CLINICAL AND IMMUNOLOGICAL CHARACTERISTICS OF CHRONIC GASTRODUODENAL PATHOLOGY IN CHILDREN WITH FOOD ALLERGY

Today, despite the large number of research reports on food allergy, there are some issues associated with its systemic character and complicated diagnosis that requiring in-depth study of this condition. The factors to be elucidated and studied in greater detail include etiologically significant risk factors for food allergy as well as the complex immunological pathogenetic mechanisms of its development. Thus, the aim of our work was to investigate the immunological status of children with inflammatory diseases of the upper gastrointestinal tract, who had a history of food allergies. Materials and methods. The study included 34 children aged 6 – 15 years with gastroduodenal pathology and food allergy manifestations, whose parents voluntarily consented to their participating in the research. All children underwent a comprehensive allergic and immunological examination. Results and discussion. The distribution of children with gastroduodenal pathology, who had a history of allergic response when consuming food, by immunoglobulin E level, was almost uniform. Analysis of cytokine status has shown a prevalence of pro-inflammatory cytokine - interleukin-4 in more than half (56.3%) of the patients with IgE-mediated allergic reactions to food vs. 38.9% of children in the comparison group. Over the study, it has been found out that elevated levels of the thymus-associated regulatory chemokine - TARC / CCL17 made up 38.3% of the total number of subjects. Conclusion. The results of the study point out the persistence of food allergic manifestations in children with chronic gastroduodenal pathology, regardless of IgE or non-IgE mediated reactions that has been confirmed by the presence of allergic inflammatory markers as interleukin-4 and TARC / CCL-17 chemokine in the deficiency of anti-inflammatory cytokine interleukin-10, which in turn necessitates the thorough monitoring of the cases and implementation of elimination measures into clinical protocols for managing this group of patients.

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Hispidulin Inhibits Mast Cell-Mediated Allergic Inflammation through Down-Regulation of Histamine Release and Inflammatory Cytokines

Molecules ◽

10.3390/molecules24112131 ◽

2019 ◽

Vol 24 (11) ◽

pp. 2131 ◽

Cited By ~ 6

Author(s):

Dong Eun Kim ◽

Kyoung-jin Min ◽

Min-Jong Kim ◽

Sang-Hyun Kim ◽

Taeg Kyu Kwon

Keyword(s):

Mast Cells ◽

Inflammatory Cytokines ◽

Immunoglobulin E ◽

Inflammatory Diseases ◽

Allergic Inflammation ◽

Interleukin 4 ◽

Type I ◽

Ige Mediated ◽

Factor Α ◽

Jnk Activation

Hispidulin (4′,5,7-trihydroxy-6-methoxyflavone) is a natural compound derived from traditional Chinese medicinal herbs, and it is known to have an anti-inflammatory effect. Here, we investigated the effect of hispidulin on the immunoglobulin E (IgE)-mediated allergic responses in rat basophilic leukemia (RBL)-2H3 mast cells. When RBL-2H3 cells were sensitized with anti-dinitrophenyl (anti-DNP) IgE and subsequently stimulated with DNP-human serum albumin (HSA), histamine and β-hexosaminidase were released from the cells by degranulation of activated mast cells. However, pretreatment with hispidulin before the stimulation of DNP-HSA markedly attenuated release of both in anti-DNP IgE-sensitized cells. Furthermore, we investigated whether hispidulin inhibits anti-DNP IgE and DNP-HSA-induced passive cutaneous anaphylaxis (PCA), as an animal model for Type I allergies. Hispidulin markedly decreased the PCA reaction and allergic edema of ears in mice. In addition, activated RBL-2H3 cells induced the expression of inflammatory cytokines (tumor necrosis factor-α and interleukin-4), which are critical for the pathogenesis of allergic disease, through the activation of c-Jun N-terminal kinase (JNK). Inhibition of JNK activation by hispidulin treatment reduced the induction of cytokine expression in the activated mast cells. Our results indicate that hispidulin might be a possible therapeutic candidate for allergic inflammatory diseases through the suppression of degranulation and inflammatory cytokines expression.

