| 1. |
- Stensson, Malin, 1970-, et al.
(author)
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Caries prevalence, caries-realted factors and plaque pH in adolescents with long-term asthma
- 2010
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In: Caries Research. - Karger : S. Karger AG. - 0008-6568 .- 1421-976X. ; 44:6, s. 540-546
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Journal article (peer-reviewed)abstract
- The aim of the present case-control study was to investigate dental caries, various caries-related factors as well as gingival condition, in 12- to 16-year-olds with long-term asthma (n = 20) and a matched healthy control group (n = 20). Data on dietary and oral hygiene habits, numbers of mutans streptococci and lactobacilli in saliva were also obtained. The plaque pH drop after a sucrose rinse was measured up to 40 min at 2 approximal tooth sites. A lower salivary flow rate was found in the asthma group compared to the control group (p < 0.05). The mean (± SD) of DFS, including manifest and initial caries, was 4.9 ± 5.5 in the asthma and 1.4 ± 2.3 (p < 0.01) in the control group. Only 1 adolescent in the asthma group was caries free compared to 13 in the control group. Concerning pH in plaque, adolescents with asthma had a lower initial value (p < 0.01) and final pH (p < 0.05) than the control group. The Cariogram data showed that 55% of the subjects in the control group had ‘a high chance of avoiding caries’ compared to 10% in the asthma group (p < 0.01). The asthmatic adolescents had higher numbers of sites with gingival bleeding (p < 0.01). To conclude, adolescents with long-term asthma had a higher total DFS and caries risk (according to Cariogram), decreased salivary rate, more gingival bleeding and lower plaque pH than adolescents without asthma.
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| 2. |
- Stensson, Malin, 1970, et al.
(author)
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Oral health in pre-school children with asthma--followed from 3 to 6 years.
- 2010
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In: International journal of paediatric dentistry / the British Paedodontic Society [and] the International Association of Dentistry for Children. - : John Wiley & Sons. - 1365-263X .- 0960-7439. ; 20:3, s. 165-72
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Journal article (peer-reviewed)abstract
- The aim of this study was to investigate caries and its determinants in preschool children with and without asthma, followed from 3 to 6 years.
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| 3. |
- Stensson, Malin, 1970, et al.
(author)
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Oral health in young adults with long-term, controlled asthma.
- 2011
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In: Acta odontologica Scandinavica. - : Informa UK Limited. - 1502-3850 .- 0001-6357. ; 69:3, s. 158-64
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To study oral health in young adults with long-term, controlled asthma. MATERIAL AND METHODS: Twenty 18- to 24-year-olds with a mean duration of asthma of 13.5 [standard deviation (SD) 5.4] years and 20 matched healthy controls were included. A clinical examination was performed and the prevalences of caries, erosions, gingival inflammation, cervicular fluid and periodontal pockets and the plaque formation rate were registered. The salivary flow rate and the numbers of mutans Streptococci and Lactobacilli in saliva were determined. Plaque pH was measured after a sucrose rinse for up to 40 min at two approximal sites. The participants were interviewed regarding dietary and oral hygiene habits. RESULTS: The mean (SD) DFS, including manifest and initial caries, was 8.6 (10.6) in the asthma group and 4.0 (5.2) in the control group (P = 0.09). Initial caries lesions were more common in the asthma group than in the control group: 6.0 (8.1) and 1.3 (2.0), respectively (P = 0.02). The asthma group had more gingivitis (P = 0.01) and a lower stimulated salivary secretion rate than the controls (P = 0.01). The asthmatics also had a somewhat, although not statistically significant, lower initial pH value in plaque and a more pronounced pH drop compared with the controls. In the asthma group, 65% reported frequent mouthbreathing, compared with 10% of the controls (P = 0.01). No differences were found in tooth-brushing or dietary habits between the groups. CONCLUSION: Young adults with long-term, controlled asthma had more initial caries, more gingival inflammation and a lower stimulated salivary secretion rate than individuals without asthma.
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| 4. |
- Abrahamsson, Thomas, et al.
