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Article ; Online: Heated egg yolk challenge predicts the natural course of hen’s egg allergy

Yu Okada / Noriyuki Yanagida / Sakura Sato / Motohiro Ebisawa

World Allergy Organization Journal, Vol 9, Iss 1, Pp 1-

a retrospective study

2016 Volume 8

Abstract: Abstract Background Children do not always outgrow hen’s egg allergies in early childhood. Because egg yolks are less allergenic than egg whites, we performed an oral food challenge with heated egg yolk slightly contaminated with egg white (EYSEW OFC) in ...

Abstract	Abstract Background Children do not always outgrow hen’s egg allergies in early childhood. Because egg yolks are less allergenic than egg whites, we performed an oral food challenge with heated egg yolk slightly contaminated with egg white (EYSEW OFC) in infants allergic to hen’s egg. We hypothesized that the EYSEW OFC results would predict the egg allergy’s natural course. Methods We retrospectively reviewed participants with hen’s egg allergy who underwent their first EYSEW OFC at 12–23 months of age between 2004 and 2010. Participants who passed the first EYSEW OFC were defined as EYSEW-tolerant, and participants who failed the OFC were defined as EYSEW-reactive. Participants who passed the EYSEW OFC underwent an OFC with half of a heated whole egg (WE OFC). Participants who passed a WE OFC were defined to be heated hen’s egg-tolerant. Participants who failed the EYSEW OFC or the WE OFC underwent another OFC at least 6 months later. We compared tolerance to heated hen’s egg at 36 months after the first EYSEW OFC between EYSEW-tolerant and EYSEW-reactive participants. Univariate and multivariate logistic regression analyses were conducted. Results Of the 197 included participants (median age: 18.3 months; range: 12.1–23.8 months), 179 (90.9 %) were EYSEW tolerant and 18 (9.1 %) were EYSEW reactive. At 36 months after the first EYSEW OFC, 164 EYSEW-tolerant (91.6 %) and 12 EYSEW-reactive participants (66.7 %) achieved heated hen’s egg tolerance. In the univariate logistic regression analyses, EYSEW-reactive participants (crude odds ratio [OR], 5.5 [95 % confidence intervals [CI], 1.8–16.6]; p = 0.003) and those with baseline egg white sIgE levels (crude OR: 3.9 per ten-fold increase [95 % CI, 1.5–10.2]; p = 0.005) had greater odds of persistent allergy to hen’s egg at 36 months after the first EYSEW OFC. In a multivariate logistic regression analysis after adjustment for baseline egg white sIgE, EYSEW-reactive participants had greater odds of persistent allergy to hen’s egg than EYSEW-tolerant participants (adjusted OR: 4.6 [95 % CI, 1.5–15.0]; p = 0.003). Conclusions Classifying infants who are allergic to hen’s egg into EYSEW tolerant and EYSEW reactive groups was useful in determining prognosis.
Keywords	Challenge test ; Egg allergy ; Food allergy ; Specific IgE ; Prognosis ; Medicine ; R ; Internal medicine ; RC31-1245 ; Specialties of internal medicine ; RC581-951 ; Immunologic diseases. Allergy ; RC581-607
Language	English
Publishing date	2016-10-01T00:00:00Z
Publisher	BioMed Central
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Better management of cow's milk allergy using a very low dose food challenge test

Yu Okada / Noriyuki Yanagida / Sakura Sato / Motohiro Ebisawa

Allergology International, Vol 64, Iss 3, Pp 272-

A retrospective study

2015 Volume 276

Abstract: Background: Low dose reactive cow's milk (CM) allergic children are at high risk of persistent CM allergy and a positive oral food challenge (OFC). The present study aimed to evaluate if the results of a very low dose (VL) OFC with these children ... ...

