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1.
Rev Med Suisse ; 17(733): 670-674, 2021 Apr 07.
Artigo em Francês | MEDLINE | ID: mdl-33830697

RESUMO

Food hypersensitivity represents a group of adverse immunological reactions linked to food ingestions such as anaphylaxis or eosinophilic esophagitis. Identification of the responsible food is currently based on a detailed history and complementary exams, mostly prick testing and assessment of serum specific IgE, either by ImmunoCAP or multiplex assay. Other skin and laboratory tools such as functional in vitro or patch testing are currently not validated although some show promising results in the field of food allergy. This article presents the different diagnostic procedures that are commonly and less commonly used in the workup of food allergies and their potential for future use in the workup of food-induced hypersensitivity reactions. Non-immunological reactions, rare entities (Heiner syndrome) and celiac disease will not be addressed in this review.


Assuntos
Anafilaxia , Hipersensibilidade Alimentar , Alérgenos , Alimentos , Hipersensibilidade Alimentar/diagnóstico , Humanos , Imunoglobulina E , Testes Cutâneos
2.
Rev Med Suisse ; 17(733): 680-683, 2021 Apr 07.
Artigo em Francês | MEDLINE | ID: mdl-33830699

RESUMO

Cannabis-fruit and vegetable syndrome is of recent discovery and linked to lipid transfer protein (LTP) sensitization. It is thought that the primary sensitization originates from the cannabis LTP (Can s 3). Sensitized patients can cross-react to others LTP homologs such as peach LTP (Pru p 3). Diagnosis may be challenging, as consumption of cannabis is often omitted by the patient and needs to be specifically addressed during the interview. Thus, meticulous history taking is mandatory. Laboratory workup includes LTP-specific IgE and skin testing. Management relies on allergen eviction.


Assuntos
Cannabis , Hipersensibilidade Alimentar , Alérgenos , Antígenos de Plantas , Reações Cruzadas , Hipersensibilidade Alimentar/diagnóstico , Frutas , Humanos , Imunoglobulina E , Proteínas de Plantas , Verduras
3.
Molecules ; 26(6)2021 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-33807029

RESUMO

Natural products are gaining more interest recently, much of which focuses on those derived from medicinal plants. The common chicory (Cichorium intybus L.), of the Astraceae family, is a prime example of this trend. It has been proven to be a feasible source of biologically relevant elements (K, Fe, Ca), vitamins (A, B1, B2, C) as well as bioactive compounds (inulin, sesquiterpene lactones, coumarin derivatives, cichoric acid, phenolic acids), which exert potent pro-health effects on the human organism. It displays choleretic and digestion-promoting, as well as appetite-increasing, anti-inflammatory and antibacterial action, all owing to its varied phytochemical composition. Hence, chicory is used most often to treat gastrointestinal disorders. Chicory was among the plants with potential against SARS-CoV-2, too. To this and other ends, roots, herb, flowers and leaves are used. Apart from its phytochemical applications, chicory is also used in gastronomy as a coffee substitute, food or drink additive. The aim of this paper is to present, in the light of the recent literature, the chemical composition and properties of chicory.


Assuntos
Chicória/química , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Antibacterianos/química , Antibacterianos/farmacologia , Antifúngicos/química , Antifúngicos/farmacologia , Antineoplásicos Fitogênicos/química , Antineoplásicos Fitogênicos/farmacologia , Antiparasitários/química , Antiparasitários/farmacologia , Antivirais/química , Antivirais/farmacologia , Chicória/fisiologia , Culinária , Hipersensibilidade Alimentar/etiologia , Humanos , Hipoglicemiantes/química , Hipoglicemiantes/farmacologia , Plantas Medicinais/química
4.
Arerugi ; 70(2): 118-126, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-33692271

