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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

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
Database	MEDical Literature Analysis and Retrieval System OnLINE

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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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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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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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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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Article: Unusual Manifestations of Kawasaki Disease in the COVID Era: A Case Series and Review of the Literature.

Kostara, Maria / Serbis, Anastasios / Pavlou, Maria / Kotanidou, Eleni / Tsabouri, Sofia / Vlahos, Antonios / Makis, Alexandros / Siomou, Ekaterini

Cureus

2023 Volume 15, Issue 12, Page(s) e51104

Abstract: Kawasaki disease (KD) is an acute medium-vessel vasculitis, mainly affecting infants older than six months and children under five years. It predisposes to the development of coronary artery aneurysms and constitutes the leading cause of acquired heart ... ...

Abstract	Kawasaki disease (KD) is an acute medium-vessel vasculitis, mainly affecting infants older than six months and children under five years. It predisposes to the development of coronary artery aneurysms and constitutes the leading cause of acquired heart disease in children. Its diagnosis is based on clinical criteria, namely, fever lasting for ≥ five days together with at least four of the five principal clinical features of the disease. Occasionally, children with KD present with fever, but they fulfill only some of the five principal criteria, and this is described as incomplete KD. Furthermore, "atypical" KD is a term that is usually used for cases that appear with rather unusual clinical manifestations, which complicate clinical judgment and may delay diagnosis and treatment. In this case series, we present four cases of KD with rather unusual clinical features: a five-year-old boy with lobar pneumonia, a six-year-old girl with orange-brown chromonychia appearing on the 10
Language	English
Publishing date	2023-12-26
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.51104
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Article: HLA Polymorphisms and Food Allergy Predisposition.

Kostara, Maria / Chondrou, Vasiliki / Sgourou, Argyro / Douros, Konstantinos / Tsabouri, Sophia

Journal of pediatric genetics

2020 Volume 9, Issue 2, Page(s) 77–86

Abstract: Food allergy (FA) is a growing health problem that affects ∼8% of the children worldwide. Although the prevalence of FA is increasing, the underlying genetic mechanisms responsible for the onset of this immune disorder are not yet clarified. Genetic ... ...

Abstract	Food allergy (FA) is a growing health problem that affects ∼8% of the children worldwide. Although the prevalence of FA is increasing, the underlying genetic mechanisms responsible for the onset of this immune disorder are not yet clarified. Genetic factors seem to play a leading role in the development of FA, though interaction with environmental factors cannot be excluded. The broader network of genetic loci mediating the risk of this complex disorder remains to be identified. The human leucocyte antigen (HLA) has been associated with various immune disorders, including FA. This review aims to unravel the potential associations between HLA gene functions and the manifestation and outcome of FA disorders. Exploring new aspects of FA development with the perspective to improve our understanding of the multifaceted etiology and the complex biological mechanisms involved in FA is essential.
Language	English
Publishing date	2020-04-01
Publishing country	Germany
Document type	Journal Article ; Review
ISSN	2146-4596
ISSN	2146-4596
DOI	10.1055/s-0040-1708521
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Article ; Online: Food allergy in children is associated with Vitamin D deficiency: A case-control study.

Kostara, Maria / Giapros, Vasileios / Serbis, Anastasios / Siomou, Ekaterini / Cholevas, Vasileios / Rallis, Dimitrios / Tsabouri, Sophia

Acta paediatrica (Oslo, Norway : 1992)

2021 Volume 111, Issue 3, Page(s) 644–645

MeSH term(s)	Case-Control Studies ; Child ; Food Hypersensitivity/complications ; Humans ; Vitamin D ; Vitamin D Deficiency/complications
Chemical Substances	Vitamin D (1406-16-2)
Language	English
Publishing date	2021-12-13
Publishing country	Norway
Document type	Letter
ZDB-ID	203487-6
ISSN	1651-2227 ; 0365-1436 ; 0803-5253
ISSN (online)	1651-2227
ISSN	0365-1436 ; 0803-5253
DOI	10.1111/apa.16206
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Article: HLA Polymorphisms and Food Allergy Predisposition

