Lui, Kit Yee. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 150-157). / Abstracts and questionnaire in English and Chinese. / Title --- p.1 / Abstract --- p.2 / Acknowledgement --- p.7 / Table of contents --- p.8 / List of tables --- p.11 / List of figures --- p.12 / Glossary of terms and abbreviations --- p.13 / Chapter Section I: --- Overview --- p.14 / Chapter Chapter 1: --- Introduction --- p.15 / Chapter 1.1 --- Prevalence of food allergy in children --- p.15 / Chapter 1.1.1 --- Methodologies for studying food allergy --- p.18 / Chapter 1.1.2 --- Skin Prick Test and its mechanism --- p.19 / Chapter 1.1.3 --- Measurement of serum specific IgE levels --- p.21 / Chapter 1.1.4 --- Gold standard for diagnosis of food allergy --- p.22 / Chapter 1.2 --- Aim of Study --- p.25 / Chapter Chapter 2: --- Plan of Study --- p.26 / Chapter Section II: --- Literature Review --- p.28 / Chapter Chapter 3: --- Epidemiology of food allergy --- p.30 / Chapter 3.1 --- Prevalence of food allergy in children in western countries --- p.30 / Chapter 3.2 --- Prevalence of atopic allergies in children in rural areas --- p.34 / Chapter 3.3 --- Euro Prevail - A standardized methodology in studying food allergies --- p.38 / Chapter 3.4 --- Epidemiology of adverse food reaction in Hong Kong pre-school children --- p.40 / Chapter Chapter 4: --- Diagnosis of food allergies --- p.44 / Chapter 4.1 --- History --- p.44 / Chapter 4.2 --- Use of Skin Prick Test for diagnosis --- p.45 / Chapter 4.3 --- Use of serum specific IgE level for diagnosis --- p.47 / Chapter 4.4 --- Use of double-blind placebo-controlled food challenge for diagnosis --- p.49 / Chapter 4.5 --- Factors affecting precise diagnosis of food allergies --- p.51 / Chapter 4.5.1 --- Procedure-related Factors --- p.51 / Chapter 4.5.1.1 --- Performance of skin prick test --- p.51 / Chapter 4.5.1.2 --- Cross-reactivity of serum specific IgE --- p.52 / Chapter 4.5.1.3 --- Different diagnostic decision points in different populations --- p.53 / Chapter 4.5.1.4 --- Sensitization and allergy --- p.54 / Chapter 4.5.1.5 --- False negative oral food challenges --- p.55 / Chapter 4.5.2 --- Patient Factors --- p.56 / Chapter 4.5.2.1 --- Age of subjects --- p.56 / Chapter 4.5.2.2 --- Diet before tests --- p.57 / Chapter 4.5.2.3 --- Anti-histamine medications --- p.57 / Chapter 4.5.2.4 --- Skin sensitivity of subjects --- p.58 / Chapter Chapter 5: --- Risk factors for development of food allergies --- p.59 / Chapter 5.1 --- Factors associated with development of food allergies --- p.59 / Chapter 5.2 --- Food allergy and asthma --- p.62 / Chapter 5.3 --- Food allergy and eczema --- p.63 / Chapter Section III: --- Original Study --- p.64 / Chapter Chapter 6: --- Methodology --- p.65 / Chapter 6.1 --- Study Population --- p.65 / Chapter 6.1.1 --- Sample size calculation --- p.66 / Chapter 6.2 --- The EuroPrevall Study --- p.67 / Chapter 6.3 --- EuroPrevall Questionnaires --- p.68 / Chapter 6.4 --- Standardized Approach for Answering Questions in the Field --- p.69 / Chapter 6.5 --- Anthropometric Measurements and Ethics Approval --- p.70 / Chapter 6.6 --- Skin Prick Testing --- p.71 / Chapter 6.7 --- Measurement of serum specific IgE level --- p.72 / Chapter 6.8 --- Classification of Subjects --- p.74 / Chapter 6.9 --- Statistical Analysis --- p.75 / Chapter Chapter 7: --- Results --- p.76 / Chapter 7.1 --- Subjects and Demography --- p.76 / Chapter 7.2 --- Reported Symptoms in Chinese Children --- p.80 / Chapter 7.3 --- Food allergen sensitization in Chinese Children --- p.81 / Chapter 7.4 --- Association between food sensitization and allergic symptoms --- p.89 / Chapter 7.5 --- Prevalence of Food Allergy in Chinese Schoolchildren --- p.93 / Chapter Chapter 8: --- Discussion --- p.96 / Chapter Chapter 9: --- Conclusion and Further Studies --- p.102 / Appendix 1 Screening questionnaire (Chinese Version) --- p.106 / Appendix 2 Screening questionnaire (English Version) --- p.109 / Appendix 3 Case-control questionnaire (Chinese Version) --- p.111 / Appendix 4 Case-control questionnaire (English Version) --- p.132 / References --- p.150

