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Winberg, Anna
Publications (10 of 20) Show all publications
Österlund, J., Winberg, A. & West, C. E. (2019). A 10-year review found increasing incidence trends of emergency egg allergy reactions and food-induced anaphylaxis in children. Acta Paediatrica, 108(2), 314-320
Open this publication in new window or tab >>A 10-year review found increasing incidence trends of emergency egg allergy reactions and food-induced anaphylaxis in children
2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 2, p. 314-320Article, review/survey (Refereed) Published
Abstract [en]

Aim: International reports have suggested that food allergies and food‐induced anaphylaxis have increased in children. We investigated the incidence of emergency food reactions over a 10‐year period.

Methods: This study retrospectively reviewed the medical records of children presenting to Umeå University hospital, Sweden, with an emergency food reaction from January 1, 2006 to December 31, 2015. Cases were identified using discharge codes for allergies and anaphylaxis. Anaphylaxis cases were included if they fulfilled the international criteria.

Results: We found emergency food allergy reactions in 519 children (58% boys) from 2006–2015 at a median age of 1.3 years. One‐third were hospitalised (32%) including 71/99 cases of anaphylaxis. Milk and eggs were the most commonly identified triggers. Emergency reactions to eggs increased during the study period with a Spearman rank correlation coefficient of 0.770 (p < 0.01) and the figures for anaphylaxis were 0.745 (p = 0.013). The incidence of food‐induced anaphylaxis increased and was 30 per 100 000 person‐years for the study period.

Conclusion: Most of the emergency reactions, treated by secondary care paediatricians and emergency physicians, were to milk and eggs. Allergic reactions to eggs increased from 2006 to 2015, as did food‐related anaphylaxis.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
Anaphylaxis, Children, Eggs, Emergency admissions, Food allergies
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-155953 (URN)10.1111/apa.14464 (DOI)000455518600021 ()29920760 (PubMedID)
Available from: 2019-02-08 Created: 2019-02-08 Last updated: 2019-02-08Bibliographically approved
Bjerg, A., Winberg, A., Johansson, R., Berthold, M., Borres, M., Hedman, L., . . . Rönmark, E. (2019). Sensitization to animal allergen components in relation to asthma among young adults in Northern Sweden. Paper presented at Congress of the European-Academy-of-Allergy-and-Clinical-Immunology (EAACI), JUN 01-05, 2019, Lisbon, PORTUGAL. Allergy. European Journal of Allergy and Clinical Immunology, 74, 291-291
Open this publication in new window or tab >>Sensitization to animal allergen components in relation to asthma among young adults in Northern Sweden
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2019 (English)In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 74, p. 291-291Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
John Wiley & Sons, 2019
National Category
Respiratory Medicine and Allergy Immunology in the medical area
Identifiers
urn:nbn:se:umu:diva-162872 (URN)000480254002114 ()
Conference
Congress of the European-Academy-of-Allergy-and-Clinical-Immunology (EAACI), JUN 01-05, 2019, Lisbon, PORTUGAL
Note

Supplement: 106

Special Issue: SI 

Meeting Abstract: PD0533

Available from: 2019-09-05 Created: 2019-09-05 Last updated: 2019-09-05Bibliographically approved
Thunqvist, P., Tufvesson, E., Bjermer, L., Winberg, A., Fellman, V., Domellöf, M., . . . Hallberg, J. (2018). Lung function after extremely preterm birth: A population-based cohort study (EXPRESS). Pediatric Pulmonology, 53(1), 64-72
Open this publication in new window or tab >>Lung function after extremely preterm birth: A population-based cohort study (EXPRESS)
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2018 (English)In: Pediatric Pulmonology, ISSN 8755-6863, E-ISSN 1099-0496, Vol. 53, no 1, p. 64-72Article in journal (Refereed) Published
Abstract [en]

Background and objectives: Follow-up studies of children and young adults born very-to-moderately preterm show persistent and significant lung function deficits. The aim of the study was to determine lung function and airway mechanics in school-aged children born in 2004 to 2007 and extremely preterm (after 22-26 weeks of gestation).

Methods: In a population-based cohort of children born extremely preterm and controls born at term (n=350), follow-up at 61/2-years-of-age was performed using spirometry and impulse oscillometry. Associations to gestational age, smallness for gestational age (SGA), and bronchopulmonary dysplasia (BPD) were assessed.

