, Radulovic S, Raulf M, Rougé P, Sastre J, Sato S, Scala E, Schmid JM, Schmid-Grendelmeier P, Schrama D, Sénéchal H, Traidl-Hoffmann C, Valverde-Monge M, van Hage M, van Ree R, Verhoeckx K, Vieths S, Wickman M, Zakzuk J, Matricardi PM, Hoffmann-Sommergruber K. EAACI Molecular Allergology User's Guide 2.0. Pediatr Allergy Immunol 2023; 34 Suppl 28:e13854. [PMID: 37186333 DOI: 10.1111/pai.13854] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 09/05/2022] [Indexed: 05/17/2023]
Abstract
Since the discovery of immunoglobulin E (IgE) as a mediator of allergic diseases in 1967, our knowledge about the immunological mechanisms of IgE-mediated allergies has remarkably increased. In addition to understanding the immune response and clinical symptoms, allergy diagnosis and management depend strongly on the precise identification of the elicitors of the IgE-mediated allergic reaction. In the past four decades, innovations in bioscience and technology have facilitated the identification and production of well-defined, highly pure molecules for component-resolved diagnosis (CRD), allowing a personalized diagnosis and management of the allergic disease for individual patients. The first edition of the "EAACI Molecular Allergology User's Guide" (MAUG) in 2016 rapidly became a key reference for clinicians, scientists, and interested readers with a background in allergology, immunology, biology, and medicine. Nevertheless, the field of molecular allergology is moving fast, and after 6 years, a new EAACI Taskforce was established to provide an updated document. The Molecular Allergology User's Guide 2.0 summarizes state-of-the-art information on allergen molecules, their clinical relevance, and their application in diagnostic algorithms for clinical practice. It is designed for both, clinicians and scientists, guiding health care professionals through the overwhelming list of different allergen molecules available for testing. Further, it provides diagnostic algorithms on the clinical relevance of allergenic molecules and gives an overview of their biology, the basic mechanisms of test formats, and the application of tests to measure allergen exposure.
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Affiliation(s)
- Stephanie Dramburg
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Christiane Hilger
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Alexandra F Santos
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom
- Children's Allergy Service, Evelina London, Guy's and St Thomas' Hospital, London, United Kingdom
| | | | - Rob C Aalberse
- Sanquin Research, Dept Immunopathology, University of Amsterdam, Amsterdam, The Netherlands
- Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Nathalie Acevedo
- Institute for Immunological Research, University of Cartagena, Cartagena de Indias, Colombia, Colombia
| | - Lorenz Aglas
- Department of Biosciences and Medical Biology, Paris Lodron University Salzburg, Salzburg, Austria
| | - Friedrich Altmann
- Department of Chemistry, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Karla L Arruda
- Department of Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brasil, Brazil
| | - Riccardo Asero
- Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy
| | - Barbara Ballmer-Weber
- Klinik für Dermatologie und Allergologie, Kantonsspital St. Gallen, St. Gallen, Switzerland
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Domingo Barber
- Institute of Applied Molecular Medicine Nemesio Diez (IMMAND), Department of Basic Medical Sciences, Facultad de Medicina, Universidad San Pablo CEU, CEU Universities, Madrid, Spain
- RETIC ARADyAL and RICORS Enfermedades Inflamatorias (REI), Madrid, Spain
| | - Kirsten Beyer
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University Munich, Munich, Germany
| | - Maria Beatrice Bilo
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
- Allergy Unit Department of Internal Medicine, University Hospital Ospedali Riuniti di Ancona, Torrette, Italy
| | - Simon Blank
- Center of Allergy and Environment (ZAUM), Technical University of Munich, School of Medicine and Helmholtz Center Munich, German Research Center for Environmental Health, Munich, Germany
| | - Philipp P Bosshard
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Heimo Breiteneder
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Helen A Brough
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
- Children's Allergy Service, Evelina London, Guy's and St Thomas' Hospital, London, United Kingdom
| | - Merima Bublin
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Dianne Campbell
- Department of Allergy and Immunology, Children's Hospital at Westmead, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
- Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Luis Caraballo
- Institute for Immunological Research, University of Cartagena, Cartagena de Indias, Colombia, Colombia
| | - Jean Christoph Caubet
- Pediatric Allergy Unit, Department of Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
| | - Giorgio Celi
- Centro DH Allergologia e Immunologia Clinica ASST- MANTOVA (MN), Mantova, Italy
| | | | - Maksymilian Chruszcz
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, South Carolina, USA
| | - Adnan Custovic
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Rebecca Czolk
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