<p>Food allergy is an IgE-mediated immunological disease, which affects almost 4% of the adult population and up to 6% of children. Proteins from milk, egg, peanuts, soybean, wheat, fish and nuts are the main cause of food allergies. A less common allergen is pea protein. The National Food Administration analyses undeclared pea protein and contaminations of pea protein in foods using rocket immunoelectrophoresis and immunodiffusion. For both methods an antiserum against pea protein is needed. The aim of this study has been to characterize a newly developed rabbit-antiserum against pea protein. It is important to know if the antiserum is specific against peas, the detection as well as the quantification limits before it can be taken into use. The results of the study show that the antiserum was not absolutely specific, since it cross-reacted with chickpeas, fenugreek and lenses. However there is an "in-house" established PCR-method that can distinguish between chickpeas, fenugreek and peas and that method can be used as a complement to the rocket immunoelectrophoresis. The PCR-method cannot be used alone because it is not quantitative. Rocket immunoelectro¬phoresis detects 0,003% pea protein with purified IgG-antibodies from the antiserum.</p>

Children with life threatening food allergies live with the constant threat of a fatal reaction, and caregivers must always be prepared to treat with an epinephrine auto-injector (EAI). This interpretive phenomenological study explored parents’ perceptions and lived experiences with prescribed EAI use for their child. The purposive sample included 10 parents of five children under 12 years of age, diagnosed with a food allergy and prescribed with an EAI who recently experienced anaphylaxis. Eight main themes emerged: perception of anaphylaxis, life challenges, isolation, anxiety, hesitation, guilt, influence of health care, and lessons learned. Parents described multiple life challenges and feelings of isolation, anxiety and hesitation during a reaction that lead to subsequent guilt. Handling reactions correctly provided parents with confidence to treat subsequent reactions. Witnessing the effects of an EAI and receiving positive feedback from health care providers further strengthened their confidence to quickly and competently intervene in future reactions. / February 2017

Doctor of Philosophy / Department of Hospitality Management and Dietetics / Deborah D. Canter / Junehee Kwon / Food allergies affect 1 in 25 school-aged children in the U.S., and Child Nutrition Professionals (CNPs) need more vigilance serving them. To assess CNPs’ knowledge, attitudes about food allergies including barriers to providing food allergy training, as well as current training practices; an online survey was conducted with randomly selected 1,500 CNPs nationwide. The survey instrument was developed based on focus groups, pilot-tested, and sent to the sample via email. About 24% or 340 CNPs completed the survey. Descriptive and inferential statistics including hierarchical and logistic regressions were calculated using SPSS. A majority of respondents currently provide allergen free meals in their districts (n=256). The mean food allergy knowledge score of CNPs was 31.9 (Standard Deviation=3.3) of 39. Respondents scored lowest on recognizing symptoms of food allergic reactions and understanding food allergen-related terminology. Years of managerial experience and previous food allergy training were positively associated with the knowledge scores. Most participants viewed food allergy as an important issue, but they faced challenges fulfilling last-minute allergen-free meal requests and purchasing allergen-free products. Sixty percent (n=200) did not provide any food allergy training. Of those who provided some sorts of training (n=140), the training was provided in groups (n=96), “one-on-one” basis (n=30), or combination of both methods (n=14). The employees were trained annually (n=76), once a year if they worked directly with the students with food allergies (n=52), and/or when they were newly hired (n=33). Lack of time and funding were barriers to providing food allergy training. Previous food allergic reactions and regulatory requirements served as cues to providing food allergy training. Previous food allergy training, knowledge, and self-efficacy were factors differentiating if food allergy training had or had not been provided in past 12 months. Systematic and regular food allergy training may be needed to ensure allergen-free meals are properly prepared. Food allergy training for CNPs to improve knowledge and self-efficacy may increase food allergy training at school food service establishments.

