scholarly journals Cytokine Expression in CD3+ Cells in an Infant with Food Protein-Induced Enterocolitis Syndrome (FPIES): Case Report

2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
F. Mori ◽  
S. Barni ◽  
A. Cianferoni ◽  
N. Pucci ◽  
M. de Martino ◽  
...  
Keyword(s):  
T Cell ◽  
Clinical Symptoms ◽  
Failure To Thrive ◽  
Food Challenge ◽  
Interleukin 4 ◽  
Food Protein ◽  
Double Blind ◽  
Ige Mediated ◽  
Th1 And Th2 Responses ◽  
Cell Expression

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy characterized by severe vomiting, diarrhea, and often failure to thrive in infants. Symptoms typically resolve after the triggering food-derived protein is removed from the diet and recur within few hours after the re-exposure to the causal protein. The diagnosis is based on clinical symptoms and a positive food challenge. In this study, we report a case of FPIES to rice in an 8-month-old boy. We performed a double-blind placebo-controlled food challenge (DBPCFC) to rice and we measured the intracellular T cell expression of interleukin-4 (IL-4); IL-10, and interferon (IFN-) pre-and post-challenge during an acute FPIES reaction and when tolerance to rice had been achieved. For the first time we describe an increase in T cell IL-4 and decrease in IFN- expression after a positive challenge with rice (i.e. rice triggered a FPIES attack) and an increase in T cell IL-10 expression after rice challenge 6 months later after a negative challenge (i.e., the child had acquired tolerance to rice) in an 8 month old with documented FPIES to rice. A Th2 activation associated with high IL-4 levels may contribute to the pathophysiology of the disease. On the other hand, T cell-derived IL-10 may play a role in the acquisition of immunotolerance by regulating the Th1 and Th2 responses.

scholarly journals Food protein‐induced enterocolitis syndrome

2020 ◽  
Vol 2 (1) ◽  
pp. 48-54
Author(s):  
Sara Anvari ◽  
Carla M. Davis
Keyword(s):  
Intestinal Inflammation ◽  
Hypovolemic Shock ◽  
Failure To Thrive ◽  
Food Challenge ◽  
Clinical History ◽  
Intestinal Lumen ◽  
Food Protein ◽  
Food Ingestion ◽  
Ige Mediated

Food protein‐induced enterocolitis syndrome (FPIES) is a non‐IgE-mediated food allergy that primarily affects the gastrointestinal tract. The underlying pathophysiology of FPIES has yet to be fully elucidated; however, FPIES is believed to be secondary to intestinal inflammation after exposure to a food antigen, which thereby leads to increased permeability and fluid shifting into the intestinal lumen. FPIES is categorized into acute and chronic forms. Acute FPIES is characterized by repetitive vomiting that occurs 1‐4 hours after food ingestion. Severe vomiting may progress to dehydration, lethargy, and pallor, which potentially leads to hypovolemic shock. In some patients, diarrhea may present within 24-hours of food ingestion. Patients are clinically well between acute episodes. Chronic FPIES presents with intermittent vomiting and/or diarrhea, followed by failure to thrive. FPIES characteristically presents in infancy, with resolution of the disease typically occurring by school age. However, analysis of recent data indicates that FPIES may persist into adulthood. In addition, late- or adult-onset FPIES has also been reported. The diagnosis of FPIES is based on clinical history; however, oral food challenge currently remains the criterion standard for diagnosis. Management of FPIES requires strict avoidance of food triggers, and treatment requires rapid fluid rehydration. Currently, there are no reliable biomarkers to diagnose FPIES; however, investigations to better understand the role of the innate immune system have been promising. Future studies are needed to better understand the true prevalence and pathophysiology of FPIES.

scholarly journals Interleukin 4 increases human synovial cell expression of VCAM-1 and T cell binding.

1994 ◽  
Vol 53 (9) ◽  
pp. 601-607 ◽  
Author(s):  
H Shimada ◽  
K Eguchi ◽  
Y Ueki ◽  
M Nakashima ◽  
I Yamashita ◽  
...  
Keyword(s):  
T Cell ◽  
Synovial Cell ◽  
Interleukin 4 ◽  
Cell Binding ◽  
Human Synovial Cell ◽  
Cell Expression

scholarly journals Interleukin-4 promotes human CD8+T cell expression of CCR7

Immunology ◽  
2007 ◽  
Vol 120 (1) ◽  
Author(s):  
Suranjith L. Seneviratne ◽  
Antony P. Black ◽  
Louise Jones ◽  
Kati di Gleria ◽  
Abigail S. Bailey ◽  
...  
Keyword(s):  
T Cell ◽  
Cd8 T Cell ◽  
Interleukin 4 ◽  
Cell Expression

scholarly journals Prevalence and Clinical Impact of IgE-Mediated Food Allergy in School Children With Asthma: A Double-Blind Placebo-Controlled Food Challenge Study

