Karla L. Davis

Section on allergy and immunology

Founded in 1948, the Section on Allergy and Immunology is dedicated to ensuring that children receive the highest quality of allergy and immunology care. To accomplish its mission, the Section provides a number of educational, training, and research programs and continually advocates for improved allergy and immunology care and services. The Section sponsors educational programs for both pediatric generalists and subspecialists at the American Academy of Pediatrics (AAP) National Conference and Exhibition (NCE) each fall and at the American Academy of Allergy Asthma & Immunology annual meeting each spring. The Section’s other educational endeavors include this annual “Best Articles Relevant to Pediatric Allergy and Immunology” supplement to Pediatrics, Visiting Professor Program, Pediatric Asthma Speaker’s Kit, online continuing medical education course on “asthma gadgets,” electronic quality improvement in practice program on asthma diagnosis and management (Education in Quality Improvement for Pediatric Practice [eQIPP], which meets the American Board of Pediatrics maintenance-ofcertification criteria), school nurse allergy tool kit, and a number of public education materials. The Section is also active in contributing to educational programs and resources such as AAP News, educational brochures, clinical reports, and many other endeavors. To support training and promote research in pediatric allergy and immunology, the Section awards travel grants to residents and training fellows to participate and present cases at the AAP NCE and provides outstanding abstract awards for training fellows and junior faculty for presentation at the American Academy of Allergy Asthma & Immunology annual meeting. In close collaboration with other subspecialty societies, the Section is actively involved with initiatives to improve subspecialty education such as the American Board of Allergy and Immunology maintenance-of-certification requirements. Section members represent the AAP in national and government conferences and provide input on federal legislation on behalf of the AAP. For more information on all AAP allergy and immunology resources and initiatives, visit www.aap.org/sections/allergy. The reviews contained in the 2011 synopsis were written by Fellows of the AAP Section on Allergy and Immunology and fellows in allergy and immunology training programs who contributed reviews with their mentors. The editor selected the journals to be reviewed on the basis of the likelihood that they would contain articles on allergy and immunology that would be of value and interest to the pediatrician. Each journal was assigned to a voluntary reviewer who was responsible for selecting articles and writing reviews of their articles. Only articles of original research were selected for review. Final selection of the articles to be included was made by the editor. The 2010–2011 journals chosen for review were Allergy, American Journal of Asthma & Allergy for Pediatricians, Archives of Pediatric and Adolescent Medicine, American Journal of Medicine, American Journal of Respiratory and Critical Care Medicine, Annals of Allergy, Asthma, and Immunology, Annals of Internal Medicine, Archives of Disease in Childhood, Archives of Internal Medicine, Blood, British Journal of Dermatology, British Medical Journal, Chest, Clinical and Experimental Allergy, Clinical Pharmacology and Therapeutics, Critical Care Medicine, European Journal of Pediatrics, European Respiratory Journal, Immunology, Journal of Allergy and Clinical Immunology, Journal of the American Academy of Dermatology, Journal of the American Medical Association, Journal of Applied Physiology, Journal of Experimental Medicine, Journal of Immunology, Journal of Infectious Diseases, Journal of Pediatric Gastroenterology and Nutrition, Journal of Pediatrics, Journal of Pharmacology and Experimental Therapeutics, Lancet, Nature, New England Journal of Medicine, Pediatrics, Medicine, Pediatric Allergy and Immunology, Pediatric Asthma, Allergy & Immunology, Pediatric Dermatology, Pediatric Infectious Disease Journal, and Science. The editor and the Section on Allergy and Immunology gratefully acknowledge the work of the reviewers and their trainees who assisted. The reviewers were Stuart L. Abramson, MD, PhD, Sugar Land, TX; James R. Banks, MD, Arnold, MD; Theresa A. Bingemann, MD, Rochester,

Diet-Induced Weight Loss in Obese Children With Asthma: A Randomized Controlled Trial