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Using oral food challenges to provide clarity and confidence when diagnosing food allergies

Journal of Food Allergy ◽

10.2500/jfa.2021.3.210002 ◽

2021 ◽

Vol 3 (1) ◽

pp. 3-7 ◽

Cited By ~ 1

Author(s):

Justin Greiwe

Keyword(s):

Food Allergy ◽

Immunoglobulin E ◽

Food Challenge ◽

Clinical History ◽

The United States ◽

Oral Immunotherapy ◽

Food Allergies ◽

Ige Mediated ◽

Challenge Education ◽

Food Challenges

A verified food allergy can be an impactful life event that leads to increased anxiety and measurable effects on quality of life. Allergists play a key role in framing this discussion and can help alleviate underlying fears by promoting confidence and clarifying safety concerns. Correctly diagnosing a patient with an immunoglobulin E (IgE) mediated food allergy remains a nuanced process fraught with the potential for error and confusion. This is especially true in situations in which the clinical history is not classic, and allergists rely too heavily on food allergy testing to provide a confirmatory diagnosis. A comprehensive medical history is critical in the diagnosis of food allergy and should be used to determine subsequent testing and interpretation of the results. Oral food challenge (OFC) is a critical procedure to identify patients with an IgE-mediated food allergy when the history and testing are not specific enough to confirm the diagnosis and can be a powerful teaching tool regardless of outcome. Although the safety and feasibility of performing OFC in a busy allergy office have always been a concern, in the hands of an experienced and trained provider, OFC is a safe and reliable procedure for patients of any age. With food allergy rates increasing and analysis of recent data that suggests that allergists across the United States are not providing this resource consistently to their patients, more emphasis needs to be placed on food challenge education and hands-on experience. The demand for OFCs will only continue to increase, especially with the growing popularity of oral immunotherapy programs; therefore, it is essential that allergists become familiar with the merits and limitations of current testing modalities and open their doors to using OFCs in the office.

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Updates on Food Allergy, Increasingly Prevalent Challenge

JURNAL BIOMEDIK (JBM) ◽

10.35790/jbm.10.3.2018.21980 ◽

2018 ◽

Vol 10 (3) ◽

pp. 152

Author(s):

Tonny Tanus ◽

Sunny Wangko

Keyword(s):

Atopic Dermatitis ◽

Food Allergy ◽

Eosinophilic Esophagitis ◽

Immunoglobulin E ◽

Pediatric Population ◽

Food Allergies ◽

Food Protein ◽

Safety Issues ◽

Ige Mediated ◽

Allergic Disorders

Abstrak: Prevalensi alergi makanan makin meningkat di seluruh dunia dan mengenai semua usia. Keparahan dan kompleksitas penyakit juga meningkat terlebih pada populasi anak. Terdapat beberapa jenis reaksi alergi yang dibahas: immunoglobulin E (IgE) mediated allergies and anaphylaxis, food triggered atopic dermatitis, eosinophilic esophagitis, dan non IgE mediated gastrointestinal food allergic disorders seperti food protein induced enterocolitis syndrome (FPIEs). Tes alergi, baik melalui kulit maupun IgE yang telah dikerjakan sekian lama masih dibebani dengan hasil positif palsu dan negatif palsu yang bermakna dengan manfaat terbatas pada beberapa alergi makanan. Selain menghindari, tidak terdapat terapi yang ampuh untuk alergi makanan. Berbagai imunoterapi telah dipelajari melalui jalur, subkutan, epikutan, oral dan sublingual yang hanya menghasilkan desensitisasi sementara dan dibebani dengan berbagai isu mengenai keamanannya. Agen biologik yang menghambat sitokin/interleukin (IL) dan molekul pada reaksi alergi makanan tampaknya merupakan pilihan yang menjanjikan. Anti IgE telah dipergunakan pada asma dan urtikaria kronis. Anti IL-4 dan IL-13 yang menghambat produksi IgE diindikasikan untuk dermatitis atopik. Anti eosinofil anti IL-5 berhasil menurunkan eksaserbasi asma. Berbagai agen biologik telah dipelajari untuk berbagai kondisi alergik dan imunologik, tetapi efektivitas dan kepraktisan terapi yang mahal ini untuk alergi makanan masih menjadi tanda tanya.Kata kunci: alergi makanan, reaksi alergi, terapi alergi makananAbstract: Food allergies have been increasing in prevalence for years affecting all ages. Disease severity and complexity have also increased, especially in the pediatric population. There are several types of reactions including: immunoglobulin-E (IgE) mediated allergies and anaphylaxis, food-triggered atopic dermatitis, eosinophilic esophagitis, and non IgE mediated gastrointestinal food allergic disorders such as FPIEs. Though allergy testing has been around for years, both skin and IgE testing are burdened by significant false positives and negatives, and are only useful in some food allergies. Avoidance is the sole therapy for food allergy. A variety of immunotherapies have been studied; subcutaneous, epicutaneous, oral, and sublingual. At best they only produce a temporary state of desensitization and have many safety issues. Examples of biologicals which block critical cytokines/interleukins (IL) in allergic conditions are Anti IgE, anti IL-4 and IL-13, and Anti eosinophils, Anti IL-5. Other biologicals are being studied for allergic conditions, but whether these expensive future treatments will be proven effective and practical in food allergy is unknown.Keywords: food allergy, allergic reaction, food allergy therapy

