Research Roundup: June/July 2018

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The latest medical news for people with allergies and food sensitivities.

Milk Allergy’s Impact on Growth

New research shows that children with persistent cow’s milk allergy tend to be shorter and weigh less than kids with peanut or tree nut allergies. The negative growth trend appears to continue through pre-adolescence, according to author Corrine Keet, MD, MS, PhD.

Why are milk-allergic kids at risk for growth problems? Dairy constitutes a large part of the American diet, contributing calories and nutrients. In addition, children with milk allergy are more likely to have eczema and asthma, which may contribute negatively to growth rates, Keet noted, adding that additional study is needed. In the meantime, pediatricians and allergists should advise their patients about eating a healthy, nutrient-dense diet and monitor their growth over time.

This research was presented at the 2018 American Academy of Allergy, Asthma & Immunology and World Allergy Joint Congress.

Gluten Neuropathy

Researchers in the U.K. recently examined peripheral neuropathy (weakness, numbness in the hands and feet) in those with gluten sensitivity to determine if a strict gluten-free diet can reduce neuropathic pain. Patients with peripheral neuropathy were determined to be gluten sensitive by the presence of gliadin, transglutaminase and/or endomysial antibodies in their blood; other risk factors for neuropathy, like diabetes, were ruled out. The research team found that study participants who strictly adhered to the gluten-free diet were significantly less likely to have peripheral neuropathic pain than those eating gluten.

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© GETTY IMAGES PLUS/ISTOCK/choreography

Gluten sensitivity is thought to be an autoimmune disease in which the ingestion of gluten causes an immune reaction that affects nerve endings, according to the study’s lead author Panagiotis Zis, MD, PhD, of the University of Sheffield in Sheffield, U.K. He recommended that all patients with neuropathy be evaluated for gluten sensitivity, adding that gluten neuropathy can exist without the small bowel inflammation characteristic of celiac disease.

The research was presented at the American Academy of Neurology 2018 Annual Meeting.

A related U.K. study published in Digestive and Liver Disease in 2017 found a high prevalence of TG6 antibodies in patients with gluten neuropathy, suggesting that TG6 antibodies (a marker of gluten ataxia) may be helpful in the diagnosis of gluten neuropathy.

Allergic to Meat & Insect Bites

Researchers at the University of North Carolina, Chapel Hill, report that patients with alpha-gal allergy (an allergy to mammalian meat induced by tick bite) are five times more likely than the general population to have an allergic reaction to an insect sting.

Those with alpha-gal allergy were also shown to be 3.6 times more likely to be sensitized to multiple insects, such as honey bees, white-faced hornets, common wasps, paper wasps and fire ants. The common wasp produced the highest reaction rate in the alpha-gal patients (about 30 percent). In the control group, it was fire ants (about 15 percent).

What’s the link between meat allergy and an allergic reaction to insect bite? Researchers were unclear about the underlying mechanism. They concluded, however, that ongoing climate change is likely to make these allergic reactions more common.

The study was presented at the 2018 American Academy of Allergy, Asthma & Immunology and World Allergy Joint Congress.

Anaphylaxis in Children

A study of almost 2,000 children admitted to North American pediatric intensive care units (PICUs) during 2010 to 2015 provides valuable insight into how anaphylaxis presents in children. The most common trigger for anaphylaxis was found to be food, with reactions to peanuts prompting about 45 percent of food-induced reactions. Tree nuts and seeds made up 19 percent of cases; milk caused 10 percent. More children died due to peanut and dairy reactions than any other food-induced anaphylaxis.

PICU admission due to anaphylaxis happened more frequently to children 6 to 18 years old. About 19 percent of patients required tracheal intubation, a treatment used less frequently in children aged 2 to 5.

Researchers found that hospital admission for anaphylaxis happened more during the fall months. Other common causes of anaphylaxis included reactions to drug, blood products and venom.

Urging better recognition, education and more rapid treatment of anaphylaxis, author Carla M. David, MD, said that “unassigned epinephrine at schools can be a huge tool,” calling it “an important initiative that should be supported.”

The research was presented at the 2018 American Academy of Allergy, Asthma & Immunology and World Allergy Joint Congress.

New Allergic Disorder: MCAS

Researchers from the University of Wisconsin School of Medicine and Public Health examined Mast Cell Activation Syndrome (MCAS), a newly recognized disorder that can cause a range of chronic symptoms, including food allergies and anaphylaxis. The condition, which appears to be inherited, was identified in 2007; diagnostic criteria were introduced in 2010. Symptoms, which are caused by mast cells incorrectly releasing chemical mediators, can negatively impact multiple systems throughout the body.

For the study, the team identified 51 patients with MCAS at the University of Wisconsin Allergy Clinic. Almost all were female (94 percent) with an average age of 45. The most common conditions associated with MCAS were allergic disease (67 percent), hypothyroidism (31 percent), depression (31 percent), Ehlers-Danlos Syndrome (a group of inherited disorders that strike connective > p. 78 tissues, 24 percent), POTS* (24 percent), anxiety (24 percent) and GERD (24 percent). All presented with a skin complaint and 90 percent reported gastrointestinal symptoms. Foods, medications and stress/anxiety were the most common reported triggers of symptoms.

Researchers concluded that MCAS is a predominantly female disorder that most often presents with skin and gastrointestinal symptoms. They found a positive biomarker in two-thirds of the patients. Many questions remain about MCAS and further study is needed.

The research was presented at the 2018 American Academy of Allergy, Asthma & Immunology and World Allergy Joint Congress.

*For more about POTS (Postural Orthostatic Tachycardia Syndrome), go to GlutenFreeAndMore.com/POTS.

More Celiac Disease?

Before it was understood that celiac disease could be treated with the gluten-free diet, it wasn’t unusual for young children who had the condition to waste away and die. Italian researchers wondered if the drop in mortality rates of celiac children under 5 over the past 20 years is contributing, at least in part, to the growing prevalence of the disease.

They conducted a review of the medical literature to find out. Looking at rates of celiac disease in school children from 1995 to 2011, they discovered the drop in the death rate of kids under 5 with celiac disease mirrored the increased rate of the condition. Thus, with fewer children dying of the disease, its prevalence was growing. The team concluded that the number of people with celiac disease will increase as faster diagnoses, new developments and the gluten-free diet continue to ensure the survival of kids who have the disease.

The study was published in the Journal of Pediatric Gastroenterology and Nutrition.

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