Publications
375 results found
Shamji MH, Boyle RJ, 2021, New innovations in allergy treatment and phenotyping, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 51, Pages: 514-517, ISSN: 0954-7894
Hilvo M, 2021, Maternal Elimination Diet and Symptoms of Cow's Milk Allergy in Breastfed Infants, JAMA PEDIATRICS, Vol: 175, Pages: 425-426, ISSN: 2168-6203
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- Citations: 3
Bramer S, Boyle R, Weaver G, et al., 2021, Use of donor human milk in nonhospitalized infants: An infant growth study, Maternal and Child Nutrition, Vol: 17, Pages: 1-9, ISSN: 1740-8695
When mother's own milk (MOM) is unavailable or insufficient, donor human milk (DHM) is recommended as the next best alternative for low birthweight infants. DHM use for healthy, term infants is increasing, but evidence for growth and tolerability is limited. This retrospective study evaluated growth in term infants in the community who received DHM from a UK milk bank. Mothers of infants receiving DHM between 2017 and 2019 were contacted (n = 49), and 31 (63.2%) agreed to participate. Fourteen infants received DHM as a supplement to other feeds (MOM and/or infant formula) and 17 were exclusively fed DHM where breastfeeding was impossible (range: 3–6 weeks). Growth was assessed by deriving z‐scores using the WHO standard for infant growth and compared with 200 exclusively breastfed infants. Multivariate regression analysis revealed no feeding method‐specific association between z‐score and age, nor between weight and age, suggesting that z‐scores and growth velocity were not affected by feeding exclusive MOM, supplemental DHM or exclusive DHM. DHM was well‐tolerated with no adverse events that led to early cessation. After receiving supplemental DHM group, 63% of infants whose mothers had no physical barrier to breastfeeding (5/8 infants) were exclusively breastfed. This novel study reports adequate growth outcomes of healthy nonhospitalized infants receiving DHM, either as the sole milk source or supplement. Prospective studies are needed to confirm whether DHM is a suitable feeding alternative for term infants in the community, optimal durations, as well as the impact of DHM availability on breastfeeding rates and maternal mental health.
Boyle RJ, Shamji MH, 2021, Aetiology and prevention of eczema, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 51, Pages: 380-381, ISSN: 0954-7894
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- Citations: 1
Perkin MR, Logan K, Marrs T, et al., 2021, Association of frequent moisturizer use in early infancy with the development of food allergy, JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, Vol: 147, Pages: 967-+, ISSN: 0091-6749
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- Citations: 36
Kelleher MM, Cro S, Van Vogt E, et al., 2021, Skincare interventions in infants for preventing eczema and food allergy: A cochrane systematic review and individual participant data meta-analysis, Clinical and Experimental Allergy, Vol: 51, Pages: 402-418, ISSN: 0954-7894
ObjectiveEczema and food allergy start in infancy and have shared genetic risk factors that affect skin barrier. We aimed to evaluate whether skincare interventions can prevent eczema or food allergy.DesignA prospectively planned individual participant data meta‐analysis was carried out within a Cochrane systematic review to determine whether skincare interventions in term infants prevent eczema or food allergy.Data sourcesCochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase and trial registries to July 2020.Eligibility criteria for selected studiesIncluded studies were randomized controlled trials of infants <1 year with healthy skin comparing a skin intervention with a control, for prevention of eczema and food allergy outcomes between 1 and 3 years.ResultsOf the 33 identified trials, 17 trials (5823 participants) had relevant outcome data and 10 (5154 participants) contributed to IPD meta‐analysis. Three of seven trials contributing to primary eczema analysis were at low risk of bias, and the single trial contributing to primary food allergy analysis was at high risk of bias. Interventions were mainly emollients, applied for the first 3–12 months. Skincare interventions probably do not change risk of eczema by age 1–3 years (RR 1.03, 95% CI 0.81, 1.31; I2=41%; moderate certainty; 3075 participants, 7 trials). Sensitivity analysis found heterogeneity was explained by increased eczema in a trial of daily bathing as part of the intervention. It is unclear whether skincare interventions increase risk of food allergy by age 1–3 years (RR 2.53, 95% CI 0.99 to 6.47; very low certainty; 996 participants, 1 trial), but they probably increase risk of local skin infections (RR 1.34, 95% CI 1.02, 1.77; I2=0%; moderate certainty; 2728 participants, 6 trials).ConclusionRegular emollients during infancy probably do not prevent eczema and probably increase local skin infections.
