FPIAP is a non-IgE mediated gastrointestinal food allergy that is the mildest form. It is characterized by the presence of blood and sometimes mucus in the stools of otherwise healthy infants. It affects infants under 6 months of age, with symptoms appearing between 2-8 weeks of life. The most common triggering foods are cow's milk protein in breastfed infants and soy, cow's milk protein, and extensively hydrolyzed formulas in formula-fed infants. The diagnosis is based on clinical history and resolution of symptoms with dietary elimination of trigger foods. Prognosis is excellent, with tolerance developing in most children by 1-3 years of age.
The document discusses definitions, descriptions, diagnosis and treatment of asthma according to GINA and PRACTALL guidelines. It provides definitions of asthma as a chronic inflammatory disease of the airways characterized by variable respiratory symptoms and airflow limitation. Diagnosis is based on symptoms, reversibility testing and variability in lung function. Treatment involves a stepwise approach starting with reliever medication and low-dose inhaled corticosteroids, escalating up treatments based on symptom control and risk of exacerbations. The goal is to achieve good symptom control and reduce risk of exacerbations and side effects.
This document summarizes recent research on peanut allergy. It discusses the rising prevalence of peanut allergy in western countries. It also examines factors that may be associated with the development of peanut allergy such as delayed introduction of peanuts in infancy, maternal diet during pregnancy/lactation, and environmental peanut exposure. The document also reviews research on diagnosing peanut allergy and the natural history of peanut allergy. It briefly discusses a new immunotherapy treatment approach called oral immunotherapy.
Alpha-Gal Syndrome, also known as red meat allergy, is caused by IgE antibodies against the carbohydrate galactose-alpha-1,3-galactose (α-Gal) found in most mammals except primates. Tick bites transmit α-Gal to humans, causing an immune response. Reactions to red meat occur 2-6 hours after consumption due to the delayed absorption of α-Gal from glycoproteins and glycolipids. Management involves avoiding red meat, organs, and secondary exposures. The syndrome is increasingly recognized globally where ticks that transmit α-Gal are present.
Oral allergy syndrome (OAS) is caused by cross-reactivity between pollen and certain raw fruits and vegetables. It occurs in up to 70% of pollen-allergic patients and involves oral itching and inflammation upon eating raw foods. Cross-reactivity is due to structural similarities between pollen and food allergens like profilin, PR-10, and lipid transfer proteins. Diagnosis involves a clinical history and skin or blood tests to specific food allergens. Treatment focuses on avoidance of raw foods and use of antihistamines for symptoms.
FPIAP is a non-IgE mediated gastrointestinal food allergy that is the mildest form. It is characterized by the presence of blood and sometimes mucus in the stools of otherwise healthy infants. It affects infants under 6 months of age, with symptoms appearing between 2-8 weeks of life. The most common triggering foods are cow's milk protein in breastfed infants and soy, cow's milk protein, and extensively hydrolyzed formulas in formula-fed infants. The diagnosis is based on clinical history and resolution of symptoms with dietary elimination of trigger foods. Prognosis is excellent, with tolerance developing in most children by 1-3 years of age.
The document discusses definitions, descriptions, diagnosis and treatment of asthma according to GINA and PRACTALL guidelines. It provides definitions of asthma as a chronic inflammatory disease of the airways characterized by variable respiratory symptoms and airflow limitation. Diagnosis is based on symptoms, reversibility testing and variability in lung function. Treatment involves a stepwise approach starting with reliever medication and low-dose inhaled corticosteroids, escalating up treatments based on symptom control and risk of exacerbations. The goal is to achieve good symptom control and reduce risk of exacerbations and side effects.
This document summarizes recent research on peanut allergy. It discusses the rising prevalence of peanut allergy in western countries. It also examines factors that may be associated with the development of peanut allergy such as delayed introduction of peanuts in infancy, maternal diet during pregnancy/lactation, and environmental peanut exposure. The document also reviews research on diagnosing peanut allergy and the natural history of peanut allergy. It briefly discusses a new immunotherapy treatment approach called oral immunotherapy.
Alpha-Gal Syndrome, also known as red meat allergy, is caused by IgE antibodies against the carbohydrate galactose-alpha-1,3-galactose (α-Gal) found in most mammals except primates. Tick bites transmit α-Gal to humans, causing an immune response. Reactions to red meat occur 2-6 hours after consumption due to the delayed absorption of α-Gal from glycoproteins and glycolipids. Management involves avoiding red meat, organs, and secondary exposures. The syndrome is increasingly recognized globally where ticks that transmit α-Gal are present.
Oral allergy syndrome (OAS) is caused by cross-reactivity between pollen and certain raw fruits and vegetables. It occurs in up to 70% of pollen-allergic patients and involves oral itching and inflammation upon eating raw foods. Cross-reactivity is due to structural similarities between pollen and food allergens like profilin, PR-10, and lipid transfer proteins. Diagnosis involves a clinical history and skin or blood tests to specific food allergens. Treatment focuses on avoidance of raw foods and use of antihistamines for symptoms.
1) A study of 651 children with pollen-related allergic rhinitis found that component-resolved diagnosis identified a lack of IgE antibodies to major allergens in a significant percentage of patients with skin prick test reactivity, calling into question the appropriateness of immunotherapy for some patients.
2) Without component-resolved diagnosis, immunotherapy would have been prescribed inappropriately in 37% of cases based on skin prick test alone.
3) Component-resolved diagnosis led European and American allergists to change their immunotherapy prescription decisions in 42-48% of cases compared to skin prick testing alone.
This document discusses wheat allergy and related topics. It begins by classifying wheat taxonomically and describing its major protein components, many of which are allergens. It then discusses the epidemiology and clinical manifestations of wheat allergy, including immediate IgE-mediated reactions, allergic contact urticaria, baker's asthma, food-dependent exercise-induced anaphylaxis, associations with atopic dermatitis, and eosinophilic gastrointestinal disorders. Mechanisms of allergenic cross-reactivity between wheat and other cereals as well as grasses are also reviewed.
This document summarizes research on drug-induced anaphylaxis in Latin America. Some key findings include:
- Drugs are a leading cause of anaphylaxis in Latin America, reported in 34% of cases in one study. NSAIDs and beta-lactams are among the most common culprits.
- Studies in Latin America found cardiovascular involvement in over 45% of anaphylaxis cases, and was more frequent in elderly patients. Shock and severe reactions were also more common in the elderly.
