allergy
The development of food allergy after liver transplantation.

Boyle RJ, Hardikar W, Tang ML.

Department of Immunology, Royal Children's Hospital, Melbourne, Australia. bob.boyle rch.org.au

The acquisition of new food allergy after orthotopic liver transplantation is now a well described phenomenon, mainly reported in children. The etiology of this phenomenon is at present unclear, but has been ascribed by some to tacrolimus treatment. Here we report a case of liver transplant acquired food allergy (LTAFA) in a child who received a split liver graft. The case is remarkable for the absence of new food allergy in the adult recipient of the same graft. This suggests that host-specific factors play an important role in the development of food allergy after liver transplantation, and emphasizes the predisposition that children have toward this phenomenon. Possible mechanisms underlying the development of food allergy after liver transplantation are discussed. In conclusion, tacrolimus treatment alone cannot account for LTAFA. Host factors such as the maturity of immune regulatory mechanisms are likely to play a critical role in the development of new food allergy after a liver transplant.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15719388&dopt=Abstract allergy medicine



allergy
Airborne chemicals cause respiratory symptoms in individuals with contact allergy.

Elberling J, Linneberg A, Mosbech H, Dirksen A, Menne T, Nielsen NH, Madsen F, Frolund L, Johansen JD.

The National Allergy Research Centre, Department of Dermatology, Gentofte University Hospital, Gentofte, Denmark. jeel gentoftehosp.kbhamt.dk

Exposure to fragrance chemicals causes various eye and airway symptoms. Individuals with perfume contact allergy report these symptoms more frequently than individuals with nickel allergy or no contact allergies. However, the associations between contact allergy and respiratory symptoms elicited by airborne chemicals other than perfumes are unclear. The study aimed to investigate the association between eye and airway symptoms elicited by airborne chemicals (other than perfumes) and contact allergy in a population-based sample. A questionnaire on respiratory symptoms was posted, in 2002, to 1189 individuals who participated in 1997/1998 in a Danish population-based study of allergic diseases. Questions about eye and airway symptoms elicited by different airborne chemicals and airborne proteins were included in the questionnaire. Data from the questionnaire were compared with data on patch testing and prick testing. Having at least 1 positive patch test (adjusted odds ratio 1.7, 95% CI 1.2-2.5) was associated with the symptoms, and the odds ratio increased with the number of positive patch tests (P-value for test for trend <0.05). Bronchial hyperreactivity, female sex and psychological vulnerability were independently associated with symptoms, but no association was found between prick test reactivity to proteins and the symptoms elicited by airborne chemicals.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15725282&dopt=Abstract allergy medicine



allergy
Resolution of peanut allergy following bone marrow transplantation for primary immunodeficiency.

Hourihane JO, Rhodes HL, Jones AM, Veys P, Connett GJ.

Division of Infection, Inflammation and Repair, University of Southampton, Southampton, UK.

Peanut allergy is a severe and life-threatening form of food allergy. Treatments are being developed but the mainstays of current management remain avoidance of peanut and appropriate use of rescue medication. We report the case of a boy with peanut allergy who required a bone marrow transplant (BMT) for combined immunodeficiency. A food challenge, 2 years after transplant, showed that his peanut allergy had resolved. Allergic disorders constitute a form of immune deviation and while we do not advocate BMT as a treatment for peanut allergy, we believe this case provides an insight into the basic mechanisms involved in food allergy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15727591&dopt=Abstract allergy medicine



allergy
Allergy-like conditions and health-care contacts among children with exclusion diets at school.

Gunnarsson N, Marklund B, Ahlstedt S, Borell L, Nordstrom G.

Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden.

Scand J Caring Sci; 2005; 19; 46-52 Allergy-like conditions and health-care contacts among children with exclusion diets at schoolAim: To find out whether children with exclusion diet at school had allergy-like conditions that could explain their food avoidance, the objective of this study was to describe health-care contacts and diagnostic testing among schoolchildren with exclusion diet and compare the magnitude of allergy-like conditions between those children who had vs. had not consulted health-care professionals. Telephone interviews were conducted with the parents of 230 schoolchildren, aged 6-18 years, with certificates for exclusion diets at school. Results: The majority of the schoolchildren (85%) had consulted health-care professionals for food-related problems, and 68% were doctor-diagnosed as having food hypersensitivity. Those who had consulted health-care professionals specifically for their food-related problems had more complex and severe problems compared with those who had not consulted health-care professionals. Breathing difficulties (27/196) and anaphylaxis (9/196) related to intake of food were reported only for those who had sought health-care professionals (n = 196). Regardless of whether the children had consulted the health-care professionals, their food-related problems were consistent with food hypersensitivity. Schoolchildren avoided food items known to be associated with food hypersensitivity such as tree nuts, fruit, egg, peanut, lactose and fish. Furthermore, 83% of the 230 children also had allergic diseases (i.e. asthma, eczema or hay fever) or were hypersensitive to other substances besides food, and 83% had at least one sibling or parent with hypersensitivity to foods or other substances. Conclusions and implications for the school nurse: Schoolchildren with food certificates for exclusion diets, based on parents' statements, have food-related and allergy-like problems that may well motivate exclusion diets at school. The school nurses can rely on the parents' information as to what foods their children should avoid, even when doctor diagnoses have not been made or health-care consultations have not been carried out.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15737165&dopt=Abstract allergy medicine



allergy
Risk of contact allergy and dermatitis at a wind turbine plant using epoxy resin-based plastics.

