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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
Ozlem Cavkaytar, George du Toit, Davide Caimmi
Non-steroidal anti-inflammatory drugs (NSAIDs) are available as over-the-counter drugs, and they are commonly used in children for their antipyretic, analgesic and anti-inflammatory effects. NSAIDs are among the most frequently reported drugs associated with hypersensitivity reactions and even with anaphylaxis. A complete evaluation of the patients based on reported clinical manifestations, timing of the reaction, presence of underlying disease and reactions to other NSAIDs allows clinicians to stratify children with a history of reaction to NSAIDs...
September 8, 2018: Pediatric Allergy and Immunology
Kate Maslin, Adam T Fox, Marleen Chambault, Rosan Meyer
BACKGROUND: Cows' milk protein allergy (CMPA) is the most common food allergy in infants in the United Kingdom. Infants with CMPA who are not exclusively breastfed require a substitute hypoallergenic formula, which are perceived as having a poor palatability. This study compares the palatability of different extensively hydrolysed formulas (EHFs) and explores healthcare professional (HCP) expectations of how palatability impacts infants and their families. METHODS: HCPs with experience of CMPA were recruited to take part in a home palatability test of four EHFs [Aptamil Pepti 1,Nutricia Ltd...
September 7, 2018: Pediatric Allergy and Immunology
María Flora Martin-Muñoz, María Teresa Belver, Elena Alonso, Lidia Zapatero, Victoria Fuentes, Mónica Piqué, Ana María Plaza, Candelaria Muñoz, Cristina Martorell, Antonio Martorell, Cristina Blasco, Blanca Villa, Catalina Gómez, Santiago Nevot, Juan Maria García, Rosario Madero, Luis Echeverria
BACKGROUND: Studies are required before incorporating egg-oral-immunotherapy (OIT) into clinical practice. The Spanish-Society of Pediatric-Allergy-Asthma and Clinical-Immunology (SEICAP) conducted a multicenter-randomized-controlled study assessing effectiveness and safety of OIT using pasteurized-egg-white (PEW) in egg-allergic-children. METHODS: One-hundred-one egg-allergic children (6-9 years) were randomized for one year: 25 to an egg-free-diet (CG) and 76 to OIT (target-dose 3...
August 31, 2018: Pediatric Allergy and Immunology
Abbas Taghavi Ardakani, Maryam Farrehi, Mohammad Reza Sharif, Vahidreza Ostadmohammadi, Naghmeh Mirhosseini, Davood Kheirkhah, Seyed Gholam Abbas Moosavi, Milad Behnejad, Russel J Reiter, Zatollah Asemi
BACKGROUND: The aim of this clinical trial was to determine the effects of melatonin administration on disease severity and sleep quality in children diagnosed with atopic dermatitis (AD). METHODS: This randomized, double-blinded, placebo-controlled trial was conducted by recruiting 70 patients, 6-12 years of age, who had been diagnosed with AD. Study participants were randomly allocated into two intervention groups to receive either 6 mg/day melatonin supplements or placebo (n=35 each group) for 6 weeks...
August 29, 2018: Pediatric Allergy and Immunology
Maria-Viola Martikainen, Teemu J Rönkkö, Bianca Schaub, Martin Täubel, Cheng Gu, Gary Wk Wong, Jing Li, Juha Pekkanen, Mika Komppula, Maija-Riitta Hirvonen, Pasi I Jalava, Marjut Roponen
BACKGROUND: Studies conducted in farm environments suggest that diverse microbial exposure promotes children's lung health. The underlying mechanisms are unclear and the development of asthma-preventive strategies has been delayed. More comprehensive investigation of the environment-induced immunoregulation is required for better understanding of asthma pathogenesis and prevention. Exposure to air pollution, including particulate matter (PM), is a risk factor for asthma, thus providing an excellent counterpoint for the farm-effect research...
August 28, 2018: Pediatric Allergy and Immunology
Yu Xia, Tingyan He, Yin Luo, Chengrong Li, Che Kang Lim, Hassan Abolhassani, Jun Yang, Lennart Hammarström
BACKGROUND: Primary immunodeficiency disorders (PID) is a group of heterogeneous diseases mainly characterized by severe and recurrent infections and an increased susceptibility to lymphoproliferative, atopic and autoimmune conditions. The clinical diagnosis should preferably be complemented by a genetic diagnosis. To date, PID-related reports from China seldom attempt to make a genetic test for their patients. METHODS: Our study aims to evaluate demographic data, clinical manifestations and molecular diagnosis of PID patients from southern China...
