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🐈 | Are dogs allergic?Explanation of main causes and symptoms, remedies, etc. [Veterinarian supervision]


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Are dogs allergic too?Explanation of main causes and symptoms, remedies, etc. [Veterinarian supervision]

 
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However, dogs with food allergies and atopic dermatitis are more likely to have flea allergies at the same time.
 

Did you know that dogs as well as humans have allergic symptoms?Symptoms and weight vary from dog to dog ... → Continue reading

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Atopic dermatitis

Atopic dermatitis(Atopy Seihifuen,English: atopic dermatitis) IsAllergiesOf those related to the reaction皮膚 OfInflammationAccompanied by[1]thing.Atopic eczema(English: atopic eczema) Is more appropriate[2].atopicThe medical term is mainly for proteinsAllergenIt is a tendency to react strongly toBronchial asthma,rhinitisMay also be crowned with other atopic allergic disorders such as[2]..If it is atopy, it is typicallyDermatitis, Rhinitis, may show symptoms of asthma, among which dermatitis (eczema) Is[2].

The majority develops in infancy, and up to 90% by age 5 years[3].

First appearance and meaning

atopicThe origin of the name means "unspecified" or "strange"Greek language"Atopos" (atopos --a = negation, topos = origin), in 1923(Polish version(English editionNamed by.Atopic dermatitisThe word appeared as a medical term in 1933.An American Salzberger dermatologist first used the name atopic dermatitis in connection with dermatitis.

Coca uses the name atopy to refer to an abnormal hypersensitivity reaction, which means that the pathogen and etiology are unknown, and it is variously expressed in the eyes, nose, bronchi, skin, etc., and is strange and mysterious.[4]..It was found that allergen-responsive raregin was detected in the blood of atopic humans, which was found to belong to immunoglobulins and was named γE, which is now called IgE.[4].

As defined by the World Allergy Organization (WAO), atopy is a tendency to produce IgE mainly by being exposed to protein allergens, which means that it is highly responsive to IgE.[2]..It can be familial and may show asthma, rhinitis, and eczema as typical symptoms.[2]..And it cannot be said to be atopy until IgE sensitization is proved by IgE test.[2].

According to the definition of the World Allergy Organization, dermatitis is used when referring to skin inflammation widely, and in the case of atopic dermatitis with common characteristics such as allergic asthma and nasal conjunctivitis, atopic dermatitis. Rather than callingAtopic eczemaIs more appropriate[2].

224 people with atopic dermatitis At an average age of 26.4 years, 91 had bronchial asthma, 166 had allergic rhinitis, 138 had persistent skin symptoms over the past year, and 1 (65). 29%) were common food allergies (wheat flour, milk, eggs, peanuts, soybeans)[5].

Cause

According to the guidelines of the Japanese Dermatological Association, atopic dermatitisepidermisIn particular, it is accompanied by skin dryness caused by abnormalities in the stratum corneum and physiological abnormalities of the skin such as barrier dysfunction, and is caused by various non-specific irritation reactions and specific allergic reactions.

Atopy predisposition

65% develop by age 1 and 90% by age 5[3].

It is estimated that the genetic factor is about 50%, but by the 21st century, childhood atopic diseases (asthma, atopic dermatitis, allergic nasal conjunctivitis) have been increasing in developed countries over the past 30 years. The increase in morbidity is difficult to explain from genetic factors, and the majority of children with atopic dermatitis do not actually belong to a genetically high-risk group.[6]..In addition, the relationship between allergic diseases and atopic diseases has been well proven.[6].

Genetic factors
By gene analysisMast cells,EosinophilBind IgE antibody toReceptorAndCytokineIt has been clarified that the loci that are involved in allergic inflammation but have concentrated genes are associated with allergies.[7].
About 3% of Japanese patients with atopic dermatitisFilaggringeneMutations are seen.Filaggrin is a protein with functions such as formation of barrier function and water retention in the stratum corneum.Having a filaggrin gene mutation tends to cause more premature onsets under 2 years of age, become more severe, and do not remit with growth.[8].. palmar hyperlinearity (enhancement of the skin pattern found in the palm, especially the ball of the thumb) is associated with mutations in the filaggrin gene.感 度(100% homozygotes, about 75% heterozygotes) ・Specificity(Approximately 95%) are both high[9].

The 2003 American Dermatology Society consensus conference on pediatric atopic dermatitis focused on the link between exposure to allergens and suppression of the development of atopic dermatitis, including food intake in pregnant women. Needs further research[10], Research has progressed.

