239 results on '"Jennifer J. Koplin"'
Search Results
2. Efficacy and safety of oral immunotherapy for peanut, cow's milk, and hen's egg allergy: A systematic review of randomized controlled trials
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Caroline J. Lodge, Nilakshi Waidyatillake, Rachel L. Peters, Merryn Netting, Xin Dai, John Burgess, Catherine J. Hornung, Kirsten P. Perrett, Mimi L. K. Tang, Jennifer J. Koplin, and Shyamali C. Dharmage more...
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desensitization ,food allergy ,oral immunotherapy ,randomized controlled trials ,sustained unresponsiveness ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Abstract Background Oral immunotherapy (OIT) is a promising treatment for food allergies; however, safety is a concern. We synthesized evidence from the best randomized controlled trials (RCTs) on efficacy/safety of OIT for desensitization (DS) and remission (sustained unresponsiveness (SU)) in IgE mediated allergy to peanut, hen's eggs, and cow's milk. Body We searched Pubmed, EMBASE, and Cochrane databases (Until Oct 22) identifying 16 eligible RCTs published in English measuring food allergy by food challenge at the beginning and at the end of the study. The Cochrane Risk of Bias tool was used to assess study quality. We found 18 eligible studies. There was evidence of efficacy for DS for all allergens: peanut (RR 11.32; 95% CI 5.93, 21.60, I2 49%, 8 studies); hen's egg (RR 4.67; 2.66, 8.21, I2 0%, 5 studies); cow's milk (RR 13.98; 3.51, 55.65, I2 0%, 4 studies) and evidence for SU for peanut (RR 7.74; 2.90, 20.69, I2 0%, 3 studies) and hen's egg (RR 6.91; 1.67, 28.57, I2 0%, 2 studies). Allergic events were increased with intervention, and risk of adrenaline use increased for peanut RR 2.96; 1.63, 5.35, I2 0%, 8 studies; egg RR 1.71; 0.42, 6.92, I2 0%, 6 studies; and milk RR 8.45; 2.02, 35.27, I2 0%, 4 studies. Conclusion We found strong evidence that peanut, hen's egg, and cow's milk OIT can induce DS and some evidence for remission. There was a high risk of allergic reactions. Generalizability to the entire food allergic population is not known. more...
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- 2023
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3. Backyard benefits? A cross-sectional study of yard size and greenness and children’s physical activity and outdoor play
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Jessica Oakley, Rachel L. Peters, Melissa Wake, Anneke C. Grobler, Jessica A. Kerr, Kate Lycett, Raisa Cassim, Melissa Russell, Cong Sun, Mimi L. K. Tang, Jennifer J. Koplin, and Suzanne Mavoa
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Children ,Physical activity, outdoor play ,Yard ,Greenness ,Built environment ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background The home environment is the most important location in young children’s lives, yet few studies have examined the relationship between the outdoor home environment and child physical activity levels, and even fewer have used objectively measured exposures and outcomes. This study examined relationships between objectively assessed home yard size and greenness, and child physical activity and outdoor play. Methods Data were drawn from the HealthNuts study, a longitudinal study of 5276 children in Melbourne, Australia. We used cross-sectional data from a sample at Wave 3 (2013–2016) when participants were aged 6 years (n = 1648). A sub-sample of 391 children had valid accelerometer data collected from Tri-axial GENEActive accelerometers worn on their non-dominant wrist for 8 consecutive days. Yard area and greenness were calculated using geographic information systems. Objective outcome measures were minutes/day in sedentary, light, and moderate-vigorous physical activity (weekday and weekend separately). Parent-reported outcome measures were minutes/day playing outdoors (weekend and weekday combined). Multi-level regression models (adjusted for child’s sex, mother’s age at the birth of child, neighbourhood socioeconomic index, maternal education, and maternal ethnicity) estimated effects of yard size and greenness on physical activity. Results Data were available on outdoor play for 1648 children and usable accelerometer data for 391. Associations between yard size/greenness and components of physical activity were minimal. For example, during weekdays, yard size was not associated with daily minutes in sedentary behaviour (β: 2.4, 95% CI: − 6.2, 11.0), light physical activity (β: 1.4, 95% CI: − 5.7, 8.5) or MVPA (β: -2.4, 95% CI: − 6.5, 1.7), with similar patterns at weekends. There was no relationship between median annual yard greenness and physical activity or play. Conclusion In our study of young children residing in higher socio-economic areas of Melbourne yard characteristics did not appear to have a major impact on children’s physical activity. Larger studies with greater variation in yard characteristics and identification of activity location are needed to better understand the importance of home outdoor spaces and guide sustainable city planning. more...
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- 2021
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4. Mass cytometry reveals cellular fingerprint associated with IgE+ peanut tolerance and allergy in early life
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Melanie R. Neeland, Sandra Andorf, Monali Manohar, Diane Dunham, Shu-Chen Lyu, Thanh D. Dang, Rachel L. Peters, Kirsten P. Perrett, Mimi L. K. Tang, Richard Saffery, Jennifer J. Koplin, and Kari C. Nadeau more...
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Science - Abstract
Food allergy is triggered by IgE, but some individuals are not allergic to peanuts despite making peanut-specific IgE, and are considered peanut-tolerant. Here, the authors identify differences in blood immune cell composition of peanut-allergic and tolerant infants using mass cytometry, which may help uncover the mechanism of allergic tolerance. more...
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- 2020
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5. Hyper-Inflammatory Monocyte Activation Following Endotoxin Exposure in Food Allergic Infants
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Melanie R. Neeland, Boris Novakovic, Thanh D. Dang, Kirsten P. Perrett, Jennifer J. Koplin, and Richard Saffery
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monocytes ,food allergy ,trained immunity ,inflammatory response ,regulatory T (Treg) cell ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Several recent studies have reported a key role for innate cell hyper-responsiveness in food allergy. This has predominantly been observed in early life, with evidence that innate immune function may return to baseline if food allergy resolves in later childhood. Hallmarks of hyper-responsiveness include increased circulating frequency of monocytes and altered innate cell cytokine responses to in vitro exposure with bacterial endotoxin. These features mirror the defining signatures of trained innate immunity, seen in other complex diseases. In this study, detailed immune cell and cytokine profiling was performed on peripheral blood mononuclear cells at baseline from 27 1 year old infants in the HealthNuts cohort (n = 16 egg allergic and n = 11 non-allergic healthy controls) and following monocyte stimulation. We show that egg allergic infants have increased frequency of circulating monocytes, reduced numbers of regulatory CD4 T cells and increased monocyte: CD4 T cell ratios relative to healthy controls. Monocytes from both egg allergic and non-allergic infants responded to endotoxin stimulation with rapid cytokine production and downregulation of the surface receptor CD16, however monocytes from egg allergic infants were hyper-responsive, producing significantly more inflammatory cytokines (TNFα, IL-6, IL-1β, IL-8) and innate cell recruiting factors (MIP-1α) than healthy controls. This work indicates that monocytes of food allergic infants are programmed to a hyper-inflammatory phenotype and that the development of food allergy may be associated with trained immunity in early life. more...
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- 2020
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6. Are food allergic consumers ready for informative precautionary allergen labelling?
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Giovanni A. Zurzolo, Rachel L. Peters, Jennifer J. Koplin, Maximilian de Courten, Michael L. Mathai, and Katrina J. Allen
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Precautionary allergen labelling ,Voluntary Incidental Trace Allergen Labelling ,Food allergy ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Abstract Precautionary allergen labelling (PAL) has resulted in consumer confusion. Previous research has shown that interpretive labels (using graphics, symbols, or colours) are better understood than the traditional forms of labels. In this study, we aimed to understand if consumers would use interpretive labels (symbol, mobile phone application and a toll-free number) with or without medical advice that was advocated by the food industry rather than the normal PAL. This is relevant information for industry and clinicians as it provides an insight into the food allergic perception regarding PAL. more...
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- 2017
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7. The state of asthma epidemiology: an overview of systematic reviews and their quality
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Jon Genuneit, Annina M. Seibold, Christian J. Apfelbacher, George N. Konstantinou, Jennifer J. Koplin, Stefania La Grutta, Kirsty Logan, Carsten Flohr, Michael R. Perkin, and for the Task Force “Overview of Systematic Reviews in Allergy Epidemiology (OSRAE)” of the EAACI Interest Group on Epidemiology more...
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Asthma ,Systematic Review ,Respiratory Syncytial Virus ,Respiratory Syncytial Virus Infection ,Occupational Asthma ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Abstract Background Recently, we have published an overview of systematic reviews in allergy epidemiology and identified asthma as the most commonly reviewed allergic disease. Building on this work, we aimed to investigate the quality of systematic reviews in asthma using the AMSTAR checklist and to provide a reference for future, more in-depth assessment of the extent of previous knowledge. Methods We included all 307 systematic reviews indexed with asthma, including occupational asthma, and/or wheeze from our previous search in PubMed and EMBASE up to December 2014 for systematic reviews on epidemiological research on allergic diseases. Topics of the included systematic reviews were indexed and we applied the AMSTAR checklist for methodological quality to all. Statistical analyses include description of lower and upper bounds of AMSTAR scores and variation across publication time and topics. Results Of 43 topics catalogued, family history, birth weight, and feeding of formula were only covered once in systematic reviews published from 2011 onwards. Overall, at least one meta-analysis was conducted for all topics except for “social determinants”, “perinatal”, “birth weight”, and “climate”. AMSTAR quality scores were significantly higher in more recently published systematic reviews, in those with meta-analysis, and in Cochrane reviews. There was evidence of variation of quality across topics even, after accounting for these characteristics. Genetic factors in asthma development were often covered by systematic reviews with some evidence of unsubstantiated updates or repetition. Conclusions We present a comprehensive overview with an indexed database of published systematic reviews in asthma epidemiology including quality scores. We highlight some topics including active smoking and pets, which should be considered for future systematic reviews. We propose that our search strategy and database could be a basis for topic-specific overviews of systematic reviews in asthma epidemiology. more...
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- 2017
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8. Factors Affecting Vitamin D Status in Infants
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Charles Fink, Rachel L. Peters, Jennifer J. Koplin, Justin Brown, and Katrina J. Allen
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vitamin D ,infants ,vitamin D supplementation ,maternal supplementation ,ethnicity ,infant formula ,breastfeeding ,UV exposure ,latitude ,socioeconomic status ,Pediatrics ,RJ1-570 - Abstract
Vitamin D is critical to children’s skeletal development and health. Despite this, the factors which determine vitamin D concentrations during infancy remain incompletely understood. This article reviews the literature assessing the factors which can affect vitamin D status in infancy, including antenatal and postnatal vitamin D supplementation. Observational data supports that dietary intake of vitamin D, UV exposure, and geographic factors contribute significantly to infants’ vitamin D status, but the relationship is unclear regarding genetic variation, ethnicity, and maternal vitamin D status. Randomised controlled trials have compared higher versus lower doses of infant vitamin D supplementation, but no studies have compared infant vitamin D supplementation to placebo and eliminated external sources of vitamin D to fully quantify its effect on vitamin D status. Knowledge gaps remain regarding the factors associated with optimal vitamin D concentrations in infants—including key factors such as ethnicity and genetic variation—and further studies are needed. more...
