Severe reactions after the intake of soy drink in birch pollen-allergic children sensitized to Gly m 4

Aim: To study the connection between reaction to soy milk and IgE sensitization to Gly m 4. Methods: Four subjects who experienced unforeseen and severe symptoms after the ingestion of soymilk were studied. Results: All children were birch pollen allergic, had high IgE responses to the PR‐10 proteins from birch and soybean, Bet v 1 and Gly m 4. All reactions took place after the ingestion of soymilk during the peak pollen season. Conclusion: This is the first time soybean‐dependant pollen‐food cross‐reaction has been reported in children experiencing reactions during the birch pollen season. These findings may well be helpful to doctors in identifying individuals at risk of severe reactions upon the ingestion of soymilk, and we foresee an increase in the number of similar cases as soy drinks are promoted for health purposes.     

Latex type I sensitization and allergy in children with atopic dermatitis. Evaluation of cross‐reactivity to some foods

Recent studies have demonstrated that allergy to natural rubber latex (NRL) is associated with cross-reactivity to certain foods. The aim of this study was to investigate the prevalence of NRL sensitization and allergy in children with atopic dermatitis (n=74). We also examined cross-reactions between latex and foods, and compared the frequency of suspected latex cross-reacting fruits in children with and without NRL-specific immunoglobulin E (IgE). Twelve of the 74 atopic children studied (16.2%; 95% confidence interval (CI), 8.7–26.6%) had circulating IgE antibodies to latex. These NRL-sensitized children were older and they showed significantly higher total IgE values (p<0.003) when compared with the group of children without NRL sensitization. Of the specific food IgE evaluations, 18.4% (93 out of 505) were positive, and 69.9% were observed in the group of children with latex-specific IgE, most frequently to potato, tomato, sweet pepper, and avocado. An isolated latex-specific IgE response without food-specific IgE was never observed. Exclusively in the latex-positive group, conformity with the report of allergic symptoms after ingestion of food and increased food-specific IgE was found. Twenty children without proven latex sensitization showed increased food-specific IgE, most frequently to potato, banana, and chestnut. Avocado-specific IgE was never determined in this patient group. No significant differences were detected concerning the sensitization to potato, banana, and kiwi between NRL-sensitized children and the group of 20 children without latex-specific IgE. The competitive CAP inhibition using sera from children with specific IgE to both latex and food showed different cross-reactivities between latex and the specific food. A close relationship existed between latex and avocado (median inhibition: 100%), whereas sensitization to latex and kiwi seemed to be independent in our study group (inhibition: <25%). In particular, for potato, cross-reactivity and co-sensitization existed. Our study demonstrated that children with atopic dermatitis are a high-risk group for latex sensitization. Increasing age, additional sensitization to ubiquitous inhaled allergens, and enhanced total serum IgE values seemed to be important variables for latex sensitization and further sensitization to the latex-associated foods. Cross-reactivity and, in some cases, co-sensitization to specific fruits and vegetables, were observed.     

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??Oral allergy syndrome??OAS?? is an IgE-mediated acute oropharyngeal hypersensitivity to food??which is caused by cross-reactivity between proteins in fresh fruits or vegetables and pollens??with a prevalence of 5% to 24 % in children. A variety of food protein antigens have been implicated in OAS. The most classic of these cross-reactive antigens include birch antigen Betv1??profilin and lipid transfer proteins??LTPs??. Symptoms are usually manifested as numbness??itching or swelling of the lips or mouth??itching or oedema of the lips?? throat??palate or gingiva??erythema of the face and tightness of the throat. OAS can be diagnosed based on clinical history??antigen-specific immunoglobulin E testing??skin prick testing and oral food challenge. If the diagnosis is established??patients should be instructed to avoid the fresh fruits and vegetables that cause symptoms??and emergency administration of epinephrine should be given for severe??generalized reactions.     