Objetivo: O objetivo desse estudo foi avaliar alterações na resposta clínica e imunológica ao camarão após a imunoterapia com Dermatophagoides pteronyssinus. Métodos: Selecionou-se 35 indivíduos alérgicos a Dermatophagoides pteronyssinus (Der p), os quais foram submetidos a testes cutâneos de leitura imediata para ácaros, baratas, camarão, tropomiosina recombinante, além de cão, gato e fungos. A detecção de IgE espcífica in vitro foi feita para o ácaro, camarão, barata americana e para suas tropomiosinas. Em todos, avaliou-se reatividade clínica ao camarão através de provocação oral. Dez pacientes foram alocados para o grupo controle, e 25 foram submetidos à imunoterapia alérgeno específica para o ácaro. Os testes cutâneos e a dosagem de IgE sérica específica foram repetidas após a indução da imunoterapia, e após 1 ano do início. A reatividade clínica ao camarão foi reavaliada no final do estudo pela provocação oral. Resultados: No grupo dos pacientes que foram submetidos à imunoterapia, observamos diminuição na reatividade nos testes cutâneos e dosagem de IgE específica para Der p, camarão e tropomiosina recombinante. Dos 10 pacientes com testes cutâneos positivos para camarão, 4 foram negativos na dosagem após um ano de imunoterapia (p= 0,04). Quanto à dosagem sérica de IgE para camarão, dos 9 positivos no início, 6 ficaram negativos (p= 0,014). Nenhum paciente submetido a imunoterapia desenvolveu nova sensibilização para camarão. Não houve alteração na reatividade clínica ao camarão após imunoterapia. Conclusão: A imunoterapia para Dermatophagoides pteronyssinus foi acompanhada de diminuição da reatividade imunológica para camarão e clinicamente não houve alteração da sensibilidade a camarão / Objective: The objective of this study was to determine changes in clinical and immunological response to shrimp after immunotherapy with Dermatophagoides pteronyssinus. Methods: We studied 35 allergic subjects to Dermatophagoides pteronyssinus (Der p), submitted to skin tests to mites, cockroach, shrimp, recombinant tropomyosin, and dog, cat and fungi. The detection of serum specific IgE was performed to mite, shrimp, and tropomyosin from American cockroach. In all patients, the clinical reactivity to shrimp was assessed through oral challenge. Ten patients were allocated to the control group, and 25 were submitted to immunotherapy for mite. Skin tests and determination of serum specific IgE were repeated after the induction of immunotherapy (3-4 months) and 1 year after of beginning of the treatment. The clinical reactivity to shrimp was assessed again at the end of the study by oral challenge. Results: In the group of patients who were undergoing immunotherapy, we observed decreased reactivity in the skin tests and specific IgE levels to Der p, shrimp and recombinant tropomyosin. Among the 10 patients with positive skin tests to shrimp, 4 were negative when assessed after one year of immunotherapy (p = 0.04). About serum specific IgE to shrimp, from the 9 positive reactors in the beginning of treatment, 6 became negative (p= 0.014). There was no change in clinical reactivity to shrimp after immunotherapy. Conclusion: The immunotherapy for Dermatophagoides pteronyssinus was accompanied by decreased immune reactivity to shrimp and clinically there was no change in sensitivity to shrimp

No description available.