Kostara, Maria / Chondrou, Vasiliki / Sgourou, Argyro / Douros, Konstantinos / Tsabouri, Sophia

Journal of Pediatric Genetics

2020 Volume 09, Issue 02, Page(s) 77–86

Abstract	Food allergy (FA) is a growing health problem that affects ∼8% of the children worldwide. Although the prevalence of FA is increasing, the underlying genetic mechanisms responsible for the onset of this immune disorder are not yet clarified. Genetic factors seem to play a leading role in the development of FA, though interaction with environmental factors cannot be excluded. The broader network of genetic loci mediating the risk of this complex disorder remains to be identified. The human leucocyte antigen (HLA) has been associated with various immune disorders, including FA. This review aims to unravel the potential associations between HLA gene functions and the manifestation and outcome of FA disorders. Exploring new aspects of FA development with the perspective to improve our understanding of the multifaceted etiology and the complex biological mechanisms involved in FA is essential.
Keywords	food allergy ; HLA system ; genetic predisposition
Language	English
Publishing date	2020-04-01
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ISSN	2146-460X ; 2146-4596
ISSN (online)	2146-460X
ISSN	2146-4596
DOI	10.1055/s-0040-1708521
Database	Thieme publisher's database

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Article ; Online: On the estimation of the effect of weight change on a health outcome using observational data, by utilising the target trial emulation framework.

Katsoulis, M / Lai, A G / Kipourou, D K / Gomes, M / Banerjee, A / Denaxas, S / Lumbers, R T / Tsilidis, K / Kostara, Maria / Belot, A / Dale, C / Sofat, R / Leyrat, C / Hemingway, H / Diaz-Ordaz, K

International journal of obesity (2005)

2023 Volume 47, Issue 12, Page(s) 1309–1317

Abstract: Background/objectives: When studying the effect of weight change between two time points on a health outcome using observational data, two main problems arise initially (i) 'when is time zero?' and (ii) 'which confounders should we account for?' From ... ...

Abstract	Background/objectives: When studying the effect of weight change between two time points on a health outcome using observational data, two main problems arise initially (i) 'when is time zero?' and (ii) 'which confounders should we account for?' From the baseline date or the 1st follow-up (when the weight change can be measured)? Different methods have been previously used in the literature that carry different sources of bias and hence produce different results. Methods: We utilised the target trial emulation framework and considered weight change as a hypothetical intervention. First, we used a simplified example from a hypothetical randomised trial where no modelling is required. Then we simulated data from an observational study where modelling is needed. We demonstrate the problems of each of these methods and suggest a strategy. Interventions: weight loss/gain vs maintenance. Results: The recommended method defines time-zero at enrolment, but adjustment for confounders (or exclusion of individuals based on levels of confounders) should be performed both at enrolment and the 1st follow-up. Conclusions: The implementation of our suggested method [adjusting for (or excluding based on) confounders measured both at baseline and the 1st follow-up] can help researchers attenuate bias by avoiding some common pitfalls. Other methods that have been widely used in the past to estimate the effect of weight change on a health outcome are more biased. However, two issues remain (i) the exposure is not well-defined as there are different ways of changing weight (however we tried to reduce this problem by excluding individuals who develop a chronic disease); and (ii) immortal time bias, which may be small if the time to first follow up is short.
MeSH term(s)	Humans ; Weight Gain ; Bias ; Outcome Assessment, Health Care
Language	English
Publishing date	2023-10-26
Publishing country	England
Document type	Observational Study ; Journal Article
ZDB-ID	752409-2
ISSN	1476-5497 ; 0307-0565
ISSN (online)	1476-5497
ISSN	0307-0565
DOI	10.1038/s41366-023-01396-0
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