Since the 1940s, there have been reports of infant food intake and the development of allergies, and such previous studies have raised two ideas: whether it is a protective effect on breast milk or by avoiding milk protein.[6]..Complete breast milk for infants is recommended as a first step in eliminating the risk of atopic dermatitis in 2010Systematic reviewSo, all 18 studies are 100% without complete breastfeedingWhey proteinThe risk of developing atopic dermatitis and atopic dermatitis was reduced by using the decomposed milk of Atopic dermatitis compared to the adjusted powder made from milk protein.[11]..Alternatively, a mother of a breast-fed infant up to 4 months of age reduces her child's incidence of atopic dermatitis by limiting her milk intake.[12]..It has been confirmed that α1 casein, the main food allergen, is transferred to breast milk.[13]..The risk of atopic dermatitis by age 4 was 4 times higher when consuming 10 solid foods by 2.9 months of age.[14].

Hypothesis about the cause

There are the following theories and they have not been clarified.

Bacterial plexus in the intestine, epidermis, lungs, oral cavity, etc.
It is highly possible that the cause is the overgrowth of Staphylococcus aureus in the epidermis due to the imbalance of indigenous bacteria in the epidermis.[15]..On the other hand, a research team from the Department of Pediatrics, Kansai Medical University, said that there was no clear correlation between the intestinal flora and the transition of allergic symptoms.[16].
There is a theory that the epidermis barrier collapses.In atopic dermatitis, it is a component related to moisturizing the skin.CeramideIs also the cause.In addition, when you take a bath, the epidermis becomes soft andCeramideSymptoms may not improve due to the decrease in.
Dietary factors
fish,ω-3 fatty acid, Sodium, lack of antioxidants, etc.[6]..When a diet with a low content of ω-6 fatty acid (mainly linoleic acid) was given to patients with atopic dermatitis, an improving effect on atopy was observed.[17].

Symptoms of dermatitis

  • Infant eczemaMay be confused with.The inflammation begins on the head and gradually extends to the face.And it spreads downward to the trunk and limbs.
  • Early childhood-In early childhood, lesions are likely to occur on the flexion side of joints such as the cubital fossa and popliteal fossa, and the lower part of the pinna is torn (ear cut).
  • After puberty, the symptoms of chronic eczema are widespread and dry.
  • The outside of the eyebrows becomes thinner (Hertge sign).
  • If you trace the reddish skin, it will turn white after a while (white dermatographic urticaria).
  • It dries and the surface becomes like a white powder, accompanied by strong itching.
  • Red eczema,NoduleAnd so on, accompanied by severe itching.PrurigoMay be accompanied by.
  • From the wet phaseInterstitial fluidMay seep out.
  • When it becomes chronic,GoosebumpIt produces a rough texture and the skin gradually thickens.
  • A lumpy wart-like prurigo may develop, which is intractable in this case.WartSometimes it becomes.
  • After puberty, symptoms are more likely to appear on the fingers, and the area from the nails to the second joint is particularly vulnerable to roughening.
  • Wet dermatitis in childhood and dry dermatitis after puberty
  • The wet type is characterized by the tendency to develop mainly around the neck and the back of the elbow and knee joints, and the dry type is characterized by the tendency to develop on the scalp, forehead, shoulders, inner thighs, and inner arms.Also, when switching to the dry type, the symptoms of the wet type tend to improve.

Diagnosis

The diagnostic criteria of the Japanese Dermatological Association are 1. Itching, 2. Characteristic rash and its distribution, and 3. Chronic / repetitive course, all three of which apply.

Inspection

Blood test
  • Eosinophil,Basophil, IgE, etc. are rising. IgE has total IgE and specific IgE, and it is investigated whether allergies such as mites are aggravating factors in specific IgE.
  • TARC (Thymus and Activation-Regulated Chemokine) is a type of chemokine measured in serum.It rises in proportion to the condition of the disease (health insurance coverage is available).
VAS (visual analog scale)
An indicator of the degree of subjective pruritus. See what percentage is 100% when itching is the strongest and 0% when it is completely free of itching.It is difficult to use as a general index because it relies on subjectivity, but it is very useful for observing the degree of improvement in itching.In addition to pruritus, this index is also used for the degree of sleep disorders caused by pruritus.
SCORAD (SCORing Atopic Dermatitis)
Range of rash (Burn (According to the law of 9), diversity of rashes such as erythema and lichenification, and VAS (itching and sleep disorders) are quantified and scored to evaluate the severity.A total of 108 points.It is popular in the United States and other countries.
EASI (Eczema Area and Severity Index)
Represents the severity of objective atopic dermatitis throughout the body.It was created by modifying the method of the Psoriasis Area and Severity Index (PASI), which makes it easy to determine the severity of atopic dermatitis based on the severity and spread of important morphological changes in atopic dermatitis. evaluate.Recommended by the Harmonising Outcome Measures for Eczema (HOME), an international group for standardizing clinical trial outcomes for atopic dermatitis.


