Non-allergic Children Research Articles

Nasal allergen challenge with Blomia tropicalis in children and adolescents.

Local allergic rhinitis (LAR) is a well-defined phenotype in adults, but still there is little data available on children. This scarcity of data can be partly attributed to the lack of standardized protocols for Nasal Allergen Challenges (NAC) in this demographic. 20 controls (control group) and 24 patients (rhinitis group) with allergic rhinitis diagnosis sensitized to Blomia tropicalis (Bt) underwent the NAC with Bt. The acoustic rhinometry was performed after instillation of increasing concentrations of Bt (5,000 BU/mL). The median reduction in the volume of the nasal cavity in its first five centimeters (V5) by the conclusion of the NAC in the rhinitis group was markedly higher than that observed in the control group, at -22.9% (range: -21.1% to -26.2%) compared to -7.7% (ranging: -4.8% to +12.8%). Our research demonstrates the efficacy and safety of the NAC protocol utilizing Bt in distinguishing allergic from non-allergic children.

Factors Associated with Weaning in Infants with Cow's Milk Allergy: A Cohort Study.

Objective: To analyze the factors associated with weaning in infants with cow's milk allergy (CMA) treated at a food allergy reference center in a state in the northeast of Brazil. Method: A prospective cohort study, with a case group (children with CMA) and two control groups (symptomatic nonallergic children [SC] and asymptomatic [AC]). At the beginning of the study, 30 children comprised the CMA group, 84 the SC group, and 52 the AC group. Survival analysis was performed to compare breastfeeding time between the three groups and an adjusted linear regression model to verify the factors associated with breastfeeding time. Results: At the beginning of the study, 33.3% of children in the CMA group, 17.1% in the SC group, and 69.6% in the AC group were exclusively breastfeeding (p = 0.005). The most common factors for weaning in children with CMA were the cow's milk elimination diet (30%), allergic symptoms in the child (20%), and breast engorgement (20%). Children who used a cup as a means of offering infant formula spent 281 more days breastfeeding compared with those who used a baby bottle (Bstd = 1.39; p = 0.031). Conclusion: Children with CMA and nonallergic gastrointestinal complaints weaned earlier compared with asymptomatic children. The main causes of weaning in CMA children were maternal difficulty adhering to the elimination diet, breast engorgement, and allergic symptoms in the child. Using a cup was the main factor associated with longer breastfeeding duration, regardless of gastrointestinal symptoms and socioeconomic factors.

Alteration of Immunoregulatory Patterns and Survival Advantage of Key Cell Types in Food Allergic Children.

All allergic responses to food indicate the failure of immunological tolerance, but it is unclear why cow's milk and egg (CME) allergies resolve more readily than reactivity to peanuts (PN). We sought to identify differences between PN and CME allergies through constitutive immune status and responses to cognate and non-cognate food antigens. Children with confirmed allergy to CME (n = 6) and PN (n = 18) and non-allergic (NA) (n = 8) controls were studied. Constitutive secretion of cytokines was tested in plasma and unstimulated mononuclear cell (PBMNC) cultures. Blood dendritic cell (DC) subsets were analyzed alongside changes in phenotypes and soluble molecules in allergen-stimulated MNC cultures with or without cytokine neutralization. We observed that in allergic children, constitutively high plasma levels IL-1β, IL-2, IL-4, IL-5 and IL-10 but less IL-12p70 than in non-allergic children was accompanied by the spontaneous secretion of sCD23, IL-1β, IL-2, IL-4, IL-5, IL-10, IL-12p70, IFN-γ and TNF-α in MNC cultures. Furthermore, blood DC subset counts differed in food allergy. Antigen-presenting cell phenotypic abnormalities were accompanied by higher B and T cell percentages with more Bcl-2 within CD69+ subsets. Cells were generally refractory to antigenic stimulation in vitro, but IL-4 neutralization led to CD152 downregulation by CD4+ T cells from PN allergic children responding to PN allergens. Canonical discriminant analyses segregated non-allergic and allergic children by their cytokine secretion patterns, revealing differences and areas of overlap between PN and CME allergies. Despite an absence of recent allergen exposure, indication of in vivo activation, in vitro responses independent of challenging antigen and the presence of unusual costimulatory molecules suggest dysregulated immunity in food allergy. Most importantly, higher Bcl-2 content within key effector cells implies survival advantage with the potential to mount abnormal responses that may give rise to the manifestations of allergy. Here, we put forward the hypothesis that the lack of apoptosis of key immune cell types might be central to the development of food allergic reactions.

