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Article ; Online: Comprehensive Diagnosis, Management, and Treatment of Sesame Allergy.

Oriel, Roxanne C / Elizur, Arnon / Sicherer, Scott H

The journal of allergy and clinical immunology. In practice

2023 Volume 12, Issue 3, Page(s) 590–597

Abstract: Sesame allergy prevalence varies regionally and by age, in the range of 0.1% to 0.9%. Reactions can be severe and potentially fatal. Resolution rates are in the range of 20% to 50%. The diagnosis requires a careful history and the use of tests, such as ... ...

Abstract	Sesame allergy prevalence varies regionally and by age, in the range of 0.1% to 0.9%. Reactions can be severe and potentially fatal. Resolution rates are in the range of 20% to 50%. The diagnosis requires a careful history and the use of tests, such as skin prick tests and serum sesame-specific IgE. The availability of serum IgE testing for the sesame protein Ses i 1 has improved diagnostic accuracy. The emerging potential for sesame basophil activation tests and additional new tests will likely improve diagnosis in coming years, further reducing the need for diagnostic oral food challenges. Although sesame proteins share homology with those in many foods, clinically relevant cross-reactivity appears uncommon. Nevertheless, sesame is a prominent allergen for those with multiple food allergies. Management may include strict avoidance, but sesame products vary dramatically in protein content. Many people with sesame allergy tolerate forms that are low in protein, such as scattered seeds, rather than sesame paste that is protein-dense. Thus, options in the approach to avoidance are possible. Studies suggest that sesame oral immunotherapy may be safe and effective, and this and additional treatment options are emerging. Here, we review the current comprehensive diagnosis, management, and treatment for sesame allergy.
MeSH term(s)	Humans ; Sesamum ; Food Hypersensitivity/diagnosis ; Food Hypersensitivity/therapy ; Food Hypersensitivity/epidemiology ; Allergens/therapeutic use ; Seeds ; Immunoglobulin E
Chemical Substances	Allergens ; Immunoglobulin E (37341-29-0)
Language	English
Publishing date	2023-11-11
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	2843237-X
ISSN	2213-2201 ; 2213-2198
ISSN (online)	2213-2201
ISSN	2213-2198
DOI	10.1016/j.jaip.2023.11.008
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Article ; Online: Eosinophil-Associated Gastrointestinal Manifestations During OIT.

Goldberg, Michael R / Epstein-Rigbi, Naama / Elizur, Arnon

Clinical reviews in allergy & immunology

2023 Volume 65, Issue 3, Page(s) 365–376

Abstract: Gastrointestinal adverse events are common during oral immunotherapy (OIT) for food allergy and range from immediate IgE-mediated reactions to non-anaphylactic clinical presentations. This review aims to summarize recent findings on non-anaphylactic ... ...

Abstract	Gastrointestinal adverse events are common during oral immunotherapy (OIT) for food allergy and range from immediate IgE-mediated reactions to non-anaphylactic clinical presentations. This review aims to summarize recent findings on non-anaphylactic eosinophil-associated gastrointestinal adverse events during OIT. Two clinical presentations of non-anaphylactic eosinophil-associated gastrointestinal adverse events during OIT are identified, each with a different paradigm for treatment, and distinguished by their time of onset. In the first clinical entity, characterized by its onset early in the course of treatment, patients present with abdominal pain, nausea, and/or vomiting. The symptoms become evident typically within weeks to months of starting OIT. These symptoms, however, are not temporally related to the time of dose administration, as in the case of immediate IgE-mediated anaphylactic reactions. While esophageal biopsies, when performed, can demonstrate eosinophilic esophagitis (EoE), baseline esophageal eosinophilia has also been observed in food allergic patients prior to OIT. A potential non-invasive biomarker, the peripheral absolute eosinophil count (AEC), often rises during these reactions and subsides after dose reduction and subsequent resolution of symptoms. OIT can usually then be resumed, albeit at a slower pace, without a recurrence of symptoms. Risk factors for development of symptoms early during OIT include a high starting dose and a baseline AEC of greater than 600. The second, and much less frequently encountered, non-anaphylactic gastrointestinal adverse event related to OIT, presents months to years after initiating OIT. In this latter group, patients present with the classical clinical symptoms and endoscopic findings of EoE. In contrast to the acute onset group, peripheral eosinophilia is usually not observed in these cases. This OIT-associated EoE has shown good response to standard EoE treatment approaches of proton pump inhibitors or swallowed steroids. Most patients with eosinophil-associated adverse reactions are able to continue OIT and remain desensitized. Treatment approaches depend on the specific subtype of these reactions and relate to the stages of OIT treatment.
MeSH term(s)	Humans ; Eosinophils/pathology ; Eosinophilic Esophagitis/drug therapy ; Immunotherapy/adverse effects ; Immunoglobulin E ; Desensitization, Immunologic/adverse effects ; Enteritis ; Eosinophilia ; Gastritis
Chemical Substances	Immunoglobulin E (37341-29-0)
Language	English
Publishing date	2023-11-14
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1239045-8
ISSN	1559-0267 ; 1080-0549
ISSN (online)	1559-0267
ISSN	1080-0549
DOI	10.1007/s12016-023-08974-0
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Article: Consumption of cow's milk formula in the nursery and the development of milk allergy.

