Bibliographic updates

The Monthly Choice
May 2015
Prof. Claude MOLINA - Dr Jacques GAYRAUD

Genetics and Allergy in 2015

1. Prediction of Atopic dermatitis in infants before leaving maternity ward
2. Cow’s Milk Allergy in Children and contact urticaria to Milk
3. Dog and cat exposure and respective pet allergy in early childhood
4. Diagnostic and experimental food challenges in adult patients with non-immediate reactions to food : role of enhancers  
5. Sensitization and Clinical allergy to peanut. Respective part of specific IgE and IgG4.

1.   Prediction of Atopic Dermatitis (AD) in infants before leaving maternity ward 
M.Kelleher et al  JACI  2015  135  930-5

Item: Paediatrics allergy – Skin allergy
Key words: Atopic dermatitis – Trans-epidermal water loss - Fillagrin

Impairment of the skin barrier function by trans-epidermal water loss measurement at birth and at 2 months predicts the development of AD at 1 year, effect independent of parental atopy of child Filaggrin mutation status. These findings have implications for the optimal timing of interventions for the prevention of AD.

2.   Cow’s Milk Allergy (CMA) in Children and contact urticaria to Milk
V.Scichter-Confino et al  Ped.All.Imm :2015 26 3 218-222
Item: Paediatrics allergy – Skin allergy
Key words: Milk allergy – Contact urticaria – Finger test -

CMA is the most common Food Allergy in infancy, generally triggered through ingestion (and in majority IgE mediated) but also through skin contact. The authors showed that the finger test (applied on the cheek by a physician finger), detects contact urticaria which exists only in patients with IgE mediated CMA. The finger test should be part of the evaluation of CMA patients and its positivity suggests the potential for multiple food allergy, especially to sesame and egg.

3.   Dog and cat exposure and respective pet allergy in early childhood
K.Pyrhonen et al Ped.All.Immun 2015 26  3  247-255
Item: Paediatrics allergy – Pet allergy
Key words: Cat, dog allergy – Early exposure to allergen – Allergy prediction.

In a nationwide population-based study (South Karelia Finland) early exposure to dog and cat at home was associated with a higher incidence of respective pet allergy (more for cats than for dogs) during the first four years of life. These results were independent of parent’s allergies.  However further evidence with longer follow-up is required to justify any recommendation, concerning early pet contacts with a view to preventing pet allergies later in life.

4.   Diagnostic and experimental food challenges in adult patients with non immediate reactions to food : role of enhancers
K.Brocow et al JACI 2015 135 4 977-9
A.Tripathi et al  JACI 2015 135 4 985-987
Item: Food allergy
Key words: Non immediate reaction to food – Provocation test – Enhancers: alcohol, exercise, aspirin.
                  
The first article provides evidence that an oral gluten challenge protocol, alone or associated with aspirin or alcohol improve the diagnosis in wheat -dependent exercise induced anaphylaxis.The second paper underlines the role of the co-factors: exercise, aspirin, alcohol as “enhancers” of  challenge positivity in non immediate food allergy (for example delayed urticaria or anaphylaxis after eating red meat or pork kidney).

5.   Sensitization and Clinical allergy to peanut. Respective part of specific IgE and IgG4.
A.F.Santos et al/ JACI 2015 135 1249-56 :   
Item: Food allergy
Key words: Peanut – Sensitization – Allergy – IgE – IgG4

Most children with detectable peanut specific IgE are not allergic although sensitized (with or not positive prick-test). Differences in IgE levels may partially explain these two phenotypes. In this study, the authors show that levels of IgE are significantly higher in Peanut Allergic patients (PA) than in  Peanut-Sensitized patients (PS). Moreover Specific IgG4 acts as IgE inhibitors in the serum of PS patients and in activation of basophil and mast cell of these patients as well in patients submitted to oral immunotherapy (POIT). Furthermore depletion of IgG4 from plasma of Children with PS and POIT partially restore mast cell activation. Future studies will explore  clinical implications of these findings.

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Last updated 14 July 2015