IgE-Mediated Fish Allergy in Children

The term hypersensitivity refers to diseases caused by an immune response, regardless of whether the response is against a pathogen, nonpathogen, or self and regardless of whether the response is directed by antibodies, lymphocytes, or innate pathways. The term anaphylaxis was coined in 1902 by Charles Richet, who received the Nobel Prize in 1913; this systemic allergic response is now known to be an immediate hypersensitivity reaction, initiated by allergen delivered to a host having allergen-specific IgE, thereby causing an IgE-mediated immunologic response and activating mast cells and basophils to secrete bioactive mediators. In 2005, the National Institutes of Health organized a consensus conference to develop a working definition of anaphylaxis, designed to be used by physicians at the bedside, as a serious allergic reaction that is rapid in onset, typically eliciting various combinations of cutaneous, cardiovascular, respiratory, and gastrointestinal manifestations, and may cause death.1,2 This facilitated the early treatment of such patients with epinephrine. Confusion arises over the misapplication of the term allergy or hypersensitivity to describe any untoward reaction to food, medications, or environmental exposures. Furthermore, non–IgE-mediated forms of local and systemic mast cell or basophil activation events can occur, causing signs and symptoms similar to those mediated by IgE. This review contains 3 figures, 9 tables, and 62 references. Keywords: allergy, hypersensitivity, anaphylaxis, interleukin, chemokines, immunoglobulin E, mast cell, eosinophil

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Allergic Response

10.2310/im.1232 ◽

2019 ◽

Author(s):

Joud Hajjar ◽

Lawrence B Schwartz

Keyword(s):

Mast Cell ◽

Immunoglobulin E ◽

Signs And Symptoms ◽

Specific Ige ◽

Consensus Conference ◽

Allergic Response ◽

Working Definition ◽

Keywords Allergy ◽

Ige Mediated ◽

Definition Of

The term hypersensitivity refers to diseases caused by an immune response, regardless of whether the response is against a pathogen, nonpathogen, or self and regardless of whether the response is directed by antibodies, lymphocytes, or innate pathways. The term anaphylaxis was coined in 1902 by Charles Richet, who received the Nobel Prize in 1913; this systemic allergic response is now known to be an immediate hypersensitivity reaction, initiated by allergen delivered to a host having allergen-specific IgE, thereby causing an IgE-mediated immunologic response and activating mast cells and basophils to secrete bioactive mediators. In 2005, the National Institutes of Health organized a consensus conference to develop a working definition of anaphylaxis, designed to be used by physicians at the bedside, as a serious allergic reaction that is rapid in onset, typically eliciting various combinations of cutaneous, cardiovascular, respiratory, and gastrointestinal manifestations, and may cause death.1,2 This facilitated the early treatment of such patients with epinephrine. Confusion arises over the misapplication of the term allergy or hypersensitivity to describe any untoward reaction to food, medications, or environmental exposures. Furthermore, non–IgE-mediated forms of local and systemic mast cell or basophil activation events can occur, causing signs and symptoms similar to those mediated by IgE. This review contains 3 figures, 9 tables, and 62 references. Keywords: allergy, hypersensitivity, anaphylaxis, interleukin, chemokines, immunoglobulin E, mast cell, eosinophil

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Clinical manifestations of immunoglobulin E‐mediated food allergy, including pollen‐food allergy syndrome

Journal of Food Allergy ◽

10.2500/jfa.2020.2.200002 ◽

2020 ◽

Vol 2 (1) ◽

pp. 22-25

Author(s):

Pooja Varshney ◽

Jacqueline A. Pongracic

Keyword(s):

Food Allergy ◽

Immunoglobulin E ◽

Acute Infection ◽

Clinical Manifestations ◽

Gastrointestinal Symptoms ◽

Physical Exertion ◽

Allergic Reactions ◽

Cutaneous Manifestations ◽

Ige Mediated ◽

Inflammatory Drugs

Immunoglobulin E-(IgE) mediated food allergy affects people of all ages but does not have a consistent presentation and may result in various manifestations, even for an individual. The onset of symptoms is usually quite rapid, minutes to a few hours after consumption of the allergen, although exceptions exist. Cutaneous and gastrointestinal symptoms are the most common clinical manifestations; however, they are not present in all allergic reactions. Clinicians, particularly those in emergency care settings, need to be aware that the lack of cutaneous manifestations does not exclude the possibility of anaphylaxis. It is extremely unusual for food allergy reactions to present with isolated upper or lower respiratory symptoms, nor is chronic urticaria a manifestation of food allergy. Clinical manifestations of IgE-mediated food allergy range from mild to severe and, in rare cases, can be fatal. Mild, localized reactions, such as those that occur in pollen‐food allergy syndrome, occur in individuals with sensitization to pollens. A small proportion of patients with this syndrome develop anaphylaxis. Alcohol, medications (nonsteroidal anti-inflammatory drugs, antacids), physical exertion, increased body temperature, acute infection, and menstruation are factors that are known to augment the severity of food-induced allergic reactions.