RESUMO

OBJECTIVE: To determine the frequency and effects of accidental ingestion of packaged processed foods, eating out, and over-the-counter sales in individuals with food allergies. METHODS: The participants were guardians of children hospitalized for an oral food challenge test during January and February 2016 at the Department of Pediatrics, Sagamihara National Hospital. We conducted a questionnaire survey on food allergies, accidental ingestion via packaged processed foods, eating out, and over-the-counter sales in the past 1 year, and the degree of understanding of the display of allergen-related information. RESULTS: A total of 442 participants were given questionnaires, and 226 provided valid responses. Among these respondents, 31% had experienced accidental ingestion (packaged processed food: 24%, food service: 12%), and approximately one quarter of the subjects with allergic symptoms had repeated accidental ingestion. About 70% of the causes were due to overlooking or misunderstanding of allergen information. Of the participants, 85% were aware that processed foods must display allergen information, and 39% were aware that there was no requirement to label food sold in food service and over-the-counter sales. CONCLUSIONS: Patients with food allergies are familiar with and repeatedly experience accidental ingestion of packaged processed foods, eating out, and over-the-counter sales. In order to prevent accidental ingestion, it is important to thoroughly check allergy labeling and to instruct patients on precautions to take when eating out or over-the-counter sales.


Assuntos
Hipersensibilidade Alimentar , Alérgenos , Criança , Ingestão de Alimentos , Hipersensibilidade Alimentar/epidemiologia , Humanos , Inquéritos e Questionários
6.
Harefuah ; 160(3): 161-166, 2021 Mar.
Artigo em Hebraico | MEDLINE | ID: mdl-33749178

RESUMO

INTRODUCTION: The effect of the pregnant mother's nutrition and the effect of the baby's nutrition during the first-year on the development of allergy and atopic disease in the baby have been studied extensively in recent years. Key recommendations for healthcare bodies in Europe and the United States include: • Allergy prevention in at-risk infants (parent or sibling with allergy): Currently, there is a consensus of healthcare organizations around the world that the recommended exclusive breastfeeding duration is the first 6 months of life for the overall health benefit of the baby. Allergy prevention in non-breastfed infants at risk: There are studies showing that fully hydrolyzed formula can reduce the risk of allergic reactions, especially atopic dermatitis, in high-risk non-breastfed babies. Some recommendations for high-risk non-breastfed infants support feeding up to 4 to 6 months with hydrolyzed formulas. Further research is needed on this subject. Soy formulas failed to prevent allergy in high-risk infants. • In case of cow's milk allergy symptoms in breastfed babies: Although a small amount of food allergens may be present in the milk, mothers should be encouraged to continue breastfeeding while avoiding consumption of cow's milk and products. • In case of cow's milk allergy symptoms in non-breastfed babies: Under six months of age, extensively hydrolyzed formula is suitable for most cases of cow's milk allergy, except for severe clinical conditions, which require amino acid formulas. Over six months, soy formulas can be considered. Exposure to solid foods: The current recommendations are to start on solids at the age of 4-6 months and there is no recommendation for avoiding known allergens, despite family history. Later introduction of peanut, fish or egg does not prevent, and may even increase, the risk of developing food allergy. In order to provide a professional and appropriate response to infants and parents, it is important to know the latest guidelines, based on research from recent years as clinical recommendations have changed over the past few decades.


Assuntos
Hipersensibilidade Alimentar , Hipersensibilidade a Leite , Alérgenos , Animais , Aleitamento Materno , Bovinos , Europa (Continente) , Feminino , Hipersensibilidade Alimentar/prevenção & controle , Humanos , Lactente , Fórmulas Infantis , Gravidez
7.
Cochrane Database Syst Rev ; 2: CD013534, 2021 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-33545739

