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Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé La Fédération française d’allergologie, après un état des lieux de l’offre de soins en 2011 a réalisé deux enquêtes auprès des enseignants en allergologie et des allergologues, enquêtes centrées sur l’offre et le parcours de soins. Celles-ci s’intègrent dans la continuité des propositions du livre blanc de 2017 sur les allergies respiratoires sévères. La mise en place de parcours de soins est l’un des enjeux majeurs pour les années à venir. Ces enquêtes permettent de mettre à jour l’offre, de voir quels sont les contraintes et atouts de la profession pour instaurer ces parcours coordonnés et les initiatives déjà en place. La Fédération déplore la perte de la moitié des allergologues ces dix dernières années mais se réjouit de la mise en lumière de plus de quarante initiatives lui faisant émettre six propositions pour favoriser une dynamique de parcours de soins en allergologie pour les années à venir. Following an inventory of care pathways in 2011, the French Federation of Allergology conducted two surveys amongst allergy training directors and allergists that focused on current allergy care pathways. These are in line with the proposals of the 2017 White Paper on severe respiratory allergies. The establishment of pathways is one of the major challenges for the years to come. These surveys help in updating therapeutic proposals and in identifying the constraints and benefits for the profession of establishing such coordinated care pathways as well as initiatives already in place. While the Federation is sad to report a fifty percent reduction in the total number of allergists over the last ten years, it is delighted to highlight more than forty initiatives, which have resulted in the issuance of six proposals to foster a dynamic pathway of care in allergy management for the coming years. [ABSTRACT FROM AUTHOR]

Résumé Le régime d’éviction est actuellement la seule prise en charge recommandée pour les enfants ayant une allergie aux protéines du lait de vache. L’immunothérapie par voie orale est considérée de plus en plus comme une alternative prometteuse au régime d’éviction, mais n’est pas exempte de risque de réactions anaphylactiques. L’utilisation de lait cuit semble réduire ce risque en comparaison du lait cru, sans l’annuler complètement. En effet, si la plupart des enfants peuvent suivre ce type de protocole sans effet indésirable majeur, cela n’est pas le cas pour tous. En particulier, le bénéfice du recours au lait cuit dans l’accélération de la guérison chez les enfants ayant un phénotype d’allergie aux protéines du lait de vache sévère (anaphylaxie à seuil bas notamment, multimorbidité atopique) devrait être évalué de façon prudente, collégiale et multidisciplinaire, dans des centres habilités à prendre en charge ces patients hautement réactifs. Avoidance is currently the only accepted form of management for children with cow's milk allergy. Oral immunotherapy has emerged as a promising alternative but carries the potential risk of anaphylactic adverse reaction. Baked milk seems to be safer than raw milk in most cases. However, severe adverse events continue to pose a real threat even in oral immunotherapy programs using baked milk. While many patients undergo successful oral immunotherapy without major safety issues, this is not the case for all patients. The benefits of oral immunotherapy with baked milk in speeding up recovery in children with a severe phenotype of cow's milk allergy should be carefully evaluated at specialized centers equipped to manage highly sensitive patients. [ABSTRACT FROM AUTHOR]

Résumé L’asthme allergique nécessite une évaluation clinique régulière afin de proposer une prise en charge thérapeutique adaptée et personnalisée. Différents biomarqueurs corrélés au non contrôle de l’asthme et à l’activité inflammatoire sous-jacente ont été étudiés. Parmi eux, l’éosinophilie pulmonaire évaluée par la FeNO et l’éosinophilie sanguine mesurée soit directement soit par le taux sérique d’ECP semblent, surtout lorsqu’elles sont élevées de façon concomitante, le reflet d’une inflammation systémique plus difficile à maîtriser, mais qui serait sensible à l’action anti-inflammatoire globale de l’omalizumab. Frequent clinical evalutation is needed in allergic asthma in order to propose personnalized medicine. Various biomarkers linked to uncontrolled asthma and to inflammatory activity have been studied. Among them, pulmonary eosinophilia evaluated by FeNO and blood eosinophilia measured directly or via serum level of ECP, mostly if pooled together, seemed to reflect systemic inflammation sensitive to global anti-inflammatory action of omalizumab. [ABSTRACT FROM AUTHOR]