Objetivo: Avaliar a prevalência e fatores de risco associados a reações adversas a alimentos (RAA) e diagnóstico médico de alergia alimentar referidas pelos pais em crianças de um a três anos de vida. Métodos: Estudo de coorte prospectivo de crianças nascidas em Ribeirão Preto, São Paulo e São Luís, Maranhão, no ano de 2010, e avaliadas para esse estudo nos três primeiros anos de vida. Em Ribeirão Preto, foram incluidas 3740 das 7702 crianças nascidas no ano de 2010. Em São Luís, participaram do estudo 3320 das 5166 crianças avaliadas ao nascimento no mesmo ano. Os responsáveis pelas crianças responderam questões referentes à ocorrência de reações adversas após a ingestão de alimentos e diagnóstico médico prévio de alergia alimentar. O estudo das associações entre os desfechos e as variáveis independentes de interesse foi feito por meio de análise univariada e por modelos log-binomiais ajustados, obtendo-se medidas de risco relativo (RR) e seus intervalos de confiança (IC). Resultados: A prevalência de reações adversas a alimentos (RAA) referidas pelos pais e de diagnóstico médico de alergia a pelo menos um alimento foi, respectivamente, de 10,7% (399/3740) e 4,4% (164/3716) em Ribeirão Preto, e de 6,4% (216/3320) e 2,7% (88/3320) em São Luís. Reações e diagnóstico de alergia ao leite de vaca ocorreram, respectivamente em 6,3% (223/3533) e 3,4% (119/3516) das crianças de Ribeirão Preto, e em 3,2% (102/3166) e 1,6% (52/3155) em São Luís. Nas duas cidades, houve concordância entre os desfechos reação a pelo menos um alimento e diagnóstico médico de alergia a pelo menos um alimento (índice kappa de 0,52 em RP e 0,51 em SL). O mesmo ocorreu para o relato de reação ao leite de vaca e diagnóstico médico de alergia ao leite (índice kappa de 0,52 em RP e 0,47 em SL). Crianças cujas mães não frequentaram universidades apresentaram menor risco de reação a pelo menos um alimento, tanto em Ribeirão Preto, 9 quanto em São Luís, e menor risco de diagnóstico médico de alergia a algum alimento em Ribeirão Preto. Os fatores associados a maior risco de diagnóstico médico de alergia a pelo menos um alimento foram a situação conjugal sem companheiro, idade de início à creche menor que 6 meses e histórico de alergia nas crianças, somente em Ribeirão Preto. O aleitamento materno exclusivo até os 6 meses associou-se a menor risco de diagnóstico médico de alergia ao leite de vaca em Ribeirão Preto. O início do leite artificial antes dos 6 meses e o início à creche antes dessa idade foram identificados como fatores de risco para diagnóstico médico de alergia ao leite de vaca nas crianças de Ribeirão Preto. Conclusões: O presente estudo contribuiu para o conhecimento da prevalência de RAA, incluindo a AA, referida pelos pais, em crianças brasileiras de até 3 anos de vida. Diferenças sociais, econômicas e culturais podem explicar as diferenças de prevalência e fatores associados a RAA e AA em RP e SL. / Objective: To evaluate the prevalence and risk factors associated with parent reported adverse reactions to food (ARF) and medical diagnosis of food allergy in 1-3 year old children. Methods: Prospective cohort study of children born in Ribeirão Preto, São Paulo and São Luís, Maranhão, in 2010, and evaluated for this study at 1-3 years of age. In Ribeirão Preto, 3740 of the 7702 children born in 2010 were included. In São Luís, 3320 of the 5166 evaluated at birth were included. Caregivers answered questions regarding the occurrence of adverse reactions after ingestion of food allergy and previous medical diagnosis of food allergy. Associations between end points and independent variables were determined by univariate analysis and log-binomial adjusted models. Relative risks (RR) and confident intervals were calculated (IC). Results: The prevalence of parent reported ARF and medical diagnosis of allergy to at least one food was, respectively, 10.7% (399/3740) and 4.4% (164/3716) in Ribeirão Preto, and 6.4% (216/3320) and 