- A study of over 800 anaphylaxis cases across Latin America found NSAIDs to be the predominant cause in adults, while beta-lactams were more common in children and
This document discusses approaches to preventing allergic diseases in children. It mentions that allergic diseases have increased rapidly in recent decades likely due to environmental and lifestyle changes. Early life exposure to allergens and microbes may influence the development of allergic immune responses. The document discusses genetic and environmental risk factors for atopic dermatitis and reviews evidence on the role of various allergens like food, aeroallergens and bacteria. It proposes that primary prevention aims to prevent sensitization to allergens, secondary prevention prevents disease progression after sensitization and tertiary prevention reduces symptoms after disease onset through allergen avoidance and treatment.
This document discusses vaccine allergies and reactions. It outlines different types of vaccine reactions including IgE-mediated and non-IgE mediated reactions. Specific allergens in vaccines like gelatin, egg, latex, and yeast are examined. Data on the risk of anaphylaxis from vaccines is presented from various studies. Skin testing for vaccine allergy diagnosis and management of patients with suspected vaccine hypersensitivity is addressed. Reactions to individual vaccines such as influenza, MMR, and yellow fever are also reviewed.
This document discusses hypersensitivity to wheat. It begins with an introduction to wheat allergy and defines it as an abnormal immunological reaction to exposure to wheat. It then covers the historical background of wheat consumption, epidemiology of wheat hypersensitivity, wheat proteins, classification of wheat hypersensitivity, IgE-mediated wheat allergy and non-celiac gluten sensitivity.
The document discusses vaccine hypersensitivity and provides the following information:
1. It outlines the evolution of immunization programs from the pre-vaccine era to modern times and discusses the relationship between vaccine usage and adverse events.
2. It reviews the epidemiology of immediate hypersensitivity reactions to vaccines in the US and Australia, finding reporting rates of 10 per 100,000 doses in the US and incidence of potential IgE-mediated reactions of 5.4 per 100,000 doses in Australia.
3. It examines allergic reactions to specific vaccine constituents like gelatin and egg, noting the need to consider alternative vaccines or precautions in individuals with a history of allergy to these ingredients.
This document summarizes several studies on the off-label use of omalizumab (anti-IgE) to treat various allergic and respiratory conditions beyond its approved use for asthma and chronic idiopathic urticaria. It also discusses other emerging biologic therapies that target specific cytokines and pathways involved in allergic inflammation and asthma pathogenesis. These include therapies targeting IL-4/IL-13 (dupilumab), IL-5 (mepolizumab, reslizumab, benralizumab), IL-17 (secukinumab, brodalumab), IL-2 (daclizumab), and thymic stromal lymphopoietin (tezepelumab). The
- Nut allergy is commonly caused by peanuts and tree nuts and can cause anaphylaxis. Peanut allergy prevalence is 0.5-2.5% in children in the UK and tree nut allergy prevalence is 0.2-2.2%.
- Diagnosis involves taking a history, skin prick tests, nut-specific IgE levels, and oral food challenges. Skin prick tests ≥3mm or nut-specific IgE levels ≥15kU/L suggest allergy.
- Cross-reactivity between peanuts and tree nuts is common, so testing for multiple nuts is often recommended for those allergic to one type of nut. Component resolved testing for Ara h 2
Dr. José Antonio Ortega Martell presented on allergic rhinitis (AR) and the role of intranasal corticosteroids (INS) in its treatment. AR is a common condition worldwide that can impair quality of life. While symptoms can be relieved by various medications, INS are the most effective treatment due to their ability to reduce inflammation and prevent exacerbations. INS work both acutely and prevent persistent minimal inflammation. Potential side effects are typically minor and can be reduced by proper administration. INS should be used as the preferred treatment for AR due to their efficacy and ability to alter the disease course over time.
1. The document summarizes various studies on prevention of allergy through modulation of the gut microbiota from early life.
2. Key areas of focus include the gut microbiota of pregnant women and its impact on the infant, early introduction of foods like peanuts and eggs to induce tolerance, use of probiotics and breastfeeding to influence the infant gut microbiota, and effects of a farm environment and dietary fibers on allergy risk.
3. Studies found that probiotics started prenatally and combined with breastfeeding were most effective in preventing eczema, and that early introduction of peanuts and eggs reduced the risk of developing an allergy to those foods.
The document discusses molecular allergy testing for peanut allergies. It begins with an introduction of the speakers and agenda. It then provides biographies of Dr. Maeve O'Connor and Dr. Rob Reinhardt, who will discuss the physician and science perspectives on molecular allergy testing. The objectives are to raise awareness of molecular allergy testing and its role in diagnosing and managing peanut allergies. Dr. O'Connor then presents on the burden of peanut allergies and limitations of traditional testing. Dr. Reinhardt discusses the science behind molecular testing and peanut components. Case studies demonstrate how component testing provides more accurate risk assessments to guide patient management decisions.
Omalizumab is an anti-IgE monoclonal antibody approved for treating allergic asthma, chronic urticaria, and other allergic diseases. It binds to IgE and forms complexes that are cleared, reducing free IgE levels and decreasing FcεRI expression on mast cells and basophils. For asthma, omalizumab improves symptoms and lung function and reduces exacerbations and steroid use. It may be more effective in patients with elevated type 2 biomarkers. Omalizumab also improves symptoms of chronic urticaria by decreasing mediators released in response to autoantibodies. Other anti-IgE biologics in development have distinct binding properties from omalizumab.
This document summarizes research on wheat allergy. It finds that wheat allergy prevalence is approximately 0.4-1% in children and 0.3-0.5% in adults. Symptoms typically present as skin reactions, gastrointestinal issues, or respiratory symptoms. Wheat allergy often resolves by ages 6-7. Key wheat allergens include alpha-amylase inhibitors, lipid transfer proteins, gliadins and glutenins. Diagnosis involves tests for wheat-specific IgE or oral food challenges. Wheat allergy is associated with increased risk of developing respiratory allergies.
1. A study examined the effect of needle length when administering the hepatitis B vaccine to obese adolescents, finding that those who received the standard 1-inch needle had lower antibody titers compared to those who received the longer 1.5-inch needle.
2. Prophylactic administration of paracetamol after vaccination was found to reduce febrile reactions but also reduce antibody responses to several vaccine antigens.
3. Influenza vaccination was found to reduce mortality risk among the elderly and protect against all-cause mortality in patients with COPD.
