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Imran S, Neeland MR, Martino DJ, Peng S, Koplin J, Dharmage SC, Tang MLK, Sawyer S, Dang T, McWilliam V, Peters RL, Prescott S, Perrett KP, Novakovic B, Saffery R. Epigenomic variability is associated with age-specific naïve CD4 T cell response to activation in infants and adolescents. Immunol Cell Biol 2023; 101:397-411. [PMID: 36760028 PMCID: PMC10952707 DOI: 10.1111/imcb.12628] [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: 04/20/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/11/2023]
Abstract
Childhood is a critical period of immune development. During this time, naïve CD4 (nCD4) T cells undergo programmed cell differentiation, mediated by epigenetic changes, in response to external stimuli leading to a baseline homeostatic state that may determine lifelong disease risk. However, the ontogeny of epigenetic signatures associated with CD4 T cell activation during key developmental periods are yet to be described. We investigated genome-wide DNA methylation (DNAm) changes associated with nCD4 T activation following 72 h culture in media+anti-CD3/CD28 beads in healthy infants (aged 12 months, n = 18) and adolescents (aged 10-15 years, n = 15). We integrated these data with transcriptomic and cytokine profiling from the same samples. nCD4 T cells from both age groups show similar extensive epigenetic reprogramming following activation, with the majority of genes involved in the T cell receptor signaling pathway associated with differential methylation. Additionally, we identified differentially methylated probes showing age-specific responses, that is, responses in only infants or adolescents, including within a cluster of T cell receptor (TCR) genes. These encoded several TCR alpha joining (TRAJ), and TCR alpha variable (TRAV) genes. Cytokine data analysis following stimulation revealed enhanced release of IFN-γ, IL-2 and IL-10, in nCD4 T cells from adolescents compared with infants. Overlapping differential methylation and cytokine responses identified four probes potentially underpinning these age-specific responses. We show that DNAm in nCD4T cells in response to activation is dynamic in infancy and adolescence, with additional evidence for age-specific effects potentially driving variation in cytokine responses between these ages.
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Affiliation(s)
- Samira Imran
- Murdoch Children's Research Institute, and Department of PaediatricsUniversity of Melbourne, Royal Children's HospitalFlemington RoadParkvilleVICAustralia
| | - Melanie R Neeland
- Murdoch Children's Research Institute, and Department of PaediatricsUniversity of Melbourne, Royal Children's HospitalFlemington RoadParkvilleVICAustralia
| | - David J. Martino
- Wal‐yan Respiratory Research Centre, Telethon Kids InstitutePerthAustralia
- University of Western AustraliaPerthWAAustralia
| | - Stephen Peng
- Murdoch Children's Research Institute, and Department of PaediatricsUniversity of Melbourne, Royal Children's HospitalFlemington RoadParkvilleVICAustralia
| | - Jennifer Koplin
- Murdoch Children's Research Institute, and Department of PaediatricsUniversity of Melbourne, Royal Children's HospitalFlemington RoadParkvilleVICAustralia
| | - Shyamali C Dharmage
- Murdoch Children's Research Institute, and Department of PaediatricsUniversity of Melbourne, Royal Children's HospitalFlemington RoadParkvilleVICAustralia
- Allergy and Lung Health UnitMelbourne School of Population and Global HealthUniversity of MelbourneMelbourneVICAustralia
| | - Mimi LK Tang
- Murdoch Children's Research Institute, and Department of PaediatricsUniversity of Melbourne, Royal Children's HospitalFlemington RoadParkvilleVICAustralia
- Department of Allergy and ImmunologyRoyal Children's HospitalMelbourneVICAustralia
| | - Susan Sawyer
- Murdoch Children's Research Institute, and Department of PaediatricsUniversity of Melbourne, Royal Children's HospitalFlemington RoadParkvilleVICAustralia
- Centre for Adolescent HealthRoyal Children's Hospital MelbourneMelbourneVICAustralia
| | - Thanh Dang
- Murdoch Children's Research Institute, and Department of PaediatricsUniversity of Melbourne, Royal Children's HospitalFlemington RoadParkvilleVICAustralia
| | - Vicki McWilliam
- Murdoch Children's Research Institute, and Department of PaediatricsUniversity of Melbourne, Royal Children's HospitalFlemington RoadParkvilleVICAustralia
- Department of Allergy and ImmunologyRoyal Children's HospitalMelbourneVICAustralia
| | - Rachel L Peters
- Murdoch Children's Research Institute, and Department of PaediatricsUniversity of Melbourne, Royal Children's HospitalFlemington RoadParkvilleVICAustralia
| | - Susan Prescott
- School of MedicineThe University of Western Australia35 Stirling HighwayCrawleyWAAustralia
- Telethon Kids Institute15 Hospital AvenueNedlandsWAAustralia
- Department of ImmunologyPerth Children's Hospital15 Hospital AvenueNedlandsWAAustralia
| | - Kirsten P Perrett
- Murdoch Children's Research Institute, and Department of PaediatricsUniversity of Melbourne, Royal Children's HospitalFlemington RoadParkvilleVICAustralia
- Department of Allergy and ImmunologyRoyal Children's HospitalMelbourneVICAustralia
| | - Boris Novakovic
- Murdoch Children's Research Institute, and Department of PaediatricsUniversity of Melbourne, Royal Children's HospitalFlemington RoadParkvilleVICAustralia
| | - Richard Saffery
- Murdoch Children's Research Institute, and Department of PaediatricsUniversity of Melbourne, Royal Children's HospitalFlemington RoadParkvilleVICAustralia
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Hua X, Dalziel K, Brettig T, Dharmage SC, Lowe A, Perrett KP, Peters RL, Ponsonby AL, Tang MLK, Koplin J. Out-of-hospital health care costs of childhood food allergy in Australia: A population-based longitudinal study. Pediatr Allergy Immunol 2022; 33:e13883. [PMID: 36433856 PMCID: PMC9828422 DOI: 10.1111/pai.13883] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Australia has one of the highest prevalence of childhood food allergy in the world, but there are no data on its economic burden in Australia. METHODS We used data from the HealthNuts study, a population-based longitudinal study undertaken in Melbourne, Australia. Infants were recruited at age 12 months between Sept 2007 and Aug 2011 with food allergy diagnosed using oral food challenges. Health care costs of out-of-hospital services were collected through data linkage to Australia's universal health insurance scheme Medicare. Two-part model was used to compare costs after controlling for potential confounders. RESULTS 2919 children were included, and 390 (13.4%) had challenge-confirmed food allergy at age 1 year. Compared with children without food allergy, children with food allergy had significantly higher costs for GP visits, specialist visits, tests, and prescriptions in the first four years of life. The total Medicare cost associated with food allergy from age 1 to 4 years was estimated to be AUD$889.7 (95% CI $566.1-$1188.3) or €411.0 (95% CI €261.5-€549.0) per child. This was projected into an annual Medicare cost of AUD$26.1 million (95% CI $20.1-$32.3 million) or €12.1 (95% CI €9.3-€14.9 million) based on population size in 2020. CONCLUSIONS Childhood food allergy causes considerable Medicare costs for out-of-hospital services in the first four years after birth in Australia. These findings can help anticipate the financial impact on the health care system associated with childhood food allergy, act as a useful costing resource for future evaluations, and inform management of childhood food allergy internationally.
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Affiliation(s)
- Xinyang Hua
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Kim Dalziel
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia.,Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Australia
| | - Tim Brettig
- Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Australia.,Murdoch Children's Research Institute, Parkville, Australia
| | - Shyamali C Dharmage
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia.,Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Australia.,Murdoch Children's Research Institute, Parkville, Australia
| | - Adrian Lowe
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia.,Murdoch Children's Research Institute, Parkville, Australia
| | - Kirsten P Perrett
- Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Australia.,Murdoch Children's Research Institute, Parkville, Australia.,Department of Allergy and Immunology, The Royal Children's Hospital, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Rachel L Peters
- Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Anne-Louise Ponsonby
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia.,Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Australia.,Murdoch Children's Research Institute, Parkville, Australia.,Florey Institute for Neuroscience and Mental Health, Parkville, Australia
| | - Mimi L K Tang
- Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Australia.,Murdoch Children's Research Institute, Parkville, Australia.,Department of Allergy and Immunology, The Royal Children's Hospital, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Jennifer Koplin
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia.,Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
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3
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Koplin J, Soriano V, Netting M, Peters R. Infant feeding patterns before and after changes to food allergy prevention guidelines in Australia. Med J Aust 2022; 217:210-211. [PMID: 35772721 PMCID: PMC9540109 DOI: 10.5694/mja2.51627] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 03/15/2022] [Accepted: 03/23/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Jennifer Koplin
- Centre for Food and Allergy Research, Murdoch Children’s Research Institute Melbourne VIC
- The University of Melbourne Melbourne VIC
| | - Victoria Soriano
- Centre for Food and Allergy Research, Murdoch Children’s Research Institute Melbourne VIC
- The University of Melbourne Melbourne VIC
| | - Merryn Netting
- South Australian Health and Medical Research Institute Adelaide SA
- The University of Adelaide Adelaide SA
| | - Rachel Peters
- The University of Melbourne Melbourne VIC
- Murdoch Children’s Research Institute Melbourne VIC
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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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5
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Kabasser S, Pratap K, Kamath S, Taki AC, Dang T, Koplin J, Perrett K, Hummel K, Radauer C, Breiteneder H, Lopata AL, Bublin M. Identification of vicilin, legumin and antimicrobial peptide 2a as macadamia nut allergens. Food Chem 2022; 370:131028. [PMID: 34525424 PMCID: PMC7614219 DOI: 10.1016/j.foodchem.2021.131028] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 08/13/2021] [Accepted: 08/29/2021] [Indexed: 12/20/2022]
Abstract
Macadamia nut is an increasingly popular food item of a healthy diet. However, macadamia nut is also a potent allergenic food. To date, there is little information about the allergenic proteins involved. In this study, using sera from macadamia nut allergic individuals, four IgE-binding proteins were detected. Their identities were determined by tandem mass spectrometry with de novo sequencing. Three IgE-reactive proteins, the vicilin Mac i 1, the legumin Mac i 2 and the antimicrobial peptide 2a/Mac i 1 (28-76) were purified from the nut while the non-specific lipid transfer protein was produced as a recombinant in Pichia pastoris. IgE-binding assays using sera from well-characterized groups of tree nut and/or peanut allergic patients revealed that the allergens were mainly recognized by sera from macadamia nut allergic individuals. Hence, these newly discovered allergens will enable molecular diagnostics to identify patients at high risk of macadamia nut allergy.
