THE ROLE OF FOOD ALLERGY IN THE DEVELOPMENT OF ATOPIC DERMATITIS. POSITION PAPER OF THE ASSOCIATION OF CHILDREN'S ALLERGISTS AND IMMUNOLOGISTS OF RUSSIA


Cite item

Full Text

Abstract

For opinion, experts Association Pediatric Allergist and Immunologist of Russia a new definition of atopic eczema: chronic recurrent inflammation of the skin, arising as a result of a violation of the epidermal barrier and entailing its further dysfunction. Maximum development atopic dermatitis reaches on the background of predisposition to IgE-mediated hypersensitivity, implemented in sensitization to surrounding allergens. Key points: 1. Allergic sensitization is not the only and main cause of atopic dermatitis. 2. Allergy special examination should be carried out to prove atopic dermatitis with food allergy. 3. Conducting eliminationprovocation tests with food allergens is necessary in case of doubt about the of allergy food reactions. 4. We recommend using skin prick test and specific IgE (solid-phase ELISA) providing a high sensitivity of 0.1-100 mgA/L. 5. A proven allergic reaction to food requires the exclusion of all foods that contain this protein for a time enough for the development of tolerance. 6. The expectation of cross-reactions should not be the reason for the exclusion of food. Only an elimination and provocation diet (test) is able to prove food intolerances. 7. Elimination diet-a temporary action, because after a few months of complete exclusion of the allergenic product from the diet, most children will be able to eat previously intolerant food. 8. In infants, the best nutrition option is breastfeeding for duration of 6 months. It is not advisable to delay the introduction of complementary foods and restriction of highly allergenic products if they are not proven hypersensitivity to it.

Full Text

Restricted Access

About the authors

Yury S. Smolkin

Association Pediatric Allergist and Immunologist of Russia; Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies

Email: smolking@df.ru

Sergei S. Masalskiy

Association Pediatric Allergist and Immunologist of Russia; Scientific Clinical Consultative Center for Allergology and Immunology; Scientific Clinical Consultative Center for Allergology and Immunology

Andrei A. Cheburkin

Association Pediatric Allergist and Immunologist of Russia; Russian Medical Academy of Continious Proffessional Education