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- 2019
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9. Early peanut introduction
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Jennifer J. Koplin, Vicki McWilliam, Victoria X. Soriano, and Rachel L. Peters
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Pulmonary and Respiratory Medicine ,Immunology ,Immunology and Allergy - Published
- 2023
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10. Food Allergen Immunotherapy in Preschool Children: Do We Have the Evidence?
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Paxton Loke, Brian P. Vickery, Stacie M. Jones, Rachel L. Peters, Graham Roberts, and Jennifer J. Koplin
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Immunology and Allergy - Published
- 2023
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11. Is antenatal or early‐life vitamin D associated with eczema or food allergy in childhood? A systematic review
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Rong Zeng, Yusi Li, Songying Shen, Xiu Qiu, Chia‐Lun Chang, Jennifer J. Koplin, Kirsten P. Perrett, Shyamali C. Dharmage, Caroline J. Lodge, and Adrian J. Lowe
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Immunology ,Immunology and Allergy - Published
- 2023
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12. Impact of a Decade of Research Into Atopic Dermatitis
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Peter D, Arkwright and Jennifer J, Koplin
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Immunology and Allergy - Abstract
The last decade has seen an unprecedented pace of change, particularly of clinical research in atopic dermatitis (AD). This review summarizes some key discoveries. Over the last 10 years, nearly half of all studies investigated the efficacy and safety of novel therapeutic agents, particularly biologics and small molecules. Clear demonstration of benefit in clinical trials with no significant safety concerns provided strong evidence leading to subsequent Food and Drug Administration approval and routine use of the anti-IL-4 receptor alpha antagonist dupilumab in patients 6 months and older, the selective Janus kinase 1 (JAK1) inhibitors upadacitinib for patients 12 years and older and abrocitinib, the IL-13 antagonist tralokinumab, and the JAK1/2 inhibitor baricitinib for adults 18 years and older. Several other drugs are in the pipeline. Other areas under the spotlight have been trials of skin moisturizers and probiotics in the prevention of AD, investigating the role of filaggrin and skin barrier function and the role of skin and gut microbiome, with Staphylococcus aureus second immunoglobulin-binding protein having been found to uniquely trigger allergic skin responses in AD. Skin microbiome, epidermal metabolites/structural components, and local inflammatory biomarkers are now commonly assessed using genomic and proteomic analysis of tape strips rather than more invasive biopsy to identify factors such as C-C motif chemokine ligand-17 that correlate with disease severity and response to therapy. Overall, the last decade has ushered in a new and exciting era in our understanding, diagnosis, and treatment of this common allergic skin disease. more...
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- 2023
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13. Challenging Best Practice of Atopic Dermatitis
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Peter D. Arkwright and Jennifer J. Koplin
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Immunology and Allergy - Published
- 2023
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14. Tree nut introduction in infants with peanut and/or egg allergy
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Julia Payne, Vicki McWilliam, Jennifer J. Koplin, Katrina J. Allen, Joanne Smart, Sandeep Arunothayaraj, and Kirsten P. Perrett
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Immunology and Allergy - Published
- 2023
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15. Comparing definitions of bronchodilator response in a population‐based cohort of 6‐year‐old children
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Shivanthan Shanthikumar, Katherine Chen, Victoria X. Soriano, Lily Nguyen, Jennifer J. Koplin, Mimi L. K. Tang, Adrian J. Lowe, Caroline J. Lodge, Nur Sabrina Idrose, Sarath Ranganathan, Bruce Thompson, Shyamali C. Dharmage, and Rachel L. Peters more...
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Pulmonary and Respiratory Medicine ,Pediatrics, Perinatology and Child Health - Published
- 2023
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16. Systematic Review of the Incidence and/or Prevalence of Eating Disorders in Individuals With Food Allergies
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Daniela Ciciulla, Victoria X. Soriano, Vicki McWilliam, Jennifer J. Koplin, and Rachel L. Peters
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Immunology and Allergy - Published
- 2023
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17. TreEAT trial: Protocol for a randomized controlled trial investigating the efficacy and safety of early introduction of tree nuts for the prevention of tree nut allergy in infants with peanut allergy
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Vicki L. McWilliam, Jennifer J. Koplin, Katie Allen, Marnie Robinson, Joanne Smart, Paxton Loke, Rachel L. Peters, Thanh Dang, Katherine J. Lee, Kim Dalziel, Dean Tey, Mark Taranto, and Kirsten P. Perrett more...
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Immunology ,Pediatrics, Perinatology and Child Health ,Immunology and Allergy - Abstract
Introduction: Children with peanut allergy are at increased risk of developing tree nut allergies, which can be severe and for most lifelong. Introduction of peanut in the first year of life can reduce the risk of peanut allergy, however, prevention strategies for tree nut allergies have not been established. We aimed to test the efficacy and safety of a novel strategy, a supervised multi-nut oral food challenge (OFC) compared to standard care for tree nut allergy prevention in infants at high risk of developing tree nut allergy, TreEAT. Methods and analysis: TreEAT is a 2-armed, open-label, randomised, controlled trial (RCT). Infants (n=212) aged 4-11months with peanut allergy will be randomised 1:1 at peanut allergy diagnosis to either a hospital-based multi-tree nut (almond, cashew, hazelnut and walnut) OFC using multi-nut butter or standard care (home introduction of individual tree nuts). All infants will be assessed at age 18months, with questionnaires and SPT to peanut and tree nuts. Peanut and tree nut OFCs will be performed as required to determine allergy status for each nut. The primary outcome is tree nut allergy at age 18 months. Secondary outcomes include peanut allergy resolution, proportion and severity of adverse events related to tree nut ingestion, number and frequency of tree nuts ingested, quality of life and parental anxiety and allergy related healthcare visits from randomisation to 18 months of age. Analyses will be performed on an intention-to-treat basis. Ethics and dissemination TreEAT was approved by the Royal Children’s Hospital Human Research Ethics Committee (#70489). Outcomes will be presented at scientific conferences and disseminated through publication. Trial registration number: ClinicalTrials.gov ID: NCT04801823 more...
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- 2023
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18. Complementary and Allergenic Food Introduction in Infants: An Umbrella Review
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Victoria X. Soriano, Daniela Ciciulla, Grace Gell, Yichao Wang, Rachel L. Peters, Vicki McWilliam, Shyamali C. Dharmage, and Jennifer J. Koplin
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Pediatrics, Perinatology and Child Health - Abstract
BACKGROUND Multiple systematic reviews examine the introduction of foods in relation to individual health outcomes, but the balance of harms and benefits has not been overviewed systematically. OBJECTIVES We aimed to perform an overview of systematic reviews on age of introduction of complementary and allergenic foods to the infant diet and long and short-term health outcomes. DATA SOURCES We searched Medline, Embase, Cochrane, and PubMed (July 25, 2022). STUDY SELECTION Included systematic reviews examining the introduction of complementary or allergenic foods before age 1. Outcomes included allergic, autoimmune, and inflammatory diseases, neurodevelopment, nutrition, and weight. DATA EXTRACTION Extraction and quality assessment were performed in duplicate (A Measurement Tool to Assess Systematic Reviews) and strength of evidence was assessed. RESULTS We screened 4015 articles and included 32 systematic reviews. There was moderate evidence that peanut and egg should be introduced from 4 to 11 months to prevent food allergy (6 of 10 reviews). Complementary food introduction was not associated with food allergy. Moderate certainty evidence suggested age of complementary food introduction was not associated with eczema. Age at introduction of gluten was not associated with celiac disease (high certainty evidence; 3 of 4 reviews). Low certainty evidence indicated that introducing solids before 4 months may increase the risk of childhood obesity, but not growth. There was insufficient evidence regarding an association between any food introduction and bone health, gastrointestinal diseases, autoimmune disorders, asthma, or allergic rhinitis. LIMITATIONS Gray literature was not included. CONCLUSIONS Current evidence supports introducing complementary foods around 6 months and allergenic foods before 11 months. more...
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- 2023
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19. Food allergy across the globe
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Vanitha Sampath, Elissa M. Abrams, Bahman Adlou, Cezmi Akdis, Mübeccel Akdis, Helen A. Brough, Susan Chan, Pantipa Chatchatee, R. Sharon Chinthrajah, Renata Rodrigues Cocco, Antoine Deschildre, Philippe Eigenmann, Cesar Galvan, Ruchi Gupta, Elham Hossny, Jennifer J. Koplin, Gideon Lack, Michael Levin, Lynette P. Shek, Mika Makela, David Mendoza-Hernandez, Antonella Muraro, Nikolaos G. Papadopoulous, Ruby Pawankar, Kirsten P. Perrett, Graham Roberts, Cansin Sackesen, Hugh Sampson, Mimi L.K. Tang, Alkis Togias, Carina Venter, Christopher Michael Warren, Lisa M. Wheatley, Gary W.K. Wong, Kirsten Beyer, Kari C. Nadeau, and Harald Renz more...
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Immunology ,Infant ,Allergens ,Breast Feeding ,Desensitization, Immunologic ,Food ,Pregnancy ,Child, Preschool ,Practice Guidelines as Topic ,Prevalence ,Animals ,Humans ,Immunology and Allergy ,Female ,Food Hypersensitivity ,Diet Therapy - Abstract
The prevalence of food allergy (FA) is increasing in some areas of the globe, highlighting the need for better strategies for prevention, diagnosis, and therapy. In the last few decades, we have made great strides in understanding the causes and mechanisms underlying FAs, prompting guideline updates. Earlier guidelines recommended avoidance of common food allergens during pregnancy and lactation and delaying the introduction of allergenic foods in children aged between 1 and 3 years. Recent guidelines for allergy prevention recommend consumption of a healthy and diverse diet without eliminating or increasing the consumption of allergenic foods during pregnancy or breast-feeding. Early introduction of allergenic foods is recommended by most guidelines for allergy prevention after a period of exclusive breast-feedng (6 months [World Health Organization] or 4 months [European Academy of Allergy and Clinical Immunology]). New diagnostics for FA have been developed with varied availability of these tests in different countries. Finally, the first oral immunotherapy drug for FA was approved by the US Food and Drug Administration and European Medicines Agency in 2020. In this review, we will address the global prevalence of FA, our current understanding of the causes of FA, and the latest guidelines for preventing, diagnosing, and treating FA. We will also discuss similarities and differences between FA guidelines. more...
