Allergy and Immunology Commons^™

Management Of Children With Food Allergies By Allergists In The United States, Aikaterini Anagnostou, Matthew Greenhawt, Jay A Lieberman, Christina E Ciaccio, Sayantani B Sindher, Blaine Creasy, Katherine Baran, Sachin Gupta, Anna Nowak-Wegrzyn

Faculty, Staff and Students Publications

BACKGROUND: Management of patients with food allergies is complex, especially in cases of patients with multiple and potentially severe food allergies. Although international guidelines exist for food allergy management, the role of the allergist in the decision-making process is key.

OBJECTIVE: Our aim was to investigate the management patterns and educational needs of practicing allergists treating patients with food allergies.

METHODS: An online survey was e-mailed to United States-based practicing allergists (N = 2833) in November-December 2021. The allergists were screened for managing 1 or more patients (including ≥25% pediatric patients) with food allergies per month. The allergists responded to …

Ga2len Anacare Consensus Statement: Potential Of Omalizumab In Food Allergy Management, Torsten Zuberbier, Antonella Muraro, Ulugbek Nurmatov, Stefania Arasi, Katarina Stevanovic, Aikaterini Anagnostou, Roberta Bonaguro, Sharon Chinthrajah, Gideon Lack, Alessandro Fiocchi, Thuy-My Le, Paul Turner, Montserrat Alvaro Lozano, Elizabeth Angier, Simona Barni, Phillippe Bégin, Barbara Ballmer-Weber, Victoria Cardona, Carsten Bindslev-Jensen, Antonella Cianferoni, Nicolette De Jong, Debra De Silva, Antoine Deschildre, Audrey Dunn Galvin, Motohiro Ebisawa, David M Fleischer, Jennifer Gerdts, Mattia Giovannini, Josefine Gradman, Susanne Halken, Syed Hasan Arshad, Ekaterina Khaleva, Susanne Lau, Richard Loh, Mika J Mäkelä, Mary Jane Marchisotto, Laura Morandini, Charlotte G Mortz, Caroline Nilsson, Anna Nowak-Wegrzyn, Marcia Podestà, Lars K Poulsen, Graham Roberts, Pablo Rodríguez Del Río, Hugh A Sampson, Angel Sánchez, Sabine Schnadt, Peter K Smith, Hania Szajewska, Natasa Teovska Mitrevska, Alice Toniolo, Carina Venter, Amena Warner, Gary W K Wong, Robert Wood, Margitta Worm

Faculty, Staff and Students Publications

Immunoglobulin E (IgE)‐mediated food allergies are the most common type of food allergy, often causing rapid symptoms after exposure to allergens posing a serious health risk and a high impact on patient's and caregiver's quality of life. Omalizumab, a humanized anti‐IgE monoclonal antibody, reduces allergic reactions by binding to circulating IgE. Omalizumab has been successfully used in allergic asthma, chronic rhinosinusitis with nasal polyps, and chronic urticaria, and was recently approved for treating IgE‐mediated food allergies by the US Food and Drug Administration (FDA). This GA2LEN ANACARE Consensus Statement presents our position on the use of omalizumab for treating IgE‐mediated …

Preparing Patients For Oral Immunotherapy (Ppoint): International Delphi Consensus For Procedural Preparation And Consent, Douglas P Mack, Timothy E Dribin, Paul J Turner, Richard L Wasserman, Mariam A Hanna, Marcus Shaker, Mimi L K Tang, Pablo Rodríguez Del Río, Brad Sobolewski, Elissa M Abrams, Aikaterini Anagnostou, Stefania Arasi, Sakina Bajowala, Philippe Bégin, Scott B Cameron, Edmond S Chan, Sharon Chinthrajah, Andrew T Clark, Paul Detjen, George Du Toit, Motohiro Ebisawa, Arnon Elizur, Jeffrey M Factor, Justin Greiwe, Jonathan O'B Hourihane, Sarah W Hughes, Douglas H Jones, Antonella Muraro, Anna Nowak-Wegrzyn, Nandinee B Patel, Amy M Scurlock, Atul N Shah, Sayantani B Sindher, Stephen Tilles, Brian P Vickery, Julie Wang, Hugh H Windom, Matthew Greenhawt

Faculty, Staff and Students Publications

BACKGROUND: Despite the promise of oral immunotherapy (OIT) to treat food allergies, this procedure is associated with potential risk. There is no current agreement about what elements should be included in the preparatory or consent process.

OBJECTIVE: We developed consensus recommendations about the OIT process considerations and patient-specific factors that should be addressed before initiating OIT and developed a consensus OIT consent process and information form.

