Lack of detection of circulating skin-specific IgE autoantibodies in dogs with moderate or severe atopic dermatitis

The pediatrician is faced with evaluating a panoply of skin rashes, a subset of which may be induced by food allergy. Acute urticaria is a common manifestation of an allergic skin response to food, but food is rarely a cause of chronic urticaria. Approximately one third of infants/children with moderate to severe atopic dermatitis have food allergy. Although diagnosis of acute urticaria provoked by a food may be evident from a straightforward history and confirmed by diagnostic tests to detect food-specific IgE antibody, determination of the role of food allergy in patients with atopic dermatitis is more difficult and may require additional diagnostic maneuvers, including elimination diets and oral food challenges. The immunopathologic basis of food-allergic disorders that affect the skin and a rational approach to diagnosis and treatment are discussed. Additional disorders that are caused by or mimic ones caused by food allergy are reviewed.

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Increased Frequency of CTLA-4 and PD-1 Expressing Regulatory T Cells and Basophils With an Activating Profile in Infants With Moderate-to-Severe Atopic Dermatitis Hypersensitized to Food Allergens

Frontiers in Pediatrics ◽

10.3389/fped.2021.734645 ◽

2021 ◽

Vol 9 ◽

Author(s):

Agurtzane Bilbao ◽

Raquel Pérez-Garay ◽

Idoia Rius ◽

Alex Irurzun ◽

Iñigo Terrén ◽

...

Keyword(s):

Atopic Dermatitis ◽

Specific Ige ◽

Treg Cells ◽

Severe Atopic Dermatitis ◽

Healthy Controls ◽

Food Allergens ◽

Phenotypic Analysis ◽

Healthy Donors ◽

Food Antigens ◽

Complementary Diet

Background: Infants with severe atopic dermatitis (AD) may be sensitized to foods that have not been introduced into their diet, posing a risk for developing an immediate hypersensitivity reaction on the first exposure to the food to which they are sensitized. The aim of this work was to perform an analysis of the sensitization profile in infants with moderate-to-severe AD and to identify cellular and molecular markers for food allergy (FA).Methods: Blood samples from healthy donors and children with moderate-to-severe AD were studied. Specific IgE to several allergens were determined using ImmunoCAP FEIA system and ISAC technology. Furthermore, using flow cytometry-based studies, basophils and regulatory T (Treg) cells were phenotypically characterized.Results: 90% of children with AD were sensitized to food antigens before introducing them into the diet, and 100% developed FA. Phenotypic analysis showed a significantly higher percentage of CTLA-4 and PD-1 expressing Treg cells in AD patients than in healthy controls. Basophils from patients exhibited a marked reduction in the expression of CD300a, higher expression of FcεRI and CXCR4, and to some extent higher expression of CD63 and CD300c.Conclusions: Infants with moderate-to-severe AD are at high risk of being sensitized to food allergens. Therefore, to avoid allergic reactions, broad-spectrum sensitization studies are necessary before introducing complementary diet. Increased expression of CTLA-4 and PD-1 suggests greater suppressive potential of Treg cells in infants with AD than healthy controls. Furthermore, our results suggest a role for CD300 molecules on circulating basophils as possible biomarkers for FA susceptibility.

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Severe atopic dermatitis in a boy with potato allergy

Pediatria i Medycyna Rodzinna ◽

10.15557/pimr.2020.0055 ◽

2020 ◽

Vol 16 (3) ◽

pp. 301-305

Author(s):

Jędrzej Przekora ◽

◽

Agata Wawrzyniak ◽

Anna Bujnowska ◽

Agnieszka Rustecka ◽

...

Keyword(s):

Atopic Dermatitis ◽

Food Allergy ◽

Dietary Intervention ◽

Paediatric Population ◽

Specific Ige ◽

Primary Treatment ◽

Elimination Diet ◽

Severe Form ◽

Severe Atopic Dermatitis ◽

Skin Prick Tests

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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THE FUNCTIONAL STATUS OF THE SKIN BARRIER IN CHILDREN WITH ATOPIC DERMATITIS

Rossiiskii Allergologicheskii ZHurnal ◽

10.36691/rja628 ◽

2013 ◽

Vol 10 (1) ◽

pp. 52-57

Author(s):

E T Kindeeva ◽

E E Varlamov ◽

A N Pampura

Keyword(s):

Staphylococcus Aureus ◽

Atopic Dermatitis ◽

Topical Therapy ◽

Skin Barrier ◽

Specific Ige ◽

Transepidermal Water Loss ◽

Severe Atopic Dermatitis ◽

Skin Ph ◽

Skin Colonization

Introduction. One of the factors in the pathogenesis of atopic dermatitis is a dysfunction of the skin barrier. Background. To reveal the features of the barrier function of the skin in children with atopic dermatitis by measuring transepidermal water loss (TEWL) and the pH of the skin. Methods. The study included 98 children with atopic dermatitis. All patients measurement was performed by TEWL (Tewameter TM 300, Multi Probe Adapter MPA 5/9, Courage + Khazaka) and the pH of the skin (Skin-pHMeter, Multi Probe Adapter MPA 5/9, Courage + Khazaka). Results. TEWL value was significantly higher in children with severe atopic dermatitis (p=0,00001), in children up to 3 years (p=0,002), in patients with skin colonization of Staphylococcus aureus (p=0,006) and with specific IgE to staphylococcal enterotoxins. Skin pH was significantly higher in children with severe atopic dermatitis (p=0,0001), and in children under the age of 3 years (p=0,04). Conclusion. The determination of the level of TEWL and skin pH to assess the degree of inflammation activity in atopic dermatitis and to justify use of topical therapy, aimed to restoring the epidermal barrier of the skin at children with atopic dermatitis, is substantiated.

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Unexpected Cat Allergy in Infants with Persistent Atopic Dermatitis

Journal of Dr Behcet Uz Children s Hospital ◽

10.5222/buchd.2021.26213 ◽

2021 ◽

Author(s):

Serdar Al ◽

Suna Asilsoy ◽

Özden Anal ◽

Dilek Tezcan ◽

Seda Şirin Köse ◽

...

Keyword(s):

Atopic Dermatitis ◽

Food Allergy ◽

Allergic Diseases ◽

Specific Ige ◽

Elimination Diet ◽

Severe Atopic Dermatitis ◽

Barrier Dysfunction ◽

Prick Test ◽

Cat Allergy ◽

History Of

Atopic dermatitis is a chronic, recurrent inflammatory skin disease usually caused by genetic predisposition, immune dysregulation, epidermal barrier dysfunction and interaction of environmental factors. Atopic dermatitis is part of atopic march and is often accompanied by food allergy. Aeroallergenic sensitization at early age is not an expected finding. Here, we present five cases with moderate-severe atopic dermatitis during infancy, in whom food allergy was detected and the symptoms improved only partially despite elimination and treatment. Sensitization was investigated in patients with a history of intense exposure to cats by specific IgE and skin prick test in infants with atopic dermatitis who had food allergy and persistant findings. Egg allergy was detected in four of the cases, wheat allergy in one. Cat allergy was present in all. Elimination diet was started in all cases. When exposure to cats was reduced, a marked improvement in the findings of atopic dermatitis was observed in all cases. Allergic diseases are increasing day by day. Unexpected aeroallergenic sensitization is now more common in the early stages of life. Allergic patients, regardless of age, should be questioned in detail for aeroallergen exposure. If it is detected; necessary preventive measures should be taken.

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