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Immunoglobulin E (IgE)-Mediated Food Allergy in Children: Epidemiology, Pathogenesis, Diagnosis, Prevention, and Management

Medicina ◽

10.3390/medicina56030111 ◽

2020 ◽

Vol 56 (3) ◽

pp. 111 ◽

Cited By ~ 1

Author(s):

Simona Barni ◽

Giulia Liccioli ◽

Lucrezia Sarti ◽

Mattia Giovannini ◽

Elio Novembre ◽

...

Keyword(s):

Food Allergy ◽

Immunoglobulin E ◽

Public Health Problem ◽

Elimination Diet ◽

Food Allergies ◽

Major Public Health Problem ◽

Double Blind ◽

Detailed Medical History ◽

Ige Mediated

A food allergy is an immunoglobulin E (IgE)-mediated hypersensitive reaction to food, which consists in the appearance of allergic symptoms; it can vary from common urticaria to even fatal anaphylaxis. The prevalence of food allergies has been increasing in the past twenty years and it represents a major public health problem in industrialized countries. The mechanism that leads to food allergies is the lack of immunologic and clinical tolerance to food allergens. The diagnosis of IgE-mediated food allergies is based on the combined use of a detailed medical history, in-vivo, and in-vitro research of specific IgE, the elimination diet, and the double-blind placebo-controlled food challenge. The only currently available treatment for allergies is the strict elimination diet. This type of attitude, which we could define as “passive”, does not overcome the risk of accidental reactions due to involuntary intake of the culprit food. For food allergy management, an “active” approach is urgently needed, such as specific allergen immunotherapy, which is currently under development and only used for research purposes. This article aims to give an updated review of IgE-mediated food allergies in pediatric populations in terms of epidemiology, pathogenesis, prevention, diagnosis, and management.

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Food allergy epidemiology and racial and/or ethnic differences

Journal of Food Allergy ◽

10.2500/jfa.2020.2.200028 ◽

2020 ◽

Vol 2 (1) ◽

pp. 11-16

Author(s):

Jialing Jiang ◽

Christopher M. Warren ◽

Rebekah L. Browning ◽

Christina E. Ciaccio ◽

Ruchi S. Gupta

Keyword(s):

Health Care ◽

Food Allergy ◽

Health Care Utilization ◽

Immunoglobulin E ◽

Allergic Sensitization ◽

The United States ◽

Health Concern ◽

Food Allergies ◽

Care Utilization ◽

Ige Mediated

In recent decades, immunoglobulin E (IgE) mediated food allergy has become a growing public health concern. Converging evidence from cross-sectional prevalence studies, health care utilization records, and cohort studies indicate that food allergies are increasingly prevalent and often severe. Although IgE-mediated food allergy has long been considered a predominantly pediatric concern, analysis of recent self-reported data suggests that food allergies may be more prevalent among adult populations than previously acknowledged, with many reported cases of adult-onset allergies as well as persistent childhood-onset allergies. Results of studies also suggest that food allergy‐related health care utilization is increasing as more individuals seek emergency treatment for food-induced anaphylaxis. Analysis of epidemiologic data also indicates that the burden of food allergies is unequally distributed. Published prevalence rates are highest in Western countries, e.g., the United States, United Kingdom, and Australia. Within these countries, there also is heterogeneity across racial and/or ethnic groups, with non-White and second-generation immigrant populations disproportionately affected. Importantly, such observations can shed light on the etiology of food allergy and inform improved clinical management, treatment, and prevention efforts. For example, there is a growing consensus that earlier introduction of allergenic foods, e.g., peanut, promotes oral tolerance and can dramatically reduce food allergy risk. In addition, much attention has been paid to the potentially deleterious effects of cutaneous allergen exposure, e.g., through eczematous skin, which can skew the immune response away from tolerance and toward allergic sensitization, thereby increasing food allergy risk. Furthermore, there is a growing appreciation for the potential protective effects of diverse microbial exposures, given mounting evidence for the immunomodulatory effects of the human microbiome. Also, when considering the geographic variability in the prevalence of certain food and environmental allergies as well as their structural similarities at the molecular level, it is believed that co-sensitization between food and environmental allergens may be a key driver of rising food allergy prevalence.

