No description available.

Allergic and hypersensitivity reactions such as anaphylaxis and asthma exacerbations may occur during air travel. Although the exact incidence of in-flight asthma and allergic emergencies is not known, we have concerns that this subject has not received the attention it warrants. There is a need to provide passengers at risk and airlines with the necessary measures to prevent and manage these emergencies. A review of the epidemiology, management and approaches to prevention of allergic and asthma emergencies during air travel is presented with the goal of increasing awareness about these important, potentially preventable medical events.

Objective: While most allergic responses to food are directed against protein epitopes and occur within 30 minutes of ingesting the allergen, recent studies suggest that delayed reactions may occur, sometimes mediated by IgE antibodies directed against carbohydrate moieties. The objective of this review is to summarize the clinical features and management of delayed hypersensitivity reactions to mammalian meat mediated by IgE antibodies to galactose-alpha 1,3-galactose (alpha-gal), an oligosaccharide.Methods: A PubMed search was conducted with MeSH terms: galactosyl-(1,3) galactose, oligosaccharides, cetuximab, allergy/hypersensitivity, and anaphylaxis. Reported cases with alpha-gal-mediated reactions were reviewed. This research study was approved by the Institutional Review Board of East Tennessee State University.Results: Thirty-two cases of adults presenting with red-meat induced allergy thought to be related to oligosaccharides have been reported in the literature so far, making this a rare and evolving syndrome. Most of these patients demonstrated delayed reactions to beef, as was seen in the case reported by us in this manuscript. IgE specific to alpha-gal was identified in most patients with variable response to skin testing with beef and pork. Inhibition studies in some cases showed that the IgE antibodies to beef were directed towards alpha-gal in the meat rather than the protein. The patients often reported history of tick bites, the significance of which is unclear at present. Reactions to cetuximab, a monoclonal antibody, are mediated by a similar mechanism, with IgE antibodies directed against an alpha-gal moiety incorporated in the drug structure.Conclusion: Alpha-gal is an oligosaccharide recently incriminated in delayed anaphylactic reactions to mammalian meats such as to beef, pork, and lamb. It appears that anaphylactic reactions to the anti-cancer biological agent, cetuximab, may be linked mechanistically to the same process. More studies are required to understand the underlying molecular basis for these delayed reactions in specific, and their broader implications for host defense in general.

京都大学 / 0048 / 新制・課程博士 / 博士(農学) / 甲第19770号 / 農博第2166号 / 新制||農||1040(附属図書館) / 学位論文||H28||N4986(農学部図書室) / 32806 / 京都大学大学院農学研究科食品生物科学専攻 / (主査)教授 河田 照雄, 教授 保川 清, 教授 橋本 渉 / 学位規則第4条第1項該当 / Doctor of Agricultural Science / Kyoto University / DGAM

Introduction: The incidence of food allergy has increased substantially in developed countries, with limited treatment and/or prevention options. Milk oligosaccharides have shown to modulate immune responses by serving as prebiotic substrates for the intestinal microbiota. However, some studies suggest that oligosaccharides may exert direct immunomodulatory effects, suggesting their therapeutic potential in preventing allergic diseases. We hypothesized that specific milk oligosaccharides including 6’sialyllactose, 2’fucosylactose, 3’sialyllactose and lacto-N-neotetraose may directly exert immunomodulatory effects on dendritic cells (DCs) and epithelial cells (ECs) by altering their phenotype and/or function in vitro. Methods: The effects of milk oligosaccharides (MOs) on bone-marrow derived DCs and the T84 and MODE-K epithelial cell lines were studied via direct treatment, in vitro. The expression of immunomodulatory cytokines and maturation markers were assessed to measure the effect of MOs on DC phenotype. Pro- and anti-inflammatory cytokines as well as NFκB p65 activity were measured to assess the effect of MOs on DC and EC function. In addition, in vitro stimulation of CD23 with IgE-Antigen complexes were used to study the effects of MOs on ECs in relation to allergy. Lastly, inhibitory antibodies for Siglec-F and PPARγ were used to elucidate the mechanism used by specific MOs to exert their effects. Results: Of the oligosaccharides studied, 6’siallylactose has direct immunomodulatory effects on DC phenotype and on DC and EC function at high concentrations. 6’sialyllactose increased DC expression of IL-10 and HO-1; it also increased CpG- and LPS- induced IL-10 release and decreased IL-12p70 release. Blocking the PPARγ receptor with GW9662 resulted in attenuation of this latter effect on IL-12p70 release. 6’sialyllactose reduced TNF-α induced IL-8 to a small but statistically significant extent and mKC to a great extent in T84 and MODE-K cells, respectively. In addition, 6’sialyllactose reduced IgE-Antigen stimulated release of IL-8 and CCL20, as well as NFκB p65 activity. Pre-treatment of cells with GW9662 resulted in attenuation of the effect of 6’SL on IL-8 release and p65 activation. In addition, 2’fucosylactose reduced CCL20 release and NFκB activity substantially, but these effects were not exerted via PPARγ. Conclusion: Some oligosaccharides are able to directly modulate the inflammatory response in DCs and ECs, via pathways involving PPARγ activation and/or NFκB inhibition. / Thesis / Master of Science (MSc)

No description available.

