scholarly journals Risk Factors in Severe Anaphylaxis: Which Matters The Most, Food or Cofactors?

2021 ◽  
Vol 32 (4) ◽  
Author(s):  
R Casas-Saucedo ◽  
C de la Cruz ◽  
G Araujo-Sánchez ◽  
S Gelis ◽  
T Jimenez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anaphylactic Shock ◽  
Lipid Transfer Protein ◽  
Clinical History ◽  
Food Group ◽  
Plant Food ◽  
Food Groups ◽  
Lipid Transfer ◽  
Related Factors ◽  
Prick Test

Background: The prevalence of anaphylactic shock, the most severe manifestation of anaphylaxis, remains unknown. Risk factors and biomarkers have not been fully identified. Objective: To identify risk factors in anaphylactic shock patients. Methods: Using lipid transfer protein (LTP)allergy as a model, the characteristics of patients who developed anaphylaxis and anaphylactic shock were compared. Demographics, pollen sensitization, foods ingested up to 2 hours before the reaction onset, and the presence of a cofactor were recorded. Culprit foods were identified by compatible clinical history and positive allergological work-up (skin prick test and/or sIgE). Results:150 reactions were evaluated, suffered by 55 patients with An (134 reactions) and 12 with AnS (16 reactions). Patients in the anaphylaxis group experienced twice as many reactions (mean [SD] 2.4[2.5] in An vs 1.3[1.5) in AnS, p<0.02). No relationship between any food group and reaction severity was found. The most frequent food involved in both groups of patients was the combination of several plant-derived foods (“plant food mix”), followed by peach and nuts. Indeed, in the “plant food mix” reactions the presence of a cofactor was more often observed than in other food groups. On the other hand, cofactors were not present in peach- and nuts-related reactions. Exercise was the most frequent cofactor in all groups. Conclusion: In our series, the severity of the reactions was not determined by the kind of food or presence of a cofactor. Anaphylactic shock seems an infrequent presentation that may be related with other individual-related factors that need further evaluation.

Detection of Wheat Lipid Transfer Protein (Tri a 14) Sensitization: Comparison between Currently Available Diagnostic Tools

2021 ◽  
pp. 1-5
Author(s):  
Clara San Bartolomé ◽  
Rosa Muñoz-Cano ◽  
Josefina Rius ◽  
Rocío Casas-Saucedo ◽  
Sara Balsells ◽  
...  
Keyword(s):  
Lipid Transfer Protein ◽  
Poor Performance ◽  
Specific Ige ◽  
Diagnostic Tools ◽  
Lipid Transfer ◽  
Prick Test ◽  
Transfer Protein ◽  
Whole Wheat ◽  
Systemic Reactions ◽  
Routine Diagnosis

<b><i>Background:</i></b> Wheat lipid transfer protein (LTP; Tri a 14) and ω5-gliadin have been described as major allergens in wheat allergy (WA) and relevant in wheat-induced anaphylaxis, frequently associated with cofactors. <b><i>Objective:</i></b> The objective of this study was to compare tools currently available in routine diagnosis to detect Tri a 14 sensitization, its clinical relevance, and cosensitization to ω5-gliadin and other LTPs. <b><i>Methods:</i></b> One hundred eighteen adults sensitized to rTri a 14 by ImmunoCAP<sup>®</sup> (cutoff ≥0.1 kU<sub>A</sub>/L) identified among 210 LTP allergic patients were included. We evaluated (1) wheat skin prick test (SPT), (2) specific IgE (sIgE) to wheat, rTri a 14, rTri a 19, peach, apple, walnut, hazelnut, and peanut LTPs using ImmunoCAP<sup>®</sup> and microarray ImmunoCAP®ISAC (cutoff ≥0.3I SU), and (3) wheat-related symptoms. <b><i>Results:</i></b> Wheat SPT and sIgE were positive in 31% and 85% of subjects, respectively. rTri a 14 by microarray was detected in 25%. Eight percent showed cosensitization to ω5-gliadin. Thirty percent referred symptoms (gastrointestinal [13%], urticaria [11%], and anaphylaxis [8%]). Cofactors (45%) were significantly associated with systemic reactions. <b><i>Conclusion:</i></b> WA due to Tri a 14 is frequently related with systemic reactions and because are frequently related to cofactors, the culprit may not be suspected. Together with the poor performance to identify Tri a 14 sensitization of the current routine diagnostic tools based on the analysis of whole wheat extract, such as wheat SPT or sIgE, there is a high risk that WA may be overlooked. Thus, when WA is suspected, sIgE Tri a 14 assessment is recommended, together with wheat and ω5-gliadin, preferably in the singleplex format, and carefully evaluated considering ≥0.1 kUA/L as a cutoff.