Abstract	Background: Low dose reactive cow's milk (CM) allergic children are at high risk of persistent CM allergy and a positive oral food challenge (OFC). The present study aimed to evaluate if the results of a very low dose (VL) OFC with these children contributes to better management of CM allergy. Methods: We retrospectively reviewed subjects with CM allergy who underwent a VL OFC with 3 mL heated CM and had a previous allergic reaction to <25 mL heated CM in the 2 years before the OFC. Subjects who passed the OFC were defined as VL tolerant, and subjects who failed were defined as VL reactive. VL tolerant subjects increased the dose to 25 mL heated CM either during an OFC in our hospital or gradually at home. Results: Of the 83 subjects (median age, 4.3 years; range, 1.0–12.9 years) who were included, 41 (49.4%) were VL tolerant, and 42 (51.6%) were VL reactive. Thirty-nine VL reactive subjects had skin and/or respiratory symptoms during the OFC. Most reactions could be treated with an antihistamine and/or a nebulized β2 agonist. The VL tolerant subjects consumed 3 mL heated CM or 10 g butter. Within the year following the OFC, 18 VL tolerant subjects (45.0%), but none of the VL reactive subjects, were able to consume 25 mL heated CM (p < 0.001). Conclusions: A VL OFC allows the management of some low dose reactive CM allergic children to change from complete avoidance to partial intake of CM.
Keywords	Milk hypersensitivity ; Disease management ; Food allergy ; Food hypersensitivity ; Specific IgE ; Medicine ; R ; Internal medicine ; RC31-1245 ; Specialties of internal medicine ; RC581-951 ; Immunologic diseases. Allergy ; RC581-607
Subject code	610
Language	English
Publishing date	2015-07-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Do Longer Intervals between Challenges Reduce the Risk of Adverse Reactions in Oral Wheat Challenges?

Noriyuki Yanagida / Takanori Imai / Sakura Sato / Motohiro Ebisawa

PLoS ONE, Vol 10, Iss 12, p e

2015 Volume 0143717

Abstract: The use of oral food challenges (OFCs) in clinics is limited because they are complicated and associated with anaphylactic symptoms. To increase their use, it is necessary to develop novel, effective, and safe methods. However, the effectiveness of ... ...

Abstract	The use of oral food challenges (OFCs) in clinics is limited because they are complicated and associated with anaphylactic symptoms. To increase their use, it is necessary to develop novel, effective, and safe methods. However, the effectiveness of different OFCs has not been compared.To investigate the effect of ingestion methods on wheat allergy symptoms and treatment during OFCs.Without changing the total challenge dose, we changed the administration method from a 5-installment dose titration every 15 min (15-min interval method) to 3 installments every 30 min (30-min interval method). We retrospectively reviewed and compared the results of 65 positive 15-min interval wheat challenge tests conducted between July 2005 and February 2008 and 87 positive 30-min interval tests conducted between March 2008 and December 2009.A history of immediate symptoms was more common for the 30-min interval method; however, no difference between methods was observed in other background parameters. Switching from the 15-min to the 30-min interval method did not increase symptoms or require treatment. The rate of cardiovascular symptoms (p = 0.032), and adrenaline use (p = 0.017) was significantly lower with the 30-min interval method. The results did not change after adjusting for the effects of immediate symptom history in multivariate analysis.This study suggests that the 30-min interval method reduces the risk of adverse events, compared to the 15-min interval method.
Keywords	Medicine ; R ; Science ; Q
Subject code	310
Language	English
Publishing date	2015-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Correction

Noriyuki Yanagida / Takanori Imai / Sakura Sato / Motohiro Ebisawa

PLoS ONE, Vol 10, Iss 12, p e

Do Longer Intervals between Challenges Reduce the Risk of Adverse Reactions in Oral Wheat Challenges?

2015 Volume 0145567

Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2015-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A Safe and Effective Method for Wheat Oral Immunotherapy

Alireza Khayatzadeh / Mohamad Gharaghozlou / Motohiro Ebisawa / Raheleh Shokouhi Shoormasti / Masoud Movahedi

Iranian Journal of Allergy, Asthma and Immunology, Vol 15, Iss

2017 Volume 6

Abstract: At present the only available management for food allergy is avoidance; however, abstaining from allergic foods can affect the quality of life. Oral Immunotherapy (OIT) is an efficient method for increasing tolerance towards food allergens. The aim of ... ...