Ridd MJ, Webb D, Roberts K, et al., 2021, Test-guided dietary management of eczema in children: A randomized controlled feasibility trial (TEST), CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 51, Pages: 452-462, ISSN: 0954-7894
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- Citations: 4
Turner P, Boyle R, Baseggio Conrado A, 2021, Food Anaphylaxis in the United Kingdom: an analysis of national data, 1998-2018, BMJ: British Medical Journal, Vol: 372, ISSN: 0959-535X
Objective To describe time trends for hospital admissions due to food anaphylaxis in the United Kingdom over the past 20 years.Design Analysis of national data, 1998-2018.Setting Data relating to hospital admissions for anaphylaxis and deaths, and prescription data for adrenaline autoinjector devices.Participants UK population as a whole and devolved nations (England, Scotland, Wales, and Northern Ireland).Main outcome measures Time trends, age, and sex distributions for hospital admissions for anaphylaxis due to food and non-food triggers, and how these admission rates compare with the case fatality rate (number of fatalities as a proportion of hospital admissions).Results Between 1998 and 2018, 101 891 people were admitted to hospital for anaphylaxis. Of these admissions, 30 700 (30.1%) were coded as due to a food trigger. Food anaphylaxis admissions increased from 1.23 to 4.04 per 100 000 population per year (from 1998 to 2018), an annual increase of 5.7% (95% confidence interval 5.5% to 5.9%, P<0.001). The largest increase in hospital admissions was observed in children younger than 15 years, with an increase from 2.1 to 9.2 admissions per 100 000 population per year (an annual increase of 6.6%, 95% confidence interval 6.3% to 7.0%). For comparison, the annual increase was 5.9% (5.6% to 6.2%) in people aged 15-59 years and 2.1% (1.8% to 3.1%) in those aged 60 years and older. 152 deaths were identified where the fatal event was probably caused by food induced anaphylaxis. The case fatality rate decreased from 0.7% to 0.19% for confirmed fatal food anaphylaxis (rate ratio 0.931, 95% confidence interval 0.904 to 0.959, P<0.001) and to 0.30% for suspected fatal food anaphylaxis (0.970, 0.945 to 0.996, P=0.024). At least 46% (86 of 187, which also includes 35 deaths in 1992-98) of deaths were triggered by peanut or tree nut. Cow’s milk was responsible for 17 of 66 (26%) deaths in school aged children. Over the same time period
Musters AH, Mashayekhi S, Flohr C, et al., 2021, Phototherapy for atopic eczema, Cochrane Database of Systematic Reviews
Kelleher MM, Cro S, Cornelius V, et al., 2021, Skin care interventions in infants for preventing eczema and food allergy., Cochrane Database of Systematic Reviews, Vol: 2021, Pages: 1-165, ISSN: 1469-493X
BACKGROUND: Eczema and food allergy are common health conditions that usually begin in early childhood and often occur together in the same people. They can be associated with an impaired skin barrier in early infancy. It is unclear whether trying to prevent or reverse an impaired skin barrier soon after birth is effective in preventing eczema or food allergy. OBJECTIVES: Primary objective To assess effects of skin care interventions, such as emollients, for primary prevention of eczema and food allergy in infants Secondary objective To identify features of study populations such as age, hereditary risk, and adherence to interventions that are associated with the greatest treatment benefit or harm for both eczema and food allergy. SEARCH METHODS: We searched the following databases up to July 2020: Cochrane Skin Specialised Register, CENTRAL, MEDLINE, and Embase. We searched two trials registers and checked reference lists of included studies and relevant systematic reviews for further references to relevant randomised controlled trials (RCTs). We contacted field experts to identify planned trials and to seek information about unpublished or incomplete trials. SELECTION CRITERIA: RCTs of skin care interventions that could potentially enhance skin barrier function, reduce dryness, or reduce subclinical inflammation in healthy term (> 37 weeks) infants (0 to 12 months) without pre-existing diagnosis of eczema, food allergy, or other skin condition were included. Comparison was standard care in the locality or no treatment. Types of skin care interventions included moisturisers/emollients; bathing products; advice regarding reducing soap exposure and bathing frequency; and use of water softeners. No minimum follow-up was required. DATA COLLECTION AND ANALYSIS: This is a prospective individual participant data (IPD) meta-analysis. We used standard Cochrane methodological procedures, and primary ana
Ruiz-Garcia M, Bartra J, Alvarez O, et al., 2021, Cardiovascular changes during peanut-induced allergic reactions in human subjects, Journal of Allergy and Clinical Immunology, Vol: 147, Pages: 633-642, ISSN: 0091-6749
