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G Kanny

Publications and source records attributed to G Kanny.

At least 73 records · Page 4Linked to original sources

[Food allergy].

Food allergy is an important public health problem. The prevalence of IgE-mediated food allergy is estimated at 3.24% of French population. Clinical pictures are varied: atopic dermatitis, urticaria and oedema, asthma, rhinitis, anaphylactic shock. Their comparative frequencies change with age. The risk of fatal anaphylactic reactions (acute asthma, anaphylactic shock, laryngeal oedema) is underlined. The role of risk factors on expression of food allergy is important: exercise, concomitant intake of alcohol, aspirin NAIDS, beta-blockers or converting enzyme inhibitors. The modifications of food habits and of food allergenicity by agro-alimentary technology, the consumption of novel foods and masked allergens explain the present aspects of food allergy. The role of intestinal flora and early diversification of food influence the acquisition of tolerance. The diagnosis of food allergy depends of the expert appraisement of the allergologist. Oral challenge tests distinguish sensitisation from true food allergy. Treatment is based on targeted eviction diet. Contact with food allergen must be avoided by other way: skin (cosmetic), respiratory tract and drug intake. The control of risk factors is essential.

Allergens↗

[Risk of serious acute asthma due to lupine flour associated with peanut allergy].

UNLABELLED: Lupine flour (lupinus albus), recently authorized in France in human food, cross-reacts with peanuts. We report a case of acute asthma in a patient with allergy to peanuts. EXEGESIS: This patient has a severe allergy to peanuts, presenting as acute asthma. Skin prick-tests to raw and cooked lupine flour were positive. The level of specific-IgE (Allerbio, France) to lupine flour were high. Oral challenge test induced acute asthma at a dose of 965 mg of lupine flour. This quantity may be included in 100 g of bread. CONCLUSION: This case report points out the fact that lupine flour is a high-risk allergen in patients presenting allergy to peanuts. It is necessary to evaluate the allergenic risk of new foods before their introduction into human daily food intake and to establish a network of allergy vigilance.

Adolescent↗

Lettuce allergy.

Explore the source record for details and available documents.

Adult↗

Influence of refining steps on trace allergenic protein content in sunflower oil.

BACKGROUND: Although allergy to sunflower seed and oil is a relatively rare occurrence, several cases of sunflower seed allergy have been observed, and we have already described one case of anaphylaxis after eating sunflower oil and margarine. OBJECTIVE: The aim of our study was to determine and characterize the allergens from sunflower oil at the different steps of the refining process: crude pressed oil (step A), acidification and neutralization (step B), pregumming by centrifugation (step C), washing (step D), bleaching (step E), gumming by filtration (step F), and deodorization (step G). METHODS: A sample of oil from each step of the process (steps A to G) was heat extracted with PBS. The protein concentration of each extract was evaluated by using the micro-Bradford assay. Samples were run on SDS-PAGE. The immunoblot was performed with the serum of a patient sensitized to sunflower seed and oil. RESULTS: The extracts obtained after each step reveal a decrease in total protein concentration from 13.6 microg/mL to 0. 22 microg/mL. The result of SDS-PAGE shows 5 bands, from 67 kd to 145 kd, with the most abundant being the 67-kd protein. The amount of this protein decreases after each step of the process. It is, however, still present in trace amounts in the refined oil. The 67-kd protein, which is mainly present in the crude oil and slightly in the refined oil, has been shown to be allergenic. CONCLUSION: Because of the presence of allergenic proteins, refined sunflower oil may pose a threat to people highly sensitized to sunflower seeds.

2S Albumins, Plant↗

[The multifood allergy syndrome].

Multiple food intolerance in infants and young children is increasingly diagnosed. More than 40% of infants less than 1 y.o. could be affected. The syndrome is characterized by the seriousness of atopic dermatitis (SCORAD > 50), by enterocolitis or failure to thrive or various associations of symptoms that may change over time. The evolution is long-lasting. Common food allergens are milk, egg, soy, wheat, but other ones can be implicated. The diagnosis is established by standardized oral challenges. Multiple etiopathogenic factors are involved: atopy, gastro-enteritis induced intestinal hyperpermeability, precocity of food diversification, breast-feeding continued after the onset of symptoms. Amino-acid based formulas have changed the evolution.

Allergens↗

[Efficiency of diagnosis of latex allergy by the combined use of three latex materials for prick-tests].

The diagnosis of latex allergy is mainly based on prick-tests. In order to improve the efficiency of the diagnosis, a comparative study of three latex materials is carried out in 64 controls and 29 patients allergic to latex = Stallergènes and Allerbio extracts, prepared from crude natural latex, and an ammoniated emulsion of rubber latex (AEL). No adverse reactions are recorded. The specificity is 100% for both extracts, 85% for AEL. Sensitivity is respectively 68%, 63%, 72%. The range of values of the wheal is significantly narrower for Stallergènes extract. 46% of allergic patients are reactive to the three materials. The combined use of three materials reaches an 80% efficiency similar to that of Rast Cap System and the addition of three prick-tests and Rast obtains an efficiency of 93.1%. Using several latex materials could increase the efficiency of the diagnosis, inasmuch as the extracts are generated from natural latex, whereas patients are sensitized to manufactured products originating from ammoniated latex.