2.7% (88/3320) in São. Luís. Reactions and medical diagnosis of allergy to cow\'s milk were reported, respectively, in 6.3% (223/3533) and 3.4% (119 / 3516) of the children from Ribeirão Preto and in 3.2% (102/3166) and 1.6% (52/3155) in São Luís. In both cities, there was agreement between the reported reactions to at least one food and medical diagnosis of allergy to at least one food (kappa of 0.52 and 0.51 in RP in SL). The same happened for reported reactions to cow\'s milk and medical diagnosis of milk allergy (kappa of 0.52 and 0.47 in RP in SL). Children whose mothers did not attend universities were less likely to report reaction to at least one food, both in Ribeirão Preto and São Luís, and had lower risk of medical diagnosis of allergy to any food in Ribeirão Preto. Factors associated with increased risk of medical diagnosis of allergy to at least one food were the marital status without partners, going to a at 11 daycare center before 6 months of age and a history of allergy in children, only in Ribeirão Preto. Exclusive breastfeeding until 6 months was associated with a lower risk of medical diagnosis of allergy to cow\'s milk in Ribeirão Preto. The beginning of the artificial milk before 6 months and going to daycare centers before this age were identified as risk factors for medical diagnosis of allergy to cow\'s milk in children of Ribeirão Preto. Conclusions: This study contributes to the knowledge of the prevalence parent reported ARF, including food allergy , in Brazilian children up to 3 years. Social, economic and cultural differences can explain the differences in prevalence and associated risk factors for ARF and AA in RP and SL.

O ovo é o alimento naturalmente mais completo, uma vez que possui todos os nutrientes necessários, como vitaminas, aminoácidos e minerais essenciais para manter uma vida. Porém, em contra partida, possui várias proteínas promotoras de alergias em considerável parcela da população mundial. Para determinar as proteínas dos alimentos alergênicos, um dos testes mais utilizados é o imunoensaios tais como ELISA (ensaio imunoenzimático - enzyme linked immunosorbent assay), onde o anticorpo reconhece o antígeno e essa conexão é mostrada por um sistema enzimático, em outras palavras, a densidade óptica. O objetivo deste estudo foi determinar a eficiência do anticorpo policlonal, produzido em laboratório, para identificar a presença do antígeno ovomucóide em ovos tratados por irradiação gama para a sua desativação. Para avaliar os tratamentos, o anticorpo policlonal foi produzido em quatro (04) coelhos da raça Nova Zelândia, do sexo feminino, com 45 dias de vida, imunizadas com ovomucóide bioconjugado. Foi utilizado o adjuvante de Freund completo na primeira imunização e a solução tampão PBS, foram realizadas, posteriormente, quatro imunizações a cada quinze dias, mais um reforço 48 horas antes da retirada do plasma sanguíneo. O soro sangüíneo foi titulado por PTA-ELISA (Plate trapped antigen). Todos os procedimentos foram aprovados pelo Comitê de Ética e Experimentação Animal do Instituto de Ciência Animal e Pastagens (IZ) e precedida de acordo com as normas europeias para o bem-estar e ética animal. Foram utilizados ovos comerciais in natura, fornecidos pelo Departamento de Genética da Universidade de Agricultura \"Luiz de Queiroz\" - ESALQ / USP. As amostras foram submetidas à radiação gama proveniente de uma fonte de Co60, do tipo Multipropósito no Instituto de Pesquisas Energéticas e Nucleares (IPEN), sob uma taxa de dose de 19,4 e 31.8Gy/hora, nas doses: 0 (controle); 10kGy; 20KGy e 30KGy, em todas as taxas. Pelo teste de ELISA, foi encontrado o alérgeno ovomucóide das amostras ovo e, pelo resultado apresentados, constatou-se que o tratamento da radiação não mostrou alterações significativas, quando avaliado por anticorpos policlonais. Assim, podemos concluir que o anticorpo produzido é capaz de identificar a proteína alergênica ovomucóide e, a irradiação gama