Search

Background: Organ transplantation in children is a vital procedure for those with end-stage organ failure, but it has been linked to the development of post-transplant allergies, especially food allergies. This phenomenon, known as transplant-acquired food allergy (TAFA), is becoming increasingly recognized, though its mechanisms remain under investigation. Pediatric transplant recipients often require lifelong immunosuppressive therapy to prevent graft rejection, which can alter immune function and heighten the risk of allergic reactions. Our review aimed to gather the latest evidence on TAFA. Methods: We conducted a PubMed search from 25 June to 5 July 2024, using specific search terms, identifying 143 articles. After screening, 36 studies were included: 24 retrospective studies, 1 prospective study, 2 cross-sectional researches, and 9 case reports/series. Results: Most studies focused on liver transplants in children. The prevalence of food allergies ranged from 3.3% to 54.3%. Tacrolimus, alongside corticosteroids, was the most commonly used immunosuppressive therapy. In addition to food allergies, some patients developed atopic dermatitis, asthma, and rhinitis. Allergic symptoms typically emerged within a year post-transplant, with common allergens including milk, eggs, fish, nuts, soy, wheat, and shellfish. Both IgE-mediated and non-IgE-mediated reactions were observed, with treatment often involving the removal of offending foods and the use of adrenaline when necessary. Conclusions: Consistent immunological monitoring, such as skin prick tests and IgE level assessments, is essential for early detection and management of allergies in these patients. Understanding the link between transplantation and allergy development is crucial for improving long-term outcomes for pediatric transplant recipients. [ABSTRACT FROM AUTHOR]

Asthma, a prevalent chronic respiratory condition characterized by inflammation of the airways and bronchoconstriction, has demonstrated a potential association with hemoglobinopathies such as thalassemia and sickle cell disease (SCD). Numerous studies have highlighted a higher prevalence of asthma among thalassemia patients compared to the general population, with rates ranging around 30%. Similarly, asthma frequently coexists with SCD, affecting approximately 20–48% of patients. Children with SCD often experience heightened lower airway obstruction and airway hyper-reactivity. Notably, the presence of asthma in SCD exacerbates respiratory symptoms and increases the risk of severe complications like acute chest syndrome, stroke, vaso-occlusive episodes, and early mortality. Several studies have noted a decrease in various cytokines such as IFN-γ and IL-10, along with higher levels of both IL-6 and IL-8, suggesting an overactivation of pro-inflammatory mechanisms in patients with hemoglobinopathies, which could trigger inflammatory conditions such as asthma. The exact mechanisms driving this association are better elucidated but may involve factors such as chronic inflammation, oxidative stress, and immune dysregulation associated with thalassemia-related complications like chronic hemolytic anemia and iron overload. This review aims to comprehensively analyze the relationship between asthma and hemoglobinopathies, with a focus on thalassemia and SCD. It emphasizes the importance of interdisciplinary collaboration among pulmonologists, hematologists, and other healthcare professionals to effectively manage this complex interplay. Understanding this link is crucial for improving care and outcomes in affected individuals. [ABSTRACT FROM AUTHOR]

Respiratory infections in children, ranging from mild to severe, are a leading cause of school absences and medical visits, creating significant socio-economic burdens for families. Recent interest has focused on resveratrol, a natural polyphenol known for its antioxidant, anti-inflammatory, and antiviral properties. When combined with carboxymethyl-β-glucan (CM-glucan), a modified polysaccharide with immunostimulatory effects, this formulation has shown potential benefits in managing respiratory diseases.Our research examines five randomized clinical trials investigating the efficacy of resveratrol and CM-glucan nasal solutions in children. The trials included children with recurrent respiratory infections (RRIs) and allergic rhinitis. The results demonstrate significant reductions in key respiratory symptoms, including nasal congestion, sneezing, coughing, and fever. In addition to symptomatic relief, the treatment was associated with fewer medical visits, decreased medication use, and reduced school absences. Importantly, the combination also showed efficacy in decreasing wheezing episodes in non-atopic children with RRIs and improving symptoms of allergic rhinitis. While these findings are promising, the studies are limited by small sample sizes and short-term follow-up periods, raising questions about the long-term efficacy and safety of the treatment. Mild and transient nasal irritation was the only reported side effect. Based on these concepts, the combination of resveratrol and carboxymethyl-β-glucan could be considered a valuable add-on strategy, complementing standard pharmacological treatments for pediatric respiratory infections and allergic conditions., Competing Interests: The authors declare no conflict of interest.