METHODS: We convened a 36-member Preparing Patients for Oral Immunotherapy (PPOINT) panel of allergy experts to develop a consensus OIT patient preparation, informed consent process, and framework form. Consensus for themes and statements was …

A Review Of Shared Decision-Making, Published Protocols, And Post-Desensitization Strategies In Oral Immunotherapy (Oit), Susan Laubach, Edwin H Kim, Matthew Greenhawt, Sally Bailey, Aikaterini Anagnostou

Faculty, Staff and Students Publications

PURPOSE OF REVIEW: The aim of this review is to highlight key published oral immunotherapy (OIT) protocols and post-desensitization strategies for the major food allergens and to cover important concepts to consider when evaluating OIT for food-allergic patients. Shared decision-making should help identify patient and family values which will help influence the type of evidence-based protocol and maintenance strategy to use.

RECENT FINDINGS: With food OIT emerging as a treatment option, there is a pressing need for patients, physicians, and other providers to have a nuanced understanding of the management choices available to them. There are now randomized controlled trials …

Development Of Ige-Mediated Food Allergies In Children With History Of Food Protein-Induced Allergic Proctocolitis: A Series Of Five Cases, Kim L. Tran, Elizabeth L. Wisner, George M. Jeha, Luke A. Wall

School of Medicine Faculty Publications

Food protein-induced allergic proctocolitis (FPIAP) is a non-IgE-mediated allergic condition that presents with hematochezia in otherwise healthy infants. It is most commonly induced by cow's milk protein via breast milk or formula. The prognosis for FPIAP is generally considered favorable with most infants achieving symptomatic resolution after diet modification. Most infants go on to tolerate the offending foods by 1–3 years of age. Over 8 years at our institution, five patients were identified and noted to have FPIAP to cow's milk during infancy with subsequent development of IgE-mediated allergic reaction to cow's milk and other foods. All five cases developed …

Delayed Presentation Of Food Protein-Induced Enterocolitis Syndrome (Fpies) To Okra In A Toddler, Hunter Hall, Sara Anvari, Fallon Schultz, Olubukola Ojuola, Nicholas L Rider

Faculty, Staff and Students Publications

BACKGROUND: Food protein-induced enterocolitis syndrome (FPIES) is a non-immunoglobulin E (IgE) -mediated food allergy predominantly observed in infants and characterized by the delayed onset of vomiting following ingestion of a trigger food. An increase in research and clinical consideration of FPIES has led to the discovery of unique deviations from the standard FPIES triggers and presentations.

CASE PRESENTATION: A 34-month-old female patient with a history of consuming okra daily presented to medical attention after developing classic FPIES symptoms to okra beginning at 14-months of age.

CONCLUSIONS: Recently, awareness about the varied nature of FPIES clinical presentation has come to light. …

Development Of A Mini Pig Model Of Peanut Allergy, Akhilesh Kumar Shakya, Brittany Backus, Lazar D Nesovic, Malini Mallick, Olivia Banister, Carla M Davis, Sara Anvari, Harvinder Singh Gill

Faculty, Staff and Students Publications

INTRODUCTION: The prevalence of peanut allergies is increasing, emphasizing the need for an animal model to enhance our understanding of peanut allergy pathogenesis and to advance diagnostic tools and therapeutic interventions. While mice are frequently used as model organisms, their allergic responses do not fully mirror those observed in humans, warranting the exploration of a higher animal model. The porcine gastrointestinal system closely resembles that of humans, and exhibits allergy symptoms akin to human responses, making pigs a promising model for peanut allergy research.

METHODS: In this study we compared two allergen sensitization protocols involving either topical allergen application after …

Quality Of Life Is Lower In Food Allergic Adolescents Compared To Young Children At A Community Educational Symposium, Diem-Tran I Nguyen, Kathleen Pitts, Kristen A Staggers, Carla M Davis

Faculty, Staff and Students Publications

INTRODUCTION: Food allergies (FA) can detrimentally impact physical, emotional, and psychological quality of life (QoL) among pediatric patients. Given the changes from childhood into adolescence, the impact of FA on QoL likely evolves with age. The purpose of this study was to determine whether QoL differed between adolescents and children with FA who participated in a Food Allergy Symposium (FAS).

