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Eczema and Food Allergy in Children

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A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Allergy and Immunology".

Deadline for manuscript submissions: closed (1 March 2024) | Viewed by 11025

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Special Issue Editors

Dr. Roxana Silvia Bumbãcea

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Guest Editor

1. Department of Allergology “Carol Davila”, University of Medicine and Pharmacy, 050474 Bucharest, Romania
2. Department of Allergy and Clinical Immunology, “Dr. Carol Davila” Nephrology Clinical Hospital, 010731 Bucharest, Romania
Interests: allergens; molecular diagnosis; atopic eczema; drug allergy; allergic rhinitis; asthma; anaphylaxis; urticaria; immunotherapy

Dr. Gavriela Maria Feketea

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Department of Pediatrics, Karamandaneio Children’s Hospital of Patra, Erithrou Stavrou 40, 26331 Patra, Greece
Interests: pediatric allergy; food allergy; asthma; allergic rhinitis; vitamin D
Special Issues, Collections and Topics in MDPI journals

Dr. Nicolaou Nicolaos

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Guest Editor

Department of Allergy and Pediatric Allergy, University of Nicosia Medical School, 2408 Nicosia, Cyprus
Interests: food allergy; molecular diagnosis; pediatric allergy

Dr. Emilia Vassilopoulou

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Guest Editor

1. Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
2. Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece
Interests: food allergy/intolerance; immunomodulation and nutrition; gut–brain axis; nutritional psychiatry; inflammaging; food histamine; food proteins; diet; nutrition; eating disorders; immunity
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Eczema (atopic dermatitis, AD) and food allergy are two separate but strongly associated conditions. Once considered only a manifestation of food allergy, eczema is the first step in the chronological progression of allergic diseases, known as atopic march. The impaired skin barrier allows epicutaneous exposure to allergens, making AD a major risk factor for the development of food allergies. However, food allergens can also be responsible for eczema flare-ups. Although international guidelines offer clear instructions regarding the diagnosis and management of these disorders, some discrepancies still persist. While skin testing and sIgE have a clearly defined role in the evaluation of food-dependent reactions, placebo-controlled, double-blind oral provocation challenge is the gold standard, distinguishing between food sensitization and allergy. In some cases, dietary avoidance may be taken into consideration, but only after a careful assessment, as nutritional deficiencies and loss of tolerance to food allergens are undesirable consequences. Early introduction of allergenic food shows promising results in preventing food allergy in high-risk patients with AD, with further studies regarding the best approach and the ideal timing of reintroduction still underway.

This Special Issue will feature an update on recent data regarding the diagnosis, management and prevention of eczema and food allergies. We invite articles focusing on all aspects of the topic, especially those with a possible impact on the daily clinical practice in paediatric allergy.

Dr. Roxana Silvia Bumbãcea
Dr. Gavriela Maria Feketea
Dr. Nicolaou Nicolaos
Dr. Emilia Vassilopoulou
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

food allergy
eczema/ atopic dermatitis
atopy patch test
molecular diagnosis
elimination diet
preventive strategies

Published Papers (6 papers)

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Research

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8 pages, 248 KiB

Open AccessArticle

Nutritional Status of Children with Newly Diagnosed Food Allergies

by Martyna Jasielska, Anna Buczyńska, Piotr Adamczyk and Urszula Grzybowska-Chlebowczyk

Children 2023, 10(10), 1687; https://doi.org/10.3390/children10101687 - 14 Oct 2023