Basophil activation test with progressively less heated forms of egg distinguishes egg allergic from tolerant children.

Diagnosis of egg allergy through basophil activation testing (BAT) has been mainly performed with an egg white extract or individual egg allergens rather than clinically more representative whole-egg extracts. Impact of heating on whole-egg extract allergenicity remains unassessed.Validating BAT with gradually less heated whole-egg extracts in egg allergy diagnosis and as tolerance marker. CD63-based BAT was performed with five progressively less heated extracts from cake, hard-boiled egg, omelet, soft-boiled, and raw egg in 10 egg allergic (EA), 10 complete egg tolerant (ET) and 12 non-egg-sensitized non-allergic (NEA) children. Cutoffs and diagnostic accuracy measures were established through ROC analysis. Changes in basophil response were assessed in 12 baked egg tolerant children undergoing an 8-month gradual egg reintroduction protocol with BAT and oral food challenges prior to each reintroduction step. Basophil responses to all egg extracts were increased in EA, but not in ET and NEA children. Responses decreased progressively with more heated egg extracts. Compared to ET children, EA children showed higher basophil sensitivity for all egg extracts. Negative BAT responses predicted clinical tolerance with a 90-100% sensitivity, 100% specificity, and false positive rate of 2.78%. In comparison, egg sIgE's (<0.35 kUA/L) had a lower specificity of 50-78% with a false positive rate of 40%. Basophil reactivity and sensitivity tended to decrease in baked egg tolerant children undergoing gradual egg reintroduction, concurrent with tolerance development. BAT with progressively less heated egg preparations is a sensitive and highly specific tool to discriminate EA from ET children.

Nasal fluid sample as a reliable matrix for determination of cytokine levels in childhood asthma

Abstract Objectives Childhood asthma is a chronic disease with high incidence worldwide. As a lifelong disease, asthma has episodes. Inflammation continues to occur in the clinical remission of asthma. It can be difficult to diagnose childhood asthma, especially in clinical remission. We hypothesized that some cytokines secreted to nasal fluid from the airway during inflammation might help diagnose clinical remission of asthma. Moreover, sampling nasal fluid is an easy and non-invasive procedure, so it may be a preferable sampling method. Methods We measured levels of some interleukins (ILs), which are IL-4, IL-5, IL-6, IL-12p70, IL-13, IL-33, granulocyte-macrophage colony-stimulating factor (GM-CSF), periostin and thymic stromal lymphopoietin (TSLP) by Luminex magnetic bead-based immunoassay in nasal fluid and in serum of asthmatic children in clinical remission. Results We found that IL-5, IL-6, IL-33, and periostin had elevated levels in nasal fluid. IL-5 and IL-33 had increased levels in the nasal fluid of the patients with immunoglobulin E (IgE) high and low phenotypes. While the nasal fluid TSLP levels were positively correlated with most of the increased serum cytokine levels of non-allergic asthmatic children, the nasal fluid GM-CSF levels were positively correlated with most of the increased serum cytokine levels of the allergic asthmatic children. Conclusions IL-5, IL-6, IL-33, and periostin had elevated levels in the nasal fluid of the patients in clinical remission. The nasal fluid GM-CSF levels of the allergic patients and nasal fluid TSLP levels of the non-allergic patients had a positive correlation with most of the serum cytokine levels. Thus, our results showed that nasal fluid might be a preferable biological sample to diagnose asthma in children.

Rural and urban exposures shape early life immune development in South African children with atopic dermatitis and nonallergic children.

Immunological traits and functions have been consistently associated with environmental exposures and are thought to shape allergic disease susceptibility and protection. In particular, specific exposures in early life may have more significant effects on the developing immune system, with potentially long-term impacts. We performed RNA-Seq on peripheral blood mononuclear cells (PBMCs) from 150 children with atopic dermatitis and healthy nonallergic children in rural and urban settings from the same ethnolinguistic AmaXhosa background in South Africa. We measured environmental exposures using questionnaires. A distinct PBMC gene expression pattern was observed in those children with atopic dermatitis (132 differentially expressed genes [DEGs]). However, the predominant influences on the immune cell transcriptome were related to early life exposures including animals, time outdoors, and types of cooking and heating fuels. Sample clustering revealed two rural groups (Rural_1 and Rural_2) that separated from the urban group (3413 and 2647 DEGs, respectively). The most significantly regulated pathways in Rural_1 children were related to innate activation of the immune system (e.g., TLR and cytokine signaling), changes in lymphocyte polarization (e.g., TH17 cells), and immune cell metabolism (i.e., oxidative phosphorylation). The Rural_2 group displayed evidence for ongoing lymphocyte activation (e.g., T cell receptor signaling), with changes in immune cell survival and proliferation (e.g., mTOR signaling, insulin signaling). This study highlights the importance of the exposome on immune development in early life and identifies potentially protective (e.g., animal) exposures and potentially detrimental (e.g., pollutant) exposures that impact key immunological pathways.

Ara h 2 Peptide Mix Improves the Diagnosis of Peanut Allergy and Is Relevant for Ara h 2–Induced Mast Cell Activation

A precise diagnosis of peanut allergy is extremely important. We identified 4 Ara h 2 peptides that improved Ara h 2-specific IgE (sIgE) diagnostic accuracy. To assess the diagnostic utility of sIgE to the mixture of these peptides and their role in mast cell response to peanut allergens. sIgE to the peptide mix was determined using ImmunoCAP. Its diagnostic utility was compared with Ara h 2-sIgE and sIgE to the individual peptides. The functional relevance of the peptides was tested on the mast cell activation test using laboratory of allergic diseases 2 cell line and flow cytometry. A total of 52 peanut-allergic (PA), 36 peanut-sensitized but tolerant, and 9 nonsensitized nonallergic children were studied. Peptide mix-sIgE improved the diagnostic performance of Ara h 2-sIgE compared with Ara h 2-sIgE alone (area under the receiver operating characteristic curve .92 vs .89, respectively; P= .056). The sensitivity and specificity of Ara h 2-sIgE combined with the peptide mix were 85% and 96%, respectively. sIgE to individual peptides had the highest specificity (91%-96%) but the lowest sensitivity (10%-52%) compared with Ara h 2-sIgE (69% specificity and 87% sensitivity) or with peptide mix-sIgE (82% specificity and 63% sensitivity). Peptide 3 directly induced mast cell activation, and the peptide mix inhibited Ara h 2-induced activation of mast cells sensitized with plasma from Ara h 2-positive PA patients. sIgE to the peptide mix improved the diagnostic performance of Ara h 2-sIgE similarly to sIgE to individual peptides. The peptides interfered with Ara h 2-induced mast cell activation, confirming its relevance in peanut allergy.

Expression of circulating angiotensin-converting enzyme 2 in children with asthma and the effects of inhaled corticosteroids.

The global spread of coronavirus disease 2019 (COVID-19) has resulted in a significant disease burden, yet asthma patients do not have the expected high morbidity and mortality rates in the pandemics of COVID-19. To find the difference of angiotensin-converting enzyme 2 (ACE2) in asthma and nonasthma children and evaluate the effect of inhaled corticosteroids (ICS) on its expression. The ACE2, immunoglobulin E (IgE), and eosinophils were tested in different children. A total of 157 children aged 3-16 years were enrolled. The expression of ACE2 in asthma children were lower than nonasthma children (T = -2.512, p = .013). Allergic nonasthma children had a significant higher ACE2 expression than children with allergic asthma (p = .013) and nonallergic asthma (p = .029). The expression of ACE2 had no significant difference between first-diagnosed asthma children and that had been treated with ICS for ≥6 months (F = 0.028, p = .598). The allergic asthma children showed a significantly higher eosinophils cells (EC) count than the allergic nonasthma (W = 200, p < .001) and nonallergic nonasthma children (W = 1089, p < .001). Nonallergic asthma children also had a significant higher EC count than the allergic non-asthma (W = 182.5, p < .001) and nonallergic non-asthma (W = 200.5, p < .001) children. There was no significant difference in IgE levels between asthmatic children and non-asthmatic children (W = 2792.5, p = .18). Circulating ACE2 levels in asthmatic children were lower than those in non-asthmatic children and ICS treatment for ≥6 months did not affect the expression of ACE2 in peripheral blood in the asthma children.