METHODS: Patients with confirmed FA were recruited at an educational community symposium in September 2018 and September 2019. Patients and/or their parents were invited to complete the Food Allergy Quality of Life Questionnaires (FAQLQ). The Food Allergy Independent Measure (FAIM) …

The Sunbeam Birth Cohort: Protocol Design, Corinne Keet, Scott H Sicherer, Supinda Bunyavanich, Cynthia Visness, Patricia C Fulkerson, Alkis Togias, Wendy Davidson, Susan Perry, Sanaz Hamrah, Agustin Calatroni, Katina Robinson, Lars Dunaway, Carla M Davis, Sara Anvari, Susan M Leong-Kee, Gurjit Khurana Hershey, Emily Defranco, Ashley Devonshire, Haejin Kim, Christine Joseph, Brent Davidson, Noel K Strong, Angela J Tsuang, Marion Groetch, Julie Wang, Jennifer Dantzer, Kim Mudd, Abimbola Aina, Wayne Shreffler, Qian Yuan, Virginia Simmons, Donald Y M Leung, Jessica Hui-Beckman, Jania Arcia Ramos, Sharon Chinthrajah, Virginia Winn, Tina Sindher, Stacie M Jones, Nirvana A Manning, Amy M Scurlock, Edwin Kim, Alison Stuebe, James E Gern, Anne Marie Singh, Jennifer Krupp, Robert A Wood

Faculty, Staff and Students Publications

BACKGROUND: Food allergy (FA) and atopic dermatitis (AD) are common conditions that often present in the first year of life. Identification of underlying mechanisms and environmental determinants of FA and AD is essential to develop and implement effective prevention and treatment strategies. Objectives: We sought to describe the design of the Systems Biology of Early Atopy (SunBEAm) birth cohort.

METHODS: Funded by the National Institute of Allergy and Infectious Diseases (NIAID) and administered through the Consortium for Food Allergy Research (CoFAR), SunBEAm is a US population-based, multicenter birth cohort that enrolls pregnant mothers, fathers, and their newborns and follows them …

Empowering Children And Families With Food Allergies: An Innovative Role For Occupational Therapy, Salma H. Bachelani, Meredith P. Gronski, Kelly A. Carlson

The Open Journal of Occupational Therapy

Food allergies (FAs) have far-reaching implications regarding occupational participation. Children with food allergies and their families experience impacts on their daily life activities. The current standard of care for FAs fails to adequately address the wide-ranging barriers to participation in home, school, and community environments. This study used a mixed-method design to examine the impacts of FA on the needs of children and families affected by FA. Eighteen parents of children with FAs and six health care providers of children with FAs were interviewed; the parents also completed two questionnaires to identify the level of impact of FA on areas …

Post Hoc Analysis Examining Symptom Severity Reduction And Symptom Absence During Food Challenges In Individuals Who Underwent Oral Immunotherapy For Peanut Allergy: Results From Three Trials, Katharina Blumchen, Andreas Kleinheinz, Ludger Klimek, Kirsten Beyer, Aikaterini Anagnostou, Christian Vogelberg, Sergejus Butovas, Robert Ryan, David Norval, Stefan Zeitler, George Du Toit

Faculty, Staff and Students Publications

PURPOSE: Peanut allergy and its current management, involving peanut avoidance and use of rescue medication during instances of accidental exposure, are burdensome to patients and their caregivers and can be a source of stress, uncertainty, and restriction. Physicians may also be frustrated with a lack of effective and safe treatments other than avoidance in the current management of peanut allergy. Efficacy, determined using double-blind, placebo-controlled food challenges (DBPCFCs), of oral immunotherapy with peanut (Arachis hypogaea) allergen powder-dnfp (PTAH; Palforzia

METHODS: Symptom data recorded during screening and/or exit DBPCFCs from participants aged 4 to 17 years receiving PTAH or placebo were …

Investigating The Potential Role Of Akkermansia Muciniphila Supplementation In Neuroinflammation: A Progress Report, Geetika Verma

Biomedical Sciences Posters and Presentations

Gut bacteria are important for proper development and function of the host immune system (1). Recent studies have provided association of altered microbiome in both food allergy and neuropsychiatric disorders (2, 3) indicating potential role of microbiome in regulating Gut-Brain-Axis. Akkermansia muciniphila belongs to the phylum Verrucomicrobia, is a commensal mucin degrading bacterial species (4). A. muciniphila protects the gut barrier by facilitating host mucus production. Since patients with food allergy have increased gut permeability, protection of intestinal barrier by increased mucus production may be beneficial in preventing allergen and pathogen infiltrations, hence, minimizing inflammation. A. muciniphila is well known …

Insights Into Microbiome And Metabolic Signatures Of Children Undergoing Peanut Oral Immunotherapy, Andrea C Blackman, Santosh Thapa, Alamelu Venkatachalam, Thomas D Horvath, Jessica K Runge, Sigmund J Haidacher, Kathleen M Hoch, Anthony M Haag, Ruth Ann Luna, Aikaterini Anagnostou

Faculty, Staff and Students Publications

BACKGROUND: Peanut oral immunotherapy has emerged as a novel, active management approach for peanut-allergic sufferers, but limited data exist currently on the role of the microbiome in successful desensitization.