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Affiliation(s)
- Stefan Kabasser
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Kunal Pratap
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia,Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia,Center for Molecular Therapeutics, James Cook University, Townsville, QLD, Australia
| | - Sandip Kamath
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia,Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia,Center for Molecular Therapeutics, James Cook University, Townsville, QLD, Australia
| | - Aya C. Taki
- School of Veterinary Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Thanh Dang
- Department of Paediatrics, Murdoch Children’s Research Institute, The University of Melbourne, Flemington Road, Parkville, VIC, Australia
| | - Jennifer Koplin
- Department of Paediatrics, Murdoch Children’s Research Institute, The University of Melbourne, Flemington Road, Parkville, VIC, Australia
| | - Kirsten Perrett
- Department of Paediatrics, Murdoch Children’s Research Institute, The University of Melbourne, Flemington Road, Parkville, VIC, Australia
| | - Karin Hummel
- VetCore Facility for Research, University of Veterinary Medicine, Vienna, Austria
| | - Christian Radauer
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Heimo Breiteneder
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Andreas L. Lopata
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia,Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia,Center for Molecular Therapeutics, James Cook University, Townsville, QLD, Australia,Corresponding authors: Merima Bublin, PhD, Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. ; Andreas L. Lopata, PhD, Pharmacy and Medical Research Building, James Cook University, Townsville, QLD, Australia,
| | - Merima Bublin
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
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6
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Brettig T, Dalziel K, Koplin J, Perrett K. Diagnostic Algorithms for Cashew Allergy in Children Reduce Oral Food Challenges and Overall Cost. J Allergy Clin Immunol 2022. [DOI: 10.1016/j.jaci.2021.12.386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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7
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Dang TD, Peters R, Neeland MR, Brettig T, Green H, McWilliam V, Tang MLK, Dharmage S, Ponsonby AL, Koplin J, Perrett KP. Ana o 3 sIgE testing increases the accuracy of cashew allergy diagnosis using a two-step model. Pediatr Allergy Immunol 2022; 33:e13705. [PMID: 34821421 DOI: 10.1111/pai.13705] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 10/20/2021] [Accepted: 11/05/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Measurement of cashew-specific IgE (sIgE) is often used to confirm sensitization but does not reliably diagnose clinical allergy. Ana o 3 is the dominant cashew allergen detected in 75-100% of patients with cashew allergy but not currently used in clinical practice. OBJECTIVES To determine if component-resolved diagnostics using specific IgE to the 2 S albumin from cashew, Ana o 3, improves the accuracy of diagnosing cashew allergy, thereby circumventing the need for an oral food challenge (OFC) in some patients. METHODS A population-based sample of 5276 children was recruited at age 1 year and followed up at age 6 years. Children with positive cashew skin prick test at age 6 underwent an OFC to clarify allergy status. Forty-seven children (mean age 5.02 ± 0.2) (33 cashew-allergic and 14 cashew-tolerant) had cashew sIgE and Ana o 3 sIgE quantified by ImmunoCAP System FEIA. RESULTS A cutoff of >0.32 kUA/L for Ana o 3 sIgE provided 95% specificity and 90% sensitivity and correctly identified 90% of clinical cashew allergy. At the same specificity, the sensitivity for cashew sIgE (>8.5 kUA/L) was only 26%. Sequential measurement of cashew sIgE followed by Ana o 3 sIgE diagnosed 90% of children with cashew allergy without the need for an OFC. CONCLUSION Ana o 3 sIgE testing provides higher diagnostic accuracy than cashew sIgE. Sequential measurement of cashew sIgE followed by Ana o 3 removed the need for a food challenge from 66% down to 12.8% (5-fold) of children compared with cashew sIgE testing alone.
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Affiliation(s)
- Thanh D Dang
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Centre for Food & Allergy Research, Melbourne, Victoria, Australia
| | - Rachel Peters
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Centre for Food & Allergy Research, Melbourne, Victoria, Australia
| | - Melanie R Neeland
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Tim Brettig
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Centre for Food & Allergy Research, Melbourne, Victoria, Australia
| | - Hayden Green
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Vicki McWilliam
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Centre for Food & Allergy Research, Melbourne, Victoria, Australia.,Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Mimi L K Tang
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Centre for Food & Allergy Research, Melbourne, Victoria, Australia.,Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Shyamali Dharmage
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Centre for Food & Allergy Research, Melbourne, Victoria, Australia.,The Allergy and Lung Health Unit for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Victoria, Australia
| | - Anne-Louise Ponsonby
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Centre for Food & Allergy Research, Melbourne, Victoria, Australia.,The Allergy and Lung Health Unit for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Victoria, Australia.,The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jennifer Koplin
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Centre for Food & Allergy Research, Melbourne, Victoria, Australia
| | - Kirsten P Perrett
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Centre for Food & Allergy Research, Melbourne, Victoria, Australia.,Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Victoria, Australia
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8
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López-Cervantes JP, Lønnebotn M, Jogi NO, Calciano L, Kuiper IN, Darby MG, Dharmage SC, Gómez-Real F, Hammer B, Bertelsen RJ, Johannessen A, Würtz AML, Mørkve Knudsen T, Koplin J, Pape K, Skulstad SM, Timm S, Tjalvin G, Krauss-Etschmann S, Accordini S, Schlünssen V, Kirkeleit J, Svanes C. The Exposome Approach in Allergies and Lung Diseases: Is It Time to Define a Preconception Exposome? Int J Environ Res Public Health 2021; 18:12684. [PMID: 34886409 PMCID: PMC8657011 DOI: 10.3390/ijerph182312684] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 11/26/2021] [Accepted: 11/29/2021] [Indexed: 12/30/2022]
Abstract
Emerging research suggests environmental exposures before conception may adversely affect allergies and lung diseases in future generations. Most studies are limited as they have focused on single exposures, not considering that these diseases have a multifactorial origin in which environmental and lifestyle factors are likely to interact. Traditional exposure assessment methods fail to capture the interactions among environmental exposures and their impact on fundamental biological processes, as well as individual and temporal factors. A valid estimation of exposure preconception is difficult since the human reproductive cycle spans decades and the access to germ cells is limited. The exposome is defined as the cumulative measure of external exposures on an organism (external exposome), and the associated biological responses (endogenous exposome) throughout the lifespan, from conception and onwards. An exposome approach implies a targeted or agnostic analysis of the concurrent and temporal multiple exposures, and may, together with recent technological advances, improve the assessment of the environmental contributors to health and disease. This review describes the current knowledge on preconception environmental exposures as related to respiratory health outcomes in offspring. We discuss the usefulness and feasibility of using an exposome approach in this research, advocating for the preconception exposure window to become included in the exposome concept.
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Affiliation(s)
- Juan Pablo López-Cervantes
- Center for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway; (M.L.); (A.J.); (G.T.); (J.K.); (C.S.)
- Department of Occupational Medicine, Haukeland University Hospital, 5021 Bergen, Norway; (N.O.J.); (T.M.K.); (S.M.S.)
| | - Marianne Lønnebotn
- Center for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway; (M.L.); (A.J.); (G.T.); (J.K.); (C.S.)
- Department of Occupational Medicine, Haukeland University Hospital, 5021 Bergen, Norway; (N.O.J.); (T.M.K.); (S.M.S.)
| | - Nils Oskar Jogi
- Department of Occupational Medicine, Haukeland University Hospital, 5021 Bergen, Norway; (N.O.J.); (T.M.K.); (S.M.S.)
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; (F.G.-R.); (R.J.B.)
| | - Lucia Calciano
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (L.C.); (S.A.)
| | | | - Matthew G. Darby
- Institute of Infectious Disease and Molecular Medicine and Division of Immunology, University of Cape Town, Cape Town 7925, South Africa;
| | - Shyamali C. Dharmage
- School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia; (S.C.D.); (J.K.)
| | - Francisco Gómez-Real
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; (F.G.-R.); (R.J.B.)
- Department of Obstetrics and Gynecology, Haukeland University Hospital, 5053 Bergen, Norway
| | - Barbara Hammer
- Department of Pulmonology, Medical University of Vienna, 1090 Vienna, Austria;
| | | | - Ane Johannessen
- Center for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway; (M.L.); (A.J.); (G.T.); (J.K.); (C.S.)
| | - Anne Mette Lund Würtz
- Danish Ramazzini Centre, Department of Public Health—Work, Environment and Health, Aarhus University, 8000 Aarhus, Denmark; (A.M.L.W.); (K.P.); (V.S.)
| | - Toril Mørkve Knudsen
- Department of Occupational Medicine, Haukeland University Hospital, 5021 Bergen, Norway; (N.O.J.); (T.M.K.); (S.M.S.)
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; (F.G.-R.); (R.J.B.)
| | - Jennifer Koplin
- School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia; (S.C.D.); (J.K.)
- Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia
| | - Kathrine Pape
- Danish Ramazzini Centre, Department of Public Health—Work, Environment and Health, Aarhus University, 8000 Aarhus, Denmark; (A.M.L.W.); (K.P.); (V.S.)
| | - Svein Magne Skulstad
- Department of Occupational Medicine, Haukeland University Hospital, 5021 Bergen, Norway; (N.O.J.); (T.M.K.); (S.M.S.)
| | - Signe Timm
- Department of Regional Health Research, University of Southern Denmark, 5230 Odense, Denmark;
- Research Unit, Kolding Hospital, University Hospital of Southern Denmark, 6000 Kolding, Denmark
| | - Gro Tjalvin
- Center for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway; (M.L.); (A.J.); (G.T.); (J.K.); (C.S.)
- Department of Occupational Medicine, Haukeland University Hospital, 5021 Bergen, Norway; (N.O.J.); (T.M.K.); (S.M.S.)
| | | | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (L.C.); (S.A.)
| | - Vivi Schlünssen
- Danish Ramazzini Centre, Department of Public Health—Work, Environment and Health, Aarhus University, 8000 Aarhus, Denmark; (A.M.L.W.); (K.P.); (V.S.)
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark
| | - Jorunn Kirkeleit
- Center for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway; (M.L.); (A.J.); (G.T.); (J.K.); (C.S.)
