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Pediatric Allergy and Immunology

Susanne Halken, Desiree Larenas-Linnemann, Graham Roberts, Moises A Calderón, Elisabeth Angier, Oliver Pfaar, Dermot D Ryan, Ioana Agache, Ignacio J I J Ansotegui, Stefania Arasi, George Du Toit, Montserrat Fernandez-Rivas, Roy Geerth van Wijk, Marek Jutel, Jörg Kleine-Tebbe, Susanne Lau, Paolo M Matricardi, Giovanni B Pajno, Nikolaos G Papadopoulos, Martin Penagos, Alexandra F Santos, Gunter J Sturm, Frans Timmermans, R Van Ree, Eva-Maria Varga, Ulrich Wahn, Maria Kristiansen, Sangeeta Dhami, Aziz Sheikh, Muraro Antonella
Allergic diseases are common and frequently coexist. Allergen immunotherapy (AIT) is a disease-modifying treatment for IgE-mediated allergic disease with effects beyond cessation of AIT that may include important preventive effects. The European Academy of Allergy and Clinical Immunology (EAACI) has developed a clinical practice guideline to provide evidence-based recommendations for AIT for prevention of i) development of allergic comorbidities in those with established allergic diseases, ii) development of first allergic condition and iii) allergic sensitization...
September 13, 2017: Pediatric Allergy and Immunology
Shiro Sugiura, Teruaki Matsui, Tomoko Furuta, Kemal Sasaki, Naoyuki Kando, Komei Ito
The purpose of oral food challenges (OFCs) has gradually transformed from a definitive diagnosis of a food allergy to determining the threshold dose of food allergens at the beginning of oral immunotherapy (OIT) or the amount of minimal intake, which has recently come to be considered a better method of managing IgE-mediated food allergy [1][2]. However, OFCs in patients with severe food allergies, defined as low-threshold and severe reactions, carry a risk of triggering anaphylaxis. To predict such severe reactions before OIT, we previously reported prediction models consisting of multiple factors for hen's egg [3] and cow's milk [4] allergy...
September 11, 2017: Pediatric Allergy and Immunology
Martina Sandberg Abelius, Malin Jedenfalk, Jan Ernerudh, Camilla Janefjord, Göran Berg, Leif Matthiesen, Maria C Jenmalm
BACKGROUND: The immunological environment during pregnancy may differ between allergic and non-allergic women. This study investigates the effect of maternal allergy on the allergen-induced cytokine and chemokine levels and if pregnancy modulates these immune responses differently in allergic and non-allergic women. METHODS: The birch-, cat-, phytohemagglutinin- and tetanus toxoid-induced interferon-γ (IFN-γ), interleukin-4 (IL)-4, IL-5, IL-10, IL-13, the T-helper 1 (Th1)-associated chemokine CXCL10 and the Th2-associated chemokine CCL17 levels were quantified in 20 women with allergic symptoms (sensitised, n=13) and 36 women without allergic symptoms (non-sensitised, n=30) at gestational weeks 10-12, 15-16, 25, 35 and 2 and 12 months postpartum...
September 11, 2017: Pediatric Allergy and Immunology
Benigna Namara, Stephen Nash, Swaib A Lule, Hellen Akurut, Harriet Mpairwe, Florence Akello, Josephine Tumusiime, Moses Kizza, Joyce Kabagenyi, Gyaviira Nkurunungi, Lawrence Muhangi, Emily L Webb, Moses Muwanga, Alison M Elliott
BACKGROUND: Helminth infections, common in low income countries, may protect against allergy-related disease. Early exposure may be key. In the Entebbe Mother and Baby Study, treating helminths during pregnancy resulted in increased eczema rates in early childhood. We followed the cohort to determine whether this translated to increased asthma rates at school-age. METHODS: This randomized, double-blind, placebo-controlled trial, conducted in Entebbe, Uganda, had three interventions...
