Reaction phenotypes in IgE-mediated food allergy and anaphylaxis

Chong, Kok Wee; Ruíz-García, Mónica; Patel, Nandinee; Boyle, Robert; Turner, Paul J.

doi:10.1016/j.anai.2019.12.023

Cited by 35 publications

(49 citation statements)

References 38 publications

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“…Allergic reactions to cow's milk and eggs usually disappears with age, while allergy to peanuts, nuts, and seafoods more often persists even into adulthood; moreover, around 30% of patients develop more than one type of allergic sensitization over time [42]. Fruit sensitization appears belatedly, exhibiting various cross-reactivities, which give rise to peculiar clinical manifestations, such as pollen-food allergy syndrome [43,44].…”

Section: Clinical Presentation and Natural Historymentioning

confidence: 99%

New Perspectives in Food Allergy

Martinis

Sirufo

Suppa

et al. 2020

IJMS

164

142

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The improvement of the knowledge of the pathophysiological mechanisms underlying the tolerance and sensitization to food antigens has recently led to a radical change in the clinical approach to food allergies. Epidemiological studies show a global increase in the prevalence of food allergy all over the world and manifestations of food allergy appear increasingly frequent also in elderly subjects. Environmental and nutritional changes have partly changed the epidemiology of allergic reactions to foods and new food allergic syndromes have emerged in recent years. The deepening of the study of the intestinal microbiota has highlighted important mechanisms of immunological adaptation of the mucosal immune system to food antigens, leading to a revolution in the concept of immunological tolerance. As a consequence, new prevention models and innovative therapeutic strategies aimed at a personalized approach to the patient affected by food allergy are emerging. This review focuses on these new perspectives and their practical implications in the management of food allergy, providing an updated view of this complex pathology.

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Section: Clinical Presentation and Natural Historymentioning

confidence: 99%

New Perspectives in Food Allergy

Martinis

Sirufo

Suppa

et al. 2020

IJMS

164

142

View full text Add to dashboard Cite

show abstract

“…Allergic diseases are characterized by diverse clinical disease phenotypes and symptoms, ranging from airway disorders such as allergic rhinitis and asthma ( 6 ) to systemic anaphylaxis as in the case of food and insect venom allergy ( 7 , 8 ), or skin eczema/atopic dermatitis ( 9 ). Although some allergic diseases are mild and can be controlled with symptomatic medication, a considerable number of patients are at risk of life-threatening episodes ( 10 ). For instance, allergic asthma can become chronic and dramatically dampen respiratory function for life.…”

Section: Introductionmentioning

confidence: 99%

CpG Adjuvant in Allergen-Specific Immunotherapy: Finding the Sweet Spot for the Induction of Immune Tolerance

et al. 2021

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Prevalence and incidence of IgE-mediated allergic diseases have increased over the past years in developed and developing countries. Allergen-specific immunotherapy (AIT) is currently the only curative treatment available for allergic diseases that has long-term efficacy. Although AIT has been proven successful as an immunomodulatory therapy since its beginnings, it still faces several unmet needs and challenges today. For instance, some patients can experience severe side effects, others are non-responders, and prolonged treatment schedules can lead to lack of patient adherence and therapy discontinuation. A common strategy to improve AIT relies on the use of adjuvants and immune modulators to boost its effects and improve its safety. Among the adjuvants tested for their clinical efficacy, CpG oligodeoxynucleotide (CpG-ODN) was investigated with limited success and without reaching phase III trials for clinical allergy treatment. However, recently discovered immune tolerance-promoting properties of CpG-ODN place this adjuvant again in a prominent position as an immune modulator for the treatment of allergic diseases. Indeed, it has been shown that the CpG-ODN dose and concentration are crucial in promoting immune regulation through the recruitment of pDCs. While low doses induce an inflammatory response, high doses of CpG-ODN trigger a tolerogenic response that can reverse a pre-established allergic milieu. Consistently, CpG-ODN has also been found to stimulate IL-10 producing B cells, so-called B regulatory cells (Bregs). Accordingly, CpG-ODN has shown its capacity to prevent and revert allergic reactions in several animal models showing its potential as both preventive and active treatment for IgE-mediated allergy. In this review, we describe how CpG-ODN-based therapies for allergic diseases, despite having shown limited success in the past, can still be exploited further as an adjuvant or immune modulator in the context of AIT and deserves additional attention. Here, we discuss the past and current knowledge, which highlights CpG-ODN as a potential adjuvant to be reevaluated for the enhancement of AIT when used in appropriate conditions and formulations.

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“…Chronic allergy encompasses several different clinical patterns and organ involvement, including rhinitis, [ 26 ] atopic dermatitis, [ 27 ] chronic urticaria, [ 28 ] conjunctivitis, [ 29 ] and asthma, [ 30 ] and may even involve oral mucosal, [ 31 ] gastrointestinal, [ 32 ] and systemic [ 33 ] manifestations. Over the past century, treatment has mainly depended on clinical severity, but not specifically on organ involvement, except for cases of asthma.…”

Section: Discussionmentioning

confidence: 99%

Differences in gut microbiota between allergic rhinitis, atopic dermatitis, and skin urticaria

Su¹,

Luo²,

Hsu³

et al. 2021

Medicine

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Introduction. Several forms of allergy have been clinically presented, including, among others, atopic dermatitis (eczema), urticaria (hives), and allergic rhinitis (rhinitis). As their detailed pathogenesis continues to be researched, we aimed in the current study to compare gut microbiota differences between eczema, hives, and rhinitis patients. Methods. We enrolled 19 eczemas, nine hives, and 11 allergic rhinitis patients in this study. Fecal samples were examined using 16S ribosomal ribonucleic acid amplicon sequencing, followed by bioinformatics and statistical analyses. We compared microbiota in dermatitis (eczema), chronic urticaria (hives), and allergic rhinitis (rhinitis). Results. All clinical data were similar between the subgroups. The microbiota results indicated that Bacteroidales species were found in skin allergies, both urticaria and eczema, when compared to rhinitis. The microbiota differs substantially between those patients with atopic dermatitis (eczema), chronic urticaria (hives), and allergic rhinitis (rhinitis), thus indicating that the gut-skin and gut-nose axes exist. Gut flora colonies differ significantly between skin allergy and nose allergy. Bacteroidales species could be a clinical link between gut flora and skin allergy; of those, Bacteroids Plebeius DSM 17135 is significantly associated with the urticaria (hives) subgroup.Conclusion. Our results demonstrated high intra-group homogeneous and high inter-group heterogeneous microbiota. The clinical symptoms of eczema, hives, and rhinitis can all be linked to specific microbiota in the current study. In this pilot study, the Ruminococcaceae and Bacteroidales species are associated with allergic disease, in line with several previous published articles, and the abundance of Firmicutes Phylum is representative of intestinal dysbiosis. In the future, a larger cohort and thorough biochemical studies are needed for confirmation.

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Reaction phenotypes in IgE-mediated food allergy and anaphylaxis

Cited by 35 publications

References 38 publications

New Perspectives in Food Allergy

New Perspectives in Food Allergy

CpG Adjuvant in Allergen-Specific Immunotherapy: Finding the Sweet Spot for the Induction of Immune Tolerance

Differences in gut microbiota between allergic rhinitis, atopic dermatitis, and skin urticaria

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