- Faculty of Science, Technology and Medicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Janet Davies
- Queensland University of Technology, Centre for Immunology and Infection Control, School of Biomedical Sciences, Herston, Queensland, Australia
- Metro North Hospital and Health Service, Emergency Operations Centre, Herston, Queensland, Australia
| | - Nikolaos Douladiris
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Bernadette Eberlein
- Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University Munich, Munich, Germany
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Kanagawa, Japan
| | - Anna Ehlers
- Chemical Biology and Drug Discovery, Utrecht University, Utrecht, The Netherlands
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Immunology and Dermatology/ Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Philippe Eigenmann
- Pediatric Allergy Unit, Department of Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
| | - Gabriele Gadermaier
- Department of Biosciences and Medical Biology, Paris Lodron University Salzburg, Salzburg, Austria
| | - Mattia Giovannini
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Francisca Gomez
- Allergy Unit IBIMA-Hospital Regional Universitario de Malaga, Malaga, Spain
- Spanish Network for Allergy research RETIC ARADyAL, Malaga, Spain
| | - Rebecca Grohman
- NYU Langone Health, Department of Internal Medicine, New York, New York, USA
| | - Carole Guillet
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Christine Hafner
- Department of Dermatology, University Hospital St. Poelten, Karl Landsteiner University of Health Sciences, St. Poelten, Austria
| | - Robert G Hamilton
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael Hauser
- Department of Biosciences and Medical Biology, Paris Lodron University Salzburg, Salzburg, Austria
| | - Thomas Hawranek
- Department of Dermatology and Allergology, Paracelsus Private Medical University, Salzburg, Austria
| | - Hans Jürgen Hoffmann
- Institute for Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
| | | | - Tomona Iizuka
- Laboratory of Protein Science, Graduate School of Life Science, Hokkaido University, Sapporo, Japan
| | - Alain Jacquet
- Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Thilo Jakob
- Department of Dermatology and Allergology, University Medical Center, Justus Liebig University Gießen, Gießen, Germany
| | - Bente Janssen-Weets
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
- Odense Research Center for Anaphylaxis, University of Southern Denmark, Odense, Denmark
| | - Uta Jappe
- Division of Clinical and Molecular Allergology, Priority Research Area Asthma and Allergy, Research Center Borstel, Borstel, Germany
- Leibniz Lung Center, Airway Research Center North (ARCN), Member of the German Center for Lung Research, Germany
- Interdisciplinary Allergy Outpatient Clinic, Dept. of Pneumology, University of Lübeck, Lübeck, Germany
| | - Marek Jutel
- Department of Clinical Immunology, Wroclaw Medical University, Wroclaw, Poland
| | - Tanja Kalic
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
- Department of Dermatology, University Hospital St. Poelten, Karl Landsteiner University of Health Sciences, St. Poelten, Austria
| | - Sandip Kamath
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Sabine Kespohl
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr- Universität Bochum, Bochum, Germany
| | - Jörg Kleine-Tebbe
- Allergy & Asthma Center Westend, Outpatient Clinic and Clinical Research Center, Berlin, Germany
| | - Edward Knol
- Department of Immunology and Dermatology/ Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - André Knulst
- Department of Immunology and Dermatology/ Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Jon R Konradsen
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Peter Korošec
- University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia
- Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | - Annette Kuehn
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Gideon Lack
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom
- Children's Allergy Service, Evelina London, Guy's and St Thomas' Hospital, London, United Kingdom
| | - Thuy-My Le
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Immunology and Dermatology/ Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Andreas Lopata
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Olga Luengo
- RETIC ARADyAL and RICORS Enfermedades Inflamatorias (REI), Madrid, Spain
- Allergy Section, Internal Medicine Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mika Mäkelä
- Division of Allergy, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Pediatric Department, Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | | | - Clare Mills
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Manchester Institute of Biotechnology, The University of Manchester, Manchester, UK
| | | | - Antonella Muraro
- Food Allergy Referral Centre, Department of Woman and Child Health, Padua University Hospital, Padua, Italy
| | - Anna Nowak-Wegrzyn
- Division of Pediatric Allergy and Immunology, NYU Grossman School of Medicine, Hassenfeld Children's Hospital, New York, New York, USA
- Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Roni Nugraha
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