Igor A. Gorlanov

Saint Petersburg State Pediatric Continuous University

References

  1. Silverberg JI, Thyssen JP, Paller AS et al. What’s in a name? Atopic dermatitis or atopic eczema, but not eczema alone. Allergy 2017; 72: 2026-30.
  2. Laird M, Lo Sicco K. Defining and Measuring the Scope of Atopic Dermatitis. Adv Exp Med Biol 2017; 1027: 93-104.
  3. Flohr C, Johansson SGO, Wahlgren CF, Williams HC. How atopic is atopic dermatitis? J Allergy Clin Immunol 2004; 114: 150-8.
  4. Roguedas-Contios AM, Misery L. What is intrinsic atopic dermatitis? Clin Rev Allergy Immunol 2011; 41 (3): 233-6.
  5. Bergmann MM et al. Evaluation of food allergy in patients with atopic dermatitis. J Allergy Clin Immunol Pract 2013; 1 (1): 22-8.
  6. Flohr C, Mann J. New insights into the epidemiology of childhood atopic dermatitis. Allergy 2014; 69: 3-16.
  7. Cipriani F, Dondi A, Ricci G. Recent advances in epidemiology and prevention of atopic eczema. Pediatr Allergy Immunol 2014; 25 (7): 630-8.
  8. Abuabara K, Yu AM, Okhovat JP et al. The prevalence of atopic dermatitis beyond childhood: A systematic review and meta-analysis of longitudinal studies. Allergy 2017; 73: 696-704.
  9. Atherton DJ, Soothill JF, Sewell M et al: A double-blind controlled crossover trial of an antigen-avoidance diet in atopic eczema. Lancet 1978; I: 401-3.
  10. Weidinger S, Beck LA, Bieber T et al. Atopic dermatitis. Nat Rev Dis Prim 2018; 4: 1.
  11. Sampson HA. Food allergy: past, present and future. Allergology International 2016; 65 (4): 363-9.
  12. Allergen nomenclature WHO/IUIS Allergen Nomenclature Sub-Committee. http://www.allergen.org/index.php
  13. Beken B, Celik V, Gokmirza Ozdemir P et al. Maternal anxiety and internet-based food elimination in suspected food allergy. Pediatr Allergy Immunol 2019. doi: 10.1111/pai.13100. [Epub ahead of print].
  14. Boyce JA, Assa'ad AH, Burks AW et al. Guidelines for the Diagnosis and Management of Food Allergy in the United States. Report of the NIAID-sponsored Expert Panel. J Allergy Clin Immunol 2010; 126 (6 Suppl.): S1-S58.
  15. Flohr C, Perkin M, Logan K et al. Atopic dermatitis and disease severity are the main risk factors for food sensitization in exclusively breastfed infants. J Invest Dermatol 2014; 134: 345-50.
  16. Toit du G, Roberts G, Sayre P.H et al. Identifying infants at high risk of peanut allergy: the Learning Early About Peanut Allergy (LEAP) screening study. J Allergy Clin Immunol 2013; 131: 135-43.
  17. Gray CL, Levin ME, Zar HJ et al. Food allergy in South African children with atopic dermatitis. Pediatr Allergy Immunol 2014; 25: 572-9.
  18. McLean WHI. Filaggrin failure-from ichthyosis vulgaris to atopic eczema and beyond. Br J Dermatol 2016; 175: 4-7.
  19. Lyons JJ, Milner JD, Stone KD. Atopic Dermatitis in Children: Clinical Features, Pathophysiology, and Treatment. Immunol Allergy Clin North Am 2015; 35 (1): 161-83.
  20. Thyssen JP, Godoy-Gijon E, Elias PM. Ichthyosis vulgaris: the filaggrin mutation disease. Br J Dermatol 2013; 168: 1155-66.
  21. Bager P, Wohlfahrt J, Thyssen JP, Melbye M. Filaggrin genotype and skin diseases independent of atopic dermatitis in childhood. Pediatr Allergy Immunol 2016; 27 (2): 162-8.
  22. Hadson TJ. Skin barrier function and allergic risk. Nature Genetics 2006; 38: 399-400.
  23. Weidinger S et al. Filaggrin mutations, atopic eczema, hay fever, and asthma in children. J Allergy Clin Immunol 2008; 121: 1203-9.
  24. Yu HS, Tu HP, Hong CH, Lee CH. Lifetime increased risk of adult onset atopic dermatitis in adolescent and adult patients with food allergy. International J Molecular Sci 2017; 18 (1): 42.
  25. Атопический дерматит у детей: обновление 2019 (на правах руководства). Согласительный документ Ассоциации детских аллергологов и иммунологов России. М.: АДАИР, 2019; Cамара: Полиграфическое объединение «Стандарт», 2019. @@Atopic dermatitis in children: update 2019 (as a guide). Conciliation document of the Association of Children's Allergologists and Immunologists of Russia. Moscow: ADAIR, 2019; Camara: Poligraficheskoe ob"edinenie "Standart", 2019 (in Russian).
  26. Sampson HA, Aceves S, Bock SA et al. Food allergy: a practice parameter update-2014. J Allergy Clin Immunol 2014; 134 (5): 1016-25.
  27. Celik-Bilgili S, Mehl A, Verstege A et al. The predictive value of specific immunoglobulin E levels in serum for the outcome of oral food challenges. Clin Exp Allergy 2005; 35: 268-73.
  28. Breuer K, Heratizadeh A, Wulf A et al. Late eczematous reactions to food in children with atopic dermatitis. Clin Exp Allergy 2004; 34: 817-24.
  29. Werfel T, Ballmer-Weber B, Eigenmann PA et al. Eczematous reactions to food in atopic eczema: position paper of the EAACI and GA2LEN. Allergy 2007; 62: 723-8.
  30. Karaman S, BahHeci SE, Nacaro lu HT et al. Is Oral Food Challenge (OFC) test safe for preschool children? Asian Pac J Allergy Immunol 2017; 35 (4): 220-3.
