Food Allergy in Children with Atopic Dermatitis (Possibilities of Laboratory Diagnosis)

Objective - determination of the frequency of manifestation of allergic reactions of reaginic and cellular types in vitro to food allergens in children with atopic dermatitis (AD). Materials and methods. We examined 284 children aged 0 to 14 years: 200 children with AD in 4 age groups and 84 control children. Investigated total IgE, histamine and serotonin in the blood. A semi-quantitative method in ELISA identified specific IgE antibodies to 67 food allergens, and in leukocyte migration capillary tube technique (LMCT) the presence of delayed-type sensitization to 42 food allergens. Results. The levels of total Ig E, histamine and serotonin in children with AD were significantly higher than the control. The average value of positive results for the presence of specific IgE antibodies to any food allergens was 46.2±4.57%. Banana, goat's milk, tomatoes, egg protein and cow's milk casein topped the ranking. According to the results of LMCT, delayed sensitization of the cell type was determined on average in 40.38±4.81% of tests. The leaders were allergens of hake, black coffee, glucose, peas, rye flour, orange, corn flour and peanuts. Conclusions.AD develops in children already at an early age (up to 3 years), with an excess of control values of total serum IgE by 4.8 times (p<0.01), histamine - by 1.3 times (p<0.01), serotonin - 1.2 times (р<0.001). Reaginic and cellular reactions are involved in the occurrence of food sensitization. Methods of laboratory diagnosis of food allergy are preferable to skin tests and allow young children to simultaneously determine sensitization to a large number of allergens.

1. Yepes-Nuñez J.J., Guyatt G.H., Gómez-Escobar L.G., Pérez-Herrera L.C., Chu A.W., Ceccaci L., Acosta-Madiedo A.S., Wen A., et al. Allergen immunotherapy for atopic dermatitis: Systematic review and meta-analysis of benefits and harms. J Allergy Clin Immunol. 2023;151(1):147-158. DOI: 10.1016/j.jaci.2022.09.020.

2. Ivanov O.L., L'vov A.N., Michenko A.V. Atopic dermatitis: modern concepts. RMJ. 2007;19:1362 (in Russ.)

3. Yew Y.W., Thyssen J.P., Silverberg J.I. A systematic review and meta-analysis of the regional and age-related differences in atopic dermatitis clinical characteristics. J Am Acad Dermatol. 2019;80(2): 390-401. DOI: 10.1016/j.jaad.2018.09.035.

4. Choi W.J., Ko J.Y., Kim J.W. Lee K.H., Park C.W., Kim K.H., Kim M.N., Lee A.Y., et al. Prevalence and risk factors for atopic dermatitis: a cross-sectional study of 6,453 Korean preschool children. Acta Derm Venereol. 2012;92(5):467-471. DOI: 10.2340/00015555-1252

5. Williams H., Robertson C., Stewart A., Aït-Khaled N., Anabwani G., Anderson R., Asher I., Beasley R., et al. Worldwide variations in the prevalence of symptoms of atopic eczema in the International Study of Asthma and Allergies in Childhood. J. Allergy Clin Immunol. 1999;103:125-138. DOI: 10.1016/s0091-6749(99)70536-1

6. Hatakka K., Piirainen L., Pohjavuori S., Poussa T., Savilahti E., Korpela R. Allergy in day care children: prevalence and environmental risk factors. Acta Paediatr. 2009;98(5):817-822. DOI: 10.1111/j.1651-2227.2008.01198.x

7. Van de Ven M.O., van den Eijnden R.J., Engels R.C. Atopic diseases and related risk factors among Dutch adolescents. Eur J Public. Health. 2006;16(5):549-558. DOI: 10.1093/eurpub/ckl022.

8. Lapidus C.S., Schwarz D.F., Honig P.J. Atopic dermatitis in children: who cares? Who pays? J Am Acad Dermatol. 1993;28(5 Pt 1):699-703. DOI: 10.1016/0190-9622(93)70096-c

9. Haileamlak A., Lewis S.A., Britton J., Venn A.J., Woldemariam D., Hubbard R., Williams H.C. Validation of the International Study of Asthma and Allergies in Children (ISAAC) and U.K. criteria for atopic eczema in Ethiopian children. Br J Dermatol. 2005;152(4):735-741. DOI: 10.1111/j.1365-2133.2005.06511.x.

