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2.
Int Arch Allergy Immunol ; 180(4): 264-273, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31597156

RESUMO

BACKGROUND: Adding baked food into the diets of patients with cow's milk allergy (MA) and hen's egg allergy (EA) has several benefits. OBJECTIVE: We aimed to determine baked and unbaked food tolerance and evaluate the effectiveness of laboratory findings on the prediction of baked and unbaked food tolerance in patients with MA and EA. METHODS: Clinical outcomes of the patients with MA and EA who had been exposed to oral food challenge with baked food were retrospectively analyzed. RESULTS: Ninety-one patients were evaluated. The median age of the study group was 22 months. Forty-nine and 42 patients had IgE-mediated MA and EA, respectively. While all patients with EA tolerated baked egg, 24.5% patients with MA could not tolerate baked cow's milk (BM). In patients with MA, BM tolerance showed negative association with milk-specific IgE, skin prick test (SPT), and prick-to-prick test (PTP), and the PTP was the most significant parameter (sensitivity 83.8%, specificity 91.7% for PTP ≤7 mm). Negative association was seen between milk-specific IgE, SPT, PTP, and unbaked milk (UBM) tolerance, and PTP was the most significant parameter (sensitivity 100%, specificity 55% for PTP ≤4 mm). In patients with EA, at the end of 6 months of baked hen's egg (BE) consumption, scrambled egg tolerance showed negative association with egg white-specific IgE level, egg white SPT and PTP. Egg white PTP was the most significant parameter (sensitivity 82.4%, specificity 96.0% for PTP ≤5 mm). CONCLUSION: Specific-IgE, SPT, and PTP should be kept in mind as parameters that can be used to predict tolerance to BM and BE for patients with MA and EA.


Assuntos
Alérgenos/administração & dosagem , Culinária/métodos , Dessensibilização Imunológica/métodos , Dieta/métodos , Hipersensibilidade a Ovo/patologia , Hipersensibilidade a Leite/patologia , Animais , Galinhas , Criança , Pré-Escolar , Ovos/efeitos adversos , Eosinófilos/imunologia , Feminino , Humanos , Tolerância Imunológica/imunologia , Imunoglobulina E/sangue , Lactente , Masculino , Leite/efeitos adversos
3.
Int Arch Allergy Immunol ; 180(4): 244-249, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31578023

RESUMO

INTRODUCTION: The usefulness of low-dose oral immunotherapy (OIT) for the treatment of egg allergy has been unclear. OBJECTIVE: To evaluate the efficacy and safety of OIT with low allergen cookies (LACs) containing a low dose of hen's egg. METHOD: Thirty-three patients with severe hen's egg allergy were randomly administered either OIT with LACs (n = 21) or placebo (n = 12). Two patients in the LACs group withdrew before completing OIT. The primary endpoint was the number of good responders (G-R), patients with negative results in the oral food challenge (OFC) with a final dose of 2 g hard-boiled egg whites after 4 months of OIT, in each group. Total OFC Aichi score for anaphylaxis/cumulative protein dose (TS/Pro) as the marker of severity of food allergy was also compared. Adverse events during OIT were evaluated using patients' diaries. RESULTS: The proportion of G-R in the LACs group was higher than in the placebo group (7/19 [37%] vs. 1/12 [8%], χ2 test; p = 0.077). The TS/Pro after OIT in the LACs group was lower than in the placebo group (median score, 44.2 vs. 104.1, p = 0.059; Mann-Whitney U test). The threshold and TS/Pro before and after OIT significantly improved in the LACs group (p = 0.015, p = 0.027, respectively; Wilcoxon signed-rank test). There were 99 recorded incidences of symptoms of 1,938 intake events in the LACs group during OIT. Of these, 90 were mild; no severe symptoms occurred. CONCLUSIONS: OIT with LACs potentially increases the OFC threshold and decreases allergy severity and is a relatively safe treatment modality.