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WAYS OF OPTIMIZING THE DIAGNOSTICS OF FOOD ALLERGIES IN CHILDREN BASED ON THE CLINICAL AND IMMUNOLOGICAL CRITERIA

Wiadomości Lekarskie ◽

10.36740/wlek202010129 ◽

2020 ◽

Vol 73 (10) ◽

pp. 2255-2260

Author(s):

Tetyana O. Kryuchko ◽

Liudmyla M. Bubyr ◽

Inna M. Nesina ◽

Olha Y. Tkachenko ◽

Olga V. Izmailova ◽

...

Keyword(s):

Atopic Dermatitis ◽

Food Allergy ◽

Interleukin 10 ◽

Interleukin 4 ◽

Food Allergies ◽

Control Group ◽

Allergic Reactions ◽

Healthy Children ◽

Clinical Criteria ◽

Immunological Markers

The aim of the research was to investigate the spectrum of food sensitization, followed by the determination of the main clinical criteria and immunological markers of food allergy in children with gastroduodenal pathology and atopic dermatitis. Materials and methods: We conducted a comprehensive clinical and immunological examination of 120 children aged from 6 to 15 years with gastroduodenal pathology (group 1; n = 64) and atopic dermatitis (group 2; n = 56), who had a history of adverse allergic reactions to food. The control group consisted of 22 apparently healthy children. Results: In the group of children with gastroduodenal pathology, the spectrum of the most common significant food allergens was represented by legumes, the reaction to which was observed in 25 (39.1%) subjects, eggs (25.0%) and fish (23.4%), which were found in every fourth child. Among patients with atopic dermatitis, the leading positions were occupied by fruits, which were registered in 20 (35.7%) children, nuts – in 15 (26.8%), honey and vegetables – in 11 (19.6%) children, respectively. The study of immunological status in comparison with the control group revealed reliable increases in pro-inflammatory T-helper-2 cytokines – interleukin-4 and chemokine TARC/CCL-17 and a simultaneous decrease in anti-inflammatory interleukin-10 in children of the 1st and 2nd groups who had gastrointestinal and skin manifestations of allergic reactions when eating food products. Conclusions: The study of peculiarities of adverse reactions to food in the examined children allowed us to identify specific clinical criteria and immunological markers of food allergy, which had certain features depending on the skin or gastrointestinal manifestations.

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Early Infant Feeding Practices as Possible Risk Factors for Immunoglobulin E-Mediated Food Allergies in Kuwait

International Journal of Pediatrics ◽

10.1155/2018/1701903 ◽

2018 ◽

Vol 2018 ◽

pp. 1-12 ◽

Cited By ~ 3

Author(s):

Dalal Alkazemi ◽

Munirah Albeajan ◽

Stan Kubow

Keyword(s):

Risk Factors ◽

Vitamin D ◽

Immunoglobulin E ◽

Food Allergies ◽

First Year ◽

Antibiotic Exposure ◽

Pediatric Allergy ◽

Potential Risk Factors ◽

Ige Mediated ◽

First Year Of Life

Objective. Early feeding and infant exposures have been suggested as potential risk factors for immunoglobulin E- (IgE-) mediated food allergy (FA). We aimed to evaluate the association between IgE-mediated FA in children and early exposures including the child’s nutritional status, breastfeeding and its duration, the age at which the solid food was first introduced, antibiotic exposure during the first year of life, and the child’s vitamin D status during infancy. Design. A case-control study. Setting and Subjects. Children aged 0–13 years were recruited from pediatric allergy and immunology clinics (PAICs) located at major government hospitals in Kuwait (total FA cases: n=100; boys = 67%), and healthy controls (n=100, boys 55%) were recruited from various vaccination units at primary healthcare centers. Results. Cow’s milk allergy was the most common type of FA. FA status was independently associated with the early exposures of exclusive breastfeeding (aOR = 15.55 (3.26–74.19), p=0.001), vitamin D deficiency or insufficiency during infancy (aOR = 5.42 (1.92–15.30), p=0.001), and antibiotic exposure during the first year of life (aOR = 5.00 (1.58–15.84), p=0.006). Conclusions. FA is highly prevalent among children in Kuwait, and our data indicate that early nutrition-related and antibiotic exposures are associated with FA risk.

