The incidence of atopic dermatitis (AD) in children is increasing. Early exposure to stress factors may be associated with the AD development. This study aimed to summarize studies that reported an association between stress exposure and AD development in later life.
Methods and findings
A comprehensive literature search was performed using online databases (PubMed, EMBASE, PsycINFO, and Web of Science) for articles published up to May 1, 2023. Eligible studies were screened and selected based on the inclusion criteria. We incorporated cohort or case-control studies published in English which explored the relationship between stress experienced by parents or children and AD. The pooled odds ratio (OR) was calculated according to the type of stress using a random-effects model. Twenty-two studies were included. AD was related to maternal distress (OR 1.29, 95% Confidence Interval [CI]: 1.13–1.47), maternal anxiety (OR 1.31, 95% CI: 1.18–1.46), and negative life events (OR 2.00, 95% CI: 1.46–2.76). Maternal depression during pregnancy was associated with AD (OR 1.21, 95% CI: 1.09–1.33), whereas no significant association was found for postpartum depression. Research on stress experienced by paternal or children is scare.
Conclusions
Early maternal stress may potentially elevate the risk of AD in their offspring. Importantly, rigorously designed studies are required to corroborate the link between maternal stress and AD in children. These studies should aim to gather insights about the impact of stress during specific trimesters of pregnancy, postnatal stress, and paternal stress, and to identify potential prevention strategies.
{"title":"Early exposure to maternal stress and risk for atopic dermatitis in children: A systematic review and meta-analysis","authors":"Yuan Ai, Jichong Huang, Ting Ting Zhu","doi":"10.1002/clt2.12346","DOIUrl":"10.1002/clt2.12346","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The incidence of atopic dermatitis (AD) in children is increasing. Early exposure to stress factors may be associated with the AD development. This study aimed to summarize studies that reported an association between stress exposure and AD development in later life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and findings</h3>\u0000 \u0000 <p>A comprehensive literature search was performed using online databases (PubMed, EMBASE, PsycINFO, and Web of Science) for articles published up to May 1, 2023. Eligible studies were screened and selected based on the inclusion criteria. We incorporated cohort or case-control studies published in English which explored the relationship between stress experienced by parents or children and AD. The pooled odds ratio (OR) was calculated according to the type of stress using a random-effects model. Twenty-two studies were included. AD was related to maternal distress (OR 1.29, 95% Confidence Interval [CI]: 1.13–1.47), maternal anxiety (OR 1.31, 95% CI: 1.18–1.46), and negative life events (OR 2.00, 95% CI: 1.46–2.76). Maternal depression during pregnancy was associated with AD (OR 1.21, 95% CI: 1.09–1.33), whereas no significant association was found for postpartum depression. Research on stress experienced by paternal or children is scare.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Early maternal stress may potentially elevate the risk of AD in their offspring. Importantly, rigorously designed studies are required to corroborate the link between maternal stress and AD in children. These studies should aim to gather insights about the impact of stress during specific trimesters of pregnancy, postnatal stress, and paternal stress, and to identify potential prevention strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12346","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140130923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maryam Jafari, Eduardo I. Cardenas, Sandra Ekstedt, Julia Arebro, Marianne Petro, Agnetha Karlsson, Eric Hjalmarsson, Daniel Arnarson, Monika Ezerskyte, Susanna Kumlien Georén, Lars Olaf Cardell
<p>Chronic rhinosinusitis with nasal polyps (CRSwNP) is an inflammatory disease of the sinonasal mucosa that is often accompanied by local <i>Staphylococcus aureus</i> colonization,<span><sup>1</sup></span> as well as comorbid asthma.<span><sup>2</sup></span> Although both CRSwNP and asthma are associated with a type 2 inflammatory profile, a growing body of literature indicates that neutrophils can also contribute to the pathophysiology of these diseases. For instance, shedding of CD62L (L-selectin) is commonly used as a marker of neutrophil activation,<span><sup>3</sup></span> and we have previously shown that neutrophils isolated from nasal polyps of patients with CRSwNP are characterized by low CD62L and high CD16 (FcγRIII) surface expression.<span><sup>4</sup></span> Moreover, we have also shown that inhaled allergen provocation results in CD62L shedding in circulating neutrophils from patients with allergic asthma.<span><sup>5</sup></span> However, the response of circulating neutrophils to bacterial stimuli has not been characterized in patients with both CRSwNP and asthma in comparison with healthy controls.</p><p>In this study, we isolated blood neutrophils from 19 patients with CRSwNP and comorbid asthma, as well as 20 healthy controls, and assessed their phenotype at baseline and in response to <i>S. aureus</i> enterotoxin A (SEA). A detailed description of the methods used can be found in Supporting Information S1, and the main characteristics of all study participants are summarized in Table 1. Freshly isolated blood neutrophils from healthy controls and patients with CRSwNP and comorbid asthma had a similar baseline surface expression of CD62L and CD16 (Figure S1), which confirms our previous findings in other cohorts of patients with CRSwNP or asthma.