allergy
Allergy prevalence in adult celiac disease.

Ciacci C, Cavallaro R, Iovino P, Sabbatini F, Palumbo A, Amoruso D, Tortora R, Mazzacca G.

Gastrointestinal Unit, Federico II University of Naples, via Pansini 5, 80131 Naples, Italy. ciacci unina.it

BACKGROUND: Celiac disease is considered to arise from an inappropriate T-cell-mediated immune response against ingested gluten in genetically predisposed people, whereas the T(H)2-type lymphocytes are mostly involved in IgE-mediated reactions. The matter of possible coexistence of T(H)1- and T(H)2-type diseases is still debated. OBJECTIVE: This study was aimed to evaluate the allergy prevalence in a large series of adults with untreated celiac disease and their families at the moment of diagnosis. We also evaluated whether 1 year of gluten-free diet had any effect on allergy prevalence in our cohort. METHODS: At the moment of celiac disease diagnosis a standardized questionnaire was administered for detailed information on presence and type of any allergy symptoms in 1044 adult patients with celiac disease, 2752 relatives, and 318 spouses. Those reporting any allergy underwent tests with dosage of serum levels of total IgE and search for serum specific IgE with a standard makeup of 20 antigens and PRICK tests in selected individuals. At follow-up visit patients with celiac disease were administered the same allergy questionnaire. RESULTS: One hundred seventy-three patients with celiac disease (16.6%), 523 relative (19%), and 43 spouses (13.5%) had at least 1 allergy (P=not significant). Atopic dermatitis was more frequent in patients with celiac disease (3.8%) and their relatives (2.3%) than in spouses (1.3%). The presence of allergy in general and atopic dermatitis was not affected by presence of overt malabsorption or duration of undiagnosed disease. Follow-up data showed no change in allergy prevalence in the cohort examined. CONCLUSION: Allergy prevalence in a large series of patients with celiac disease is not different from that of their relatives and spouses. However, atopic dermatitis was about 3 times more frequent in patients with celiac disease and 2 times more frequent in their relatives than in spouses. One year of gluten-free diet did not change allergy prevalence in the celiac group under investigation.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15208605&dopt=Abstract allergy medicine



allergy
A neonatal swine model for peanut allergy.

Helm RM, Furuta GT, Stanley JS, Ye J, Cockrell G, Connaughton C, Simpson P, Bannon GA, Burks AW.

Division of Allergy/Immunology, Department of Pediatrics, Arkansas Children's Hospital Research Institute, University of Arkansas for Medical Sciences, Little Rock 72201, USA.

BACKGROUND: Peanut allergy represents a significant health threat in the United States. The factors contributing to the severity of the allergic response and the immunopathogenic mechanisms underlying peanut allergy remain to be completely characterized. As yet, no animal model has been developed that will completely mimic the physical, immunologic, and histologic features of food allergy. OBJECTIVE: The purpose of this investigation was to develop a neonatal pig model of peanut allergy that would mimic the allergic symptoms and the immunologic and histologic profile of human peanut allergy. METHODS: Newborn piglets sensitized intraperitoneally with peanut extract and cholera toxin were orally challenged repeatedly with peanut meal. Physical symptoms, including emesis, lethargy, diarrhea, and respiratory distress, were monitored to determine the allergic response. Immunologic assessment was conducted through use of skin testing and the antigenic response to peanut proteins. Histologically, tissues derived from the esophagus, stomach, small intestine, and colon were assessed for morphologic changes after the oral challenge. RESULTS: Peanut-sensitized pigs responded with physical symptoms that mimicked those seen in double-blinded, placebo-controlled oral food challenges to peanuts in children and adults. Skin testing suggested an IgE-mediated response; this was confirmed by a negative passive cutaneous anaphylaxis response of heat-treated sera obtained from peanut-sensitized animals. Damage to villi of the small intestine was similar to that seen in endoscopically obtained tissue specimens from certain food-allergic individuals. CONCLUSION: The neonatal pig model of peanut allergy mimics the physical and immunologic characteristics of peanut allergy in human beings. The model will be useful for determining IgE-mediated mechanisms and conducting endoscopic histologic assessment of tissues and immunotherapeutic intervention strategies with repeated allergen challenges.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11799380&dopt=Abstract allergy medicine



allergy
Segregation analyses of asthma and respiratory allergy: the Humboldt family study.

Chen Y, Schnell AH, Rennie DC, Elston RC, Lockinger LA, Dosman JA.

Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, Canada K1H 8M5. chen zeus.med.uottawa.ca

We performed segregation analyses of asthma and respiratory allergy based on data from 309 nuclear families comprising 1,053 individuals living in the town of Humboldt, Saskatchewan, in 1993, using the REGD program of the S.A.G.E. program package. For adults, information on asthma and history of respiratory allergy was provided by the subjects themselves, and for children by their parents. When asthma was considered as the trait in segregation analysis, models of no major effect, with or without familial effects, were rejected, but they were not rejected after adjusting for history of respiratory allergy. The major gene hypothesis was not rejected before adjusting for history of respiratory allergy. When respiratory allergy was analyzed as the trait, both major gene and multifactorial models fitted the data well, regardless of whether there was adjustment for asthma or not. Other covariates adjusted for in the segregation analyses were age, sex, number of household smokers, current smoking, number of household members, generation, and house type. The data suggest that a major gene related to respiratory allergy may explain the familial aggregation of asthma. Copyright 2001 Wiley-Liss, Inc.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11746023&dopt=Abstract allergy medicine



allergy
Cytokine expression profiles during murine contact allergy: T helper 2 cytokines are expressed irrespective of the type of contact allergen.

Ulrich P, Grenet O, Bluemel J, Vohr HW, Wiemann C, Grundler O, Suter W.

PCS-Genetic and Experimental Toxicology, Novartis Pharma AG, Basel, Switzerland. peter.ulrich pharma.novartis.com

We have investigated the cytokine response pattern following sensitisation (induction) of BALB/c mice with different chemicals (dinitrochlorobenzene, dinitrofluorobenzene, oxazolone, glutaraldehyde, formaldehyde, trimellitic anhydride, croton oil) and elicitation (challenge) of contact allergy in sensitised animals. The results of our investigations showed that different chemicals induced both T helper (Th) 1 cytokines [interleukin (IL) 2, interferon beta (IFNgamma) [corrected] and Th2 cytokines (IL-4, IL-10) at different stages during murine contact allergy. We also confirmed our previous findings that IL-4 and IL-10 release were up-regulated during the challenge phase regardless the contact allergen used, whereas the release of IFNgamma [corrected] did not show a clear preference for being up- or down-regulated. In our hands, the increased expression of Th2 cytokines after challenge exposure to contact allergens appeared as a stable marker of secondary contact allergenic responses. Quantitative differences in the expression of IL-4 were observed between different contact allergens. The present results clearly indicate that skin sensitisers were able to elicit cytokine response patterns, which could not be related to a clear-cut Th1 or Th2 type of cytokine response. Furthermore, dermal application of contact allergens produced different kinetics of cytokine secretion upon induction and challenge. In our hands, the co-expression of Th1 and Th2 type cytokines appeared as a universal consequence of dermal application of contact allergens to responsive mice. Our results indicate that co-expression of Th1 and Th2 cytokines during contact allergy is an important feature of murine contact allergy in responsive mice and that chemicals differ in their potency to induce the expression of these cytokines. Furthermore, the results do not support the view that different chemicals induce Th1 or Th2 cytokines in a mutually exclusive manner depending on their preference for inducing either contact or respiratory allergy. The results are expected to renew the discussion about the usefulness of the Th1/Th2 paradigm in certain areas of immunotoxicology.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11757671&dopt=Abstract allergy medicine



allergy
[Natural history of occupational allergy to latex in health care workers]

[Article in Polish]

Palczynski C, Walusiak J, Wittczak T, Krakowiak A, Ruta U, Kiec-Swierczynska M, Gorski P.

Kliniki Chorob Zawodowych, Osrodka Alergii Zawodowej i Srodowiskowej, Kliniki i Osrodka, Instytutu Medycyny Pracy, Lodzi.

The analysis of natural history of allergy to natural rubber latex (NRL) in health care workers, including the influence of exposure cessation on the clinical status and objective allergy markers was the objective of the study. The study covered 58 patients with recognised allergy to NRL. Of this number, 26 were followed up for 2 years after diagnosing NRL allergy. Medical examination, skin prick tests for common allergens and NRL, determination of total serum IgE and NRL-specific IgE antibodies, rest spirometry and non-specific bronchial hyperactivity test with histamine were performed. The retrospective analysis of clinical manifestation of NRL allergy revealed in 36% of patients progression of symptoms from local urticaria and rhinitis to systemic reactions. Two years after the cessation of exposure to NRL, symptoms became less severe in the majority of patients and even a clearance of allergic symptoms was observed, as well as the decrease in doses of inhalative glicocorticosteroids was noted. This was accompanied by the decline in non-specific bronchial hyperactivity. Although the skin prick tests showed the tendency to remain positive, the decrease in the level of specific anti-NRL IgE was found in 10 patients (including the RAST negativisation in one case). In conclusion, clinical progress from NRL-induced contact urticaria and allergic rhinitis to systemic reactions was observed only in part of patients with NRL allergy, which cannot be taken as a rule. Significant reduction of clinical symptoms or even total remission of NRL-allergic symptoms could be observed after exposure cessation.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11761666&dopt=Abstract allergy medicine



allergy
The impact of childhood food allergy on quality of life.

