Teruaki Matsui

Sun exposure inversely related to food sensitization during infancy

Autumn and winter birth (AWB) has been reported to be a risk factor for the development of food allergies. However, the association between seasonal factors and allergic sensitization during early infancy remains unclear.

A workshop with practical training for anaphylaxis management improves the self-efficacy of school personnel

BACKGROUND School personnel are required to guarantee a secure school environment for children suffering from severe food allergies. We organized a workshop for school personnel to learn the appropriate management of anaphylaxis that included practical training with an adrenaline auto-injector (AAI). The objective of this study was to evaluate the workshop in terms of the improvement of self-efficacy (SE) of participants to deal with anaphylaxis. METHODS All 93 school nurses, 73 schoolteachers and 110 childcare workers participating in the study completed a questionnaire before and after the workshop. The SE of the participants was evaluated using an original 15-item questionnaire. RESULTS Before the workshop, the SE of school nurses was the highest among the profession groups, and being involved with children prescribed an AAI was a common factor associated with a high SE. After the workshop, the SE increased in all groups, but most apparently in school nurses and those involved with children prescribed an AAI. The presence of an emergency plan was positively associated with the SE of schoolteachers only after the workshop, even though no such association existed beforehand. CONCLUSIONS Practical instruction of school nurses and school personnel involved with children prescribed an AAI resulted in dramatic improvement of the SE. These people are expected to play a central role in the development of an anaphylaxis management plan in their schools.

The relationship between the season of birth and early-onset food allergies in children.

This study examined the relationship between the season of birth (SoB) and other factors with the development of FA.

Development of a prediction model for a severe reaction in cow's milk challenges

In addition to their conventional purposes, which is for the definitive diagnosis of a food allergy or for the discernment of tolerance to the allergen,1 oral food challenges (OFCs) are performed to determine the threshold dose of food allergens for risk-assessment or minimal avoidance. More severe reactions tend to be provoked in these OFC settings. We have already reported a model for predicting severe allergic reactions provoked in boiled egg challenges.2 In the present study, we developed a model for predicting a severe reaction to a milk OFC. This newmodel was developed via a similar method to that used for the egg challenge.2 An open OFC of milk was performed in accordance with the Japanese Guideline for Food Allergy 20143 throughout the study period. Raw cows milk was administered in a gradient dose (typically 4 to 5 doses from 0.2-0.5-1-2-5-10-20 ml) every 30e40 min. The challenge was stopped if the patient exhibited an objective allergic reaction corresponding to 5 points of the total score (TS) of Anaphylaxis Scoring Aichi (ASCA).2,4 To quantify the overall severity of the result of OFCs, the TS/Pro2 was applied, which was calculated by dividing the TS by the cumulative protein dose (Pro) of milk (3.3% of whole milk) administered before the appearance of symptoms. We divided patients in the development dataset into two groups (severe cases and non-severe cases) based on the median value of the TS/Pro of the development dataset. The development dataset was obtained from OFCs to cows milk from April 2012 to May 2013. During this period, 220 OFCs to milk were conducted, and 144 (65.5%) of thosewere positive. The appropriate laboratory data (specific IgE to milk and total IgE) collected within 180 days from OFC were missing in 37 cases, and 10 OFCs performed during the OIT were also excluded. As a result, 97 cases were analyzed. To validate this model in an independent clinical setting (validation dataset), 95 consecutive OFCs to milk (70 positive and 25 negative) with appropriate data and conditions from June 2013 to March 2014 were analyzed in a prospective manner. This study was approved by the institutional review board of Aichi Childrens Health and Medical Center. All analyses were performed with the STATA software program (version 12.1 for Mac; STATA Inc., College Station, TX, USA). For all analyses, a 2-sided probability value below 0.05 was considered to indicate statistical significance. The characteristics of the datasets are shown in Supplementary Table 1. Based on the median value of TS/Pro in the development dataset, we defined severe cases as TS/Pro 80 (n 1⁄4 49) and non-

Development of a prediction model for severe wheat allergy

9. Song W-J, Sintobin I, Sohn K-H, et al. Staphylococcal enterotoxin IgE sensitization in lateonset severe eosinophilic asthma in the elderly. Clin Exp Allergy. 2016;46:411-421. 10. Beeh KM, Ksoll M, Buhl R. Elevation of total serum immunoglobulin E is associated with asthma in nonallergic individuals. Eur Respir J. 2000;16:609-614. 11. Kalesnikoff J, Huber M, Lam V, et al. Monomeric IgE stimulates signaling pathways in mast cells that lead to cytokine production and cell survival. Immunity. 2001;14:801-811. 12. Foroughi S, Foster B, Kim N, et al. AntiIgE treatment of eosinophilassociated gastrointestinal disorders. J Allergy Clin Immunol. 2007;120:594-601.

Artificial sweeteners and mixture of food additives cause to break oral tolerance and induce food allergy in murine oral tolerance model for food allergy

Processed foods are part of daily life. Almost all processed foods contain food additives such as sweeteners, preservatives and colourants. From childhood, it is difficult to avoid consuming food additives. It is thought that oral tolerance for food antigens is acquired during early life. If tolerance fails, adverse immune responses to food proteins may occur.

Eppikajutsuto Protects against Food Allergy Induced by Ovalbumin in a Murine Model

Background: Currently, there are no efficient medications available for the prevention and treatment of food allergy (FA). Herbal medicines, including traditional Japanese Kampo medicines (TJKMs), are promising therapeutic drugs. Methods: We screened 18 TJKMs for treatment of FA symptoms in a mouse FA model induced by ovalbumin (OVA). BALB/c mice were sensitized intraperitoneally by an OVA/aluminum hydroxide gel mixture followed by 4 booster doses of oral OVA and FA symptom induction by 50 mg of OVA. TJKMs were orally administered for 28 days from the day of sensitization to the day before FA symptom induction. Evaluated FA symptoms included a decrease in body temperature and allergic diarrhea. Allergic sensitization was determined by plasma OVA-specific IgE levels. Cytokine mRNA levels in mesenteric lymph nodes, plasma mouse mast cell protease-1, and the number of mast cells in the small and large intestines were analyzed. Additionally, the therapeutic effect of the TJKM eppikajutsuto (EJT) on mast cell degranulation was determined in active anaphylaxis and passive cutaneous anaphylaxis models. Results: EJT effectively prevented FA symptoms. Although OVA-specific IgE levels and the intestinal mast cell numbers were not different between the EJT-treated and untreated FA mice, plasma mMcpt1 and IL-4 levels were lower in EJT-treated FA mice than untreated FA mice. EJT could alleviate symptoms in both active and passive anaphylaxis models. Conclusion: EJT prevented OVA-induced FA symptoms in a mouse model, suggesting that EJT might exert its therapeutic activity via IL-4 suppression and the inhibition of mucosal mast cell degranulation.