<span><sup>4, 5</sup></span> Notably, most patients included in our study received inhaled corticosteroids (ICS) (Table S1), and a previous study suggests that ICS can impact the baseline surface expression of CD62L in unstimulated neutrophils.<span><sup>6</sup></span> Nevertheless, the study by Pasternak et al. also determined that ICS have no impact on CD62L expression when administered via active inhaler, and our patients received ICS exclusively via active inhaler.</p><p>Interestingly, in vitro stimulation with SEA for 2 h resulted in a marked decrease in CD62L surface expression in neutrophils from healthy controls, but not in neutrophils from patients with CRSwNP and asthma (Figure 1A,B). No significant changes in the neutrophil activation markers CD11b, CD66b or IL-1β were detected in either study group at this timepoint (Figure S2). Nevertheless, neutrophils from both study groups had a similar decrease in CD62L surface expression 4 h post-stimulation (Figure 1C,D), as well as a similar increase in CD66b surface expression at this timepoint (Figure S3A–C). In addition, neutrophils from healthy controls had an increase in CD11b and IL-1β expression 4 h post-stimulation, while ne
Maryam Jafari、Sandra Ekstedt、Eric Hjalmarsson、Monika Ezerskyte、Susanna Kumlien Georén和Lars Olaf Cardell设计了研究大纲。Maryam Jafari、Julia Arebro、Marianne Petro、Agnetha Karlsson 和 Daniel Arnarson 收集了患者材料。Maryam Jafari、Sandra Ekstedt 和 Marianne Petro 进行了中性粒细胞刺激和流式细胞仪评估。玛丽亚姆-贾法里和爱德华多-卡德纳斯（Eduardo I. Cardenas）对收集到的数据进行了分析和汇编，并进行了所有统计分析。Maryam Jafari、Eduardo I. Cardenas、Eric Hjalmarsson 和 Lars Olaf Cardell 起草了原稿，所有作者都阅读并审阅了原稿。所有作者都对文章做出了贡献，并批准了提交的版本。作者声明没有利益冲突。
{"title":"Delayed neutrophil shedding of CD62L in patients with chronic rhinosinusitis with nasal polyps and asthma: Implications for Staphylococcus aureus colonization and corticosteroid treatment","authors":"Maryam Jafari, Eduardo I. Cardenas, Sandra Ekstedt, Julia Arebro, Marianne Petro, Agnetha Karlsson, Eric Hjalmarsson, Daniel Arnarson, Monika Ezerskyte, Susanna Kumlien Georén, Lars Olaf Cardell","doi":"10.1002/clt2.12347","DOIUrl":"10.1002/clt2.12347","url":null,"abstract":"<p>Chronic rhinosinusitis with nasal polyps (CRSwNP) is an inflammatory disease of the sinonasal mucosa that is often accompanied by local <i>Staphylococcus aureus</i> colonization,<span><sup>1</sup></span> as well as comorbid asthma.<span><sup>2</sup></span> Although both CRSwNP and asthma are associated with a type 2 inflammatory profile, a growing body of literature indicates that neutrophils can also contribute to the pathophysiology of these diseases. For instance, shedding of CD62L (L-selectin) is commonly used as a marker of neutrophil activation,<span><sup>3</sup></span> and we have previously shown that neutrophils isolated from nasal polyps of patients with CRSwNP are characterized by low CD62L and high CD16 (FcγRIII) surface expression.<span><sup>4</sup></span> Moreover, we have also shown that inhaled allergen provocation results in CD62L shedding in circulating neutrophils from patients with allergic asthma.<span><sup>5</sup></span> However, the response of circulating neutrophils to bacterial stimuli has not been characterized in patients with both CRSwNP and asthma in comparison with healthy controls.</p><p>In this study, we isolated blood neutrophils from 19 patients with CRSwNP and comorbid asthma, as well as 20 healthy controls, and assessed their phenotype at baseline and in response to <i>S. aureus</i> enterotoxin A (SEA). A detailed description of the methods used can be found in Supporting Information S1, and the main characteristics of all study participants are summarized in Table 1. Freshly isolated blood neutrophils from healthy controls and patients with CRSwNP and comorbid asthma had a similar baseline surface expression of CD62L and CD16 (Figure S1), which confirms our previous findings in other cohorts of patients with CRSwNP or asthma.<span><sup>4, 5</sup></span> Notably, most patients included in our study received inhaled corticosteroids (ICS) (Table S1), and a previous study suggests that ICS can impact the baseline surface expression of CD62L in unstimulated neutrophils.<span><sup>6</sup></span> Nevertheless, the study by Pasternak et al. also determined that ICS have no impact on CD62L expression when administered via active inhaler, and our patients received ICS exclusively via active inhaler.</p><p>Interestingly, in vitro stimulation with SEA for 2 h resulted in a marked decrease in CD62L surface expression in neutrophils from healthy controls, but not in neutrophils from patients with CRSwNP and asthma (Figure 1A,B). No significant changes in the neutrophil activation markers CD11b, CD66b or IL-1β were detected in either study group at this timepoint (Figure S2). Nevertheless, neutrophils from both study groups had a similar decrease in CD62L surface expression 4 h post-stimulation (Figure 1C,D), as well as a similar increase in CD66b surface expression at this timepoint (Figure S3A–C). In addition, neutrophils from healthy controls had an increase in CD11b and IL-1β expression 4 h post-stimulation, while ne","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12347","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140093518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The impact of non-pharmacological interventions (NPIs) on asthma prevention and management is insufficiently examined. We aim to comprehensively evaluate and synthesize existing evidence regarding the effectiveness of various NPIs throughout the life course.