- Department of Aquatic Product Technology, Faculty of Fisheries and Marine Science, IPB University, Bogor, Indonesia
| | - Markus Ollert
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
- Odense Research Center for Anaphylaxis, University of Southern Denmark, Odense, Denmark
| | - Kati Palosuo
- Department of Allergology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - Sarita Ulhas Patil
- Division of Rheumatology, Allergy and Immunology, Departments of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Division of Allergy and Immunology, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Thomas Platts-Mills
- Division of Allergy and Clinical Immunology, University of Virginia, Charlottesville, Virginia, USA
| | | | - Pascal Poncet
- Institut Pasteur, Immunology Department, Paris, France
- Allergy & Environment Research Team Armand Trousseau Children Hospital, APHP, Paris, France
| | - Ekaterina Potapova
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Lars K Poulsen
- Allergy Clinic, Department of Dermatology and Allergy, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark
| | - Christian Radauer
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Suzana Radulovic
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
- Children's Allergy Service, Evelina London, Guy's and St Thomas' Hospital, London, United Kingdom
| | - Monika Raulf
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr- Universität Bochum, Bochum, Germany
| | - Pierre Rougé
- UMR 152 PharmaDev, IRD, Université Paul Sabatier, Faculté de Pharmacie, Toulouse, France
| | - Joaquin Sastre
- Allergy Service, Fundación Jiménez Díaz; CIBER de Enfermedades Respiratorias (CIBERES); Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
| | - Sakura Sato
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Enrico Scala
- Clinical and Laboratory Molecular Allergy Unit - IDI- IRCCS, Fondazione L M Monti Rome, Rome, Italy
| | - Johannes M Schmid
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
| | - Peter Schmid-Grendelmeier
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
- Christine Kühne Center for Allergy Research and Education CK-CARE, Davos, Switzerland
| | - Denise Schrama
- Centre of Marine Sciences (CCMAR), Universidade do Algarve, Faro, Portugal
| | - Hélène Sénéchal
- Allergy & Environment Research Team Armand Trousseau Children Hospital, APHP, Paris, France
| | - Claudia Traidl-Hoffmann
- Christine Kühne Center for Allergy Research and Education CK-CARE, Davos, Switzerland
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Marcela Valverde-Monge
- Allergy Service, Fundación Jiménez Díaz; CIBER de Enfermedades Respiratorias (CIBERES); Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
| | - Marianne van Hage
- Department of Medicine Solna, Division of Immunology and Allergy, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Ronald van Ree
- Department of Experimental Immunology and Department of Otorhinolaryngology, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Kitty Verhoeckx
- Department of Immunology and Dermatology/ Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Stefan Vieths
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - Magnus Wickman
- Department of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Josefina Zakzuk
- Institute for Immunological Research, University of Cartagena, Cartagena de Indias, Colombia, Colombia
| | - Paolo M Matricardi
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
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Scurlock AM, Brown E, Davis CM. Food insecurity in children and adults with food allergies. Ann Allergy Asthma Immunol 2022; 129:424-429. [PMID: 35987455 DOI: 10.1016/j.anai.2022.08.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/12/2022] [Accepted: 08/12/2022] [Indexed: 12/14/2022]
Abstract
Food allergy is a substantial public health concern associated with risk of severe or potentially life-threatening reactions and requiring life-altering changes in dietary habits. This increasingly prevalent health concern is associated with adverse medical, nutritional, psychosocial, and economic effects on the estimated 32 million affected individuals in the United States. Management of food allergy requires life-altering dietary modifications and constant vigilance to avoid implicated allergens to minimize the risk of anaphylaxis, which can lead to considerable anxiety and reduced quality of life. Specialized diets are expensive and often difficult to access, particularly for low-income and minority individuals with food allergy. The overlap of food insecurity with diet-treated illnesses further increases the burden on patients with food allergies and their families, with overall rates of food insecurity increasing substantially during the coronavirus disease 2019 pandemic. Universal screening to identify food insecure households and connect them with appropriate resources is a critical step in addressing unmet needs at the individual and family level. At the systems level, integrated advocacy approaches addressing the complex interplay between multiple societal issues such as poverty, systemic racism, wage inequality, housing insecurity, lack of transportation, and other social determinants of health are vital to ensure access to safe, healthy, nutritionally complete options for patients with food allergies and their families.
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Affiliation(s)
- Amy M Scurlock
- Department of Pediatrics, Arkansas Children's Hospital and Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
| | | | - Carla M Davis
- Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
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Thivalapill N, Andy-Nweye AB, Bilaver LA, Tobin MC, Sharma HP, Assa'ad AH, Warren C, Jiang J, Chura A, Gupta RS, Mahdavinia M. Sensitization to house dust mite and cockroach may mediate the racial difference in shellfish allergy. Pediatr Allergy Immunol 2022; 33:e13837. [PMID: 36003047 DOI: 10.1111/pai.13837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 07/10/2022] [Accepted: 07/13/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Neil Thivalapill
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Aame B Andy-Nweye
- Division of Allergy and Immunology, Department of Medicine and Department of Pediatrics, Rush University Medical Center, Chicago, Illinois, USA
| | - Lucy A Bilaver
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Mary C Tobin
- Division of Allergy and Immunology, Department of Medicine and Department of Pediatrics, Rush University Medical Center, Chicago, Illinois, USA
| | - Hemant P Sharma
- Division of Allergy and Immunology, Children's National Health Systems, Washington, District of Columbia, USA
| | - Amal H Assa'ad
- Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Christopher Warren
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jialing Jiang
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Annika Chura
- Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Ruchi S Gupta
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Advanced General Pediatrics and Primary Care, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Mahboobeh Mahdavinia
- Division of Allergy and Immunology, Department of Medicine and Department of Pediatrics, Rush University Medical Center, Chicago, Illinois, USA
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Jafri S, Janzen J, Kim R, Abrams EM, Gruber J, Protudjer JLP. Burden of Allergic Disease in Racial and Ethnic Structurally Oppressed Communities Within Canada and the United States: A Scoping Review. The Journal of Allergy and Clinical Immunology: In Practice 2022; 10:2995-3001. [PMID: 35995399 DOI: 10.1016/j.jaip.2022.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND The social determinants of health have been extensively studied as potential mediating variables in the development and/or progression of many chronic illnesses, including allergic diseases, and may contribute to social inequities as barriers in accessing health care. OBJECTIVE We aimed to perform a scoping literature review to describe the burden of disease and access to health care for treatment of allergic disease within literature specific to structurally oppressed racial and ethnic populations. METHODS We performed a scoping review, guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines for Scoping Reviews, of 3 scientific databases and 5 relevant gray literature sites. Search strategy including keywords describing race and ethnicity were selected based on the acceptable nomenclature in Canada and the United States. We imposed no restrictions on date or country of publication, study design, or age of participants. RESULTS Our literature search yielded 1,198 potentially relevant articles following deduplication. After title and abstract, and subsequently full-text screening, a total of 12 (1.08% of all articles) were included. These 12 included studies pointed toward a higher burden of allergic and atopic disease, including increased presentations to emergency departments, hospitalizations, mortality, younger age of diagnosis, and/or greater severity of disease, among Black or African American individuals, than the general population. Allergies beyond the top 9 food allergens, eosinophilic esophagitis, and asthma appeared to be more prevalent and more severe in this population than in the general population. There appears to be an increased burden of allergic and atopic disease among the Indigenous Peoples of Canada, whereas this was not noted for Latinx or Hispanic populations, in part due to a paucity of studies involving these populations. Owing to a lack of published literature, no conclusions could be drawn regarding allergy and atopy in Native American populations. CONCLUSIONS Structurally oppressed racial and ethnic communities may face an increased burden of allergic and atopic disease-but that this may be magnified by issues regarding oppression, access, and social environment that warrant further investigation.