Background: Food allergy is the commonest cause of anaphylaxis. Changes in posture during acute reactions can trigger fatal outcomes, but the impact of allergic reactions on the cardiovascular system in non-fatal reactions remains poorly understood. Objective: To systematically evaluate changes in cardiovascular function during acute allergic reactions to peanut. Methods: Participants underwent double-blind placebo-controlled food challenge topeanut as part of a clinical trial. Changes in hemodynamic parameters (heart rate, stroke volume, blood pressure, peripheral blood flow) and electrocardiogram during food challenges were assessed using continuous monitoring. ClinicalTrials.gov Identifier: NCT02665793 Results: 57 adults (median age 24 (IQR 20-29) years, 53% female) participated; 22 (39%) had anaphylaxis. Acute reactions were associated with significant changes in stroke volume (mean decrease 4.2%, 95%CI 0.8 to 7.6; p=0.03), heart rate (mean increase 11.6%, 95%CI 8.4 to 14.8; p<0.0001) and peripheral blood flow (mean increase 19.7%, 95%CI 10.8 to 28.6; p<0.0001), irrespective of reaction severity. These changes were reproduced at subsequent repeat peanut challenge in 26 participants, and could be reversed with administration of intravenous fluids which resulted in faster resolution of abdominal symptoms. Conclusions: In this first detailed human study of cardiovascular changes during food-allergic reactions, we found evidence for significant fluid redistribution, independent of reaction severity. This provides a sound rationale for optimizing venous return during significant allergic reactions to food. Finally, these data provide a new paradigm for understanding severity in anaphylaxis, where poor outcomes occur due to a failure in compensatory mechanisms.Ruiz-Garcia et al 5 Clinical Implication: Significant changes in cardiovascular function, including decreased stroke volume, occur during peanut-induced allergic reactions in adults irrespective of severit
Shamji MH, Boyle RJ, 2021, What does climate change mean for people with pollen allergy?, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 51, Pages: 202-205, ISSN: 0954-7894
Boyle RJ, Shamji MH, 2021, Allergy prevention, Clinical and Experimental Allergy, Vol: 51, Pages: 4-5, ISSN: 0954-7894
Smires S, Afach S, Mazaud C, et al., 2021, Quality and Reporting Completeness of Systematic Reviews and Meta-Analyses in Dermatology, JOURNAL OF INVESTIGATIVE DERMATOLOGY, Vol: 141, Pages: 64-71, ISSN: 0022-202X
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- Citations: 7
Turner P, Boyle R, Durham S, 2021, Limited effect of intramuscular epinephrine on cardiovascular parameters during peanut-induced anaphylaxis: an observational cohort study, Journal of Allergy and Clinical Immunology: In Practice, Vol: 9, Pages: 527-530.e1, ISSN: 2213-2198
Musters AH, Mashayekhi S, Harvey J, et al., 2021, Phototherapy for atopic eczema, COCHRANE DATABASE OF SYSTEMATIC REVIEWS, ISSN: 1469-493X
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- Citations: 13
Ridd MJ, Webb D, Roberts K, et al., 2021, TRIAL OF ECZEMA ALLERGY SCREENING TESTS (TEST): FEASIBILITY RANDOMISED CONTROLLED TRIAL (RCT) WITH NESTED QUALITATIVE STUDY, Publisher: ACTA DERMATO-VENEREOLOGICA, Pages: 27-27, ISSN: 0001-5555
Roberts G, Almqvist C, Boyle R, et al., 2020, Developments allergy in 2019 through the eyes of clinical and experimental allergy, part I mechanisms, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 50, Pages: 1294-1301, ISSN: 0954-7894
Roberts G, Almqvist C, Boyle R, et al., 2020, Developments allergy in 2019 through the eyes of Clinical and Experimental Allergy, Part II clinical allergy, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 50, Pages: 1302-1312, ISSN: 0954-7894
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- Citations: 1
Boyle R, Brown N, Chiang WC, et al., 2020, Partially hydrolysed, prebiotic supplemented whey formula for the prevention of allergic manifestations in high risk infants: a multicentre double-blind randomised controlled trial (Retraction of Vol 5, art no P30, 2015), Clinical and Translational Allergy, Vol: 10, ISSN: 2045-7022
Sim K, Mijakoski D, Stoleski S, et al., 2020, Outcomes for clinical trials of food allergy treatments, ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY, Vol: 125, Pages: 535-542, ISSN: 1081-1206
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- Citations: 10
Argiz L, Infante S, Machinena A, et al., 2020, Reactions on re-exposure following negative and inconclusive follow-up food challenges in children with acute FPIES, JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, Vol: 8, Pages: 3228-+, ISSN: 2213-2198
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- Citations: 10
de Silva D, Halken S, Singh C, et al., 2020, Preventing food allergy in infancy and childhood: Systematic review of randomised controlled trials, PEDIATRIC ALLERGY AND IMMUNOLOGY, Vol: 31, Pages: 813-826, ISSN: 0905-6157
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- Citations: 75
Ridd MJ, Roberts K, Webb D, et al., 2020, What is the value of test-guided dietary advice for children with eczema? Trial of eczema allergy screening tests (TEST) feasibility randomised controlled trial (RCT) with nested qualitative study, European-Academy-of-Allergology-and-Clinical-Immunology Digital Congress (EAACI), Publisher: WILEY, Pages: 193-193, ISSN: 0105-4538