Methods
We conducted a systematic search and screening of reviews that examined the effectiveness of various NPIs on asthma prevention and control in the Cochrane Library, PubMed, Embase, and Ovid databases. Data extraction was performed by considering the type of NPIs and the life course stages of the target population. Recommendations were provided by considering the quality of review assessed using the AMSTAR2 tool and the consistency of findings across reviews.
Results
We identified 145 reviews and mapped the evidence on the impact of 25 subtypes of NPIs on asthma prevention and control based on five stages of life course. Reviews indicated a shift of focus and various impacts of major NPIs on asthma prevention and control across life courses, while a few types of NPIs, such as physical exercise, appeared to be beneficial in children, adolescents and adults. Consistent and high-level evidence was observed only for psychological intervention on asthma control and quality of life among adults and older adults. Potential benefit with high-level evidence was reported on certain NPIs, such as vitamin D in reducing risk of developing asthma in offsprings in the prenatal stage, digital health interventions in improving asthma control from childhood to older adulthood, and breathing exercise in improving quality of life, asthma-related symptoms and lung function in adulthood and older adulthood.
Conclusion
This study emphasizes the significance of delivering NPIs to improve asthma prevention and management and highlights the heterogeneity regarding the impact of NPIs across life courses. High-quality research is urgently needed to further strengthen the evidence base of NPIs and tailored interventions should be considered in guideline development.
{"title":"Non-pharmacological interventions for asthma prevention and management across the life course: Umbrella review","authors":"Xunliang Tong, Xinyue Zhang, Mengyuan Wang, Zijun Wang, Fawu Dong, Enying Gong, Torsten Zuberbier, Yanming Li","doi":"10.1002/clt2.12344","DOIUrl":"10.1002/clt2.12344","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The impact of non-pharmacological interventions (NPIs) on asthma prevention and management is insufficiently examined. We aim to comprehensively evaluate and synthesize existing evidence regarding the effectiveness of various NPIs throughout the life course.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic search and screening of reviews that examined the effectiveness of various NPIs on asthma prevention and control in the Cochrane Library, PubMed, Embase, and Ovid databases. Data extraction was performed by considering the type of NPIs and the life course stages of the target population. Recommendations were provided by considering the quality of review assessed using the AMSTAR2 tool and the consistency of findings across reviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 145 reviews and mapped the evidence on the impact of 25 subtypes of NPIs on asthma prevention and control based on five stages of life course. Reviews indicated a shift of focus and various impacts of major NPIs on asthma prevention and control across life courses, while a few types of NPIs, such as physical exercise, appeared to be beneficial in children, adolescents and adults. Consistent and high-level evidence was observed only for psychological intervention on asthma control and quality of life among adults and older adults. Potential benefit with high-level evidence was reported on certain NPIs, such as vitamin D in reducing risk of developing asthma in offsprings in the prenatal stage, digital health interventions in improving asthma control from childhood to older adulthood, and breathing exercise in improving quality of life, asthma-related symptoms and lung function in adulthood and older adulthood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study emphasizes the significance of delivering NPIs to improve asthma prevention and management and highlights the heterogeneity regarding the impact of NPIs across life courses. High-quality research is urgently needed to further strengthen the evidence base of NPIs and tailored interventions should be considered in guideline development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12344","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139995783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Semra Demir, Deniz Eyice-Karabacak, Emek Kocatürk, Derya Ünal, İlkim Deniz Toprak, Pelin Korkmaz, Ayşe Feyza Aslan, Işıl Göğem İmren, Bahar Dikicier, Nevzat Kahveci, Nida Öztop, Rabia Öztaş Kara, Halim İşsever, Marcus Maurer, Karsten Weller, Aslı Gelincik
Background
Determination of control level in recurrent angioedema (RAE) is necessary to guide management. Here, we validated a Turkish version of the angioedema control test (AECT) for 4-week (AECT-4wk) and for 3-month (AECT-3mth) and assessed their utility in monitoring RAE.
Method
The recommended structured translation process for patient-reported outcome measures was completed. The final versions were administered to 51 patients with mast cell-mediated angioedema (MMAE) and 38 patients with hereditary angioedema, and the minimal clinically important difference (MCID) was determined. Additionally, anchor surveys comprising angioedema activity score for 28 days (AAS-28 day), visual analog score for angioedema control, Likert scale for the control level from the patient's perspective (LS-AEC), angioedema quality of life, short form-12 (SF-12) and patients' assessment of treatment sufficiency were applied.