Assuntos
Dessensibilização Imunológica/métodos , Hipersensibilidade a Ovo/terapia , Administração Oral , Alérgenos/administração & dosagem , Animais , Galinhas , Criança , Dessensibilização Imunológica/efeitos adversos , Método Duplo-Cego , Ovos/efeitos adversos , Humanos
6.
JAMA ; 321(11): 1081-1095, 2019 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-30874756

RESUMO

Importance: Cholesterol is a common nutrient in the human diet and eggs are a major source of dietary cholesterol. Whether dietary cholesterol or egg consumption is associated with cardiovascular disease (CVD) and mortality remains controversial. Objective: To determine the associations of dietary cholesterol or egg consumption with incident CVD and all-cause mortality. Design, Setting, and Participants: Individual participant data were pooled from 6 prospective US cohorts using data collected between March 25, 1985, and August 31, 2016. Self-reported diet data were harmonized using a standardized protocol. Exposures: Dietary cholesterol (mg/day) or egg consumption (number/day). Main Outcomes and Measures: Hazard ratio (HR) and absolute risk difference (ARD) over the entire follow-up for incident CVD (composite of fatal and nonfatal coronary heart disease, stroke, heart failure, and other CVD deaths) and all-cause mortality, adjusting for demographic, socioeconomic, and behavioral factors. Results: This analysis included 29 615 participants (mean [SD] age, 51.6 [13.5] years at baseline) of whom 13 299 (44.9%) were men and 9204 (31.1%) were black. During a median follow-up of 17.5 years (interquartile range, 13.0-21.7; maximum, 31.3), there were 5400 incident CVD events and 6132 all-cause deaths. The associations of dietary cholesterol or egg consumption with incident CVD and all-cause mortality were monotonic (all P values for nonlinear terms, .19-.83). Each additional 300 mg of dietary cholesterol consumed per day was significantly associated with higher risk of incident CVD (adjusted HR, 1.17 [95% CI, 1.09-1.26]; adjusted ARD, 3.24% [95% CI, 1.39%-5.08%]) and all-cause mortality (adjusted HR, 1.18 [95% CI, 1.10-1.26]; adjusted ARD, 4.43% [95% CI, 2.51%-6.36%]). Each additional half an egg consumed per day was significantly associated with higher risk of incident CVD (adjusted HR, 1.06 [95% CI, 1.03-1.10]; adjusted ARD, 1.11% [95% CI, 0.32%-1.89%]) and all-cause mortality (adjusted HR, 1.08 [95% CI, 1.04-1.11]; adjusted ARD, 1.93% [95% CI, 1.10%-2.76%]). The associations between egg consumption and incident CVD (adjusted HR, 0.99 [95% CI, 0.93-1.05]; adjusted ARD, -0.47% [95% CI, -1.83% to 0.88%]) and all-cause mortality (adjusted HR, 1.03 [95% CI, 0.97-1.09]; adjusted ARD, 0.71% [95% CI, -0.85% to 2.28%]) were no longer significant after adjusting for dietary cholesterol consumption. Conclusions and Relevance: Among US adults, higher consumption of dietary cholesterol or eggs was significantly associated with higher risk of incident CVD and all-cause mortality in a dose-response manner. These results should be considered in the development of dietary guidelines and updates.


Assuntos
Doenças Cardiovasculares/etiologia , Colesterol na Dieta/efeitos adversos , Ovos/efeitos adversos , Mortalidade , Adulto , Idoso , Dieta , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Estudos Prospectivos , Fatores de Risco , Autorrelato
7.
Immun Inflamm Dis ; 7(2): 74-85, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30859748

