Development Of Allergy In Children Research Articles

Association between Breastfeeding and Development of Atopy

Objective: This study aimed to investigate the relationship between breastfeeding and the development of atopy. Methods: A hospital-based cross-sectional study was conducted in the pediatrics and obstetrics/gynecological clinics' waiting areas and admission wards of the Maternity and Children Hospital in Hail region, between November 2022 and February 2023, targeting mothers with at least one child over the age of one month. Results: A sample of 423 children from Hail was studied in the current research. Most of them were over 12 months old. Although most of the participants believed that breastfeeding reduced the incidence of atopic skin disease, the most prevalent type of feeding was formula feeding, followed by mixed feeding and exclusive breastfeeding. The study showed no significant effects of breastfeeding type on the development of allergies in children, as well as breastfeeding type and duration. However, there was a significant association between formula feeding and the development of allergic rhinitis, as it increases the incidence. Conclusion: The findings of this study demonstrated that no definitive link could be made between breastfeeding duration and the development of atopy or between breastfeeding type and the occurrence of atopy in children. However, the study showed that formula feeding was a significant risk factor for the development of allergic rhinitis.

The role of the intestinal microbiome in the development of allergies in children

ABSTRACT
 To date, a clear correlation has been revealed between disorders of the intestinal microbiota in childhood and immune and metabolic disorders in the later period. Experimental data, confirming the long-term health benefits caused by the intestinal microbiota of infants, indicate the participation of the intestinal microbiota of children in modulating risk factors associated with a specific state of adult health, which justifies the expediency of developing strategies for influencing the development, composition and activity of the intestinal microbiome of infants using probiotics and/or prebiotics, synbiotics and postbiotics.
 The composition of the intestinal microbiome of a child depends on its gestational age, method of delivery, type of feeding, environmental conditions and plays a vital role throughout a persons life.
 The intrauterine and neonatal periods represent critical stages in the formation of the childs microbiome, the violation of which is associated with the development of various pathological conditions in the childs body, including allergic ones, while early correction of intestinal microbial communities can serve as a basis for preventing allergic sensitization.
 The review article presents an analysis of current data on the role of the intestinal microbiota in the development of atopic diseases in children and discusses the possibilities of preventive and therapeutic use of nutraceuticals with pro-, pre- and postbiotic effects, their effects on the development, composition and activity of the intestinal microbiome in children with atopias.

Impact of Maternal Factors on Presence of Peanut Allergy in Children

The impact of maternal factors on food allergy development in children remains under investigation. We sought to identify the number and type of potential risk factors in mothers of children with peanut allergy (M-PA) compared to mothers of children without peanut allergy (M-nPA). We hypothesized that M-PA would have a higher number of risk factors present compared to M-nPA.

Prevalence and risk factors for food allergy in children: a review of epidemiological studies

BACKGROUND: Food allergy is an actual problem in pediatric practice. In recent decades, there has been an increase in the prevalence of food allergies, as well as an increase in the number of severe cases.
 AIM: To assess the prevalence of food allergy and the role of hereditary and environmental factors in food allergy development in children according to epidemiological cohorts and cross-sectional studies.
 MATERIALS AND METHODS: A systematic review of epidemiological cohorts and cross-sectional studies published between January 1, 2000 and December 31, 2021, was conducted This review investigated the developmental factors and prevalence of food allergy.
 RESULTS: This review made it possible to generalize and systematize the accumulated worldwide scientific data on food allergy. An analysis of epidemiological studies revealed a significant prevalence of food allergy, which reflected the natural course of the disease; the highest rates were found among young children, and by school age, the prevalence of symptoms and confirmed food allergy is gradually decreasing. Based on epidemiological data, the main risk factors for food allergy are hereditary predisposition and environmental factors that modify the microbial environment.
 CONCLUSION: It is necessary to further study the genetic markers of food allergy, as well as the role of microbiotic factors in the implementation of hereditary predisposition to allergic diseases.

