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  1. Article ; Online: Exanthematous reactions to drugs in children.

    Atanaskovic-Markovic, Marina / Tsabouri, Sophia

    Current opinion in allergy and clinical immunology

    2021  Volume 21, Issue 4, Page(s) 335–339

    Abstract: Purpose of review: The true exanthematous reactions to drugs in children are rare and overdiagnosed. Drugs may cause exanthema either due to inducing an immune response or because of their interaction with viruses, if drugs are taken in the course of a ... ...

    Abstract Purpose of review: The true exanthematous reactions to drugs in children are rare and overdiagnosed. Drugs may cause exanthema either due to inducing an immune response or because of their interaction with viruses, if drugs are taken in the course of a viral infection. Also, viral infections are very often in children and they can provoke an exanthema which is difficult to differentiate from exanthematous reactions to drugs. Consequently, the majority of children are incorrectly labeled as 'allergic'.
    Recent findings: The correct diagnosis of exanthematous drug reactions in children is still an important and hot topic. Most information about the approach and management of drug hypersensitivity in children is applied from available guidelines and consensus statement for adults. Recently, a systematic clinical approach for timely differential diagnosis and management of rashes in children who present a cutaneous exanthema while receiving a drug, is proposed.
    Summary: It is important to consider the detailed clinical history of appearing and developing exanthematous drug reaction, as well as physical examination which includes the description and the distribution of exanthema and at the end making the appropriate diagnosis. Thus, it could reduce overdiagnosis and promote appropriate procedures, that will prevent the overlabeling of drug hypersensitivity in children.
    MeSH term(s) Child ; Drug Hypersensitivity/diagnosis ; Drug Hypersensitivity/epidemiology ; Drug-Related Side Effects and Adverse Reactions ; Exanthema/chemically induced ; Exanthema/diagnosis ; Humans ; Virus Diseases
    Language English
    Publishing date 2021-04-12
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2088710-3
    ISSN 1473-6322 ; 1528-4050
    ISSN (online) 1473-6322
    ISSN 1528-4050
    DOI 10.1097/ACI.0000000000000749
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  2. Article ; Online: Skin eruptions in children: Drug hypersensitivity vs viral exanthema.

    Tsabouri, Sophia / Atanaskovic-Markovic, Marina

    Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology

    2021  Volume 32, Issue 5, Page(s) 824–834

    Abstract: Childhood rashes or exanthemas are common and are usually relatively benign. There are many causes of rash in children, including mainly viruses, and less often bacterial toxins, drugs, allergens and other diseases. Viral exanthema often appears while ... ...

    Abstract Childhood rashes or exanthemas are common and are usually relatively benign. There are many causes of rash in children, including mainly viruses, and less often bacterial toxins, drugs, allergens and other diseases. Viral exanthema often appears while children are taking a medication in the course of a viral infection; it can mimic drug exanthema and is perceived as a drug allergy in 10% of cases. In the vast majority of cases, the distinction between virus-induced and drug-induced skin eruption during the acute phase is not possible. The drugs most commonly implicated are beta-lactams (BL) and non-steroidal anti-inflammatory drugs (NSAIDs). Viruses, commonly Epstein-Barr virus (EBV), human herpesvirus 6 (HHV6) and cytomegalovirus (CMV), and the bacterium, Mycoplasma pneumoniae, may cause exanthema either from the infection itself (active or latent) or because of interaction with drugs that are taken simultaneously. Determination of the exact diagnosis requires a careful clinical history and thorough physical examination. Haematological and biochemical investigations and histology are not always helpful in differentiating between the two types of exanthema. Serological and polymerase chain reaction (PCR) assays can be helpful, although a concomitant acute infection does not exclude drug hypersensitivity. A drug provocation test (DPT) is although considered the gold standard for the diagnosis and is not preferred by the patients. Skin tests are not well tolerated, and in vitro tests, such as the basophil activation test and lymphocyte transformation, are of low sensitivity and specificity and their relevance is debatable. Based on current evidence, we propose a systematic clinical approach for timely differential diagnosis and management of rashes in children who present a cutaneous eruption while receiving a drug.
    MeSH term(s) Child ; Drug Hypersensitivity/diagnosis ; Epstein-Barr Virus Infections ; Exanthema/diagnosis ; Herpesvirus 4, Human ; Humans ; Skin Tests ; Virus Diseases/diagnosis
    Language English
    Publishing date 2021-03-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 1057059-7
    ISSN 1399-3038 ; 0905-6157 ; 0906-5784
    ISSN (online) 1399-3038
    ISSN 0905-6157 ; 0906-5784
    DOI 10.1111/pai.13485
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  3. Article ; Online: The links between allergen exposure and sensitization in children and adolescents: an overview for the clinician.

    Moustaki, Maria / Loukou, Ioanna / Tsabouri, Sophia / Douros, Konstantinos

    Expert review of clinical immunology

    2022  Volume 18, Issue 6, Page(s) 581–590

    Abstract: Introduction: The links between allergen exposure and sensitization are complex and depend not only on the type of allergen but on various genetic and environmental factors.: Areas covered: This review discusses the link between allergen exposure and ...

    Abstract Introduction: The links between allergen exposure and sensitization are complex and depend not only on the type of allergen but on various genetic and environmental factors.
    Areas covered: This review discusses the link between allergen exposure and atopic sensitization for different types of allergens and the factors that mediate or affect this link. For the purposes of this review search of PubMed was undertaken to identify English language articles using the terms 'sensitization' and 'allergen exposure' and 'children/or adolescents.'
    Expert opinion: Regarding food sensitization, the available data for peanuts and eggs suggest that there is a window period between 4 and 6 months of age when the introduction of these foods may limit sensitization and clinically overt allergy to the respective foods. As far as it concerns aeroallergens, it seems that there is a complex and variable relationship between mite exposure and specific sensitization especially if the exposure occurs early in life. Early exposure to dog allergens does not seem to be associated with specific sensitization; regarding cats, the results are still inconsistent. Several factors may mediate the relationship between early exposure to allergens and the development of sensitization or clinical allergy.
    MeSH term(s) Adolescent ; Allergens ; Animals ; Dogs ; Humans ; Hypersensitivity/epidemiology ; Hypersensitivity, Immediate ; Mites
    Chemical Substances Allergens
    Language English
    Publishing date 2022-05-06
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2274260-8
    ISSN 1744-8409 ; 1744-666X
    ISSN (online) 1744-8409
    ISSN 1744-666X
    DOI 10.1080/1744666X.2022.2072297
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  4. Article: Vitamin D and Omega-3 (Fatty Acid) Supplementation in Pregnancy for the Primary Prevention of Food Allergy in Children-Literature Review.

    Feketea, Gavriela / Kostara, Maria / Bumbacea, Roxana Silvia / Vassilopoulou, Emilia / Tsabouri, Sophia

    Children (Basel, Switzerland)

    2023  Volume 10, Issue 3

    Abstract: During the last decades the prevalence of food allergy (FA), an adverse immune response to a specific food antigen, has risen, with negative effects on the quality of life (QoL) of many children and their families. The pathogenesis of FA is complex, ... ...

    Abstract During the last decades the prevalence of food allergy (FA), an adverse immune response to a specific food antigen, has risen, with negative effects on the quality of life (QoL) of many children and their families. The pathogenesis of FA is complex, involving both genetic and environmental factors. SPINK5, STAT6, HLA and FOXP3 are some of the genes that are reported to be implicated in FA development. Regarding environmental factors, particular interest has been focused on modification of the dietary habits of pregnant women for the primary prevention of FA. Specifically, Vitamin D and omega-3 (Ω-3) fatty acid supplementation during pregnancy may influence the development of FA in the offspring. Vitamin D is a hormone with various actions, including mediation of the immune system, reducing the production of inflammatory cytokines and promoting tolerance. Vitamin D deficiency in pregnancy suppresses T-regulatory cells in the fetus, and Vitamin D supplementation might protect against FA development. Dietary Ω-3 fatty acids are found mainly in fish and vegetable oils. They are beneficial for human health, playing a role in the immune system as anti-inflammatory agents, and providing cell membrane stabilization with inhibition of antigen presentation. It is documented that maternal supplementation with Ω-3 during pregnancy may protect from allergic sensitization in the children. The aim of this literature review was to explore the potential preventive role of maternal supplementation during pregnancy with Vitamin D and Ω-3 in the development of FA in the offspring. With the prevalence of FA rising, all the possible protective mechanisms and measures for FA prevention need to be explored, starting with those that can be modified.
    Language English
    Publishing date 2023-02-27
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2732685-8
    ISSN 2227-9067
    ISSN 2227-9067
    DOI 10.3390/children10030468
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  5. Article: Characteristics of Exogenous Allergen in Breast Milk and Their Impact on Oral Tolerance Induction.

    Kosmeri, Chrysoula / Rallis, Dimitrios / Kostara, Maria / Siomou, Ekaterini / Tsabouri, Sophia

    Frontiers in pediatrics

    2022  Volume 10, Page(s) 830718

    Abstract: Food allergy is a common health problem in childhood since its prevalence was estimated to range from 6. 5 to 24.6% in European countries. Recently, a lot of research has focused on the impact of breastfeeding on oral tolerance induction. Since it was ... ...