  31. Anagnostou K. Safety of Oral Food Challenges in Early Life. Children (Basel) 2018; 5 (6): 65.
  32. Федеральные клинические рекомендации по оказанию медицинской помощи детям с пищевой аллергией. Союз педиатров России. 2015. @@Federal'nye klinicheskie rekomendatsii po okazaniiu meditsinskoi pomoshchi detiam s pishchevoi allergiei. Soiuz pediatrov Rossii. 2015. (in Russian).
  33. Аллергия к белкам коровьего молока у детей. Клинические рекомендации. Союз педиатров России. 2016. @@Allergiia k belkam korov'ego moloka u detei. Klinicheskie rekomendatsii. Soiuz pediatrov Rossii. 2016 (in Russian).
  34. Pettersson ME, Koppelman GH, Flokstra-de Blok BMJ et al. Prediction of the severity of allergic reactions to foods. Allergy 2018; 73 (7): 1532-40.
  35. Mamikoglu B. Beef, pork, and milk allergy (cross reactivity with each other and pet allergies). Otolaryngol Head Neck Surg 2005; 133 (4): 534-7.
  36. Bousquet J, Heinzerling L, Bachert C et al. Practical guide to skin prick tests in allergy to aeroallergens. Allergy 2012; 67: 18-24.
  37. Kowalski ML et al. Risk and safety requirements for diagnostic and therapeutic procedures in allergology: World Allergy Organization Statement. World Allergy Organization J 2016; 9 (1): 33.
  38. Bernstein I, Li JT, Bernstein DI et al. Allergy Diagnostic Testing: An Updated Practice ParameterI. Ann Allergy Asthma Immunol 2008; 100 (Suppl. 3): S1-148.
  39. Bock SA, Atkins FM. Patterns of food hypersensitivity during sixteen years of double-blind, placebo-controlled food challenges. J Pediatr 1990; 117: 561-7.
  40. Chang A, Robison R, Cai M, Singh AM. Natural history of food triggered atopic dermatitis and development of immediate reactions in children. J Allergy Clin Immunol Pract 2016; 4 (2): 229-36.
  41. Jones SM, Sampson HA. The role of allergens in atopic dermatitis. In: Leung DYM, ed. Atopic dermatitis: from pathogenesis to treatment. Austin: R G Landes Co, 1996; p. 41-66.
  42. Twaroch TE, Curin M, Valenta R, Swoboda I. Mold Allergens in Respiratory Allergy: From Structure to Therapy. Allergy Asthma Immunol Res 2015; 7 (3): 205-20.
  43. Ferreira H, Alves M, Pineda F et al. Cross-Reactivity Between Molds and Mushrooms. Pediatric Allergy Immunol Pulmonol 2017; 30 (2): 126-8.
  44. Berin MC, Sampson HA. Food allergy: an enigmatic epidemic. Trends Immunol 2013; 34 (8): 390-7.
  45. Sampson HA, Scanlon SM. Natural history of food hypersensitivity in children with atopic dermatitis. J Pediatr 1989; 115: 23-7.
  46. Burks AW, Mallory SB, Williams LW et al. Atopic dermatitis: Clinical relevance of food hypersensitivity reactions. J Pediatr 1998; 113: 447-51.
  47. Young MC. Elimination Diets in Eczema - A Cautionary Tale. J Allergy Clin Immunol 2016; 4 (2): 237-8.
  48. Kim JS, Nowak-Wegrzyn A, Sicherer SH et al. Dietary baked milk accelerates the resolution of cow's milk allergy in children. J Allergy Clin Immunol 2011; 128 (1): 125-31.
  49. Sampson HA. The immunopathogenic role of food hypersensitivity in atopic dermatitis. Acta Derm Venereol Suppl (Stockh) 1992; 176: 34-7.
  50. Bergmann MM, Caubet JC, Boguniewicz M, Eigenmann PA. Evaluation of food allergy in patients with atopic dermatitis. J Allergy Clin Immunol 2013; 1 (1): 22-8.
  51. The Handbook of Pediatric Nutrition. Gaithersburg. Aspen Publishers 1993; p. 107-44.
  52. Panel, NIAID-Sponsored Expert. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol 2010; 126 (6): S1-S58.
  53. Schrander JJP, van den Bogart JPH, Forget PP et al. Cow’s milk protein intolerance in infants under 1 year of age: a prospective epidemiological study. Eur J Pediatr 1993; 152: 640-4.
  54. Sampson HA. The evaluation and management of food allergy in atopic dermatitis. Clin Dermatol 2003; 21: 183-92.
  55. Sampson H, Gerthvan Wijk R, Bindslev-Jensen C et al. Standardizing double-blind, placebo-controlled oral food challenges: American Academy of Allergy, Asthma & Immunology-European Academy of Allergy and Clinical Immunology PRACTALL consensus report. J Allergy Clin Immunol 2012; 130: 1260-74.
  56. Popescu Florin-Dan. Cross-reactivity between aeroallergens and food allergens. World J Methodol 2015; 5 (2): 31-50.
  57. Cox L, Williams B, Sicherer S et al. American College of Allergy, Asthma and Immunology Test Task Force; American Academy of Allergy, Asthma and Immunology Specific IgE Test Task Force. Pearls and pitfalls of allergy diagnostic testing: report from the American College of Allergy, Asthma and Immunology/American Academy of Allergy, Asthma and Immunology Specific IgE Test Task Force. Ann Allergy Asthma Immunol 2008; 101 (6): 580-92.
  58. Sampson HA, Albergo R. Comparison of results of prick skin tests, RAST, and double-blind placebo-controlled food challenges in children with atopic dermatitis. J Allergy Clin Immunol 1984; 74: 26-33.

Copyright (c) 2020 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 74329 от 19.11.2018 г.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies