Influence of the gut microbiome on IgE and non-IgE-mediated food allergies

Congress of the European-Academy-of-Allergy-and-Clinical-Immunology (EAACI) -- MAY 26-30, 2018 -- Munich, GERMANYWOS: 000441690400204Background: The prevalence of food allergy (FA) in children has been increasing in last decade. Recent studies show changes in gut microbiome with FA. However, whether gut microbiome may differ between IgE and non‐IgE‐mediated FA is not defined. The aim of this study is to examine the intestinal microbiome composition in infants with IgE and non‐IgE‐mediated FA and healthy infants. Method: Infants younger than 1‐year‐old, breastfed and diagnosed with FA by a physician were included in the study. DNA was isolated from stool samples of infants with non‐IgE‐mediated FA (n = 25) and IgE‐mediated FA (n = 11) and healthy infants (n = 7). Whole genome shotgun sequencing was applied to identify the composition of microbial DNA (an average depth of 3.1 ± 0.8 million paired end reads and 0.9 ± 0.2 gigabase pairs). Results: There were compositional differences among 3 different groups. Shannon index was significantly higher in IgE‐mediated FA compared to non‐IgE‐mediated FA group (Kruskal‐Wallis test, P = 0.034). Even though β‐diversity was similar, the Sparse Partial Least Square Discriminant Analysis (sPLS‐DA) demonstrated that there were taxa‐level differences among three groups. In species level, Veillonella parvula was in a significantly higher density in healthy infants compared to IgE and non‐IgE‐mediated FA groups. Rahnella aquatilis and Lactobacillus salivarius were significantly lower and Treponema succinifaciens significantly higher in IgE‐mediated FA group compared to other groups. Additionally, Prevotella sp. oral taxon 299 was significantly lower in non‐IgE‐mediated FA group compared to others. Prevotella sp oral taxon 299 was related to mucus in stool whereas urticaria related species were Olsenall uli, Bactreoides thetaiotaomicron, Klebsiella variiocola, Rahnella aquatilis, Treponema succinfaciens, Ethanoligenens harbinenese. Conclusion: Analysis of microbiome differences in FA patients may aid in the understanding of the disease process. The present data suggest that there are compositional variations mostly in species‐ level among infants with FA and healthy ones. Our results suggest that the gut microbiome has a stronger relationship to IgE‐mediated than non‐IgE‐mediated FA. Further functional analysis of the microbiome may help better understand the changes seen in the gut microbiome in FAs and improve our knowledge in the disease etiopathology.European Academy of Allergy and Clinical Immunolog

Examination of Primary Mathematics Student Teachers’ Modelling Competencies

Modelling competencies are the competencies to understand the real problem and to set up a model based on reality, to set up a mathematical model from the real model, to solve mathematical questions within this mathematical model, to interpret mathematical results in a real situation, and to validate the solution (Blum & Kaiser, 1997, cited in Maaß, 2006). The purpose of this study is to examine modelling competencies of primary mathematics student teachers in the solution process of a modelling problem. The approaches primary mathematics student teachers were videotaped and analyzed using thematic coding. In accordance with the data obtained from the study, it was identified that the participants showed approaches in the context of all competencies except the competencies to interpret mathematical results in a real situation. The participants showed inadequate approaches on interpreting the obtained mathematical results

Over restrictive elimination of foods in children with food allergy

Background. Previous studies demonstrated critical deficits in diagnosis and management of childhood food allergy (FA), and recent developments in FA research support adopting a proactive approach in FA management. Our objective was to describe FA knowledge and management patterns of pediatricians. Method. We applied a 24-item survey to 170 general pediatricians, pediatric allergists and pediatric gastroenterologists practicing in Turkey. Results. Some IgE-mediated symptoms of FA such as cough, urticaria, wheezing and anaphylaxis were falsely recognized as symptoms of non-IgE-mediated FA by 30%, 29%, 25% and 19% of the participants, respectively. By contrast, 50% of the participants falsely recognized bloody stool, a finding of IgE-mediated FA. Most frequently and least frequently used diagnostic tools were specific IgE (30.5%) and oral food challenge test (1.7%), respectively. Maternal diet restrictions and infant diet restrictions were advised by 82% and 82%, respectively. Percentages of physicians eliminating only 1 food were 21%, 19%; 2 foods were 15%, 11%; 3 foods were 7%, 8%; 4-5 foods were 8%, 11%; 5 to 10 foods were 21%, 26%; and >10 foods were 28%, 25% from the maternal and infant diet, respectively. Cow’s milk, cheese, butter, yoghurt, baked milk products and hen’s egg were the most commonly restricted items. Conclusion. Overall, FA knowledge of pediatricians was fair. Pediatricians utilize an overly restrictive approach when advising diet eliminations in FA. Recent developments favor a more proactive approach to induce immune tolerance and need to be encouraged in pediatric clinical practice. Future educational efforts should focus on emphasizing the deleterious effects of injudicious and extensive eliminations