em tais taxas não apresenta mudanças na estrutura da proteína, por esta forma de avaliação. Porém, apresentou algumas alterações na cor e viscosidade visual das amostras de ovos / The egg is the most complete natural food; it has all the necessary nutrients such as vitamins, aminoacids and essential minerals to maintain a life. However, although, has several proteins that promote allergies in considerable part of the world population. To determine allergenic food proteins, one of the most used tests is the immunoassays such as ELISA (enzyme linked immunosorbent assay), where the antibody recognizes the antigen and this connection is showed by an enzymatic system, in other words, optical density. The aim of this study was to determine the polyclonal antibody efficiency, produced in laboratory, to identify the presence the ovomucoid antigen in treated eggs by gamma irradiation for its inactivation. To evaluate the treatments, polyclonal antibody was produced in four New Zealand female rabbits, at 45 days old, immunized with bioconjugated ovomucoid. Was used Freund Complete Adjuvant at first immunization and PBS Buffer at four subsequently immunizations every fifteen days, plus a booster 48 hours before the blood retreated. The blood serum was tittered by PTAELISA (Plate trapped antigen). All procedures were approved by Institute of Animal Science and Pastures (IZ)´s Committee of Ethical and Animal Experimentation and preceded according to European Norms for ethical and animal welfare. It was used, in nature, commercial laying eggs, from the Genetic Department of Agricultural University Luiz de Queiroz ESALQ/USP. So the samples were submitted to the gamma radiation coming from a source of Co60, type Multipurpose at the Energetically Researches and Nuclear Institute (IPEN), under a dose rate of 19.4 and 31.8Gy/hour, in the doses: 0 (control); 10KGy; 20KGy and 30KGy, in all rates. By the ELISAs test we can find the egg allergen ovomucoid and the radiation treatment do not showed considerable changes. So we can concluded that the antibody produced is capable of identify the ovomucoid allergenic protein and the gamma irradiation in such rates does not shows changes in that protein, therefore showed some changes in the color and visual viscosity of the egg samples

Objetivo: Avaliar a prevalência e fatores de risco associados a reações adversas a alimentos (RAA) e diagnóstico médico de alergia alimentar referidas pelos pais em crianças de um a três anos de vida. Métodos: Estudo de coorte prospectivo de crianças nascidas em Ribeirão Preto, São Paulo e São Luís, Maranhão, no ano de 2010, e avaliadas para esse estudo nos três primeiros anos de vida. Em Ribeirão Preto, foram incluidas 3740 das 7702 crianças nascidas no ano de 2010. Em São Luís, participaram do estudo 3320 das 5166 crianças avaliadas ao nascimento no mesmo ano. Os responsáveis pelas crianças responderam questões referentes à ocorrência de reações adversas após a ingestão de alimentos e diagnóstico médico prévio de alergia alimentar. O estudo das associações entre os desfechos e as variáveis independentes de interesse foi feito por meio de análise univariada e por modelos log-binomiais ajustados, obtendo-se medidas de risco relativo (RR) e seus intervalos de confiança (IC). Resultados: A prevalência de reações adversas a alimentos (RAA) referidas pelos pais e de diagnóstico médico de alergia a pelo menos um alimento foi, respectivamente, de 10,7% (399/3740) e 4,4% (164/3716) em Ribeirão Preto, e de 6,4% (216/3320) e 2,7% (88/3320) em São Luís. Reações e diagnóstico de alergia ao leite de vaca ocorreram, respectivamente em 6,3% (223/3533) e 3,4% (119/3516) das crianças de Ribeirão Preto, e em 3,2% (102/3166) e 1,6% (52/3155) em São Luís. Nas duas cidades, houve concordância entre os desfechos reação a pelo menos um alimento e diagnóstico médico de alergia a pelo menos um alimento (índice kappa de 0,52 em RP e 0,51 em SL). O mesmo ocorreu para o