scholarly journals IgE sensitisation predicts threshold but not anaphylaxis during oral food challenges to cow's milk

2021 ◽  
Author(s):  
Paul Turner ◽  
Bettina Duca ◽  
Sophia Chastell A ◽  
Olaya Alvarez ◽  
Raphaelle Bazire ◽  
...  
Keyword(s):  
Food Allergy ◽  
Young People ◽  
Risk Stratification ◽  
Clinical Setting ◽  
Clinical Utility ◽  
Cow’S Milk ◽  
Reaction Threshold ◽  
Knowledge Gaps ◽  
Food Challenges ◽  
Existing Data

Predicting reaction threshold and severity are important to improve the management of food allergy, however the determinants of, and relationship between, these parameters are significant knowledge gaps. Identifying robust predictors could enable the reliable risk-stratification of food-allergic individuals. In this series of young people with CM-allergy undergoing DBPCFC – the largest reported in the literature – we did identify any baseline marker which predicted the occurrence of anaphylaxis at challenge, consistent with existing data. There is one report of IgE-sensitisation being predictive of severity in CM-allergy, however the authors included non-reactive patients in their analysis which significantly skewed the analyses, resulting in misleading conclusions. IgE-sensitisation in our cohort, particularly to casein, was predictive of LOAEL. Including an assessment of casein IgE may therefore be of clinical utility when evaluating patients with CM-allergy in the clinical setting.

Suspected food allergy in adults: mapping 208 open food challenges with allergy tests and risk stratification

2020 ◽  
pp. jclinpath-2020-206994
Author(s):  
Kavitha Sooriyakumar ◽  
Omar Mohamed ◽  
Toni Osborne ◽  
Sarah C Beck ◽  
Cathryn Melchior ◽  
...  
Keyword(s):  
Food Allergy ◽  
Risk Stratification ◽  
Food Challenges

Bridging the Knowledge Gaps in Arrhythmogenic Cardiovascular Conditions: The Critical Role of Registries

2016 ◽  
Vol 10 (2) ◽  
pp. 1 ◽  
Author(s):  
Melody Hermel ◽  
Rebecca Duffy ◽  
Alexander Orfanos ◽  
Isabelle Hack ◽  
Shayna McEnteggart ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Natural History ◽  
Risk Stratification ◽  
Critical Role ◽  
Knowledge Gaps ◽  
Level Of Evidence ◽  
The Future

Cardiac registries have filled many gaps in knowledge related to arrhythmogenic cardiovascular conditions. Despite the less robust level of evidence available in registries when compared with clinical trials, registries have contributed a range of clinically useful information. In this review, the authors discuss the role that registries have played – related to diagnosis, natural history, risk stratification, treatment, and genetics of arrhythmogenic cardiovascular conditions – in closing knowledge gaps, and their role in the future.

Alteration of Allergen Fold of Bos d 5 into a Hypoallergenic Vaccine for Immunotherapy of Cow’s Milk Allergy

2021 ◽  
pp. 1-12
Author(s):  
Yaqiong Cui ◽  
Yang Yu ◽  
Shuxiang Lin ◽  
Li Xu ◽  
Liuxu Li ◽  
...  
Keyword(s):  
Food Allergy ◽  
T Cell ◽  
Cow’S Milk Allergy ◽  
Cow’S Milk ◽  
Milk Allergy ◽  
T Cell Epitopes ◽  
Dot Blot ◽  
Allergen Specific Immunotherapy ◽  
Cow's Milk ◽  
Cow's Milk Allergy

<b><i>Background:</i></b> Cow’s milk allergy (CMA) is the most common IgE-mediated food allergy and Bos d 5 is the major allergen in cow’s milk proteins. More than 60% of the patients with CMA are sensitized to this protein. <b><i>Methods and Results:</i></b> A recombinant protein, encoded by a synthetic gene and consisting of reassembled Bos d 5 fragments, was expressed in <i>E. coli</i> strain BL21 (DE3) cells and purified to homogeneity. The B5M lacked relevant IgE-reactivity and allergenic activity compared with Bos d 5 in dot-blot and basophil activation assays. T-cell proliferation experiments demonstrated that B5M preserved the main T cell epitopes of Bos d 5. Immunization of rabbits with B5M induced protective IgG antibodies that blocked the binding of patients’ IgE antibodies to the wild-type allergen and inhibited the degranulation of basophils induced by Bos d 5. <b><i>Conclusion:</i></b> Thus, we developed a new strategy, which was based on rational molecular reassembly for allergen-specific immunotherapy (AIT) of CMA and food allergy.

