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  • 1.
    Agyemang, Amanda
    et al.
    Kravis Childrens Hosp, Icahn Sch Med Mt Sinai, Jaffe Food Allergy Inst, Div Allergy & Immunol,Dept Pediat, New York, NY USA.
    Saf, Sarah
    Kravis Childrens Hosp, Icahn Sch Med Mt Sinai, Jaffe Food Allergy Inst, Div Allergy & Immunol,Dept Pediat, New York, NY USA;Hop Enfants Armand Trousseau, Ctr Asthme & Allergies, Dept Allergol, Paris, France.
    Sifers, Travis
    Kravis Childrens Hosp, Icahn Sch Med Mt Sinai, Jaffe Food Allergy Inst, Div Allergy & Immunol,Dept Pediat, New York, NY USA.
    Mishoe, Michelle
    Kravis Childrens Hosp, Icahn Sch Med Mt Sinai, Jaffe Food Allergy Inst, Div Allergy & Immunol,Dept Pediat, New York, NY USA.
    Borres, Magnus P
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research. Thermo Fisher Sci, Uppsala, Sweden.
    Sampson, Hugh A.
    Kravis Childrens Hosp, Icahn Sch Med Mt Sinai, Jaffe Food Allergy Inst, Div Allergy & Immunol,Dept Pediat, New York, NY USA.
    Nowak-Wegrzyn, Anna
    Kravis Childrens Hosp, Icahn Sch Med Mt Sinai, Jaffe Food Allergy Inst, Div Allergy & Immunol,Dept Pediat, New York, NY USA.
    Utilizing boiled milk sIgE as a predictor of baked milk tolerance in cow's milk allergic children2019In: Journal of Allergy and Clinical Immunology: In Practice, ISSN 2213-2198, E-ISSN 2213-2201, Vol. 7, no 6, p. 2049-2051Article in journal (Refereed)
  • 2.
    Andorf, Sandra
    et al.
    Stanford Univ, Dept Med, Div Pulm & Crit Care Med, Stanford, CA 94305 USA.;Stanford Univ, Sean N Parker Ctr Allergy & Asthma Res, Stanford, CA 94305 USA..
    Borres, Magnus P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Thermo Fisher Sci, Immunodiagnost, Uppsala, Sweden..
    Block, Whitney
    Stanford Univ, Dept Med, Div Pulm & Crit Care Med, Stanford, CA 94305 USA.;Stanford Univ, Sean N Parker Ctr Allergy & Asthma Res, Stanford, CA 94305 USA..
    Tupa, Dana
    Stanford Univ, Dept Med, Div Pulm & Crit Care Med, Stanford, CA 94305 USA.;Stanford Univ, Sean N Parker Ctr Allergy & Asthma Res, Stanford, CA 94305 USA..
    Bollyky, Jennifer B.
    Stanford Univ, Dept Med, Div Gen Med, Stanford, CA 94305 USA..
    Sampath, Vanitha
    Stanford Univ, Dept Med, Div Pulm & Crit Care Med, Stanford, CA 94305 USA.;Stanford Univ, Sean N Parker Ctr Allergy & Asthma Res, Stanford, CA 94305 USA..
    Elizur, Arnon
    Stanford Univ, Dept Med, Div Pulm & Crit Care Med, Stanford, CA 94305 USA.;Stanford Univ, Sean N Parker Ctr Allergy & Asthma Res, Stanford, CA 94305 USA..
    Lidholm, Jonas
    Thermo Fisher Sci, Immunodiagnost, Uppsala, Sweden..
    Jones, Joseph E.
    Thermo Fisher Sci, Immunodiagnost, Kalamazoo, MI USA..
    Galli, Stephen J.
    Stanford Univ, Sean N Parker Ctr Allergy & Asthma Res, Stanford, CA 94305 USA.;Stanford Univ, Sch Med, Dept Pathol, Stanford, CA 94305 USA.;Stanford Univ, Sch Med, Dept Microbiol & Immunol, Stanford, CA 94305 USA..
    Chinthrajah, Rebecca S.
    Stanford Univ, Dept Med, Div Pulm & Crit Care Med, Stanford, CA 94305 USA.;Stanford Univ, Sean N Parker Ctr Allergy & Asthma Res, Stanford, CA 94305 USA..
    Nadeau, Kari C.
    Stanford Univ, Dept Med, Div Pulm & Crit Care Med, Stanford, CA 94305 USA.;Stanford Univ, Sean N Parker Ctr Allergy & Asthma Res, Stanford, CA 94305 USA..
    Association of Clinical Reactivity with Sensitization to Allergen Components in Multifood-Allergic Children2017In: Journal of Allergy and Clinical Immunology: In Practice, ISSN 2213-2198, E-ISSN 2213-2201, Vol. 5, no 5, p. 1325-1334.e4Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Thirty percent of children with food allergies have multiple simultaneous allergies; however, the features of these multiple allergies are not well characterized serologically or clinically. OBJECTIVE: We comprehensively evaluated 60 multifood-allergic patients by measuring serum IgE to key allergen components, evaluating clinical histories and medication use, performing skin tests, and conducting double-blind, placebo-controlled food challenges (DBPCFCs). METHODS: Sixty participants with multiple food allergies were characterized by clinical history, DBPCFCs, total IgE, specific IgE, and component-resolved diagnostics (IgE and IgG4) data. The food allergens tested were almond, egg, milk, sesame, peanut, pecan, walnut, hazelnut, cashew, pistachio, soy, and wheat. RESULTS: Our data demonstrate that of the reactions observed during a graded DBPCFC, gastrointestinal reactions occurred more often in boys than in girls, as well as in individuals with high levels of IgE to 2S albumins from cashew, walnut, and hazelnut. Certain food allergies often occurred concomitantly in individuals (ie, cashew/pistachio and walnut/pecan/hazelnut). IgE testing to components further corroborated serological relationships between and among these clustered food allergies. CONCLUSIONS: Associations of certain food allergies were shown by DBPCFC outcomes as well as by correlations in IgE reactivity to structurally related food allergen components. Each of these criteria independently demonstrated a significant association between allergies to cashew and pistachio, as well as among allergies to walnut, pecan, and hazelnut. (C) 2017 American Academy of Allergy, Asthma & Immunology

  • 3. Bengtsson, U
    et al.
    Knutson, TW
    Knutson, L
    Dannaeus, A
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Women's and Children's Health.
    Hallgren, R
    Department of Medical Sciences.
    Ahlstedt, S
    Eosinophil cationic protein and histamine after intestinal challenge in patients with cow´s milk intolerance1997In: J Allergy Clin Immunol, Vol. 100, p. 216-Article in journal (Refereed)
  • 4. Bengtsson, U
    et al.
    Knutson, TW
    Knutson, L
    Dannaeus, A
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Women's and Children's Health.
    Hallgren, R
    Ahlstedt, S
    Increased levels of hyaluronan and albumin after intestinal challenge in adult patients with cow's milk intolerance1996In: Clinical & Experimental Allergy, Vol. 26, p. 96-Article in journal (Refereed)
  • 5. Devenney, Irene
    et al.
    Norrman, Gunilla
    Uppsala University, Interfaculty Units, Centrum för klinisk forskning, Gävleborg.
    Oldaeus, Göran
    Strömberg, Leif
    Fälth-Magnusson, Karin
    A new model for low-dose food challenge in children with allergy to milk or egg.2006In: Acta Paediatr, ISSN 0803-5253, Vol. 95, no 9, p. 1133-9Article in journal (Refereed)
    Abstract [en]

    Division of Paediatrics, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, Linköping, and Paediatric Clinic, County Hospital Ryhov, Fonköping, Sweden. irene.devenney@lio.se

    BACKGROUND: Atopic eczema and food allergy are common in early childhood. Children seem to gradually develop tolerance to milk and egg, and it is a relief for families when their child can tolerate small amounts of these basic foods, even if larger doses may still cause symptoms. AIM: To develop a model for low-dose oral food challenge, facilitating re-/introduction of milk or egg. METHODS: In 39 children sensitized to milk and/or egg, we performed 52 challenges using a new standardized model for low-dose oral food challenge. The recipes were validated for blinding with sensorial tests. RESULTS: Four children challenged to milk had a positive challenge outcome. There were no significant differences with respect to family history, associated atopic manifestations, nutritional supply, eczema severity, or skin-prick test compared with the non-reacting children, but total and specific IgE values were significantly higher. All but two of the non-reacting children were able to introduce milk and egg into their diet without problems. CONCLUSION: We report recipes and a protocol to be used for standardized open and double-blind placebo-controlled low-dose food challenge in young children, enabling the introduction of small amounts of egg and milk into the diet during tolerance development.

  • 6.
    Dreborg, Sten
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Cow's milk protein allergy and common gastrointestinal symptoms in infants2016In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 3, p. 253-254Article in journal (Refereed)
    Abstract [en]

    In their review on the management of functional gastrointestinal disorders and cow's milk protein allergy (CMPA) in infants (1), Vandenplas et al discuss infantile colic, regurgitation and constipation and the relationship between these symptoms, which are common in infants, to CMPA. The group starts by stating that CMPA can only be diagnosed by a double blind placebo controlled food challenge. However, this can be replaced by an open challenge in infants as long as the challenge is performed under the supervision of an experienced team (2, 3). The authors acknowledge that sensitisation to cow's milk indicates possible CMPA and the need for a challenge to reach a proper diagnosis of CMPA. But then they make some some statements that I feel blur the message (1).