September 11, 2017: Pediatric Allergy and Immunology
Kohei Ogawa, Satomi Tanaka, Limin Yang, Naoko Arata, Haruhiko Sago, Kiwako Yamamoto-Hanada, Masami Narita, Yukihiro Ohya
BACKGROUND: Although the beta-2 receptor agonist (B2RA) is occasionally prescribed in the prenatal period for women with preterm labor, few studies have referred to the long-term effects of intrauterine exposure to B2RA on fetus. We examined the association between intrauterine exposure to B2RA and asthma in the offspring. METHODS: We obtained data from a hospital-based birth cohort study conducted in Tokyo, Japan. The outcomes of interest were three indicators, consisting of current wheeze, current asthma and ever asthma at 5 years of age, based on the International Study of Asthma and Allergies in Childhood questionnaire...
September 11, 2017: Pediatric Allergy and Immunology
Carla Martins, Diana Silva, Milton Severo, João Rufo, Inês Paciência, Joana Madureira, Patrícia Padrão, Pedro Moreira, Luís Delgado, Eduardo Oliveira Fernandes, Henrique Barros, Pekka Malmberg, André Moreira
Spirometry and exhaled nitric oxide are two important complimentary tools to identify and assess asthma control in children. We aimed to determine the ability of a new suggested spirometry adjusted exhaled nitric oxide (NO) index in doing that. A random sample of 1602 schoolchildren were screened by a health questionnaire, skin-prick tests, spirometry with bronchodilation and exhaled NO. A total of 662 children were included with median (IQR) exhaled NO 11(14) ppb. ROC curves using exhaled NO equations from Malmberg, Kovesi and Buchvald, and spirometry adjusted exhaled NO values were applied to identify asthmatic children and uncontrolled asthma...
September 11, 2017: Pediatric Allergy and Immunology
Luis Moral, Jean-Cristoph Caubet
Suspected allergy to penicillins and cephalosporins is very common in childhood. After a proper evaluation, allergy will be confirmed only in a small portion of them. Intradermal tests are usually part of the allergy workup, but they are painful for children and time-consuming, and their role has been debated. A systematic review found only two studies reporting a positive predictive value of skin tests in children of 36% and 33%, respectively, leading to a high rate of inaccurate diagnosis. Moreover, considering that skin tests are negative in more than 90-95% of cases, an oral provocation test (OPT) is finally needed to confirm tolerance in most of these children...
September 11, 2017: Pediatric Allergy and Immunology
S M Dermendzhiev, R Sokolova, A A Chokoeva
A 16-year-old male patient, presented with one month-history of complaints of an acute pain in the neck, accompanied by relapsing acute headache, sometimes irradiating forward the left arm. The patient had been diagnosed with hereditary angioedema (HAE) type I at age of 7, because of recurrent, non-pruritic edemas, affecting the skin of the face, neck, chest and abdomen, accompanied by colic-like intestinal spasms and relapsing bronchospasms, occurring without provocation and laboratory confirmed low serum levels of C1 inhibitor (Fig...
September 7, 2017: Pediatric Allergy and Immunology
Birgit Filipiak-Pittroff, Sibylle Koletzko, Ursula Krämer, Marie Standl, Carl-Peter Bauer, Dietrich Berdel, Andrea von Berg
Breastfeeding has major benefits on infant health outcomes and their physical and mental development, but the effect on allergic disease risk remains controversial (1-3). We used the large GINIplus cohort (4) to study short and long term effects of full breastfeeding during the first 4 months compared to formula or mixed feeding on the occurrence of eczema, allergic rhinitis and asthma from birth up to age of 15 years. This article is protected by copyright. All rights reserved.