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Abstract

Background: Most published pediatric guidelines on food allergy highlight the importance of nutritional counseling and dietary adequacy to avoid either growth retardation or nutritional deficiencies. The aim of the study was an assessment of the nutritional status of children with IgE-mediated food allergies. Material and method: 45 patients with newly diagnosed food allergy (FA) and 33 healthy controls were analyzed (aged 6 to 72 months, 60.2% boys). The nutritional status was assessed using anthropometric measurements (body weight and length) and serum laboratory tests. The results were analyzed with the Statistica 12 software (Tulsa, OK, USA). Results: 82%, 40%, 8.8%, and 6.6% of the studied children demonstrated allergy to hen’s egg, cow’s milk, pork meat, and wheat/rye, respectively. Z-score BMI < −2SD was more often found in the FA subjects under 30 months of age than in the controls (p = 0.04). As many as 77.8% of the FA subjects and 78.8% of the controls were of normal height (hSDS: −0.23 ± 1.74 and −0.31 ± 1.49, respectively, p = 0.8). Retinol binding protein four serum concentration was significantly lower in the FA group (17.01 ± 3.84 mg/L) than in the controls (20.47 ± 4.87 mg/L, p < 0.001). No statistically significant differences were observed between the FA group and the controls (either in the younger or the older age group) (p > 0.05) for the serum concentrations of total protein, total cholesterol, thyroxin-binding prealbumin (TBPA), 25(OH)D, hemoglobin level or white blood cells. Conclusions: In patients under 30 months of age, one of the symptoms of food allergy may be body weight deficiency, while short stature is less common at the time of diagnosis. Full article

(This article belongs to the Special Issue Eczema and Food Allergy in Children)

16 pages, 318 KiB

Open AccessArticle

The Effect of Food Allergen Exclusion on the Growth of Saudi Children

by Manar Abdulaziz Bin Obaid, Sahar Abdulaziz AlSedairy, Hamza Ali Alghamdi, Ghzail M. Aljameel, Eman Alidrissi, Mofareh AlZahrani and Manal Abdulaziz Binobead

Children 2023, 10(9), 1468; https://doi.org/10.3390/children10091468 - 28 Aug 2023

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Abstract

With a variety of symptoms that can impede children’s development, food allergies are an important public health concern. With the help of information from the King Fahad Medical City Hospital in Riyadh, we looked at how restricting certain foods affected the growth of Saudi children who had food allergies. An anonymous self-administered questionnaire asking about the individuals’ demographics and their restricted eating habits was completed by 72 children (48 boys and 24 girls) between the ages of 2 and 14. The sensitivity of six allergens (hen eggs, cow milk, fish, wheat, peanuts, and soybeans), anthropometric indices, specific Immunoglobulin E (IgE) levels, and sensitivity were examined. The Statistical Package for Social Science (SPSS), version 26, was used to analyze the data. Chi-square and t-tests were used to examine the relationships between various category variables. According to the findings, most of the mothers of the children were between the ages of 30 and 40 (80.6%), had a college degree (72.3%), were unemployed (59.7%), and had a monthly family income between 5000 and 15,000 SAR (69.4%). Both sexes had specific IgE antibodies for allergens in classes 2 and 3, with boys having noticeably (p ≤ 0.05) higher quantities than girls. While females were more sensitive to fish and peanuts, boys were more likely than girls to show specific IgE sensitivity to egg white, cow milk, wheat, and soybeans. Both sexes’ allergy levels were considerably (p ≤ 0.01) higher in children aged 5.01 to 10 than in other age groups. In terms of classifications of thinness, overweightness, and obesity, boys were slenderer than girls, and a greater percentage of boys than girls were overweight or obese. The exclusion of hen eggs, cow milk, wheat, and peanuts from the diet had a significant and detrimental effect on body mass index (BMI) and height-for-age ratio among children with impaired growth, in contrast to the demographic factors, which had a significant and favorable effect on the growth of other children. In conclusion, restrictions on food allergens impairs growth in Saudi children, particularly boys’ growth. Full article

(This article belongs to the Special Issue Eczema and Food Allergy in Children)

14 pages, 886 KiB

Open AccessArticle

Parental Knowledge about Allergies and Problems with an Elimination Diet in Children Aged 3 to 6 Years

by Malgorzata Kostecka, Joanna Kostecka-Jarecka, Julianna Kostecka, Katarzyna Iłowiecka, Katarzyna Kolasa, Gabriela Gutowska and Magdalena Sawic

