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  1. Article ; Online: Real-world data are critical for the implementation of preschool food allergen immunotherapy.

    Chua, Gilbert T / Greenhawt, Matthew / Shaker, Marcus / Soller, Lianne / Abrams, Elissa M / Cameron, Scott B / Cook, Victoria E / Erdle, Stephanie C / Fleischer, David M / Mak, Raymond / Vander Leek, Timothy K / Chan, Edmond S

    The journal of allergy and clinical immunology. In practice

    2023  Volume 11, Issue 8, Page(s) 2624–2625

    MeSH term(s) Child, Preschool ; Humans ; Allergens/therapeutic use ; Food Hypersensitivity/therapy ; Desensitization, Immunologic ; Immunotherapy
    Chemical Substances Allergens
    Language English
    Publishing date 2023-04-21
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2843237-X
    ISSN 2213-2201 ; 2213-2198
    ISSN (online) 2213-2201
    ISSN 2213-2198
    DOI 10.1016/j.jaip.2023.05.037
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  2. Article ; Online: Reply to "Peanut allergy prevention: A mother's perspective".

    Chua, Gilbert T / Greenhawt, Matthew / Shaker, Marcus / Soller, Lianne / Abrams, Elissa M / Cameron, Scott B / Cook, Victoria E / Erdle, Stephanie C / Fleischer, David M / Mak, Raymond / Vander Leek, Timothy K / Chan, Edmond S

    The journal of allergy and clinical immunology. In practice

    2023  Volume 11, Issue 5, Page(s) 1574–1575

    MeSH term(s) Female ; Humans ; Mothers ; Peanut Hypersensitivity
    Language English
    Publishing date 2023-05-06
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2843237-X
    ISSN 2213-2201 ; 2213-2198
    ISSN (online) 2213-2201
    ISSN 2213-2198
    DOI 10.1016/j.jaip.2023.02.012
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  3. Article ; Online: The COVID-19 Pandemic in 2021: Avoiding Overdiagnosis of Anaphylaxis Risk While Safely Vaccinating the World.

    Greenhawt, Matthew / Abrams, Elissa M / Oppenheimer, John / Vander Leek, Timothy K / Mack, Douglas P / Singer, Alexander G / Shaker, Marcus

    The journal of allergy and clinical immunology. In practice

    2021  Volume 9, Issue 4, Page(s) 1438–1441

    MeSH term(s) Anaphylaxis/diagnosis ; Anaphylaxis/epidemiology ; Anaphylaxis/prevention & control ; COVID-19 ; Humans ; Medical Overuse ; Pandemics ; RNA, Messenger ; SARS-CoV-2 ; Vaccines
    Chemical Substances RNA, Messenger ; Vaccines
    Language English
    Publishing date 2021-01-30
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2843237-X
    ISSN 2213-2201 ; 2213-2198
    ISSN (online) 2213-2201
    ISSN 2213-2198
    DOI 10.1016/j.jaip.2021.01.022
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  4. Article: Safety and effectiveness of the Canadian food ladders for children with IgE-mediated food allergies to cow's milk and/or egg.

    Chomyn, Alanna / Chan, Edmond S / Yeung, Joanne / Cameron, Scott / Chua, Gilbert T / Vander Leek, Timothy K / Williams, Brock A / Soller, Lianne / Abrams, Elissa M / Mak, Raymond / Wong, Tiffany

    Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology

    2023  Volume 19, Issue 1, Page(s) 94

    Abstract: Background: Food ladders are tools designed to facilitate home-based dietary advancement in children with food allergies through stepwise exposures to increasingly allergenic forms of milk and egg. Several studies have now documented safety and efficacy ...