(author)
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No effect of probiotics on respiratory allergies : a seven-year follow-up of a randomized controlled trial in infancy
- 2013
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In: Pediatric Allergy and Immunology. - : Wiley. - 0905-6157 .- 1399-3038. ; 24:6, s. 556-561
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Journal article (peer-reviewed)abstract
- Background: Supplementation with the probioticLactobacillus reuteri reduced the incidence of IgE-associated allergic disease in infancy. This treatment might therefore also reduce the risk of asthma and allergic rhinoconjunctivitis in school age.Objective: To evaluate whether perinatal and infant supplementation withL.reuteri reduced the prevalence of respiratory allergic disease in school age and to explore whether this supplementation was associated with any long-term side effects.Methods: A randomized, placebo-controlled trial with oral supplementation withL.reuteriATCC 55730 (1x10(8)CFU) during the last month of gestation and through the first year of life comprising 232 families with allergic disease, of whom 184 completed a 7-yr follow-up. The primary outcomes at 7yr of age were allergic disease and skin prick test reactivity (ClinicalTrials.govID NCT01285830).Results: The prevalence of asthma (15% in the probiotic vs. 16% in placebo group), allergic rhinoconjunctivitis (27% vs. 20%), eczema (21% vs. 19%) and skin prick test reactivity (29% vs. 26%) was similar in the probiotic and placebo group. Growth indices and gastrointestinal symptoms were similar in the two groups. No severe adverse events were reported.Conclusion: The effect ofL.reuteri on sensitization andIgE-associated eczema in infancy did not lead to a lower prevalence of respiratory allergic disease in school age. Thus, the effect ofL.reuteri on the immune system seems to be transient. Administration ofL.reuteri during the last weeks of gestation and in infancy was not associated with any long-term side effects.
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| 5. |
- Abrahamsson, Thomas R, 1968-, et al.
(author)
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Probiotics in prevention of IgE-associated eczema : a double-blind, randomized, placebo-controlled trial
- 2007
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In: Journal of Allergy and Clinical Immunology. - : Elsevier BV. - 0091-6749 .- 1097-6825. ; 119:5, s. 1174-1180
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Journal article (peer-reviewed)abstract
- BACKGROUND: An altered microbial exposure may underlie the increase of allergic diseases in affluent societies. Probiotics may alleviate and even prevent eczema in infants. OBJECTIVE: To prevent eczema and sensitization in infants with a family history of allergic disease by oral supplementation with the probiotic Lactobacillus reuteri. METHODS: Double-blind, randomized, placebo-controlled trial, which comprised 232 families with allergic disease, of whom 188 completed the study. The mothers received L reuteri ATCC 55730 (1 x 10(8) colony forming units) daily from gestational week 36 until delivery. Their babies then continued with the same product from birth until 12 months of age and were followed up for another year. Primary outcome was allergic disease, with or without positive skin prick test or circulating IgE to food allergens. RESULTS: The cumulative incidence of eczema was similar, 36% in the treated versus 34% in the placebo group. The L reuteri group had less IgE-associated eczema during the second year, 8% versus 20% (P = .02), however. Skin prick test reactivity was also less common in the treated than in the placebo group, significantly so for infants with mothers with allergies, 14% versus 31% (P = .02). Wheeze and other potentially allergic diseases were not affected. CONCLUSION: Although a preventive effect of probiotics on infant eczema was not confirmed, the treated infants had less IgE-associated eczema at 2 years of age and therefore possibly run a reduced risk to develop later respiratory allergic disease. CLINICAL IMPLICATION: Probiotics may reduce the incidence of IgE-associated eczema in infancy.
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| 6. |
- Devenney, Irene, et al.
(author)
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A new model for low-dose food challenge in children with allergy to milk or egg.
- 2006
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In: Acta Paediatr. - : Wiley. - 0803-5253 .- 1651-2227. ; 95:9, s. 1133-9
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Journal article (peer-reviewed)abstract
- Division of Paediatrics, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, Linköping, and Paediatric Clinic, County Hospital Ryhov, Fonköping, Sweden. irene.devenney@lio.seBACKGROUND: Atopic eczema and food allergy are common in early childhood. Children seem to gradually develop tolerance to milk and egg, and it is a relief for families when their child can tolerate small amounts of these basic foods, even if larger doses may still cause symptoms. AIM: To develop a model for low-dose oral food challenge, facilitating re-/introduction of milk or egg. METHODS: In 39 children sensitized to milk and/or egg, we performed 52 challenges using a new standardized model for low-dose oral food challenge. The recipes were validated for blinding with sensorial tests. RESULTS: Four children challenged to milk had a positive challenge outcome. There were no significant differences with respect to family history, associated atopic manifestations, nutritional supply, eczema severity, or skin-prick test compared with the non-reacting children, but total and specific IgE values were significantly higher. All but two of the non-reacting children were able to introduce milk and egg into their diet without problems. CONCLUSION: We report recipes and a protocol to be used for standardized open and double-blind placebo-controlled low-dose food challenge in young children, enabling the introduction of small amounts of egg and milk into the diet during tolerance development.
