Food allergy is linked to season of birth, sun exposure, and vitamin D deficiency.

The season of birth and ultraviolet B exposure have been related to the occurrence of food allergy. The levels of vitamin D produced from skin by ultraviolet B exposure might reflect this relationship. Vitamin D is known to induce antimicrobial peptides, protect intestinal flora, enhance the gut epithelial barrier, suppress mast cell activation and IgE synthesis from B cells, and increase the number of tolerogenic dendritic cells and IL-10-producing regulatory T cells. Vitamin D deficiency has been shown to exacerbate sensitization and allergic symptoms in a murine model of food allergy. However, in clinical situations, contradictory observations have been reported regarding the relationship between food allergy and vitamin D deficiency/supplementation. In this review, we have explored the links between food allergy and vitamin D levels. One explanation for the discrepant findings is confounding factors such as race, age, residency, skin color, and epigenetic changes that contribute to vitamin D levels. In addition, the season of birth influences the development of atopic dermatitis, which could lead to food sensitization. Finally, ultraviolet radiation could lead to regulatory T cell expansion and immunosuppression, irrespective of vitamin D status. Based on our current understanding, we believe that correction of vitamin D deficiency by supplementation, appropriate skin care, and sufficient ultraviolet radiation exposure could alter the prognosis of food allergy. To identify potential treatment strategies for food allergy, it is essential to gain a better understanding of the appropriate levels of vitamin D and ultraviolet radiation exposure.

Eppikajutsuto Protects against Food Allergy Induced by Ovalbumin in a Murine Model.

BACKGROUND: Currently, there are no efficient medications available for the prevention and treatment of food allergy (FA). Herbal medicines, including traditional Japanese Kampo medicines (TJKMs), are promising therapeutic drugs. METHODS: We screened 18 TJKMs for treatment of FA symptoms in a mouse FA model induced by ovalbumin (OVA). BALB/c mice were sensitized intraperitoneally by an OVA/aluminum hydroxide gel mixture followed by 4 booster doses of oral OVA and FA symptom induction by 50 mg of OVA. TJKMs were orally administered for 28 days from the day of sensitization to the day before FA symptom induction. Evaluated FA symptoms included a decrease in body temperature and allergic diarrhea. Allergic sensitization was determined by plasma OVA-specific IgE levels. Cytokine mRNA levels in mesenteric lymph nodes, plasma mouse mast cell protease-1, and the number of mast cells in the small and large intestines were analyzed. Additionally, the therapeutic effect of the TJKM eppikajutsuto (EJT) on mast cell degranulation was determined in active anaphylaxis and passive cutaneous anaphylaxis models. RESULTS: EJT effectively prevented FA symptoms. Although OVA-specific IgE levels and the intestinal mast cell numbers were not different between the EJT-treated and untreated FA mice, plasma mMcpt1 and IL-4 levels were lower in EJT-treated FA mice than untreated FA mice. EJT could alleviate symptoms in both active and passive anaphylaxis models. CONCLUSION: EJT prevented OVA-induced FA symptoms in a mouse model, suggesting that EJT might exert its therapeutic activity via IL-4 suppression and the inhibition of mucosal mast cell degranulation.

Treatment of the chronic itch of atopic dermatitis using standard drugs and kampo medicines.

Atopic dermatitis is a common skin disease accompanied by intense itching. Relapsing eczema is caused by immune imbalances and skin-barrier disruption. The immunopathy and barrier dysfunction are closely related to the onset of itching and subsequent scratching, and intractable dermatitis is amplified by the itch-scratch cycle. The standard therapy for atopic dermatitis is topical corticosteroids and immunosuppressants to lessen the inflammation, along with moisturizing agents to improve the physiologic skin dysfunction. Corticosteroids are the primary treatment for the inflammation in atopic dermatitis. Some clinical trials demonstrated a tendency for the alleviation of pruritus with long-term treatment. Tacrolimus results in instant burning and itching in the short term, but they resolve a few days after the beginning of use and then are relieved. Substance P is a neuropeptide released from sensory nerve fibers and a neurotransmitter of pain and itching. Basic experimental reports indicated that the antipruritic effect of tacrolimus is probably dependent on depleting substance P, followed by transient induction. Oral administration of antihistamines and antiallergics is used as adjunctive pharmacotherapy for pruritus. It is known that second-generation antihistamines are less sedative or nonsedative drugs compared with the first generation, and the drugs have additional efficacy in blocking some chemical mediators. Japanese traditional Kampo medicines are also used for the treatment of atopic dermatitis. This paper discusses the efficacy of representative Kampo medicines in the treatment of inflammation and itching based on murine atopic dermatitis models. Information on the mechanism of action of Kampo medicines will result in more choice of pharmacotherapeutic agents for complex diseases such as atopic dermatitis.