Soluble CD30 serum levels in atopic dermatitis and bronchial asthma and its relationship with disease severity in pediatric age

CD30 is a transmembrane molecule that may be expressed on a proportion of activated T-lymphocytes and has been reported to be a marker of Th2 phenotype. A soluble form of CD30 (sCD30) is released by CD30+ cells in vivo. Our objective was to evaluate serum sCD30 levels in children with atopic dermatitis (AD) or bronchial asthma and to investigate its relation to disease severity. This study included of 60 infants and children, of whom 18 had AD, 22 had bronchial asthma and 20 were healthy matched subjects. Severity of AD was assessed according to the objective Scoring Atopic Dermatitis (obj-SCORAD) index. Laboratory investigations included complete blood count, serum total immunoglobulin E (IgE) and serum sCD30 by ELISA. Serum levels of sCD30 in AD (77.7+/-27.9 U/ml) and asthmatic patients (49.2+/-21.5 U/ml) were significantly increased compared with the control group (18.2+/-7.0 U/ml) (t=8.8, p<0.0001; t=6.4, p<0.0001, respectively). In patients with AD, sCD30 levels were shown to correlate with obj-SCORAD (r=0.96, p<0.0001). Patients with moderate persistent asthma had significantly elevated sCD30 levels than those with mild persistent asthma (t=3.4, p<0.01). In addition, sCD30 was inversely correlated to peak expiratory flow rate (r=-0.78, p<0.0001). Levels of sCD30 did not correlate with age, disease duration or serum total IgE (p>0.05). In conclusion, serum sCD30 levels correlate with the severity of AD and bronchial asthma. It appears to be an additional objective marker that may be useful for follow up and may help to improve research and management of these diseases.     

Cytokine profile of food‐allergic post‐liver transplant children is identified by high levels of IL‐5 and low IL‐10 secretion from patients' peripheral blood mononuclear cells

Severe allergic reaction to food following liver transplantation is a well‐known phenomenon. However, the mechanisms underlying this phenomenon are not yet elucidated. This study aimed to reveal the nature of the immune response in post‐transplanted allergic patients and compare them to non‐allergic transplanted as well as allergic and non‐allergic control subjects, with focus on cytokine milieu. Post‐liver transplant patients with and without allergic reactions as well as food‐allergic but otherwise healthy and healthy non‐allergic control patients were recruited. We reviewed patient records and routine laboratory tests and assayed subjects' PBMCs, studying cytokine secretion profile in response to different stimuli. Post‐transplant patients with food allergy showed a unique cytokine profile in response to various stimuli, with extremely elevated IL‐5, low IL‐10 secretion, and somewhat higher IFN‐γ. T regulatory cell number was not significantly different among the groups of patients and controls. Immune response of food‐allergic post‐liver transplant patients is identified by a unique cytokine profile when compared to allergic but otherwise healthy individuals.     

Age-dependent changes of serum soluble CD30 concentration in children

CD30 was originally described as a marker on Reed-Sternberg cells in Hodgkin lymphoma. The extracellular portion of CD30 is proteolytically cleaved from CD30+ cells, to produce a soluble form of the molecule (sCD30) detectable in serum. Measurement of sCD30 concentration in serum has been suggested to be a potential tool in monitoring of inflammatory status in variety of diseases. Several investigators reported the relevance for sCD30 as a predictive marker for allograft rejection following organ transplantation. The aim of the study was to verify whether sCD30 serum concentrations may be affected by an age in healthy children. Heparinized venous blood was taken from 78 healthy children. For the analysis of sCD30 levels, the commercially available sCD30 ELISA was used. The sCD30 was detected in all serum samples and concentrations ranged from 6.75 to 68.07ng/mL. The statistical analysis of all individuals showed that sCD30 concentration was significantly age depended (r=-0.618, p<0.0001). When sCD30 concentrations were analyzed in regard to gender, no significant differences were identified in age subgroups.     

Serum levels of interleukin 4 and soluble CD23 in children with allergic disorders

In order to clarify the clinical significance of serum interleukin 4 (IL-4) levels, we measured serum IL-4 concentrations in allergic and non-allergic children using a highly sensitive sandwich ELISA. The limit of detection of the assay was 0.15 pg/ml in serum samples. Serum IL-4 was detected in 96.3% (53/55) of non-allergic controls, in 92.9% (183/197) of allergic children, in 70% (7/10) of cord blood samples and in 86.7% (26/30) of neonates. The IL-4 levels in sera from non-allergic controls were relatively constant during the ages examined and all samples were under 1.5 pg/ml. In allergic children, the serum levels of IL-4 were significantly elevated, particularly at age 13-24 months. The serum levels of IL-4 did not differ in children with different clinical manifestations of allergy, such as bronchial asthma, and atopic dermatitis. The serum level of soluble CD23 (sCD23) showed an age-dependent change in allergic and non-allergic children and was significantly higher in allergic than in non-allergic infants aged 7 to 12 months, but not in other age groups. There was no significant correlation among serum levels of IL-4, sCD23 and IgE.     