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The transcriptional program, functional heterogeneity, and clinical targeting of mast cells

Journal of Experimental Medicine ◽

10.1084/jem.20170910 ◽

2017 ◽

Vol 214 (9) ◽

pp. 2491-2506 ◽

Cited By ~ 45

Author(s):

Gökhan Cildir ◽

Harshita Pant ◽

Angel F. Lopez ◽

Vinay Tergaonkar

Keyword(s):

Mast Cell ◽

Mast Cells ◽

Immunoglobulin E ◽

Inflammatory Diseases ◽

Small Population ◽

Transcriptional Program ◽

Cell Functions ◽

New Concepts ◽

Health And Disease ◽

Ige Mediated

Mast cells are unique tissue-resident immune cells that express an array of receptors that can be activated by several extracellular cues, including antigen–immunoglobulin E (IgE) complexes, bacteria, viruses, cytokines, hormones, peptides, and drugs. Mast cells constitute a small population in tissues, but their extraordinary ability to respond rapidly by releasing granule-stored and newly made mediators underpins their importance in health and disease. In this review, we document the biology of mast cells and introduce new concepts and opinions regarding their role in human diseases beyond IgE-mediated allergic responses and antiparasitic functions. We bring to light recent discoveries and developments in mast cell research, including regulation of mast cell functions, differentiation, survival, and novel mouse models. Finally, we highlight the current and future opportunities for therapeutic intervention of mast cell functions in inflammatory diseases.

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Food allergies are associated with increased disease activity in multiple sclerosis

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2018-319301 ◽

2018 ◽

Vol 90 (6) ◽

pp. 629-635 ◽

Cited By ~ 3

Author(s):

Rami Fakih ◽

Camilo Diaz-Cruz ◽

Alicia S Chua ◽

Cindy Gonzalez ◽

Brian C Healy ◽

...

Keyword(s):

Multiple Sclerosis ◽

Food Allergy ◽

Disease Activity ◽

Food Allergies ◽

Cumulative Number ◽

Biological Mechanisms ◽

Longitudinal Investigation ◽

Disability Status ◽

History Of ◽

Self Administered Questionnaire

ObjectiveThe association between allergy and multiple sclerosis (MS) is still unclear. In our study, we assessed the association between a self-reported history of allergic conditions with MS clinical and MRI disease activity.MethodsA subset of 1349 patients enrolled in the Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women’s Hospital (CLIMB) study completed a self-administered questionnaire on environmental, food and drug allergies. Patients were distributed among four allergy groups: (1) environmental, (2) food, (3) drug, (4) no known allergies (NKA). Clinical (number of attacks, expanded disability status scale (EDSS), MS severity score (MSSS)) and radiological variables (presence of gadolinium-enhancing lesions and lesion count), and their associations with the different allergy groups or those with NKA, were assessed.ResultsThe food allergy group had a 1.38 times higher rate for cumulative number of attacks compared with the NKA group (P=0.0062); this difference remained significant in the adjusted analysis (relapse rate ratio 1.27, P=0.0305). The food allergy group showed more than twice the likelihood (OR 2.53, P=0.0096) of having gadolinium-enhancing lesions on MRI. The environmental and drug allergy groups did not show significant differences when compared with the NKA group. The EDSS and MSSS were not affected by any type of allergy.ConclusionsMS patients with food allergy had more relapses and a higher likelihood of gadolinium-enhancing lesions compared with patients with no known allergy. Future prospective studies are needed to confirm our findings and investigate underlying biological mechanisms, which may unveil new therapeutic and preventative strategies for MS.

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Food Allergies

10.2310/tywc.4077 ◽

2018 ◽

Author(s):

Edmond A. Hooker ◽

Charles Kircher

Keyword(s):

Food Allergy ◽

Action Plan ◽

The United States ◽

Emergency Department Visits ◽

Food Allergies ◽

Cell Mediated Immunity ◽

Clinical Criteria ◽

Rome Iii ◽

Ige Mediated ◽

Irritable Bowel

Food allergies are responsible for a considerable number of emergency department visits. Food allergy can be divided into classic (i.e., IgE-mediated) reactions to specific allergens after exposure via skin or mucosal membrane and non–IgE-mediated food allergies, which include T cell–mediated immunity, enteropathies to specific proteins, and mixed disorders (e.g., eosinophilic esophagitis). Food-induced anaphylaxis can be life threatening and requires immediate treatment with epinephrine, even if the causative agent has not been identified. This review describes the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes for patients with food allergies. Figures show IgE-mediated allergic reactions to food and other allergens, classification of adverse reactions to foods, commercially available epinephrine autoinjectors, a sample anaphylaxis action plan, and a map showing school access to epinephrine in the United States as of September 4, 2014. Tables list potential food allergies with estimated self-reported prevalence, National Institute of Allergy and Infectious Disease clinical criteria of anaphylaxis, non–IgE-mediated food intolerance disorders, Rome III diagnostic criteria for irritable bowel syndrome, food allergy mimickers, and potential criteria for prolonged observation. This review contains 5 highly rendered figures, 6 tables, and 54 references.

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