August 28, 2018: Pediatric Allergy and Immunology
Laura Toivonen, Kohei Hasegawa, Nadim J Ajami, Juan C Celedón, Jonathan M Mansbach, Joseph F Petrosino, Carlos A Camargo
Bronchiolitis is the leading cause of hospitalization in U.S. infants, among which approximately 15% require intensive care.1 Emerging evidence suggest a complex interplay between viral infection, airway microbiota, and host immune response in the pathobiology of bronchiolitis.2 Vitamin D compounds have pleiotropic regulatory roles on both innate and adaptive immune responses.3 Low levels of 25-hydroxyvitamin D (25OHD), the major circulating form of vitamin D, have been found to be associated with higher risk and severity of acute respiratory infections (ARIs) in children...
August 28, 2018: Pediatric Allergy and Immunology
Tsung-Ju Wu, Shih-Chun Pan, Bing-Yu Chen, Wei-Shan Chin, Yue Leon Guo
Research has reported heterogeneity in longitudinal wheezing patterns arising in childhood. Data-driven approaches have also identified 4 wheezing trajectory phenotypes in childhood asthma in 2 longitudinal cohorts when the types of transient early and prolonged early wheezing were grouped together. However, a large-scale study following patients from birth to the age of 10 years revealed 3 asthma trajectory phenotypes. This article is protected by copyright. All rights reserved.
August 24, 2018: Pediatric Allergy and Immunology
Tshegofatso Mabelane, Wisdom Basera, Maresa Botha, Heidi Facey Thomas, Jordache Ramjith, Michael E Levin
BACKGROUND: Severe meat allergy with anaphylaxis may be caused by sensitisation to alpha-gal. Levels of alpha-gal sensitisation that correlate with high risk of meat allergy are currently unknown. We have identified an area with a high prevalence of reported red meat allergy which offered the opportunity to evaluate the diagnostic value of IgE antibody tests. METHODS: To determine levels of alpha-gal IgE and alpha-gal:total IgE ratio in a large cohort of subjects with challenge proven meat allergy compared with control subjects from the same environment, we conducted fieldwork assessing 131 participants who reported adverse reactions to meat, and 26 control subjects, by questionnaires, IgE sensitisation to alpha-gal and oral food challenge to beef sausage...
August 24, 2018: Pediatric Allergy and Immunology
Andreas Boeck, Katja Landgraf-Rauf, Vanessa Vogelsang, Diana Siemens, Olivia Prazeres da Costa, Elisabeth Klucker, Erika von Mutius, Thorsten Buch, Ulrich Mansmann, Bianca Schaub
BACKGROUND: Asthma is the most common chronic disease in children. Underlying immunological mechanisms - in particular of different phenotypes - are still just partly understood. The objective of the study is the identification of distinct cellular pathways in allergic asthmatics (AA) and non-allergic asthmatics (NA) vs healthy controls (HC). METHODS: Peripheral blood mononuclear cells (PBMCs) of steroid-naïve children (n(AA/NA/HC) = 35/13/34)) from the CLARA study (n=275) were stimulated (anti-CD3/CD28, LpA) or kept unstimulated...
August 13, 2018: Pediatric Allergy and Immunology
Claudia Fantacci, Paolo Mariotti, Stefano Miceli Sopo, Pietro Ferrara, Claudia Rendeli, Antonio Chiaretti
Melkersson-Rosenthal syndrome (MRS) is a rare, noncaseating granulomatous disease consisting of persistent or recurrent orofacial edema, relapsing peripheral facial paralysis and fissured tongue (1). Oligosymptomatic and monosymptomatic forms are more common than the complete triad (2). MRS is more frequent in young adults between the second and the third decades of life (3), while data about childhood are actually poor. This article is protected by copyright. All rights reserved.
August 13, 2018: Pediatric Allergy and Immunology
Michael R Goldberg, Liat Nachshon, Tali Sinai, Naama Epstein-Rigbi, Yael Oren, Eli Eisenberg, Yitzhak Katz, Arnon Elizur
BACKGROUND: Earlier studies noted that young adults with IgE-mediated cow's milk allergy (IgE-CMA) have significantly lower bone mineral density (BMD) than age- and gender-matched controls. We sought to identify additional risk factors contributing to the low BMD in IgE-CMA patients. METHODS: Post-pubertal (defined by Tanner stage V) IgE-CMA patients (n=78, 16-30-years-old females; 17.5-30-years-old males) were evaluated prospectively for BMD using a DXA scan, serum values of bone turnover factor, and dietary and lifestyle questionnaires...