Alteration of taste perception, food neophobia and oral microbiota composition in children with food allergy

Currently, the mechanisms underlying sensory perception and sensory performance in children with food allergies are far from being understood. As well, only recently, single research afforded the oral host-commensal milieu, addressing oral microbial communities in children with peanut allergies. To bridge the current gaps in knowledge both in the sensory and microbial fields, a psychophysiological case–control study was performed in allergic children (n = 29) and a healthy sex-age-matched control group (n = 30). Taste perception, food neophobia, and liking were compared in allergic and non-allergic children. The same subjects were characterized for their oral microbiota composition by addressing saliva to assess whether specific profiles were associated with the loss of oral tolerance in children with food allergies. Our study evidenced an impaired ability to correctly identify taste qualities in the allergic group compared to controls. These results were also consistent with anatomical data related to the fungiform papillae on the tongue, which are lower in number in the allergic group. Furthermore, distinct oral microbial profiles were associated with allergic disease, with significant down-representations of the phylum Firmicutes and of the genera Veillonella spp., Streptococcus spp., Prevotella spp., and Neisseria spp. For the first time, this study emphasizes the link between sensory perception and food allergy, which is a novel and whole-organism view of this pathology. Our data indicated that an impaired taste perception, as regards both functionality and physiologically, was associated with food allergy, which marginally influences the food neophobia attitude. It is also accompanied by compositional shifts in oral microbiota, which is, in turn, another actor of this complex interplay and is deeply interconnected with mucosal immunity. This multidisciplinary research will likely open exciting new approaches to therapeutic interventions.

Growth and Nutritional Biomarkers in Brazilian Infants with Cow's Milk Allergy at Diagnosis and 18-Month Follow-Up: A Prospective Cohort Study.

This study aimed to describe the growth, body protein status, and micronutrient biomarkers of Brazilian infants with cow's milk allergy (CMPA) at baseline and at 18 months of follow-up in comparison with their healthy peers. Thirty infants with CMPA younger than six months of age were included in this longitudinal study, and their nutritional status was compared with that of 24 non-allergic age-matched children. Anthropometric measurements were used to assess growth, and blood and urine samples were analyzed for protein and micronutrient status. Mixed linear models adjusted for birth weight, socioeconomic status, infant feeding at baseline, weight-for-age, C-reactive protein, serum albumin, micronutrient dietary supplementation, and salt consumption were employed to evaluate the evolution of nutritional parameters throughout the follow-up period. Overall, the mean age of the children at enrolment was 2.9 (standard deviation 1.7) months, and 29 children (53.7%) were male. Infants with CMPA showed a higher prevalence of functional iron depletion (transferrin saturation <20) (p=0.027), lower serum ferritin (p=0.009), and lower urinary iodine (p=0.034) levels than non-allergic children at baseline. Patients with CMPA showed a higher increment in weight-for-age and length-for-age over time than those in the control group (p<0.01). Mixed linear analyses showed a significantly lower increase in serum vitamin B12 (s-B12) (p=0.001) and urinary iodine (p<0.001) concentrations over time compared to the control group. Infants with CMPA on a cow's milk elimination diet had a higher weight and length at 18 months of follow-up but showed signs of inadequate iron, iodine, and B-12 vitamin status.

Impact of Penicillin Allergy Labels on Children Treated for Outpatient Respiratory Infections.

Penicillin allergy is the most common antibiotic allergy, yet most children labeled as allergic tolerate penicillin. The impact of inaccurate penicillin allergy labels (PALs) on pediatric outpatients is unknown. The objective of this study was to compare outcomes between children with and without a PAL after treatment for outpatient respiratory tract infections (RTI). A retrospective, longitudinal birth cohort study was performed in children who received care in 90 pediatric primary care practices in Philadelphia and Houston metropolitan areas. Prescribing and clinical outcomes of children with a PAL at the time of an RTI were compared to non-allergic children, adjusting for potential confounders. Antibiotics were prescribed for 663,473 non-recurrent RTIs among 200,977 children. Children with a PAL (5% of cohort) were more likely than non-allergic children to receive broad-spectrum antibiotics (adjusted relative risk (aRR) 3.24, 95% CI 3.22-3.26) and second-line antibiotics (aRR 4.87, 95% CI 4.83, 4.89). Compared to non-allergic children receiving first-line antibiotics, children with a PAL were more likely to return with adverse drug events (aRR 1.28, 95% CI 1.18-1.39). There was no difference in treatment failure between groups (aRR 0.95, 95% CI 0.90-1.00). PALs lead to higher rates of broad-spectrum and second-line antibiotic prescribing in children treated for RTIs in primary care and contribute to unnecessary healthcare utilization through increased adverse events. Given the frequency of PALs, efforts to prevent inappropriate penicillin allergy labeling and promote de-labeling of existing inaccurate allergy labels may improve care of children treated for common bacterial infections.

