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Pediatric Allergy and Immunology

Giovanni Battista Pajno, Riccardo Castagnoli, Muraro Antonella, Montserrat Alvaro-Lozano, Cezmi A Akdis, Műbeccel Akdis, Stefania Arasi
IgE-mediated food allergy (FA) is a potentially life-threatening condition with a negative impact on quality of life and an increasing prevalence in westernized countries in the recent two decades. A strict avoidance of the triggering food(s) represents the current standard approach. However, an elimination diet may be difficult and frustrating, in particular for common foods, (e.g. milk, egg, and peanut). Food allergy immunotherapy (FA-AIT) may provide an active treatment that enables to increase the amount of food that the patient can intake without reaction during treatment (i...
February 15, 2019: Pediatric Allergy and Immunology
A S Bedin, J P Molès, D Rutagwera, N Nagot, C Kankasa, T Tylleskär, J M Valverde-Villegas, M Durand, P Van de Perre, E Tuaillon
BACKGROUND: Human breast milk cells remains poorly characterised for the presence of unconventional T lymphocytes and innate lymphoid cells (ILCs). METHODS: Early breast milk were collected from eight HIV-uninfected and eleven HIV infected women three to twelve days after delivery. Mucosal associated innate lymphocytes (MAIT cells), TCR γδ cells, and innate lymphoid cells (ILCs) were analyzed in breast milk and paired blood samples. RESULTS: CD161+/TRAV1-2+ MAIT cells were detected in breast milk, accounting for a median (IQR) of 0...
February 13, 2019: Pediatric Allergy and Immunology
Jean-Luc Fauquert
Allergic conjunctivitis (AC) in childhood often poses problems of diagnosis and management for the allergist. We present the salient points concerning the diagnosis and treatment of ocular allergy (OA) emerging from a large cohort survey conducted jointly in the departments of ophthalmology and paediatric allergy in a French teaching hospital. Seasonal acute conjunctivitis (SAC) is a common disorder and not overly difficult to diagnose and treat when associated with rhinitis leading to allergic rhinoconjunctivitis...
February 11, 2019: Pediatric Allergy and Immunology
Qingxiang Zeng, Wenlong Liu, Renzhong Luo, Gen Lu
BACKGROUND: Regulatory T cells (Tregs) play central roles in limiting airway allergic inflammation and preventing inappropriate Th2 responses to environmental allergens. This study aims to evaluate the role of miR-181a and miR-155 in the regulation of the differentiation and function of Tregs through both in vivo and in vitro studies. METHODS: The CD4+ T cell and Tregs were purified from peripheral blood mononuclear cells (PBMCs) in allergic rhinitis (AR) children, respectively...
February 8, 2019: Pediatric Allergy and Immunology
Stefanie Metzler, Remo Frei, Elisabeth Schmaußer-Hechfellner, Erika von Mutius, Juha Pekkanen, Anne M Karvonen, Pirkka V Kirjavainen, Jean-Charles Dalphin, Amandine Divaret-Chauveau, Josef Riedler, Roger Lauener, Caroline Roduit
BACKGROUND: Allergies are a serious public health issue and prevalences are rising worldwide. The role of antibiotics in the development of allergies has repeatedly been discussed, as results remain inconsistent. The aim of this study was to investigate the association between pre- & postnatal antibiotic exposure and subsequent development of allergies (atopic dermatitis, food allergy, asthma, atopic sensitization and allergic rhinitis). METHODS: A total of 1080 children who participated in a European birth cohort study (PASTURE) were included in this analysis...
February 8, 2019: Pediatric Allergy and Immunology
Lucia Diaferio, Anca Mirela Chiriac, Maria Chiara Leoni, Riccardo Castagnoli, Silvia Caimmi, Vito Leonardo Miniello, Pascal Demoly, Davide Caimmi
There is no perfect agreement on how to perform an allergy work-up in suspected beta-lactam (BL) allergic children, since skin test (ST)-induced pain is often a limitation. The aim of the study was to assess the possibility of reducing the number of ST in children when performing a complete allergy work-up for BL hypersensitivity reactions. A retrospective analysis of all patients referring to the Allergy Unit of the University Hospital of Montpellier (France) with positive responses in immediate- and non-immediate-reading ST to a BL over a 16-years period was performed, to determine the positive predictive value (PPV) of ST...
February 7, 2019: Pediatric Allergy and Immunology
Kristina Johansson, Henry J McSorley
It has become increasingly clear that interleukin-33 (IL-33) plays a crucial role in initiation of type 2 immunity. The last decade of intense research has uncovered multiple mechanisms through which IL-33 targets key effector cells of the allergic immune response. Recently, IL-33 has been implicated in shaping the immune system of the lungs early in life, at a time which is crucial in the subsequent development of allergic asthma. In this review, we will address the current literature describing the role of IL-33 in the healthy and diseased lung...
