Significance of food allergy in atopic dermatitis in children

Background. Atopic dermatitis is the most common inflammatory skin disease in childhood, affecting almost 20 % of children. Food allergies affect one of three children with atopic dermatitis, and allergies to peanuts, eggs and milk are the predominant food allergies in the world. The purpose was to assess the prevalence of food allergies in the group of patients with atopic dermatitis, to determine the association of food allergies with anamnestic and clinical parameters of atopic dermatitis. Materials and methods. Children with atopic dermatitis (n = 116) were included in the study from September 2020 to August 2021 in Kyiv, Ukraine. Food sensitization was established by determining specific immunoglobulin E (sIgE) to food allergens using immunochemiluminescent method on the ImmunoCAP 100 system (Thermo Fisher Scientific Inc., Phadia, Sweden). Results. The average age of children in the main group (59 boys and 57 girls) was 6.8 years. All 116 patients at the time of examination had manifestations of atopic dermatitis in the form of erythematous itchy rash. The number of children with food allergy was 23 (19.8 %). Among food allergens, positive sIgE were found: in 14 patients (12 %) — to milk, in 13 (11.2 %) — to eggs, in 5 (4.3 %) — to fish, and in 4 people (3.4 %) — to hazelnuts. Food sensitization was significantly more common in children with moderate-to-severe atopic dermatitis than in the group of patients with mild atopic dermatitis (χ2 = 7.555, p < 0.05). Children with food sensitization had an earlier onset of atopic dermatitis — the average age of manifestations onset was 8 months, and in the group of children without food allergy, it was 18 months. Children with a parental history of atopic diseases were significantly more likely to have concomitant food allergy (χ2 = 12.831, p < 0.05). Conclusions. Given the significant association between early onset as well as moderate-to-severe atopic dermatitis and food sensitization, it is likely that food sensitization occurs primarily through an inflamed skin barrier in eczematous skin, which could potentially lead to clinical food allergy.

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Atopy Patch Test in the Diagnosis of Food Allergy in Children with Atopic Dermatitis

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2017.132 ◽

2006 ◽

Vol 49 (4) ◽

pp. 199-201 ◽

Cited By ~ 4

Author(s):

Miloš Jeseňák ◽

Peter Bánovčin

Keyword(s):

Atopic Dermatitis ◽

Food Allergy ◽

Patch Test ◽

Task Force ◽

Allergic Diseases ◽

Food Allergies ◽

Controlled Clinical Trial ◽

Atopy Patch Test ◽

Food Allergens ◽

Additional Tool

Atopic eczema/dermatitis syndrome (AEDS) is one of the most common chronic allergic diseases in children. Among the allergens found to be relevant in AEDS, aeroallergens and food allergens are the most important. The exposure of these patients to their relevant protein allergens can trigger an exacerbation or maintain the disease. AEDS is frequently associated with food allergy, which complicates the management in approximately 40% of these children. Atopy patch test (APT) can help in detecting food allergies in children with AEDS. The earliest publication on patch testing in eczema was described in 1937 by Rostenberg, but the first controlled clinical trial was provided by Mitchell in 1982. APT with food allergens were introduced into clinical use in 1996 by the group of Isolauri. APT test is performed epicutaneously with typical immediate-type allergens (aeroallergens or foods). As a number of apparently minor test modifications greatly influence the sensitivity, specificity, and reproducibility of the APT, the European Task Force on Atopic Dermatitis (ETFAD) has developed a standardized APT technique. APT has developed into a valuable additional tool in the diagnostic work-up of food allergy in infants and children with atopic dermatitis.

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Intrinsic Atopic Dermatitis: Titration of Precipitins in the Screening of Food Allergens for Prescription of Elimination Diets and Desensitization Strategies

European Journal of Clinical Medicine ◽

10.24018/clinicmed.2021.2.6.129 ◽

2021 ◽

Vol 2 (6) ◽

pp. 1-9

Author(s):

Celso E. Olivier ◽

Daiana G. Pinto ◽

Ana P. M. Teixeira ◽

Jhéssica L. S. Santana ◽

Raquel A. P. G. Santos ◽

...

