New opportunities for the allergy prevention in brest fed and formula fed infants

Author(s):  
О.А. Боковская ◽  
Е.А. Турганова

В течение последних лет частота встречаемости пищевой аллергии у детей постоянно увеличивается. Одной из наиболее частых причин пищевой аллергии у детей грудного возраста является аллергия на коровье молоко. Распространенность пищевой аллергии коррелирует с растущим объемом исследований и публикаций, изучающих связь факторов окружающей среды с формированием оральной толерантности в раннем возрасте. Управление этим процессом происходит в критический период развития, который получил название «окно возможностей», и ключевая роль принадлежит микробиоте и ее метаболитам. В течение этого периода влияние окружающей среды может иметь долгосрочное воздействие на состав микробиоты, иммунную регуляцию и восприимчивость к болезням. События во время этого критического окна влияют на долгосрочное здоровье человека. Ранняя колонизация сообществом микробов в рамках определенного критического временного окна имеет решающее значение для правильного развития иммунной системы. Грудное молоко остается золотым стандартом вскармливания, но роль его в профилактике пищевой аллергии на сегодняшний день не доказана. Более детальное изучение иммунологических факторов грудного молока и механизмов диалога между микробиотой и иммунной системой, в частности, действия определенных компонентов (пробиотики, пребиотики и метаболиты), помогает разработке новых стратегий профилактики иммуноопосредованных заболеваний, в т. ч. пищевой аллергии. Пребиотики, пробиотики и метаболиты представляют на сегодняшний день огромный интерес для управления аллергией через ускорение формирования иммунологической толерантности не только для первичной, но и для вторичной профилактики при лечении аллергии к белкам коровьего молока. In recent years, the incidence of food allergies in children has been steadily increasing. One of the most common causes of food allergy in infants is cow's milk allergy. The prevalence of food allergy correlates with a growing body of research and publications investigating the relationship of environmental factors and immune development inthe newborn. The «window of opportunity» is critical period of early immune development, and the key role belongs to the microbiota and its metabolites. During this period, environmental influences can have long-term effects on microbiota composition, immune regulation, and susceptibility to disease. Events during this critical window affect long-term human health. Early colonization by the microbial community within a certain critical time window is critical for the proper development of the immune system. Breast milk remains the gold standard for feeding, but its role in preventing food allergies has yet to be proven. A more detailed study of the immunological factors of breast milk and the mechanisms of microbiome-immune crosstalk, in particular, the action of certain components (probiotics, prebiotics and metabolites), helps to develop new preventive strategies. Prebiotics, probiotics and metabolites are of great interest today for managing allergies by accelerating the formation of immunological tolerance not only for primary, but also for secondary prevention in the treatment of allergy to cow's milk proteins.

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3680
Author(s):  
Mia Stråvik ◽  
Malin Barman ◽  
Bill Hesselmar ◽  
Anna Sandin ◽  
Agnes E. Wold ◽  
...  

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.


2015 ◽  
Vol 55 (1) ◽  
pp. 13
Author(s):  
Mulya Safri ◽  
Aulia Rahman Putra

Background Atopic diseases are common in children and a serious health problem worldwide. Atopic dermatitis, food allergies, asthma and allergic rhinitis, have been described as the natural progression of allergic diseases, also known as the “allergic march”. Cow’s milk protein is known to be a common trigger of food allergies and hypersensitivity reactions during infancy. Objective To give an overview of the breast milk substitutes (BMS) and incidence of early allergy onset (allergic march) in atopic infants aged 0-6 months. Methods This cross-sectional study included a total of 40 atopic infants collected by consecutive sampling. A questionnaire was used for interview that inquired information on the type of BMS used, initial allergy complaints, the age of the emergence of early allergic symptoms, and the breakdown for BMS type. Univariate analysis was carried out to describe their characteristics as frequency distributions and percentages of each variables. Results Atopic dermatitis and wheezing were more common in boys (62.5%). Atopic dermatitis was the most common initial symptom to occur in atopic infants (52.5%). Atopic dermatitis and wheezing occurred together in 27.5% subjects. Early allergy symptoms that first occurred at the age of 1 month were seen in 42.9% for atopic dermatitis category, 37.5% for wheezing category, and 63.6% for both symptoms category, respectively. Cow’s milk was the most common type of BMS given to atopic infants in the first 6 months of life (47.5%). Conclusion Early symptoms of allergies, such as atopic dermatitis and wheezing, are more common in boys than girls. Atopic dermatitis is the most common early symptom to arise, but both symptoms occur at an early age, often during the first month of life. 


2019 ◽  
Vol 16 (2) ◽  
pp. 38-44
Author(s):  
S Yu Petrova ◽  
S V Khlgatian ◽  
V M Berzhets ◽  
L A Pishchulina ◽  
A V Vasilyeva

Identification of offending allergens in patients with food allergy is a very important part of an allergist’s activity. Objective. To study the structure оf sensitization to food allergens among children in Moscow and Moscow region and to determine the significance of sensitization to milk proteins . Methods. The level and class of specific IgE in blood serum of children with IgEmediated allergic diseases were examined with RIDA AllergyScreen method. Serum of children with high level of specific IgE to milk allergenic proteins was studied. The level and ratio of specific IgE to individual milk allergens were revealed. Results. The structure of sensitization to food allergens was determined. It was revealed that cow’s milk allergens are the leading triggers of food allergy, especially in early childhood in Moscow and the Moscow region. The features of sensitization to cow’s milk proteins among children were analyzed. Conclusions. According to the study, about half of children with IgEmediated food allergies in Moscow and the Moscow region have sensitization to cow’s milk proteins. The leading role in the frequency of sensitization belongs to whey proteins of milk. Among them sensitization to а-lactalbumin was detected more often. The questions about the selection of hypoallergenic milk formulas for feeding of children with allergy to cow’s milk proteins were discussed.


