Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology最新文献

{"title":"Low-dose oral cow's milk challenge outcome for patients on complete avoidance: A multicenter study in Japan.","authors":"Yuki Sakaguchi, Ken-Ichi Nagakura, Kyohei Takahashi, Hiroaki Taniguchi, Mika Ogata, Ikuo Okafuji, Yumi Koike, Yasusuke Kawada, Komei Ito, Mizuho Nagao, Katsushi Miura, Tatsuki Fukuie, Sakura Sato, Noriyuki Yanagida, Motohiro Ebisawa","doi":"10.1111/pai.70105","DOIUrl":"10.1111/pai.70105","url":null,"abstract":"<p><strong>Background: </strong>Few studies have reported significant risk factors for allergic symptoms during low-dose (1-3 mL) cow's milk (CM) oral food challenges (OFCs). We investigated patients from multiple centers in Japan to identify high-risk, low-dose CM OFCs and conducted these tests at allergy-specialized facilities.</p><p><strong>Methods: </strong>We retrospectively collected the results of the first low-dose CM OFCs performed at 10 hospitals in Japan between January and December 2019. All patients completely eliminated CM and underwent low-dose CM OFCs. The risk factors for positive OFC and anaphylaxis were analyzed using logistic regression analyses.</p><p><strong>Results: </strong>We included 244 patients (median age: 2.5 years). The median level of CM-specific immunoglobulin E (sIgE) was 13.1 (interquartile range: 3.7-45.6) kU_A/L. The rates of positive and anaphylaxis among positive for CM OFCs were 44% and 19%, respectively. Multivariate analyses that separately analyzed each sIgE identified high CM sIgE and casein sIgE levels as significant risk factors for OFC positivity (both p < .001). The optimal cut-off values for CM and casein sIgE levels to predict positive CM OFCs from receiver operating characteristic curves were 5.4 and 7.3 kU_A/L, respectively. When CM sIgE or casein sIgE levels were ≥10.9 kU_A/L or ≥ 11.5 kU_A/L, they corresponded to 5% predicted probabilities of anaphylaxis. Furthermore, when their levels are ≥100 kU_A/L, the predicted probabilities increase to 20%.</p><p><strong>Conclusion: </strong>CM and casein sIgE levels should be considered when predicting low-dose CM OFC outcomes.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 5","pages":"e70105"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postinfectious manifestations in two pediatric female X-linked carriers of chronic granulomatous disease.","authors":"Lizbeth Blancas-Galicia, Tiareth Cova-Guzmán, Selma Scheffler-Mendoza, Francisco Rivas-Larrauri, Juan Carlos Bustamante-Ogando, Sara Espinosa-Padilla, Marco Antonio Yamazaki-Nakashimada","doi":"10.1111/pai.70114","DOIUrl":"https://doi.org/10.1111/pai.70114","url":null,"abstract":"","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 5","pages":"e70114"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial comment on the special issue: \"Pediatric skin allergy\".","authors":"Polina Pyatilova, Agnes Sze-Yin Leung, Elizabeth Huiwen Tham, Philippe Eigenmann","doi":"10.1111/pai.70116","DOIUrl":"https://doi.org/10.1111/pai.70116","url":null,"abstract":"","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":"36 5","pages":"e70116"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mediators linking obesity to childhood asthma.","authors":"Yang-Ching Chen,&nbsp;Yen-Tsung Huang,&nbsp;Wen-Harn Pan,&nbsp;Yungling L Lee","doi":"10.1111/pai.13859","DOIUrl":"https://doi.org/10.1111/pai.13859","url":null,"abstract":"<p><strong>Background: </strong>Obesity and asthma are highly associated, but the mechanisms underlying the association remain unknown. We examined five mediators linking obesity with childhood asthma: (1) pulmonary function impairment, (2) airway inflammation, (3) physical fitness, (4) sleep-disordered breathing (SDB), and (5) early puberty.</p><p><strong>Methods: </strong>A Mendelian randomization (MR) study with mediation analysis of data obtained from 5965 children as part of the Taiwan Children Health Study. Observational analysis, MR two-stage least-squares method, and MR sensitivity analysis were carried out to investigate each causal pathway. Prospective cohort analyses were used to strengthen the findings.