Résumé Les allergies alimentaires sont des maladies multiples en termes de sévérité, d’évolution et d’association à des comorbidités allergiques. Cet article aborde les différents phénotypes d’allergie alimentaire à partir de cohortes néonatales et de cohortes de patients atteints d’allergie alimentaire, en s’orientant sur les allergies alimentaires les plus préoccupantes, c’est-à-dire : (1) les allergies alimentaires à risque de passage d’une maladie atopique à l’autre au cours de l’enfance (de l’allergie alimentaire et/ou à l’allergie cutanée à l’allergie respiratoire ; (2) et les allergies alimentaires sévères. Dans le futur, l’approche phénotypique des allergies alimentaires permettra d’aller vers une médecine personnalisée en termes de prévention et de thérapeutiques ciblées. Food allergies, in terms of severity, evolution and association with various other allergic diseases, are actually multiple diseases. In this article, we approach the different food allergy phenotypes beginning with neonatal cohorts and cohorts of patients suffering from food allergy, focusing on the most disturbing food allergies, that is to say: (1) those with food allergy at risk of developing one atopic disease or another during the course of their childhood (food allergy to cutaneous allergy and/or respiratory allergy); (2) to severe food allergies. In the future, the phenotypic approach to food allergies will lead us to a personalized form of medicine in terms of prevention and therapeutic targets. [ABSTRACT FROM AUTHOR]

Résumé MASK-rhinite (Mobile Airways Sentinel Network pour la rhinite allergique et la multimorbidité de l’asthme) est un système de technologie de l’information et des communications (TIC) centré sur le patient. Une application gratuite pour téléphones mobiles (appelée Allergy Diary ) a été développée et lancée dans 23 pays. Plusieurs résultats obtenus par MASK permettent d’avoir une approche plus proche des besoins du patient allergique. MASK permettra une meilleure approche de l’automédication, de la médecine personnalisée et de l’autonomisation des patients. MASK-rhinitis (Mobile Airways Sentinel NetworK for allergic rhinitis and multiple morbidities in asthma) is a patient-based information and communications technology (ICT). A free mobile-phone application (Allergy Diary) has been developed and launched in 23 countries. Thanks to results obtained via MASK, it has been possible to devise an approach that more closely fits the needs of allergy patients. MASK will lead to improvements in self-medication, personalised medicine and patient autonomy. [ABSTRACT FROM AUTHOR]

Résumé L’immunothérapie allergénique est connue depuis longtemps en allergie respiratoire, dans sa modalité sublinguale ou sous-cutanée. L’immunothérapie allergénique par voie orale est utilisée plus récemment dans l’allergie alimentaire. Il est proposé d’évaluer, dans une revue narrative de la littérature, la fréquence et les facteurs de risque de leurs effets indésirables éventuels. Allergenic immunotherapy has long been used in respiratory allergy in its sublingual and sub-cutaneous forms. Oral allergenic immunotherapy has been used more recently in treating food allergies. Via a narrative literature review, we propose to assess the incidence of any adverse events as well as associated risk factors. [ABSTRACT FROM AUTHOR]

Résumé Il reste difficile actuellement de distinguer a priori les différents phénotypes d’asthme du nourrisson, et notamment de distinguer l’asthme à risque de persistance et de sévérité de l’asthme transitoire. Il est essentiel d’améliorer la prédiction du pronostic de l’asthme au cours de l’enfance, car l’asthme à début précoce concerne une proportion non négligeable, environ 10 %, de la population générale pédiatrique. L’épithélium pulmonaire sécrète différentes protéines, dont certaines, appelées pneumoprotéines, sont dorénavant dosables dans le sérum. Certaines d’entre elles pourraient constituer une piste intéressante dans la recherche de biomarqueurs associés aux phénotypes de l’asthme. At present, it is still difficult to distinguish a priori different phenotypes of early-onset asthma in infants, especially to be able to differentiate infants with asthma who are at risk of persistence and severity from those with transient wheezing. It is thus essential to improve the prediction of the prognosis of early-onset asthma because of its high frequency, about 10%, in the pediatric general population. The pulmonary epithelium secretes into the serum a variety of proteins, including some known as pneumoproteins, and these proteins can now be assayed in the serum. Some of them might represent an interesting way in the search of new biomarkers associated with particular asthma phenotypes. [ABSTRACT FROM AUTHOR]

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: Les voies de recherche du traitement de l’asthme allergique sont représentées par les traitements susceptibles de modifier la marche allergique comme : la modification de l’air intérieur et extérieur, l’immunothérapie allergénique, et probablement les traitements ciblés comme l’omalizumab. Les nouvelles thérapeutiques pour les enfants souffrant d’asthme allergique sévère sont basées sur les phénotypes d’asthme permettant de définir des thérapeutiques ciblées basées sur des voies physiopathologiques différentes. [ABSTRACT FROM AUTHOR]

