Aneta Krogulska

FOXP3, IL-10, and TGF-β genes expression in children with IgE-dependent food allergy.

BackgroundRegulatory T cells (Tregs) have an essential role in tolerance and immune regulation. However, few and controversial data have been published to date on the role and number of these cells in food allergic children. The forkhead/winged-helix transcription factor box protein 3 (FOXP3) is considered the most reliable marker for Tregs.ObjectiveThis study aims to investigate the FOXP3, interleukin (IL)-10, and transforming growth factor (TGF-β) genes expression in children with IgE-dependent food allergy.Material and MethodsThe study group consisted of 54 children with IgE-dependent food allergy (FA) and a control group of 26 non-atopic healthy children. The diagnosis of FA was established using questionnaires, clinical criteria, skin prick tests, serum sIgE antibodies (UniCAP 100 Pharmacia Upjohn), and a double-blind placebo control food challenge. In order to assess gene expression, the isolation of nucleated cells was performed using Histopaque-1077 (Sigma-Aldrich, Germany). The concentration of RNA obtained was measured using a super-sensitive NanoDrop ND1000 spectrophotometer (Thermo Scientific, USA). A reverse transcription reaction was performed using a commercially available set of High Capacity cDNA Archive Kit (Applied Biosystems, USA). Analysis have been carried out in the genetic analyzer 7900HT Real-Time PCR (Applied Biosystems, USA).ResultsThe average level of the FOXP3 gene expression in the studied group was 2.19 ± 1.16 and in the control group 2.88 ± 1.66 (p = 0.03). The average level of IL10 mRNA expression in the study group was 13.6 ± 1.07 and was significantly lower than corresponding values in the control group 14.3 ± 1.1 (p = 0.01). There were no significant differences in the average level of the TGF-β mRNA expression in the study group (3.4 ± 0.4) and controls (3.5 ± 0.3; p > 0.05). The FOXP3 gene expression was the highest in children who acquired tolerance to food (3.54 ± 0.75), lower in heated allergen-tolerant children (2.43 ± 0.81), and the lowest in heated allergen-reactive children (1.18 ± 0.5; p = 0.001 control vs heated allergen reactive; p = 0.005 heated allergen tolerant vs heated allergen reactive; p = 0.001 outgrown vs heated allergen reactive). The significant tendency toward lower total IgE levels with a higher FOXP3 mRNA expression was detected (n = 54; Pearson r = −0.4393; p = 0.001).ConclusionsChildren with FA showed statistically significant lower level of the FOXP3 and IL10 gene expression than healthy children. Children acquiring tolerance to the food show significantly higher levels of the FOXP3 gene expression than children with active FA. The correlation between the level of FOXP3 and total IgE was detected.

Bronchial reactivity in schoolchildren allergic to food

BACKGROUND Food allergy (FA) is associated with an increased risk of asthma. OBJECTIVE To evaluate whether bronchial hyperreactivity (BHR) occurs in children with FA depending on the presence of respiratory symptoms. METHODS Fifty-four children with FA and 62 without FA were studied for BHR, defined as a provocation concentration of methacholine that caused a decrease in forced expiratory volume in 1 second of 20% (PC20). The diagnosis of FA was established using questionnaires, clinical criteria, skin prick tests, serum specific IgE antibodies, and a double-blind placebo-controlled food challenge. RESULTS Among nonasthmatic children, BHR was diagnosed in 15 (47%) with FA and in 7 (17%) without FA (P < .005); BHR was demonstrated in 7 children (41%) with FA alone. All the patients with asthma with or without FA had BHR. The mean (SD) PC20 in children with FA alone was 2.8 [1.38] mg/mL and was significantly higher than that in children with asthma alone (0.88 [1.01] mg/mL) or with asthma and FA (0.96 [0.83] mg/mL) (P < .001). BHR was detected in 5 children (36%) with a mild anaphylactic reaction provoked by food, in 23 (74%) with a moderate reaction, and in all the children with a severe reaction. CONCLUSIONS Children with FA had increased BHR independent of respiratory symptoms. Although BHR occurs in asymptomatic children with FA, its course is milder than that in children with FA and asthma. Factors that determine BHR prevalence in children with FA are similar to those in children without FA.