Children 2022, 9(11), 1693; https://doi.org/10.3390/children9111693 - 04 Nov 2022

Cited by 1 | Viewed by 1636

Abstract

Allergic diseases are highly prevalent, and they can exert a significant influence on the patients’ physical and mental well-being, thus affecting the quality of their lives and society as a whole. The aim of this study was to evaluate parental knowledge about allergens, allergy symptoms, and treatment of allergies, and to identify problems with adherence to an elimination diet and the underlying difficulties. Twelve kindergartens and the parents of 1350 preschoolers took part in the first stage of the study. In a screening trial, allergies were diagnosed in 197 children, and their parents participated in the second stage of the study. The child’s age at the onset of the first symptoms was significantly correlated with allergy type. Age was significantly correlated with selected symptoms of an allergic reaction, and skin allergies were more prevalent in younger children. Erythema, skin reddening, and urticaria occurred more frequently in children aged 3–4 years (OR 1.45; 95%CI 1.24–1.77, p < 0.05) and were diagnosed in skin tests (OR 1.36; 95%CI 1.22–1.59, p < 0.05). Allergies to numerous food items were associated with a long-term elimination diet (OR 1.89; 95%CI 1.33–2.19, p < 0.01), as well as problems with preparing safe meals, shopping for food, or dietary adherence when eating out. According to the respondents, lack of support from other family members and compliance with dietary restrictions in kindergartens and when eating out posed the greatest barriers to dietary adherence. Parents do not have sufficient knowledge about environmental allergens and effective strategies for coping with acute allergic reactions, including anaphylactic shock. Children with diagnosed food allergies should enjoy a similar quality of life to their healthy peers, which is why the parents should be educated about diet therapy, duration of treatment, and safe food substitutes. Full article

(This article belongs to the Special Issue Eczema and Food Allergy in Children)

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Review

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11 pages, 645 KiB

Open AccessReview

Atopic Dermatitis in Italian Pre-School Children: Literature Review of Epidemiological Data with a Focus on Disease Prevalence and Severity

by Iria Neri, Carlotta Galeone, Claudio Pelucchi, Gianluca Ronci, Paolo Matruglio, Maria Paola Pedone and Elena Galli

Children 2023, 10(10), 1629; https://doi.org/10.3390/children10101629 - 29 Sep 2023

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Abstract

Atopic dermatitis (AD) is one of the most common diseases worldwide. Severe AD has a major impact on the quality of life of patients. We performed a systematic literature review on the epidemiology of AD in Italian pre-school children (age 0–5 years) and we assessed the available data on the severity of AD. In August 2022, we performed a bibliographic search using PubMed/Medline and EMBASE. We identified 10 studies with Italian data on the prevalence and/or incidence of AD in pre-school children. The period (12 months) prevalence of AD varied widely across studies, ranging between 4.0% and 42.2%, with median estimates of 14.3% among all studies and 11.8% among studies from 2010 onwards. Applied to the Italian population, this leads to a prevalence of 309,000–375,000 pre-school AD cases. Only one study computed the incidence of AD, reporting rates of 9 cases per 100 person-years in children aged 0–1 year, and 2.5 cases per 100 person-years in children aged 1–4 years. Severity data from Italy were also reviewed, across three identified three studies. A point estimate found 8.4% of cases were considered severe in one study based on the Patient-Oriented Eczema Measure (POEM), with an overall range of 7.8–11% across different Italian studies and according to various severity score types. Full article

(This article belongs to the Special Issue Eczema and Food Allergy in Children)

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18 pages, 464 KiB

Open AccessReview

Food Allergy Education and Management in Early Learning and Childcare Centres: A Scoping Review on Current Practices and Gaps

by Mae Jhelene L. Santos, Kaitlyn A. Merrill, Moshe Ben-Shoshan, Jennifer D. Gerdts, Don Giesbrecht, Elana Lavine, Susan Prentice, Julia Upton and Jennifer L. P. Protudjer