Sicherer SH, Noone SA, Munoz-Furlong A.

Department of Pediatrics, Jaffe Food Allergy Institute, Mount Sinai School of Medicine, New York, New York, USA. scott.sicherer mssm.edu

BACKGROUND: Food allergy affects >6% of children, but the impact of this disease on health-related quality of life has not been well studied. METHODS: Parental perceptions of physical and psychosocial functioning were measured with the Children's Health Questionnaire (CHQ-PF50). This tool and an additional allergy-related questionnaire were sent to 400 members of the Food Allergy and Anaphylaxis Network with children aged 5 to 18, an age group on which the tool has been validated. RESULTS: Surveys were completed by 253 parents (63%). The mean age of the food-allergic children was 10.8 years (range, 5 to 18 yrs); 59% were male. Sixty-eight percent were allergic to one or two foods, the remainder to more than two foods. Concomitant chronic atopic diseases included: asthma with atopic dermatitis (33%), atopic dermatitis alone (13%), asthma alone (33%), and 21% had neither asthma nor atopic dermatitis. In comparison to previously established norms, the families scored significantly lower (more than 10 scale score points lower and P < 0.0001) for general health perception (GH), emotional impact on the parent (PE), and limitation on family activities (FA). Associated atopic disease, influenced primarily by those with both asthma and atopic dermatitis, accounted for a significant reduction in the GH scale (analysis of variance, P = 0.0001), but not for measures of PE and FA. Within the study group, food-allergic individuals with several (more than two) food allergies had significantly lower (P < 0.05) scores for 7 of 12 scales compared with individuals with few (one or two) food allergies. However, those with one or two food allergies scored significantly lower (P < 0.0001) than established norms on scales for GH, PE, and FA. CONCLUSIONS: Childhood food allergy has a significant impact on GH, PE, and FA. Factors that influence reductions in these scales include associated atopic disease and the number of foods being avoided.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11770692&dopt=Abstract allergy medicine



allergy
[Current features of food allergies: the need of allergy surveillance]

[Article in French]

Moneret-Vautrin DA.

Service de Medecine Interne-Immunologie Clinique et Allergologie, CHU de Nancy-Hopital Central, Avenue de Lattre de Tassigny-54035 Nancy.

The prevalence of food allergy in European populations has been evaluated at between 1.8 and 4.4%. In the French population it is 3.24%. This frequency, as well as the gravity of some manifestations, has already led to preventive and curative measures being taken in school settings. This increase is related to multiple environmental factors: changes in intestinal microflora, early diversification of foods in children, interference of drugs favoring clinical severity in adults. Allergenicity can be modified by food industry techniques. The appearance of novel foods (exotic proteins or those derived from animal feed, and soon GMOs), the growing use of food proteins as ingredients, constitute new risks. The absence of validated experimental methods for evaluating the allergic risk of food proteins makes it necessary to implement a policy of allergy vigilance for novel foods. Studies concerning the allergic risk for lupin flour, a new ingredient used in baked goods, are given as an example. They indicate the frequency of sensitization and cross peanut-lupin flour allergy, the low reactive threshold, indicating the risk of the level of incorporation presently allowed. They make possible current screening for this allergy in the population. Allergy vigilance is a recent concept that aims to set up surveillance of food allergy risks in a manner analogous to that of pharmacovigilance for drugs. A project for creating such a structure is being discussed. Although the central structure remains at the initiative of the Agence Francaise de Securite Sanitaire de l'Alimentation (French Agency for Food Safety) and the Institut de Veille Sanitaire (Institute of Health) the authors specify what a peripheral network of allergists should be, analyze the desired content of the bi-directional flow of information, and propose envisaging an intermediate regulatory organization, specialized in the diagnosis and treatment of food allergies. The ongoing idea is that environmental pressures on the genetics of atopic disease lead to a continuum of IgE-dependent responses towards all the potential allergens in the entire population. Consequently, the creation of such a structure is advised in the name of the Precautionary Principle.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11717849&dopt=Abstract allergy medicine