  • 7.
    Dreborg, Sten
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Debates in allergy medicine: food intolerance does not exist.2015In: World Allergy Organization Journal, ISSN 1731-3317, E-ISSN 1939-4551, Vol. 8, no 37Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The term "intolerance" is not mentioned in the World Allergy Organization (WAO) document on allergy nomenclature. "Intolerance" has been used to describe some non-immunological diseases. However, pediatric gastroenterologists mix allergy and intolerance, e.g. by using the term "cow's milk protein allergy/intolerance (CMPA/I)", lumping together all types of mechanisms for not tolerating cow's milk. The basis for this mix is the fact that double-blind oral food challenges are time-consuming and expensive. Therefore, cow's milk exclusion and reintroduction is proposed to be used in primary care for the diagnosis of CMPA in children with common gastrointestinal (GI) problems such as colic and constipation. This may lead to a widespread use of hypoallergenic formulas in children without proven CMPA. In lay language, intolerance describes "not tolerating".

    OBJECTIVE: To discuss the reasons why the term "intolerance" should not be used in the area of allergy.

    RESULTS: Presently, intolerance is not part of the allergy nomenclature. It is used by lay persons to describe "not tolerating". Pediatricians use intolerance to describe non-immunological hypersensitivity such as lactose intolerance which is acceptable. However, using the mixed term CMPA/I describing a variety of gastrointestinal symptoms in children, should be avoided. The WAO Nomenclature does not clearly distinguish between non-IgE-mediated allergy and non-allergic hypersensitivity.

    CONCLUSION: The term "intolerance" should not be used within the area of allergy. Intolerance should be better defined and the term restricted to some non-immunological/non-allergic diseases and not mixed with allergy, e.g. by using the term CMPA/I. A revision of the WAO nomenclature is proposed.

  • 8.
    Dreborg, Sten
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Heine, RG
    Höst, A
    Varga, E-M
    Pettoello-Mantovani, M
    Çokugras, H
    Moya, M
    Konstantopoulos, A
    The management of food allergy in infants with special emphasis on cow’s milk allergy2012In: European Paediatric Association Newsletter, no 13, p. 4-5Article in journal (Other academic)
  • 9.
    Edqvist, Jenny
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Hassan, Mariam
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Protein and Energy Intake in Children with Cow’s Milk Protein Allergy: The results of three-day estimated food records in Swedish children 2-11 years of age compared to control group2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Cow’s Milk Protein Allergy (CMA) is one of the most common food allergies among young children. There is no effective treatment for CMA aside from elimination diets, which increase the risk for malnutrition. Proper nutritional counseling on a regular basis is recommended for children with CMA in order to guarantee an adequate dietary intake.

    Objective: The purpose of this study was to estimate the energy and protein intake among Swedish children 2-11 years of age with CMA and compare it with control group of children with no food allergies as well as with dietary recommendations.

    Method: Families who were interested in participating in this study (n=20) were asked to fill in a three-day estimated food record as well as answer a questionnaire.

    Results: Results show that the average daily intake of energy and protein in children 2-11 years with CMA was almost 10% lower compared to non-allergic children of the same age. The estimated energy intake in both groups was close to the daily requirements of the Nordic Nutrition Recommendations (NNR), as opposed to that by the America Academy of Pediatrics (AAP). The estimated protein intake in both groups was higher than the NNR and WHO daily recommendations per kg/day. The questionnaire shows that 60% of families of children with CMA have previously received nutritional support from a clinical dietitian. Most families of allergic children choose either soya-based or oat-based products as alternatives to milk, all of which contain less protein than milk. While none of the children in both groups reached the recommended daily intake for calcium, only 30% of children with CMA took calcium supplements. None of the children in both groups reached the recommended daily intake for vitamin D.

    Conclusion: Results of this study suggests an increased need for nutritional guidance by a clinical dietitian on a regular basis among children aged 2-11 years with CMA, as these children were found to have almost 10% lower average daily intake of both energy and protein than non-allergic children of the same age. Alternatives to milk used among families of children with CMA contain less protein than milk. Low calcium intake among children with CMA suggests a need for calcium supplements among all children with CMA. Vitamin D intake was low among all children in this study.

  • 10. Englund, H.
    et al.
    Kuitunen, M.
    Moverare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Borres, M. P.
    Makela, M.
    IgE and IgG(4) antibody levels towards milk components are associated with outcome of oral immunotherapy in Finnish milk allergic children2013In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 68, no Suppl. s97, p. 327-327Article in journal (Other academic)
  • 11.
    Enroth, Stefan
    et al.
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Genomics.
    Dahlbom, Ingrid
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Hansson, Tony
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Genomics. Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Johansson, Åsa
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Genomics.
    Gyllensten, Ulf
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Genomics.
    Prevalence and sensitization of atopic allergy and coeliac disease in the Northern Sweden Population Health Study2013In: International Journal of Circumpolar Health, ISSN 2242-3982, E-ISSN 2242-3982, Vol. 72, p. 21403-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Atopic allergy is effected by a number of environmental exposures, such as dry air and time spent outdoors, but there are few estimates of the prevalence in populations from sub-arctic areas.

    OBJECTIVE:

    To determine the prevalence and severity of symptoms of food, inhalation and skin-related allergens and coeliac disease (CD) in the sub-arctic region of Sweden. To study the correlation between self-reported allergy and allergy test results. To estimate the heritability of these estimates.

    STUDY DESIGN:

    The study was conducted in Karesuando and Soppero in Northern Sweden as part of the Northern Sweden Population Health Study (n=1,068). We used a questionnaire for self-reported allergy and CD status and measured inhalation-related allergens using Phadiatop, food-related allergens using the F×5 assay and IgA and IgG antibodies against tissue transglutaminase (anti-tTG) to indicate prevalence of CD.

    RESULTS:

    The prevalence of self-reported allergy was very high, with 42.3% reporting mild to severe allergy. Inhalation-related allergy was reported in 26.7%, food-related allergy in 24.9% and skin-related allergy in 2.4% of the participants. Of inhalation-related allergy, 11.0% reported reactions against fur and 14.6% against pollen/grass. Among food-related reactions, 14.9% reported milk (protein and lactose) as the cause. The IgE measurements showed that 18.4% had elevated values for inhalation allergens and 11.7% for food allergens. Self-reported allergies and symptoms were positively correlated (p<0.01) with age- and sex-corrected inhalation allergens. Allergy prevalence was inversely correlated with age and number of hours spent outdoors. High levels of IgA and IgG anti-tTG antibodies, CD-related allergens, were found in 1.4 and 0.6% of participants, respectively. All allergens were found to be significantly (p<3 e-10) heritable, with estimated heritabilities ranging from 0.34 (F×5) to 0.65 (IgA).

    CONCLUSIONS:

    Self-reported allergy correlated well with the antibody measurements. The prevalence of allergy was highest in the young and those working inside. Heritability of atopy and sensitization was high. The prevalence of CD-related autoantibodies was high and did not coincide with the self-reported allergy.

  • 12.
    Fiocchi, Alessandro
    et al.
    Thermo Fisher Sci, Uppsala, Sweden..
    Pecora, Valentina
    Thermo Fisher Sci, Uppsala, Sweden..
    Petersson, Carl Johan
    Pediat Hosp Bambino Gesu, Vatican City, Vatican..
    Dahdah, Lamia
    Thermo Fisher Sci, Uppsala, Sweden..
    Borres, Magnus P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. Pediat Hosp Bambino Gesu, Vatican City, Vatican..
    Amengual, Maria J.
    Corp Sanit Parc Tauli, Sabadell, Spain..
    Huss-Marp, Johannes
    Univ Freiburg, Dept Dermatol, Allergy Res Grp, D-79106 Freiburg, Germany..
    Mazzina, Oscar
    Thermo Fisher Sci, Uppsala, Sweden..
    Di Girolamo, Francesco
    Thermo Fisher Sci, Uppsala, Sweden..
    Sensitization pattern to inhalant and food allergens in symptomatic children at first evaluation2015In: The Italian Journal of Pediatrics, ISSN 1720-8424, E-ISSN 1824-7288, Vol. 41, article id 96Article in journal (Refereed)
    Abstract [en]

    Background: Data on specific IgE sensitization prevalence in children with allergy-like symptoms seen in the primary care setting are rare. Early diagnosis of allergic diseases is important to prevent clinical manifestations, exacerbations or expansion of allergic diseases to other organ systems. The present study aims to assess the usefulness of early serological diagnosis in children with common allergic symptoms. Methods: 532 children (<15 years of age), with at least one of ten allergy-like symptoms, from 21 primary care centers in two geographic areas of Italy and Spain were included in the study. Patients were tested with, either Phadiatop (R) Infant (0-5 years of age) or Phadiatop (R) and food mix (fx5e) (>5 years of age) to discriminate atopic from non-atopic subjects. A blood sample of atopic subjects was taken for additional 6-26 specific IgE antibody determinations from a predefined panel using the ImmunoCAP (R) System. Results: 267 children (50.2 %) were positive in the initial test and were classified as atopic. 14 % were mono-sensitized, 37 % were sensitized to 2-3 allergens and 49 % to more than 3 allergens. The average number of symptoms in the atopic group was 3.3 vs 2.8 in the non-atopic group. The prevalence of sensitization to single allergens was highest for grass and ragweed pollen and house-dust mites (19-28 %). Sensitization to tree allergens was highest for olive tree (16.5 %). Cow's milk and egg white were the most sensitizing foods (similar to 15 %). Food allergen sensitization predominated in younger children (OR = 2.8) whereas the inverse occurred with inhalant allergens (OR = 2.5 to 5.6). A significant positive correlation between patient age and the number of sensitizations was found. Conclusions: Specific IgE sensitization in children with allergy-like symptoms is common. Multiple sensitization is predominating. Number of clinical symptoms was higher in the atopic group compared to the non-atopic without a correlation with the number of positive allergens. Age seems to play a crucial role in the development of sensitization with a significant positive correlation between patient age and the number of sensitizations.