scholarly journals Dietary patterns of US Chinese Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1008-1008
Author(s):  
Alexander Dong ◽  
Dana Dychtwald ◽  
Lisa Lanza ◽  
Qun Le ◽  
Stephanie Bergren
Keyword(s):  
Higher Education ◽  
Older Adults ◽  
Demographic Factors ◽  
Total Sample ◽  
Food Group ◽  
Primary Objective ◽  
Food Groups ◽  
Related Factors ◽  
Chinese Older Adults ◽  
Westernized Diet

Abstract A westernized diet, characterized by intake of foods high in fat and sugar, has been associated with several chronic conditions. However, the dietary pattern of US Chinese older adults is not well understood. The primary objective of this study was to determine the relationship between years of US residence and other demographic factors and the intake of foods high in fats and sugar. As part of the Population Study of Chinese Elderly, participants were given a 48-item food frequency questionnaire, which were further placed into primary food groups. Each group was then categorized into whether they consumed the food group at least once a week. The total sample was 59% female with an average age of 75, with 49% consuming fatty foods and 85% consuming sweets in the past week. Using logistic regression (N=3053), each additional year of US residence (range of 0-93 years) was associated with a higher dietary intake of fats (OR: 1.01 (95%CI:1.01-1.02)) and sweets (OR: 1.01 (95%CI:1.00-1.02)). Additionally, higher education was associated with lower consumption of fats (OR: 0.98 (95%CI:0.96, 0.99)) and higher income was associated with higher consumption of fats (OR: 1.11 (95%CI: 1.04, 1.18)). For sweets, women compared to men were 54% less likely to consume sweets in the last week (OR: 0.46 (95%CI:0.36, 0.59)), and higher education was associated a greater likelihood of consuming sweets (OR: 1.07 (95%CI: 1.05, 1.10)). Study findings suggest that immigration related factors and demographic factors may influence consumption of a westernized diet high in fats and sugars.

scholarly journals Identification and Purification of Novel Low-Molecular-Weight Lupine Allergens as Components for Personalized Diagnostics

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 409
Author(s):  
Uta Jappe ◽  
Arabella Karstedt ◽  
Daniela Warneke ◽  
Saskia Hellmig ◽  
Marisa Böttger ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Expressed Sequence Tag ◽  
Lipid Transfer Protein ◽  
Extraction Methods ◽  
Low Molecular Weight ◽  
Lipid Transfer ◽  
Prick Test ◽  
Ige Reactivity ◽  
Potential Marker ◽  
Marker Allergens

Lupine flour is a valuable food due to its favorable nutritional properties. In spite of its allergenic potential, its use is increasing. Three lupine species, Lupinus angustifolius, L. luteus, and L. albus are relevant for human nutrition. The aim of this study is to clarify whether the species differ with regard to their allergen composition and whether anaphylaxis marker allergens could be identified in lupine. Patients with the following characteristics were included: lupine allergy, suspected lupine allergy, lupine sensitization only, and peanut allergy. Lupine sensitization was detected via CAP-FEIA (ImmunoCAP) and skin prick test. Protein, DNA and expressed sequence tag (EST) databases were queried for lupine proteins homologous to already known legume allergens. Different extraction methods applied on seeds from all species were examined by SDS-PAGE and screened by immunoblotting for IgE-binding proteins. The extracts underwent different and successive chromatography methods. Low-molecular-weight components were purified and investigated for IgE-reactivity. Proteomics revealed a molecular diversity of the three species, which was confirmed when investigated for IgE-reactivity. Three new allergens, L. albus profilin, L. angustifolius and L. luteus lipid transfer protein (LTP), were identified. LTP as a potential marker allergen for severity is a valuable additional candidate for molecular allergy diagnostic tests.