Results: Children born extremely preterm had lower forced vital capacity (FVC, z-score: -0.7, 95%CI: -1.0;-0.4), forced expiratory volume (FEV1, z-score: -1.1, 95%CI: -1.4; -0.8), higher frequency-dependence of resistance (R5-20, 0.09, 95%CI: 0.05; 0.12 kPaL(-1)s(-1)) and larger area under the reactance curve (AX, 0.78, 95%CI: 0.49; 1.07kPaL(-1)) than controls. In children born at 22-24 weeks of gestation, 24% had FVC and 44% had FEV1 below the lower limit of normal. SGA and severe BPD only marginally contributed to pulmonary outcomes. Asthma-like disease was reported in 40% of extremely preterm children and 15% of controls.

Conclusion: Many children born extremely preterm have altered airway mechanics and significant obstructive reduction in lung function. This warrants consideration for treatment and continued follow-up.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
lung function tests, preterm birth, respiratory mechanics
National Category
Respiratory Medicine and Allergy Pediatrics
Identifiers
urn:nbn:se:umu:diva-143630 (URN)10.1002/ppul.23919 (DOI)000418247800013 ()29152899 (PubMedID)
Available from: 2018-01-29 Created: 2018-01-29 Last updated: 2019-02-08Bibliographically approved
Strinnholm, Å., Hedman, L., Winberg, A., Jansson, S.-A., Lindh, V. & Rönmark, E. (2017). Health Related Quality of Life among schoolchildren aged 12-13 years in relation to food hypersensitivity phenotypes: a population-based study. Clinical and Translational Allergy, 7, Article ID 20.
Open this publication in new window or tab >>Health Related Quality of Life among schoolchildren aged 12-13 years in relation to food hypersensitivity phenotypes: a population-based study
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2017 (English)In: Clinical and Translational Allergy, ISSN 2045-7022, E-ISSN 2045-7022, Vol. 7, article id 20Article in journal (Other academic) Published
Abstract [en]

Background:

While Health Related Quality of Life has been investigated among children with IgE-mediated food allergy, less is known about quality of life among children with other types of hypersensitivity to food. The aim of this study was to investigate Health Related Quality of Life (HRQL) in children with and without food hypersensitivity. Further, we compared HRQL between children with different phenotypes of food hypersensitivity.  

Methods:

In a large population-based cohort of schoolchildren in Northern Sweden, the parents of 2,612 (96% of invited) completed a questionnaire. All 125 (5%) children who reported complete elimination of milk, egg, fish or wheat due to food hypersensitivity were invited to a clinical examination and 94 children participated. Of these, 75 children also completed a generic (KIDSCREEN -52) and a disease-specific HRQL questionnaire (FAQLQ-TF). Thereafter, these children were categorised into the different phenotypes: current food allergy, outgrown food allergy, and lactose intolerance. Additionally, 209 children with unrestricted diets answered the generic questionnaire.

Results:

The median score of all KIDSCREEN -52 domains were above the population norm of 50 both in children with and without food hypersensitivity. No significant differences in distribution in generic or disease-specific HRQL were found between children with or without food hypersensitivity. There were no significant differences in HRQL between children with different phenotypes of food hypersensitivity. However, children with current food allergy tended to have the lowest HRQL. Further, poor HRQL defined as ≥75th percentile for the disease specific score was significantly more common in the current food allergy phenotype in the domain Emotional impact and the total FAQLQ, compared to the other phenotypes.

Conclusions:  

In this population-based study, 12-13 year old children reported good HRQL regardless of having food hypersensitivity or not. However, the children with the current phenotype reported lower HRQL than the other phenotypes. 

Place, publisher, year, edition, pages
BioMed Central, 2017
National Category
Public Health, Global Health, Social Medicine and Epidemiology Respiratory Medicine and Allergy Nursing
Identifiers
urn:nbn:se:umu:diva-132250 (URN)10.1186/s13601-017-0156-9 (DOI)000405007100001 ()28680560 (PubMedID)
Note

Originally included in thesis in manuscript form 

Available from: 2017-03-08 Created: 2017-03-08 Last updated: 2018-09-19Bibliographically approved
Strinnholm, Å., Winberg, A., Hedman, L., Rönmark, E. & Lindh, V. (2017). Reintroduction failure is common among adolescents after double-blind placebo-controlled food challenges. Acta Paediatrica, 106(2), 282-287
Open this publication in new window or tab >>Reintroduction failure is common among adolescents after double-blind placebo-controlled food challenges
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2017 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 2, p. 282-287Article in journal (Refereed) Published
Abstract [en]

AIM: There has been a lack of research on adolescents' who undergo double-blind placebo-controlled food challenges. The aim of this study was to investigate food allergic adolescents' experiences and consequences of double-blind placebo-controlled food challenges.

