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Background Characterization of allergic responses to cockroach (CR), a common aeroallergen associated with asthma, has focused mainly on IgE reactivity, but little is known about T cell responses, particularly in children. We conducted a functional evaluation of CR allergen‐specific T cell reactivity in a cohort of CR allergic children with asthma. Methods Peripheral blood mononuclear cells (PBMCs) were obtained from 71 children, with mild‐to‐moderate asthma who were enrolled in a CR immunotherapy (IT) clinical trial, prior to treatment initiation. PBMC were stimulated with peptide pools derived from 11 CR allergens, and CD4+ T cell responses assessed by intracellular cytokine staining. Results Highly heterogeneous responses in T cell reactivity were observed among participants, both in terms of the magnitude of cytokine response and allergen immunodominance. Reactivity against Bla g 9 and Bla g 5 was most frequent. The phenotype of the T cell response was dominated by IL‐4 production and a Th2 polarized profile in 54.9% of participants, but IFNγ production and Th1 polarization was observed in 25.3% of the participants. The numbers of regulatory CD4+ T cells were also highly variable and the magnitude of effector responses and Th2 polarization were positively correlated with serum IgE levels specific to a clinical CR extract. Conclusions Our results demonstrate that in children with mild‐to‐moderate asthma, CR‐specific T cell responses display a wide range of magnitude, allergen dominance, and polarization. These results will enable examination of whether any of the variables measured are affected by IT and/or are predictive of clinical outcomes.

Objective: To evaluate a brief educational tool for pediatricians developed to address known gaps in food allergy knowledge. Study Design: Pre- and post-assessments were administered to a convenience sample of 61 US pediatricians completing the Food Allergy Comprehension Tool between February and March of 2010. McNemar’s and Wilcoxon signed rank tests were used to determine whether clinical knowledge of food allergy and level of comfort in caring for food-allergic children increased significantly after reviewing the tool. Logistic regression models were used to measure the association of participant characteristics with increased knowledge and comfort. Results: Sixty-one percent of surveyed physicians answered more knowledge questions correctly after reviewing the tool. Significantly more participants correctly indicated that anaphylaxis poses the greatest threat to teenagers rather than young children, and correctly rejected chronic nasal problems as a symptom of food allergy (p

Background Prenatal maternal smoking and prematurity independently affect wheezing and asthma in childhood.

To cite this article: Liu X, Wang G, Hong X, Wang D, Tsai H-J, Zhang S, Arguelles L, Kumar R, Wang H, Liu R, Zhou Y, Pearson C, Ortiz K, Schleimer R, Holt P, Pongracic J, Price HE, Langman C, Wang X. Gene–vitamin D interactions on food sensitization: a prospective birth cohort study. Allergy 2011; 66: 1442–1448. Abstract Background: It has been hypothesized that vitamin D deficiency (VDD) contributes to the development of food sensitization (FS) and then food allergy. However, the epidemiological evidence is conflicting. We aim to examine whether cord blood VDD is associated with FS and whether such association can be modified by genetic variants in a prospective birth cohort. Methods: This study included 649 children who were enrolled at birth and followed from birth onward at the Boston Medical Center. We defined VDD as cord blood 25(OH)D

Parents of food-allergic children are responsible for risk assessment and management of their child's condition. Such practices are likely informed by parental knowledge, attitudes, and beliefs of food allergy. Our objective was to characterize food allergy knowledge and perceptions among parents with food-allergic children. Parents were recruited nationally between January 2008 and 2009 to complete the validated, web-based Chicago Food Allergy Research Survey for Parents of Children with Food Allergy. Findings were analyzed to provide composite/itemized knowledge scores, describe attitudes and beliefs, and examine the effects of participant characteristics on response. A sample of 2945 parents was obtained. Participants had an average knowledge score of 75% correct (range 19-100%). Strengths were observed in each content domain; e.g., 95% of participants accurately identified the signs of a milk-induced reaction. Weaknesses were limited to items assessing food allergy triggers/environmental risks and perceptions of susceptibility/prevalence; e.g., 52% of parents incorrectly believed young children are at higher risk for fatal anaphylaxis than adolescents. Parental attitudes/beliefs were diverse, although 85% agreed children should carry an EpiPen at school and 91% felt schools should have staff trained in food allergy. One in four parents reported food allergy caused a strain on their marriage/relationship, and 40% reported experiencing hostility from other parents when trying to accommodate their child's food allergy. In conclusion, parents in our study exhibited solid baseline knowledge although several important misconceptions were identified. While a broad spectrum of parental perceptions was observed, a large proportion of parents reported that their child's food allergy had an adverse impact on personal relationships and also agreed on certain policies to address food allergy in schools.

To cite this article: Matsui EC, Sampson HA, Bahnson HT, Gruchalla RS, Pongracic JA, Teach SJ, Gergen PJ, Bloomberg GR, Chmiel JF, Liu AH, Kattan M, Sorkness CA, Steinbach SF, Story RE, Visness CM, on behalf of the Inner-city Asthma Consortium. Allergen-specific IgE as a biomarker of exposure plus sensitization in inner-city adolescents with asthma. Allergy 2010; 65: 1414–1422. Abstract Background: Relationships among allergen-specific IgE levels, allergen exposure and asthma severity are poorly understood since sensitization has previously been evaluated as a dichotomous, rather than continuous characteristic. Methods: Five hundred and forty-six inner-city adolescents enrolled in the Asthma Control Evaluation study underwent exhaled nitric oxide (FENO) measurement, lung function testing, and completion of a questionnaire. Allergen-specific IgE levels and blood eosinophils were quantified. Dust samples were collected from the participants’ bedrooms for quantification of allergen concentrations. Participants were followed for 12 months and clinical outcomes were tracked. Results: Among sensitized participants, allergen-specific IgE levels were correlated with the corresponding settled dust allergen levels for cockroach, dust mite, and mouse (r = 0.38, 0.34, 0.19, respectively; P

Summary Background The atopic march is well documented, but the interrelationship of food allergy (FA) and asthma is not well understood. Objective The aim of this study was to examine the strength of the association and temporal relationships between FA and asthma. Methods This analysis included 271 children 6 years (older group) and 296 children

Background There have been numerous studies of asthma in twins, but no study has evaluated whether lung function predictive models yield similar results between twin and general populations. We sought to evaluate this in late childhood and adolescent subjects. Methods We generated cross-sectional, sex- and age-specific regression models of FEV1, and FVC, in a community-based cohort of 3140 healthy, non-smoking Chinese twins using generalized estimating equations to adjust for correlations within twin pairs. We applied the model to a healthy non-smoking general population cohort of 2187 subjects from the same region, and compared %predicted FEV1 and FVC values between the two populations. Results Stratified by age and sex, the associations of height with FEV1 or FVC varied by age group. During the adolescent growth spurt (age 13 for girls and ages 14-16 for boys), the associations of height with FEV1 or FVC were nonlinear and greater than that seen at other ages. During adolescence, FEV1 and FVC for a given height increased with age. The percent predicted values of FEV1 and FVC in the twin population were similar to that of the general population. Conclusions Twin and general populations have similar patterns of lung function change over middle childhood and adolescence. Similar equations may be used to estimate percent predicted values. Finally, a single prediction equation cannot completely describe patterns of lung function from childhood through adolescence due to puberty related changes. Pediatr Pulmonol. 2007; 42:631–639. © 2007 Wiley-Liss, Inc.