Adolescent↗

Cross-allergenicity of peanut and lupine: the risk of lupine allergy in patients allergic to peanuts.

BACKGROUND: Peanut allergy is common, but cross-allergy between legumes is rare. Proteins from Lupinus albus are increasingly eaten in the form of seeds or additives to wheat flour. The risk of cross-allergenicity is still insufficiently known. OBJECTIVE: We sought to study the risk of cross-allergy to lupine in patients allergic to peanut and to study lupine allergenicity. METHODS: Twenty-four patients allergic to peanuts were studied by means of skin prick tests with native lupine flour from Lupinus albus. Double-blind oral challenge tests were performed with lupine flour and peanut in 8 of these patients. Specific IgEs were assayed for peanut, lupine flour, and pollen in 6 sera. RAST inhibition tests for lupine pollen by peanut were performed on 4 of these sera. Peanut and lupine flour immunoblots were carried out for 6 sera, and crossed immunoblot inhibitions for peanut by lupine flour and lupine flour by peanut were carried out for 2 sera. RESULTS: The skin prick test responses with lupine flour were positive in 11 (44%) subjects. The challenge test responses were positive in 7 of 8 subjects at the same doses as with peanut. The major lupine flour allergen (molecular mass, 43 kd) is present in peanuts. The RAST inhibition and immunoblot tests indicated cross-reactivity of peanut with the lupine flour and pollen. CONCLUSIONS: The risk of crossed peanut-lupine allergy is high, contrary to the risk with other legumes. The inclusion of 10% lupine flour in wheat flour without mandatory labeling makes lupine a hidden allergen, presenting a major risk of cross-reaction in subjects already allergic to peanut products. A high sensitizing potential can also be postulated for this legume.

Adolescent↗

[A case of Kimura disease treated with interferon and general corticoid therapy].

INTRODUCTION: A case of Kimura's disease that occurred in a 5-year-old Caucasian boy after a tick bite is reported. When the child was 16 years old, symptoms developed. They included voluminous bilateral neck and head lymph nodes associated with hypereosinophilia (1,640/mm3), and increased IgE levels (18,866 KU/L). Clinical and immunological effects of treatment by interferon-alpha and steroids are presented. EXEGESIS: Pathological and histological examination showed typical features of dense lymphoid cell infiltrates containing many eosinophils, mast cells, and vascular hyperplasia. Percentages of CD4+, CD27-, CD7- cells were increased In the blood and lymph nodes, showing a profile typical of TH2. IL-5 production by these cells was markedly increased and was inhibited by IFN-alpha and IFN-beta in vitro. No etiology was found. The role of antigens of Ixodes ricinus is discussed. Three surgical excisions of adenopathies were not successful. Treatment by IFN-alpha (Introna, Schering-Plough, 5.10(6) U/week) and a bolus of methylprednisolone hemisuccinate (1 g/month) was started. Eight months later, the size of the lymph nodes had decreased; however, eosinophil counts and ECP and IgE levels were still high. The decrease in corticosteroid induced a subsequent, slight increase in the size of the lymph nodes and a marked increase in ECP. CONCLUSION: This is the first description of treatment of Kimura's disease by interferon-alpha and steroids. The disease outcome does not suggest that interferon-alpha may predominate.

Adolescent↗

[Hyperglobulinemia E syndrome with recurrent infections (Job's syndrome)].

INTRODUCTION: To provide definition and nosology of hyperimmunoglobulinemia E previously termed Job's syndrome or Buckleys' syndrome in the literature. Generalization of IgE dosages makes it more commonly diagnosed, though sometimes diagnosis may not be accurate. CURRENT KNOWLEDGE AND KEY POINTS: The clinical picture is dominated by recurring cutaneous and visceral bacterial infections, particularly infections due to staphylococci, and severe generalized eczema, which may be associated with osteoporosis. Biochemistry includes a high level of total and specific IgE and immunological abnormalities dominated by frequent absence of immune antibodies to staphylococci and disorders of neutrophil chemotaxis. Current pathogenic studies show dysregulation of TH1 and TH2 lymphocytes in favor of TH2 activation with depressed TH1 activation, leading to an imbalance in cytokine synthesis. FUTURE PROSPECTS AND PROJECTS: New therapeutical possibilities with alpha and gamma interferon.

Antiviral Agents↗

[Food allergens in children].

Food hypersensitivity is increasing, with clinical indications and allergens multiplying and evolving. We report our experience with clinical indications and distribution of allergens in children with food hypersensitivity. Data were established in a prospective study at medical centres in Nancy and Toulouse (France). We studied 378 children with food hypersensitivity indicated by food challenge, which account for 74.2% of food hypersensitivity. Clinical features were: atopic dermatitis (46.5%), urticaria (17.9%), oedema (14.2%), asthma (8.4%), anaphylaxis (5.2%), gastro-intestinal symptoms (2.1%), oral syndrome (1.8%) and rhino-conjunctivitis (0.5%). Five allergens accounted for 82% of confirmed food hypersensitivity: egg (51.8%), peanut (34.3%), milk (11.6%), mustard (8.9%) and codfish (7.1%). Allergens according to the symptoms showed that peanut allergies were more serious than other food allergy. Allergens according to age showed that peanut allergy is the first food allergy occurring after the age of three. There exists a modification in children's allergen distribution. Peanut allergy is increasing seriously, and diagnosis with food challenge is a necessity.

