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Article ; Online: Editorial Comment on "Feasibility and safety of introducing cashew nut spread in infant diets-a randomized trial".

Leung, Agnes Sze-Yin / Eigenmann, Philippe

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

2023 Volume 34, Issue 6, Page(s) e13978

MeSH term(s)	Humans ; Infant ; Anacardium ; Diet ; Feasibility Studies ; Nut Hypersensitivity ; Nuts ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2023-06-26
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	1057059-7
ISSN	1399-3038 ; 0905-6157 ; 0906-5784
ISSN (online)	1399-3038
ISSN	0905-6157 ; 0906-5784
DOI	10.1111/pai.13978
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Article ; Online: Editorial comment on the special issue "Omics in food allergy".

Castagnoli, Riccardo / Taietti, Ivan / Leung, Agnes Sze-Yin / Eigenmann, Philippe

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

2024 Volume 35, Issue 3, Page(s) e14113

MeSH term(s)	Humans ; Food Hypersensitivity/diagnosis ; Multiomics
Language	English
Publishing date	2024-03-23
Publishing country	England
Document type	Editorial ; Introductory 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.14113
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Article ; Online: From preschool wheezing to asthma: Environmental determinants.

Xing, Yuhan / Leung, Agnes Sze-Yin / Wong, Gary Wing-Kin

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

2023 Volume 34, Issue 11, Page(s) e14049

Abstract: Wheezing is common among preschool children, representing a group of highly heterogeneous conditions with varying natural history. Several phenotypes of wheezing have been proposed to facilitate the identification of young children who are at risk of ... ...

Abstract	Wheezing is common among preschool children, representing a group of highly heterogeneous conditions with varying natural history. Several phenotypes of wheezing have been proposed to facilitate the identification of young children who are at risk of subsequent development of asthma. Epidemiological and immunological studies across different populations have revealed the key role of environmental factors in influencing the progression from preschool wheezing to childhood asthma. Significant risk factors include severe respiratory infections, allergic sensitization, and exposure to tobacco smoke. In contrast, a farming/rural environment has been linked to asthma protection in both human and animal studies. Early and intense exposures to microorganisms and microbial metabolites have been demonstrated to alter host immune responses to allergens and viruses, thereby driving the trajectory away from wheezing illness and asthma. Ongoing clinical trials of candidate microbes and microbial products have shown promise in shaping the immune function to reduce episodes of viral-induced wheezing. Moreover, restoring immune training may be especially important for young children who had reduced microbial exposure due to pandemic restrictions. A comprehensive understanding of the role of modifiable environmental factors will pave the way for developing targeted prevention strategies for preschool wheezing and asthma.
MeSH term(s)	Animals ; Humans ; Child, Preschool ; Infant ; Child ; Respiratory Sounds/etiology ; Asthma/epidemiology ; Asthma/etiology ; Asthma/prevention & control ; Risk Factors ; Allergens ; Respiratory Tract Infections
Chemical Substances	Allergens
Language	English
Publishing date	2023-11-28
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1057059-7
ISSN	1399-3038 ; 0905-6157 ; 0906-5784
ISSN (online)	1399-3038
ISSN	0905-6157 ; 0906-5784
DOI	10.1111/pai.14049
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Article ; Online: Role of skin management in the prevention of atopic dermatitis and food allergy.

Tham, Elizabeth Huiwen / Yamamoto-Hanada, Kiwako / Leung, Agnes Sze Yin / Ohya, Yukihiro

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

2024 Volume 35, Issue 3, Page(s) e14094

Abstract: Food allergy is postulated to originate from cutaneous sensitization through a disrupted skin barrier, particularly in atopic dermatitis (AD). Strategies for food allergy prevention currently centre around early allergic food introduction, but there is ... ...

Abstract	Food allergy is postulated to originate from cutaneous sensitization through a disrupted skin barrier, particularly in atopic dermatitis (AD). Strategies for food allergy prevention currently centre around early allergic food introduction, but there is now increasing evidence for the role of early skin barrier restoration in the form of prophylactic emollient therapy and early aggressive, proactive treatment of established AD for food allergy prevention. Research gaps that remain to be addressed include the type of emollient or anti-inflammatory medication, which confers the greatest efficacy in preventive or proactive skin treatment, respectively, the duration of therapy, and the window of opportunity for these interventions.
MeSH term(s)	Humans ; Dermatitis, Atopic ; Emollients/therapeutic use ; Food Hypersensitivity ; Skin ; Allergens
Chemical Substances	Emollients ; Allergens
Language	English
Publishing date	2024-03-14
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1057059-7
ISSN	1399-3038 ; 0905-6157 ; 0906-5784
ISSN (online)	1399-3038
ISSN	0905-6157 ; 0906-5784
DOI	10.1111/pai.14094
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Article ; Online: Editorial comment on "Sensitisation to peach allergen Pru p 7 is associated with severe clinical symptoms in a Spanish population".

