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Interview with Montserrat Alvaro Lozano, Barcelona University
Montserrat Alvaro Lozano discusses the status of food allergy and immunotherapy in pediatrics “"There are many food allergic children who have the risk of |
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Section reports
Pediatric section report June 2020
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Training and certifications in Pediatric Allergology
Please find here more information on:
European accreditation of Pediatric Allergology Training Centres
Certification as European Specialist in Pediatric Allergology
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Task Forces
Food immunotherapy practice in Europe (FIND project)
Food allergy is a worldwide pandemic where the standard treatment is limited to avoidance or rescue medication in cases of accidental exposure. In the last decade, scientists developed a promising treatment called food immunotherapy. This is the first food allergy treatment that ameliorates the reactions´ severity or in some cases even allows the patient to incorporate the culprit food into his/her diet. However, this treatment is still being researched and is only being used regularly in some European countries. EAACI believes it should be used in highly specialized centres for daily care across Europe. Therefore, this task force aims to analyse the countries where food immunotherapy is becoming a standard treatment to provide a comprehensive recommendation in terms of facilities, patient selection and treatment characteristics to other countries. The goal is to provide a solid recommendation basis to facilitate the implementation of food immunotherapy as a treatment across Europe.
Chair: Pablo Rodriguez del Rio
Secretary: Montserrat Alvaro
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Allergic diseases in adolescents and young people
Although adolescents and young people are regarded as a healthy age group, death rates due to food allergy reactions and asthma are highest at this age. Furthermore, healthcare resources are not focused on this age group although this is a critical period for the development of allergic diseases. Besides being life threatening, allergic diseases such as allergic rhinitis and atopic dermatitis can impair work and school performances and negatively impact quality of life, self-esteem and identity in young people.
Although adolescents and young people are regarded as a healthy age group, death rates due to food allergy reactions and asthma are highest at this age. Furthermore, healthcare resources are not focused on this age group although this is a critical period for the development of allergic diseases. Besides being life threatening, allergic diseases such as allergic rhinitis and atopic dermatitis can impair work and school performances and negatively impact quality of life, self-esteem and identity in young people.
The aim of this task force is to focus on this age group and seek to determine the particular features of these allergic diseases, including their challenges, specific needs and efficient management strategies. This will allow the task force to produce clear recommendations to optimise healthcare for this critical age, as well as to identify unmet needs and pinpoint further required efforts in the field.
Chair: Graham Roberts
Secretary: Marta Vazquez Ortiz
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Clinical outcomes of efficacy in food allergen immunotherapy trials
Food allergy represents a prevalent disease, affecting around 8% of European children and 2-5% of adults. Standard treatment is based upon avoidance and the use of rescue medication in case of accidental exposure to the trigger. For the last decades, but especially in the last 10 years, important advances have been made in order to provide an etiological treatment to treat this disease. All these treatments, so called food immunotherapy, aim first at protecting the patient by increasing his/her reactivity threshold, and in some cases, patients are even allowed to introduce these foods (mostly milk, egg and peanut) freely in their diets. All these advances are being achieved thanks to the effort of both Academia and Industry by conducting large food immunotherapy trials to provide evidence of its efficacy. However, the way efficacy is measured significantly varies from study to study, limiting the chances to make direct comparisons, and thus, potentially selecting the most suitable for each candidate in the future if these become available.
Food allergy represents a prevalent disease, affecting around 8% of European children and 2-5% of adults. Standard treatment is based upon avoidance and the use of rescue medication in case of accidental exposure to the trigger. For the last decades, but especially in the last 10 years, important advances have been made in order to provide an etiological treatment to treat this disease. All these treatments, so called food immunotherapy, aim first at protecting the patient by increasing his/her reactivity threshold, and in some cases, patients are even allowed to introduce these foods (mostly milk, egg and peanut) freely in their diets. All these advances are being achieved thanks to the effort of both Academia and Industry by conducting large food immunotherapy trials to provide evidence of its efficacy. However, the way efficacy is measured significantly varies from study to study, limiting the chances to make direct comparisons, and thus, potentially selecting the most suitable for each candidate in the future if these become available.
The aim of the current task force is to evaluate all clinical variables of efficacy used in food immunotherapy trials, and try to make recommendations on the convenience of using each of them. Eventually, the team might be able to make recommendations for the selection of this variables in future immunotherapy trials.
Chair: Pablo Rodriguez del Rio
Secretary: Montserrat Fernandez Rivas
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Targeting the skin barrier in atopic dermatitis
There is a strong need to identify new management approaches for the prevention of atopic dermatitis (AD), due to its substantial burden on patients’ quality of life and health-care resources. In addition, AD is associated with higher risk of developing other atopic diseases. Increasing evidence suggests that skin barrier abnormalities play an essential role in initiation of early AD. The difficulties to target the underlying immune dysregulation, put forward the potential for early interventional approaches targeting skin repair. The aim of this task force is to provide evidence on whether the daily use of topical treatments soon after birth (before the onset of AD) and for the first months of life could reduce the occurrence of AD and/or its severity, thus representing a low cost, easy to apply, safe and effective approach for the primary prevention of AD and atopic march, at least in some phenotypes.
Chair: Elena Galli
Secretary: Pasquale Comberiati
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Chronic urticaria in children
Chronic Urticaria in Children (CU-Kids) Task Force: we are establishing a research and clinical network for the optimal, evidence-based diagnosis and management of CU in children. This is taskforce is led by the paediatric section and clinicians who see children with CU. We comprise several relevant stakeholders from dermatology, allergy, primary care, research, immunology, epidemiology, pharmacology, biologicals prescribers, the junior section, patient representation and (through clinical networking, specialist nurses and a pharmacist). We have begun to:
identify clinical centres and colleagues who treat children with urticaria, including attendance at CU focus meetings nationally and internationally. Increase the expertise of participants for research and talks on CU in children, especially with regards to difficult to manage CU and the use of biologicals in the younger age groups:
- several members of the taskforce are involved in clinical audit and service improvement work, and new research involving the medical and supportive management of children with CU across Europe
- develop on the online survey of current clinical practice, needs and recommendations to formulate a report
- plan an EAACI position paper on CU in children for the next taskforce application
Chair: Sophia Tsabouri
Secretary: Tabi Leslie
Non-IgE mediated allergy
The “Exploring non-IgE mediated Allergy” (ENIGMA) Task Force in an established task force, that has been working on areas that have been poorly defined/explored in non-IgE mediated food allergies for the last 2 years. The ENIGMA task force is the only multidisciplinary EU-based group consisting of world-renowned allergist, gastroenterologist, dietitians and psychologist to take on the challenging task of trying to come up with practical (evidence based) guidance on diagnosis and management of this delayed food allergy. This Task Force has filled an essential gap in EAACI and also in the world allergy environment, where non-IgE mediated food allergy, outside of EoE (covered by a separate Task force) remains poorly understood and diagnosis and management guidance is limited. The rational for this group has been to review current literature, produce guidance documents for clinical use and improve knowledge through teaching in this area. The group has already had a publication accepted on non-IgE mediated food allergies in breastfed children, which the ENIGMA Task Force hopes will lead to improving the diagnosis and management of this condition in breastfed children.
Chair: Rosan Meyer
Secretary: Carina Venter
Last updated 02 June 2020