OBJECTIVE: We examined the oral and gut microbiome in a cohort of 17 children undergoing peanut oral immunotherapy with the aim to identify the microbiome signatures associated with successful desensitization. We also set out to characterize their fecal metabolic profiles after successful therapy.

METHODS: Participants gradually built up their daily dose from 2 mg (starting dose) to 300 mg (maintenance dose) within approximately 40 weeks. We collected a buccal and stool …

An Investigation Of Healthcare Supports For Those With Food Allergy In Ireland, Joseph Bolger, Nicola Blake, Sneha Vinod

International Undergraduate Journal of Health Sciences

Introduction: In Ireland, around 5% of children and 3% adults have food allergy (134,000 people). This current paper describes a survey that was carried out on a subset of service-users with the aim of identifying whether there is a need for increased specialist medical services and/or for a funded charity such as Anaphylaxis Ireland, defunct since 2015.

Materials & Methods: These needs were assessed via an online survey using Google Forms. The survey was conducted from 17-27th February 2020. There were 31 questions in total, relating to topics such as symptoms, clinical wait times, satisfaction with care provided and demand …

Full Issue: The International Undergraduate Journal Of Health Sciences, Volume 1, Issue 1, June 2021, Iujhs Full Issue

International Undergraduate Journal of Health Sciences

The full June 2021 issue (Volume 1, Issue 1) of the International Undergraduate Journal of Health Sciences

Food Allergy Among University Students: Uncharted Territory., Ali Hassan, Amna Alsaihati, Malak Al Shammari, Haitham Alaithan, Wejdan Al-Johani, Nouf Alshamlan, Salman Aljubran

Manuscripts, Articles, Book Chapters and Other Papers

Background: Food allergy is a growing global health concern, with limited studies conducted in developing countries. High-risk behavior regarding allergies is common among young adults, making them prone to severe allergic reactions. This study aimed to estimate the prevalence of food allergies among Imam Abdulrahman Bin Faisal University (IAU) students and to determine the rate of high-risk behaviors in this group.

Methods: An online survey was conducted among IAU students enrolled between the academic years of 2008 and 2018. The survey addressed food allergies with respect to age of onset, allergy testing, self-injectable epinephrine (SIE) prescription, associated allergic conditions, and …

Development And Evolution Of Risk Assessment For Food Allergens, Rene W. R. Crevel, Joseph Baumert, Athanasia Baka, Geert Houben, André C. Knulst, Astrid Kruizinga, Stefano Luccioli, Stephen L. Taylor, Charlotte B. Madsen

Department of Food Science and Technology: Faculty Publications

The need to assess the risk from food allergens derives directly from the need to manage effectively this food safety hazard. Work spanning the last two decades dispelled the initial thinking that food allergens were so unique that the risk they posed was not amenable to established risk assessment approaches and methodologies. Food allergens possess some unique characteristics, which make a simple safety assessment approach based on the establishment of absolute population thresholds inadequate. Dose distribution modelling of MEDs permitted the quantification of the risk of reaction at the population level and has been readily integrated with consumption and contamination …

Translating Reference Doses Into Allergen Management Practice: Challenges For Stakeholders, René W. R. Crevel, Joseph Baumert, Stefano Luccioli, Athanasia Baka, Sue Hattersley, Jonathan O.B. Hourihane, Stefan Ronsmans, Frans Timmermans, Rachel Ward, Yong-Joo Chung

Department of Food Science and Technology: Faculty Publications

Risk assessment describes the impact of a particular hazard as a function of dose and exposure. It forms the foundation of risk management and contributes to the overall decision-making process, but is not its endpoint. This paper outlines a risk analysis framework to underpin decision-making in the area of allergen cross-contact. Specifically, it identifies challenges relevant to each component of the risk analysis: risk assessment (data gaps and output interpretation); risk management (clear and realistic objectives); and risk communication (clear articulation of risk and benefit). Translation of the outputs from risk assessment models into risk management measures must be informed …

Presentation Of Allergen In Different Food Preparations Affects The Nature Of The Allergic Reaction: A Case Series, K. E. C. Grimshaw, R. M. King, Julie A. Nordlee, S. L. Hefle, John O. Warner, J. O.'B. Hourihane

Department of Food Science and Technology: Faculty Publications

Background: Characterization of fatal and nonfatal reactions to food indicates that the majority of reactions are due to the ingestion of prepared foods rather than the nonprocessed allergen. In an ongoing study that used a double-blind placebo-controlled food challenge to investigate peanut allergy and clinical symptoms, the observed reaction severity in four of the first six subjects was greater than anticipated. We hypothesized that this was due to differences in the composition of the challenge vehicle.

Objective: The aim was to investigate whether the severity of observed challenge reactions would be repeated on rechallenge with a lower fat …