Association of serum-soluble CD26 and CD30 levels with asthma, lung function and bronchial hyper-responsiveness at school age

Aim: There is a need for markers of Th1 and Th2 imbalance in diseases such as asthma. CD30 is an activation marker of Th2 cells, and importance of Th1 marker CD26 was recently found in adult asthma. We studied whether serum‐soluble CD30 (sCD30) or serum‐soluble CD26 (sCD26) could support early diagnosis of asthma in children at school age. Methods: sCD26 and sCD30 were measured in 34 children with clinically confirmed asthma, 31 with possible asthma and in 147 controls. In addition, the associations of flow volume spirometry, methacholine inhalation challenge and free running test results with serum sCD26 or sCD30 were analysed. Results: Serum sCD30 was significantly higher in children with confirmed asthma (mean 91.5 IU/mL, SD 23.0) than in the controls (78.8 IU/mL, 25.9; p = 0.042). No significant differences were found in serum sCD26 levels between the groups. There was a negative correlation of mean mid expiratory flow values with serum sCD26 (r = ?0.22, p = 0.0018). Neither methacholine inhalation challenge nor free running test results were associated with serum sCD26 or sCD30. Conclusion: Serum sCD30 was higher in children with asthma. However, marked overlap in serum sCD30 between asthmatic and healthy children limits the usefulness of sCD30 as a diagnostic marker of asthma.     

Cytokine levels in healthy and allergic mothers and their children during the first year of life

To assess the regulatory changes of immune system in children genetically pre-disposed to allergic diseases and in their mothers, we tested cytokines IL-4, IL-5, IL-6, IL-10, IL-13, IFN- γ and TGF- β in 21 healthy and 21 allergic mothers (serum at the time of delivery, colostrum and milk throughout the suckling period) and their children (cord blood, venous blood and stool filtrates) up to 1 yr of age. Samples were taken at the time of delivery, 4 days post-partum and then after 3, 6 and 12 months. Significant differences between the healthy and the allergic group were found in the levels of IL-4, IL-10, IL-13 and IFN- γ . The levels of IL-4 in the allergic group were generally higher; the levels in the sera of children of allergic mothers during the post-natal life decreased, reaching levels typical for the healthy group at 1 yr of age. Allergic mothers exhibited markedly higher IL-10 levels in the serum at the time of delivery and in milk 3 months after delivery than healthy mothers while after 6 months the IL-10 levels in all samples from the allergic group were very low. Children from allergic group had lower intestinal content of IL-13 in comparison with the healthy counterparts. At 1 yr of age, the levels of IFN- γ in sera and stool of children from the allergic group sharply increased. TGF- β levels in the sera of both groups were high, while in the milk they were relatively low and substantially lower that in the children's stool. TGF- β of mammary secretions is therefore unlikely to exert a decisive regulatory influence on the children's immunity. Long-term clinical monitoring of the children will be performed to evaluate the potential prognostic significance of these changes for the future development of allergies.     

哮喘患儿血清IL 12 TGFβ1 与IgE 水平变化的研究

目的：检测哮喘患儿不同病期的白细胞介素12 ( IL-12) 、转化生长因子β1 ( TGFβ1 ) 与免疫球蛋白E( IgE) 水平变化的规律,并探讨不同病期IL-12,TGFβ1水平与IgE水平的相关性,据此阐述它们在哮喘中的临床意义。方法：采用ELISA 方法检测85例哮喘患儿及30例正常儿童的血清IL-12,TGFβ1与总IgE 水平。结果：哮喘组血清IL-12,TGFβ1水平明显低于对照组,而IgE 水平则哮喘组明显高于对照组,且发作期IL-12,TGFβ1 水平（28.42±10.73 ng/L,40.25±11.73 pg/mL）明显低于缓解期（40.42±15.26 ng/L,65.41±22.38 pg/mL）,差异有显著性 (P< 0. 01),缓解期血清IL-12,TGFβ1 水平明显低于对照组（67.42±20.58 ng/L,178.54±90.56 pg/mL）,差异有显著性(P<0.01),发作期血清IgE 水平（280.35±80.54 IU/mL）明显高于缓解期（145.67±51.25 IU/mL）, 差异有显著性(P< 0.01), 缓解期血清IgE 水平明显高于对照组（53.61±13.32 IU/mL）, 差异有显著性(P<0.01),哮喘患儿血清IL-12,TGFβ1水平与IgE呈负相关(P< 0.01)。结论：哮喘患儿存在IL-12,TGFβ1及IgE 水平失衡,提示IL-12,TGFβ1 在哮喘的发病中起着重要作用,检测它们的水平可为哮喘的诊断及判断病情提供依据。     

