Barbara Kamer

Role of selenium and zinc in the pathogenesis of food allergy in infants and young children

Introduction Selenium and zinc are indispensable microelements for normal functioning and development of the human body. They are cofactors of many enzymes of the antioxidative barrier (selenium – glutathione peroxidase; zinc – superoxide dismutase). The aim of the study was to evaluate the importance of selenium and zinc in the pathogenesis of food allergy in small children. Material and methods The study was performed in 134 children with food allergy, aged 1 to 36 months. The control group was composed of 36 children at the same age, without clinical symptoms of food intolerance. Each child had estimated serum levels of zinc and selenium. Furthermore, the authors evaluated activity of glutathione peroxidase (GSH-Px) in erythrocyte lysates and serum. Tests were performed twice, before and after 6-month administration of elimination diet. Results The obtained results showed that children with food allergy had significantly lower concentrations of selenium, zinc and examined enzymes in comparison to children from the control group. Concentration of selenium and zinc as well as activity of examined enzymes increased after application of eliminative diet. Conclusions In children with allergy decreased concentrations of selenium and zinc, and lower values of glutathione peroxidase and superoxide dismutase which increased after elimination diet were affirmed. These observations suggest their role in pathogenesis of food allergy. Conducted observations indicate the need to monitor trace elements content in the diet in children with food allergy. The results showed that children with food allergy had a weakened antioxidative barrier.

Natural history of IgE-dependent food allergy diagnosed in children during the first three years of life

PURPOSE The aim of the study was to analyze: the course of allergy diagnosed during first three years of life, frequency of food tolerance development and impact of factors which have potential meaning in that process. MATERIAL AND METHODS The study was performed in 115 children with IgE-dependent allergy, diagnosed during first three years of life, treated in 2nd Department of Pediatrics and Allergology of Polish Mothers Health Center in Lodz. All children were invited to our clinic in order to analyze course of the allergy after period of minimum 5 years since diagnosis. RESULTS The results of the study revealed that food tolerance was acquired by high percentage of examined children (87.9%) among 83 children with food allergy. However among 32 children with initial inhalant allergy there were still no food sensitizations. The frequency of this process increased with age of examined children. The study revealed that such factors as lack of family history of atopy, clinical manifestation limited to one system, lack of inhalant allergy, type of allergen, good social conditions, have positive impact on tolerance development. CONCLUSIONS High percentage of children with food allergy is able to develop the status of food immunotolerance. Factors which predispose to development of food allergy have also negative impact on ability to acquiring tolerance to harmful food. The study indicates the need of constant and wide education about decreasing exposure to allergy predisposing factors which could increase chance of food tolerance development.

Prevalence of atopic dermatitis in infants during the first six months of life: authors' observations.

Introduction Atopic dermatitis (AD) is a frequent chronic skin disease in infants. It creates great difficulties, both diagnostic and therapeutic. Aim To assess the prevalence of atopic dermatitis in infants during the first 6 months of life. Material and methods The analysis comprised 2256 children at the age of not more than 6 months, treated at the 2nd Department of Paediatrics and Allergology of the Polish Mothers Memorial Hospital in Lodz, Poland, during seven years. Out of all the patients, children with cutaneous changes were isolated, and the location, type and aetiology of changes were assessed. Results Dermal changes were diagnosed in 471 children, including 391 (17.3% of all the patients) with atopic dermatitis. Out of the children with AD, IgE-dependent allergy was identified in 39.9%. Cows milk protein was the most frequent sensitising allergen. In 71.6% of the infants, cutaneous changes were disseminated and involved at least two areas of the body. All of them were strongly itching. An applied elimination diet, together with anti-allergic medications in some of the children, provided a clear clinical improvement. Conclusions Performed studies demonstrated the prevalence of atopic dermatitis in 17.3% of examined children. The changes in children with AD were disseminated, what was confirmed already at the infantile age. The obtained clinical improvement after the applied therapy indicates a relationship between the observed symptoms and allergic disease.

