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3.
Food Drug Law J ; 72(1): 103-40, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29140656

RESUMO

In a world where food allergy is still an incurable disease, law and regulation stand as necessary mechanisms to provide food-allergic consumers with the information they need to protect their health. The Food Allergen Labeling and Consumer Protection Act of 2004 provided specific labeling requirements for the "Top Eight" allergens in the U.S.: milk, soy, gluten, egg, tree nut, peanut, fish, and Crustacean shellfish. Since then, sesame has become more prevalent as an allergen and remains just as dangerous, inducing anaphylactic shock in some sesame-allergic individuals. Yet sesame remains unregulated, despite advocates and congressional members arguing for its inclusion. This note entertains one solution to this problem by exploring the most strategic way to bring a sesame allergy class action against a private food company under California's consumer protection statutes. Because this kind of class action does not have much, if any, precedent, this note analyzes the basic, preliminary issues that any litigant would have to navigate around to certify a class, including preemption, standing, and the claim itself, by focusing on how courts have examined these issues in the recent "natural" class action litigation. It also analyzes the legal, moral, and practical aspects of choosing a type of relief, as well as whom to include in the class. Finally, this note briefly considers how FDA itself can ensure sesame is regulated on the labels of food products, given that some of the legal issues may well be insurmountable for this particular class action. This note explores the potential solutions to difficult legal hurdles in constructing a sesame allergy class action, arguing that litigating a sesame allergy class action­even if it is not ultimately successful­could start a productive conversation that might lead Congress or FDA to provide greater public health and consumer protection for those with sesame allergy.


Assuntos
Rotulagem de Alimentos/legislação & jurisprudência , Hipersensibilidade a Nozes e Amendoim , Sesamum , Humanos , Estados Unidos , United States Food and Drug Administration
4.
Clin Exp Allergy ; 47(8): 1032-1037, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28544327

RESUMO

BACKGROUND: Food allergies pose a considerable world-wide public health burden with incidence as high as one in ten in 12-month-old infants. Few food allergy genetic risk variants have yet been identified. The Th2 immune gene IL13 is a highly plausible genetic candidate as it is central to the initiation of IgE class switching in B cells. OBJECTIVE: Here, we sought to investigate whether genetic polymorphisms at IL13 are associated with the development of challenge-proven IgE-mediated food allergy. METHOD: We genotyped nine IL13 "tag" single nucleotide polymorphisms (tag SNPs) in 367 challenge-proven food allergic cases, 199 food-sensitized tolerant cases and 156 non-food allergic controls from the HealthNuts study. 12-month-old infants were phenotyped using open oral food challenges. SNPs were tested using Cochran-Mantel-Haenszel test adjusted for ancestry strata. A replication study was conducted in an independent, co-located sample of four paediatric cohorts consisting of 203 food allergic cases and 330 non-food allergic controls. Replication sample phenotypes were defined by clinical history of reactivity, 95% PPV or challenge, and IL13 genotyping was performed. RESULTS: IL13 rs1295686 was associated with challenge-proven food allergy in the discovery sample (P=.003; OR=1.75; CI=1.20-2.53). This association was also detected in the replication sample (P=.03, OR=1.37, CI=1.03-1.82) and further supported by a meta-analysis (P=.0006, OR=1.50). However, we cannot rule out an association with food sensitization. Carriage of the rs1295686 variant A allele was also associated with elevated total plasma IgE. CONCLUSIONS AND CLINICAL RELAVANCE: We show for the first time, in two independent cohorts, that IL13 polymorphism rs1295686 (in complete linkage disequilibrium with functional variant rs20541) is associated with challenge-proven food allergy.