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé L’allergie au lait de chèvre ou/et de brebis (LCLB) est une allergie peu fréquente mais parfois responsable de manifestations graves. Nous rapportons 108 observations de patients, enfants et adultes, atteints d’une vraie allergie LCLB. Les manifestations cliniques sont immédiates et surviennent le plus souvent après ingestion de fromage de LCLB chez des patients atopiques. Le diagnostic repose sur l’apparition de signes cliniques au décours de l’ingestion de l’aliment. Le bilan allergologique comprend des tests cutanés d’allergologie et un dosage des IgE spécifiques lait de chèvre ou lait de brebis. De nombreux accidents par ingestion accidentelle sont décrits par les patients, ce qui pose le problème des allergènes qui ne sont pas à déclaration obligatoire. Allergy to goat milk and/or sheep milk (GMSM) is an infrequent allergy but it is sometimes responsible for severe reactions. We report observations of 108 patients – children and adults – affected by a true GM or SM allergy. The clinical manifestations in allergic patients are immediate and arise most often after ingestion of GM or SM cheese. The diagnosis is based on the onset of clinical signs when eating the food. The allergy workup includes allergy skin tests and an assay for serum IgE specific for the goat milk and/or the sheep milk. Many reactions have been described by our patients after accidental ingestion, which poses a problem because declaration of the presence of these allergens in foods is not obligatory. [ABSTRACT FROM AUTHOR]

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of IBS, Immuno-analyse & Biologie Specialisee is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of IBS, Immuno-analyse & Biologie Specialisee is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction L’asthme allergique est une maladie inflammatoire des bronches liée à une réponse immune inappropriée secondaire à l’inhalation de pneumallergènes. Un déficit en lymphocytes T régulateurs (Tregs) pourrait être responsable de cette réponse immune aberrante. L’omalizumab est un anticorps monoclonal dirigé contre le domaine C-Epsilon3 des IgE, utilisé en traitement additionnel dans l’asthme sévère allergique. L’objectif de notre étude est d’évaluer le taux de Treg circulants (évalué par marquage FoxP3) comme marqueur d’efficacité de l’omalizumab en relation avec le contrôle de l’asthme. Méthodes Nous avons réalisé une étude longitudinale, prospective, monocentrique chez des enfants atteints d’asthme sévère allergique, non contrôlé sous traitement maximal, traités par omalizumab. Nous avons évalué avant traitement puis après 16 semaines : le contrôle de l’asthme, les EFR, le taux sanguin de polynucléaires éosinophiles et de Treg évalués par FoxP3. Résultats Vingt et un patients ont été inclus. Le taux de patients avec un asthme contrôlé ou partiellement contrôlé augmentait à 16 semaines de 0 % à 42,9 % et 52,4 % respectivement. Le pourcentage de Treg augmentait significativement de 4,6 ± 1,6 % à 5,7 ± 1,9 % à 16 semaines ( p = 0,02) et le taux de polynucléaires éosinophiles diminuait significativement de 460 ± 316 à 320 ± 200/mm 3 ( p = 0,02). L’évolution du contrôle de « non contrôlé » à « contrôlé » à 16 semaines était expliquée par la variable Treg ( p < 0,01) alors qu’il n’y avait pas d’association significative avec l’éosinophilie ( p = 0,6). Conclusion Dans notre population, le traitement par omalizumab améliore le contrôle de l’asthme. L’amélioration du contrôle est associée à une augmentation significative des Treg. Le taux de Treg paraît associé au contrôle de l’asthme et pourrait représenter un biomarqueur d’efficacité de l’omalizumab. [ABSTRACT FROM AUTHOR]