The concordance between component tests and clinical history in British adults with suspected pollen-food syndrome to peanut and hazelnut

2017 ◽  
Vol 71 (3) ◽  
pp. 239-245 ◽  
Author(s):  
Sarah C Beck ◽  
Aarnoud P Huissoon ◽  
Donna Collins ◽  
Alex G Richter ◽  
Mamidipudi T Krishna
Keyword(s):  
Storage Protein ◽  
Lipid Transfer Protein ◽  
Protein S ◽  
Clinical History ◽  
Specific Ige ◽  
Lipid Transfer ◽  
Group 2 ◽  
Food Challenges ◽  
Systemic Symptoms ◽  
Group 1

BackgroundMild oropharyngeal symptoms to peanut/hazelnut occur in ~30% of patients with pollen-food syndrome (PFS). Component tests are considered a useful adjunct to the diagnosis and may help differentiate PFS from those at a risk of anaphylaxis due to storage protein/lipid transfer protein (LTP) sensitisation.AimsTo assess concordance between component tests and clinical history in suspected PFS to peanut/hazelnut in a specialist clinic.MethodsAdult patients were classified into PFS (group 1, n=69) and PFS with mild systemic symptoms (group 2, n=45) based on clinical history. Specific IgE (sIgE) of ≥0.35 kUA/L was considered positive as per manufacturers’ recommendation. Kappa (κ) inter-rater agreement was calculated for concordance between clinical classification and test profiles.ResultsGroup 1 hazelnut: 85% monosensitised to Cor a1, 12% to storage protein/s or LTP and 3% negative to all components. Group 1 peanut: 41% monosensitised to Ara h8, 44% to storage protein/s or ±LTP and 15% negative to all components. Group 2 hazelnut: 67% monosensitised to Cor a1, 16% sensitised to storage protein/s and 17% negative to all components. Group 2 peanut: 19% monosensitised to Ara h8, 62% sensitised to storage protein/s and/or LTP and 19% negative to all components.SIgE to Ara h8 and Cor a1 were greater in group 1 versus group 2: (median (IQR) kUA/L; hazelnut: 12.1 (7.8-25.2) vs 2.4 (0.36-6.3), p<0.001; peanut: 2.4 (0.10-21.1) vs 0.3 (0-3), p<0.01)).ConclusionConcordance between component tests and clinical history for adults with PFS was good for hazelnut (κ=0.63) but poor for peanut (κ=−0.12). Food challenges are warranted in discordant cases for an accurate diagnosis.

scholarly journals Beer, Cider, and Wine Allergy

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Rhea A. Bansal ◽  
Susan Tadros ◽  
Amolak S. Bansal
Keyword(s):  
Lipid Transfer Protein ◽  
Specific Ige ◽  
Alcoholic Beverages ◽  
Food Groups ◽  
Lipid Transfer ◽  
Case Presentation ◽  
Blue Cheese ◽  
Transfer Protein ◽  
Ige Reactivity ◽  
Specific Proteins

Background. Allergy to beer is often due to specific proteins in barley and sometimes to lipid transfer protein. Allergy to wine is frequently due to a sensitivity to grape proteins. We present a rare case of allergy to beer, wine, and cider resulting from IgE reactivity to yeasts and moulds which also explained the patient’s additional sensitivity to yeast extracts and blue cheese. Case Presentation. The patient’s symptoms included throat and facial itching accompanied by mild wheeze and severe urticaria. Diagnosis of allergy to yeast was confirmed by specific IgE testing as well as that to relevant foods and beverages. The patient’s ongoing management included advice to avoid beer, wine, and other food groups containing specific yeasts, in addition to carrying a short acting nonsedating antihistamine as well as an adrenaline autoinjector. Conclusions. Cases of yeast allergy are extremely rare in medical literature but may be underrecognised and should be considered in patients presenting with reactions to alcoholic beverages and other yeast-containing products.

scholarly journals LTP Allergy Follow-Up Study: Development of Allergy to New Plant Foods 10 Years Later

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2165
Author(s):  
Diana Betancor ◽  
Alicia Gomez-Lopez ◽  
Carlos Villalobos-Vilda ◽  
Emilio Nuñez-Borque ◽  
Sergio Fernández-Bravo ◽  
...  
Keyword(s):  
Food Allergy ◽  
Lipid Transfer Protein ◽  
Specific Ige ◽  
Cross Reactivity ◽  
Allergic Reactions ◽  
Plant Food ◽  
Lipid Transfer ◽  
Plant Foods ◽  
Transfer Protein