ME Jensen, PG Gibson, CE Collins, JM Hilton, LG Wood. Clin Exp Allergy. 2013;43(7):775–784 The goal of this study was to assess if dietary intervention (DI) can achieve weight loss in obese asthmatic children and if diet-induced weight loss leads to changes in asthma outcomes. The study evaluated 32 obese (BMI z score ≥1.64 SD score) Australian children aged 8 to 17 years, with a physician diagnosis of asthma. Exclusion criteria included unexplained weight change during the past 3 months, inflammatory or endocrine disorders, and respiratory disorders other than asthma. In this 10-week, randomized controlled trial, 32 obese asthmatic children were randomized to …

Accidental Ingestions in Children With Peanut Allergy

Yu JA, Kagan R, Verreault N, et al. J Allergy Clin Immunol. 2006;118:466–472 PURPOSE OF THE STUDY. To determine the current frequency of accidental exposures occurring in peanut-allergic children and identify factors associated with exposure. STUDY POPULATION. Children 4 years of age and older, who were diagnosed with peanut allergy at the Montreal Childrens Hospital Allergy Clinic (Quebec, Canada) between January 2000 and February 2005. METHODS. Parents of children with peanut allergy completed questionnaires about accidental exposure to peanut occurring over the preceding year. Details of the accidental exposure requested included age of the child, quantity and type of food ingested, location of ingestion, allergic symptoms, onset and duration of reaction, and treatment administered. Medical charts were reviewed to confirm eligibility criteria, demographic information, atopic history, family history, details of the initial and most severe accidental reaction, number of previous accidental reactions, and previous use of epinephrine. RESULTS. A total of 252 (57.7%) of 437 parents of children with peanut allergy completed a questionnaire. Chart review allowed comparison between participants and nonparticipants. Of participants, 62% were boys and the mean age was 8.1 years. The mean age at diagnosis was 2 years. There were 35 accidental exposures among 29 children over a period of 244 patient-years (annual incidence rate: 14.3%). Reactions were mild (15), moderate (16), and severe (4). Of the 20 children with reactions that were moderate to severe, only 4 received epinephrine. Eighty percent of children attended schools that prohibit peanut; only 1 accidental exposure occurred at school. Neither univariate nor multivariate logistic regression analyses identified any clinically important associations with inadvertent exposure to peanut. CONCLUSIONS. Children with peanut allergy residing in Quebec had an annual incidence rate of accidental exposure to peanut of 14.3%. This finding is substantially lower than previously reported incidence rates. Predictors of accidental exposure could not be identified. REVIEWER COMMENTS. In this study, only 1 of 35 accidental exposures occurred in school. Coupled with the lower incidence of accidental exposures reported in this study, these data may suggest that enhanced education about and awareness of peanut allergy in the public sector have been effective. The majority of accidental exposures occurred at the patients home (14) or the home of a friend or relative (12), which underscores the critical importance of education of the family, friends, and caregivers of children with peanut allergy.

Enterovirus Infections in Early Childhood and the Risk of Atopic Disease—A Nested Case-Control Study

L Korhonen, A Kondrashova, S Tauriainen. Clin Exp Allergy. 2013;43(6):625–632 The goal of this study was to assess the relationship between enterovirus infections in the first 2 years of life and atopic diseases. It also studied the importance of different enterovirus serotypes in atopic diseases. The study population was derived from the Finnish DIPP (Diabetes Prediction and Prevention) Study. Newborn infants with HLA-DQB1 risk alleles had clinic visits every 3 to 6 months for the first 2 years of life and at subsequent intervals of 6 to 12 months. At each visit, children had a comprehensive history and physical examination performed and a venous blood sample obtained. …

Age-Dependent Sting Recurrence and Outcome in Immunotherapy-Treated Children With Anaphylaxis to Hymenoptera Venom

AI Stritzke, PA Eng. Clin Exp Allergy. 2013;43(8):950–955 The goal of this study was to investigate the rate of sting recurrence and outcome of Hymenoptera venom anaphylaxis in children treated with venom immunotherapy (VIT). The study included a cohort of 83 Swiss children consecutively referred for Hymenoptera venom anaphylaxis between 1990 and 2007. Inclusion criteria were diagnosis of Hymenoptera anaphylaxis followed by commencement of VIT. Diagnosis of Hymenoptera anaphylaxis required a sting followed by a systemic adverse reaction affecting the respiratory and/or cardiovascular system, a positive intracutaneous test result with European honey bee (BV) and/or Vespula (VV) venom, and specific IgE (>0.7 kU/L) to …