Oral Nigella sativa oil ameliorates ovalbumin-induced bronchial asthma in mice.

Nigella sativa oil (NSO) is used in folk medicine as a therapy for many diseases including bronchial asthma. We investigated the possible modulating effects of NSO on asthma-like phenotypes in a mouse model of bronchial asthma. BALB/c mice were actively sensitized by intraperitoneal injections of 50 µg ovalbumin (OVA) with 1mg alum on days 0 and 12. Starting on day 22, they were exposed to OVA (1% (w/v), in sterile physiological saline) for 30 min, three times every 4th day. Negative control animals were exposed to saline in a similar manner. NSO was administered orally for 31 day from day 0 to day 30. On the day of sensitization and challenge, NSO was given 30 min before the treatment. Airway function, number of inflammatory cells in bronchoalveolar lavage fluid (BALF), levels of interleukin (IL)-4, IL-5, IL-13 and interferon (IFN)-γ in BALF, serum levels of total IgE, OVA-specific IgE, IgG1 and IgG2a, and histopathological examination of lung tissues were investigated. Oral treatment with NSO showed significant decrease in airway hyperresponsiveness, the number of total leukocytes, macrophages and eosinophils, levels of IL-4, IL-5 and IL-13 in BALF, serum levels of total IgE, OVA-specific IgE and IgG1, and significant increase in BALF level of IFN-γ and serum level of OVA-specific IgG2a, indicating restoration of local Th1/Th2 balance. Furthermore, it significantly abrogated the histopathological changes of the lungs, as the images were nearly normal. These results suggest that the treatment with oral NSO could be a promising treatment for bronchial asthma in humans.

Effect of bakumijiogan, an herbal formula in traditional Chinese medicine, on atopic dermatitis-like skin lesions induced by mite antigen in NC/Jic mice.

We evaluated the effectiveness of bakumijiogan (BJG), an herbal formula in traditional Chinese medicine used to treat atopic dermatitis (AD), using a NC/Jic mouse model of AD. AD symptoms were induced by repeated injections of Dermatophagoides farinae antigen (Df-antigen) into the ear auricle at 2- to 3-d intervals for 16 d. Ear thickness dramatically increased up to 16 d after the first injection of Df-antigen. Daily oral administration of BJG from 7 d before to 16 d after the first injection significantly reduced ear swelling. Serum concentrations of total immunoglobulin (Ig)E and Df-antigen-specific IgG1 were augmented when assayed 17 d after the first injection of Df-antigen, and these increases were slightly suppressed by BJG administration. Serum interferon (IFN)-gamma and lesional IFN-gamma mRNA levels were significantly higher, whereas lesional IL-1alpha and tumor necrosis factor-alpha mRNA levels were lower in BJG-treated mice than those in control mice. These results suggest that BJG suppressed AD-like symptoms by correcting the Th1/Th2 imbalance skewed toward Th2. Evaluation of herbal constituents in BJG revealed that the combination of two herbal ingredients, ophiopogon tuber and schisandra fruit, mainly contributed to the effects of BJG.

Pharmacological characterization of a chronic pruritus model induced by multiple application of 2,4,6-trinitrochlorobenzene in NC mice.

Female NC/Jic mice were sensitized and challenged repeatedly at 48 h intervals for 10 and 30 days by painting 1% 2,4,6-trinitrochlorobenzene (TNCB) on both ears. Mice challenged with TNCB for 30 days developed an inflammatory dermatitis with high immunoglobulin E (IgE) titer. Histological analysis with acidic Toluidine Blue staining revealed that dermal mast cells markedly differentiated and intensely degranulated, consistent with a dramatic increase in scratching behavior. A significant increase in total scratching events could be observed in mice treated with TNCB for a short period of 10 days. Extending the term of TNCB application to 30 days, the IgE titer and number of mast cells elevated significantly, and thus various drugs were evaluated pharmacologically by using the mice treated with TNCB for 30 days. Terfenadine and cyproheptadine attenuated the chronic scratching behavior. Tacrolimus and dexamethasone were less effective and cromolyn showed no effect. In addition, terfenadine and tacrolimus suppressed the degranulation of mast cells. The present chronic scratching model could be suitable to evaluate drugs effective for suppression of mast cell differentiation and degranulation by irritation, and may represent a promising tool to develop new drugs for inflammatory pruritus associated with, for example, atopic dermatitis.