RESUMO

BACKGROUND: Eczema and food allergy are common health conditions that usually begin in early childhood and often occur together in the same people. They can be associated with an impaired skin barrier in early infancy. It is unclear whether trying to prevent or reverse an impaired skin barrier soon after birth is effective in preventing eczema or food allergy. OBJECTIVES: Primary objective To assess effects of skin care interventions, such as emollients, for primary prevention of eczema and food allergy in infants Secondary objective To identify features of study populations such as age, hereditary risk, and adherence to interventions that are associated with the greatest treatment benefit or harm for both eczema and food allergy. SEARCH METHODS: We searched the following databases up to July 2020: Cochrane Skin Specialised Register, CENTRAL, MEDLINE, and Embase. We searched two trials registers and checked reference lists of included studies and relevant systematic reviews for further references to relevant randomised controlled trials (RCTs). We contacted field experts to identify planned trials and to seek information about unpublished or incomplete trials. SELECTION CRITERIA: RCTs of skin care interventions that could potentially enhance skin barrier function, reduce dryness, or reduce subclinical inflammation in healthy term (> 37 weeks) infants (0 to 12 months) without pre-existing diagnosis of eczema, food allergy, or other skin condition were included. Comparison was standard care in the locality or no treatment. Types of skin care interventions included moisturisers/emollients; bathing products; advice regarding reducing soap exposure and bathing frequency; and use of water softeners. No minimum follow-up was required. DATA COLLECTION AND ANALYSIS: This is a prospective individual participant data (IPD) meta-analysis. We used standard Cochrane methodological procedures, and primary analyses used the IPD dataset. Primary outcomes were cumulative incidence of eczema and cumulative incidence of immunoglobulin (Ig)E-mediated food allergy by one to three years, both measured by the closest available time point to two years. Secondary outcomes included adverse events during the intervention period; eczema severity (clinician-assessed); parent report of eczema severity; time to onset of eczema; parent report of immediate food allergy; and allergic sensitisation to food or inhalant allergen. MAIN RESULTS: This review identified 33 RCTs, comprising 25,827 participants. A total of 17 studies, randomising 5823 participants, reported information on one or more outcomes specified in this review. Eleven studies randomising 5217 participants, with 10 of these studies providing IPD, were included in one or more meta-analysis (range 2 to 9 studies per individual meta-analysis). Most studies were conducted at children's hospitals. All interventions were compared against no skin care intervention or local standard care. Of the 17 studies that reported our outcomes, 13 assessed emollients. Twenty-five studies, including all those contributing data to meta-analyses, randomised newborns up to age three weeks to receive a skin care intervention or standard infant skin care. Eight of the 11 studies contributing to meta-analyses recruited infants at high risk of developing eczema or food allergy, although definition of high risk varied between studies. Durations of intervention and follow-up ranged from 24 hours to two years. We assessed most of this review's evidence as low certainty or had some concerns of risk of bias. A rating of some concerns was most often due to lack of blinding of outcome assessors or significant missing data, which could have impacted outcome measurement but was judged unlikely to have done so. Evidence for the primary food allergy outcome was rated as high risk of bias due to inclusion of only one trial where findings varied when different assumptions were made about missing data. Skin care interventions during infancy probably do not change risk of eczema by one to two years of age (risk ratio (RR) 1.03, 95% confidence interval (CI) 0.81 to 1.31; moderate-certainty evidence; 3075 participants, 7 trials) nor time to onset of eczema (hazard ratio 0.86, 95% CI 0.65 to 1.14; moderate-certainty evidence; 3349 participants, 9 trials). It is unclear whether skin care interventions during infancy change risk of IgE-mediated food allergy by one to two years of age (RR 2.53, 95% CI 0.99 to 6.47; 996 participants, 1 trial) or allergic sensitisation to a food allergen at age one to two years (RR 0.86, 95% CI 0.28 to 2.69; 1055 participants, 2 trials) due to very low-certainty evidence for these outcomes. Skin care interventions during infancy may slightly increase risk of parent report of immediate reaction to a common food allergen at two years (RR 1.27, 95% CI 1.00 to 1.61; low-certainty evidence; 1171 participants, 1 trial). However, this was only seen for cow's milk, and may be unreliable due to significant over-reporting of cow's milk allergy in infants. Skin care interventions during infancy probably increase risk of skin infection over the intervention period (RR 1.34, 95% CI 1.02 to 1.77; moderate-certainty evidence; 2728 participants, 6 trials) and may increase risk of infant slippage over the intervention period (RR 1.42, 95% CI 0.67 to 2.99; low-certainty evidence; 2538 participants, 4 trials) or stinging/allergic reactions to moisturisers (RR 2.24, 95% 0.67 to 7.43; low-certainty evidence; 343 participants, 4 trials), although confidence intervals for slippages and stinging/allergic reactions are wide and include the possibility of no effect or reduced risk. Preplanned subgroup analyses show that effects of interventions were not influenced by age, duration of intervention, hereditary risk, FLG mutation,  or classification of intervention type for risk of developing eczema. We could not evaluate these effects on risk of food allergy. Evidence was insufficient to show whether adherence to interventions influenced the relationship between skin care interventions and risk of developing eczema or food allergy. AUTHORS' CONCLUSIONS: Skin care interventions such as emollients during the first year of life in healthy infants are probably not effective for preventing eczema, and probably increase risk of skin infection. Effects of skin care interventions on risk of food allergy are uncertain. Further work is needed to understand whether different approaches to infant skin care might promote or prevent eczema and to evaluate effects on food allergy based on robust outcome assessments.


