Jing Li1, Ludmila M Ogorodova2, Padukudru Anand Mahesh3, Maggie Haitian Wang4, Olga Sergeevna Fedorova2, Ting Fan Leung5, Montserrat Fernandez-Rivas6, E N Clare Mills7, James Potts8, Ischa Kummeling9, Serge A Versteeg9, Ronald van Ree10, Maria Yazdanbakhsh11, Peter G J Burney8, Gary W K Wong12. 1. Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. 2. Department of Pediatrics, Siberian State Medical University, Tomsk, Russia. 3. Department of TB and Respiratory Medicine, JSS Medical College, JSS University and Allergy Asthma Associates, Mysore, India. 4. School of Public Health, Chinese University of Hong Kong, Shatin, NT, Hong Kong, China. 5. Department of Pediatrics, Chinese University of Hong Kong, Hong Kong, China. 6. Allergy Department, Hospital Clinico San Carlos, IdISSC, Madrid, Spain. 7. School of Translational Medicine, Manchester Academic Health Science Centre and Manchester Interdisciplinary Biocentre, The University of Manchester, Manchester, United Kingdom. 8. Department of Respiratory Epidemiology and Public Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom. 9. Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands. 10. Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands; Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands. 11. Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands. 12. Department of Pediatrics, Chinese University of Hong Kong, Hong Kong, China. Electronic address: wingkinwong@cuhk.edu.hk.
Abstract
BACKGROUND: A clear understanding of the differences in the epidemiology of food allergy between rural and urban populations may provide insights into the causes of increasing prevalence of food allergy in the developed world. OBJECTIVE: We used a standardized methodology to determine the prevalence and types of food-specific allergic sensitization and food allergies in schoolchildren from urban and rural regions of China, Russia, and India. METHODS: The current study is a multicenter epidemiological survey of children recruited from 5 cities in China (Hong Kong and Guangzhou), Russia (Tomsk), and India (Bengaluru and Mysore) and 1 rural county in Southern China (Shaoguan). A total of 35,549 children aged 6 to 11 years from 3 countries participated in this survey. Random samples of children from 3 countries were first screened by the EuroPrevall screening questionnaire. Children with and without a history of adverse reactions to foods were then recruited for the subsequent case-control comparative studies. We determined the prevalence rates of food-specific IgE sensitization and food allergies using the predefined criteria. RESULTS: The prevalence rates of food-specific IgE sensitization (≥0.7 kU/L) to at least 1 food were 16.6% in Hong Kong, 7.0% in Guangzhou, 16.8% in rural Shaoguan, 8.0% in Tomsk, and 19.1% in India. Using a definition of probable food allergy as reporting allergic symptoms within 2 hours of ingestion of a specific food plus the presence of allergic sensitization to the specific food (positive IgE and/or positive skin prick test result), the prevalence of food allergy was highest in Hong Kong (1.50%), intermediate in Russia (0.87%), and lowest in Guangzhou (0.21%), Shaoguan (0.69%), and India (0.14%). For children recruited from Hong Kong, both sensitization and food allergy were significantly higher in children who were born and raised in Hong Kong when compared with those who were born in mainland China and migrated to Hong Kong, highlighting the importance of early-life exposures in affecting the subsequent development of food sensitization and food allergy. CONCLUSIONS: There are wide variations in the prevalence of food-specific IgE sensitization and food allergy in the 3 participating countries. Food allergy appears to be less common when compared with developed countries. The variations in the prevalence of food allergen sensitization cannot be explained by the differences in the degree of urbanization. Despite the high prevalence of food-specific IgE sensitization in India and rural China, food allergy is still extremely uncommon. In addition to IgE sensitization, other factors must play important roles resulting in the clinical manifestations of food allergies.
BACKGROUND: A clear understanding of the differences in the epidemiology of food allergy between rural and urban populations may provide insights into the causes of increasing prevalence of food allergy in the developed world. OBJECTIVE: We used a standardized methodology to determine the prevalence and types of food-specific allergic sensitization and food allergies in schoolchildren from urban and rural regions of China, Russia, and India. METHODS: The current study is a multicenter epidemiological survey of children recruited from 5 cities in China (Hong Kong and Guangzhou), Russia (Tomsk), and India (Bengaluru and Mysore) and 1 rural county in Southern China (Shaoguan). A total of 35,549 children aged 6 to 11 years from 3 countries participated in this survey. Random samples of children from 3 countries were first screened by the EuroPrevall screening questionnaire. Children with and without a history of adverse reactions to foods were then recruited for the subsequent case-control comparative studies. We determined the prevalence rates of food-specific IgE sensitization and food allergies using the predefined criteria. RESULTS: The prevalence rates of food-specific IgE sensitization (≥0.7 kU/L) to at least 1 food were 16.6% in Hong Kong, 7.0% in Guangzhou, 16.8% in rural Shaoguan, 8.0% in Tomsk, and 19.1% in India. Using a definition of probable food allergy as reporting allergic symptoms within 2 hours of ingestion of a specific food plus the presence of allergic sensitization to the specific food (positive IgE and/or positive skin prick test result), the prevalence of food allergy was highest in Hong Kong (1.50%), intermediate in Russia (0.87%), and lowest in Guangzhou (0.21%), Shaoguan (0.69%), and India (0.14%). For children recruited from Hong Kong, both sensitization and food allergy were significantly higher in children who were born and raised in Hong Kong when compared with those who were born in mainland China and migrated to Hong Kong, highlighting the importance of early-life exposures in affecting the subsequent development of food sensitization and food allergy. CONCLUSIONS: There are wide variations in the prevalence of food-specific IgE sensitization and food allergy in the 3 participating countries. Food allergy appears to be less common when compared with developed countries. The variations in the prevalence of food allergen sensitization cannot be explained by the differences in the degree of urbanization. Despite the high prevalence of food-specific IgE sensitization in India and rural China, food allergy is still extremely uncommon. In addition to IgE sensitization, other factors must play important roles resulting in the clinical manifestations of food allergies.
Authors: Stephen C Dreskin; Stef J Koppelman; Sandra Andorf; Kari C Nadeau; Anjeli Kalra; Werner Braun; Surendra S Negi; Xueni Chen; Catherine H Schein Journal: J Allergy Clin Immunol Date: 2020-11-18 Impact factor: 10.793
Authors: Benjamin Zepeda-Ortega; Anne Goh; Paraskevi Xepapadaki; Aline Sprikkelman; Nicolaos Nicolaou; Rosa Elena Huerta Hernandez; Amir Hamzah Abdul Latiff; Miu Ting Yat; Mohamed Diab; Bakr Al Hussaini; Budi Setiabudiawan; Urszula Kudla; R J Joost van Neerven; Leilani Muhardi; John O Warner Journal: Front Immunol Date: 2021-06-10 Impact factor: 7.561
Authors: Christine Y Y Wai; Nicki Y H Leung; Ka Hou Chu; Patrick S C Leung; Agnes S Y Leung; Gary W K Wong; Ting Fan Leung Journal: Int J Mol Sci Date: 2020-03-23 Impact factor: 5.923