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Original Article
Allergy
Regional differences in diagnosis and management of cow's milk allergy
Fabian Hendricx, Emma Robert, Jaime A. Ramirez-Mayans, Karen Rubi Ignorosa Arellano, Erick M. Toro Monjaraz, Yvan Vandenplas
Clin Exp Pediatr. 2024;67(11):601-607.   Published online October 28, 2024
· Although there is broad consensus on many aspects regarding the symptoms, diagnosis, and treatment of cow's milk allergy, the impact of geographical, cultural, and socioeconomic factors remains unestablished.
· Availability and cost of formula for the management of cow's milk allergy have a major impact on the therapeutic choice.
· Region-specific guidelines for the treatment of cow's milk allergy are required.
Review Article
Allergy
Recent advances in food allergen immunotherapy
You Hoon Jeon, Edwin H. Kim
Clin Exp Pediatr. 2024;67(8):386-394.   Published online December 7, 2023
· To enhance the safety of food allergen immunotherapy, alternative approaches such as sublingual immunotherapy, epicutaneous immunotherapy, low-dose oral immunotherapy (OIT), and omalizumab with OIT are being explored.
· Factors such as causative allergen type, natural outgrowth, symptom severity, and patient age should be considered.
· Individualized food allergen immunotherapy plans should be established to determine the most beneficial treatment for each patient.
Practical issues of oral immunotherapy for egg or milk allergy
Sukyung Kim, Kangmo Ahn, Jihyun Kim
Clin Exp Pediatr. 2024;67(3):140-148.   Published online June 19, 2023
· Oral immunotherapy should be supervised by pediatricians with experience administering oral food challenge tests and managing allergic reactions.
· Food allergen intake is gradually increased and maintained for years.
· Patients may experience allergic reactions and psychological problems.
· Adjunctive therapies (biologics, antihistamines, and leukotriene receptor antagonists) may improve efficacy and safety.
· Contraindications include uncontrolled asthma, malignancy, active autoimmune disorders, and beta-blocker usage.
Skin and oral intervention for food allergy prevention based on dual allergen exposure hypothesis
Kiwako Yamamoto-Hanada, Yukihiro Ohya
Clin Exp Pediatr. 2024;67(10):477-485.   Published online June 14, 2023
To prevent food allergy in infants, based on the dual allergen exposure hypothesis, we recommend a personalized approach consisting of both skin intervention (eczema treatment to achieve early remission and well-controlled skin without eczema to prevent percutaneous immunoglobulin E sensitization) and oral intervention (early allergenic food introduction).
New approaches to immunotherapy in house dust mite allergy
In Sik Kim
Clin Exp Pediatr. 2023;66(4):161-168.   Published online October 25, 2022
Allergen immunotherapy (AIT) has developed over the last few decades and has emerged as a promising treatment. House dust mite (HDM) is a target allergen in AIT, and various modified HDM allergens have been improved for their efficacy. Moreover, clinical trials have proved their significantly therapeutic effects in allergy. This article review focuses on HDM allergens developed for AIT efficacy,...
Drug Allergy in Children: What Should We Know?
Ji Soo Park, Dong In Suh
Clin Exp Pediatr. 2020;63(6):203-210.   Published online November 12, 2019
The drug allergy “label” may have a lifetime of consequences for a child. Many children with alleged drug allergies are proven to be tolerant to the culprit medication when challenged. The field of drug hypersensitivity is a recently evolving field of research, but studies on its epidemiology and diagnostic tools are lacking in children. Clinical history is significant in the...
Original Article
Allergy
Asthma predictive index as a useful diagnostic tool in preschool children: a cross-sectional study in Korea
Dong Hyeon Lee, Ji-Won Kwon, Hyung Young Kim, Ju-Hee Seo, Hyo-Bin Kim, So-Yeon Lee, Gwang-Cheon Jang, Dae-Jin Song, Woo Kyung Kim, Young-Ho Jung, Soo-Jong Hong, Jung Yeon Shim
Clin Exp Pediatr. 2020;63(3):104-109.   Published online November 8, 2019
Question: Is physician-diagnosed current asthma in preschool children associated with the asthma predictive index, atopic sensitization, or pulmonary function test?
Finding: Physician-diagnosed current asthma in preschool children was associated with the asthma predictive index, but not with spirometry, methacholine provocation test, fractional expiratory nitric oxide level, and atopic sensitization.
Meaning: Physician-diagnosed asthma in preschool children may be different from classic atopic asthma in school children or adolescents.
Review Article
Nutrition
A perspective on partially hydrolyzed protein infant formula in nonexclusively breastfed infants
Yvan Vandenplas, Zakiudin Munasir, Badriul Hegar, Dewi Kumarawati, Ahmad Suryawan, Muzal Kadim, Julistio Tb Djais, Ray Wagiu Basrowi, Deni Krisnamurti
Clin Exp Pediatr. 2019;62(5):149-154.   Published online January 14, 2019
The World Health Organization recommends that infants should be exclusively breastfed for the first 6 months of life to provide optimal nutrition in this critical period of life. After this, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to 2 years of age or beyond. For nonbreastfed infants, infant formula is an available option...
Allergy
Particulate matter and childhood allergic diseases
Song-I Yang
Clin Exp Pediatr. 2019;62(1):22-29.   Published online November 7, 2018
Particulate matter (PM) is a ubiquitous air pollutant that is a growing public health concern. Previous studies have suggested that PM is associated with asthma development and exacerbation of asthma symptoms. Although several studies have suggested increased risks of atopic dermatitis, allergic rhinitis, and allergic sensitization in relation to PM exposure, the evidence remains inconsistent. The plausible mechanisms underlying these...
Original Article
Allergy
Clostridium difficile colonization and/or infection during infancy and the risk of childhood allergic diseases
Sun Hwa Lee, Yun Na Gong, Eell Ryoo
Clin Exp Pediatr. 2017;60(5):145-150.   Published online May 31, 2017
Purpose