Pediatric turbinoplasty: what is the impact of allergy on long-term outcomes?

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The use of inferior turbinoplasty (IT) in pediatric patients is controversial, especially in the presence of allergic rhinitis. The objective of this study was to assess the long-term results of radiofrequency inferior turbinoplasty in allergic versus non-allergic children.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Children operated between 2017 and 2019 and whose intervention included radiofrequency IT were included. Multiple scores were collected in 2021 through a telephone call to parents. A comparison was made between allergic children (AC) and non-allergic children (NAC). &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; 41 children were included. Parents of AC reported a higher degree of dissatisfaction with surgery (AC: 0.8±1 verses NAC: 0.2±0.5, p=0.026). AC revealed a greater dependence on medication in order to control nasal obstruction (41% in AC vs 6% in NAC, p=0.010). The total Nasal Obstruction Symptom Evaluation (NOSE) score was higher in AC (mean AC 26±25 verses mean NAC 5±12, p=0.003). The sinus and nasal quality of life 5 SN-5 score was higher in AC (mean AC 2.5±1 vs NAC mean 1.4±0.8, p&amp;lt;0.001).AC had a lower score on the SN-5 quality of life scale (mean AC 6.6±2.4 vs NAC mean 8.3±1.8, p=0.014).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Radiofrequency IT alone does not seem effective in the long-term resolution of nasal obstruction in AC.&lt;/p&gt;&lt;p class="abstract"&gt; &lt;/p&gt;

Are allergic diseases and internalizing and externalizing behaviours in children related? A cross-sectional study

IntroductionThe prevalence of allergies in children has grown in last few decades. Allergies are very often associated with physical, mental, and emotional problems that could be detected through child’s behaviour and feelings.Objectivesto describe and compare children’s behaviour (internalizing and externalizing) across a sample of children aged 6–11 years with and without allergic diseases.MethodsThis was a cross-sectional observational case-control study. A survey to 366 families (194 allergic cases and 172 controls), including a child behaviour checklist (CBCL) and a socio-demographic questionnaire with questions related to family, school education, health conditions and allergy symptoms, was administered.ResultsChildren with a diagnosis of allergy showed higher scores in the overall CBCL score (standardised mean differences [SMD]= 0.47; confidence intervals [CI]: 0.26–0.68) and in the internalizing and externalizing factors (SMD=0.52 and SMD=0.36, respectively) than non-allergic children. Odds ratio (OR) analyses showed a higher risk (OR=2.76; 95% CI [1.61 to 4.72]) of developing a behavioural difficulty in children diagnosed with allergies. Age and level of asthma appear as modulatory variables.ConclusionsChildren aged 6–11 years diagnosed with allergies showed larger behavioural problems than non-allergic children. This relationship is stronger in internalizing behaviours. These findings suggest the importance of attending to them and treating them in the early stages of diagnosis to avoid future psychological disorders.DisclosureNo significant relationships.

Long-Chain Polyunsaturated Fatty Acid Status at Birth and Development of Childhood Allergy: A Systematic Review.

The associations of fetal fatty acids status to immune-related health parameters later in life are unclear. Our aim is to collect all available information on the relationship between fatty acid status at birth and allergy in childhood. Systematic literature search was performed on Ovid MEDLINE, Cochrane Library, and Embase. The search retrieved 897 articles without duplicates; 14 articles remained after excluding those that did not fit into our inclusion criteria. When the dichotomous parameter of suffering or not from allergic condition in childhood was analyzed, cord blood eicosapentaenoic acid (EPA) values proved to be significantly lower in allergic than non-allergic children in four comparisons from three studies. When the linear parameters of odds ratios and relative risks for allergy were taken into consideration, high cord blood EPA, but also high docosahexaenoic acid (DHA) and high total n-3 long-chain polyunsaturated fatty acid values were associated to clinically relevant reduction (at least 38%) in eight comparisons from five studies. Within the cord blood samples, higher EPA, docosapentaenoic acid, and DHA values were significantly and negatively associated in eight correlation analyses from three studies with laboratory parameters considered to reflect allergic trait. The data reported here may provide information for defining optimal fatty acid intakes for pregnant women.

Gut Microbiome and Metabolomics Profiles of Allergic and Non-Allergic Childhood Asthma.