Breastfeeding and allergy development in children

Breastfeeding and allergy development in children

Association between Household Income and Allergy Development in Children: The Japan Environment and Children’s Study

Background: Socioeconomic status has been found to be associated with allergic diseases in children, but results are inconsistent. This study aimed to assess the association between household income and the development of allergic disease in children at 3 years old. Methods: We used data from 72,180 participants from the Japan Environment and Children’s Study, which is a prospective birth cohort study with participants recruited from January 2011 to March 2014. We examined the associations between household income and allergic diseases (asthma, eczema, and food allergies) in children, adjusting for covariates using multivariate logistic regression. Results: The percentages of doctor-diagnosed allergies at 3 years old were 7.5% for asthma, 7.2% for eczema, and 6.2% for food allergies. Children from households with an annual income of <2 million yen (approx. 18,000 USD) had a significantly higher risk of doctor-diagnosed asthma and eczema than those from households with an income of 4–6 million yen. The adjusted odds ratios (aORs) were 1.17 (95% confidence interval [CI] 1.03–1.34) and 1.21 (95% CI 1.06–1.39). Children from households with an income of >6 million yen tended to have an increased risk of food allergies (aOR 1.07, 95% CI 0.98–1.15). Conclusion: Low household income was a risk for doctor-diagnosed asthma and eczema, suggesting that public health professionals should recognize low-income groups as vulnerable populations for these conditions.

Prenatal Exposure to Di-Ethyl Phthalate (DEP) Is Related to Increasing Neonatal IgE Levels and the Altering of the Immune Polarization of Helper-T Cells.

Introduction: Phthalates are substances that are added to plastic products to increase their plasticity. These substances are released easily into the environment and can act as endocrine disruptors. Epidemiological studies in children have showed inconsistent findings regarding the relationship between prenatal or postnatal exposure to phthalates and the risk of allergic disease. Our hypothesis is that prenatal exposure to phthalates may contribute to the development of allergies in children. Material and methods: The objective of this study was to determine the associations between urinary phthalate metabolite concentrations in pregnant women, maternal atopic diathesis, maternal lifestyle, and cord blood IgE. Pregnant mothers and paired newborns (n = 101) were enrolled from an antenatal clinic. The epidemiologic data and the clinical information were collected using standard questionnaires and medical records. The maternal blood and urine samples were collected at 24–28 weeks gestation, and cord blood IgE, IL-12p70, IL-4, and IL-10 levels were determined from the newborns at birth. The link between phthalates and maternal IgE was also assessed. To investigate the effects of phthalates on neonatal immunity, cord blood mononuclear cells (MNCs) were used for cytokine induction in another in vitro experiment. Results: We found that maternal urine monoethyl phthalate (MEP) (a metabolite of di-ethyl phthalate (DEP)) concentrations are positively correlated with the cord blood IgE of the corresponding newborns. The cord blood IL-12p70 levels of mothers with higher maternal urine MEP groups (high DEP exposure) were lower than mothers with low DEP exposure. In vitro experiments demonstrated that DEP could enhance IL-4 production of cord blood MNCs rather than adult MNCs. Conclusion: Prenatal DEP exposure is related to neonatal IgE level and alternation of cytokines relevant to Th1/Th2 polarization. This suggests the existence of a link between prenatal exposure to specific plasticizers and the future development of allergies.