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- 2021
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20. Epidemiology of eczema in South-Eastern Australia
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Berihun M. Zeleke, Adrian J. Lowe, Shyamali C. Dharmage, Diego J. Lopez, Jennifer J. Koplin, Rachel L. Peters, Victoria X. Soriano, Mimi L. K. Tang, E. Haydn Walters, George A. Varigos, Caroline J. Lodge, Jennifer L. Perret, and Michael J. Abramson more...
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Dermatology - Abstract
Eczema is a common chronic debilitating skin condition in childhood. Data on the epidemiology and natural history of eczema across the life course are lacking. This analysis aimed to describe these epidemiological features in Australian children and adults.Data collected on eczema from four Australian cohort studies were analysed: namely HealthNuts, Melbourne Atopic Cohort Study (MACS), Tasmanian Longitudinal Health Study (TAHS) and the Australian arm of the European Community Respiratory Health Survey (ECRHS).Among children aged under 6 years, 28.8%-35.6% have ever-had eczema, and 16.7%-26.6% had 'current eczema'. Among those aged 6-12 years, 14.6%-24.7% had 'current eczema' with 12.0%-18.5% of those at ages of 6 and 10 years classified as having moderate-to-severe eczema according to the Scoring of Atopic Dermatitis (SCORAD) index. In adults, the prevalence of 'eczema ever' ranged between 13.8% and 48.4%. The 12-month period prevalence of eczema was 15.1% at age 18, while current eczema was 8.5% at an average age of 51, and 8.8% at an average age 53 years. Eczema was more common among young boys, but this difference became non-significant for older children and early adolescents. In contrast, eczema was more common for adult women than men.Eczema is common both in children and adults. The proportion of severe eczema in children was substantial. more...
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- 2022
21. Immuno‐epigenomic analysis identifies attenuated interferon responses in naïve <scp>CD4</scp> T cells of adolescents with peanut and multi‐food allergy
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Samira Imran, Melanie R. Neeland, Stephen Peng, Amanda Vlahos, David Martino, Shyamali C. Dharmage, Mimi L. K. Tang, Susan Sawyer, Thanh D. Dang, Vicki McWilliam, Rachel L. Peters, Jennifer J. Koplin, Kirsten P. Perrett, Boris Novakovic, and Richard Saffery more...
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CD4-Positive T-Lymphocytes ,Arachis ,Immunology ,Pediatrics, Perinatology and Child Health ,Humans ,Cytokines ,Immunology and Allergy ,Interferons ,Food Hypersensitivity - Abstract
IgE-mediated food allergies have been linked to suboptimal naïve CD4 T (nCD4T) cell activation in infancy, underlined by epigenetic and transcriptomic variation. Similar attenuated nCD4T cell activation in adolescents with food allergy have also been reported, but these are yet to be linked to specific epigenetic or transcriptional changes.We generated genome-wide DNA methylation data in purified nCD4 T cells at quiescence and following activation in a cohort of adolescents (aged 10-15 years old) with peanut allergy (peanut only or peanut + ≥1 additional food allergy) (FA, n = 29), and age-matched non-food allergic controls (NA, n = 18). Additionally, we assessed transcriptome-wide gene expression and cytokine production in these cells following activation.We found widespread changes in DNA methylation in both NA and FA nCD4T cells in response to activation, associated with the T cell receptor signaling pathway. Adolescents with FA exhibit unique DNA methylation signatures at quiescence and post-activation at key genes involved in Th1/Th2 differentiation (RUNX3, RXRA, NFKB1A, IL4R), including a differentially methylated region (DMR) at the TNFRSF6B promoter, linked to Th1 proliferation. Combined analysis of DNA methylation, transcriptomic data and cytokine output in the same samples identified an attenuated interferon response in nCD4T cells from FA individuals following activation, with decreased expression of several interferon genes, including IFN-γ and a DMR at a key downstream gene, BST2.We find that attenuated nCD4T cell responses from adolescents with food allergy are associated with specific epigenetic variation, including disruption of interferon responses, indicating dysregulation of key immune pathways that may contribute to a persistent FA phenotype. However, we recognize the small sample size, and the consequent restraint on reporting adjusted p-value statistics as limitations of the study. Further study is required to validate these findings. more...
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- 2022
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22. Time trends in adrenaline auto‐injector dispensing patterns using Australian Pharmaceutical Benefits Scheme data
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Harriet Hiscock, Yichao Wang, Simon Horne, Katrina J. Allen, Shaoke Lei, Rachel L. Peters, and Jennifer J. Koplin
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Adult ,medicine.medical_specialty ,education.field_of_study ,Epinephrine ,business.industry ,Time trends ,Population ,Australia ,Pharmaceutical Benefits Scheme ,Auto-Injector ,Proxy (climate) ,Pharmaceutical Preparations ,General Practitioners ,Pediatrics, Perinatology and Child Health ,Epidemiology ,Humans ,Medicine ,Cumulative incidence ,Medical prescription ,Child ,business ,education ,Anaphylaxis ,Demography - Abstract
AIM: Adrenaline auto-injector (AAI) dispensing data, a community-based proxy for number of individuals at risk of anaphylaxis, provides complementary information on time trends of anaphylaxis risk in addition to hospital admission data. We examined trends of AAI dispensing over a 10-year period (from January 2005 to December 2014) in Australia. METHODS: Individuals with dispensed AAI were identified from a 10% random sample of Australian Pharmaceutical Benefits Scheme (PBS) data. PBS is the Australian national drug subsidy programme covering all Australians. Cumulative incidence and incidence rates of individuals with AAI were calculated. We assessed difference by age, sex, state and time trends. RESULTS: The cumulative incidence of individuals with AAI in 2005-2014 was 75.43/100 000 (95%CI 75.07-75.80/100 000). Incidence rate of individuals with AAI increased from 2005 to 2014 (from 71.47 to 82.07 per 100 000 person-years) although this varied by state. Over the time assessed, there was a shift to more prescriptions being provided by general practitioners (GP) rather than specialists. Children (0-19 years) were more likely to have been prescribed an AAI from a specialist and adults from a GP. CONCLUSION: Overall, an increase in dispensed AAI mirrored other evidence for a rising prevalence of allergy. This increase could also reflect changes in prescribing practices or increased awareness and education of health-care professionals on anaphylaxis and indications for prescribing AAI. The rising rate of AAI prescribed by GPs compared to decreasing rates by specialists suggests a changing response of the Australian health-care system to the increased burden of anaphylaxis. more...
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- 2021
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23. A pragmatic approach to infant feeding for food allergy prevention
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Vicki McWilliam, Carina Venter, Matthew Greenhawt, Kirsten P. Perrett, Mimi L. K. Tang, Jennifer J. Koplin, and Rachel L. Peters
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Breast Feeding ,Emollients ,Food ,Immunology ,Pediatrics, Perinatology and Child Health ,Humans ,Immunology and Allergy ,Female ,Infant Food ,Allergens ,Vitamin D ,Food Hypersensitivity - Abstract
Early introduction of allergenic foods into an infant's diet is currently the most promising strategy to prevent food allergy, with infant guidelines around the world shifting from promoting avoidance to actively encourage the introduction of allergenic foods in the infant diet. Infant feeding guidelines vary according to regional public health priorities, and knowledge gaps remain, resulting in ongoing challenges for clinicians and families to translate guidelines into practical strategies for the introduction of complementary foods for food allergy prevention. Evidence from Australia demonstrates high community support and uptake of revised guidelines with most parents introducing allergenic foods in the first year of life, although this has not had the expected impact on substantially reducing food allergy prevalence. To uptake of guidelines from other countries is less clear, and several barriers have been noted in infant feeding RCTs, which may warrant intervention strategies. Further research is needed to understand additional strategies for food allergy prevention, particularly in infants who develop food allergy prior to when they are developmentally ready to commence solids. Several RCTs are underway investigating preventative strategies that target the window before allergen ingestion, such as vitamin D supplementation, emollient use, and immunizations that prime the immune response away from a Th2-driven allergic phenotype. Further research is also needed to understand the role of the environment and the host environment in the development of tolerance to foods. more...
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- 2022
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24. Ana o 3 <scp>sIgE</scp> and diagnostic algorithms reduce cost of cashew allergy diagnosis in children compared with skin prick test: A cost comparison analysis
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Tim Brettig, Kim Dalziel, Jennifer J. Koplin, Thanh Dang, Lars Lange, Vicki McWilliam, Sakura Sato, Savvas Savvatianos, and Kirsten P. Perrett
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Immunology ,Pediatrics, Perinatology and Child Health ,Costs and Cost Analysis ,Humans ,Immunology and Allergy ,Anacardium ,Allergens ,Immunoglobulin E ,Child ,Egg Hypersensitivity ,Algorithms ,Skin Tests - Abstract
In the absence of a clear clinical history of reaction, diagnosis of cashew allergy using skin prick tests (SPT) or cashew-specific IgE requires a high number of oral food challenges (OFC). By using Ana o 3 sIgE alone, or a two-step diagnostic algorithm using cashew sIgE followed by Ana o 3 sIgE, there is a reduced need for OFC. We aimed to perform a cost comparison for both of these approaches compared with cashew SPT alone.Pooled individual-level data from 6 studies were used to determine diagnostic accuracy and OFC rate. Two studies used cashew SPT (n = 567, 198 allergic), with 95% positive and negative predictive values of ≥12 mm and3 mm. Four studies were included in the pathways for Ana o 3 sIgE alone or a 2-step algorithm incorporating cashew and Ana o 3 sIgE (n = 271, 156 allergic). Cut-offs used were ≥8.5kUA/L and ≤0.1kUA/L for cashew sIgE and ≥0.35kUA/L and ≤0.1kUA/L for Ana o 3 sIgE. Costs were constructed based on unit prices from hospital inpatient admissions, expenses incurred by families, individual patient data on allergic reaction types and rates, and adrenaline autoinjector carriage, applying a health system perspective.Modeled data through the Ana o 3 pathway resulted in a 46.43% cost reduction (€307,406/1000 patients) compared with using cashew SPT alone (€573,854/1000 patients). The 2-step algorithm resulted in a 44.94% cost reduction compared with SPT alone (€315,952.82/1000 patients). Both the Ana o 3 pathway and 2-step algorithm resulted in a 79%-80% reduction in OFCs compared with SPT.Using Ana o 3 as a standalone test for cashew allergy diagnosis or a 2-step algorithm incorporating cashew sIgE and Ana o 3 sIgE is accurate and results in a large reduction in both OFCs and health system costs compared with cashew SPT alone. more...
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- 2022
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25. Author response for 'The role of short‐term grass pollen exposure in food skin‐prick test reactivity, food allergy, and eczema flares in children'
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null Nur Sabrina Idrose, null Caroline J. Lodge, null Rachel L. Peters, null Jo A. Douglass, null Jennifer J. Koplin, null Adrian J. Lowe, null Kirsten P. Perrett, null Mimi L. K. Tang, null Ed J. Newbigin, null Michael J. Abramson, null Bircan Erbas, null Don Vicendese, and null Shyamali C. Dharmage more...