Abstract	At present the only available management for food allergy is avoidance; however, abstaining from allergic foods can affect the quality of life. Oral Immunotherapy (OIT) is an efficient method for increasing tolerance towards food allergens. The aim of this study was desensitizing patients above five years of age with wheat allergy and evaluating the safety and efficacy of OIT for children with IgE-mediated wheat allergy. The method of Rush Oral Immunotherapy (ROIT) was performed on 8 anaphylactic wheat allergic patients as well as outpatient method on 5 non-anaphylactic ones. In ROIT, build-up phase was performed during several days, but in outpatient, the amount of ingestion gradually increased to 5.2 g wheat protein within several weeks. After that, maintenance doses were prescribed daily for 3 months. Then, if the oral food challenge (OFC) was negative, the patients were considered to be in desensitized state, which meant they had to continue eating same doses without interruption. In ROIT, build-up phase continued for about 4.6 days during which, 21 from 71 doses, showed clinical symptoms (29.6%). On the contrary, outpatient method lasted approximately 72.4 days in which 356 doses were used and symptoms developed in only 9 doses (2.5%). In total –regardless of type of build-up phase– 12 patients could complete the maintenance phase with 1080 doses that 28 of them (2.6%) developed mild symptoms. Our OIT study proved to be safe and effective, although it is utterly evident that further investigation on more patients is necessary.
Keywords	Food allergy ; Food hypersensitivity ; Food immunotherapy ; Oral desensitization ; Wheat ; Wheat hypersensitivity ; Medicine ; R
Subject code	610
Language	English
Publishing date	2017-12-01T00:00:00Z
Publisher	Tehran University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Acute asthma management during SARS-CoV2-pandemic 2020

Michael Levin / Ignacio J. Ansotegui / Jonathan Bernstein / Yoon-Seok Chang / Manana Chikhladze / Motohiro Ebisawa / Alessandro Fiocchi / Enrico Heffler / Bryan Martin / Mario Morais-Almeida / Nikolaos G. Papadopoulos / David Peden / Gary W.K. Wong

World Allergy Organization Journal, Vol 13, Iss 5, Pp - (2020)

2020

Abstract: Background: The current COVID-19 pandemic has changed many medical practices in order to provide additional protection to both our patients and healthcare providers. In many cases this includes seeing patients through electronic means such as telehealth ... ...

Abstract	Background: The current COVID-19 pandemic has changed many medical practices in order to provide additional protection to both our patients and healthcare providers. In many cases this includes seeing patients through electronic means such as telehealth or telephone rather than seeing them in person. Asthma exacerbations cannot always be treated in this way. Problem: Current emergency unit asthma guidelines recommend bronchodilators be administered by metered dose inhaler (MDI) and spacer for mild-moderate asthma and include it as a choice even in severe asthma, but many emergency units continue to prefer nebulised therapy for patients who urgently require beta-agonists. The utilization of nebulised therapy potentially increases the risk of aerosolization of the coronavirus. Since nosocomial transmission of respiratory pathogens is a major threat in the context of the SARS-CoV-2 pandemic, use of nebulised therapy is of even greater concern due to the potential increased risk of infection spread to nearby patients and healthcare workers. Practical implications: We propose a risk stratification plan that aims to avoid nebulised therapy, when possible, by providing an algorithm to help better delineate those who require nebulised therapy. Protocols that include strategies to allow flexibility in using MDIs rather than nebulisers in all but the most severe patients should help mitigate this risk of aerosolised infection transmission to patients and health care providers. Furthermore, expedient treatment of patients with high dose MDI therapy augmented with more rapid initiation of systemic therapy may help ensure patients are less likely to deteriorate to the stage where nebulisers are required.
Keywords	Asthma ; COVID-19 ; Exacerbation ; Infectious risk ; Inhalers ; Protocol ; Immunologic diseases. Allergy ; RC581-607 ; covid19
Subject code	610
Language	English
Publishing date	2020-05-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Japanese Guideline for Childhood Asthma 2014

Yuhei Hamasaki / Yoichi Kohno / Motohiro Ebisawa / Naomi Kondo / Sankei Nishima / Toshiyuki Nishimuta / Akihiro Morikawa

Allergology International, Vol 63, Iss 3, Pp 335-

2014 Volume 356

Abstract: The Japanese Guideline for the Diagnosis and Treatment of Allergic Diseases 2013 (JAGL 2013) describes childhood asthma after the Japanese Pediatric Guideline for the Treatment and Management of Asthma 2012 (JPGL 2012) by the Japanese Society of ... ...