    Abstract Food allergy is a common health problem in childhood since its prevalence was estimated to range from 6. 5 to 24.6% in European countries. Recently, a lot of research has focused on the impact of breastfeeding on oral tolerance induction. Since it was found that breast milk contains immunologically active food antigens, it would be very helpful to clarify the factors of antigen shedding that promotes oral tolerance. This narrative review aimed to summarize the latest evidence from experimental and human studies regarding allergen characteristics in human milk that may influence oral tolerance induction. A literature search in PubMed, MEDLINE, and Google Scholar was conducted. The diet of the mother was found to have a direct impact on allergen amount in the breastmilk, while antigens had different kinetics in human milk between women and depending on the antigen. The mode of antigen consumption, such as the cooking of an antigen, may also affect the allergenicity of the antigen in human milk. The dose of the antigen in human milk is in the range of nanograms per milliliter; however, it was found to have a tolerogenic effect. Furthermore, the presence of antigen-specific immunoglobulins, forming immune complexes with antigens, was found more tolerogenic compared to free allergens in experimental studies, and this is related to the immune status of the mother. While examining available data, this review highlights gaps in knowledge regarding allergen characteristics that may influence oral tolerance.
    Language English
    Publishing date 2022-03-04
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2711999-3
    ISSN 2296-2360
    ISSN 2296-2360
    DOI 10.3389/fped.2022.830718
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  6. Article ; Online: Epigenetic/genetic variations in CG-rich elements of immune-related genes contribute to food allergy development during childhood.

    Kostara, Maria / Chondrou, Vasiliki / Fotopoulos, Vassilis / Sgourou, Argyro / Tsabouri, Sophia

    Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology

    2022  Volume 33, Issue 6, Page(s) e13812

    Abstract: Background: Genetic areas of FOXP3 TSDR, human leukocyte antigen-G (HLA-G) upstream of CpG island 96, CpG41 and CpG73 islands of the HLA-DRB1 and HLA-DQB1 genes respectively, previously documented to display immune-modulatory properties, were subjected ... ...

    Abstract Background: Genetic areas of FOXP3 TSDR, human leukocyte antigen-G (HLA-G) upstream of CpG island 96, CpG41 and CpG73 islands of the HLA-DRB1 and HLA-DQB1 genes respectively, previously documented to display immune-modulatory properties, were subjected to epigenetic/genetic analysis to assess their influence in IgE-mediated food allergy (FA) development in children.
    Methods: Sixty-four orally challenged and IgE-tested food allergic subjects together with 44 controls were recruited. Targeted pyrosequencing analysis to detect DNA methylation status and genetic variations was utilized and experimental results obtained were analyzed by a statistical software platform and correlated to clinical data. Also, transcription factor (TF) binding sites in study areas were unmasked by the JASPAR prediction database.
    Results: Parents' smoking was significantly correlated with aberrant methylation patterns, regardless of food allergic or control status. HLA-G promoter region showed a trend for hypomethylation in food allergic subjects, with one of the CG sites displaying significantly decreased methylation values. Rs1233333, residing within the HLA-G promoter region preserved a protective role toward DNA methylation. Variable methylation patterns were recorded for CpG41 of the HLA-DRB1 gene and hypermethylation of the region was significantly correlated with the presence of single nucleotide polymorphisms (SNPs). TFs' recognition sites, located in studied genetic areas and exerting pivotal regulatory biological roles, are potentially affected by divergent DNA methylation status.
    Conclusions: We propose that HLA-G expression is triggered by food-derived allergens, providing a Treg
    MeSH term(s) Child ; DNA Methylation ; Epigenesis, Genetic ; Food Hypersensitivity/genetics ; Forkhead Transcription Factors/genetics ; Forkhead Transcription Factors/metabolism ; HLA-DRB1 Chains/genetics ; HLA-DRB1 Chains/metabolism ; HLA-G Antigens/genetics ; HLA-G Antigens/metabolism ; Humans ; Immunoglobulin E/metabolism ; Polymorphism, Single Nucleotide
    Chemical Substances Forkhead Transcription Factors ; HLA-DRB1 Chains ; HLA-G Antigens ; Immunoglobulin E (37341-29-0)
    Language English
    Publishing date 2022-06-27
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1057059-7
    ISSN 1399-3038 ; 0905-6157 ; 0906-5784
    ISSN (online) 1399-3038
    ISSN 0905-6157 ; 0906-5784
    DOI 10.1111/pai.13812
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  7. Article: Corrigendum: Characteristics of Exogenous Allergen in Breast Milk and Their Impact on Oral Tolerance Induction.

