Erken Çocukluk Dönemde Anormal Bağışıklık: Alerji ve Yüksek Oranda Antinükleer Antikorların Birlikte Görülmesi

Öz

Amaç: Alerji ve otoantikor üretimi, aşırı duyarlılık nedeniyle ortaya çıkan bağışıklık sistemi ile ilgili iki anormal durumdur. Erken çocukluk döneminde başlayan alerjilerle otoantikorların ilişkilendirilip ilişkilendirilemeyeceği henüz netlik kazanamamıştır. Bu çalışma, üç yaş altındaki alerjik çocuklarda antinükleer antikorların (ANA) varlığını değerlendirmeyi amaçlamaktadır. Gereç ve yöntem: Alerjik çocuklar (yaş < 3 yıl; n=40), klinik ve laboratuvar bulgularına dayanarak bir uzman tarafından teşhis edilmiştir. ANA düzeyleri, ticari bir ELISA testi ile ölçülmüştür. Demografik veriler, toplam ve spesifik (yumurta, süt) IgE düzeyleri ile kan eozinofil yüzdeleri hastane kayıtlarından elde edilmiştir. Kontrol grubu, alerjisi olmayan sağlıklı bireylerden oluşturulmuştur. Bulgular: Sağlıklı kontrol grubunda 8 birey (8/40, %20) ANA pozitif çıkarken, 17 alerjik çocuk (17/40, %42.5) ANA pozitif bulunmuştur (p<0.05). ANA pozitifliği, yumurta alerjisi olan 8 çocukta, süt alerjisi olan 2 çocukta, hem yumurta hem de süt alerjisi olan 4 çocukta ve nedeni bilinmeyen alerjisi olan 3 çocukta gözlemlenmiştir. ANA pozitifliği ile IgE düzeyleri ve eozinofil yüzdeleri arasında anlamlı bir ilişki bulunmamıştır (p>0.05). Ayrıca, alerjik çocuklarda ANA düzeyleri ile kaşıntı veya egzama varlığı arasında bir ilişki tespit edilmemiştir. Sonuç: Bu çalışma, alerji ile ANA pozitifliği arasındaki ilişkinin erken çocukluk döneminde başladığını göstermekte ve bu iki durumun potansiyel etkileşimleri üzerine yapılacak gelecekteki araştırmaların bu kritik döneme odaklanması gerektiğini önermektedir. Ayrıca, her iki bağışıklık anomalisinin benzer mekanizmalarla düzenlenip düzenlenmediğinin belirlenmesi amacıyla daha fazla araştırma yapılması gerektiği sonucuna varılmaktadır.

Anahtar Kelimeler

• Alerji
• Otoantikor
• ANA
• Çocuklar

Coexistence of Allergy and Antinuclear Antibody in Early Childhood

Öz

Background: Allergy and autoantibody production are two abnormal conditions of the immune system, resulting from hypersensitivity. It remains unclear whether autoantibodies are also present in association with allergies that begin during early childhood. This study aims to evaluate the presence of antinuclear antibodies (ANA) in allergic children under the age of three. Methods: Allergic children (age < 3 years; n=40) were diagnosed by a specialist based on clinical and laboratory findings. ANA levels were measured using a commercial ELISA test. Demographic data, total and specific (egg, milk) IgE levels, and blood eosinophil percentages were obtained from hospital records. The control group was composed of healthy individuals without allergies. Results: In the healthy control group, 8 individuals (8/40, 20%) were ANA positive, while 17 allergic children (17/40, 42.5%) tested positive for ANA (p<0.05). ANA positivity was observed in 8 children with an egg allergy, 2 children with a milk allergy, 4 children with both egg and milk allergies, and 3 children with an unknown allergy cause. No significant correlation was found between ANA positivity, IgE levels, and eosinophil percentages (p>0.05). Additionally, no relationship was found between ANA levels and the presence of itching or eczema in allergic children. Conclusions: This study suggests that the relationship between allergies and ANA positivity begins in early childhood and recommends that future studies on the potential interactions of these two conditions should focus on this critical period. Additionally, further research is needed to determine whether both immune anomalies are regulated by similar mechanisms.

Anahtar Kelimeler

• Allergy
• Autoantibody
• ANA
• Children.

Destekleyen Kurum

None

Etik Beyan

Ethical approval for the study was obtained from the Scientific Research and Publication Ethics Committee of İnönü University (protocol no 2023/4721).

Teşekkür

None

Kaynakça

1. 1. Chad Z. Allergies in children. PCH. 2001;6(8):555-66. http://dx.doLorgll0.4038/sljch.v46i4.8386
2. 2. Ridolo E, Caffarelli C, Olivieri E, et al. Quality of sleep in allergic children and their parents. Allergol. Immunopathol. 2015;43(2):180-4. https://doi.org/10.1016/j.aller.2014.01.004
3. 3. Jarosz M, Syed S, Błachut M, Badura Brzoza K. Emotional distress and quality of life in allergic diseases. Wiad Lek. 2020;73(2):370-3. doi: 10.36740/WLek20200213
4. 4. Antolín-Amérigo D, Manso L, Caminati M, et al. Quality of life in patients with food allergy. Clin. Mol. Allergy. 2016;14:1-10. https://doi.org/10.1186/s12948-016-0041-4
5. 5. Gupta R, Holdford D, Bilaver L, Dyer A, Holl JL, Meltzer D. The economic impact of childhood food allergy in the United States. JAMA pediatrics. 2013;167(11):1026-31. doi:10.1001/jamapediatrics.2013.2376
6. 6. Taha M., Samavati L. Antiphospholipid antibodies in COVID-19: a meta-analysis and systematic review. RMD open, 2021; 7(2), e001580. https://doi.org/10.1136/rmdopen-2021-001580
7. 7. Goncalves D, Mezidi M, Bastard P, et al. Antibodies against type I interferon: detection and association with severe clinical outcome in COVID‐19 patients. CTI, 2021 10(8), e1327. https://doi.org/10.1002/cti2.1327
8. 8. Fagyas M, Nagy Jr B, Ráduly A.P., Mányiné I. S., et al. The majority of severe COVID-19 patients develop anti-cardiac autoantibodies. Geroscience, 2022; 44(5):2347-2360. https://doi.org/10.1007/s11357-022-00649-6