February 7, 2019: Pediatric Allergy and Immunology
Francesca Cipriani, Salvatore Tripodi, Valentina Panetta, Serena Perna, Ekaterina Potapova, Arianna Dondi, Roberto Bernardini, Carlo Caffarelli, Antonella Casani, Rosa Cervone, Loredana Chini, Pasquale Comberiati, Giovanna De Castro, Michele Miraglia Del Giudice, Iride Dello Iacono, Andrea Di Rienzo Businco, Marcella Gallucci, Arianna Giannetti, Carla Mastrorilli, Viviana Moschese, Simone Pelosi, Ifigenia Sfika, Elena Varin, Valeria Villella, Anna Maria Zicari, Giulia Brindisi, Giampaolo Ricci, Paolo Maria Matricardi
BACKGROUND: Pollen-related seasonal allergic rhinoconjunctivitis (SAR) is a very frequent pediatric disease in westernized countries. Risk factors and disease phenotypes have been thoroughly examined in several cross-sectional studies. By contrast, only a few studies have examined disease evolution in patient cohorts. We investigated predictive biomarkers of disease evolution in a large cohort of children with SAR. METHODS: During 2015-2017 (follow-up), we re-examined 401 patients from those enrolled in 2009-2011 (baseline) by the "Panallergens in Pediatrics" study, a large multicenter survey of Italian children with SAR...
February 7, 2019: Pediatric Allergy and Immunology
M Atanaskovic-Markovic, E Gomes, J Cernadas, G du Toit, M Kidon, S Kuyucu, F Mori, C Ponvert, I Terreehorst, J C Caubet
Drug hypersensitivity reactions (DHR) constitute a major and common public health problem, particularly in children. One of the most severe manifestations of DHR is anaphylaxis, which might be associated with a life-threatening risk. During those past decades, anaphylaxis has received particularly a lot of attention and international consensus guidelines have been recently published. Whilst drug-induced anaphylaxis is more commonly reported in adulthood, less is known about the role of drugs in pediatric anaphylaxis...
February 7, 2019: Pediatric Allergy and Immunology
Li-Wei Gao, Qing-Qin Yin, Yue-Juan Tong, Jin-Gang Gui, Xiu-Yun Liu, Xue-Li Feng, Ju Yin, Jun Liu, Yan Guo, Yao Yao, Bao-Ping Xu, Jian-Xin He, Kun-Ling Shen, Yu-Lung Lau, Zai-Fang Jiang
BACKGROUND: Chronic granulomatous disease (CGD) is a rare disease in China, and very little large-scale studies have been conducted to date. We aimed to investigate the clinical and genetic features of CGD in Chinese pediatric patients. METHODS: Pediatric patients with CGD from Beijing Children's Hospital, Capital Medical University, China were enrolled from January 2006 to December 2016. RESULTS: A total of 159 pediatric patients with CGD were enrolled...
February 4, 2019: Pediatric Allergy and Immunology
Ying Luo, Guo-Qiang Zhang, Zhong-Yue Li
BACKGROUND: The role of atopy patch test (APT) in the diagnosis of food allergy (FA) remains largely controversial. In our meta-analysis, we aim to evaluate the accuracy of APT for diagnosing FA in children. METHODS: Pubmed, Embase and Cochrane Library were searched for studies regarding the diagnostic value of APT for FA in children compared to oral food challenge (double-blind placebo-controlled food challenge and/or open food challenge). The last search was conducted on November 11, 2017...
January 31, 2019: Pediatric Allergy and Immunology
Hagen Ott
Neonatal and infantile erythroderma (NIE) represent the common clinical phenotype of heterogenous diseases ranging from benign and transient skin conditions to fatal multiorgan disorders. NIE regularly demands a comprehensive diagnostic workup in a multiprofessional setting, especially if newborns and young infants with the disease develop a failure to thrive and concomitant infectious, neurological or metabolic complications. By obtaining a detailed medical history and performing a thorough clinical examination, targeted diagnostic steps can be scheduled for most affected children...
January 31, 2019: Pediatric Allergy and Immunology
Sho Hamano, Asuka Yamamoto, Daisuke Fukuhara, Kunimasa Yan
Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy in infants characterised by repetitive vomiting and diarrhoea occurring within one to four hours of ingesting the offending food.1 Diagnosis of FPIES is difficult because patients present with non-specific symptoms such as vomiting and diarrhoea, and useful diagnostic biomarkers are lacking.1 We report on three infants who had FPIES with a transient increase in serum thymus and activation regulated chemokine (TARC) levels one day after ingesting the offending food...
January 29, 2019: Pediatric Allergy and Immunology
Maryam Ayazi, Mohammad Reza Fazlollahi, Iraj Mohammadzadeh, Abbas Fayezi, Mohammad Nabavi, Seyed Alireza Mahdaviani, Masoud Movahedi, Marzieh Heidarzadeh, Shiva Saghafi, Sajedeh Mohammadian, Henriette Farkas, Zahra Pourpak
Hereditary angioedema is an autosomal dominant deficiency of C1-inhibitor (C1-INH-HAE). This rare but potentially fatal disease gives rise to episodes of bradykinin-mediated edema in face, trunk, extremities, genitalia, gastrointestinal tract and upper airway.(1) This leads to severe outcomes including asphyxiation, unnecessary emergency abdominal surgeries, and a considerably diminished quality of life in addition to high economic burden for the health care system. Rare nature, misleading symptoms, and a lack of awareness among health care providers have resulted in a worldwide delayed diagnosis of C1-INH-HAE...