  • 13.
    Frischmeyer-Guerrerio, Pamela A.
    et al.
    NIAID, Lab Allerg Dis, NIH, 9000 Rockville Pike, Bethesda, MD 20892 USA.
    Rasooly, Marjohn
    Leidos Biomed Res Inc, Clin Res Directorate, Clin Monitoring Res Program, NCI Campus, Frederick, MD USA.
    Gu, Wenjuan
    Leidos Biomed Res Inc, Clin Res Directorate, Clin Monitoring Res Program, NCI Campus, Frederick, MD USA.
    Levin, Samara
    NIAID, Lab Allerg Dis, NIH, 9000 Rockville Pike, Bethesda, MD 20892 USA.
    Jhamnani, Rekha D.
    NIAID, Lab Allerg Dis, NIH, 9000 Rockville Pike, Bethesda, MD 20892 USA.
    Milner, Joshua D.
    NIAID, Lab Allerg Dis, NIH, 9000 Rockville Pike, Bethesda, MD 20892 USA.
    Stone, Kelly
    NIAID, Lab Allerg Dis, NIH, 9000 Rockville Pike, Bethesda, MD 20892 USA.
    Guerrerio, Anthony L.
    Johns Hopkins Sch Med, Dept Pediat, Baltimore, MD USA.
    Jones, Joseph
    Phadia US Inc, Thermo Fisher Sci, ImmunoDiagnost Branch, Portage, MI USA.
    Borres, Magnus P
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Brittain, Erica
    NIH, Biostat Res Branch, DCR, Bldg 10, Bethesda, MD 20892 USA.
    IgE testing can predict food allergy status in patients with moderate to severe atopic dermatitis2019In: Annals of Allergy, Asthma & Immunology, ISSN 1081-1206, E-ISSN 1534-4436, Vol. 122, no 4, p. 393-400Article in journal (Refereed)
    Abstract [en]

    Background: Diagnosing food allergy in patients with atopic dermatitis (AD) is complicated by their high rate of asymptomatic sensitization to foods, which can lead to misdiagnosis and unnecessary food avoidance.

    Objective: We sought to determine whether food-specific (sIgE) or component immunoglobulin (Ig) E levels could predict allergic status in patients with moderate to severe AD and elevated total IgE.

    Methods: Seventy-eight children (median age, 10.7 years) with moderate to severe AD were assessed for a history of clinical reactivity to milk, egg, peanut, wheat, and soy. The IgE levels for each food and its components were determined by ImmunoCAP. The level and pattern of IgE reactivity to each food and its components, and their ratio to total IgE, were compared between subjects who were allergic and tolerant to each food.

    Results: Ninety-one percent of subjects were sensitized, and 51% reported allergic reactivity to at least 1 of the 5 most common food allergens. Allergy to milk, egg, and peanut were most common, and IgE levels to each of these foods were significantly higher in the allergic group. Component IgEs most associated with milk, egg, and peanut allergy were Bos d8, Gal d1, and Ara h2, respectively. The ratio of sIgE to total IgE offered no advantage to sIgE alone in predicting allergy.

    Conclusion: Specific IgE levels and the pattern of IgE reactivity to food components can distinguish AD subjects allergic vs tolerant to the major food allergens and may therefore be helpful in guiding the clinical management of these patients. 

  • 14.
    Holmström, Mats
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Thelin, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Kolmodin-Hedman, Birgitta
    Van Hage, Marianne
    Nasal complaints and signs of disease in farmers: a methodological study2008In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 128, no 2, p. 193-200Article in journal (Refereed)
    Abstract [en]

    CONCLUSION: The methods used in this study are suitable for field studies that involve examinations of groups of workers. For individual examinations, there is no gold standard method that can discriminate work-related discomfort from other causes of rhinitis. OBJECTIVES: Studies of the effects of occupation on farmers' health have mainly focused on lower airways; few studies have examined effects on upper airways. This study investigated nasal functions in three groups of farmers (swine, milk and grain producers) and a control group using different methods, suitable for field studies. SUBJECTS AND METHODS: Health-related complaints were examined and several functional tests, such as expirogram, olfactory threshold test, acoustic rhinometry, nasal lavage with biomarkers of inflammation (eosinophilic cationic proteins (ECP), myeloperoxidase (MPO), tryptase, albumin) and allergy tests were performed. The different tests were correlated to nasal complaints and to each other. RESULTS: Nasal blockage complaints were more common among farmers; overall, nasal polyps were more frequent in grain producers. Objective parameters showed more pronounced mucosal swelling in farmers and higher concentrations of ECP in nasal lavage compared with controls. Lung function, olfactory threshold, atopy frequency and allergen-specific IgE to the storage mite Lepidoglyphus destructor did not differ between farmers and controls. Mucosal swelling measured with acoustic rhinometry was more pronounced in subjects with nasal complaints, hypersensitivity, nasal polyps and symptoms from lower airways. There was a correlation between biomarkers in nasal lavage (MPO, albumin and ECP).

  • 15. Ito, Komei
    et al.
    Futamura, Masaki
    Movérare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Tanaka, Akira
    Kawabe, Tsutomu
    Sakamoto, Tatsuo
    Borres, Magnus P
    The usefulness of casein-specific IgE and IgG4 antibodies in cow's milk allergic children2012In: Clinical and Molecular Allergy, ISSN 1476-7961, E-ISSN 1476-7961, Vol. 10, no 1, p. 1-Article in journal (Refereed)
    Abstract [en]

    Background

    Cow's milk allergy is one of the most common food allergies among younger children. We investigated IgE antibodies to milk, and IgE and IgG4 antibodies to casein, α-lactalbumin and β-lactoglobulin in cow's milk allergic (CMA) and non-allergic (non-CMA) children in order to study their clinical usefulness.

    Methods

    Eighty-three children with suspected milk allergy (median age: 3.5 years, range: 0.8-15.8 years) were diagnosed as CMA (n = 61) or non-CMA (n = 22) based on an open milk challenge or convincing clinical history. Their serum concentrations of allergen-specific (s) IgE and IgG4 antibodies were measured using ImmunoCAP®. For the sIgG4 analysis, 28 atopic and 31 non-atopic control children were additionally included (all non-milk sensitized).

    Results

    The CMA group had significantly higher levels of milk-, casein- and β-lactoglobulin-sIgE antibodies as compared to the non-CMA group. The casein test showed the best discriminating performance with a clinical decision point of 6.6 kUA/L corresponding to 100% specificity. All but one of the CMA children aged > 5 years had casein-sIgE levels > 6.6 kUA/L. The non-CMA group had significantly higher sIgG4 levels against all three milk allergens compared to the CMA group. This was most pronounced for casein-sIgG4 in non-CMA children without history of previous milk allergy. These children had significantly higher casein-sIgG4 levels compared to any other group, including the non-milk sensitized control children.

    Conclusions

    High levels of casein-sIgE antibodies are strongly associated with milk allergy in children and might be associated with prolonged allergy. Elevated casein-sIgG4 levels in milk-sensitized individuals on normal diet indicate a modified Th2 response. However, the protective role of IgG4 antibodies in milk allergy is unclear.

  • 16.
    Johnson, Jennifer
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Malinovschi, Andrei
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Alving, Kjell
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Lidholm, J.
    Borres, M. P.
    Nordvall, Lennart
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Milk and peanut hypersensitivity in young asthmatics in relation to asthma control and airway inflammation results from the MIDAS study2013In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 68, no Suppl. s97, p. 145-146Article in journal (Other academic)
  • 17.
    Jonasson, Kristoffer
    Uppsala University, Disciplinary Domain of Science and Technology, Biology, Biology Education Centre.
    Biokemisk och immunologisk karaktärisering av pepsin-spjälkade mjölkallergener2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Milk allergens were digested by allowing them to flow through a chromatography column, where pepsin was conjugated to the stationary phase of the column. The allergen fragments were then characterized both biochemically, by using SDS-PAGE and gel permeation chromatography, and immunologically, by examining their reactivity to IgE and monoclonal antibodies.