This document discusses adverse allergic reactions that can occur after vaccination. It describes immunoglobulin E-mediated reactions, which occur rapidly after vaccination and involve symptoms like hives, swelling, wheezing, and potentially anaphylaxis. These reactions are usually caused by allergies to vaccine ingredients like gelatin, egg, milk, yeast, latex, and dextran. Non-IgE mediated reactions are also described, which cause local inflammation at the injection site and are not allergic reactions. Specific vaccine ingredients that can cause reactions like thimerosal, formaldehyde, aluminum, and antimicrobials are also outlined. The document provides guidance on diagnosing and managing allergic reactions depending on the suspected allergen
This document discusses the use of probiotics in the neonatal intensive care unit (NICU) to help prevent diseases like necrotizing enterocolitis (NEC). It provides background on the development of the infant gut microbiome and how probiotics may benefit preterm infants by competing with pathogens, producing antimicrobial substances, and modulating the immune system. Several studies cited found probiotic supplementation significantly reduced the risk of NEC and mortality in very low birth weight infants. Meta-analyses support the routine use of probiotics in the NICU.
The science of maternal vaccination - Slideset by prof Kathryn EdwardsWAidid
Pregnancy is a time of immunologic changes with an increased susceptibility to some infections, and maternal immunization can provide protection to the baby through the transfer of IgG induced by vaccine across the placenta. Prof. Edwards tackles in this slide set the fundamentals of maternal immunization.
Learn more on www.waidid.org
1) A study of 651 children with pollen-related allergic rhinitis found that component-resolved diagnosis identified a lack of IgE antibodies to major allergens in a significant percentage of patients with skin prick test reactivity, calling into question the appropriateness of immunotherapy for some patients.
2) Without component-resolved diagnosis, immunotherapy would have been prescribed inappropriately in 37% of cases based on skin prick test alone.
3) Component-resolved diagnosis led European and American allergists to change their immunotherapy prescription decisions in 42-48% of cases compared to skin prick testing alone.
This document discusses wheat allergy and related topics. It begins by classifying wheat taxonomically and describing its major protein components, many of which are allergens. It then discusses the epidemiology and clinical manifestations of wheat allergy, including immediate IgE-mediated reactions, allergic contact urticaria, baker's asthma, food-dependent exercise-induced anaphylaxis, associations with atopic dermatitis, and eosinophilic gastrointestinal disorders. Mechanisms of allergenic cross-reactivity between wheat and other cereals as well as grasses are also reviewed.
This document summarizes research on drug-induced anaphylaxis in Latin America. Some key findings include:
- Drugs are a leading cause of anaphylaxis in Latin America, reported in 34% of cases in one study. NSAIDs and beta-lactams are among the most common culprits.
- Studies in Latin America found cardiovascular involvement in over 45% of anaphylaxis cases, and was more frequent in elderly patients. Shock and severe reactions were also more common in the elderly.
- A study of over 800 anaphylaxis cases across Latin America found NSAIDs to be the predominant cause in adults, while beta-lactams were more common in children and
This document discusses approaches to preventing allergic diseases in children. It mentions that allergic diseases have increased rapidly in recent decades likely due to environmental and lifestyle changes. Early life exposure to allergens and microbes may influence the development of allergic immune responses. The document discusses genetic and environmental risk factors for atopic dermatitis and reviews evidence on the role of various allergens like food, aeroallergens and bacteria. It proposes that primary prevention aims to prevent sensitization to allergens, secondary prevention prevents disease progression after sensitization and tertiary prevention reduces symptoms after disease onset through allergen avoidance and treatment.
This document discusses vaccine allergies and reactions. It outlines different types of vaccine reactions including IgE-mediated and non-IgE mediated reactions. Specific allergens in vaccines like gelatin, egg, latex, and yeast are examined. Data on the risk of anaphylaxis from vaccines is presented from various studies. Skin testing for vaccine allergy diagnosis and management of patients with suspected vaccine hypersensitivity is addressed. Reactions to individual vaccines such as influenza, MMR, and yellow fever are also reviewed.
This document discusses hypersensitivity to wheat. It begins with an introduction to wheat allergy and defines it as an abnormal immunological reaction to exposure to wheat. It then covers the historical background of wheat consumption, epidemiology of wheat hypersensitivity, wheat proteins, classification of wheat hypersensitivity, IgE-mediated wheat allergy and non-celiac gluten sensitivity.
The document discusses vaccine hypersensitivity and provides the following information:
1. It outlines the evolution of immunization programs from the pre-vaccine era to modern times and discusses the relationship between vaccine usage and adverse events.
2. It reviews the epidemiology of immediate hypersensitivity reactions to vaccines in the US and Australia, finding reporting rates of 10 per 100,000 doses in the US and incidence of potential IgE-mediated reactions of 5.4 per 100,000 doses in Australia.
3. It examines allergic reactions to specific vaccine constituents like gelatin and egg, noting the need to consider alternative vaccines or precautions in individuals with a history of allergy to these ingredients.
This document summarizes several studies on the off-label use of omalizumab (anti-IgE) to treat various allergic and respiratory conditions beyond its approved use for asthma and chronic idiopathic urticaria. It also discusses other emerging biologic therapies that target specific cytokines and pathways involved in allergic inflammation and asthma pathogenesis. These include therapies targeting IL-4/IL-13 (dupilumab), IL-5 (mepolizumab, reslizumab, benralizumab), IL-17 (secukinumab, brodalumab), IL-2 (daclizumab), and thymic stromal lymphopoietin (tezepelumab). The
- Nut allergy is commonly caused by peanuts and tree nuts and can cause anaphylaxis. Peanut allergy prevalence is 0.5-2.5% in children in the UK and tree nut allergy prevalence is 0.2-2.2%.
- Diagnosis involves taking a history, skin prick tests, nut-specific IgE levels, and oral food challenges. Skin prick tests ≥3mm or nut-specific IgE levels ≥15kU/L suggest allergy.
- Cross-reactivity between peanuts and tree nuts is common, so testing for multiple nuts is often recommended for those allergic to one type of nut. Component resolved testing for Ara h 2
Dr. José Antonio Ortega Martell presented on allergic rhinitis (AR) and the role of intranasal corticosteroids (INS) in its treatment. AR is a common condition worldwide that can impair quality of life. While symptoms can be relieved by various medications, INS are the most effective treatment due to their ability to reduce inflammation and prevent exacerbations. INS work both acutely and prevent persistent minimal inflammation. Potential side effects are typically minor and can be reduced by proper administration. INS should be used as the preferred treatment for AR due to their efficacy and ability to alter the disease course over time.
