Prevention of allergy
Where are we in 2015 ?
Dr Masy Nadine
European Exam in Allergology
UEMS Examination EAACI
Certificat...
The gut microbiota :
in the early development of both local and systemic immune maturation and programming
Studies on prev...
Microbial Activities and Intestinal Homeostasis: A Delicate Balance Between Health and DiseaseChristina L. Ohland1 and Chr...
The gut microbiota :
in the early development of both local and systemic immune maturation and programming
Studies on prev...
The immune system and the
gut microbiota: friends or
foes? N. Cerf-Bensussan,
V.Gaboriau-Routhiau.
Nature Reviews Immunolo...
Studies on prevention :
5. The gut microbiota of the pregnant woman
Gut microbiota and allergy: the importance of the preg...
Studies on prevention :
6. The gut microbiota of the pregnant woman
Epigenetic changes of the promoter region of immunoreg...
Studies on prevention :
7. The gut microbiota of the pregnant woman
There is a temporal dissociation between the major cha...
Seventeen studies, reporting data from 4755 children
(2381 in the probiotic group and 2374 in the control group)
Infants t...
In a recent large meta-analysis performed on 25 trials,
the authors concluded that a prenatal and/or early-life probi-
oti...
Studies on prevention :
10. Microbial exposure and colonization
Promising candidates for allergy preventionJames E. Gern, ...
Studies on prevention :
11. Epigenetics and farm exposure in childhood
Michel S, Busato F, Genuneit J, et al. Farm exposur...
Studies on prevention :
12. Early moisturizing in infants at risk for
atopic dermatitis
Simpson EL, Chalmers JR, Hanifin J...
Horimukai K, Morita K, Narita M, Kondo M, et al. Application of moisturizer to neonates prevents development of atopic der...
Gueniche A, Knaudt B, Schuck E, et al. Effects of non-pathogenic gram-negative bacterium Vitreoscilla filiformis lysate on...
Gueniche A, Knaudt B, Schuck E, et al. Effects of non-pathogenic gram-negative bacterium Vitreoscilla filiformis lysate on...
Gueniche A, Knaudt B, Schuck E, et al. Effects of non-pathogenic gram-negative bacterium Vitreoscilla filiformis lysate on...
Studies on prevention :
17. Studies on weaning
Du Toit G, Katz Y, Sasieni P, et al. Early consumption of peanuts in infanc...
Studies on prevention :
18. Studies on weaning : peanut
Du Toit G, Katz Y, Sasieni P, et al. Early consumption of peanuts ...
Studies on prevention :
19. Studies on weaning : Israelic children
Du Toit G, Katz Y, Sasieni P, et al. Early consumption ...
Studies on prevention :
20. Studies on weaning : peanut consumption
Du Toit G, Roberts G, Sayre PH, et al. Randomized tria...
Studies on prevention :
21. Guidelines of the AAAAI
early peanut introduction
J Allergy Clin Immunol 2015;136:258-61
The A...
Studies on prevention :
22. Early exposure to cow’s milk protein
Katz Y, Rajuan N, Goldberg MR, et al. Early exposure to c...
Studies on prevention :
23. Studies on weaning : early egg introduction
Palmer DJ, Metcalfe J, Makrides M, et al. Early re...
Studies on prevention :
24. Studies on weaning : early egg introduction
Palmer DJ, Metcalfe J, Makrides M, et al. Early re...
Studies on prevention :
25. Studies on weaning :
early egg introduction (Melbourne, Australia)
Koplin JJ, Osborne NJ, Wake...
Studies on prevention :
26. Studies on weaning :
early egg introduction (Melbourne, Australia)
Koplin JJ, Osborne NJ, Wake...
Studies on prevention :
27. Studies on weaning : early egg introduction
(Melbourne, Australia)
Koplin JJ, Osborne NJ, Wake...
Studies on prevention :
28. Studies on breastfeeding:
Peroni DG, Pescollderungg L, PiacentiniGL, et al. Immune regulatory ...
Studies on prevention :
29. Studies on breastfeeding:
Peroni DG, Pescollderungg L, PiacentiniGL, et al. Immune regulatory ...