Children 2023, 10(7), 1175; https://doi.org/10.3390/children10071175 - 06 Jul 2023

Cited by 1 | Viewed by 1531

Abstract

Anaphylaxis has occurred in preschools/schools yet there are no consistent food allergy (FA) management practices in early learning and childcare centres (ELCC) across jurisdictions. Presently, there are no reviews that have synthesized FA-related knowledge and management practices within ELCC. We aimed to perform a scoping review of FA management in ELCC, and report on perceived gaps or barriers. A PRISMA-ScR-guided search was conducted for North American, European and Australian articles in English/French in the OVID-MedLine, Scopus, and PsycInfo databases. Two independent reviewers screened the titles/abstracts of 2010 articles and full-text screened 77 articles; 15 of which were specifically related to ELCC. If the two reviewers could not agree to the relevance of a given study, a third reviewer provided guidance. This third reviewer also screened French articles. Thematic and descriptive reports of the studies were presented. We reported solely on pre-Coronavirus Disease pandemic ELCC studies. We included ten articles in this review, which provide evidence that ELCC staff have variable baseline knowledge, comprehension, experience, and practices in place to manage FA. ELCC staff also have limited FA-related training and experience regarding administration of epinephrine auto-injectors (EAI). Emergency Anaphylaxis Plans (EAP) were described in four studies. One study reported the parental influence on the site’s food purchasing and FA management. Three studies provided educational interventions, which demonstrated increased and sustained FA-related knowledge and confidence post-intervention. Participants deemed the training beneficial and desired annual training and more FA resources to be available. Across jurisdictions, ELCC staff have provided care and administered EAI in emergencies, but training remained variable. Communication and care planning amongst ELCC staff, and parents, is crucial. Annual education, available EAI and EAPs are tools necessary for effectively managing emergencies. Full article

(This article belongs to the Special Issue Eczema and Food Allergy in Children)

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17 pages, 861 KiB

Open AccessReview

Vitamin D and Omega-3 (Fatty Acid) Supplementation in Pregnancy for the Primary Prevention of Food Allergy in Children-Literature Review

by Gavriela Feketea, Maria Kostara, Roxana Silvia Bumbacea, Emilia Vassilopoulou and Sophia Tsabouri

Children 2023, 10(3), 468; https://doi.org/10.3390/children10030468 - 27 Feb 2023

Cited by 3 | Viewed by 2830

Abstract

During the last decades the prevalence of food allergy (FA), an adverse immune response to a specific food antigen, has risen, with negative effects on the quality of life (QoL) of many children and their families. The pathogenesis of FA is complex, involving both genetic and environmental factors. SPINK5, STAT6, HLA and FOXP3 are some of the genes that are reported to be implicated in FA development. Regarding environmental factors, particular interest has been focused on modification of the dietary habits of pregnant women for the primary prevention of FA. Specifically, Vitamin D and omega-3 (Ω-3) fatty acid supplementation during pregnancy may influence the development of FA in the offspring. Vitamin D is a hormone with various actions, including mediation of the immune system, reducing the production of inflammatory cytokines and promoting tolerance. Vitamin D deficiency in pregnancy suppresses T-regulatory cells in the fetus, and Vitamin D supplementation might protect against FA development. Dietary Ω-3 fatty acids are found mainly in fish and vegetable oils. They are beneficial for human health, playing a role in the immune system as anti-inflammatory agents, and providing cell membrane stabilization with inhibition of antigen presentation. It is documented that maternal supplementation with Ω-3 during pregnancy may protect from allergic sensitization in the children. The aim of this literature review was to explore the potential preventive role of maternal supplementation during pregnancy with Vitamin D and Ω-3 in the development of FA in the offspring. With the prevalence of FA rising, all the possible protective mechanisms and measures for FA prevention need to be explored, starting with those that can be modified. Full article

(This article belongs to the Special Issue Eczema and Food Allergy in Children)

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