Revue Francaise d Allergologie最新文献

Background

White mulberry (Morus alba) pollen grains trigger allergic diseases including asthma, allergic rhinitis, and allergic conjunctivitis. Non-specific lipid transfer proteins (nsLTPs) are robust allergens found in higher plants. Although it was isolated and immunologically characterized in the fruits of Morus nigra, it has not yet been determined whether nsLTP is one of the M. alba pollen allergens.

Objective

This study aims to examine the possible allergenicity of M. alba pollen nsLTP by producing it recombinantly, followed by immunoblotting.

Methods

Total RNA was isolated from M. alba pollen grains, and the nsLTP gene was obtained by reverse transcriptase polymerase reaction. It was cloned into Escherichia coli using pQE2 plasmid and purified by immobilized metal affinity chromatography following the expression. To confirm the immunoreactivity of the purified r-nsLTP, immunoblotting was performed with the serum of patients allergic to M. alba pollen. B-cell epitopes of nsLTP were also predicted using the bioinformatics tools, namely Bioinformatics Predicted Antigenic Peptides, BepiPred-2.0, and the Immune Epitope Database, whereas T-cell epitopes were estimated by using NetMHCIIpan-4.0 and NetMHCII-2.3 servers.

Results

The r-nsLTP showed positive results in immunoblotting with sera of 7/7 (100%) of M. alba allergic patients. Five B-cell epitopes (26–31, 43–50, 65–71, 92–100, 105–115) and three T-cell epitopes (57–65, 78–86, 105–113) were predicted by in silico analyses.

Conclusion

Data obtained in this study are expected to support the use of r-nsLTP in solutions for diagnosis and treatment of M. alba allergy and cross-reactivities between nsLTPs, as well as recombinant allergen production for vaccination.

Study objective

The study aims to analyse 36 children presenting with acute fish and shellfish food protein-induced enterocolitis syndrome.

Patients and methods

This is a retrospective, single-centre study conducted between 2016 and 2024. Diagnosis was established based on the international diagnostic criteria published in 2017.

Results

The most frequently implicated foods were cod and prawns. The median age at first reaction was 12 months for fish and 61 months for shellfish. Only one out of 35 patients showed positive allergological tests, but 21 out of 36 patients had a personal history of atopy. Twenty-eight patients reacted exclusively to fish, 6 exclusively to shellfish, and 2 to both. Eight patients reacted to multiple types of fish, while 13 tolerated types of fish other than the one responsible for the initial reaction. Four children also reacted to other types of food.

Conclusion

This study confirms that fish is one of the most important triggers of food protein-induced enterocolitis in children in Europe and that reactions to shellfish are more frequent at a later age. These patients generally tolerate other types of fish and shellfish than those responsible for the initial reaction. Therefore, it is important to encourage patients to incorporate other varieties of these foods in their diet, if necessary with an introduction through an oral food challenge.

The development of oral immunotherapy in food allergy calls for ethical reflection. Material norms of justice are expected when individuals are entitled to receive particular goods due to their health condition, while their availability is not total. After outlining how these issues arise in medical literature, this paper draws on Aristotle's philosophy to present the dual face of justice: while it is socially indispensable, it is also an individual virtue. Contemporary doctrines propose competing standards for the allocation of goods, ranging from utilitarianism to procedural justice. For the clinician, torn between the care of the individual patient and collective concerns, the virtue of justice may be the only way to resolve dilemmas that principles alone cannot address.

Hyaluronic acid dermal fillers are becoming a very popular choice for patients wanting to undergo non-invasive facial rejuvenation. It's known to be a relatively safe procedure. Delayed inflammatory reactions to hyaluronic acid fillers are uncommon with frequent spontaneous resolution. These reactions can be triggered by many situations like infections or vaccination. We report a case of delayed inflammatory reaction to hyaluronic acid dermal fillers post SARS COV 2 vaccination.

The food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy, often underdiagnosed despite an increasing prevalence. This study aims to assess the impact of FPIES on the quality of life and identify risk factors for psychosocial distress. We collected data from a cohort of 48 pediatric patients with FPIES, recruited by private and hospital allergists through telephone interviews with families. Quality of life, assessed through QUALIN and Peds QL questionnaires, is generally preserved, but psychopathological aspects and sociability are affected. Parental concerns are significant, with 61% experiencing anxiety during the food diversification period. Regarding emotional well-being, 85% of parents express concerns, while FPIES induces stress in 75% of them. Family activity limitations affect 62% of families. FPIES impacts the social life of children (54%) and has a significant financial impact on 57% of families. Negative influences on quality of life include a history of hospitalization, the number of emergency room visits for FPIES, cow's milk as a triggering food, and FPIES to multiple foods. These results emphasize the importance of considering psychosocial dimensions in the overall management of FPIES.