Keyword(s):

Atopic Dermatitis ◽

Food Allergy ◽

Food Allergen ◽

Elimination Diet ◽

Food Allergies ◽

P Value ◽

Food Allergens ◽

Diagnosis And Management ◽

Ige Mediated ◽

Positive Correlation Coefficient

Background: The diagnosis of non-IgE mediated food allergies may be a complex puzzle when there is no start point to establish an elimination diet to allow a clear clinical field to initiate diagnostic Oral Food Challenges tests. Objective: To evaluate the opportunity of the tube titration of precipitins to select food allergens to proceed with elimination diets to assist the diagnosis and management of adult patients with Food Allergy manifested as Intrinsic Atopic Dermatitis (IAD). Methods: The tube titration of specific precipitins against anamnesis-chosen food allergens were performed in 64 IAD patients and their titers were associated with an Improvement Verbal Scale Rate (IVSR) of the patient’s perception of the benefits of the Precipitins-based Elimination Diet (PED) performed with these specific food allergens, as well correlated with their positive or negative perception of the impairment of symptoms after the reintroduction of the Symptom-Related Food Allergen (SRFA). Results: In most cases, the PED contributed to a significant clinical improvement that allowed the patients to evaluate the individual effect of the reintroduction of each food allergen on their diets. There was a significant positive correlation coefficient between the titers of the food-specific titration of precipitins and the percentage of positive SRFA (Pearson r = 0.91; p-value = 0.0004). Conclusion: The semiquantitative titration of specific precipitins against food allergens is a promising triage test to select food allergens to proceed with elimination diets to support the diagnosis and management of non-IgE mediated Food Allergy in patients with Intrinsic Atopic Dermatitis.

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CHARACTERISTICS OF SENSITIZATION IN CHILDREN WITH SEVERE ATOPIC DERMATITIS FOR THE FIRST FOUR YEARS OF LIFE

Rossiiskii Allergologicheskii ZHurnal ◽

10.36691/rja296 ◽

2017 ◽

Vol 14 (4-5) ◽

pp. 61-65

Author(s):

E M Kamaltynova ◽

M C Afanasyeva ◽

O S Fedorova ◽

E G Belonogova

Keyword(s):

Atopic Dermatitis ◽

House Dust Mites ◽

Severe Atopic Dermatitis ◽

Dust Mites ◽

Food Allergens ◽

Blood Tests ◽

One Year ◽

Food Sensitization ◽

Chicken Protein

Background. To reveal the regularities of sensitization formation in children with atopic dermatitis (AD) in first four years of life. Methods. Continuous crosssectional study of 69 children with an established diagnosis of AD from age 0 to 4 years was conducted. Severity was assessed according to the SCORAD scale. Clinical examination included: general and biochemical blood tests, determination of total IgE and allergenspecific IgE (IgEs) in serum against the most common epidermal and food allergens with ImmunoCAP, Phadia IDM (Sweden) technology. Results. Diagnostically significant levels of IgEs to these allergens had 68,11% of patients. Sensitization to cow’s milk was estimated in 38,98% (n=23), to chicken egg and its components in 67,92% (n=36), to chicken protein in 67,44% (n=29), to yolk in 54,28% (n=19), to cat epithelium in 47,5% (n=19) of children. Conclusion. Sensitization to food allergens marks the early development of sensitization to exogenous allergens, predominantly to the cat epithelium. Sensitization to house dust mites develops less frequently, but can also occur in children under one year of age. Sensitization to cat epithelium can accompany food sensitization as well as to be an independent cause of AD.

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Update on Atopic Dermatitis

Acta Médica Portuguesa ◽

10.20344/amp.11963 ◽

2019 ◽

Vol 32 (9) ◽

pp. 606 ◽

Cited By ~ 9

Author(s):

Tiago Torres ◽

Eduarda Osório Ferreira ◽

Margarida Gonçalo ◽

Pedro Mendes-Bastos ◽

Manuela Selores ◽

...

Keyword(s):

Atopic Dermatitis ◽

Disease Severity ◽

Clinical Manifestations ◽

Skin Barrier ◽

Future Research ◽

Severe Atopic Dermatitis ◽

Inadequate Response ◽

Barrier Dysfunction ◽

Therapeutic Goals ◽

Global Health Issue

With an increasing prevalence during the past decades, atopic dermatitis has become a global health issue. A literature search following a targeted approach was undertaken to perform this non-systematic review, which intends to provide an overview of the epidemiology, pathophysiology, clinical features, comorbidities, and current therapies for the treatment of atopic dermatitis. In sum, this is a heterogeneous skin disorder associated with variable morphology, distribution, and disease course. Although not completely understood, its pathogenesis is complex and seems to result from a combination of genetic and environmental factors that induce skin barrier dysfunction, cutaneous and systemic immune dysregulation, skin microbiota dysbiosis, and a strong genetic influence. Diagnosis is based on specific criteria that consider patient and family history and clinical manifestations. Overall disease severity must be determined by evaluating both objective signs and subjective symptoms. Therapeutic goals require a multistep approach, focusing on reducing pruritus and establishing disease control. Patients should be advised on basic skin care and avoidance of triggers. Topical anti-inflammatory agents should be considered in disease flares or chronic/recurrent lesions. In case of inadequate response, phototherapy, systemic immunosuppressants and, more recently, dupilumab, should be added. Nevertheless, the treatment of moderate-to-severe atopic dermatitis remains challenging and novel, efficacious, safe and targeted treatments are urgently needed. In conclusion, although the last few years have seen important improvement in the understanding of the disease, future research in atopic dermatitis will continue exploring gene-environment interactions and how it affects pathophysiology, disease severity, and treatment outcomes.