Progress

The atopic dermatitis treatment guideline states as follows.

Generally, if the condition is chronic but the symptoms are maintained in a controlled state by appropriate treatment, it will be natural.RemissionIs also a promising disease.It is clearly stated.

Major complications

People with atopic dermatitis generally have weak skin, and when they were childrenDiaper rashWith various cosmetics, ointments, detergents, etc.Contact dermatitisIt is known that it is easy to cause.With nodules, mainly in areas with strong allergic reactionsPrurigo(Prurigo nodularis) may occur.It may become chronic or intractable.Alopecia areataThe merger of is also known.

Infection

Ophthalmic disease

recently白内障,Retinal detachmentThe number of cases of merging is increasing[18]..Retinal detachment is thought to be caused by a series of physical stimuli such as scratching when facial symptoms are severe and behaviors such as tapping the face to relieve itching.What is the cause of cataracts?

  • Retinal detachmentLike, it may be because it rubs or hits strongly from itching on the face or eyelids.
  • Since the crystalline lens is embryologically in the same category as skin cells, lesions similar to atopic dermatitis may occur.

There is a theory such as.In any case, the usual onset with agingSenile cataractIt is thought that it is caused by a different cause, andCrystalline lensIt is sometimes called "atopic cataract" because of the difference in the symptom pattern that it often becomes cloudy from the nucleus rather than from the cortex.Since cataract is mentioned as a side effect of oral steroids, the side effect of external steroids is suspected as the cause, but the causal relationship with external agents is unknown because there are no statistics (when it occurs as a side effect of internal steroids, cataracts). notGlaucomaIncidence rate is higher).Since glaucoma is less common in patients with atopic dermatitis who are treated with topical agents alone, it has been concluded that topical steroids are not directly associated with cataracts.

complications

In atopic dermatitis, various pathogenic microbial infections are likely to be complicated.[19]..In the virusHerpes simplex virusIt is contagious and has a higher morbidity rate than healthy subjects, and when it becomes severe, small blisters spread over a wide area, and it is called Kaposi's varicella-like rash or herpes eczema.Molluscum contagiosum is more likely to be intractable in atopic dermatitis.

治療

Drug therapy

steroid(Corticosteroid)[19]
External steroids (corticosteroids) have the effect of suppressing the immune response and improving symptoms.There are ranks for external preparations, which are divided into "Weak", "Medium", "Strong", "Very Strong", and "Strongest". Use properly according to the site of inflammation.Side effects of topical steroids include skin atrophy, induction of skin infections, and telangiectasia.In addition, proactive therapy with topical steroids (preventing exacerbation of symptoms by externally applying steroids once or twice a week even when atopic dermatitis is in remission) is performed in each country for the purpose of preventing recurrence. Is the usage. It is attracting attention as a method for controlling skin symptoms of atopic dermatitis in combination with the TARC test.In addition, external drugs have fewer side effects than oral drugs.
Japanese related societies are instructing to apply "to cover eczema", but instead, in 2016, more than 5% of patients were taught to "apply steroids as thinly as possible", which is standard. It is believed that there is no guidance on traditional treatment methods.[20].
Tacrolimus ointment(Protopic ointment)[19]
Of immunosuppressive drugsTacrolimusIs formulated as an external preparation.The concentration is 0.1% for adults and 0.03% for children. It began to be used as a clinical trial in 1993 and was approved in June 1999.While it has the "strong" strength of steroids, it does not act on normal skin (because of its large molecular weight) and has the property of penetrating only into highly inflamed and broken skin, which is a side effect of steroids such as the face and neck. It is easy to use on the face and neck where steroids tend to appear strongly.It is said to be particularly effective for cervical ripple-like deposits caused by atopic dermatitis.Some people may feel a tingling sensation or hot flashes at the beginning of use, but it often subsides gradually.It is prohibited to use during pregnancy and lactation.In addition, although no effects on the fetus, newborns and infants have been reported, in Japan, it is indicated for children aged 6 to 2 years and for adults 16 years or older.It is said that strong sun bathing after external use should be avoided.Regarding the problem of the risk of developing skin cancer and lymphoma, it has been reported that the spontaneous incidence rate is not exceeded even if tacrolimus ointment is applied externally.
Proactive therapy --A treatment method in which an anti-inflammatory external drug is applied to a place that was originally inflamed after the symptoms have subsided with steroids.Relapse can be suppressed for a long period of time.Keio University Hospital Dermatology Atopy Outpatient Department reports the usefulness of proactive therapy using tacrolimus ointment.[21].
AntihistamineDrugs / anti-allergic drugs[19]
If itching is severe, anti-allergic drugs and antihistamines are used as an adjunct as needed.Patients with atopic dermatitis often have a virtuous cycle of rash → itching → scratching → rash.Therefore, anti-allergic drugs that have the effect of suppressing itching in the sense of breaking the vicious circle are effective to some extent.It takes several weeks for the effect to appear.
Moisturizing external medicine[19]
In the actual prescription, oily ones such as petrolatum and Plastibase®, and creamy moisturizers with moderate moisture (Hildoid® Soft ointment etc.) is often prescribed, but it can be expected to be effective not only for those prescribed at medical institutions but also for skin care products that can be purchased at pharmacies and drug stores.However, the sensitive skin of the patient may cause contact dermatitis depending on the product, so it is important to select a product that is comfortable to use and does not cause irritation.It's a good idea to experiment and find a moisturizer that suits you.It is expected that more evidence on specific usage and self-care will be accumulated in the future.
CyclosporineOral therapy[19]
CyclosporineOral therapy was also approved in Japan in 2008 as a powerful option for the treatment of atopic dermatitis (only the original neoral).When taking cyclosporine, the package insert and guidelines should be observed regarding the indication, dosage, and duration of use, and it is necessary to explain the efficacy and danger to the patient or his / her family in advance and to obtain the understanding. be. TDM (Drug Blood Concentration Measurement) is required.
Dupilumab
It was launched in April 2018 as an indication for atopic dermatitis, which is inadequately effective with existing treatments.It is the first antibody drug for atopic dermatitis.
Delgositinib
The world's first non-steroidal external JAK (Janus kinase) Launched in June 2020 as an inhibitor.
Upadacitinib-Abrocitinib
Oral JAK inhibitor
Chinese medicine therapy[19]
Herbal medicineIs used in combination with Western medicine and is used as a supplement.It is effective in relieving inflammation and itching.Gastrointestinal symptoms, with occasional drug eruption, were included in 2003 papers reported between 2009 and September 9.EBM surveyAlthough the usefulness of Chinese herbal medicine was shown, no serious harmfulness was observed.
110 cases registered during the 2006 months from April to September 4 at approximately 9 facilities nationwide were targeted.GPSPWas done with reference to, and as a result, 24 weeksHochuekkitoIn the comprehensive evaluation of rash and the amount of external preparation used, 88.7% of the patients were more than effective.In the majority of cases, the effect beyond the maintenance of symptoms can be expected, and many cases in which atopic dermatitis was relieved were observed.No particularly serious side effects were seen.Cases in which a causal relationship with pomalidomide could not be completely ruled out were found in 1.5% and 397 of 6 cases, and were frustrating.insomnia,Stomach leaning,constipationFor example, he is recovering immediately after discontinuing medication.[22].

Folk remedies

Folk remedies include external medicine, acupuncture and moxibustion combined with Chinese medicine, diet, etc., and although improvement of skin symptoms is recognized, the reliability of the results is not high because the target group has not been set.ProbioticsThere are many overseas studies on this, and the results are various.[19]..There is spa therapy,Kusatsu OnsenIs improving itching by improving skin symptoms.[23]..The spring quality of Kusatsu is highly acidic and has a bactericidal action, and contains sulfur depending on the location.

Life guidance

In general, the following lifestyle guidance is useful for atopic dermatitis.[18].
  • Keep your skin clean by bathing and showering.
  • Keep the room clean and create an environment with the right temperature and humidity.
  • Live a regular life and avoid drinking and eating.
  • Wear mild clothing.
  • Cut your nails short to avoid scratching skin damage.
  • Eye lesions by scratching and tapping the rash around the eye白内障,Retinal fissure, Retinal detachment), and see an ophthalmologist regularly in cases of severe facial symptoms.
  • BacteriaFungus・ Be careful to keep your skin in good condition as it is prone to viral skin infections.