relato de reação ao leite de vaca e diagnóstico médico de alergia ao leite (índice kappa de 0,52 em RP e 0,47 em SL). Crianças cujas mães não frequentaram universidades apresentaram menor risco de reação a pelo menos um alimento, tanto em Ribeirão Preto, 9 quanto em São Luís, e menor risco de diagnóstico médico de alergia a algum alimento em Ribeirão Preto. Os fatores associados a maior risco de diagnóstico médico de alergia a pelo menos um alimento foram a situação conjugal sem companheiro, idade de início à creche menor que 6 meses e histórico de alergia nas crianças, somente em Ribeirão Preto. O aleitamento materno exclusivo até os 6 meses associou-se a menor risco de diagnóstico médico de alergia ao leite de vaca em Ribeirão Preto. O início do leite artificial antes dos 6 meses e o início à creche antes dessa idade foram identificados como fatores de risco para diagnóstico médico de alergia ao leite de vaca nas crianças de Ribeirão Preto. Conclusões: O presente estudo contribuiu para o conhecimento da prevalência de RAA, incluindo a AA, referida pelos pais, em crianças brasileiras de até 3 anos de vida. Diferenças sociais, econômicas e culturais podem explicar as diferenças de prevalência e fatores associados a RAA e AA em RP e SL. / Objective: To evaluate the prevalence and risk factors associated with parent reported adverse reactions to food (ARF) and medical diagnosis of food allergy in 1-3 year old children. Methods: Prospective cohort study of children born in Ribeirão Preto, São Paulo and São Luís, Maranhão, in 2010, and evaluated for this study at 1-3 years of age. In Ribeirão Preto, 3740 of the 7702 children born in 2010 were included. In São Luís, 3320 of the 5166 evaluated at birth were included. Caregivers answered questions regarding the occurrence of adverse reactions after ingestion of food allergy and previous medical diagnosis of food allergy. Associations between end points and independent variables were determined by univariate analysis and log-binomial adjusted models. Relative risks (RR) and confident intervals were calculated (IC). Results: The prevalence of parent reported ARF and medical diagnosis of allergy to at least one food was, respectively, 10.7% (399/3740) and 4.4% (164/3716) in Ribeirão Preto, and 6.4% (216/3320) and 2.7% (88/3320) in São. Luís. Reactions and medical diagnosis of allergy to cow\'s milk were reported, respectively, in 6.3% (223/3533) and 3.4% (119 / 3516) of the children from Ribeirão Preto and in 3.2% (102/3166) and 1.6% (52/3155) in São Luís. In both cities, there was agreement between the reported reactions to at least one food and medical diagnosis of allergy to at least one food (kappa of 0.52 and 0.51 in RP in SL). The same happened for reported reactions to cow\'s milk and medical diagnosis of milk allergy (kappa of 0.52 and 0.47 in RP in SL). Children whose mothers did not attend universities were less likely to report reaction to at least one food, both in Ribeirão Preto and São Luís, and had lower risk of medical diagnosis of allergy to any food in Ribeirão Preto. Factors associated with increased risk of medical diagnosis of allergy to at least one food were the marital status without partners, going to a at 11 daycare center before 6 months of age and a history of allergy in children, only in Ribeirão Preto. Exclusive breastfeeding until 6 months was associated with a lower risk of medical diagnosis of allergy to cow\'s milk in Ribeirão Preto. The beginning of the artificial milk before 6 months and going to daycare centers before this age were identified as risk factors for medical diagnosis of allergy to cow\'s milk in children of Ribeirão Preto. Conclusions: This study contributes to the knowledge of the prevalence parent reported ARF, including food allergy , in Brazilian children up to 3 years. Social, economic and cultural differences can explain the differences in prevalence and associated risk factors for ARF and AA in RP and SL.

