Racial Differences in Food Allergy Phenotype and Health Care Utilization among US Children

Mahdavinia, Mahboobeh; Fox, Susan; Smith, Bridget; James, Christine; Palmisano, Erica L.; Mohammed, Aisha; Zahid, Zeeshan; Assa’ad, Amal; Tobin, Mary C.; Gupta, Ruchi S.

doi:10.1016/j.jaip.2016.10.006

Cited by 106 publications

(55 citation statements)

References 24 publications

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“…In general, anaphylaxis was common [7–9, 20, 21], more associated with repeated use of epinephrine [27] and more fatal [23] among Caucasians compared to Black, Latino/Hispanic and Asian ethnicities. In contrast, Mahdavinia et al (2017) reported that Caucasians had a lower rate of food allergy associated anaphylaxis than African American and Hispanic children [37]. Additionally, Buka et al (2015) reported that Caucasians had less incidence, and were less likely to present with severe anaphylactic symptoms than South Asian British children living in Birmingham [38].…”

Section: Discussionmentioning

confidence: 99%

Anaphylaxis triggers in a large tertiary care hospital in Qatar: a retrospective study

Abunada

Al‐Nesf

Thalib

et al. 2018

World Allergy Organization Journal

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BackgroundAnaphylaxis is a serious allergic disease that may lead to death if not immediately recognized and treated. Triggers of anaphylaxis including food, drugs, and insect stings can vary widely. The incidence of anaphylaxis seems to be affected by age, sex, atopy, and geographic location. This study aims to examine the common triggers of anaphylaxis in Qatar.MethodsA total of 1068 electronic medical records were audited using power chart system: 446 from the medical coding system of anaphylaxis and 622 from the epinephrine auto-injectors (EAIs) dispensed during January 2012–December 2017.ResultsOf 1068 patients, 574 (53.5%) had anaphylaxis; male to female ratio was 1.2, and 300 patients (77.9%) were less than 10 years old. The common triggers were food (n = 316, 55.0%), insect stings (n = 161, 28.0%), and drugs (n = 103, 17.9%). Common anaphylaxis food triggers were nuts (n = 173, 30.1%), eggs (n = 89, 15.5%), and seafood (n = 72, 12.5%), and common anaphylaxis medication triggers were antibiotics (n = 49, 8.5%) and nonsteroidal anti-inflammatory drugs (n = 30, 5.2%). Interestingly, 135 anaphylactic patients (23.5%) were due to black ant stings. The anaphylaxis triggers varied significantly between children and adults. Among children (less than 10 years), three quarters of the events were triggered by food (223, 74.3%) while among adults (20–55 years), insect stings (n = 59, 43.0%) and drugs (n = 44, 32.0%) were dominant.DiscussionThis is the first national study stratifying anaphylaxis triggers among different age groups in Qatar. This study will serve as a guide for clinical practice in allergy clinics in Qatar and will help to assess future trends of anaphylaxis in Qatar.Electronic supplementary materialThe online version of this article (10.1186/s40413-018-0200-9) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Anaphylaxis triggers in a large tertiary care hospital in Qatar: a retrospective study

Abunada

Al‐Nesf

Thalib

et al. 2018

World Allergy Organization Journal

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“…158, 159 Reasons for these ethnic disparities remain unclear, but may reflect true genetic differences, environmental factors, including socioeconomic status, or a combination of factors. Nevertheless, a handful of genetic polymorphisms have been described that may influence development of anaphylaxis.…”

Section: Genetic Diversity/host Factors Influencing Anaphylaxismentioning

confidence: 99%

The pathophysiology of anaphylaxis

Reber

Hernandez

Galli

2017

Journal of Allergy and Clinical Immunology

367

364

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Anaphylaxis is a severe, systemic hypersensitivity reaction that is rapid in onset and characterized by life-threatening airway, breathing, and/or circulatory problems, and that is usually associated with skin and mucosal changes. Because it can be triggered in some people by minute amounts of antigen (e.g. certain foods or single insect stings), anaphylaxis can be considered the most aberrant example of an imbalance between the cost and benefit of an immune response. This review will describe current understanding of the immunopathogenesis and pathophysiology of anaphylaxis, focusing on the roles of IgE and IgG antibodies, immune effector cells, and mediators thought to contribute to examples of the disorder. Evidence from studies of anaphylaxis in humans will be discussed, as well as insights gained from analyses of animal models, including mice genetically deficient in the antibodies, antibody receptors, effector cells, or mediators implicated in anaphylaxis, and mice which have been “humanized” for some of these elements. We also will review possible host factors which may influence the occurrence or severity of anaphylaxis. Finally, we will speculate about anaphylaxis from an evolutionary perspective, and argue that, in the context of severe envenomation by arthropods or reptiles, anaphylaxis may even provide a survival advantage.

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“…in a retrospective cohort study of children aged 0‐17 years consulting at two allergy tertiary care centres in the USA. The African American or Hispanic children were found to have more severe FA profiles more commonly associated with allergic comorbidities than the non‐Hispanic White children . Corn, seafood and fish allergies were more frequent in African American and Hispanic children, wheat or soybean allergies more common in those of African American origin, and nut allergies in White children.…”

Section: Determinants Of Severe Food Allergy Phenotypesmentioning

confidence: 93%

“…The African American or Hispanic children were found to have more severe FA profiles more commonly associated with allergic comorbidities than the non-Hispanic White children. 31 Corn, seafood and fish allergies were more frequent in African American and Hispanic children, wheat or soybean allergies more common in those of African American origin, and nut allergies in White children. These differences may be attributed to cultural dietary habits, food introduction practices, different living conditions and genetic backgrounds.…”

Section: Influence Of Gender and Ethnic Backgroundmentioning

confidence: 95%

Food allergy phenotypes: The key to personalized therapy

Deschildre

Lejeune

Cap

et al. 2017

Clin Experimental Allergy

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Food allergies (FAs) are of increasing public health concern and are characterized by a large spectrum of diseases. Their diversity is well known for immunologic pathways (IgE, non-IgE-mediated FAs) and natural history. Many other factors and patient characteristics are involved including type of food, exposure route, allergic comorbidities, gender, racial and ethnic backgrounds, cofactors and health conditions. Food allergen components and sensitization profiles are also involved in FA phenotypes. A new approach to chronic disorders based on the identification of phenotypes through extensive knowledge of all the complex components is also applicable to FAs and could lead towards integrative care management. Diagnostic biomarkers for FAs are emerging which also contribute to better care modalities. The aim of this article was to highlight current knowledge regarding the phenotypic diversity of FA. This review will focus on IgE-mediated FAs and how identifying phenotypes may help to better understand the pathophysiological complexity, improve diagnosis and lead to personalized treatment strategies.

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Racial Differences in Food Allergy Phenotype and Health Care Utilization among US Children

Cited by 106 publications

References 24 publications

Anaphylaxis triggers in a large tertiary care hospital in Qatar: a retrospective study

Anaphylaxis triggers in a large tertiary care hospital in Qatar: a retrospective study

The pathophysiology of anaphylaxis

Food allergy phenotypes: The key to personalized therapy

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