Immunopathology of allergy - Natural history of allergy

19 important questions on Immunopathology of allergy - Natural history of allergy

What is the "Atopic March"?

Infantile eczema and food allergy are the start of getting allergic airway disease (rhinitis and asthma) later on.

When is the incidence of atopic eczema the highest?

During the first 2 years of life, in childhood and in puberty for females.

Do children loose their atopic eczema?

Yes, 2/3rd will loose their symptoms up to the age of 3 years.
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Children developing atopic eczema later in life (after the age of 5 years) are more likely to outgrow their eczema compared to those children, who had an earlier onset of disease (during first years of life). T/F

True

Which foods can cause atopic eczema?

  • Cow's milk
  • Hen's egg
  • Wheat
  • Soy

What is the incidence of asthma?

4% at 6 years of age and more prevalent in boyds
9% at 20 years

When is the incidence of asthma the highest?

During preschool and early school age, also females in puberty.

Is family history important in asthma?

Yes, atopic family history is a major risk factor

Which food allergens induce IgE-mediated sensitization the most frequent?

  • Hen's egg
  • Cow's milk
  • Peanut

Children with sensitisation to any allergen before the age of 3 years and sensitisation to inhalant allergens have an increased risk for asthma at school age. T/F

True

All children with infantile eczema show a sensitisation to food allergens and will develop classical allergy. T/F

False, NOT all

Sensitisation to food precedes sensitisation to inhalant allergens. T/F

True

Remission of allergic asthma occurs not frequently up to the age of 20 years. T/F

True

There have been no genome wide association (GWA) studies on food allergy. T/F

True

What is a locus (plural: loci)?

A specific, fixed position on a chromosome where a particular gene or genetic marker is located

What are the major drivers of pathogenesis?

Results from studies using high density association mapping suggest that these are the major drivers of pathogenesis:
  • Epithelial events
  • Innate immune function

Epigenetic modifications result in changes in the expression of genetic material and can occur by 3 processes:

  1. Histone modification: adding or removing acetyl groups --> cell's ability to access and read associated sequence
  2. DNA methylation, adding a methyl group to cytosine bases --> may restrict access to the DNA for transcription into mRNA
  3. MicroRNA mediated changes --> Gene expression can be regulated at the post-transcriptional level by microRNAs, which can further modify mRNA transcripts and histones to alter the expression of genes

What is the FOXP3 gene?

It is important for the anti-inflammatory function of Treg cells.

What were differences between an asthmatic and healthy twin?

Asthmatic twin had

  • increase DNA methylation
  • decreased expression of FOXP3 gene
  • decreased function of non-allergic effector T cells through methylation of the IFN-gamma gene

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