    Kosmeri, Chrysoula / Rallis, Dimitrios / Kostara, Maria / Giapros, Vasileios / Siomou, Ekaterini / Tsabouri, Sophia

    Frontiers in pediatrics

    2022  Volume 10, Page(s) 898795

    Abstract: This corrects the article DOI: 10.3389/fped.2022.830718.]. ...

    Abstract [This corrects the article DOI: 10.3389/fped.2022.830718.].
    Language English
    Publishing date 2022-04-14
    Publishing country Switzerland
    Document type Published Erratum
    ZDB-ID 2711999-3
    ISSN 2296-2360
    ISSN 2296-2360
    DOI 10.3389/fped.2022.898795
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  8. Article ; Online: A rare case of hypereosinophilic obliterative bronchiolitis in an adolescent girl.

    Zioga, Aikaterini / Fouzas, Sotirios / Kostara, Maria / Domouzoglou, Eleni / Giantsouli, Anastasia / Siomou, Ekaterini / Tsabouri, Sophia

    Pediatric pulmonology

    2022  Volume 57, Issue 12, Page(s) 3180–3182

    MeSH term(s) Female ; Adolescent ; Humans ; Bronchiolitis Obliterans/diagnostic imaging ; Bronchiolitis Obliterans/etiology ; Lung Transplantation ; Eosinophilia
    Language English
    Publishing date 2022-09-14
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 632784-9
    ISSN 1099-0496 ; 8755-6863
    ISSN (online) 1099-0496
    ISSN 8755-6863
    DOI 10.1002/ppul.26130
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  9. Article ; Online: More data are needed about vitamin D supplements in pregnancy and infancy including any impact on allergies.

    Douros, Konstantinos / Loukou, Ioanna / Tsabouri, Sophia

    Acta paediatrica (Oslo, Norway : 1992)

    2020  Volume 110, Issue 3, Page(s) 753–754

    MeSH term(s) Dietary Supplements ; Female ; Humans ; Hypersensitivity/epidemiology ; Hypersensitivity/etiology ; Hypersensitivity/prevention & control ; Infant ; Pregnancy ; Vitamin D ; Vitamin D Deficiency/epidemiology ; Vitamin D Deficiency/prevention & control ; Vitamins
    Chemical Substances Vitamins ; Vitamin D (1406-16-2)
    Language English
    Publishing date 2020-10-06
    Publishing country Norway
    Document type Journal Article
    ZDB-ID 203487-6
    ISSN 1651-2227 ; 0365-1436 ; 0803-5253
    ISSN (online) 1651-2227
    ISSN 0365-1436 ; 0803-5253
    DOI 10.1111/apa.15592
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  10. Article ; Online: Risk Factors for Severity in Children with Coronavirus Disease 2019: A Comprehensive Literature Review.

    Tsabouri, Sophia / Makis, Alexandros / Kosmeri, Chrysoula / Siomou, Ekaterini

    Pediatric clinics of North America

    2020  Volume 68, Issue 1, Page(s) 321–338

    Abstract: The coronavirus disease 2019 (COVID-19) pandemic has affected hundreds of thousands of people. The authors performed a comprehensive literature review to identify the underlying mechanisms and risk factors for severe COVID-19 in children. Children have ... ...

    Abstract The coronavirus disease 2019 (COVID-19) pandemic has affected hundreds of thousands of people. The authors performed a comprehensive literature review to identify the underlying mechanisms and risk factors for severe COVID-19 in children. Children have accounted for 1.7% to 2% of the diagnosed cases of COVID-19. They often have milder disease than adults, and child deaths have been rare. The documented risk factors for severe disease in children are young age and underlying comorbidities. It is unclear whether male gender and certain laboratory and imaging findings are also risk factors. Reports on other potential factors have not been published.
    MeSH term(s) Adolescent ; Age Factors ; COVID-19/epidemiology ; Child ; Child, Preschool ; Coinfection/epidemiology ; Coronavirus ; Disease Progression ; Female ; Humans ; Infant ; Male ; Risk Factors ; SARS-CoV-2 ; Severity of Illness Index ; Systemic Inflammatory Response Syndrome/epidemiology
    Language English
    Publishing date 2020-07-30
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 215711-1
    ISSN 1557-8240 ; 0031-3955
    ISSN (online) 1557-8240
    ISSN 0031-3955
    DOI 10.1016/j.pcl.2020.07.014
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