10. Yuksel H., Dinc G., Sakar A., Yilmaz O., Yorgancioglu A., Celik P., Ozcan C. Prevalence and comorbidity of allergic eczema, rhinitis, and asthma in a city in western Turkey. Investig Allergol Clin Immunol. 2008;18(1):31-35.

11. Gallyamova Yu., Chernysheva M., Tikhonova Yu. Prevalence of Atopic Dermatitis in Children in Russian Federation. Current Pediatrics. 2009;8(2):122-123 (in Russ.). EDN: KXFTWF.

12. Bogdanova E.V. Prevalence of atopic dermatitis among children 0-14 years old in the Russian Federation. Forcipe. 2022;5(2):76 (in Russ.). EDN: XYALOV.

13. Koz'eva V.V. Prevalence of bronchial asthma and atopic dermatitis in children. Alleya nauki. 2017;3(9):469-472 (in Russ.). EDN: YULEVT.

14. Volosovets A.P., Beketova G.V., Berezenko V.S., Mityuryaeva I.A., Volosovets T.N., Pochinok T.V. Dynamics of morbidity and prevalence of atopic dermatitis in children of Ukraine over the past 20 years: medical and environmental aspects. Pediatriya. Vostochnaya Evropa. 2021;9(2):206-216 (in Russ.). DOI: 10.34883/PI.2021.9.2.005. EDN: BFQAZD.

15. Shokouhi Shoormasti R., Sabetkish N., Kazemnejad A., Vahabi N., Fazlollahi M.R., Pourpak Z. Are the most common food allergens in an Iranian atopic population compatible with worldwide reports? A systemic review and meta-analysis with molecular classification of frequent allergens. Allergol Immunopathol (Madr). 2019;47(6):604-618. DOI: 10.1016/j.aller.2019.04.005.

16. Kelleher M.M., Cro S., Cornelius V., Carlsen K.C.L., Skjerven H.O., Rehbinder E.M., Lowe A.J., Dissanayake E., et al. Skin care interventions in infants for preventing eczema and food allergy. Cochrane Database Syst Rev. 2021;2(2):CD013534. DOI: 10.1002/14651858.CD013534.pub2.

17. Pelucchi C., Galeone C., Bach J.F., La Vecchia C., Chatenoud L. Pet exposure and risk of atopic dermatitis at the pediatric age: a meta-analysis of birth cohort studies. J Allergy Clin Immunol. 2013;132(3):616-622.e7. DOI: 10.1016/j.jaci.2013.04.009.

18. Zajnullina O.N., Pechkurov D.V., KHismatullina Z.R. Dushina K.Yu., Gankovskaya L.V. Study of the Level of Integrins ITGA4 and ITGB7 in Blood Serum in Children with Atopic Dermatitis.Russian Journal of Clinical Dermatology and Venereology. 2020;19(6):817-822 (in Russ.). DOI: 10.17116/klinderma202019061817. EDN: BYVQFP.

19. Hulshof L., Overbeek S.A., Wyllie A.L., Chu M.L.J.N., Bogaert D., de Jager W., Knippels L.M.J., Sanders E.A.M., et al. Exploring Immune Development in Infants With Moderate to Severe Atopic Dermatitis. Front Immunol. 2018;9:630. DOI: 10.3389/fimmu.2018.00630.

20. Kenmoe S., Kengne-Nde C, Modiyinji A.F., Bigna J.J., Njouom R. Association of early viral lower respiratory infections and subsequent development of atopy, a systematic review and meta-analysis of cohort studies. PLoS One. 2020;15(4):e0231816. DOI: 10.1371/journal.pone.0231816.

21. Fedenko E.S. Atopic Dermatitis. In: Allergology and Immunology: National Guidelines. Khaitov R.M., Ilyina N.I., editors. Moscow: GEOTAR-Media, 2009: 436-456 (in Russ.)

22. Luo Y., Zhang G.Q., Li Z.Y. The diagnostic value of APT for food allergy in children: a systematic review and meta-analysis. Pediatr Allergy Immunol. 2019;30(4):451-461. DOI: 10.1111/pai.13031.

23. Proshina L.YA. Study of histamine and serotonin in one blood sample. Laboratornoe delo. 1981;(2):90-93 (in Russ.)

24. Potemkina A.M. Diagnosis and treatment of allergic diseases in children. Kazan: Kazan University Publishing House, 1990. 412 p. (in Russ.)

25. Trunova O.A. Individual selection of immunomodulatory and vitamin preparations for miners who often suffer from ARVI. Lіkars'ka sprava. 1996;(10-12):148-152 (in Russ.)