Clark, Evangéline / Giovannini, Mattia / Leung, Agnes Sze Yin / Caimmi, Davide

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

2023 Volume 34, Issue 12, Page(s) e14059

MeSH term(s)	Humans ; Prunus persica ; Allergens ; Antigens, Plant ; Plant Proteins ; Food Hypersensitivity/diagnosis
Chemical Substances	Allergens ; Antigens, Plant ; Plant Proteins
Language	English
Publishing date	2023-12-26
Publishing country	England
Document type	Editorial
ZDB-ID	1057059-7
ISSN	1399-3038 ; 0905-6157 ; 0906-5784
ISSN (online)	1399-3038
ISSN	0905-6157 ; 0906-5784
DOI	10.1111/pai.14059
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Article ; Online: Development and validation of assessment tools for food allergy-related knowledge and management confidence.

Leung, Agnes Sze Yin / Cheng, Nam Sze / Cheng, James Wesley Ching-Hei / Pun, Jack / Leung, Ting Fan

The journal of allergy and clinical immunology. Global

2023 Volume 2, Issue 3, Page(s) 100098

Abstract: Background: Given the life-threatening nature of food allergy (FA), it is important to assess the level of knowledge among families with food-allergic patients and their ability to cope with anaphylaxis. This study constructed a FA knowledge ... ...

Abstract	Background: Given the life-threatening nature of food allergy (FA), it is important to assess the level of knowledge among families with food-allergic patients and their ability to cope with anaphylaxis. This study constructed a FA knowledge questionnaire (FAKQ) and confidence in FA management skills (CIFAMS) questionnaire to assess understanding and attitudes toward FA management in food-allergic families. Methods: Items from literature review and expert panel showing ≥80% content validity index and semantic equivalence were selected for translation into Chinese. These questionnaires underwent feasibility pilot testing followed by cross-sectional validation to assess their psychometric properties of internal consistency, test-retest reliability, and construct validity with a FA quality-of-life questionnaire and discriminant validity. Exploratory factor analysis was performed to confirm their factor structure. Results: A total of 155 subjects (104 patients and 51 parents) completed a 20-item FAKQ and 10-item CIFAMS. Both tools showed acceptable internal consistency in baseline and retest groups. FAKQ and CIFAMS correlated for all subjects ( Conclusion: FAKQ and CIFAMS developed by our group are valid and reliable in assessing knowledge and confidence in FA management in patients and parents. These tools are crucial for formulating education programs and advocacy campaigns for FA.
Language	English
Publishing date	2023-03-23
Publishing country	United States
Document type	Journal Article
ISSN	2772-8293
ISSN (online)	2772-8293
DOI	10.1016/j.jacig.2023.100098
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Article ; Online: High prevalence of sacroiliitis and early structural changes in the sacroiliac joint in children with enthesitis-related arthritis: findings from a tertiary centre in Hong Kong.

Chan, Oi Man / Lai, Billy Ming-Hei / Leung, Agnes Sze-Yin / Leung, Ting Fan / Ho, Assunta Chi-Hang

Pediatric rheumatology online journal

2023 Volume 21, Issue 1, Page(s) 45

Abstract: Background: Epidemiological studies have demonstrated a wide, unexplained disparity in the prevalence of juvenile idiopathic arthritis (JIA) subtypes depending on geographical location, ethnicity and other factors. Enthesitis-related arthritis (ERA) is ... ...