METHODS: This qualitative, descriptive interview study included 17 adolescents aged 14-15 years with total elimination of cows' milk, hens' eggs or cod due to food allergies. The participants, who were initially identified from a large population-based cohort study, were interviewed 18 months after completing their challenges.

RESULTS: The double-blind placebo-controlled food challenge proved to be a complex experience for the adolescents, involving fear of potential reactions and the hope that the food could be reintroduced. Experiences during the challenge were described in three themes: facing fears in a secure environment, being hesitant but curious about unknown tastes and waiting for unknown food reactions. Experiences after the challenge were desribed in two themes: gaining control and freedom and continuing old habits. A negative challenge was not consistently associated with the reintroduction of the challenged food.

CONCLUSION: This study highlighted the importance of considering the adolescents' expectations and experiences of the challenge and the reintroduction process to ensure desirable changes in their dietary habits. Follow ups should be performed regardless of the outcome of challenges.

Keywords
adolescents, double-blind placebo-controlled food challenges, food allergy, qualitative study, reintroduction
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-128114 (URN)10.1111/apa.13673 (DOI)000397337100017 ()27859574 (PubMedID)
Available from: 2016-11-23 Created: 2016-11-23 Last updated: 2018-06-09Bibliographically approved
Winberg, A., Nagaeva, O., Nagaev, I., Lundell, C., Arencibia, I., Mincheva Nilsson, L., . . . West, C. (2016). Dynamics of cytokine mRNA expression and fecal biomarkers in school-children undergoing a double-blind placebo-controlled food challenge series. Cytokine, 88, 259-266
Open this publication in new window or tab >>Dynamics of cytokine mRNA expression and fecal biomarkers in school-children undergoing a double-blind placebo-controlled food challenge series
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2016 (English)In: Cytokine, ISSN 1043-4666, E-ISSN 1096-0023, Vol. 88, p. 259-266Article in journal (Refereed) Published
Abstract [en]

Background: There is need for prognostic markers for symptomatic food allergy since current diagnostic methods are insufficient and/or time and labor consuming. Objective: To estimate the cytokine mRNA profiles in peripheral blood mononuclear cells (PBMC) before and after a double-blind placebo-controlled food challenge series in schoolchildren with suspected allergy to milk, egg or cod and in healthy controls. Analyses of fecal inflammatory biomarkers before and after the challenge were included. Methods: Twelve-year-old children from a population-based cohort reporting complete avoidance of milk, egg, cod or wheat due to perceived hypersensitivity were clinically examined and those with suspected food allergy were evaluated with a 3-session double-blind placebo-controlled food challenge (n = 18). Seven healthy controls participated in a double-blind challenge with egg. Before and after the challenge series, the cytokine mRNA expression was quantified for 13 cytokines discriminating between humoral Th2-, cytotoxic Thl-, regulatory Th3/Tr1- and inflammatory responses. Fecal calprotectin and eosinophil-derived neurotoxin (EDN) were also analyzed in children with suspected food allergy before and after the challenge series. Results: Pre challenge, children with suspected food allergy had higher IL-13 and TNF-alpha expression and lower IFN-gamma and IL-15 expression compared to healthy controls (all p < 0.05). Children with challenge proven food allergy had increased IL13 and IL-10 expression compared to the levels seen in negative challenges (p < 0.05). Post challenge, IL-1 beta and IL-6 mRNA levels were elevated in the food allergic children compared to controls (p < 0.05). Fecal calprotectin and EDN levels were higher in challenge-proven food allergy compared to a negative challenge although not statistically significantly. Conclusion & clinical relevance: Increased baseline mRNA levels of the Th2-related cytokine IL-13 and the regulatory cytokine IL-10 predicted a positive food challenge outcome. These cytokines in combination with fecal calprotectin and EDN might serve as future prognostic markers for symptomatic, IgEmediated food allergy but need further validation in a larger patient cohort.

