Research

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395 KiB

Open AccessArticle

Kiwifruit Allergy in Children: Characterization of Main Allergens and Patterns of Recognition

by Ana Moreno Álvarez, Leticia Vila Sexto, Luda Bardina, Galina Grishina and Hugh. A. Sampson

Children 2015, 2(4), 424-438; https://doi.org/10.3390/children2040424 - 19 Oct 2015

Cited by 14 | Viewed by 5676

Kiwifruit allergy has been described mostly in the adult population, but immunoglobulin (Ig)E-mediated allergic reactions to kiwifruit appear to be occurring more frequently in children. To date, 13 allergens from kiwifruit have been identified. Our aim was to identify kiwifruit allergens in a [...] Read more.

Kiwifruit allergy has been described mostly in the adult population, but immunoglobulin (Ig)E-mediated allergic reactions to kiwifruit appear to be occurring more frequently in children. To date, 13 allergens from kiwifruit have been identified. Our aim was to identify kiwifruit allergens in a kiwifruit allergic-pediatric population, describing clinical manifestations and patterns of recognition. Twenty-four children were included. Diagnosis of kiwifruit allergy was based on compatible clinical manifestations and demonstration of specific IgE by skin prick test (SPT) and/or serum-specific IgE determination. SDS-PAGE and immunoblotting were performed with kiwifruit extract, and proteins of interest were further analyzed by mass spectrometry/mass spectrometry. For component-resolved in vitro diagnosis, sera of kiwifruit-allergic patients were analyzed by an allergen microarray assay. Act d 1 and Act d 2 were bound by IgE from 15 of 24 children. Two children with systemic manifestations recognized a protein of 15 kDa, homologous to Act d 5. Act d 1 was the allergen with the highest frequency of recognition on microarray chip, followed by Act d 2 and Act d 8. Kiwifruit allergic children develop systemic reactions most frequently following ingestion compared to adults. Act d 1 and Act d 2 are major allergens in the pediatric age group. Full article

(This article belongs to the Special Issue Recent Advances in Pediatric Food Allergy)

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210 KiB

Open AccessArticle

Egg Food Challenges are Associated with More Gastrointestinal Reactions

by Malika Gupta, Liron D. Grossmann, Jonathan M. Spergel and Antonella Cianferoni

Children 2015, 2(3), 371-381; https://doi.org/10.3390/children2030371 - 17 Aug 2015

Cited by 15 | Viewed by 6026

Abstract

Egg allergy is a common pediatric allergy, and is usually outgrown by elementary school age. There is, therefore, a need to perform an oral food challenge (OFC) to establish the presence of food allergy to egg. In this study, we conducted a retrospective [...] Read more.

Egg allergy is a common pediatric allergy, and is usually outgrown by elementary school age. There is, therefore, a need to perform an oral food challenge (OFC) to establish the presence of food allergy to egg. In this study, we conducted a retrospective review of 2304 OFCs at a pediatric center and analyzed the severity of reactions during egg OFCs and compared them with other foods. The gastrointestinal system (GI) has been reported as more affected in egg food challenge. This study confirmed that 11% of patients undergoing egg OFC had GI symptoms vs. 7% undergoing food challenges for other foods or compared to milk, peanut and tree nut, individually. However, the involvement of lower respiratory tract was less frequent with egg than observed in peanut and tree nut OFC and similar to observed rate in milk. In conclusion, our study confirmed that OFC to egg causes more GI symptoms and less respiratory symptoms compared to other foods, in particular peanuts and tree nuts. However, 27% of children who failed egg OFC had lower respiratory tract reactions and required the use of epinephrine, similarly to children undergoing milk challenge. Full article

(This article belongs to the Special Issue Recent Advances in Pediatric Food Allergy)

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260 KiB

Open AccessArticle

Food Allergy Knowledge and Attitudes among School Nurses in an Urban Public School District

by Sarah Twichell, Kathleen Wang, Humaira Robinson, Maria Acebal and Hemant Sharma

Children 2015, 2(3), 330-341; https://doi.org/10.3390/children2030330 - 21 Jul 2015

Cited by 12 | Viewed by 6580

Abstract

Since food allergy knowledge and perceptions may influence prevention and management of school-based reactions, we evaluated them among nurses in an urban school district. All District of Columbia public school nurses were asked to anonymously complete a food allergy knowledge and attitude questionnaire. [...] Read more.