Studies on prevention :
30. Studies on hypo-allergenic milks :
• von Berg A, Filipiak-Pittroff B, Kramer U, Link E, et al....
Studies on prevention :
31. Studies on hypo-allergenic milks :
• Nieto A, Wahn U, Bufe A, Eigenmann P, et al. Allergy and ...
Studies on prevention :
32. Studies on hypo-allergenic milks :
Nieto A, Wahn U, Bufe A, Eigenmann P, et al. Allergy and as...
Studies on prevention :
33. Studies on the gut microbiome in pregnancy:
Koren O, Goodrich JK, Cullender TC, Spor A, et al....
Studies on prevention :
34. Studies on the gut microbiome in pregnancy:
Koren O, Goodrich JK, Cullender TC, Spor A, et al....
Studies on prevention :
35. Studies on immunotherapy :
Bae JM, Choi YY, Park CO, Chung KY, Lee KH. Efficacy of allergen-sp...
Studies on prevention :
36. Studies on immunotherapy :
Prevention of New Sensitizations by Specific Immunotherapy in Child...
Studies on prevention :
37. Studies on food immunotherapy :
OIT for
peanut
OIT can result in desensitisation in children, ...
Studies on prevention :
38. Studies on food immunotherapy :
Tang ML, Ponsonby AL, Orsini F, et al. Administration of a pro...
Studies on prevention :
39. Studies on immunotherapy :
Determinants of efficacy and safety in epicutaneous allergen immuno...
Studies on prevention :
40. Studies on immunotherapy :
Prevention of oral food allergy sensitization via skin application ...
Mondoulet L, Dioszeghy V, Puteaux E, et al. Specific epicutaneous immunotherapy prevents sensitization to
new allergens in...
Studies on prevention :
42. Studies on immunotherapy :
Chang YC, Chow YH, Sun HL, et al. Alleviation of respiratory syncyt...
Studies on prevention :
43. Studies on immunotherapy :
Mpairwe H, Webb EL, Muhangi L, et al. Antihelminthic treatment duri...
Studies on prevention :
44. Studies on immunotherapy :
Mpairwe H, Webb EL, Muhangi L, et al. Antihelminthic treatment duri...
Studies on prevention :
45. Studies on immunotherapy :
In utero priming by worms protects against respiratory allergies. H...
They are three types of primary prevention strategies
- early administration of bacterial products (most studies are on pr...
Thank you
Dr Masy Nadine
European Exam in Allergology
UEMS Examination EAACI
Certificate of excellence in Allergology and ...
of 48

Prevention in allergy

New targets in prevention of allergy
Published on: Mar 4, 2016
Published in: Health & Medicine      
Source: www.slideshare.net


Transcripts - Prevention in allergy

  • 1. Prevention of allergy Where are we in 2015 ? Dr Masy Nadine European Exam in Allergology UEMS Examination EAACI Certificate of excellence in Allergology and Clinical Immunology Berlin, 17th of november 2015 Allergy Course “Targets for Prevention”
  • 2. The gut microbiota : in the early development of both local and systemic immune maturation and programming Studies on prevention : 1. The gut microbiota its localisation Microbial Activities and Intestinal Homeostasis: A Delicate Balance Between Health and DiseaseChristina L. Ohland1 and Christian Jobin1,2 (Cell Mol Gastroenterol Hepatol 2015;1:28–40
  • 3. Microbial Activities and Intestinal Homeostasis: A Delicate Balance Between Health and DiseaseChristina L. Ohland1 and Christian Jobin1,2 (Cell Mol Gastroenterol Hepatol 2015;1:28–40 Studies on prevention : 2. The gut microbiota and intestinal homeostasis
  • 4. The gut microbiota : in the early development of both local and systemic immune maturation and programming Studies on prevention : 3. The gut microbiota and fiber diet Increase in dietary fiber dampens allergic responses in the lung. Gary B Huffnagle. Nature Medicine 20, 120–121 (2014