RESUMO

INTRODUCTION: Allergen-specific immunoglobulin isotype formation associated with immunoglobulin class-switching during the lactation period is the immunological background for food allergy in infants. We analyzed the serial changes in the production of feeding type-related egg- and milk-specific immunoglobulin isotypes from birth to 6 months of age with or without eczema in 84 infants. METHODS: Allergen-specific immunoglobulin G1 (IgG1), IgG2, IgG3, IgG4, IgA, and IgE levels of hen's egg and bovine milk were measured in cord blood and blood samples from infants at 2, 4, and 6 months of age by the densely carboxylated protein microarray. RESULTS: Formula and mixed feeding were associated with a rapid increase in cow's milk allergen-specific immunoglobulins and feeding type-related significant differences in casein-specific immunoglobulin levels were detected. Breast and mixed feeding were associated with slow but significant increase in ovalbumin-specific IgG1 and IgE levels, but not other immunoglobulins. We found two different immunoglobulin isotype formation at 6 months of age with low- or high-affinity IgE against ovalbumin. One isotype formation pattern had relatively high ovalbumin-specific IgG1 levels, detectable IgG2, and low-affinity IgE, while the other had low ovalbumin-specific IgG1 levels, undetectable IgG2, and high levels of high-affinity IgE. The incidence of eczema was significantly higher in the latter pattern (84.6%), compared with the remaining infants (42.2%). CONCLUSIONS: Feeding practice-related allergen sensitization and immunoglobulin isotype formation were identified during the lactation period. The development of eczema during the lactation period could potentially modify the immunoglobulin isotype formation with high levels of high-affinity IgE.


Assuntos
Alérgenos/imunologia , Eczema/imunologia , Hipersensibilidade a Ovo/imunologia , Ovos/efeitos adversos , Switching de Imunoglobulina/imunologia , Imunoglobulina E/imunologia , Hipersensibilidade a Leite/imunologia , Leite/efeitos adversos , Fatores Etários , Animais , Afinidade de Anticorpos/imunologia , Formação de Anticorpos/imunologia , Especificidade de Anticorpos/imunologia , Bovinos , Galinhas , Eczema/complicações , Hipersensibilidade a Ovo/complicações , Hipersensibilidade a Ovo/genética , Feminino , Humanos , Isotipos de Imunoglobulinas/genética , Isotipos de Imunoglobulinas/imunologia , Lactente , Recém-Nascido , Masculino , Hipersensibilidade a Leite/complicações , Hipersensibilidade a Leite/genética , Gravidez
8.
Cell Mol Biol (Noisy-le-grand) ; 65(1): 14-18, 2019 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-30782302

RESUMO

Poultry consumption, as well as egg consumption for brain cancer risk remains an important topic. The objective of this meta-analysis is to investigate the role of poultry and egg consumption for brain cancer risk. All articles about poultry and egg consumption for brain cancer were retrieved from PubMed, Web of knowledge and Wan Fang Med Online. The data was analyzed using Stata 12.0 software. Ten articles (6 articles for poultry and 5 articles for egg) were included. For poultry consumption, the summarized relative risk (RR) was 0.901 (95%CI= 0.703-1.154) for brain cancer risk, with high between-study heterogeneity (I2= 60.7%, P=0.018). Four studies reported the association between poultry consumption and glioma risk, yielding a RR of 0.873 (95%CI= 0.737-1.034, I2= 0.0%, P=0.838). The association between egg consumption and brain cancer risk was not significant (RR= 0.998, 95%CI= 0.552-1.805), with significant heterogeneity (I2= 82.6%, P< 0.001). The pooled RR for glioma risk was 1.472 (95%CI= 0.935-2.316). In summary, our results concluded that poultry and egg consumption may be not associated with the risk of brain cancer. Due to the limited quality of evidence currently available, more studies related to poultry and egg consumption for brain cancer is necessary.


Assuntos
Neoplasias Encefálicas/epidemiologia , Neoplasias Encefálicas/etiologia , Ovos/efeitos adversos , Comportamento Alimentar , Produtos Avícolas/efeitos adversos , Animais , Humanos , Fatores de Risco
9.
Ann Allergy Asthma Immunol ; 122(4): 393-400.e2, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30639434