Results
The Turkish AECT versions showed good convergent validity with a substantial correlation with anchor tools and known-group validity. Excellent internal consistency and reproducibility were observed. Equal or more than 10 of 16 points scored with the AECT-4wk and AECT-3mth identified patients with well-controlled disease. The disease activity, control and burden parameters were consistent with the disease control level defined depending on the cut-off point 10 of AECT. Three-point changes in AECT-4wk and -3 mt could detect MCID in disease control in all patients.
Conclusions
Turkish AECT versions are valid and reliable tools for assessing and monitoring disease control in patients with RAE. The use of the Turkish versions of the AECT in routine patient care, clinical trials and angioedema research is recommended.
{"title":"Monitoring recurrent angioedema: Findings from the Turkish angioedema control test validation study","authors":"Semra Demir, Deniz Eyice-Karabacak, Emek Kocatürk, Derya Ünal, İlkim Deniz Toprak, Pelin Korkmaz, Ayşe Feyza Aslan, Işıl Göğem İmren, Bahar Dikicier, Nevzat Kahveci, Nida Öztop, Rabia Öztaş Kara, Halim İşsever, Marcus Maurer, Karsten Weller, Aslı Gelincik","doi":"10.1002/clt2.12342","DOIUrl":"10.1002/clt2.12342","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Determination of control level in recurrent angioedema (RAE) is necessary to guide management. Here, we validated a Turkish version of the angioedema control test (AECT) for 4-week (AECT-4wk) and for 3-month (AECT-3mth) and assessed their utility in monitoring RAE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The recommended structured translation process for patient-reported outcome measures was completed. The final versions were administered to 51 patients with mast cell-mediated angioedema (MMAE) and 38 patients with hereditary angioedema, and the minimal clinically important difference (MCID) was determined. Additionally, anchor surveys comprising angioedema activity score for 28 days (AAS-28 day), visual analog score for angioedema control, Likert scale for the control level from the patient's perspective (LS-AEC), angioedema quality of life, short form-12 (SF-12) and patients' assessment of treatment sufficiency were applied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The Turkish AECT versions showed good convergent validity with a substantial correlation with anchor tools and known-group validity. Excellent internal consistency and reproducibility were observed. Equal or more than 10 of 16 points scored with the AECT-4wk and AECT-3mth identified patients with well-controlled disease. The disease activity, control and burden parameters were consistent with the disease control level defined depending on the cut-off point 10 of AECT. Three-point changes in AECT-4wk and -3 mt could detect MCID in disease control in all patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Turkish AECT versions are valid and reliable tools for assessing and monitoring disease control in patients with RAE. The use of the Turkish versions of the AECT in routine patient care, clinical trials and angioedema research is recommended.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12342","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Murat Türk, Emek Kocatürk, Ragıp Ertaş, Luis Felipe Ensina, Silvia Mariel Ferrucci, Clive Grattan, Christian Vestergaard, Torsten Zuberbier, Marcus Maurer, Ana Maria Giménez-Arnau
Background
Although there have been significant advances in the treatment of chronic spontaneous urticaria (CSU) in recent years, there remains a lack of clear guidance on when and how to step down treatment in responders. This study aims to investigate stepping down approaches of different steps of CSU treatment from a global perspective.
Methods
“Stepping down chronic spontaneous urticaria treatment” (SDown-CSU) is an international, multicenter, observational, cross-sectional, survey-based study of the Urticaria Centers of Reference and Excellence (UCARE) network. The questionnaire included 48 questions completed by physicians in the UCARE network.
Results
Surveys completed by 103 physicians from 81 UCAREs and 34 countries were analyzed. Seventy-eight percent of the participants responded that they had a national urticaria management guideline written by their professional societies and 28% responded that they had to operate under a regulatory guideline proposed by central health funding organizations. Seventy-two and 58.7% of these national recommendations do not contain any detailed information on when and/or how CSU treatment should be discontinued. There was a lack of detailed information on antihistamines and cyclosporine in particular. A predefined maximum duration was generally not applicable to omalizumab and cyclosporine (81% and 82%, respectively). Nearly all UCAREs step down omalizumab within 6 months from the first controlled status and 42% discontinue cyclosporine after 6 months regardless of the control status.
Conclusions
The findings from the SDown-CSU study clearly highlight a global need for guidance on the process of stepping down treatment in CSU. Additionally, the study offers a step-down algorithm applicable to all stages of CSU treatment.
