Theoretical and practical aspects of food allergy in the XXI century. EAACI 2021
https://doi.org/10.31146/1682-8658-ecg-202-6-157-164
Abstract
High prevalence of food allergy (FA), increasing frequency of severe cases despite the progress achieved in the study of this pathology makes it necessary to develop new methods for diagnosis, treatment and prevention of food allergies. At the Congress of the European Academy of Allergology and Clinical Immunology (EAACI) 2021 current problems of allergology and immunology were considered, such as the influence of environmental factors on the development of FA, including the effects of microplastic contamination in food on development of allergic diseases, global warming, large-scale urbanization, that lead to an imbalance in the microbiota of the macroorganism, reduction in its diversity, followed by alterations in gut microbial colonization and the development of FA; determination of FA markers with detecting previously unidentified allergens that cause severe allergic reactions. Assessment of risk factors and biomarkers of the severity of FA was discussed, as well as the importance of component diagnostics, which allows predicting acute allergic reactions, determining indications for prescribing AIT, and maximizing individualization of treatment. Innovative treatment approaches were presented using biological therapy, the role of pre- and probiotics, fecal microbiota therapy in restoring the microbiome; features of the diet that regulates the gut microbiota. In considering the prevention of FA changes were made to the previous EAACI recommendations for monitoring children in the first year of life, monitoring the state of adolescents with FA.
About the Authors
Z. V. Nesterenko
St. Petersburg State Pediatric Medical University
Russian Federation
Russian Federation
A. I. Khavkin
Research Clinical Institute of Childhood of the Moscow Region»
Russian Federation
Russian Federation
References
1. Muraro A., Halken S., Arshad S. H., et al; EAACI Food Allergy and Anaphylaxis Guidelines Group. EAACI food allergy and anaphylaxis guidelines. Primary prevention of food allergy. Allergy. 2014 May;69(5):590-601. doi: 10.1111/all.12398.
2. Gupta R.S., Warren SM., Smith B. M., et al. Prevalence and severity of food allergies among US adults. JAMA Netw Open. 2019;2(1): e185630. doi:10.1001/jamanetworkopen.20185630.
3. Lack G. Update on risk factors for food allergy. J. Allergy Clin Immunol. 2012; 129(5):1187-1197. doi: 10.1001/jamanetworkopen.2018.5630.
4. Pechkurov D. V., Poretskova G. Yu., Tyazheva A. A., Konovalova A. M. Food allergy masks in children. Prakticheskaja medicina (Practical medicine). 2018;2 (113): 5-8. (In Russ.) @@Печкуров Д. В., Порецкова Г. Ю., Тяжева А. А., Коновалова А. М. Маски пищевой аллергии у детей. Практическая медицина. 2018; 2(113): 5-8.
5. Rosenberg, Zilber-Rosenberg.Interaction between the Microbiome and Diet: The Hologenome Concept. J Nutr Food Sci. 2016;(6):545. doi: 10.4172/2155-9600.1000545.
6. Makarova S. G., Boldyreva M. N., Lavrova T. E., Petrovskaya M. I.Intestinal microbiocenosis, food tolerance and food allergy. Current state of the problem. Vopr. sovr. Pediatrii. (Мodern pediatrics). 2014; 13 (3): 21-29. (In Russ.) doi: 10.15690/vsp.v13i3.1024. @@Макарова С. Г., Болдырева М. Н. Лаврова Т. Е., Петровская М. И. Кишечный микробиоценоз, пищевая толерантность и пищевая аллергия. Современное состояние проблемы. Вопр. совр. Педиатрии. 2014; 13(3):21-29. doi: 10.15690/vsp.v13i3.1024.
7. Sicherer S. H., Sampson H. A. Food allergy: A review and update on epidemiology, pathogenesis, diagnosis, prevention, and management. J Allergy Clin Immunol. 2018 Jan;141(1):41-58. doi: 10.1016/j.jaci.2017.11.003.
8. Spergel J. М. Delay Food Introduction to Prevent Food Allergy? It Doesn’t Work. Medscаpe. 2015. 18 P.
9. Fouhy F., Wathkins C., Hill C. J., O`Shea C., Nagle B., Dempsey E. M., et al. Perinatal factors affect the gut microbiota up to four years after birth. Nature Communications. 2019;(10):1517. doi: 10.1038/s41467-019-09252-4.
10. Gurova M. M., Novikova V. P. Evolutionary aspects of neonatal gastroenterology: the formation of the intestinal microbiome and the importance of nutritional factors in the first months of life. Voprosy detskoj dietologii (Pediatric Dietetics). 2018; 16 (1): 34-41. (In Russ.) doi: 10.20953/1727-5784-2018-1-34-41. @@Гурова М. М., Новикова В. П. Эволюционные аспекты неонатальной гастроэнтерологии: формирование кишечного микробиома и значение фактора питания в первые месяцы жизни. Вопросы детской диетологии.2018;16(1):34-41. doi: 10.20953/1727-5784-2018-1-34-41.
11. Murdaca G. Vitamin D and Microbiota: Is There a Link with Allergies? Int. J. Mol. Sci. 2021; 22(8): 4288. doi: 10.3390/ijms22084288.
12. Bora S. A., Kennett M. J., Smith P. B., Patterson A. D., Cantorna M. T. Regulation of vitamin D metabolism following disruption of the microbiota using broad spectrum antibiotics. J. Nutr. Biochem. 2018; 56: 65-73. doi: 10.1016/j.jnutbio.2018.01.011.
13. Malaguarnera L. Vitamin D and microbiota: Two sides of the same coin in the immunomodulatory aspects.Int. Immunopharmacol. 2020; 79: 106112. doi: 10.1016/j.intimp.2019.106112.
14. Murdaca G., Tonacci A., Negrini S., Greco M., Borro M., Puppo F., Gangemi S. Emerging role of vitamin D in autoimmune diseases: An update on evidence and therapeutic implications. Autoimmun Rev. 2019 Sep;18(9):102350. doi: 10.1016/j.autrev.2019.102350.
15. Yamamoto E. A., Jоrgensen T. N. Relationships Between Vitamin D, Gut Microbiome, and Systemic Autoimmunity. Front. Immunol. 2020; 10: 1-13. doi: 10.3389/fimmu.2019.03141.
16. Prokofieva E. S., Makhonko M. N., Shkrobova N. V. Plastic and its impact on the health of current residents. Bulletin of Medical Internet Conferences. 2013; 3(11):1176-1178. (In Russ.) @@Прокофьева Е. С., Махонько М. Н., Шкробова Н. В. Пластик и его влияние на здоровье современных потребителей. Bulletin of Medical Internet Conferences. 2013; 3(11):1176-1178.
17. Logan A. C., Jacka F. N., Prescott S. L. Immune-Microbiota Interactions: Dysbiosis as a Global Health Issue. Curr Allergy Asthma Rep. 2016; 16(2):13. doi: 10.1007/s11882-015-0590-5.
18. Haahtela T. Hunt for the origin of allergy - comparing the Finnish and Russian Karelia. Clin. Exp. Allergy. 2015; 45: 891-901. doi:10.1111/cea.12527.
19. Prescott S. L., Pawankar R., Allen K. J., Campbell D. E. A global survey of changing patterns of food allergy burden in children. World Allergy Organ J. 2013 Dec 4;6(1):21. doi: 10.1186/1939-4551-6-21.
20. Strachan D. P. Family size, infection and atopy: the first decade of the hygiene hypothesis. Thorax. 2000;5(1):52-59. doi: 10.1136/thorax.55.suppl_1. s.2.
21. Macharadze D. Sh. On the pathogenesis of food allergy. Pediatrija. (Pediatrics). 2016; 95 (6): 151-157. (In Russ.) @@Мачарадзе Д. Ш. О патогенезе пищевой аллергии. Педиатрия. 2016; 95 (6): 151-157.
22. Huang Y. J., Marsland B. J., Bunyavanich S. The microbiome in allergic disease: Current understanding and future opportunities-2017 PRACTALL document of the American Academy of Allergy, Asthma & Immunology and the European Academy of Allergy and Clinical Immunology. J Allergy Clin Immunol. 2017; 139(4): 1099-1110. doi: 10.1016/j.jaci.2017.02.007.
