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Gastrointestinal (GI) allergies are divided into immunoglobulin E (IgE)-mediated, non-IgE-mediated, and mixed types. In addition to non-IgE-mediated, overlapping eosinophilic GI disorders (EGIDs) have increased in Japan. EGIDs, a mixed-type allergy category, include eosinophilic esophagitis (EoE) and non-EoE EGIDs. The number of EoE cases has increased in Western countries, followed by Asian countries. Recent GI allergies may also be associated with type 2 inflammation. |
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Allergen immunotherapy (AIT) has developed over the last few decades and has emerged as a promising treatment. House dust mite (HDM) is a target allergen in AIT, and various modified HDM allergens have been improved for their efficacy. Moreover, clinical trials have proved their significantly therapeutic effects in allergy. This article review focuses on HDM allergens developed for AIT efficacy,... |
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The risk of sudden acute respiratory syndrome coronavirus 2 infection and severe coronavirus disease 2019 (COVID-19) outcomes is not elevated in patients with the type 2 phenotype and well-controlled asthma. Inhaled corticosteroids, intranasal corticosteroids, and topical steroids can be safely used in COVID-19 patients. Biologics can be safely used by patients with allergic diseases without concern about antibody responses. |
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· Asthma in infants and preschoolers involves heterogeneous phenotypes. · Asthma diagnosis is based on symptom patterns, therapeutic responses, and the presence of risk factors with careful consideration of differential diagnosis. · Daily inhaled corticosteroid therapy remains the most effective strategy for managing persistent asthma symptoms irrespective of phenotype. · Future research, including genetic and molecular studies, is needed to develop a clear definition of asthma and personalized therapeutic approaches. |
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In the early days of the coronavirus disease 2019 (COVID-19) pandemic, allergic diseases, especially asthma, were considered to be risk factors for severe COVID-19 infection, hospitalization, and death. These concerns stemmed from the idea that individuals with allergic diseases are generally more susceptible to respiratory virus infections, which are major causes of exacerbation of allergic diseases. However, epidemiologic data with... |
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∙ Food intake strategies for preventing food allergies have undergone major changes over the past 20 years. ∙ In children with atopic dermatitis, indiscriminate food restrictions without diagnostic testing leads to nutritional imbalance and poor growth. ∙ When determining food restrictions for pediatric patients with atopic dermatitis, an accurate food allergy diagnosis must be preceded, and continuous parental education about food intake is required. |
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Question: What are the distinctive features of rural children with atopic dermatitis? Finding: Birch and dog dander were the second most sensitized aeroallergens (32.6%), followed by house dust mites. Doctors and guardians reported food allergy comorbidities differently (19.9% and 43.5%, respectively). Dietary restrictions without medical evaluation were observed in 39.7% of patients. Meaning: Effects of pollen distribution and indirect animal exposure should be evaluated. Evidence-based dietary restrictions must be implemented. |
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This national cohort study included all Korean children born in 2008 and 2009 observed over a period of more than 10 years. Our findings demonstrate that it is possible to analyze disease onset prior to hospitalization based on information such as lifestyle, eating habits, and risk factors by integrating National Health Insurance System data with national health screening data. |
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Question: Is age at the time of complementary food introduction associated with asthma and atopic dermatitis (AD) in early childhood? Finding: We found no significant association between age at the time of complementary food introduction and the incidence of AD and asthma in Koreans aged 1–3 years. Meaning: Our findings suggest that the influence of individual allergenic foods on the development of AD and asthma should be clarified. |
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Question: What are the roles of cofactors in food allergies and food-induced anaphylaxis? Finding: Cofactors reportedly play a role in approximately 14%–30% of anaphylactic reactions. Cofactors such as exercise, infection, nonsteroidal anti-inflammatory drugs, dehydration, and alcohol can increase intestinal permeability and antigen uptake, thereby causing allergic symptoms. Meaning: Routine assessment of the possible involvement of cofactors is essential for the management of patients with food-induced anaphylaxis. |