RESUMO

BACKGROUND: Diagnosing food allergy in patients with atopic dermatitis (AD) is complicated by their high rate of asymptomatic sensitization to foods, which can lead to misdiagnosis and unnecessary food avoidance. OBJECTIVE: We sought to determine whether food-specific (sIgE) or component immunoglobulin (Ig) E levels could predict allergic status in patients with moderate to severe AD and elevated total IgE. METHODS: Seventy-eight children (median age, 10.7 years) with moderate to severe AD were assessed for a history of clinical reactivity to milk, egg, peanut, wheat, and soy. The IgE levels for each food and its components were determined by ImmunoCAP. The level and pattern of IgE reactivity to each food and its components, and their ratio to total IgE, were compared between subjects who were allergic and tolerant to each food. RESULTS: Ninety-one percent of subjects were sensitized, and 51% reported allergic reactivity to at least 1 of the 5 most common food allergens. Allergy to milk, egg, and peanut were most common, and IgE levels to each of these foods were significantly higher in the allergic group. Component IgEs most associated with milk, egg, and peanut allergy were Bos d8, Gal d1, and Ara h2, respectively. The ratio of sIgE to total IgE offered no advantage to sIgE alone in predicting allergy. CONCLUSION: Specific IgE levels and the pattern of IgE reactivity to food components can distinguish AD subjects allergic vs tolerant to the major food allergens and may therefore be helpful in guiding the clinical management of these patients.


Assuntos
Dermatite Atópica/diagnóstico , Hipersensibilidade Alimentar/diagnóstico , Imunoglobulina E/sangue , Adolescente , Adulto , Animais , Arachis/efeitos adversos , Criança , Pré-Escolar , Dermatite Atópica/sangue , Dermatite Atópica/imunologia , Ovos/efeitos adversos , Feminino , Hipersensibilidade Alimentar/sangue , Hipersensibilidade Alimentar/imunologia , Humanos , Masculino , Leite/efeitos adversos , Índice de Gravidade de Doença , Adulto Jovem
10.
Eur J Nutr ; 58(2): 785-796, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29680985

RESUMO

PURPOSE: Eggs are highly nutritious but concerns over their cholesterol content have led to dietary avoidance among many. There are also important international differences in relevant dietary guidance. We conducted the first prospective study in China investigating the association of egg consumption, cardiovascular disease (CVD) mortality, and a meta-analysis. METHODS: We included 28,024 participants without CVD at baseline (2003-8) in Guangzhou Biobank Cohort Study. All-cause and CVD mortality were identified through record linkage. We used Cox proportional hazards regression. We followed the Meta-analysis Of Observational Studies in Epidemiology reporting guidelines. RESULTS: During 275,343 person-years follow-up (average 9.8 years), we found 2685 all-cause and 873 CVD deaths. We found no significant difference in all-cause mortality between higher (7+ eggs/week) and low consumption (< 1 egg/week) [adjusted hazard ratio (HR) 1.08, 95% confidence interval (CI) 0.93-1.24], and mortality from CVD (0.99, 95% CI 0.76-1.27), ischemic heart disease (IHD) (0.92, 95% CI 0.63-1.36), or stroke (0.88, 95% CI 0.57-1.35). The updated meta-analyses including our results showed that 7+ eggs/week was not associated with all-cause mortality (HR 1.09, 95% CI 0.997-1.200) or IHD (HR 0.97, 95% CI 0.90-1.05), but associated with a small reduction in stroke (HR 0.91. 95% CI 0.85-0.98). CONCLUSIONS: Eating one egg daily is not associated with increase in CVD or all-cause mortality. The small observed reduction in stroke risk needs to be confirmed. Our findings support current guidelines recommending eggs as part of a healthy diet, and should be considered in other dietary recommendations.


Assuntos
Doenças Cardiovasculares/epidemiologia , Dieta/métodos , Ovos/efeitos adversos , China/epidemiologia , Estudos de Coortes , Morte , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Acidente Vascular Cerebral/mortalidade , Inquéritos e Questionários
11.
Pediatr Allergy Immunol ; 30(2): 225-233, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30475427