Keywords
cytokines, fecal biomarkers, food allergy, children, IL-10, IL-13, tolerance
National Category
Pediatrics Immunology in the medical area
Identifiers
urn:nbn:se:umu:diva-114048 (URN)10.1016/j.cyto.2016.09.014 (DOI)000386862100033 ()27697703 (PubMedID)
Note

Originally published in thesis in manuscript form.

Available from: 2016-01-11 Created: 2016-01-11 Last updated: 2018-06-07Bibliographically approved
Winberg, A. (2016). Epidemiology of food hypersensitivity in schoolchildren: Validation with double-blind placebo-controlled food challenges and biomarkers. (Doctoral dissertation). Umeå: Umeå University
Open this publication in new window or tab >>Epidemiology of food hypersensitivity in schoolchildren: Validation with double-blind placebo-controlled food challenges and biomarkers
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: This thesis focuses on the incidence and remission of reported food hypersensitivity in schoolchildren followed from 8 to 12 -years of age and the prevalence of hypersensitivity to milk, egg, cod and wheat among 12-year olds investigated by reported data, clinical investigation and double-blind placebo-controlled food challenges and biomarkers.

Methods: The studies are mainly based on a population based cohort recruited in 2006 from three municipalities in Northern Sweden. All children in first and second grade, aged 7-8 years, were invited to a parental questionnaire study and 2585 (96% of invited) participated. The children in two of the municipalities were also invited to a skin prick test with airborne allergens. At age 11-12 years, there was a follow-up of the cohort using the same methods, with the addition of a child interview and assessment of body mass index (BMI).

At the follow-up, children who reported milk hypersensitivity were invited to structured interviews and children reporting complete elimination of milk, egg, cod or wheat due to perceived hypersensitivity were invited to a clinical examination and blood sampling. According to test results, the children were categorized into different food hypersensitivity phenotypes according to preset criteria. Children categorized as current food allergy were then invited to further evaluation with a double-blind placebo-controlled food-challenge using newly developed recipes. Before their use, the recipes were successfully validated regarding detectable sensorial differences between the active and placebo substances in a separate cohort of healthy schoolchildren (n=275).

Before and after the challenge series blood samples were collected for analyses of cytokine mRNA expression in peripheral blood mononuclear cells including hallmark cytokines for the humoral allergy-promoting T helper (Th) 2 response, cellular cytotoxicity-promoting Th1 response, inflammatory-, and T regulatory responses. Fecal inflammatory biomarkers were also analyzed before and after the challenge series.

Results: Reported food hypersensitivity increased from 21% at age 7-8 years to 26% at 11-12 years. There was a high incidence (15%) as well as a high remission (33%) of reported food hypersensitivity. Risk factors associated with incidence and remission were different for milk hypersensitivity and hypersensitivity to foods other than milk. The agreement between reported symptoms to milk, egg, cod, wheat, soy and peanut and sensitization to the culprit food was poor. At 11 to 12-years of age the prevalence of reported allergy to milk, egg, cod or wheat was 4.8% while the allergy prevalence according to clinical evaluation was 1.4%. This figure was further halved when evaluated with double-blind placebo-controlled food challenges.

The majority of children with reported allergy to milk, egg, cod and wheat were categorized as other food hypersensitivity phenotypes, the most common being probable lactose intolerance (40%) and outgrown food allergy (19%). Even though reported milk hypersensitivity among the 11-12 year olds was 14.5%, only 3% were categorized as current milk allergy. Current and outgrown milk allergy was associated with other atopic disorders and a lower BMI (OR 0.8, 95% CI 0.80-0.98). Before the challenge series, the mRNA expression of the cytokines IL-13 and IL-10 were higher among children with a positive compared to a negative challenge outcome.

Conclusion: Reported food hypersensitivity was common among school children in Northern Sweden and increased from 7-8 years to 11-12 years of age, and both the incidence and remission of reported hypersensitivity was high. There was an 8-fold difference in the prevalence of allergy to milk, egg, cod or wheat when reported data was assessed by clinical examinations and double-blind placebo-controlled food challenges. Allergy to milk, egg, cod and wheat was an uncommon cause of complete avoidance of these foods due to perceived hypersensitivity. Some of the analyzed biomarkers might serve as prognostic markers for symptomatic, IgE-mediated food allergy but need further validation.

