Skip to main content

Asthma

  • Chapter
  • First Online:
Pediatric Food Allergy
  • 782 Accesses

Abstract

Food allergy is growing in prevalence across the nation. Asthma exists as a comorbidity in a large proportion of children with food allergy as part of the atopic march. Food allergy alone can pose its challenges in diagnosis and management and can change based on ethnicity and gender. With the addition of asthma, children can be predisposed to increased risk of severe or fatal reactions. Care must thus be taken to ensure that symptoms of asthma are recognized and diagnosed early on, and appropriate treatment is administered. In this chapter, we give an overview of both food allergy and asthma, their clinical presentation and pathophysiology, presence as a comorbidity, diagnosis and management. We also address the increased risks that food allergy poses in children with asthma and how to best manage these risks.

AE is supported by the National Research Service Award for Fellowship in Immunology and Allergy, National Institute of Allergy and Infectious Diseases T32 AI60515-01

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

ACT:

Asthma control test

EAACI:

European Academy of Allergy and Clinical Immunology

ED:

Emergency department

FAAP:

Food Action Allergy Plan

FARE:

Food Allergy Research and Education

FEV1:

Forced expiratory volume in 1 second

FVC:

Forced vital capacity

ICU:

Intensive care unit

NCHS:

National Center for Health Statistics

NHANES:

National Health and Nutrition Examination Survey

NHIS:

National Health Interview Survey

OFC:

Oral food challenge

OIT:

Oral immunotherapy

References

  1. Gupta R, Holdford D, Bilaver L, Dyer A, Holl JL, Meltzer D. The economic impact of childhood food allergy in the United States. JAMA Pediatr. 2013;167(11):1026–31.

    PubMed  Google Scholar 

  2. Allen KJ, Koplin JJ. The epidemiology of IgE-mediated food allergy and anaphylaxis. Immunol Allergy Clin N Am. 2012;32(1):35–50.

    Google Scholar 

  3. Gupta RS, Warren CM, Smith BM, Blumenstock JA, Jiang JL, Davis MM, et al. The public health impact of parent-reported childhood food allergies in the United States. Pediatrics. 2018;142(6):e20181235.

    PubMed  PubMed Central  Google Scholar 

  4. Black LI, Benson V. Tables of Summary Health Statistics for U.S. Children: 2016 National Health Interview Survey, C-2a, 2018. Available from: https://ftp.cdc.gov/pub/Health_Statistics/NCHS/NHIS/SHS/2016_SHS_Table_C-2.pdf

  5. Keet CA, Savage JH, Seopaul S, Peng RD, Wood RA, Matsui EC. Temporal trends and racial/ethnic disparity in self-reported pediatric food allergy in the United States. Ann Allergy Asthma Immunol. 2014;112(3):222–9.e3.

    PubMed  PubMed Central  Google Scholar 

  6. Mahdavinia M, Fox SR, Smith BM, James C, Palmisano EL, Mohammed A, et al. Racial differences in food allergy phenotype and health care utilization among US children. J Allergy Clin Immunol Pract. 2017;5(2):352–7.e1.

    PubMed  Google Scholar 

  7. Koplin JJ, Allen KJ, Gurrin LC, Peters RL, Lowe AJ, Tang ML, et al. The impact of family history of allergy on risk of food allergy: a population-based study of infants. Int J Environ Res Public Health. 2013;10(11):5364–77.

    PubMed  PubMed Central  Google Scholar 

  8. Bock SA, Munoz-Furlong A, Sampson HA. Fatalities due to anaphylactic reactions to foods. J Allergy Clin Immunol. 2001;107(1):191–3.

    CAS  PubMed  Google Scholar 

  9. Collaborators GBDM. Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1084–150.

    Google Scholar 

  10. Jang J, Gary Chan KC, Huang H, Sullivan SD. Trends in cost and outcomes among adult and pediatric patients with asthma: 2000-2009. Ann Allergy Asthma Immunol. 2013;111(6):516–22.

    PubMed  Google Scholar 

  11. Ferrante G, La Grutta S. The burden of pediatric asthma. Front Pediatr. 2018;6:186.

    PubMed  PubMed Central  Google Scholar 

  12. Papi A, Brightling C, Pedersen SE, Reddel HK. Asthma. Lancet. 2018;391(10122):783–800.

    PubMed  Google Scholar 

  13. Akinbami LJ, Moorman JE, Simon AE, Schoendorf KC. Trends in racial disparities for asthma outcomes among children 0 to 17 years, 2001–2010. J Allergy Clin Immunol. 2014;134(3):547–53.e5.

    PubMed  PubMed Central  Google Scholar 

  14. Ross MK, Romero T, Sim MS, Szilagyi PG. Obese- and allergic-related asthma phenotypes among children across the United States. J Asthma. 2018;56:1–10.

