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Hugh A. Sampson - One of the best experts on this subject based on the ideXlab platform.

  • Early-life gut microbiome and Egg Allergy.
    Allergy, 2018
    Co-Authors: Mina Fazlollahi, Robert A. Wood, Yoojin Chun, Alexander Grishin, A.w. Burks, Peter Dawson, Stacie M. Jones, Donald Y.m. Leung, Hugh A. Sampson, Scott H. Sicherer
    Abstract:

    Background Gut microbiota may play a role in Egg Allergy. We sought to examine the association between early-life gut microbiota and Egg Allergy. Methods We studied 141 children with Egg Allergy and controls from the multicenter Consortium of Food Allergy Research study. At enrollment (age 3 to 16 months), fecal samples were collected, and clinical evaluation, Egg-specific IgE measurement, and Egg skin prick test were performed. Gut microbiome was profiled by 16S rRNA sequencing. Analyses for the primary outcome of Egg Allergy at enrollment, and the secondary outcomes of Egg sensitization at enrollment and resolution of Egg Allergy by age 8 years, were performed using Quantitative Insights into Microbial Ecology, Phylogenetic Investigation of Communities by Reconstruction of Unobserved States, and Statistical Analysis of Metagenomic Profiles. Results Compared to controls, increased alpha diversity and distinct taxa (PERMANOVA P = 5.0 × 10-4 ) characterized the early-life gut microbiome of children with Egg Allergy. Genera from the Lachnospiraceae, Streptococcaceae, and Leuconostocaceae families were differentially abundant in children with Egg Allergy. Predicted metagenome functional analyses showed differential purine metabolism by the gut microbiota of Egg-allergic subjects (Kruskal-Wallis Padj = 0.021). Greater gut microbiome diversity and genera from Lachnospiraceae and Ruminococcaceae were associated with Egg sensitization (PERMANOVA P = 5.0 × 10-4 ). Among those with Egg Allergy, there was no association between early-life gut microbiota and Egg Allergy resolution by age 8 years. Conclusion The distinct early-life gut microbiota in Egg-allergic and Egg-sensitized children identified by our study may point to targets for preventive or therapeutic intervention.

  • Immunologic changes in children with Egg Allergy ingesting extensively heated Egg.
    Journal of Allergy and Clinical Immunology, 2008
    Co-Authors: Heather Lemon-mulé, Hugh A. Sampson, Scott H. Sicherer, Wayne G. Shreffler, Sally Noone, Anna Nowak-wegrzyn
    Abstract:

    Background Prior studies have suggested that heated Egg might be tolerated by some children with Egg Allergy. Objective We sought to confirm tolerance of heated Egg in a subset of children with Egg Allergy, to evaluate clinical and immunologic predictors of heated Egg tolerance, to characterize immunologic changes associated with continued ingestion of heated Egg, and to determine whether a diet incorporating heated Egg is well tolerated. Methods Subjects with documented IgE-mediated Egg Allergy underwent physician-supervised oral food challenges to extensively heated Egg (in the form of a muffin and a waffle), with tolerant subjects also undergoing regular Egg challenges (in a form of scrambled Egg or French toast). Heated Egg–tolerant subjects incorporated heated Egg into their diets. Skin prick test wheal diameters and Egg white, ovalbumin, and ovomucoid IgE levels, as well as ovalbumin and ovomucoid IgG4 levels, were measured at baseline for all subjects and at 3, 6, and 12 months for those tolerant of heated Egg. Results Sixty-four of 117 subjects tolerated heated Egg, 23 tolerated regular Egg, and 27 reacted to heated Egg. Heated Egg–reactive subjects had larger skin test wheals and greater Egg white–specific, ovalbumin-specific, and ovomucoid-specific IgE levels compared with heated Egg– and Egg-tolerant subjects. Continued ingestion of heated Egg was associated with decreased skin test wheal diameters and ovalbumin-specific IgE levels and increased ovalbumin-specific and ovomucoid-specific IgG4 levels. Conclusions The majority of subjects with Egg Allergy were tolerant of heated Egg. Continued ingestion of heated Egg was well tolerated and associated with immunologic changes that paralleled the changes observed with the development of clinical tolerance to regular Egg.

  • specificity of ige antibodies to sequential epitopes of hen s Egg ovomucoid as a marker for persistence of Egg Allergy
    Allergy, 2007
    Co-Authors: Kirsi M Jarvinen, Kirsten Beyer, Leticia Vila, Ludmilla Bardina, Michelle Mishoe, Hugh A. Sampson
    Abstract:

    Background:  Approximately two-thirds of Egg-allergic infants become tolerant within the first 5 years of life. Objective:  We sought (1) to compare the recognition of sequential (linear) and conformational binding sites of ovomucoid, ovalbumin and ovotransferrin, by IgE antibodies of children with persistent and transient Egg Allergy, (2) to identify immunodominant IgE-and IgG-binding epitopes of ovomucoid, and (3) to compare epitope-specificity of IgE antibodies between patients with differing natural histories of Egg Allergy. Methods:  Using immunodot-blots or ImmunoCAPs, IgE-antibodies against conformational (native) and sequential (reduced and alkylated) Egg proteins were determined at the time of clinical reactivity in patients who retained their Allergy and in those who developed clinical tolerance. IgE- and IgG-binding epitopes were mapped for ovomucoid using overlapping decapeptides on SPOTs membranes. Recognition of the major IgE-binding epitopes were compared between patients with differing natural histories of Egg Allergy. Results:  The patients with long-lasting Egg Allergy had a higher concentrations of IgE antibodies against sequential and native ovomucoid and ovalbumin than the children who subsequently gained tolerance (P < 0.01). Four major IgE-binding epitopes were identified in ovomucoid at amino acid 1–10, 9–20, 47–56, and 113–124. IgE antibodies of all seven patients with persistent Egg Allergy recognized these epitopes whereas none of the 11 children who outgrew their Egg Allergy did so. Conclusions:  Patients with persistent Egg Allergy develop IgE antibodies against more sequential and conformational epitopes of ovomucoid and ovalbumin. The presence of serum IgE antibodies to specific sequential epitopes of ovomucoid may be used as a screening instrument for persistent Egg Allergy.