Elizur, Arnon / Rachel-Jossefi, Shirel / Rachmiel, Marianna / Eisenberg, Eli / Katz, Yitzhak

Clinical and translational allergy

2024 Volume 14, Issue 4, Page(s) e12352

Abstract: Background: The effect of the amount of transient cow's milk formula (CMF) consumed during the first days of life on IgE-cow's milk allergy (IgE-CMA) is unknown.: Methods: A cohort of 58 patients with IgE-CMA was identified from a large scale ... ...

Abstract	Background: The effect of the amount of transient cow's milk formula (CMF) consumed during the first days of life on IgE-cow's milk allergy (IgE-CMA) is unknown. Methods: A cohort of 58 patients with IgE-CMA was identified from a large scale population-based study of 13,019 infants followed from birth. A group of 116 infants matched for sex and breastfeeding only duration (beyond the nursery period), and another random group of 259 healthy infants were used as controls. Parents were interviewed and the infants' medical records were searched to assess CMF consumption in the nursery. Results: While 96% of the mothers of the 174 infants (58 with Cow's milk allergy and 116 controls) reported on exclusive breastfeeding during the stay in the nursery, CMF consumption was documented in 96 (55%) of the infants. Of those, most (57; 59%) received one to three feedings, 20 (21%) received four to nine feedings, and 19 (20%) received ≥10 feedings. Fewer formula feeds (1-3) were significantly more common in the allergic group than ≥4 feeds (p = 0.0003) and no feeds at all (p = 0.02) compared to controls (n = 116). Of those exclusively breastfed in the nursery, 13/23 allergic infants (57%) introduced CMF at age 105-194 days (the period with highest-risk for IgE-CMA) compared to 33/98 (34%) from the random control group (n = 259) (p = 0.04). Conclusions: Most infants end up receiving few CMF feeds in the nursery. Transient CMF in the nursery is associated with increased risk of IgE-CMA.
Language	English
Publishing date	2024-04-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2630865-4
ISSN	2045-7022
ISSN	2045-7022
DOI	10.1002/clt2.12352
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Article ; Online: Reply to "Intense allergic reactions to personalized oral immunotherapy treatments for food allergies at home".

Nachshon, Liat / Schwartz, Naama / Levy, Michael B / Goldberg, Michael / Epstein-Rigbi, Naama / Katz, Yitzhak / Elizur, Arnon

The journal of allergy and clinical immunology. In practice

2024 Volume 12, Issue 3, Page(s) 797–798

MeSH term(s)	Humans ; Food Hypersensitivity/therapy ; Administration, Oral ; Immunotherapy/adverse effects
Language	English
Publishing date	2024-02-24
Publishing country	United States
Document type	Letter
ZDB-ID	2843237-X
ISSN	2213-2201 ; 2213-2198
ISSN (online)	2213-2201
ISSN	2213-2198
DOI	10.1016/j.jaip.2023.11.014
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Article ; Online: Pro: Skin prick testing with fresh foods.

Elizur, Arnon / Goldberg, Michael R

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology

2020 Volume 124, Issue 5, Page(s) 441–442

MeSH term(s)	Allergens/immunology ; Antigens, Plant/immunology ; Cross Reactions ; Food Hypersensitivity/diagnosis ; Fruit/immunology ; Humans ; Immunoglobulin E/metabolism ; Nuts/immunology ; Predictive Value of Tests ; Reference Standards ; Reproducibility of Results ; Skin Tests/methods
Chemical Substances	Allergens ; Antigens, Plant ; Immunoglobulin E (37341-29-0)
Language	English
Publishing date	2020-03-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	1228189-x
ISSN	1534-4436 ; 0003-4738 ; 1081-1206
ISSN (online)	1534-4436
ISSN	0003-4738 ; 1081-1206
DOI	10.1016/j.anai.2019.11.032
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Article ; Online: A machine learning approach for stratifying risk for food allergies utilizing electronic medical record data.