Abstract	The Japanese Guideline for the Diagnosis and Treatment of Allergic Diseases 2013 (JAGL 2013) describes childhood asthma after the Japanese Pediatric Guideline for the Treatment and Management of Asthma 2012 (JPGL 2012) by the Japanese Society of Pediatric Allergy and Clinical Immunology. JAGL 2013 provides information on diagnosis by age group from infancy to puberty (0–15 years of age), treatment for acute exacerbations, long-term management by anti-inflammatory drugs, daily life guidance, and patient education to allow non-specialist physicians to refer to this guideline for routine medical treatment. JAGL differs from the Global Initiative for Asthma Guideline (GINA) in that JAGL emphasizes early diagnosis and intervention at <2 years and 2–5 years of age. A management method, including step-up or step-down of long-term management drugs based on the status of asthma control levels, as in JAGL, is easy to understand, and thus the Guideline is suitable as a frame of reference for routine medical treatment. JAGL has also introduced treatment and management using a control test on children, recommending that the physician aim at complete control by avoiding exacerbation factors and by appropriate use of anti-inflammatory drugs.
Keywords	acute exacerbation ; anti-inflammatory drugs ; childhood asthma ; guideline ; long-term management ; Medicine ; R ; Internal medicine ; RC31-1245 ; Specialties of internal medicine ; RC581-951 ; Immunologic diseases. Allergy ; RC581-607
Subject code	610
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Skin Prick Test is Not Useful in the Diagnosis of the Immediate Type Food Allergy Tolerance Acquisition

Takanori Imai / Noriyuki Yanagida / Mika Ogata / Takatsugu Komata / Morimitsu Tomikawa / Motohiro Ebisawa

Allergology International, Vol 63, Iss 2, Pp 205-

2014 Volume 210

Abstract: Background: : Some studies have been reported about positioning of SPT in the diagnosis of food allergy. On the other hand, it is not yet clear about the positioning of SPT in the diagnosis of tolerance acquisition of the immediate type food allergy. ... ...

Abstract	Background: : Some studies have been reported about positioning of SPT in the diagnosis of food allergy. On the other hand, it is not yet clear about the positioning of SPT in the diagnosis of tolerance acquisition of the immediate type food allergy. Methods: The retrospective study had been conducted for 236 egg allergic children (51.3 months in mean), 127 milk allergic children (53.4 months), and 96 wheat allergic children (42.6 months). The retrospective analysis of serum nonspecific and antigen-specific IgE levels, SPT, and OFC had been conducted for each allergic patient. All OFC had been conducted to verify the acquisition of tolerance against eliminated food. Results: The OFC was positive in 61 (25.8%) hen's egg allergies, 34 (26.8%) milk allergies and 33 (34.4%) wheat allergies. The greatest AUC for each allergen is as following; hen's egg for egg white specific IgE at 0.745, milk/histamine (wheal) index at 0.718, and wheat for wheal size at 0.597. For the predictive decision points, the highest accuracy rate was at 25.8% for an egg white wheal of 9.5 mm, at 26.8% for a milk wheal of 9.5 mm, and at 34.4% for a wheal of 6.5 mm. Conclusions: As a result of this analysis, the diagnostic accuracy of SPT had not been satisfactory to judge the acquisition of tolerance in allergic children for eggs, milk and wheat. Therefore, this is not a strong evidence to testify the tolerance of the immediate type food allergy.
Keywords	food allergy ; food hypersensitivity ; oral food challenge ; skin prick test ; tolerance acquisition ; Medicine ; R ; Internal medicine ; RC31-1245 ; Specialties of internal medicine ; RC581-951 ; Immunologic diseases. Allergy ; RC581-607
Subject code	610
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Japan Food Allergen Labeling RegulationâHistory and Evaluation

Akiyama, Hiroshi / Motohiro Ebisawa / Takanori Imai

Advances in food and nutrition research. 2011, v. 62

2011

Abstract: According to a national survey of food allergy cases, the food-labeling system for specific allergenic ingredients (i.e., egg, milk, wheat, buckwheat, and peanut) in Japan was mandated under law on April 1, 2002. By Japanese law, labeling of allergens is ...