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- 2022
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26. The role of short-term grass pollen exposure in food skin-prick test reactivity, food allergy, and eczema flares in children
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Nur Sabrina Idrose, Caroline J. Lodge, Rachel L. Peters, Jo A. Douglass, Jennifer J. Koplin, Adrian J. Lowe, Kirsten P. Perrett, Mimi L. K. Tang, Ed J. Newbigin, Michael J. Abramson, Bircan Erbas, Don Vicendese, and Shyamali C. Dharmage more...
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Arachis ,Immunology ,Eczema ,Infant ,Allergens ,Immunoglobulin E ,Poaceae ,Pediatrics, Perinatology and Child Health ,Immunology and Allergy ,Humans ,Pollen ,Child ,Food Hypersensitivity ,Skin Tests - Abstract
While the relationship between pollen and respiratory allergies is well-documented, the role of short-term pollen exposure in food allergy and eczema flares has not previously been explored. We aimed to investigate these associations in a population-based sample of children.We investigated 1- (n = 1108) and 6-year-old (n = 675) children in the grass pollen season from the HealthNuts cohort. Grass pollen concentrations were considered on the day of testing (lag 0), up to three days before (lag 1-lag 3) and cumulatively (lag 0-3). Associations between grass pollen and food skin-prick test reactivity (SPT ≥ 2 mm at age 1 year and ≥ 3 mm at age 6 years), eczema flares, challenge-confirmed food allergy, reaction threshold to oral food challenges (OFC), and serum food-specific IgE levels were analyzed using either logistic or quantile regression models. Atopy and family history of allergic disease were considered as potent effect modifiers.Grass pollen at lag 0-3 (every 20 grains/msup3/supincrease) was associated with an up to 1.2-fold increased odds of food SPT reactivity and eczema flares in 6-year-olds. In 1-year-olds, the associations were only observed for peanut in those with a family history of food allergy. Increasing grass pollen concentrations were associated with a lower reaction threshold to OFC and higher serum IgE levels in peanut-allergic 1-year-olds only.Increasing grass pollen concentration was associated with increased risk of food SPT reactivity and eczema flares in children. The associations in peanut-allergic infants may be related to immune activation and/or peanut and grass pollen cross-reactivity leading to a lower reaction threshold. more...
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- 2022
27. Detection and management of milk allergy: Delphi consensus study
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Hilary I. Allen, Ursula Pendower, Miriam Santer, Marion Groetch, Mitchell Cohen, Simon H. Murch, Hywel C. Williams, Daniel Munblit, Yitzhak Katz, Neeraj Gupta, Sabeen Adil, Justine Baines, Eefje G. P. M. de Bont, Matthew Ridd, Victoria L. Sibson, Alison McFadden, Jennifer J. Koplin, Josephine Munene, Michael R. Perkin, Scott H. Sicherer, Robert J. Boyle, Family Medicine, and RS: CAPHRI - R5 - Optimising Patient Care more...
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Allergy ,Delphi Technique ,breastfeeding ,Immunology ,DIAGNOSIS ,GUIDELINES ,overdiagnosis ,FOOD ALLERGY ,Cow's milk allergy ,1117 Public Health and Health Services ,fluids and secretions ,Humans ,Immunology and Allergy ,Child ,FORMULA ,Science & Technology ,food and beverages ,Infant ,Reproducibility of Results ,Allergens ,Milk Proteins ,Infant Formula ,Delphi consensus ,1107 Immunology ,Child, Preschool ,1111 Nutrition and Dietetics ,Female ,Milk Hypersensitivity ,Life Sciences & Biomedicine - Abstract
BackgroundThere is significant overdiagnosis of milk allergy in young children in some countries, leading to unnecessary use of specialized formula. This guidance, developed by experts without commercial ties to the formula industry, aims to reduce milk allergy overdiagnosis and support carers of children with suspected milk allergy.MethodsDelphi study involving two rounds of anonymous consensus building and an open meeting between January and July 2021. Seventeen experts in general practice, nutrition, midwifery, health visiting, lactation support and relevant areas of paediatrics participated, located in Europe, North America, Middle East, Africa, Australia and Asia. Five authors of previous milk allergy guidelines and seven parents provided feedback.FindingsParticipants agreed on 38 essential recommendations through consensus. Recommendations highlighted the importance of reproducibility and specificity for diagnosing milk allergy in children with acute or delayed symptoms temporally related to milk protein ingestion; and distinguished between children directly consuming milk protein and exclusively breastfed infants. Consensus was reached that maternal dietary restriction is not usually necessary to manage milk allergy, and that for exclusively breastfed infants with chronic symptoms, milk allergy diagnosis should only be considered in specific, rare circumstances. Consensus was reached that milk allergy diagnosis does not need to be considered for stool changes, aversive feeding or occasional spots of blood in stool, if there is no temporal relationship with milk protein ingestion. When compared with previous guidelines, these consensus recommendations resulted in more restrictive criteria for detecting milk allergy and a more limited role for maternal dietary exclusions and specialized formula.InterpretationThese new milk allergy recommendations from non-conflicted, multidisciplinary experts advise narrower criteria, more prominent support for breastfeeding and less use of specialized formula, compared with current guidelines. more...
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- 2022
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28. Association Between Earlier Introduction of Peanut and Prevalence of Peanut Allergy in Infants in Australia
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Victoria X. Soriano, Rachel L. Peters, Margarita Moreno-Betancur, Anne-Louise Ponsonby, Grace Gell, Alexsandria Odoi, Kirsten P. Perrett, Mimi L. K. Tang, Lyle C. Gurrin, Katrina J. Allen, Shyamali C. Dharmage, and Jennifer J. Koplin more...
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Male ,Arachis ,Australia ,Infant ,General Medicine ,Feeding Behavior ,Cross-Sectional Studies ,Risk Factors ,Prevalence ,Humans ,Female ,Peanut Hypersensitivity ,Child ,Infant Nutritional Physiological Phenomena ,Original Investigation - Abstract
IMPORTANCE: Randomized clinical trials showed that earlier peanut introduction can prevent peanut allergy in select high-risk populations. This led to changes in infant feeding guidelines in 2016 to recommend early peanut introduction for all infants to reduce the risk of peanut allergy. OBJECTIVE: To measure the change in population prevalence of peanut allergy in infants after the introduction of these new guidelines and evaluate the association between early peanut introduction and peanut allergy. DESIGN: Two population-based cross-sectional samples of infants aged 12 months were recruited 10 years apart using the same sampling frame and methods to allow comparison of changes over time. Infants were recruited from immunization centers around Melbourne, Australia. Infants attending their 12-month immunization visit were eligible to participate (eligible age range, 11-15 months), regardless of history of peanut exposure or allergy history. EXPOSURES: Questionnaires collected data on demographics, food allergy risk factors, peanut introduction, and reactions. MAIN OUTCOME AND MEASURES: All infants underwent skin prick tests to peanut and those with positive results underwent oral food challenges. Prevalence estimates were standardized to account for changes in population demographics over time. RESULTS: This study included 7209 infants (1933 in 2018-2019 and 5276 in 2007-2011). Of the participants in the older vs more recent cohort, 51.8% vs 50.8% were male; median (IQR) ages were 12.5 (12.2-13.0) months vs 12.4 (12.2-12.9) months. There was an increase in infants of East Asian ancestry over time (16.5% in 2018-2019 vs 10.5% in 2007-2011), which is a food allergy risk factor. After standardizing for infant ancestry and other demographics changes, peanut allergy prevalence was 2.6% (95% CI, 1.8%-3.4%) in 2018-2019, compared with 3.1% in 2007-2011 (difference, −0.5% [95% CI, −1.4% to 0.4%]; P = .26). Earlier age of peanut introduction was significantly associated with a lower risk of peanut allergy among infants of Australian ancestry in 2018-2019 (age 12 months compared with age 6 months or younger: adjusted odds ratio, 0.08 [05% CI, 0.02-0.36]; age 12 months compared with 7 to less than 10 months: adjusted odds ratio, 0.09 [95% CI, 0.02-0.53]), but not significant among infants of East Asian ancestry (P for interaction = .002). CONCLUSIONS AND RELEVANCE: In cross-sectional analyses, introduction of a guideline recommending early peanut introduction in Australia was not associated with a statistically significant lower or higher prevalence of peanut allergy across the population. more...
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- 2022
29. Childhood vaccination and allergy: A systematic review and meta‐analysis
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Nilakshi T Waidyatillake, Rachel L. Peters, Shyamali C Dhamage, Caroline J Lodge, Marie J Estcourt, John Burgess, Elizabeth Enoh, Adrian J. Lowe, Samidi Navaratna, and Jennifer J. Koplin
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0301 basic medicine ,medicine.medical_specialty ,business.industry ,Immunology ,Drug allergy ,medicine.disease ,Measles ,Vaccination ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,030228 respiratory system ,Meta-analysis ,Internal medicine ,medicine ,Immunology and Allergy ,Pertussis vaccine ,business ,BCG vaccine ,Asthma ,medicine.drug ,Cohort study - Abstract
Background and objective As the rise in prevalence of allergic diseases worldwide corresponds in time with increasing infant vaccination, it has been hypothesized that childhood vaccination may increase the risk of allergic disease. We aimed to synthesize the literature on the association between childhood vaccination and allergy. Design We searched the electronic databases PubMed and EMBASE (January 1946-January 2018) using vaccination and allergy terms. Methods Two authors selected papers according to the inclusion criteria. Pooled effects across studies were estimated using random-effects meta-analysis. Due to inadequate number of homogeneous publications on newer and underused vaccines, meta-analysis was limited to allergic outcomes following administration of (Bacillus Calmette-Guerin) BCG, measles or pertussis vaccination. The review was prospectively registered in the PROSPERO systematic review registry (NO: CRD42017071009). Results A total of 35 publications based on cohort studies and 7 publications based on randomized controlled trials (RCTs) met the inclusion criteria. RCTs: From 2 studies, early vaccination with BCG vaccine was associated with a reduced risk of eczema (RR = 0.83; 95% CI = 0.73-0.93; I2 = 0%) but not food allergy or asthma. No association was found between pertussis vaccine and any allergic outcome based on a single RCT. Cohort studies Childhood measles vaccination was associated with a reduced risk of eczema (RR = 0.65; 95% CI = 0.47-0.90, I2 = 0.0%), asthma (RR = 0.78; 95% CI = 0.62-0.98, I2 = 93.9%) and, with a similar, statistically non-significant reduction in sensitization (RR = 0.78; 95% CI = 0.61-1.01, I2 = 19.4%). Conclusions We found no evidence that childhood vaccination with commonly administered vaccines was associated with increased risk of later allergic disease. Our results from pooled analysis of both RCTs and cohort studies suggest that vaccination with BCG and measles vaccines were associated with a reduced risk of eczema. more...