Landau, Tamar / Gamrasni, Keren / Barlev, Yotam / Elizur, Arnon / Benor, Shira / Mimouni, Francis / Brandwein, Michael

Allergy

2023 Volume 79, Issue 2, Page(s) 499–502

MeSH term(s)	Humans ; Electronic Health Records ; Food Hypersensitivity/diagnosis ; Food Hypersensitivity/epidemiology ; Machine Learning
Language	English
Publishing date	2023-08-09
Publishing country	Denmark
Document type	Letter
ZDB-ID	391933-x
ISSN	1398-9995 ; 0105-4538
ISSN (online)	1398-9995
ISSN	0105-4538
DOI	10.1111/all.15839
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Article ; Online: Safe administration of the Pfizer-BioNtTech COVID-19 vaccine following an immediate reaction to the first dose.

Kessel, Aharon / Bamberger, Ellen / Nachshon, Liat / Rosman, Yossi / Confino-Cohen, Ronit / Elizur, Arnon

Allergy

2021 Volume 76, Issue 11, Page(s) 3538–3540

MeSH term(s)	COVID-19 ; COVID-19 Vaccines ; Humans ; SARS-CoV-2
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2021-08-16
Publishing country	Denmark
Document type	Letter
ZDB-ID	391933-x
ISSN	1398-9995 ; 0105-4538
ISSN (online)	1398-9995
ISSN	0105-4538
DOI	10.1111/all.15038
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Article ; Online: Primary spontaneous pneumothorax in children: A single institutional experience.

Klin, Baruch / Elizur, Arnon / Bibi, Haim / Abu-Kishk, Ibrahim

Asian journal of surgery

2021 Volume 44, Issue 7, Page(s) 969–973

Abstract: Background: The treatment of primary spontaneous pneumothorax (PSP) remains controversial. We aimed to examine the role of chest computed tomography (CT), the advantages of pigtail catheter versus chest tube regarding duration of drainage or ... ...

Abstract	Background: The treatment of primary spontaneous pneumothorax (PSP) remains controversial. We aimed to examine the role of chest computed tomography (CT), the advantages of pigtail catheter versus chest tube regarding duration of drainage or hospitalization period, and the impact of small PSP and surgical treatment on recurrence rate. Methods: We retrospectively reviewed the medical records of 109 children with PSP (20 years' period). Patients with recurrent and those with non-recurrent PSP were compared. Results: We recorded 183 episodes of PSP (45% recurrences), 89 patients (97%) were male, and the median age at presentation was 16 years. There were no significant differences between recurrence and non-recurrence PSP regarding age, gender, medical background, presentation symptoms, type of chest drain, median hospitalization length and median follow-up period. Recurrences were less frequent among patients who presented with small PSP and were treated conservatively (P = 0.029). PSP was almost always unilateral and the recurrence was observed ipsilateral in almost 80% of the cases. CT was more frequently used and blebs/bullae were more frequently found among patients with recurrent PSP. Pigtail use had no advantage in reducing hospitalization period and surgical procedures prevented recurrences. Conclusion: The size of pneumothorax at presentation helps to predict recurrences. There are no differences regarding duration of drainage or hospitalization period in the use of pigtail compared to chest tube. CT helps evaluate findings in the lungs in recurrent cases of PSP and surgery prevents recurrences effectively.
MeSH term(s)	Chest Tubes ; Child ; Drainage ; Humans ; Male ; Pneumothorax/diagnostic imaging ; Pneumothorax/etiology ; Pneumothorax/surgery ; Recurrence ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; Treatment Outcome
Language	English
Publishing date	2021-02-10
Publishing country	China
Document type	Journal Article
ZDB-ID	1068461-x
ISSN	0219-3108 ; 1015-9584
ISSN (online)	0219-3108
ISSN	1015-9584
DOI	10.1016/j.asjsur.2021.01.028
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Article ; Online: Informing Risk Management for Patients With Cow's Milk Allergy Based on Threshold Dose Distributions Using Low-Dose Food Challenges.