There are eight randomized controlled trials in which psychological interventions in the intensity of itching and scratching in atopic dermatitis are effective.Meta-analysisIs required to be implemented,Behavior therapy,Cognitive behavioral therapy, Includes a structured education program, stress management, aromatherapy massage was ineffective compared to the placebo group (stress management reduced anxiety, aroma was no different than just massage)[24].

Topical steroids and atopy business

In Japan, in the 1990s, media reports on atopic dermatitis and topical steroidsNews stationIt was done on a large scale in Japan, and false information was spread.The scam that used the misunderstanding is "Atopy businessThere are many cases of arrests of traders.There is also an example of a doctor doing an atopy business, which has become a problem.

footnote

  1. ^ Reference link
  2. ^ a b c d e f g Definition of allergies by the World Allergy Organization (WAO) / European Academy of Allergies and Clinical Immunology (EAACI) (World Allergy Organization)
  3. ^ a b Atopic dermatitis: a type of eczema, April 2003. NIH publication no. 03-4272. p.4.
  4. ^ a b Hirotsugu Kano "What is atopy?(Pdf) Maternal and Child Health Information, No. 57, May 2008, 5-.
  5. ^ Celakovská J, Bukač J (2014). “Analysis of food allergy in atopic dermatitis patients --association with concomitant allergic diseases”. Indian J Dermatol 59 (5): 445–50. two:10.4103/0019-5154.139867. PMC 4171910. PMID 25284847. https://doi.org/10.4103/0019-5154.139867. 
  6. ^ a b c d Halken S, Høst A (2000). “The lessons of noninterventional and interventional prospective studies on the development of atopic disease during childhood”. allergies 55 (9): 793–802. PMID 11003443. http://onlinelibrary.wiley.com/doi/10.1034/j.1398-9995.2000.00117.x/full. 
  7. ^ Ono SJ Author AND "Annu Rev Immunol" Journal 2000; 18: 347-66.
  8. ^ Barker JN et al. J Invest Dermatol 127: 564,2007, XNUMX.
  9. ^ Brown SJ et al. Br J Dermatol 161: 884,2009, XNUMX.
  10. ^ Eichenfield LF, Hanifin JM, Luger TA, Stevens SR, Pride HB (2003). “Consensus conference on pediatric atopic dermatitis”. J. Am. Acad. Dermatol. 49 (6): 1088–95. two:10.1067 / S0190. PMID 14639390. http://www.jaad.org/article/S0190-9622(03)02539-8/fulltext. 
  11. ^ Alexander DD, Schmitt DF, Tran NL, Barraj LM, Cushing CA (2010). “Partially hydrolyzed 100% whey protein infant formula and atopic dermatitis risk reduction: a systematic review of the literature”. N 68 (4): 232–45. two:10.1111 / j.1753-4887.2010.00281.x. PMID 20416019. 
  12. ^ Jirapinyo P, Densupsoontorn N, Kangwanpornsiri C, Limlikhit T (2013). “Lower prevalence of atopic dermatitis in breast-fed infants whose allergic mothers restrict dairy products”. J Med Assoc Thai 96 (2): 192–5. PMID 23936985. 
  13. ^ Coscia A, Orrù S, Di Nicola P, et al. (2012). “Cow's milk proteins in human milk”. J. Biol. Regul. Homeost. Agents 26 (3 Suppl): 39–42. PMID 23158513. 
  14. ^ “Early solid feeding and recurrent childhood eczema: a 10-year longitudinal study”. Pediatrics 86 (4): 541–6. (1990). PMID 2216619. 
  15. ^ Atopic dermatitis is caused by abnormal bacterial foci of the skin-Understanding the relationship between Staphylococcus aureus and dermatitis-Expectations for new treatment strategies- Keio University Press Release April 2015, 4 (PDF)
  16. ^ Kazuhiro Hattori et al. (2003) Examination of the effect of administration of bifidobacteria powder on children with atopic dermatitis on the intestinal flora and allergic symptoms of children Allergies 52 (1), 20-30, 2003-01-30
  17. ^ Taeko Shimoda "Effect of low n-6 series polyunsaturated fatty acid diet in patients with atopic dermatitis (Natural Science)"Bulletin of Kyushu Women's University" Natural Sciences 37 (2), 2000-09, 15-23NOT 110004624905
  18. ^ a b c "Atopic Dermatitis Treatment Guidelines" edited by the Japanese Dermatological Association Retrieved November 2022, 3.
  19. ^ a b c d e f g h Ministry of Health, Labor and Welfare research group (EBM and data collection for better treatment)
  20. ^ Eriko Horii (December 2016, 12). “The Ministry of Health, Labor and Welfare is the first draft basic guideline for the development of a base hospital for allergy treatment”. Mainichi Newspapers. http://mainichi.jp/articles/20161211/k00/00e/040/115000c 2017/8/15Browse. 
  21. ^ Hiroko Kasai, Hiroshi Kawasaki, Zen Ebihara "Proactive Therapy with Tacrolimus Ointment for Adult Atopic Dermatitis Patients-A Study on Transition from Reactive Therapy", Journal of the Japanese Society of Dermatology, No. 6, 2014, 1141 -Page 47.
  22. ^ Clinical research report of Hochuekkito June 2009 Kracie Pharmaceutical
  23. ^ Kosei Tamura, Kazuo Kubota "Effect of Kusatsu Onsen therapy on itching of atopic dermatitis"Journal of the Japanese Association of Physical and Environmental Health, Vol. 65, No. 1, 2001, pp. 19-19," two:10.11390 / onki1962.65.19, NOT 130004124988.
  24. ^ Chida Y, Steptoe A, Hirakawa N, Sudo N, Kubo C (2007). “The effects of psychological intervention on atopic dermatitis. A systematic review and meta-analysis”. Int. Arch. Allergy Immunol. (1): 1–9. two:10.1159/000101940. PMID 17449959. https://www.karger.com/Article/FullText/101940. 

References

Related item

外部 リンク

Related organizations

Food allergy

Food allergy(Allergies to food,English: Food allergy) Is a detrimental symptom (skin, mucous membrane, digestive organs, respiratory organs, anaphylactic reaction, etc.) that occurs through an immunological mechanism after ingesting the causative food.FoodDepending onAnaphylactic shockMay develop and be life-threatening. In some groups laterAtopic dermatitis,asthmaTo progress toAllergy marchIs the first allergic reaction of the hypothesis.

The prevalence rate decreases with age after reaching the peak at 0 years old, and most of them develop in infancy.[1].. In Europe, America and Asia乳 幼 児からEarly childhoodAs a major cause of food allergiesChicken eggsmilkOccupies more than half of them[1][2].. In Japanese epidemiologyAdolescenceAs the number of cases increased, the number of cases caused by crustaceans decreased, and the amount of milk decreased.adultAfter the period,crustacean,wheat,fruit,seafoodAre the main foods that cause allergies[1].. According to statistics of 3,882 Japanese people, the top three foods that cause foods are chicken eggs 3%, milk 38.3%, and wheat 15.9% (pulled by the large number of infants).[1].. Peanuts are the main cause in the West but rare in Asia[2].. Wheat allergies are common in Japan and South Korea, but in other Asian countries it may be due to cooking[2].

As a countermeasure, remove the causative food to the minimum necessary. For clinical research stage treatmentOral immunotherapyIn 2017, ensuring safety was an issue because the frequency of serious symptoms was not low.[3].. Since 2015, infants with food allergies to eggs and peanuts with atopic dermatitis have been shown to develop tolerance faster through early exposure to food.[4].. on the other hand,Milk allergyIn addition, there are some results that resistance is acquired faster when using mixed milk derived from soybeans and rice.[5][6].. About foods that are often the cause, in JapanFood Sanitation ActArticle 19Specific raw materialIt is obligatory to display designated items as.

Age of onset

日本の3,882例の統計からは、0歳時の約1,250例(約30%と少し)を頂点として、1歳児で約700例、2歳児で約400弱、4歳で200例を下回り、年齢を重ねるほどに漸減し、多くは乳幼児期に発症する[1].

16% of milk allergies by age 79 and 68-78% of chicken eggs develop resistance to IgE[7]..Only 20% of children who are allergic to peanut allergies develop tolerance, and many of them need to be managed even as adults.[8].

Prevalence Epidemiology

The number of affected people has doubled in the United States and the United Kingdom compared to the 1990s and 2000s, and the cause is unknown.[2].