Circulating proteins associated with allergy development in infants\u2014an exploratory analysis

BackgroundProtein profiles that can predict allergy development in children are lacking and the ideal sampling age is unknown. By applying an exploratory proteomics approach in the prospective FARMFLORA birth cohort, we sought to identify previously unknown circulating proteins in early life that associate to protection or risk for development of allergy up to 8 years of age.MethodsWe analyzed plasma prepared from umbilical cord blood (n = 38) and blood collected at 1 month (n = 42), 4 months (n = 39), 18 months (n = 42), 36 months (n = 42) and 8 years (n = 44) of age. We profiled 230 proteins with a multiplexed assay and evaluated the global structure of the data with principal component analysis (PCA). Protein profiles informative to allergic disease at 18 months, 36 months and/or 8 years were evaluated using Lasso logistic regression and random forest.ResultsTwo clusters emerged in the PCA analysis that separated samples obtained at birth and at 1 month of age from samples obtained later. Differences between the clusters were mostly driven by abundant plasma proteins. For the prediction of allergy, both Lasso logistic regression and random forest were most informative with samples collected at 1 month of age. A Lasso model with 27 proteins together with farm environment differentiated children who remained healthy from those developing allergy. This protein panel was primarily composed of antigen-presenting MHC class I molecules, interleukins and chemokines.ConclusionSampled at one month of age, circulating proteins that reflect processes of the immune system may predict the development of allergic disease later in childhood.

Allergy development is associated with consumption of breastmilk with a reduced microbial richness in the first month of life.

Early colonization with a diverse microbiota seems to play a crucial role for appropriate immune maturation during childhood. Breastmilk microbiota is one important source of microbes for the infant, transferred together with maternal IgA antibodies. We previously observed that allergy development during childhood was associated with aberrant IgA responses to the gut microbiota already at 1month of age, when the IgA antibodies are predominantly maternally derived in breastfed infants. To determine the microbial composition and IgA-coated bacteria in breastmilk in relation to allergy development in children participating in an intervention trial with pre- and post-natal Lactobacillus reuteri supplementation. A combination of flow cytometric cell sorting and 16S rRNA gene sequencing was used to characterize the bacterial recognition patterns by IgA in breastmilk samples collected one month post-partum from 40 mothers whose children did or did not develop allergic and asthmatic symptoms during the first 7years of age. The milk fed to children developing allergic manifestations had significantly lower bacterial richness, when compared to the milk given to children that remained healthy. Probiotic treatment influenced the breastmilk microbiota composition. However, the proportions of IgA-coated bacteria, the total bacterial load and the patterns of IgA-coating were similar in breastmilk between mothers of healthy children and those developing allergies. Consumption of breastmilk with a reduced microbial richness in the first month of life may play an important role in allergy development during childhood.

Indoor dust acts as an adjuvant to promote sensitization to peanut through the airway

There is growing evidence that environmental peanut exposure through non-oral routes, including the skin and respiratory tract, can result in peanut sensitization. Environmental adjuvants in indoor dust can promote sensitization to inhaled antigens, but whether they contribute to peanut allergy development is unclear. We investigated whether indoor dust promotes airway sensitization to peanut and peanut allergy development in mice. Female and male C57BL/6J mice were exposed via the airways to peanut, indoor dust extract, or both for 2 weeks. Mice were then challenged with peanut and assessed for anaphylaxis. Peanut-specific immunoglobulins, peanut uptake by lung conventional dendritic cells (cDCs), lung innate cytokines, and T cell differentiation in lung-draining lymph nodes were quantified. Innate cytokine production by primary human bronchial epithelial cells exposed to indoor dust was also determined. Inhalational exposure to low levels of peanut in combination with indoor dust, but neither alone, resulted in production of peanut-specific IgE and development of anaphylaxis upon peanut challenge. Indoor dust triggered production of innate cytokines in murine lungs and in primary human bronchial epithelial cells. Additionally, inhaled indoor dust stimulated maturation and migration of peanut-laden lung type 1 cDCs to draining lymph nodes. Inhalational exposure to peanut and indoor dust induced peanut-specific T helper 2 cell differentiation and accumulation of T follicular helper cells in draining lymph nodes, which were associated with increased B cell numbers and peanut-specific immunoglobulin production. Indoor dust promotes airway sensitization to peanut and development of peanut allergy in mice. Our findings suggest that environmental adjuvants in indoor dust may be determinants of peanut allergy development in children.

