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REVIEW
Susan Waserman, Philippe Bégin, Wade Watson
Food allergy is defined as an adverse immunologic response to a food protein. Food-related reactions are associated with a broad range of signs and symptoms that may involve any body system, including the skin, gastrointestinal and respiratory tracts, and cardiovascular system. Immunoglobulin E (IgE)-mediated food allergy is a leading cause of anaphylaxis and, therefore, referral to an allergist for timely and appropriate diagnosis and treatment is imperative. Diagnosis entails a careful history and diagnostic tests, such as skin prick tests, serum-specific IgE and, if indicated, an oral food challenge...
2018: Allergy, Asthma, and Clinical Immunology
#22
JOURNAL ARTICLE
K Simonyté Sjödin, M-L Hammarström, P Rydén, A Sjödin, O Hernell, L Engstrand, C E West
BACKGROUND: Compositional changes in the early-life gut microbiota have been implicated in IgE-associated allergic diseases, but there is lack of longitudinal studies. We examined gut microbiota development from infancy to school age in relation to onset of IgE-associated allergic diseases. At 8 years of age, we also examined the relationship between gut microbiota and T-cell regulation, estimated as responses to polyclonal T-cell activation. METHODS: Stool samples were collected from 93 children at 4, 6, 13 months, and 8 years of age...
January 2019: Allergy
#23
JOURNAL ARTICLE
C E Rosenberg, M K Mingler, J M Caldwell, M H Collins, P C Fulkerson, D W Morris, V A Mukkada, P E Putnam, T Shoda, T Wen, M E Rothenberg
BACKGROUND: Recent data associate eosinophilic esophagitis (EoE) with IgG4 rather than IgE, but its significance and function have not been determined. Our aims were to measure esophageal IgG4 levels and to determine functional correlations as assessed by histologic and transcriptome analyses. METHODS: This case-control study included pediatric subjects with EoE (≥15 eosinophils/HPF) and non-EoE controls. Protein lysates were analyzed for IgA, IgM, and IgG1-IgG4 using the Luminex 100 system; IgE was quantified by ELISA...
September 2018: Allergy
#24
REVIEW
K Martens, B Pugin, I De Boeck, I Spacova, B Steelant, S F Seys, S Lebeer, P W Hellings
Probiotics are live microorganisms that, when administered in adequate amounts, confer health benefit on the host. The therapeutic effects of probiotics have been mostly studied in the gastrointestinal tract, but recent evidence points toward the potential of these bacteria to prevent and/or treat chronic airway diseases. In this review, possible mechanisms of action of probiotics in the airways are described, with a particular focus on their capacity to modulate the epithelial barrier function and their mode of interaction with the immune system...
October 2018: Allergy
#25
REVIEW
Paul J Dowling, Hannah Neuhaus, Brooke I Polk
Eosinophilic esophagitis (EoE) is a chronic, immune-mediated inflammatory disease with incompletely understood pathogenesis. Though disease manifestations were initially ascribed to a delayed reaction to food allergens, emerging evidence suggests that modifiable host factors and environmental allergen exposure may also play critical roles in the pathogenesis and ongoing manifestations of EoE. As with other atopic diseases, lack of early-life exposure to microbial pathogens leads to an immune tolerance defect and reprograms the commensal gut microflora toward a type 2 T helper (Th2) phenotype; the esophageal microbiota, a rich environment consisting of diverse bacterial species, is greatly altered by inflammation...
December 2019: Clinical Reviews in Allergy & Immunology
#26
REVIEW
John K DiBaise, Lucinda A Harris, Brent Goodman
Postural tachycardia syndrome (POTS) is one of the most common causes of orthostatic intolerance and is being increasingly recognized in clinical practice. Gastrointestinal (GI) symptoms are reported commonly in patients with POTS and pose a considerable management challenge, making it imperative that gastroenterologists be aware of this condition and its GI comorbidities. Although the evidence presented herein does not prove causation, it does support an association between GI symptoms, GI dysmotility, and POTS...
October 2018: American Journal of Gastroenterology
#27
REVIEW
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 the overall effect. The impact of number and type of foods eliminated and comorbidities has yielded varying results, although there seems to be a trend towards worsening growth with atopic dermatitis and the avoidance of cow's milk...