  • 18.
    Kim, Jeong-Lim
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences.
    Environmental Factors in Relation to Asthma and Respiratory Symptoms among Schoolchildren in Sweden and Korea2006Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis studied environmental factors in relation to asthma and respiratory symptoms among schoolchildren in two countries. In Sweden, 1014 pupils (5-14 year) in 8 schools participated. Wheeze was reported by 7.8%, current asthma by 5.9%, doctor-diagnosed asthma by 7.7%, cat allergy by 6.8% and dog allergy by 4.8%. Current asthma was less common among those consuming more fresh milk and fish. Doctor-diagnosed asthma was less common among those consuming olive oil. Cat, dog and horse allergens were common in settled dust and related to respiratory symptoms. Pupils consuming butter and fresh milk had less respiratory symptoms in relation to allergen exposure. In schools with increased levels of microbial volatile organic compounds and selected plasticizers (Texanol and TXIB) asthma and respiratory symptoms were more common.

    In Korea, 2365 pupils (9-11 year) in 12 schools participated (96%). In total, wheeze was reported by 8.0%, current asthma by 5.7%, doctor-diagnosed asthma by 5.4%, cat allergy by 2.6% and dog allergy by 4.9%. Contamination of dog and mite (Dermatophagoides farinae) allergen was common while cat allergen was uncommon. Remodelling, changing floor and building dampness at home were positively associated with asthma and respiratory symptoms. The strongest associations were found for floor dampness. Indoor/outdoor concentration of NO2, formaldehyde and ultrafine particles (UFP) at schools were positively associated with asthma and respiratory symptoms.

    When comparing Sweden and Korea, Korean pupils had more breathlessness and asthma but reported less cat and pollen allergy. Swedish schools had CO2-levels below 1000 ppm, while most Korean schools exceeded this standard. Since both home and school environment may affect pupil’s asthma and respiratory symptoms, air quality should be an important health issue. Moreover, changes in dietary habits may be beneficial to decrease asthma and allergies. Furthermore, interaction between diet and environment needs to be further investigated.

    List of papers
    1. Current asthma and respiratory symptoms among pupils in relation to dietary factors and allergens in the school environment.
    Open this publication in new window or tab >>Current asthma and respiratory symptoms among pupils in relation to dietary factors and allergens in the school environment.
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    2005 In: Indoor Air, ISSN 0905-6947, Vol. 15, no 3, p. 170-182Article in journal (Refereed) Published
    Identifiers
    urn:nbn:se:uu:diva-95268 (URN)
    Available from: 2006-12-20 Created: 2006-12-20Bibliographically approved
    2. Indoor molds, bacteria, microbial volatile organic compounds and plasticizers in schools: associations with asthma and respiratory symptoms in pupils
    Open this publication in new window or tab >>Indoor molds, bacteria, microbial volatile organic compounds and plasticizers in schools: associations with asthma and respiratory symptoms in pupils
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    2007 (English)In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 17, no 2, p. 153-163Article in journal (Refereed) Published
    Abstract [en]

    We investigated asthma and atopy in relation to microbial and plasticizer exposure. Pupils in eight primary schools in Uppsala (Sweden) answered a questionnaire, 1014 (68%) participated. Totally, 7.7% reported doctor-diagnosed asthma, 5.9% current asthma, and 12.2% allergy to pollen/pets. Wheeze was reported by 7.8%, 4.5% reported daytime breathlessness, and 2.0% nocturnal breathlessness. Measurements were performed in 23 classrooms (May–June), 74% had <1000 ppm CO2 indoors. None had visible mold growth or dampness. Mean total microbial volatile organic compound (MVOC) concentration was 423 ng/m3 indoors and 123 ng/m3 outdoors. Indoor concentration of TMPD-MIB (2,2,4-trimethyl-1,3-pentanediol monoisobutyrate, Texanol) and TMPD-DIB (2,2,4-trimethyl-1,3-pentanediol diisobutyrate, TXIB), two common plasticizers, were 0.89 and 1.64 μg/m3, respectively. MVOC and plasticizer concentration were correlated (r = 0.5; P < 0.01). Mold concentration was 360 cfu/m3 indoors and 980 cfu/m3 outdoors. At higher indoor concentrations of total MVOC, nocturnal breathlessness (P < 0.01) and doctor-diagnosed asthma (P < 0.05) were more common. Moreover, there were positive associations between nocturnal breathlessness and 3-methylfuran (P < 0.01), 3-methyl-1-butanol (P < 0.05), dimethyldisulfide (P < 0.01), 2-heptanone (P < 0.01), 1-octen-3-ol (P < 0.05), 3-octanone (P < 0.05), TMPD-MIB (P < 0.05), and TMPD-DIB (P < 0.01). TMPD-DIB was positively associated with wheeze (P < 0.05), daytime breathlessness (P < 0.05), doctor-diagnosed asthma (P < 0.05), and current asthma (P < 0.05). In conclusion, exposure to MVOC and plasticizers at school may be a risk factor for asthmatic symptoms in children.

    Keywords
    Asthma, Microbial volatile organic compounds (MVOCs), Plasticizer, Pupil, Respiratory symptoms, School
    National Category
    Medical and Health Sciences Engineering and Technology
    Identifiers
    urn:nbn:se:uu:diva-95269 (URN)10.1111/j.1600-0668.2006.00466.x (DOI)000245155700008 ()17391238 (PubMedID)
    Available from: 2006-12-20 Created: 2006-12-20 Last updated: 2017-12-14Bibliographically approved
    3. Respiratory symptoms, asthma and allergen levels in schools: comparison between Korea and Sweden
    Open this publication in new window or tab >>Respiratory symptoms, asthma and allergen levels in schools: comparison between Korea and Sweden
    2007 (English)In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 17, no 2, p. 122-129Article in journal (Refereed) Published
    Abstract [en]

    We studied reports on respiratory symptoms, asthma and atopic sensitisation in relation to allergen contamination in Korean schools and compared with data from a previous Swedish study performed in eight primary schools. Korean pupils (n = 2365) in 12 primary schools first completed a questionnaire. Then airborne and settled dust were collected from 34 classrooms and analyzed for allergens by ELISA. In both countries, boys reported more symptoms. The prevalence of wheeze was similar, while daytime [odds ratio (OR) = 14.0, 95% confidence interval (CI) = 9.0–21.9] and nocturnal breathlessness (OR = 3.1, 95% CI = 1.5–6.4) were much higher among Korean students. In Korean schools, dog allergen (Can f 1) was the most common followed by mite allergen (Der f 1), while cat (Fel d 1), dog, and horse allergen (Equ cx) were abundant in Sweden. Moreover, CO2 levels were high in most Korean schools (range 907–4113 ppm). There was an association between allergen levels in dust and air samples, and number of pet-keepers in the classrooms. In conclusion, allergen contamination in Korean schools may be an important public issue.

    Keywords
    Asthma, Allergy, Furry pet allergen, House dust-mite allergen (Der p 1/f 1), school-pupil
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-95270 (URN)10.1111/j.1600-0668.2006.00460.x (DOI)000245155700004 ()17391234 (PubMedID)
    Available from: 2006-12-20 Created: 2006-12-20 Last updated: 2017-12-14Bibliographically approved
    4. Respiratory symptoms and asthma among Korean pupils in relation to home, school and outdoor environment.
    Open this publication in new window or tab >>Respiratory symptoms and asthma among Korean pupils in relation to home, school and outdoor environment.
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    Manuscript (Other academic)
    Identifiers
    urn:nbn:se:uu:diva-95271 (URN)
    Available from: 2006-12-20 Created: 2006-12-20 Last updated: 2010-01-13Bibliographically approved
  • 19. Kuitunen, M.
    et al.
    Englund, H.
    Remes, S.
    Moverare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Pelkonen, A.
    Borres, Magnus P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Makela, M. J.
    High IgE levels to -lactalbumin, -lactoglobulin and casein predict less successful cow's milk oral immunotherapy2015In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 70, no 8, p. 955-962Article in journal (Refereed)
    Abstract [en]

    BackgroundA new treatment option for persistent cow's milk allergy (CMA) is oral immunotherapy (OIT). Not all patients develop tolerance during therapy, and markers to identify those who will benefit from it are needed. The objective was to study the IgE and IgG(4) antibody profiles to milk and milk proteins before and after OIT in relation to clinical outcome. MethodsSeventy-six children (5-17years) with challenge-verified CMA were subjected to a 6-month OIT protocol. The treatment aimed at reaching a maintenance dose of 200ml CM (high dose=HD). Those who did not reach target were analysed as a low-dose (LD) group. Sera were characterized before and after OIT regarding serum levels of IgE and IgG(4) to milk and five milk allergen components evaluated together with clinical CMA symptoms and outcome of OIT. ResultsFifty-five (72%) patients reached the maintenance dose (HD) during therapy. High specific IgE levels towards the milk allergens -lactalbumin (P=0.048), -lactoglobulin (P=0.006) and casein (P=0.015) before OIT start were associated with lower maintenance dose reached. Patients who developed desensitization had a larger increase in IgG(4) levels to -lactalbumin (P=0.034), -lactoglobulin (P=0.010), casein (P=0.047) and lactoferrin (P=0.030) during treatment than those who failed. ConclusionsComponent-resolved diagnostics before OIT can help to identify children with lower probability of a successful OIT outcome, as high IgE levels to -lactalbumin, -lactoglobulin and casein are associated with lower maintenance dose reached. An increase in the IgG(4) concentration to milk components during treatment indicated effective desensitization.