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Wheat Allergy in Children: A Comprehensive Update

Medicina ◽

10.3390/medicina55070400 ◽

2019 ◽

Vol 55 (7) ◽

pp. 400 ◽

Cited By ~ 4

Author(s):

Ricci ◽

Andreozzi ◽

Cipriani ◽

Giannetti ◽

Gallucci ◽

...

Keyword(s):

Immunoglobulin E ◽

Clinical Manifestations ◽

Specific Ige ◽

Oral Immunotherapy ◽

Wheat Allergy ◽

Specific Ige Antibodies ◽

Ige Mediated ◽

Exercise Induced ◽

Dependent Mechanism

Gluten-related disorders are very common in pediatric patients. Wheat allergy is triggered by an immunoglobulin E (IgE)-dependent mechanism; its prevalence varies according to the age and region, and in Europe has been estimated to be lower than 1%. Many studies investigated the potential role of several external factors that can influence the risk to developing wheat allergy, but results are still inconclusive. It can be responsible for several clinical manifestations depending on the route of allergen exposure: food-dependent exercise-induced anaphylaxis (FDEIA), occupational rhinitis or asthma (also known as baker’s asthma), and contact urticaria. The prognosis of IgE-mediated wheat allergy in children is generally favorable, with the majority of children becoming tolerant by school age. Patients who experienced an anaphylactic reaction prior to 3 years of age and patients with higher level of wheat- or ω-5 gliadin-specific IgE antibodies seem to be at higher risk of persistent wheat allergy. The current management of patients is dietary avoidance. Nowadays, oral immunotherapy has been proposed for wheat allergy with promising results, even if further studies are necessary to establish the best protocol in order to promote tolerance in wheat-allergic children.

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Classification of adverse food reactions

Journal of Food Allergy ◽

10.2500/jfa.2020.2.200022 ◽

2020 ◽

Vol 2 (1) ◽

pp. 3-6

Author(s):

Amanda L. Cox ◽

Scott H. Sicherer

Keyword(s):

Food Allergy ◽

Immune Responses ◽

Classification System ◽

Dairy Products ◽

Adverse Reactions ◽

Immunoglobulin E ◽

Signs And Symptoms ◽

General Classification ◽

Ige Mediated

Foods can induce adverse reactions by a variety of mechanisms. An understanding of the characteristic signs and symptoms and the related mechanisms of adverse food reactions allows the clinician to efficiently diagnose and treat patients. Adverse reactions to foods can be classified based on whether there is a nonimmunologic or immunologic basis for symptoms. Food intolerance, or a nonimmunologic reaction, includes a range of responses to foods that result primarily from an individual’s intrinsic inability to metabolize a component of the food, e.g., lactose sugar in dairy products. Other nonimmunologic adverse reactions may be attributed to food toxins or pharmacologic properties pharmacologic properties of foods themselves. Immunologic adverse reactions, in contrast, involve immune responses to food and are termed food allergy. Food allergy may further be categorized based on the underlying immunopathophysiology as immunoglobulin E (IgE) mediated, non‐IgE mediated, or cell mediated. Some chronic allergic responses involve a combination of immune mechanisms. This review provides a general classification system for adverse food reactions and describes specific conditions.

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Assessment of IgE-Mediated and Non-IgE-Mediated Cow’s Milk Protein Allergy in Children

ARS Medica Tomitana ◽

10.2478/arsm-2019-0026 ◽

2019 ◽

Vol 25 (3) ◽

pp. 129-131

Author(s):

Balasa Adriana ◽

Mihai Cristina ◽

Pruna Irina ◽

Chisnoiu Tatiana ◽

Daineanu Diana ◽

...