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Affiliation(s)
- Syeda Jafri
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jacob Janzen
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Rebecca Kim
- Department of Biomedical and Molecular Science, Faculty of Arts and Science, Queen's University, Kingston, Ontario, Canada
| | - Elissa M Abrams
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada; Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Jackie Gruber
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; British Columbia Institute of Technology, Burnaby, British Columbia, Canada
| | - Jennifer L P Protudjer
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada; Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; George and Fay Yee Centre for Healthcare Innovation, Winnipeg, Manitoba, Canada; Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden.
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Warren C, Bartell T, Nimmagadda SR, Bilaver LA, Koplin J, Gupta R. Socioeconomic Determinants of Food Allergy Burden-A clinical introduction. Ann Allergy Asthma Immunol 2022; 129:407-416. [PMID: 35914663 DOI: 10.1016/j.anai.2022.07.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/30/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This review characterizes what is currently known about how prevalence, severity, distribution, and management of food allergy (FA) differs across socioeconomic strata and provides guidance for practicing clinicians about how to improve equity in research participation, healthcare delivery, and patient outcomes through a deeper understanding of the socioeconomic determinants of FA. DATA SOURCES Epidemiological and biomedical literature published prior to April 2022. RESULTS Socioeconomic status (SES) is a complex concept that not only encompasses economic resources (e.g., income, wealth) but also a person's social, economic and political power and standing, each of which can impact health. However, in many studies of individuals and families with FA, assessment of SES has been limited and often a respondent's membership within a racial and ethnic group is utilized as a proxy for low SES. As a whole, findings from US-population-based studies indicate a consistent trend: those who self-identify as non-Hispanic Black, and to a lesser extent other subpopulations who identify as being of non-White race and ethnicity, experience a greater burden of food-allergic sensitization and disease including higher rates of emergency health care utilization and food-induced anaphylactic fatality as compared to those identifying as White. CONCLUSION Reports of FA management and outcomes highlight inequities among specific low SES populations in the US. Clinicians can and should act to reduce inequities by engaging more diverse populations in clinical research, equitably implementing FA risk screening and prevention, thoughtfully utilizing emerging technologies to ameliorate disparities based on SES in healthcare delivery and outcomes, and advocating for social change.
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Affiliation(s)
- Christopher Warren
- Northwestern University, Feinberg School of Medicine, Department of Preventive Medicine and Center for Food Allergy and Asthma Research.
| | - Tami Bartell
- Patrick M. Magoon Institute for Healthy Communities, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Sai R Nimmagadda
- Northwestern University, Feinberg School of Medicine, Center for Food Allergy and Asthma Research; Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA, Division of Allergy and Immunology
| | - Lucy A Bilaver
- Northwestern University, Feinberg School of Medicine, Department of Pediatrics and Center for Food Allergy and Asthma Research
| | - Jennifer Koplin
- Murdoch Children's Research Institute Melbourne, Melbourne, Vic., Australia. Department of Paediatrics and School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - Ruchi Gupta
- Center for Food Allergy & Asthma Research; Institute for Public Health and Medicine, Northwestern Feinberg School of Medicine; Ann & Robert H. Lurie Children's Hospital of Chicago
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Halima O, Najar FZ, Wahab A, Gamagedara S, Chowdhury AI, Foster SB, Shaheen N, Ahsan N. Lentil allergens identification and quantification: An update from omics perspective. Food Chemistry: Molecular Sciences 2022; 4:100109. [PMID: 35495776 PMCID: PMC9043643 DOI: 10.1016/j.fochms.2022.100109] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 03/31/2022] [Accepted: 04/10/2022] [Indexed: 02/08/2023]
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Bartnikas LM, Dupuis R, Wang J, Phipatanakul W. Food Allergies in Inner-City Schools: Addressing Disparities and Improving Management. Ann Allergy Asthma Immunol 2022; 129:430-439. [PMID: 35568300 DOI: 10.1016/j.anai.2022.04.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 03/28/2022] [Accepted: 04/04/2022] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Food allergy (FA) affects approximately 8% of children in the United States. Management comprises both preventing and treating allergic reactions, which poses unique challenges in the inner-city school setting. In this article, we review the epidemiology of FA in school-aged children and management challenges and opportunities specific to the inner-city population. DATA SOURCES A literature search of the PubMed database was performed to identify published literature on FA epidemiology, FA management, school policies, disparities, inner-city, race, ethnicity, and socioeconomic status. STUDY SELECTIONS Relevant articles on FA management best practices and challenges in schools, with a particular emphasis on inner-city schools and populations and socioeconomic, racial, and ethnic disparities, were reviewed in detail. RESULTS Disparities in FA prevalence, management, and treatment exist. Additional research is needed to better characterize these disparities and elucidate the mechanisms leading to them. There is a lack of evidence-based interventions for the prevention and treatment of food allergic reactions in schools and specifically in inner-city schools, in which a greater proportion of students may rely on school food. CONCLUSION There are opportunities for partnership among health care providers, schools, and communities to address unmet needs in FA management and disparities in the inner-city school setting.