  • 20. Larssen, Pia
    et al.
    Wik, Lotta
    Uppsala University, Science for Life Laboratory, SciLifeLab.
    Czarnewski, Paulo
    Eldh, Maria
    Löf, Liza
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology.
    Ronquist, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Dubois, Louise
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Freyhult, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cancer Pharmacology and Computational Medicine. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Gallant, Caroline
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology.
    Oelrich, Johan
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Molecular tools.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Ronquist, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Villablanca, Eduardo
    Landegren, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Gabrielsson, Susanne
    Kamali-Moghaddam, Masood
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Tracing Cellular Origin of Human Exosomes Using Multiplex Proximity Extension Assay2017In: Molecular & cellular proteomics (online), ISSN 1535-9476, E-ISSN 1535-9484, Vol. 16, no 3, p. 502-511Article in journal (Refereed)
    Abstract [en]

    Extracellular vesicles (EVs) are membrane-coated objects such as exosomes and microvesicles, released by many cell-types. Their presence in body fluids and the variable surface composition and content render them attractive potential biomarkers. The ability to determine their cellular origin could greatly move the field forward. We used multiplex proximity extension assays (PEA) to identify with high specificity and sensitivity the protein profiles of exosomes of different origins, including seven cell lines and two different body fluids. By comparing cells and exosomes, we successfully identified the cells originating the exosomes. Furthermore, by principal component analysis of protein patterns human milk EVs and prostasomes released from prostate acinar cells clustered with cell lines from breast and prostate tissues, respectively. Milk exosomes uniquely expressed CXCL5, MIA and KLK6, while prostasomes carried NKX31, GSTP1 and SRC, highlighting that EVs originating from different origins express distinct proteins. In conclusion, PEA provides a powerful protein screening tool in exosome research, for purposes of identifying the cell source of exosomes, or new biomarkers in diseases such as cancer and inflammation.

  • 21.
    Lidén, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Kristjánsson, G.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Valtysdottir, S.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Venge, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Hällgren, R.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Cow's milk protein sensitivity assessed by the mucosal patch technique is related to irritable bowel syndrome in patients with primary Sjögren's syndrome2008In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 38, no 6, p. 929-935Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Patients with primary Sjögren's syndrome (pSS) are reported to have a variety of gastrointestinal symptoms partly attributed to an overrepresentation of celiac disease. We have observed that irritable bowel syndrome (IBS)-like symptoms are frequent complaints in this patient group. Allergic manifestations to various drugs are also common in pSS. A role of food allergy in IBS has been proposed. OBJECTIVE: This study is aimed at evaluating the mucosal response to rectal challenge with cow's milk protein (CM) in patients with pSS and relates possible CM reactivity to their intestinal symptoms. Methods: A rectal challenge with CM was performed in 21 patients with pSS and 18 healthy controls. Fifteen hours after challenge the mucosal production of nitric oxide (NO) and the release of myeloperoxidase (MPO) as signs of mucosal inflammatory reaction were measured using the mucosal patch technique. RESULTS: Eight out of 21 patients with pSS had a definite increase of mucosal NO synthesis and the luminal release of MPO after rectal CM challenge. This sign of milk sensitivity was not linked to IgG/IgA antibodies to milk proteins. The symptoms for IBS according to Rome III criteria were fulfilled in 13 patients. All patients who were CM sensitive suffered from IBS. In a small open study, patients reactive to CM reported an improvement of intestinal symptoms on a CM-free diet. CONCLUSION: A rectal mucosal inflammatory response after CM challenge is seen in 38% of patients with pSS as a sign of CM sensitivity. IBS-like symptoms were common in pSS, linked to CM sensitivity.

  • 22.
    Lundholm, Linnéa
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Biochemistry and Microbiology.
    Characterization of a rabbit-antiserum for detection of pea protein in foods2008Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    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.

  • 23. Mikkelsen, Andrea
    et al.
    Mehlig, Kirsten
    Borres, Magnus P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Oxelmark, Lena
    Bjorkelund, Cecilia
    Lissner, Lauren
    Monitoring the impact of cow's milk allergy on children and their families with the FLIP questionnaire - a six-month follow-up study2015In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 26, no 5, p. 409-415Article in journal (Refereed)
    Abstract [en]

    BackgroundMany children with cow's milk allergy (CMA) develop tolerance, but, challenges in daily life may remain. Using the Food hypersensitivity famiLy ImPact questionnaire (FLIP), we sought to monitor changes in the impact of CMA over time. MethodsFamilies of children with CMA, who participated in the validation of the FLIP, were re-approached 6months later for follow-up. Change in reported difficulties was assessed by paired sample t-test and mixed models, stratifying by outgrown vs. persistent CMA. ResultsImpact on families with children who had outgrown CMA (n=20) decreased in the FLIP's total score (p=0.0001) and in two subscales; Health and Emotions (p=0.0001) and Everyday Life (p=0.0001). In contrast, no significant improvements were registered in nutritional concerns. Impact on the group with persistent CMA (n=57) was unchanged at follow-up except for more impact on Everyday Life (p=0.001). In the final analysis comparing longitudinal changes in the groups, the strongest differences were observed for the subscales Health & Emotions and Everyday Life; for the Nutrition subscale, the between-group changes also differed, but to lesser extent. ConclusionsWe have documented the varying impact of CMA on parents and children over time. Families who were still affected continued to experience impact in daily life. Despite development of tolerance, families who were no longer affected revealed continuing nutritional concerns. Follow-ups should be offered even after outgrown CMA to encourage progression to unrestricted diet, to prevent eating disorders and to promote healthy growth.

  • 24.
    Nilsson, Nora
    et al.
    Karolinska Inst, Lung Allergy Dept, Stockholm, Sweden;Karolinska Univ Hosp, Astrid Lindgren Childrens Hosp, Stockholm, Sweden;Karolinska Inst, Ctr Allergy Res, Stockholm, Sweden.
    Nilsson, Caroline
    Karolinska Inst, Dept Clin Sci & Educ, Sodersjukhuset, Stockholm, Sweden;Sachs Childrens Hosp, Stockholm, Sweden.
    Ekoff, Helena
    ImmunoDiagnost, Thermo Fisher Sci, Uppsala, Sweden.
    Wieser-Pahr, Sandra
    Med Univ Vienna, Div Immunopathol, Dept Pathophysiol & Allergy Res, Ctr Pathophysiol Infectiol & Immunol, Vienna, Austria;Med Univ Vienna, Christian Doppler Lab Dev Allergen Chips, Vienna, Austria.
    Borres, Magnus P
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research. ImmunoDiagnost, Thermo Fisher Sci, Uppsala, Sweden.
    Valenta, Rudolf
    Med Univ Vienna, Div Immunopathol, Dept Pathophysiol & Allergy Res, Ctr Pathophysiol Infectiol & Immunol, Vienna, Austria;Med Univ Vienna, Christian Doppler Lab Dev Allergen Chips, Vienna, Austria.
    Hedlin, Gunilla
    Karolinska Inst, Lung Allergy Dept, Stockholm, Sweden;Karolinska Univ Hosp, Astrid Lindgren Childrens Hosp, Stockholm, Sweden;Karolinska Inst, Ctr Allergy Res, Stockholm, Sweden.
    Sjolander, Sigrid
    ImmunoDiagnost, Thermo Fisher Sci, Uppsala, Sweden.
    Grass-Allergic Children Frequently Show Asymptomatic Low-Level IgE Co-Sensitization and Cross-Reactivity to Wheat2018In: International Archives of Allergy and Immunology, ISSN 1018-2438, E-ISSN 1423-0097, Vol. 177, no 2, p. 135-144Article in journal (Refereed)
    Abstract [en]

    Background: Specific immunoglobulin E (IgE) sensitization to wheat is more common than a doctor's confirmed wheat allergy and is also frequently observed in grass pollen-allergic patients (pollinosis patients). Thus, the objective of this study was to investigate the level and feature of serological IgE cross-reactivity between grass pollen and wheat in a cohort of pollinosis subjects with no diagnosis of wheat allergy. Methods: Seventy-two children, aged 5-17 years, with a doctor's diagnosis of pollinosis, IgE towards grass pollen, and currently eating wheat were recruited. Serum samples were analyzed for IgE against wheat, timothy grass/wheatspecific allergen components, Pru p 3, and cross-reactive carbohydrate determinants (CCD) and specific IgE-binding inhibition experiments were performed. Results: Sixty per- cent of the grass pollen subjects were sensitized to wheat with a median of 0.5 kU(A)/L. Wheat-sensitized subjects were more often sensitized to the two allergens, Phl p 12 and CCD, known to be cross-reactive between grass and wheat. Sensitizations to seven wheat-specific allergens derived from the gluten fraction were, with the exception of one individual, only found in wheat-sensitized subjects. These subjects also more often reported current and past history of allergy to staple foods (milk, egg, wheat, soy, and fish). Conclusion: Wheat sensitization caused by cross-reactivity but also by sensitization to wheat-specific allergens was common in the grass-allergic children and also associated with allergy to staple foods other than wheat. The results indicate the presence of a subgroup of pollinosis patients with simultaneous sensitization to wheat and food allergy not only caused by cross-reactions.