    Abstract Background: Food ladders are tools designed to facilitate home-based dietary advancement in children with food allergies through stepwise exposures to increasingly allergenic forms of milk and egg. Several studies have now documented safety and efficacy of food ladders. In 2021, we published a Canadian adaptation of the previously existing milk and egg ladders originating in Europe using foods more readily available/consumed in Canada. Our study adds to the growing body of evidence supporting food ladder use and provides safety and effectiveness data for our Canadian adaptation of the milk and egg ladders.
    Methods: Surveys were distributed to families of children using the Canadian Milk Ladder and/or the Canadian Egg Ladder at baseline, with follow up surveys at 3 months, 6 months, and 12 months. Data were analyzed using REDCap and descriptive and inferential statistics are presented.
    Results: One hundred and nine participants were started on milk/egg ladders between September 2020 and June 2022. 53 participants responded to follow up surveys. Only 2 of 53 (3.8%) participants reported receiving epinephrine during the study. Severe grade 4 reactions (defined according to the modified World Allergy Organization grading system) were not reported by any participants. Minor cutaneous adverse reactions were common, with about 71% (n = 10/14) of respondents reporting cutaneous adverse reactions by 1 year of food ladder use. An increasing proportion of participants could tolerate most foods from steps 2-4 foods after 3, 6, and 12 months of the food ladder compared to baseline.
    Conclusion: The Canadian food ladders are safe tools for children with cow's milk and/or egg allergies, and participants tolerated a larger range of foods with food ladder use compared to baseline.
    Language English
    Publishing date 2023-11-06
    Publishing country England
    Document type Letter
    ZDB-ID 2434973-2
    ISSN 1710-1492 ; 1710-1484
    ISSN (online) 1710-1492
    ISSN 1710-1484
    DOI 10.1186/s13223-023-00847-7
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  5. Article: Anaphylaxis.

    Fischer, David / Vander Leek, Timothy K / Ellis, Anne K / Kim, Harold

    Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology

    2018  Volume 14, Issue Suppl 2, Page(s) 54

    Abstract: Anaphylaxis is an acute, potentially fatal systemic allergic reaction with varied mechanisms and clinical presentations. Although prompt recognition and treatment of anaphylaxis are imperative, both patients and healthcare professionals often fail to ... ...

    Abstract Anaphylaxis is an acute, potentially fatal systemic allergic reaction with varied mechanisms and clinical presentations. Although prompt recognition and treatment of anaphylaxis are imperative, both patients and healthcare professionals often fail to recognize and diagnose early signs and symptoms of the condition. Clinical manifestations vary widely; however, the most common signs are cutaneous symptoms, including urticaria, angioedema, erythema and pruritus. Immediate intramuscular administration of epinephrine into the anterolateral thigh is first-line therapy, even if the diagnosis is uncertain. The mainstays of long-term management include specialist assessment, avoidance measures, and the provision of an epinephrine auto-injector and an individualized anaphylaxis action plan. This article provides an overview of the causes, clinical features, diagnosis and acute and long-term management of this serious allergic reaction.
    Language English
    Publishing date 2018-09-12
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2434973-2
    ISSN 1710-1492 ; 1710-1484
    ISSN (online) 1710-1492
    ISSN 1710-1484
    DOI 10.1186/s13223-018-0283-4
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  6. Article: COVID-19 vaccine testing & administration guidance for allergists/immunologists from the Canadian Society of Allergy and Clinical Immunology (CSACI).

    Vander Leek, Timothy K / Chan, Edmond S / Connors, Lori / Derfalvi, Beata / Ellis, Anne K / Upton, Julia E M / Abrams, Elissa M

    Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology

    2021  Volume 17, Issue 1, Page(s) 29

    Abstract: Background: Safe and effective vaccines provide the first hope for mitigating the devastating health and economic impacts resulting from coronavirus disease 2019 (COVID-19) and related public health orders. Recent case reports of reactions to COVID-19 ... ...

    Abstract Background: Safe and effective vaccines provide the first hope for mitigating the devastating health and economic impacts resulting from coronavirus disease 2019 (COVID-19) and related public health orders. Recent case reports of reactions to COVID-19 vaccines have raised questions about their safety for use in individuals with allergies and those who are immunocompromised. In this document, we aim to address these concerns and provide guidance for allergists/immunologists.
    Methods: Scoping review of the literature regarding COVID-19 vaccination, adverse or allergic reactions, and immunocompromise from PubMed over the term of December 2020 to present date. We filtered our search with the terms "human" and "English" and limited the search to the relevant subject age range with the term "adult." Reports resulting from these searches and relevant references cited in those reports were reviewed and cited on the basis of their relevance.
    Results: Assessment by an allergist is warranted in any individual with a suspected allergy to a COVID-19 vaccine or any of its components. Assessment by an allergist is NOT required for individuals with a history of unrelated allergies, including to allergies to foods, drugs, insect venom or environmental allergens. COVID-19 vaccines should be offered to immunocompromised patients if the benefit is deemed to outweigh any potential risks of vaccination.
    Interpretation: This review provides the first Canadian guidance regarding assessment of an adolescent and adult with a suspected allergy to one of the COVID-19 vaccines currently available, or any of their known allergenic components, and for patients who are immunocompromised who require vaccination for COVID-19. As information is updated this guidance will be updated accordingly.
    Language English
    Publishing date 2021-03-15
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2434973-2
    ISSN 1710-1492 ; 1710-1484
    ISSN (online) 1710-1492
    ISSN 1710-1484
    DOI 10.1186/s13223-021-00529-2
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  7. Article ; Online: Home-Based Peanut Oral Immunotherapy for Low-Risk Peanut-Allergic Preschoolers During the COVID-19 Pandemic and Beyond.