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Affiliation(s)
- Lisa M Bartnikas
- Department of Medicine, Division of Immunology, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, Massachusetts
| | - Roxanne Dupuis
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Julie Wang
- Department of Pediatrics, Division of Allergy and Immunology, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Wanda Phipatanakul
- Department of Medicine, Division of Immunology, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, Massachusetts.
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16
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Tepler E, Wong KH, Soffer GK. Health disparities in pediatric food allergy. Ann Allergy Asthma Immunol 2022; 129:417-423. [PMID: 35476967 DOI: 10.1016/j.anai.2022.04.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To review the current literature regarding the health disparities in the prevalence, diagnosis, and management of pediatric food allergy and discuss possible interventions. DATA SOURCES Literature search of PubMed and Google Scholar databases regarding pediatric food allergy and health disparities. STUDY SELECTIONS Original research articles, reviews, and guidelines on health disparities in pediatric food allergy were included in this review. RESULTS The overall prevalence of food allergy appears to be increasing and disproportionately affecting minority groups. Racial and socioeconomic disparities are evident across all aspects of food allergy care: diagnosis, prevention, acute management (eg, access to epinephrine autoinjectors, visits to emergency department), and long-term management (eg, oral immunotherapy). Children of minority populations and those of low socioeconomic status are at a greater risk of food insecurity, which is further exacerbated by the high cost of allergen-free foods and limited support from food assistance programs. CONCLUSION Racial, ethnic, and socioeconomic disparities in food allergy among children in the United States are evident and negatively affect the outcomes of children with food allergies. Active efforts to decrease racial and socioeconomic disparities, through education, research, and advocacy, will be important to help improve health outcomes in food allergy for all children, regardless of their race, ethnicity, or socioeconomic status.
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Affiliation(s)
- Elizabeth Tepler
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut.