January 28, 2019: Pediatric Allergy and Immunology
Tiina Kaisa Kauppila, Marita Paassilta, Anna Kaarina Kukkonen, Mikael Kuitunen, Anna Susanna Pelkonen, Mika Juhani Makela
BACKGROUND: The safety and efficacy of long-term milk oral immunotherapy (OIT) in Finnish children with persistent cow's milk allergy (CMA) was evaluated in an open-label, non-randomized study. METHODS: During the 11-year study, 296 children aged 5 years or older with immunoglobulin E (IgE)-mediated CMA started milk OIT. Follow-up data was collected at three timepoints: the post build-up phase, one year thereafter, and at the cross-sectional long-term follow-up between January 2016 and December 2017...
January 27, 2019: Pediatric Allergy and Immunology
Olympia Tsilochristou, Marialena Kyriakakou, Ioanna Manolaraki, John Lakoumentas, Ekaterini Tiligada, Pavlos Maragkoudakis, Nikolaos Douladiris, Nikolaos G Papadopoulos
BACKGROUND: There is little evidence on the incidence and characteristics of local allergic rhinitis (LAR) in children. Most studies have included subjects with perennial rhinitis only and results are based on the investigation of no more than three allergens per study. Our aim was to determine the proportion of children with LAR amongst children with chronic, difficult to treat, perennial or seasonal, rhinitis but no evidence of sensitization to aeroallergens, or other alternative diagnosis...
January 27, 2019: Pediatric Allergy and Immunology
Parisa Amirifar, Mohammad Reza Ranjouri, Reza Yazdani, Hassan Abolhassani, Asghar Aghamohammadi
Ataxia telangiectasia (A-T) is an autosomal recessive primary immunodeficiency (PID) disease that is caused by mutations in ataxia telangiectasia mutated (ATM) gene encoding a serine/threonine protein kinase. A-T patients represent a broad range of clinical manifestations including progressive cerebellar ataxia, oculocutaneous telangiectasia, variable immunodeficiency, radiosensitivity, susceptibility to malignancies and increased metabolic diseases. This congenital disorder has phenotypic heterogeneity, and the severity of symptoms varies in different patients based on severity of mutations and disease progression...
January 27, 2019: Pediatric Allergy and Immunology
Maleewan Kitcharoensakkul, Andrew L Kau, Leonard B Bacharier, Charles W Goss, Avraham Beigelman
Specific or selective antibody deficiency (SAD) is one of the most commonly identified immune defects among patients with recurrent sinopulmonary infections.1 SAD is defined as an impaired response to polysaccharide antigens and can be detected in approximately 15% of children older than 2 years old referred for evaluation of recurrent infections.2, 3 The diagnosis of SAD requires the documentation of an adequate response to polysaccharide antigens measured by immune response to the 23-polyvalent pneumococcal vaccine (Pneumovax® , 23-PPV) and exclusion of other causes of immunodeficiency...
January 25, 2019: Pediatric Allergy and Immunology
Marta Sacchetti, Vincenza Regine, Flavio Mantelli, Loredana Chini, Viviana Moschese, Matteo Bonini, Lucia Pugliese, Barbara Suligoi, Alessandro Lambiase
BACKGROUND: Schoolchildren screening for allergic diseases may improve early identification and management of atopic children. The aim of this study was to perform a schoolchildren screening program for identification of children with allergic diseases. METHODS: All parents of children attending to 13 primary schools in the city of Rome were requested to fill-in a demographic data form and the ChAt questionnaire. Allergological evaluation was performed in the children with suspect of allergy (ChAt score>2)...
January 25, 2019: Pediatric Allergy and Immunology
Maja Popovic, Valentina Fiano, Francesca Fasanelli, Morena Trevisan, Chiara Grasso, Manuela Bianca Assumma, Anna Gillio-Tos, Silvia Polidoro, Laura De Marco, Franca Rusconi, Franco Merletti, Daniela Zugna, Lorenzo Richiardi
BACKGROUND: Epigenetics may play a role in wheezing and asthma development. We aimed to examine infant saliva DNA methylation in association with early childhood wheezing. METHODS: A case-control study was nested within the NINFEA birth cohort with 68 cases matched to 68 controls by sex, age (between 6 and 18 months, median: 10.3 months) and season at saliva sampling. Using a bump hunting region-based approach we examined associations between saliva methylome measured using Illumina Infinium HumanMethylation450k array and wheezing between 6 and 18 months of age...
January 25, 2019: Pediatric Allergy and Immunology
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