<p>Among food allergies, peanut has attracted the most research attention because the allergy is typically lifelong, often severe and potentially fatal. Furthermore, other than epinephrine, there are no treatments available to date. A decade of research has provided a great deal of insight into the factors that promote and regulate the <em>development </em>of allergic responses. However, less in known about the factors involved in the <em>elicitation</em> of the most common and severe manifestation of peanut allergy, namely anaphylaxis. The research in this thesis centers on the investigation of cellular and molecular pathways leading to peanut-induced anaphylaxis (PIA) as well as potential therapeutic targets. Specifically presented are: i) the development and characterization of a mouse model of PIA (Chapter 2), ii) the role of molecules including histamine, leukotrienes (LT) and platelet-activating factor (PAF) (Chapter 3) and, iii) the relative contribution of mast cells, basophils and macrophages as well as IgE and IgG₁(Chapter 4). Our data show that oral sensitization to peanut in C57BL/6 mice generated local and systemic markers of type-2 immunity that was associated with robust and consistent clinical anaphylaxis following antigen challenge. In this context, concurrent blockade of PAF and histamine receptors markedly decreases the severity of these reactions. Moreover, they demonstrate that distinctive immune effector pathways involving activation of mast cells (via IgE and IgG₁) and macrophages (via IgG₁) cooperate to elicit a broad range of systemic reactions to peanut. These findings highlight that concomitant and progressive recruitment of immune-effector pathways leads to a full range of anaphylactic reactions and therefore, therapeutic strategies for PIA may need to target several pathways or, alternatively shared components within these pathways. Combination therapy blocking both PAF and histamine may represent such as a therapeutic approach.</p> / Doctor of Philosophy (Medical Science)

L’allergie alimentaire est un problème majeur de santé publique. Sa prévalence est estimée à 5 % chez l’adulte et à 8 % chez l’enfant dans les pays industrialisés. L’objectif de cette thèse est d’apporter une contribution à la diététique diagnostique et thérapeutique de l’allergie alimentaire. Nos travaux ont porté sur l’allergie alimentaire au pois jaune et au sésame. Le pois jaune est un allergène émergent à risque de réaction grave. Son seuil réactogène est bas, soit 0,13 g de protéines alors que la teneur des aliments peut atteindre 20 g/100g. L’étude de 35 personnes allergiques au sésame a permis de définir que le seuil réactogène pouvant déclencher une réaction chez 5% de la population allergique se situe entre 1,2 et 4,0 mg de protéines de sésame. Nous avons validé la progression optimale des doses de sésame pour le test de provocation orale en lien avec le consensus européen Europrevall. L’absence d’harmonisation internationale concernant les allergènes à déclaration obligatoire, nous a conduit dans une seconde partie, à étudier l’impact de l’allergie alimentaire sur la décision, l’organisation et le déroulement d’un séjour à l’étranger. Cette étude réalisée en collaboration avec l’Observatoire Régional de Santé et des Affaires Sociales de Lorraine et les associations française et belge pour la prévention des allergies montre, sur un panel de 102 répondants, que l’allergie alimentaire contraint 14 % des répondants à ne pas voyager à l’étranger et que 30% des personnes ayant voyagé ont présenté une réaction allergique. Les accidents sont survenus principalement dans les restaurants. Ces résultats soulignent la nécessité de développer un système d’information et de formation des personnes allergiques et des professionnels de l’alimentation pour mettre en oeuvre des stratégies de prévention du risque. / Food allergy is a major public health problem. Its prevalence is estimated at 5% in adults and 8% in children in industrialized countries. The objective of this thesis is to bring a contribution to the diagnostic and therapeutic dietetics in food allergy. Our work focused on yellow pea and sesame food allergies. Yellow pea is an emerging allergen with risk of a severe reaction. Its reactogenic threshold is of 0.13 g of protein while the content of food can reach 20 g / 100g. The study of 35 people allergic to sesame has enabled the identification of the reactogenic threshold that can trigger a reaction in 5% of the allergic population. It is estimated between 1.2 and 4.0 mg of sesame protein. We validated optimal progression dosing scheme for sesame for oral challenge test taking in account the European consensus Europrevall. Lack of international harmonization on mandatory allergens, led us in a second part of this thesis, to study the impact of food allergy on the decision, trip organization and a stay abroad of an allergic person. This study, conducted in collaboration with the regional health observatory and Social Affairs of Lorraine and the French and Belgian associations for allergy prevention shows, on a panel of 102 respondents, that food allergy forced 14% of respondents do not travel abroad and that 30% of people who have traveled had an allergic reaction. The accidents occurred mainly in restaurants. These results highlight the need to develop an information system and training of allergies and food professionals to implement risk prevention strategies.