The Food Protein-Induced Enterocolitis Syndrome (FPIES) is a non-IgE-mediated food allergy, primarily manifesting in young children through vomiting. There are numerous differences regarding the implicated foods depending on the country and population studied. The study focused on a regional cohort of 48 children with FPIES in France, aiming to identify the most common triggers and provide appropriate dietary advice to families. Data were collected through telephone interviews with the families of FPIES patients. The results revealed that cow's milk was the most frequent trigger (67%), followed by egg (21%), beef, and fish (10% each). A correlation between reactions to beef and cow's milk was observed. The most commonly reported symptoms were vomiting, followed by abdominal pain, pallor, and diarrhea. IgE sensitization was present in 19% of tested children, with no statistically significant influence on FPIES recovery. In conclusion, this study emphasizes the significance of regional peculiarities in FPIES trigger foods and suggests that dietary recommendations should be adjusted accordingly.

The prevalence of food allergies has been on the rise recently, manifesting in various systemic symptoms. This report presents a rare case of acute pancreatitis in an adult triggered by cow's milk allergy. Although few reports exist linking different food allergens to pancreatitis, this case underscores the importance of considering food allergies in the differential diagnosis of gastrointestinal disorders, beyond typical symptoms like urticaria, pruritus, vomiting, and diarrhea. Allergy patients presenting with only gastrointestinal symptoms may be misdiagnosed as having food intolerances such as lactose intolerance.

The European Baseline Series (EBS) of patch tests is the essential tool for allergological exploration of patients suspected of allergic contact dermatitis. The main objective of our study was to define the epidemiological, clinical characteristics, and sensitization profile to contact allergens of the EBS among all patients who underwent contact allergological exploration in an allergology clinic in Algeria over a 15-year period (from 2007 to 2022). Our aim was to generate a map of allergic contact dermatitis in Eastern Algeria to support prevention efforts on a national scale.

Methods

Our study was a retrospective descriptive monocentric study conducted in an allergology and contact allergen exploration medical office in Constantine, Algeria. It included all EBS performed between March 2007 and February 2022 on patients who were either first-time visitors or referred for patch testing.

Results

A total of 202 patients suspected of contact dermatitis were tested, with ages ranging from 3 to 75 years. Among them, 125 were female (61.9%) and 77 were male (38.1%). Of these, 138 patients (68.8%) (45 males, 93 females) tested positive for one or more allergens. Fifty-eight patients (42%) had a positive reaction to more than two contact allergens. The most common positive reactions were observed with nickel (30.2%), cobalt (28.2%), potassium dichromate (27.2%), myroxylon pereirae (9.9%), and fragrance mix I (8.4%). Sensitivity to nickel was more frequent among females (P < 0.0001), while sensitivity to potassium dichromate was more frequent among males (P = 0.01).

Conclusions

The distribution of different causes of contact allergy identified through EBS was similar to what is observed in Europe. It allowed us to define, based on the sensitization profile of the patients included in our study, the most frequent causes of allergic contact dermatitis within our population. However, the emergence of new contact allergens can only be identified if Algeria establishes an allergo-vigilance network, similar to that in Europe, enabling both the evolution of patch test compositions and the detection of new allergic risks within the population.

Study objective

The objective of this study was to apprehend information practices of patients receiving allergy care.

Patients and methods

We conducted a prospective monocentric study administering a questionnaire to 200 patients consulting for any type of allergy in a French university hospital center. Respondents provided answers on their socio-demographic characteristics, personal practices for seeking information on allergies, understanding of the information shared by allergists, and doctor's attitude.

Results

In all, 68% of patients declared informing themselves on allergies. Healthcare professionals were their main sources of information (allergist 66%, family doctor 57%, other specialists 5%), followed by the Internet (22%), leaflets from pharmaceutical laboratories (16%), and traditional media (television 11%, press 6%, radio, 2%). Patients expressed the need for information and explanations from the allergist, regarding the diagnosed allergy, adverse effects, and duration of treatment. Thirty-one percent of them encountered difficulty in understanding the information shared by the doctor during the consultation, especially in patients suffering from respiratory allergies, with a short clinical history, an educational level below high school diploma and among those who do not seek information on allergies besides medical consultation.

Discussion and conclusion

The study led to identify first outlines on information practices of allergy patients. The work will be continued by a qualitative study.