PurposeThis study aimed to investigate the characteristics of gut bacteria and the derived metabolites among allergic asthmatic children, non-allergic asthmatic children and healthy children without asthma.MethodsFecal samples were collected from 57 participants, including 20 healthy children, 27 allergic asthmatic children, and 10 non-allergic asthmatic children. 16S rRNA gene sequencing was conducted for analyzing gut bacterial compositions and untargeted metabolomics was used to analyze the alterations of gut microbe-derived metabolites. The associations between gut bacterial compositions and metabolites were analyzed by the method of Spearman correlation.ResultsThe results showed that the compositions and metabolites of gut microbiome were altered both in allergic and non-allergic asthmatics compared with healthy controls. Chao1 (p = 0.025) index reflected a higher bacterial richness and Simpson (p = 0.024) index showed a lower diversity in asthma group. PERMANOVA analysis showed significant differences among the three groups based on unweighted UniFrac distance (p = 0.001). Both allergic and non-allergic asthmatics showed a higher relative abundance of Proteobacteria and a lower relative abundance of genera from Clostridia. More bacteria were altered in non-allergic asthmatics compared with allergic asthmatics. Metabolomics analysis identified that 42 metabolites were significantly associated with allergic asthma, and 58 metabolites were significantly associated with non-allergic asthma (multiple linear regression, p < 0.05). Histamine was 4 folds up-regulated only in the non-allergic asthma group. The relative abundance of Candidatus Accumulib was significantly correlated with the upregulation of histamine. The relative abundance of genera from Clostridia was significantly correlated with the downregulation of lipid and tryptophan metabolism.ConclusionThe altered gut microbes was associated with the mechanism of asthma attack through metabolites in allergic and non-allergic asthma group, respectively. The result suggested that gut microbiome had an impact on the development of both allergic and non-allergic asthma. The distinct gut microbiome and microbiome-derived metabolites in non-allergic asthma children suggested that gut microbiome might play a critical role in modulation of asthma phenotype.

Neonatal Antibiotics and Food Allergy Are Associated With FGIDs at 4-6 Years of Age.

Antibiotics may contribute to the development of functional gastrointestinal disorders (FGIDs). This study aimed to determine whether antibiotics during the first week of life, infantile colic in the first year of life, gut-associated immune markers at 1 year of age, and allergies at 4-6 years of age in term-born children were associated with a higher prevalence of FGIDs at 4-6 years of age. A prospective observational cohort of 436 term-born infants was followed up at the age of 4-6 years; 151 received broad-spectrum antibiotics (AB+), and 285 healthy controls (AB-). Validated Questionnaire On Pediatric Gastrointestinal Symptoms-Rome III and International Study of Asthma and Allergy in Childhood questionnaires were sent to parents of 418 available children. The independent t-test, chi-squared test or non-parametric test and logistic multivariate regression analyses were used. In total, 340 of 418 (81%) questionnaires were completed. Only the presence of functional abdominal pain was significantly higher in AB+ than AB- (4% vs 0.4%, respectively, P = 0.045). Children with food allergy fulfilled significantly more often the criteria for irritable bowel syndrome (IBS) and abdominal migraine (26% vs 9%, P = 0.002 and 7% vs 1%, P = 0.043, respectively) compared to non-allergic children. No differences in FGIDs existed at the age of 4-6 years between children with and without a history of infantile colic. There were significant differences in gut-associated immune markers between children with and without FGIDs. Antibiotics during the first week of life resulted in a higher risk for functional abdominal pain at 4-6 years. Furthermore, food allergy was associated with IBS and abdominal migraine at 4-6years.

Associations between depressive and anxiety levels and allergic rhinitis in children: a cross-sectional study

ABSTRACT Objective: To investigate the associations between the depressive and anxiety levels and allergic rhinitis (AR) in children. Methods: Children less than 15 years old admitted to our hospital from April 2017 to December 2019 were enrolled in this study, including 692 AR children in the patient group and 713 normal individuals in the control group. The Screen for Child Anxiety Related Emotional Disorders (SCARED) was used to detect their depressive and anxiety levels, and the Middle Childhood Temperament Questionnaire (MCTQ) was used to evaluate their dominant affective temperaments. The comparisons of scale scores between these groups, and the correlation analysis between SCARED scores and MCTQ scores were conducted. Results: The mean SCARED scores of the patient group were significantly higher than the control group (P < 0.05). The patient group also had more AR children with the depressive temperament and anxious temperament than the control group (P<0.01). Strong correlations were found between the SCARED scores and MCTQ scores. Conclusion: The AR children had obvious depressive and anxious trends than non-allergic children. Screening the temperaments and detecting the depression and anxiety symptoms were imperative for AR children, especially for those with depression and anxious moods.