Prevalence and clinical impact of IgE-mediated food allergy in school children with asthma: a double-blind placebo-controlled food challenge study.

Purpose Recent studies indirectly suggest a possible link between food allergy (FA) and asthma. Most of them have evaluated the occurrence of FA in asthmatic children, especially in the first year of life, using questionnaire-based studies or specific IgE (sIgE) assay. The aim of this study was to evaluate the prevalence and clinical impact of IgE-mediated FA in school children with asthma using a double-blind placebo-controlled food challenge (DBPCFC). Methods The study group consisted of school children with atopic asthma who were admitted to the Department of Pediatric Allergology, Gastroenterology and Nutrition, Medical University of Lodz, for the evaluation of food hypersensitivity. The diagnosis of FA was established using questionnaires, sIgE analysis, and the DBPCFC. Asthma severity and asthma control state were also assessed. Results A relationship between consumed food and complaints was reported in 180 children (49.7%). Seventy children (19.3%) were sensitized to food allergens. IgE-mediated FA was confirmed in 24 children (6.6%), while 11 children (3%) demonstrated respiratory symptoms. Food-induced asthma exacerbations were observed in 9 patients (2.5%). Statistically significant differences in the prevalence of atopic dermatitis (P<0.002), urticaria (P<0.03), digestive symptoms (P<0.03), rhinitis (P<0.02), sIgE level (P<0.001), positive family history of atopy (P<0.001) and FA in history (P<0.001) were found between asthmatic children with FA and those without. Children with food-induced asthma exacerbations demonstrated significantly greater severity, poorer controls, and worse morbidity compared to those without. Conclusions Although food-induced respiratory reactions in children with asthma were rare, they were classified as severe and associated with worse morbidity, greater severity, and poorer control. As the most commonly observed symptoms were coughing and rhinitis, which can be easily misdiagnosed, a proper diagnosis is essential for improving the management of both clinical conditions.

The impact of food allergens on airway responsiveness in schoolchildren with asthma: A DBPCFC study

Despite the growing evidence of a possible link between asthma and food allergy (FA), so far, the involvement of food in inducing respiratory symptoms has not been fully evaluated. The objective of this study was to evaluate the impact of food allergens on respiratory symptoms and bronchial reactivity (BHR) in schoolchildren with asthma.

Evaluation of Receptor Expression on Immune System Cells in the Peripheral Blood of Asthmatic Children Undergoing Food Challenges

Background: The role of food allergens in the induction of allergic reactions in the airways is not completely understood. The aim of the present study was to evaluate fluorocytometric assays of the peripheral blood during food challenge tests in children with asthma and food allergy. Patients and Methods: 22 children with asthma and concomitant food allergy and 18 children with asthma without food allergy participated in the study. Oral challenge tests were performed using double-blind, placebo-controlled food challenge. Blood samples were collected before and 4 and 24 h after the challenge. CD25 and CD23 antigen expression was determined with monoclonal antibodies using a FACSCalibur flow. Results: The evaluation of the CD25+ T subpopulation and CD19+CD23+ B lymphocytes revealed statistically significant differences between the study group and the control group. In children with asthma and food allergy, the cell pool consisted (on average) of 9 ± 2.8% of CD3+CD25+ cells before the challenge and of 10.3 ± 3.8% (mean delta: 1.623; p = 0.01) after the provocation. However, placebo challenge did not significantly change the number of this T-lymphocyte subpopulation (mean delta: –0.121; p > 0.05). The highest increase in the CD25+ T-subpopulation expression was found in patients with respiratory reactions during the positive food challenge (mean delta: 4.065; p < 0.004). Conclusions: An increase in CD25+ T-lymphocyte and CD23 B-lymphocyte populations after food allergen challenge may indicate their significant role in the pathogenesis of the active phase of the immunoinflammatory process in children with asthma and concomitant food allergy.