  • 5. The immune system and the gut microbiota: friends or foes? N. Cerf-Bensussan, V.Gaboriau-Routhiau. Nature Reviews Immunology 10, 735-744 (October 2010) Studies on prevention : 4. The gut microbiota and altered host system
  • 6. Studies on prevention : 5. The gut microbiota of the pregnant woman Gut microbiota and allergy: the importance of the pregnancy period Thomas R. Abrahamsson, Richard You Wu, Maria C. Jenmalm Pediatric Research (2015) 77, 214–219 doi:10.1038/pr.2014.165 A possible route for bacteria originating from the gut to reach the placental tissue during pregnancy. Dendritic cells (DCs) actively penetrate the epithelium, sample the microbes within the gut lumen, and transport them to the placenta…
  • 7. Studies on prevention : 6. The gut microbiota of the pregnant woman Epigenetic changes of the promoter region of immunoregulatory genes important for allergy development could explain how the effect of microbial exposure to the mother during or even before pregnancy is transferred to the next generation… Gut microbiota and allergy: the importance of the pregnancy period Thomas R. Abrahamsson, Richard You Wu, Maria C. Jenmalm Pediatric Research (2015) 77, 214–219 doi:10.1038/pr.2014.165
  • 8. Studies on prevention : 7. The gut microbiota of the pregnant woman There is a temporal dissociation between the major changes in microbial exposure to children in westernized countries, which occurred during the first half of the century, and the onset of the accelerating increase in allergic diseases… Gut microbiota and allergy: the importance of the pregnancy period Thomas R. Abrahamsson, Richard You Wu, Maria C. Jenmalm Pediatric Research (2015) 77, 214–219 doi:10.1038/pr.2014.165
  • 9. Seventeen studies, reporting data from 4755 children (2381 in the probiotic group and 2374 in the control group) Infants treated with probiotics had a significantly lower RR for eczema compared to controls. No significant dif- ference in terms of prevention of asthma or rhinoconjunctivitis The results of the meta-analysis show that probiotic supplementation prevents infantile eczema, thus suggesting a new potential indication for probiotic use in pregnancy and infancy. Studies on prevention : 8. Probiotics started prenatally and in combination with breastfeeding and it is mainly probiotics started prenatally and in combination with breastfeeding, showing the best effectiveness Gut microbiota and allergy: the importance of the pregnancy period Zuccotti G, Meneghin F, Aceti A, Barone G, et al. Probiotics for prevention of atopic diseases in infants: systemic review and meta-analysis. Allergy 2015: 70: 1356–71.
  • 10. In a recent large meta-analysis performed on 25 trials, the authors concluded that a prenatal and/or early-life probi- otic Lactobacillus, Bifidobacterium, and Saccharomyces administration reduces the risk of atopic sensitization but may not reduce the risk of asthma/wheezing. Studies on prevention : 9. Probiotics started prenatally and in combination with breastfeeding Dugoua J-J, Machado M, Zhu X, Chen X, Koren G, Einarson TR. Probiotic safety in pregnancy: a systematic review and meta- analysis of randomized controlled trials of Lactobacillus, Bifidobacterium, and Saccharomyces spp. J Obstet Gynaecol Can 2009;31:542–552.
  • 11. Studies on prevention : 10. Microbial exposure and colonization Promising candidates for allergy preventionJames E. Gern, MD, FAAAAIMadison, Wis J Allergy Clin Immunol 2015;136:23-8.)