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- 2021
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30. Update on food allergy
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Rachel Peters, Alexandra F. Santos, Jennifer J. Koplin, and Marta Krawiec
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food allergy ,medicine.medical_specialty ,diagnosis ,business.industry ,Public health ,digestive, oral, and skin physiology ,Immunology ,Reviews ,Review ,medicine.disease ,Patient care ,Clinical Practice ,skin prick test ,basophil activation test ,Food allergy ,Environmental health ,Pediatrics, Perinatology and Child Health ,Immunology and Allergy ,Medicine ,biologics ,IgE ,immunotherapy ,business ,Immune mechanisms - Abstract
Food allergy is a major public health issue with growing prevalence in the urbanized world and significant impact on the lives of allergic patients and their families. Research into the risk factors that have contributed to this increase and their underlying immune mechanisms could lead us to definitive ways for treatment and prevention of food allergy. For the time being, introduction of peanut and other allergenic foods in the diet at the time of weaning seems to be an effective way to prevent the development of food allergy. Improved diagnosis and appropriate management and support of food allergic patients are central to patient care with food immunotherapy and biologics making the transition to clinical practice. With the new available treatments, it is becoming increasingly important to include patients' and family preferences to provide a management plan tailored to their needs. more...
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- 2021
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31. Updated threshold dose-distribution data for sesame
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Paul J. Turner, Magdalena Gretzinger, Nandinee Patel, Helen A. Brough, R. Sharon Chinthrajah, Motohiro Ebisawa, Arnon Elizur, Jennifer J. Koplin, Rachel L. Peters, Natasha Purington, Anna Nowak‐Wegrzyn, Sarah Saf, Hugh A. Sampson, Joost Westerhout, W. Marty Blom, Joseph L. Baumert, Geert F. Houben, and Benjamin C. Remington more...
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Science & Technology ,Allergy ,1107 Immunology ,Immunology ,Immunology and Allergy ,Humans ,Life Sciences & Biomedicine ,Sesamum - Published
- 2022
32. Community-Based Adverse Food Reactions and Anaphylaxis in Children with IgE-Mediated Food Allergy at Age 6 Years: A Population-Based Study
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Yichao Wang, Mimi L.K. Tang, Vicki McWilliam, Shyamali C. Dharmage, Katrina J. Allen, Jennifer J. Koplin, HealthNuts investigators, Kirsten P Perrett, Adrian J. Lowe, Anne-Louise Ponsonby, and Rachel L. Peters more...
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Allergy ,Pediatrics ,medicine.medical_specialty ,Population ,03 medical and health sciences ,0302 clinical medicine ,Food allergy ,medicine ,Humans ,Immunology and Allergy ,030212 general & internal medicine ,Child ,Adverse effect ,education ,Anaphylaxis ,education.field_of_study ,Oral food challenge ,business.industry ,Adverse food reaction ,Australia ,Infant ,Odds ratio ,Allergens ,Immunoglobulin E ,medicine.disease ,030228 respiratory system ,business ,Food Hypersensitivity - Abstract
Background Few studies have investigated adverse food reactions among food-allergic children in a population-based sample, which is critical for the development of evidence-based management strategies. Objective We aimed to evaluate the frequency, characteristics, and risk factors for adverse food reactions, including anaphylaxis, among food-allergic 6-year-old-children using the population-based HealthNuts study. Methods The HealthNuts study of 5276 infants (1-year-old) followed them up at age 6 years (84.4% participated). A total of 260 children with IgE-mediated food allergy who completed a questionnaire detailing recent adverse food reactions were included in this analysis. Results Among food-allergic children, 44.6% (95% CI, 38.6%-50.8%) reported an adverse food reaction in the last 12 months and 10.8% (95% CI, 7.5%-15.2%) reported an anaphylactic reaction, although only half of these were recognized as anaphylaxis by parents. Adrenaline autoinjectors were used in 25% (4 of 16) of recognized anaphylaxis episodes. Nut allergy was associated with a reduced risk of having an adverse reaction (adjusted odds ratio, 0.3; 95% CI, 0.1-0.7). There were trends that adverse reactions were more likely in children with at least 1 parent born in Asia compared with both parents born in Australia (adjusted odds ratio, 1.9; 95% CI, 0.9-3.9), and in children with 3 or more food allergies compared with children with a single food allergy (adjusted odds ratio, 1.8; 95% CI, 0.9-3.5). Conclusions Adverse food reactions occurred in almost half of all food-allergic 6-year-old children and anaphylaxis occurred in 1 in 10 children over a 12-month period. Anaphylaxis was poorly recognized and adrenaline autoinjectors were not used appropriately. Improved regular education on the prevention, recognition, and management of adverse food reactions is urgently needed. more...
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- 2020
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33. Associations between grass pollen exposures in utero and in early life with food allergy in 12-month-old infants
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Mimi L.K. Tang, Adrian J. Lowe, Shyamali C. Dharmage, Noor H. A. Suaini, Jennifer J. Koplin, Anne-Louise Ponsonby, Katrina J. Allen, Agus Salim, Nugroho Harry Susanto, and Bircan Erbas
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Health, Toxicology and Mutagenesis ,Population ,Peanut allergy ,Physiology ,010501 environmental sciences ,medicine.disease_cause ,01 natural sciences ,03 medical and health sciences ,0302 clinical medicine ,Food allergy ,Pollen ,otorhinolaryngologic diseases ,medicine ,030212 general & internal medicine ,education ,0105 earth and related environmental sciences ,education.field_of_study ,Pregnancy ,Public Health, Environmental and Occupational Health ,food and beverages ,General Medicine ,Odds ratio ,medicine.disease ,Pollution ,In utero ,Cohort - Abstract
Birth during pollen seasons may influence food allergy risk but no study has assessed pollen exposure. Using the HealthNuts population-based cohort of 5276 infants, we assessed grass pollen exposures, in utero and up to the first 6 months of life, on hen's egg, sesame and peanut allergy outcomes at 12 months. Cumulative pollen exposure in the first 7 days of life increased risk of peanut sensitization aMOR (adjusted multinomial odds ratio) = 1.21 (95% CI: 1.01-1.44). Exposure between first 4-6 months of life increased risk of hen's egg aMOR = 1.02 (95% CI: 1.004-1.04) and sensitization to all foods aMOR = 1.02 (95% CI: 1.003-1.04). Grass pollen exposure was associated with food challenge diagnosed food allergy, but only among infants with a maternal history of food allergy. Exposure to grass pollen in the intrauterine period and infancy may be important but more studies are needed to replicate these findings. more...
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- 2020
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34. No obvious impact of caesarean delivery on childhood allergic outcomes: findings from Australian cohorts
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Anne-Louise Ponsonby, David Burgner, Mimi L.K. Tang, Sarath Ranganathan, Melissa Wake, Jennifer J. Koplin, Katrina J. Allen, Karen E. Lamb, Adrian J. Lowe, Jessica E. Miller, Zijun Liao, Rachel L. Peters, and Shyamali C. Dharmage more...
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Male ,medicine.medical_specialty ,Pediatrics ,Longitudinal study ,Vital Capacity ,Population ,Eczema ,Logistic regression ,03 medical and health sciences ,0302 clinical medicine ,Forced Expiratory Volume ,Epidemiology ,Prevalence ,medicine ,Humans ,Longitudinal Studies ,Prospective Studies ,030212 general & internal medicine ,Child ,education ,Prospective cohort study ,Lung ,Asthma ,education.field_of_study ,Cesarean Section ,business.industry ,Australia ,medicine.disease ,Delivery mode ,030228 respiratory system ,Spirometry ,Pediatrics, Perinatology and Child Health ,Female ,business ,Breast feeding - Abstract
Background and objectiveAs caesarean delivery and childhood allergy continue to rise, their inter-relationships may change. We examined whether caesarean delivery predicts allergic disease and impaired lung function in two contemporary harmonised population-based cohorts.MethodsParent-reported asthma and eczema data were drawn from two prospective Australian infant cohorts, HealthNuts (n=5276, born 2006–2010) and the Longitudinal Study of Australian Children (LSAC, n=5107, born 2003–2004) at age 6–7 years, and spirometric lung function from LSAC’s Child Health CheckPoint (n=1756) at age 11–12 years. Logistic regression estimated associations between delivery mode and current asthma and eczema at 6–7 years, and linear regression examined lung function at 11–12 years. Models were adjusted for potential confounding factors.ResultsComplete case analysis included 3135 HealthNuts and 3654 LSAC children (32.2% and 30.9% born by caesarean, respectively). An association was evident between caesarean delivery and asthma at age 6–7 years in HealthNuts (adjusted OR (aOR) 1.25, 95% CI 1.00 to 1.57) but not in LSAC (aOR 1.05, 95% CI 0.86 to 1.28), while neither study showed clear associations with eczema (HealthNuts: aOR 1.09, 95% CI 0.88 to 1.35; LSAC: aOR 0.89, 95% CI 0.69 to 1.15). Spirometric lung function parameters at age 11–12 years were similar by delivery mode. Associations were not modified by duration of breast feeding, maternal history of asthma/eczema, childcare attendance, number of older siblings or pet exposure.ConclusionsIn two unselected populations using harmonised protocols, the likely association of caesarean delivery with developing childhood allergy was small. more...
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- 2020
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35. The association between environmental greenness and the risk of food allergy: A population-based study in Melbourne, Australia
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Rachel L. Peters, David Sutherland, Shyamali C. Dharmage, Adrian J. Lowe, Kirsten P. Perrett, Mimi L. K. Tang, Kate Lycett, Luke D. Knibbs, Jennifer J. Koplin, and Suzanne Mavoa
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Immunology ,Pediatrics, Perinatology and Child Health ,Australia ,Immunology and Allergy ,Humans ,Infant ,Allergens ,Egg Hypersensitivity ,Food Hypersensitivity ,Skin Tests - Abstract
While exposure to environmental greenness in childhood has shown mixed associations with the development of allergic disease, the relationship with food allergy has not been explored. We investigated the association between exposure to environmental greenness and challenge-confirmed food allergy in a large population-based cohort.The HealthNuts study recruited 5276 12-month-old infants in Melbourne, Australia, who underwent skin prick testing to peanut, egg, and sesame; infants with a detectable wheal underwent food challenges to determine food allergy status. Environmental greenness was estimated using the normalized difference vegetation index (NDVI) for five buffer zones around the infant's home address: at the home, 100 m, 500 m, 800 m, and 1600 m radial distances. Environmental greenness was categorized into 3 tertiles and mixed effects logistic regression models quantified the association between greenness and the risk of food allergy, adjusting for confounding and accounting for clustering at the neighborhood level.NDVI data were available for n = 5097. For most buffer zones, medium and high greenness, compared to low greenness, was associated with an increased risk of peanut allergy (eg, 100 m tertile 2 aOR 1.89 95% CI 1.22-2.95, tertile 3 aOR 1.78 95% CI 1.13-2.82). For egg allergy, the effect sizes were smaller (100 m tertile 2 aOR 1.52 95% CI 1.16-1.97, tertile 3 aOR 1.38 95% CI 1.05-1.82). Socioeconomic status (SES) modified the association between greenness and peanut allergy, but not egg allergy; associations were apparent in the low SES group but not in the high SES group (p for interaction 0.08 at 100 m). Air pollution (PM2.5) also modified the associations between environmental greenness and food allergy, with associations present in high air pollution areas but not low (p for interaction at 100 m 0.05 for peanut and 0.06 for egg allergy.) CONCLUSION: Increased exposure to environmental greenness in the first year of life was associated with an increased risk of food allergy. Increased greenness may correlate with higher pollen levels which may trigger innate immune responses skewing the immune system to the Th2-dependent allergic phenotype; additionally, some pollen and food allergens are cross-reactive. Given the mixed data on greenness and other allergies, the relationship appears complex and may also be influenced by confounding variables outside those that were measured in this study. more...
