Food Allergy In Atopic Dermatitis Research Articles

The role of food allergy in atopic dermatitis

Atopic dermatitis (AD) is a chronic, pruritic, inflammatory skin disease affecting more than 10% of all children. Sensitization to foods triggers isolated skin symptoms in about 30% of children. These symptoms include immediate reactions within minutes after ingesting food without exacerbation of AD and early and late exacerbations of AD. It is important to identify clinically relevant sensitizations to foods using skin prick tests, a specific IgE blood test (ImmunoCAP; Phadia, Portage, MI, USA), and double-blind, placebo-controlled food challenges to initiate appropriate dietary interventions and avoid unnecessary dietary restrictions. Children with AD triggered by food allergens demonstrate a distinct immune response upon stimulation of their peripheral blood mononuclear cells with food allergen. A defective skin barrier and increased intestinal permeability appear to facilitate allergen sensitization. Appropriate skin care to maintain skin barrier function and dietary avoidance of highly allergenic foods during infancy may help to prevent allergen sensitization, thereby reducing the severity of AD and food allergies.

The clinical significance of food specific IgE/IgG4 in food specific atopic dermatitis

Food is closely associated with the pathogenesis of atopic dermatitis. Food allergy is usually mediated by IgE antibody to specific food proteins and determination of specific IgE antibody is the basis of the common diagnostic test for food allergy. IgG4 have been reported as blocking antibody and the protective effects of blocking antibody may be clear in inhalant allergy. However, the role of IgG4 in food allergy is still a matter of debate. In this study, the clinical significance of food allergen-specific IgE/IgG4 in atopic dermatitis was investigated and compared with that of IgE. A total of 97 patients who fulfilled the diagnostic criteria for atopic dermatitis participated in this study. Skin prick test and allergy patch test were performed. Specific IgE and IgG4 concentration were measured using allergy protein chip, 'AllergyChip'. Double blinded placebo controlled food challenge test (DBPCFC) was performed for the diagnosis of allergy to milk, egg white, wheat, and soybean. DBPCFCs for milk, egg white, soybean, and wheat were performed. The positive rates were 31.7% (19/60) in milk, 36.7% (18/49) in egg white, 30.4% (7/23) in soybean, and 34.8% (8/23) in wheat. Mean IgE/IgG4 levels in DBPCFC (+) subjects is higher than those in DBPCFC (-) subjects in all food items studied. Of them, there were significantly different between two groups in egg white and wheat (Egg white in DBPCFC (+) vs. (-): 0.4 +/- 0.3 vs. 0.2 +/- 0.2, wheat in DBPCFC (+) vs. (-): 1.2 +/- 1.2 vs. 0.3 +/- 0.3, p < 0.05). Allergen-specific IgE/IgG4 may provide one of the clues to understand the mechanism of food allergy in atopic dermatitis. The present study suggests that protein microarray can be one of the useful methods to assess ongoing status of allergic diseases.

The Role of Food Allergy in Atopic Dermatitis

The Role of Food Allergy in Atopic Dermatitis

Skin prick testing to food allergens in breast‐fed young infants with moderate to severe atopic dermatitis

SUMMARY The role of food allergy in atopic dermatitis is controversial. This study presents results of skin prick tests to 31 different food allergens in a selected population of predominantly breast-fed young infants who had moderate to severe generalized atopic dermatitis. Of the 59 infants (22 female, mean age 26.5 weeks) tested, 54 infants (91.5%) had positive responses to one or more foods, 53 infants (90%) were positive to one or more of the five common food allergens (egg white, cow's milk, peanuts, wheat or soy) and 80% were positive to egg white, which was by far the most common positive test. A total of 37 infants had strongly positive responses to one or more foods, with 33 of these 37 having strongly positive responses to egg white. The significance of these responses is discussed. It is concluded that positive skin prick tests to foods, particularly to egg white, are very common in this selected population of breast-fed infants with moderate to severe atopic dermatitis.

Role of food allergy in atopic dermatitis.