The gut microbiota can influence several diseases through immune modulation; however, the exact role of microbes such as Clostridium difficileand the relationship between microbiota colonization and allergic diseases are not well known. This study aimed to determine the relationship between C. difficilecolonization and/or infection (CDCI) during infancy and allergic diseases during early childhood.

Methods

Infants 1–12 months of age presenting changes in...

Review Article
Allergy
IgE-mediated food allergies in children: prevalence, triggers, and management
Sooyoung Lee
Clin Exp Pediatr. 2017;60(4):99-105.   Published online April 25, 2017

Food allergy (FA) is a serious health problem, and severe FA such as food-induced anaphylaxis can often be life threatening. The incidence of FA has been increasing especially in children. They usually develop early in life and affect up to 10% of children. The 2 most common food allergens worldwide are milk and eggs, while the third one varies depending...

A practical view of immunotherapy for food allergy
Tae Won Song
Clin Exp Pediatr. 2016;59(2):47-53.   Published online February 29, 2016

Food allergy is common and sometimes life threatening for Korean children. The current standard treatment of allergen avoidance and self-injectable epinephrine does not change the natural course of food allergy. Recently, oral, sublingual, and epicutaneous immunotherapies have been studied for their effectiveness against food allergy. While various rates of desensitization (36% to 100%) and tolerance (28% to 75%) have been...

Effectiveness and safety of seasonal influenza vaccination in children with underlying respiratory diseases and allergy
Jin-Han Kang
Clin Exp Pediatr. 2014;57(4):164-170.   Published online April 30, 2014

Influenza causes acute respiratory infections and various complications. Children in the high-risk group have higher complication and hospitalization rates than high-risk elderly individuals. Influenza prevention in children is important, as they can be a source infection spread in their communities. Influenza vaccination is strongly recommended for high-risk children with chronic underlying circulatory and respiratory disease, immature infants, and children receiving...

Food protein-induced proctocolitis: Is this allergic disorder a reality or a phantom in neonates?
Jin-Bok Hwang, Jeana Hong
Clin Exp Pediatr. 2013;56(12):514-518.   Published online December 20, 2013

The etiology of small and fresh rectal bleeding in neonates who are not sick is usually unknown; the only known cause is food protein-induced proctocolitis (FPIPC). It has been recently reported that FPIPC is a rare cause of rectal bleeding in newborns, and most cases have been proved to be due to idiopathic neonatal transient colitis. A recommended strategy for...

Mechanisms of immune tolerance to allergens in children
Umut C. Kucuksezer, Cevdet Ozdemir, Mübeccel Akdis, Cezmi A. Akdis
Clin Exp Pediatr. 2013;56(12):505-513.   Published online December 20, 2013

Because the prevalence of allergic diseases has significantly increased in recent years, understanding the causes and mechanisms of these disorders is of high importance, and intense investigations are ongoing. Current knowledge pinpoints immune tolerance mechanisms as indispensable for healthy immune response to allergens in daily life. It is evident that development and maintenance of allergens-pecific T cell tolerance is of...