  • 12. Studies on prevention : 11. Epigenetics and farm exposure in childhood Michel S, Busato F, Genuneit J, et al. Farm exposure and time trends in early childhood may influence DNA methylation in genes related to asthma and allergy. Allergy 2013;68:355–64. Farming seems to influence methylation in a number of the genes and gene families. It suggests the feasibility of such studies in asthma, and it highlights that a strong protective environmental factor, such as growing up on a farm, which is associated with disease development influences methylation and that timing of DNA collection for analysis is crucial
  • 13. Studies on prevention : 12. Early moisturizing in infants at risk for atopic dermatitis Simpson EL, Chalmers JR, Hanifin JM, et al. Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention. J Allergy Clin Immunol 2014: 134: 818–23.DU TEXTE DE
  • 14. Horimukai K, Morita K, Narita M, Kondo M, et al. Application of moisturizer to neonates prevents development of atopic dermatitis. J Allergy Clin Immunol 2014: 134: 824– 30. Studies on prevention : 13. Early moisturizing in infants at risk for atopic dermatitis
  • 15. Gueniche A, Knaudt B, Schuck E, et al. Effects of non-pathogenic gram-negative bacterium Vitreoscilla filiformis lysate on atopic dermatitis: a prospective, randomized, double-blind, placebo- controlled clinical study. Br J Dermatol 2008: 159: 1357–63. Effects of Vitreoscilla filiformis treatment on atopic dermatitis lesions. (Gram-negative aerobic bacterium) Patients treated (a)with placebo (b) with V. filiformis lysate before and on day 29 of treatment. Studies on prevention : 14. Early moisturizing with bacterial products
  • 16. Gueniche A, Knaudt B, Schuck E, et al. Effects of non-pathogenic gram-negative bacterium Vitreoscilla filiformis lysate on atopic dermatitis: a prospective, randomized, double-blind, placebo- controlled clinical study. Br J Dermatol 2008: 159: 1357–63. Effects of Vitreoscilla filiformis treatment on pruritus. The mean visual analogue scale (VAS) score for pruritus by visit and treatment group with its 95% confidence interval. Compared with baseline a significant decrease was observed only in the V. filiformis group (verum), already by day 15 (P < 0·0002) and on day 29 (P < 0·0001). The between-group difference concerning pruritus VAS endpoint was also significant on day 29 (P = 0·017) as well as the course of pruritus development (the time by treatment interaction; P = 0·008). Studies on prevention : 15. Early moisturizing with bacterial products
  • 17. Gueniche A, Knaudt B, Schuck E, et al. Effects of non-pathogenic gram-negative bacterium Vitreoscilla filiformis lysate on atopic dermatitis: a prospective, randomized, double-blind, placebo- controlled clinical study. Br J Dermatol 2008: 159: 1357–63. Effects of Vitreoscilla filiformis treatment on SCORing of Atopic Dermatitis (SCORAD). Compared with baseline a significant decrease was observed only in the V. filiformis group (verum), Studies on prevention : 16. Early moisturizing with bacterial products
  • 18. Studies on prevention : 17. Studies on weaning Du Toit G, Katz Y, Sasieni P, et al. Early consumption of peanuts in infancy is associated with a low prevalence of peanut allergy. J Allergy Clin Immunol 2008: 122: 984–91. In one study, it was found that the risk of peanut allergy was 10 times higher among Jewish children in UK, compared to Israeli children of similar ancestry, which was attributed to the early introduction of peanuts in the Israeli children
  • 19. Studies on prevention : 18. Studies on weaning : peanut Du Toit G, Katz Y, Sasieni P, et al. Early consumption of peanuts in infancy is associated with a low prevalence of peanut allergy. J Allergy Clin Immunol 2008: 122: 984–91. UK UK ISRAEL
  • 20. Studies on prevention : 19. Studies on weaning : Israelic children Du Toit G, Katz Y, Sasieni P, et al. Early consumption of peanuts in infancy is associated with a low prevalence of peanut allergy. J Allergy Clin Immunol 2008: 122: 984–91.
  • 21. Studies on prevention : 20. Studies on weaning : peanut consumption Du Toit G, Roberts G, Sayre PH, et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med 2015: 372: 803–13. The British LEAP study (Learning Early About Peanut Allergy), 640 ‘high-risk’ babies (defined as those with egg allergy, severe eczema or both) The infants were assigned to two groups: those whose parents were to regularly feed them peanut and those whose parents were told to have their children avoid peanut altogether. The children, enrolled between the ages of 4 and 11 months, were given a conclusive peanut food challenge at age 5. At that age, on average, only 3.2% of the ‘consumption’ group had developed a peanut allergy, compared to more than 17.2% in the ‘avoidance’ group. They reported that in the peanut consumption group, at a high risk of developing allergy, showed a reduction of the odds that a peanut allergy will develop by a remarkable 70–80%. The results of the study have huge implications on the early introduction of allergic foods to prevent food allergy. YES NO
  • 22. Studies on prevention : 21. Guidelines of the AAAAI early peanut introduction J Allergy Clin Immunol 2015;136:258-61 The American Academy of Allergy, Asthma and Immunology (AAAAI) implemented the study in their new guidelines on allergy prevention
  • 23. Studies on prevention : 22. Early exposure to cow’s milk protein Katz Y, Rajuan N, Goldberg MR, et al. Early exposure to cow’s milk protein is protective against IgE-mediated cow’s milk protein allergy. J Allergy Clin Immunol 2010: 126: 77–82. Supplementation at birth with CMP (cow’s milk protein) should be recommended to promote its tolerance. For those patients with IgE- mediated CMP allergy, soy is a reasonable feeding alternative.