Atopowe testy płatkowe, punktowe testy skórne i swoiste IgE w diagnostyce alergii pokarmowej u dzieci z atopowym zapaleniem skóry☆☆☆

Wprowadzenie Alergeny pokarmowe mogą odgrywac istotną role w zaostrzeniach i podtrzymywaniu zmian skornych u dzieci z atopowym zapaleniem skory. Wydaje sie, ze atopowe testy platkowe z alergenami pokarmowymi mogą byc przydatne w ustalaniu uczulającego pokarmu, co moze prowadzic do poprawy efektow leczenia. Cel Ocena znaczenia atopowych testow platkowych z alergenami pokarmowymi u dzieci z atopowym zapaleniem skory i podejrzeniem wspolistniejącej alergii pokarmowej. Material i metody Badaniami objeto 80 dzieci (w wieku 6 miesiecy–18 lat) z atopowym zapaleniem skory. W metodzie badawczej zastosowano: badanie kwestionariuszowe, ocene IgE swoistych metodą UniCAP 100, atopowe testy platkowe z alergenami pokarmowymi, z zastosowaniem Finn Chambers firmy Chemotechnique Diagnostics, proby prowokacyjne metodą otwartą i podwojnie ślepą kontrolowaną placebo. Wyniki Spośrod 80 dzieci niepoządane reakcje na pokarmy zgloszono u 46, tj. 57,5% dzieci. Dodatnie wyniki SPT z alergenami pokarmowymi uzyskano u 25 (31,3%) dzieci. Obecnośc swoistych IgE stwierdzono u 36 (45%) dzieci. Dodatnie wyniki atopowych testow platkowych z alergenami: mleka krowiego, jajka i mąki pszennej, uzyskano u 18 (22,5%) dzieci. Probom prowokacyjnym poddano 55 (68,7%) dzieci, u ktorych wysunieto podejrzenie alergii pokarmowej. U 20 (25%) dzieci uzyskano dodatni wynik proby prowokacyjnej. Swoistośc APT dla mleka −87,5%, a dla jajka −91%. Poźna faza reakcji w probach prowokacyjnych byla związana z dodatnimi wynikami testow platkowych (p Wnioski Alergie pokarmową rozpoznano u 25% dzieci z atopowym zapaleniem skory. Atopowe testy platkowe z alergenami pokarmowymi mogą stanowic istotną dodatkową metode diagnostyczną w weryfikacji alergii pokarmowej u dzieci z atopowym zapaleniem skory.

The diagnosis and management of food allergies. Position paper of the Food Allergy Section the Polish Society of Allergology

The paper concerns the current position of the Polish Society of Allergology Food Allergy Section on the diagnosis and management of food allergies. The aim of this position is to provide evidence-based recommendations on the diagnosis and management of patients with allergic hypersensitivity to foods. This position statement includes a systematic review of studies in three areas, namely, the epidemiology, diagnosis and management of food allergies. While taking into account the specific Polish setting, in this publication we also used the current European Academy of Allergy and Clinical Immunology (EAACI) position paper and other current position statements, including those of the United States National Institute of Allergy and Infectious Diseases (NIAID).

The influence of dietary immunomodulatory factors on development of food allergy in children

In the last few years many studies have been conducted on the role of dietary and environmental factors in the prevention of allergic diseases among children. Many studies have shown that the diet of pregnant women and children in their early postnatal life, rich in antioxidants, vitamin D, and fatty acids is beneficial as it reduces the risk of allergy in their future life. Moreover, there are many reports about the main role of gut microbiota and probiotics in the allergy prevention, what can indicate new ways of procedures in allergic diseases.

Can mild abdominal pain be the only sign of developing Crohn’s disease? A case report

Agnieszka Sakson-Słomińska1, Zuzanna Wasielewska1, Anna Szaflarska-Popławska2, Aneta Krogulska1