Author(s):  
Albina Galimova ◽  
Svetlana Vyazankina ◽  
Svetlana Makarova ◽  
Oksana Ereshko

Food allergy is a potentially life-threatening condition in which there are no approved pathogenetic treatments other than elimination of the causal allergen and relief of acute allergic conditions. IgE- mediated form of food allergy remains a serious and growing problem worldwide. Its prevalence is steadily increasing, and is a severe psychosocial and economic burden for patients and their families. Cow's milk and products based on it are important components of a child's diet, which are introduced into the diet of children of the first year of life, but can cause allergic reactions. The traditional management of children with cow's milk allergy consists in prescribing an elimination dairy-free diet and a significant part of patients form tolerance to milk proteins by the age of 5 years. However, with persistent forms of allergy to cows milk proteins, the question is raised about the need for "active" tactics of patient management in order to form tolerance. Oral immunotherapy is a promising approach to the treatment of food allergies based on a gradual increase in the allergen taken, by analogy with standardized immunotherapy for respiratory allergens, until a maintenance dose is reached. Each stage of oral immunotherapy should be considered as a personalized therapy. This review contains an analysis of available studies on the effectiveness of oral immunotherapy in the treatment of allergy to cow's milk proteins.


Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 1051 ◽  
Author(s):  
Julie D. Flom ◽  
Scott H. Sicherer

Immunoglobulin E (IgE)-mediated cow’s milk allergy (CMA) is one of the most common food allergies in infants and young children. CMA can result in anaphylactic reactions, and has long term implications on growth and nutrition. There are several studies in diverse populations assessing the epidemiology of CMA. However, assessment is complicated by the presence of other immune-mediated reactions to cow’s milk. These include non-IgE and mixed (IgE and non-IgE) reactions and common non-immune mediated reactions, such as lactose intolerance. Estimates of prevalence and population-level patterns are further complicated by the natural history of CMA (given its relatively high rate of resolution) and variation in phenotype (with a large proportion of patients able to tolerate baked cow’s milk). Prevalence, natural history, demographic patterns, and long-term outcomes of CMA have been explored in several disparate populations over the past 30 to 40 years, with differences seen based on the method of outcome assessment, study population, time period, and geographic region. The primary aim of this review is to describe the epidemiology of CMA. The review also briefly discusses topics related to prevalence studies and specific implications of CMA, including severity, natural course, nutritional impact, and risk factors.


2021 ◽  
Vol 2 ◽  
Author(s):  
Laura Carucci ◽  
Serena Coppola ◽  
Anna Luzzetti ◽  
Luana Voto ◽  
Veronica Giglio ◽  
...  

Cow's milk allergy (CMA) is one of the most common food allergies and one of the main causes of food-induced anaphylaxis in the pediatric age. Moreover, up to 45% of CMA children develop other atopic manifestations later in life, a phenomenon commonly named atopic march. Thus, CMA imposes a significant cost to health care systems as well as to families, and has emerged as one of the most expensive allergic diseases. The immunonutrition strategy builds its foundation on the ability of selected dietary factors to modulate immune system development and function. Recent studies highlighted the potential of immunonutrition in the management of CMA. This review is focused on the mechanisms and long-term clinical outcomes of the immunonutrition approach in children with CMA.


Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2637
Author(s):  
Lucia Liotti ◽  
Annamaria Bianchi ◽  
Paolo Bottau ◽  
Silvia Caimmi ◽  
Giuseppe Crisafulli ◽  
...  

The COVID-19 pandemic is the most challenging global health crisis of our times. Vaccination against COVID-19 plays a key role to control the current pandemic situation. The risk of allergic reactions to new COVID-19 vaccines is low. However, there is a debate on the safety in allergic patients following post marketing findings by different agencies. Our aim is to understand from current experiences whether children with cow’s milk or food allergy are at higher risk than a general population for allergic reactions to COVID-19 vaccines. Current data indicate that patients with a history of allergy to cow’s milk or other foods, even if severe, should receive COVID-19 vaccine in a setting with availability of treatments for anaphylactic reactions and under medical supervision. Recipients should be discharged after a protracted observation period of 30 min if no reaction developed.


Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 497
Author(s):  
Aikaterini Anagnostou

Background: Food allergies are common, affecting 1 in 13 school children in the United States and their prevalence is increasing. Many misconceptions exist with regards to food allergy prevention, diagnosis and management. Objective: The main objective of this review is to address misconceptions with regards to food allergies and discuss the optimal, evidence-based approach for patients who carry this diagnosis. Observations: Common misconceptions in terms of food allergy prevention include beliefs that breastfeeding and delayed introduction of allergenic foods prevent the development of food allergies. In terms of diagnosis, statements such as ‘larger skin prick tests or/and higher levels of food-specific IgE can predict the severity of food-induced allergic reactions’, or ‘Tryptase is always elevated in food-induced anaphylaxis’ are inaccurate. Additionally, egg allergy is not a contraindication for receiving the influenza vaccine, food-allergy related fatalities are rare and peanut oral immunotherapy, despite reported benefits, is not a cure for food allergies. Finally, not all infants with eczema will develop food allergies and epinephrine auto-injectors may unfortunately be both unavailable and underused in food-triggered anaphylaxis. Conclusions and relevance: Healthcare professionals must be familiar with recent evidence in the food allergy field and avoid common misunderstandings that may negatively affect prevention, diagnosis and management of this chronic disease.


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