Abstract [sv]

Bakgrund: Födoämnesöverkänslighet håller på att bli ett stort och kostsamt hälsoproblem i västvärlden. Prevalensen av rapporterad födoämnes-överkänslighet bland barn ökar, men det är fortfarande oklart om detta avspeglar en sann ökning i populationen. Det finns en stor spridning mellan uppmätta prevalenstal i olika studier och i de få studier där man följt upp rapporterade data med objektiva metoder ses en hög överrapportering.

Data saknas om reell prevalens av födoämnesöverkänslighet bland skolbarn i Sverige. Befintliga prevalensdata baseras på rapporterad födoämnes-överkänslighet och studier saknas där angiven födoämnesöverkänslighet i en barnpopulationskohort validerats med objektiva metoder. Även om dubbelblinda provokationer räknas som ”gold standard” används i praktiken endast sjukhistoria, pricktest och analys av specifikt Immunoglubulin E (IgE) samt öppna provokationer för diagnostik. Metoderna har flera felkällor och mer tillförlitlig diagnostisk behövs, särskilt vid sena och svårtolkade symtom. Korrekt diagnos är särskilt viktig när baslivsmedel har eliminerats eftersom kostrestriktionerna riskerar att leda till negativa konsekvenser för livskvalitet och intag av viktiga näringsämnen.

Syfte: Studierna i denna avhandling fokuserade på incidens och remission av födoämnesöverkänslighet bland skolbarn i Norrbotten, som följdes från 7-8 år till 11-12 års ålder, och på prevalens av överkänslighet mot mjölk, ägg, fisk och vete bland 12-åringar, undersökt med rapporterade data, klinisk undersökning samt dubbelblinda placebokontrollerade födoämnes-provokationer och biomarkörer.

Metod: Den huvudsakliga delen av det här projektet är baserat på en populations-baserad kohort som rekryterades 2006 från 3 kommuner i norra Sverige. Föräldrar till alla barn i klass 1 och 2 (7-8 år) bjöds in till ett frågeformulär, som besvarades av 96% (n=2585) av de inbjudna. Barnen från två av kommunerna, Luleå och Kiruna, bjöds också in till ett pricktest med 10 vanliga luftburna allergen och 90% (n=1700) av de inbjudna deltog. År 2010, när barnen var 11-12 år, gjordes en studieuppföljning med samma metoder och med ytterligare tillägg av en intervju med barnet och bestämning av body mass index (BMI). Studiedeltagandet i enkäter och pricktest var lika högt vid uppföljningen som vid studiestart.

Vid studieuppföljningen bjöds barn med rapporterad mjölköverkänslighet in till en strukturerad intervju och barn som helt undvek mjölk, ägg, fisk eller vete på grund av upplevd överkänslighet, bjöds in till klinisk undersökning och provtagning. Baserat på testresultaten kategoriserades barnen i olika fenotyper av födoämnesöverkänslighet utifrån förutbestämda kriterier. Barn som bedömdes ha en aktuell födoämnesallergi bjöds därefter in till vidare utredning med dubbelblind placebokontrollerad födoämnes-provokation. De recept som användes vid de dubbelblinda provokationerna hade dessförinnan validerats avseende detekterbara smak- och konsistens-skillnader mellan aktiv- och placebosubstans i en separat kohort av friska skolbarn (n=275).

Före och efter den dubbelblinda provokationen samlades blodprover in för analys av cytokin mRNA-uttryck i mononukleära celler. Analyserna inkluderade cytokiner kännetecknande för humoralt allergidrivande T-hjälpar 2 (Th2) svar, cellulärt cytotoxiskt drivande Th1 svar samt inflammatoriskt- och T-reglerande svar. Vidare insamlades avföringsprover för analys av inflammatoriska biomarkörer före och efter genomgången provokationsserie.

Resultat: Prevalensen av föräldrarapporterad födoämnesöverkänslighet ökade från 21% vid 7-8 år till nästan 26% vid 11-12 års ålder. Incidensen av rapporterad födoämnesöverkänslighet var hög (15%), liksom remissionen (33%). Riskfaktorer associerade med incidens och remission var olika för mjölk-överkänslighet och överkänslighet mot andra födoämnen. Vi såg också en bristande samstämmighet mellan föräldrarapporterad överkänslighet mot mjölk, ägg, fisk, vete, soja och jordnöt och IgE-sensibilisering mot det aktuella födoämnet.