Clinical efficacy and mechanism of probiotics in allergic diseases
Ha-Jung Kim, Hyung Young Kim, So-Yeon Lee, Ju-Hee Seo, Eun Lee, Soo-Jong Hong
Clin Exp Pediatr. 2013;56(9):369-376.   Published online September 30, 2013

A complex interplay between genetic and environmental factors partially contributes to the development of allergic diseases by affecting development during prenatal and early life. To explain the dramatic increase in the prevalence of allergic diseases, the hygiene hypothesis proposed that early exposure to infection prevented allergic diseases. The hygiene hypothesis has changed to the microbial hypothesis, in which exposure to...

Ambient air pollution and allergic diseases in children
Byoung-Ju Kim, Soo-Jong Hong
Clin Exp Pediatr. 2012;55(6):185-192.   Published online June 21, 2012

The prevalence of allergic diseases has increased worldwide, a phenomenon that can be largely attributed to environmental effects. Among environmental factors, air pollution due to traffic is thought to be a major threat to childhood health. Residing near busy roadways is associated with increased asthma hospitalization, decreased lung function, and increased prevalence and severity of wheezing and allergic rhinitis. Recently,...

Food allergy
Youngshin Han, Jihyun Kim, Kangmo Ahn
Clin Exp Pediatr. 2012;55(5):153-158.   Published online May 21, 2012

Food allergy is an important public health problem affecting 5% of infants and children in Korea. Food allergy is defined as an immune response triggered by food proteins. Food allergy is highly associated with atopic dermatitis and is one of the most common triggers of potentially fatal anaphylaxis in the community. Sensitization to food allergens can occur in the gastrointestinal...

Oral food challenges in children
Hye Yung Yum, Hyeon Jong Yang, Kyung Won Kim, Tae Won Song, Woo Kyung Kim, Jung Hee Kim, Kang Mo Ahn, Hyun Hee Kim, Soo Young Lee, Bok Yang Pyun
Clin Exp Pediatr. 2011;54(1):6-10.   Published online January 31, 2011

Many patients assume that allergic reactions against foods are responsible for triggering or worsening their allergic symptoms. Therefore, it is important to identify patients who would benefit from an elimination diet, while avoiding unnecessary dietary restrictions. The diagnosis of food allergy depends on the thorough review of the patients's medical history, results of supplemented trials of dietary elimination, and in...

Original Article
Toll-like receptor 9 expression and interferon-α secretion upon CpG-ODN stimulation in allergic subjects
Man Yong Han, Hye Mi Jee, Hyeong Yoon Kim, Cho Ae Lee, Hyo-Jin Cho, Seong-Gyu Hwang, Kyu-Earn Kim
Clin Exp Pediatr. 2009;52(9):1015-1020.   Published online September 15, 2009

Purpose:The aim of this study is to explore the effect of the Toll-like receptor 9 (TLR9) expressed in plasmacytoid dendritic cells (pDCs) that respond to antigen to Th2 immune deviation in allergic patients. Methods:Subjects consisted of 19 allergic patients and 17 healthy volunteers. Skin prick tests and nasal provocation tests were performed for the two groups. Peripheral blood mononuclear cells (PBMCs)...
Case Report
Effect of cytokines in breast milk on infant during the first two-years of life
Woo Kyung Kim, Hae-Sun Yoon
Clin Exp Pediatr. 2007;50(9):912-918.   Published online September 15, 2007
Purpose : Breast milk contains several components that provide specific immunity and affect the maturation of the infant's immune system. Allergic disease (AD), including atopic eczema, asthma, allergic rhinitis, and food allergy is characterized by an imbalance between cytokines produced by distinct T-helper cell subtypes. The aim of the study was to investigate the concentrations of cytokines and chemokines that...
Original Article
Analysis of cow's milk specific IgE positive patients in newborns
Gil Sang Lee, Nam Kyung Baek, Won Duck Kim
Clin Exp Pediatr. 2006;49(10):1061-1066.   Published online October 15, 2006
Purpose : The purpose of this study was to research whether measurement of cow's milk specific IgE on the newborn would be helpful in the diagnosis of cow's milk allergy. We tried to find out the relation between cow's milk specific IgE and other allergy diseases by following up cases. Methods : We reviewed clinical features of 87 episodes in infants...
DNA Methylation Change of IL-4 Gene from T Cell in Allergic Children
Jae Won Oh, Myung Gul Yum, Chang Ryul Kim, In-Joon Seol, Su A Shin, Ha Baik Lee, Se Jin Jang
Clin Exp Pediatr. 2005;48(6):634-639.   Published online June 15, 2005
Purpose : An understanding of the immunological process is required if primary prevention of atopic diseases is to be developed in early childhood. But, it is too hard to distinguish atopy from nonatopy under the age of two clinically, because the expression of phenotype and cytokines is vague in early childhood. We evaluated DNA methylation changes at Th2 interleukin-4 gene...
Clinical Lecture
Approach to the Children with Recurrent Infections
Jae Ho Lee
Clin Exp Pediatr. 2005;48(5):461-468.   Published online May 15, 2005
The major function of immune system is to protect infections. The immune systems are composed of innate and adaptive immunity. In adaptive immunity, the cellular and humoral components interact each other. Neonates and infants are infected frequently, because immune systems are naive and easy to expose to infectious agents. The complete history and physical examination is essential to evaluate the...
Medical Lecture Course
Role of Mast Cells in Allergic Inflammation and Innate Immunity
Kangmo Ahn
Clin Exp Pediatr. 2004;47(11):1137-1141.   Published online November 15, 2004
Mast cells play a key role in elicitation of the early-phase and late-phase IgE-mediated allergic inflammatory reactions. Mast cells are derived from pluripotent stem cells from the bone marrow. These cells migrate through circulation into connective tissues and mucosal surfaces where they mature. On the cell surfaces, mast cells have high affinity IgE receptor(FcεRI), which react with specific IgE to...
Original Article
Analysis and Evaluation of the Reliability of Medical Information on Food Allergies on the Internet
Young Bun Cho, Young Shin Yoon, Ji Yeon Chang, Sun Mi Kim, Kwi Sook Kim, Chang Hee Choi
Clin Exp Pediatr. 2004;47(8):868-872.   Published online August 15, 2004

Purpose: The information in the internet is increasing and the number of people using the Internet to obtain medical information is increasing rapidly too. But, compared to the amount of information, the quality of information is extremely variable. To assess the accuracy of medical information on the Internet, the quality of information about food allergies available on the internet examined. Methods:...
The Significance of Serologic Allergy Tests in Children with Recurrent Pneumonia
Yoon Hee Sim, Sin Weon Yun, Soo Ahn Chae, Dong Keun Lee
Clin Exp Pediatr. 2004;47(6):634-640.   Published online June 15, 2004
Purpose : Pneumonia is one of the most common respiratory diseases in hospitalized children, and often recurs. It has been reported that asthma is one of the significant contributing factors to recurrent pneumonia. On the basis of similarities between asthma and recurrent pneumonia, we intended to evaluate the influence of allergy on recurrent pneumonia. Methods : Seventy one children with...
Clinical Lecture
Food Allergy
Soo-Young Lee
Clin Exp Pediatr. 2004;47(3):240-246.   Published online March 15, 2004
Food allergy is one of the clinical clusters due to food-induced allergic inflammation against dietary proteins which induced by IgE-mediated and/or non-IgE mediated mechanisms. Food allergic reactions are responsible for a variety of clinical symptoms involving the skin, gastrointestinal tract, and respiratory tract. Sometimes the life threatening anaphylactic reactions would be induced, especially by peanuts, tree nuts and buckwheat allergy....
Original Article
Measles, Mumps, and Rubella Immunization in Children with Egg Allergies
Seung Yeon Nam, Eun Hee Jung, Jin A Jung, Yong Min Park, Kyoung Hee Jeon, Ju Suk Lee, Gi Young Jang, Kang Mo Ahn, Sang Il Lee
Clin Exp Pediatr. 2001;44(9):1031-1035.   Published online September 15, 2001
Purpose : The safety of MMR(Measles, Mumps, and Rubella) immunization to children with egg allergies has been debated for decades because the live attenuated virus used in the vaccine is grown in cultured chick-embryo fibroblasts. Many studies that investigated adverse reactions to MMR vaccine have been reported abroad, but there has been no report in Korean children. So, this study is aimed at determining...
A Follow-Up Study of Intractable Diarrhea in Early Infancy: Clinical Features of Cow's Milk Allergy and Cow Milk-Sensitive Enteropathy
Young Rak Kwon, Young Ho Ahn, Jin Bok Hwang, Chang Ho Han, Hai Lee Chung, Young Dae Kwon
Clin Exp Pediatr. 1995;38(11):1515-1524.   Published online November 15, 1995
Purpose : The multiplicity of poorly defined illnesses and the variability of clinical and laboratory features elicited by milk ingestion in sensitized infants has made it difficult to differentiate them from the more common forms of cow milk intolerance. Following up the cases of intractable diarrhea in early infancy(illI), We investigated the clinical features of cow's milk allergy(CMA) and cow...