1. The document summarizes various studies on prevention of allergy through modulation of the gut microbiota from early life.
2. Key areas of focus include the gut microbiota of pregnant women and its impact on the infant, early introduction of foods like peanuts and eggs to induce tolerance, use of probiotics and breastfeeding to influence the infant gut microbiota, and effects of a farm environment and dietary fibers on allergy risk.
3. Studies found that probiotics started prenatally and combined with breastfeeding were most effective in preventing eczema, and that early introduction of peanuts and eggs reduced the risk of developing an allergy to those foods.
The document discusses molecular allergy testing for peanut allergies. It begins with an introduction of the speakers and agenda. It then provides biographies of Dr. Maeve O'Connor and Dr. Rob Reinhardt, who will discuss the physician and science perspectives on molecular allergy testing. The objectives are to raise awareness of molecular allergy testing and its role in diagnosing and managing peanut allergies. Dr. O'Connor then presents on the burden of peanut allergies and limitations of traditional testing. Dr. Reinhardt discusses the science behind molecular testing and peanut components. Case studies demonstrate how component testing provides more accurate risk assessments to guide patient management decisions.
Omalizumab is an anti-IgE monoclonal antibody approved for treating allergic asthma, chronic urticaria, and other allergic diseases. It binds to IgE and forms complexes that are cleared, reducing free IgE levels and decreasing FcεRI expression on mast cells and basophils. For asthma, omalizumab improves symptoms and lung function and reduces exacerbations and steroid use. It may be more effective in patients with elevated type 2 biomarkers. Omalizumab also improves symptoms of chronic urticaria by decreasing mediators released in response to autoantibodies. Other anti-IgE biologics in development have distinct binding properties from omalizumab.
This document summarizes research on wheat allergy. It finds that wheat allergy prevalence is approximately 0.4-1% in children and 0.3-0.5% in adults. Symptoms typically present as skin reactions, gastrointestinal issues, or respiratory symptoms. Wheat allergy often resolves by ages 6-7. Key wheat allergens include alpha-amylase inhibitors, lipid transfer proteins, gliadins and glutenins. Diagnosis involves tests for wheat-specific IgE or oral food challenges. Wheat allergy is associated with increased risk of developing respiratory allergies.
1. A study examined the effect of needle length when administering the hepatitis B vaccine to obese adolescents, finding that those who received the standard 1-inch needle had lower antibody titers compared to those who received the longer 1.5-inch needle.
2. Prophylactic administration of paracetamol after vaccination was found to reduce febrile reactions but also reduce antibody responses to several vaccine antigens.
3. Influenza vaccination was found to reduce mortality risk among the elderly and protect against all-cause mortality in patients with COPD.
This document discusses adverse allergic reactions that can occur after vaccination. It describes immunoglobulin E-mediated reactions, which occur rapidly after vaccination and involve symptoms like hives, swelling, wheezing, and potentially anaphylaxis. These reactions are usually caused by allergies to vaccine ingredients like gelatin, egg, milk, yeast, latex, and dextran. Non-IgE mediated reactions are also described, which cause local inflammation at the injection site and are not allergic reactions. Specific vaccine ingredients that can cause reactions like thimerosal, formaldehyde, aluminum, and antimicrobials are also outlined. The document provides guidance on diagnosing and managing allergic reactions depending on the suspected allergen
This document discusses the use of probiotics in the neonatal intensive care unit (NICU) to help prevent diseases like necrotizing enterocolitis (NEC). It provides background on the development of the infant gut microbiome and how probiotics may benefit preterm infants by competing with pathogens, producing antimicrobial substances, and modulating the immune system. Several studies cited found probiotic supplementation significantly reduced the risk of NEC and mortality in very low birth weight infants. Meta-analyses support the routine use of probiotics in the NICU.
The science of maternal vaccination - Slideset by prof Kathryn EdwardsWAidid
Pregnancy is a time of immunologic changes with an increased susceptibility to some infections, and maternal immunization can provide protection to the baby through the transfer of IgG induced by vaccine across the placenta. Prof. Edwards tackles in this slide set the fundamentals of maternal immunization.
Learn more on www.waidid.org
This document discusses maternal probiotic supplementation to reduce infant eczema. It finds that probiotic supplementation during pregnancy and breastfeeding is associated with decreased prevalence of eczema in infants. Certain probiotic strains, such as Bifidobacterium bifidum, Bifidobacterium lactis, and Lactobacillus acidophilus, taken for longer durations (4-6 months before and after birth) can reduce infant eczema incidence by modulating the immune system and reducing inflammatory responses.
This document discusses maternal probiotic supplementation to reduce infant eczema. It finds that probiotic supplementation during pregnancy and breastfeeding is associated with decreased prevalence of eczema in infants. Certain probiotic strains, such as Bifidobacterium bifidum, Bifidobacterium lactis, and Lactobacillus acidophilus, taken for longer durations (4-6 months before and after birth) can reduce infant eczema incidence by modulating the immune system and reducing inflammatory responses.
<마더세이프라운드> Pregnancy outcome of women exposed to lactobacillus during preg...mothersafe
This study examined the pregnancy outcomes of 104 women who took probiotics during early pregnancy. The results showed no meaningful correlations between probiotic exposure and adverse infant outcomes like preterm birth, low birth weight, or birth defects. Previous studies have found probiotics may help prevent allergic diseases by modulating immune function and intestinal microbiota in early life. A review found certain probiotic strains were safe during pregnancy but their effect on allergic disease requires more research.
2013 August - Pearls in Allergy and ImmunologyJuan Aldave
This summary discusses two articles from the Annals of Allergy, Asthma & Immunology. The first article reports a case of relapsing polychondritis, an immune-mediated cartilage inflammation, in a patient who also had hypogammaglobulinemia of unknown origin. The patient's polychondritis significantly improved with corticosteroids and methotrexate. The second article reviews advances in the diagnosis and management of insect sting allergy, noting epidemiology, risk stratification of patients, diagnostic tests and their limitations, and novel diagnostic approaches such as basophil activation testing.
Food allergy has been long recognized and well documented. Other adverse reactions to foods first referred to as “toxic idiopathies” by John Freeman, co inventor of immunotherapy, at the early part of the 1900s can be mediated by and have their impact on the nervous and endocrine systems. It can also be mediated by pharmacologic mechanisms and can also affect any part of the body. There’s a great clinical need to accurately identify triggers of adverse reactivity as they have now been linked with even the most serious of modern maladies and diseases. In fact, inflammation is the hallmark of metabolic syndrome. Given the multitude of pathogenic mechanisms underlying adverse reactions to foods and other environmental exposures it is necessary that a utilizable and cost effective technology be understood so that its application be utilized under the appropriate circumstances.