The unusually large striae distensae all over the body

Striae distensae or stretch marks are cutaneous changes which may appear everywhere on the body, except for the face, and they usually occur in stretching areas. We want to present unusually large striae that developed nearly all the body of a 14-year-old patient during steroid therapy. Such huge striae are very rare, especially when the doses of steroids are not high. Widely spread striae are not a serious disease or disability, but only a cosmetic problem. However, they may lead to a persistent complex and feeling of inferiority or even cause serious depression states, especially in teenagers, as in this case.

The usefulness of soluble transferrin receptor (sTfR) in differentiating anemia occurring in young children

We evaluated the usefulness of soluble transferrin receptor (sTfR) and of the sTfR/log ferritin index (sTfR/logF) in the differentiation of anemia in young children. 96 children, aged 6–36 months, were examined. From these, four groups were distinguished: 1 — (IDA): 33 children with anemia due to iron deficiency; 2 — (IA): 19 children with infectious anemia without iron deficiency; 3 — (IA + ID): 16 children with infectious anemia and iron deficiency; and 4 — a comparator group (CG): 28 healthy children without iron deficiency. The soluble transferrin receptor, hematological indices and iron balance were evaluated and the sTfR/logF was calculated for each examined child. It was proved that the mean values of sTfR and sTfR/logF were substantially higher in children with anemia due to iron deficiency, and in those with infectious anemia and iron deficiency, vs. those with infectious anemia or in healthy children. This suggests that both sTfR and the sTfR/logF are good indicators of iron deficiency and could be useful in the differential diagnostics of anemia, especially in young children.

Pre- and postnatal exposure of children to tobacco smoke during the first four years of life - observations of the authors

INTRODUCTION Environmental exposure to tobacco smoke is a significant threat for human health, where the higher is its degree, the more immature the human organism is. Therefore, the exposure to Tobacco smoke in foetal life exerts unfavourable effects on developing foetus and may cause early and distant results in children. MATERIAL AND METHODS The study comprised 318 children in their first four years of life, treated for various medical conditions. The examined children were divided into two groups, Group 1--children exposed to Tobacco smoke--and Group 2--a control group with children from non-smoking families. History data were obtained on the basis of a specially designed questionnaire, used by the doctor in an individual conversation with parent. In each third child from the group 1 cotinine concentration in urine was assayed by the method of high performance liquid chromatography-UV-VIS and the cotinine/creatinine ratio was calculated. RESULTS OF STUDY: Results demonstrated environmental exposure to tobacco smoke in 173 children (Group 1). Out of them 31.2% were the children whose mothers had smoked also during pregnancy (Subgroup A). The other 119 children from Group 1 were accounted to Subgroup B, i.e., children, where other household members had been smoking cigarettes. A comparative group comprised 143 children from non-smoking families. The results demonstrated then that 17% of all the examined children were those, exposed to tobacco smoke effects already in their foetal life, predisposing them to prematurity and low birth weight. Moreover, it was observed that the young age and lower education level of their parents, together with worse housing conditions, may suggest a predisposing character and role of the mentioned factors.

The retrospective evaluation of pneumonia and bronchitis cases in infants and small children with atopic dermatitis in the practice of a family doctor – personal observations

PURPOSE The purpose of the work is to estimate the occurrence of lower respiratory tract infections in infants and small children with atopic dermatitis and to compare them with a group of children at the same age without features of allergy. MATERIAL AND METHODS The study has been conducted on the basis of the retrospective analysis of medical documentation of individual history of disease among children born in 2005 - 2008 treated in an outpatient clinic. RESULTS Children suffering from atopic dermatitis are more prone to pneumonia and bronchitis. They are also more often hospitalized due to these reasons. Also, this group of patients is more liable to wheezing in the time of infection. CONCLUSIONS Infants and small children with atopic dermatitis are more prone to lower respiratory tract infections. Recurrence of infections within the respiratory system may be an important risk factor for asthma.

Evaluation of TLR4 expression and chosen parameters of oxidative-antioxidative balance in young children with food allergy.