November 2018: Pediatric Allergy and Immunology
#28
REVIEW
Evan S Dellon, Chris A Liacouras, Javier Molina-Infante, Glenn T Furuta, Jonathan M Spergel, Noam Zevit, Stuart J Spechler, Stephen E Attwood, Alex Straumann, Seema S Aceves, Jeffrey A Alexander, Dan Atkins, Nicoleta C Arva, Carine Blanchard, Peter A Bonis, Wendy M Book, Kelley E Capocelli, Mirna Chehade, Edaire Cheng, Margaret H Collins, Carla M Davis, Jorge A Dias, Carlo Di Lorenzo, Ranjan Dohil, Christophe Dupont, Gary W Falk, Cristina T Ferreira, Adam Fox, Nirmala P Gonsalves, Sandeep K Gupta, David A Katzka, Yoshikazu Kinoshita, Calies Menard-Katcher, Ellyn Kodroff, David C Metz, Stephan Miehlke, Amanda B Muir, Vincent A Mukkada, Simon Murch, Samuel Nurko, Yoshikazu Ohtsuka, Rok Orel, Alexandra Papadopoulou, Kathryn A Peterson, Hamish Philpott, Philip E Putnam, Joel E Richter, Rachel Rosen, Marc E Rothenberg, Alain Schoepfer, Melissa M Scott, Neil Shah, Javed Sheikh, Rhonda F Souza, Mary J Strobel, Nicholas J Talley, Michael F Vaezi, Yvan Vandenplas, Mario C Vieira, Marjorie M Walker, Joshua B Wechsler, Barry K Wershil, Ting Wen, Guang-Yu Yang, Ikuo Hirano, Albert J Bredenoord
BACKGROUND & AIMS: Over the last decade, clinical experiences and research studies raised concerns regarding use of proton pump inhibitors (PPIs) as part of the diagnostic strategy for eosinophilic esophagitis (EoE). We aimed to clarify the use of PPIs in the evaluation and treatment of children and adults with suspected EoE to develop updated international consensus criteria for EoE diagnosis. METHODS: A consensus conference was convened to address the issue of PPI use for esophageal eosinophilia using a process consistent with standards described in the Appraisal of Guidelines for Research and Evaluation II...
October 2018: Gastroenterology
#29
REVIEW
Mark Rochman, Nurit P Azouz, Marc E Rothenberg
Eosinophilic esophagitis (EoE) is a chronic, allergen-driven inflammatory disease of the esophagus characterized predominantly by eosinophilic inflammation, leading to esophageal dysfunction. Converging data have placed the esophageal epithelium at the center of disease pathogenesis. In particular, the main EoE disease susceptibility loci at 2p23 and 5p22 encode for gene products that are produced by the esophageal epithelium: the intracellular protease calpain 14 and thymic stromal lymphopoietin, respectively...
July 2018: Journal of Allergy and Clinical Immunology
#30
REVIEW
Stacy B Menees, Corey Powell, Jacob Kurlander, Akash Goel, William D Chey
OBJECTIVES: Irritable bowel syndrome (IBS) is viewed as a diagnosis of exclusion by most providers. The aim of our study was to perform a systematic review and meta-analysis to evaluate the utility of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fecal calprotectin, and fecal lactoferrin to distinguish between patients with IBS and inflammatory bowel disease (IBD) and healthy controls (HCs). METHODS: A systematic online database search was performed...
March 2015: American Journal of Gastroenterology
#31
REVIEW
Joana Gomes-Belo, Farah Hannachi, Kate Swan, Alexandra F Santos
An accurate diagnosis of food allergy is extremely important to guide safe and yet not overly restrictive dietary management. The cornerstone of the diagnosis of food allergy is the clinical history; it allows appropriate selection of the allergens to be tested and interpretation of the results of allergy tests, namely Skin Prick Test (SPT), Specific IgE (sIgE) to allergen extracts and, more recently, specific IgE to allergen components and the Basophil Activation Test (BAT). SPT and sIgE to allergen extracts are very sensitive methods to detect IgE sensitization to a specific food and assess the possibility of spontaneous resolution...
2018: Current Pediatric Reviews
#32
REVIEW
Jonathan Spergel, Seema S Aceves
Eosinophilic esophagitis (EoE) is a disorder of increasing prevalence worldwide, causing clinical symptoms of vomiting, failure to thrive, and dysphagia and complications of esophageal remodeling with strictures and food impactions. Molecular profiling demonstrates EoE to be an eosinophil-predominant disorder with a TH 2 cytokine profile reminiscent of other allergic diseases, such as asthma, allergic rhinitis, and atopic dermatitis. Environmental antigens in the form of foods and aeroallergens induce eosinophil, basophil, mast cell, and T-cell infiltration...