| | - Katelyn H Wong
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut
| | - Gary K Soffer
- Section of Allergy and Immunology, Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut
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Mahdavinia M, Bilaver LA, Fox S, Pappalardo AA, Andy-Nweye AB, Sharma HP, Assa’ad AH, Gupta RS, Tobin MC. Racial disparity in treatment of gastroesophageal reflux disease in children with food allergy. J Allergy Clin Immunol Pract 2022; 10:339-342.e2. [PMID: 34678499 PMCID: PMC8748421 DOI: 10.1016/j.jaip.2021.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 01/03/2023]
Affiliation(s)
- Mahboobeh Mahdavinia
- Division of Allergy and Immunology, Department of Medicine and Department of Pediatrics, Rush University Medical Center, Chicago, Ill
| | - Lucy A Bilaver
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Susan Fox
- Division of Allergy and Immunology, Department of Medicine and Department of Pediatrics, Rush University Medical Center, Chicago, Ill
| | - Andrea A Pappalardo
- University of Illinois at Chicago, Department of Medicine and Pediatrics, Chicago, Ill
| | - Aame B Andy-Nweye
- Division of Allergy and Immunology, Department of Medicine and Department of Pediatrics, Rush University Medical Center, Chicago, Ill
| | - Hemant P. Sharma
- Division of Allergy and Immunology, Children’s National Health Systems, Washington, DC
| | - Amal H. Assa’ad
- Division of Allergy & Immunology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Ruchi S. Gupta
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill,Advanced General Pediatrics and Primary Care, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Ill
| | - Mary C. Tobin
- Division of Allergy and Immunology, Department of Medicine and Department of Pediatrics, Rush University Medical Center, Chicago, Ill
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Coleman AT, Sharma H, Robinson A, Pappalardo AA, Vincent E, Fierstein JL, Frazier M, Bilaver L, Jiang J, Choi JJ, Kulkarni A, Fox S, Warren C, Mahdavinia M, Tobin M, Assa'ad A, Gupta R. Access to Allergen-Free Food Among Black and White Children with Food Allergy in the FORWARD Study. J Allergy Clin Immunol Pract 2022; 10:182-188. [PMID: 34419681 PMCID: PMC9527819 DOI: 10.1016/j.jaip.2021.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/30/2021] [Accepted: 08/05/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Racial differences in access to allergen-free food have not been fully described among children with food allergy (FA). OBJECTIVE To examine access to allergen-free foods among Black and White children with FA. METHODS Black and White children with FA were enrolled in Food Allergy Outcomes Related to White and African American Racial Differences (FORWARD), a multisite prospective cohort study at 4 urban US centers. Caregivers completed questionnaires regarding access to allergen-free foods. Univariable statistics described demographics. Bivariable statistics evaluated crude associations with access to allergen-free foods. Multivariable logistic regression evaluated the adjusted effect of race on access to allergen-free foods. Geospatial analyses examined the distribution of race, socioeconomic status, and food desert residence. RESULTS Among participants (n = 336), White caregivers (88.1%) were more likely to report access to allergen-free foods than Black caregivers (59%) (P < .001). White caregivers were more likely to purchase allergen-free foods online (35.2%) than Black caregivers (12%) (P < .001). Although Black children were more likely to live in a food desert, access to allergen-free food was not related to food desert residence. In the unadjusted analysis, White children were 5.2 times as likely to have access than Black children (P < .001); after adjusting for demographics, this increase in access was no longer significant (P = .08). Other predictors of access to allergen-free foods included online food purchasing, annual household income, respondent education level, milk allergy, and child age >5 years. CONCLUSION In the FORWARD cohort, Black children have less access to allergen-free foods than White children, but much of the difference is accounted for by socioeconomic status and other participant characteristics.
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Affiliation(s)
- Amaziah T Coleman
- Division of Allergy and Immunology, Children's National Hospital, Washington, DC.
| | - Hemant Sharma
- Division of Allergy and Immunology, Children's National Hospital, Washington, DC
| | - Adam Robinson
- Division of Allergy and Immunology, Children's National Hospital, Washington, DC
| | - Andrea A Pappalardo
- Department of Medicine and Pediatrics, University of Illinois at Chicago, Chicago, Ill
| | - Eileen Vincent
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Jamie L Fierstein
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Mech Frazier
- Department of Research Services, Northwestern University Libraries, Chicago, Ill
| | - Lucy Bilaver
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Jialing Jiang
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Johnathan J Choi
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Ashwin Kulkarni
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Susan Fox
- Division of Allergy/Immunology, Rush University Medical Center, Chicago, Ill
| | - Christopher Warren
- Advanced General Pediatrics and Primary Care, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
| | | | - Mary Tobin
- Division of Allergy/Immunology, Rush University Medical Center, Chicago, Ill
| | - Amal Assa'ad
- Division of Allergy & Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Ruchi Gupta
- Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill; Advanced General Pediatrics and Primary Care, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