Drug Allergy

A new Annals feature in 2018, “From the Pages of AllergyWatch” is devoted to publishing synopses of Allergy and Asthma literature relevant to a topic of emphasis. These unbiased synopses and comments by our Editors have been previously printed in the AllergyWatch bimonthly newsletter, and it is our hope that presenting carefully selected article summaries and comments in the Annals will serve as a valuable educational resource for practicing allergists. For this edition of Annals, focusing on Drug Allergy, From Pages of Allergy Watch highlights reviews of articles that concentrate on reactions to medications. The initial report investigates the impact of PPI and antibiotics that can impact the microbiome on the development of allergy in children. The next review raises the concern about risk for dementia with H1 antihistamines. The potential risk for complications of infections in patients with penicillin allergy is reviewed in the next article. And lastly, a new strategy for management of patients with radio-contrast reaction is reported. A new Annals feature in 2018, “From the Pages of AllergyWatch” is devoted to publishing synopses of Allergy and Asthma literature relevant to a topic of emphasis. These unbiased synopses and comments by our Editors have been previously printed in the AllergyWatch bimonthly newsletter, and it is our hope that presenting carefully selected article summaries and comments in the Annals will serve as a valuable educational resource for practicing allergists.

Oral microbiota maturation during the first 7years of life in relation to allergy development.

Allergic diseases have become a major public health problem in affluent societies. Microbial colonization early in life seems to be critical for instructing regulation on immune system maturation and allergy development in children. Even though the oral cavity is the first site of encounter between a majority of foreign antigens and the immune system, the influence of oral bacteria on allergy development has not yet been reported. We sought to determine the bacterial composition in longitudinally collected saliva samples during childhood in relation to allergy development. Illumina sequencing of the 16S rDNA gene was used to characterize the oral bacterial composition in saliva samples collected at 3, 6, 12, 24months, and 7years of age from children developing allergic symptoms and sensitization (n=47) and children staying healthy (n=33) up to 7years of age. Children developing allergic disease, particularly asthma, had lower diversity of salivary bacteria together with highly divergent bacterial composition at 7years of age, showing a clearly altered oral microbiota in these individuals, likely as a consequence of an impaired immune system during infancy. Moreover, the relative amounts of several bacterial species, including increased abundance of Gemella haemolysans in children developing allergies and Lactobacillus gasseri and L.crispatus in healthy children, were distinctive during early infancy, likely influencing early immune maturation. Early changes in oral microbial composition seem to influence immune maturation and allergy development. Future experiments should test the probiotic potential of L.gasseri and L.crispatus isolates.

Trends in folic acid supplementation during pregnancy - the effect on allergy development in children.

IntroductionThe results of some previous studies suggested that maternal folate supplementation during pregnancy may contribute to allergy development in offspring.AimThis study was performed to examine the influence of maternal folic acid intake prior to and during pregnancy on the development of various types of allergy in children taking into account the timing and dosage of supplemented folate.Material and methodsThe retrospective study was performed between 2010 and 2014 in 307 child-mother pairs (203 allergic children and 104 children without allergy symptoms, aged 2–72 months). Allergy diagnosis was based on medical history, physical examination, positive results of allergic tests: specific IgE and/or skin prick tests and double-blind, placebo-controlled food challenge. The data concerning maternal folate supplementation prior to and during pregnancy were obtained based on a questionnaire.ResultsMothers of allergic children used to take folic acid more frequently in the preconception period (42.9%), in the 1st (94.1%) and the 2nd/3rd (81.3%) trimester of pregnancy than mothers of the healthy ones (30.8%, 82.7% and 55.8%, respectively) (p < 0.05). Maternal intake of folate in a dosage higher than recommended (> 0.4 mg/day) was more often observed in the group of allergic subjects, especially in children with combined sensitization to food and inhalant allergens, than in the control group (p < 0.05).ConclusionsOur results suggest an impact of maternal folic acid supplementation prior to and during pregnancy on allergy development in children. Further observations are required to establish the role of folate in fetal epigenetic modifications.