RESUMO

BACKGROUND: Hen's egg food allergy is frequent in childhood and phenotypically heterogeneous. Some children can tolerate extensively heated egg. We investigated whether individual relative responses could differentiate children who tolerate baked egg. METHODS: Reactivities to raw, pasteurized or hard-boiled egg (E), egg white (EW), and egg yolk (EY) fractions were tested by skin prick test (SPT) in 54 egg-allergic children. IgE-sensitization to EW and EY was determined by ImmunoCAP and IgE-binding to EW and 8 EW proteins and to EY and 4 EY sub-fractions by ELISA. Population heterogeneity was assessed by hierarchical ascending classification upon individual variations of reactivity and links between classifications and clinical features by analyzing the contingency tables. RESULTS: All children had positive SPT to raw E and raw EW and 72% to raw EY. Heating decreased SPT-reactivity for some children, pasteurization being less effective than hard-boiling. Children were classed into three classes from relative SPT-reactivity to raw fractions, two from variations of SPT-reactivity with each thermal processing or EW/EY ratio of sensitization, and four from their sensitization pattern. Classifications according to heating were found independent of each other. SPT variations with hard-boiling, IgE-sensitization (ratio or pattern) were linked to allowance by the physicians of egg in baked products. CONCLUSIONS: Egg-allergic children were often both sensitized to EY and EW, and heterogeneous patterns of relative responses were evidenced. Irrespective of age and level of sensitization, a low EW/EY ratio or SPT getting null with hard-boiling was found in children allowed to eat baked egg.


Assuntos
Hipersensibilidade a Ovo/imunologia , Ovos/efeitos adversos , Tolerância Imunológica/imunologia , Administração Oral , Biomarcadores/sangue , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Feminino , França , Calefação , Humanos , Imunoglobulina E/sangue , Lactente , Masculino , Pasteurização , Testes Cutâneos/métodos
12.
Am J Clin Nutr ; 108(5): 1121-1128, 2018 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-30329007

RESUMO

Background: Meat intake is associated with increased risk of type 2 diabetes (T2D). It is not clear if egg intake is associated with T2D risk because purported associations may be due to concurrent consumption of eggs with meat. Objective: Our aim was to differentiate any associations between meat and egg consumption and the risk of T2D. Design: In this longitudinal study, 55,851 participants of the Adventist Health Study 2 who were free of diabetes provided demographic, anthropometric, and dietary data at baseline. Meat and egg intakes were assessed with a validated quantitative food-frequency questionnaire. Responses to 2 follow-up questionnaires determined incident T2D cases. Multivariate-adjusted logistic regression was used to determine relations between meat and egg intake and incident T2D. Results: T2D cases identified during a mean 5.3 y of follow-up totaled 2772. Meat intake of >0 to <25 g/d, ≥25 to <70 g/d, and ≥70 g/d significantly increased the risk of T2D compared with no meat intake (OR: 1.29; 95% CI: 1.16, 1.44; OR: 1.42; 95% CI: 1.25, 1.61; and OR: 1.65; 95% CI: 1.39, 1.96, respectively; P-trend < 0.0001). Egg intake compared with no egg intake was not associated with T2D risk. A significant meat-egg interaction (P = 0.019) showed that within every category of egg intake, there was an incremental rise in T2D risk as meat intake increased. However, within categories of meat intake, increasing egg intake did not increase the risk of T2D except among nonmeat-eaters consuming ≥5 eggs/wk (OR: 1.52; 95% CI: 1.09, 2.12). Conclusions: Meat consumption, but not egg consumption, is independently associated with T2D risk. Egg intake seems not to increase T2D risk further with meat intake. Our findings suggest that the purported egg-T2D risk relation in US populations may be biased due to failure to investigate egg-meat interactions. Further investigations are needed to ascertain T2D risk among nonmeat-eaters with high egg intakes.