    Chua, Gilbert T / Chan, Edmond S / Soller, Lianne / Cook, Victoria E / Vander Leek, Timothy K / Mak, Raymond

    Frontiers in allergy

    2021  Volume 2, Page(s) 725165

    Abstract: The coronavirus disease 2019 (COVID-19) pandemic has led to the deprioritization of non-emergency services, such as oral food challenges and the initiation of oral immunotherapy (OIT) for food-allergic children. Recent studies have suggested that home- ... ...

    Abstract The coronavirus disease 2019 (COVID-19) pandemic has led to the deprioritization of non-emergency services, such as oral food challenges and the initiation of oral immunotherapy (OIT) for food-allergic children. Recent studies have suggested that home-based peanut OIT could be a safe and effective option for low-risk peanut-allergic children. In the period between September 1, 2020, and January 31, 2021, nine preschoolers with a history of mild allergic reactions to peanut underwent home-based peanut OIT. Eight of them (88.9%) completed the build-up phase at home in 11-28 weeks, tolerating a daily maintenance dose of 320 mg peanut protein. During the build-up, six patients (75.0%) reported urticaria, three (33.3%) reported gastrointestinal tract symptoms, and one (14.3%) reported oral pruritis. None of the patients developed anaphylaxis, required epinephrine, or attended emergency services related to OIT. One or two virtual follow-up visits were completed per patient during the build-up phase. Our case series shows that home-based OIT could be offered to the low-risk preschoolers during the COVID-19 pandemic when non-emergency services are limited and could be considered beyond the pandemic, especially for the families living in the rural or remote areas that may otherwise be unable to access OIT.
    Language English
    Publishing date 2021-09-24
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2673-6101
    ISSN (online) 2673-6101
    DOI 10.3389/falgy.2021.725165
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  8. Article: Patient selection for milk and egg ladders using a food ladder safety checklist.

    Chua, Gilbert T / Chan, Edmond S / Yeung, Joanne / Cameron, Scott B / Soller, Lianne / Williams, Brock A / Chomyn, Alanna / Vander Leek, Timothy K / Abrams, Elissa M / Mak, Raymond / Wong, Tiffany

    Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology

    2022  Volume 18, Issue 1, Page(s) 51

    Abstract: A food ladder is a form of home-based dietary advancement therapy that gradually increases exposure to an allergenic food through the gradual introduction of egg or milk containing food with increasing quantity and allergenicity from extensively heated ... ...

    Abstract A food ladder is a form of home-based dietary advancement therapy that gradually increases exposure to an allergenic food through the gradual introduction of egg or milk containing food with increasing quantity and allergenicity from extensively heated forms, such as baked goods, to less processed products. While widely considered safe, the food ladder is not risk-free and most of the egg and milk ladder studies only included preschoolers with mild egg and milk allergies, and with no or well-controlled asthma. We propose a Food Ladder Safety Checklist to assist with patient selection using "4 A's" based on available evidence for food ladders, including Age, active or poorly controlled Asthma, history of Anaphylaxis, and Adherence.
    Language English
    Publishing date 2022-06-12
    Publishing country England
    Document type Letter
    ZDB-ID 2434973-2
    ISSN 1710-1492 ; 1710-1484
    ISSN (online) 1710-1492
    ISSN 1710-1484
    DOI 10.1186/s13223-022-00696-w
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  9. Article: Dietary exposures and allergy prevention in high-risk infants.