Assuntos
Alelos , Imunoglobulina E/imunologia , Interleucina-13/genética , Desequilíbrio de Ligação , Hipersensibilidade a Nozes e Amendoim , Polimorfismo de Nucleotídeo Único , Células Th2/imunologia , Austrália , Feminino , Humanos , Lactente , Interleucina-13/imunologia , Masculino , Metanálise como Assunto , Hipersensibilidade a Nozes e Amendoim/genética , Hipersensibilidade a Nozes e Amendoim/imunologia , Hipersensibilidade a Nozes e Amendoim/patologia , Células Th2/patologia
5.
Pediatr Allergy Immunol ; 28(3): 245-250, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28140482

RESUMO

BACKGROUND: Peanut allergy in children is often associated with allergies to tree nuts and/or legumes. The aim of this study was to analyze in cluster a cohort of children allergic to peanuts and assessed for cross-reactivity to nuts and legumes and to identify different phenotypes. METHODS: We included retrospectively 317 children with peanut allergy evaluated at the Allergy Unit of the Saint Vincent Hospital of Lille in the last 12 years. A complete workup for peanut allergy and nuts and legumes was carried out for each patient. A hierarchical agglomerative clustering method was used to search for clusters of individuals in the evaluated cohort. RESULTS: Cross-allergy to TN and/or other legumes was identified in 137 patients (43.2%), atopic dermatitis being a major risk factor (adjusted OR = 16 [95% CI: 7.4-37]; p < 0.001). Three phenotypes emerged from cluster analysis. Cluster 1 (72 patients) is characterized by high level of rAra h 2, low threshold reactive doses for peanut and high proportion of asthma; Cluster 2 (93 patients) is characterized by high threshold reactive doses for peanut and the lowest proportion of cross-allergy to TN and/or legumes; Cluster 3 (152 patients) has a high risk of cross-allergy to TN and/or legumes and most patients suffer from eczema. CONCLUSIONS: The three phenotypes highlighted by this study could be useful to identify children with high risk of cross-allergic reaction to TNs and legumes early after PA diagnosis.


Assuntos
Arachis/imunologia , Reações Cruzadas/imunologia , Fabaceae/imunologia , Hipersensibilidade a Nozes e Amendoim/imunologia , Nozes/imunologia , Criança , Pré-Escolar , Análise por Conglomerados , Feminino , Humanos , Masculino , Fenótipo , Estudos Retrospectivos , Testes Cutâneos
6.
Cell Mol Immunol ; 14(9): 770-782, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27063469

RESUMO

Allergen-specific immunotherapy has been proposed as an attractive strategy to actively treat food allergy using the following three different immunotherapy routes: oral (OIT), sublingual (SLIT) and epicutaneous (EPIT) immunotherapy. Regulatory T cells (Tregs) have been shown to have a pivotal role in the mechanisms of immunotherapy. The aim of this study was to compare the phenotype and function of Tregs induced in peanut-sensitized BALB/c mice using these three routes of treatment. We show that although EPIT, OIT and SLIT were all able to effectively desensitize peanut-sensitized mice, they induced different subsets of Tregs. Foxp3+ Tregs were induced by the three treatment routes but with greater numbers induced by EPIT. EPIT and OIT also increased the level of LAP+ Tregs, whereas SLIT induced IL-10+ cells. The suppressive activity of EPIT-induced Tregs did not depend on IL-10 but required CTLA-4, whereas OIT acted through both mechanisms and SLIT was strictly dependent on IL-10. Moreover, the three routes influenced the homing properties of induced Tregs differently, with a larger repertoire of chemokine receptors expressed by EPIT-induced Tregs compared with OIT- and SLIT- induced cells, resulting in different protective consequences against allergen exposure. Furthermore, whereas OIT- or SLIT-induced Tregs lost their suppressive activities after treatment was discontinued, the suppressive activities of EPIT-induced Tregs were still effective 8 weeks after the end of treatment, suggesting the induction of a more long-lasting tolerance. In summary, EPIT, OIT and SLIT mediated desensitization through the induction of different subsets of Tregs, leading to important differences in the subsequent protection against allergen exposure and the possible induction of tolerance.