Ruiz-Garcia M, Skypala I, Durham S, et al., 2020, Intravenous fluids are effective for managing cardiovascular changes and gastrointestinal symptoms during food-related anaphylaxis, European-Academy-of-Allergology-and-Clinical-Immunology Digital Congress (EAACI), Publisher: WILEY, Pages: 239-240, ISSN: 0105-4538
Ierodiakonou D, Patel N, Chong KW, et al., 2020, Need for more than one dose of adrenaline to treat anaphylaxis: A systematic review and meta-analysis, European-Academy-of-Allergology-and-Clinical-Immunology Digital Congress (EAACI), Publisher: WILEY, Pages: 49-49, ISSN: 0105-4538
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- Citations: 1
Jarrold K, Helfer B, Eskander M, et al., 2020, Guidance for the conduct and reporting of clinical trials of breast milk substitutes., JAMA Pediatrics, ISSN: 2168-6203
Importance: Breast milk substitutes (BMS) are important nutritional products evaluated in clinical trials. Concerns have been raised about the risk of bias in BMS trials, the reliability of claims that arise from such trials, and the potential for BMS trials to undermine breastfeeding in trial participants. Existing clinical trial guidance does not fully address issues specific to BMS trials. Objectives: To establish new methodological criteria to guide the design, conduct, analysis, and reporting of BMS trials and to support clinical trialists designing and undertaking BMS trials, editors and peer reviewers assessing trial reports for publication, and regulators evaluating the safety, nutritional adequacy, and efficacy of BMS products. Design, Setting, and Participants: A modified Delphi method was conducted, involving 3 rounds of anonymous questionnaires and a face-to-face consensus meeting between January 1 and October 24, 2018. Participants were 23 experts in BMS trials, BMS regulation, trial methods, breastfeeding support, infant feeding research, and medical publishing, and were affiliated with institutions across Europe, North America, and Australasia. Guidance development was supported by an industry consultation, analysis of methodological issues in a sample of published BMS trials, and consultations with BMS trial participants and a research ethics committee. Results: An initial 73 criteria, derived from the literature, were sent to the experts. The final consensus guidance contains 54 essential criteria and 4 recommended criteria. An 18-point checklist summarizes the criteria that are specific to BMS trials. Key themes emphasized in the guidance are research integrity and transparency of reporting, supporting breastfeeding in trial participants, accurate description of trial interventions, and use of valid and meaningful outcome measures. Conclusions and Relevance: Implementation of this guidance should enhance the quality and validity of BMS trials, prot
Munblit D, Crawley H, Hyde R, et al., 2020, Health and nutrition claims for infant formula are poorly substantiated and potentially harmful, BMJ: British Medical Journal, Vol: 369, Pages: 1-8, ISSN: 0959-535X
Vazquez-Ortiz M, Argiz L, Machinena A, et al., 2020, Diagnostic criteria for acute FPIES: What are we missing?, JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, Vol: 8, Pages: 1717-+, ISSN: 2213-2198
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- Citations: 11
Chong KW, Ruiz-Garcia M, Patel N, et al., 2020, Reaction phenotypes in IgE-mediated food allergy and anaphylaxis, Annals of Allergy, Asthma, and Immunology, Vol: 124, Pages: 473-478, ISSN: 1081-1206
ObjectiveFood allergy encompasses a range of food hypersensitivities. Different clinical phenotypes for food allergy likely exist in much the same way as endotype discovery is now a major research theme in asthma. We discuss the emerging evidence for different reaction phenotypes (ie, symptoms experienced after allergen exposure in food allergic individuals) and their relevance for clinical practice.Data SourcesPublished and unpublished literature relating to reaction phenotypes in food allergy.Study SelectionAuthors assessment of the available data.ResultsFood anaphylaxis may be pathophysiologically different than anaphylaxis caused by nonfood triggers. Currently, there are no robust, clinically useful predictors of severity in food allergy. It is likely that patient-specific reaction phenotypes exist in food allergy, which may affect the risk of severe anaphylaxis. Allergen immunotherapy may modulate these phenotypes.ConclusionData are emerging to confirm our clinical experience that many food allergic patients experience stereotypical symptoms after allergen exposure, both in the community and at supervised oral food challenge, in a manner that varies among patients. Integrating data sets from different cohorts and applying unbiased machine-based learning analyses may demonstrate specific food allergy endotypes in a similar way to asthma. Whether this results in improvements in patient management (eg, through facilitating risk stratification or affecting the decision to prescribe an epinephrine autoinjector and, perhaps, the number of devices) remains to be determined, but given our current inability to predict which patients are most at risk of severe food allergic reactions, this will clearly be an important area of research in the future.
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