    Google Scholar 

  15. Sismanopoulos N, Delivanis DA, Mavrommati D, Hatziagelaki E, Conti P, Theoharides TC. Do mast cells link obesity and asthma? Allergy. 2013;68(1):8–15.

    CAS  PubMed  Google Scholar 

  16. Muraro A, Werfel T, Hoffmann-Sommergruber K, Roberts G, Beyer K, Bindslev-Jensen C, et al. EAACI food allergy and anaphylaxis guidelines: diagnosis and management of food allergy. Allergy. 2014;69(8):1008–25.

    CAS  PubMed  Google Scholar 

  17. Jackson DJ. Early-life viral infections and the development of asthma: a target for asthma prevention? Curr Opin Allergy Clin Immunol. 2014;14(2):131–6.

    PubMed  PubMed Central  Google Scholar 

  18. Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ. Asthma and wheezing in the first six years of life. The Group Health Medical Associates. N Engl J Med. 1995;332(3):133–8.

    CAS  PubMed  Google Scholar 

  19. Hovland V, Riiser A, Mowinckel P, Carlsen KH, Lodrup Carlsen KC. The significance of early recurrent wheeze for asthma outcomes in late childhood. Eur Respir J. 2013;41(4):838–45.

    PubMed  Google Scholar 

  20. Morgan WJ, Stern DA, Sherrill DL, Guerra S, Holberg CJ, Guilbert TW, et al. Outcome of asthma and wheezing in the first 6 years of life: follow-up through adolescence. Am J Respir Crit Care Med. 2005;172(10):1253–8.

    PubMed  PubMed Central  Google Scholar 

  21. Stern DA, Morgan WJ, Halonen M, Wright AL, Martinez FD. Wheezing and bronchial hyper-responsiveness in early childhood as predictors of newly diagnosed asthma in early adulthood: a longitudinal birth-cohort study. Lancet. 2008;372(9643):1058–64.

    PubMed  PubMed Central  Google Scholar 

  22. Muraro A, Roberts G, Worm M, Bilo MB, Brockow K, Fernandez Rivas M, et al. Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology. Allergy. 2014;69(8):1026–45.

    CAS  PubMed  Google Scholar 

  23. Sampson HA, Munoz-Furlong A, Campbell RL, Adkinson NF Jr, Bock SA, Branum A, et al. Second symposium on the definition and management of anaphylaxis: summary report – second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. Ann Emerg Med. 2006;47(4):373–80.

    PubMed  Google Scholar 

  24. Longo G, Berti I, Burks AW, Krauss B, Barbi E. IgE-mediated food allergy in children. Lancet. 2013;382(9905):1656–64.

    CAS  PubMed  Google Scholar 

  25. Shaker M. New insights into the allergic march. Curr Opin Pediatr. 2014;26(4):516–20.

    PubMed  Google Scholar 

  26. Flohr C, Perkin M, Logan K, Marrs T, Radulovic S, Campbell LE, et al. Atopic dermatitis and disease severity are the main risk factors for food sensitization in exclusively breastfed infants. J Invest Dermatol. 2014;134(2):345–50.

    CAS  PubMed  Google Scholar 

  27. Dharmage SC, Lowe AJ, Matheson MC, Burgess JA, Allen KJ, Abramson MJ. Atopic dermatitis and the atopic march revisited. Allergy. 2014;69(1):17–27.

    CAS  PubMed  Google Scholar 

  28. Bantz SK, Zhu Z, Zheng T. The atopic march: progression from atopic dermatitis to allergic rhinitis and asthma. J Clin Cell Immunol. 2014;5(2):67–73.

    Google Scholar 

  29. Boyce JA, Assa’ad A, Burks AW, Jones SM, Sampson HA, Wood RA, et al. Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-sponsored expert panel report. J Allergy Clin Immunol. 2010;126(6):1105–18.

    PubMed  PubMed Central  Google Scholar 

  30. Schroeder A, Kumar R, Pongracic JA, Sullivan CL, Caruso DM, Costello J, et al. Food allergy is associated with an increased risk of asthma. Clin Exp Allergy. 2009;39(2):261–70.

    CAS  PubMed  PubMed Central  Google Scholar 

  31. Anagnostou A. Anaphylaxis in children: epidemiology risk factors and management. Curr Pediatr Rev. 2018;14(3):180–6.

    PubMed  Google Scholar 

  32. Friedlander JL, Sheehan WJ, Baxi SN, Kopel LS, Gaffin JM, Ozonoff A, et al. Food allergy and increased asthma morbidity in a School-based inner-city Asthma Study. J Allergy Clin Immunol Pract. 2013;1(5):479–84.

    PubMed  PubMed Central  Google Scholar 

  33. Calvani M, Cardinale F, Martelli A, Muraro A, Pucci N, Savino F, et al. Risk factors for severe pediatric food anaphylaxis in Italy. Pediatr Allergy Immunol. 2011;22(8):813–9.