Abstract	According to a national survey of food allergy cases, the food-labeling system for specific allergenic ingredients (i.e., egg, milk, wheat, buckwheat, and peanut) in Japan was mandated under law on April 1, 2002. By Japanese law, labeling of allergens is designated as mandatory or recommended based on the number of cases of actual illness and the degree of seriousness. Mandatory labeling is enforced by the ministerial ordinance, and the ministerial notification recommends that foods containing walnut and soybean be labeled with subspecific allergenic ingredients. Additional labeling of shrimp/prawn and crab has also become mandatory since 2008. To monitor the validity of the labeling system, the Japanese government announced the official methods for detection of allergens in a November 2002 ministry notification. These official methods, including two kinds of enzyme-linked immunosorbent assay kits for screening, Western blotting analyses for egg and milk, and polymerase chain reaction analyses for wheat, buckwheat, peanut, shrimp/prawn and crab as confirmation tests, have provided a means to monitor the labeling system. To standardize the official methods, the Japanese government described the validation protocol criteria in the 2006 official guidelines. The guidelines stipulate that any food containing allergen proteins at greater than 10mg/kg must be labeled under the Law. This review covers the selection of the specific allergenic ingredients by the Japanese government, the implementation of regulatory action levels and the detection methods to support them, and the assessment of the effectiveness of this approach.
Keywords	allergenicity ; allergens ; buckwheat ; crabs ; eggs ; enzyme-linked immunosorbent assay ; food allergies ; food labeling ; foods ; guidelines ; ingredients ; milk ; national surveys ; peanuts ; polymerase chain reaction ; proteins ; screening ; shrimp ; soybeans ; walnuts ; Western blotting ; wheat ; Japan
Language	English
Size	p. 139-171.
Publishing place	Elsevier Science & Technology
Document type	Article
ZDB-ID	1011108-6
ISSN	1043-4526
ISSN	1043-4526
DOI	10.1016/B978-0-12-385989-1.00004-1
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Japanese Guideline for Food Allergy 2014

Atsuo Urisu / Motohiro Ebisawa / Komei Ito / Yukoh Aihara / Setsuko Ito / Mitsufumi Mayumi / Yoichi Kohno / Naomi Kondo

Allergology International, Vol 63, Iss 3, Pp 399-

2014 Volume 419

Abstract: A food allergy is defined as "a phenomenon in which adverse reactions are caused through antigen-specific immunological mechanisms after exposure to given food." Various symptoms of food allergy occur in many organs. Food allergies are classified roughly ...

Abstract	A food allergy is defined as "a phenomenon in which adverse reactions are caused through antigen-specific immunological mechanisms after exposure to given food." Various symptoms of food allergy occur in many organs. Food allergies are classified roughly into 4 clinical types: (1) neonatal and infantile gastrointestinal allergy, (2) infantile atopic dermatitis associated with food allergy, (3) immediate-type food allergy (urticaria, anaphylaxis, etc.), and (4) food dependent exercise-induced anaphylaxis and oral allergy syndrome (i.e., specific forms of immediate food allergy). The therapy for food allergies includes treatment of and prophylactic measures against hypersensitivity such as anaphylaxis. A fundamental prophylactic measure is the elimination diet. However, elimination diets should be used only if necessary because of the patient-related burden. For this purpose, it is very important that causative foods be accurately identified. There are a number of means available to identify causative foods, including the history taking, a skin prick test, detection of antigen-specific IgE antibodies in the blood, the basophil histamine release test, the elimination diet test, and the oral challenge test, etc. Of these, the oral challenge test is the most reliable. However, it should be conducted under the supervision of experienced physicians because it may cause adverse reactions, such as anaphylaxis.
Keywords	elimination diet ; food allergy ; IgE-mediated type ; non-IgE-mediated type ; oral food challenge ; Medicine ; R ; Internal medicine ; RC31-1245 ; Specialties of internal medicine ; RC581-951 ; Immunologic diseases. Allergy ; RC581-607
Subject code	590
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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