Assuntos
Eczema/prevenção & controle , Emolientes/uso terapêutico , Hipersensibilidade Alimentar/prevenção & controle , Higiene da Pele/métodos , Viés , Feminino , Hipersensibilidade Alimentar/imunologia , Humanos , Hipersensibilidade Imediata/imunologia , Imunoglobulina E/imunologia , Lactente , Recém-Nascido , Masculino , Hipersensibilidade a Leite/etiologia , Dermatopatias Infecciosas/epidemiologia , Sabões
8.
Allergol. immunopatol ; 49(1): 11-16, ene.-feb. 2021. tab, graf
Artigo em Inglês | IBECS | ID: ibc-199220

RESUMO

BACKGROUND: The prevalence of allergic disorders is on the rise, affecting about 10% of the population. In this retrospective cohort, we investigated prevalence of allergic disorders, associated risk factors, and the outcome of food allergies. MATERIAL AND METHODS: We analyzed data from birth cohorts of two university hospitals' well-child outpatient clinics. Factors related to onset and type of allergic diseases were assessed from demographic, socioeconomic, and clinical data. RESULTS: Analyses were performed on 949 (431F/518M) infants at a mean current age of 28 ± 6 months. Any allergic disease was established among 177 cases (22%); atopic dermatitis in 123 (12.8%), respiratory allergies in 55 (5.7%), and food allergy in 41 (4.3%). The risk for allergic disorders was found to be significantly increased for male gender (OR: 2.31, 95% CI; 1.54-3.46), and positive parental atopy (OR: 1.94, 95% CI; 1.31-2.86). The risk of food allergies was significantly higher in the male gender (OR: 2.47, 95% CI; 1.21-5.02), who consumed egg-white between 6 and 12 months (OR: 2.34, 95% CI; 1.22-4.48), and who were formula-fed before 6 months (OR: 2.16, 95% CI; 1.14-4.10). We found no significant association between the rate of food allergy outgrowth or food induced-anaphylaxis with regards to the timing of introducing egg-white into the diet. CONCLUSIONS: Although the introduction of egg-white into infant diet at 6-12 months of life appeared as an independent risk for any food allergy, none of the patients developed anaphylaxis. Age at symptom onset and outgrowing food allergy were similar compared to those introduced egg-white after 12 months. We recommend promoting exclusive breastfeeding during the first 6 months of life, and avoidance of prolonged restrictive diets for children with food allergy


No disponible


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Hipersensibilidade a Ovo/epidemiologia , Hipersensibilidade Alimentar/epidemiologia , Fatores de Risco , Turquia/epidemiologia , Estudos Retrospectivos , Dermatite Atópica/epidemiologia , Dermatite Atópica/terapia , Modelos Logísticos
9.
Allergol. immunopatol ; 49(1): 68-78, ene.-feb. 2021. tab, graf
Artigo em Inglês | IBECS | ID: ibc-199228