September 7, 2017: Pediatric Allergy and Immunology
Lucy Sucic, Virginie Galati-Fournier, Urs Kym, Viktoria Pfeifle, Stephanie Gros, Karl-Herbert Schäfer, Stefan Holland-Cunz, Simone Keck
Appendectomy of an inflamed appendix has been reported to be protective in the pathogenesis of ulcerative colitis (UC) in both mice and human (1, 2). In mice, the contribution of a suppressive T cell subset has been described. However, no human prospective study has investigated the generation of those protective cells. Using immunofluorescence microscopy we evaluate for the first time the generation of suppressor T cells during pediatric acute appendicitis in a small control-matched cohort study. This article is protected by copyright...
September 7, 2017: Pediatric Allergy and Immunology
Guillaume Pouessel, Stépanie Lejeune, Marie-Pierre Dupond, Annie Renard, Camille Fallot, Antoine Deschildre
The Individual Healthcare Plan (IHP) was implemented in schools in France in 2003 to improve management of allergic children. Our objectives were to assess the practical aspects of IHP (excluding asthma) and allergic reactions occurring at school. METHODS: Prospective study conducted in the North Department (France) during the 2015/2016 school-year. Two questionnaires were developed: one for the school doctors (n=67) and one for the school principals (n=2372). RESULTS: Data from 336 (25%) of the 1325 IHPs (0...
September 7, 2017: Pediatric Allergy and Immunology
N B Eijsvoogel, M I Hollegien, L A Bok, G Derksen-Lubsen, F P J Dikken, A C A P Leenders, A Pijning, E D M Post, M Wojciechowski, R Schmitz, M Hilbink, E de Vries
Children with Down syndrome (DS) often suffer from respiratory symptoms like wheezing, cough and dyspnea, especially in their preschool years(1). Healthcare professionals (and parents) often associate these symptoms with allergy or asthma(1-3), and prescribe anti-allergic and anti-asthmatic medication, especially in young DS children(3). Literature shows that allergic sensitization is present in around 27 to 40% of children in western countries(4-7). This article is protected by copyright. All rights reserved...
September 7, 2017: Pediatric Allergy and Immunology
Ricarda Meincke, Jitka Pokladnikova, Julie Straznicka, Ronald H B Meyboom, David Niedrig, Stefan Russmann, Ludek Jahodar
BACKGROUND: The use of herbal medicines in children and the general population is continually on the rise with an overall herbal lifetime and current use ranging between 0.8-85.5% and 2.2-8.9%, respectively. Although acute hypersensitivity reactions are generally considered to be rare, little knowledge exists on the frequency and type of these reactions especially in specific populations like children. OBJECTIVES: To assess the patterns of acute hypersensitivity reactions to herbal medicines reported to the WHO global individual case safety report (ICSR) database VigiBase(®) in children...
August 28, 2017: Pediatric Allergy and Immunology
Roxane Labrosse, François Graham, Philippe Bégin, Kathryn Samaan, Louis Paradis, Anne Des Roches, Jonathan Lacombe-Barrios
Fixed drug eruption (FDE) is a distinctive type of delayed drug hypersensitivity that presents with dermal inflammation of limited involvement recurring at the same location upon exposure to the culprit drug. It is typically characterized by an erythematous single lesion with sharp margins, even though multiple-site involvement can also occur. Appropriate testing to confirm diagnosis is still debated, although graded drug provocation test (DPT) seems to be more sensitive (1). Drugs most frequently associated with FDE include analgesics, antimalarials, barbiturates and antibiotics, including amoxicillin (2, 3)...
August 28, 2017: Pediatric Allergy and Immunology
Leonard Rosenfeld, Andreas Mas Marques, Sandra Niendorf, Jörg Hofmann, Alexander Gratopp, Jörn-Sven Kühl, Johannes H Schulte, Horst von Bernuth, Sebastian Voigt
Rotavirus (RV) infections are the major cause of severe gastroenteritis in children under five years of age, causing 215,000 deaths per year worldwide mainly due to dehydration in countries with weak economic resources (1). In the immunocompetent host RV infections are self-limiting and mortality is low in high-income countries. Notifications of RV cases have declined from 49,000 in season 2012/2013 to 25,000 in season 2015/2016 (2) since RV vaccination has been recommended by the Standing Committee on Vaccination (STIKO) in Germany in 2013...