August 11, 2018: Pediatric Allergy and Immunology
Francesco Saettini, Daniele Moratto, Andrea Grioni, Silvia Maitz, Maria Iascone, Carmelo Rizzari, Fabio Pavan, Marco Spinelli, Laura Rachele Bettini, Andrea Biondi, Raffaele Badolato
The Rubinstein-Taybi syndrome (RSTS; OMIM #180849, #613684) is a rare developmental disorder characterized by craniofacial dysmorphisms, broad thumbs and toes, and mental and growth deficiency. It affects equally males and females, with prevalence of 1:100.000 to 1:125.000 liveborn infants. Mutations in the cyclic adenosine monophosphate response element-binding protein (CREB)-binding protein (CREBBP) or in the E1A-associated protein p300 (EP300) have been demonstrated in 55% (RSTS1) and up to 8% of the patients (RSTS2), respectively...
August 4, 2018: Pediatric Allergy and Immunology
Asya V Kudryavtseva, Katerina A Neskorodova, Petra Staubach
The present survey represents the latest data on diagnosis and management of childhood urticaria. It has been observed that urticaria occurs less often in children than adults, with symptoms rarely lasting for over 6 weeks. Triggers or aggravating factors can be found only in 21-55% of cases. Finding autoantibodies in children does not impact a disease prognosis, unlike in adult patients, where the presence of autoantibodies is associated with a more prolonged run of the disease, a more severe prognosis and more intensive treatment methods...
August 4, 2018: Pediatric Allergy and Immunology
Umit Murat Sahiner, Esra Birben, Serpil Erzurum, Cansin Sackesen, Omer Kalayci
An imbalance between the production of reactive oxygen species and the capacity of antioxidant defense mechanisms favoring oxidants is called oxidative stress and is implicated in asthmatic inflammation and severity. Major reactive oxygen species that are formed endogenously include hydrogen peroxide, superoxide anion, hydroxyl radical and hypohalite radical; and the major antioxidants that fight against the endogenous and environmental oxidants are superoxide dismutase, catalase and glutathione. Despite the well known presence of oxidative stress in asthma, studies that target oxidative burden using a variety of nutritional, pharmacological and environmental approaches have generally been disappointing...
August 1, 2018: Pediatric Allergy and Immunology
Sandra Scheiblhofer, Josef Thalhamer, Richard Weiss
Allergen-specific immunotherapy, which is performed by subcutaneous injection or sublingual application of allergen extracts, represents an effective treatment against type I allergic diseases. However, due to the long duration and adverse reactions, only a minority of patients decides to undergo this treatment. Alternatively, early prophylactic intervention in young children has been proposed to stop the increase in patient numbers. Plasmid DNA and mRNA vaccines encoding allergens have been shown to induce T helper 1 as well as T regulatory responses, which modulate or counteract allergic T helper 2-biased reactions...
July 31, 2018: Pediatric Allergy and Immunology
Benjamin C Remington, Tanja Krone, Stef Koppelman
BACKGROUND: The clinical relevance of increasing an allergic individual's peanut sensitivity threshold by immunotherapy, i.e., eliciting dose (ED) to 300 or 1000 mg peanut protein, has not been previously characterized in a European population. In this study, we quantify the clinical benefits of an increased threshold of reaction following immunotherapy for the peanut-allergic individual. METHODS: Quantitative risk assessments incorporated numerous inputs to predict the risk of an allergic reaction after exposure to residual peanut protein in packaged foods...
July 28, 2018: Pediatric Allergy and Immunology
Chien-Hung Lin, Peir-Haur Hung, Hsiao-Yun Hu, Chi-Jung Chung, Tsung-Hsien Chen, Kuan-Yu Hung
BACKGROUND: Urticaria is one of the most common diseases seen in clinical practice, whereas several reports have proposed that urticaria may have a link with autoimmune disorders. Few studies have examined the clinical association between urticaria with systemic lupus erythematosus (SLE). By conducting a nationwide population-based case-control study in Taiwan, we evaluated the risk of SLE in children with a prior clinical diagnosis of urticaria. METHODS: Using 2000-2011 claims data from the Taiwanese National Health Insurance Research Database, we identified 2105 SLE children during 2004-2011 as the study group, along with randomly selected 8420 non-SLE patients matched (1:4) for age, sex, and first diagnosis date as the control group...
July 28, 2018: Pediatric Allergy and Immunology
Rosan Meyer
The elimination of food allergens that contribute essential nutrients in paediatrics, may lead to the development of nutritional disorders. The most common nutritional disorders include poor growth, micronutrient deficiencies and feeding difficulties. Of the aforementioned, growth faltering has been well studied and is seen as a common presenting factor in paediatric food allergy. However, the use of different criteria and cut-off values makes it difficult to establish and overall effect. The impact of number and type of foods eliminated and co-morbidities have yielded varying results, although there seems to be a trend towards worsening growth with atopic dermatitis and the avoidance of cow's milk...
July 25, 2018: Pediatric Allergy and Immunology
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