- Department of Occupational Medicine, Haukeland University Hospital, 5021 Bergen, Norway; (N.O.J.); (T.M.K.); (S.M.S.)
| | - Cecilie Svanes
- Center for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway; (M.L.); (A.J.); (G.T.); (J.K.); (C.S.)
- Department of Occupational Medicine, Haukeland University Hospital, 5021 Bergen, Norway; (N.O.J.); (T.M.K.); (S.M.S.)
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9
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Idrose N, Lodge C, Koplin J, Vicendese D, Douglass J, Dharmage S. 552The lung function and airway inflammation markers associated with short-term pollen exposure- A systematic review. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Experimental challenge studies have shown that pollen can affect the lungs and airways. Here, we systematically reviewed community-based studies investigating outdoor pollen exposure, lung function and/or airway inflammation.
Methods
Four online databases were searched. The search strategy included terms relating to both exposure and outcomes. Inclusion criteria were studies published in English that were representative of the community. We only considered cross-sectional or short-term longitudinal studies which investigated pollen exposure by levels or season. Study quality assessment was performed using the Newcastle-Ottawa scale. Meta-analysis was conducted using random-effects models.
Results
We included 27 of 6,551 studies identified from the search. Qualitative synthesis indicated associations between pollen exposure and predominantly type-2 inflammation in both the upper and lower airways, but little evidence for lung function changes. People with ever asthma and/or seasonal allergic rhinitis (SAR) were at higher risk of such airway inflammation. Meta-analysis confirmed a positive relationship between pollen season and eosinophilic airway inflammation in people with ever SAR but the results between studies were highly variable. Heterogeneity was reduced after further subgrouping by age and the forest plots indicated that eosinophilic airway inflammation to outdoor pollen exposure increased with age.
Conclusion
Among people with ever asthma and ever SAR, exposure to increased ambient pollen triggers type-2 airway inflammation rather than a non-specific or innate inflammation.
Key messages
This review indicates pollen exposure influences predominantly type-2 airway inflammation, but little evidence on lung function.
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Affiliation(s)
| | | | | | - Don Vicendese
- University Of Melbourne, Melbourne, Australia
- La Trobe University, Bundoora, Australia
| | - Jo Douglass
- University Of Melbourne, Melbourne, Australia
- Royal Melbourne Hospital, Melbourne, Australia
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10
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Soriano V, Koplin J, Forrester M, Peters R, O'Hely M, Dharmage S, Wright R, Ranganathan S, Burgner D, Thompson K, Dwyer T, Vuillermin P, Ponsonby AL. 357Infant pacifier sanitization and risk of food allergy: the Barwon Infant Study. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Environmental microbial exposure and human gut microbiota play a role in development of the immune system and susceptibility to food allergy. Pacifier use has been inconsistently associated with allergy, but the association between sanitization and food allergy is unknown. We investigated the association between infant pacifier use, with a consideration of sanitization, and food allergy at age 1 in the Barwon Infant Study (BIS).
Methods
Questionnaire data were collected prospectively from pregnant mothers from the Barwon region of south-east Australia at baseline and at infant ages 1, 6, and 12 months. Pacifier sanitization was defined as the joint exposure of a pacifier and cleaning methods (antiseptic, mouth, tap water, boiling). Challenge-proven food allergy was determined at age 1.
Results
Any pacifier use at 6 months was associated with food allergy (aOR, 1.94; 95% CI, 1.04-3.61), but not at other ages. This overall association was driven by the joint exposure pacifier-antiseptic use (aOR, 5.90; 95% CI, 2.18-15.97) compared to no pacifier use. Among pacifier users, pacifier-antiseptic was still associated with food allergy (aOR, 3.88; 95% CI, 1.55-9.72) when compared to pacifier-no antiseptic use. Further, increased use of pacifier-antiseptic at 0, 1 or 2 interviews over the first 6 months was associated with higher food allergy risk (ptrend=0.005).
Conclusions
Joint exposure to antiseptics and pacifiers at 6 months increased the odds of food allergy, showing a trend with increased use over time.
Key messages
This is the first report of pacifiers used with antiseptic being positively associated with challenge-proven food allergy.
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Affiliation(s)
- Victoria Soriano
- Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Jennifer Koplin
- Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Mike Forrester
- School of Medicine, Deakin University, Geelong, Australia
- Children's Services, Barwon Health, Geelong, Australia
- St John of God Hospital, Geelong, Australia
| | - Rachel Peters
- Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Martin O'Hely
- Murdoch Children's Research Institute, Parkville, Australia
- School of Medicine, Deakin University, Geelong, Australia
- Child Health Research Unit, Barwon Health, Geelong, Australia
| | - Shyamali Dharmage
- School of Population and Global Health, University of Melbourne, Parkville, Australia
| | - Rosemary Wright
- Research School of Population Health, Australian National University, Canberra, Australia
| | | | - David Burgner
- Murdoch Children's Research Institute, Parkville, Australia
| | | | - Terence Dwyer
- Murdoch Children's Research Institute, Parkville, Australia
| | - Peter Vuillermin
- Murdoch Children's Research Institute, Parkville, Australia
- School of Medicine, Deakin University, Geelong, Australia
- Children's Services, Barwon Health, Geelong, Australia
| | - Anne-Louise Ponsonby
- School of Population and Global Health, University of Melbourne, Parkville, Australia
- Neuroepidemiology Research Group, Florey Institute for Neuroscience and Mental Health, Parkville, Australia
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11
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Imran S, Neeland MR, Koplin J, Dharmage S, Tang MLK, Sawyer S, Dang T, McWilliam V, Peters R, Perrett KP, Novakovic B, Saffery R. Epigenetic programming underpins B-cell dysfunction in peanut and multi-food allergy. Clin Transl Immunology 2021; 10:e1324. [PMID: 34466226 PMCID: PMC8384135 DOI: 10.1002/cti2.1324] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/07/2021] [Accepted: 07/16/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Rates of IgE-mediated food allergy (FA) have increased over the last few decades, and mounting evidence implicates disruption of epigenetic profiles in various immune cell types in FA development. Recent data implicate B-cell dysfunction in FA; however, few studies have examined epigenetic changes within these cells. METHODS We assessed epigenetic and transcriptomic profiles in purified B cells from adolescents with FA, comparing single-food-allergic (peanut only), multi-food-allergic (peanut and ≥1 other food) and non-allergic (control) individuals. Adolescents represent a phenotype of persistent and severe FA indicative of a common immune deviation. RESULTS We identified 144 differentially methylated probes (DMPs) and 116 differentially expressed genes (DEGs) that distinguish B cells of individuals with FA from controls, including differential methylation of the PM20D1 promoter previously associated with allergic disorders. Subgroup comparisons found 729 DMPs specific to either single-food- or multi-food-allergic individuals, suggesting epigenetic distinctions between allergy groups. This included two regions with increased methylation near three S100 genes in multi-food-allergic individuals. Ontology results of DEGs specific to multi-food-allergic individuals revealed enrichment of terms associated with myeloid cell activation. Motif enrichment analysis of promoters associated with DMPs and DEGs showed differential enrichment for motifs recognised by transcription factors regulating B- and T-cell development, B-cell lineage determination and TGF-β signalling pathway between the multi-food-allergic and single-food-allergic groups. CONCLUSION Our data highlight epigenetic changes in B cells associated with peanut allergy, distinguishing features of the epigenome between single-food- and multi-food-allergic individuals and revealing differential developmental pathways potentially underpinning these distinct phenotypes.
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Affiliation(s)
- Samira Imran
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
| | - Melanie R Neeland
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
| | - Jennifer Koplin
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
| | - Shyamali Dharmage
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
- Allergy and Lung Health UnitMelbourne School of Population and Global HealthUniversity of MelbourneCarltonVICAustralia
| | - Mimi LK Tang
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
- Department of Allergy and ImmunologyRoyal Children's HospitalMelbourneVICAustralia
| | - Susan Sawyer
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
- Centre for Adolescent HealthRoyal Children's HospitalMelbourneVICAustralia
| | - Thanh Dang
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
| | - Vicki McWilliam
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
- Department of Allergy and ImmunologyRoyal Children's HospitalMelbourneVICAustralia
| | - Rachel Peters
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
| | - Kirsten P Perrett
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
- Department of Allergy and ImmunologyRoyal Children's HospitalMelbourneVICAustralia
| | - Boris Novakovic
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
| | - Richard Saffery
- Murdoch Children’s Research Institute, and Department of PaediatricsUniversity of MelbourneRoyal Children's HospitalParkvilleVICAustralia
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12
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Navaratna S, Estcourt MJ, Burgess J, Waidyatillake N, Enoh E, Lowe AJ, Peters R, Koplin J, Dhamage SC, Lodge CJ. Childhood vaccination and allergy: A systematic review and meta-analysis. Allergy 2021; 76:2135-2152. [PMID: 33569761 DOI: 10.1111/all.14771] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 12/04/2020] [Accepted: 12/23/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND OBJECTIVE As the rise in prevalence of allergic diseases worldwide corresponds in time with increasing infant vaccination, it has been hypothesized that childhood vaccination may increase the risk of allergic disease. We aimed to synthesize the literature on the association between childhood vaccination and allergy. DESIGN We searched the electronic databases PubMed and EMBASE (January 1946-January 2018) using vaccination and allergy terms. METHODS Two authors selected papers according to the inclusion criteria. Pooled effects across studies were estimated using random-effects meta-analysis. Due to inadequate number of homogeneous publications on newer and underused vaccines, meta-analysis was limited to allergic outcomes following administration of (Bacillus Calmette-Guérin) BCG, measles or pertussis vaccination. The review was prospectively registered in the PROSPERO systematic review registry (NO: CRD42017071009). RESULTS A total of 35 publications based on cohort studies and 7 publications based on randomized controlled trials (RCTs) met the inclusion criteria. RCTs: From 2 studies, early vaccination with BCG vaccine was associated with a reduced risk of eczema (RR = 0.83; 95% CI = 0.73-0.93; I2 = 0%) but not food allergy or asthma. No association was found between pertussis vaccine and any allergic outcome based on a single RCT. COHORT STUDIES Childhood measles vaccination was associated with a reduced risk of eczema (RR = 0.65; 95% CI = 0.47-0.90, I2 = 0.0%), asthma (RR = 0.78; 95% CI = 0.62-0.98, I2 = 93.9%) and, with a similar, statistically non-significant reduction in sensitization (RR = 0.78; 95% CI = 0.61-1.01, I2 = 19.4%). CONCLUSIONS We found no evidence that childhood vaccination with commonly administered vaccines was associated with increased risk of later allergic disease. Our results from pooled analysis of both RCTs and cohort studies suggest that vaccination with BCG and measles vaccines were associated with a reduced risk of eczema.
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Affiliation(s)
- Samidi Navaratna
- Faculty of Medicine Department of Community Medicine University of Peradeniya Kandy Sri Lanka
| | - Marie J. Estcourt
- Wesfarmers Centre of Vaccines & Infectious Diseases Telethon Kids InstitutePerth Children's Hospital Nedlands Australia
| | - John Burgess
- Allergy and Lung Health Unit Centre for Epidemiology and Biostatistics Melbourne School of Population and Global Health The University of Melbourne Parkville Vic. Australia
| | - Nilakshi Waidyatillake
- Allergy and Lung Health Unit Centre for Epidemiology and Biostatistics Melbourne School of Population and Global Health The University of Melbourne Parkville Vic. Australia
| | - Elizabeth Enoh
- Reproductive Health Programme United Nations Population Fund (UNFPA) Yaounde Cameroon
| | - Adrian J. Lowe
- Allergy and Lung Health Unit Centre for Epidemiology and Biostatistics Melbourne School of Population and Global Health The University of Melbourne Parkville Vic. Australia
- Murdoch Children's Research InstituteRoyal Children’s Hospital Parkville Vic. Australia
| | - Rachel Peters
- Murdoch Children's Research InstituteRoyal Children’s Hospital Parkville Vic. Australia
- Department of Paediatrics The University of Melbourne Parkville Vic. Australia
| | - Jennifer Koplin
- Allergy and Lung Health Unit Centre for Epidemiology and Biostatistics Melbourne School of Population and Global Health The University of Melbourne Parkville Vic. Australia
- Murdoch Children's Research InstituteRoyal Children’s Hospital Parkville Vic. Australia
- Department of Paediatrics The University of Melbourne Parkville Vic. Australia
| | - Shyamali C. Dhamage
- Allergy and Lung Health Unit Centre for Epidemiology and Biostatistics Melbourne School of Population and Global Health The University of Melbourne Parkville Vic. Australia
- Murdoch Children's Research InstituteRoyal Children’s Hospital Parkville Vic. Australia
- Centre for Food and Allergy Research (CFAR) Murdoch Children’s Research Institute Parkville Vic. Australia
| | - Caroline J. Lodge
- Allergy and Lung Health Unit Centre for Epidemiology and Biostatistics Melbourne School of Population and Global Health The University of Melbourne Parkville Vic. Australia
- Murdoch Children's Research InstituteRoyal Children’s Hospital Parkville Vic. Australia
- Centre for Food and Allergy Research (CFAR) Murdoch Children’s Research Institute Parkville Vic. Australia
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13
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Perkin MR, Togias A, Koplin J, Sicherer S. Food Allergy Prevention: More Than Peanut. J Allergy Clin Immunol Pract 2021; 8:1-13. [PMID: 31950900 DOI: 10.1016/j.jaip.2019.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/05/2019] [Accepted: 11/05/2019] [Indexed: 12/28/2022]
Abstract
Given an apparent increase in food allergies worldwide, the focus on prevention strategies has intensified. Following the Learning Early About Peanut study, there is now a widespread acceptance that peanut should be introduced promptly into the diet of high-risk infants. However, most food allergies are caused by triggers other than peanut and additional prevention strategies are being evaluated. The appreciation of the role of an impaired skin barrier in the process of food sensitization and subsequent allergy has led to a spectrum of dermatologically orientated studies. Other prevention strategies address the role of the microbiome, dietary components, and other modifiable risk factors. With regard to early introduction of foods other than peanut, studies are heterogeneous in design and governmental and professional society response to the early introduction trials has varied, ranging from new guidelines confining advice specifically to peanut, to ones recommending prompt introduction of a broad spectrum of allergenic foods. Much remains to be determined with regard to the acceptability and uptake of the new guidelines and their impact on infant feeding behavior and food allergy outcomes. This review discusses the panoply of prevention approaches, their promise, and limitations.
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Affiliation(s)
- Michael R Perkin
- Population Health Research Institute, St George's, University of London, London, United Kingdom.
| | - Alkis Togias
- Division of Allergy, Immunology and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Jennifer Koplin
- Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Scott Sicherer
- Department of Pediatrics, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY
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14
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Burgess JA, Dharmage SC, Allen K, Koplin J, Garcia-Larsen V, Boyle R, Waidyatillake N, Lodge CJ. Age at introduction to complementary solid food and food allergy and sensitization: A systematic review and meta-analysis. Clin Exp Allergy 2019; 49:754-769. [PMID: 30861244 DOI: 10.1111/cea.13383] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 12/11/2018] [Accepted: 02/11/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND OBJECTIVE An infant's age at introduction of complementary solids may contribute to food allergy. We aimed to synthesize the literature on the association between age at introduction of complementary solids, excluding milk products, and food allergy and sensitization. DESIGN We searched the electronic databases PubMed and EMBASE (January 1946-February 2017) using solid food, allergy and sensitization terms. METHODS Two authors selected papers according to inclusion criteria, identifying 16 cohort studies, 1 case-control study and 8 randomized controlled trials (RCTs). Pooled effects across studies were estimated using random-effects meta-analysis. RESULTS Cohort studies-Introducing complementary solids at age ≥ 4 months vs <4 months was not associated with food allergy (OR 1.22; 95% CI, 0.76-1.96) but was associated with food sensitization (OR 1.93; 95% CI 1.57-2.38). First exposure from age 4 to 6 months vs <4 months was not associated with food allergy (OR 1.01; 95% CI, 0.64-1.60) but was associated with food sensitization (OR 2.46; 95% CI 1.55-3.86). Randomized controlled trials-Egg exposure from age 4 months was associated with reduced egg allergy (OR 0.63, 95% CI, 0.44-0.90) and sensitization (OR 0.76, 95% CI, 0.51-0.95). Peanut exposure from age 4 months compared to delayed exposure was associated with reduced peanut allergy (OR 0.28, 95% CI 0.14-0.57). CONCLUSIONS We found no evidence from observational studies that introducing solids before 4 months protected against food allergy, but there was evidence for protection against food sensitization. From RCTs, introducing egg from 4 to 6 months and peanut from 4 to 11 months reduced the risk of egg allergy, peanut allergy and egg sensitization. PROSPERO systematic review registry (CRD42016033473).
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Affiliation(s)
- John A Burgess
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.,Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Katrina Allen
- Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Jennifer Koplin
- Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Vanessa Garcia-Larsen
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Robert Boyle
- Department of Paediatric Allergy, Imperial College London, London, UK
| | - Nilakshi Waidyatillake
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Caroline J Lodge
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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15
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Neeland M, Novakovic B, Koplin J, Dang TD, Saffery R, Allen K. Innate Immune Memory in Paediatric Food Allergy. J Allergy Clin Immunol 2019. [DOI: 10.1016/j.jaci.2018.12.977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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16
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Soriano V, Peters R, Dharmage SC, Ponsonby AL, Allen K, Perret K, Gurrin LC, Koplin J. Earlier Ingestion of Peanuts Following Change to Infant Feeding Guidelines in Australia. J Allergy Clin Immunol 2019. [DOI: 10.1016/j.jaci.2018.12.947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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17
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Wang Y, Koplin J, Lei S, Peters R, Horne S, Hiscock H, Allen K. Time Trends in Adrenaline Auto-Injector Dispensing Patterns Using Australian Pharmaceutical Benefits Scheme Data. J Allergy Clin Immunol 2019. [DOI: 10.1016/j.jaci.2018.12.976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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18
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Peters R, Koplin J, Ponsonby AL, Perret K, Dharmage SC, Allen K. The Natural History of Peanut and Egg Allergy and Predictors of Persistence: The Healthnuts Longitudinal Study, 6-Year-Old Follow-up. J Allergy Clin Immunol 2019. [DOI: 10.1016/j.jaci.2018.12.946] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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19
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Zakaria R, Fink C, Koplin J, Allen K, Greaves RF. Need of a dedicated isotopic internal standard for accurate 3-epi-25(OH)D3 quantification by LC-MS/MS. ACTA ACUST UNITED AC 2018; 57:e141-e144. [DOI: 10.1515/cclm-2018-1033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 10/30/2018] [Indexed: 11/15/2022]
Affiliation(s)
- Rosita Zakaria
- School of Health and Biomedical Sciences , RMIT University , Bundoora, VIC , Australia
- Murdoch Children’s Research Institute , Parkville, VIC , Australia
| | - Charles Fink
- Murdoch Children’s Research Institute , Parkville, VIC , Australia
- Monash University , Department of Medicine, Nursing and Health Sciences , Clayton, VIC , Australia
| | - Jennifer Koplin
- Murdoch Children’s Research Institute , Parkville, VIC , Australia
| | - Katie Allen
- School of Health and Biomedical Sciences , RMIT University , Bundoora, VIC , Australia
- Murdoch Children’s Research Institute , Parkville, VIC , Australia
- Department of Paediatrics , University of Melbourne , Melbourne, VIC , Australia
| | - Ronda F. Greaves
- School of Health and Biomedical Sciences , RMIT University , Bundoora, VIC , Australia
- Murdoch Children’s Research Institute , Parkville, VIC , Australia
- Victorian Clinical Genetics Services , Biochemical Genetics , Parkville, VIC 3052 , Australia
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20
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Arkwright PD, MacMahon J, Koplin J, Rajput S, Cross S, Fitzsimons R, Davidson N, Deshpande V, Rao N, Lumsden C, Lacy D, Allen KJ, Vance G, Mwenechanya J, Fox AT, Erlewyn-Lajeunesse M, Mistry H, Hourihane JO. Severity and threshold of peanut reactivity during hospital-based open oral food challenges: An international multicenter survey. Pediatr Allergy Immunol 2018; 29:754-761. [PMID: 30022517 DOI: 10.1111/pai.12959] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 06/12/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Peanut allergy is classically managed by food avoidance. Immunotherapy programs are available at some academic centers for selected patients reacting to small amounts of peanut during food challenge. We aimed to determine and compare reaction thresholds and prevalence of anaphylaxis during peanut oral challenges at multiple specialist allergy centers. METHODS A retrospective, international survey of anonymized case records from seven specialist pediatric allergy centers from the UK and Ireland, as well as the Australian HealthNuts study. Demographic information, allergy test results, reaction severity and threshold during open oral peanut challenges were collated and analyzed. RESULTS Of the 1634 children aged 1-18 years old included, 525 (32%) failed their peanut challenge. Twenty-eight percent reacted to 25 mg, while 38% only reacted after consuming 1 g or more of whole peanut. Anaphylaxis (55 [11%]) was 3 times more common in teenagers than younger children and the likelihood increased at all ages as children consuming more peanut at the challenge. Children who developed anaphylaxis to 25-200 mg of whole peanut were significantly older. Previous history of reaction did not predict reaction threshold or severity. CONCLUSIONS More than a third of the children in this large international cohort tolerated the equivalent of one peanut in an oral challenge. Anaphylaxis, particularly to small amounts of peanut, was more common in older children. Tailored immunotherapy programs might be considered not only for children with low, but also higher reaction thresholds. Whether these programs could prevent heightened sensitivity and anaphylaxis to peanut with age also deserves further study.
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Affiliation(s)
- Peter D Arkwright
- Royal Manchester Children's Hospital, University of Manchester, Manchester, UK
| | | | - Jennifer Koplin
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia
| | - Shelly Rajput
- Royal Manchester Children's Hospital, University of Manchester, Manchester, UK
| | | | | | - Neil Davidson
- Great North Children's Hospital, Newcastle upon Tyne, UK
| | | | - Naveen Rao
- University Hospital of South Manchester, Manchester, UK
| | | | - David Lacy
- Wirral University Teaching Hospital, Wirral, UK
| | - Katrina J Allen
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia
| | - Gillian Vance
- Great North Children's Hospital, Newcastle upon Tyne, UK
| | | | - Adam T Fox
- Guy's & St Thomas' Hospitals NHS Foundation Trust, London, UK
| | | | - Hitesh Mistry
- Division of Pharmacy, University of Manchester, Manchester, UK
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21
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Gómez Real F, Burgess JA, Villani S, Dratva J, Heinrich J, Janson C, Jarvis D, Koplin J, Leynaert B, Lodge C, Lærum BN, Matheson MC, Norbäck D, Omenaas ER, Skulstad SM, Sunyer J, Dharmage SC, Svanes C. Maternal age at delivery, lung function and asthma in offspring: a population-based survey. Eur Respir J 2018; 51:13993003.01611-2016. [PMID: 29880541 DOI: 10.1183/13993003.01611-2016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 04/21/2018] [Indexed: 01/15/2023]
Abstract
There is limited information about potential impact of maternal age on the respiratory health of offspring. We investigated the association of maternal age at delivery with adult offspring's lung function, respiratory symptoms and asthma, and potential differences according to offspring sex.10 692 adults from 13 countries participating in the European Community Respiratory Health Survey (ECRHS) II responded to standardised interviews and provided lung function measurements and serum for IgE measurements at age 25-55 years. In logistic and linear multilevel mixed models we adjusted for participants' characteristics (age, education, centre, number of older siblings) and maternal characteristics (smoking in pregnancy, education) while investigating for differential effects by sex. Maternal age was validated in a subsample using data from the Norwegian birth registry.Increasing maternal age was associated with increasing forced expiratory volume in 1 s (2.33 mL per year, 95% CI 0.34-4.32 mL per year), more consistent in females (ptrend 0.025) than in males (ptrend 0.14). Asthma (OR 0.85, 95% CI 0.79-0.92) and respiratory symptoms (OR 0.87, 95% CI 0.82-0.92) decreased with increasing maternal age (per 5 years) in females, but not in males (pinteraction 0.05 and 0.001, respectively). The results were consistent across centres and not explained by confounding factors.Maternal ageing was related to higher adult lung function and less asthma/symptoms in females. Biological characteristics in offspring related to maternal ageing are plausible and need further investigation.
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Affiliation(s)
- Francisco Gómez Real
- Dept of Clinical Science, University of Bergen, Bergen, Norway.,Dept of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway
| | - John A Burgess
- Allergy and Lung Health Unit, School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Simona Villani
- Unit of Biostatistics and Clinical Epidemiology, Dept of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Julia Dratva
- Institute of Social and Preventive Medicine, Swiss Tropical Institute, Basel, Switzerland
| | - Joachim Heinrich
- Molecular Epidemiology, Forschungszentrum für Umwelt und Gesundheit, National Research Center for Environment and Health, Neuherberg, Germany
| | - Christer Janson
- Dept of Medical Sciences, Respiratory: Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Debbie Jarvis
- Dept of Public Health Sciences, Imperial College, London, UK
| | - Jennifer Koplin
- Allergy and Lung Health Unit, School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Bénédicte Leynaert
- Inserm, UMR 1152, Pathophysiology and Epidemiology of Respiratory Diseases, Paris, France.,University Paris Diderot Paris 7, Paris, France
| | - Caroline Lodge
- Allergy and Lung Health Unit, School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Birger N Lærum
- Dept of Clinical Science, University of Bergen, Bergen, Norway
| | - Melanie C Matheson
- Allergy and Lung Health Unit, School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Dan Norbäck
- Dept of Medical Sciences, Respiratory: Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Ernst R Omenaas
- Dept of Clinical Science, University of Bergen, Bergen, Norway.,Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Svein M Skulstad
- Dept of Clinical Science, University of Bergen, Bergen, Norway.,Dept of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Jordi Sunyer
- Centre de Recerca Epidemiológica i Ambiental, Barcelona, Spain
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, School of Population and Global Health, University of Melbourne, Melbourne, Australia.,These authors contributed equally
| | - Cecilie Svanes
- Dept of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.,Centre for International Health, University of Bergen, Bergen, Norway.,These authors contributed equally
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22
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Svanes C, Koplin J, Skulstad SM, Johannessen A, Bertelsen RJ, Benediktsdottir B, Bråbäck L, Elie Carsin A, Dharmage S, Dratva J, Forsberg B, Gislason T, Heinrich J, Holm M, Janson C, Jarvis D, Jögi R, Krauss-Etschmann S, Lindberg E, Macsali F, Malinovschi A, Modig L, Norbäck D, Omenaas E, Waatevik Saure E, Sigsgaard T, Skorge TD, Svanes Ø, Torén K, Torres C, Schlünssen V, Gomez Real F. Father's environment before conception and asthma risk in his children: a multi-generation analysis of the Respiratory Health In Northern Europe study. Int J Epidemiol 2018; 46:235-245. [PMID: 27565179 DOI: 10.1093/ije/dyw151] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2016] [Indexed: 01/04/2023] Open
Abstract
Background Whereas it is generally accepted that maternal environment plays a key role in child health, emerging evidence suggests that paternal environment before conception also impacts child health. We aimed to investigate the association between children's asthma risk and parental smoking and welding exposures prior to conception. Methods In a longitudinal, multi-country study, parents of 24 168 offspring aged 2-51 years provided information on their life-course smoking habits, occupational exposure to welding and metal fumes, and offspring's asthma before/after age 10 years and hay fever. Logistic regressions investigated the relevant associations controlled for age, study centre, parental characteristics (age, asthma, education) and clustering by family. Results Non-allergic early-onset asthma (asthma without hay fever, present in 5.8%) was more common in the offspring with fathers who smoked before conception {odds ratio [OR] = 1.68 [95% confidence interval (CI) = 1.18-2.41]}, whereas mothers' smoking before conception did not predict offspring asthma. The risk was highest if father started smoking before age 15 years [3.24 (1.67-6.27)], even if he stopped more than 5 years before conception [2.68 (1.17-6.13)]. Fathers' pre-conception welding was independently associated with non-allergic asthma in his offspring [1.80 (1.29-2.50)]. There was no effect if the father started welding or smoking after birth. The associations were consistent across countries. Conclusions Environmental exposures in young men appear to influence the respiratory health of their offspring born many years later. Influences during susceptible stages of spermatocyte development might be important and needs further investigation in humans. We hypothesize that protecting young men from harmful exposures may lead to improved respiratory health in future generations.
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Affiliation(s)
- Cecilie Svanes
- Centre for International Health, University of Bergen, Norway.,Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Norway
| | - Jennifer Koplin
- Centre for International Health, University of Bergen, Norway.,School of Population and Global Health, University of Melbourne, Australia.,Murdoch Childrens Research Institute, Melbourne, Australia
| | - Svein Magne Skulstad
- Department of Clinical Science, University of Bergen, Norway.,Department of Obstetrics, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Ane Johannessen
- Department of Clinical Science, University of Bergen, Norway.,Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Randi Jakobsen Bertelsen
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Norway
| | - Byndis Benediktsdottir
- Department of Allergy, Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland.,University of Iceland, Medical Faculty
| | - Lennart Bråbäck
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Anne Elie Carsin
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Shyamali Dharmage
- Department of Clinical Science, University of Bergen, Norway.,School of Population and Global Health, University of Melbourne, Australia
| | - Julia Dratva
- Centre for International Health, University of Bergen, Norway.,Department of Epidemiology and Public Health, Gender & Health, Swiss Tropical and Public Health Institute, Basel University, Switzerland
| | - Bertil Forsberg
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Thorarinn Gislason
- Department of Allergy, Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland.,University of Iceland, Medical Faculty
| | | | - Mathias Holm
- Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | | | - Deborah Jarvis
- Faculty of Medicine, National Heart & Lung Institute, Imperial College, London, UK
| | - Rain Jögi
- Lung Clinic, Foundation Tartu University Clinics, Tartu, Estonia.,Department of Pulmonary Medicine, Tartu University, Estonia
| | - Susanne Krauss-Etschmann
- Research Center Borstel, Leibniz-Center for Medicine and Biosciences, Divison of Experimental Asthma Research, University of Kiel, Germany
| | - Eva Lindberg
- Department of Medical Sciences, Uppsala University, Sweden
| | - Ferenc Macsali
- Department of Obstetrics and Gynecology, Haukeland, University Hospital, Bergen, Norway
| | | | - Lars Modig
- Centre for International Health, University of Bergen, Norway.,Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University, Sweden
| | - Ernst Omenaas
- Department of Clinical Science, University of Bergen, Norway.,Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | | | | | - Trude Duelien Skorge
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Øistein Svanes
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Norway
| | - Kjell Torén
- Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Carl Torres
- Department of Clinical Science, University of Bergen, Norway
| | | | - Francisco Gomez Real
- Department of Clinical Science, University of Bergen, Norway.,Department of Obstetrics and Gynecology, Haukeland, University Hospital, Bergen, Norway
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23
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Wang Y, Jane Allen K, Koplin J, Suaini NH. Asian Migrants Have a Different Profile of Allergy and Anaphylaxis Than Australian-Born Children: A State-Wide Survey. J Allergy Clin Immunol 2018. [DOI: 10.1016/j.jaci.2017.12.956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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24
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Kamath SD, Johnston EB, Iyer S, Schaeffer PM, Koplin J, Allen K, Lopata AL. IgE reactivity to shrimp allergens in infants and their cross-reactivity to house dust mite. Pediatr Allergy Immunol 2017; 28:703-707. [PMID: 28782222 DOI: 10.1111/pai.12764] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Sandip D Kamath
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Qld, Australia.,Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Qld, Australia.,Centre for Biodiscovery and Molecular Development of Therapeutics, James Cook University, Townsville, Qld, Australia.,Centre for Food Allergy and Research, Murdoch Childrens Research Institute, Melbourne, Vic., Australia
| | - Elecia B Johnston
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Qld, Australia.,Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Qld, Australia.,Centre for Biodiscovery and Molecular Development of Therapeutics, James Cook University, Townsville, Qld, Australia
| | - Swati Iyer
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Qld, Australia.,Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Qld, Australia.,Centre for Biodiscovery and Molecular Development of Therapeutics, James Cook University, Townsville, Qld, Australia
| | - Patrick M Schaeffer
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Qld, Australia.,Centre for Biodiscovery and Molecular Development of Therapeutics, James Cook University, Townsville, Qld, Australia.,Supramolecular& Synthetic Biology Group, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Qld, Australia
| | - Jennifer Koplin
- Centre for Food Allergy and Research, Murdoch Childrens Research Institute, Melbourne, Vic., Australia.,University of Melbourne, Melbourne, Vic., Australia
| | - Katrina Allen
- Centre for Food Allergy and Research, Murdoch Childrens Research Institute, Melbourne, Vic., Australia.,University of Melbourne, Melbourne, Vic., Australia
| | - Andreas L Lopata
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Qld, Australia.,Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Qld, Australia.,Centre for Biodiscovery and Molecular Development of Therapeutics, James Cook University, Townsville, Qld, Australia.,Centre for Food Allergy and Research, Murdoch Childrens Research Institute, Melbourne, Vic., Australia
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25
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Ashley SE, Tan HTT, Vuillermin P, Dharmage SC, Tang MLK, Koplin J, Gurrin LC, Lowe A, Lodge C, Ponsonby AL, Molloy J, Martin P, Matheson MC, Saffery R, Allen KJ, Ellis JA, Martino D. The skin barrier function gene SPINK5 is associated with challenge-proven IgE-mediated food allergy in infants. Allergy 2017; 72:1356-1364. [PMID: 28213955 DOI: 10.1111/all.13143] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND A defective skin barrier is hypothesized to be an important route of sensitization to dietary antigens and may lead to food allergy in some children. Missense mutations in the serine peptidase inhibitor Kazal type 5 (SPINK5) skin barrier gene have previously been associated with allergic conditions. OBJECTIVE To determine whether genetic variants in and around SPINK5 are associated with IgE-mediated food allergy. METHOD We genotyped 71 "tag" single nucleotide polymorphisms (tag-SNPs) within a region spanning ~263 kb including SPINK5 (~61 kb) in n=722 (n=367 food-allergic, n=199 food-sensitized-tolerant and n=156 non-food-allergic controls) 12-month-old infants (discovery sample) phenotyped for food allergy with the gold standard oral food challenge. Transepidermal water loss (TEWL) measures were collected at 12 months from a subset (n=150) of these individuals. SNPs were tested for association with food allergy using the Cochran-Mantel-Haenszel test adjusting for ancestry strata. Association analyses were replicated in an independent sample group derived from four paediatric cohorts, total n=533 (n=203 food-allergic, n=330 non-food-allergic), mean age 2.5 years, with food allergy defined by either clinical history of reactivity, 95% positive predictive value (PPV) or challenge, corrected for ancestry by principal components. RESULTS SPINK5 variant rs9325071 (A⟶G) was associated with challenge-proven food allergy in the discovery sample (P=.001, OR=2.95, CI=1.49-5.83). This association was further supported by replication (P=.007, OR=1.58, CI=1.13-2.20) and by meta-analysis (P=.0004, OR=1.65). Variant rs9325071 is associated with decreased SPINK5 gene expression in the skin in publicly available genotype-tissue expression data, and we generated preliminary evidence for association of this SNP with elevated TEWL also. CONCLUSIONS We report, for the first time, association between SPINK5 variant rs9325071 and challenge-proven IgE-mediated food allergy.
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26
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Field M, Sasaki M, Koplin J, Sawyer S, Tang M, Dharmage S, McWilliam V, Pezic A, Douglass J, Allen K. P33: ARE SCHOOLS BANNING NUTS? RESULTS FROM A POPULATION-BASED SURVEY OF VICTORIAN SCHOOLS. Intern Med J 2017. [DOI: 10.1111/imj.33_13578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M Field
- Murdoch Children’s Research Institute; Melbourne Australia
| | - M Sasaki
- Murdoch Children’s Research Institute; Melbourne Australia
| | - J Koplin
- Murdoch Children’s Research Institute; Melbourne Australia
- Centre for Food and Allergy Research; Melbourne Australia
- The University of Melbourne; Melbourne Australia
| | - S Sawyer
- Murdoch Children’s Research Institute; Melbourne Australia
- The University of Melbourne; Melbourne Australia
- The Royal Children’s Hospital Melbourne; Melbourne Australia
| | - M Tang
- Murdoch Children’s Research Institute; Melbourne Australia
- Centre for Food and Allergy Research; Melbourne Australia
- The University of Melbourne; Melbourne Australia
- The Royal Children’s Hospital Melbourne; Melbourne Australia
| | - S Dharmage
- Murdoch Children’s Research Institute; Melbourne Australia
- Centre for Food and Allergy Research; Melbourne Australia
- The University of Melbourne; Melbourne Australia
| | - V McWilliam
- Murdoch Children’s Research Institute; Melbourne Australia
- Centre for Food and Allergy Research; Melbourne Australia
- The University of Melbourne; Melbourne Australia
- The Royal Children’s Hospital Melbourne; Melbourne Australia
| | - A Pezic
- Murdoch Children’s Research Institute; Melbourne Australia
| | - J Douglass
- The University of Melbourne; Melbourne Australia
- The Royal Melbourne Hospital; Melbourne Australia
| | - K Allen
- Murdoch Children’s Research Institute; Melbourne Australia
- Centre for Food and Allergy Research; Melbourne Australia
- The University of Melbourne; Melbourne Australia
- The Royal Children’s Hospital Melbourne; Melbourne Australia
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27
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Ashley SE, Tan HTT, Peters R, Allen KJ, Vuillermin P, Dharmage SC, Tang MLK, Koplin J, Lowe A, Ponsonby AL, Molloy J, Matheson MC, Saffery R, Ellis JA, Martino D. Genetic variation at the Th2 immune gene IL13 is associated with IgE-mediated paediatric food allergy. Clin Exp Allergy 2017; 47:1032-1037. [PMID: 28544327 DOI: 10.1111/cea.12942] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 01/20/2017] [Accepted: 03/01/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Food allergies pose a considerable world-wide public health burden with incidence as high as one in ten in 12-month-old infants. Few food allergy genetic risk variants have yet been identified. The Th2 immune gene IL13 is a highly plausible genetic candidate as it is central to the initiation of IgE class switching in B cells. OBJECTIVE Here, we sought to investigate whether genetic polymorphisms at IL13 are associated with the development of challenge-proven IgE-mediated food allergy. METHOD We genotyped nine IL13 "tag" single nucleotide polymorphisms (tag SNPs) in 367 challenge-proven food allergic cases, 199 food-sensitized tolerant cases and 156 non-food allergic controls from the HealthNuts study. 12-month-old infants were phenotyped using open oral food challenges. SNPs were tested using Cochran-Mantel-Haenszel test adjusted for ancestry strata. A replication study was conducted in an independent, co-located sample of four paediatric cohorts consisting of 203 food allergic cases and 330 non-food allergic controls. Replication sample phenotypes were defined by clinical history of reactivity, 95% PPV or challenge, and IL13 genotyping was performed. RESULTS IL13 rs1295686 was associated with challenge-proven food allergy in the discovery sample (P=.003; OR=1.75; CI=1.20-2.53). This association was also detected in the replication sample (P=.03, OR=1.37, CI=1.03-1.82) and further supported by a meta-analysis (P=.0006, OR=1.50). However, we cannot rule out an association with food sensitization. Carriage of the rs1295686 variant A allele was also associated with elevated total plasma IgE. CONCLUSIONS AND CLINICAL RELAVANCE We show for the first time, in two independent cohorts, that IL13 polymorphism rs1295686 (in complete linkage disequilibrium with functional variant rs20541) is associated with challenge-proven food allergy.
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Affiliation(s)
- S E Ashley
- Murdoch Childrens Research Institute, Royal Children's Hospital, Australia.,The Hudson Institute, Monash Translational Health Precinct (MTHP), Monash University, Clayton, Australia
| | - H-T T Tan
- Murdoch Childrens Research Institute, Royal Children's Hospital, Australia.,Department of Immunology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - R Peters
- Murdoch Childrens Research Institute, Royal Children's Hospital, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - K J Allen
- Murdoch Childrens Research Institute, Royal Children's Hospital, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia.,Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia.,Institute of Inflammation and Repair, University of Manchester, UK
| | - P Vuillermin
- Murdoch Childrens Research Institute, Royal Children's Hospital, Australia.,Barwon Health, Child Health Research Unit, Geelong, Australia.,Deakin University, Waurn Ponds, Australia
| | - S C Dharmage
- Murdoch Childrens Research Institute, Royal Children's Hospital, Australia.,Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - M L K Tang
- Murdoch Childrens Research Institute, Royal Children's Hospital, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia.,Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia
| | - J Koplin
- Murdoch Childrens Research Institute, Royal Children's Hospital, Australia.,Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - A Lowe
- Murdoch Childrens Research Institute, Royal Children's Hospital, Australia.,Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - A-L Ponsonby
- Murdoch Childrens Research Institute, Royal Children's Hospital, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - J Molloy
- Murdoch Childrens Research Institute, Royal Children's Hospital, Australia.,Barwon Health, Child Health Research Unit, Geelong, Australia.,Deakin University, Waurn Ponds, Australia
| | - M C Matheson
- Murdoch Childrens Research Institute, Royal Children's Hospital, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - R Saffery
- Murdoch Childrens Research Institute, Royal Children's Hospital, Australia.,The Hudson Institute, Monash Translational Health Precinct (MTHP), Monash University, Clayton, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - J A Ellis
- Murdoch Childrens Research Institute, Royal Children's Hospital, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia.,Centre for Social and Early Emotional Development, Faculty of Health, Deakin University, Australia
| | - D Martino
- Murdoch Childrens Research Institute, Royal Children's Hospital, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia.,University of Western Australia, Department of Paediatrics, Australia
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28
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Koplin J, Allen KJ. Reply. J Allergy Clin Immunol 2017; 139:1406-1407. [PMID: 28139314 DOI: 10.1016/j.jaci.2016.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 11/14/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Jennifer Koplin
- Murdoch Childrens Research Institute, Royal Children's Hospital, Victoria, Australia
| | - Katrina J Allen
- Murdoch Childrens Research Institute, Royal Children's Hospital, Victoria, Australia.
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29
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Martino DJ, Ashley S, Koplin J, Ellis J, Saffery R, Dharmage SC, Gurrin L, Matheson MC, Kalb B, Marenholz I, Beyer K, Lee Y, Hong X, Wang X, Vukcevic D, Motyer A, Leslie S, Allen KJ, Ferreira MAR. Genomewide association study of peanut allergy reproduces association with amino acid polymorphisms in
HLA
‐
DRB
1. Clin Exp Allergy 2017; 47:217-223. [DOI: 10.1111/cea.12863] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 11/06/2016] [Accepted: 11/07/2016] [Indexed: 02/02/2023]
Affiliation(s)
- D. J. Martino
- Department of Paediatrics Murdoch Childrens Research Institute The Royal Children's Hospital The University of Melbourne Melbourne Vic. Australia
| | - S. Ashley
- Department of Paediatrics Murdoch Childrens Research Institute The Royal Children's Hospital The University of Melbourne Melbourne Vic. Australia
- Hudson Institute of Medical Research Clayton Vic. Australia
| | - J. Koplin
- Department of Paediatrics Murdoch Childrens Research Institute The Royal Children's Hospital The University of Melbourne Melbourne Vic. Australia
- School of Population and Global Health The University of Melbourne Melbourne Vic. Australia
| | - J. Ellis
- Department of Paediatrics Murdoch Childrens Research Institute The Royal Children's Hospital The University of Melbourne Melbourne Vic. Australia
| | - R. Saffery
- Department of Paediatrics Murdoch Childrens Research Institute The Royal Children's Hospital The University of Melbourne Melbourne Vic. Australia
| | - S. C. Dharmage
- School of Population and Global Health The University of Melbourne Melbourne Vic. Australia
| | - L. Gurrin
- School of Population and Global Health The University of Melbourne Melbourne Vic. Australia
| | - M. C. Matheson
- School of Population and Global Health The University of Melbourne Melbourne Vic. Australia
| | - B. Kalb
- Pediatric Pneumology and Immunology Charité Universitätsmedizin Berlin Berlin Germany
- Clinic for Pediatric Allergy, Experimental and Clinical Research Center of MDC Charité Berlin Germany
- Max‐Delbrück‐Center for Molecular Medicine (MDC) Berlin Germany
| | - I. Marenholz
- Clinic for Pediatric Allergy, Experimental and Clinical Research Center of MDC Charité Berlin Germany
- Max‐Delbrück‐Center for Molecular Medicine (MDC) Berlin Germany
| | - K. Beyer
- Pediatric Pneumology and Immunology Charité Universitätsmedizin Berlin Berlin Germany
| | - Y.‐A. Lee
- Clinic for Pediatric Allergy, Experimental and Clinical Research Center of MDC Charité Berlin Germany
- Max‐Delbrück‐Center for Molecular Medicine (MDC) Berlin Germany
| | - X. Hong
- Department of Population, Family and Reproductive Health Center on the Early Life Origins of Disease Johns Hopkins University Bloomberg School of Public Health Baltimore MD USA
| | - X. Wang
- Department of Population, Family and Reproductive Health Center on the Early Life Origins of Disease Johns Hopkins University Bloomberg School of Public Health Baltimore MD USA
| | - D. Vukcevic
- Department of Paediatrics Murdoch Childrens Research Institute The Royal Children's Hospital The University of Melbourne Melbourne Vic. Australia
- Centre for Systems Genomics Schools of Mathematics and Statistics and Biosciences The University of Melbourne Melbourne Vic. Australia
| | - A. Motyer
- Department of Paediatrics Murdoch Childrens Research Institute The Royal Children's Hospital The University of Melbourne Melbourne Vic. Australia
- Centre for Systems Genomics Schools of Mathematics and Statistics and Biosciences The University of Melbourne Melbourne Vic. Australia
| | - S. Leslie
- Department of Paediatrics Murdoch Childrens Research Institute The Royal Children's Hospital The University of Melbourne Melbourne Vic. Australia
- Centre for Systems Genomics Schools of Mathematics and Statistics and Biosciences The University of Melbourne Melbourne Vic. Australia
| | - K. J. Allen
- Department of Paediatrics Murdoch Childrens Research Institute The Royal Children's Hospital The University of Melbourne Melbourne Vic. Australia
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30
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Abramson MJ, Koplin J, Hoy R, Dharmage SC. Population-wide preventive interventions for reducing the burden of chronic respiratory disease. Int J Tuberc Lung Dis 2016; 19:1007-18. [PMID: 26260817 DOI: 10.5588/ijtld.15.0034] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Chronic obstructive pulmonary disease and asthma impose a substantial burden of disease. This narrative review focuses on potential population-wide interventions that are likely to have an impact on these diseases. The developmental origins of adult disease commence in utero, with maternal nutrition being of particular interest. However, to date, trials of maternal allergen avoidance, dietary supplementation or probiotics have not shown consistent protective effects against asthma. Poor indoor air quality, especially from biomass fuels as well as second-hand tobacco smoke, is a well-recognised risk factor for chronic respiratory diseases. This can be modified by cleaner fuels, cooking stoves or heaters, and improved ventilation. Although allergens are a risk factor for childhood asthma, the results of interventions to reduce exposures have been disappointing. Traffic-related air pollution is associated with an increased incidence of asthma in children. Primary prevention of the adverse effects of air pollution has focused on the development of ambient air quality guidelines, but enforcement remains a challenge in many countries. Occupational asthma may be induced by sensitisers or irritants in the workplace. Prevention involves eliminating the agent or reducing exposure as far as possible, which is more effective than respiratory protective equipment. Smoking cessation remains a key proven preventive strategy for chronic respiratory diseases. There is now an international framework for tobacco control, and recent innovations include plain packaging of tobacco. Chronic respiratory diseases can be substantially prevented by the above population-wide interventions.
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Affiliation(s)
- M J Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - J Koplin
- Murdoch Childrens Research Institute, Melbourne, Australia; Allergy & Lung Health Unit, School of Population & Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - R Hoy
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - S C Dharmage
- Murdoch Childrens Research Institute, Melbourne, Australia; Allergy & Lung Health Unit, School of Population & Global Health, University of Melbourne, Melbourne, Victoria, Australia
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Beck C, Koplin J, Dharmage S, Wake M, Gurrin L, McWilliam V, Tang M, Sun C, Foskey R, Allen KJ, Robertson C, Hill D, Vuillermin P, Osborne N, Mathers M, Peters R, Dang T, Tey D, Robinson M, Zurzolo G, Thiele L, Czech H, Shaw H, Anderson D, Eckert J, Bertalli N, Sanjeevan J, Tan T, Martin P, Garner C, Trembath K, Crawford H, Suaini N, Ferreira M, Martino D, Saffery R, Ellis J, Saffery R, Molloy J, Brewerton M, Licciardi P, Tilbrook K, Chhabra S. Persistent Food Allergy and Food Allergy Coexistent with Eczema Is Associated with Reduced Growth in the First 4 Years of Life. The Journal of Allergy and Clinical Immunology: In Practice 2016; 4:248-56.e3. [DOI: 10.1016/j.jaip.2015.08.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 08/07/2015] [Accepted: 08/27/2015] [Indexed: 11/29/2022]
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Martino D, Dang T, Sexton-Oates A, Prescott S, Tang ML, Dharmage S, Gurrin L, Koplin J, Ponsonby AL, Allen KJ, Saffery R. Using methylation signatures to distinguish food allergy from tolerance. Pathology 2016. [DOI: 10.1016/j.pathol.2015.12.122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Allen KJ, Panjari M, Koplin J, Dharmage S, Peters RL, Gurrin L, Sawyer S, McWilliam VL, Eckert JK, Vicendese D, Erbas B, Matheson MC, Tang ML, Douglass J, Ponsonby AL, Dwyer T, Goldfeld S. Nut Allergy Prevalence and Differences Between Asian-Born Children and Australian-Born Children of Asian Descent: A State-Wide Survey of Children at Primary School Entry in Victoria, Australia. J Allergy Clin Immunol 2016. [DOI: 10.1016/j.jaci.2015.12.635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Molloy J, Ponsonby AL, Allen K, Tang M, Collier F, Ward A, Koplin J, Vuillermin P. Is Low Vitamin D Status A Risk Factor For Food Allergy? Current Evidence And Future Directions. Mini Rev Med Chem 2015; 15:944-52. [DOI: 10.2174/1389557515666150519111328] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 03/14/2015] [Accepted: 05/12/2015] [Indexed: 11/22/2022]
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Molloy J, Saffery R, Koplin J, Ponsonby A, Tang MLK, Collier F, Allen K, Vuillermin P. Maternal antenatal folate levels and offspring risk of IgE‐mediated food sensitisation. Clin Transl Allergy 2015. [PMCID: PMC4412176 DOI: 10.1186/2045-7022-5-s3-p90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- John Molloy
- Child Health Research UnitBarwon HealthGeelong HospitalVictoriaAustralia
- Murdoch Children's Research InstituteParkvilleAustralia
- School of MedicineDeakin UniversityWaurn PondsAustralia
| | - Richard Saffery
- Murdoch Children's Research InstituteParkvilleAustralia
- University of MelbourneParkvilleVictoriaAustralia
| | - Jennifer Koplin
- Murdoch Children's Research InstituteParkvilleAustralia
- University of MelbourneParkvilleVictoriaAustralia
| | | | - Mimi LK Tang
- Murdoch Children's Research InstituteParkvilleAustralia
- University of MelbourneParkvilleVictoriaAustralia
- Department of Allergy and ImmunologyRoyal Children's HospitalParkvilleVictoriaAustralia
| | - Fiona Collier
- Child Health Research UnitBarwon HealthGeelong HospitalVictoriaAustralia
- School of MedicineDeakin UniversityWaurn PondsAustralia
| | - Katrina Allen
- Murdoch Children's Research InstituteParkvilleAustralia
- University of MelbourneParkvilleVictoriaAustralia
- Department of Allergy and ImmunologyRoyal Children's HospitalParkvilleVictoriaAustralia
| | - Peter Vuillermin
- Child Health Research UnitBarwon HealthGeelong HospitalVictoriaAustralia
- Murdoch Children's Research InstituteParkvilleAustralia
- School of MedicineDeakin UniversityWaurn PondsAustralia
- University of MelbourneParkvilleVictoriaAustralia
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Martino D, Dang T, Sexton-Oates A, Prescott S, Tang MLK, Dharmage S, Gurrin L, Koplin J, Ponsonby AL, Allen KJ, Saffery R. Blood DNA methylation biomarkers predict clinical reactivity in food-sensitized infants. J Allergy Clin Immunol 2015; 135:1319-28.e1-12. [PMID: 25678091 DOI: 10.1016/j.jaci.2014.12.1933] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 11/28/2014] [Accepted: 12/29/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND The diagnosis of food allergy (FA) can be challenging because approximately half of food-sensitized patients are asymptomatic. Current diagnostic tests are excellent makers of sensitization but poor predictors of clinical reactivity. Thus oral food challenges (OFCs) are required to determine a patient's risk of reactivity. OBJECTIVE We sought to discover genomic biomarkers of clinical FA with utility for predicting food challenge outcomes. METHODS Genome-wide DNA methylation (DNAm) profiling was performed on blood mononuclear cells from volunteers who had undergone objective OFCs, concurrent skin prick tests, and specific IgE tests. Fifty-eight food-sensitized patients (aged 11-15 months) were assessed, half of whom were clinically reactive. Thirteen nonallergic control subjects were also assessed. Reproducibility was assessed in an additional 48 samples by using methylation data from an independent population of patients with clinical FA. RESULTS Using a supervised learning approach, we discovered a DNAm signature of 96 CpG sites that predict clinical outcomes. Diagnostic scores were derived from these 96 methylation sites, and cutoffs were determined in a sensitivity analysis. Methylation biomarkers outperformed allergen-specific IgE and skin prick tests for predicting OFC outcomes. FA status was correctly predicted in the replication cohort with an accuracy of 79.2%. CONCLUSION DNAm biomarkers with clinical utility for predicting food challenge outcomes are readily detectable in blood. The development of this technology in detailed follow-up studies will yield highly innovative diagnostic assays.
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Affiliation(s)
- David Martino
- Centre for Food and Allergy Research, Murdoch Childrens Research Institute, Parkville, Australia; Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Australia; University of Melbourne Department of Paediatrics, Melbourne, Australia; In-FLAME, the International Inflammation Network, World Universities Network (WUN), Perth, Australia
| | - Thanh Dang
- Centre for Food and Allergy Research, Murdoch Childrens Research Institute, Parkville, Australia; Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Australia
| | | | - Susan Prescott
- Centre for Food and Allergy Research, Murdoch Childrens Research Institute, Parkville, Australia; School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; In-FLAME, the International Inflammation Network, World Universities Network (WUN), Perth, Australia
| | - Mimi L K Tang
- Centre for Food and Allergy Research, Murdoch Childrens Research Institute, Parkville, Australia; Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Australia; University of Melbourne Department of Paediatrics, Melbourne, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia
| | - Shyamali Dharmage
- Centre for Food and Allergy Research, Murdoch Childrens Research Institute, Parkville, Australia; School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Lyle Gurrin
- Centre for Food and Allergy Research, Murdoch Childrens Research Institute, Parkville, Australia; School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Jennifer Koplin
- Centre for Food and Allergy Research, Murdoch Childrens Research Institute, Parkville, Australia; School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Anne-Louise Ponsonby
- Centre for Food and Allergy Research, Murdoch Childrens Research Institute, Parkville, Australia; Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Australia; University of Melbourne Department of Paediatrics, Melbourne, Australia
| | - Katrina J Allen
- Centre for Food and Allergy Research, Murdoch Childrens Research Institute, Parkville, Australia; Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Australia; University of Melbourne Department of Paediatrics, Melbourne, Australia; In-FLAME, the International Inflammation Network, World Universities Network (WUN), Perth, Australia; Institute of Inflammation and Repair, University of Manchester, Manchester, United Kingdom.
| | - Richard Saffery
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Australia; University of Melbourne Department of Paediatrics, Melbourne, Australia
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Peters RL, Allen KJ, Dharmage S, Koplin J, Dang T, Lowe A, Tang ML, Gurrin L. Natural History of Peanut Allergy and Predictors of Persistence in the First 4 Years of Life: A Population-Based Assessment. J Allergy Clin Immunol 2015. [DOI: 10.1016/j.jaci.2014.12.1902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Eckert JK, Martin P, Lowe A, Koplin J, Dharmage S, Gurrin L, Tang ML, Ponsonby AL, Matheson M, Hill D, Allen KJ. Which Infants With Eczema Are At Risk Of Food Allergy? Results From A Population Based Study. J Allergy Clin Immunol 2014. [DOI: 10.1016/j.jaci.2013.12.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Peters R, Dharmage S, Gurrin L, Koplin J, Ponsonby AL, Lowe A, Tang ML, Tey D, Hill D, Robinson M, Czech H, Thiele L, Osborne N, Allen KJ. The Natural History and Clinical Predictors Of Egg Allergy In The First 2 Years Of Life: A Prospective, Population-Based, Cohort Study. J Allergy Clin Immunol 2014. [DOI: 10.1016/j.jaci.2013.12.596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tey D, Allen KJ, Peters R, Koplin J, Tang ML, Gurrin L, Ponsonby AL, Lowe A, Wake M, Dharmage S. Population Response To Change In Infant Feeding Guidelines For Allergy Prevention. J Allergy Clin Immunol 2014. [DOI: 10.1016/j.jaci.2013.12.1019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Allen KJ, Koplin J, Ponsonby AL, Vuillermin P, Dharmage SC. Reply: To PMID 23453797. J Allergy Clin Immunol 2013; 132:1011-2. [PMID: 23954350 DOI: 10.1016/j.jaci.2013.06.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 06/19/2013] [Indexed: 11/16/2022]
Affiliation(s)
- Katrina J Allen
- Murdoch Childrens Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia.
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Peters R, Gurrin L, Dharmage S, Tang M, Koplin J, Danchin M, Hiscock H, Allen K. Food allergy and anaphylaxis – 2053. New diagnostic algorithms that will reduce the need for oral food challenges. World Allergy Organ J 2013. [PMCID: PMC3643411 DOI: 10.1186/1939-4551-6-s1-p136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Allen K, Koplin J, Ponsonby AL, Gurrin L, Wake M, Vuillermin P, Dharmage S. Food allergy and anaphylaxis – 2052. Vitamin D insufficiency is associated with challenge-proven food allergy in infants. World Allergy Organ J 2013. [PMCID: PMC3643489 DOI: 10.1186/1939-4551-6-s1-p135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Allen K, Koplin J, Gurrin L, Gibson M, Thiele L, Miles L, Aurich K, Hill D, Lowe A, Matheson M. Prevalence and Environmental Predictors of Food Allergy in Infants. J Allergy Clin Immunol 2009. [DOI: 10.1016/j.jaci.2008.12.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Koplin J, Allen K, Gurrin L, Osborne N, Tang MLK, Dharmage S. Is caesarean delivery associated with sensitization to food allergens and IgE-mediated food allergy: a systematic review. Pediatr Allergy Immunol 2008; 19:682-7. [PMID: 19076564 DOI: 10.1111/j.1399-3038.2008.00731.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Several studies have shown differences in the composition of the gastrointestinal flora of children who develop sensitization to food allergens compared with non-allergic children. It has been hypothesized that changes in the gut microbiota resulting from caesarean section delivery could increase a child's risk of developing food allergy; however, studies examining the relationship between mode of delivery and food allergy have produced conflicting results. The objective of this review was to determine whether there is sufficient evidence to support an association between delivery by caesarean section and the development of sensitization to food allergens and immunoglobulin E (IgE) mediated food allergy. Using predefined inclusion and exclusion criteria, MEDLINE and PubMed were searched for studies investigating the relationship between caesarean section delivery and food allergy. The information on the quality of the studies and results were extracted and analysed systematically. The search identified four relevant studies as per our protocol. Symptomatic food allergy was used as the outcome in two studies and was found to occur more frequently in children born by caesarean section in one study while the second study found no association between food allergy diagnoses and mode of delivery. The other two studies measured levels of food antigen-specific IgE, with both studies showing an increase in sensitization to food allergens among children born by caesarean section. Overall, there is evidence that the risk of developing IgE-mediated sensitization to food allergens is increased among children delivered by caesarean section, however further studies using objectively diagnosed food allergy as the outcome are needed to verify whether this equates to an increase in confirmed food allergy. Future birth cohort studies should control for the effects of mode of delivery when investigating environmental modifiers of food allergy.
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Affiliation(s)
- Jennifer Koplin
- Murdoch Children's Research Institute and Department of Paediatrics, The University of Melbourne, Victoria, Melbourne, Australia
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Koplin J, Dharmage SC, Gurrin L, Osborne N, Tang ML, Lowe AJ, Hosking C, Hill D, Allen KJ. Soy consumption is not a risk factor for peanut sensitization. J Allergy Clin Immunol 2008; 121:1455-9. [DOI: 10.1016/j.jaci.2008.03.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Revised: 02/14/2008] [Accepted: 03/20/2008] [Indexed: 10/22/2022]
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