{"title":"A global perspective on stepping down chronic spontaneous urticaria treatment: Results of the Urticaria Centers of Reference and Excellence SDown-CSU study","authors":"Murat Türk, Emek Kocatürk, Ragıp Ertaş, Luis Felipe Ensina, Silvia Mariel Ferrucci, Clive Grattan, Christian Vestergaard, Torsten Zuberbier, Marcus Maurer, Ana Maria Giménez-Arnau","doi":"10.1002/clt2.12343","DOIUrl":"10.1002/clt2.12343","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although there have been significant advances in the treatment of chronic spontaneous urticaria (CSU) in recent years, there remains a lack of clear guidance on when and how to step down treatment in responders. This study aims to investigate stepping down approaches of different steps of CSU treatment from a global perspective.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>“Stepping down chronic spontaneous urticaria treatment” (SDown-CSU) is an international, multicenter, observational, cross-sectional, survey-based study of the Urticaria Centers of Reference and Excellence (UCARE) network. The questionnaire included 48 questions completed by physicians in the UCARE network.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Surveys completed by 103 physicians from 81 UCAREs and 34 countries were analyzed. Seventy-eight percent of the participants responded that they had a national urticaria management guideline written by their professional societies and 28% responded that they had to operate under a regulatory guideline proposed by central health funding organizations. Seventy-two and 58.7% of these national recommendations do not contain any detailed information on when and/or how CSU treatment should be discontinued. There was a lack of detailed information on antihistamines and cyclosporine in particular. A predefined maximum duration was generally not applicable to omalizumab and cyclosporine (81% and 82%, respectively). Nearly all UCAREs step down omalizumab within 6 months from the first controlled status and 42% discontinue cyclosporine after 6 months regardless of the control status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings from the SDown-CSU study clearly highlight a global need for guidance on the process of stepping down treatment in CSU. Additionally, the study offers a step-down algorithm applicable to all stages of CSU treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 2","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12343","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139729141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purevsuren Losol, Magdalena Wolska, Tomasz P. Wypych, Lu Yao, Liam O'Mahony, Milena Sokolowska
Background
Allergic diseases, including respiratory and food allergies, as well as allergic skin conditions have surged in prevalence in recent decades. In allergic diseases, the gut microbiome is dysbiotic, with reduced diversity of beneficial bacteria and increased abundance of potential pathogens. Research findings suggest that the microbiome, which is highly influenced by environmental and dietary factors, plays a central role in the development, progression, and severity of allergic diseases. The microbiome generates metabolites, which can regulate many of the host’s cellular metabolic processes and host immune responses.
Aims and Methods
Our goal is to provide a narrative and comprehensive literature review of the mechanisms through which microbial metabolites regulate host immune function and immune metabolism both in homeostasis and in the context of allergic diseases.
Results and Discussion
We describe key microbial metabolites such as short-chain fatty acids, amino acids, bile acids and polyamines, elucidating their mechanisms of action, cellular targets and their roles in regulating metabolism within innate and adaptive immune cells. Furthermore, we characterize the role of bacterial metabolites in the pathogenesis of allergic diseases including allergic asthma, atopic dermatitis and food allergy.
Conclusion
Future research efforts should focus on investigating the physiological functions of microbiota-derived metabolites to help develop new diagnostic and therapeutic interventions for allergic diseases.
{"title":"A cross talk between microbial metabolites and host immunity: Its relevance for allergic diseases","authors":"Purevsuren Losol, Magdalena Wolska, Tomasz P. Wypych, Lu Yao, Liam O'Mahony, Milena Sokolowska","doi":"10.1002/clt2.12339","DOIUrl":"10.1002/clt2.12339","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Allergic diseases, including respiratory and food allergies, as well as allergic skin conditions have surged in prevalence in recent decades. In allergic diseases, the gut microbiome is dysbiotic, with reduced diversity of beneficial bacteria and increased abundance of potential pathogens. Research findings suggest that the microbiome, which is highly influenced by environmental and dietary factors, plays a central role in the development, progression, and severity of allergic diseases. The microbiome generates metabolites, which can regulate many of the host’s cellular metabolic processes and host immune responses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Methods</h3>\u0000 \u0000 <p>Our goal is to provide a narrative and comprehensive literature review of the mechanisms through which microbial metabolites regulate host immune function and immune metabolism both in homeostasis and in the context of allergic diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results and Discussion</h3>\u0000 \u0000 <p>We describe key microbial metabolites such as short-chain fatty acids, amino acids, bile acids and polyamines, elucidating their mechanisms of action, cellular targets and their roles in regulating metabolism within innate and adaptive immune cells. Furthermore, we characterize the role of bacterial metabolites in the pathogenesis of allergic diseases including allergic asthma, atopic dermatitis and food allergy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Future research efforts should focus on investigating the physiological functions of microbiota-derived metabolites to help develop new diagnostic and therapeutic interventions for allergic diseases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 2","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12339","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139717350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yang Qin, Weijun Huang, Rui Zheng, Qixing Wang, Qingqing Yu, Yin Li, Kai Wang, Jun Tang
Background
The efficacy and safety of the novel immunotherapy method, intra-cervical lymphatic immunotherapy (ICLIT), need to be investigated. Comparing it with subcutaneous immunotherapy (SCIT), we clarified the long-term efficacy and safety of intra-cervical lymphatic immunotherapy on allergic rhinitis (AR), and investigated the improvement of clinical efficacy of the booster injection at 1 year after ICLIT treatment.
Methods
Ninety adult patients with dust mite allergy were randomly divided into 3 groups: 30 in the SCIT group, 30 in the ILCLIT group, and 30 in ICLIT booster group. Changes in total symptom score (TSS), nasal symptom score (TNSS), ocular symptom score (TOSS) and total medication score (TMS) were evaluated in the three groups. Adverse reactions were recorded, and serum dust mite specific IgE (sIgE) and specific IgG4 were assessed in the ICLIT group and ICLIT booster group.
Results
TSS, TNSS, TOSS, and TMS scores were significantly lower in the three groups at 36 months after treatment (p < 0. 05). And at 36 months the ICLIT-booster group showed results similar to SCIT and superior to ICLIT (p < 0. 05). Serum specific IgE decreased in all three groups at 12 and 36 months after treatment, p < 0.01. The ICLIT group and the ICLIT booster group showed a significant increase in sIgG4, p < 0.01. None of the patients in the three groups had any serious systemic adverse effects during the 3-year follow-up.
Conclusion
The ICLIT treatment is effective and safe on AR. One booster injection of allergens at 1 year can greatly improve its long-term efficacy.
{"title":"The long-term efficacy of intra-cervical lymphatic immunotherapy on adults with allergic rhinitis: A randomized controlled study","authors":"Yang Qin, Weijun Huang, Rui Zheng, Qixing Wang, Qingqing Yu, Yin Li, Kai Wang, Jun Tang","doi":"10.1002/clt2.12341","DOIUrl":"https://doi.org/10.1002/clt2.12341","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The efficacy and safety of the novel immunotherapy method, intra-cervical lymphatic immunotherapy (ICLIT), need to be investigated. Comparing it with subcutaneous immunotherapy (SCIT), we clarified the long-term efficacy and safety of intra-cervical lymphatic immunotherapy on allergic rhinitis (AR), and investigated the improvement of clinical efficacy of the booster injection at 1 year after ICLIT treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ninety adult patients with dust mite allergy were randomly divided into 3 groups: 30 in the SCIT group, 30 in the ILCLIT group, and 30 in ICLIT booster group. Changes in total symptom score (TSS), nasal symptom score (TNSS), ocular symptom score (TOSS) and total medication score (TMS) were evaluated in the three groups. Adverse reactions were recorded, and serum dust mite specific IgE (sIgE) and specific IgG4 were assessed in the ICLIT group and ICLIT booster group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>TSS, TNSS, TOSS, and TMS scores were significantly lower in the three groups at 36 months after treatment (<i>p</i> < 0. 05). And at 36 months the ICLIT-booster group showed results similar to SCIT and superior to ICLIT (<i>p</i> < 0. 05). Serum specific IgE decreased in all three groups at 12 and 36 months after treatment, <i>p</i> < 0.01. The ICLIT group and the ICLIT booster group showed a significant increase in sIgG4, <i>p</i> < 0.01. None of the patients in the three groups had any serious systemic adverse effects during the 3-year follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The ICLIT treatment is effective and safe on AR. One booster injection of allergens at 1 year can greatly improve its long-term efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registry</h3>\u0000 \u0000 <p>Clinical trial registration number: ChiCTR1800017130.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 2","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12341","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139719866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giulia C. I. Spolidoro, Sungkutu Nyassi, Daniil Lisik, Athina Ioannidou, Mohamed Mustafa Ali, Yohannes Tesfaye Amera, Graciela Rovner, Ekaterina Khaleva, Carina Venter, Ronald van Ree, Margitta Worm, Berber Vlieg-Boerstra, Aziz Sheikh, Antonella Muraro, Graham Roberts, Bright I. Nwaru
Background
The 2014 estimates of prevalence of food allergy (FA) in Europe published by the European Academy of Allergy and Clinical Immunology included only the eight so-called big foods (cow's milk/egg/wheat/soy/peanut/tree nuts/fish/shellfish). Those estimates have recently been updated. Complementing this, we sought to identify and estimate the prevalence of allergy to other foods that have been reported during the last decade.
Methods
Six databases were searched for studies published 2012–2021. Random-effects meta-analysis was performed to derive pooled prevalence of allergy to each food.
Results
Twenty-seven studies were included, containing a total of 66 FAs. Among the most frequently reported FAs, the lifetime and point prevalence range of self-reported kiwi allergy was 0.1%–1.0% and 0.2%–8.1%, respectively, while the food challenge (FC)-verified kiwi allergy point prevalence range was 0.01%–0.10%. The point prevalence range for self-reported peach allergy was 0.2%–3.2%, while the range for FC-verified peach allergy was 0.02%–0.05%. The lifetime and point prevalence range for self-reported tomato allergy was 0.01%–1.8% and 0.2%–2.1%, respectively.
Conclusion
Allergy to some foods traditionally not considered important are now emerging as relevant FAs. The focus on FA in Europe should not be limited to the so-called eight big FA, but extended to other types of foods which need to be considered both for clinical purposes and population risk assessment.
{"title":"Food allergy outside the eight big foods in Europe: A systematic review and meta-analysis","authors":"Giulia C. I. Spolidoro, Sungkutu Nyassi, Daniil Lisik, Athina Ioannidou, Mohamed Mustafa Ali, Yohannes Tesfaye Amera, Graciela Rovner, Ekaterina Khaleva, Carina Venter, Ronald van Ree, Margitta Worm, Berber Vlieg-Boerstra, Aziz Sheikh, Antonella Muraro, Graham Roberts, Bright I. Nwaru","doi":"10.1002/clt2.12338","DOIUrl":"https://doi.org/10.1002/clt2.12338","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The 2014 estimates of prevalence of food allergy (FA) in Europe published by the European Academy of Allergy and Clinical Immunology included only the eight so-called big foods (cow's milk/egg/wheat/soy/peanut/tree nuts/fish/shellfish). Those estimates have recently been updated. Complementing this, we sought to identify and estimate the prevalence of allergy to other foods that have been reported during the last decade.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Six databases were searched for studies published 2012–2021. Random-effects meta-analysis was performed to derive pooled prevalence of allergy to each food.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-seven studies were included, containing a total of 66 FAs. Among the most frequently reported FAs, the lifetime and point prevalence range of self-reported kiwi allergy was 0.1%–1.0% and 0.2%–8.1%, respectively, while the food challenge (FC)-verified kiwi allergy point prevalence range was 0.01%–0.10%. The point prevalence range for self-reported peach allergy was 0.2%–3.2%, while the range for FC-verified peach allergy was 0.02%–0.05%. The lifetime and point prevalence range for self-reported tomato allergy was 0.01%–1.8% and 0.2%–2.1%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Allergy to some foods traditionally not considered important are now emerging as relevant FAs. The focus on FA in Europe should not be limited to the so-called eight big FA, but extended to other types of foods which need to be considered both for clinical purposes and population risk assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 2","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12338","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139700543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katariina Lajunen, Anette M. Määttä, Kristiina Malmström, Satu Kalliola, Hanna Knihtilä, Terhi Savinko, L. Pekka Malmberg, Anna S. Pelkonen, Mika J. Mäkelä
Background
The use of component-resolved allergy diagnostics has provided a clearer understanding of the species-specific sensitization and severity of potential allergic reactions. This cross-sectional study aimed to determine whether sensitization to allergen components in furry animals is indicative of blood eosinophilia, a positive fractional exhaled nitric oxide (FeNO) test, abnormal lung function, and asthma symptoms in children. Additionally, we investigated whether having pets during childhood affects the development of asthma or allergic sensitization to furry animals.
Methods
We recruited 203 children aged 4–17 years with asthma diagnosis based on abnormal lung function and 33 controls. IgE-sensitization to allergen components for dogs, cats, and horses was analyzed using a multiplex microarray. Children were tested with FeNO, impulse oscillometry, spirometry, methacholine challenge, and skin prick test. A questionnaire was used to investigate pet ownership and symptom profile.
Results
FeNO results and blood eosinophilia revealed a correlation with sensitization to all furry animal allergens, particularly lipocalins (r = 0.203–0.560 and 0.206–0.560, respectively). Can f 3 was found to correlate with baseline R5 (r = 0.298). No association between methacholine challenge results and sensitization to furry animal allergens was found. Children with asthma who were sensitized to Can f 1, Can f 6, or both frequently reported asthma symptoms. Dog ownership was associated with a lower level of IgE-sensitization to lipocalins, fewer asthma symptoms, and less blood eosinophilia.
Conclusion
Furry animal allergen component IgE-sensitization is a risk factor for type 2-inflammation and asthma symptoms.
背景成分解析过敏诊断法的使用使人们对物种特异性过敏和潜在过敏反应的严重程度有了更清楚的了解。本横断面研究旨在确定对毛茸茸动物中过敏原成分的过敏是否会导致儿童血液中出现嗜酸性粒细胞增多、呼出一氧化氮（FeNO）检测呈阳性、肺功能异常和哮喘症状。此外，我们还研究了童年时期饲养宠物是否会影响哮喘或对毛茸茸动物过敏的发生。 方法 我们招募了 203 名根据肺功能异常诊断为哮喘的 4-17 岁儿童和 33 名对照组儿童。使用多重芯片分析了狗、猫和马过敏原成分的 IgE 致敏情况。对儿童进行了 FeNO、脉冲振荡仪、肺活量测定、甲基胆碱挑战和皮肤点刺试验。调查问卷用于调查宠物拥有情况和症状特征。 结果 FeNO 结果和血液嗜酸性粒细胞增多与所有毛茸茸的动物过敏原的致敏性有关，尤其是脂钙蛋白（r 分别为 0.203-0.560 和 0.206-0.560）。Can f 3 与基线 R5 相关（r = 0.298）。未发现甲基胆碱挑战结果与毛茸茸动物过敏原致敏之间存在关联。对 Can f 1、Can f 6 或两者都过敏的哮喘患儿经常报告哮喘症状。养狗与脂联素的 IgE 致敏水平较低、哮喘症状较少和血液嗜酸性粒细胞减少有关。 结论 毛茸茸的动物过敏原成分 IgE 致敏是导致 2 型炎症和哮喘症状的危险因素。
{"title":"Pets, furry animal allergen components, and asthma in childhood","authors":"Katariina Lajunen, Anette M. Määttä, Kristiina Malmström, Satu Kalliola, Hanna Knihtilä, Terhi Savinko, L. Pekka Malmberg, Anna S. Pelkonen, Mika J. Mäkelä","doi":"10.1002/clt2.12337","DOIUrl":"https://doi.org/10.1002/clt2.12337","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The use of component-resolved allergy diagnostics has provided a clearer understanding of the species-specific sensitization and severity of potential allergic reactions. This cross-sectional study aimed to determine whether sensitization to allergen components in furry animals is indicative of blood eosinophilia, a positive fractional exhaled nitric oxide (FeNO) test, abnormal lung function, and asthma symptoms in children. Additionally, we investigated whether having pets during childhood affects the development of asthma or allergic sensitization to furry animals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We recruited 203 children aged 4–17 years with asthma diagnosis based on abnormal lung function and 33 controls. IgE-sensitization to allergen components for dogs, cats, and horses was analyzed using a multiplex microarray. Children were tested with FeNO, impulse oscillometry, spirometry, methacholine challenge, and skin prick test. A questionnaire was used to investigate pet ownership and symptom profile.