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Food allergy: knowledge level of food handlers at school canteens

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.243 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M Liz Martins ◽

I Estrela

Keyword(s):

Food Allergy ◽

Public Health Problem ◽

School Level ◽

Food Allergies ◽

Surveillance Systems ◽

Knowledge Level ◽

Food Handlers ◽

High School Level ◽

Number Of Children ◽

High Knowledge

Abstract Background Food allergy becomes a public health problem whose prevalence in children is increasing. Due to the daily number of children using school canteens, these settings play an important role on allergic reactions prevention, being essential to know the knowledge level of food handlers. Methods This study focused on Portuguese schools of the city of Porto, that daily offer 6500 lunches to children aged 3 to 10 years old. The study was performed in all school canteens having children with food allergies (n = 25). To evaluate knowledge level on food allergy, a questionnaire was applied to all food handlers responsible for meals serving, considering hot topics related to food allergy and cross contamination practices. Each question was scored: 0 (lack); 1 (correct); -1 (incorrect), ranged 0 to 20 points. The knowledge level was converted in a 4-level scale: <50% (non-acceptable); 50-74% (acceptable); 75-89% (good); 90-100% (very good). Results Despite of 44.9% of food handlers presented a good level knowledge, it was observed that 38.8% of participants showed non-acceptable values. The knowledge mean level was 11.9 (±4.1) points. A high knowledge was observed for cooks (13.8±3.0) and canteen managers (20.0±0.0) (p = 0.006), as well as, for a high school level. Only 36.7% of participants had training on food allergy, with no influence on knowledge level (0.610). Participants having training on food safety has a higher knowledge level (13.0±3.9) than food handlers having no training (9.8±3.7) (p = 0.008). The majority of respondents showed to know food handling good practices when exposed to case studies related to food allergy. Conclusions A positive level of knowledge on food allergies was observed for the majority of food handlers. Nevertheless, a high number of participants had no training on food allergy. This work has a potential impact on children's health, awareness for the need to implement regular training actions and surveillance systems at school canteens. Key messages A large number of food handlers showed non-acceptable knowledge levels and no training on food allergy. Professional category influenced knowledge, being important the motivation and training of all employees.

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Food sensitization rate and immediate-type food allergy incidence among infantile atopic dermatitis

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2017.12.517 ◽

2018 ◽

Vol 141 (2) ◽

pp. AB162

Author(s):

Yuki Ejiri ◽

Tetsuharu Manabe ◽

Noriyuki Yanagida ◽

Sakura Sato ◽

Motohiro Ebisawa

Keyword(s):

Atopic Dermatitis ◽

Food Allergy ◽

Sensitization Rate ◽

Food Sensitization

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Сolloidal silicon dioxide use (Polisorb MP) at food allergy skin and gastrointestinal manifestations

Pediatrics (Suppl Consilium Medicum) ◽

10.26442/26586630.2021.2.200967 ◽

2021 ◽

pp. 158-164

Author(s):

Vera P. Vavilova ◽

Alexander M. Vavilov ◽

Sofia A. Tsarkova ◽

Irina A. Nechaeva ◽

Ekaterina Iu. Burmistrova ◽

...

Keyword(s):