  • Specificity of IgE antibodies to sequential epitopes of hen's Egg ovomucoid as a marker for persistence of Egg Allergy.
    Allergy, 2007
    Co-Authors: Kirsi M Jarvinen, Kirsten Beyer, Leticia Vila, Ludmilla Bardina, Michelle Mishoe, Hugh A. Sampson
    Abstract:

    Background:  Approximately two-thirds of Egg-allergic infants become tolerant within the first 5 years of life. Objective:  We sought (1) to compare the recognition of sequential (linear) and conformational binding sites of ovomucoid, ovalbumin and ovotransferrin, by IgE antibodies of children with persistent and transient Egg Allergy, (2) to identify immunodominant IgE-and IgG-binding epitopes of ovomucoid, and (3) to compare epitope-specificity of IgE antibodies between patients with differing natural histories of Egg Allergy. Methods:  Using immunodot-blots or ImmunoCAPs, IgE-antibodies against conformational (native) and sequential (reduced and alkylated) Egg proteins were determined at the time of clinical reactivity in patients who retained their Allergy and in those who developed clinical tolerance. IgE- and IgG-binding epitopes were mapped for ovomucoid using overlapping decapeptides on SPOTs membranes. Recognition of the major IgE-binding epitopes were compared between patients with differing natural histories of Egg Allergy. Results:  The patients with long-lasting Egg Allergy had a higher concentrations of IgE antibodies against sequential and native ovomucoid and ovalbumin than the children who subsequently gained tolerance (P 

  • Safe administration of influenza vaccine to patients with Egg Allergy
    The Journal of Pediatrics, 1998
    Co-Authors: John M. James, Hugh A. Sampson, Robert S. Zeiger, Mitchell R. Lester, Mary Beth Fasano, James E. Gern, Lyndon E. Mansfield, Howard J. Schwartz, Hugh H. Windom, Steven B. Machtinger
    Abstract:

    Abstract Objectives: Specific recommendations for administering the influenza vaccine to patients with Egg Allergy are based on limited scientific data. The objectives of this investigation were to determine the safety of a 2-dose administration of an influenza vaccine to patients with Egg Allergy and to evaluate the usefulness of skin testing with the influenza vaccine before administration. Study design: In this multicenter clinical trial, clinical histories of Egg Allergy were confirmed by skin testing with Egg and, if possible, by oral challenges with Egg. Subjects with Egg Allergy received the vaccine in 2 doses, 30 minutes apart; the first dose was one tenth and the second dose nine tenths of the recommended dose as determined by age. Subjects without Egg Allergy were recruited as control subjects and received 1 age-determined dose of the vaccine. Skin prick tests with the influenza vaccine were performed on all subjects. Results: From 1994 to 1997, 83 subjects with Egg Allergy and 124 control subjects were evaluated. The content of ovalbumin/ovomucoid was 0.1, 1.2, and 0.02 μg/mL, respectively in the 1994-95, 1995-96, and 1996-97 influenza vaccines. Results of vaccine skin prick tests were positive in 4 subjects with Egg Allergy and in 1 control subject. All patients with Egg Allergy tolerated the vaccination protocol without any significant allergic reactions. Conclusions: These results demonstrate that patients with Egg Allergy, even those with significant allergic reactions after Egg ingestion, can safely receive an influenza vaccine in a 2-dose protocol when the vaccine preparation contains no more than 1.2 μg/mL Egg protein. (J Pediatr 1998;133:624-8)

Mimi L K Tang - One of the best experts on this subject based on the ideXlab platform.

  • Egg allergen specific IgE diversity predicts resolution of Egg Allergy in the population cohort HealthNuts.
    Allergy, 2018
    Co-Authors: Thanh D. Dang, Jennifer J Koplin, Shyamali C Dharmage, Annelouise Ponsonby, Mimi L K Tang, Lyle C Gurrin, Rachel L. Peters, David Martino, Melanie R. Neeland, Katrina J. Allen
    Abstract:

    BACKGROUND IgE-mediated Egg Allergy presents as one of the most common food allergies in children. Measurement of Egg white specific IgE (sIgE) levels in serum or skin prick test has been shown to be a poor predictor of clinical Allergy to raw Egg white, and also to baked or cooked Egg. Recent developments in component resolved diagnostic (CRD) technology have enabled us to improve the way in which we diagnose and predict peanut Allergy by examining IgE specificity to individual peptides. OBJECTIVES We aimed to investigate whether Egg CRD could improve current methods to diagnose various Egg Allergy phenotypes as well as predict the development of tolerance to Egg. METHODS Using the HealthNuts cohort of food challenge-proven Egg allergic and Egg-sensitized and Egg-tolerant, age-matched 12-month infants with longitudinal follow-up at 2 and 4 years (n = 451), we measured serum Egg white, Gal d 1, 2, 3 and 5 sIgE using ImmunoCAP. RESULTS Gal d 1 sensitization increased the risk of persistent Egg Allergy by 2.5-fold. The production of sIgE to all four Egg allergens (Gal d 1, 2, 3 or 5) increased the risk of having persistent raw Egg Allergy fourfold (OR 4.19 (95% CI: 1.25-14.07). We did not find any improvements of using Gal d 1, 2, 3 or 5 to diagnose current Egg Allergy compared to Egg white sIgE. CONCLUSION Sensitization to multiple Egg allergens Gal d 1, 2, 3 or 5 may be a prognostic marker that could be useful for patient management and identifying individuals at risk of developing persistent Egg Allergy.