KEY LEARNING POINTS
• The natural ability of certain foods to initiate an inflammatory response and induce metabolic disruptions and counterbalancing mechanisms to prevent that
• How foods can trigger “danger signals” for the immune system
Pharmacologic vs. immunologic reactions to foods
• Is there a common final pathway of all these mechanisms that can reliably indicate triggers of clinical pathology?
• Cellular testing vs. serologic testing: The advantages of cellular testing
The document summarizes research on probiotics and their effects on children's microbiota and risk of developing eczema. It discusses how the microbiota is established at birth and stabilizes by age 3, influenced by factors like delivery method and breastfeeding. WHO guidelines recommend certain probiotics to prevent eczema in high-risk pregnant women, breastfeeding mothers, and infants. Several studies specifically examined the probiotic Lactobacillus rhamnosus HN001 and found it reduced the risk and prevalence of eczema in children up to age 6 compared to placebo or other probiotics.
The document discusses food immunotherapy for treating food allergies. It provides definitions and outlines immune mechanisms and efficacy evidence from studies on peanut, cow's milk, egg, and wheat oral immunotherapy (OIT). Peanut OIT studies showed 67-78% of children achieved desensitization and 21-46% achieved sustained unresponsiveness. Cow's milk and egg OIT also demonstrated desensitization in 50-75% of children. Wheat OIT studies found 52-69% achieved desensitization. OIT was effective at increasing tolerance but also increased rates of adverse events during treatment.
Efficacy and safety of immunomodulators in pediatric age - Slideset by Profes...WAidid
«The first cause of recurrent infections in children is... childhood itself.» (J. Gary Wheeler)
Is it possibe to treat and prevent recurrent respiratory infections (RTIs) in pediatric age? Some studies have shown that immunostimulants/immunomodulators can reduce and prevent RTIs in children.
To learn more please visit www.waidid.org
Group B Streptococcus (GBS) is a bacteria that can cause neonatal infections. Studies show the rate of early onset GBS in newborns has declined with the introduction of antibiotic prophylaxis during labor for women with risk factors. Risk factors include premature rupture of membranes, fever, previous GBS-infected baby. Guidelines recommend antibiotics for women in labor with risk factors to prevent transmission of GBS to the newborn around birth.
Explore the cell's role in mediating adverse reactions 7 c09Paul Thiessen
This document discusses the role of neutrophils and macrophages in mediating various physiological and pathological processes. It summarizes several scientific studies that found:
1) Neutrophils can be recruited by substances like gliadin and mediate local inflammatory responses in tissues like the intestine.
2) Neutrophils and macrophages produce reactive molecules that can damage cells and tissues, and their activation levels correlate with conditions like infertility and acute coronary syndrome.
3) Chronic activation of the innate immune system by these cells may underlie metabolic syndrome by stimulating inflammation and hormonal changes.
4) Oxidative stress can increase blood levels of modified lipids implicated in atherosclerosis, coinciding with increased neutrophil counts.
Neonatal infectious diseases jornal 2nd topicRobin Thomas
This document summarizes neonatal sepsis, which is divided into early onset sepsis (EOS) occurring in the first week of life, and late onset sepsis (LOS) occurring after the first week. EOS is often caused by maternal transmission of organisms like Group B Streptococcus. LOS is attributed to postnatal pathogens acquired in the hospital and common organisms include coagulase-negative Staphylococci. Preterm and very low birth weight infants are especially at risk due to immunological immaturity. Blood cultures remain the gold standard for diagnosis but biomarkers like CRP and PCT are also used. Prevention strategies focus on identifying at-risk mothers, intrapartum antibiotic prophylaxis, and reducing hospital-acquired
Recent top papers in pediatric infectious diseases: pediatric infections - Sl...WAidid
Slideset on:
- Zika virus and fetal/neonatal microcephaly
- Microbiota, infections and immune response to vaccines
- Antibiotic use and weight gain in childhood
This document summarizes a talk on probiotics and mucosal immunity interactions in early life. It discusses how the microbiota changes throughout life, from pregnancy and birth through adulthood. Signals from the environment, including probiotics, shape immune development during critical windows. While some probiotic studies show benefits, effects depend on many factors and probiotics alone may not be sufficient. The microbiota plays an important role in immune maturation, and disturbances could impact health through epigenetic changes. Careful consideration of the microbiota is needed when evaluating human development and health.
Immunogenicity – i.e. immune response generated in the mother.
Transfer of antibodies to fetus Split –Vision Vaccine
Clinical efficacy in mother
Clinical efficacy in newborn
( up to 6 months of age )
Effectiveness of the Influenza vaccine . Dr. Sharda Jain , Lifecare Cent...Lifecare Centre
Effectiveness of vaccine can be judged in 4 ways
Immunogenicity – i.e. immune response generated in the mother.
Transfer of antibodies to fetus
Clinical efficacy in mother
Clinical efficacy in newborn
( up to 6 months of age )
This document discusses necrotizing enterocolitis (NEC) in preterm infants. It notes that NEC is an enigma due to inconsistent definitions and the lumping together of different diseases under the term NEC. There is no clear consensus on what constitutes "classic NEC". The document explores potential causes of NEC like dysbiosis of the gut microbiome from overuse of antibiotics and lack of enteral feeding in preterm infants. It summarizes evidence that common neonatal practices may disrupt the developing microbiome and increase the risk of NEC. While some studies found probiotics reduced NEC rates, the largest and most recent trial found no effect, demonstrating more research is still needed to understand and prevent N
This document summarizes evidence and guidelines around the evaluation and management of possible early-onset neonatal sepsis. It finds that restricting unnecessary evaluation and antibiotics is important. Clinical monitoring can identify red flags and is often sufficient for well-appearing late preterm and term infants, especially with serial exams over 12 hours. While tests have limited predictive value, stopping antibiotics by 36 hours for reassuring infants is recommended. Several adjuvant therapies like exchange transfusions, immunoglobulins, and colony stimulating factors show promise but require more research before routine use.
1) The study examined the effect of probiotics in preventing necrotizing enterocolitis (NEC) in preterm neonates compared to a control group.