RESUMO

INTRODUCTION: Several studies have shown interactions between food allergy (FA) and asthma, but the influence of FA in asthma traits has been scarcely studied. METHODS: A real-world retrospective observational study was conducted among patients between 3 and 18 years old referred to our Asthma Clinic from November 2014 to November 2017. Data were obtained from daily clinical practice. Only patients properly diagnosed with asthma and FA were included. RESULTS: 815 patients were included: 483 asthmatics and 332 non-asthmatics and 180 FA and 635 no FA. Food allergy was statistically more prevalent among asthma patients (p = 0.014). In a high pollen exposure area, Madrid, among subjects with asthma (121 FA, 362 no-FA), sensitiza­tion to lipid transfer protein (LTP) (p = 0.016, OR: 3.064, RR: 2.512) and pollen (p = 0.016, OR: 3.064, RR: 2.512) are risk factors to have a concomitant FA diagnosis, whereas sensitization to profilin is not. Peripheral blood eosinophils were higher in subjects with asthma and FA (≥450 eos/μL) than in asthmatics without FA (≤300 eos/μL) (p = 0.031). Blood eosinophilia, using a cut-off >300 eos/μL, was only present in the FA group. Therefore, this trait should be considered when phenotyping a patient as eosinophilic asthma. Sex had an impact on several variables: height, weight, BMI, blood eosinophils count, sensitization profile, and early-onset asthma. CONCLUSIONS: Asthma and FA are closely related and the presence of FA should be investigated in every asthma patient. This study shows an association between asthma with concomitant FA and sensitization to pollen and LTP, blood eosinophilia, and growth alterations. Differences between boys and girls were also described, so a sex-specific approach is recommended


No disponible


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Hipersensibilidade Alimentar/epidemiologia , Hipersensibilidade Alimentar/imunologia , Asma/diagnóstico , Hipersensibilidade Imediata , Estudos Retrospectivos , Eosinofilia/sangue , Rinite Alérgica Sazonal/epidemiologia , Rinite Alérgica Sazonal/imunologia , Alérgenos/administração & dosagem , Alérgenos/imunologia , Análise de Variância
10.
Allergol. immunopatol ; 49(1): 150-152, ene.-feb. 2021.
Artigo em Inglês | IBECS | ID: ibc-197112

RESUMO

Food allergy immunotherapy is a promising allergen-specific approach to manage food allergy in children, although it is not exempt from adverse events, even severe. The adverse events are not predictable and furthermore cofactors can play a role in triggering them. During the COVID-19 pandemic, patients on food allergy immunotherapy should be provided with sugges-tions on how to proceed in the event of COVID-19 infection occurring or is suspected. These recommendations would be of support to clinical practitioners dealing with patients on food allergy immunotherapy since there is little data in the literature on the topic


No disponible


Assuntos
Humanos , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Pandemias , Hipersensibilidade Alimentar/complicações , Hipersensibilidade Alimentar/tratamento farmacológico , Dessensibilização Imunológica/métodos , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico
12.
Allergol Immunopathol (Madr) ; 49(1): 150-152, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33528943

RESUMO

Food allergy immunotherapy is a promising allergen-specific approach to manage food allergy in children, although it is not exempt from adverse events, even severe. The adverse events are not predictable and furthermore cofactors can play a role in triggering them. During the COVID-19 pandemic, patients on food allergy immunotherapy should be provided with suggestions on how to proceed in the event of COVID-19 infection occurring or is suspected. These recommendations would be of support to clinical practitioners dealing with patients on food allergy immunotherapy since there is little data in the literature on the topic.


Assuntos
Hipersensibilidade Alimentar/complicações , Hipersensibilidade Alimentar/terapia , Imunoterapia/efeitos adversos , /complicações , Criança , Protocolos Clínicos , Hipersensibilidade Alimentar/imunologia , Humanos , Corpo Clínico/educação
13.
Rev Med Liege ; 76(2): 77-82, 2021 Feb.
Artigo em Francês | MEDLINE | ID: mdl-33543851

RESUMO

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy. Its pathophysiology is still poorly understood. FPIES mainly affects infant and young children, although cases have been reported in adults. Its symptomatology is restricted to gastrointestinal manifestations and the onset of allergic reaction subsequent to exposure is delayed. The most common culprit for children is cow's milk. Initial clinical presentation of FPIES is oftentimes acute, though it can also be chronic. Diagnosis relies on clinical criteria, which have been recently redefined and subject to international consensus. Through two clinical cases, this report aims to describe the characteristics of this emerging disease as well as delineate the treatment thereof.