Since food allergy knowledge and perceptions may influence prevention and management of school-based reactions, we evaluated them among nurses in an urban school district. All District of Columbia public school nurses were asked to anonymously complete a food allergy knowledge and attitude questionnaire. Knowledge scores were calculated as percentage of correct responses. Attitude responses were tabulated across five-point Likert scales, ranging from strongly disagree to strongly agree. The knowledge questionnaire was completed by 87% of eligible nurses and the attitude questionnaire by 83%. The mean total knowledge score was 76 ± 13 with domain score highest for symptom recognition and lowest for treatment. Regarding attitudes, most (94%) felt food allergy is a serious health problem, for which schools should have guidelines (94%). Fewer believed that nut-free schools (82%) and allergen-free tables (44%) should be implemented. Negative perceptions of parents were identified as: parents of food-allergic children are overprotective (55%) and make unreasonable requests of schools (15%). Food allergy knowledge deficits and mixed attitudes exist among this sample of urban school nurses, particularly related to management of reactions and perceptions of parents. Food allergy education of school nurses should be targeted to improve their knowledge and attitudes. Full article

(This article belongs to the Special Issue Recent Advances in Pediatric Food Allergy)

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805 KiB

Open AccessArticle

Cow’s Milk Protein Allergy from Diagnosis to Management: A Very Different Journey for General Practitioners and Parents

by Adriana C. Lozinsky, Rosan Meyer, Katherine Anagnostou, Robert Dziubak, Kate Reeve, Heather Godwin, Adam T. Fox and Neil Shah

Children 2015, 2(3), 317-329; https://doi.org/10.3390/children2030317 - 21 Jul 2015

Cited by 30 | Viewed by 10538

Abstract

Cow’s milk protein allergy (CMPA) is the most common food allergy in infants and can affect a family’s quality of life. The purpose of this paper is to evaluate the knowledge and experience of general practitioners (GPs) in terms of CMPA diagnosis and [...] Read more.

Cow’s milk protein allergy (CMPA) is the most common food allergy in infants and can affect a family’s quality of life. The purpose of this paper is to evaluate the knowledge and experience of general practitioners (GPs) in terms of CMPA diagnosis and management and to explore the views of parents on the current diagnostic process. Two surveys were conducted in June 2014, which collected data from GPs and parents of infants diagnosed with CMPA in the United Kingdom. The questionnaires included quantitative and qualitative questions, which measured self-reported knowledge, management and perceived treatment progression, and the educational needs of GPs. We also explored parents’ experiences of local healthcare support in relation to CMPA. A total of 403 GPs and 300 parents completed the surveys. The main symptoms of CMPA and diagnosis period differed between GPs and parents. Other key points include different perceptions on symptom presentation and improvement, lack of awareness from GPs about current guidelines, and the significant burden on both families and GPs. This is the first study attempting to establish GP and parental experience in diagnosing CMPA. It is notable that the difference can be improved through training, appropriate diagnostic tools and improved communication between physicians and parents. Full article

(This article belongs to the Special Issue Recent Advances in Pediatric Food Allergy)

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336 KiB

Open AccessArticle

Parental Perception, Prevalence and Primary Care Physicians’ Knowledge on Childhood Food Allergy in Croatia

by Tamara Voskresensky Baricic, Marija Catipovic, Erina L. Cetinic, Vlado Krmek and Ivona Horvat

Children 2015, 2(3), 305-316; https://doi.org/10.3390/children2030305 - 17 Jul 2015

Cited by 12 | Viewed by 5694

Abstract

Food allergy in children is increasing and the perception of food allergy among parents is even more common. In a questionnaire-based study of 702 children aged 6 to 48 months in four primary care settings, the aim was to determine the prevalence of [...] Read more.

Food allergy in children is increasing and the perception of food allergy among parents is even more common. In a questionnaire-based study of 702 children aged 6 to 48 months in four primary care settings, the aim was to determine the prevalence of perception vs. proven food allergy, parental anxiety and general pediatrician knowledge of food allergy. In 95/702 children (13.5%) parentally-reported food was associated reactions. IgE and/or skin prick test (SPT) and/or an open provocation test were performed in 48 (6.8%) and allergy was proven in 38 (5.4%) children. Discrepancy between parental perception and proven allergy is significant (p < 0.001), especially for food other than milk, egg and peanut (p < 0.001). Allergy to milk was the most common. Allergy to peanut was significantly more common in children ≥2 years (p < 0.05). Severe reactions occurred in 5/95 (5.2%) of all children and in 5/38 (13.1%) of allergic children, in 3/5 caused by peanut. Parents of children with proven allergy do not experience high degree of anxiety. The perception of food allergy among general pediatricians is limited, and in children with severe reactions precautionary measures and information to parents were insufficient. Parents and general pediatricians need additional education in food allergy. Full article