Atopic Dermatitis ◽

Food Allergy ◽

Abdominal Pain ◽

Silicon Dioxide ◽

Life Quality ◽

Allergic Diseases ◽

Food Allergies ◽

Control Groups ◽

Gastrointestinal Manifestations ◽

Skin Manifestations

Background. At present, due to high prevalence of allergic diseases which start in early childhood, the search for new prevention and treatment methods is in great demand. Aim. To study the effectiveness of the Russian-produced enterosorbent colloidal silicon dioxide in the treatment of patients with food allergies combined with atopic dermatitis and gastrointestinal manifestations. Materials and methods. An open, randomized, comparative clinical study of the enterosorbent (colloidal silicon dioxide) effectiveness has been conducted in parallel groups of infants and preschool children with food allergy skin and gastrointestinal manifestations. The main groups (1 67 children with food allergies and atopic dermatitis skin manifestations, 3 60 children with food allergies and gastrointestinal manifestations) received, along with basic medication, colloidal silicon dioxide enterosorbent day at an age-specific dosage twice a for 1014 days. Control groups (2 60 children with food allergies and atopic dermatitis skin manifestations, 4 60 children with food allergies and gastrointestinal manifestations) did not receive enterosorbent. All children underwent a clinical, functional and laboratory status assessment, including medical records analysis, a pediatrician clinical examination, narrow specialists (allergist-immunologist) examination, laboratory and instrumental research. The treatment effectiveness was being evaluated on the 14th day after the initiation of therapy and after 30 days. The therapy effectiveness was assessed based on regression of skin syndrome clinical and gastrointestinal manifestations, intoxication syndrome and laboratory parameters (IgE, hemogram eosinophilia duration). The study was conducted from 2017 to 2019. On the basis of LLC Modern Medical Technologies Clinics (Kemerovo). Results. Therapy with colloidal silicon dioxide increases the significance of food allergy skin manifestations positive dynamics, which makes it possible to reduce the volume of medication and the duration of topical glucocorticosteroids use to 5.340.35 days, in the compared group 10.520.85 days (p=0.002). All patients with food allergy combined with atopic dermatitis in the main and control groups noted positive clinical dynamics, appearing as decrease in the skin inflammatory reaction area and intensity. However, the of colloidal silicon dioxide use accelerates skin syndrome condition normalization significantly (group 1 skin syndrome persisted in 2.92.0% after 14 days, in group 2 18.34.9%; p=0.003). Colloidal silicon dioxide use accelerates humoral immunity state normalization (IgE) and peripheral blood parameters (hemogram eosinophilia). Colloidal silicon dioxide therapy accelerates food allergy gastrointestinal manifestations positive dynamics in children. Two weeks after the sorbent therapy started, gastrointestinal tract lesions symptoms frequency is less than in patients in the compared group. Diarrhea frequency before treatment started was 48.36.5%, 45.06.4% in the compared groups. After two weeks it decreased to 6.73.2% with the Polisorb therapy and to 16.64.8% in the compared group (p=0.003). Abdominal pain was noted by patients of both groups equally often before the study began. After 2 weeks, abdominal pain was noted by ten percent 10.03.9% of patients taking colloidal silicon dioxide and 25.05.6% of the compared group (p=0.009). Conclusion. Taking into account the composition of the colloidal silicon dioxide, it makes sense to include this medication in childrens food allergies complex treatment starting from infancy, which contributes to a more rapid relief of gastrointestinal system damage symptoms, life quality improvement for children and their parents, and decrease in medication load. When using colloidal silicon dioxide in children with food allergies, a faster dynamics of disease symptoms relief (p=0.003) was noted, which allows us to conclude that it is highly effective in the treatment of allergic diseases associated with food sensitization.

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Dupilumab in Moderate-to-Severe Atopic Dermatitis With or Without Comorbid Food Allergy: Pooled Analysis of 2 Randomized Phase 3 Trials (LIBERTY AD SOLO 1 & 2)

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2017.12.418 ◽

2018 ◽

Vol 141 (2) ◽

pp. AB131

Author(s):

Eric L. Simpson ◽

Jean-Philippe Lacour ◽

Jonathan I. Silverberg ◽

Margitta Worm ◽

Andreas Wollenberg ◽

...

Keyword(s):

Atopic Dermatitis ◽

Food Allergy ◽

Pooled Analysis ◽

Severe Atopic Dermatitis ◽

Phase 3

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A Review on Identified Major Food Allergens: Characteristics and Role in Food Allergy

The Indian Journal of Nutrition and Dietetics ◽

10.21048/ijnd.2017.54.3.11626 ◽

2017 ◽

Vol 54 (3) ◽

pp. 346

Author(s):

Chhavi Arya ◽

Chetna Jantwal

Keyword(s):

Food Allergy ◽

Food Allergies ◽

Allergic Reactions ◽

Food Allergens ◽

Food Groups ◽

Consumer Protection Act ◽

Major Food ◽

Life Threatening ◽

Major Allergens ◽

Allergen Labeling

Food allergens are the substances present in food that cause food allergy. Human body reactions to food allergens range from mild to severe life threatening anaphylactic shock. At least seventy different foods have been reported to cause allergic reactions and several other foods have been identified which have the potential to provoke allergic reactions. Majority of the identified food allergens are proteins. The Food Allergen Labeling and Consumer Protection Act (FALCPA) identifies eight major food groups i.e. milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat, and soybeans as major allergy causing foods. These eight foods are believed to account for 90 per cent of food allergies and are responsible for most serious reactions to foods. Several studies have been done which identify the major allergens in various foods. The present paper attempts to review the major allergens present in various food.

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