Introduction: Allergy to nonspecific lipid transfer protein (nsLTP) is the main cause of plant-food allergy in Spain. nsLTPs are widely distributed in the plant kingdom and have high cross-reactivity but extremely variable clinical expression. Little is known about the natural evolution of this allergy, which complicates management. The objective of this study was to assess the development of allergy to new plant foods in nsLTP-sensitized patients 10 years after diagnosis. Methods: One hundred fifty-one patients showing specific IgE to nsLTP determined by ISAC (Thermofisher) were included. After clinical workup (i.e., anamnesis, skin test, and challenge when needed), these patients were divided into two groups: 113 patients allergic to one or more plant food (74.5%) and 38 patients not allergic to any plant food (25.1%). Ten years later, a telephone interview was conducted to check whether patients had developed additional allergic reactions to plant foods. Results: Ten years after diagnosis, 35 of the 113 (31%) plant-food-allergic patients sensitized to nsLTP reported reactions to new, previously tolerated plant foods, mainly Rosaceae/Prunoideae fruits and nuts followed by vegetables, Rosacea/Pomoideae fruits, legumes, and cereals. Five out of 38 (13.2%) patients previously sensitized to nsLTP but without allergy to any plant food had experienced allergic reactions to some plant food: two to Rosaceae/Prunoideae fruits, two to Rosaceae/Prunoideae fruit and nuts, and one to legumes. Conclusion: Patients sensitized to nsLTP developed allergic reactions to other plant foods, mainly Rosaceae-Prunoideae fruits and nuts. This was more frequent among plant-food-allergic patients than among those who had never had plant-food allergy.

Critical Review on Suicide Among Nurses

Crisis ◽  
2015 ◽  
Vol 36 (2) ◽  
pp. 91-101 ◽  
Author(s):  
Marie Alderson ◽  
Xavier Parent-Rocheleau ◽  
Brian Mishara
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
High Stress ◽  
Related Factors ◽  
Work Settings ◽  
Work Related ◽  
High Prevalence ◽  
Full Text Review ◽  
The Subject ◽  
Psychiatric Problems

Background: Research shows that there is a high prevalence of suicide among nurses. Despite this, it has been 15 years since the last literature review on the subject was published. Aim: The aim of this article is to review the knowledge currently available on the risk of suicide among nurses and on contributory risk factors. Method: A search was conducted in electronic databases using keywords related to prevalence and risk factors of suicide among nurses. The abstracts were analyzed by reviewers according to selection criteria. Selected articles were submitted to a full-text review and their key elements were summarized. Results: Only nine articles were eligible for inclusion in this review. The results of this literature review highlight both the troubling high prevalence of suicide among nurses as well as the persistent lack of studies that examine this issue. Conclusion: Considering that the effects of several factors related to nurses' work and work settings are associated with high stress, distress, or psychiatric problems, we highlight the relevance of investigating work-related factors associated with nurses' risk of suicide. Several avenues for future studies are discussed as well as possible research methods.

Inadequate Dietary Intakes: Among Pregnant Women

2012 ◽  
Vol 73 (2) ◽  
pp. 72-77 ◽  
Author(s):  
Jennifer K. Fowler ◽  
Susan E. Evers ◽  
M. Karen Campbell
Keyword(s):  
Pregnant Women ◽  
Food Group ◽  
Reproductive Age ◽  
Dietary Intakes ◽  
Food Groups ◽  
Eating Behaviours ◽  
Prenatal Health ◽  
Canadian City ◽  
Minimum Number ◽  
Health Project

Purpose: Eating behaviours were assessed among pregnant women in a mid-sized Canadian city. Methods: As part of the Prenatal Health Project, we interviewed 2313 pregnant women in London, Ontario. Subjects also completed a food frequency questionnaire. Recruitment took place in ultrasound clinics at 10 to 22 weeks of gestation. The main outcome measures were number of daily servings for each food group, measured against the minimum number recommended by the 2007 Eating Well with Canada’s Food Guide (CFG), the proportion of women consuming the recommended number of servings for each and all of the four food groups, and factors associated with adequate consumption. We also determined the number of servings of “other foods.” Analysis included descriptive statistics and logistic regression, all at p<0.05. Results: A total of 3.5% of women consumed the recommended number of servings for all four food groups; 15.3% did not consume the minimum number of servings of foods for any of the four food groups. Women for whom this was their first pregnancy were less likely to consume the recommended number of servings from all four food groups (odds ratio=0.41; confidence interval=0.23, 0.74). Conclusions: Very few pregnant women consumed food group servings consistent with the 2007 recommendations. Strategies to improve dietary behaviours must focus on the establishment of healthy eating behaviours among women of reproductive age.

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