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Pediatric Allergy and Immunology

Josefina Zakzuk, Dilia Mercado, Adriana Bornacelly, Jorge Sánchez, Velky Ahumada, Nathalie Acevedo, Luis Caraballo
BACKGROUND: In tropical zones perennial exposure to house dust mite (HDM) allergens and helminth infections are present. Studying the impact of these conditions on the inception and evolution of allergic diseases is necessary to have an accurate view of their natural history. We aimed to evaluate the dynamics of genuine sensitization to B. tropicalis and Ascaris in children from the FRAAT birth cohort and the effects of helminth infection, environmental HDM allergen levels and sociodemographic factors...
November 13, 2018: Pediatric Allergy and Immunology
María Flora Martin-Muñoz, Elena Alonso Lebrero, Lidia Zapatero, Victoria Fuentes Aparicio, Mónica Piquer Gibert, Ana María Plaza Martín, Candelaria Muñoz, María Teresa Belver, Cristina Martorell-Calatayud, Antonio Martorell-Aragonés, Cristina Blasco, Blanca Vilá, Catalina Gómez, Santiago Nevot, Juan Miguel García Martín, Rosario Madero, Luis Echeverría
BACKGROUND: It is unknown which are the most suitable maintenance-pattern and egg-consumption to maintain the desensitization state after ending the oral immunotherapy (OIT). This multicentre-randomized-controlled trial compared two maintenance OIT patterns with pasteurized-egg-white (PEW), evaluating the egg-consumption effect on the desensitization state after ending the OIT. METHODS: One-hundred-one children with confirmed egg allergy were randomized: 25 to an egg-free diet (CG) and 76 to an OIT year with PEW and two maintenance patterns, 38 patients daily 3...
November 10, 2018: Pediatric Allergy and Immunology
R Meyer, A T Fox, A Chebar Lozinsky, L J Michaelis, N Shah
The rise in food allergy has been described as the "second wave" of the allergy epidemic, with some developed countries reporting a prevalence of 10% of challenge proven food allergies. Recognition of the Allergic March has played a crucial role in identifying causality in allergic conditions, linking atopic dermatitis to food allergy and food allergy to other atopic disorders, thereby highlighting opportunities in prevention and the importance of early intervention. This publication will establish the value of weaving the less well understood, non-IgE mediated, food allergy into the Allergic March and mapping its progression through childhood and its associated co-morbidities...
November 7, 2018: Pediatric Allergy and Immunology
Bing-Yu Chen, Chi-Hsien Chen, Yu-Chen Chuang, Ying-Hsuan Wu, Shih-Chun Pan, Yue Leon Guo
BACKGROUND: Childhood asthma is a common condition whose prevalence is changing. Shift in environmental exposure was one of plausible explanation. This study investigated changes in the association between childhood asthma and ambient air pollution occurring over time. METHOD: A nationwide questionnaire survey concerning respiratory illness and symptoms was administered to Taiwanese elementary and middle school students in 2011 and repeatedly in 2016-2017. During the study period, the concentrations of ambient air pollutants were obtained from the Environmental Protection Administration (EPA) monitoring stations...
October 29, 2018: Pediatric Allergy and Immunology
Mikaïl Berdi, Blandine de Lauzon-Guillain, Anne Forhan, Florence Anne Castelli, François Fenaille, Marie-Aline Charles, Barbara Heude, Christophe Junot, Karine Adel-Patient
BACKGROUND: Breastmilk (BM) may participate in driving gut barrier function and immunity in the neonate. We analyzed immune and growth factor concentrations in early BM, and their association with maternal/environmental characteristics and with food allergy (FA) in childhood. METHODS: One BM sample was collected in maternity from some mothers in the EDEN birth-cohort (n=2002 mother-child dyads). A random selection was performed among available samples (sub-cohort, n=272), for which all deliveries were full-term, various maternal/environmental characteristics were recorded and parents answered yearly the question "Has a medical doctor diagnosed a FA in your child?" (26 parent-reported FA cases)...
October 27, 2018: Pediatric Allergy and Immunology
Johannes Savolainen, Barbara Mascialino, Elina Pensamo, K Magnus Åberg, Maija Silvan, Magnus P Borres, Krista Korhonen
BACKGROUND: Food allergies can substantially burden patients and families by negatively affecting finances, social relationships and personal perceptions of health. This study was performed under the Finnish Allergy Programme aimed at reducing avoidance diets to foods in schoolchildren by 50%. The main goal of this study was to investigate how many children could be freed from diet restrictions in a Finnish school district through a diagnostic algorithm including Component-Resolved Diagnostics and food challenge...
October 22, 2018: Pediatric Allergy and Immunology
Francesca Colombo, Patrizia Restani, Elio Massimo Novembre, Simona Barni, Chiara Di Lorenzo, Francesca Orgiu, Simone Biella, Francesca Mori
Allergy to hen's eggs is among the most common hypersensitivity in children (1) whereas, allergy to eggs from other species' is less frequent and usually observed in patients already allergic to hen's eggs (2). So far, only few reports suggest the possibility of selective immunoreactivity to proteins from eggs of different birds (2,3). This article is protected by copyright. All rights reserved.