Abstract	Background: Epidemiological studies have demonstrated a wide, unexplained disparity in the prevalence of juvenile idiopathic arthritis (JIA) subtypes depending on geographical location, ethnicity and other factors. Enthesitis-related arthritis (ERA) is more prevalent in Southeast Asia. Axial involvement in ERA patients is increasingly recognised to occur early in the disease course. Inflammation in the sacroiliac joint (SIJ) observed on MRI seems highly predictive of subsequent structural radiographic progression. The resulting structural damage can have significant impacts on both functional status and spinal mobility. This study aimed to evaluate the clinical characteristics of ERA in a tertiary centre in Hong Kong. The primary objective of the study was to provide a comprehensive description of the clinical course and radiological findings of the SIJ among ERA patients. Method: Paediatric patients diagnosed with JIA attending the paediatric rheumatology clinic from January 1990 to December 2020 were recruited from our registry based at the Prince of Wales Hospital. Results: In our cohort, 101 children were included. The median age of diagnosis was 11 years, interquartile range (IQR) 8-15 years. The median follow-up duration was 7 years (IQR 2-11.5 years). ERA was the most prevalent subtype (40%), followed by oligoarticular JIA (17%). Axial involvement was frequently reported in our cohort of ERA patients. 78% demonstrated radiological evidence of sacroiliitis. Among those, 81% had bilateral involvement. The median duration from disease onset to confirmation of radiological sacroiliitis was 17 months (IQR 4-62 months). Among the ERA patients, 73% had structural changes of the SIJ. Alarmingly, 70% of these patients had already developed radiological structural changes when sacroiliitis was first detected on imaging (IQR 0-12 months). Erosion was the most common finding (73%), followed by sclerosis (63%), joint space narrowing (23%), ankylosis (7%) and fatty change (3%). The duration from symptom onset to diagnosis was significantly longer in ERA patients with SIJ structural changes (9 vs 2 months, p = 0.009), comparing with those without. Conclusion: We found that a high proportion of ERA patients had sacroiliitis and a significant number of them had radiological structural changes during early disease. Our findings illustrate the importance of prompt diagnosis and early treatment in these children.
MeSH term(s)	Humans ; Child ; Adolescent ; Sacroiliitis/diagnostic imaging ; Sacroiliitis/epidemiology ; Sacroiliac Joint/diagnostic imaging ; Arthritis, Juvenile/complications ; Arthritis, Juvenile/diagnostic imaging ; Arthritis, Juvenile/epidemiology ; Prevalence ; Hong Kong/epidemiology ; Retrospective Studies ; Magnetic Resonance Imaging/methods
Language	English
Publishing date	2023-05-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2279468-2
ISSN	1546-0096 ; 1546-0096
ISSN (online)	1546-0096
ISSN	1546-0096
DOI	10.1186/s12969-023-00825-8
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Article ; Online: A novel infant microbiome formula (SIM03) improved eczema severity and quality of life in preschool children.

Chan, Oi Man / Xu, Wenye / Cheng, Nam Sze / Leung, Agnes Sze Yin / Ching, Jessica Yuet Ling / Fong, Brian Leong Yuen / Cheong, Pui Kuan / Zhang, Lin / Chan, Francis Ka Leung / Ng, Siew Chien / Leung, Ting Fan

Scientific reports

2024 Volume 14, Issue 1, Page(s) 3168

Abstract: Altered gut microbiome composition has been reported in children with eczema and interventions that restore beneficial bacteria in the gut may improve eczema. This open-label pilot study aimed to investigate the efficacy of a novel infant microbiome ... ...

Abstract	Altered gut microbiome composition has been reported in children with eczema and interventions that restore beneficial bacteria in the gut may improve eczema. This open-label pilot study aimed to investigate the efficacy of a novel infant microbiome formula (SIM03) in young children with eczema. Pre-school Chinese children aged 1-5 years old with eczema received SIM03 twice daily for three months. The novelty of SIM03 consists of both the use of a patented microencapsulation technology to protect the viability of unique Bifidobacterium bifidum and Bifidobacterium breve strains identified through big data analysis of large metagenomic datasets of young Chinese children. Paired stool samples at baseline and following SIM03 were analyzed by metagenomics sequencing. Generalized estimating equation was used to analyze changes in eczema severity, skin biophysical parameters, quality of life and stool microbiome. Twenty children aged 3.0 ± 1.6 years (10 with severe eczema) were recruited. Treatment compliance was ≥ 98%. SCORing Atopic Dermatitis score decreased significantly at two months (P = 0.008) and three months (P < 0.001), while quality of life improved significantly at 1, 2, and 3 months. The relative abundance of B. breve and microbial pathways on acetate and acetyl-CoA synthesis were enriched in stool samples at one month (P = 0.0014). Children who demonstrated increased B. bifidum after SIM03 showed improvement in sleep loss (P = 0.045). Relative abundance of B. breve correlated inversely with eczema extent (P = 0.023) and intensity (P = 0.019) only among patients with increased B. breve at Month 3. No serious adverse event was observed. In conclusion, SIM03 is well tolerated. This patented microbiome formula improves disease severity and quality of life in young eczematous children by enhancing the delivery of B. bifidum and B. breve in the gut. SIM03 is a potential treatment option for childhood eczema.
MeSH term(s)	Humans ; Infant ; Child, Preschool ; Child ; Quality of Life ; Pilot Projects ; Dermatitis, Atopic/therapy ; Dermatitis, Atopic/microbiology ; Bifidobacterium bifidum ; Gastrointestinal Microbiome/genetics ; Eczema/therapy
Language	English
Publishing date	2024-02-07
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-024-53848-w
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Article ; Online: Immune modulation by rural exposures and allergy protection.