Prenatal and Postnatal Probiotics Reduces Maternal but Not Childhood Allergic Diseases: A Randomized, Double-Blind, Placebo-Controlled Trial

CY Ou, HC Kuo, L Wang. Clin Exp Allergy. 2012;42(9):1386–1396 To evaluate the prevalence of allergen sensitization and development of allergic diseases in high-risk infants following prenatal and postnatal probiotic supplementation. The study population included 191 pregnant women with atopic diseases determined by history, total immunoglobulin E (IgE) concentration >100 kU/L, and/or positive specific IgE concentration >0.7 kU/L for at least 1 of the following: Dermatophagoides pteronyssinus , cockroach, egg white, milk protein, shrimp, or peanut. Pregnant mothers were assigned to receive Lactobacillus GG (LGG) …

Pets at Birth Do Not Increase Allergic Disease in At-Risk Children

CJ Lodge, AJ Lowe, LC Gurrin. Clin Exp Allergy. 2012;42(9):1377–1385 To investigate the relationship between pet keeping at birth and the risk of sensitization, wheeze, allergic rhinitis, and eczema over the first 12 years in a cohort selected for familial allergy. A total of 620 infants were enrolled in a prospective birth cohort in Australia between 1990 and 1994. Eligible infants had at least 1 first-degree family member with a history of eczema, asthma, allergic rhinitis, or severe food allergy. Data on pet keeping, demographics, and cord blood samples were collected. Demographic information included parental smoking history, presence of carpets in the home, number of siblings, parental history of atopic …

Oral Rush Desensitization to Egg: Efficacy and Safety

Rodriguez R Garcia, JM Urra, F Feo-Brito. Clin Exp Allergy. 2011;41(9):1289–1296 Previously published oral desensitization protocols require weeks to months. The current study evaluates the safety, efficacy, and immunologic effects of a rapid egg oral desensitization protocol. Twenty-three patients between 5 and 17 years of age with symptomatic immunoglobulin (Ig) E-mediated egg allergy were recruited from the Allergy Clinic of Ciudad Real General Hospital. Patients had a clinical history of IgE-mediated egg allergy and at least 1 of the following: a positive skin prick test to commercial egg extract, detection of serum specific IgE (>0.35 kU/L) to egg white or its proteins measured by fluorescence …

Pre- and Post-natal Exposure to Antibiotics and the Development of Eczema, Recurrent Wheezing, and Atopic Sensitization in Children Up to the Age of 4 Years

S Dom, JH Droste, MA Sariachvili. Clin Exp Allergy. 2010;40(9):1378–1387 To investigate the relationship of indirect prenatal and postnatal antibiotic exposure and the subsequent development of eczema, recurrent wheeze, and atopic sensitization in early childhood. The study population of 773 children was obtained from a prospective project regarding the Influence of Perinatal Factors on the Occurrence of Asthma and Allergies (PIPO cohort) in Belgium. Of 2006 women recruited at 20 weeks of pregnancy, 1072 agreed to participate (total cohort population: 1128 children). Children were included in the current study if information on …

Efficacy of Probiotic Lactobacillus GG on Allergic Sensitization and Asthma in Infants at Risk

MA Rose, F Stieglitz, A Koksal, R Schubert, J Schulze, S Zielen. Clin Exp Allergy. 2010;40(9):1398–1405 Previous studies have yielded conflicting data regarding the effects of probiotics on the prevention and treatment of allergic diseases. This prospective study examined the impact of dietary supplementation with Lactobacillus rhamnosus strain GG (ATCC 53103) on allergic sensitization, asthma, and atopic eczema. Children ( N = 131) between the ages of 6 and 24 months with a history of at least 2 physician-diagnosed episodes of wheezing within the previous year and a first-degree relative with atopic disease were recruited from a clinic of the Childrens Hospital at …