Assuntos
Enterocolite , Hipersensibilidade Alimentar , Adulto , Alérgenos , Animais , Bovinos , Criança , Pré-Escolar , Proteínas na Dieta , Enterocolite/diagnóstico , Enterocolite/etiologia , Feminino , Hipersensibilidade Alimentar/diagnóstico , Hipersensibilidade Alimentar/etiologia , Humanos , Lactente , Síndrome
15.
Curr Allergy Asthma Rep ; 21(2): 8, 2021 02 09.
Artigo em Inglês | MEDLINE | ID: mdl-33560451

RESUMO

PURPOSE OF REVIEW: The coronavirus disease 2019 (COVID-19) has challenged healthcare system capacities and safety for health care workers, reshaping doctor-patient interaction favoring e-Health or telemedicine. The pandemic situation may make difficult to prioritize patients with allergies diseases (AD), face-to-face evaluation, and moreover concern about the possible COVID-19 diagnosis, since COVID-19 shared many symptoms in common with AD. Being COVID-19 a novel disease, everyone is susceptible; there are some advances on vaccine and specific treatment. We evaluate existing literature on allergic diseases (AD): allergic rhinitis, asthma, food allergy, drug allergy, and skin allergy, and potential underlying mechanisms for any interrelationship between AD and COVID-19. RECENT FINDINGS: There is inconclusive and controversial evidence of the association between AD and the risk of adverse clinical outcomes of COVID-19. AD patients should minimize hospital and face-to-face visits, and those who have used biologics and allergen immunotherapy should continue the treatment. It is essential to wear personal protective equipment for the protection of health care workers. Social distancing, rational use of facemasks, eye protection, and hand disinfection for health care workers and patients deserve further attention and promotion. Teleconsultation during COVID-19 times for AD patients is very encouraging and telemedicine platform can provide a reliable service in patient care.


Assuntos
Asma/terapia , Hipersensibilidade Alimentar/terapia , Controle de Infecções/métodos , Rinite Alérgica/terapia , Telemedicina , Asma/imunologia , Produtos Biológicos , Dermatite Alérgica de Contato/imunologia , Dermatite Alérgica de Contato/terapia , Dermatite Atópica/imunologia , Dermatite Atópica/terapia , Dessensibilização Imunológica , Gerenciamento Clínico , Surtos de Doenças , Hipersensibilidade a Drogas/imunologia , Hipersensibilidade a Drogas/terapia , Hipersensibilidade Alimentar/imunologia , Pessoal de Saúde , Humanos , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Rinite Alérgica/imunologia
16.
Curr Opin Allergy Clin Immunol ; 21(2): 159-165, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33534416

RESUMO

PURPOSE OF REVIEW: To summarize the impact of the COVID-19 pandemic on the practice of paediatric allergy. RECENT FINDINGS: Given significant overlap in symptoms, care must be taken to differentiate routine allergic conditions from COVID-19 infection but it appears that most allergic diseases are not risk factors for a severe COVID-19 course. The full impact of restricted allergy/immunology ambulatory services will take months to years to fully understand. One benefit of having to adapt practice style is greater awareness and acceptance of shared decision-making and recognition of preference-sensitive care options in food allergy, in particular for approaches towards allergy prevention, treatment, and anaphylaxis care. Social distancing and masks have helped reduce spread of common respiratory viruses, which may be helping to lower the incidence of viral-associated wheezing episodes, enhancing evidence of the effects of preventing exposure of young children to respiratory viruses on asthma pathogenesis, as well as on allergic rhinitis. There has been a revolution in the rise of telemedicine to increase access to high-quality allergy/immunology specialty care. SUMMARY: Although the field has adapted to remain operational in the face of a significant challenge, it is important to apply lessons learned to evolve patient care and optimize treatment in the aftermath of the pandemic.