Xing, Yuhan / Tsang, Miranda Sin-Man / Yang, Zhaowei / Wang, Maggie Haitian / Pivniouk, Vadim / Leung, Agnes Sze-Yin / Leung, Ting-Fan / Roponen, Marjut / Schaub, Bianca / Vercelli, Donata / Wong, Chun-Kwok / Li, Jing / Wong, Gary Wing-Kin

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

2024 Volume 35, Issue 2, Page(s) e14086

Abstract: Background: Growing up on traditional farms protects children from the development of asthma and allergies. However, we have identified distinct asthma-protective factors, such as poultry exposure. This study aims to examine the biological effect of ... ...

Abstract	Background: Growing up on traditional farms protects children from the development of asthma and allergies. However, we have identified distinct asthma-protective factors, such as poultry exposure. This study aims to examine the biological effect of rural exposure in China. Methods: We recruited 67 rural children (7.4 ± 0.9 years) and 79 urban children (6.8 ± 0.6 years). Depending on the personal history of exposure to domestic poultry (DP), rural children were further divided into those with DP exposure (DP Results: There was a stepwise increase in the percentage of eosinophils (%) from rural DP Conclusions: Immune responses of rural children were dampened compared to urban children and those exposed to DP had further downregulated immune responsiveness. DP dust extracts ameliorated Th2-driven allergic airway inflammation in mice. Determining active protective components in the rural environment may provide directions for the development of primary prevention of asthma.
MeSH term(s)	Child ; Humans ; Animals ; Mice ; Lipopolysaccharides/adverse effects ; Hypersensitivity ; Asthma ; Allergens ; Cytokines/metabolism ; Dust ; Inflammation ; Disease Models, Animal ; Immunity ; Mice, Inbred BALB C ; Ovalbumin/adverse effects
Chemical Substances	Lipopolysaccharides ; Allergens ; Cytokines ; Dust ; Ovalbumin (9006-59-1)
Language	English
Publishing date	2024-02-14
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.14086
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Article ; Online: Disparities in pediatric anaphylaxis triggers and management across Asia.

Leung, Agnes Sze Yin / Tham, Elizabeth Huiwen / Pacharn, Punchama / Xing, Yuhan / Trinh, Hoang Kim Tu / Lee, Sooyoung / Ahn, Kangmo / Chatchatee, Pantipa / Sato, Sakura / Ebisawa, Motohiro / Lee, Bee Wah / Wong, Gary Wing Kin

Allergy

2024

Abstract: Background: The epidemiology and management of anaphylaxis are not well-reported in Asia.: Methods: A regional pediatric anaphylaxis registry was established by the Asia-Pacific Research Network for Anaphylaxis (APRA), using standardized protocols ... ...

Abstract	Background: The epidemiology and management of anaphylaxis are not well-reported in Asia. Methods: A regional pediatric anaphylaxis registry was established by the Asia-Pacific Research Network for Anaphylaxis (APRA), using standardized protocols for prospective data collection, to evaluate the triggers and management of anaphylaxis in the Asia-Pacific region. Pediatric patients below 18 years presenting with anaphylaxis across four Asian countries/cities (Thailand, Singapore, Hong Kong (HK), and Qingdao) were included. Allergen triggers, symptoms, anaphylaxis severity, and management were compared. Results: Between 2019 and 2022, 721 anaphylaxis episodes in 689 patients from 16 centers were identified. The mean age at anaphylaxis presentation was 7.0 years (SD = 5.2) and 60% were male. Food was the most common trigger (62%), particularly eggs and cow's milk in children aged 3 years and below. In school-age children, nut anaphylaxis was most common in HK and Singapore, but was rare in the other countries, and wheat was the top allergen in Bangkok. Shellfish anaphylaxis was most common in children aged 7-17. Adrenaline was administered in 60% of cases, with 9% given adrenaline before hospital arrival. Adrenaline devices were prescribed in up to 82% of cases in Thailand but none in Qingdao. Conclusions: The APRA identified food as the main trigger of anaphylaxis in children, but causative allergens differed even across Asian countries. Fewer than two-thirds of cases received adrenaline treatment, pre-hospital adrenaline usage was low, and adrenaline device prescription remained suboptimal. The registry recognizes an unmet need to strengthen anaphylaxis care and research in Asia-Pacific.
Language	English
Publishing date	2024-03-10
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	391933-x
ISSN	1398-9995 ; 0105-4538
ISSN (online)	1398-9995
ISSN	0105-4538
DOI	10.1111/all.16098
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