Tang Chi-Yan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (leaves 89-112). / Abstracts in English and Chinese. / Abstract --- p.i / Acknowledgements --- p.vi / Table of contents --- p.viii / List of Tables --- p.xi / List of Figures --- p.xii / List of Abbreviations --- p.xiv / Chapter Chapter 1. --- General introduction --- p.1 / Chapter Chapter 2. --- Literature review --- p.4 / Chapter 2.1 --- History and prevalence of food allergy --- p.4 / Chapter 2.2 --- Mechanism and clinical symptoms of food allergy --- p.6 / Chapter 2.3 --- Tropomyosin as a major shellfish allergen --- p.13 / Chapter 2.4 --- Use of animal model in the studies of food allergy --- p.22 / Chapter 2.5 --- Future approaches for treatment of food allergy --- p.27 / Chapter Chapter 3. --- Cloning and expression of recombinant tropomyosin --- p.30 / Chapter 3.1 --- Introduction --- p.30 / Chapter 3.2 --- Materials and Methods --- p.31 / Chapter 3.2.1 --- Design of PCR primers for amplification of tropomyosin gene --- p.31 / Chapter 3.2.2 --- Cloning of PCR-amplified cDNA into vector --- p.32 / Chapter 3.2.3 --- Transformation of competent E. coli Ml5 cells --- p.34 / Chapter 3.2.4 --- Confirmation of DNA sequence of the cloned vector --- p.34 / Chapter 3.2.5 --- Induction of the recombinant protein --- p.35 / Chapter 3.2.6 --- Purification and storage of the recombinant protein under native condition --- p.36 / Chapter 3.2.7 --- Concentration measurement and storage of the recombinant protein --- p.37 / Chapter 3.2.8 --- Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) --- p.38 / Chapter 3.2.9 --- Regeneration of the Ni-NTA column --- p.40 / Chapter 3.3 --- Results and discussion --- p.42 / Chapter 3.3.1 --- DNA sequence of the cloned vector --- p.42 / Chapter 3.3.2 --- Expression of the recombinant protein --- p.42 / Chapter 3.3.3 --- Sodium dodecyl sulfate polyacrylamide gel eletrophoresis (SDS-PAGE) --- p.43 / Chapter Chapter 4. --- Induction of hypersensitive response to shrimp tropomyosin in mice --- p.47 / Chapter 4.1 --- Introduction --- p.47 / Chapter 4.2 --- Materials and methods --- p.52 / Chapter 4.2.1 --- Mice and reagents --- p.52 / Chapter 4.2.2 --- Animal sensitization and challenge --- p.53 / Chapter 4.2.3 --- Morphological and behavioral changes --- p.54 / Chapter 4.2.4 --- Tropomyosin-specific IgE level --- p.55 / Chapter 4.2.5 --- Passive cutaneous anaphylaxis (PCA) reaction --- p.56 / Chapter 4.2.6 --- Tropomyosin-specific cellular proliferation level of splenocytes --- p.56 / Chapter 4.2.7 --- Cytokine profiles of splenoctyes --- p.58 / Chapter 4.2.8 --- Histological examination of small intestine --- p.59 / Chapter 4.2.9 --- Statistical analysis --- p.59 / Chapter 4.3 --- Results --- p.63 / Chapter 4.3.1 --- Morphological and behavioral changes after challenge --- p.63 / Chapter 4.3.2 --- Tropomyosin-specific IgE level --- p.63 / Chapter 4.3.3 --- Passive cutaneous anaphylaxis (PCA) --- p.64 / Chapter 4.3.4 --- Tropomyosin-specific cellular proliferation level of splenocytes --- p.68 / Chapter 4.3.5 --- Cytokine profiles of splenocytes --- p.70 / Chapter 4.3.6 --- Histology of small intestines --- p.76 / Chapter 4.4 --- Discussion --- p.79 / Chapter Chapter 5. --- General conclusion --- p.88 / References --- p.89