</p><p><strong>Results: </strong>The increased asthma risk associated with obesity was found to be mostly mediated through impaired pulmonary function, low physical fitness, and early puberty. In the MR analysis, body mass index was negatively associated with FEV1/FVC and physical fitness index (β = -2.17 and -0.71; 95% CI, -3.92 to -0.42 and -1.30 to -0.13, respectively) and positively associated with early puberty (OR, 1.09; 95% CI, 1.02-1.17). High FEV1/FVC and physical fitness index reduced asthma risk (OR, 0.98 and 0.93; 95% CI, 0.97-0.99 and 0.88-0.98, respectively), whereas SDB and early puberty increased the risk of asthma (OR, 1.03 and 1.22; 95% CI, 1.01-1.05 and 1.05-1.42, respectively). Temporal causality was strengthened in prospective cohort analyses. The three main mediators were low physical fitness, impaired pulmonary function, and early puberty, with mediation proportions of 73.76%, 61.63%, and 27.66%, respectively.</p><p><strong>Conclusions: </strong>Interventions promoting physical fitness and pulmonary function might effectively reduce obesity-induced asthma risk.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":" ","pages":"e13859"},"PeriodicalIF":4.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40669343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and management of food allergy-associated gastroesophageal reflux disease in young children-EAACI position paper.","authors":"Rosan Meyer,&nbsp;Yvan Vandenplas,&nbsp;Adriana Chebar Lozinsky,&nbsp;Mario C Vieira,&nbsp;Roberto Berni Canani,&nbsp;Christophe Dupont,&nbsp;Pinar Uysal,&nbsp;Ozlem Cavkaytar,&nbsp;Rebecca Knibb,&nbsp;David M Fleischer,&nbsp;Anna Nowak-Wegrzyn,&nbsp;Carina Venter","doi":"10.1111/pai.13856","DOIUrl":"https://doi.org/10.1111/pai.13856","url":null,"abstract":"<p><p>Gastro-oesophageal reflux (GOR) and food allergy (FA) are common conditions, especially during the first 12 months of life. When GOR leads to troublesome symptoms, that affect the daily functioning of the infant and family, it is referred to as GOR disease (GORD). The role of food allergens as a cause of GORD remains controversial. This European Academy of Allergy and Clinical Immunology (EAACI) position paper aims to review the evidence for FA-associated GORD in young children and translate this into clinical practice that guides healthcare professionals through the diagnosis of suspected FA-associated GORD and medical and dietary management. The task force (TF) on non-IgE mediated allergy consists of EAACI experts in paediatric gastroenterology, allergy, dietetics and psychology from Europe, United Kingdom, United States, Turkey and Brazil. Six clinical questions were formulated, amended and approved by the TF to guide this publication. A systematic literature search using PubMed, Cochrane and EMBASE databases (until June 2021) using predefined inclusion criteria based on the 6 questions was used. The TF also gained access to the database from the European Society of Paediatric Gastroenterology and Hepatology working group, who published guidelines on GORD and ensured that all publications used within that position paper were included. For each of the 6 questions, practice points were formulated, followed by a modified Delphi method consisting of anonymous web-based voting that was repeated with modified practice points where required, until at least 80% consensus for each practice point was achieved. This TF position paper shares the process, the discussion and consensus on all practice points on FA-associated GORD.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":" ","pages":"e13856"},"PeriodicalIF":4.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40657083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ITGB4 deficiency induces DNA damage by downregulating HDAC1 in airway epithelial cells under stress stimulation.","authors":"Kun Xu,&nbsp;Ye Yao,&nbsp;Huijun Liu,&nbsp;Ming Yang,&nbsp;Lin Yuan,&nbsp;Xizi Du,&nbsp;Yu Yang,&nbsp;Ling Qin,&nbsp;Weijie Wang,&nbsp;Kai Zhou,&nbsp;Xinyu Wu,&nbsp;Chi Liu","doi":"10.1111/pai.13871","DOIUrl":"https://doi.org/10.1111/pai.13871","url":null,"abstract":"<p><strong>Background: </strong>DNA damage in airway epithelia under exogenous disruptors can trigger various pulmonary diseases. Integrin beta 4 (ITGB4) is a structural adhesion molecule, which is indicated to regulate the process of DNA damage in airway epithelia for its unique long cytoplasmic domain subunit.</p><p><strong>Methods: </strong>The expression level of ITGB4 and the degree of DNA damage were observed in the house dust mite (HDM)-stressed model and ozone-challenged model, respectively. Besides, ITGB4 conditional knockout mice and ITGB4-deficient airway epithelial cells were constructed to observe the influence of ITGB4 deficiency on DNA damage. Furthermore, the influence of ITGB4 deficiency on HDAC1 expression in airway epithelia was determined under stress stimulation. Finally, corresponding intervention strategies were carried out to verify the involvement of the ITGB4-mediated HDAC1 pathway in DNA damage of airway epithelial cells.</p><p><strong>Results: </strong>HDM stress and ozone challenge reduced the expression of ITGB4, which is accompanied by the increased expression of 8-oxoG and γ-H2AX both in vivo and in vitro. Moreover, ITGB4 deficiency in airway epithelia aggravates the degree of DNA damage under HDM stimulation and ozone stress, respectively. Furthermore, ITGB4 deficiency downregulated the expression of HDAC1 during DNA damage, and restoring HDAC1 can reverse the enhanced DNA damage in airway epithelial cells after exogenous stress.</p><p><strong>Conclusions: </strong>This study confirmed the involvement of ITGB4 in the regulation of DNA damage through mediating HDAC1 in airway epithelial cells under exogenous stress. These results supply some useful insights into the mechanism of DNA damage in airway epithelial cells, which would provide possible targets for early prediction and intervention of pulmonary diseases.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":" ","pages":"e13871"},"PeriodicalIF":4.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40657086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the food allergy quality of life questionnaire series in Chinese families with food-allergic children.","authors":"Agnes Sze Yin Leung,&nbsp;Nam Sze Cheng,&nbsp;Rebecca Ming Yan Li,&nbsp;Pui Fung Li,&nbsp;Yat Laam Lee,&nbsp;Tik Wai Fu,&nbsp;Bertine Flokstra-de Blok,&nbsp;Ting Fan Leung","doi":"10.1111/pai.13865","DOIUrl":"https://doi.org/10.1111/pai.13865","url":null,"abstract":"<p><strong>Background: </strong>Anxiety from accidental exposure and vigilant dietary monitoring impair the quality of life (QoL) of food-allergic patients. A comprehensive food allergy-specific questionnaire allows patients to accurately report their QoL. This study validated the Food Allergy Quality of Life Questionnaire (FAQLQ) series and assessed the QoL of Chinese food-allergic patients and their caregivers.</p><p><strong>Methods: </strong>FAQLQ series developed by EuroPrevall consists of four separate questionnaires for parents, children, adolescents and adults. All questionnaires were translated into traditional Chinese by standard forward and backward methods. A cross-sectional study was conducted on food-allergic patients and children's parents using an age-appropriate questionnaire. The performance indices of FAQLQ and their correlation with independent measures of food allergy were analyzed, and factor analysis was performed to confirm the factor structure of FAQLQ questionnaires.</p><p><strong>Results: </strong>Cross-sectional validation was performed on 214 participants, with 40 reassessed for test-retest reliability. Overall scores for the FAQLQ series had good internal consistency with Cronbach's α ≥.90. Good construct validity was demonstrated by correlations between FAQLQ-Parent Form, FAQLQ-Child Form, FAQLQ-Teenager Form, FAQLQ-Adult Form and Food Allergy Independent Measure (FAIM) scores, except in 0- to 3-year-old children. Test-retest analyses revealed a significant correlation between total FAQLQ score, parent-reported FAIM and food anxiety domain in 4-6 years, and between total score and FAIM in 7-12 years. Exploratory factor analysis categorized items in the FAQLQ series into three to four domains.</p><p><strong>Conclusion: </strong>FAQLQ series provide a valid and reliable measure for QoL in Chinese food-allergic patients and caregivers, except for parents of children aged 0-3 years. Items for all FAQLQ questionnaires are categorized into different functional domains in our population.