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Comments on asthma development and prognosis, and diagnosis of cow's milk allergy
Philippe Eigenmann
doi : 10.1111/pai.13639
Volume 32, Issue 7 p. 1401-1404
Pediatric problematic severe asthma: Recent advances in management
Elizabeth Scotney,Saskia Burchett,Thomas Goddard,Sejal Saglani
doi : 10.1111/pai.13543
Volume 32, Issue 7 p. 1405-1415
Problematic severe asthma remains a significant challenge to manage, accounting for the majority of healthcare utilization among children with asthma. The heterogeneity is recognized and the clinical phenotypes of “difficult-to-treat” asthma (DA) and “severe therapy-resistant asthma” (STRA) help to guide management. Recent evidence supports molecular distinctions between these phenotypes and shows poor correlations between peripheral and airway markers of inflammation, especially in STRA. Airway neutrophils in the context of childhood severe asthma have been explored, but their role in disease causation, protection, or as bystanders remain unknown, and thus, treatment implications are unclear. Several novel management strategies, including once-daily maintenance therapy, single-device maintenance and reliever therapy, and novel biological treatments are being increasingly used for DA and STRA. However, pediatric data for efficacy of novel treatments is scarce, and when available, is restricted to adolescents. The aim of this review is to highlight recent advances in objective biomarkers that aid stratification and management of childhood severe asthma and to highlight gaps in pediatric evidence. Specifically, the urgent need for efficacy studies to improve the management of problematic severe asthma in children younger than 12 years.
Pathogenesis of IgE-mediated food allergy and implications for future immunotherapeutics
Nicole Ramsey,M. Cecilia Berin
doi : 10.1111/pai.13501
Volume 32, Issue 7 p. 1416-1425
Our understanding of the immune basis of food allergy has grown rapidly in parallel with the development of new immune-targeted interventions for the treatment of food allergy. Local tissue factors, including the composition of skin and gastrointestinal microbiota and production of Th2-inducing cytokines (TSLP, IL-33, and IL-25) from barrier sites, have been shown not only to contribute to the development of food allergy, but also to act as effective targets for treatment in mice. Ongoing clinical trials are testing the targeting of these factors in human disease. There is a growing understanding of the contribution of IL-13 to the induction of high-affinity IgE and the need for continual T-cell help in the maintenance of long-lived IgE. This provides a strong rationale to test biologics targeting both IL-4 and IL-13 in the treatment of established food allergy. Various forms of allergen immunotherapy for food allergy have clearly shown that low specific IgE and elevated specific IgG4 are predictive of sustained treatment effect. Treatments that mimic that immune response, for example, lowering IgE, with monoclonal antibodies such as omalizumab, or administering allergen-specific IgG, are in various stages of investigation. As we gain more opportunities to use immune-modifying treatments for the treatment of food allergy, studies of the immune and clinical response to those interventions will continue to rapidly advance our understanding of the immune basis of food allergy and tolerance.
An EAACI Task Force report on allergy to beta-lactams in children: Clinical entities and diagnostic procedures
Natalia Blanca-Lopez,Marina Atanaskovic-Markovic,Eva R. Gomes,Mona Kidon,Semanur Kuyucu,Francesca Mori,Ozge Soyer,Jean-Christoph Caubet
doi : 10.1111/pai.13529
Volume 32, Issue 7 p. 1426-1436
Beta-lactam (BL) allergy suspicion is common in children and constitutes a major public health problem, with an impact on patient's health and on medical costs. However, it has been found that most of these reactions are not confirmed by a complete allergic workup. The diagnostic value of the currently available allergy tests has been investigated intensively recently by different groups throughout the world. This has led to major changes in the management of children with a suspected BL allergy. Particularly, it is now well accepted that skin tests can be skipped before the drug provocation test in children with a benign non-immediate reaction to BL. However, there is still a debate on the optimal allergic workup to perform in children with a benign immediate reaction. In addition, management of children with severe cutaneous adverse drug reactions remains difficult. In this review, based on a selection of the most relevant studies found in the literature, we will review and discuss the diagnosis of different forms of BL allergy in children.
Mediterranean diet and lung function, sensitization, and asthma at school age: The PARIS cohort
Hélène Amazouz,Célina Roda,Nicole Beydon,Guillaume Lezmi,Mélisande Bourgoin-Heck,Jocelyne Just,Isabelle Momas,Fanny Rancière
doi : 10.1111/pai.13527
Volume 32, Issue 7 p. 1437-1444
The Mediterranean diet (MD) has known health benefits, but its specific impact on allergy development is unclear. As part of the PARIS birth cohort follow-up, we aimed to investigate the adherence of 8-year-old children to the MD and its association with allergic/respiratory morbidity at school age.