October 22, 2018: Pediatric Allergy and Immunology
Jenny Hallberg, Natalia Ballardini, Catarina Almqvist, Marit Westman, Marianne van Hage, Gunnar Lilja, Anna Bergström, Inger Kull, Erik Melén
BACKGROUND: Both allergic and non-allergic rhinitis are associated with worse asthma control. However, it is unclear how IgE sensitization and/or rhinitis are associated to lung function. We therefore evaluated the effect of rhinitis and sensitization on lung function, including the periphery of the airway system, and inflammatory biomarkers in individuals with and without asthma. METHODS: Participants in the BAMSE longitudinal birth cohort study underwent measures of spirometry, impulse oscillometry and FeNO at age 16 years...
October 20, 2018: Pediatric Allergy and Immunology
Patrícia Dias de Araújo, Ana Paula Duarte de Souza, Renato T Stein, Bárbara Nery Porto, Liana Antunes, Rodrigo Godinho, Stefanie Primon Muraro, Rita Mattiello, Edgar E Sarria, Giovana Dos Santos, Leonardo Araújo Pinto, Marcus H Jones, Cristina Bonorino, Paulo Márcio Pitrez
Severe therapy-resistant asthma (STRA) is characterized by frequent symptoms, asthma exacerbations and hospitalizations, despite the use of continuous high-dose corticosteroid therapy and other controller medications. Inflammation of the airways and symptoms varies widely in children with STRA and most patients present only with mild lung function abnormalities. Low Th2 cell response (1), low IL-10 production and increased IL-33 have been reported in this group of patients (2,3). This article is protected by copyright...
October 19, 2018: Pediatric Allergy and Immunology
Evelyn Xiu Ling Loo, Elizabeth Huiwen Tham, Kee Wei Phang, Anne Goh, Oon Hoe Teoh, Yap Seng Chong, Peter D Gluckman, Keith M Godfrey, Hugo Van Bever, Bee Wah Lee, Mary Foong-Fong Chong, Lynette Pei-Chi Shek
There is increasing evidence to support the Developmental Origins of Health and Disease (DOHaD) concept that fetal life and early life exposures are important determinants of fetal immune regulation and the development of disorders in later life, including allergies. Among the early life exposures, maternal vitamin D [25(OH)D] status during pregnancy, in particular 25(OH)D insufficiency (25(OH)D concentration of 50-75nmol/l) and/or 25(OH)D deficiency (25(OH)D concentration <50nmol/l) has been associated with allergic outcomes such as eczema, asthma and rhinitis in their offspring...
October 19, 2018: Pediatric Allergy and Immunology
Kimberly Berger, Brenda Eskenazi, John Balmes, Katie Kogut, Nina Holland, Antonia M Calafat, Kim G Harley
BACKGROUND: Asthma and allergy prevalence is increasing in United States children. In utero exposure to chemicals used in personal care products and plastics may contribute to increase in these diseases. METHODS: We quantified urinary concentrations of eight phthalate metabolites and bisphenol A in mothers twice during pregnancy in 1999-2000 in Salinas, California. We assessed probable asthma, aeroallergies, eczema, and spirometry in their age 7 children, and measured T helper 1 and T helper 2 cells in blood at ages 2, 5, and 7 (N=392)...
October 18, 2018: Pediatric Allergy and Immunology
Nikolaos Douladiris, Victoria Garib, Margit Focke Tejkl, Rudolf Valenta, Nikolaos G Papadopoulos, Birgit Linhart
BACKGROUND: Skin testing represents a commonly used first diagnostic method in clinical practice but allergen extracts may vary in composition and often contain cross-reactive allergens and therefore do not always allow the precise identification of the sensitizing allergen source. Our aim was to investigate the suitability of a single recombinant hybrid molecule, consisting of the four major timothy grass pollen allergens (Phl p 1, Phl p 2, Phl p 5, Phl p 6) for in vivo diagnosis of genuine grass pollen allergy in children suffering from pollinosis...
October 14, 2018: Pediatric Allergy and Immunology
Kristian Assing, Christian Nielsen, Henrik T Hansen, Marianne A Jakobsen, Kristin Skogstrand, Charlotte Brasch, Ulla B Hartling, Niels Fisker
A first born boy to unrelated healthy Danish parents was presented with marked neutro- and lymphocytosis after birth (Table 1). His umbilical cord did not separate until age five weeks. Due to chronic skin infection (without pus formation) and protracted leucocytosis (haematological malignancy was excluded) he was referred to our university hospital at the age of 11 months This article is protected by copyright. All rights reserved.
October 12, 2018: Pediatric Allergy and Immunology
Paraskevi Xepapadaki, Sophia Kostoudi, Kassiani Tzeli, Nikolaos Kitsioulis, Nikolaos G Papadopoulos
Food allergens are the most common triggers of anaphylactic cases during childhood, as documented in the European Anaphylaxis Registry (1). Recent data suggest that infections may act as augmenting factors in anaphylactic reactions, while their role in anaphylaxis induction during aeroallergen and oral immunotherapy procedures is well-documented (2). The proposed mode of action involves, in rather generic terms, either lowering the "sub-threshold" allergen dose for anaphylaxis occurrence and/or modulation of clinical tolerance...