Background: Food allergy affects an estimated 8% of children and 3% of adults in the United States. Food‐allergic individuals increasingly use the web for medical information. We sought to determine the educational quality of food allergy YouTube videos. Methods: We performed a YouTube search using keywords “food allergy” and “food allergies”. The 300 most viewed videos were included and analyzed for characteristics, source, and content. Source was further classified as healthcare provider, alternative medicine provider, patient, company, media, and professional society. A scoring system (FA‐DQS) was created to evaluate quality (−10 to +34 points). Negative points were assigned for misleading information. Eight reviewers scored each video independently. Results: Three hundred videos were analyzed, with a median of 6351.50 views, 19 likes, and 1 dislike. More video presenters were female (54.3%). The most common type of video source was alternative medicine provider (26.3%). Alternative treatments included the following: water fast, juicing, Ayurveda, apple cider, yoga, visualization, and sea moss. Controversial diagnostics included kinesiology, IgG testing, and pulse test. Almost half of the videos depicted a non‐IgE‐mediated reaction (49.0%).Videos by professional societies had the highest FA‐DQS (7.27). Scores for videos by professional societies were significantly different from other sources (P < .001). There was a high degree of agreement among reviewers (ICC = 0.820; P < .001). Conclusion: YouTube videos on food allergy frequently recommend controversial diagnostics and commonly depict non‐IgE‐mediated reactions. There is a need for high‐quality, evidence‐based, educational videos on food allergy.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2017-04-19T12:01:26Z No. of bitstreams: 1 Érika Campos Gomes.pdf: 620457 bytes, checksum: 3e9a7035999fd61c70de3db7af57ca5d (MD5) / Made available in DSpace on 2017-04-19T12:01:26Z (GMT). No. of bitstreams: 1 Érika Campos Gomes.pdf: 620457 bytes, checksum: 3e9a7035999fd61c70de3db7af57ca5d (MD5) Previous issue date: 2017-04-06 / Food allergies have increased considerably and it affects approximately 8% of children. To this day, there are no available cures and the only way of coping with the allergies is to avoid contact with the allergen and emergency treatment of symptoms in case of accidental exposure. The constant dread of anaphylaxis incidents and the vigilance needed to avoid the exposure to the allergen puts significant pressure on the family as a whole, affecting daily activities and consequently quality of life. The objective of this qualitative research is to investigate the main effects of allergy management, its effects on fraternal relationships and intervention techniques to conflict situations arising from the allergy in sibling relations. In this research, we studied mothers found in an online allergy support group hosted on Facebook who had a son/daughter diagnosed with a food allergy age 12 and below and with siblings ages 15 and below who may or may not have a food allergy. The participants answered a questionnaire to better define the family, to gather further information on the allergies and took part in an online discussion board. We identified as the most prominent effects of food allergy changes in daily routine, internal conflicts, conflicts within the nuclear family, conflicts within the extended family and the overall experiences regarding living in with risk. We observed support, complicity and feelings of jealousy and anger in sibling relations as consequences of the food allergy. Conflict mediation strategies used by mothers to deal with conflict in sibling relations involve privation and negotiation. Understanding the complexities and individuality of the particular effects of food allergies in family life, especially in sibling relations is important in order to develop coping techniques which take into account the everlasting care regarding the allergy and the needs of all family members, especially each sibling / A alergia alimentar tem aumentado consideravelmente e afeta aproximadamente 8% das crianças. Até o momento, não existe cura e as únicas formas de enfrentamento são evitar contato com o alérgeno e o tratamento emergencial de sintomas em caso de exposição acidental. O receio constante de episódios de anafilaxia e a vigilância necessária para evitar a exposição ao alergênico coloca uma pressão significativa sobre a família, impactando nas atividades diárias e qualidade de vida. Esta pesquisa qualitativa teve como objetivo investigar os principais efeitos familiares do gerenciamento da alergia alimentar, sua interferência na relação fraterna e as formas de intervenção em situações de conflito que podem surgir entre os irmãos em função da alergia. Participaram desta pesquisa mães originárias de um grupo de apoio do Facebook focado em alergia alimentar, que tinham um filho de até 12 anos com diagnóstico de alergia alimentar e com irmãos com até 15 anos, sendo estes, alérgicos ou não. As participantes responderam a um questionário de identificação das famílias e de detalhamento das alergias e participaram de um fórum de discussão on-line. Foi possível verificar como principais efeitos familiares do gerenciamento da alergia: as especificidades da rotina diária, as consequências das restrições alimentares que envolvem conflitos internos, com a família nuclear e extensa, e a experiência de conviver com risco. O apoio e a cumplicidade, assim como sentimentos de ciúmes e raiva, foram observados no relacionamento fraterno como decorrências da alergia. As estratégias de manejo de conflitos entre os irmãos relativos à alergia envolvem a privação e a negociação. Compreender a complexidade e individualidade do efeito da alergia alimentar na vida familiar, especialmente no relacionamento fraterno, mostra-se importante para elaborar formas de enfrentamento que levem em consideração os cuidados indispensáveis à alergia e as demandas de cada membro da família, em particular, de cada filho