Food allergy and atopic dermatitis often occur in the same patient. Based on clinical data from the past few decades, it is clear that foods such as cow's milk and hen's eggs can directly provoke flares of atopic dermatitis particularly in sensitized infants, whereas inhaled allergens and pollen-related foods are of greater importance in older children, adolescents and adults. Because the role and immunology of food allergy in atopic dermatitis remain controversial, here we review data that mainly focus on skin eczema and food allergy. Clinical studies have revealed that more than 50% of all children with atopic dermatitis that can be exacerbated by certain foods will react with a worsening of skin eczema alone or in addition to immediate symptoms. Adolescents and adults also react to foods, but reactions to 'classical' food allergens such as hen's eggs and cow's milk are not as common as in childhood. Subgroups of children and of adults with atopic dermatitis do, however, react to pollen-associated foods. Both immunoglobulin E associated and independent T-cell mediated responses appear to be involved in clinical eczematous reactions. Food-induced eczema should be diagnosed only by a thorough diagnostic procedure, taking into account the patient's history, the degree of sensitization and the clinical relevance of the sensitization. More clinical and immunological studies are needed to unravel the pathophysiology and the different rates of clinical responsiveness to different foodstuffs in patients with atopic dermatitis.

Clinical significance antigen-specific IgG 4 for the diagnosis of food allergy in atopic dermatitis : The comparison of serum antigen-specific IgE and IgG4 levels with the results of DBPCFC for milk and egg white

Rationale Allergen-specific IgG 4 has been known to have protective effects for allergy provocation as a blocking antibody. The clinical significance of food-specific IgG4 for food allergy provocation was investigated. Methods A total of 68 atopic dermatitis patients were involved. The serum levels of food-specific IgE and IgG4 were measured by Pharmacia UniCAP and using allergy protein chip of Food BioTech APC. Double-blind placebo-controlled food challenges (DPBCFC) for milk and egg white were performed. The results of DBPCFC were compared the serum levels of allergen-specific IgE and IgG4. Results The mean serum milk-specific IgE level of atopic dermatitis patients with milk allergy was lower than the level of those without milk allergy. Moreover, mean serum milk-specific IgG4 levels were also significantly low in atopic dermatitis patients with milk allergy than in those without milk allergy. The results showed also similar pattern in egg white. Conclusions The measurement of serum allergen-specific-IgG4 levels as well as IgE may be necessary for the diagnosis of food allergy.

The evaluation and management of food allergy in atopic dermatitis

Atopic dermatitis (AD) is a form of eczema that generally begins in early infancy and is characterized by extreme pruritus, chronically relapsing course, and distinctive morphology and distribution. AD is typically the first clinical manifestation of a child prone to develop atopic disease, with 50% of all AD developing in the first year of life and 80% by 5 years of age. Approximately 80% of children with AD develop asthma or allergic rhinitis; many lose their AD with the onset of respiratory allergy. The acute rash of AD is typically an erythematous, papulovesicular eruption, occasionally with weeping and crusting that is more commonly seen in early life. It typically progresses to a subacute form marked by erythema and scaling papules, and, especially in older patients, to a chronic form characterized by thickened, lichenified skin and fibrous papules. The distribution of the rash varies with age, involving the cheeks and extensor surfaces of the arms and legs in infancy, the flexor surfaces in the young child, and flexor surfaces, hands, and feet in the teenage patient and young adult. Atopic dermatitis is identified by a constellation of symptoms. Standard diagnostic criteria exist and are an accepted standard for diagnosing atopic dermatitis, and the SCORAD Index adapted by the European Task Force on Atopic Dermatitis provides a standardized method for gauging severity. The pathogenic role of allergy in atopic dermatitis has been debated since Besnier first described the eczematous rash that has become known as AD. However, recent studies delineating the immunopathogenic role of immunoglobulin (Ig)E-bearing antigen-presenting cells (eg, Langerhans cells and other dendritic cells) in establishing the initial Th2 lymphocytic response and of the IgE-mediated late-phase response in provoking cutaneous inflammation, numerous clinical studies demonstrating the provocation and resolution of skin symptoms in a subset of AD patients with the introduction and elimination of allergen, and the development of a murine model of a food-induced eczematous rash leave little doubt about the pathogenic role of allergy in some AD patients.