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19
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Brewer AG, Jiang J, Warren CM, Sharma HP, Tobin MC, Assa’ad A, Gupta RS. Racial differences in timing of food allergen introduction. J Allergy Clin Immunol Pract 2022; 10:329-332.e2. [PMID: 34688964 PMCID: PMC8748399 DOI: 10.1016/j.jaip.2021.10.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 01/03/2023]
Affiliation(s)
- Audrey G. Brewer
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, United States,Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
| | - Jialing Jiang
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
| | - Christopher M. Warren
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
| | - Hemant P. Sharma
- Children’s National Hospital, Washington, District of Columbia, United States
| | - Mary C. Tobin
- Rush University Medical Center, Chicago, Illinois, United States
| | - Amal Assa’ad
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
| | - Ruchi S. Gupta
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, United States,Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States,Corresponding Author: Ruchi S Gupta, MD MPH, 750 N Lake Shore Drive, Suite 680, Chicago, IL 60611, U.S.A., Phone: 312-503-5581,
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20
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Aldakheel FM. Allergic Diseases: A Comprehensive Review on Risk Factors, Immunological Mechanisms, Link with COVID-19, Potential Treatments, and Role of Allergen Bioinformatics. Int J Environ Res Public Health 2021; 18:12105. [PMID: 34831860 DOI: 10.3390/ijerph182212105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/02/2021] [Accepted: 11/16/2021] [Indexed: 12/24/2022]
Abstract
The prevalence of allergic diseases is regarded as one of the key challenges in health worldwide. Although the precise mechanisms underlying this rapid increase in prevalence are unknown, emerging evidence suggests that genetic and environmental factors play a significant role. The immune system, microbiota, viruses, and bacteria have all been linked to the onset of allergy disorders in recent years. Avoiding allergen exposure is the best treatment option; however, steroids, antihistamines, and other symptom-relieving drugs are also used. Allergen bioinformatics encompasses both computational tools/methods and allergen-related data resources for managing, archiving, and analyzing allergological data. This study highlights allergy-promoting mechanisms, algorithms, and concepts in allergen bioinformatics, as well as major areas for future research in the field of allergology.
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21
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Clarke AE, Elliott SJ, St Pierre Y, Soller L, La Vieille S, Ben-Shoshan M. Demographic characteristics associated with food allergy in a Nationwide Canadian Study. Allergy Asthma Clin Immunol 2021; 17:72. [PMID: 34274025 PMCID: PMC8285771 DOI: 10.1186/s13223-021-00572-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/28/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION We conducted a nationwide Canadian telephone survey on food allergy prevalence between February 2016 and January 2017, targeting vulnerable populations (New, Indigenous, and lower-income Canadians). OBJECTIVE To examine the independent effect of demographic characteristics on food allergy. METHODS Canadian households with vulnerable populations were targeted using Canadian Census data and the household respondent reported whether each household member had a perceived (self-reported) or probable (self-report of a convincing history or physician diagnosis) food allergy. The association between perceived and probable food allergy and demographic characteristics was assessed through weighted multivariable random effects logistic regressions. RESULTS Children, females, Canadian-born participants, adults with post-secondary education, and those residing in smaller households were more likely to report perceived or probable food allergy. Although immigrant parents self-reported less food allergy, Canadian-born children of Southeast/East Asian immigrant versus other immigrant or Canadian-born parents reported more food allergy. CONCLUSION We have demonstrated clear associations between demographic characteristics and food allergy, which may provide important clues to the environmental determinants of food allergy.
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Affiliation(s)
- Ann E Clarke
- Division of Rheumatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Susan J Elliott
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, ON, Canada
| | - Yvan St Pierre
- Division of Clinical Epidemiology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Lianne Soller
- Division of Allergy and Immunology, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Sebastien La Vieille
- Bureau of Chemical Safety, Health Canada, Ottawa, ON, Canada.,Food Science Department, Faculty of Agricultural and Nutrition Sciences, Laval University, Quebec City, QC, Canada
| | - Moshe Ben-Shoshan
- Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada
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22
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Davis CM. Moving FORWARD Toward Racial Equity in Food Allergy. J Allergy Clin Immunol Pract 2021; 9:2874-2875. [PMID: 34246438 PMCID: PMC10644374 DOI: 10.1016/j.jaip.2021.04.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 11/22/2022]
Affiliation(s)
- Carla M Davis
- Texas Children's Hospital Food Allergy Program, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.
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