October 12, 2018: Pediatric Allergy and Immunology
Nikolaos G Papadopoulos, Adnan Čustović, Michael D Cabana, Philip R Lee, Sharon D Dell, Antoine Deschildre, Gunilla Hedlin, Elham Hossny, Peter Le Souëf, Paolo M Matricardi, Antonio Nieto, Wanda Phipatanakul, Paulo M Pitrez, Petr Pohunek, Marcela Gavornikova, Xavier Jaumont, David B Price
BACKGROUND: Despite remarkable advances in our understanding of asthma, there are still several unmet needs associated with the management of pediatric asthma. METHODS: A two-day, face-to-face, meeting was held in London, United Kingdom, on 28th and 29th October 2017 involving a group of international expert clinicians and scientists in asthma management to discuss the challenges and unmet needs that remain to be addressed in pediatric asthma. RESULTS: These unmet needs include a lack of clinical efficacy and safety evidence, and limited availability of non-steroid-based alternative therapies in patients <6 years of age...
October 12, 2018: Pediatric Allergy and Immunology
Danielle Clifford, Carol Ni Chaoimh, Eve Stanley, Jonathan O'B Hourihane
BACKGROUND: Insect venom is the second most common cause of anaphylaxis outside of medical encounters. Stings cause over 20% of all anaphylactic deaths and 7% of anaphylaxis in children. To date there have been no longitudinal studies of insect sting events or allergy in preschool children. METHODS: A prospective longitudinal nested observational study in the BASELINE Birth Cohort Study (n=2,137). Sting-related questions were asked at 6 and 12months, 2 and 5years...
October 8, 2018: Pediatric Allergy and Immunology
Yoshitaka Okamoto, Shigeharu Fujieda, Mitsuhiro Okano, Hideaki Hida, Shinji Kakudo, Keisuke Masuyama
BACKGROUND: The efficacy and safety of 300 index of reactivity (IR) tablets of house dust mite (HDM) allergen extracts in Japanese pediatric (5-16 years old) patients with allergic rhinitis (AR) were assessed in a double-blind, randomized, placebo-controlled study (JAPIC CTI-152981). METHODS: Patients were randomized 1:1 to HDM sublingual tablets or placebo once daily for 52 weeks. The primary endpoint was Average Adjusted Symptom Score (AASS; average of daily Rhinitis Total Symptom Scores, comprising sneezing, rhinorrhea, nasal congestion, and nasal pruritus, adjusted for rescue medication use), analyzed during Weeks 48-52 (mixed-effects model for repeated measures)...
October 3, 2018: Pediatric Allergy and Immunology
P A Eigenmann, C Akdis, J Bousquet, C Grattan, K Hoffmann-Sommergruber, P W Hellings, I Agache
This review highlights research advances and important achievements in food allergy, anaphylaxis and drug allergy that were published in the Journals of the European Academy of Allergy and Clinical Immunology (EAACI) in 2017. Food allergy and anaphylaxis research have continued to rapidly accelerate, with increasing numbers of outstanding developments in 2017. We saw new studies on the mechanisms, diagnosis, prevention of food allergy and novel food allergens. Drug hypersensitivity, as well as hereditory angioedema, have been highlighted in the present review as the focus of recent developments...
October 1, 2018: Pediatric Allergy and Immunology
Elizabeth Huiwen Tham, Pei Ting Tan, Evelyn Xiu Ling Loo, Anne Eng Neo Goh, Oon Hoe Teoh, Fabian Yap, Kok Hian Tan, Keith M Godfrey, Hugo Ps Van Bever, Bee Wah Lee, Eric Andrew Finkelstein, Yap Seng Chong, Lynette Pei-Chi Shek
The "hygiene hypothesis" proposes that microbial exposures in early life - such as a farming lifestyle, early childcare attendance, older siblings and pet ownership protect against atopy by maintaining a balanced Th1/Th2 immune cytokine milieu.1-3 The newly described "biodiversity hypothesis" or "old friends" hypothesis further suggests that co-evolved trans-generationally transmitted commensal microbiota played important immunoregulatory roles, which have now been diminished due to loss of biodiversity in modern urbanized environments...
September 23, 2018: Pediatric Allergy and Immunology
Line Hedegaard Toftlund, Lone Agertoft, Susanne Halken, Gitte Zachariassen
BACKGROUND: In very preterm-born children alveolar maturation is challenged and lung function is often compromised during childhood. So far, very few studies have focused on type of early nutrition and lung function in children born preterm. METHODS: This study is a six years follow-up of 281 very preterm-born infants (VPI) with a gestational age (GA) < 32+0 weeks. Infants breastfed at discharge from hospital were randomized to unfortified (UHM) or fortified (FHM) mother's (human) milk, whereas those not breastfed received a preterm formula (PF)...
September 8, 2018: Pediatric Allergy and Immunology
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