New Clinical Advances in Pediatric Allergic Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Pediatrics".

Deadline for manuscript submissions: 28 February 2025 | Viewed by 4012

Special Issue Editor


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Guest Editor
Allergy Unit, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
Interests: allergic diseases; inflammation; allergy diagnosis; allergic sensitization; autoimmunity; respiratory allergic diseases; precision medicine; microbiota; biotics
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Special Issue Information

Dear Colleagues,

Pediatric allergic diseases encompass a group of conditions including food allergy, atopic dermatitis, eosinophilic esophagitis, asthma, and allergic rhinitis, that share several inflammatory pathways and risk factors.

In the last decade, several studies have shown that an early introduction of allergenic foods prevents the development of food allergies, especially in children that are at high risk of conditions such as eczema; however, the dose, frequency and duration to reach oral tolerance as well as the role of other environmental factors need to be further explored.

The increasing availability of new foods poses an increasing likelihood of the development of novel allergens and risk for severe allergic reactions.

New insights in non-IgE and mixed food allergies increase awareness of these conditions among clinicians; nonetheless, the diagnosis remain challenging given the variability in symptom presentation, clinical similarity to other diseases and the lack of a pathogenic diagnostic tests or biomarkers.

The increasing knowledge of different phenotypes and endotypes has shifted the existing paradigms in the approach to allergic diseases, moving towards a personalized approach. Concerning food allergies, individuals who need higher levels of allergen exposure to induce symptoms may be able to take a less restrictive approach to allergen avoidance.

Active management options, such as food immunotherapy, also show promise in increasing the threshold of reaction, providing patients with alternatives to strict food avoidance.

Many new treatment options are available for school age asthma, including biological targeting type-2 inflammation, but a paucity of options are available for children with poorly controlled asthma, who do not have evidence of type 2 inflammation.

Before personalizing one’s treatment, it is pivotal to make a correct diagnosis, avoiding the risk of misdiagnosis, and optimize basic management.

The aim of this Special Issue is to bring up-to-date information on new clinical advances in pediatric allergic diseases, and we welcome manuscripts that address any of these issues.

Dr. Enza D'Auria
Guest Editor

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Keywords

  • allergic diseases
  • biomarkers
  • tailor treatment
  • allergen immunotherapy
  • biologics

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Published Papers (2 papers)

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Research

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16 pages, 1048 KiB  
Article
Exploring TSLP and IL-33 Serum Levels and Genetic Variants: Unveiling Their Limited Potential as Biomarkers for Mild Asthma in Children
by Joanna Połomska, Hanna Sikorska-Szaflik, Anna Drabik-Chamerska, Barbara Sozańska and Anna Dębińska
J. Clin. Med. 2024, 13(9), 2542; https://doi.org/10.3390/jcm13092542 - 26 Apr 2024
Cited by 2 | Viewed by 1115
Abstract
As the burden of mild asthma is not well understood, the significance of expanding research in the group of patients with mild asthma is emphasized. Thymic stromal lymphopoietin (TSLP) and interleukin 33 (IL-33) are involved in the pathogenesis of atopy and the immune [...] Read more.
As the burden of mild asthma is not well understood, the significance of expanding research in the group of patients with mild asthma is emphasized. Thymic stromal lymphopoietin (TSLP) and interleukin 33 (IL-33) are involved in the pathogenesis of atopy and the immune response to inhaled environmental insults, such as allergens, in asthmatic patients. Objectives: The objective of this study was to explore the correlation between specific polymorphisms within the genes encoding TSLP and IL-33, as well as the concentrations of TSLP and IL-33 in the serum, and the occurrence of pediatric mild asthma. Methods: The analysis encompassed 52 pediatric patients diagnosed with mild bronchial asthma, including both atopic and non-atopic cases, and a control group of 26 non-asthmatic children. Recruitment was conducted through a comprehensive questionnaire. Parameters such as allergic sensitization, serum levels of circulating TSLP and IL-33, and the identification of single-nucleotide polymorphisms in TSLP (rs11466750 and rs2289277) and IL-33 (rs992969 and rs1888909) were assessed for all participants. Results: Significantly lower mean serum TSLP concentrations were observed in asthmatic subjects compared to the control group, with atopic asthma patients showing even lower TSLP levels than non-atopic counterparts. No significant differences were found in mean serum IL-33 concentrations between the two groups. Considering the allele model, for both tested SNPs of IL-33, we observed that patients with asthma, atopic asthma, and atopy statistically less frequently possess the risk allele. Conclusions: Our study findings suggest that IL-33 and TSLP do not serve as ideal biomarkers for mild asthma in children. Their effectiveness as biomarkers might be more relevant for assessing disease severity rather than identifying asthma in pediatric patients. Further research focusing on the association between TSLP and IL-33 gene polymorphisms and asthma is expected to significantly advance disease management. Full article
(This article belongs to the Special Issue New Clinical Advances in Pediatric Allergic Diseases)
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Review

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33 pages, 1571 KiB  
Review
Malnutrition and Allergies: Tipping the Immune Balance towards Health
by Emilia Vassilopoulou, Carina Venter and Franziska Roth-Walter
J. Clin. Med. 2024, 13(16), 4713; https://doi.org/10.3390/jcm13164713 - 11 Aug 2024
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Abstract
Malnutrition, which includes macro- and micronutrient deficiencies, is common in individuals with allergic dermatitis, food allergies, rhinitis, and asthma. Prolonged deficiencies of proteins, minerals, and vitamins promote Th2 inflammation, setting the stage for allergic sensitization. Consequently, malnutrition, which includes micronutrient deficiencies, fosters the [...] Read more.
Malnutrition, which includes macro- and micronutrient deficiencies, is common in individuals with allergic dermatitis, food allergies, rhinitis, and asthma. Prolonged deficiencies of proteins, minerals, and vitamins promote Th2 inflammation, setting the stage for allergic sensitization. Consequently, malnutrition, which includes micronutrient deficiencies, fosters the development of allergies, while an adequate supply of micronutrients promotes immune cells with regulatory and tolerogenic phenotypes. As protein and micronutrient deficiencies mimic an infection, the body’s innate response limits access to these nutrients by reducing their dietary absorption. This review highlights our current understanding of the physiological functions of allergenic proteins, iron, and vitamin A, particularly regarding their reduced bioavailability under inflamed conditions, necessitating different dietary approaches to improve their absorption. Additionally, the role of most allergens as nutrient binders and their involvement in nutritional immunity will be briefly summarized. Their ability to bind nutrients and their close association with immune cells can trigger exaggerated immune responses and allergies in individuals with deficiencies. However, in nutrient-rich conditions, these allergens can also provide nutrients to immune cells and promote health. Full article
(This article belongs to the Special Issue New Clinical Advances in Pediatric Allergic Diseases)
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