Beyond Bones : A review of pre-natal vitamin D levels and allergy development in children

Although the connection between vitamin D, the immune system, and allergies encompass a large area of research, a consensus about the specifics of the vitamin’s role in the developing immune system has yet to be reached. At the same time, prevalence of allergies and hypersensitization has seen a dramatic increase in the last 50 years, especially in developed nations, with very little understanding as to why. Some have connected the so-called allergy pandemic to vitamin D, placing the blame on either the similarly concerning vitamin D deficiency prevalence or the rise in supplementation of the vitamin (and thus, an argued excess). Through conducting a non-exhaustive review of the literature, the aim of this paper was to answer the question: Does prenatal vitamin D insufficiency or exposure result in increased risk of developing an atopic condition, including eczema, asthma, and food allergy sensitization? For food allergies and eczema, there is support for both increased and decreased exposure causing each condition, as well as support for vitamin D having no effect at all. The debate around asthma is more specific and focuses on whether elevated vitamin D has a detrimental effect or not. The current evidence is largely based in observational research and findings are still very inconsistent, but as new intervention studies are conducted, a more definitive answer should eventually emerge.

Maternal allergic disease history affects childhood allergy development through impairment of neonatal regulatory T-cells.

BackgroundMaternal allergic disease history and impaired regulatory T-cells (Tregs) are critical risk factors for allergy development in children. However, the mechanisms that underlie these risk factors remain poorly defined. Therefore, the aim of this study was to assess whether maternal allergies affect the Tregs of offspring and lead to allergy development in childhood.MethodsA total of 332 mothers of healthy newborns (234 from no allergic mothers, 98 from allergic mothers) were recruited to this study. Detailed questionnaires were administered yearly to determine the allergy status of the mothers and the newborns from birth to 3 years of age. Cord blood samples obtained at the time of birth were analysed for Treg counts, as well Treg activity, based on their response to Toll-like receptor (TLR) stimuli such as lipid A (LPA) and peptidoglycans (PPG). Surface markers, associated genes, suppressive capacity, and cytokine levels of Tregs were also measured. Possible correlations between Treg activity and maternal or neonate allergies were assessed. In addition, environmental microbial content and other known risk factors for allergies were measured.ResultsCord blood mononuclear cells (CBMCs) from offspring with allergic mothers showed fewer CD4+CD25+FOXP3+ T cells, lower expression levels of associated genes, and reduced cytokine production of interleukin (IL)-10 and interferon-γ (P < 0.05), especially via the PPG-TLR2 pathway. Suppression of effector T cells by Tregs from children of mothers with allergies was impaired, especially IL-13 production by Type 2 T helper (Th2) cells (P = 0.026). Children who developed allergies in the first 3 years of life had lower numbers of CD4+CD25+FOXP3+ T cells and reduced FOXP3 expression and IL-10 production as newborns (P < 0.05). Maternal allergic background was identified as a risk factor for allergy development in the children (Odds ratio (OR) = 2.46, 95 % CI = 1.05–5.79); while declining Treg numbers, IL-10 production, and FOXP3 expression in neonates (PPG and LPA stimulated) were identified as independent risk factors for allergic diseases in offspring at 3 years of age after adjusting for maternal allergic history and environmental factors (P < 0.05).ConclusionMaternal allergy correlated with impaired Tregs in neonates, and this could enhance the susceptibility of offspring to allergic diseases in early childhood due to an imbalance of Th1 and Th2 cells.