Assuntos
Diabetes Mellitus Tipo 2/etiologia , Dieta , Ovos/efeitos adversos , Comportamento Alimentar , Carne/efeitos adversos , Adulto , Idoso , Inquéritos sobre Dietas , Ingestão de Energia , Feminino , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Razão de Chances , Estudos Prospectivos , Fatores de Risco
14.
Allergy ; 73(11): 2214-2223, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30028905

RESUMO

BACKGROUND: Studies suggest early egg introduction (EEI) in the first year of life is associated with reduced risk of developing egg allergy. No US recommendations exist regarding optimally implementing EEI. METHODS: Using simulation and Markov modelling over a 20-year horizon, we explored optimal EEI strategies applied to US, European and Canadian populations, comparing screening of high-risk infants (skin prick testing [SPT] or serum-specific IgE[sIgE]) before introducing cooked egg at 6 months of life vs egg introduction at home, without screening, for all infants. RESULTS: A no-screen approach dominated egg SPT screening of high-risk infants with early-onset eczema. Base model per-patient incremental costs of SPT were $6865 US dollars (USD), 6801 euros and $10 610 Canadian dollars (CAD). For egg sIgE screening in primary care settings, base model incremental costs were $16 722 USD, 18 072 euros and $28 193 CAD. As the simulation concluded 2.5% were egg allergic without screening vs 9.5%, 12% and 21.4% of children undergoing SPT, delayed introduction or sIgE screening. Incremental societal costs from screening reached $2 009 351 175 USD for SPT and $4 894 445 790 USD for sIgE testing. In sensitivity analyses, if the risk of reaction with initial egg ingestion was ≥22.5%, SPT before EEI became a preferred strategy. A no-screen approach dominated both EEI of raw pasteurized egg and delayed cooked egg introduction approaches. CONCLUSIONS: Assuming initial reaction rates < 22.5%, a no-screening EEI cooked egg approach has superior health and economic benefits in terms of number of egg allergy cases prevented and total healthcare costs vs screening testing.


Assuntos
Exposição Dietética , Hipersensibilidade a Ovo/epidemiologia , Hipersensibilidade a Ovo/prevenção & controle , Fatores Etários , Criança , Pré-Escolar , Hipersensibilidade a Ovo/diagnóstico , Hipersensibilidade a Ovo/imunologia , Ovos/efeitos adversos , Feminino , Humanos , Imunoglobulina E/imunologia , Lactente , Masculino , Cadeias de Markov , Vigilância em Saúde Pública , Comportamento de Redução do Risco , Sensibilidade e Especificidade , Testes Cutâneos/economia , Testes Cutâneos/métodos
15.
Ital J Pediatr ; 44(1): 77, 2018 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-29980243

RESUMO

The relationship between the timing of introduction of complementary foods and later allergy is a topic of current discussion. Although the European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) has recently recommended that potentially allergenic foods may be introduced when complementary feeding is commenced, any time after 4 months, recommendations about egg introduction would be needed mainly for infants with high risk of developing food allergy. Before the first administration in these infants an adequate topical therapy and an evaluation of whole egg-specific IgE serum antibody levels or skin prick tests for egg should be recommended.


Assuntos
Arachis , Hipersensibilidade Alimentar/imunologia , Tolerância Imunológica/fisiologia , Fenômenos Fisiológicos da Nutrição do Lactente , Ovos/efeitos adversos , Feminino , Hipersensibilidade Alimentar/diagnóstico , Humanos , Lactente , Alimentos Infantis , Masculino , Testes Cutâneos
16.
Int Arch Allergy Immunol ; 177(1): 40-44, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29874663

RESUMO

BACKGROUND: Many researchers have made efforts to develop diagnostic tools for predicting the outcome of oral food challenges (OFCs). The aim of this study was to assess the diagnostic value of the skin prick test (SPT) and blood-specific IgE concentrations based on the outcome of the OFCs for heated and raw hen egg. METHODS: This study included 103 children with suspected hen egg allergy (HEA; median age 23 months, range 10-155; 72 boys, 31 girls). Forty-three patients were diagnosed with HEA by OFC. Of 60 patients who tolerated heated egg white (HEW), 22 underwent the OFC for raw hen egg and 7 developed adverse reactions after ingesting raw egg. Their wheal diameters and specific IgE levels for egg white and ovomucoid were determined. RESULTS: Wheal diameters as well as blood-specific IgE levels for egg white and ovomucoid were significantly larger in children with positive OFC results for HEW than in those with negative results. However, there were no significant differences between the positive and negative test results for raw hen egg white (REW) in wheal diameter or blood-specific IgE levels. CONCLUSIONS: The SPT and blood-specific IgE can be used to diagnose HEA. However, the provocation test for REW in children without HEW allergy is important because the values of SPT and specific IgE were not significantly different between children with and without raw egg allergy.