Adolescent↗

Human basophil activation measured by CD63 expression and LTC4 release in IgE-mediated food allergy.

BACKGROUND: IgE-dependent basophil activation induced by an allergen elicit the release of LTC4 and the expression of the CD63 membrane marker. OBJECTIVE: The aim of this study was to check if flow cytometric analysis of basophil activation could be applied to food allergy diagnosis and if this method paralleled LTC4 release. METHODS: Patients were selected by the clinical history, skin tests, and provocation tests. Basophil activation induced by food extracts was studied in 24 control subjects and in 27 patients having a food allergy by LTC4 release test (LRT) and by flow cytometric anti-IgE+, CD63 + cell counting (BAT = basophil activation test). In case of negative anti-IgE response a passive blood donor basophil passive sensitization step was added to LRT and BAT. Leucocyte histamine release test was performed in 11 patients. RESULTS: Basophil activation test was positive in 18/31 cases and LRT in 22/34 cases for food-allergic patients and, respectively, in 1/33 and 1/35 cases for the controls. A correlation was observed between specific IgE, BAT, and LRT. Basophil activation test and LRT performed after passive sensitization had an excellent sensitivity only for specific IgE levels ranging between 3.5 and 35 KU/L. CONCLUSION: The present study shows that allergen-induced LTC4 release and anti-IgE, antiCD63 bicolor flow cytometric analysis of basophil activation may be used for food allergy diagnosis. Both tests have a good sensitivity and specificity. Basophil activation test and LRT are more efficient than histamine release test in case of high spontaneous histamine release, frequently observed in case of food allergy.

Adolescent↗

Food hypersensitivity in children: clinical aspects and distribution of allergens.

The aims of this work were to investigate, in children and adolescents, the clinical aspects of food hypersensitivity and the distribution of allergens, in a prospective and descriptive study. Five hundred and forty-four pediatric cases from a series of 703 patients with food allergies, confirmed by food challenge, were studied. Their clinical characteristics and the distribution according to allergen were investigated. There was a family history of atopic disease in 70.5% of patients. Atopic dermatitis was the main symptom (275/544; 50.5% of patients), followed by urticaria and angio-edema (165/544; 30%). There was asthma in 8.6% of patients (47 children) and anaphylaxis in 4.5% (27 patients). The rarest signs were rhinitis (n=2; 0.3%), oral allergy syndrome (n=8; 1.4%), and gastrointestinal signs (n=11; 2%). Five allergens accounted for 78% of food hypersensitivity. These allergens were: eggs (36%), peanuts (24%), cow's milk (8%), mustard (6%), and cod (4%). Peanut was the most common allergen for children over the age of 3 yr. In this selected population, sensitivity of individuals to more than three foods was unusual (5%). Atopic dermatitis was the main symptom of food allergy in children. The symptoms changed over time, with respiratory disorders, oral allergy syndrome and ocular problems occuring later. Anaphylaxis also occured mostly in older children. Five allergens were responsible for more than three-quarters of food allergies in children. However, the number of allergens implicated was higher for the group of children over the age of 6 yr than for younger children.

Adolescent↗

[Food allergy to wheat flour in adults].

Wheat flour is a basic foodstuff. Food allergy has been especially described in children, in the form of atopic dermatitis. Food allergy in adults is rare and especially described in the form of anaphylactic shock sometimes induced by effort. Four observations of adult food allergy are presented. The IgE dependent mechanism is documented. The positive oral provocation tests needed doses of 17 to 30 grams. One crossed sensitivity between rye and barley was seen. The major allergen was probably gluten, particularly gliadines. Sensitization was probably due to prolonged inhalation of wheat flour. The authors stress the possibility of food allergy to wheat flour by other mechanisms, the difficulty of diagnosis, needed for a diet without cereal and gluten that is now non reimbursable.

Adult↗

Histamine content does not influence the tolerance of wine in normal subjects.

Histamine has been incriminated as having a responsibility for intolerance reaction to wines. We have made a study by double blind oral provocation test to find the effect of ingestion of a histamine-rich (22.8 mg.l-1) and a histamine free wine in eight healthy subjects. Blood samples were taken at 0, 10, 30 and 45 minutes after ingestion of the wine for measurement of plasma histamine and methylhistamine. Urines were collected 5 hours before and 5 hours after ingestion for measurement of urinary methylhistamine. No subject presented a reaction of intolerance after ingestion of wine rich or poor in histamine. No change in plasma histamine and plasma and urinary methylhistamine was seen. This study shows that the amount of histamine in wine has no clinical or biological effect in healthy subjects, and this emphasized the efficiency in man of the systems for degradation of histamine that is absorbed by the alimentary tract.

Adult↗