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Rhinitis is among the most common respiratory diseases in children. Nonallergic rhinitis, which involves nasal symptoms without evidence of systemic allergic inflammation or infection, is a heterogeneous entity with diverse manifestations and intensities. Nonallergic rhinitis accounts for 16%–89% of the chronic rhinitis cases, affecting 1%–50% (median 10%) of the total pediatric population. The clinical course of nonallergic rhinitis is generally... |
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Question: What factors are associated with bronchial hyperresponsiveness (BHR) in adolescents with childhood asthma? Finding: Age, mold sensitization, and increased eosinophil count were associated with BHR in boys versus a reduced forced expiratory volume in 1 second/forced vital capacity ratio in girls. Early mold sensitization was a risk factor for persistent BHR in boys only. Meaning: Sex-specific differences were observed in the factors associated with BHR in adolescents. |
Identifying phenotypes and endotypes of asthma patients is challenging, and eosinophilic phenotypes are generally characterized by severe or refractory asthma. Biologicals targeting eosinophils are promising for the control of severe or refractory asthma symptoms. To ensure proper treatment, increased understanding of the diverse phenotypes of high Th2 inflammation in pediatric asthma is needed. |
•In allergic eosinophilic asthma, eosinophils act as important effector cells and antigen-presenting cells, while in nonallergic eosinophilic asthma, type 2 innate lymphoid cells play an important role in eosinophil activation. •Sputum eosinophil counts can be helpful for evaluating allergic airway inflammation in asthma. • Anti-interleukin-5 has broadened the scope of asthma treatment. |
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The prevalence of pollen-food allergy syndrome (PFAS) in Korean children with pollen allergy was recently reported to be 42.7%. PFAS can cause a wide range of symptoms from mild allergy to severe anaphylaxis depending on the nature of food allergens that share the epitopes with pollen. Cases of anaphylaxis caused by PFAS have recently increased. Treatments for PFAS should be individualized for patients according to the severity of symptoms. |
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Question: What should be considered in children who complain of pork allergies? Finding: History of raising a cat, the onset of symptoms after the ingestion of pork and specific IgE tests to pork, cat, milk, and Alpha-gal are needed. Meaning: Pork cat syndrome could be the cause of pork allergies. |
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Although the efficacy of montelukast is inferior to that of ICS, both physicians and parents prefer montelukast to ICSs. EDN may be a useful biomarker for the treatment and monitoring of preschool children with asthma. The US FDA requires boxed warning about serious neuropsychiatric events of montelukast, therefore, physicians should consider the benefits and risks of montelukast before prescribing it. |
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Background: Major questions remain regarding the agestratified trends of allergic diseases and asthma in Korea.
Purpose: To identify the estimated recent prevalence and 10- year trends in asthma, allergic rhinitis, and atopic dermatitis among the Korean population from 2008 to 2017. Methods: This nationwide cross-sectional survey (Korean National Health and Nutrition Examination Survey) over 10 years (2008–2017) examined representative samples of the... |
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The drug allergy “label” may have a lifetime of consequences for a child. Many children with alleged drug allergies are proven to be tolerant to the culprit medication when challenged. The field of drug hypersensitivity is a recently evolving field of research, but studies on its epidemiology and diagnostic tools are lacking in children. Clinical history is significant in the... |
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Question: Is physician-diagnosed current asthma in preschool children associated with the asthma predictive index, atopic sensitization, or pulmonary function test? Finding: Physician-diagnosed current asthma in preschool children was associated with the asthma predictive index, but not with spirometry, methacholine provocation test, fractional expiratory nitric oxide level, and atopic sensitization. Meaning: Physician-diagnosed asthma in preschool children may be different from classic atopic asthma in school children or adolescents. |
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Background: Researchers have shown that eosinophil peroxidase (EPO) is a relatively accurate marker of eosinophilia and eosinophil activity. However, its use as a marker of eosinophilic inflammation in nasal secretions is limited because the diagnostic cutoff values of EPO for use as a one-time test for allergic diseases such as allergic rhinitis have not been established.
Purpose: To identify the correlation... |
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