Effect of early-life antibiotic exposure and IL-13 polymorphism on atopic dermatitis phenotype
Min Jee Park,So-Yeon Lee,Si Hyeon Lee,Mi-Jin Kang,Kun Baek Song,Sungsu Jung,Ji-sun Yoon,Dong In Suh,Youn Ho Shin,Kyung Won Kim,Kangmo Ahn,Soo-Jong Hong
doi : 10.1111/pai.13531
Volume 32, Issue 7 p. 1445-1454
Although atopic dermatitis (AD) is associated with certain gene variants, the rapidly increasing incidence of AD suggests that environmental factors contribute to disease development. In this study, we investigated the association of AD incidence and phenotype with antibiotic exposure within 6 months of age, considering the dose administered and genetic risk.
Association between maternal ritodrine hydrochloride administration during pregnancy and childhood wheezing up to three years of age: The Japan environment and children's study
Tsuyoshi Murata,Hyo Kyozuka,Shun Yasuda,Toma Fukuda,Akiko Yamaguchi,Hajime Maeda,Akiko Sato,Yuka Ogata,Kosei Shinoki,Mitsuaki Hosoya,Seiji Yasumura,Koichi Hashimoto,Hidekazu Nishigori,Keiya Fujimori,The Japan Environment, Children’s Study (JECS) Group
doi : 10.1111/pai.13545
Volume 32, Issue 7 p. 1455-1463
The effects of maternal ritodrine hydrochloride administration (MRA) during pregnancy on fetuses and offspring are not entirely clear. The present study aimed to evaluate the association between MRA and childhood wheezing using data from a nationwide Japanese birth cohort study.
Decision tree-based rules outperform risk scores for childhood asthma prognosis
Arthur H. Owora,Robert S. Tepper,Clare D. Ramsey,Allan B. Becker
doi : 10.1111/pai.13530
Volume 32, Issue 7 p. 1464-1473
There are no widely accepted prognostic tools for childhood asthma; this is in part due to the multifactorial and time-dependent nature of mechanisms and risk factors that contribute to asthma development. Our study objective was to develop and evaluate the prognostic performance of conditional inference decision tree–based rules using the Pediatric Asthma Risk Score (PARS) predictors as an alternative to the existing logistic regression-based risk score for childhood asthma prediction at 7 years in a high-risk population.
Exhaled breath condensate pH determinants in school-aged children: A population-based study
Tiago Azenha Rama,Inês Paciência,João Cavaleiro Rufo,Diana Silva,Pedro Cunha,Milton Severo,Patrícia Padrão,Pedro Moreira,Luís Delgado,André Moreira
doi : 10.1111/pai.13564
Volume 32, Issue 7 p. 1474-1481
Exhaled breath condensate (EBC) pH is a promising biomarker of airway inflammation. Lack of method standardization and interstudy variability precludes its use in clinical practice. While endogenous determinants have been described, underlying mechanisms for variability are mostly unknown. Thus, we aimed to assess the association between asthma and EBC pH in children, while studying potential environmental factors for interstudy variability.
Combinatorial advantage of Ses i 1-specific IgE and basophil activation for diagnosis of sesame food allergy
Michael R. Goldberg,Michael Y. Appel,Liat Nachshon,Marie Holmqvist,Naama Epstein-Rigbi,Michael B. Levy,Jonas Lidholm,Arnon Elizur
doi : 10.1111/pai.13533
Volume 32, Issue 7 p. 1482-1489
The prevalence of sesame food allergy (SFA) is increasing worldwide with the potential of anaphylactic reactions upon exposure. Utility of specific component IgE testing as an alternative to the oral food challenge (OFC), the diagnostic standard, is being investigated.
Factors associated with outcome of egg allergy 1 year after oral food challenge: A good baseline quality of life may be beneficial
Kana Hamada,Mizuho Nagao,Ryo Imakiire,Kanae Furuya,Yumi Mizuno,Yasunori Sato,Mayumi Matsunaga,Shingo Yamada,Kazutaka Nogami,Miyuki Hoshi,Taiga Kobori,Keigo Kainuma,Kazumoto Iijima,Takao Fujisawa
doi : 10.1111/pai.13534
Volume 32, Issue 7 p. 1490-1496
Safely liberalizing the diet to include an allergenic food may accelerate resolution of food allergy. The outcome of liberalization, however, varies among patients.
Symptom scores in the diagnosis of pediatric cow’s milk protein allergy: A systematic review
Georgina Thompson,Zhivko Zhelev,Jaime Peters,Sara Khalid,Simon Briscoe,Liz Shaw,Michael Nunns,Sian Ludman,Christopher Hyde
doi : 10.1111/pai.13537
Volume 32, Issue 7 p. 1497-1507
Cow's milk protein allergy (CMPA) is an immune-mediated allergic response to proteins in milk that is common in infants. Broad CMPA symptoms make diagnosis a challenge, particularly in primary care. Symptom scores may improve a clinician's awareness of symptoms, indicating a need for further testing. This systematic review examined the development and evaluation of such symptom scores for use in infants.