Clinical pharmacology of the H1‐receptor antagonists cetirizine and loratadine in children

H₁‐receptor antagonists are widely used in children but are not as well‐studied in children as they are in adults. Our objective was to determine the onset and duration of action and the relative potency of the H₁‐receptor antagonists cetirizine and loratadine in children. We performed a prospective, randomized, placebo‐controlled, double‐blind, crossover, single‐dose study of cetirizine and loratadine using suppression of the histamine‐induced wheal and flare as the primary outcome. In 15 allergic children, mean age 9 years, compared with baseline, cetirizine (10 mg) suppressed the wheals and flares significantly from 0.25 to 24 h, achieving nearly 100% of flare suppression from 2 to 24 h, inclusive, and loratadine (10 mg) suppressed the wheals and flares significantly from 0.75 to 24 h, inclusive. Cetirizine suppressed the wheals and flares significantly more than loratadine from 0.25 to 1 h, inclusive, and at 0.5, 1, 2, 3, 5, 6, 7, and 24 h, respectively. Placebo also suppressed the wheal and flare significantly at some assessment times. Cetirizine and loratadine both have excellent antihistaminic activity in children, with a rapid onset of action and a 24‐h duration of action in this population.     

Expression of and responses to CD2 and CD3 in 18‐month‐old children with and without atopic dermatitis

We hypothesize that atopy is associated with a reduced T‐cell function early in life and an imbalance in cytokine production. The purpose of this study was to investigate the expression of and responses to CD2 and CD3 in children who did or did not develop atopic dermatitis early in life. The expression of CD2 and CD3 was analyzed by flow cytometry, and proliferation of CD2 and CD3 was studied by ³H‐thymidine incorporation in phytohaemagglutinin (PHA)‐ and anti‐CD3‐stimulated peripheral blood mononuclear cells (PBMC) of 18‐month‐old children, 25 with and 29 without atopic dermatitis. Exogenous interleukin (IL)‐2 was added to compensate for possible functional differences in accessory cells. Anti‐CD3‐induced secretion of IL‐4, IL‐5, IL‐6, IL‐10, IL‐13, and interferon‐γ (IFN‐γ) was analyzed by enzyme‐linked immunosorbent assay (ELISA). Atopy was associated with a low proportion of CD2⁺ lymphocytes. Responsiveness to PHA, which activates lymphocytes partly via the sheep erythrocyte receptor, CD2, was reduced in the allergic children. The anti‐CD3‐induced proliferation declined more rapidly with antibody dilution in the allergic than in the non‐allergic children. Atopic dermatitis was associated with high levels of anti‐CD3‐stimulated IL‐5 secretion. The IL‐4/IL‐10 and IL‐4/IFN‐γ ratios were higher in children with elevated total immunoglobulin E (IgE) levels. Skin prick test‐negative children with eczema produced higher levels of IL‐10 than skin prick test‐positive children. In conclusion, atopic children have a reduced T‐cell function. Atopic dermatitis is associated with increased IL‐5 production, while high total IgE levels are associated with high IL‐4/IFN‐γ and IL‐4/IL‐10 ratios.     

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??Abdominal pain is a common symptom of food allergy. It may be the main symptom of some diseases of digestive system?? such as infant colic. It may be accompany symptom of some diseases?? such as eosinophilic gastroenteritis?? or it is a manifestation of systemic disease?? such as anaphylaxis. Oral tolerance development?? bacterial intestinal microflora?? intestinal barrier function?? transepithelial transport of food antigens?? eosinophil recruitment in the gastrointestinal tract?? and effect of food allergens on gastrointestinal motility are the contribution to pathophysiology of gastrointestinal food allergy.