PubMed Health⌕ Search

Biomedical subjects

G Hattevig

Publications and source records attributed to G Hattevig.

At least 19 recordsLinked to original sources

[Both risky and "healthy" factors in the allergy prevention counseling].

Most recommendations in order to prevent childhood allergy are based on data gained in retrospective studies. In future it is important that such recommendations are based on intervention studies. Results from prospective birth cohort studies may also be used, since ethical issues must be taken into consideration when interfering on matters like parental smoking, breast-feeding, the keeping of furred pets and the unsuitability of living in damp houses.

Breast Feeding↗

Effect of maternal diet during lactation on development of bovine insulin-binding antibodies in children at risk for allergy.

BACKGROUND: The role of exposure to dietary antigens through maternal milk is intriguing, because it may result either in immunization or in tolerance. Exposure to cow's milk proteins results in antibody formation against bovine insulin in infants at risk for type 1 diabetes. OBJECTIVE: To study the appearance of IgG antibodies to bovine and human insulin in infants with an atopic family history whose mothers followed a cow's milk-free diet during the first 3 months of lactation. METHODS: In a prospective cohort study on prevention of food allergies, 123 infants were exclusively breast-fed or received supplementation with a hydrolyzed casein-based formula (Nutramigen) until the age of 6 months. The mothers either avoided cow's milk during the first 3 months of lactation (diet group) or had an unrestricted diet (nondiet group). The levels of IgG antibodies to bovine and human insulin were determined by enzyme immunoassay at 3, 6, 12, and 18 months and at 4 years. In addition, cord blood was obtained at birth and a maternal sample at delivery. RESULTS: At 3 months, IgG antibodies to bovine insulin were low in both dietary groups (median levels 0.150 and 0. 114 optical density units in the diet and nondiet groups). After exposure to dietary insulin, IgG antibodies to bovine insulin increased in both groups, reaching a peak at 12 months in the nondiet group and at 18 months in the diet group. At 18 months, IgG antibodies to bovine insulin were lower in infants in the nondiet group than in infants in the diet group (0.287 vs 0.500, P<.0001). At 4 years, the antibodies no longer differed between the groups. CONCLUSION: The exposure to cow's milk proteins through breast milk during the first 3 months of life resulted in decreased levels of antibodies to dietary bovine insulin at 18 months of age, suggesting a role for breast milk antigens in early tolerance induction.

Adult↗

Effects of maternal dietary avoidance during lactation on allergy in children at 10 years of age.

This study investigated the long-term effects of maternal dietary avoidance during lactation on the occurrence of atopic symptoms, development of immunoglobulin E (IgE) antibodies to food and inhaled allergens and occurrence of positive skin-prick tests (SPT) in 65 children with a family history of atopy whose mothers adhered to a diet devoid of eggs, cow's milk and fish during the first 3 months of lactation (D group) and in a matched group of 50 children with mothers not practising such a diet (ND group). The diets of the D and ND children were similar. All children attended 7 follow-ups from the age of 3 months to the age of 10 y. After the first follow-up there was a 100% retention of participants. The results of the seventh follow-up at 10 y are presented. Total IgE values and IgE antibodies to seven food and seven inhaled allergens were determined by the Phadebas IgE CAP and the Phadebas RAST, respectively. SPT were conducted for five food and seven inhaled allergens. High rates of atopic symptoms occurred in both groups, but there were no differences between the groups. Sensitization to the three foods avoided by the mothers during lactation was similar, but the overall test reactivity to foods was lower in the D group. Sensitization to inhaled allergens was similar in the two groups. During the 10 y of follow-up, there was no difference between the groups in the occurrence of indoor furred animals, tobacco smoking, changes in heredity for atopy or development of total IgE, but a higher rate of maternal sensitization was found in the ND group, as judged by a screening test for IgE antibodies to inhalants (Phadiatop). The results do not support general recommendations to implement prophylactic maternal dietary avoidance during lactation in allergy-prone families.

Breast Feeding↗

Development of IgG1 and IgG4 antibodies against beta-lactoglobulin and ovalbumin in healthy and atopic children.