Assuntos
Asma/epidemiologia , Dermatite Atópica/epidemiologia , Eczema/epidemiologia , Hipersensibilidade Alimentar/epidemiologia , Pandemias , Rinite Alérgica/epidemiologia , Asma/terapia , Criança , Pré-Escolar , Comorbidade , Dermatite Atópica/terapia , Gerenciamento Clínico , Eczema/terapia , Hipersensibilidade Alimentar/terapia , Humanos , Rinite Alérgica/terapia , Telemedicina
17.
BMJ ; 372: n251, 2021 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-33597169

RESUMO

OBJECTIVE: To describe time trends for hospital admissions due to food anaphylaxis in the United Kingdom over the past 20 years. DESIGN: Analysis of national data, 1998-2018. SETTING: Data relating to hospital admissions for anaphylaxis and deaths, and prescription data for adrenaline autoinjector devices. PARTICIPANTS: UK population as a whole and devolved nations (England, Scotland, Wales, and Northern Ireland). MAIN OUTCOME MEASURES: Time trends, age, and sex distributions for hospital admissions for anaphylaxis due to food and non-food triggers, and how these admission rates compare with the case fatality rate (number of fatalities as a proportion of hospital admissions). RESULTS: Between 1998 and 2018, 101 891 people were admitted to hospital for anaphylaxis. Of these admissions, 30 700 (30.1%) were coded as due to a food trigger. Food anaphylaxis admissions increased from 1.23 to 4.04 per 100 000 population per year (from 1998 to 2018), an annual increase of 5.7% (95% confidence interval 5.5% to 5.9%, P<0.001). The largest increase in hospital admissions was observed in children younger than 15 years, with an increase from 2.1 to 9.2 admissions per 100 000 population per year (an annual increase of 6.6%, 95% confidence interval 6.3% to 7.0%). For comparison, the annual increase was 5.9% (5.6% to 6.2%) in people aged 15-59 years and 2.1% (1.8% to 3.1%) in those aged 60 years and older. 152 deaths were identified where the fatal event was probably caused by food induced anaphylaxis. The case fatality rate decreased from 0.7% to 0.19% for confirmed fatal food anaphylaxis (rate ratio 0.931, 95% confidence interval 0.904 to 0.959, P<0.001) and to 0.30% for suspected fatal food anaphylaxis (0.970, 0.945 to 0.996, P=0.024). At least 46% (86 of 187, which also includes 35 deaths in 1992-98) of deaths were triggered by peanut or tree nut. Cow's milk was responsible for 17 of 66 (26%) deaths in school aged children. Over the same time period, prescriptions for adrenaline autoinjectors increased by 336% (estimated rate ratio 1.113, 95% confidence interval 1.112 to 1.113; an increase of 11% per year). CONCLUSIONS: Hospital admissions for food induced anaphylaxis have increased from 1998 to 2018, however the case fatality rate has decreased. In school aged children, cow's milk is now the most common single cause of fatal anaphylaxis.


Assuntos
Anafilaxia/epidemiologia , Hipersensibilidade Alimentar/epidemiologia , Hospitalização/tendências , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Anafilaxia/tratamento farmacológico , Criança , Pré-Escolar , Epinefrina/uso terapêutico , Feminino , Hipersensibilidade Alimentar/tratamento farmacológico , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Simpatomiméticos/uso terapêutico , Reino Unido/epidemiologia , Adulto Jovem
18.
J Chromatogr A ; 1639: 461877, 2021 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-33545578

RESUMO

An analytical approach using high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) was developed to simultaneously detect Fagopyrum esculentum Moench (buckwheat) and cereals containing gluten (Triticum species including wheat and spelt, rye, barley, and oats) that were specified in regulations for food allergen labeling on processed foods. Trypsin-digested peptides were purified from different processed food commodities and heptapeptides derived from buckwheat 13S globulin (GFIVQAR, m/z 395.8 [precursor] > 177.0 [product]) and Triticum low molecular weight glutenin (QIPEQSR, m/z 429.3 [precursor] > 616.2 [product]) were specifically detected each species at levels as low as 0.050-0.056 µg/L and 0.028-0.032 µg/L, respectively. Detection of these synthetic peptides was quantitative to over 100 µg/L by reference to the synthetic peptide calibration curves and at recovery rates, 76.6 ± 4.1%-104.8 ± 17.1% and 82.4 ± 2.0%-105.8 ± 5.3%, for GFIVQAR and QIPEQSR, respectively, when 1-1,000 µg of these peptides were spiked into a retort tomato sauce for pasta or dried instant soup. In combination with LC-MS/MS detection methods specific to other cereals containing gluten (rye, barley, and oats), the developed analytical approach was applicable to a wide variety of processed food commodities for food allergen labeling.