Keyword(s):

Primary Care Physicians ◽

Milk Protein ◽

Immunoglobulin E ◽

Clinical Manifestations ◽

Specific Ige ◽

Cow Milk ◽

Cow’S Milk ◽

Cow's Milk ◽

Ige Mediated ◽

Cow’S Milk Protein

Abstract Cow’s milk protein allergy (CMPA) is the most common food allergy found in children under 3 years of age. In most cases, it occurs in infancy. Early diagnosis and appropriate treatment can decrease the risk of impaired growth. In our study, we evaluated 40 children, with ages between 1 month and 3 years, diagnosed with IgE-mediated or non-IgE-mediated CMPA, from january to december 2017, in the Department of Pediatrics of the Clinical Emergency County Hospital of Constanta. The inclusion criteria consisted of: age, natural or artificial feeding, specific IgE levels, CoMiSS score, and clinical manifestations. The Cow’s Milk-related-Symptom-Score (CoMiSS) was developed as a screening and diagnostic tool for CMPA prediction, and can guide pediatricians and primary care physicians to make an early diagnostic, as it can be easily missed. We observed a higher number of cases of CMPA registered among children who were artificially fed (57,5%), followed by those with mixed nutrition (25%), the remaining (17,5%) being represented by exclusively breastfed infants. The most frequent clinical manifestations were rashes (87,5%), failure to thrive (82,5%), regurgitation (50%) and diarrhea (35%). Further data should be collected to prove if the association between a CoMiSS score higher than 12 and specific IgE-mediated CMPA is clinically relevant, and can predict, based on clinical examination and anamnesis, high serum levels of specific immunoglobulin E. The prognosis can depend on the titre of specific IgE at the time of diagnosis, as they are more likely to develop several crossed allergies and less prone to become tolerant to cow milk proteins than those with non-IgE-mediated CMPA.

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Prevention of food allergy

Allergy and Asthma Proceedings ◽

10.2500/aap.2019.40.4269 ◽

2019 ◽

Vol 40 (6) ◽

pp. 450-452 ◽

Cited By ~ 1

Author(s):

Ashley L. Devonshire ◽

Rachel Glick Robison

Keyword(s):

Food Allergy ◽

Peanut Allergy ◽

Immunoglobulin E ◽

Skin Prick Testing ◽

Clinical Manifestations ◽

Conclusive Evidence ◽

Severe Atopic Dermatitis ◽

Early Introduction ◽

Infant Diet ◽

Specific Immunoglobulin E

Primary prevention and secondary prevention in the context of food allergy refer to prevention of the development of sensitization (i.e., the presence of food-specific immunoglobulin E (IgE) as measured by skin-prick testing and/or laboratory testing) and sensitization plus the clinical manifestations of food allergy, respectively. Until recently, interventions that target the prevention of food allergy have been limited. Although exclusive breast-feeding for the first 6 months of life has been a long-standing recommendation due to associated health benefits, recommendations regarding complementary feeding in infancy have significantly changed over the past 20 years. There now is evidence to support early introduction of peanut into the diet of infants with egg allergy, severe atopic dermatitis, or both diagnoses, defined as high risk for peanut allergy, to try to prevent development of peanut allergy. Although guideline-based recommendations are not available for early introduction of additional allergenic foods, this topic is being actively studied. There is no evidence to support additional dietary modification of the maternal or infant diet for the prevention of food allergy. Similarly, there is no conclusive evidence to support maternal avoidance diets for the prevention of food allergy.

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Alergia à Proteína do Leite de Vaca Persistente em Adulto: Relato de Caso / Persistent Cow’s Milk Allergy in Adult: Case Report

REVISTA CIÊNCIAS EM SAÚDE ◽

10.21876/rcsfmit.v5i4.400 ◽

1970 ◽

Vol 5 (4) ◽

pp. 51-60

Author(s):

José Henrique Pereira Pinto ◽

Renan Lemos de Toledo ◽

William do Prado Franquelo

Keyword(s):