  • 25.
    Norrman, Gunilla
    et al.
    Uppsala University, Interfaculty Units, Centrum för klinisk forskning, Gävleborg.
    Tomicić, Sara
    Böttcher, Malin Fagerås
    Oldaeus, Göran
    Strömberg, Leif
    Fälth-magnusson, Karin
    Significant improvement of eczema with skin care and food elimination in small children.2005In: Acta Paediatr, ISSN 0803-5253, Vol. 94, no 10, p. 1384-8Article in journal (Refereed)
    Abstract [en]

    AIM: To evaluate common methods of investigation and treatment in children younger than 2 y of age with eczema, with or without sensitization to food allergens. METHODS: One hundred and twenty-three children younger than 2 y of age with eczema and suspected food allergy were included in this prospective study. The children underwent skin-prick test with cow's milk, fresh hen's egg white and wheat. Specific IgE to milk and egg white was analysed. The eczema extent and severity was estimated with SCORAD before and after treatment. Children with a positive skin-prick test were instructed to exclude that food item from their diet. All children were treated with emollients and topical steroids when needed. RESULTS: Sixty-two of the children were skin-prick positive to at least one of the allergens; 62% had mild, 30% moderate and 8% severe eczema at their first visit. After treatment, 90% had mild, 10% moderate and 0% severe eczema. Forty-six per cent of the children had circulating IgE antibodies to milk or egg white. Ten per cent had specific IgE but negative skin-prick test to the same allergen. This subgroup improved their eczema significantly without elimination diet. CONCLUSION: The conventional treatments for children with eczema, i.e. skin care and food elimination, are effective. The beneficial effect of skin care as the first step should not be neglected, and it may not be necessary to eliminate food allergens to relieve skin symptoms in all food-sensitized children with eczema.

  • 26.
    Olsson, Karl Wilhelm
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Sindelar, Richard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Perinatal, Neonatal and Pediatric Cardiology Research.
    Early Biochemical Markers Associated with Development of Necrotizing Enterocolitis2017In: Selected Abstracts of the 2nd Congress of joint European Neonatal Societies (jENS 2017), 2017, Vol. 6Conference paper (Refereed)
    Abstract [en]

    Selected Abstracts of the 2nd Congress of joint European Neonatal Societies (jENS 2017); Venice (Italy); October 31-November 4, 2017

    58th ESPR Annual Meeting, 7th International Congress of UENPS, 3rd International Congress of EFCNI

    ORGANIZING INSTITUTIONSEuropean Society for Paediatric Research (ESPR), European Society for Neonatology (ESN), Union of European Neonatal & Perinatal Societies (UENPS), European Foundation for the Care of Newborn Infants (EFCNI)

    ORGANIZING COMMITTEELuc Zimmermann (President of ESPR), Morten Breindahl (President of ESN), Manuel Sánchez Luna (President of UENPS), Silke Mader (Chairwoman of the Executive Board and Co-Founder of EFCNI)

    SCIENTIFIC COMMITTEEVirgilio P. Carnielli (Congress President Chair), Pierre Gressens (Past Scientific President), Umberto Simeoni, Manon Benders, Neil Marlow, Ola D. Saugstad, Petra Hüppi, Agnes van den Hoogen

    Session "Neonatal Gastrointestinal Physiology and NEC"

    ABS 1. DETRIMENTAL MUCOSAL EFFECT OF IBUPROFEN IN THE IMMATURE HUMAN INTESTINE • E. Tremblay, E. Ferretti, M.-P. Thibault, D. Grynspan, K.M. Burghardt, M. Bettolli, C. Babakissa, E. Levy, J.-F. Beaulieu; Research Consortium on Child Intestinal Inflammation

    ABS 2. CORRELATION BETWEEN CALPROTECTIN LEVELS IN MECONIUM AND VITAMIN D STATUS IN CORD BLOOD: ASSOCIATION WITH INTESTINAL DISTRESS DURING NEONATAL PERIOD • S.H. Park, W.H. Kim, Y.M. Lee

    ABS 3. COMPARISON OF FECAL CALPROTECTIN LEVELS ACCORDING TO FEEDING KINDS IN VERY PRETERM INFANTS • J.H. Park, N.H. Lee, S.Y. Shin, C.S. Kim, S.L. Lee, W.M. Lee

    ABS 4. NEONATAL MORBIDITY OF EXTREME PRETERM INFANTS BEFORE AND AFTER THE INTRODUCTION OF A DONOR HUMAN MILK BANK AT THE PERINATAL CENTER GROßHADERN • V. Lieftüchter, M. Kujawa, A. Schuze, A.W. Flemmer, S. Herber-Jonat

    ABS 5. IS NEAR INFRARED SPECTROSCOPY A RELIABLE TECHNIQUE TO MEASURE GUT PERFUSION IN PRETERM INFANTS? • J. Banerjee, T.S. Leung, N. Aladangady

    ABS 6. EARLY BIOCHEMICAL MARKERS ASSOCIATED WITH DEVELOPMENT OF NECROTIZING ENTEROCOLITIS • K.W. Olsson, R. Sindelar

    ABS 7. OPTICAL PROPERTIES OF EARLY STOOL FROM PRETERM INFANTS: IMPORTANT TO CONSIDER FOR ABDOMINAL OXIMETRY BASED ON NEAR-INFRARED SPECTROSCOPY • H. Isler, D. Schenk, J. Bernhard, F. Scholkmann, S. Kleiser, D. Ostojic, D. Bassler, M. Wolf, T. Karen

    ABS 8. STOOLING PATTERN AND GASTRIC RESIDUALS ARE NOT USEFUL TOOLS FOR EARLY DIAGNOSIS OF NECROTISING ENTEROCOLITIS IN PRETERM INFANTS • S. Carlsson, M. Domellöf, A. Elfvin

    ABS 9. REFERENCE VALUES OF ZONULIN IN TERM NEONATES • A. Tarko, A. Suchojad, A. Jarosz-Lesz, M. Majcherczyk, M. Michalec, I. Maruniak-Chudek

    ABS 10. DETERMINANTS OF THE NEED FOR TREATMENT IN PREMATURE INFANTS WITH SUSPECTED NECROTISING ENTEROCOLITIS • N. Bussmann, A. El-Khuffash, D. Corcoran

    ABS 11. EFFECT OF ANTIBIOTIC PROPHYLAXIS DURING REMOVAL OF A CENTRAL VENOUS CATHETER ON DEVELOPMENT OF THE NEONATAL INTESTINAL MICROBIOTA • E. d’Haens, R. Zwittink, C. Belzer, M. Hemels, R. van Lingen, I. Renes, J. Knol, D. van Zoeren-Grobben

    ABS 12. NEWBORNS WITH ULTRASOUND FINDING OF GAS IN HEPATIC PORTAL VENOUS SYSTEM: ANALYSIS OF RISK FACTORS, CLINICAL AND LABORATORY FINDINGS AND DEVELOPMENT OF ALLERGY • J. Lozar Krivec, A. Nyasha Zimani, N. Zupančič, D. Paro-Panjan

    ABS 13. NEONATAL FECAL BIOMARKERS OF NECROTIZING ENTEROCOLITIS • I. Tofé, M.V. Rodriguez-Benitez, C. Hernandez-Chirlaque, M. Gil-Campos, M.D. Ruiz-Gonzalez, A. Martinez

    ABS 14. THE OPEN ABDOMEN: A CHALLENGE FOR NEONATOLOGISTS AND NEONATAL SURGEONS. THE KAROLINSKA EXPERIENCE • M. Bartocci, E. Palleri, A. Svenningsson, T. Wester

    ABS 15. ANOGENITAL STIMULATION IN RATS DOES NOT INCREASE GASTRIC EMPTYING • C.H. Ferreira, J. Belik

    ABS 16. THE PRETERM INFANT GASTRIC EMPTYING RATE IS DEPENDENT ON THE FEED VOLUME AND NOT ON POSTNATAL AGE • C.H. Ferreira, F.E. Martinez, G.C. Crott, J. Belik

    ABS 17. NECROTIZING ENTEROCOLITIS IN A NEONATAL INTENSIVE CARE UNIT • M. Branco, I. Falcão, T. Lopes, E. Proença, A. Almeida, C. Carvalho, L. Pinho

    ABS 18. SPONTANEOUS INTESTINAL PERFORATION: A DIAGNOSTIC CHALLENGE IN THE NEWBORN • M. Branco, T. Lopes, I. Falcão, L. Pinho, C. Enes, A. Almeida, C. Carvalho, E. Proença

    ABS 19. OUTCOMES OF EXTREMELY LOW BIRTH WEIGHT BABIES RECEIVING SURGICAL TREATMENT FOR NECROTISING ENTEROCOLITIS • J. Ashton, C. Charlesworth, P. Yajamanyam

    ABS 20. ASSESSMENT OF ENZYMOTHERAPY EFFICACY IN CASE OF LACTASE INSUFFICIENCY IN PRETERM INFANTS • O. Vlasova, L. Koliubakina

    ABS 21. THE NORWEGIAN PRETERM INFANT GUT (PINGU) STUDY: A METAGENOMIC APPROACH TO GUT MICROBIOTA COMPOSITION AND RESISTOME IN INFANTS SUPPLEMENTED WITH PROBIOTICS • E. Esaiassen, E. Hjerde, P. Cavanagh, T. Pedersen, J. Andresen, S. Rettedal, R. Støen, B. Nakstad, N.P. Willassen, C. Klingenberg

    ABS 22. NECROTIZING ENTEROCOLITIS: WHAT ASPECTS IN 2017? • H. Ben Salem, I. Kasraoui, M.T. Lamouchi, E.D. Bouaicha, N. Kasdallah, S. Blibech, M. Doagi

    ABS 23. ROUTINE PROBIOTICS FOR PRETERM NEONATES: EXPERIENCE IN A TERTIARY AUSTRALIAN NEONATAL INTENSIVE CARE UNIT • G. Deshpande, V. Shingde, L. Downe, J. Xiao, M. Taber

    ABS 24. MATERNAL RISK FACTORS FOR NEC IN PREMATURES INFANTS WITH GA UNDER 28 WEEKS • L. Olariu, G. Olariu, S. Olariu

    Keywords 2nd Congress of joint European Neonatal Societies; jENS 2017; Venice; 2017; Session “Neonatal Gastrointestinal Physiology and NEC” Full Text: PDF Number of abstract views: 1475 Number of PDF views/downloads: 2487

  • 27.
    Protudjer, Jennifer L. P.
    et al.
    Stockholm Cty Council, Ctr Occupat & Environm Med, S-11365 Stockholm, Sweden;Karolinska Inst, Inst Environm Med, S-17111 Stockholm, Sweden.
    Olen, Ola
    Karolinska Inst, Dept Med Solna, Clin Epidemiol Unit, S-17176 Stockholm, Sweden;South Gen Hosp, Sachs Children & Youth Hosp, S-11883 Stockholm, Sweden;Karolinska Inst, Dept Clin Sci & Educ, Sodersjukhuset, S-11883 Stockholm, Sweden.
    Vetander, Mirja
    Karolinska Inst, Inst Environm Med, S-17111 Stockholm, Sweden;South Gen Hosp, Sachs Children & Youth Hosp, S-11883 Stockholm, Sweden.
    Kull, Inger
    Karolinska Inst, Inst Environm Med, S-17111 Stockholm, Sweden;South Gen Hosp, Sachs Children & Youth Hosp, S-11883 Stockholm, Sweden;Karolinska Inst, Dept Clin Sci & Educ, Sodersjukhuset, S-11883 Stockholm, Sweden.
    Melen, Erik
    Karolinska Inst, Inst Environm Med, S-17111 Stockholm, Sweden;South Gen Hosp, Sachs Children & Youth Hosp, S-11883 Stockholm, Sweden.
    van Hage, Marianne
    Karolinska Inst, Immunol & Allergy Unit, Dept Med Solna, S-17176 Stockholm, Sweden;Karolinska Univ Hosp, S-17176 Stockholm, Sweden.
    Wickman, Magnus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Inst Environm Med, S-17111 Stockholm, Sweden.
    Bergström, Anna
    Stockholm Cty Council, Ctr Occupat & Environm Med, S-11365 Stockholm, Sweden;Karolinska Inst, Inst Environm Med, S-17111 Stockholm, Sweden.
    Milk-Related Symptoms and Immunoglobulin E Reactivity in Swedish Children from Early Life to Adolescence2018In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 10, no 5, article id 651Article in journal (Refereed)
    Abstract [en]

    Cow's milk often causes symptoms in infants. Whereas, some continue to experience symptoms through childhood, others become tolerant. Yet, the ages at which persistence and tolerance occur are less clear. Thus, we examined the age of onset and persistence of milk-related symptoms from early life to adolescence, and Immunoglobulin E (IgE) milk reactivity, focusing on gender differences in a large, population-based birth cohort. Overall, 20.0% (537/2985) of children, with a comparable gender distribution, had early life milk-related symptoms. At 16y, approximately 2% (62/2985) children had persistent symptoms and high milk IgE levels (e.g., median at 4 years: 1.5 kU(A)/L) that were beginning in early life. In contrast, 94% had transient symptoms and low median IgE levels (early life: 0.63 kU(A)/L, 8y: 0.72 kU(A)/L; 16 years: 1.1 kU(A)/L). Also, at 16 years, approximately 6% of females and 3% of males without any previously reported symptoms reported adolescent-onset of symptoms (p < 0.001). Such symptoms were almost exclusively gastrointestinal symptoms and were not associated with detectable IgE. In conclusion, early life milk-related symptoms are common, although most cases are transient by 16 years. Twice as many females vs. males report adolescent-onset symptoms, and particularly gastrointestinal symptoms. Children with persistent symptoms have both a higher prevalence and higher milk IgE levels, as compared to other phenotypes.

  • 28. Takaoka, M
    et al.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Diet among Japanese female university students and asthmatic symptoms, infections, pollen and furry pet allergy2008In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 102, no 7, p. 1045-54Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To study associations between diet, respiratory symptoms and allergy among female university students in Japan. METHODS: A standardised questionnaire was distributed to students in Kobe and Kamakura (N=153). Multiple logistic/linear regression was applied, controlling for age, smoking, heredity and diet. RESULTS: Totally 15.7% reported doctor-diagnosed asthma, 3.3% current asthma medication, 56.9% pollen allergy, 15.7% cat allergy, 11.1% dog allergy, 25.0% wheeze, 24.2% daytime and 9.3% nocturnal attacks of breathlessness. Meat consumption was related to wheeze (OR=2.00; 95% CI 1.12-3.60) and respiratory infections (OR=2.10; 95% CI 1.08-4.09). Fish consumption was related to less respiratory infections (OR=0.49; 95% CI 9.28-0.86), seafood to less pollen allergy (OR=0.66; 95% CI 0.44-0.99), and milk consumption to less daytime breathlessness (OR=0.72; 95% CI 0.55-0.95). Fast food consumption was related to wheeze (OR=1.89; 95% CI 1.23-2.91), daytime breathlessness (OR=1.50; 95% CI 1.00-2.28) and pollen allergy (OR=1.69; 95% CI 1.07-2.65). In total, 23.0% used butter, 21.7% margarine, 40.1% olive oil and 55.3% rapeseed oil. Those consuming butter (OR=2.65; 95% CI 1.11-6.32) and rapeseed oil (OR=2.35; 95% CI 1.03-5.38) had more wheeze. Those consuming margarine had more nocturnal breathlessness (OR=4.40; 95% CI 1.42-13.7). An asthma symptom score was related to fast food (p<0.05) and margarine consumption (p<0.01). Factor analysis identified five dietary patterns. A pattern including fast food, juice and soft drinks was related to wheeze and respiratory infections. CONCLUSION: Fish, seafood and milk consumption seems to be beneficial, while butter, margarine, rapeseed oil, fast food and soft drinks could be risk factors for allergy and respiratory health.

  • 29.
    Tsolakis, Nikolaos
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Study of biomarkers for improved diagnosis and therapy monitoring in young asthmatics2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Type-2 asthma is often related to atopy and is characterized by elevated type-2 biomarkers. However, less is known about the pathophysiology of non-type 2 asthma, factors associated therewith, and the stability of different asthma phenotypes over time.

    Aims: To identify an IgE antibody concentration and putative biomarkers that better separate non-type 2 from type-2 asthma. To study the association between longitudinal changes in inflammatory biomarkers and clinical outcomes. To investigate the pattern of IgE sensitization to different cat allergen components and its impact on type-2 biomarkers in young asthmatics.

    Methods: The present thesis is based on the MIDAS asthma cohort, which includes asthmatics (n = 408) and healthy controls (n = 118), aged 10–35 years at baseline, with a follow-up visit 43{23-65} months later. All the subjects were characterized with regard to IgE sensitization, inflammation was assessed based on fractional exhaled NO (FeNO), blood eosinophil count (B-Eos) and other biomarkers, both type-2 and non-type 2, and lung function was evaluated with spirometry.

    Results: FeNO and B-Eos maintained associations with clinical asthma outcomes in the IgE antibody concentration range 0.10–0.34 kUA/L, but not below 0.10 kUA/L. Non-atopic asthmatics with perceived cow’s milk hypersensitivity had poorer asthma-related quality of life than those with atopic asthma, and were characterized by clinically significant non-type 2 inflammation. Furthermore, longitudinal increase in height-adjusted FeNO associated independently with decline in lung function. IgE sensitization to cat lipocalins and/or cat serum albumin were independently associated with FeNO and B-Eos.