2015 ◽  
Vol 7 (6) ◽  
pp. 547 ◽  
Author(s):  
Aneta Krogulska ◽  
Jarosław Dynowski ◽  
Marzena Funkowicz ◽  
Beata Małachowska ◽  
Krystyna Wąsowska-Królikowska
Keyword(s):  
Food Allergy ◽  
School Children ◽  
Food Challenge ◽  
Clinical Impact ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Challenge Study ◽  
Children With Asthma ◽  
Ige Mediated

scholarly journals Alergia Alimentaria, puntos clave para la práctica clínica

2021 ◽  
Vol 67 (3) ◽  
Author(s):  
BLANCA E DEL RIO NAVARRO ◽  
Omar Josúe Saucedo Ramírez ◽  
Joaquín A. Pimentel Hayashi
Keyword(s):  
Food Allergy ◽  
Food Challenge ◽  
Elimination Diet ◽  
Oral Immunotherapy ◽  
Industrialized Countries ◽  
Double Blind ◽  
Immunological Mechanisms ◽  
Hen’S Egg ◽  
Ige Mediated

Food allergy is an immune reaction that occurs frequently in pediatric age, its prevalence is higher in industrialized countries, affecting 8% of the population, the most frequently involved foods are milk, hen’s egg, soybeans, peanuts, fish, wheat, seafood and tree nuts. Food allergy can be divided into three groups: IgE-mediated, non-IgE-mediated, and mixed food allergy. The symptoms will depend on the immunological mechanisms and can be divided into immediate or no immediate, the immediate symptoms appear in the first two hours of intake and the no immediate symptoms after the second hour and up to 72 hours. Diagnosis of food allergy requires a medical history, physical examination and laboratory tests; misdiagnosis can lead to unnecessary elimination diets. The gold standard is the double-blind placebo controlled oral food challenge. The main treatment is food restriction, the nutritional and psychological implications that this entails must be taken into account; Another treatment option is oral immunotherapy, it is recommended in patients who cannot carry out an elimination diet and it has a significant impact on quality of life.

scholarly journals Frequency of positive oral food challenges and their outcomes in the allergy unit of a tertiary-care pediatric hospital

2021 ◽  
Vol 49 (3) ◽  
pp. 120-130
Author(s):  
Guilia Ballini ◽  
Chiara Gavagni ◽  
Caterina Guidotti ◽  
Giulia Ciolini ◽  
Giulia Liccioli ◽  
...  
Keyword(s):  
Chart Review ◽  
Tertiary Care ◽  
Food Challenge ◽  
Retrospective Chart Review ◽  
Food Protein ◽  
Pediatric Hospital ◽  
Pediatric Allergy ◽  
Trained Personnel ◽  
Ige Mediated ◽  
Food Challenges

Introduction and objective: The oral food challenge (OFC) is the gold standard to diagnose food allergy (FA); however, it is not a procedure free from the risk of having significant allergic reactions, even life-threatening.The aims of our study were to evaluate the frequency of positive OFCs performed in chil-dren with a suspected diagnosis of IgE- and non-IgE–mediated (food protein–induced enterocolitis syndrome (FPIES)) FA and how the failed challenges were managed.Materials and methods: A retrospective chart review was done on all children who have had OFCs in a tertiary-care pediatric allergy unit from 2017 to 2019.Results: 682 patients were enrolled and 2206 challenges were performed: 2058 (93%) for IgE-mediated FA and 148 (7%) for FPIES. There were 262 (11.8%) challenge failures. The transfer to the emergency department was required 3 times (1.1%). None of the failed challenges resulted in death or hospitalization and 13.3% challenges did not require any treatment.Conclusions: Our findings confirm that food challenges can be performed safely in a specialized setting by well-trained personnel; all food challenge reactions, even the most serious, were reversible, thanks to a prompt recognition and treatment that generally did not worsen over time.