Vid 11-12 års ålder var prevalensen av rapporterad allergi mot mjölk, ägg, fisk eller vete 4.8%, medan prevalensen baserad på klinisk undersökning och provtagning var 1.4%. Prevalenssiffran halverades ytterligare när kliniskt bedömd födoämnesallergi validerades med dubbelblinda placebo-kontrollerade födoämnesprovokationer. Majoriteten av barnen med rapporterad allergi mot mjölk, ägg, fisk eller vete klassificerades som andra fenotyper av födoämnesöverkänslighet, varav de vanligast förekommande var möjlig laktosintolerans (40%) och utläkt födoämnesallergi (19%).

Även om förekomsten av rapporterad mjölköverkänslighet bland 11-12 åringarna var så hög som 14.5%, kategoriserades bara 3% av dessa som en aktuell mjölkallergi. Mjölkallergi, aktuell eller utläkt, var associerat med andra atopirelaterade tillstånd och ett lägre BMI (OR 0.82, 95% CI 0.80-0.98) jämfört med barn som inte undvek mjölkprodukter.

Före den dubbelblinda provokationsserien var mRNA-uttrycket av den Th2-relaterade cytokinen IL-13 och den regulatoriska cytokinen IL-10 högre bland barn med provokationspåvisad födoämnesallergi jämfört med barn med en negativ födoämnesprovokation. Såväl före som efter provokationsserien kunde högre nivåer av inflammationsmarkörerna eosinofil-deriverat neurotoxin (EDN) och kalprotektin uppmätas i avföringsprover från barn med positivt provokationsutfall jämfört med barn med negativ födoämnesprovokation. Skillnaderna i uppmätta nivåer av biomarkörer i faeces uppnådde dock inte statistisk signifikans.

Slutsats: Rapporterad födoämnesöverkänslighet var vanligt förekommande bland skolbarn i Norrbotten och ökade från 7-8 år till 11-12 års ålder. Incidensen av rapporterad födoämnesöverkänslighet var hög, liksom remissionen. Prevalensen av rapporterad allergi mot mjölk, ägg, fisk eller vete var 8 gånger högre än den prevalens som kunde påvisas med dubbelblind placebokontrollerad födoämnesprovokation. Allergi mot mjölk, ägg, fisk och vete var en ovanlig orsak till att barn helt undvek dessa födoämnen på grund av upplevd överkänslighet. Några av de biomarkörer som analyserades innan provokationsserierna visade lovande resultat som möjliga, framtida prognostiska markörer för symptomatisk, IgE-medierad födoämnesallergi. Dessa resultat behöver dock valideras med ytterligare studier.

Place, publisher, year, edition, pages
Umeå: Umeå University, 2016. p. 108
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1763
Series
The Obstructive Lung Disease in Northern Sweden (OLIN) Studies ; Thesis XV
Keywords
food hypersensitivity, schoolchildren, epidemiology, food challenges, biomarkers
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-114047 (URN)978-91-7601-367-0 (ISBN)
Public defence
2016-02-19, Norrlands Universitetssjukhus, Bergasalen, By 27, Umeå universitet, Umeå, 13:00 (English)
Opponent
Supervisors
Available from: 2016-01-29 Created: 2016-01-11 Last updated: 2018-06-07Bibliographically approved
Winberg, A., West, C., Strinnholm, Å., Nordström, L., Hedman, L. & Rönmark, E. (2016). Milk allergy is a minor cause of milk avoidance due to perceived hypersensitivity among schoolchildren in Northern Sweden. Acta Paediatrica, 105(2), 206-214
Open this publication in new window or tab >>Milk allergy is a minor cause of milk avoidance due to perceived hypersensitivity among schoolchildren in Northern Sweden
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2016 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 2, p. 206-214Article in journal (Refereed) Published
Abstract [en]

AIM: We investigated phenotypes of milk hypersensitivity among schoolchildren aged 11-12 in Northern Sweden.

METHODS: In a population-based cohort, 1,824 (98%) children aged 11-12 participated in a questionnaire survey, skin prick testing, interviews on food hypersensitivity and assessment of body mass index (BMI). Of the 265 children reporting milk hypersensitivity, milk avoidance and no celiac disease, 236 (89%) participated in a structured interview and blood samples for analyses of milk-specific Immunoglobulin E. The children were then categorised into milk hypersensitivity phenotypes according to preset criteria.