23. Datema M. R, Lyons S. A., Fernández-Rivas M., et al. Estimating the Risk of Severe Peanut Allergy Using Clinical Background and IgE Sensitization Profiles. Fronties in Allergy. 2021;(2): 670789. doi: 10.3389/falgy.2021.670789.
24. Asero R., Jimeno L., Barber D. Preliminary Results of a Skin Prick Test-Based Study of the Prevalence and Clinical Impact of Hypersensitivity to Pollen Panallergens (Polcalcin and Profilin). J Investig Allergol Clin Immunol. 2010; 20(1): 35-38.
25. Shogenova L. A., Misirov I. M., Shogenova M. S., Borukaeva I. Kh. Molecular diagnostics in allergology. Colloquium-Journal. 2019; 18 (42). (In Russ.) doi: 10.24411/2520-6990-2019-10594. @@Шогенова Л. А., Мисиров И. М., Шогенова М. С., Борукаева И. Х. Молекулярная диагностика в аллергологии. Colloquium-Journal. 2019; 18(42). doi: 10.24411/2520-6990-2019-10594.
26. Ferrer M., Sastre J., Jáuregui I., et al. Effect of Antihistamine Up-Dosing in Chronic Urticaria. J Investig Allergol Clin Immunol. 2011; 21(3): 34-43.
27. Sastre J., Davila I. Dupilumab: A New Paradigm for the Treatment of Allergic Diseases. J Investig Allergol Clin Immunol. 2018; 28(3): 139-150. doi: 10.18176/jiaci.0254.
28. Andorf S., Purington N., Blok W.M, Long A. J., Tupa D., Brittain D., et al. Anti-IgE treatment with oral immunotherapy in multifood allergic participants: a double-blind, randomized, controlled trial. Lancet Gastroenterol Hepatol. 2018; 3:85-94. doi: 10.1016/S2468-1253(17)30392-8.
29. Labrosse R., Graham F., Des Roches A., Begin P. The use of omalizumab in food oral immunotherapy. Arch.Immunol Ther Exp. (Warsz). 2017; 65:189-199. doi: 10.1007/s00005-016-0420-z.
30. Kurbacheva O. M., Galitskaya M. A. The place of omalizumab in the treatment of allergic diseases. Medicinskij sovet. (Мedical quorum). 2019; (15): 38-49. (In Russ.) doi: 10.21518/2079-701X-2019-15-38-49. @@Курбачёва О. М., Галицкая М. А. Место омализумаба в терапии аллергических заболеваний. Медицинский совет. 2019; (15): 38-49. doi: 10.21518/2079-701X-2019-15-38-49.
31. Lieberman J.A., Chehade M. Use of omalizumab in the treatment of food allergy and anaphylaxis. Curr Allergy Asthma Rep. 2013;13(1):78-84. doi: 10.1007/s11882-012-0316-x.
32. Frei R., Akdis M., O’Mahony L. Prebiotics, probiotics, synbiotics, and the immune system: experimental data and clinical evidence. Curr Opin Gastroenterol. 2015; 31:153-158. doi: 10.1097/MOG.0000000000000151.
33. Sonnenburg J.L., Bäckhed F. Diet-microbiota interactions as moderators of human metabolism. Nature. 2016; 535:56-64. doi: 10.1038/nature18846.
34. Gordon B. R. Dietary and Nutritional Influences on Allergy Prevention. Dietary and Nutritional Influences on Allergy Prevention. 2018; 5(5): 182-186. doi:10.1007/s40521-018-0182-4.
35. Shanahan L., Zucker N., Copeland W. E., Costello E. J., Angold A. Are children and adolescents with food allergies at increased risk for psychopathology? J Psychosom Res. 2014;77(6):468-73. doi: 10.1016/j.jpsychores.2014.10.005.
36. Lebovidge J.S, Kalish L, Strauch H, Schneider L. C. Assessment of psychological distress among children and adolescents with food allergy. Journal of allergy and clinical immunology. 2009; 124(6):1282-8. doi: 10.1016/j.jaci.2009.08.045.