    Abrams, Elissa M / Watson, Wade / Vander Leek, Timothy K / Atkinson, Adelle / Primeau, Marie-Noel / Francoeur, Marie-Josee / McHenry, Mary / Lavine, Elana / Orkin, Julia / Cummings, Carl / Blair, Becky / Chan, Edmond S

    Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology

    2022  Volume 18, Issue 1, Page(s) 36

    Abstract: Infants at high risk for developing a food allergy have either an atopic condition (such as eczema) themselves or an immediate family member with such a condition. Breastfeeding should be promoted and supported regardless of issues pertaining to food ... ...

    Abstract Infants at high risk for developing a food allergy have either an atopic condition (such as eczema) themselves or an immediate family member with such a condition. Breastfeeding should be promoted and supported regardless of issues pertaining to food allergy prevention, but for infants whose mothers cannot or choose not to breastfeed, using a specific formula (i.e., hydrolyzed formula) is not recommended to prevent food allergies. When cow's milk protein formula has been introduced in an infant's diet, make sure that regular ingestion (as little as 10 mL daily) is maintained to prevent loss of tolerance. For high-risk infants, there is compelling evidence that introducing allergenic foods early-at around 6 months, but not before 4 months of age-can prevent common food allergies, and allergies to peanut and egg in particular. Once an allergenic food has been introduced, regular ingestion (e.g., a few times a week) is important to maintain tolerance. Common allergenic foods can be introduced without pausing for days between new foods, and the risk for a severe reaction at first exposure in infancy is extremely low. Pre-emptive in-office screening before introducing allergenic foods is not recommended. No recommendations can be made at this time about the role of maternal dietary modification during pregnancy or lactation, or about supplementing with vitamin D, omega 3, or pre- or probiotics as means to prevent food allergy.
    Language English
    Publishing date 2022-04-30
    Publishing country England
    Document type Journal Article
    ZDB-ID 2434973-2
    ISSN 1710-1492 ; 1710-1484
    ISSN (online) 1710-1492
    ISSN 1710-1484
    DOI 10.1186/s13223-021-00638-y
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  10. Article ; Online: The Case for Prompt Salvage Infant Peanut Oral Immunotherapy Following Failed Primary Prevention.

    Chua, Gilbert T / Greenhawt, Matthew / Shaker, Marcus / Soller, Lianne / Abrams, Elissa M / Cameron, Scott B / Cook, Victoria E / Erdle, Stephanie C / Fleischer, David M / Mak, Raymond / Vander Leek, Timothy K / Chan, Edmond S

    The journal of allergy and clinical immunology. In practice

    2022  Volume 10, Issue 10, Page(s) 2561–2569

    Abstract: Recent guideline recommendations have shifted from recommending prolonged avoidance of allergenic foods in the first 3 years of life to a primary prevention approach involving the deliberate early introduction to infants at risk of developing food ... ...

    Abstract Recent guideline recommendations have shifted from recommending prolonged avoidance of allergenic foods in the first 3 years of life to a primary prevention approach involving the deliberate early introduction to infants at risk of developing food allergy. Despite this, some infants, especially those with severe eczema who are at highest risk for developing peanut allergy, fail to receive the preventative benefits of early peanut introduction due to hesitancy and other factors. Difficulty adhering to regular ingestion after introduction further reduces the effectiveness of primary prevention. As emerging real-world evidence has demonstrated that performing peanut oral immunotherapy (OIT) among infants is effective and safe, peanut OIT could be a treatment option for infants with peanut allergy. This review discusses the benefits, risks, and barriers to offering peanut OIT to infants who fail primary prevention strategies. We propose the novel concept that infants with peanut allergy be offered peanut OIT as soon as possible after failed peanut introduction through a shared decision-making process with the family, where there is a preference for active management rather than avoidance.
    MeSH term(s) Administration, Oral ; Allergens/therapeutic use ; Arachis ; Desensitization, Immunologic ; Food Hypersensitivity/prevention & control ; Humans ; Immunologic Factors ; Infant ; Peanut Hypersensitivity/prevention & control ; Primary Prevention
    Chemical Substances Allergens ; Immunologic Factors
    Language English
    Publishing date 2022-06-23
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2843237-X
    ISSN 2213-2201 ; 2213-2198
    ISSN (online) 2213-2201
    ISSN 2213-2198
    DOI 10.1016/j.jaip.2022.05.040
    Database MEDical Literature Analysis and Retrieval System OnLINE

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