  • 24. Studies on prevention : 23. Studies on weaning : early egg introduction Palmer DJ, Metcalfe J, Makrides M, et al. Early regular egg exposure in infants with eczema: a randomized controlled trial. J Allergy Clin Immunol 2013: 132: 387–92.
  • 25. Studies on prevention : 24. Studies on weaning : early egg introduction Palmer DJ, Metcalfe J, Makrides M, et al. Early regular egg exposure in infants with eczema: a randomized controlled trial. J Allergy Clin Immunol 2013: 132: 387–92. Induction of immune tolerance pathways and reduction in the egg allergy rate can be achieved by early regular oral exposure to egg • from 4 months of age • in infants with moderate-to-severe eczema. The earlier introduction of egg in solid foods does not appear to increase the risk of egg allergy in this high-risk group. However, caution needs to be taken when these high-risk infants are first exposed to egg because many have sensitization already and clinical reactivity by 4 months of age. This points to much earlier events in the initiation of food sensitization, well before the introduction of complementary feeding. Clinical implications: Caution needs to be taken when infants with moderate-to- severe eczema are first exposed to egg because many have sensitization already and clinical reactivity by 4 months of age.
  • 26. Studies on prevention : 25. Studies on weaning : early egg introduction (Melbourne, Australia) Koplin JJ, Osborne NJ, Wake M, Martin PE, Gurrin LC, Robinson MN, et al. Can early introduction of egg prevent egg allergy in infants? A population-based study. J Allergy Clin Immunol 2010;126:807-13. the observational Australian HealthNuts study suggested that first exposure to more allergenic (unbaked) egg was more likely to reduce the egg allergy risk
  • 27. Studies on prevention : 26. Studies on weaning : early egg introduction (Melbourne, Australia) Koplin JJ, Osborne NJ, Wake M, Martin PE, Gurrin LC, Robinson MN, et al. Can early introduction of egg prevent egg allergy in infants? A population-based study. J Allergy Clin Immunol 2010;126:807-13.
  • 28. Studies on prevention : 27. Studies on weaning : early egg introduction (Melbourne, Australia) Koplin JJ, Osborne NJ, Wake M, Martin PE, Gurrin LC, Robinson MN, et al. Can early introduction of egg prevent egg allergy in infants? A population-based study. J Allergy Clin Immunol 2010;126:807-13. The observational Australian HealthNuts study suggested that first exposure to more allergenic (unbaked) egg was more likely to reduce the egg allergy risk In low-allergy risk infants Baked eggs : cake and biscuits Cooked eggs = hard-boiled,soft-boiled, fried or poached eggs
  • 29. Studies on prevention : 28. Studies on breastfeeding: Peroni DG, Pescollderungg L, PiacentiniGL, et al. Immune regulatory cytokines in the milk of lactating women from farming and urban environments. Pediatr Allergy Immunol 2010: 21: 977–82.
  • 30. Studies on prevention : 29. Studies on breastfeeding: Peroni DG, Pescollderungg L, PiacentiniGL, et al. Immune regulatory cytokines in the milk of lactating women from farming and urban environments. Pediatr Allergy Immunol 2010: 21: 977–82.