    Conclusions: Our findings demonstrated that a cut-off of 0.10 kUA/L for IgE antibodies appeared to be useful for ruling out type-2 asthma in young subjects. A subgroup of non-atopic asthmatics was characterized by perceived cow’s milk hypersensitivity and non-type 2 inflammation. Longitudinal changes in FeNO associated with lung function decline in asthmatics. IgE sensitization to minor cat allergen components may promote both local and systemic type 2 inflammation.

    List of papers
    1. The absence of serum IgE antibodies indicates non-type 2 disease in young asthmatics
    Open this publication in new window or tab >>The absence of serum IgE antibodies indicates non-type 2 disease in young asthmatics
    Show others...
    2018 (English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 48, no 6, p. 722-730Article in journal (Refereed) Published
    Abstract [en]

    Background:

    Atopic asthma is associated with elevated type-2 biomarkers such as fraction of exhaled nitric oxide (FeNO) and blood eosinophil (B-Eos) count. However, increased type 2 markers have also been reported in traditionally defined non-atopic asthma.

    Objective:

    To determine a clinically useful level of IgE sensitization for ruling out type 2 asthma. Methods: Asthmatics (N=408; age 10-35years) were analysed using the multi-allergen tests Phadiatop and fx5 (ImmunoCAP). Subjects were grouped based on IgE-antibody concentrations: 0.35kU(A)/L for at least one test (n=326) or <0.35kU(A)/L for both tests (n=82). he latter group was subsequently divided into 2 groups: IgE 0.10-0.34kU(A)/L (n=34) and IgE<0.10kU(A)/L (n=48). The relationships between type 2 biomarkers, and inadequate asthma control (ACT<20), reduced lung function (FEV1<80%), recent asthma attacks and airway hyperresponsiveness (AHR) to methacholine were determined.

    Results:

    In univariate analyses, at least one type 2 marker related to each asthma outcome in subjects with IgE 0.35kU(A)/L. In subjects with IgE 0.10-0.34kU(A)/L, elevated FeNO related to reduced lung function (P=.008) and B-Eos to AHR (P=.03). No associations were found in subjects with IgE<0.10kU(A)/L. In multivariate analysis, a relationship between FeNO and reduced lung function remained in subjects with IgE<0.35kU(A)/L (P=.03).

    Conclusion and Clinical Relevance:

    Clinically relevant elevation of type 2 biomarkers was seen in young asthmatics with IgE antibodies <0.35kU(A)/L, but not those with IgE<0.10kU(A)/L. It seems possible to define non-type 2 asthma through sensitive IgE-antibody measurement.

    Place, publisher, year, edition, pages
    John Wiley & Sons, 2018
    National Category
    Respiratory Medicine and Allergy
    Identifiers
    urn:nbn:se:uu:diva-343518 (URN)10.1111/cea.13103 (DOI)000434080100012 ()29377450 (PubMedID)
    Funder
    Swedish Foundation for Strategic Research Swedish Heart Lung FoundationSwedish Asthma and Allergy Association
    Available from: 2018-02-27 Created: 2018-02-27 Last updated: 2018-11-26Bibliographically approved
    2. Clinical and inflammatory characterization of a subgroup of non-type 2 asthma in young subjects
    Open this publication in new window or tab >>Clinical and inflammatory characterization of a subgroup of non-type 2 asthma in young subjects
    Show others...
    (English)Manuscript (preprint) (Other academic)
    National Category
    Pediatrics Respiratory Medicine and Allergy
    Identifiers
    urn:nbn:se:uu:diva-366878 (URN)
    Available from: 2018-11-26 Created: 2018-11-26 Last updated: 2018-11-26
    3. Relationship between longitudinal changes in type-2 inflammation and clinical outcomes in young asthmatics
    Open this publication in new window or tab >>Relationship between longitudinal changes in type-2 inflammation and clinical outcomes in young asthmatics
    Show others...
    (English)Manuscript (preprint) (Other academic)
    National Category
    Pediatrics Respiratory Medicine and Allergy
    Identifiers
    urn:nbn:se:uu:diva-366872 (URN)
    Available from: 2018-11-26 Created: 2018-11-26 Last updated: 2018-11-26
    4. Sensitization to minor cat allergen components is associated with type-2 biomarkers in young asthmatics
    Open this publication in new window or tab >>Sensitization to minor cat allergen components is associated with type-2 biomarkers in young asthmatics
    Show others...
    2018 (English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 48, no 9, p. 1186-1194Article in journal (Refereed) Published
    Abstract [en]

    Background: Cat allergy is a major trigger of asthma world-wide. Molecular patterns of cat sensitization vary between individuals, but their relationship to inflammation in asthmatics has not been extensively studied.

    Objective: To investigate the prevalence and levels of IgE antibodies against different cat allergen components and their relationship to type-2 inflammation and total IgE among young asthmatic subjects sensitized to furry animals.

    Methods: Patients with asthma (age 10-35 years; n = 266) and IgE sensitization to cat, dog or horse extract (ImmunoCAP), were analysed for IgE to the cat allergen components Fel d 1 (secretoglobin), Fel d 2 (serum albumin), Fel d 4 and Fel d 7 (lipocalins). Independent associations between IgE-antibody concentrations, and fraction of exhaled nitric oxide (FeNO), blood eosinophil (B-Eos) count, and total IgE were analysed by multiple linear regression after adjustment for possible confounders.

    Results: The level of IgE against Fel d 2 was independently related to FeNO (P = .012) and total IgE (P < .001), and IgE against Fel d 4 associated with B-Eos count (P = .009) and total IgE (P < .001). IgE antibodies against Fel d 1 or cat extract did not independently relate to these inflammatory markers (P = .23-.51).

    Conclusions: Levels of IgE to lipocalin (Fel d 4) and serum albumin (Fel d 2), but not to secretoglobin (Fel d 1) or cat extract, were independently associated with type-2 biomarkers and total IgE in young asthmatics.

    Clinical relevance: We suggest that measurement of IgE to minor cat allergen components may be useful when investigating asthma morbidity in cat allergic subjects.

    Keywords
    asthma, clinical immunology, eosinophils, IgE, immunologic tests
    National Category
    Respiratory Medicine and Allergy
    Identifiers
    urn:nbn:se:uu:diva-364158 (URN)10.1111/cea.13135 (DOI)000443113000010 ()29575179 (PubMedID)
    Funder
    Swedish Foundation for Strategic Research VINNOVASwedish Heart Lung FoundationSwedish Asthma and Allergy Association
    Available from: 2018-11-01 Created: 2018-11-01 Last updated: 2018-11-26Bibliographically approved
  • 30.
    Tsolakis, Nikolaos
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Nordvall, Lennart
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Rydell, N.
    Thermo Fisher Sci, ImmunoDiagnost, Uppsala, Sweden.
    Malinovschi, Andrei
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Alving, Kjell
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Characterization of a subgroup of non-type 2 asthma with cow's milk hypersensitivity in young subjects2019In: Clinical and Translational Allergy, ISSN 2045-7022, E-ISSN 2045-7022, Vol. 9, article id 12Article in journal (Refereed)
    Abstract [en]

    Background: Asthma with atopy is often characterized by type 2 inflammation but less progress has been made in defining non-type 2 asthma. We have previously identified a subgroup of young non-atopic asthmatics with perceived food hypersensitivity and poor asthma control. Objective: Our aim was to further characterize this subgroup of non-type 2 asthmatics, including the use of a broad panel of inflammation-related proteins. Methods: Sex-and age-matched subjects (10-35 years old) were divided into three groups with regard to history of asthma and atopy: non-atopic asthmatics with perceived cow's milk hypersensitivity but with IgE antibodies < 0.35 kU(A)/L (NAA; n = 24), non-atopic controls with IgE < 0.35 kU(A)/L (NAC; n = 24), and atopic asthmatics with IgE >= 0.35 kU(A)/L (AA; n = 29). Serum or plasma were analysed using the multi-allergen tests Phadiatop and fx5 (Immuno-CAP), a multiplex immunoassay comprising 92 inflammation-related proteins (Proseek Inflammation), and an ELISA for human neutrophil lipocalin (S-HNL). Fraction of exhaled nitric oxide (FeNO), blood eosinophil (B-Eos) count, C-reactive protein (CRP), airway responsiveness to methacholine - (PD20), and asthma-related quality of life (mAQLQ) were also measured. Results: NAA had lower FeNO (p < 0.001) and B-Eos count (p < 0.001), but scored worse on mAQLQ (p = 0.045) compared with AA. NAA displayed higher levels of matrix metalloproteinase-1 (MMP-1) compared with both NAC (p = 0.011) and AA (p = 0.001), and lower - PD20 compared with NAC (p < 0.001). In NAA, S-HNL correlated negatively with -PD20 (rho = -0.048, p < 0.05) and CRP correlated negatively with mAQLQ (rho = -0.439, p < 0.05). Conclusion: In a subgroup of non-atopic young asthmatics with perceived cow's milk hypersensitivity we observed poor asthma-related quality of life, airway hyperresponsiveness, and clinically relevant non-type 2 inflammation. MMP-1 was elevated in this group, which deserves further studies.

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