9. 9. Pascolini S, Vannini A, Deleonardi G, et al. COVID‐19 and immunological dysregulation: can autoantibodies be useful? CTI. 2021;14(2):502-8. https://doi.org/10.1111/cts.12908
10. 10. Mitratza M, Klijs B, Hak A.E, Kardaun J.W., Kunst, A.E. Systemic autoimmune disease as a cause of death: mortality burden and comorbidities. Rheumatology, 2021;60(3), 1321-1330. https://doi.org/10.1093/rheumatology/keaa537
11. 11. Dinse G.E., Parks C.G., Weinberg C.R. et al. Increasing prevalence of antinuclear antibodies in the United States. A&R. 2020; 72(6):1026. doi: 10.1002/art.41214
12. 12. Grygiel-Górniak B, Rogacka N, Rogacki M, Puszczewicz M. Antinuclear antibodies in autoimmune and allergic diseases. Reumatologia. 2017;55(6):298-304. https://doi.org/10.5114/reum.2017.72627
13. 13. Maurer M, Altrichter S, Schmetzer O, Scheffel J, Church MK, Metz M. Immunoglobulin E-mediated autoimmunity. Front. immunol. 2018;9:359991. https://doi.org/10.3389/fimmu.2018.00689
14. 14. Vojdani A, Gushgari LR, Vojdani E. Interaction between food antigens and the immune system: Association with autoimmune disorders. Autoimmun. Rev. 2020;19(3):102459. https://doi.org/10.1016/j.autrev.2020.102459
15. 15. Valenta R, Mittermann I, Werfel T, Garn H, Renz H. Linking allergy to autoimmune disease. Trends Immunol. 2009;30(3):109-16. doi: 10.1016/j.it.2008.12.004
16. 16. Charles N, Rivera J. Basophils and IgE: Linking the Allergic Environment to Autoimmunity. The Open Allergy Journal. 2010;3(1). doi: 10.2174/1874838401003010081
17. 17. Wananukul S, Voramethkul W, Kaewopas Y, et al. Prevalence of positive antinuclear antibodies in healthy children. Asian Pac J Allergy Immunol. 2005;23(2-3):153–7. doi: 10.1177/101053950502300306
18. 18. Sperotto F, Brachi S, Seguso M, et al. Prevalence of antinuclear antibodies in a general pediatric cohort from the Veneto region. Pediatric Rheumatology. 2013;11(Suppl 2):P18. doi: 10.1186/1546-0096-11-S2-P18
19. 19. Kreiner E, Waage J, Standl M, et al. Shared genetic variants suggest common pathways in allergy and autoimmune diseases. J Allergy Clin Immunol. 2017;140(3):771-81. https://doi.org/10.1016/j.jaci.2016.10.055
20. 20. Rottem M, Gershwin ME, Shoenfeld Y. Allergic disease and autoimmune effectors pathways. J. Immunol. Res. 2002;9:161-7. https://doi.org/10.1080/1044667031000137638
21. 21. Pacheco-Gonzalez R, Avila C, Dávila I, et al. Analysis of FOXP3 gene in children with allergy and autoimmune diseases. Allergol Immunopath. 2016;44(1):32-40. https://doi.org/10.1016/j.aller.2015.01.012
22. 22. Krishna MT, Subramanian A, Adderley NJ, Zemedikun DT, Gkoutos GV, Nirantharakumar K. Allergic diseases and long-term risk of autoimmune disorders: longitudinal cohort study and cluster analysis. Eur. Respir. J. 2019;54(5).
23. 23. Agache I, Duca L, Anghel M, Pamfil G. Antinuclear antibodies in asthma patients- a special asthma phenotype? IJAAI. 2009;8(1):49-52.
24. 24. Valenta R, Mittermann I, Werfel T. et al. Linking allergy to autoimmune disease. Trends Immunol. 2009; 30(3):109-116. doi: 10.1016/j.it.2008.12.004
25. 25. Abbas AK, Lichtman AH, Pillai S. Basic Immunology: Functions and Disorders of the Immune System, 6th ed: Elsevier India; 2019.
26. 26. Yazıcı D. Assessment of inflammatory biomarkers, total IgE levels, SNOT-22 scores in allergic rhinitis patients. ENT Updates. 2019;9(2):128-32. doi: 10.32448/entupdates.581445
27. 27. Nagata M, Nakagome K, Soma T. Mechanisms of eosinophilic inflammation. Asia Pac. Allergy. 2020;10(2):e14. doi: 10.5415/apallergy.2020.10.e14
28. 28. Vojdani A, Kharrazian D, Mukherjee PS. The prevalence of antibodies against wheat and milk proteins in blood donors and their contribution to neuroimmune reactivities. Nutrients. 2014;6(1):15-36. https://doi.org/10.3390/nu6010015
29. 29. Vojdani A, O'Bryan T, Green J, et al. Immune response to dietary proteins, gliadin and cerebellar peptides in children with autism. Nutr. Neurosci. 2004;7(3):151-61. https://doi.org/10.1080/10284150400004155