Clinical and genetic evaluations of rare childhood epilepsies in Turkey's national cohort

Objective: As new-generation sequencing methods develop, rare epilepsy is increasing and burdening national health systems—community building among rare epilepsies fuels collaboration, research, and resource development. Comorbidities should be carefully considered in diagnosing and treating children with rare epilepsy. This multicentric study aimed to evaluate the clinical features and comorbidities of children diagnosed with rare childhood genetic epilepsies. Methods: This multicentric study evaluated demographics, clinical findings, neuromotor developmental progress, and concomitant comorbid diseases of childhood rare genetic epilepsies. We included 156 patients from the nine tertiary health centers in our research. Results: The gene variants were distributed to 36 patients (23.1%) with SCN1A, 14 (9%) with KCNQ2, 10 (6.4%) with PCDH19, 6 (3.8%) with SCN8A, 5 (3.2%) with SLC2A1, 5 (3.2%) with WWOX, respectively. The remaining 80 patients (51.3%) were with other gene variants. Comorbid conditions are present in 82% of patients, most commonly intellectual disability (70%), developmental delay (32.1%), and movement disorders 12.8%. Most of the rare genetic epileptic children (52%) were using more than three anti-seizure drugs. In terms of developmental delay in children with rare epilepsy, the neuromotor developmental delay was found to progress with age, shown at the end of 2nd year of treatment. In addition, comorbidity, number of drugs, multiple types of seizures, seizure frequency, age at diagnosis of epilepsy, and duration of epilepsy all affected neuromotor developmental status (p <.05). Significance: Despite using multiple antiseizure medications, most of our patients had drug-resistant epilepsy and concomitant developmental delay. Since a complete cure cannot be achieved in most of these patients further studies with centers' collaboration might help improve therapeutic decisions and precision treatment methods

Evaluation of possible COVID-19 reinfection in children: A multicenter clinical study

Background: Although it was originally unknown whether there would be cases of reinfection of coronavirus disease 2019 (COVID-19) as seen with other coronaviruses, cases of reinfection were reported from various regions recently. However, there is little information about reinfection in children. Methods: In this study, we aimed to investigate the incidence and clinical findings of reinfection in pediatric patients who had recovered from COVID-19. We retrospectively evaluated all patients under 18 years of age with COVID-19 infection from a total of eight healthcare facilities in Turkey, between March 2020 and July 2021. Possible reinfection was defined as a record of confirmed COVID-19 infection based on positive reverse transcription-polymerase chain reaction (RT-PCR) test results at least 3 months apart. Results: A possible reinfection was detected in 11 out of 8840 children, which yielded an incidence of 0.12%. The median duration between two episodes of COVID-19 was 196 (92–483) days. When initial and second episodes were compared, the rates of symptomatic and asymptomatic disease were similar for both, as was the severity of the disease (p = 1.000). Also, there was no significant difference in duration of symptoms (p = 0.498) or in hospitalization rates (p = 1.000). Only one patient died 15 days after PCR positivity, which resulted in a 9.1% mortality rate for cases of reinfection in pediatric patients. Conclusion: We observed that children with COVID-19 were less likely to be exposed to reinfection when compared with adults. Although the clinical spectrum of reinfection was mostly similar to the first episode, we reported death of a healthy child during the reinfection

Over restrictive elimination of foods in children with food allergy

Background. Previous studies demonstrated critical deficits in diagnosis and management of childhood food allergy (FA), and recent developments in FA research support adopting a proactive approach in FA management. Our objective was to describe FA knowledge and management patterns of pediatricians. Method. We applied a 24-item survey to 170 general pediatricians, pediatric allergists and pediatric gastroenterologists practicing in Turkey. Results. Some IgE-mediated symptoms of FA such as cough, urticaria, wheezing and anaphylaxis were falsely recognized as symptoms of non-IgE-mediated FA by 30%, 29%, 25% and 19% of the participants, respectively. By contrast, 50% of the participants falsely recognized bloody stool, a finding of IgE-mediated FA. Most frequently and least frequently used diagnostic tools were specific IgE (30.5%) and oral food challenge test (1.7%), respectively. Maternal diet restrictions and infant diet restrictions were advised by 82% and 82%, respectively. Percentages of physicians eliminating only 1 food were 21%, 19%; 2 foods were 15%, 11%; 3 foods were 7%, 8%; 4-5 foods were 8%, 11%; 5 to 10 foods were 21%, 26%; and >10 foods were 28%, 25% from the maternal and infant diet, respectively. Cow’s milk, cheese, butter, yoghurt, baked milk products and hen’s egg were the most commonly restricted items. Conclusion. Overall, FA knowledge of pediatricians was fair. Pediatricians utilize an overly restrictive approach when advising diet eliminations in FA. Recent developments favor a more proactive approach to induce immune tolerance and need to be encouraged in pediatric clinical practice. Future educational efforts should focus on emphasizing the deleterious effects of injudicious and extensive eliminations. © 2021, Turkish National Pediatric Society. All rights reserved