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":" ","pages":"e13865"},"PeriodicalIF":4.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40657084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased nasal plasmacytoid dendritic cells are associated with recurrent wheezing following severe respiratory syncytial virus bronchiolitis in infancy.","authors":"Maleewan Kitcharoensakkul,&nbsp;Leonard B Bacharier,&nbsp;Huiqing Yin-Declue,&nbsp;Jonathan S Boomer,&nbsp;Daphne Lew,&nbsp;Charles W Goss,&nbsp;Mario Castro","doi":"10.1111/pai.13869","DOIUrl":"https://doi.org/10.1111/pai.13869","url":null,"abstract":"To the Editor: Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract illnesses in young children.1 The pathogenesis of subsequent asthma and reduced lung function following severe RSV bronchiolitis remain unclear. As only a fraction of these children develop recurrent wheezing and asthma, the variation in host factors and immune response are thought to be important in determining these outcomes.2 Pulmonary dendritic cells (DCs) modulate Tcell responses and limit airway inflammation in RSVinfected mice3,4; and differences in DC subsets exist between young children hospitalized with RSV and healthy controls5 leading us to hypothesize that children who develop recurrent wheeze following RSV bronchiolitis have a discrepancy in the frequency of peripheral and/or nasal DCs, compared with children who do not wheeze following severe RSV bronchiolitis in infancy. In this study, nasal wash and blood samples were collected from infants &lt;1 year of age while hospitalized with their first episode of RSVconfirmed bronchiolitis enrolled in the RSV Bronchiolitis in Early Life 2 (RBEL2) study from 2009 to 2012.2 Nasal wash samples were collected from patients by nasal suctioning, in accordance with a validated protocol.6 We excluded children with history of previous wheezing, asthma, congenital heart, and lung anomalies, cystic fibrosis, and history of regular use of reflux medications, bronchodilators, and antiinflammatory medications. Informed consent was obtained from the parents/guardian of all patients at enrollment, and the study was approved by the Institutional Review Board at Washington University. Of 209 children in the cohort, 194 children had nasal and/ or blood samples at entry. Adequate nasal washes were obtained from 122 (58%) and blood samples were obtained from 178 (85%) children. The mean duration of bronchiolitis symptoms to blood collection was 1.7 ± 1.1 days. The mean duration of bronchiolitis symptoms to nasal sample collection was 0.9 ± 0.4 days. The methods for the assessment of nasal DCs, and blood DCs were previously published.7,8 (detailed methods are provided in this article's Online Repository). Plasmacytoid DCs (pDC) were identified as Lin− (CD3, CD19,CD14, CD20, CD16, CD56), CD123 +, HLADR+, and myeloid DCs (mDC) were identified as Lin− CD11c+ HLADR+. Type −1 myeloid DCs (mDC1) were identified by CD1c, and type −2 myeloid DCs (mDC2s) were identified by CD141 (BCDA3) expression. The wheezing outcomes were obtained during telephone interviews with parents/guardians every 6 months. Wheezing was defined as a positive response to either “Has your child had wheezing with colds?” or “Has your child had wheezing without colds?”. Recurrent wheezing was defined as three or more wheezing episodes. Ttests, chisquare tests, and Fisher's exact tests were used to test for clinical variable differences between the wheezing groups (recurrent vs no wheezing). Age at most recent followup and all variables which differed betw","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":" ","pages":"e13869"},"PeriodicalIF":4.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40669344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal peanut and egg consumption during breastfeeding randomized pilot trial.","authors":"Debra J Palmer,&nbsp;Desiree T Silva,&nbsp;Susan L Prescott","doi":"10.1111/pai.13845","DOIUrl":"https://doi.org/10.1111/pai.13845","url":null,"abstract":"In conclusion, this pilot trial was unable to give conclusive results on the effects of maternal egg and peanut consumption during the first 6 months of breastfeeding on infant egg and peanut allergy outcomes. However, this trial has provided valuable pilot trial evidence and informed the study design of the current large- scale, multi-center, randomized controlled trial known as the PrEggNut Study. 10 This trial was supported by grants from Telethon- Perth Children's Hospital Research Fund, and The Financial Markets Foundation for Children.","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":" ","pages":"e13845"},"PeriodicalIF":4.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33483159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of food-dependent exercise-induced anaphylaxis due to grape gibberellin-regulated protein.","authors":"Takae Kobayashi,&nbsp;Naoshi Shimojo,&nbsp;Masashi Nakamura,&nbsp;Kayoko Matsunaga,&nbsp;Joon Nakata,&nbsp;Kazunori Tagami,&nbsp;Keiko Momma,&nbsp;Hiroshi Narita,&nbsp;Yasuto Kondo","doi":"10.1111/pai.13850","DOIUrl":"https://doi.org/10.1111/pai.13850","url":null,"abstract":"To the Editor, Increasing incidences of anaphylaxis caused by fruits have recently been reported.1 Reports on peaches and apples causing immediate hypersensitive reactions and fooddependent exerciseinduced anaphylaxis (FDEIA) are noted; however, reports on grapes are limited.2,3 While gibberellinregulated protein (GRP) has been identified as an allergen that induces severe allergic reactions in some fruits and is present in grapes,4 its involvement in grape allergy is unknown. Here, we report a case of FDEIA due to grapes with positive results in the skin prick test (SPT) and enzymelinked immunosorbent assay (ELISA) with purified grape GRP, and demonstrated the crossantigenicity of grape and peach GRPs. To the best of our knowledge, this is the first report of FDEIA caused by grape GRP. An 11yearold boy presented with abdominal pain, respiratory distress, and systemic urticaria after eating grapes, followed by playing soccer for 30 min, was brought to our emergency room and admitted after an intramuscular adrenaline injection. He had a history of atopic dermatitis, allergic rhinitis, and peach allergy since the age of 9 years when he developed systemic urticaria after ingesting one raw peach. According to the Japanese Guidelines for Food Allergy, an oral food challenge (OFC) was performed where 600 g of grapes was negative. On another day, the exercise provocation test (treadmill test, the standard Bruce protocol) was negative for intake of 300 g of grapes and exercise for 15 min. On yet another day, the exercise provocation test was conducted again with the combination of 10 mg/kg (0.28 g) acetylsalicylic acid followed by 350 g of grapes 30 min later and 15 min of exercise 30 min after that. Eye redness, pruritus at the tips of the extremities, and a rash over the entire face appeared within 2 min. After 5 min, he had facial edema and developed respiratory distress (Figure S1). Adrenaline was administered intramuscularly in the left vastus lateralis, and his symptoms improved notably. Thus, he was diagnosed with FDEIA secondary to grapes. He was discharged after treatment and counseling, and had no recurrences thereafter. His specific immunoglobulin E (sIgE) titers were measured using ImmunoCAP® (Thermo Fisher Diagnostics, Inc.). The sIgE titers were positive for rPru p 7 (4.24 UA/ml), peach (1.5 UA/ml), apple (0.79 UA/ml), cedar (41.2 UA/ml), and cypress (19.2 UA/ml). It was positive for alder (5.55 UA/ml) but negative for rPru p 1, 3, and 4 (&lt;0.10 UA/ml). These results strongly suggested the involvement of GRP, which was proven by introducing purified grape GRP. This study was conducted in accordance with the principles of the Declaration of Helsinki and approved by the Institutional Review Board of Fujita Health University (approval number: HM21417). Written informed consent was obtained from the patient's parents for this study. Detailed information on the materials and methods used is provided in the online supplement. Grape and peach GRPs ","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":" ","pages":"e13850"},"PeriodicalIF":4.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33483161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}