De Novo Food Allergy in Pediatric Recipients of Liver Transplant.

Allergic and atopic conditions, including food allergy, asthma, eczema and eosinophilic disease of the gastrointestinal tract after liver transplant in previously non-allergic children have been increasingly described. After a liver transplant, children can present mild to severe reactions to food allergens (ie, from urticaria-angioedema to life-threatening anaphylactic reactions). De novo post-transplant food allergy may become clinically evident in children who undergo liver transplant between a few months and a few years of transplant. The present narrative review aims to describe the spectrum of de novo post-transplant food allergy development, the current theories of pathogenesis, risk factors and to suggest possible clinical management strategies.

Nationwide paediatric cohort study of a protective association between allergy and complicated appendicitis.

In a nationwide cohort the potentially protective association between allergy and complicated appendicitis was analysed, and the influence of seasonal antigens, antihistamine treatment, and timing of allergy onset assessed. Some 1 112 571 children born between 2000 and 2010 were followed from birth until the end of 2014. A cross-sectional analysis of appendicitis cases, with comparison of allergic versus non-allergic children for absolute risk and odds of complicated appendicitis was first undertaken. This was followed by a longitudinal analysis of children with allergy and matched controls who had never had an allergy, for incidence rate and hazard of subsequent complicated or simple appendicitis. Of all children, 20.4 per cent developed allergy and 0.6 per cent had appendicitis during follow-up. Among children with appendicitis, complicated appendicitis was more common among non-allergic children (18.9 per cent, 948 of 5016) than allergic children (12.8 per cent, 173 of 1351) (P < 0.001), and allergic children had a lower adjusted odds of complicated appendicitis (adjusted odds ratio (OR) 0.80, 95 per cent c.i. 0.67 to 0.96; P = 0.021 ). The risk of complicated appendicitis among children with manifest allergy was reduced by one-third in the longitudinal analysis (incidence rate 0.13 versus 0.20 per 1000 person-years; hazard ratio (HR) 0.68, 95 per cent c.i. 0.58 to 0.81; P < 0.001), whereas the risk of simple appendicitis remained unchanged (incidence rate 0.91 versus 0.91; HR 1.00, 0.94 to 1.07; P = 0.932 ). Seasonal antigen exposure was a protective factor (adjusted OR 0.82, 0.71 to 0.94; P = 0.004) and ongoing antihistamine medication a risk factor (adjusted OR 2.28, 1.21 to 4.28; P = 0.012). Children with allergy have a lower risk of complicated appendicitis, but the same overall risk of simple appendicitis. Seasonal antigen exposure reduced, and antihistamine treatment increased, the risk of complicated disease.

Asthmatic Versus Non-Allergic Children in Relation to The Presence of Cow Milk Protein

Background: Cow’s milk allergy is among the most frequent food allergies in young children and one of the risk factors of asthma. Objective: The study aimed to assess the role of Cow’s milk allergy (CMA) to induce asthma and to study the effect cow milk protein on asthmatic and non-allergic children to prevent occurrence of asthma among children. Patients and methods: A case-control study that was carried out in Pulmonology Unit of Pediatric Department, Faculty of Medicine, Zagazig University Hospital. The patients were investigated at Medical Community and Immunology Department. The study included 154 child divided equally into two groups. Group A included patients with bronchial asthma and group B (control) included age- and sex-matched healthy individuals. Iinvestigations: complete blood picture, renal and liver function tests, skin prick test, total immunoglobulin (IgE) was done for all participants. Results: There was high statistically significant difference between the two studied groups as regards skin pick test. There was statistically significant increase in the levels of both total and specific Ig E in allergic group compared to control group. There was high significant increase in the severity recorded in respiratory function test in allergic group compared to control group. There was non-significant difference between the two groups regarding GIT manifestation. There was high statistically significant difference between the two groups regarding skin and respiratory manifestations. Conclusion: CMA can exacerbate the symptoms in children with asthma. Therefore, it is worth considering a possible role of food allergy in asthma in young children, particularly when asthma is not adequately controlled in spite of proper routine management.