Atopy Patch Test (APT)--its role in diagnosis of food allergy in atopic dermatitis.

During the past few years, the Atopy Patch Test (APT) has become a valuable additional tool in the diagnostic work-up of food allergy in infants and children with atopic dermatitis. A positive APT may help to prevent restrictive and unnecessary diets which may be the consequence of misjudging late reactions by clinical assessment alone. Furthermore, the combination of positive atopy patch tests together with defined levels of specific IgE (cow milk = 0.35 kU/l and egg = 17.5 kU/l) makes DBPCFC superfluous for suspected milk and egg allergy. However, several open questions indicate the need for further studies.

Atopic dermatitis: An update

Atopic dermatitis: An update

Importance of food allergy in atopic dermatitis.

AllergyVolume 53, Issue s46 p. 139-142 Importance of food allergy in atopic dermatitis A. Oehling, Corresponding Author A. Oehling Department of Allergology and Cllnical Immunology. University Clinic, Faculty of Medicine, University of Navarre. SpainDepartment of Allergology and Clinical Immunology University Clinic Faculty of Medicine Universih of Navarre SpainSearch for more papers by this authorA. Resano, A. Resano Department of Allergology and Cllnical Immunology. University Clinic, Faculty of Medicine, University of Navarre. SpainSearch for more papers by this authorM. L. Sanz, M. L. Sanz Department of Allergology and Cllnical Immunology. University Clinic, Faculty of Medicine, University of Navarre. SpainSearch for more papers by this authorM. Fernandez Benitez, M. Fernandez Benitez Department of Allergology and Cllnical Immunology. University Clinic, Faculty of Medicine, University of Navarre. SpainSearch for more papers by this author A. Oehling, Corresponding Author A. Oehling Department of Allergology and Cllnical Immunology. University Clinic, Faculty of Medicine, University of Navarre. SpainDepartment of Allergology and Clinical Immunology University Clinic Faculty of Medicine Universih of Navarre SpainSearch for more papers by this authorA. Resano, A. Resano Department of Allergology and Cllnical Immunology. University Clinic, Faculty of Medicine, University of Navarre. SpainSearch for more papers by this authorM. L. Sanz, M. L. Sanz Department of Allergology and Cllnical Immunology. University Clinic, Faculty of Medicine, University of Navarre. SpainSearch for more papers by this authorM. Fernandez Benitez, M. Fernandez Benitez Department of Allergology and Cllnical Immunology. University Clinic, Faculty of Medicine, University of Navarre. SpainSearch for more papers by this author First published: 30 December 2008 https://doi.org/10.1111/j.1398-9995.1998.tb04985.xCitations: 10AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume53, Issues46October 1998Pages 139-142 RelatedInformation

食物アレルギー，特に，アトピー性皮膚炎における食物アレルギー

食物アレルギー，特に，アトピー性皮膚炎における食物アレルギー

Food Allergy in Atopic Dermatitis

Food Allergy in Atopic Dermatitis

Results of food testing in atopic dermatitis

Skin testing to find food allergy in atopic dermatitis is recommcnded from the age of 4 months up the early adulthood. Scratch, scratch-chamber, prick and intra?cutancous tests may be used. In order to obtain optimal benefit from skin testing, both commercial extracts and fresh foodstuffs must be used. Extracts of protein-rich foods. such as fish, egg and nuts, work very well in skin tests, but fruits and vegetablas lose their allergenicity easily in the extraction process and that is why they are tested in raw state. The younger the patient the better the correlation bctween the skin test results and the challenge tests. The nature of the allergen also has a great influence on the clinical relevancy of the skin tests. Extracts of various cereals correlate for example in almost every case with skin reactivity alone and not with symptoms from ingested cereals.