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- 2022
36. An Overview of Environmental Risk Factors for Food Allergy
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Rachel L. Peters, Suzanne Mavoa, and Jennifer J. Koplin
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food allergy ,Health, Toxicology and Mutagenesis ,air pollution ,Public Health, Environmental and Occupational Health ,vitamin D ,Review ,Allergens ,environmental greenness ,Risk Factors ,pollen ,Humans ,Medicine ,Food Hypersensitivity ,biodiversity - Abstract
IgE-mediated food allergy is an increasing public health concern in many regions around the world. Although genetics play a role in the development of food allergy, the reported increase has occurred largely within a single generation and therefore it is unlikely that this can be accounted for by changes in the human genome. Environmental factors must play a key role. While there is strong evidence to support the early introduction of allergenic solids to prevent food allergy, this is unlikely to be sufficient to prevent all food allergy. The purpose of this review is to summarize the evidence on risk factors for food allergy with a focus the outdoor physical environment. We discuss emerging evidence of mechanisms that could explain a role for vitamin D, air pollution, environmental greenness, and pollen exposure in the development of food allergy. We also describe the recent extension of the dual allergen exposure hypothesis to potentially include the respiratory epithelial barrier in addition to the skin. Few existing studies have examined the relationship between these environmental factors with objective measures of IgE-mediated food allergy and further research in this area is needed. Future research also needs to consider the complex interplay between multiple environmental factors. more...
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- 2022
37. An International First: Stakeholder Consensus Statement for Food Allergen Management in Packaged Foods and Food Service for Australia and New Zealand
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Ingrid Roche, Sandra L. Vale, Catherine J. Hornung, Giovanni A. Zurzolo, Merryn J. Netting, Shyamali C. Dharmage, Caroline Gray, Nanju A. Lee, Jasmine Lacis-Lee, Penelope F. Jorgensen, Jill Smith, Wendy Freeman, Kirsten P. Perrett, Sally Voukelatos, Vicki L. McWilliam, Kirsten Grinter, Jennifer J. Koplin, Maria Said, and Dianne E. Campbell more...
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Food Labeling ,Australia ,Food Services ,Immunology and Allergy ,Humans ,Allergens ,Food Hypersensitivity ,New Zealand - Abstract
Food-allergic consumers encounter inadequate, confusing, and ambiguous allergen information for packaged and unpackaged foods. Key Australian and New Zealand allergy organizations convened multiple forums to facilitate discussions among consumers, food manufacturers, food retailers, regulatory bodies, researchers, and health professionals to develop a unified approach to improving food allergen management. The following stakeholder consensus statement provides a foundation for advocacy for improved food allergen management and safety. It is the responsibility of consumers to: 1. declare their food allergies and read food labels (including ingredient lists and allergen declaration statements), and 2. ultimately make their own judgment about the foods they choose to consume. We consider that to enable consumers to make informed decisions about their safety, It is the responsibility of packaged food manufacturers to: 1. follow robust allergen management practices including quantitative risk assessment, and 2. use clear, consistent labeling to inform consumers about that food's allergen content, including the possible presence of unintended allergens. It is the responsibility of food service establishments and providers to: 1. follow robust allergen management practices, and 2. ensure that staff understand and can inform consumers about the allergen content of the food they provide, including the possible presence of unintended allergens. more...
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- 2021
38. Striving for Evidence-Based Management of Food Allergies
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Peter D. Arkwright and Jennifer J. Koplin
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Immunology and Allergy ,Humans ,Food Hypersensitivity - Published
- 2021
39. 357Infant pacifier sanitization and risk of food allergy: the Barwon Infant Study
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Sarath Ranganathan, David Burgner, Kristie Thompson, Victoria X. Soriano, Rachel L. Peters, Anne-Louise Ponsonby, Terence Dwyer, Martin O'Hely, Rosemary Wright, Jennifer J. Koplin, Peter Vuillermin, Shyamali C. Dharmage, and Mike Forrester more...
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Pregnancy ,Allergy ,Cleaning methods ,Epidemiology ,medicine.drug_class ,business.industry ,General Medicine ,medicine.disease ,Questionnaire data ,Human gut ,Antiseptic ,Food allergy ,Environmental health ,Pacifier ,medicine ,business - Abstract
Background Environmental microbial exposure and human gut microbiota play a role in development of the immune system and susceptibility to food allergy. Pacifier use has been inconsistently associated with allergy, but the association between sanitization and food allergy is unknown. We investigated the association between infant pacifier use, with a consideration of sanitization, and food allergy at age 1 in the Barwon Infant Study (BIS). Methods Questionnaire data were collected prospectively from pregnant mothers from the Barwon region of south-east Australia at baseline and at infant ages 1, 6, and 12 months. Pacifier sanitization was defined as the joint exposure of a pacifier and cleaning methods (antiseptic, mouth, tap water, boiling). Challenge-proven food allergy was determined at age 1. Results Any pacifier use at 6 months was associated with food allergy (aOR, 1.94; 95% CI, 1.04-3.61), but not at other ages. This overall association was driven by the joint exposure pacifier-antiseptic use (aOR, 5.90; 95% CI, 2.18-15.97) compared to no pacifier use. Among pacifier users, pacifier-antiseptic was still associated with food allergy (aOR, 3.88; 95% CI, 1.55-9.72) when compared to pacifier-no antiseptic use. Further, increased use of pacifier-antiseptic at 0, 1 or 2 interviews over the first 6 months was associated with higher food allergy risk (ptrend=0.005). Conclusions Joint exposure to antiseptics and pacifiers at 6 months increased the odds of food allergy, showing a trend with increased use over time. Key messages This is the first report of pacifiers used with antiseptic being positively associated with challenge-proven food allergy. more...
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- 2021
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40. 552The lung function and airway inflammation markers associated with short-term pollen exposure- A systematic review
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Jo A Douglass, Shyamali C. Dharmage, Caroline J Lodge, Don Vicendese, Jennifer J. Koplin, and N. Sabrina Idrose
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Lung ,Epidemiology ,business.industry ,Inflammation ,General Medicine ,Respiratory physiology ,medicine.disease ,medicine.disease_cause ,Pulmonary function testing ,medicine.anatomical_structure ,Pollen ,Immunology ,Eosinophilic ,medicine ,Hay fever ,medicine.symptom ,business ,Asthma - Abstract
Background Experimental challenge studies have shown that pollen can affect the lungs and airways. Here, we systematically reviewed community-based studies investigating outdoor pollen exposure, lung function and/or airway inflammation. Methods Four online databases were searched. The search strategy included terms relating to both exposure and outcomes. Inclusion criteria were studies published in English that were representative of the community. We only considered cross-sectional or short-term longitudinal studies which investigated pollen exposure by levels or season. Study quality assessment was performed using the Newcastle-Ottawa scale. Meta-analysis was conducted using random-effects models. Results We included 27 of 6,551 studies identified from the search. Qualitative synthesis indicated associations between pollen exposure and predominantly type-2 inflammation in both the upper and lower airways, but little evidence for lung function changes. People with ever asthma and/or seasonal allergic rhinitis (SAR) were at higher risk of such airway inflammation. Meta-analysis confirmed a positive relationship between pollen season and eosinophilic airway inflammation in people with ever SAR but the results between studies were highly variable. Heterogeneity was reduced after further subgrouping by age and the forest plots indicated that eosinophilic airway inflammation to outdoor pollen exposure increased with age. Conclusion Among people with ever asthma and ever SAR, exposure to increased ambient pollen triggers type-2 airway inflammation rather than a non-specific or innate inflammation. Key messages This review indicates pollen exposure influences predominantly type-2 airway inflammation, but little evidence on lung function. more...
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- 2021
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41. Backyard benefits? A cross-sectional study of yard size and greenness and children’s physical activity and outdoor play
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Anneke Grobler, Jessica A Kerr, Suzanne Mavoa, Cong Sun, Melissa Russell, Mimi L.K. Tang, Melissa Wake, Kate Lycett, Jennifer J. Koplin, Raisa Cassim, Jessica Oakley, and Rachel L. Peters
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Longitudinal study ,Physical activity, outdoor play ,greenness ,Cross-sectional study ,physical activity ,yard ,030209 endocrinology & metabolism ,03 medical and health sciences ,0302 clinical medicine ,children ,Accelerometry ,Humans ,Medicine ,Longitudinal Studies ,030212 general & internal medicine ,Child ,Exercise ,Socioeconomic status ,Neighbourhood (mathematics) ,business.industry ,Research ,Australia ,Public Health, Environmental and Occupational Health ,Regression analysis ,medicine.disease ,built environment ,Obesity ,Yard ,Cross-Sectional Studies ,Child, Preschool ,outdoor play ,Public aspects of medicine ,RA1-1270 ,Biostatistics ,business ,Demography - Abstract
Background The home environment is the most important location in young children’s lives, yet few studies have examined the relationship between the outdoor home environment and child physical activity levels, and even fewer have used objectively measured exposures and outcomes. This study examined relationships between objectively assessed home yard size and greenness, and child physical activity and outdoor play. Methods Data were drawn from the HealthNuts study, a longitudinal study of 5276 children in Melbourne, Australia. We used cross-sectional data from a sample at Wave 3 (2013–2016) when participants were aged 6 years (n = 1648). A sub-sample of 391 children had valid accelerometer data collected from Tri-axial GENEActive accelerometers worn on their non-dominant wrist for 8 consecutive days. Yard area and greenness were calculated using geographic information systems. Objective outcome measures were minutes/day in sedentary, light, and moderate-vigorous physical activity (weekday and weekend separately). Parent-reported outcome measures were minutes/day playing outdoors (weekend and weekday combined). Multi-level regression models (adjusted for child’s sex, mother’s age at the birth of child, neighbourhood socioeconomic index, maternal education, and maternal ethnicity) estimated effects of yard size and greenness on physical activity. Results Data were available on outdoor play for 1648 children and usable accelerometer data for 391. Associations between yard size/greenness and components of physical activity were minimal. For example, during weekdays, yard size was not associated with daily minutes in sedentary behaviour (β: 2.4, 95% CI: − 6.2, 11.0), light physical activity (β: 1.4, 95% CI: − 5.7, 8.5) or MVPA (β: -2.4, 95% CI: − 6.5, 1.7), with similar patterns at weekends. There was no relationship between median annual yard greenness and physical activity or play. Conclusion In our study of young children residing in higher socio-economic areas of Melbourne yard characteristics did not appear to have a major impact on children’s physical activity. Larger studies with greater variation in yard characteristics and identification of activity location are needed to better understand the importance of home outdoor spaces and guide sustainable city planning. more...
