| High prevalence of food sensitisation in young children with liver disease: a clue to food allergy pathogenesis? | |
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MedLine Citation:
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PMID: 23050587 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: The pathogenesis of food allergy is not completely understood - animal models suggest hepatic mechanisms may be important for immune tolerance to orally ingested antigens, but there is little direct evidence for this in humans. OBJECTIVES: We investigated whether there is an association between liver dysfunction or transplantation in young children and IgE sensitisation to food. METHODS: We evaluated paired pre- and post- liver transplant sera from children aged 0-36 months treated at a single centre during 2001-2008. Sera were assayed for total IgE and cow's milk, egg and peanut-specific IgE. We quantified hepatic dysfunction pre-transplant using the Paediatric End-stage Liver Disease (PELD) score. We also assessed 70 children after renal transplant to establish whether any association between liver transplant and food sensitisation was organ specific. RESULTS: Paired sera were available from 50 of 94 children who had a liver transplant during the study period. 35 of 50 (70%) had IgE sensitisation (≥0.35 kUa/l) to ≥1 food pre-transplant and 18 (36%) post-transplant (p = 0.001). Ten (20%) children had food-specific IgE levels that carry high probability of challenge-confirmed food allergy pre-transplant. Food sensitisation pre-transplant was associated with severity of liver dysfunction [mean (s.d.) pre-transplant PELD score 1.52 (0.13) in food sensitised, 0.77 (0.22) in non-sensitised children p = 0.004]. Total IgE level was raised in 34/42 (81%) pre-transplant and fell significantly post-transplant. Interview assessment of the parents of 40 children revealed that 13 (33%) had a history consistent with food allergy. These findings were not replicated in the renal transplant group. CONCLUSIONS: Young children with severe liver dysfunction appear to have a high prevalence of food sensitisation. Hepatic mechanisms may therefore be important for establishing immune tolerance to dietary antigens in humans. |
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Authors:
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Chrysothemis Brown; Natasha Haringman; Charlotte Davies; Claudia Gore; Munther Hussain; Giorgina Mieli-Vergani; Diego Vergani; John O Warner; Stephen D Marks; Robert J Boyle |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-10-11 |
Journal Detail:
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Title: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology Volume: - ISSN: 1399-3038 ISO Abbreviation: Pediatr Allergy Immunol Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-10-11 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9106718 Medline TA: Pediatr Allergy Immunol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2012 John Wiley & Sons A/S. |
Affiliation:
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Department of Paediatrics, Imperial College London, London, UK. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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