Region

The prevalence of food allergies in Asia is comparable to that in Europe and the United States, and because of the abundance of seafoodcrustaceanAllergies are common and extremely low in peanuts[2].. Peanut allergies are doubling in the West[2], Severe anaphylaxis is also increasing[9].. Milk, eggs, peanuts, nuts, wheat, crustacean shellfish, fish and soybeans are common in the West, but the prevalence of fish and soybeans is questionable and low in those papers.[2].

Eggs and milk are the most common in babies and toddlers[2].. Among children, eggs are the most common in Asia and milk is the second. Wheat allergies are rare in most Asian countries, but common in Japan and South Korea[2].. Buckwheat is a major allergy to Japanese school children[2].

Anaphylaxis under the age of 6 is most common in milk, and shellfish are common from then on until the age of 18.[2].. In Japan and South Korea, wheat is a major cause of anaphylaxis in children and is also an important trigger for anaphylaxis in Thailand and Singapore.[2].

In adults, peanut and nut anaphylaxis is common in the United Kingdom, Australia and other Western countries.[2].. Anaphylaxis caused by shellfish is the most common and is the main cause in most Asian countries such as China, Thailand and Singapore, as well as in the United States and Australia.[2].. In Korea, wheat and buckwheat are the main ingredients[2].

Onset epidemiology

Pregnant mother's peanut intake is independent of her child's peanut allergy[10].Randomized controlled trialIn, there is no preventive effect on the onset of allergies by early intake of chicken eggs to healthy infants of 4 to 6 months, and if they are already allergic, increase the frequency of allergic reactions as a group.[11].

Diagnosis

Food allergies cannot be diagnosed simply by having symptoms that appear to be an allergic reaction after eating. In fact, food allergies are often confused with intolerance due to enzyme deficiency and reactions due to the pharmacological action of substances contained in food. Type I that develops immediately after ingestion for food allergiesAllergiesThere are cases of non-type I allergy, in which symptoms appear after several hours or more.

Tests such as RAST should only be used for cases considered to be type I allergy. These testsfalse positiveSince there are many cases, judge from the medical history and inspect only what is necessary. AlsoRastThe clinical significance of these results differs depending on the food antigen and the age of the patient, even if the values ​​are the same. For example, in infants, wheat is often positive for RAST, so low egg white positivity is considered to be more clinically significant than moderate wheat positivity.

hay feverIf it gets worse in the seasonOral allergy syndromeThere is a possibility of. Especially in the case of adults.

治療

Anaphylactic shockIf this happens, treat anaphylactic shock. seafood,nut,Peanuts,BuckwheatIs known to often cause severe anaphylaxis. AlsoasthmaIt is said that patients with a history of anaphylaxis are also likely to develop serious anaphylaxis.

The principle of treatment is to remove the causative food, but many children have food allergies, and severely removed foods may adversely affect nutrition. If the cause cannot be identified, it is desirable to see an allergist.

By ingesting an amount of causative food that does not cause an allergic reactionGet used to the body,Oral immunotherapyIs also carried out at dedicated institutions and hospitals. In the clinical research stage, the frequency of immediate symptoms of oral immunotherapy in hospital is 58-71%, and the frequency of adrenaline use for anaphylactic shock is 6-9%, and the frequency of serious symptoms is not low. It is a high-risk treatment method, and ensuring safety was an issue in 2017.[3].

Since 2015, studies have shown that infants with food allergies to eggs and peanuts with atopic dermatitis develop resistance faster with treatment for eczema and early exposure to food after 4 months.[4].. Rigorous multicenter randomized controlled trials are needed to find the best method[12].

Milk allergySo, in a 2016 survey for new milk allergy guidelines by the World Allergy Organization, milk allergies lasted around 40 months with the use of milk proteolytic milk, with formulas derived from soybeans and rice. Evidence that it took about 24 months when used[5]Is also appearing[6].

Cause food

The foods that cause food allergies that are subject to allergen tests include the following, and of these, the foods that are subject to labeling under the law are generally determined in consideration of the number of cases and severity.