Allergen-specific IgG show distinct patterns in persistent and transient food allergy
Richard T. McKendry,Matthew Kwok,Oliver Hemmings,Louisa K. James,Alexandra F. Santos
doi : 10.1111/pai.13567
Volume 32, Issue 7 p. 1508-1518
Immediate food-allergic reactions are IgE-mediated, but many individuals with detectable allergen-specific IgE do not react to the food. Allergen-specific IgG may interfere with allergen-IgE interaction and/or through intracellular inhibitory signalling to suppress mast cell and basophil response to food allergens. We aimed to understand the role of allergen-specific IgG in food allergy and natural tolerance.
Clinical, immunological, and genetic features in 780 patients with autoimmune lymphoproliferative syndrome (ALPS) and ALPS-like diseases: A systematic review
Nasim Hafezi,Majid Zaki-Dizaji,Matineh Nirouei,Gelayol Asadi,Niusha Sharifinejad,Mahnaz Jamee,Seyed Erfan Rasouli,Haleh Hamedifar,Araz Sabzevari,Zahra Chavoshzadeh,Reza Yazdani,Hassan Abolhassani,Asghar Aghamohammadi,Gholamreza Azizi
doi : 10.1111/pai.13535
Volume 32, Issue 7 p. 1519-1532
Autoimmune lymphoproliferative syndrome (ALPS) is a group of genetic disorders characterized by early-onset lymphoproliferation, autoimmune cytopenias, and susceptibility to lymphoma. The majority of ALPS patients carry heterozygous germline mutations in the TNFRSF6 gene. In this study, we conducted a systematic review of patients with ALPS and ALPS-like syndrome.
Newer-generation antihistamines and the risk of adverse events in children: A systematic review
Michael Miligkos,Maria Dakoutrou,Eleni Statha,Nikoletta A. Theochari,Ilektra Antonia Mavroeidi,?oanna Pankozidou,Irene Papaconstadopoulos,Nikolaos G. Papadopoulos
doi : 10.1111/pai.13522
Volume 32, Issue 7 p. 1533-1558
H1-antihistamines (AHs) are widely used for the treatment of allergic diseases, being one of the most commonly prescribed classes of medications in pediatrics. Newer-generation AHs are associated with fewer adverse effects compared with first-generation AHs. However, their relative harms in the pediatric population still need scrutiny.
The economic burden of allergic comorbidities in pediatric severe asthma
Gizem Pamuk,Muriel Le Bourgeois,Rola Abou Taam,Antoine Neuraz,Jacques de Blic,Christophe Delacourt,Guillaume Lezmi
doi : 10.1111/pai.13532
Volume 32, Issue 7 p. 1559-1565
Handling budesonide nebules to maximize the dispensed drug
Taciano Rocha,Rod Rhem,Leigh J Sowerby,Myrna B. Dolovich
doi : 10.1111/pai.13544
Volume 32, Issue 7 p. 1566-1568
Caregiver views on virtual management of food allergy: A mixed-methods study
Edmond S. Chan,Samira Jeimy,Mariam Hanna,Victoria E Cook,Douglas P. Mack,Elissa M. Abrams,Lianne Soller,Tiffany Wong,Jennifer LP. Protudjer
doi : 10.1111/pai.13539
Volume 32, Issue 7 p. 1568-1572
Use of an egg ladder for home egg introduction in children with IgE-mediated egg allergy
Leah Thomas,Jan Belcher,Rachael Phillips,Kahn Preece,Rani Bhatia
doi : 10.1111/pai.13541
Volume 32, Issue 7 p. 1572-1574
Association between transferrin saturation and celiac disease: A two-sample Mendelian randomization study
Zhenwei Tang,Minxue Shen,Xiang Chen,Yaozhong Liu
doi : 10.1111/pai.13565
Volume 32, Issue 7 p. 1575-1577
Asthma is associated with lower respiratory tract involvement and worse clinical score in children with COVID-19
Anna Clara Rabha,Fátima Rodrigues Fernandes,Dirceu Solé,Leonard Benjamin Bacharier,Gustavo Falbo Wandalsen
doi : 10.1111/pai.13536
Volume 32, Issue 7 p. 1577-1580
Food allergic reactions during the Covid-19 pandemic lockdown in Israeli children
Nadira Musallam,Ilan Dalal,Meital Almog,Larisa Epov,Azriel Romem,Ellen Bamberger,Avigdor Mandelberg,Aharon Kessel
doi : 10.1111/pai.13540
Volume 32, Issue 7 p. 1580-1584
Comment on Gerner T. et al.
Diána Elmer,Tímea Csákvári,Lilla Horváth,Imre Boncz
doi : 10.1111/pai.13546
Volume 32, Issue 7 p. 1585-1587
Comments on Miceli Sopo et al.
Simona Barni,Mattia Giovannini,Giulia Liccioli,Lucrezia Sarti,Francesca Mori
doi : 10.1111/pai.13563
Volume 32, Issue 7 p. 1588-1589
Reply to Barni et al.
Stefano Miceli Sopo,Dario Sinatti,Mariannita Gelsomino
doi : 10.1111/pai.13566
Volume 32, Issue 7 p. 1590-1590