Phenotypes and natural history of food protein‐induced enterocolitis syndrome in the east Mediterranean region

2020 ◽  
Vol 41 (6) ◽  
pp. 420-427 ◽  
Author(s):  
Melike Ocak ◽  
Ayşegül Akarsu ◽  
Umit Murat Sahiner ◽  
Ozge Soyer ◽  
Bulent Enis Sekerel
Keyword(s):  
Clinical Symptoms ◽  
Emergency Department Visits ◽  
Interquartile Range ◽  
Cow’S Milk ◽  
Food Protein ◽  
Cow's Milk ◽  
Hen’S Egg ◽  
History Of ◽  
Ige Mediated ◽  
East Mediterranean Region

Background: Food protein‐induced enterocolitis syndrome (FPIES) is a rare non-IgE mediated food allergy. Objective: To delineate the differences in the spectrum of culprit foods, remission patterns, and predictors among varying cultures. Methods: We reviewed demographics, culprit foods, outcomes, and predictors in 81 children with a diagnosis of FPIES who were followed up between 2015 and 2020. Results: Eighty-one patients (55.6% boys) were enrolled, including 72 with acute FPIES and 9 with chronic FPIES. Hen’s egg was the most common culprit food (36.6%), followed by fish (26.9%), and cow’s milk (21.5%). Interestingly, cow’s milk was significantly prevalent in chronic FPIES cases (p = 0.006). The most common clinical symptoms were vomiting (100%), pallor (63.4%), and lethargy (55.9%). Emergency department visits were noted in 39 patients (41.9%), of whom 37 (39.8%) were treated with intravenous (IV) fluid. The subjects were followed up for a median (interquartile range) of 19.4 months (12.3‐41.2 months), and 26 subjects (32.1%) achieved tolerance. The median (interquartile range) age at tolerance was 2.5 years (2.1‐3.2 years). With regard to the culprit foods, hen’s egg was observed more frequently in the subjects with resolved FPIES cases (p = 0.008), whereas fish FPIES cases were high in the persistent group (p = 0.001). IgE sensitization of the culprit food was found to be an independent risk factor for the persistence of FPIES (odds ratio 4.855 [95% confidence interval, 1.131‐20.844]; p = 0.034). Conclusion: In our cohort, unlike other published series, hen’s egg and fish were the two most common culprit foods. Fish differed from other culprit foods, with significantly delayed onset and persistence, and may create a model that allows for the understanding of the disease.

scholarly journals Influence of Antihistamines on Basophil Activation Test in Food Allergy to Milk and Egg

Diagnostics ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 44
Author(s):  
Eleonora Nucera ◽  
Riccardo Inchingolo ◽  
Rosario Nicotra ◽  
Manuela Ferraironi ◽  
Anna Giulia Ricci ◽  
...  
Keyword(s):  
Food Allergy ◽  
Food Challenge ◽  
Basophil Activation Test ◽  
Basophil Activation ◽  
Double Blind ◽  
Positive Skin ◽  
Activation Test ◽  
History Of ◽  
Ige Mediated ◽  
Food Allergy Diagnosis

Background: The basophil activation test (BAT) is used to improve the accuracy of food allergy diagnosis. To date, the influence of antiallergic drugs on BAT reactivity is poorly investigated. The aim of the study was to investigate if BAT results were influenced by antihistamine intake for 3 months in a cohort of patients with IgE-mediated food allergy to milk or egg. Methods: A retrospective, single-center, observational study was performed. We enrolled subjects with history of hypersensitivity reaction after specific food ingestion, positive skin prick tests and specific IgEs, concomitant allergic rhinitis, and, contraindication to the double-blind, placebo-controlled food challenge due to personal history of systemic reactions related to the ingestion of culprit food. Validated allergens (α-lactoalbumin, β-lactoglobulin, casein, egg white, and yolk) for BAT were used. Results: Thirty-nine patients with well-documented food symptoms and positive allergological workup were included in the study. BAT was positive in 29 patients. The mean percentages of CD63+ expression to specific culprit allergen did not change after the administration of drugs. Conclusions: This was the first study assessing the effects of oral antihistamines on basophil reactivity in cow’s milk and egg food allergy. Antihistamines do not interfere with BAT results.

scholarly journals The limited utility of the double-blind food challenge in diagnosing non-IgE mediated cow’s milk allergy in infants

2018 ◽  
Vol 141 (2) ◽  
pp. AB256
Author(s):  
Kathleen G. Wallace ◽  
Yamini V. Virkud ◽  
Sarita U. Patil ◽  
Joseph B. Leader ◽  
Caroline Southwick ◽  
...  
Keyword(s):  
Food Challenge ◽  
Cow’S Milk Allergy ◽  
Cow’S Milk ◽  
Milk Allergy ◽  
Double Blind ◽  
Cow's Milk ◽  
Cow's Milk Allergy ◽  
Ige Mediated
Sign in / Sign up

Export Citation Format

Share Document