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| 7. |
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| 8. |
- Ekbäck, Marie, et al.
(author)
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Severe Eczema in Infancy Can Predict Asthma Development. A Prospective Study to the Age of 10 Years
- 2014
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In: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 9:6, s. e99609-
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Journal article (peer-reviewed)abstract
- Background: Children with atopic eczema in infancy often develop allergic rhinoconjunctivitis and asthma, but the term "atopic march has been questioned as the relations between atopic disorders seem more complicated than one condition progressing into another. Objective: In this prospective multicenter study we followed children with eczema from infancy to the age of 10 years focusing on sensitization to allergens, severity of eczema and development of allergic airway symptoms at 4.5 and 10 years of age. Methods: On inclusion, 123 children were examined. Hanifin-Rajka criteria and SCORAD index were used to describe the eczema. Episodes of wheezing were registered, skin prick tests and IgE tests were conducted and questionnaires were filled out. Procedures were repeated at 4.5 and 10 years of age with additional examinations for ARC and asthma. Results: 94 out of 123 completed the entire study. High SCORAD points on inclusion were correlated with the risk of developing ARC, (B = 9.86, P = 0.01) and asthma, (B = 10.17, P = 0.01). For infants with eczema and wheezing at the first visit, the OR for developing asthma was 4.05(P = 0.01). ARC at 4.5 years of age resulted in an OR of 11.28(P = 0.00) for asthma development at 10 years. Conclusion: This study indicates that infant eczema with high SCORAD points is associated with an increased risk of asthma at 10 years of age. Children with eczema and wheezing episodes during infancy are more likely to develop asthma than are infants with eczema alone. Eczema in infancy combined with early onset of ARC seems to indicate a more severe allergic disease, which often leads to asthma development. The progression from eczema in infancy to ARC at an early age and asthma later in childhood shown in this study supports the relevance of the term "atopic march, at least in more severe allergic disease.
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| 9. |
- Giampietro, P.G., et al.
(author)
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Hypoallergenicity of an extensively hydrolyzed whey formula
- 2001
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In: Pediatric Allergy and Immunology. - : Wiley. - 0905-6157 .- 1399-3038. ; 12:2, s. 83-86
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Journal article (peer-reviewed)abstract
- Several different protein hydrolysate-based infant formulas have been promoted as hypoallergenic and considered suitable for the dietary management of cow's milk allergy (CMA). Accepting that none of the hydrolysate-based products is completely safe, the American Academy of Pediatrics (AAP) recommends that these formulas should be tested in a double-blind placebo-controlled setting and tolerated by at least 90% of children with proven CMA. In principle, this recommendation is also endorsed by the European Society of Paediatric Gastroenterology and Nutrition (ESPGAN) and the European Society of Paediatric Allergy and Clinical Immunology (ESPACI). In this two-center study, 32 children with proven CMA were tested with the extensive hydrolysate whey formula Nutrilon Pepti, for comparison with Profylac (extensive) and Nan HA (partial) whey hydrolysate products. Skin-prick tests (SPTs) were, respectively, positive to the three hydrolysate formulas in 19%, 15%, and 32% of children. After oral challenge it was concluded that 97% (95% CI: 85-100%) of the children tolerated Nutrilon Pepti, 94% (95% CI: 75-100%) tolerated Profylac, and 64% (95% CI: 37-81%) tolerated Nan HA. This study demonstrates that the extensive hydrolysates Nutrilon Pepti and Profylac are well tolerated in a population of children with proven CMA and that both products can be considered safe for their intended use. This study confirms that a very small number of children react even to extensively hydrolyzed formulas. SPT prior to oral exposure to the hydrolysate-based formulas can indicate whether a child is at risk of showing reactions to the product. Introduction of new products to these children should be carried out under a doctor's supervision. However, the majority of the SPT-positive children did tolerate the two extensively hydrolyzed whey-based formulas tested.