37. Van Nood E., Dijkgraaf M. G., Keller J. J. Duodenal infusion of feces for recurrent Clostridium difficile. N Engl J Med. 2013; 368:2145. doi: 10.1056/NEJMoa1205037.
38. Youngster I., Russell G. H., Pindar C., Ziv-Baran T., Sauk J., Hohmann E. L. Oral, capsulized frozen fecal mcrobiolota transplantation for relapsing Clostridium difficile infection. JAMA. 2014; 312:1772-8. doi: 10.1001/jama.2014.13875.
39. Goyal M. S., Venkatesh S., Milbrandt J., Gordon J. I., Raichle M. E. Feeding the brain and nurturing the mind: linking nutrition and the gut microbiota to brain development. Proc Natl Acad Sci USA. 2015;112(46):14105. doi: 10.1073/pnas.1511465112.
40. Halken S., Muraro A., de Debra S., et al. EAACI guideline: Preventing the development of food allergy in infants and young children (2020 update). Pediatr Allergy Immunology.2021 202; 32(5):843-858. doi: 10.1111/pai.13496.
41. Makarova S. G., Namazova-Baranova L.S., Vishneva E. A., Turti T. V., Akoev Yu.S., Petrovskaya M. I. Primary prevention as an effective response to the epidemic of allergic diseases. Pediatricheskaja farmakologija (Pediatric Pharmacology). 2015; 12 (1): 67-74. (In Russ.) @@Макарова С. Г., Намазова-Баранова Л.С., Вишнева Е. А., Турти Т. В., Акоев Ю. С., Петровская М. И. Первичная профилактика как эффективный ответ на эпидемию аллергических болезней. Педиатрическая фармакология. 2015; 12(1):67-74.
42. [Federal clinical guidelines for the provision of medical care to children with food allergies]. Moscow. 2015. 17 P. (In Russ.) @@Федеральные клинические рекомендации по оказанию медицинской помощи детям с пищевой аллергией. Москва. 2015:17.
43. [National program of optimization of feeding of children of the first year of life in the Russian Federation]. Moscow. 2019. (In Russ.) @@Национальная программа оптимизации вскармливания детей первого года жизни в Российской Федерации, Москва. 2019.
44. Belmer S. V., Khavkin A. I., Aleshina E. O., et al.Intestinal microbiota in children: norm, disorders, correction. Moscow. Medical practice. 2020. 472 P. (In Russ.) @@Бельмер С. В., Хавкин А. И., Алешина Е. О., Алешкин А. В., Бехтерева М. К., Новикова В. П. и др. Кишечная микробиота у детей: норма, нарушения, коррекция. Москва: Мед.практика. 2020: 472.
45. Karpeeva Yu.S., Novikova V. P., Khavkin A. I., Kovtun T. A., Makarkin D. V., Fedotova O. B. Myrobiota and human diseases: possibilities of dietary correction. Rossijskij vestnik perinatologii i pediatrii = Russian Bulletin of Perinatology and Pediatrics. 2020; 65 (5): 116-125. (In Russ.) doi: 10.21508/1027-4065-2020-65-5-116-125. @@Карпеева Ю. С., Новикова В. П., Хавкин А. И., Ковтун Т. А., Макаркин Д. В., Федотова О. Б. Миробиота и болезни человека: возможности диетической коррекции. Российский вестник перинатологии и педиатрии. 2020;65(5):116-125.
46. Pyreva E. A., Gordeeva E. A. A paradigm shift in allergy prevention in children. Lechashhij vrach = Doctor. 2021; 1 (24): 41-45. (In Russ.) doi: 10.262995/OS.2021.93.77.009. @@Пырьева Е. А., Гордеева Е. А. Смена парадигм в профилактике аллергии у детей. Лечащий врач. 2021; 1 (24): 41-45. doi: 10.262995/OS.2021.93.77.009.
Review
For citations:
Nesterenko Z.V., Khavkin A.I. Theoretical and practical aspects of food allergy in the XXI century. EAACI 2021. Experimental and Clinical Gastroenterology. 2022;(6):157-164. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-202-6-157-164
Views:
306
Email this article 