Assuntos
Arachis/efeitos adversos , Imunização , Hipersensibilidade a Nozes e Amendoim/imunologia , Hipersensibilidade a Nozes e Amendoim/urina , Receptores de Retorno de Linfócitos/metabolismo , Imunoterapia Sublingual , Linfócitos T Reguladores/imunologia , Administração Cutânea , Administração Oral , Animais , Feminino , Linfonodos/metabolismo , Camundongos Endogâmicos BALB C , Fenótipo , Baço/metabolismo , Células Th2/imunologia
7.
Allergy ; 72(3): 507-510, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27892597

RESUMO

Peanut (PN) and tree nuts (TNs) are common causes of anaphylaxis in Western countries, but no information is available in Korea. To feature clinical characteristics of anaphylaxis caused by PN, TNs, and seeds, a retrospective medical record review was performed in 14 university hospitals in Korea (2009-2013). One hundred and twenty-six cases were identified, with the mean age of 4.9 years. PN, walnut (WN), and pine nut accounted for 32.5%, 41.3%, and 7.1%, respectively. The median values of specific IgE (sIgE) to PN, WN, and pine nut were 10.50, 8.74, and 4.61 kUA /l, respectively. Among 50 cases managed in the emergency department, 52.0% were treated with epinephrine, 66.0% with steroid, 94.0% with antihistamines, 36.0% with oxygen, and 48.0% with bronchodilator. In conclusion, WN, PN, and pine nut were the three most common triggers of anaphylaxis in Korean children, and anaphylaxis could occur at remarkably low levels of sIgE.


Assuntos
Anafilaxia/epidemiologia , Anafilaxia/etiologia , Hipersensibilidade a Nozes e Amendoim/epidemiologia , Sementes/efeitos adversos , Adolescente , Alérgenos/imunologia , Criança , Pré-Escolar , Feminino , Humanos , Imunoglobulina E/sangue , Imunoglobulina E/imunologia , Lactente , Masculino , Hipersensibilidade a Nozes e Amendoim/imunologia
10.
Rev Invest Clin ; 67(6): 379-86, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26950743

RESUMO

OBJECTIVE: To identify the prevalence of perceived and probable allergic reactions to peanuts, tree nuts, sesame seed, or seafood and its association with the personal history of allergic disease. METHODS: A cross-sectional study was performed in four cities of the metropolitan area of Guadalajara, located in western Mexico. Through sampling by gender and age, 1,126 subjects were included. Using a structured questionnaire, we investigated: (i) history of atopic disease, (ii) perception of allergic reaction after food intake, and (iii) probable allergic reaction to peanuts, tree nuts, sesame, or seafood. Prevalence and 95% confidence intervals were calculated. A multivariate analysis of factors associated to perceived and probable allergic reactions to food was performed by logistic regression. RESULTS: Men were 49.8%; mean age was 28.1 years; personal history of atopic disease included: allergic rhinitis (6.9%), asthma (6.8%), and atopic dermatitis (3.8%). Prevalence of perceived and probable food allergy was, respectively: pecan 0.4 and 0.3%; peanut 0.6 and 0.6%; sesame 0.1 and 0.1%; shellfish 4.2 and 4.0% (mainly shrimp); mollusk 0.8 and 0.7%; fish 1.4 and 1.2%. Asthma was significantly associated with perceived and probable allergy to pecans, peanuts, fish, or seafood. Atopic dermatitis was associated with perceived and probable allergic reaction to sea snail, seafood, shellfish, or mollusks. Finally, allergic rhinitis was associated with allergy to shrimp and crustaceans. CONCLUSIONS: This study shows that the prevalence of peanut, tree nut, sesame seed, and seafood allergy in this Mexican population is similar to that reported in developed countries.


Assuntos
Hipersensibilidade Alimentar/epidemiologia , Hipersensibilidade a Nozes e Amendoim/epidemiologia , Sesamum/imunologia , Hipersensibilidade a Frutos do Mar/epidemiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Alimentos Marinhos/efeitos adversos , Sesamum/efeitos adversos , Inquéritos e Questionários , Adulto Jovem
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