Immune Response ◽

Case Report ◽

Inflammatory Disease ◽

Clinical Manifestations ◽

Milk Proteins ◽

Cow’S Milk ◽

Cow's Milk ◽

Current Prevalence ◽

Keywords Allergy ◽

Ige Mediated

RESUMOIntrodução: Alergia à Proteína do Leite de Vaca (APLV) é uma doença inflamatória secundária à reação imunológica contra uma ou mais proteínas do leite de vaca (LV) que afeta principalmente a faixa pediátrica. A real prevalência é discutida em muitos estudos. As manifestações clínicas dependem do tipo da resposta imunológica, ser IgE mediada ou não. Os sintomas se iniciam por volta dos 06 meses de vida e na maioria dos casos, esse processo alérgico regride, com o paciente desenvolvendo tolerância até a adolescência. Casuística: Relata-se um caso de um paciente do sexo masculino, apresentando desde os 6 meses de idade de anafilaxia e broncoespasmo. Nesta época foi levado em hospitais e ambulatórios sendo diagnosticado e tratado como asma apenas, porém sem sucesso. Aos 18 anos, em consulta com especialista foi diagnosticado com APLV, apesar da dieta de exclusão, apresentou diversas reações anafiláticas, devido a ingestão acidental do alérgeno. Discussão: O paciente iniciou os primeiros sintomas quando houve contato com LV e apresentou teste laboratorial com valores compatíveis a patologia. Segundo a literatura a prevalência de APLV cai para menos de 1% aos 6 anos de vida e está persistência pode estar associada a múltiplos fatores, no caso relatado, o paciente não apresentou tolerância até o presente momento. Conclusão: APLV é uma doença usualmente de criança em que, se estas não adquirirem tolerância, complicações podem perdurar indefinidamente. O Diagnóstico precoce e o manejo adequado desta condição, revela grande importância na qualidade de vida e na prevenção de anafilaxia.Palavras chave: Alergia, Proteína do leite de vaca, Anafilaxia. ABSTRACT Introduction: Allergy to cow's milk (CMPA) is an inflammatory disease Introduction: Allergy to cow's milk (CMPA) is an inflammatory disease secondary to immune response against one or more cow's milk proteins (LV) which primarily affects pediatric patients. The current prevalence is discussed in many studies. The clinical manifestations depend on the type of immune response, being IgE mediated or not. Symptoms start at about 06 months of life and in most cases, the allergic process subsides, and the patient develops tolerance through adolescence. Case Report: We report the case of a male patient, who was presenting, since his 06 months of age, anaphylaxis and bronchospasm. At that time he was taken into hospitals and clinics being diagnosed and treated as asthma, but without success. At 18, in consultation with expert was diagnosed with CMPA, and despite the exclusion diet, presented several anaphylactic reactions due to accidental ingestion of the allergen. Discussion: The patient began the first symptoms when there was contact with LV and presented laboratory test values compatible with the pathology. According to the literature the prevalence of CMPA drops to less than 1% to 6 years of life and this persistence can be associated with multiple factors, in our case, the patient did not develop tolerance to date. Conclusion: CMPA is usually a child disease but ,if they do not acquire tolerance, complications can last indefinitely. Early diagnosis and appropriate management of this condition, reveals a great deal on quality of life and prevention of anaphylaxis. Keywords: Allergy, Cow’s milk protein, Anaphylaxis.

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Immunologic Pathophysiology and Airway Remodeling Mechanism in Severe Asthma: Focused on IgE-Mediated Pathways

Diagnostics ◽

10.3390/diagnostics11010083 ◽

2021 ◽

Vol 11 (1) ◽

pp. 83

Author(s):

Shih-Lung Cheng

Keyword(s):

Severe Asthma ◽

Immunoglobulin E ◽

Airway Remodeling ◽

Real Life ◽

Allergic Diseases ◽

Proinflammatory Mediators ◽

Small Subgroup ◽

Humanized Monoclonal Antibody ◽

Severe Allergic Asthma ◽

Ige Mediated

Despite the expansion of the understanding in asthma pathophysiology and the continual advances in disease management, a small subgroup of patients remains partially controlled or refractory to standard treatments. Upon the identification of immunoglobulin E (IgE) and other inflammatory mediators, investigations and developments of targeted agents have thrived. Omalizumab is a humanized monoclonal antibody that specifically targets the circulating IgE, which in turn impedes and reduces subsequent releases of the proinflammatory mediators. In the past decade, omalizumab has been proven to be efficacious and well-tolerated in the treatment of moderate-to-severe asthma in both trials and real-life studies, most notably in reducing exacerbation rates and corticosteroid use. While growing evidence has demonstrated that omalizumab may be potentially beneficial in treating other allergic diseases, its indication remains confined to treating severe allergic asthma and chronic idiopathic urticaria. Future efforts may be bestowed on determining the optimal length of omalizumab treatment, seeking biomarkers that could better predict treatment response and as well as extending its indications.

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