BACKGROUND: The IgG responses to food antigens are preferentially restricted to the IgG1 and IgG4 subclasses. Increased levels of IgG1 and IgG4 antibodies against food allergens have been reported in girls and adults with current atopic eczema. OBJECTIVE: To study the relation between the levels of IgG1 and IgG4 antibodies against beta-lactoglobulin and ovalbumin and the development of atopic disease. MATERIAL AND METHODS: Atopic symptoms were recorded in 36 girls from birth to 7 years of age. Blood samples were taken at 3 and 8 months and at 2, 4, and 7 years. IgG1 and IgG4 antibodies were measured by ELISA. RESULTS: Anti-beta-lactoglobulin IgG1 was detected at all ages, peaking at 8 months. Anti-beta-lactoglobulin IgG4 antibodies were detected in 18 to 29 girls at different ages and the antibody levels peaked at 2 years. The levels of anti-beta-lactoglobulin IgG1 were lower in atopic, as compared with healthy individuals at 4 and 7 years (P < .01 and P < .05) and lower anti-beta-lactoglobulin IgG4 antibody levels were found in atopic individuals (P < .05) at 4 years. Anti-ovalbumin IgG1 antibodies were detected in 3/35 girls at 3 months and in 16/35 to 26/35 girls later in life. The number of positive samples and antibody levels peaked at 2 years. Anti-ovalbumin IgG4 positive samples increased from 4/33 at 8 months to 30/32 at 7 years. The levels increased up to 2 years and then remained stable. The anti-ovalbumin IgG1 antibody levels were lower in atopic girls at 4 years (P < .05), while the anti-ovalbumin IgG4 antibody levels were similar at all ages. CONCLUSION: An early IgG1 response and later appearing IgG4 antibodies to the two food antigens beta-lactoglobulin and ovalbumin are common during the first years of life. The levels were similar in the nonatopic and the atopic girls up to four years; then they tended to be lower in the first group.

Adult↗

Season of birth as predictor of atopic manifestations.

The relation between month of birth, sensitisation, and manifestations of atopy was assessed in 209 children who were followed from birth to 12-15 years. Children born during the tree pollen season were less likely to develop allergic rhinoconjunctivitis, IgE antibodies to pollen, or a positive screening test for IgE antibodies (odds ratio 0.28, 0.41, 0.35, respectively) than children born during the rest of the year. The prevalence of IgE antibodies to food and animal dander at 9 months and to atopic disease was higher in children born in the autumn and winter, that is, September to February, compared to the spring and summer (egg 20% v 6%; milk 10% v 2%). Thus sensitisation to pollen and allergic rhinoconjunctivitis is least common in children born in the spring, while birth in September to February is associated with an increased incidence of sensitisation to food and of atopic disease.

Dermatitis, Allergic Contact↗

Tongue necrosis due to vasculitis.

We describe a 7-year-old boy with necrosis of the tongue due to a generalized vasculitis, with symptoms and signs consistent with periarteritis nodosa and appearing after an infection with streptococci. Approximately one-third of the tongue had to be extirpated.

Child↗

Appearance of atopic disease in relation to serum IgE antibodies in children followed up from birth for 4 to 15 years.

BACKGROUND: Few studies have addressed the relationship between sensitization and the development of atopic disease over many years. OBJECTIVE: To study the temporal relationship between the appearance of IgE antibodies in serum and atopic disease, we studied 324 children from three different groups, who were followed up prospectively from birth for 4, 12, and 15 years, respectively. METHODS: Serum samples were obtained at various ages and analyzed for IgE antibodies against egg white, cow's milk, wheat, animal dander, house dust mite, birch and timothy with Phadebas RAST (Kabi Pharmacia Diagnostics AB, Uppsala, Sweden) or Pharmacia CAP system. In addition, a screening test for atopy, the Phadiatop Paediatric test (Kabi Pharmacia Diagnostics AB) was performed. Presence of atopic disease was assessed by means of clinical examination, interviews, and questionnaires. RESULTS: In 135 children IgE antibodies were detected at least once to at least one allergen. Antibodies to egg white appeared in 46 children before or at 2 years of age: in 57% of them IgE antibodies to inhalants developed within the next 2 years, and in 19 of 25 (76%) IgE antibodies to inhalants developed before or at 12 to 15 years. Antibodies to inhalant allergens appeared in 55 children during the first 4 years of life and in 64 before 12 to 15 years. Among the former 48% and among the latter 32% had previously detectable egg white antibodies. Atopic disease appeared before or at age 4 years in 80% of the 40 children with IgE antibodies against egg white up to 9 months of age and in 69% of the 58 children who had a positive Phadiatop Paediatric test result in infancy. CONCLUSIONS: IgE antibodies in children are usually associated with current or later topic disease. Sensitization to foods in infants is usually associated with appearance of IgE antibodies to inhalants later in life.