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- 2021
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42. Deriving individual threshold doses from clinical food challenge data for population risk assessment of food allergens
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Benjamin C. Remington, Joost Westerhout, Jennifer J. Koplin, Thuy My Le, Hugh A. Sampson, W. Marty Blom, Wayne G. Shreffler, Matthew Greenhawt, René W.R. Crevel, Geert F. Houben, Montserrat Fernandez-Rivas, Jonathan O'b Hourihane, Katrina J. Allen, Anthony E.J. Dubois, Joseph L. Baumert, Barbara Ballmer-Weber, Astrid G. Kruizinga, Steve L. Taylor, Paul Turner, University of Zurich, Blom, W Marty, and Groningen Research Institute for Asthma and COPD (GRIAC) more...
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Male ,no observed adverse effect level-lowest observed adverse effect level derivation ,double-blind, placebo-controlled food challenge ,Administration, Oral ,CHILDREN ,food challenge ,placebo-controlled food challenge ,DOUBLE-BLIND ,threshold ,eliciting dose ,Immunology and Allergy ,Decision-making ,Risk management ,education.field_of_study ,Biological Variation, Individual ,10177 Dermatology Clinic ,risk assessment ,Child, Preschool ,no observed adverse effect level–lowest observed adverse effect level derivation ,2723 Immunology and Allergy ,Female ,Risk assessment ,Food Hypersensitivity ,medicine.medical_specialty ,Resource (biology) ,EUROPE ,Maximum Tolerated Dose ,Clinical Decision-Making ,Population ,Immunology ,610 Medicine & health ,PEANUT ,DIAGNOSIS ,risk management ,Double-Blind Method ,Population Groups ,Food allergy ,Environmental health ,medicine ,Journal Article ,Humans ,education ,No-Observed-Adverse-Effect Level ,2403 Immunology ,decision-making process ,business.industry ,Public health ,Infant ,Allergens ,Placebo Effect ,medicine.disease ,Food ,Immunization ,Population Risk ,business - Abstract
Background: Food allergies are a significant public health issue, and the only effective management option currently available is strict avoidance of all foods containing the allergen. In view of the practical impossibility of limiting risks to zero, quantitative allergen risk assessment and management strategies are needed. Objective: We sought to develop appropriate methods for informing population-based risk assessments and risk management programs to benefit all stakeholders but particularly patients with food allergy. Methods: Individual thresholds for food allergens (maximum tolerable doses and minimum eliciting doses) can ideally be established through double-blind, placebo-controlled food challenges. If double-blind, placebo-controlled food challenge data are not available, data from widely used open food challenges using predefined objective criteria can also provide useful data regarding minimum eliciting doses. For more than 20 years, the Netherlands Organisation for Applied Scientific Research and the Food Allergy Research and Resource Program at the University of Nebraska-Lincoln have been collecting individual maximum tolerable doses and minimum eliciting doses that produce objective symptoms from published and unpublished clinical data to better refine knowledge regarding the sensitivity of the population to food allergens. Results: In this article we provide in-depth insights into the methodology applied by the Netherlands Organisation for Applied Scientific Research and Food Allergy Research and Resource Program to derive individual maximum tolerable doses and minimum eliciting doses for objective symptoms from clinical food challenge data. More than 90 examples for determining individual allergic thresholds are presented. Conclusion: With the methodology presented in this article, we aim to stimulate harmonization and transparency in quantitative food allergen risk assessment and risk management programs, encouraging their wider adoption. © 2019 American Academy of Allergy, Asthma & Immunology more...
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- 2019
43. Infant and young child feeding interventions targeting overweight and obesity: A narrative review
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Melissa Wake, Jessica A Kerr, Katrina J. Allen, Carley Garner, Shyamali C. Dharmage, Caroline J Lodge, and Jennifer J. Koplin
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Male ,Gerontology ,Pediatric Obesity ,Endocrinology, Diabetes and Metabolism ,Breastfeeding ,Psychological intervention ,030209 endocrinology & metabolism ,Health Promotion ,Overweight ,Cochrane Library ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Behavior Therapy ,law ,Humans ,Medicine ,030212 general & internal medicine ,Adiposity ,Randomized Controlled Trials as Topic ,business.industry ,Infant, Newborn ,Public Health, Environmental and Occupational Health ,Infant ,Feeding Behavior ,Observational Studies as Topic ,Breast Feeding ,Systematic review ,Child, Preschool ,Female ,medicine.symptom ,Child Nutritional Physiological Phenomena ,business ,Breast feeding ,Body mass index ,Systematic Reviews as Topic - Abstract
findings from systematic reviews into infant feeding and later adiposity are largely negative. World Health Organization (WHO) is auspicing Healthy Life Trajectories Initiative (HeLTI), a suite of trials aiming to prevent overweight/obesity in childhood. To inform planning, this narrative review sought to detail potentially effective components of nutrition-related interventions involving children aged 0 to 2 years. Systematic searches of PubMed and the Cochrane Library (2006-2016) identified 108 systematic reviews. These included 31 randomized trials in the age group of interest. Of these, 11 reported greater than or equal to 1 statistically significant (P more...
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- 2019
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44. Genetic determinants of paediatric food allergy: A systematic review
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Justine A. Ellis, Katrina J. Allen, Victoria X. Soriano, David Martino, Noor H. A. Suaini, Yichao Wang, and Jennifer J. Koplin
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0301 basic medicine ,Candidate gene ,DNA Copy Number Variations ,Immunology ,Peanut allergy ,MEDLINE ,Genome-wide association study ,Filaggrin Proteins ,Population stratification ,Polymorphism, Single Nucleotide ,03 medical and health sciences ,0302 clinical medicine ,Food allergy ,Environmental health ,Odds Ratio ,medicine ,Humans ,Immunology and Allergy ,Genetic Predisposition to Disease ,Child ,Alleles ,Genetic Association Studies ,Genetic association ,business.industry ,Age Factors ,Odds ratio ,medicine.disease ,030104 developmental biology ,030228 respiratory system ,business ,Food Hypersensitivity - Abstract
Background The genetic determinants of food allergy have not been systematically reviewed. We therefore systematically reviewed the literature on the genetic basis of food allergy, identifying areas for further investigation. Methods We searched three electronic databases (MEDLINE, EMBASE and PubMed) on 9 January 2018. Two authors screened retrieved articles for review according to inclusion criteria and extracted relevant information on study characteristics and measures of association. Eligible studies included those that reported an unaffected nonatopic control group, had genetic information and were carried out in children. Results Of the 2088 studies retrieved, 32 met our inclusion criteria. Five were genome-wide association studies, and the remaining were candidate gene studies. Twenty-two of the studies were carried out in a predominantly Caucasian population with the remaining 10 from Asian-specific populations or unspecified ethnicity. We found FLG, HLA, IL10, IL13, as well as some evidence for other variants (SPINK5, SERPINB and C11orf30) that are associated with food allergy. Conclusions Little genetic research has been carried out in food allergy, with FLG, HLA and IL13 being the most reproducible genes for an association with food allergy. Despite promising results, existing genetic studies on food allergy are inundated with issues such as inadequate sample size and absence of multiple testing correction. Few included replication analyses or population stratification measures. Studies addressing these limitations along with functional studies are therefore needed to unravel the mechanisms of action of the identified genes. more...
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- 2019
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45. Diagnosing Peanut Allergy with Fewer Oral Food Challenges
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Hugh A. Sampson, Kirsten P Perrett, and Jennifer J. Koplin
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medicine.medical_specialty ,Allergy ,Peanut allergy ,Administration, Oral ,Negative Test Result ,Immunoglobulin E ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,medicine ,Humans ,Immunology and Allergy ,Peanut Hypersensitivity ,030212 general & internal medicine ,Overdiagnosis ,Child ,Intensive care medicine ,biology ,Oral food challenge ,business.industry ,food and beverages ,Allergens ,medicine.disease ,Basophil activation ,030228 respiratory system ,Food ,biology.protein ,business ,Algorithms - Abstract
Diagnosis of peanut allergy presents a significant clinical challenge. Accurate diagnosis is critical for patient management and prevention of allergic reactions, whereas overdiagnosis or failure to diagnose tolerance in a previously allergic patient can lead to unnecessary dietary restrictions and impaired quality of life. Oral food challenges, the criterion standard for diagnosis, pose a risk of potentially severe allergic reactions, and are time- and resource- intensive. In this article, we review other currently available tests for peanut allergy and present the strengths and weaknesses of each to assist the clinician in determining which test might be appropriate for their patients, as well as highlighting emerging tests currently in development. Traditional tests for peanut-specific IgE (skin prick testing and specific IgE) remain useful as first-line tests-a negative test result is useful for excluding peanut allergy and a high positive result has a high specificity for peanut allergy. For those with an intermediate positive test result, Ara h 2 testing might be useful as a second step. Basophil activation tests and peanut protein epitope-specific IgE analyses appear promising in recent studies; however, further research is required into standardization, validation, and cost-effectiveness. Given the limitations of existing tests for peanut allergy, there remains a clear need for improvement. Finding a safe and affordable method for peanut allergy diagnosis that is both sensitive and specific remains an active area of research. more...