Katz, Yitzhak / Melchior, Michal / Elizur, Arnon / Nachshon, Liat / Remington, Benjamin Carl / Leshno, Moshe

The journal of allergy and clinical immunology. In practice

2022 Volume 11, Issue 4, Page(s) 1116–1122

Abstract: Background: The safe consumption of foods depends on their allergen content in relation to patients' lowest observed adverse effect level (LOAEL) and no observed adverse effect level (NOAEL), as well as other factors. In the case of milk, data on LOAEL ... ...

Abstract	Background: The safe consumption of foods depends on their allergen content in relation to patients' lowest observed adverse effect level (LOAEL) and no observed adverse effect level (NOAEL), as well as other factors. In the case of milk, data on LOAEL and NOAEL are limited and conflicting. Objective: To determine the threshold dose distribution and the lowest individual eliciting dose (ED) for milk in a large group of milk-allergic patients METHODS: Individuals with confirmed cow's milk allergy who underwent a diagnostic or pre-oral immunotherapy open milk oral food challenge at the Institute of Allergy, Immunology, and Pediatric Pulmonology at Shamir Medical Center between 2010 and 2015 were included. A subgroup of patients with severe milk allergy underwent a modified challenge with a 90- to 120-minute interval after a starting dose of 0.3 mg cow's milk protein. Results: A total of 866 participants (193 with diagnostic challenges and 673 with pre-oral immunotherapy challenges) were included in the study. The discrete ED Conclusion: This report provides valuable information about milk NOAELs, LOAELs, and EDs that might assist regulators in decisions about food labeling in general, and milk in particular.
MeSH term(s)	Female ; Animals ; Cattle ; Humans ; Milk Hypersensitivity/diagnosis ; Milk ; Milk Proteins ; Allergens ; Risk Management
Chemical Substances	Milk Proteins ; Allergens
Language	English
Publishing date	2022-11-12
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2843237-X
ISSN	2213-2201 ; 2213-2198
ISSN (online)	2213-2201
ISSN	2213-2198
DOI	10.1016/j.jaip.2022.10.044
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Article ; Online: Recipient-independent, high-accuracy FMT-response prediction and optimization in mice and humans.

Shtossel, Oshrit / Turjeman, Sondra / Riumin, Alona / Goldberg, Michael R / Elizur, Arnon / Bekor, Yarin / Mor, Hadar / Koren, Omry / Louzoun, Yoram

Microbiome

2023 Volume 11, Issue 1, Page(s) 181

Abstract: Background: Some microbiota compositions are associated with negative outcomes, including among others, obesity, allergies, and the failure to respond to treatment. Microbiota manipulation or supplementation can restore a community associated with a ... ...

Abstract	Background: Some microbiota compositions are associated with negative outcomes, including among others, obesity, allergies, and the failure to respond to treatment. Microbiota manipulation or supplementation can restore a community associated with a healthy condition. Such interventions are typically probiotics or fecal microbiota transplantation (FMT). FMT donor selection is currently based on donor phenotype, rather than the anticipated microbiota composition in the recipient and associated health benefits. However, the donor and post-transplant recipient conditions differ drastically. We here propose an algorithm to identify ideal donors and predict the expected outcome of FMT based on donor microbiome alone. We also demonstrate how to optimize FMT for different required outcomes. Results: We show, using multiple microbiome properties, that donor and post-transplant recipient microbiota differ widely and propose a tool to predict the recipient post-transplant condition (engraftment success and clinical outcome), using only the donors' microbiome and, when available, demographics for transplantations from humans to either mice or other humans (with or without antibiotic pre-treatment). We validated the predictor using a de novo FMT experiment highlighting the possibility of choosing transplants that optimize an array of required goals. We then extend the method to characterize a best-planned transplant (bacterial cocktail) by combining the predictor and a generative genetic algorithm (GA). We further show that a limited number of taxa is enough for an FMT to produce a desired microbiome or phenotype. Conclusions: Off-the-shelf FMT requires recipient-independent optimized FMT selection. Such a transplant can be from an optimal donor or from a cultured set of microbes. We have here shown the feasibility of both types of manipulations in mouse and human recipients. Video Abstract.
MeSH term(s)	Humans ; Animals ; Mice ; Fecal Microbiota Transplantation ; Feces/microbiology ; Gastrointestinal Microbiome ; Treatment Outcome ; Microbiota
Language	English
Publishing date	2023-08-14
Publishing country	England
Document type	Video-Audio Media ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2697425-3
ISSN	2049-2618 ; 2049-2618
ISSN (online)	2049-2618
ISSN	2049-2618
DOI	10.1186/s40168-023-01623-w
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