Assuntos
Alérgenos/análise , Grão Comestível/química , Análise de Alimentos , Hipersensibilidade Alimentar/diagnóstico , Espectrometria de Massas em Tandem/métodos , Cromatografia Líquida de Alta Pressão , Peptídeos/análise
19.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(1): 123-129, 2021 Jan 06.
Artigo em Chinês | MEDLINE | ID: mdl-33455144

RESUMO

Allergic diseases have continued to increase year by year causing serious physical and mental injury to patients, families and individuals. This increase has been driven by conventional environmental and nutritional changes but is also created by the continual introduction of food additives into the diet and novel interior decoration materials into the living space. The causes of allergic diseases are complex and diverse, and the medical laboratory often is not be able to identify the allergic trigger; this creates a difficult environment to identify the appropriate clinical treatment for disease prevention and control. Physicians must be able to identify these triggers to help patients avoid the underlying allergenic cause of their disease. This can only be done by actively knowing a patient's medical history, identifying the clinical manifestations of hypersensitivity and utilizing confirmatory testing as an important clinical tool in identifying the allergic source.


Assuntos
Hipersensibilidade Alimentar , Hipersensibilidade , Alérgenos , Dieta , Hipersensibilidade Alimentar/diagnóstico , Humanos , Hipersensibilidade/diagnóstico
20.
J Med Microbiol ; 70(3)2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33439115

RESUMO

Introduction. Food allergies (FAs) occur due to intestinal immune dysfunction elicited by dysbiotic conditions. It was previously determined by us that Citrobacter species propagate in the faeces of mice with FAs and worsen allergic symptoms by inducing the allergenic cytokine IL-33. Dendritic cells can play important roles in regulation of FA responses.Hypothesis. Citrobacter species propagating in intestines of mice worsen allergic symptoms by stimulating dendritic cells to induce IL-33 expression.Aim. The aim of the present study was to analyse whether C. koseri stimulates dendritic cells to induce IL-33 expression.Methodology. IL-33 expression was evaluated in a DC2.4 mouse dendritic cell line stimulated by live or heat-inactivated C. koseri JCM1658, ATP, LPS extracted from C. koseri JCM1658 or other enterobacteria by real-time PCR. The ATP concentration and number of live bacteria in the culture supernatant were measured simultaneously.Results. Live C. koseri JCM1658 induced higher levels of IL-33 expression than other enterobacteria tested, but such a response was not elicited by heat-inactivated C. koseri JCM1658. LPS extracted from C. koseri JCM1658 did not induce IL-33 expression and suppressed live C. koseri JCM1658-induced IL-33 expression via the activation of Toll-like receptor 4 signalling. Furthermore, ATP produced by C. koseri JCM1658 stimulated dendritic cells to induce IL-33 expression by stimulating the P2X7 receptor, and LPS attenuated extracellular ATP-induced IL-33 expression. C. koseri JCM1658 was observed to proliferate more vigorously and produce more ATP than other enterobacteria.Conclusion. C. koseri acts as an allergenic bacterium through ATP production, stimulating dendritic cells to induce IL-33 expression, while LPS released from inactivated C. koseri JCM1658 attenuates this allergenicity.


Assuntos
Trifosfato de Adenosina/metabolismo , Citrobacter koseri/patogenicidade , Infecções por Enterobacteriaceae , Hipersensibilidade Alimentar , Interleucina-33/imunologia , Animais , Linhagem Celular , Células Dendríticas/microbiologia , Infecções por Enterobacteriaceae/imunologia , Infecções por Enterobacteriaceae/microbiologia , Hipersensibilidade Alimentar/imunologia , Hipersensibilidade Alimentar/microbiologia , Camundongos , Transdução de Sinais
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