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- 2019
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46. Determination of haemoglobin derivatives in aged dried blood spot to estimate haematocrit
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Jennifer J. Koplin, Ronda F. Greaves, Nick Crinis, Lidia De Rosa, Peter J. Roche, Rosita Zakaria, and Katrina J. Allen
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Adult ,Quality Control ,Analyte ,Time Factors ,Adolescent ,Formates ,Coefficient of variation ,Clinical Biochemistry ,030204 cardiovascular system & hematology ,Hematocrit ,01 natural sciences ,Matrix (chemical analysis) ,Hemoglobins ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Child ,Aged ,Dried Blood Spot Testing ,Whole blood ,Aged, 80 and over ,Chromatography ,medicine.diagnostic_test ,Chemistry ,010401 analytical chemistry ,Biochemistry (medical) ,Infant ,Reproducibility of Results ,General Medicine ,Middle Aged ,0104 chemical sciences ,Dried blood spot ,Spectrophotometry ,Therapeutic drug monitoring ,Child, Preschool ,Calibration - Abstract
Introduction Dried blood spot (DBS) sample applications now encompass analytes related to clinical diagnosis, epidemiological studies, therapeutic drug monitoring, pharmacokinetic and toxicokinetic studies. Haematocrit (Hct) and haemoglobin (Hb) at very high or low concentrations may influence the accuracy of measurement quantification of the DBS sample. In this study, we aimed to predict the Hct of the punched DBS through primary spectrophotometric estimation of its haemoglobin-derivative (Hb-drv) content. Methods Formic acid solution was used to elute Hb-drv content of 3.2 mm spotted blood from its dry matrix. Direct spectrometry measurement was utilised to scan the extracted Hb-drv in the visible spectrum range of 520–600 nm. The linear relationship between an individual’s Hct percentage and Hb-drv concentration was applied to estimate the Hct level of the blood spot. De-identified whole blood samples were used for the method development and evaluation studies. Results The Hb-drv estimation is valid in samples >2 months old. Method validation experiments DBS demonstrate linearity between 82.5 and 207.5 g/L, average coefficient of variation of 3.6% (intra-assay) and 7.7% (inter-assay), analytical recovery of 84%, and a high positive correlation (r=0.88) between Hb-drv and the original whole blood Hct. The Bland-Altman difference plot demonstrates a mean difference of 2.4% between the calculated DBS Hct and the directly measured Hct from fresh whole bloods. Conclusions We have successfully developed a simple Hb-drv method to estimate Hct in aged DBS samples. This method can be incorporated into DBS analytical work-flow for the in-situ estimation of Hct and subsequent correction of the analyte of interest as required. more...
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- 2019
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47. The natural history of peanut and egg allergy in children up to age 6 years in the HealthNuts population-based longitudinal study
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Rachel L. Peters, Imma Guarnieri, Mimi L.K. Tang, Adrian J. Lowe, Shyamali C. Dharmage, Kirsten P. Perrett, Lyle C. Gurrin, and Jennifer J. Koplin
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Arachis ,Immunology ,Eczema ,Infant ,Allergens ,Child, Preschool ,Humans ,Immunology and Allergy ,Peanut Hypersensitivity ,Longitudinal Studies ,Child ,Egg Hypersensitivity ,Food Hypersensitivity ,Skin Tests - Abstract
Prospectively collected data on the natural history of food allergy are lacking.We examined the natural history of egg and peanut allergy in children from age 1 to 6 years and assessed whether a skin prick test (SPT) result or other clinical factors at diagnosis are associated with the persistence or resolution of food allergy in early childhood.The HealthNuts cohort consists of 5276 children who were recruited at age 1 year and have been followed prospectively. Children with food allergy at age 1 year (peanut [n = 156] or raw egg [n = 471] allergy ) and children who developed new sensitizations or food reactions after age 1 year were assessed for food sensitization and allergy (confirmed by oral food challenge when indicated) at the 6-year follow-up.New-onset food allergy developed by age 6 years was more common for peanut (0.7% [95% CI = 0.5%-1.1%]) than egg (0.09% [95% CI = 0.03%-0.3%]). Egg allergy resolved more commonly (89% [95% CI = 85%-92%]) than peanut allergy (29% [95% CI = 22%-38%]) by age 6 years. The overall weighted prevalence of peanut allergy at age 6 years was 3.1% (95% CI = 2.6-3.7%) and that of egg allergy was 1.2% (95% = CI 0.9%-1.6%). The factors at age 1 year associated with persistence of peanut allergy were peanut SPT result of 8 mm or larger (odds ratio [OR] = 2.35 [95% CI 1.08-5.12]), sensitization to tree nuts (adjusted OR [aOR] = 2.51 [95% CI = 1.00-6.35]), and early-onset severe eczema (aOR = 3.23, [95% CI 1.17-8.88]). Factors at age 1 associated with persistence of egg allergy at age 6 were egg SPT result of 4 mm or larger (OR = 2.98 [95% CI 1.35-6.36]), other (peanut and/or sesame) food sensitizations (aOR = 2.80 [95% CI = 1.11-7.03]), baked egg allergy (aOR = 7.41 [95% CI = 2.16-25.3]), and early-onset severe eczema (aOR = 3.77 [95% CI = 1.35-10.52]).Most egg allergy and nearly one-third of peanut allergy resolves naturally by age 6 years. The prevalence of peanut allergy at age 6 years was similar to that observed at age 1 year, largely owing to new-onset food peanut allergy after age 1 year. Infants with early-onset eczema, larger SPT wheals, or multiple food sensitizations and/or allergies were less likely to acquire tolerance to either peanut or egg. more...
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- 2022
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48. Children With Food Allergy Are at Risk of Lower Lung Function on High-Pollen Days
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N. Sabrina Idrose, Don Vicendese, Rachel L. Peters, Jennifer J. Koplin, Jo A. Douglass, E. Haydn Walters, Jennifer L. Perret, Adrian J. Lowe, Mimi L.K. Tang, Ed J. Newbigin, Bircan Erbas, Caroline J. Lodge, and Shyamali C. Dharmage more...
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Forced Expiratory Volume ,Eczema ,Humans ,Pollen ,Rhinitis, Allergic, Seasonal ,Immunology and Allergy ,Child ,Lung ,Asthma ,Food Hypersensitivity ,Bronchodilator Agents - Abstract
Grass pollen exposure is a risk factor for childhood asthma hospital attendances. However, its short-term influence on lung function, especially among those with other allergic conditions, has been less well-studied.To investigate this association in a population-based sample of children.Within the HealthNuts cohort, 641 children performed spirometry during the grass pollen season. Grass pollen concentration was considered on the day of testing (lag 0), up to 3 days before (lag 1-lag 3), and cumulatively (lag 0-3). We used linear regression to assess the relevant associations and examined potential interactions with current asthma, hay fever or eczema, and food allergy.Associations were observed only in children with allergic disease (P value for interaction ≤ 0.1). In children with food allergy, grass pollen concentration was associated with a lower ratio of forced expiratory volume in 1 second to forced vital capacity (FEVA proactive approach needs to be enforced to manage susceptible children, especially those with food allergy, before high-grass pollen days. more...
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- 2022
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49. Mode of Birth Is Not Associated With Food Allergy Risk in Infants
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Anne Currell, Jennifer J. Koplin, Adrian J. Lowe, Kirsten P. Perrett, Anne-Louise Ponsonby, Mimi L.K. Tang, Shyamali C. Dharmage, and Rachel L. Peters
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Dogs ,Cesarean Section ,Elective Surgical Procedures ,Pregnancy ,Animals ,Humans ,Immunology and Allergy ,Female ,Allergens ,Food Hypersensitivity ,Skin Tests - Abstract
The association between mode of delivery and the risk of food allergy remains unclear due to the absence of studies with both challenge-proven food allergy outcomes and detailed information on the type of caesarean delivery.We assessed whether emergency or elective caesarean, or caesarean delivery in the presence or absence of labor initiation, is associated with the risk of food allergy.The HealthNuts study recruited 5276 12-month-old infants who underwent skin prick testing and oral food challenge to ascertain food allergy status, and linked the child's study data to additional birth data from the Victorian Perinatal Data Collection.Parents of 3006 children consented to data linkage, and birth data were obtained on 2045. In this subgroup, 30% were born by caesarean and 13% had food allergy. Caesarean delivery, compared with vaginal birth, was not associated with the risk of food allergy (adjusted odds ratio [aOR]: 0.95, 95% confidence interval [CI]: 0.70, 1.30). Neither caesarean delivery before the onset of labor, nor after the onset of labor, was associated with the risk of food allergy (aOR: 0.83, 95% CI: 0.55-1.23 and aOR: 1.13, 95% CI: 0.75-1.72, respectively). Delivery by elective or emergency caesarean, compared with vaginal delivery, was not associated with risk of food allergy (aOR: 1.05, 95% CI: 0.71-1.55 and aOR: 0.86, 95% CI: 0.56-1.31). There was no evidence of effect modification by breastfeeding, older siblings, pet dog ownership, or maternal allergy.Caesarean delivery, either with or without labor, or elective or emergency, was not associated with the risk of food allergy in a population-based cohort of 12-month-old infants. more...
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- 2022
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50. Altered immune cell profiles and impaired CD4 T-cell activation in single and multi-food allergic adolescents
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Thanh D. Dang, Jennifer J. Koplin, Melanie R Neeland, Richard Saffery, Vicki McWilliam, Kirsten P Perrett, and Sandra Andorf
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CD4-Positive T-Lymphocytes ,Male ,Allergy ,Adolescent ,Immunology ,Peanut allergy ,Immunophenotyping ,Interferon-gamma ,Immune system ,Food allergy ,Immunology and Allergy ,Medicine ,Cluster Analysis ,Humans ,Peanut Hypersensitivity ,Child ,Egg Hypersensitivity ,Innate immune system ,business.industry ,Interleukin-6 ,Tumor Necrosis Factor-alpha ,Adverse food reaction ,CD28 ,Dendritic cell ,medicine.disease ,Case-Control Studies ,Leukocytes, Mononuclear ,Cytokines ,Female ,Nut Hypersensitivity ,business ,Food Hypersensitivity - Abstract
Background Approximately 5% of adolescents have a food allergy, with peanut and tree nut allergies the most common. Having two or more food allergies in adolescence also doubles the risk of any adverse food reaction, and is associated with increased dietary and social burden. Investigations of immune function in persistently food allergic children are rare. Objective In the present study, we aimed to investigate the immune mechanisms that underlie food allergy in adolescence. Methods We used high-dimensional flow cytometry, unsupervised computational analysis and functional studies to comprehensively phenotype a range of non-antigen-specific immune parameters in a group of well-characterized adolescents with clinically defined single peanut allergy, multi-food allergy and aged-matched non-food allergic controls. Results We show that food allergic adolescents have higher circulating proportions of dendritic cells (p = .0084, FDR-adjusted p = .087, median in no FA: 0.63% live cells, in FA: 0.93%), and higher frequency of activated, memory-like Tregs relative to non-food allergic adolescents (p = .011, FDR-adjusted p = .087, median in no FA: 0.49% live cells, in FA: 0.65%). Cytokine profiling revealed that CD3/CD28 stimulated naive CD4 T cells from food allergic adolescents produced less IL-6 (p = .0020, FDR-adjusted p = .018, median log2 fold change [stimulated/unstimulated] in no FA: 3.03, in FA: 1.92) and TNFα (p = .0044, FDR-adjusted p = .020, median in no FA: 9.16, in FA: 8.64) and may secrete less IFNγ (p = .035, FDR-adjusted p = .11, median in no FA: 6.29, in FA: 5.67) than naive CD4 T cells from non-food allergic controls. No differences between clinical groups were observed for LPS-stimulated monocyte secretion of cytokines. Conclusions These results have important implications for understanding the evolution of the immune response in food allergy throughout childhood, revealing that dendritic cell and T-cell signatures previously identified in early life may persist through to adolescence. more...
- Published
- 2021
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