Foods that cause allergies
Food nameResponse in JapanRemarks
egg"Specific raw materials"
Obliged to display as
There are also egg yolk allergies and egg white allergies instead of whole eggs
wheat
ShrimpShrimp # food allergiesSee also
Crab
SobaBuckwheat # allergySee also
peanutsPeanut # Peanut allergySee also
milk
Abalone"Similar to specific raw materials"
Encourage to display as
The squid
How much
Orange
Cashew nuts
Kiwi fruit
beef
Walnut
ゴ マ
Salmon
Mackerel
soy
chicken
banana
豚 肉
Matsutake
Peaches
Sweet potato
Apples
gelatin
Rice
Barley(barley)
Millet(millet)
Hie(稗)
Millet(millet)
corn
Green beans
pea
Almond
coconut
Chestnut(Chestnut)rubberIs said to have similar allergies
(Main component with similar molecular structure and unique odor (Rubber protein) Is included)
Strawberry
melon
mango
Avocado
Pear
Tomato
celery
parsley
onion
watermelon
carrot
potato
sweet potato
Pumpkin
Spinach
Bamboo shoot
garlic
Mustard
Wasabi
Cacaoチ ョ コ レ ー ト(Including quasi-chocolate and chocolate sweets in Japan) ・cocoaetc.
Chocolate allergySee also
Clams
Oyster
Scallop
Octopus
Horse mackerel
イ ワ シ
Cod
Tuna
Tarako

footnote

[How to use footnotes]

Source

  1. ^ a b c d e Japan Pediatric Allergy Society Food Allergy Committee "Food Allergy Practice Guidelines 2012 Digest Version"Chapter 2 Epidemiology", viewed August 2017, 8.
  2. ^ a b c d e f g h i j k l m n o Lee AJ, Thalayasingam M, Lee BW (2013). “Food allergy in Asia: how does it compare?”. Asia Pac Allergy 3 (1): 3–14. two:10.5415 / apallergy.2013.3.1.3. PMC 3563019. PMID 23403837. https://apallergy.org/DOIx.php?id=10.5415/apallergy.2013.3.1.3. 
  3. ^ a b "Dyspnea and cardiopulmonary arrest due to milk allergy treatment! The fear of immunotherapy that dares to take allergens”. HEALTH PRESS (December 2017, 12). 2017/12/23Browse.
  4. ^ a b Natsume (May 2017, 5). “Prevention of Childhood Food Allergies-Recent Findings”. Weekly Medical Newspaper. http://www.igaku-shoin.co.jp/paperDetail.do?id=PA03222_02#bun 2017/8/15Browse. 
  5. ^ a b Terracciano L, Bouygue GR, Sarratud T, Veglia F, Martelli A, Fiocchi A (2010). “Impact of dietary regimen on the duration of cow's milk allergy: a random allocation study”. Clin. Exp. Allergy 40 (4): 637–42. two:10.1111 / j.1365-2222.2009.03427.x. PMID 20067480. 
  6. ^ a b Fiocchi A, Dahda L, Dupont C, Campoy C, Fierro V, Nieto A (2016). “Cow's milk allergy: towards an update of DRACMA guidelines”. World Allergy Organ J 9 (1): 35. two:10.1186 / s40413-016-0125-0. PMC 5109783. PMID 27895813. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5109783/. 
  7. ^ “[In memory of Professor VG Ginzburg”] (Russian). Vestn Rentgenol Radiol 45 (5): 109. (1970). two:10.3390 / children2040439. PMID 4928773. http://www.mdpi.com/2227-9067/2/4/439. 
  8. ^ Yun J, Katelaris CH (2009). “Food allergy in adolescents and adults”. Intern Med J 39 (7): 475–8. two:10.1111 / j.1445-5994.2009.01967.x. PMID 19382983. 
  9. ^ Sumathi Reddy (August 2017, 8). “Serious acute food allergies, significantly increased in rice”. Wall Street Journal. http://jp.wsj.com/articles/SB12800216862765424235404583345464259655922 2017/8/15Browse. 
  10. ^ Fox AT, Sasieni P, du Toit G, Syed H, Lack G (2009). “Household peanut consumption as a risk factor for the development of peanut allergy”. J. Allergy Clin. Immunol. 123 (2): 417–23. two:10.1016 / j.jaci.2008.12.014. PMID 19203660. 
  11. ^ Bellach J, Schwarz V, Ahrens B, et al. (2017). “Randomized placebo-controlled trial of hen's egg consumption for primary prevention in infants”. J. Allergy Clin. Immunol. 139 (5): 1591–1599.e2. two:10.1016 / j.jaci.2016.06.045. PMID 27523961. 
  12. ^ Nowak-Węgrzyn A, Chatchatee P (2017). “Mechanisms of Tolerance Induction”. Ann. Nutr. Metab. 70 Suppl 2: 7–24. two:10.1159/000457915. PMID 28521317. 

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