Anna Kaarina Kukkonen

Airway inflammation in probiotic-treated children at 5 years

To cite this article: Kukkonen AK, Kuitunen M, Savilahti E, Pelkonen A, Malmberg P, Mäkelä M. Airway inflammation in probiotic‐treated children at 5 years. Pediatr Allergy and Immunol 2011; 22: 249–251.

Impact of Maternal Allergy and Use of Probiotics during Pregnancy on Breast Milk Cytokines and Food Antibodies and Development of Allergy in Children until 5 Years

Background: Whether breast milk (BM) can protect against allergy has been studied extensively, with conflicting results. Variations in mothers’ BM composition may explain some of the conflicting results. Our aim was to assess the impact of maternal allergy and probiotic intervention on BM food antibodies, transforming growth factor (TGF)-β2 and interleukin (IL)-10 and their impact on allergy development in children until the ages of 2 and 5. Methods: We measured total IgA, IgA antibodies to cow’s milk (CM), casein, β-lactoglobulin and ovalbumin (OVA), TGF-β2 and IL-10 in 364 colostrum samples and 321 BM samples taken at 3 months from mothers participating in a prospective study evaluating the allergy-preventive effect of probiotics in a cohort with an increased risk for allergy. Results: CM, casein and OVA antibodies, TGF-β2 and IL-10 were detectable in most samples. Maternal allergy was associated with raised levels of IgA to casein (p = 0.04) and lower levels of TGF-β2 (p = 0.006) in mature BM. Probiotic supplementation was associated with increased IL-10 (p = 0.046) and decreased casein IgA antibodies (p = 0.027) in mature BM. High OVA IgA antibodies in colostrum were associated with the development of atopy by the age of 2, while low levels in mature BM were a significant risk factor for the development of eczema by the age of 2. TGF-β2 levels in BM constituted a risk for development of allergy by the age of 2. Conclusions: The immunologic composition of BM was only slightly affected by maternal atopy and could be altered by probiotic supplementation. Small effects of BM components on allergy development in children were evident.

Ara h 2 and Ara 6 are the best predictors of severe peanut allergy: a double‐blind placebo‐controlled study

Component‐resolved diagnostics offers a modern tool in peanut allergy, but studies applying consistently double‐blind placebo‐controlled challenges are lacking. We aimed to optimize diagnostics for moderate‐to‐severe peanut allergy in a birch‐endemic region and to create an oral‐peanut challenge with its allergen activity characterized.

Randomized trial comparing natural and synthetic surfactant: increased infection rate after natural surfactant?

The efficacy of a natural porcine surfactant and a synthetic surfactant were compared in a randomized trial. In three neonatal intensive care units, 228 neonates with respiratory distress and a ratio of arterial to alveolar partial pressure of oxygen <0.22 were randomly assigned to receive either Curosurf 100mgkg−1 or Exosurf Neonatal 5 ml kg−1. After Curosurf, the fraction of inspired oxygen was lower from 15min (0.45 ± 0.22 vs 0.70 ± 0.22, p = 0.0001) to 6 h (0.48 ± 0.26 vs 0.64 ± 0.23,p= 0.0001) and the mean airway pressure was lower at 1 h (8.3 3.2 mmH2O vs 9.4 ± 3.1 mmH2O β= 0.01). Thereafter the respiratory parameters were similar. The duration of mechanical ventilation (median 6 vs 5 d) and the duration of oxygen supplementation (median 5 vs 4 d) were similar for Curosurf and Exosurf After Curosurf, C‐reactive protein value over 40 mg r1 occurred in 45% (vs 12%; RR 3.62, 95%CI 2.12‐6.17, p = 0.001), leukopenia in 52% (vs 28%; RR 1.85, 95%CI 1.31‐2.61, β= 0.001) and bacteraemia in 11% (vs 4%; RR3.17, 95%CI 1.05‐9.52, p < 0.05).

Ovalbumin-specific immunoglobulins A and G levels at age 2 years are associated with the occurrence of atopic disorders

Background Humoral responses to food antigens may reflect the propensity of a childs immune system to develop tolerance to innocuous antigens. Early nutrition as well as probiotics may influence these immunological responses.

Protective and Risk Factors for Allergic Diseases in High-Risk Children at the Ages of Two and Five Years

Background: Environmental and lifestyle factors such as breast-feeding and pets seem to affect atopic disease prevalence. We identified risk factors for allergic diseases. Methods: We prospectively followed until the age of 5 years a cohort of 1,223 children born into allergic families, who participated in a randomized placebo-controlled trial of probiotics as preventive against allergic disease. We evaluated the cumulative incidence of allergic diseases with questionnaires and examined all children at the ages of 2 and 5 years. Results: Compared to allergy in one parent only, allergy in both parents conferred an increased risk of allergic disease at the ages of 2 (OR 1.64; 95% CI 1.11–2.42, p = 0.013) and 5 (OR 1.83; 95% CI 1.24–2.70, p = 0.002) and at the age of 2 for eczema (OR 1.74; 95% CI 1.17–2.58, p = 0.006). Exclusive breast-feeding over 2 months elevated the risk of eczema at the ages of 2 (OR 1.73; 95% CI 1.15–2.61, p = 0.009) and 5 (OR 1.51; 95% CI 1.03–2.23, p = 0.036). Cat or dog exposure at 0–2 years and at 0–5 years protected against IgE sensitization until 5 years of age (OR 0.60; 95% CI 0.37–1.00, p = 0.048, and OR 0.61; 95% CI 0.39–0.96, p = 0.033), and exposure at the ages of 0–5 years protected against allergic rhinitis until the age of 5 (OR 0.46; 95% CI 0.25–0.85, p = 0.013) in the probiotic group. Conclusions: Allergy in both parents is an independent predictor of eczema and of allergic disease until the ages of 2 and 5. Long, exclusive breast-feeding was associated with increased eczema at the ages of 2 and 5, and cat or dog exposure was associated with decreased IgE sensitization and allergic rhinitis in the probiotic group.

Cross‐sensitization profiles of edible nuts in a birch‐endemic area

Sensitization to birch pollen causes cross‐sensitization to nuts, but rarely leads to clinical nut allergy. The aim was to study sensitizations to nuts in individuals sensitized to birch pollen and examine cross‐reactivities between birch and nut species.

Intestinal defensin secretion in infancy is associated with the emergence of sensitization and atopic dermatitis

Intestinal flora and innate immunity, and their interactions impact adaptive immunity.

Double‐blind placebo‐controlled challenge showed that peanut oral immunotherapy was effective for severe allergy without negative effects on airway inflammation

This study examined the efficacy and the safety of peanut oral immunotherapy (OIT).

Burden of allergy diets in Finnish day care reduced by change in practices.

Nonessential allergy diets in children with mild symptoms may harm the development of immunological tolerance and impose a burden on families and day care. We aimed to reduce the high prevalence of allergy diets in day care by reforming the practices for inquiring about need of special diets from parents.