Introduction L’immunothérapie par voie orale (ITO) à l’arachide exclue le plus souvent les allergiques à risque anaphylaxique élevé [1,2] . Objectif Tolérance d’une ITO à l’arachide chez des enfants atteints d’allergie à seuil bas. Méthodes Enfants allergique à l’arachide (AA) ayant des prick tests et/ou des IgE spécifiques vis à vis de l’arachide native positifs (papule ≥ 3 mm et ≥ 0, 35 KUI/L respectivement) et test de provocation en double aveugle contre placebo (TPODACP) positif. Après détermination du seuil réactogène (SR), début de l’ITO avec augmentation des doses en milieu hospitalier tous les 1 à 3 mois pour atteindre 2 g d’arachide. Résultats 36 AA âgés en moyenne de 8 ans 10 mois, 67 % de sexe masculin sont inclus. TPODACP initial : 50 % ont un SR ≤ 80 mg, avec une médiane de 20 mg. 70 %, débutent l’ITO à ≤ 150 mg, 15 % entre 50-800 mg et 15 % à ≥ 800 mg. Après un durée moyenne d’ITO de 296 ± 96 jours, les effets indésirables sont rares (30 %) et majoritairement mineurs (syndrome oral et/ou des troubles digestifs) 82 % et obligent à l’arrêt de l’ITO pour 3 enfants. 3 ont terminé l’ITO avec succès et tolèrent jusqu’à 7 g d’arachide. Conclusion L’ITO semble être bien tolérée pour les AA à seuil réactogène bas. [ABSTRACT FROM AUTHOR]

Abstract Background Metabolomics measures an intermediate stage between genotype and phenotype, and may therefore be useful for breeding. Our objectives were to investigate genetic parameters and accuracies of predicted breeding values for malting quality (MQ) traits when integrating both genomic and metabolomic information. In total, 2430 plots of 562 malting spring barley lines from three years and two locations were included. Five MQ traits were measured in wort produced from each plot. Metabolomic features used were 24,018 nuclear magnetic resonance intensities measured on each wort sample. Methods for statistical analyses were genomic best linear unbiased prediction (GBLUP) and metabolomic-genomic best linear unbiased prediction (MGBLUP). Accuracies of predicted breeding values were compared using two cross-validation strategies: leave-one-year-out (LOYO) and leave-one-line-out (LOLO), and the increase in accuracy from the successive inclusion of first, metabolomic data on the lines in the validation population (VP), and second, both metabolomic data and phenotypes on the lines in the VP, was investigated using the linear regression (LR) method. Results For all traits, we saw that the metabolome-mediated heritability was substantial. Cross-validation results showed that, in general, prediction accuracies from MGBLUP and GBLUP were similar when phenotypes and metabolomic data were recorded on the same plots. Results from the LR method showed that for all traits, except one, accuracy of MGBLUP increased when including metabolomic data on the lines of the VP, and further increased when including also phenotypes. However, in general the increase in accuracy of MGBLUP when including both metabolomic data and phenotypes on lines of the VP was similar to the increase in accuracy of GBLUP when including phenotypes on the lines of the VP. Therefore, we found that, when metabolomic data were included on the lines of the VP, accuracies substantially increased for lines without phenotypic records, but they did not increase much when phenotypes were already known. Conclusions MGBLUP is a useful approach to combine phenotypic, genomic and metabolomic data for predicting breeding values for MQ traits. We believe that our results have significant implications for practical breeding of barley and potentially many other species.

Abstract Background Maternal effects influence juvenile traits such as body weight and early growth in broilers. Ignoring significant maternal effects leads to reduced accuracy and inflated predicted breeding values. Including genetic and environmental direct-maternal covariances into prediction models in broilers can increase the accuracy and limit inflation of predicted breeding values better than simply adding maternal effects to the model. To test this hypothesis, we applied a model accounting for direct-maternal genetic covariance and direct-maternal environmental covariance to estimate breeding values. Results This model, and simplified versions of it, were tested using simulated broiler populations and then was applied to a large broiler population for validation. The real population analyzed consisted of a commercial line of broilers, for which body weight at a common slaughter age was recorded for 41 selection rounds. The direct-maternal genetic covariance was negative whereas the direct-maternal environmental covariance was positive. Simulated populations were created to mimic the real population. The predictive ability of the models was assessed by cross-validation, where the validation birds were all from the last five selection rounds. Accuracy of prediction was defined as the correlation between the predicted breeding values estimated without the phenotypic records of the validation population and a predictor. The predictors were the breeding values estimated using all the phenotypic information and the phenotypes corrected for the fixed effects, and for the simulated data, the true breeding values. In the real data, adding the environmental covariance, with or without also adding the genetic covariance, increased the accuracy, or reduced deflation of breeding values compared with a model not including dam–offspring covariance. Nevertheless, in the simulated data, reduction in the inflation of breeding values was possible and was associated with a gain in accuracy of up to 6% compared with a model not including both forms of direct-maternal covariance. Conclusions In this paper, we propose a simple approach to estimate the environmental direct-maternal covariance using standard software for REML analysis. The genetic covariance between dam and offspring was negative whereas the corresponding environmental covariance was positive. Considering both covariances in models for genetic evaluation increased the accuracy of predicted breeding values.