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| 10. |
- Norrman, Gunilla, et al.
(author)
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Significant improvement of eczema with skin care and food elimination in small children.
- 2005
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In: Acta Paediatr. - : Wiley. - 0803-5253 .- 1651-2227. ; 94:10, s. 1384-8
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Journal article (peer-reviewed)abstract
- AIM: To evaluate common methods of investigation and treatment in children younger than 2 y of age with eczema, with or without sensitization to food allergens. METHODS: One hundred and twenty-three children younger than 2 y of age with eczema and suspected food allergy were included in this prospective study. The children underwent skin-prick test with cow's milk, fresh hen's egg white and wheat. Specific IgE to milk and egg white was analysed. The eczema extent and severity was estimated with SCORAD before and after treatment. Children with a positive skin-prick test were instructed to exclude that food item from their diet. All children were treated with emollients and topical steroids when needed. RESULTS: Sixty-two of the children were skin-prick positive to at least one of the allergens; 62% had mild, 30% moderate and 8% severe eczema at their first visit. After treatment, 90% had mild, 10% moderate and 0% severe eczema. Forty-six per cent of the children had circulating IgE antibodies to milk or egg white. Ten per cent had specific IgE but negative skin-prick test to the same allergen. This subgroup improved their eczema significantly without elimination diet. CONCLUSION: The conventional treatments for children with eczema, i.e. skin care and food elimination, are effective. The beneficial effect of skin care as the first step should not be neglected, and it may not be necessary to eliminate food allergens to relieve skin symptoms in all food-sensitized children with eczema.
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| 11. |
- Oldaéus, Göran
(author)
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Cows' milk hydrolysates : Prevention and treatment of cows' milk allergy
- 1998
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Doctoral thesis (other academic/artistic)abstract
- Cows' milk allergy (CMA) develops early in infancy and the incidence is 2-5% in developed countries. The onset of symptoms is in most cases related to the introduction of a cows' ntilk based formula. The treatment of choice is total avoidance of cows' milk proteins and, at least in infancy, replacement with a whole protein soy or a hydrolysed cows' milk based formula (HP). The hypoallergenicity of HPs has been questioned, and studies evaluating remaining antigenicity and allergenicity as well as the allergy preventive effect of early feeding with HFs have been prompted.In vivo allergenicity of HPs was studied by skin prick tests and double-blind placebo controlled oral challenges in cows' milk allergic children, and in vitro allergenicity was analysed by RAST, RAST inhibition, immunoblotting and dot immunobinding. The protein content of the HPs was analysed by chromatography, electrophoresis, and determination of i)-lactoglobulin by ELISA (I,Il). The allergy preventive effect of feeding a partially (pHF) and an extensively HP (eHF) compared with a regular cows' milk formula from the start of weaning up to 9 months of age, was evaluated in a randomised, blinded study including infants from families with a history of allergy. The children were followed from birth up to 18 months of age (Ill). The antibody response to cows' milk antigens was analysed at 9 months of age with a chemiluminometric assay (IgE) and a sensitive ELISA (IgG) in a subgroup of these infants, who were fed a randomised formula for at least 3 months (IV). The presence of cord blood IgE, IgG, IgG1 and IgG4 antibodies to cows' milk antigens in relation to subsequent cows' milk sensitisation or allergic disease was evaluated (V).All tested HPs retained some allergenicity, but it was higher for pHPs than for eHPs, both in vivo and in vitro. The content of i)lactoglobulin was more than 2000 times higher in a pHF than in the eHFs. An allergy preventive effect was seen for the eHP but not the pHP on the develop-ment of cumulative atopic symptoms and atopic dermatitis. The lgG response to i)-lactoglobulin was more pronounced in the pHP than in the eHP fed group, but markedly reduced in both groups compared with the regular formula group. Cows' milk specific IgE antibodies were detected in 14% of cord blood sera, but the predictive capacity of these antibodies to detect subsequent cows' milk sensitisation and atopic disease up to 18 months of age was poor.In conclusion, all HPs may retain antigens capable of eliciting allergic reactions, but eHPs are far less allergenic than pHFs. Only eHPs should be recommended for treatment and prevention of cows' milk allergy.
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