Allergy prevention through nutrition intervention Abdulwahab Telmesani FRCPC, FAAP Associate prof of Pediatrics College of Medicine and Medical science Umm Al-Qura University - PowerPoint PPT Presentation

Loading...

PPT – Allergy prevention through nutrition intervention Abdulwahab Telmesani FRCPC, FAAP Associate prof of Pediatrics College of Medicine and Medical science Umm Al-Qura University PowerPoint presentation | free to download - id: 460017-ZWFlY



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Allergy prevention through nutrition intervention Abdulwahab Telmesani FRCPC, FAAP Associate prof of Pediatrics College of Medicine and Medical science Umm Al-Qura University

Description:

Allergy prevention through nutrition intervention Abdulwahab Telmesani FRCPC, FAAP Associate prof of Pediatrics College of Medicine and Medical science – PowerPoint PPT presentation

Number of Views:180
Avg rating:3.0/5.0
Slides: 60
Provided by: 5686181
Learn more at: http://uqu.edu.sa
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Allergy prevention through nutrition intervention Abdulwahab Telmesani FRCPC, FAAP Associate prof of Pediatrics College of Medicine and Medical science Umm Al-Qura University


1
Allergy prevention through nutrition
interventionAbdulwahab TelmesaniFRCPC,
FAAPAssociate prof of PediatricsCollege of
Medicine and Medical scienceUmm Al-Qura
University
2
???? ????? ????? ????????
???? ??????? ??? ???? ?????
????? _________????
?????? ????????? ??????????????
?? ???? ??? ???????????????? ??????????????

??????(????? ?????)


3
  • ???? ??????? ?? ?????? ?????? ????? ?????
    ???????? ????????????
  • ________
  • ???? ???? ?? ????? ????? ????? ???? ???? ???
    ??????????
  • ________
  • ?? ?????? ???? ??? ?? ??? ???? ???? ???? ???
    ????? ?????

  • ???? ?????

4
(No Transcript)
5
(No Transcript)
6
(No Transcript)
7
EVE PBUH
  • Had no formulas
  • Had no infants cereals
  • No blenders

8
(No Transcript)
9
(No Transcript)
10
(No Transcript)
11
Recent trends in infant nutrition
  • NO
  • For Early infant feeding




Aggett PJ et al

a commentary by the ESPGHAN Committee on
Nutrition.

J Pediatr
Gastroenterol Nutr. 2001
12
Incidence of allergies increases
Incidence of allergy over the last 20 years



S H Downs et al


Arch Dis Child
2001842023.
13
Food Allergy
14
Small Gut Allergy
  • Main Target Organ
  • Main Port of Entry

15
Food Allergy Level of Contact
  • G.I 50 - 80
  • Skin 20 - 40
  • Respiratory 10- 25

16
Gut is a major lymphoid organ
  • Network of Macrophages
  • Mast Cells
  • Ig producing Cells
  • T- cells

17
Immune response
Antigen exposure (e.g.bacteria,pollen,protein)
Mucosal barrier (e.g.skin,gut)
Immunologic processing
Allergy
Protection Tolerance
18
Pathogenesis
  • Type I allergy
  • Degranulation of mast cells
  • Type III allergy
  • Immune-complex mediated Spread from G.I to
    distant organs e.g. skin, kidney etc.
  • Type IV
  • T-cells Antigens Production of cytokines
  • (IL-4, interferon-?, TNF- a etc.),
    Esinophilic
  • gastroenteritis

19
T Cell Balance
  • Th1 ________ Th0 _________ Th2

20
Hygiene hypothesis
  • Infections stimulate Th 1 response
  • Th1 cytokines inhibit Th 2 function
  • lack of microbial exposure due to improved
    hygiene is responsible for the observed increase
    in allergies

21
T Cell Balance
  • Th1 ________ Th0 _________ Th2

22
T Cell Imbalance
  • Th1 ___ Th0 _______Th2

23
(No Transcript)
24
REVIEW
  • Distinct differences between CMP-specific T
    cell reactivity in the blood of infants with or
    with out CMA, especially expressed by the release
    of Th2 cytokines

  • R. P. Schade et al

  • clin. Exp. Allergy 2003

25
POSPECTIVE COHORT STUDY
  • We conclude that in infants at atopic risk,
    exclusive breast-feeding for at least 4 months is
    effective in reducing atopic dermatitis

  • Schoetzau et al

  • Pediatr Allergy Immunol 2002

26
  • How about when breastfeeding is not possible
  • ?