2) 115 preterm infants weighing 750-1500g or less than 32 weeks gestation received probiotics or did not (control). The probiotic group had significantly lower incidence of NEC and fewer cases of elevated C-reactive protein.
3) However, there were no significant differences between the groups in duration of oxygen therapy, total parenteral nutrition, time to full feeding, or length of hospital stay. The study results suggest probiotics have a protective effect against NEC in preterm infants.
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201911 - Tripodi - Immunoterapia specifica alla luce della e-mobile health?Asmallergie
1. The document discusses using digital solutions like mobile health to improve allergen immunotherapy (AIT) by combining clinical research data and mobile health for AIT prescription.
2. It proposes the "@IT-2020" process, a flexible 4-step modular approach for prescribing AIT for pollen allergy patients in Southern Europe/Mediterranean countries, to be validated in a pilot study (2016-2017) and multicenter study (2018-2019).
3. The 4 diagnostic steps of "@IT-2020" and validation testing are described, aiming to determine genuine vs false sensitization, primary sensitization, and the relationship between sensitization and symptoms to guide personalized AIT prescription.
201911 - Rossi - L'asma grave è sempre “grave”?Asmallergie
This document discusses a study of 437 patients with severe asthma (GINA step V) in Italy. The main findings were:
- The average annual exacerbation rate was 3.75.
- The mean blood eosinophil level was 536.7 cells/mcL and average serum total IgE was 470.3 kU/L.
- 64% were on regular oral corticosteroids, 57% with omalizumab and 11.2% with mepolizumab.
- The most common comorbidities were rhinitis, nasal polyposis, and bronchiectasis. Bronchiectasis was associated with more frequent severe exacerbations.
201911 - Conte - Asma eosinofilico: i farmaci biologici che contrastano l'azi...Asmallergie
This document summarizes a presentation about eosinophilic asthma and biological drugs that target interleukin-5 (IL-5). It discusses the role of eosinophils and IL-5 in asthma, clinical studies of anti-IL-5 drugs like mepolizumab and benralizumab, and real-world experience with these therapies. The presentation covers the pathophysiology of eosinophilic asthma, how anti-IL-5 drugs work, results from major clinical trials showing reduced exacerbations and oral corticosteroid use, and insights from real-world studies on treatment response and outcomes. It emphasizes the importance of patient phenotypes and endotypes in guiding therapy selection for severe asthma.
201911 - Villalta - Novità in ambito di diagnostica molecolare nella sensibil...Asmallergie
This document discusses advances in molecular diagnostics for mite sensitization. It begins with a brief history of allergy to house dust mites and an overview of the major allergenic molecules from mites, including Der p 1, Der p 2, and Der p 23. It describes the concept of "molecular spreading" where the IgE response spreads from initial sensitization to major allergens to include other milder allergens over time. The document then covers classical and molecular diagnostic techniques for mite allergy. It concludes by discussing the potential predictive role of antibody patterns to different mite allergens.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
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Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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3. 90% delle cellule del corpo umano sono microbi (cellule umane in grigio)
99% dei geni del corpo umano appartengono ai microbi
(i geni umani sono rappresentati dalla formica)
MJ.Blaser, Trans Am Clin Climatol Assoc. 2012; 123: 230–241.
.,
4. Razionale
• Il microbioma svolge un ruolo importante nello
sviluppo immunologico precoce, con la
possibilità che la manipolazione sperimentale
possa modulare il sistema immunitario
• Se il microbioma è in grado di modulare lo
sviluppo del sistema immunitario ciò comporta
che esso svolga un ruolo importante nello
sviluppo e nella manifestazione delle malattie
allergiche.
5. • Importanza della
esposizione precoce ad
un dato ambiente nella
programmazione dei
disordini immuno-mediati.
• Complessa interazione
geni-ambiente, dove
quest’ultimo potrebbe
agire attraverso
modificazioni
epigenetiche
dell’espressione genica.
Esposizione precoce e ambiente
6. M. Weng and W. A. Walker Dev Orig Health Dis. 2013
The role of gut microbiota in programming
the immune phenotype
8. Bach JF. N Engl J Med. 2002;347(12):911–20
The Effect of Infections on Susceptibility
to Autoimmune and Allergic Diseases
9. Bach JF. N Engl J Med. 2002;347(12):911–20
The Effect of Infections on Susceptibility
to Autoimmune and Allergic Diseases
10. Bach JF. N Engl J Med. 2002;347(12):911–20
The Effect of Infections on Susceptibility
to Autoimmune and Allergic Diseases
11. Atopy and Asthma in Migrants
• L’immigrazione verso Paesi
con maggiore prevalenza di
allergia causa più allergie e
asma nei migranti, rispetto
alla prevalenza nel loro Paese
di origine.
• L’effetto è tempo-dipendente.
• L’acquisizione dell’allergia è
influenzata dall’età all’epoca
della migrazione.
Rottem M et al. Int Arch Allergy Immunol. 2005;136(2):198–204
12. Ambiente e allergie
Dati di popolazioni con eredità genetica simile ma esposti a
differenti condizioni socio-economiche:
• Ipotesi dell’igiene (Strachan D, BMJ 1989)
• Bambini finlandesi più spesso sensibilizzati ad allergeni e con più
elevati valori di IgE specifiche, rispetto ai bambini della Karelia
(Russia), simili geneticamente ma a più basso tenore di vita (Seiskari T,
CEA 2007)
• Asma e rinite allergica più frequenti nella Germania Ovest rispetto a
quella dell’Est, con aumento di prevalenza dopo l’unificazione (von
Mutius E, AJRCCM 1994)
• Stile di vita antroposofico (Steiner) associato a minore prevalenza di
asma e sensibilizzazione allergica (Alm JS, Lancet 1999)
• Effetto protettivo, sul rischio di asma e allergie, del vivere in fattoria
durante la gravidanza e nei primi anni di vita (von Mutius, Nat Rev
Immunol 2010)
• Ruolo delle endotossine (Braun-Fahrländer C, NEJM 2002) e del latte
non pastorizzato (Perkin MR, JACI 2006)
13. Innate Immunity and Asthma Risk in Amish
and Hutterite Farm Children
• Two distinctive U.S. farming
populations the Amish of Indiana
and the Hutterites of South Dakota
• These two particular groups of
farmers originated in Europe, the
Amish in Switzerland and the
Hutterites in South Tyrol
• Emigrated to the United States in
the 1700s and 1800s, respectively
• Genetically indistinguishable
• Their lifestyles are similar
Stein MM et al. N Engl J Med 2016;375:411-21
Amish Hutterites
14. Innate Immunity and Asthma Risk in Amish
and Hutterite Farm Children
Stein MM et al. N Engl J Med 2016;375:411-21
Large family sizes
Comparable schooling
(to 8th grade)
High-fat diet
Amish
(n=157)
Hutterite
(n=80)
Asthma 5.2% 21.3%
Allergic
sensitization
7.2% 33.3%
15. Innate Immunity and Asthma Risk in Amish
and Hutterite Farm Children
Stein MM et al. N Engl J Med 2016;375:411-21
Amish: Traditional farming Hutterites: Modern farming
22. M Kalliomäki et al. J Allergy Clin Immunol 2001;107:129-34.
Distinct patterns of neonatal gut microflora in infants
in whom atopy was and was not developing
23. “..higher levels of Clostridium and lower levels of Bifidobacterium species.