RESULTS: In all, 14.5% reported milk hypersensitivity. Of these, 3% were categorised as current milk allergy, 23% as outgrown milk allergy, 40% as probable lactose intolerance and 11% were non-definable. Furthermore, 23% had discontinued their elimination diet. Milk allergy was associated with other atopic disorders and lower BMI, with an odds Ratio of 0.82 and 95% confidence interval of 0.80-0.98. Only 2% had previously undergone an oral challenge.

CONCLUSION: The most common symptom phenotypes among Swedish children aged 11-12 with self-reported milk hypersensitivity and milk avoidance, were lactose intolerance and outgrown milk allergy while current milk allergy was uncommon. Children with milk allergy had a lower BMI and most lacked a challenge proven diagnosis. 

Keywords
reference equations, reference sample, Z-scores, percentiles, linear regression, spline functions
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-112382 (URN)10.1111/apa.13253 (DOI)000367921500024 ()26518972 (PubMedID)
Note

Publiceras 2016 Feb;105(2):206-214

Available from: 2015-12-07 Created: 2015-12-07 Last updated: 2018-06-07Bibliographically approved
Bjerg, A., Winberg, A., Berthold, M., Mattsson, L., Borres, M. P. & Rönmark, E. (2015). A population-based study of animal component sensitization, asthma, and rhinitis in schoolchildren. Pediatric Allergy and Immunology, 26(6), 557-563
Open this publication in new window or tab >>A population-based study of animal component sensitization, asthma, and rhinitis in schoolchildren
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2015 (English)In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 26, no 6, p. 557-563Article in journal (Refereed) Published
Abstract [en]

Background: Animal sensitization is a major determinant of asthma in children. Component-resolved studies of unselected pediatric populations are lacking. The aim was to describe sensitization to animal components and the association with asthma and rhinitis in animal-sensitized schoolchildren. Methods: A random sample of 696 children (11-12years) from a Swedish population-based cohort was tested for sensitization to cat, dog, and horse dander using ImmunoCAP. Sera from animal-sensitized children were further analyzed by microarray including three allergen components from cat, four from dog, and two from horse. The parents completed an expanded ISAAC questionnaire. Results: Of 259 animal-sensitized children (0.1 kU(A)/l), 51% were sensitized to all three, 23% to two, and 25% to one species. Current asthma and asthma symptoms following contact with cats were associated with co-sensitization to Fel d 1 and Fel d 4. This association was seen already at moderate-level sensitization (1-15 ISU) to Fel d 4, at which level most children were sensitized to Fel d 1, as well. In dog-sensitized children, the majority was sensitized to more than one dog component, and co-sensitization to Can f 5 and Can f 1/f 2 conferred the greatest risk for asthma. Sensitization to the highly cross-reactive serum albumins was uncommon and not associated with asthma. Conclusions: Among schoolchildren in northern Sweden, where mite allergy is uncommon, furry animals were the primary perennial sensitizers. Asthma was associated with higher levels of component sensitization, and sensitization to more than one component from the same animal conferred the greatest risk.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2015
Keywords
children, allergy, furry animals, allergen components, component-resolved diagnosis, asthma, rhinitis
National Category
Immunology in the medical area Pediatrics
Identifiers
urn:nbn:se:umu:diva-109914 (URN)10.1111/pai.12422 (DOI)000361476700011 ()26059105 (PubMedID)
Available from: 2015-10-14 Created: 2015-10-09 Last updated: 2018-06-07Bibliographically approved
Winberg, A., West, C. E., Strinnholm, Å., Nordström, L., Hedman, L. & Rönmark, E. (2015). Assessment of allergy to cow's milk, hen's egg, cod, and wheat in a population-based cohort of Swedish schoolchildren. Paper presented at Congress of the European-Academy-of-Allergy-and-Clinical-Immunology, JUN 06-10, 2015, Barcelona, SPAIN. Allergy. European Journal of Allergy and Clinical Immunology, 70, 266-267
Open this publication in new window or tab >>Assessment of allergy to cow's milk, hen's egg, cod, and wheat in a population-based cohort of Swedish schoolchildren
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2015 (English)In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 70, p. 266-267Article in journal, Meeting abstract (Other academic) Published
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-118437 (URN)10.1111/all.12717 (DOI)000369950701393 ()
Conference
Congress of the European-Academy-of-Allergy-and-Clinical-Immunology, JUN 06-10, 2015, Barcelona, SPAIN
Available from: 2016-04-04 Created: 2016-03-18 Last updated: 2018-06-07Bibliographically approved
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