27
AN EXTENSIVE REVIEW BY AN EXPERT GROUP
  • In infants, breast-feeding with avoidance
    of solid food and cows milk for at least 4-6
    months is the most effective preventive regimen.
    In the absence of breast milk, formula with
    documented reduced allergenicity for at least 4-6
    months should be used


  • Section on Pediatrics,


  • European Academy of Allergology and


  • Immunology


  • Muraro et al


  • Pediatr. Allergy Immunol 2004

28
Frequency of Atopic Symptoms in Infants With a
Family Risk of Allergy
Y. VANDENPLAS et al. J Pediatr 1995
29
Predisposition to food allergy
  • Family history (atopy, asthma etc.)
  • Immune deficiency (IgA)
  • Gut barrier defect
  • Early antigen exposure
  • Antigen provocation

30
G.I Manifestations
  • Vomiting
  • Diarrhea
  • Malabsorption
  • Esinophilic gastroenteritis
  • Allergic colitis
  • FTT

31
Skin Manifestations
  • Atopic Dermatitis
  • -12 Prevalence in School children
  • -80 Have high IgE and positive skin test to
  • food antigens

32
Respiratory Manifestations
  • Allergic Rhinitis
  • Asthma

33
Diagnosis
  • Elimination and Challenge
  • Skin testing
  • G.I. Biopsy

34
Therapy
35
  • Food allergy is a a diagnosis frequently
    entertained, occasionally evaluated and rarely
    established

  • Franz Ingelfiger

36
Therapy
  • Elimination Diet
  • Medical e.g. Ketotifen, SCG, Stroids etc.

37
Brake
38
(No Transcript)
39
Therapy
  • Elimination Diet
  • Medical e.g. Ketotifen, SCG, Stroids etc.

40
Prevention
41
Prevention
  • Identify infants at risk
  • Exclusive BREST MILK for 4-6/12
  • Hydrolyzed (partial, extensive) formula as an
    alternative to B.M when truly not possible
  • Delay solid food after 6 months
  • Avoid Cows milk and Eggs in the first year

42
Prevention cont.
  • Remove house hold allergens
  • -Smoking
  • -Pets
  • -Mite/Molds
  • Avoid early day care centers
  • -decreases respiratory infections

43
Cows milk protein avoidance and development of
childhood wheeze in children with family history
of atopy Ram FSF, Ducharme FM, Scarlett J
  • Background In infants with a family history of
    atopy, food allergen avoidance has been advocated
    as means of preventing the development of atopic
    disease. When breast-feeding is not possible or
    supplemental feeding is needed, alternative
    choices include soy based and hydrolysed cows
    milk formulas.

  • (Cochrane Review)

44
  • Authors' conclusions Breast-milk should remain
    the feed of choice for all babies. In infants
    with at least one first degree relative with
    atopy, hydrolysed formula for a minimum of four
    months combined with dietary restrictions and
    environment measures may reduce the risk of
    developing asthma or wheeze in the first year of
    life. There is insufficient evidence to suggest
    that soya-based milk formula has any benefit.

  • (Cochrane Review)

45
(No Transcript)
46
Probiotic (For Life)

47
Probiotic
  • Lactobacillus Bacteria
  • Bifidobacteria spp

48
Porbiotic or no probiotic ?
49
Porbiotic
  • Recent current research and publications are
    more pro probiotic

50
Probiotics Allergy managementEczema severity
(SCORAD score)
Isolauri E et al. Probiotics in management of
atopic eczema..Clin Exp Allergy 2000301604-1610
51
Intestinal flora and allergy Colonisation
frequency
Björksten B, Sepp E, Julge K,. Allergy
development and the intestinal microflora during
the first Year of life. J Allergy Clin Immunol
2001
52
Porbiotic Benefits2000 - 2005
  • Four weeks of LGG improved the intestinal
    inflammation in infants with atopy and CMA
  • In vitro LGG and Bb modified the cytokines
  • In mice Probiotic prevented the Th2 dominance
    caused by antibiotics in mice
  • Probiotic help in decreasing the rate of
    sensitization of infants during their weaning
    period
  • LcS suppressed IgE and IgI in a food allergy
    model

53
(No Transcript)
54
OBSERVATIONAL BIRTH COHORT STUDY
  • Parental eczema is the major risk factor for
    eczema. But in this study, each month of
    breastfeeding also increased the risk
  • R.L.
    Bergmann et al

  • Clin Exp All 2002

55
Grabbing the bull by the horn for allergy
preventionEditorial
  • It may be more appropiate in an allergen
    modification strategy to expose the fetus and
    infants to high doses in some form of
    immunotherapy

  • J. O. Warner

  • Editor in chief

  • Pediar Allergy Immunol 2004

56
  • ?? ????? ??? ?????

57
  • ???? ??? ??? ?????
  • ??????? 67

58
  • ????? ??????? ??? ????
  • ?????? 143

59
(No Transcript)
About PowerShow.com