This discrepant composition precedes the development of atopy.”
Atopici Non atopici differenza
Enterococchi 72% 96% P<0.05
Bifidobatteri 17%-39% 42%-69% P<0.05
Stafilococco aur. 61% 23% p<0.05
Clostridi 10.3 (log10) 7.2 (log10) P<0.05
Bacterioidi 9.9 (log10) 10.6 (log10) P<0.05
Björkstén B et al. J Allergy Clin Immunol. 2001 Oct;108(4):516-20
Allergy development and the intestinal
microflora during the first year of life
24. Abrahamsson, JACI 2012; 129:434.
Low diversity of the gut microbiota in infants
with atopic eczema.
• Microbial diversity and
composition were analyzed
with barcoded 16S rDNA
454-pyrosequencing in stool
samples
• at 1 week, 1 month, and 12
months of age
• in 20 infants with IgE-
associated eczema and
• 20 normal infants
25. Caesarean delivery and risk of atopy and
allergic disesase: meta-analyses
• Meta-analisi di 26 studi
• Taglio cesareo aumenta il rischio di asma e allergie?
• C-section was associated with an increased
summary OR of food allergy/food atopy (OR 1.32,
95% CI 1.12–1.55; six studies)
• allergic rhinitis (OR 1.23, 95% CI 1.12–1.35; seven
studies)
• asthma (OR 1.18, 95% CI 1.05–1.32; 13 studies),
• hospitalization for asthma (OR 1.21, 95% CI 1.12–
1.31; seven studies)
Bager P et al. Clinical and Experimental Allergy, 38, 634–642
26. Probiotics prevent IgE-associated allergy until
age 5 years in cesarean-delivered children but
not in the total cohort
• Studio DBPC
• randomizzate 1223 coppie
madre-bambino ad alto
rischio allergico
• miscela di probiotici (2
lactobacilli, bifidobacteria,
and propionibacteria)
• placebo
• durante l’ultimo mese di
gravidanza e al neonato
fino al 6°mese
Kutuinen M eet al. J Allergy Clin Immunol 2009;123:335-41.
p=0,036
TC senza prob
TC con prob
“..less IgE-associated allergic disease
occurred in cesarean delivered
children receiving probiotics (24.3%
vs 40.5%; OR 0.47; 95% CI, 0.23% to
0.96%; p=0.035)
Bifidobatteri fecali
27. Pfefferle PI et al JACI 2013;131:1453-63
parto vaginale
Possible mechanisms of prenatal and postnatal
induction of tolerance by microbial components
28. taglio cesareo
Pfefferle PI et al JACI 2013;131:1453-63
Possible mechanisms of prenatal and postnatal
induction of tolerance by microbial components
29. Pfefferle PI et al. Allergology International. 2014;63:3-10
Periodo perinatale
“window of opportunity”
Microbial Exposure and Onset of Allergic
Diseases – Potential Prevention Strategies?
31. Batteri Lattici
Lactobacillus acidophilus
Lactobacillus bulgaricus
Lactobacillus brevis
Lactobacillus casei
Lactobacillus casei Shirota
Lactobacillus johnsonii
Lactobacillus plantarum
Lactobacillus rhamnosus GG
Lactobacillus reuteri
Lactobacillus salivarius
Bifidobatteri
Bifidobacterium animalis
Bifidobacterium bifidum
Bifidobacterium breve
Bifidobacterium infantis
Bifidobacterium lactis
Bifidobacterium longum
Altri batteri
Bacillus cereus
Escherichia coli Nissle 1917
Streptococcus thermophilus
Principali microorganismi utilizzati come probiotici
Batteri
Saccharomyces boulardii
Lieviti
32. Non tutti i probiotici sono uguali
Nella scelta di un probiotico, il tipo di patologia, la specificità del ceppo e
la quantità da somministrare rappresentano fattori determinanti
Bifidobacterium animalis strain DN-173 010
Bifidobacterium acti regularis
33. Pelucchi C et al. Epidemiology. 2012 May;23(3):402-14
Probiotics supplementation during pregnancy or
infancy for the prevention of atopic dermatitis: a
meta-analysis
34. Eigenmann PA. Curr Opin Allergy Clin Immunol 2013, 13:426–431
Evidence of preventive effect of probiotics and
prebiotics for infantile eczema
35. Eigenmann PA. Curr Opin Allergy Clin Immunol 2013, 13:426–431
Evidence of preventive effect of probiotics and
prebiotics for infantile eczema
36. Meta-analysis of probiotics and/or prebiotics
for the prevention of eczema
• RCT, doppio cieco
• Donne in gravidanza e bb < 2aa con o senza
familiarità per allergie
• Probiotici (qualsiasi ceppo) e/o prebiotici per
periodi variabili di tempo o placebo
• Outcome primario: incidenza di eczema nei
primi 2 anni
• Outcome secondario: sensibilizzazione (SPT/IgE)
Dang D et al. Journal of International Medical Research 2013; 41(5) 1426–1436
37. 2550 partecipanti
- 31%
Dang D et al. Journal of International Medical Research 2013; 41(5) 1426–1436
Meta-analysis of probiotics and/or prebiotics
for the prevention of eczema
38. 2550 partecipanti
- 31%
Dang D et al. Journal of International Medical Research 2013; 41(5) 1426–1436
Meta-analysis of probiotics and/or prebiotics
for the prevention of eczema
Lattobacilli +
bifidobatteri
- 42%
39. Probiotic supplementation during pregnancy or
infancy for the prevention of asthma and wheeze:
systematic review and meta-analysis
• Valutare l’associazione tra supplementazione con probiotici
durante la gravidanza o nel lattante (1^ anno) e comparsa di
asma/wheezing
• RS e meta-analisi di RCTs (agosto 2013)
• Outcome primario: diagnosi di asma/wheeze formulata dal
medico
• 20 trials elegibili (4866 bb), eterogenei per tipo di probiotico
e durata del trattamento
• Non evidenze a supporto del ruolo protettivo della
supplementazione perinatale su rischio di asma/wheeze
Azad MB et al. BMJ 2013;347:f6471
40. Probiotic supplementation during pregnancy or
infancy for the prevention of asthma and wheeze:
systematic review and meta-analysis
Azad MB et al. BMJ 2013;347:f6471
41. Probiotic supplementation during pregnancy or
infancy for the prevention of asthma and wheeze:
systematic review and meta-analysis
Azad MB et al. BMJ 2013;347:f6471
42. Allergy, 2014
There is no evidence to support the
use of probiotics (also prebiotics) for
food allergy prevention
43. Probiotics for the prevention of allergy: A systematic
review and meta-analysis of randomized controlled
trials
Cuello-Garcia CA et al.
J Allergy Clin Immunol.
2015 Oct;136(4):952-61
44. Probiotics for the prevention of allergy: A systematic
review and meta-analysis of randomized controlled
trials
Cuello-Garcia CA et al. J Allergy Clin Immunol. 2015 Oct;136(4):952-61
45. Probiotics for the prevention of allergy: A systematic
review and meta-analysis of randomized controlled
trials
Cuello-Garcia CA et al. J Allergy Clin Immunol. 2015 Oct;136(4):952-61
46. Probiotics for Prevention of Atopy and Food
Hypersensitivity in Early Childhood
Zhang GQ et al. Medicine 2016;95(8):e2562
Atopia
47. Probiotics for Prevention of Atopy and Food
Hypersensitivity in Early Childhood
Zhang GQ et al. Medicine 2016;95(8):e2562
Allergia
alimentare
48. World Allergy Organization-McMaster University
Guidelines for Allergic Disease Prevention
(GLAD-P): Probiotics
• A systematic review
• 29 publications
• 12 various probiotics single or
in combination
• In line with the EAACI, the
WAO experts agreed that
probiotic supplementation
cannot be recommended for
reducing the risk of allergy in
children
• However, the WAO considered
that there is a likely net benefit
from using probiotics for
preventing eczema
Fiocchi A et al. World Allergy Organization Journal (2015) 8:4
WAO suggests:
• a) using probiotics in pregnant
women at high risk for having
an allergic child;
• b) using probiotics in women
who breastfeed infants at high
risk of developing allergy; and
• c) using probiotics in infants at
high risk of developing allergy
All recommendations
were conditional and supported
by a very low quality of
evidence.
49. Recommendations on probiotics in allergy
prevention should not be based on pooling data
from different strains
One important limitation of the WAO guidelines is
the lack of answers to the most important practical
questions:
• Which probiotic(s) should be used to reduce the
risk of eczema?
• When should one start the administration of
probiotics with proven efficacy?
• When should one stop?
• What is the dose of an effective probiotic?
Szajewska H et al. J Allergy Clin Immunol. 2015 Nov;136(5):1422
50. Recommendations on probiotics in allergy
prevention should not be based on pooling data
from different strains
Szajewska H et al. J Allergy Clin Immunol. 2015 Nov;136(5):1422
Even with regard to Lactobacillus rhamnosus GG, although the pooled results of 4
randomized controlled trials indicate a trend toward a reduction in the risk of eczema
at 12 to 24 months, the difference between the Lactobacillus rhamnosus GG and
control groups was not statistically significant
51. Early Probiotic Supplementation for Eczema and
Asthma Prevention: A Randomized Controlled Trial
51Cabana MD et al. Pediatrics 2017;140(3):e20163000
RCT-DBPC con Lactobacillus rhamnosus GG (LGG)
For the first 6 months of life, intervention infants (n = 92) received a daily
dose of 10 billion CFU of LGG and infants were accrued over a 6-year period
52. Early Probiotic Supplementation for Eczema and
Asthma Prevention: A Randomized Controlled Trial
52Cabana MD et al. Pediatrics 2017;140(3):e20163000
CONCLUSIONS: For high-risk infants, early LGG supplementation
for the first 6 months of life does not appear to prevent the
development of eczema or asthma at 2 years of age.
RCT-DBPC con Lactobacillus rhamnosus GG (LGG)
For the first 6 months of life, intervention infants (n = 92) received a daily
dose of 10 billion CFU of LGG and infants were accrued over a 6-year period
53.
54.
55. Probiotics for the Treatment of Atopic Dermatitis in
Children: A Systematic Review and Meta-Analysis of
Randomized Controlled Trials
55Huang R. Front. Cell. Infect. Microbiol 2017; 7:392
56. Probiotics for the Treatment of Atopic Dermatitis in
Children: A Systematic Review and Meta-Analysis of
Randomized Controlled Trials
56Huang R. Front. Cell. Infect. Microbiol 2017; 7:392
Our present work demonstrated that probiotics may have the
potential to decrease SCORAD values in children with AD.
However, the findings presented here must be generalized
with caution because of heterogeneity. The results are a
source of optimism with regard to the management of AD in
children. More adequately powered RCTs using standardized
measurements are necessary to assess which species of
probiotics and dosages and what treatment periods are most
efficacious for children with AD
57. The role of probiotics in prevention and treatment
for patients with allergic rhinitis:
A systematic review
Peng Y et al. Am J Rhinol Allergy. 2015 Jul-Aug;29(4):292-8.
Prevenzione della rinite allergica
58. The role of probiotics in prevention and treatment
for patients with allergic rhinitis:
A systematic review
Peng Y et al. Am J Rhinol Allergy. 2015 Jul-Aug;29(4):292-8.
Sintomi e qualità di vita
59. The role of probiotics in prevention and treatment
for patients with allergic rhinitis:
A systematic review
Peng Y et al. Am J Rhinol Allergy. 2015 Jul-Aug;29(4):292-8.
Effetti sul
sistema
immunitario
60. The microbiome in allergic disease: Current
understanding and future opportunities
Huang YJ et al. J Allergy Clin Immunol 2017;139:1099-110
Because asthma, AD, and food allergy are complex and heterogeneous diseases, it is unlikely that the
microbiota implicated in these diseases or even the microbiome in its entirety can fully capture the
interdependent dynamics of the molecular networks involved in these diseases