(This article belongs to the Special Issue Recent Advances in Pediatric Food Allergy)

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305 KiB

Open AccessArticle

The Relationship Between the Status of Unnecessary Accommodations Being Made to Unconfirmed Food Allergy Students and the Presence or Absence of a Doctor’s Diagnosis

by Yurika Ganaha, Minoru Kobayashi, Yonathan Asikin, Taichi Gushiken and Sumie Shinjo

Children 2015, 2(2), 228-243; https://doi.org/10.3390/children2020228 - 01 Jun 2015

Viewed by 4576

Abstract

The present study investigated the current state of unnecessary children food allergy accommodation and the medical efforts to confirm the existence of food allergies in school lunch service kitchens in Okinawa, Japan, including kitchens accommodating food allergy students by requiring medical documentation at [...] Read more.

The present study investigated the current state of unnecessary children food allergy accommodation and the medical efforts to confirm the existence of food allergies in school lunch service kitchens in Okinawa, Japan, including kitchens accommodating food allergy students by requiring medical documentation at the start and during provisions being made (Double Diagnosis), requiring medical documentation at the start only (Single Diagnosis), and with no medical documentation (Non-Diagnosis). Unnecessary accommodations are being made to unconfirmed food allergy students, wherein the more medical consultation was required, the lower the food allergy incident rate was and the more food allergens were diagnosed (Non-Diagnosis > Single Diagnosis > Double Diagnosis). This study suggests the possibility that unconfirmed food allergy students may be receiving unnecessary food allergy accommodations per school lunches, and the number of unnecessary food allergy provisions being made could be reduced by requiring medical documentation at the start and during these provisions. Full article

(This article belongs to the Special Issue Recent Advances in Pediatric Food Allergy)

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Review

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670 KiB

Open AccessReview

Recent Advances in Management of Pediatric Food Allergy

by Katherine Anagnostou, Kate Swan and Adam T. Fox

Children 2015, 2(4), 439-452; https://doi.org/10.3390/children2040439 - 15 Dec 2015

Cited by 2 | Viewed by 5503

Abstract

Many children now suffer with a food allergy, immunoglobulin E (IgE) and/or non-IgE mediated. Food allergies have a significant impact on the child’s quality of life, as well as that of their family, due to the resultant dietary restrictions and the constant threat [...] Read more.

Many children now suffer with a food allergy, immunoglobulin E (IgE) and/or non-IgE mediated. Food allergies have a significant impact on the child’s quality of life, as well as that of their family, due to the resultant dietary restrictions and the constant threat of a potentially life-threatening reaction. At present, there is no cure for food allergies, but there are exciting advances occurring in the management of IgE mediated allergies, including a more active approach to management with anticipatory screening testing, early introduction of common food allergens, active tolerance induction, use of biologics and active risk management. These areas will be discussed in this review. Full article

(This article belongs to the Special Issue Recent Advances in Pediatric Food Allergy)

233 KiB

Open AccessReview

The Role of Skin Barrier in the Pathogenesis of Food Allergy

by Neema Izadi, Minnelly Luu, Peck Y. Ong and Jonathan S. Tam

Children 2015, 2(3), 382-402; https://doi.org/10.3390/children2030382 - 02 Sep 2015

Cited by 14 | Viewed by 5436

Abstract

Food allergy is a serious public health problem with an increasing prevalence. Current management is limited to food avoidance and emergency treatment. Research into the pathogenesis of food allergy has helped to shape our understanding of how patients become sensitized to an allergen. [...] Read more.

Food allergy is a serious public health problem with an increasing prevalence. Current management is limited to food avoidance and emergency treatment. Research into the pathogenesis of food allergy has helped to shape our understanding of how patients become sensitized to an allergen. Classically, food sensitization was thought to occur through the gastrointestinal tract, but alternative routes of sensitization are being explored, specifically through the skin. Damaged skin barrier may play a crucial role in the development of food sensitization. Better understanding of how patients initially become sensitized may help lead to the development of a safe and effective treatment for food allergies or better prevention strategies. Full article

(This article belongs to the Special Issue Recent Advances in Pediatric Food Allergy)

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