Rasmussen K, Carstensen O, Ponten A, Gruvberger B, Isaksson M, Bruze M.

Department of Occupational Medicine, Herning Hospital, 7400, Herning, Denmark, heckra ringamt.dk.

Aims: To identify workplace and individual risk factors for occupational contact allergy and dermatitis. Methods: A cross-sectional study was carried out at an international company producing wind turbine systems in Denmark. A cohort of 724 production workers at four facilities was highly exposed to epoxy resin as well as other chemicals. A screening questionnaire (participation rate 84.7%) was followed by an interview by an occupational physician and a dermatological examination, including patch testing, for a comprehensive list of potential workplace sensitizers. Results: Clinically diagnosed dermatitis was found among 214 workers (35.8%) and contact allergy to materials used in the workplace was found in 66 workers (10.9% of the total population and 20.3% of those who underwent patch testing). Of the 66 workers with a work-related allergy, 40 (60.6%) were allergic to epoxy compounds, 25 (37.9%) to hardeners and ten (15.2%) to other workplace materials, where one person showed an allergy only to these materials. Experiencing contact allergy was related to older age and longer employment in the workplace-however, neither of these risk factors was significant. The main risk factor for current dermatitis was contact allergy to materials used in the workplace, determined by patch testing, OR=5.4 (95% CI 3.9-9.9). Fewer days of absence from work was also related to current dermatitis, OR=2.0 (95% CI 1.2-3.5). Conclusions: In a cohort of workers with extensive exposure to chemicals related to epoxy-resin systems, contact dermatitis and allergy was prevalent. Older age and longer duration of employment at the workplace were individual risk factors for allergy to workplace materials, whilst work-related allergies and longer duration of employment at the workplace were significant risk factors for current dermatitis.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15739094&dopt=Abstract allergy medicine



allergy
Epidemiology of alternaria alternata allergy: a prospective study in 6840 italian asthmatic children.

Cantani A, Ciaschi V.

Department of Pediatrics, Allergy and Clinical Immunology Division, University "La Sapienza", Rome, Italy.

BACKGROUND: The prevalence of Alternaria Alternata (AA), a mold causing in children severe asthma is scarcely known, also due to the underdiagnosis of AA allergy, frequently due to multiple sensitizations to molds. OBJECTIVE: To analyze this issue we prospectively studied all children attending our Division between January 4, 1990 and December 31, 1997. METHODS: A total of 6840 children with asthma or allergic rhinitis were evaluated. Diagnosis was established by family and personal history, physical examination, skin prick tests (SPTs) and RAST (Radio Allergo-Sorbent Test) for inhalants including AA. We further evaluated: (1) sensitization only to AA allergens without positivity for additional inhalants; (2) prevalence of AA positivity among children with asthma or allergic rhinitis; (3) concordance between SPTs and RAST for allergy to molds, (4) proportion of children treated with specific immunotherapy (SIT). RESULTS: Among the 6840 children 213 were positive to AA (3.3%), only 89/6840 children (1.3%) had AA monosensitization (p = 0.0001), a concordance between SPTs and RAST was present in 21/89 (23.6%) children (p = 0.0009), and only 9 children out of 89 were SIT treated. Concerning the clinical manifestations, 83 had asthma or allergic rhinitis, and 6 had asthma associated with atopic dermatitis. Family history was positive in 82.9% of children. The mean onset of AA sensitivity was at age 4 for males, and at age 5 for females. CONCLUSIONS: In childhood, AA allergy is a genetic affection. The SPT concordance with history and clinical examination appears to be operative. Due to life-threatening reactions in children with AA allergy, we suggest that those with suspected inhalant allergy be tested with AA allergens, and treated with SIT if positive.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15745389&dopt=Abstract allergy medicine



allergy
Overweight is associated with allergy in school children of Taiwan and Vietnam but not Japan.

Irei AV, Sato Y, Lin TL, Wang MF, Chan YC, Hung NT, Kunii D, Sakai T, Kaneda M, Yamamoto S.

Department of Food Sciences and Nutrition, Graduate School of Human Culture, Nara Women's University, Nara, Japan.

We collected information concerning diagnosed allergy from 2027 school children in Japan, Taiwan and Vietnam. Children were classified according to the age and sex-specific body mass index (BMI) per-age as indicator of weight status. Logistic regression was performed to examine the relationship between percentiles of BMI-per-age and allergy. Compared with children at the lowest percentile group Taiwanese children at > 85th percentile group showed a tendency toward higher risk of allergy (OR = 1.79, 95% CI 0.98 to 3.27; p = 0.060). When children with rhino-conjunctivitis were excluded from the analysis the association reached statistical significance (OR = 2.89, 95% CI 1.08 to 7.75; p = 0.035). Vietnamese children at > 85th percentile group showed a significantly higher risk of allergy (OR = 2.34, 95% CI 1.06 to 5.17; p = 0.035). This association was not observed when children with atopic dermatitis or food allergy were excluded from the analysis, although a tendency toward increased risk of allergy at BMI-per-age > 85th percentile remained. Our study sample of Japanese school children showed no association between being overweight and allergy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15751271&dopt=Abstract allergy medicine