  • Debates in Allergy Medicine: Oral immunotherapy shortens the duration of milk and Egg Allergy - the con argument
    World Allergy Organization Journal, 2018
    Co-Authors: Wenyin Loh, Mimi L K Tang
    Abstract:

    Oral immunotherapy (OIT) has been shown to be effective for inducing desensitization in children with cow’s milk and Egg Allergy. In contrast, there is limited evidence that OIT can induce tolerance or sustained unresponsiveness in food allergic patients. Sustained unresponsiveness, determined by a food challenge following a period of secondary avoidance, has been suggested to reflect a more enduring state of tolerance and is pertinent when considering the ability of OIT to shorten the duration of food Allergy. While it has been shown that children who tolerate baked forms of Egg and milk are more likely to develop tolerance compared to those who are allergic to baked forms of these foods, there is no convincing evidence that OIT using modified allergen in baked foods can hasten resolution of cow’s milk and Egg Allergy. Instead, it is likely that baked milk and baked Egg tolerant children represent a sub-phenotype of milk and Egg Allergy that is more likely to resolve spontaneously over time.

  • The Natural History and Clinical Predictors Of Egg Allergy In The First 2 Years Of Life: A Prospective, Population-Based, Cohort Study
    Journal of Allergy and Clinical Immunology, 2014
    Co-Authors: Rachel L. Peters, Jennifer J Koplin, Shyamali C Dharmage, Annelouise Ponsonby, Mimi L K Tang, Adrian J Lowe, Lyle C Gurrin, Marnie Robinson, Dean Tey, David E. Hill
    Abstract:

    Background There is a paucity of data examining the natural history of and risk factors for Egg Allergy persistence, the most common IgE-mediated food Allergy in infants. Objective We aimed to assess the natural history of Egg Allergy and identify clinical predictors for persistent Egg Allergy in a population-based cohort. Methods The HealthNuts study is a prospective, population-based cohort study of 5276 infants who underwent skin prick tests to 4 allergens, including Egg. Infants with a detectable wheal were offered hospital-based oral food challenges (OFCs) to Egg, irrespective of skin prick test wheal sizes. Infants with challenge-confirmed raw Egg Allergy were offered baked Egg OFCs at age 1 year and follow-up at age 2 years, with repeat OFCs to raw Egg. Results One hundred forty infants with challenge-confirmed Egg Allergy at age 1 year participated in the follow-up. Egg Allergy resolved in 66 (47%) infants (95% CI, 37% to 56%) by 2 years of age; however, resolution was lower in children with baked Egg Allergy at age 1 year compared with baked Egg tolerance (13% and 56%, respectively; adjusted odds ratio, 5.27; 95% CI, 1.36-20.50; P  = .02). In the subgroup of infants who were tolerant to baked Egg at age 1 year, frequent ingestion of baked Egg (≥5 times per month) compared with infrequent ingestion (0-4 times per month) increased the likelihood of tolerance (adjusted odds ratio, 3.52; 95% CI, 1.38-8.98; P  = .009). Mutation in the filaggrin gene was not associated with the resolution of either Egg Allergy or Egg sensitization at age 2 years. Conclusion Phenotyping of Egg Allergy (baked Egg tolerant vs allergic) should be considered in the management of this Allergy because it has prognostic implications and eases dietary restrictions. Randomized controlled trials for Egg oral immunotherapy should consider stratifying at baseline by the baked Egg subphenotype to account for the differential rate of tolerance development.

  • environmental and demographic risk factors for Egg Allergy in a population based study of infants
    Allergy, 2012
    Co-Authors: Jennifer J Koplin, Shyamali C Dharmage, Annelouise Ponsonby, Mimi L K Tang, Adrian J Lowe, Lyle C Gurrin, Nicholas J Osborne, Pamela E Martin, Marnie Robinson
    Abstract:

    Background Although Egg Allergy is the most common food Allergy in infants and young children, risk factors for Egg Allergy remain largely unknown. This study examined the relationship between environmental and demographic factors and Egg Allergy in a population-based infant cohort. Methods In a study of 5276 infants (HealthNuts), infants underwent skin prick testing (SPT) to Egg white at 12 months of age. Questionnaire data on relevant exposures were obtained. 699/873 (80%) infants eligible for oral food challenge (detectable wheal on SPT) attended for formal assessment of Egg Allergy status; 453 had confirmed Egg Allergy (positive challenge and SPT ≥ 2 mm). Associations between environmental and demographic factors and Egg Allergy were investigated using multivariable logistic regression. Results Children with older siblings and those with a pet dog at home were less likely to develop Egg Allergy by 1 year of age (adjusted OR [aOR], 0.72; 95% CI, 0.62, 0.83 per sibling; and aOR, 0.72; 95% CI, 0.52, 0.99, respectively). Caesarean section delivery, antibiotic use in infancy, childcare attendance and maternal age were not associated with Egg Allergy. History of allergic disease in an immediate family member and having parents born in East Asia were strong risk factors for infantile Egg Allergy (aOR, 1.82; 95% CI, 1.40, 2.36; and aOR, 3.30; 95% CI, 2.45, 4.45, respectively). Conclusions Exposure in the first year of life to siblings and dogs may decrease the risk of subsequent Egg Allergy. Infants with a family history of Allergy and those with parents born in East Asia are at increased risk of Egg Allergy.

  • Environmental and demographic risk factors for Egg Allergy in a population‐based study of infants
    Allergy, 2012
    Co-Authors: Jennifer J Koplin, Shyamali C Dharmage, Annelouise Ponsonby, Mimi L K Tang, Adrian J Lowe, Lyle C Gurrin, Nicholas J Osborne, Pamela E Martin, Marnie Robinson, Melissa Wake
    Abstract:

    Background Although Egg Allergy is the most common food Allergy in infants and young children, risk factors for Egg Allergy remain largely unknown. This study examined the relationship between environmental and demographic factors and Egg Allergy in a population-based infant cohort. Methods In a study of 5276 infants (HealthNuts), infants underwent skin prick testing (SPT) to Egg white at 12 months of age. Questionnaire data on relevant exposures were obtained. 699/873 (80%) infants eligible for oral food challenge (detectable wheal on SPT) attended for formal assessment of Egg Allergy status; 453 had confirmed Egg Allergy (positive challenge and SPT ≥ 2 mm). Associations between environmental and demographic factors and Egg Allergy were investigated using multivariable logistic regression. Results Children with older siblings and those with a pet dog at home were less likely to develop Egg Allergy by 1 year of age (adjusted OR [aOR], 0.72; 95% CI, 0.62, 0.83 per sibling; and aOR, 0.72; 95% CI, 0.52, 0.99, respectively). Caesarean section delivery, antibiotic use in infancy, childcare attendance and maternal age were not associated with Egg Allergy. History of allergic disease in an immediate family member and having parents born in East Asia were strong risk factors for infantile Egg Allergy (aOR, 1.82; 95% CI, 1.40, 2.36; and aOR, 3.30; 95% CI, 2.45, 4.45, respectively). Conclusions Exposure in the first year of life to siblings and dogs may decrease the risk of subsequent Egg Allergy. Infants with a family history of Allergy and those with parents born in East Asia are at increased risk of Egg Allergy.