The authors evaluated mRNA TLR4 expression on neutrophils and the chosen parameters of oxidative-antioxidative balance in blood of 35 children with food allergy (17 of them with IgE-dependent allergy and 18 with IgE-independent allergy) and 15 healthy children without any allergy. The age of these children ranged from 1 to 36 months. Children with food allergy in comparison with healthy children were found to have lower mRNA TLR4 expression, higher average value of chemiluminescence (CL) and its increase after stimulation by fMLP, PMA and OZ as well as lower TAS values. Disturbances of oxidative-antioxidative balance were found in children with food allergy. We suggest that natural immunity is involved in the development of food allergy mechanisms. Moreover, chemiluminescence can be used as an additional diagnostic test.

Częstość mykoplazmatycznych zapaleń płuc u dzieci w Łodzi i makroregionie na podstawie obserwacji własnych

Wstep Zakazenia ukladu oddechowego u dzieci stanowią czesty problem kliniczny. Wśrod czynnikow etiologicznych istotne znaczenie ma Mycoplasma pneumoniae . Cel pracy Autorzy ocenili czestośc zakazenia Mycoplasma pneumoniae jako czynnika przyczynowego zapalen pluc u dzieci. Material i metody Analizą objeto lącznie 23 779 dzieci w wieku od 1 miesiąca do 18 roku zycia leczonych na wybranych oddzialach dzieciecych w Łodzi i makroregionu lodzkiego w okresie od 2003 do 2007 r. Wyniki Wykazano wystepowanie zakazenia Mycoplasma pneumoniae u 1313 dzieci (5,5%). Zaobserwowano stopniowy wzrost czestości mykoplazmatycznych zapalen pluc w poszczegolnych latach obserwacji, z najwiekszym nasileniem w ostatnich dwoch latach. Stwierdzono rowniez, ze zakazenie Mycoplasma pneumoniae wystepowalo w kazdej grupie wiekowej, przy czym w najwyzszym odsetku (43,7%) u dzieci powyzej siodmego roku zycia, a w najnizszym u dzieci 2–3-letnich (16,2%) i u niemowląt (17,9%). Wnioski Stwierdzenie u 5,5% dzieci zakazenia Mycoplasma pneumoniae wskazuje na istotny udzial tego czynnika w etiologii zapalen pluc u dzieci. Wykazano, ze Mycoplasma pneumoniae jest rowniez przyczyną zapalenia pluc u niemowląt i malych dzieci. Wczesne rozpoznanie ma istotne znaczenie, poniewaz umozliwia wdrozenie prawidlowego leczenia.

Trends in folic acid supplementation during pregnancy – the effect on allergy development in children

Introduction The results of some previous studies suggested that maternal folate supplementation during pregnancy may contribute to allergy development in offspring. Aim This study was performed to examine the influence of maternal folic acid intake prior to and during pregnancy on the development of various types of allergy in children taking into account the timing and dosage of supplemented folate. Material and methods The retrospective study was performed between 2010 and 2014 in 307 child-mother pairs (203 allergic children and 104 children without allergy symptoms, aged 2–72 months). Allergy diagnosis was based on medical history, physical examination, positive results of allergic tests: specific IgE and/or skin prick tests and double-blind, placebo-controlled food challenge. The data concerning maternal folate supplementation prior to and during pregnancy were obtained based on a questionnaire. Results Mothers of allergic children used to take folic acid more frequently in the preconception period (42.9%), in the 1st (94.1%) and the 2nd/3rd (81.3%) trimester of pregnancy than mothers of the healthy ones (30.8%, 82.7% and 55.8%, respectively) (p < 0.05). Maternal intake of folate in a dosage higher than recommended (> 0.4 mg/day) was more often observed in the group of allergic subjects, especially in children with combined sensitization to food and inhalant allergens, than in the control group (p < 0.05). Conclusions Our results suggest an impact of maternal folic acid supplementation prior to and during pregnancy on allergy development in children. Further observations are required to establish the role of folate in fetal epigenetic modifications.