scholarly journals Improved prospects for food allergy prevention

2017 ◽  
Vol 9 (4) ◽  
pp. 254 ◽  
Author(s):  
Rohan Ameratunga
Keyword(s):  
Food Allergy ◽  
High Risk ◽  
Allergy Prevention ◽  
Window Of Opportunity ◽  
Early Introduction ◽  
The World ◽  
Food Challenges ◽  
High Risk Children

ABSTRACT Three recent publications from Professor Gideon Lack have fundamentally changed our understanding of how to prevent food allergy. His team has shown that early introduction of allergenic foods may prevent food allergy in most but not all high-risk children. Various allergy and paediatric societies around the world are changing their recommendations based on these three studies. It appears there is a window of opportunity to safely introduce allergenic foods to high-risk children. This has resource implications, as some of these children will need testing and food challenges.

Nutritional Management of Pediatric Food Hypersensitivity

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_3) ◽  
pp. 1645-1653 ◽  
Author(s):  
Shideh Mofidi
Keyword(s):  
Food Allergy ◽  
Food Group ◽  
Food Hypersensitivity ◽  
Nutritional Management ◽  
Short Term ◽  
Solid Foods ◽  
Breastfed Infants ◽  
Food Challenges ◽  
In Infants And Children

The diagnosis and management of food allergy requires attention to several important dietary issues. Successful exclusion of identified dietary allergens requires extensive education regarding the interpretation of ingredient labels of commercial products and an appreciation for issues of cross-contact in settings such as restaurants and commercial manufacturing. Once a food or food group is eliminated, attention must be focused on potential dietary insufficiencies resulting from these exclusions. These dietary issues are also central to the successful use of diagnostic elimination diets and physician-supervised oral food challenges. This review provides a framework for the dietary management of food hypersensitivity in infants and children both for short-term diagnostic and long-term therapeutic purposes. In addition, approaches for maternal dietary restriction for breastfed infants with food allergy and the introduction of solid foods to atopic infants are reviewed.

scholarly journals Maternal Intake of Cow’s Milk during Lactation Is Associated with Lower Prevalence of Food Allergy in Offspring

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3680
Author(s):  
Mia Stråvik ◽  
Malin Barman ◽  
Bill Hesselmar ◽  
Anna Sandin ◽  
Agnes E. Wold ◽  
...  
Keyword(s):  
Food Allergy ◽  
Breast Milk ◽  
Maternal Diet ◽  
Maternal Blood ◽  
Cow’S Milk ◽  
Lower Prevalence ◽  
Food Frequency ◽  
Lactating Women ◽  
Cow's Milk ◽  
Pregnancy And Lactation

Maternal diet during pregnancy and lactation may affect the propensity of the child to develop an allergy. The aim was to assess and compare the dietary intake of pregnant and lactating women, validate it with biomarkers, and to relate these data to physician-diagnosed allergy in the offspring at 12 months of age. Maternal diet during pregnancy and lactation was assessed by repeated semi-quantitative food frequency questionnaires in a prospective Swedish birth cohort (n = 508). Fatty acid proportions were measured in maternal breast milk and erythrocytes. Allergy was diagnosed at 12 months of age by a pediatrician specialized in allergy. An increased maternal intake of cow’s milk during lactation, confirmed with biomarkers (fatty acids C15:0 and C17:0) in the maternal blood and breast milk, was associated with a lower prevalence of physician-diagnosed food allergy by 12 months of age. Intake of fruit and berries during lactation was associated with a higher prevalence of atopic eczema at 12 months of age. Our results suggest that maternal diet modulates the infant’s immune system, thereby influencing subsequent allergy development.

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