July 2018: Journal of Allergy and Clinical Immunology
#33
JOURNAL ARTICLE
Antonio Di Sabatino, Marco V Lenti, Gino R Corazza, Carmen Gianfrani
Autoimmune and allergic disorders are highly prevalent conditions in which an altered or abnormal immune response is mounted against self- or environmental antigens, respectively. Antigen-based immunotherapy is a therapeutic option aimed at restoring the specific immune tolerance toward pathogenic antigens while leaving the rest of the immune system unaffected. This strategy proved efficacy especially in allergic diseases, including asthma, allergic rhinitis, and food allergies, but still has shortcomings for the treatment of autoimmune diseases...
2018: Frontiers in Medicine
#34
JOURNAL ARTICLE
Alexander J Schuyler, Jeffrey M Wilson, Anubha Tripathi, Scott P Commins, Princess U Ogbogu, Patrice G Kruzsewski, Barrett H Barnes, Emily C McGowan, Lisa J Workman, Jonas Lidholm, Sheryl L Rifas-Shiman, Emily Oken, Diane R Gold, Thomas A E Platts-Mills, Elizabeth A Erwin
BACKGROUND: Allergen-specific IgG4 (sIgG4 ) antibodies are often associated with tolerance, but sIgG4 antibodies to causally relevant foods have been reported recently in adults with eosinophilic esophagitis (EoE). Prevalence and levels of food sIgG4 are not well established in the general pediatric population. OBJECTIVE: We sought to investigate serum food sIgG4 with component diagnostics in children with EoE and children from an unselected birth cohort and to explore the effects of sex, age, and milk consumption on sIgG4 levels...
July 2018: Journal of Allergy and Clinical Immunology
#35
REVIEW
Mery Munoz-Persy, Alfredo J Lucendo
UNLABELLED: Eosinophilic esophagitis (EoE) is a unique form of non-IgE-mediated food allergy characterized by esophageal eosinophilic infiltration that commonly causes dysphagia and food impaction in children and adolescents. Assessing the efficacy of dietary restrictions or drug therapies to achieve clinical and histologic resolution of EoE through randomized controlled trials and meta-analyses has resulted in new evidence-based guidelines. Avoiding food triggers is the only therapy targeting the cause of the disease...
May 2018: European Journal of Pediatrics
#36
JOURNAL ARTICLE
Prolonged Time to Diagnosis of Eosinophilic Esophagitis Despite Increasing Knowledge of the Disease.
Craig C Reed, Nathaniel T Koutlas, Benjamin S Robey, Jason Hansen, Evan S Dellon
Eosinophilic esophagitis (EoE) is a chronic condition characterized by eosinophilic-predominant inflammation and esophageal dysfunction.1,2 EoE represents a rapidly increasing cause of morbidity and a growing health problem.
October 2018: Clinical Gastroenterology and Hepatology
#37
REVIEW
Vanitha Sampath, Sayantani B Sindher, Wenming Zhang, Kari C Nadeau
No abstract text is available yet for this article.
March 2018: Annals of Allergy, Asthma & Immunology
#38
COMMENT
Samuel Ellison, Hamish Philpott
No abstract text is available yet for this article.
August 2018: Journal of Pediatric Gastroenterology and Nutrition
#39
JOURNAL ARTICLE
Rachel Rosen, Yvan Vandenplas, Maartje Singendonk, Michael Cabana, Carlo DiLorenzo, Frederic Gottrand, Sandeep Gupta, Miranda Langendam, Annamaria Staiano, Nikhil Thapar, Neelesh Tipnis, Merit Tabbers
This document serves as an update of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) 2009 clinical guidelines for the diagnosis and management of gastroesophageal reflux disease (GERD) in infants and children and is intended to be applied in daily practice and as a basis for clinical trials. Eight clinical questions addressing diagnostic, therapeutic and prognostic topics were formulated...
March 2018: Journal of Pediatric Gastroenterology and Nutrition
#40
EDITORIAL
Eunice Odiase, Armond Schwartz, Rhonda F Souza, Jason Martin, Vani Konda, Stuart Jon Spechler
No abstract text is available yet for this article.
April 2018: Gastroenterology
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