Marnie Robinson - One of the best experts on this subject based on the ideXlab platform.

  • The Natural History and Clinical Predictors Of Egg Allergy In The First 2 Years Of Life: A Prospective, Population-Based, Cohort Study
    Journal of Allergy and Clinical Immunology, 2014
    Co-Authors: Rachel L. Peters, Jennifer J Koplin, Shyamali C Dharmage, Annelouise Ponsonby, Mimi L K Tang, Adrian J Lowe, Lyle C Gurrin, Marnie Robinson, Dean Tey, David E. Hill
    Abstract:

    Background There is a paucity of data examining the natural history of and risk factors for Egg Allergy persistence, the most common IgE-mediated food Allergy in infants. Objective We aimed to assess the natural history of Egg Allergy and identify clinical predictors for persistent Egg Allergy in a population-based cohort. Methods The HealthNuts study is a prospective, population-based cohort study of 5276 infants who underwent skin prick tests to 4 allergens, including Egg. Infants with a detectable wheal were offered hospital-based oral food challenges (OFCs) to Egg, irrespective of skin prick test wheal sizes. Infants with challenge-confirmed raw Egg Allergy were offered baked Egg OFCs at age 1 year and follow-up at age 2 years, with repeat OFCs to raw Egg. Results One hundred forty infants with challenge-confirmed Egg Allergy at age 1 year participated in the follow-up. Egg Allergy resolved in 66 (47%) infants (95% CI, 37% to 56%) by 2 years of age; however, resolution was lower in children with baked Egg Allergy at age 1 year compared with baked Egg tolerance (13% and 56%, respectively; adjusted odds ratio, 5.27; 95% CI, 1.36-20.50; P  = .02). In the subgroup of infants who were tolerant to baked Egg at age 1 year, frequent ingestion of baked Egg (≥5 times per month) compared with infrequent ingestion (0-4 times per month) increased the likelihood of tolerance (adjusted odds ratio, 3.52; 95% CI, 1.38-8.98; P  = .009). Mutation in the filaggrin gene was not associated with the resolution of either Egg Allergy or Egg sensitization at age 2 years. Conclusion Phenotyping of Egg Allergy (baked Egg tolerant vs allergic) should be considered in the management of this Allergy because it has prognostic implications and eases dietary restrictions. Randomized controlled trials for Egg oral immunotherapy should consider stratifying at baseline by the baked Egg subphenotype to account for the differential rate of tolerance development.

  • environmental and demographic risk factors for Egg Allergy in a population based study of infants
    Allergy, 2012
    Co-Authors: Jennifer J Koplin, Shyamali C Dharmage, Annelouise Ponsonby, Mimi L K Tang, Adrian J Lowe, Lyle C Gurrin, Nicholas J Osborne, Pamela E Martin, Marnie Robinson
    Abstract:

    Background Although Egg Allergy is the most common food Allergy in infants and young children, risk factors for Egg Allergy remain largely unknown. This study examined the relationship between environmental and demographic factors and Egg Allergy in a population-based infant cohort. Methods In a study of 5276 infants (HealthNuts), infants underwent skin prick testing (SPT) to Egg white at 12 months of age. Questionnaire data on relevant exposures were obtained. 699/873 (80%) infants eligible for oral food challenge (detectable wheal on SPT) attended for formal assessment of Egg Allergy status; 453 had confirmed Egg Allergy (positive challenge and SPT ≥ 2 mm). Associations between environmental and demographic factors and Egg Allergy were investigated using multivariable logistic regression. Results Children with older siblings and those with a pet dog at home were less likely to develop Egg Allergy by 1 year of age (adjusted OR [aOR], 0.72; 95% CI, 0.62, 0.83 per sibling; and aOR, 0.72; 95% CI, 0.52, 0.99, respectively). Caesarean section delivery, antibiotic use in infancy, childcare attendance and maternal age were not associated with Egg Allergy. History of allergic disease in an immediate family member and having parents born in East Asia were strong risk factors for infantile Egg Allergy (aOR, 1.82; 95% CI, 1.40, 2.36; and aOR, 3.30; 95% CI, 2.45, 4.45, respectively). Conclusions Exposure in the first year of life to siblings and dogs may decrease the risk of subsequent Egg Allergy. Infants with a family history of Allergy and those with parents born in East Asia are at increased risk of Egg Allergy.

  • Environmental and demographic risk factors for Egg Allergy in a population‐based study of infants
    Allergy, 2012
    Co-Authors: Jennifer J Koplin, Shyamali C Dharmage, Annelouise Ponsonby, Mimi L K Tang, Adrian J Lowe, Lyle C Gurrin, Nicholas J Osborne, Pamela E Martin, Marnie Robinson, Melissa Wake
    Abstract:

    Background Although Egg Allergy is the most common food Allergy in infants and young children, risk factors for Egg Allergy remain largely unknown. This study examined the relationship between environmental and demographic factors and Egg Allergy in a population-based infant cohort. Methods In a study of 5276 infants (HealthNuts), infants underwent skin prick testing (SPT) to Egg white at 12 months of age. Questionnaire data on relevant exposures were obtained. 699/873 (80%) infants eligible for oral food challenge (detectable wheal on SPT) attended for formal assessment of Egg Allergy status; 453 had confirmed Egg Allergy (positive challenge and SPT ≥ 2 mm). Associations between environmental and demographic factors and Egg Allergy were investigated using multivariable logistic regression. Results Children with older siblings and those with a pet dog at home were less likely to develop Egg Allergy by 1 year of age (adjusted OR [aOR], 0.72; 95% CI, 0.62, 0.83 per sibling; and aOR, 0.72; 95% CI, 0.52, 0.99, respectively). Caesarean section delivery, antibiotic use in infancy, childcare attendance and maternal age were not associated with Egg Allergy. History of allergic disease in an immediate family member and having parents born in East Asia were strong risk factors for infantile Egg Allergy (aOR, 1.82; 95% CI, 1.40, 2.36; and aOR, 3.30; 95% CI, 2.45, 4.45, respectively). Conclusions Exposure in the first year of life to siblings and dogs may decrease the risk of subsequent Egg Allergy. Infants with a family history of Allergy and those with parents born in East Asia are at increased risk of Egg Allergy.

  • Can early introduction of Egg prevent Egg Allergy in infants? A population-based study.
    Journal of Allergy and Clinical Immunology, 2010
    Co-Authors: Jennifer J Koplin, Lyle C Gurrin, Nicholas J Osborne, Pamela E Martin, Marnie Robinson, Melissa Wake, Dean Tey, Marjolein Slaa, Leone Thiele, Lucy Miles
    Abstract:

    Background: Infant feeding guidelines have long recommended delaying introduction of solids and allergenic foods to prevent Allergy in high-risk infants, despite a paucity of evidence. Objective: We aimed to determine whether confirmed Egg Allergy in 12-month-old infants is associated with (1) duration of breast-feeding and (2) ages of introducing Egg and solids. Methods: In a population-based cross-sectional study (HealthNuts) parents reported on infant feeding and potential confounding factors before skin prick testing for Egg white. Egg-sensitized infants were then offered an Egg oral food challenge. Multiple logistic regression was used to investigate associations between diet and Egg Allergy adjusted for possible confounding factors. Results: A total of 2589 infants (73% response) participated. Compared with introduction at 4 to 6 months, introducing Egg into the diet later was associated with higher risks of Egg Allergy (adjusted odds ratios [ORs], 1.6 [95% CI, 1.0-2.6] and 3.4 [95% CI, 1.8-6.5] for introduction at 10-12 and after 12 months, respectively). These findings persisted even in children without risk factors (OR, 3.3 [95% CI, 1.1-9.9]; 10-12 months). At age 4 to 6 months, first exposure as cooked Egg reduced the risk of Egg Allergy compared with first exposure as Egg in baked goods (OR, 0.2 [95% CI, 0.06-0.71]). Duration of breast-feeding and age at introduction of solids were not associated with Egg Allergy. Conclusions: Introduction of cooked Egg at 4 to 6 months of age might protect against Egg Allergy. Changes in infant feeding guidelines could have a significant effect on childhood Egg Allergy and possibly food Allergy more generally.

Jennifer J Koplin - One of the best experts on this subject based on the ideXlab platform.

  • Egg allergen specific IgE diversity predicts resolution of Egg Allergy in the population cohort HealthNuts.
    Allergy, 2018
    Co-Authors: Thanh D. Dang, Jennifer J Koplin, Shyamali C Dharmage, Annelouise Ponsonby, Mimi L K Tang, Lyle C Gurrin, Rachel L. Peters, David Martino, Melanie R. Neeland, Katrina J. Allen
    Abstract:

    BACKGROUND IgE-mediated Egg Allergy presents as one of the most common food allergies in children. Measurement of Egg white specific IgE (sIgE) levels in serum or skin prick test has been shown to be a poor predictor of clinical Allergy to raw Egg white, and also to baked or cooked Egg. Recent developments in component resolved diagnostic (CRD) technology have enabled us to improve the way in which we diagnose and predict peanut Allergy by examining IgE specificity to individual peptides. OBJECTIVES We aimed to investigate whether Egg CRD could improve current methods to diagnose various Egg Allergy phenotypes as well as predict the development of tolerance to Egg. METHODS Using the HealthNuts cohort of food challenge-proven Egg allergic and Egg-sensitized and Egg-tolerant, age-matched 12-month infants with longitudinal follow-up at 2 and 4 years (n = 451), we measured serum Egg white, Gal d 1, 2, 3 and 5 sIgE using ImmunoCAP. RESULTS Gal d 1 sensitization increased the risk of persistent Egg Allergy by 2.5-fold. The production of sIgE to all four Egg allergens (Gal d 1, 2, 3 or 5) increased the risk of having persistent raw Egg Allergy fourfold (OR 4.19 (95% CI: 1.25-14.07). We did not find any improvements of using Gal d 1, 2, 3 or 5 to diagnose current Egg Allergy compared to Egg white sIgE. CONCLUSION Sensitization to multiple Egg allergens Gal d 1, 2, 3 or 5 may be a prognostic marker that could be useful for patient management and identifying individuals at risk of developing persistent Egg Allergy.

  • The Natural History and Clinical Predictors Of Egg Allergy In The First 2 Years Of Life: A Prospective, Population-Based, Cohort Study
    Journal of Allergy and Clinical Immunology, 2014
    Co-Authors: Rachel L. Peters, Jennifer J Koplin, Shyamali C Dharmage, Annelouise Ponsonby, Mimi L K Tang, Adrian J Lowe, Lyle C Gurrin, Marnie Robinson, Dean Tey, David E. Hill
    Abstract:

    Background There is a paucity of data examining the natural history of and risk factors for Egg Allergy persistence, the most common IgE-mediated food Allergy in infants. Objective We aimed to assess the natural history of Egg Allergy and identify clinical predictors for persistent Egg Allergy in a population-based cohort. Methods The HealthNuts study is a prospective, population-based cohort study of 5276 infants who underwent skin prick tests to 4 allergens, including Egg. Infants with a detectable wheal were offered hospital-based oral food challenges (OFCs) to Egg, irrespective of skin prick test wheal sizes. Infants with challenge-confirmed raw Egg Allergy were offered baked Egg OFCs at age 1 year and follow-up at age 2 years, with repeat OFCs to raw Egg. Results One hundred forty infants with challenge-confirmed Egg Allergy at age 1 year participated in the follow-up. Egg Allergy resolved in 66 (47%) infants (95% CI, 37% to 56%) by 2 years of age; however, resolution was lower in children with baked Egg Allergy at age 1 year compared with baked Egg tolerance (13% and 56%, respectively; adjusted odds ratio, 5.27; 95% CI, 1.36-20.50; P  = .02). In the subgroup of infants who were tolerant to baked Egg at age 1 year, frequent ingestion of baked Egg (≥5 times per month) compared with infrequent ingestion (0-4 times per month) increased the likelihood of tolerance (adjusted odds ratio, 3.52; 95% CI, 1.38-8.98; P  = .009). Mutation in the filaggrin gene was not associated with the resolution of either Egg Allergy or Egg sensitization at age 2 years. Conclusion Phenotyping of Egg Allergy (baked Egg tolerant vs allergic) should be considered in the management of this Allergy because it has prognostic implications and eases dietary restrictions. Randomized controlled trials for Egg oral immunotherapy should consider stratifying at baseline by the baked Egg subphenotype to account for the differential rate of tolerance development.

  • environmental and demographic risk factors for Egg Allergy in a population based study of infants
    Allergy, 2012
    Co-Authors: Jennifer J Koplin, Shyamali C Dharmage, Annelouise Ponsonby, Mimi L K Tang, Adrian J Lowe, Lyle C Gurrin, Nicholas J Osborne, Pamela E Martin, Marnie Robinson
    Abstract:

    Background Although Egg Allergy is the most common food Allergy in infants and young children, risk factors for Egg Allergy remain largely unknown. This study examined the relationship between environmental and demographic factors and Egg Allergy in a population-based infant cohort. Methods In a study of 5276 infants (HealthNuts), infants underwent skin prick testing (SPT) to Egg white at 12 months of age. Questionnaire data on relevant exposures were obtained. 699/873 (80%) infants eligible for oral food challenge (detectable wheal on SPT) attended for formal assessment of Egg Allergy status; 453 had confirmed Egg Allergy (positive challenge and SPT ≥ 2 mm). Associations between environmental and demographic factors and Egg Allergy were investigated using multivariable logistic regression. Results Children with older siblings and those with a pet dog at home were less likely to develop Egg Allergy by 1 year of age (adjusted OR [aOR], 0.72; 95% CI, 0.62, 0.83 per sibling; and aOR, 0.72; 95% CI, 0.52, 0.99, respectively). Caesarean section delivery, antibiotic use in infancy, childcare attendance and maternal age were not associated with Egg Allergy. History of allergic disease in an immediate family member and having parents born in East Asia were strong risk factors for infantile Egg Allergy (aOR, 1.82; 95% CI, 1.40, 2.36; and aOR, 3.30; 95% CI, 2.45, 4.45, respectively). Conclusions Exposure in the first year of life to siblings and dogs may decrease the risk of subsequent Egg Allergy. Infants with a family history of Allergy and those with parents born in East Asia are at increased risk of Egg Allergy.

  • Environmental and demographic risk factors for Egg Allergy in a population‐based study of infants
    Allergy, 2012
    Co-Authors: Jennifer J Koplin, Shyamali C Dharmage, Annelouise Ponsonby, Mimi L K Tang, Adrian J Lowe, Lyle C Gurrin, Nicholas J Osborne, Pamela E Martin, Marnie Robinson, Melissa Wake
    Abstract:

    Background Although Egg Allergy is the most common food Allergy in infants and young children, risk factors for Egg Allergy remain largely unknown. This study examined the relationship between environmental and demographic factors and Egg Allergy in a population-based infant cohort. Methods In a study of 5276 infants (HealthNuts), infants underwent skin prick testing (SPT) to Egg white at 12 months of age. Questionnaire data on relevant exposures were obtained. 699/873 (80%) infants eligible for oral food challenge (detectable wheal on SPT) attended for formal assessment of Egg Allergy status; 453 had confirmed Egg Allergy (positive challenge and SPT ≥ 2 mm). Associations between environmental and demographic factors and Egg Allergy were investigated using multivariable logistic regression. Results Children with older siblings and those with a pet dog at home were less likely to develop Egg Allergy by 1 year of age (adjusted OR [aOR], 0.72; 95% CI, 0.62, 0.83 per sibling; and aOR, 0.72; 95% CI, 0.52, 0.99, respectively). Caesarean section delivery, antibiotic use in infancy, childcare attendance and maternal age were not associated with Egg Allergy. History of allergic disease in an immediate family member and having parents born in East Asia were strong risk factors for infantile Egg Allergy (aOR, 1.82; 95% CI, 1.40, 2.36; and aOR, 3.30; 95% CI, 2.45, 4.45, respectively). Conclusions Exposure in the first year of life to siblings and dogs may decrease the risk of subsequent Egg Allergy. Infants with a family history of Allergy and those with parents born in East Asia are at increased risk of Egg Allergy.

  • Can early introduction of Egg prevent Egg Allergy in infants? A population-based study.
    Journal of Allergy and Clinical Immunology, 2010
    Co-Authors: Jennifer J Koplin, Lyle C Gurrin, Nicholas J Osborne, Pamela E Martin, Marnie Robinson, Melissa Wake, Dean Tey, Marjolein Slaa, Leone Thiele, Lucy Miles
    Abstract:

    Background: Infant feeding guidelines have long recommended delaying introduction of solids and allergenic foods to prevent Allergy in high-risk infants, despite a paucity of evidence. Objective: We aimed to determine whether confirmed Egg Allergy in 12-month-old infants is associated with (1) duration of breast-feeding and (2) ages of introducing Egg and solids. Methods: In a population-based cross-sectional study (HealthNuts) parents reported on infant feeding and potential confounding factors before skin prick testing for Egg white. Egg-sensitized infants were then offered an Egg oral food challenge. Multiple logistic regression was used to investigate associations between diet and Egg Allergy adjusted for possible confounding factors. Results: A total of 2589 infants (73% response) participated. Compared with introduction at 4 to 6 months, introducing Egg into the diet later was associated with higher risks of Egg Allergy (adjusted odds ratios [ORs], 1.6 [95% CI, 1.0-2.6] and 3.4 [95% CI, 1.8-6.5] for introduction at 10-12 and after 12 months, respectively). These findings persisted even in children without risk factors (OR, 3.3 [95% CI, 1.1-9.9]; 10-12 months). At age 4 to 6 months, first exposure as cooked Egg reduced the risk of Egg Allergy compared with first exposure as Egg in baked goods (OR, 0.2 [95% CI, 0.06-0.71]). Duration of breast-feeding and age at introduction of solids were not associated with Egg Allergy. Conclusions: Introduction of cooked Egg at 4 to 6 months of age might protect against Egg Allergy. Changes in infant feeding guidelines could have a significant effect on childhood Egg Allergy and possibly food Allergy more generally.

Stacie M. Jones - One of the best experts on this subject based on the ideXlab platform.

  • Early-life gut microbiome and Egg Allergy.
    Allergy, 2018
    Co-Authors: Mina Fazlollahi, Robert A. Wood, Yoojin Chun, Alexander Grishin, A.w. Burks, Peter Dawson, Stacie M. Jones, Donald Y.m. Leung, Hugh A. Sampson, Scott H. Sicherer
    Abstract:

    Background Gut microbiota may play a role in Egg Allergy. We sought to examine the association between early-life gut microbiota and Egg Allergy. Methods We studied 141 children with Egg Allergy and controls from the multicenter Consortium of Food Allergy Research study. At enrollment (age 3 to 16 months), fecal samples were collected, and clinical evaluation, Egg-specific IgE measurement, and Egg skin prick test were performed. Gut microbiome was profiled by 16S rRNA sequencing. Analyses for the primary outcome of Egg Allergy at enrollment, and the secondary outcomes of Egg sensitization at enrollment and resolution of Egg Allergy by age 8 years, were performed using Quantitative Insights into Microbial Ecology, Phylogenetic Investigation of Communities by Reconstruction of Unobserved States, and Statistical Analysis of Metagenomic Profiles. Results Compared to controls, increased alpha diversity and distinct taxa (PERMANOVA P = 5.0 × 10-4 ) characterized the early-life gut microbiome of children with Egg Allergy. Genera from the Lachnospiraceae, Streptococcaceae, and Leuconostocaceae families were differentially abundant in children with Egg Allergy. Predicted metagenome functional analyses showed differential purine metabolism by the gut microbiota of Egg-allergic subjects (Kruskal-Wallis Padj = 0.021). Greater gut microbiome diversity and genera from Lachnospiraceae and Ruminococcaceae were associated with Egg sensitization (PERMANOVA P = 5.0 × 10-4 ). Among those with Egg Allergy, there was no association between early-life gut microbiota and Egg Allergy resolution by age 8 years. Conclusion The distinct early-life gut microbiota in Egg-allergic and Egg-sensitized children identified by our study may point to targets for preventive or therapeutic intervention.

  • Transcriptional Profiling of Egg Allergy and Relationship to Disease Phenotype.
    PLOS ONE, 2016
    Co-Authors: Roman Kosoy, Robert A. Wood, Alexander Grishin, Stacie M. Jones, Donald Y.m. Leung, Scott H. Sicherer, A. Wesley Burks, Charuta Agashe, Wendy F. Davidson, Robert Lindblad
    Abstract:

    Background Egg Allergy is one of the most common food allergies of childhood. There is a lack of information on the immunologic basis of Egg Allergy beyond the role of IgE. Objective To use transcriptional profiling as a novel approach to uncover immunologic processes associated with different phenotypes of Egg Allergy. Methods Peripheral blood mononuclear cells (PBMCs) were obtained from Egg-allergic children who were defined as reactive (BER) or tolerant (BET) to baked Egg, and from food allergic controls (AC) who were Egg non-allergic. PBMCs were stimulated with Egg white protein. Gene transcription was measured by microarray after 24 h, and cytokine secretion by multiplex assay after 5 days. Results The transcriptional response of PBMCs to Egg protein differed between BER and BET versus AC subjects. Compared to the AC group, the BER group displayed increased expression of genes associated with allergic inflammation as well as corresponding increased secretion of IL-5, IL-9 and TNF-α. A similar pattern was observed for the BET group. Further similarities in gene expression patterns between BER and BET groups, as well as some important differences, were revealed using a novel Immune Annotation resource developed for this project. This approach identified several novel processes not previously associated with Egg Allergy, including positive associations with TLR4-stimulated myeloid cells and activated NK cells, and negative associations with an induced Treg signature. Further pathway analysis of differentially expressed genes comparing BER to BET subjects showed significant enrichment of IFN-α and IFN-γ response genes, as well as genes associated with virally-infected DCs. Conclusions Transcriptional profiling identified several novel pathways and processes that differed when comparing the response to Egg allergen in BET, BER, and AC groups. We conclude that this approach is a useful hypothesis-generating mechanism to identify novel immune processes associated with Allergy and tolerance to forms of Egg.

  • The natural history of Egg Allergy in an observational cohort.
    Journal of Allergy and Clinical Immunology, 2014
    Co-Authors: Robert A. Wood, Stacie M. Jones, Scott H. Sicherer, Brian P. Vickery, Andrew H. Liu, David Fleischer, Alice K. Henning, Lloyd Mayer, A. Wesley Burks, Alexander Grishin
    Abstract:

    Background There are few studies on the natural history of Egg Allergy, and most are single-site and nonlongitudinal and have not identified early predictors of outcomes. Objective We sought to describe the natural course of Egg Allergy and to identify early prognostic markers. Methods Children age 3 to 15 months were enrolled in a multicenter observational study with either (1) a convincing history of an immediate allergic reaction to Egg, milk, or both with a positive skin prick test (SPT) response to the trigger food and/or (2) moderate-to-severe atopic dermatitis and a positive SPT response to Egg or milk. Children enrolled with a clinical history of Egg Allergy were followed longitudinally, and resolution was established based on successful ingestion. Results The cohort with Egg Allergy consists of 213 children followed to a median age of 74 months. Egg Allergy resolved in 105 (49.3%) children at a median age of 72 months. Factors that were most predictive of resolution included the following: initial reaction characteristics (isolated urticaria/angioedema vs other presentations), baseline Egg-specific IgE level, Egg SPT wheal size, atopic dermatitis severity, IgG 4 level, and IL-4 response (all  P Conclusions In this cohort of infants with Egg Allergy, approximately one half had resolved over 74 months of follow-up. Baseline Egg-specific IgE levels and initial reaction characteristics were important predictors of the likelihood of resolution.

  • Oral immunotherapy for treatment of Egg Allergy in children.
    New England Journal of Medicine, 2012
    Co-Authors: A. Wesley Burks, Robert A. Wood, Stacie M. Jones, Scott H. Sicherer, Brian P. Vickery, David Fleischer, Alice K. Henning, Robert Lindblad, Donald Stablein, Andrew H. Liu
    Abstract:

    BACKGROUND For Egg Allergy, dietary avoidance is the only currently approved treatment. We evaluated oral immunotherapy using Egg-white powder for the treatment of children with Egg Allergy. METHODS In this double-blind, randomized, placebo-controlled study, 55 children, 5 to 11 years of age, with Egg Allergy received oral immunotherapy (40 children) or placebo (15). Initial dose-escalation, build-up, and maintenance phases were followed by an oral food challenge with Egg-white powder at 10 months and at 22 months. Children who successfully passed the challenge at 22 months discontinued oral immunotherapy and avoided all Egg consumption for 4 to 6 weeks. At 24 months, these children underwent an oral food challenge with Egg-white powder and a cooked Egg to test for sustained unresponsiveness. Children who passed this challenge at 24 months were placed on a diet with ad libitum Egg consumption and were evaluated for continuation of sustained unresponsiveness at 30 months and 36 months. RESULTS After 10 months of therapy, none of the children who received placebo and 55% of those who received oral immunotherapy passed the oral food challenge and were considered to be desensitized; after 22 months, 75% of children in the oral-immunotherapy group were desensitized. In the oral-immunotherapy group, 28% (11 of 40 children) passed the oral food challenge at 24 months and were considered to have sustained unresponsiveness. At 30 months and 36 months, all children who had passed the oral food challenge at 24 months were consuming Egg. Of the immune markers measured, small wheal diameters on skin-prick testing and increases in Eggspecific IgG4 antibody levels were associated with passing the oral food challenge at 24 months. CONCLUSIONS These results show that oral immunotherapy can desensitize a high proportion of children with Egg Allergy and induce sustained unresponsiveness in a clinically significant subset. (Funded by the National Institutes of Health; ClinicalTrials.gov number, NCT00461097.)

  • The Natural History of Egg Allergy
    Pediatrics, 2008
    Co-Authors: Matthew C. Bell, Stacie M. Jones
    Abstract:

    Savage JH, Matsui EC, Skripak JM, Wood RA. J Allergy Clin Immunol . 2007;120(6):1413–1417 PURPOSE OF THE STUDY. To estimate the proportion of children with Egg Allergy who develop Egg tolerance and to identify predictors of tolerance development. STUDY POPULATION. Subjects were 881 Egg-allergic children identified by chart review from an academic Allergy practice. Egg Allergy was defined as a clear history of immunoglobulin E (IgE)–mediated allergic reaction to Egg ingestion or an Egg-specific IgE level of >2 kU/L without known tolerance. METHODS. Information was collected and included demographics, symptoms at Egg-Allergy diagnosis, presence of other atopic diseases and food allergies, dietary history, age/symptoms with Egg exposure, Egg skin-prick tests, Egg-specific IgE, oral food challenge results, and outcome of Egg and other food allergies. Three definitions were used to define oral tolerance to Egg in all 881 subjects: definition 1 included those children who passed a formal oral food challenge or had successful home introduction of Egg; definition 2 included children who met definition 1 and had an Egg-specific IgE level of RESULTS. Of the 881 subjects, the median age at the initial visit was 14 months, and median follow-up was 4.9 years with 68% male subjects. Most (93%) had at least 1 other food Allergy, 54% had asthma, 55% had allergic rhinitis, and 81% had eczema. Of 881 subjects, 375 (43%) had a documented history of allergic reaction to Egg and evidence of Egg sensitization. The other 506 subjects were included on the basis of an Egg-specific IgE level of >2 kU/L. When defined by the most conservative definition (definition 1), 4% outgrew their Egg Allergy by 4 years of age, 26% by 8 years of age, 48% by 12 years of age, and 68% by 16 years of age. Using definition 2, 11% were tolerant at 4 years of age, 41% by 8 years of age, 65% by 12 years of age, and 82% by 16 years of age. Using definition 3, 19% developed tolerance by 4 years of age, 55% by 8 years of age, 76% by 12 years of age, and 91% by 16 years of age. When the relationship of peak Egg IgE levels and the development of tolerance was examined, children with a peak IgE level of 50 kU/L were the slowest and generally did not develop tolerance. The median time to tolerance was higher in children with other atopic disease (eg, 13.5 years for asthmatic children versus 8.5 years for nonasthmatic children [ P P P = .055]). CONCLUSIONS. This study supports the general idea that most children with Egg Allergy will eventually outgrow their Allergy, but at an older age than previously implicated. Egg-specific IgE levels are predictive of tolerance development, and the presence of other atopic disease delays the process. REVIEWER COMMENTS. This study provides the largest comprehensive natural-history evaluation of children with Egg Allergy. The work done by this group serves to highlight the importance of specific IgE measurements in children with Egg Allergy and is very useful for our overall understanding of the delayed development of tolerance. This information is very helpful for anticipatory guidance and disease management of children with Egg Allergy.