Assuntos
Alérgenos/imunologia , Hipersensibilidade a Ovo/diagnóstico , Hipersensibilidade a Ovo/imunologia , Ovos/efeitos adversos , Alérgenos/administração & dosagem , Criança , Pré-Escolar , Clara de Ovo/efeitos adversos , Feminino , Humanos , Imunoglobulina E/sangue , Imunoglobulina E/imunologia , Testes Imunológicos , Lactente , Masculino , Razão de Chances , Curva ROC , Testes Cutâneos
17.
Nutr Diabetes ; 8(1): 20, 2018 04 25.
Artigo em Inglês | MEDLINE | ID: mdl-29695709

RESUMO

BACKGROUND/OBJECTIVES: It remains unclear if high egg consumption has beneficial or adverse effects on cardiometabolic health. The present study prospectively evaluated the longitudinal association between egg-consumption levels and incident cardiovascular disease (CVD) among Korean adults. SUBJECTS/METHODS: We conducted a prospective cohort study of 9248 Korean adults aged 40-69 years without CVD or cancer at the baseline from the Korean Genome and Epidemiology Study, Ansung-Ansan cohort, South Korea. The egg intake of the participants was estimated using a validated semiquantitative food frequency questionnaire at the baseline and the second follow-up examination and categorized into quartiles. CVD cases were identified using biennial questionnaires and confirmed through repeated in-depth personal interviews. Hazard ratios (HR) and 95% confidence interval (CI) were analyzed using Cox proportional hazard regression. RESULTS: During the average follow-up of 7.3 years, 570 cases of CVD were newly diagnosed. After adjusting for multiple confounding variables, egg-intake levels were not associated with CVD incidence (HR: 1.14, 95% CI: 0.87-1.49, P for trend: 0.7). However, the association was modified by type 2 diabetes mellitus (T2DM) status. Egg consumption was significantly associated with an increased risk for incident CVD among participants with T2DM; individuals with the highest egg intake (4.2 ± 0.04 eggs/week) had a 2.8 times higher incidence of CVD (HR: 2.81, 95% CI: 1.25-6.30, P for trend: 0.02) than those with the lowest egg intake (0.1 ± 0.02 eggs/week). However, no association was observed among individuals without T2DM (HR: 1.03, 95% CI: 0.77-1.38, P for trend: 0.8). CONCLUSIONS: Higher egg consumption may increase the risk for CVD in Korean patients with T2DM. Our findings provide a basis for the development of an optimal dietary cholesterol intake guideline for the Korean population.


Assuntos
Doenças Cardiovasculares/etiologia , Diabetes Mellitus Tipo 2/complicações , Dieta , Ovos/efeitos adversos , Comportamento Alimentar , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , Inquéritos sobre Dietas , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , República da Coreia , Inquéritos e Questionários
18.
J Agric Food Chem ; 66(11): 2970-2976, 2018 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-29493227

RESUMO

This work aimed to assess the contribution of the major egg white proteins, ovalbumin, ovomucoid, and lysozyme, to the induction and elicitation of allergenic responses. For this purpose, BALB/c mice were orally administered either the individual egg allergens or a mixture of the three proteins in the same proportion, to evaluate their relative allergenicity avoiding their different abundance in egg white. Cholera toxin was used as a T helper 2 (Th2)-polarizing adjuvant. Ovomucoid and lysozyme triggered the most severe anaphylaxis reactions upon oral challenge. In comparison to ovalbumin and ovomucoid, lysozyme was a more active promotor of early immunoglobulin E and immunoglobulin G1 production and stimulated stronger Th2-biased responses from both mesenteric lymph node and spleen cells. These results indicate that lysozyme is highly immunogenic and should be considered as a major allergen, whose clinical usefulness in the diagnosis, prognosis, and therapeutic approaches of egg allergy deserves further consideration.