  • 31. Studies on prevention : 30. Studies on hypo-allergenic milks : • von Berg A, Filipiak-Pittroff B, Kramer U, Link E, et al. Preventive effect of hydrolyzed infant formulas persists until age 6 years: long-term results from the German Infant Nutritional Intervention Study (GINI). J Allergy Clin Immunol 2008: 121: 1442–7.
  • 32. Studies on prevention : 31. Studies on hypo-allergenic milks : • Nieto A, Wahn U, Bufe A, Eigenmann P, et al. Allergy and asthma prevention 2014. Pediatr Allergy Immunol 2014: 25: 516–33.
  • 33. Studies on prevention : 32. Studies on hypo-allergenic milks : Nieto A, Wahn U, Bufe A, Eigenmann P, et al. Allergy and asthma prevention 2014. Pediatr Allergy Immunol 2014: 25: 516–33.
  • 34. Studies on prevention : 33. Studies on the gut microbiome in pregnancy: Koren O, Goodrich JK, Cullender TC, Spor A, et al. Host remodeling of the gut microbiome and metabolic changes during pregnancy. Cell 2012: 150: 470–80. T1 Trimester 1 T3 Trimester 3
  • 35. Studies on prevention : 34. Studies on the gut microbiome in pregnancy: Koren O, Goodrich JK, Cullender TC, Spor A, et al. Host remodeling of the gut microbiome and metabolic changes during pregnancy. Cell 2012: 150: 470–80. Actinobacteria (which includes Bifidobacteria) and Proteobacteria seem to undergo a significant distributive change in the last trimester of pregnancy, and it could be that focussing on Bifidobacteria is a better way to go Perhaps probiotics need to be started earlier in pregnancy (from the onset?), as the dynamics of the own microbiota, changing from the beginning of pregnancy, have been shown. Unfortunately, there are no comparative studies of microbiota during pregnancy between allergic and non-allergic women.
  • 36. Studies on prevention : 35. Studies on immunotherapy : Bae JM, Choi YY, Park CO, Chung KY, Lee KH. Efficacy of allergen-specific immunotherapy for atopic dermatitis: a systematic review and meta-analysis of randomized control trials. J Allergy Clin Immunol 2013: 132: 110–7.
  • 37. Studies on prevention : 36. Studies on immunotherapy : Prevention of New Sensitizations by Specific Immunotherapy in Children With Rhinitis and/or Asthma Monosensitized to House Dust Mite. J Investig Allergol Clin Immunol 2007; Vol. 17(2): 85-91 Effect on SIT on the medication score
  • 38. Studies on prevention : 37. Studies on food immunotherapy : OIT for peanut OIT can result in desensitisation in children, and that this is associated with evidence of underlying immune-modulation. However, this treatment approach was associated with a substantial risk of adverse events, although the majority of these were mild. In view of the risk of adverse events and the lack of evidence of long-term benefits, allergen-specific peanut OIT cannot currently be recommended as a treatment for the management of patients with IgE-mediated peanut allergy. Larger RCTs are needed to investigate the acceptability, long- term effectiveness and cost-effectiveness of safer treatment regimens, particularly in relation to the induction of clinical and immunological tolerance. Nurmatov U, Venderbosch I, Devereux G, Simons FE, Sheikh A. Allergen-specific oral immunotherapy for peanut allergy. Cochrane Database Syst Rev 2012: 9: CD009014.
  • 39. Studies on prevention : 38. Studies on food immunotherapy : Tang ML, Ponsonby AL, Orsini F, et al. Administration of a probiotic with peanut oral immunotherapy: a randomized trial. J Allergy Clin Immunol 2015: 135: 737–44. OIT for peanut and probiotics This is the first randomized placebo-controlled trial evaluating the novel co-administration of probiotic and peanut OIT and assessing for sustained unresponsiveness in children with peanut allergy. PPOIT was effective in inducing two-week sustained unresponsiveness, and immune changes that likely reflect reprogramming of the peanut- specific immune response. Further work is required to confirm sustained unresponsiveness after a longer period of secondary peanut elimination and to clarify the relative contributions of probiotic vs OIT.