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>FeNO results and blood eosinophilia revealed a correlation with sensitization to all furry animal allergens, particularly lipocalins (<i>r</i> = 0.203–0.560 and 0.206–0.560, respectively). Can f 3 was found to correlate with baseline R5 (<i>r</i> = 0.298). No association between methacholine challenge results and sensitization to furry animal allergens was found. Children with asthma who were sensitized to Can f 1, Can f 6, or both frequently reported asthma symptoms. Dog ownership was associated with a lower level of IgE-sensitization to lipocalins, fewer asthma symptoms, and less blood eosinophilia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Furry animal allergen component IgE-sensitization is a risk factor for type 2-inflammation and asthma symptoms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 2","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12337","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139682869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rebecca C. Knibb, Lily Hawkins, Cassandra Screti, M. Hazel Gowland, Mamidipudi Thirumala Krishna, George du Toit, Christina J. Jones
Background
Food hypersensitivity (FHS) management requires daily risk assessments of all food and drinks consumed to prevent unpleasant and potentially fatal adverse reactions. Most research has focussed on food allergy in children and families. Little is known about the impact on adults or those with other FHS, such as food intolerance or coeliac disease. This study assessed differences in practices and risk assessment behaviours when eating out for adults with FHS.
Methods
Adult UK residents (N = 930; 820 females, 90 males; 95% White; mean age 50 years [±16.6SD]), with food allergy (18%), food intolerance (23%) coeliac disease (44%) or multiple FHS (15%) completed an online survey.
Results
Adults checked information to identify foods causing a reaction always or most of the time when eating out. However, adults with food intolerance reported checking significantly less often than adults with other FHS (all ps < 0.001). Adults reporting more severe FHS, medical rather than self-diagnosis of FHS, previous anaphylaxis, had called an ambulance or been in hospital due to a reaction checked information significantly more often (all ps < 0.001), but were also less confident in the information provided (all ps < 0.05). Adults with allergy, coeliac disease or multiple FHS were also less confident in written and verbal information provided than those with food intolerance (p < 0.01). The type of FHS, greater perceived severity of FHS and having a medical diagnosis consistently predicted risk assessment behaviours when eating out (all ps < 0.001).
Conclusion
Clinicians, patients and the food industry should be aware that the type of FHS, patient-perceived severity and past experience of reactions affect risk assessment behaviours when eating out. This should be considered when providing clinical advice and emergency plans.
{"title":"Risk assessment behaviour when eating out in adults with food hypersensitivity","authors":"Rebecca C. Knibb, Lily Hawkins, Cassandra Screti, M. Hazel Gowland, Mamidipudi Thirumala Krishna, George du Toit, Christina J. Jones","doi":"10.1002/clt2.12336","DOIUrl":"https://doi.org/10.1002/clt2.12336","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Food hypersensitivity (FHS) management requires daily risk assessments of all food and drinks consumed to prevent unpleasant and potentially fatal adverse reactions. Most research has focussed on food allergy in children and families. Little is known about the impact on adults or those with other FHS, such as food intolerance or coeliac disease. This study assessed differences in practices and risk assessment behaviours when eating out for adults with FHS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adult UK residents (<i>N</i> = 930; 820 females, 90 males; 95% White; mean age 50 years [±16.6SD]), with food allergy (18%), food intolerance (23%) coeliac disease (44%) or multiple FHS (15%) completed an online survey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Adults checked information to identify foods causing a reaction always or most of the time when eating out. However, adults with food intolerance reported checking significantly less often than adults with other FHS (all <i>p</i>s < 0.001). Adults reporting more severe FHS, medical rather than self-diagnosis of FHS, previous anaphylaxis, had called an ambulance or been in hospital due to a reaction checked information significantly more often (all <i>p</i>s < 0.001), but were also less confident in the information provided (all <i>p</i>s < 0.05). Adults with allergy, coeliac disease or multiple FHS were also less confident in written and verbal information provided than those with food intolerance (<i>p</i> < 0.01). The type of FHS, greater perceived severity of FHS and having a medical diagnosis consistently predicted risk assessment behaviours when eating out (all <i>p</i>s < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Clinicians, patients and the food industry should be aware that the type of FHS, patient-perceived severity and past experience of reactions affect risk assessment behaviours when eating out. This should be considered when providing clinical advice and emergency plans.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"14 2","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.12336","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139655588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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