    PubMed  Google Scholar 

  34. Sampson HA, Mendelson L, Rosen JP. Fatal and near-fatal anaphylactic reactions to food in children and adolescents. N Engl J Med. 1992;327(6):380–4.

    CAS  PubMed  Google Scholar 

  35. Simons FE. First-aid treatment of anaphylaxis to food: focus on epinephrine. J Allergy Clin Immunol. 2004;113(5):837–44.

    CAS  PubMed  Google Scholar 

  36. Zicari AM, Indinnimeo L, De Castro G, Zappala D, Tancredi G, Bonci E, et al. Food allergy and the development of asthma symptoms. Int J Immunopathol Pharmacol. 2012;25(3):731–40.

    CAS  PubMed  Google Scholar 

  37. Savage J, Johns CB. Food allergy: epidemiology and natural history. Immunol Allergy Clin North Am. 2015;35(1):45–59.

    PubMed  Google Scholar 

  38. Jat KR. Spirometry in children. Prim Care Respir J. 2013;22(2):221–9.

    PubMed  PubMed Central  Google Scholar 

  39. Krogulska A, Dynowski J, Jedrzejczyk M, Sardecka I, Malachowska B, Wasowska-Krolikowska K. The impact of food allergens on airway responsiveness in schoolchildren with asthma: a DBPCFC study. Pediatr Pulmonol. 2016;51(8):787–95.

    PubMed  Google Scholar 

  40. Vazquez-Ortiz M, Alvaro M, Piquer M, Giner MT, Dominguez O, Lozano J, et al. Life-threatening anaphylaxis to egg and milk oral immunotherapy in asthmatic teenagers. Ann Allergy Asthma Immunol. 2014;113(4):482–4.

    PubMed  Google Scholar 

  41. Banasiak NC. Implementation of the asthma control test in primary care to improve patient outcomes. J Pediatr Health Care. 2018;32(6):591–9.

    PubMed  Google Scholar 

  42. Food Allergy & Anaphylaxis Emergency Care Plan. Food Allergy Research and Education (FARE). https://www.foodallergy.org/life-with-food-allergies/food-allergy-anaphylaxis-emergency-care-plan. Accessed May 2019.

  43. Walkner M, Warren C, Gupta RS. Quality of life in food Allergy patients and their families. Pediatr Clin N Am. 2015;62(6):1453–61.

    Google Scholar 

  44. Eldredge C, Patterson L, White B, Schellhase K. Assessing the readiness of a school system to adopt food allergy management guidelines. Wis Med J. 2014;113(4):155–61.

    Google Scholar 

  45. Crenesse D, Berlioz M, Bourrier T, Albertini M. Spirometry in children aged 3 to 5 years: reliability of forced expiratory maneuvers. Pediatr Pulmonol. 2001;32(1):56–61.

    CAS  PubMed  Google Scholar 

  46. Santos AF, Gomes-Belo J, Hannachi F, Swan K. Advances in food allergy diagnosis. Curr Pediatr Rev. 2018;14(3):139–49.

    PubMed  Google Scholar 

  47. Parrish CP, Har D, Andrew Bird J. Current status of potential therapies for IgE-mediated food allergy. Curr Allergy Asthma Rep. 2018;18(3):18.

    PubMed  Google Scholar 

  48. Varshney P, Steele PH, Vickery BP, Bird JA, Thyagarajan A, Scurlock AM, et al. Adverse reactions during peanut oral immunotherapy home dosing. J Allergy Clin Immunol. 2009;124(6):1351–2.

    PubMed  PubMed Central  Google Scholar 

  49. Elizur A, Goldberg MR, Levy MB, Nachshon L, Katz Y. Oral immunotherapy in cow’s milk allergic patients: course and long-term outcome according to asthma status. Ann Allergy Asthma Immunol. 2015;114(3):240–4.e1.

    CAS  PubMed  Google Scholar 

  50. Schneider LC, Rachid R, LeBovidge J, Blood E, Mittal M, Umetsu DT. A pilot study of omalizumab to facilitate rapid oral desensitization in high-risk peanut-allergic patients. J Allergy Clin Immunol. 2013;132(6):1368–74.

    CAS  PubMed  PubMed Central  Google Scholar 

  51. Dantzer JA, Wood RA. The use of omalizumab in allergen immunotherapy. Clin Exp Allergy. 2018;48(3):232–40.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Amy A. Eapen .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Eapen, A.A., Assa’ad, A. (2020). Asthma. In: Gupta, R. (eds) Pediatric Food Allergy . Springer, Cham. https://doi.org/10.1007/978-3-030-33292-1_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-33292-1_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-33291-4

  • Online ISBN: 978-3-030-33292-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics