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1
Barilo, Anna A., Svetlana V. Smirnova, V. D. Belenyuk, Andrei A. Savchenko, and Aleksandr G. Borisov. "Issues of specific <i>in vitro</i> allergological diagnosis of atopic conditions." Russian Journal of Immunology 26, no. 1 (December 22, 2022): 69–76. http://dx.doi.org/10.46235/1028-7221-1156-ios.
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There is a steady increase in the prevalence of allergic diseases of atopic origin worldwide, e.g., atopic bronchial asthma (ABA) and atopic dermatitis (AD). Identification of a causally significant allergen in allergic patients is crucial for the diagnosis, therapy and prevention of allergic diseases. Korea has developed the Allergy-Q multiplex test to detect specific IgE. Allergy-Q is based on an immunoblotting method using a nitrocellulose membrane as a solid phase for allergen immobilization and can detect allergen-specific IgE simultaneously to 107 allergens. Our aim was to conduct a comparative analysis for detectable allergen-specific IgE antibodies to food, fungal, pollen, household, epidermal allergens in blood serum by immunoblotting method using the Allergy-Q test system in patients with atopic dermatitis, atopic bronchial asthma and psoriasis.
The study included patients with atopic dermatitis (AD, group 1, n = 9), atopic bronchial asthma (ABA, group 2, n = 14) and psoriasis (PS, group 3, n = 17). The concentration of total immunoglobulin E and allergen-specific immunoglobulins of class E in blood serum to 32 most common food, fungal, pollen, household, epidermal allergens was determined by the immunoblotting method using the Allergy-Q test system (Korea).
We have found that sensitization of atopic origin was observed in all patients with AD (n = 9), in 85.7% (n = 12) of patients with atopic bronchial asthma, and in 47.1% (n = 8) of patients with psoriasis. Polyvalent sensitization was shown to prevail in all groups of the examined persons. When studying the spectrum of sensitization to food allergens, a significantly increased frequency of positive reactions to cows milk protein was found in the group of patients with AAA as compared with AD and PS groups. Among all studied groups, sensitization to the Alternaria fungi was found at the highest frequency in the group of patients with ABA. Sensitization to ragweed pollen was very common in all groups of patients. Sensitization to household and epidermal allergens in the groups with AD and AAA was noted for all studied allergens with the highest positivity rates for the feline epithelium and dog dander.
In the present study, the Allergy-Q system showed an agreement with preliminary data from a specific allergological examinations. This relationship suggests a potential for usage of the Allergy-Q immunoblotting method as a highly effective alternative to other in vitro tests for diagnosing atopy. An advantage of the Allergy-Q Multiplex Serum Allergen-Specific IgE Detection Kit is a short processing time, small amount of blood sample, and broader clinical information on the causative allergens.
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Ali, Abdellah H. K. "Food and Aeroallergen Sensitization in IgE -Mediated Asthma in Egypt." Open Respiratory Medicine Journal 15, no. 1 (December 31, 2021): 52–58. http://dx.doi.org/10.2174/1874306402115010052.
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Purpose: Identifying the distribution of allergens is valuable to the effective diagnosis and treatment of allergic disease. So, our aim is to explore the sensitization of food and aeroallergens in Egyptian patients with atopic asthma. Methods: Cross-sectional study recruited 268 Egyptian patients with atopic asthma. Asthmatic patients were assessed by the enzyme allegro sorbent test (EAST) method for specific IgE to a panel of 19 common regional inhaled allergens and 15 food allergens. Results and Discussion: One hundred percent of the patients were sensitive to at least one allergen. Allergy to food allergens only was 2.9%; inhaled allergens only were 26.2% and both were70.9%. Fungi (62%) were the most frequent sensitizing aeroallergen amongst our asthmatic patients, followed by the pollen allergens (42.5%) and house dust mites (HDMs) (26%). Cows’ milk (30.5%) was the most frequent sensitizing food amongst our asthmatic patients, followed by eggs (22.4%) and fish (21.6%). Mono-sensitized patients accounted for 6.7% of all cases, while polysensitized was 93.3%. Moderate and severe asthma showed a significantly higher frequency of polysensitization compared to mild asthma. Conclusion: Fungi and cow's milk are the chief sensitizing allergens in Egyptian patients with atopic asthma. This study represents the first report of sensitization in atopic adult asthma using a large extract panel in Upper Egypt.
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Zhang, Wei, Biao Xie, Meina Liu, and Yupeng Wang. "Associations between sensitisation to allergens and allergic diseases: a hospital-based case–control study in China." BMJ Open 12, no. 2 (February 2022): e050047. http://dx.doi.org/10.1136/bmjopen-2021-050047.
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ObjectivesTo assess the associations of sensitisation to common allergens with atopic dermatitis, allergic rhinitis and allergic asthma in adults.DesignCase–control study.SettingData were collected from the First Affiliated Hospital of Harbin Medical University in Harbin, China.ParticipantsCases were 5111 patients with physician-diagnosed atopic dermatitis (n=2631), allergic asthma (n=1320) and allergic rhinitis (n=1160) recruited from the department of allergy from March 2009 to December 2017. Controls were 2576 healthy adults who underwent physical examination at the same hospital during the same period.Main outcome measuresSpecific IgE levels to 16 common food, indoor and outdoor allergens were assessed in all participants. Adjusted ORs and 95% CIs for the association between allergen sensitisation and allergic diseases were estimated using multivariate logistic regression.ResultsThe prevalence of allergen sensitisation was higher in patients with atopic dermatitis (indoor=17.14%, outdoor=12.85%, food=21.44%), allergic rhinitis (indoor=23.18%, outdoor=26.81%, food=8.94%) and allergic asthma (indoor=24.65%, outdoor=16.46%, food=14.31%) compared with controls (indoor=11.03%, outdoor=6.84%, food=5.83%). After adjustment for potential confounding variables, there was a dose–response relevance between the levels of allergen-specific IgE and allergic diseases (p trend <0.0001). The number of allergens to which a patient was sensitised increased the risk of allergic diseases (atopic dermatitis: highest adjusted OR=4.28, 95% CI 2.57 to 7.11; allergic rhinitis: highest adjusted OR=13.00, 95% CI 3.76 to 45.00; allergic asthma: OR=2.37, 95% CI 1.67 to 3.37).ConclusionThere was a dose–response relevance between levels of allergen-specific IgE and allergic diseases’ prevalence, and multiple sensitisations increased the risk of allergic diseases. This study provides evidence for the prophylaxis of allergic diseases.
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Lei, Dawn K., and Carol Saltoun. "Allergen immunotherapy: definition, indications, and reactions." Allergy and Asthma Proceedings 40, no. 6 (November 1, 2019): 369–71. http://dx.doi.org/10.2500/aap.2019.40.4249.
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Specific allergen immunotherapy is the administration of increasing amounts of specific allergens to which the patient has type I immediate hypersensitivity. It is a disease-modifying therapy, indicated for the treatment of allergic rhinitis, allergic conjunctivitis, allergic asthma, and Hymenoptera hypersensitivity. Specific immunoglobulin E (IgE) antibodies for appropriate allergens for immunotherapy must be documented. Indications for allergen immunotherapy include (1) inadequate symptom control despite pharmacotherapy and avoidance measures; (2) a desire to reduce the morbidity from allergic rhinitis and/or asthma, or reduce the risk of anaphylaxis from a future insect sting; (3) when the patient experiences undesirable adverse effects from pharmacotherapy; and (4) when avoidance is not possible. Several studies reported that immunotherapy in allergic rhinitis seems to prevent the development of new allergic sensitizations and/or new onset asthma. Humoral-, cellular-, and tissue-level changes occur with allergen immunotherapy, including induction of allergen-specific regulatory T and B cells, interleukin 10, and transforming growth factor β production; suppression of T-helper type 2 cell proliferation; large increases in anti-allergen IgG4 antibodies; and reduction in basophil, mast cell, and eosinophil mediator release. Allergen immunotherapy can be administered either subcutaneously in the physician's office or sublingually by the patient at home. The use of immunotherapy in food allergy is still under investigation.
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Klimov, A. V., P. Yu Isaev, V. V. Klimov, and V. S. Sviridova. "Endotypes of allergic rhinitis and asthma accompanying food allergy." Bulletin of Siberian Medicine 18, no. 2 (August 11, 2019): 287–89. http://dx.doi.org/10.20538/1682-0363-2019-2-287-289.
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61 people suffering from persistent allergic rhinitis and asthma accompanying food allergies were studied using case histories, the NHANES questionnaire, polyspecific serum levels, allergen-specific IgE, IL4, IFNg and IL10 assays, and allergy skin tests. Four different endotypes have been identified, including entopic, which can be the basis for new approaches to the diagnosis and treatment of allergic rhinitis and asthma.
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Logan, Kirsty, George Du Toit, Mattia Giovannini, Victor Turcanu, and Gideon Lack. "Pediatric Allergic Diseases, Food Allergy, and Oral Tolerance." Annual Review of Cell and Developmental Biology 36, no. 1 (October 6, 2020): 511–28. http://dx.doi.org/10.1146/annurev-cellbio-100818-125346.
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Pediatric allergic disease is a significant health concern worldwide, and the prevalence of childhood eczema, asthma, allergic rhinitis, and food allergy continues to increase. Evidence to support specific interventions for the prevention of eczema, asthma, and allergic rhinitis is limited, and no consensus on prevention strategies has been reached. Randomized controlled trials investigating the prevention of food allergy via oral tolerance induction and the early introduction of allergenic foods have been successful in reducing peanut and egg allergy prevalence. Infant weaning guidelines in the United Sates were recently amended to actively encourage the introduction of peanut for prevention of peanut allergy.
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Knyziak-Mędrzycka, Izabela, Emilia Majsiak, and Bożena Cukrowska. "Allergic March in Children: The Significance of Precision Allergy Molecular Diagnosis (PAMD@) in Predicting Atopy Development and Planning Allergen-Specific Immunotherapy." Nutrients 15, no. 4 (February 15, 2023): 978. http://dx.doi.org/10.3390/nu15040978.
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The allergic march is a progression of naturally occurring symptoms whose nature changes with age. The classic allergic march typically begins in infancy and manifests in the form of atopic dermatitis and food allergy. As immune tolerance develops over time, these conditions may resolve by the age of 3–5 years; however, they may evolve into allergic rhinitis and bronchial asthma. Traditional diagnostic assessments, such as skin prick testing or serum allergen-specific immunoglobulin E (sIgE) level testing, are conducted to introduce effective treatment. Recent years saw the emergence of precision allergy molecular diagnosis (PAMD@), which assesses sIgE against allergenic molecules. This new technology helps more accurately evaluate the patient’s allergy profile, which helps create more precise dietary specifications and personalize allergen-specific immunotherapy. This review presents possible predictions regarding the allergic march and the means of controlling it based on PAMD@ results.
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Huang, Yan-yan, Yan-tong Liang, Jia-min Wu, Wei-tong Wu, Xin-tong Liu, Ting-ting Ye, Xiao-rong Chen, Xin-An Zeng, Muhammad Faisal Manzoor, and Lang-hong Wang. "Advances in the Study of Probiotics for Immunomodulation and Intervention in Food Allergy." Molecules 28, no. 3 (January 27, 2023): 1242. http://dx.doi.org/10.3390/molecules28031242.
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Food allergies are a serious food safety and public health issue. Soybean, dairy, aquatic, poultry, and nut products are common allergens inducing allergic reactions and adverse symptoms such as atopic dermatitis, allergic eczema, allergic asthma, and allergic rhinitis. Probiotics are assumed as an essential ingredient in maintaining intestinal microorganisms’ composition. They have unique physiological roles and therapeutic effects in maintaining the mucosal barrier, immune function, and gastrointestinal tract, inhibiting the invasion of pathogenic bacteria, and preventing diarrhea and food allergies. Multiple pieces of evidence reveal a significant disruptive effect of probiotics on food allergy pathology and progression mechanisms. Thus, this review describes the allergenic proteins as an entry point and briefly describes the application of probiotics in allergenic foods. Then, the role of probiotics in preventing and curing allergic diseases by regulating human immunity through intestinal flora and intestinal barrier, modulating host immune active cells, and improving host amino acid metabolism are described in detail. The anti-allergic role of probiotics in the function and metabolism of the gastrointestinal tract has been comprehensively explored to furnish insights for relieving food allergy symptoms and preventing food allergy.
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di Palmo, Emanuela, Marcella Gallucci, Francesca Cipriani, Luca Bertelli, Arianna Giannetti, and Giampaolo Ricci. "Asthma and Food Allergy: Which Risks?" Medicina 55, no. 9 (August 21, 2019): 509. http://dx.doi.org/10.3390/medicina55090509.
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Over the past few decades, an increase in the prevalence of asthma and food allergy has been observed in the pediatric population. In infants, food sensitization, particularly to egg, has increased the risk of developing allergic asthma. This is even more likely if sensitization to food allergens occurs early within the first few years of life. It is indeed known that both diseases may be present simultaneously in the pediatric population, but coexistence may negatively influence the severity of both conditions by increasing the risk of life-threatening asthmatic episodes as well as food-related anaphylaxis. Therefore, an accurate clinical and phenotype characterization of this high-risk group of children with both asthma and food allergy and a more aggressive management might lead to reducing related morbidity and mortality. The aim of this review is to provide an updated overview on the close link between food allergy and asthma and their negative mutual influence.
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Dange, Hemalata V. "INVOLVEMENT OF SOME ALLERGENS OF PLANT AND ANIMAL ORIGIN IN ALLERGIC REACTIONS RELATED TO RESPIRATORY SYSTEM." Journal of Medical pharmaceutical and allied sciences 11, no. 6 (November 15, 2021): 76–74. http://dx.doi.org/10.22270/jmpas.v10i6.1947.
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In India, the prevalence of allergic responses and bronchial asthma is on the rise, which is a major public health concern. Increased exposure to an allergen, a substance that causes a reaction, can cause allergy sensitization in genetically vulnerable people. Continued exposure to allergens can raise the risk of allergic diseases which can further progress into life threating respiratory diseases. Allergic reactions to a variety of indoor and outdoor allergens play a key role in severe breathing disorders such as asthma and chronic obstructive pulmonary disease (COPD). There are distinctive kinds of allergens like animal proteins and animal dander, pollen, food, fungi, mould, Insects, Bird droppings and many others. The common allergens that cause respiratory difficulties have been identified after an honest effort. A modest retrospective analysis of 160 patients was done. Their medical history was gathered in order to determine whether or not they had been exposed to allergies in the past. All of the study participants were given a Skin prick test (SPT) with a variety of allergens, and their allergy status was evaluated based on the results. Most allergens, such as dust mites, pollen grains, and pigeon droppings, have been discovered to cause severe respiratory allergies, which can lead to life-threatening respiratory complications.
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Adhianto, Gary, and Hendra S. "Clinical manifestations of allergic rhinitis in children at Denpasar Hospital." Paediatrica Indonesiana 41, no. 3 (June 30, 2001): 160. http://dx.doi.org/10.14238/pi41.3.2001.160-5.
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This is a retrospective study by collecting data from the medical record of children diagnosed as allergic rhinitis at the Pediatric Allergy & Immunology out patient clinic at Denpasar Hospital between January 1996 and December 2000. Reported data including identifying patient, signs and symptoms, atopic history of the family, skin prick test (SPT) result and the environmental factors. Fifty-five from 297 children (18.5%) attending the Pediatric Allergy & Immunology out patient clinic were diagnosed as allergic rhinitis. Thirty nine were male and 16 female. The age ranged from 6 months to 15 years old. The majority of signs and symptom were sneezing and rhinorrhea (26%), itchy nose (23%), blocked nose (14%) and itchy eyes(12%).. Four children had history of atopic dermatitis, 1 food allergy, 10 asthma, 3 urticaria, 2 drug allaaaergy, 4 h-ad history of both atopic dermatitis and urticaria, 13 both asthma and urticaria, 2 both asthma and drug allergy and 6 children had no history of allergic diseases. Thirty three (60%) one of the parents and 12 (21.8%) both parents ever had allergic diseases. According to SPT, 27 (55.1%) of this children had positive reaction to inhalant allergen, 13 (26.5%) to food allergen and 13 (26.5%) had negative reaction.
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Tadjieva, G. Z., O. S. Mirzaev, and Kh N. Shadieva. "Skin Test Results in Patients with Allergies in Samarkand Region." Doctor.Ru 19, no. 11 (2020): 56–60. http://dx.doi.org/10.31550/1727-2378-2020-19-11-56-60.
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Study Objective: To assess skin test results in patients with some allergies. Design: Perspective comparative study. Materials and Methods. We examined 1,963 patients with allergies who presented to Tadjieva Allergo-Medical Service LLC (Samarkand) in 2018–2019. 895 patients consented to and underwent allergy testing with scarification skin tests; they had various allergies (bronchial asthma, allergic rhinoconjunctivitis, allergic bronchitis, atopic dermatitis, urticaria). We used 76 types of most common allergens, including 24 plant allergens, 7 domestic allergens, 13 fungal allergens, 3 epidermal allergens, 27 food allergens, histamine and control test. Results. Most common, positive test results were seen with saltwort (42.9%), plantain (39.5%), wormwood (33.7%), pigweed (26.6%), quitch grass (27.3%), cultivated plant mix (corn, rye, barley, oats, wheat) (41.8%), wild grasses (dart grass, scleranthus, bluegrass, ryegrass, brome grass, couch grass, red-tailed fescue grass, foxtail, timothy) (40.4%). In domestic allergens, the highest number of positive test results accounted for Acarus siro (29.1%), Tyrophagus putrescentiae (24.6%), Dermatophagoides pteronyssinus (21.8%), D. farinae (20.9%) mites. Still, the most severe are the diseases caused by hypersensitivity to fungal allergens Аlternaria alternatа (8.7%), Candida (8.9%). Polyvalent sensibilization was recorded in the majority of cases; but it was not a factor of severity and did not correlated with the duration of the disease. Conclusion. The results allow verifying aetiological factors of allergies in each case; later it can be used for targeted molecular diagnosis and allergen-specific immunotherapy. Keywords: allergies, allergen-specific immunotherapy, skin tests, plant, domestic, fungal allergens, polysensitization.
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Rao, Shobitha. "A cross sectional study of patients with poorly controlled asthma at a referral centre." International Journal of Advances in Medicine 6, no. 2 (March 25, 2019): 393. http://dx.doi.org/10.18203/2349-3933.ijam20191147.
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Background: Asthma is a common chronic disease of the airways. Poorly controlled asthma has significant impact on social and economic factors. This study was done to analyse the clinical profile of patients with poorly controlled asthma.Methods: This is an observational, cross sectional study. Total of 100 patients were evaluated. Data collected included symptomatology, assessment of asthma control by asthma control test scoring, spirometry, body mass index, co-morbidities and allergy testing report.Results: Among the 100 patients studied, 52% (n=52) were in the age group of 30 to 60 years. 48% (n=48) were males and 52% (n=52) were females. 76% (n=76) patients had adhered to treatment for bronchial asthma as advised which was in line with standard therapy. 86% (n=86) had co-existing illness. They included allergic rhinitis, obesity, GERD, anxiety, atopic dermatitis and chronic urticaria. 78% (n=78) of these cases were sensitized to indoor and outdoor allergens. 89% of sensitized cases were to house dust mite (n=70 of 78). This was followed by cockroach sensitization which was seen in 30.7% cases (n=24 of 78). Other allergens included pollens in 28.2% cases (n=22 of 78), aspergillus in 25.6% cases (n=20 of 78) and food allergens in 23% cases (n=18 of 78).Conclusions: Poorly controlled asthma cases require detailed evaluation of comorbid conditions and allergen sensitization profiles. Management of these conditions along with allergen control measures may benefit these patients along with step up of therapy.
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Derkach, E., and N. Aliakhnovich. "Oral-pharyngeal and skin testing in the diagnosis of food allergy to tangerine." Immunopathology, Allergology, Infectology 2021, no. 3 (July 1, 2021): 98–104. http://dx.doi.org/10.14427/jipai.2021.3.98.
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The purpose. To assess the diagnostic significance of the oral-pharyngeal challenge test with extract (1) and tangerine juice (2) in comparison with intradermal allergy test with tangerine extract and prick-prick test with fresh tangerine in patients with food allergy. Materials and methods. The peroxidase activity of the oral fluid was assessed in healthy individuals after breakfast. Patients with allergic reactions to tangerine (study group), patients with allergic rhinitis, bronchial asthma and hay fever, but without food allergy (risk group) and healthy individuals (control group) underwent oral-pharyngeal challenge test with tangerine allergen extract (20 PNU/ ml)/freshly squeezed tangerine juice (1 PNU/ml) followed by evaluation of peroxidase activity of the oral fluid, intradermal tests with tangerine extract and prick-prick tests with fresh tangerine were performed. Results. The majority of patients with food allergy to tangerine had polyvalent sensitization to household/epidermal (76%) and pollen allergens (39%). The most common manifestation of tangerine allergy were urticaria (48% of cases), bronchospasm (21% of cases) and oral allergy syndrome (10%) After breakfast, the optical density of the oral fluid decreased compared to the initial level in all healthy volunteers (p=0,001). After oral-pharyngeal challenge test with tangerine extract (1) and juice (2), the average increase of peroxidase activity of the oral fluid in patients with food allergy was М1=+23,5 [7,0;40,1], М2=+41,4 [4,2;78,6], which was significantly higher than in controls M1=-2,1 [-9,6;5,4], p1=0,038, M2=+4,4 [-9,6;18,4], p2=0,047 and in patients with chronic allergopathology, but without food allergy M2=+0,4 [-13,1;13,8], p2=0,049. The positive prick-prick test with fresh tangerine was observed in 44% of patients in the study group, the standard intradermal test with tangerine allergen extract - in 12%. The intradermal test with tangerine extract and prick-prick test with fresh tangerine were negative in patients without food allergy and healthy individuals. Conclusions. The oral-pharyngeal challenge test with extract (1) and tangerine juice (2), prick-prick test with fresh tangerine (3) can be used in the diagnosis of food allergy to tangerine. The sensitivity and specificity of the challenge test with tangerine allergen extract were 53% and 88%, with tangerine juice – 44% and 89%, prick-prick test with fresh tangerine – 44% and 100%. The proposed tests had a higher diagnostic efficiency than the standard intradermal test with tangerine allergen extract (p1=0,01, p2=0,03, p3=0,039).
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Vininski, McKenna S., Sunanda Rajput, Nicholas J. Hobbs, and Joseph J. Dolence. "Understanding sex differences in the allergic immune response to food." AIMS Allergy and Immunology 6, no. 3 (2022): 90–105. http://dx.doi.org/10.3934/allergy.2022009.
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<abstract> <p>Food allergies are of great public health concern due to their rising prevalence. Our understanding of how the immune system reacts to food remains incomplete. Allergic responses vary between individuals with food allergies. This variability could be caused by genetic, environmental, hormonal, or metabolic factors that impact immune responses mounted against allergens found in foods. Peanut (PN) allergy is one of the most severe and persistent of food allergies, warranting examination into how sensitization occurs to drive IgE-mediated allergic reactions. In recent years, much has been learned about the mechanisms behind the initiation of IgE-mediated food allergies, but additional questions remain. One unresolved issue is whether sex hormones impact the development of food allergies. Sex differences are known to exist in other allergic diseases, so this poses the question about whether the same phenomenon is occurring in food allergies. Studies show that females exhibit a higher prevalence of atopic conditions, such as allergic asthma and eczema, relative to males. Discovering such sex differences in allergic diseases provide a basis for investigating the mechanisms of how hormones influence the development of IgE-mediated reactions to foods. Analysis of existing food allergy demographics found that they occur more frequently in male children and adult females, which is comparable to allergic asthma. This paper reviews existing allergic mechanisms, sensitization routes, as well as how sex hormones may play a role in how the immune system reacts to common food allergens such as PN.</p> </abstract>
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Sicherer, Scott H., Anne Muñoz-Furlong, Ramon Murphy, Robert A. Wood, and Hugh A. Sampson. "Symposium: Pediatric Food Allergy." Pediatrics 111, Supplement_3 (June 1, 2003): 1591–94. http://dx.doi.org/10.1542/peds.111.s3.1591.
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Food allergy seems to be increasing in prevalence,1 significantly decreases the quality of life for patients and their families,2 and has become a common diagnostic and management issue for the pediatrician.3 Studies now a decade old showed that 6% to 8% of children younger than 3 years experience documented adverse reactions to foods. Several studies have defined the prevalence of allergy to specific foods in childhood. Population-based studies document a prevalence of cow milk allergy in 1.9% to 3.2% of infants and young children,4 egg allergy5–7 in 2.6% of children by age 2.5 years,8 and peanut allergy in 0.4% to 0.6% of those younger than 18 years.9,10 Overall, the typical allergens of infancy and early childhood are egg, milk, peanut, wheat, and soy, whereas allergens that are responsible for severe reactions in older children and adults are primarily caused by peanut, tree nuts, and seafood. Allergy to fruits and vegetables are prominent but usually not severe.11–13 For diagnostic purposes, it is instructive to consider the prevalence of food allergy as a cause of specific disorders. For example, food allergy accounts for 20% of acute urticaria,14,15 is present in 37% of children with moderate to severe atopic dermatitis16,17 and approximately 5% with atopic asthma,18 and is the most frequent cause of anaphylaxis outside the hospital setting.19–22
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Lykova, M. A. "SENSITIZATION TO PET ALLERGENS AMONG THE PATIENTS OF AALERGOLOGIC CLNIC." Asthma and allergy 2021, no. 3 (2021): 43–49. http://dx.doi.org/10.31655/2307-3373-2021-3-43-49.
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SENSITIZATION TO PET ALLERGENS AMONG THE PATIENTS OF ALLERGOLOGIC CLINIC M. A. Lykova Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine KIA «Forpost», Kyiv, Ukraine Abstract. The aim: to study the prevalence and structure of sensitization to pet allergens among patients of the allergy clinic. Material and methods of research. The results of a multiplex study (determination of specific IgE to 112 allergenic proteins using the ImmunoCap ISAC test system) in 553 patients who came to the immunology and allergology clinic "Forpost" with complaints of respiratory and / or skin manifestations of allergopathology were analyzed. Results. Sensitization to animal allergens was found in 46.1 % of children of group 1 (0–6 years), 62.8 % of children of group 2 (7–18 years) and 42.6 % of adults. Most patients of all ages (96 %) were also sensitized to other (food and / or inhalation) allergens. In all groups of subjects, sensitization to cat allergens prevailed (44.6 % of all animals sensitized to allergens in the group of children 0–6 years, 43.4 % in the group of children 7–18 years, and 42.7 % in the group of adults) and dogs 12.3 %, 6.6 % and 17.7 % respectively). In all age groups, sensitization to the main cat allergen Fel d1 (uteroglobin) prevailed, in children age groups lipocalin also caused a high frequency of sensitization, in particular Can f1 and Fel d4, while in the adult group the frequency of sensitization to prostatic falkrelin canine was in second place. Conclusions. Animal allergens, especially cats and dogs, play an important role in the development of allergic diseases. Most patients with sensitization to one animal species have specific IgE to cat or dog proteins, suggesting that sensitization to horse and mouse allergens may be more frequent due to cross-reactivity. In the structure of sensitization, the most common allergen in all age groups is the major cat allergen Fel d1. In the younger age group, serum albumin is also important, and in adults — prostatic kallikrein Can f5, which should be considered when choosing the appropriate allergen molecules for diagnosis in patients with hypersensitivity to animal allergens before allergen-specific immunotherapy. Key words: hypersensitivity, sensitization, animal allergens, allergic rhinitis, bronchial asthma. Maryana A. Lykova Shupyk National Healthcare University of Ukraine Post-graduate student of the department of phthisiology and pulmonology, KIA «Forpost», physician allergist-immunologist 10, M. Amosova str., 03038, Kyiv, Ukraine, maryana_lykova@ukr.net Аsthma and Allergy, 2021, 3, P. 43–49.
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Mahmood, Faiza, Geir Hetland, Ivo Nentwich, Mohammad Reza Mirlashari, Reza Ghiasvand, and Lise Sofie Haug Nissen-Meyer. "Agaricus blazei-Based Mushroom Extract Supplementation to Birch Allergic Blood Donors: A Randomized Clinical Trial." Nutrients 11, no. 10 (October 2, 2019): 2339. http://dx.doi.org/10.3390/nu11102339.
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Since Agaricus blazei Murill (AbM) extract reduced specific IgE and ameliorated a skewed Th1/Th2 balance in a mouse allergy model, it was tested in blood donors with self-reported, IgE-positive, birch pollen allergy and/or asthma. Sixty recruited donors were randomized in a placebo-controlled, double-blinded study with pre-seasonal, 7-week, oral supplementation with the AbM-based extract AndosanTM. Before and after the pollen season, questionnaires were answered for allergic rhino-conjunctivitis, asthma, and medication; serum IgE was measured, and Bet v 1-induced basophil activation was determined by CD63 expression. The reported general allergy and asthma symptoms and medication were significantly reduced in the AbM compared to the placebo group during pollen season. During the season, there was significant reduction in specific IgE anti-Bet v 1 and anti-t3 (birch pollen extract) levels in the AbM compared with the placebo group. While the maximal allergen concentrations needed for eliciting basophil activation before the season, changed significantly in the placebo group to lower concentrations (i.e., enhanced sensitization) after the season, these concentrations remained similar in the AndosanTM AbM extract group. Hence, the prophylactic effect of oral supplementation before the season with the AbM-based AndosanTM extract on aeroallergen-induced allergy was associated with reduced specific IgE levels during the season and basophils becoming less sensitive to allergen activation.
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Calamelli, E., G. Ricci, V. Dell’Omo, B. Bendandi, and M. Masi. "Food Allergy in Children with Asthma: Prevalence and Correlation with Clinical Severity of Respiratory Disease." Open Allergy Journal 1, no. 1 (June 17, 2008): 5–11. http://dx.doi.org/10.2174/1874838400801010005.
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Epidemiological evidence suggests that there is a link between asthma and food allergy. The aim of this study was to estimate the prevalence of food allergy in asthmatic children and to evaluate a possible impact of food allergy on asthma severity. The study enrolled 103 asthmatic children (mean age: 11 years). Skin prick-test, dosage of specific IgE to a standardized panel of inhalant and food allergens and spirometric evaluation was made for each patient. Twenty-four (23%) patients presented food allergy, 75 (77%) were sensitized to at least one food. A lower rate of children with controlled symptoms was found in children with food allergy and a higher rate of persistent asthma was found in children sensitized to at least 4 foods. In conclusion, food allergy/sensitization should always be investigated in asthmatic children for its association with increasing severity (only in food sensitized patients) and reduced control of asthmatic symptoms.
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Valenta, R., M. Duchene, C. Ebner, P. Valent, C. Sillaber, P. Deviller, F. Ferreira, M. Tejkl, H. Edelmann, and D. Kraft. "Profilins constitute a novel family of functional plant pan-allergens." Journal of Experimental Medicine 175, no. 2 (February 1, 1992): 377–85. http://dx.doi.org/10.1084/jem.175.2.377.
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Type I allergy is a major health problem in industrialized countries where up to 15% of the population suffer from allergic symptoms (rhinitis, conjunctivitis, and asthma). Previously, we identified a cDNA clone that encoded a birch pollen allergen as profilin. Profilins constitute a ubiquitous family of proteins that control actin polymerization in eukaryotic cells; in particular, profilin participates in the acrosomal reaction of animal sperm cells. Although profilins had been unknown in plants so far, our finding led to the assumption that profilins might have similar functions in pollens during plant fertilization and therefore represent allergenic components in almost all pollens. We show that profilins are prominent allergens that can be isolated from tree pollens (Betula verrucosa, birch), from pollens of grasses (Phleum pratense, timothy grass), and weeds (Artemisia vulgaris, mugwort). About 20% of all pollen allergic patients tested (n = 65) displayed immunoglobulin E (IgE) reactivity to recombinant birch profilin that was expressed in pKK223-3. An IgE inhibition experiment performed with recombinant birch profilin and purified natural profilins from timothy grass and mugwort indicates common IgE epitopes. Moreover, all pollen profilins purified from these far distantly related plant species, and likewise the purified recombinant birch profilin, are able to elicit dose-dependent histamine release via high affinity Fc epsilon receptor of blood basophils from profilin allergic patients. The presence of profilin and possibly related proteins as crossreacting allergenic components in various plants therefore provides an explanation as to why certain allergic patients display type I allergic reactions with pollens and even food from distantly related plants. A functional pan-allergen, like profilin, available as purified recombinant protein, may be a useful diagnostic and probably therapeutic reagent.
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Kovyazina, N. A., N. A. Alkhutova, A. V. Kamaev, O. V. Trusova, O. L. Zhizhina, and M. O. Egorova. "Studying informativity of specific IgE levels to whole cow milk allergen and its components, as well as to soy and gluten in children." Medical Immunology (Russia) 24, no. 2 (December 9, 2019): 317–26. http://dx.doi.org/10.15789/1563-0625-sio-1774.
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Successive development of immunological tolerance to cow’s milk proteins largely depends on the timeliness and validity of the elimination diet and is most difficult in IgE-mediated food allergy. From 2012 to 2017, when examining children aged 3 months to 10 years, we found some cases with high levels of specific IgE to beta-lactoglobulin that exceeded the levels of specific IgE to the whole cow’s milk allergen (the latter is often used as a screening allergen). The aim of this study was to assess the informativity of studying the levels of specific IgE to the whole cow’s milk allergens in blood serum of children at early, preschool and primary school age. We have also included gluten (gluten) and soy as possible components of early childhood nutrition into the list of allergens under study. The study involved 100 children aged 9 months to 12 years. Clinical selection criteria included presence of anamnestic data on exacerbation of atopic dermatitis, urticaria, exacerbation of rhinitis/asthma, diarrhea, constipation or abdominal pain in response to usage of cow’s milk and/or dairy products during the last 6 months. It is shown that extended study of specific IgE levels to whole cow’s milk allergen, its components, as well as to soy and gluten, increases the accuracy of laboratory diagnostics and differential diagnosis of IgEmediated form of food allergy to cow’s milk proteins, compared with determination of serum IgE to whole cow’s milk as a screening test. A detailed study of specific IgE to milk components allowed to confirm the presence of IgE-mediated form of allergy to cow’s milk in 7% of the examined children with signs of food allergy, but in absence of specific IgE to whole cow’s milk allergen. We have also shown that in 29% of cases, the level of specific IgE to milk components was higher than those to whole cow’s milk allergen. The results of this study may be of practical importance, since the form of food allergy, as well as intensity and dynamics of reduction of production of specific IgE, are accepted criteria to forecast development of tolerance to cow’s milk proteins. In addition, identification of specific allergen (including soy bean allergen) that causes the most intense production of specific IgE, may be importance for administration of a reasonable elimination diet. The most significant allergens for diagnosis and differential diagnostics of allergy to cow’s milk in children, in addition to the “whole cow’s milk, f2” preparation, are the following allergens: “whey, f236”, “beta-lactoglobulin, f77” and “soy, f14”.
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Nur'aeny, Nanan. "ORAL ALLERGY SYNDROME (OAS) AKIBAT REAKSI ALERGI MAKANAN." B-Dent, Jurnal Kedokteran Gigi Universitas Baiturrahmah 2, no. 2 (November 10, 2018): 125–32. http://dx.doi.org/10.33854/jbdjbd.20.
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Allergic condition such as itching of the skin, or runny nose and sneezing are widely known, but different case of allergic reaction in the mouth. Are still unknown, one of them is Oral Allergy Syndrome (OAS). Almost everyone knows food allergens such as shrimp, or marine fish, but actually fresh fruits and vegetables also can trigger allergic reactions like OAS in the form of itching or swelling of the lips, tongue, palate, and pharynx. Author intends to provide further information about the OAS in this paper. The mechanism of OAS is a type I, immunoglobulin E-mediated hypersensitivity reaction, common in atopic people with history of atopic rhinitis, bronchial asthma, or urticaria. Food allergen that causes OAS have a cross reaction/ homolog with pollen from protein pathogen respons / PR-10 family, such as Bet v 1 (Birch) and Bet v 2 (Birch). Some OAS allergens from vegetables that homolog with Bet v 1 includes celery (Api g 1) and soybean (Gly m 4), and other allergens from fruits homolog with Bet v 2, such as Ana c1 alergen pineapple. The diagnosis of OAS based on medical history, clinical examination and diagnostic tests includes skin prick test, specific IgE serum, or basophil activation test, and cellular antigen stimulation test with an enzyme-linked immunosorbent assay. Management of OAS consists of non-pharmacological includes information and education to avoid the causes, and give suggestion to eat cooked food. Pharmacologically are prescription of antihistamines or epinephrine injection in case of emergencies. Signs and symptoms of OAS in fact have long been found, but its diagnosis and management are still not widely known. Dentist should know about signs and symptoms of food allergy in the oral mucosa include OAS which caused by fruits and vegetables such as celery, soybean, carrot, apple, pineapple, and strawberry, so finally dentist will provide good management for the patient..
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Mokronosova, Marina A., and Tatiana M. Zheltikova. "Clinical and immunological characteristics of sensitization to tropomyosins." Russian Journal of Allergy 18, no. 1 (March 15, 2021): 73–78. http://dx.doi.org/10.36691/rja1399.
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Tropomyosins are a family of allergenic proteins found in large quantities in all invertebrates. Tropomyosins sensitization causes a life-threatening allergic reaction up to anaphylaxis after eating seafood. Identifying the source of primary sensitization is important to predict the allergic reaction severity. This article describes a clinical case of chronic recurrent urticaria in an 8-year-old boy with tropomyosins sensitization.
An 8-year-old boy was diagnosed with the following: controlled atopic phenotype bronchial asthma, food allergy (oral allergy syndrome), and chronic recurrent spontaneous urticaria. Component diagnostics revealed IgE-aB to tropomyosins in high concentrations from 38.79 to 43.38 kUA/l and cat and dog uteroglobin and lipocalins in high concentrations from 7.79 to 43.38 kUA/l.
It is necessary to specify the primary sensitizer to analyze the clinical significance of allergens that provoke sensitization to various groups of allergens. In this case, sensitization to tropomyosins is most likely described as caused by either a helminthic invasion or midge bites. Therefore, food allergic reactions to tropomyosins caused from crustaceans were not observed.
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Prucha, Hanna, Wenchieh Chen, Claudia Traidl-Hoffmann, Antonia Todorova, Cezmi Akdis, Roger Lauener, and Johannes Ring. "Atopic eczema and allergies: Practical relevance for diagnostic work-up." Community Based Medical Journal 2, no. 2 (October 28, 2013): 15–24. http://dx.doi.org/10.3329/cbmj.v2i2.16693.
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Atopic eczema (AE) is a chronic relapsing skin disease mostly starting in childhood and often associated with allergic asthma and rhinoconjunctivitis. In the etiopathophysiology of atopic eczema skin barrier disturbance and immune deviation with a predominant Th2 response and IgE production are central. Allergy tests belong to the diagnostic work-up of AE patients, first in order to differentiate between the extrinsic (IgE-associated) from the intrinsic (non-IgE-associated) form of the disease. Essntially allergy tests are mandatory in order to find individual provocation factors for exacerbation or maintenance of eczema. These allergy tests include skin prick test (SPT), radio-allergo-sorbent test (RAST) for specific IgE antibodies against common allergens and APT. Since numerous AE patients suffer from contact allergy, therefore classical patch testing is mandatory. Although SPT and RAST have a quite high sensitivity, but the specificity of APT is much higher; revealing the fact that by APT the relevance of a certain allergen for the actual skin disease can be confidently evaluated. In suspected food allergy the gold standard is still double-blind placebo-controlled oral provocation test which should be performed in a symptom-free period after an individual elimination diet and under emergency conditions, since anaphylactic reactions may occur in AE patients. In the long-term management of AE patients educational programs eczema school have proved to be helpful. DOI: http://dx.doi.org/10.3329/cbmj.v2i2.16693 Community Based Medical Journal 2013 July: Vol.02 No 02: 15-24
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Esmail, Dina, Zeinab Ashour, Dina Sheha, Nesrine Mohamed, Amany AbdAllah, Omneya Zeyada, and Amira Elmahdi. "Frequency of ragweed sensitization and allergy among patients with respiratory allergy." Egyptian journal of Immunology 29, no. 4 (October 1, 2022): 115–24. http://dx.doi.org/10.55133/eji.290411.
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Pollen is well known to cause seasonal allergy. Ragweed sensitization and allergy represent a worldwide challenge for allergists. Ambrosia is one of the major genera in the Asteraceae family which includes at least 51 species known as “ragweed”. The current study aimed at determining frequency of ragweed sensitization and allergy among patients with respiratory allergy. The study included 220 subjects selected from patients attended the Allergy Clinic, Ain Shams University. All patients were subjected to detailed medical history, clinical examination, asthma severity grading according to the Global Initiative for Asthma (GINA) guidelines, allergic rhinitis severity grading according to the allergic rhinitis and its impact on asthma (ARIA) guidelines, pulmonary function tests for asthmatic patients, complete blood count with differential for detection of eosinophilia, serum total IgE and skin prick testing (SPT) to ragweed pollen together with common inhalants and common food allergens. Specific IgE for Ambrosia artemisiifolia was done for patients who showed positive SPT to ragweed pollen. About 34% of patients had positive SPT to ragweed, 30.5% were sensitized to ragweed and 3.2% allergic. Specific IgE for A. artemisiifolia was positive in 33.8%. There was a statistically significant association between ragweed sensitization and level of asthma control and disease duration. We concluded that ragweed sensitization is less common as the frequency of Ambrosia pollen sensitization was about one third of the studied allergic patients.
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Alsharairi, Naser A. "Diet and Food Allergy as Risk Factors for Asthma in the Arabian Gulf Region: Current Evidence and Future Research Needs." International Journal of Environmental Research and Public Health 16, no. 20 (October 12, 2019): 3852. http://dx.doi.org/10.3390/ijerph16203852.
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Asthma is a chronic respiratory disease which is associated with higher levels of systemic inflammation. The causes of asthma remain poorly understood. Unhealthy diet and food allergy are potential risk factors for developing asthma. The prevalence of asthma in the Arabian Gulf region (AGR), and Kuwait, Saudi Arabia and Qatar in particular, is higher than in other Eastern Mediterranean countries. In the AGR, diets tend to be of low nutritional value due to high levels of total energy, cholesterol, sodium, added sugars and saturated fat, and low levels of fiber, fruit and vegetables. A few studies that include children and adults in the AGR have suggested a potential link between unhealthy diets/specific food allergens and increased risk of asthma, however, the association of food allergy with asthma is still a controversial issue. The aim of this commentary is to consider the evidence from the AGR regarding the effects of diet/food allergy on asthma risk that may be used to make recommendations for future research.
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Furrie, Elizabeth. "Probiotics and allergy." Proceedings of the Nutrition Society 64, no. 4 (November 2005): 465–69. http://dx.doi.org/10.1079/pns2005466.
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Allergy is caused by an immune reaction that is out of all proportion to the antigenic stimuli. Classical allergy is a type I hypersensitivity reaction mediated by the interaction of mast cells (and eosinophils) coated with allergen-specific IgE and a cross-linking allergen. The physiological outcome is inflammation commonly displayed by urticaria, rhinitis, vomiting and diarrhoea, depending on the route of allergen entry. In extreme reactions anaphylactic shock can result that may lead to death. Chronic allergic responses most commonly present themselves as asthma and eczema. All these symptoms are the consequence of an imbalanced immune system making an unsuitable response to an environmental or food antigen. On bacterial colonisation of the colon after birth the appropriate microbiological stimuli is essential to redress the balance of the skewed T-helper 2 immune response present in the newborn. This normal interaction between baby and microbes is thought to be compromised in the Western world, with a reduction in bifidobacteria and an increase in clostridial species, particularly in bottle-fed infants. The use of probiotic therapy to prevent allergic disease has been demonstrated in two studies using a probiotic Lactobacillus rhamnosus GG in neonates. A long-term reduction in allergy has been shown in the test group, with lactobacillus reducing the incidence of atopic eczema. Management of allergy through probiotics has also been demonstrated in infants, using lactobacilli to control atopic eczema and cow's milk allergy. Unfortunately, these positive results have not been repeated in studies with older children and young adults.
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Pérez-Herrera, Lucía C., Sergio Moreno-López, Daniel Peñaranda, Elizabeth García, Edgardo Chapman, and Augusto Peñaranda. "Frequency of self-reported allergies at a high-complexity referral hospital in Colombia, a tropical Latin American country." Allergologia et Immunopathologia 49, no. 5 (September 1, 2021): 100–105. http://dx.doi.org/10.15586/aei.v49i5.449.
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Background: The frequency of allergic diseases in tropical Latin American populations is poorly understood, and certain particularities can impact their natural history and risk factors. Objective: The study aimed to determine the frequency of self-reported allergies (allergic diseases, drug, and food allergies) in patients who attended the Hospital Universitario Fundación Santa Fe de Bogotá, Colombia. Material and methods: A retrospective study was conducted to assess the frequency of self-reported allergies reported by all the patients who attended an allergy referral center between June and December 2019. Results: A total of 60978 patients were included. Allergic rhinitis was reported by 1.51% (n= 921), asthma by 1.28% (n = 782), and atopic dermatitis by 0.41% (n = 250) of the study population. A higher frequency of self-reported allergic diseases (rhinitis, asthma, and dermatitis) was found in the younger populations, while drug allergies were more frequently reported in adults. The most frequently self-reported drug allergies were penicillin allergy (4.07%, n = 2479), and non-steroidal anti-inflammatory drug (NSAID) allergy (1.85%, n = 1116). The most commonly reported food allergens included shellfish (0.58%), fruits (0.54%), cow’s milk protein (0.37%), and eggs (0.21%). Conclusion: The distribution of food allergens showed a higher frequency of shrimp and fruit allergies compared to previous studies on African, Asian, and Arabic tropical populations that describe a higher predominance of egg and milk allergies. Patients reporting allergic diseases should always be referred to the allergology department for confirmatory testing.
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Ricci, Andreozzi, Cipriani, Giannetti, Gallucci, and Caffarelli. "Wheat Allergy in Children: A Comprehensive Update." Medicina 55, no. 7 (July 23, 2019): 400. http://dx.doi.org/10.3390/medicina55070400.
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Gluten-related disorders are very common in pediatric patients. Wheat allergy is triggered by an immunoglobulin E (IgE)-dependent mechanism; its prevalence varies according to the age and region, and in Europe has been estimated to be lower than 1%. Many studies investigated the potential role of several external factors that can influence the risk to developing wheat allergy, but results are still inconclusive. It can be responsible for several clinical manifestations depending on the route of allergen exposure: food-dependent exercise-induced anaphylaxis (FDEIA), occupational rhinitis or asthma (also known as baker’s asthma), and contact urticaria. The prognosis of IgE-mediated wheat allergy in children is generally favorable, with the majority of children becoming tolerant by school age. Patients who experienced an anaphylactic reaction prior to 3 years of age and patients with higher level of wheat- or ω-5 gliadin-specific IgE antibodies seem to be at higher risk of persistent wheat allergy. The current management of patients is dietary avoidance. Nowadays, oral immunotherapy has been proposed for wheat allergy with promising results, even if further studies are necessary to establish the best protocol in order to promote tolerance in wheat-allergic children.
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Cha, Lily Myung-Jin, Won Seok Lee, Man Yong Han, and Kyung Suk Lee. "The Timely Administration of Epinephrine and Related Factors in Children with Anaphylaxis." Journal of Clinical Medicine 11, no. 19 (September 20, 2022): 5494. http://dx.doi.org/10.3390/jcm11195494.
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Anaphylaxis is a severe allergic reaction that requires immediate recognition and intervention. This study investigated the factors related to the timely administration of epinephrine in cases of pediatric anaphylaxis. We performed a retrospective chart review of 107 patients who visited a pediatric emergency center with anaphylaxis between 2015 and 2017. In total, 76 patients received epinephrine injections. We analyzed factors including allergy history, anaphylaxis signs and symptoms, allergen sensitization, anaphylaxis triggers, and time of epinephrine injection. Anaphylactic patients who received epinephrine took a median of 50 min to arrive at the hospital, and patients who did not receive epinephrine took a median of 94 min. Epinephrine administration was significantly delayed by more than 60 min from symptom onset in patients <2 years old. Patients presenting with wheezing symptoms or history of bronchial asthma were significantly more likely to receive epinephrine within 60 min of symptoms onset, while patients with food allergen sensitization were significantly more likely to receive epinephrine within 30 min of hospital arrival. Wheezing, history of asthma, age (≥2 years old), food triggers, and food allergen sensitivity were significant factors for the rapid administration of epinephrine. An immediate diagnosis of anaphylaxis and a rapid administration of epinephrine are essential.
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Prilutskiy, O. S., and Yu A. Lyhina. "Allergy to lemon: case of oral allergic syndrome associated with allergic otitis media and labyrinthitis in a patient with polysensibilization and multiple manifestations of allergy." Russian Journal of Allergy 16, no. 2 (June 15, 2019): 25–32. http://dx.doi.org/10.36691/rja1194.
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Oral allergic syndrome is an IgEmediated allergic reaction to foods of plant origin in persons with sensitization to various pollen allergens. A clinical case of oral allergy syndrome caused by consumption of lemon in a 25-year-old woman with sensitization to many groups of allergens and presence of allergic otitis media and allergy-induced labyrinthitis is presented. The patient had a history of seasonal allergic rhinoconjunctivitis, bronchial asthma, contact allergic dermatitis, urticaria as a manifestation of drug allergy. In vivo (skin prick tests, prick-prick tests) and in vitro allergen specific diagnostics allowed to work out the individual diet and a hypoallergenic regime in this case.
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Tsuge, Mitsuru, Masanori Ikeda, Naomi Matsumoto, Takashi Yorifuji, and Hirokazu Tsukahara. "Current Insights into Atopic March." Children 8, no. 11 (November 19, 2021): 1067. http://dx.doi.org/10.3390/children8111067.
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The incidence of allergic diseases is increasing, and research on their epidemiology, pathophysiology, and the prevention of onset is urgently needed. The onset of allergic disease begins in infancy with atopic dermatitis and food allergy and develops into allergic asthma and allergic rhinitis in childhood; the process is defined as “atopic march”. Atopic march is caused by multiple immunological pathways, including allergen exposure, environmental pollutants, skin barrier dysfunction, type 2 inflammation, and oxidative stress, which promote the progression of atopic march. Using recent evidence, herein, we explain the involvement of allergic inflammatory conditions and oxidative stress in the process of atopic march, its epidemiology, and methods for prevention of onset.
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Dubakiene, Ruta, Odilija Rudzeviciene, Indre Butiene, Indre Sezaite, Malvina Petronyte, Dalia Vaicekauskaite, and Aurelija Zvirbliene. "Studies on Early Allergic Sensitization in the Lithuanian Birth Cohort." Scientific World Journal 2012 (2012): 1–6. http://dx.doi.org/10.1100/2012/909524.
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Cohort studies are of great importance in defining the mechanism responsible for the development of allergy-associated diseases, such as atopic dermatitis, allergic asthma, and allergic rhinoconjunctivitis. Although these disorders share genetic and environmental risk factors, it is still under debate whether they are linked or develop sequentially along an atopic pathway. The current study was aimed to determine the pattern of allergy sensitization in the Lithuanian birth cohort “Alergemol” (n= 1558) established as a part of the multicenter European birth cohort “EuroPrevall”. Early sensitization to food allergens in the “Alergemol” birth cohort was analysed. The analysis revealed 1.3% and 2.8% of symptomatic-sensitized subjects at 6 and 12 months of age, respectively. The sensitization pattern in response to different allergens in the group of infants with food allergy symptoms was studied using allergological methodsin vivoandin vitro. The impact of maternal and environmental risk factors on the early development of food allergy in at 6 and 12 months of age was evaluated. Our data showed that maternal diet, diseases, the use of antibiotics, and tobacco smoke during pregnancy had no significant impact on the early sensitization to food allergens. However, infants of atopic mothers were significantly more often sensitized to egg as compared to the infants of nonatopic mothers.
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Ochfeld, Elisa N., and Jacqueline A. Pongracic. "Food allergy: Diagnosis and treatment." Allergy and Asthma Proceedings 40, no. 6 (November 1, 2019): 446–49. http://dx.doi.org/10.2500/aap.2019.40.4268.
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Immunoglobulin E‐mediated food reactions usually develop within minutes of food ingestion. Although most reactions are not life-threatening, fatalities do occur. Risk factors for fatal food-induced anaphylaxis include the presence of asthma (a risk factor for anaphylaxis in general), failure to use epinephrine autoinjectors promptly, a history of severe reactions, known food allergy, denial of symptoms, and adolescent and young adult age. The most commonly implicated foods are cow's milk, egg, peanut, soy, tree nuts, fish, shellfish, and wheat. Peanut, tree nuts, and seafood are the most common food allergens in adults, whereas cow's milk, peanut, egg, soy, and wheat are more common in children. The major food allergens are glycoproteins, which are generally water soluble and stable to the effects of heat, proteases, and acids. Recent studies showed that natural tolerance can be acquired at a later age than previously thought, even during adolescence. Allergies to peanut, tree nuts, and seafood are frequently life-long. Patients and their caregivers should be taught when and how to administer injectable epinephrine. In terms of primary prevention, there is evidence that early introduction, followed by ongoing regular consumption of peanut has a protective effect on the development of peanut allergy.
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Kryvopustovа, M. V. "Structure of sensitization and clinical course of asthma in school-age children sensitized to cat allergens." CHILD`S HEALTH 17, no. 1 (April 28, 2022): 7–10. http://dx.doi.org/10.22141/2224-0551.17.1.2022.1485.
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Background. Asthma is an actual problem of modern pediatrics, and allergy to cats is important in its development. The study was aimed to investigate the structure of sensitization and features of the clinical course of asthma in school-age children sensitized to cat allergens. Materials and methods. The results of a study of 430 children aged 6–17 years with sensitization to cat allergens were analyzed. Results. Sensitization to Fel d 1 was detected in 96.05 % of patients, Fel d 2 — in 6.74 %, Fel d 4 — in 21.63 %, Fel d 7 — in 25.81 %. Sensitization to one of the allergens of cats prevailed, among the combinations — a combination of Fel d 1 and Fel d 7. Concomitant sensitization to pollen, dogs, house dust mites, food, etc. is also shown. There is a strong correlation between sensitization to Fel d 7 cat lipocalin and Can f 1 dog lipocalin. The correlation between the presence of severe asthma and the number of cat allergens, sensitization to three or more cat allergens, to three lipocalin Fel d 4, Fel d 7, Can f 1 is shown. Conclusions. In school-age children with asthma and sensitization to cat allergens, sensitization to uteroglobin Fel d 1 dominates. Sensitization to lipocalin Fel d 7 was detected in 25.81 % of cases. There is a direct correlation between the presence of severe asthma and the number of allergens in cats. The cross-reactivity of cat lipocalin Fel d 7 and the basic canine allergen Can f 1 should be considered. The clinical significance in severe asthma sensitization to three lipocalins Fel d 4, Fel d 7, Can f 1 is shown.
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Przekora, Jędrzej, Agata Wawrzyniak, Anna Bujnowska, Agnieszka Rustecka, and Bolesław Kalicki. "Severe atopic dermatitis in a boy with potato allergy." Pediatria i Medycyna Rodzinna 16, no. 3 (October 30, 2020): 301–5. http://dx.doi.org/10.15557/pimr.2020.0055.
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Food allergy is an important problem in the paediatric population. Food products that are most likely to induce allergic reactions include cow’s milk, wheat, peanuts, hen’s eggs, fish and seafood. Food-allergy-related diseases include, among other things, atopic dermatitis, urticaria and asthma. Anaphylactic shock is the most severe form of allergic reaction. Intramuscular adrenalin at a dose of 0.01 mg/kg body weight (maximum dose 0.3–0.5 mg) is the primary treatment for anaphylaxis. An elimination diet is the treatment of choice in food allergy. If symptoms persist despite dietary intervention, extended diagnosis using skin prick tests and/or specific IgE measurements should be performed. We present a clinical case of a 2.5-year-old boy with erythroderma secondary to atopic dermatitis, who was referred to our Department due to the lack of improvement after outpatient treatment. It was found during hospital stay that the symptoms were caused by potato allergens.
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Tamazouzt, Sarah, Karine Adel-Patient, Antoine Deschildre, Caroline Roduit, Marie Aline Charles, Blandine de Lauzon-Guillain, and Amandine Divaret-Chauveau. "Prevalence of Food Allergy in France up to 5.5 Years of Age: Results from the ELFE Cohort." Nutrients 14, no. 17 (September 2, 2022): 3624. http://dx.doi.org/10.3390/nu14173624.
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Background: In France, updated data on food allergies (FAs) are lacking, despite the need for efficient FA management and prevention. This study aimed to evaluate the prevalence of FAs in children in France, describe the most common allergens and determine the prevalence of atopic diseases in children with FAs. Methods: The ELFE study comprises a French nationwide birth cohort, including 18,329 children born in 2011. FAs were assessed by parental reports of food avoidance based on medical advice related to FAs, provided at 2 months and 2, 3.5 and 5.5 years of age. Data regarding FAs were available for 16,400 children. Data were weighted to account for selection and attrition bias. Results: From birth to 5.5 years of age, FAs were reported for 5.94% (95% CI: 5.54–6.34) children. Milk was the most common allergen, followed by egg, peanut, exotic fruits, tree nuts, gluten and fish. Among children with FAs, 20.5% had an allergy to at least two different groups of allergens; 71% reported eczema at least once before 5.5 years of age; 24.4% reported incidence of asthma; and 42.3% reported incidence of allergic rhinitis or conjunctivitis. Conclusion: In France, the prevalence of FAs in children up to 5.5 years of age is approximately 6%. It was demonstrated that 1 in 5 children with allergies had multiple FAs.
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Stelmaszczyk-Emmel, Anna, Anna Zawadzka-Krajewska, Eliza Głodkowska-Mrówka, and Urszula Demkow. "FoxP3 Tregs Response to Sublingual Allergen Specific Immunotherapy in Children Depends on the Manifestation of Allergy." Journal of Immunology Research 2015 (2015): 1–7. http://dx.doi.org/10.1155/2015/731381.
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Over the last decades allergic diseases has become a major health problem worldwide. The only specific treatment to date is allergen specific immunotherapy (ASIT). Although it was shown that ASIT generates allergen-tolerant T cells, detailed mechanism underlying its activity is still unclear and there is no reliable method to monitor its effectiveness. The aim of our study was to evaluate ASIT influence on the frequency of forkhead box P3 (FoxP3) Tregs in allergic children with various clinical manifestations. The relative number of FoxP3 Tregs in 32 blood samples from allergic children at baseline and/or after 1 year of ASIT was assessed by flow cytometry. In the entire studied group, the percentage of FoxP3 Tregs did not increase 1 year after ASIT. Nevertheless, the percentage of FoxP3 Tregs after ASIT significantly increased in children with respiratory allergy (conjunctivitis, asthma, and rhinitis) coexisting with nonrespiratory manifestations (food allergy and/or atopic dermatitis), whereas, in patients with respiratory allergy only, the percentage of FoxP3 Tregs decreased. To the best of our knowledge, this is the first report showing various differential FoxP3 Tregs response to ASIT in allergic children. FoxP3 Tregs number could be useful in treatment monitoring. Further studies are warranted to confirm these observations.
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Macchiaverni, Patricia, Ulrike Gehring, Akila Rekima, Alet H. Wijga, and Valerie Verhasselt. "House Dust Mite Exposure through Human Milk and Dust: What Matters for Child Allergy Risk?" Nutrients 14, no. 10 (May 17, 2022): 2095. http://dx.doi.org/10.3390/nu14102095.
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Allergies are major noncommunicable diseases associated with significant morbidity, reduced quality of life, and high healthcare costs. Despite decades of research, it is still unknown if early-life exposure to indoor allergens plays a role in the development of IgE-mediated allergy and asthma. The objective of this study is to contribute to the identification of early-life risk factors for developing allergy. We addressed whether two different sources of house dust mite Der p 1 allergen exposure during early life, i.e., human milk and dust, have different relationships with IgE levels and asthma outcomes in children. We performed longitudinal analyses in 249 mother–child pairs using data from the PIAMA birth cohort. Asthma symptoms and serum total and specific IgE levels in children were available for the first 16 years of life. Der p 1 levels were measured in human milk and dust samples from infant mattresses. We observed that infant exposure to Der p 1 through human milk was associated with an increased risk of having high levels of serum IgE (top tertile > 150 kU/mL) in childhood as compared to infants exposed to human milk with undetectable Der p 1 [adjusted OR (95% CI) 1.83 (1.05–3.20) p = 0.0294]. The Der p 1 content in infant mattress dust was not associated with increased IgE levels in childhood. The risk of asthma and Der p 1 sensitization was neither associated with Der p 1 in human milk nor with Der p 1 in dust. In conclusion, high levels of IgE in childhood were associated with Der p 1 exposure through human milk but not exposure from mattress dust. This observation suggests that human milk is a source of Der p 1 exposure that is relevant to allergy development and fosters the need for research on the determinants of Der p 1 levels in human milk.
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Han, Hongwei, Florence Roan, Laura Johnston, Paul J. Bryce, and Steven F. Ziegler. "Distinct tissue-specific functions for TSLP and IL-33 in the atopic march." Journal of Immunology 196, no. 1_Supplement (May 1, 2016): 68.6. http://dx.doi.org/10.4049/jimmunol.196.supp.68.6.
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Abstract Atopic dermatitis (AD) often precedes asthma and food allergy, indicating that epicutaneous sensitization to allergens may be important in the induction of allergic responses at other barrier surfaces. Our study demonstrated a central role for IL-33 in this “atopic march.” We showed that mice exposed to antigen in the skin, in the presence of IL-33, developed severe airway inflammation when later challenged in the lung, and developed allergic diarrhea following oral antigen challenge. In addition, IL-33-driven allergic disease occurred in a thymic stromal lymphopoietin (TSLP)-independent manner. In contrast, IL-33 signaling was required for local inflammation following epicutaneous TSLP/OVA sensitization and during challenge in allergic gastrointestinal disease, but was dispensable during challenge in TSLP-mediated airway disease. These data reveal critical, site-specific roles for IL-33 in the “atopic march” that lead from atopic dermatitis to allergic asthma and gastrointestinal allergy.
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Ding, Bo, Shiwen Gao, Jun Huang, Songdi Gong, Jiahui Lin, Guoliang Ding, Qiuzhi Shen, et al. "Analysis of factors influencing the determination of indications for allergen-specific immunotherapy." Allergologia et Immunopathologia 51, no. 1 (January 1, 2023): 168–76. http://dx.doi.org/10.15586/aei.v51i1.756.
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Objective: To develop a questionnaire and a scoring system for evaluating physicians’ knowledge of allergen immunotherapy (AIT). Methods: Questionnaire was designed using the Questionnaire Star tool. A total of 1024 physicians were assessed, and based on the score divided into accurate judgment and inaccurate judgment groups. Statistical analysis was done, and counting data were expressed as frequen-cies and percentage values. Chi-square test and multi-factor logistic analysis were used to determine influencing factors on the indications for AIT. Results: Physician’s age, grade of the hospital, and pediatric specialty influenced the accurate judgment of AIT indication after adjustment for independent variables (P < 0.05). In all, 80.5% physicians exercised accurate assessment for allergic rhinitis. Allergic conjunctivitis was judged accurately by 47.0% physicians. Bronchial asthma was judged accurately by 71.0% physicians, and atopic dermatitis by 61.3% physicians, with a higher accuracy rate for pediatricians than non-pediatricians for all the mentioned conditions (P < 0.05). There was no significant difference in the accuracy of judgment between pediatricians and non-pediatricians in terms of AIT for food allergy and dust mite sensitization (P > 0.05). Conclusion: The results of our study demonstrated a high accuracy judgment rate among clinicians for rhinitis, asthma, and dermatitis, and a low accuracy rate for desensitization of healthy people with allergic conjunctivitis, food allergies, and allergen sensitization.
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Levy, Soloni Afra Pires, Sergio Duarte Dortas Junior, Andrea Huguenim Silva Pires, Augusto Tiaqui Abe, Solange Oliveira Rodrigues Valle, Vilma Perez Coelho, Ludwig Ruppert Hahnstadt, and Alfeu Tavares França. "Atopy patch test (APT) in the diagnosis of food allergy in children with atopic dermatitis." Anais Brasileiros de Dermatologia 87, no. 5 (October 2012): 724–28. http://dx.doi.org/10.1590/s0365-05962012000500009.
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BACKGROUND: Atopic Dermatitis is a chronic inflammatory skin disease. Food allergens are important in the pathogenesis in 1/3 of the cases. Several mechanisms are involved in the pathogenesis of Atopic Dermatitis. Immediate reactions are identified by both measurement of specific IgE and skin prick test. Atopy Patch Test seems to be relevant in the investigation of patients with suspected delayed-type reactions. OBJECTIVES: To evaluate the standardization of this method concerning allergen concentration, occlusion time and interpretation, and determine the specificity and sensitivity of the Atopy Patch Test according to the skin prick test and specific IgE levels in food allergy diagnosis in children with Atopic Dermatitis. METHODS: Seventy-two children, aged 2-12 years were selected and followed at the allergy clinic of the Hospital São Zacharias. Skin prick test, specific IgE and food Atopy Patch Test (cow's milk, egg, soy and wheat) were carried out. Three groups were submitted to the Atopy Patch Test: (1) Atopic Dermatitis with or without Rhinitis and Asthma; (2) Rhinitis and or Asthma without AD; (3) Healthy individuals. RESULTS: In group 1, 40% of the patients presented positive reactions. The longer the exposure time (48h and 72h), the higher the sensitivity. In group 2, the test was more specific than sensitive for all the extracts, with increased sensitivity the longer the time of exposure (72h). In group 3, 8.3% presented positive tests. CONCLUSION: APT evidenced a great diagnostic value in late-phase reactions to food, with high specificity. It showed to be a specific and reliable tool in comparison with the healthy group's results.
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Hazel Gowland, M. "Food allergen avoidance: risk assessment for life." Proceedings of the Nutrition Society 61, no. 1 (February 2002): 39–43. http://dx.doi.org/10.1079/pns2001128.
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The skills and knowledge required to carry out food allergen avoidance are becoming increasingly sophisticated. It is not enough to know the names of a handful of dishes which contain a known allergen as an ingredient. Many lifestyles now depend on food prepared away from the home. New product development has introduced a wide range of ingredients and dishes which are labour saving, exciting and innovative. Product traceability now depends on advanced technological support as it struggles to keep up with foods manufactured, prepared and served in ever more complex circumstances. Consumers are now faced with ‘a jungle of choices’. However, those individuals who need to avoid a known allergen, particularly in trace quantities, often find that the food choice deemed suitable is poor, and the information available inadequate or even dangerously misleading. There are two important groups for whom this situation is a major concern. Thousands of families with young children are forced to live with the possibility that everyday foods may be contaminated by a known allergen which could kill in minutes. They live on their nerves, reading every packet and resorting to hyperprotective childcare and vigilance. In addition, the youngest independent consumers, teenagers and those in their twenties, may have little first-hand experience of food preparation. They may be ill-equipped in food-allergen risk assessment. Sadly, those who die from anaphylaxis or allergen-triggered asthma are often in this age-group. Current initiatives to support consumers at risk include a recognised standard for manufacturers seeking to eliminate an allergen from their production, and the integration of food allergy into training for caterers and food standards enforcement professionals.
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Obbagy, Julie E., Laural K. English, Yat Ping Wong, Nancy F. Butte, Kathryn G. Dewey, David M. Fleischer, Mary Kay Fox, et al. "Complementary feeding and food allergy, atopic dermatitis/eczema, asthma, and allergic rhinitis: a systematic review." American Journal of Clinical Nutrition 109, Supplement_1 (March 1, 2019): 890S—934S. http://dx.doi.org/10.1093/ajcn/nqy220.
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ABSTRACTBackgroundNutrition during infancy and toddlerhood may influence health and disease prevention across the life span. Complementary feeding (CF) starts when human milk or infant formula is complemented by other foods and beverages, beginning during infancy and continuing to age 24 mo.ObjectivesThe aim of this study was to describe systematic reviews conducted for the USDA and the Department of Health and Human Services Pregnancy and Birth to 24 Months Project to answer the following question: What is the relationship between the timing of the introduction of complementary foods and beverages (CFBs), or types and amounts of CFBs consumed, and the development of food allergy, atopic dermatitis/eczema, asthma, and allergic rhinitis?MethodsThe literature was searched using 4 databases (CINAHL, Cochrane, Embase, PubMed) to identify articles published from January 1980 to February 2017 that met predetermined inclusion criteria. For each study, data were extracted and risk of bias was assessed. The evidence was qualitatively synthesized to develop a conclusion statement, and the strength of the evidence was graded.ResultsThirty-one included articles addressed the timing of CFB introduction, and 47 articles addressed the types and amounts of CFBs consumed.ConclusionsModerate evidence suggests that there is no relationship between the age at which CF first begins and the risk of developing food allergy, atopic dermatitis/eczema, or childhood asthma. Limited to strong evidence, depending on the specific food, suggests that introducing allergenic foods in the first year of life (after 4 mo) does not increase the risk of food allergy and atopic dermatitis/eczema but may prevent peanut and egg allergy. There is not enough evidence to determine a relationship between diet diversity or dietary patterns and atopic disease. Research is needed to address gaps and limitations in the evidence on CF and atopic disease, including research that uses valid and reliable diagnostic measures and accounts for key confounders and potential reverse causality.
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Käck, Ulrika, Elisabet Einarsdottir, Marianne van Hage, Anna Asarnoj, Anna James, Anna Nopp, Kaarel Krjutškov, et al. "Nasal upregulation of CST1 in dog-sensitised children with severe allergic airway disease." ERJ Open Research 7, no. 2 (February 18, 2021): 00917–2020. http://dx.doi.org/10.1183/23120541.00917-2020.
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BackgroundThe clinical presentation of children sensitised to dog dander varies from asymptomatic to severe allergic airway disease, but the genetic mechanisms underlying these differences are not clear. The objective of the present study was to investigate nasal transcriptomic profiles associated with dog dander sensitisation in school children and to reveal clinical symptoms related with these profiles.MethodsRNA was extracted from nasal epithelial cell brushings of children sensitised to dog dander and healthy controls. Blood sample analyses included IgE against dog dander, dog allergen molecules, other airborne and food allergens, basophil activation and white blood cell counts. Clinical history of asthma and rhinitis was recorded, and lung function was assessed (spirometry, methacholine provocation and exhaled nitric oxide fraction).ResultsThe most overexpressed gene in children sensitised to dog dander compared to healthy controls was CST1, coding for Cystatin 1. A cluster of these children with enhanced CST1 expression showed lower forced expiratory volume in 1 s, increased bronchial hyperreactivity, pronounced eosinophilia and higher basophil allergen threshold sensitivity compared with other children sensitised to dog dander. In addition, multi-sensitisation to lipocalins was more common in this group.ConclusionsOverexpression of CST1 is associated with more severe allergic airway disease in children sensitised to dog dander. CST1 is thus a possible biomarker of the severity of allergic airway disease and a possible therapeutic target for the future treatment of airborne allergy.
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Niewiem, Monika, and Urszula Grzybowska-Chlebowczyk. "Intestinal Barrier Permeability in Allergic Diseases." Nutrients 14, no. 9 (April 30, 2022): 1893. http://dx.doi.org/10.3390/nu14091893.
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The role of intestinal permeability (IP) markers among children and adults with food allergies is not fully understood, and the identification of biological indicators/markers that predict growth retardation in children with allergic diseases and atopy has not been well explained. Studies have shown that patients with atopic diseases respond abnormally to food allergens. Accordingly, differences in the types of immune complexes formed in response to antigen challenges are significant, which seems to underlie the systemic signs of the food allergy. Increased intestinal permeability over the course of a food allergy allows allergens to penetrate through the intestinal barrier and stimulate the submucosal immune system. Additionally, the release of cytokines and inflammatory mediators enhances the degradation of the epithelial barrier and leads to an improper cycle, resulting in increased intestinal permeability. Several studies have also demonstrated increased permeability of the epithelial cells in those afflicted with atopic eczema and bronchial asthma. Ongoing research is aimed at finding various indicators to assess IP in patients with atopic diseases.
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Trailokya, Abhijit, and Soumen Roy. "Bilastine - Novel anti histamine drug for allergic rhinitis." IP Indian Journal of Immunology and Respiratory Medicine 7, no. 1 (April 15, 2022): 6–10. http://dx.doi.org/10.18231/j.ijirm.2022.003.
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The immune system is a fundamental part of human protection against infection and disease.The immune system can occasionally lead to unfavourable reactions in the host which are known as hypersensitivity reactions. The exaggerated immune reactivity (hypersensitivity) to certain environmental substances (allergens) like airborne pollens, dust, mites, pet dander, and reactions to certain foods that normally have little effect on most people is known as allergy. The incidence of allergic disease like allergic rhinitis (AR), food borne allergy, asthma and anaphylactic reactions are prevalent in 25% of populations predominately in adolescents and adults in industrialised countries. Bilastine is a novel second-generation non-sedative, highly selective histamine H1 receptor antagonist that suppresses some allergic inflammatory processes that inhibits the release of histamine from mast cells and is approved in the treatment allergic rhinitis, urticaria and pruritus associated with skin diseases. This review covers the safety, efficacy and pharmacological aspects of Bilastine as an important product for treatment of allergic rhinitis.
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Arokiaraj, L. Anand, and T. R. Gobinaath. "Prevalence and risk factors for bronchial asthma in an urban area of Puducherry: a cross-sectional study." International Journal of Contemporary Pediatrics 5, no. 6 (October 22, 2018): 2249. http://dx.doi.org/10.18203/2349-3291.ijcp20184290.
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Background: Food allergy is mostly IgE-mediated which is estimated to affect 6% to 8% children and 3% to 4% adults the clinical and social impact of which takes a hard toll in early childhood. The objective of this study is to study the magnitude of food allergy and differences in food allergens among the urban and rural school-going children.Methods: A cross-sectional study was conducted among 350 school going children, aged 5-10 years, attending to two private schools (n=192) and two government schools (n=158) in the urban and rural field practice areas respectively and data regarding food allergens was collected using a semi-structured proforma.Results: There was a significant higher (p<0.001) proportion of wheeze symptomatics among the urban (n=70, 44.3%) than the rural students (n=37, 19.3%). The students had higher allergies to Ice-cream (14.57%, n=51), prawn (11.14%, n=39), peanut (14.57%, n=51), garlic (14.57%, n=51), fish (11.14%, n=39) and milk (11.14%, n=39).Conclusions: There was a higher proportion of food allergy among the urban school students compared to the rural students. The food allergens also varied significantly in their influence on food allergy among the urban and rural areas.
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Moroni, L., A. Cariddi, S. Sartorelli, E. Della Torre, T. Germanò, G. A. Ramirez, E. Bozzolo, M. R. Yacoub, and L. Dagna. "AB0512 ALLERGIC PROFILE AND ALLERGEN-SPECIFIC IMMUNOTHERAPY IN EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS (EGPA): A SINGLE CENTER OBSERVATIONAL STUDY." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1553.1–1554. http://dx.doi.org/10.1136/annrheumdis-2020-eular.1766.
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Background:Eosinophilic granulomatosis with polyangiitis (EGPA), previously known as Churg-Strauss syndrome, is a systemic disease characterized by late onset asthma associated with small- and/or medium-size vessel vasculitis, besides eosinophil-mediated cytotoxic organ damage. About 20-30% of patients with EGPA displays allergic manifestations related with inhalant sensitization, while prevalence of food and drug allergy is unknown in this context. Moreover, some authors in the past hypothesized in favor of a possible role of allergen-specific immunotherapy (ASIT) as a trigger of disease.Objectives:Aim of the present study is to establish the prevalence of each category allergen sensitization and to determine whether atopy or specific immunotherapy could influence clinical expression of the disease.Methods:Our study consisted in a retrospective demographic and clinical data collection regarding EGPA history (including age at diagnosis, organ and tissue involvement, autoantibody profile) and the presence of allergic comorbidities or previous drug hypersensitivity reactions. Patients without either proven allergic reactions or positive tests have been excluded.Results:Fifty-three (53) patients with definitive diagnosis of EGPA have been included in the analysis among which 25 (47.2%) with chronic respiratory allergy or previous acute allergic reaction. Among allergic patients 15 (60%) resulted sensitized towards inhalants and among them 13 (86.7%) displayed multiple sensitization. Drug allergy affected 13 patients (52%), food 4 (16%). Among 15 patients with respiratory allergy, 13 were eligible to allergen-specific immunotherapy (ASIT). Seven (7) subjects underwent ASIT prior EGPA diagnosis with an average time-to-EGPA of 16.2 years. No statistically significant difference was found in terms of sex, age at diagnosis, positivity for or specificity of anti-neutrophil cytoplasm antibodies (ANCA), eosinophil count at onset, pattern of clinical manifestations comparing allergic vs. non-allergic, ASIT vs. non-ASIT, ASIT vs. allergic, ASIT vs. eligible.Conclusion:Among patients with EGPA allergies are highly prevalent, particularly towards inhalants and drugs. In the great majority of patients multiple sensitization profile is found. Atopy doesn’t seem to be associated with specific patterns of disease presentation. The absence of correlation between inhalant ASIT exposure and variation in mode and time of EGPA onset doesn’t support the hypothesis of a its potential role in triggering the disease.References:[1]Berti A et al. Severe/uncontrolled asthma and overall survival in atopic patients with eosinophilic granulomatosis with polyangiitis. Respiratory Medicine 2018; DOI: 10.1016/j.rmed.2018.07.017[2]Cottin V et al. Respiratory manifestations of eosinophilic granulomatosis with polyangiitis (Churg–Strauss). European Respiratory Journal 2016; DOI: 10.1183/13993003.00097-2016Disclosure of Interests:Luca Moroni: None declared, adriana cariddi: None declared, Silvia Sartorelli: None declared, Emanuel Della Torre: None declared, Tommaso Germanò: None declared, Giuseppe Alvise Ramirez: None declared, Enrica Bozzolo: None declared, Mona-Rita Yacoub: None declared, Lorenzo Dagna Grant/research support from: The Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR) received unresctricted research/educational grants from Abbvie, Bristol-Myers Squibb, Celgene, Janssen, Merk Sharp & Dohme, Mundipharma Pharmaceuticals, Novartis, Pfizer, Roche, Sanofi-Genzyme, and SOBI., Consultant of: Prof Lorenzo Dagna received consultation honoraria from Abbvie, Amgen, Biogen, Bristol-Myers Squibb, Celltrion, Novartis, Pfizer, Roche, Sanofi-Genzyme, and SOBI.
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D’Errico, Stefano, Alessandro Santurro, Matteo Scopetti, Paola Frati, and Vittorio Fineschi. "Fatal food-induced anaphylaxis: Determination of tryptase and specific IgE on cadaveric blood samples. What else for a better methodological standard?" International Journal of Immunopathology and Pharmacology 34 (January 2020): 205873842095057. http://dx.doi.org/10.1177/2058738420950579.
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Post-mortem investigation in cases of fatal anaphylaxis is required to provide clarifications on the presence of macroscopic pathological changes, histological features, and immunohistochemical positivity suggestive of the diagnosis, on biochemical evidence of anaphylaxis and on the presence of serological data indicative of the allergen responsible for the anaphylactic reaction. We describe the case of a 16-year-old boy with a medical history of allergic asthma, celiac disease, and known food-induced allergy for fish, fresh milk, peanuts, hazelnuts, walnuts, apples, kiwis, and peaches. Acute onset of dyspnea followed by cyanosis of the lips and respiratory failure was described immediately after having an ice cream sandwich. Unsuccessful rescues were immediately attempted with oral administration of betamethasone, intramuscular injection of adrenaline, and cardiopulmonary resuscitation. A complete post-mortem examination was performed. Serum dosage of mast cell beta-tryptase from femoral blood detecting serum values of 41.4 mg/l. Determination of specific IgE on cadaveric blood samples confirmed the anamnestic data related to sensitization for several food allergens, including cod parvalbumin, tropomyosin, brazil nut, omega-5-gliadin of foods derived from wheat and gluten. The cause of death was identified in a cardiorespiratory failure due to anaphylactic shock in a poly-allergic subject and anaphylaxis was ascribed to the wheat contained in the ice cream sandwich eaten immediately before the onset of respiratory symptoms. The need is to implement an interdisciplinary approach capable to ascertain the sensitivity and specificity of the diagnostic tests currently in use as well as to evaluate the possibility of introducing new biomarkers in practice.