Assuntos
Hipersensibilidade a Ovo/imunologia , Proteínas do Ovo/imunologia , Animais , Galinhas , Ovos/efeitos adversos , Ovos/análise , Feminino , Humanos , Imunoglobulina E/imunologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Muramidase/imunologia , Ovalbumina/imunologia , Ovomucina/imunologia
19.
Curr Opin Allergy Clin Immunol ; 18(3): 214-221, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29601353

RESUMO

PURPOSE OF REVIEW: To assess the recent studies that focus on specific immunoglobulin E (sIgE) testing and basophil activation test (BAT) for diagnosing IgE-mediated food allergies. RECENT FINDINGS: The sIgE to allergen extract or component can predict reactivity to food. The cutoff value based on the positive predictive value (PPV) of sIgE can be considered whenever deciding whether oral food challenge (OFC) is required to diagnose hen's egg, cow's milk, wheat, peanut, and cashew nut allergy. However, PPV varies depending on the patients' background, OFC methodology, challenge foods, and assay methodology. Component-resolved diagnostics (CRD) has been used for food allergy diagnosis. Ovomucoid and omega-5 gliadin are good diagnostic markers for heated egg and wheat allergy. More recently, CRD of peanut, tree nuts, and seed have been investigated. Ara h 2 showed the best diagnostic accuracy for peanut allergy; other storage proteins, such as Jug r 1 for walnut, Ana o 3 for cashew nut, Ses i 1 for sesame, and Fag e 3 for buckwheat, are also better markers than allergen extracts. Some studies suggested that BAT has superior specificity than skin prick test and sIgE testing. SUMMARY: The sIgE testing and BAT can improve diagnostic accuracy. CRD provides additional information that can help determine whether OFCs should be performed to diagnose food allergy.


Assuntos
Alérgenos/análise , Hipersensibilidade Alimentar/diagnóstico , Imunoglobulina E/sangue , Testes Imunológicos/métodos , Alérgenos/imunologia , Biomarcadores/análise , Laticínios/efeitos adversos , Proteínas na Dieta/imunologia , Ovos/efeitos adversos , Hipersensibilidade Alimentar/sangue , Hipersensibilidade Alimentar/imunologia , Humanos , Imunoglobulina E/imunologia , Nozes/imunologia , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Triticum/imunologia
20.
Artigo em Inglês | MEDLINE | ID: mdl-29461206

RESUMO

BACKGROUND: Oral immunotherapy (OIT) is a new approach in patients with food allergy. Various immunological mechanisms underlie the reversal of food allergy. In this paper, we study possible changes in peripheral cytokine patterns during OIT. METHODS: Determinations of cytokines in peripheral blood were made in children who had milk or egg allergy and who received OIT. The determinations were made before and after OIT, and again following a final repeat oral challenge a month after a diet excluding the culprit food. RESULTS: No significant changes were registered in the cytokines studied (IL-2, IL-4, IL-6, IL-10, IL-12, IL-17, IFNγ, and TNF) at any of the 3 time points. Similarly, no differences in cytokine pattern were observed between children who had presented anaphylaxis during OIT and those who overcame or did not overcome the final oral challenge. DISCUSSION: Peripheral cytokines do not undergo significant changes during the OIT process. They are not predictors of serious adverse reactions or the final result of the OIT.


Assuntos
Citocinas/sangue , Hipersensibilidade a Ovo/imunologia , Hipersensibilidade a Ovo/terapia , Ovos/efeitos adversos , Hipersensibilidade a Leite/imunologia , Hipersensibilidade a Leite/terapia , Leite/imunologia , Administração Oral , Alérgenos/imunologia , Anafilaxia/tratamento farmacológico , Anafilaxia/imunologia , Animais , Criança , Citocinas/imunologia , Hipersensibilidade a Ovo/sangue , Feminino , Humanos , Imunoterapia/métodos , Masculino , Hipersensibilidade a Leite/sangue
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