  • 40. Studies on prevention : 39. Studies on immunotherapy : Determinants of efficacy and safety in epicutaneous allergen immunotherapy: summary of three clinical trials. Allergy, Volume 70, Issue 6, June 2015, Pages: 707–710, G. Senti, S. von Moos, F. Tay, N. Graf, P. Johansen and T. M. Kündig Epicutaneous immunotherapy Prior to the pollen season 2009, patients received six patches (allergen extract: n = 48; placebo: n = 50) with weekly intervals, administered onto tape-stripped skin. Allergen EPIT produced a median symptom improvement of 48% in 2009 and 40% in the treatment-free follow-up year 2010 as compared to 10% and 15% improvement after placebo EPIT (P = 0.003). After allergen EPIT but not placebo EPIT, conjunctival allergen reactivity was significantly decreased and allergen- specific IgG4 responses were significantly elevated (P < 0.001).
  • 41. Studies on prevention : 40. Studies on immunotherapy : Prevention of oral food allergy sensitization via skin application of food allergen in a mouse model. Allergy, Volume 67, Issue 5, May 2012, Pages: 622–629, W. Li, Z. Zhang, A. Saxon and K. Zhang Epicutaneous immunotherapy with food in a mouse model Treg
  • 42. Mondoulet L, Dioszeghy V, Puteaux E, et al. Specific epicutaneous immunotherapy prevents sensitization to new allergens in a murine model. J Allergy Clin Immunol 2015: 135: 1546–57. Epicutaneous immunotherapy with food in a mouse model (EPIT) Treg Studies on prevention : 41. Studies on immunotherapy :
  • 43. Studies on prevention : 42. Studies on immunotherapy : Chang YC, Chow YH, Sun HL, et al. Alleviation of respiratory syncytial virus replication and inflammation by fungal immunomodulatory protein from Flammulina velutipes. Antiviral Res 2014: 110: 124–31. • Non-specific IT, using Th1 or Treg cell stimulants, such as bacterial antigens, should also become a subject of research in primary prevention. • One example is the anti-inflammatory and inhibitory effect on RSV replication of the golden needle mushroom (Flammulina velutipes) Non-specific immunotherapy using Th1 or Treg cell stimulants Non-specific immunotherapy FIP-fve proteinFlammulina velutipes
  • 44. Studies on prevention : 43. Studies on immunotherapy : Mpairwe H, Webb EL, Muhangi L, et al. Antihelminthic treatment during pregnancy is associated with increased risk of infantile eczema: randomized-controlled trial results. Pediatr Allergy Immunol 2011: 22: 305– 12. Non-specific immunotherapy , using immunomodulating agents like helminths during pregnancy Schistosoma mansoni Decreased risk of eczema in infants
  • 45. Studies on prevention : 44. Studies on immunotherapy : Mpairwe H, Webb EL, Muhangi L, et al. Antihelminthic treatment during pregnancy is associated with increased risk of infantile eczema: randomized-controlled trial results. Pediatr Allergy Immunol 2011: 22: 305– 12. Antihelminthic treatment of pregnant African mothers with Schistosoma mansoni Schistosoma mansoni Praziquantel Increased risk of eczema in infants Albendazole
  • 46. Studies on prevention : 45. Studies on immunotherapy : In utero priming by worms protects against respiratory allergies. Hermelijn H. Smits, Cezmi A. Akdis. Journal of Allergy and Clinical Immunology, Vol. 134, Issue 6, p 1280–1281 In utero priming by Schistosoma mansoni
  • 47. They are three types of primary prevention strategies - early administration of bacterial products (most studies are on probiotics) - early moisturizing in infants at risk for atopic dermatitis - early exposure to allergenic foods (studies are on milk,peanut and egg) - the use of immunotherapy - the use of immunomodulatory treatments (mushrooms proteins, worms products...)  much more research needs to be carried out  we have to define what advice can really be given in clinical practice Take home messages on prevention in allergy Berlin, 17th of november 2015 Allergy Course “Targets for Prevention”
  • 48. Thank you Dr Masy Nadine European Exam in Allergology UEMS Examination EAACI Certificate of excellence in Allergology and Clinical Immunology Berlin, 17th of november 2015 Allergy Course “Targets for Prevention”

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