Adolescent↗

Appearance of IgE antibodies to ingested and inhaled allergens during the first 12 years of life in atopic and non-atopic children.

The appearance and course of serum immunoglobulin E-antibodies (IgE-ab) to egg-white (EW), cow's milk (CM) and inhalants (pollen, danders and mite) were followed from birth to 12 years of age in 84 children unselected for family history of atopy. During the follow-up 36 children developed atopic symptoms and 48 children did not. IgE-ab to EW and CM reached a peak prevalence at 8 months of age--with high concentrations almost exclusively in atopics and disappeared successively during childhood. IgE-ab to inhalants appeared from 2 years of age and then in increasing frequency during childhood. Similar to the pattern of IgE-ab to EW and CM, transient low levels of IgE-ab to inhalants were commonly encountered in non-atopic children while high concentrations without tendency to decline were almost exclusively seen in atopics. High responders to EW-antigen during infancy were usually also high responders to inhalants during childhood. Clinical allergy to EW and CM and subsequent tolerance appeared early in childhood, whereas allergy to inhalants appeared later and did not disappear. The temporary low-grade IgE antibody response in non-atopic individuals to eaten and inhaled allergens is similar to the results of animal studies demonstrating a transient IgE production followed by tolerance.

Administration, Inhalation↗

Maternal avoidance of eggs, cow's milk, and fish during lactation: effect on allergic manifestations, skin-prick tests, and specific IgE antibodies in children at age 4 years.

Two matched groups of children with a family history of atopy/allergy were observed from birth. In one group (n = 65) the mothers had a diet free from eggs, cow's milk, and fish during the first 3 months of lactation, whereas the mothers in the other group (n = 50) had a normal diet. Atopic/allergic manifestations, skin-prick tests, and specific IgE antibodies to egg white and cow's milk during the first 18 months of life have been reported previously. At 4 years of age the children underwent a clinical examination, skin-prick tests, and determination of specific IgE antibodies in serum against certain food and inhalant allergens. Both the cumulative incidence and the current prevalence of atopic dermatitis were significantly lower in the group of children whose mothers had adhered to a hypoallergenic diet during lactation, whereas all other atopic manifestations were similar. The number of children with positive skin-prick tests and specific IgE antibodies did not differ significantly, but the number of positive skin-prick tests and specific IgE antibody reactions in serum was significantly lower in the children of mothers adhering to the diet, indicating a milder degree of sensitization in these children.

Animals↗

The effect of maternal avoidance of eggs, cow's milk, and fish during lactation on the development of IgE, IgG, and IgA antibodies in infants.

Serum levels of IgE, IgE antibodies to egg white (EW) and cow's milk (CM), IgG, and IgA antibodies to ovalbumin (OA) and beta-lactoglobulin (BLG) were measured in a group of 115 infants with a family history of atopy/allergy at birth and at 3, 6, 9, 12, and 18 months of age. The mothers of 65 infants avoided eggs, CM, and fish during the first 3 months of lactation (maternal antigen avoidance diet, D group), whereas the remaining 50 mothers had no diet restrictions (no maternal antigen avoidance diet, ND group). CM was introduced after 6 months of age and EW after 9 months. The only statistically significant difference between the D and ND group infants was a lower rate of specimens with IgE antibodies to EW and/or CM in the infants at 3 months of age (p = 0.008). IgE antibodies to EW and/or CM appeared in 62 infants during the study period and often during complete breast-feeding. In 40 of the infants, IgE antibodies appeared before the introduction of EW and CM into the diet. The IgE concentrations of the D and the ND group infants were similar. Cord-blood IgE was a poor predictor of atopy/allergy; for example, only seven of 103 infants with double heredity for atopy/allergy had values above the 90th percentile of our normal reference. The concentrations of IgG antibodies to OA and BLG were similar in the two groups. The levels decreased significantly (p less than 0.001) from birth to 6 months of age, indicating a passive placental transfer.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Effect of maternal avoidance of eggs, cow's milk and fish during lactation upon allergic manifestations in infants.

Atopic/allergic manifestations and skin-prick tests (SPT) to egg white, cow's milk (CM) and fish were evaluated during the first 18 months of life in two matched groups of infants with a family history of atopy/allergy. In one group (n = 65) the mothers had a diet free from eggs, CM and fish during the first 3 months postpartum, whereas the mothers in the other group (n = 50) consumed an ordinary diet. The diet of the infants was similar in both groups, i.e. CM was not supplied until 6 months of age, and eggs and fish not until 9 months of age. The incidence of atopic dermatitis was significantly lower in the maternal diet group during the first 6 months postpartum (10.8 and 28%, respectively) but not after that age. Other atopic/allergic manifestations did not differ and the number of positive SPT to egg white, CM or fish at 9 months of age was similar in both groups.

Animals↗

Clinical symptoms and IgE responses to common food proteins and inhalants in the first 7 years of life.

A group of eighty-six children followed from birth to 4 years of age and previously reported was now re-investigated at the age of 7 years. The prevalence of atopy/allergy was 15%. All of the children with current atopy/allergy had had previous manifestations during their first 4 years of life. No child was allergic to milk at the age of 7 years and only two of the six children with a previous allergy to eggs retained their allergy. No other children had developed allergies to milk or eggs. Only one of the eight children with an elevated level of IgE antibodies to egg white (RAST class 1 or more) during infancy still had increased concentrations of such antibodies. No child had developed an elevated level of IgE antibodies to egg white or milk after the first year of life. Clinical allergies to inhalants had increased from 1% at 4 years of age to 7% at 7 years. Children with elevated levels of IgE antibodies to inhalants had increased from 7% at 4 years of age to 10% at 7 years. The majority of them had had increased levels of IgE antibodies to egg white during infancy. The specificity of an elevated level of cord blood IgE, i.e. above 0.9 kU/l for predicting atopy/allergy during the first 7 years of life and for current atopy/allergy at 7 years of age were both 95%. The corresponding figures for presence of elevated levels of IgE antibodies to egg white (positive RAST) during infancy were 98 and 97%, respectively. The sensitivity of the cord blood IgE predictor was 14 and 17%, respectively and for a positive RAST to egg white during infancy 32 and 50%, respectively.

Allergens↗

The prevalence of allergy and IgE antibodies to inhalant allergens in Swedish school children.

Out of 242 children (10 and 14 years of age) in one school-district 221 (93%) were evaluated for atopy/allergy by a questionnaire, interview, physical examination and determination of S-IgE and IgE-antibodies (RAST) to pollen, animal danders and house dust mite. Eighteen months after the initial examination all 221 children were re-interviewed. All children with previous or current symptoms of atopy/allergy, all children with positive RAST despite a negative history and 20 non-atopic/non-allergic RAST-negative children were tested with a skin prick test (SPT). At the initial examination the cumulative incidence of atopy/allergy was 32.6% and positive RAST was obtained in 40 children (18.1%). At the follow-up the incidence of atopic/allergic symptoms during the last 18 months was 25.8%. The current prevalence of allergy to pollen and danders, assessed by interview only, was 19% and 9% respectively while determined by both interview and positive SPT 15% and 5% respectively. The mean S-IgE (78 kU/l) of the children with current symptoms differed significantly (p less than 0.001) from that (19 kU/l) of the non-atopic ones. There was no relationship between S-IgE and the stage of puberty. Ten of the 11 children with positive RAST, but no atopy/allergy initially, developed clinical atopy/allergy during the follow-up.

Adolescent↗

Terbutaline slow-release tablets in children with bronchial asthma. Effect and pharmacokinetics compared with plain terbutaline tablets.

The effect of terbutaline sulphate in slow-release (SR) tablets (Bricanyl Depot), 5 mg twice daily, was compared with that of terbutaline sulphate in ordinary tablets (Bricanyl), 2.5 mg three times daily, in a double-blind, randomized, cross-over study during 2 consecutive weeks in 10 asthmatic children. Plasma concentrations and urinary excretion of terbutaline were measured at various times during both treatment periods. The SR tablets produced a higher mean plasma concentration in the morning and a smaller peak-trough variation over the day than the ordinary ones. No differences between the two treatments were observed concerning FEV1 (forced expiratory volume in 1 s). Tremor, measured with an opto-electronic tremorgraph, was about the same for two treatments and not significantly different from tremor seen in healthy children. The reported side effects were less frequent in the SR tablet period.

Adolescent↗