August 17, 2017: Pediatric Allergy and Immunology
Manuel José Ferreira de Magalhães, Rita da Silva Amaral, Ana Margarida Pereira, Ana Isabel Alves de Sá E Sousa Santos, Maria Inês Águeda de Azevedo, Luís Filipe Ribeiro de Azevedo, João Almeida Lopes Fonseca
BACKGROUND: Childhood asthma is very prevalent and costs can be high, especially in severe disease. This study aimed to estimate the cost of asthma in Portuguese children and the variations by level of asthma control. METHODS: A nationwide, population- and prevalence-based cost-of-illness study with a societal perspective was conducted. We measured direct and indirect costs using a bottom-up approach and a human capital method, respectively, for 208 children (<18 years), from two national repositories...
August 17, 2017: Pediatric Allergy and Immunology
Ireneous N Soyiri, Bright I Nwaru, Aziz Sheikh
We welcome the critique by Apfelbacher and colleagues (1) of our overview of patient-reported outcome measures (PROMS) in allergy and asthma clinical studies in children (2) . Our focus was on identifying valid instruments and in so doing we relied on our own detailed systematic reviews in relation to asthma and food allergy (3-5) , recent evidence-based guidelines on PROMS in allergy (6) , and systematic reviews undertaken by others in atopic eczema/dermatitis and allergic rhinitis (7) . We agree that on a closer look at the primary evidence in relation to PROMs for atopic eczema/dermatitis, whilst there is some evidence of validation work in relation to Infants' Dermatitis Quality of Life Index (IDQOL) (8 9) , the overall validity of this instrument still remains to be established...
August 17, 2017: Pediatric Allergy and Immunology
John Wei-Liang Tan, Paul J Turner, Carolina Valerio, Rebecca Sertori, Elizabeth H Barnes, Dianne E Campbell
The timing of introduction of solids and/or complementary feeds continues to be an area of intense interest with respect to allergy prevention and general optimal infant nutrition. There is recent evidence from RCTs (1-3) and a meta-analysis(1), that the earlier introduction of peanut (between 4 and 11 months) and egg (between 4 and 6 months), in infants at higher risk of allergic disease, may be beneficial. However, concerns have been raised over the impact this may have on duration of breastfeeding, nutrition and growth, when a high protein and calorie-containing food, such as egg or peanut, is introduced...
August 17, 2017: Pediatric Allergy and Immunology
Bright I Nwaru, Kishor Hadkhale, Niina Hämäläinen, Hanna-Mari Takkinen, Suvi Ahonen, Jorma Ilonen, Jorma Toppari, Onni Niemelä, Anna-Maija Haapala, Riitta Veijola, Mikael Knip, Suvi M Virtanen
BACKGROUND: Early-life vitamin D intake has been linked to asthma risk in childhood, but the role of longitudinal vitamin D exposure has not been previously evaluated. We investigated the association between vitamin D intake during the first 4 years of life and asthma risk by age 5. METHODS: Within a Finnish population-based birth cohort, 182 incident asthma cases were matched to 728 controls on sex, genetic risk for type 1 diabetes, delivery hospital, and time of birth...
August 17, 2017: Pediatric Allergy and Immunology
Mª Victoria Moreno, Esther Caparrós, Javier Fernández, Purificación González-Delgado
FPIES is a severe non-IgE-mediated food hypersensitivity that typically occurs within the first months of life characterized by profuse vomiting and diarrhea, with progression to dehydration and shock in some patients (1). Normally, it is caused by cow's milk and/or soy but in the last years many other foods have been implicated. This article is protected by copyright. All rights reserved.
August 8, 2017: Pediatric Allergy and Immunology
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