A Possible Role of Elevated Breast Milk Lactoferrin and the Cytokine IL-17 Levels in Predicting Early Allergy in Infants: A Pilot Study

In this study, we examined the relationship between levels of lactoferrin (LF) and IL-17 in human serum and breast milk and the development of allergy in children. LF and IL-17 levels were determined by ELISA in healthy (n=19) and allergic mothers (n=21) on the 5th day after delivery. Two years later, information on breastfeeding and allergic outcomes was collected by questionnaires from parents of both groups and district child care nurses. Significantly higher concentrations of LF were found in the breast milk of allergic mothers compared to the healthy controls. At 2 years of age, only those three infants became allergic from the atopic group in whose starting breast milk samples a very high LF level (306 μg mg–1 protein) or simultaneously elevated concentrations of LF and IL-17 were measured. These findings indicate that the very early measurement of LF and IL-17 levels in the breast milk of allergic mothers may help to predict the allergy development in their infants.

Update on Early Nutrition and Food Allergy in Children.

With growing evidence of an increase in the prevalence, food allergy has been emerged as a new public health problem. As treatment and management of food allergy remain challenging, more attention has been paid to the importance of prevention of food allergy. Although the exact mechanism of recent epidemic is not fully understood, it is suggested that nutritional exposure in early life may play an important role in food allergy development. The underlying hypothesis is that nutritional status or food exposure in the critical period of fetal development can affect the programming of immune system and modify the risk of immunologic reactions to foods in postnatal life. We review accumulating epidemiological studies to examine an association between nutritional exposure during pregnancy or early infancy and food allergy development in children. We also discuss recent advances in the studies of the genetic and epigenetic regulation of food allergy and evaluate the role of early nutrition in food allergy development to provide a new perspective on the prevention of food allergy.

Possible prevention of food allergies in children with short bowel syndrome: A retrospective pediatric study

summary Background and aims: Short bowel syndrome is the major cause of intestinal failure. Patients often require parenteral nutrition for a variable period of time to survive, but there is no consensus on the optimal feeding formula during the weaning from parenteral nutrition. Aim of this study was to retrospectively analyze the development of food allergy in children with short bowel syndrome weaned with a hydrolyzed or an amino acid-based formula. Methods: Clinical data were recorded for each patient. We also collected results of allergy tests of patients who had allergic reactions. Results: Forty-seven children with intestinal failure (26 males; mean age of 4.53 ± 3.85 years), followedup at the Department of Pediatrics since 2000, were retrospectively evaluated. Thirty-eight of 47 children (80%) had residual bowel < 100 cm requiring a mean duration of 17.36 ± 6.7 months of parenteral nutrition. In this group 22/38 children were weaned from parenteral nutrition with amino acid-based formula and 16 with hydrolyzed formula. Adverse events were reported in 16/38 children and 10 of these, all weaned with hydrolyzed formula, received diagnosis of cow's milk allergy. None of the 22 children weaned with amino acid-based formula developed allergic reactions. Conclusions: Children weaned with hydrolyzed formula have an increased risk of developing cow's milk allergy in comparison to those weaned with amino acid-based formula and its use may have a role in the prevention of food allergies. The reduced length intestinal residual (<100 cm) is a risk factor for the development of allergic reactions.

Breast-Milk Characteristics Protecting Against Allergy

Breast milk and colostrum are the first feeding sources for a child, providing nutrients, growth factors and immunological components, which are crucial for the newborn's correct development and health. Length of exclusive breastfeeding and time of solid foods introduction is a key factor that may influence allergy development. There is an emerging evidence of a relationship between breastfeeding, milk composition and lower risk of chronic diseases, such as diabetes, obesity, hypertension and allergies. This review examines current evidence regarding humoral and cellular characteristics of breast-milk, and potential role of environment, maternal diet and breastfeeding on the allergy development in children.

Cytokine profiling of umbilical cord blood plasma

Background Cytokines have been shown to be important signal molecules in the development of allergy and asthma, especially the regulatory cytokine IL-10, which has been shown to correlate with higher risk of allergy development in children [1]. Research results regarding cytokine levels in umbilical cord blood plasma vary greatly; some studies find the concentration of cytokines detectable whereas other studies do not. The purpose of this pilot study was to determine if cytokines could be measured from cord blood plasma using IL-10 ELISAs and xMAP Luminex assay.