Background: Food allergies, particularly their severe and persistent forms, have a significant impact on children’s quality of life (QoL). Understanding and enhancing QoL is a crucial component of food allergy management. This study aimed to evaluate the QoL of Turkish children aged 0-12 years with IgE-mediated tree nut allergies (TNA) and explore influential factors, including parental anxiety. Methods: Primary caregiver-parents of children diagnosed with TNA completed the valid and reliable Food Allergy Quality of Life Questionnaire-Parent Form (FAQLQ-PF) and State-Trait Anxiety Inventory (STAI) to assess QoL and parental anxiety, respectively. Results: The study included 88 parents, predominantly mothers (83%). The children had a median age of 12 months (IQR 7.25-19.5). The mean FAQLQ-PF score was 3.55±1.34 without a statistical significance between age groups (0-3 years 3.15±1.28; 4-6 years 3.76±1.42; 7-12 years 3.73±1.19). Parents reported significantly worse FAQLQ-PF scores for children with hazelnut allergy, with a history of anaphylaxis, and who had to use an adrenaline autoinjector. State and trait anxiety scores were strongly correlated (r=0.584, p<0.001). There was significant but weak correlations between FAQLQ-PF and STAI domains. The multivariate linear regression analysis revealed that having a hazelnut allergy, a history of anaphylaxis, and higher parental state anxiety were all associated with poorer FAQLQ-PF scores, but, fathers tended to report better level of QoL. Conclusions: The QoL of Turkish children with TNA, as reported by parents, is influenced by various factors. Understanding and addressing these factors are crucial for a deeper understanding of how to enhance the accuracy of QoL assessment.

Food allergy is an increasingly common disease worldwide, and is thought to be driven by an uncontrolled type 2 immune response. Current knowledge about the underlying mechanisms that initiate and promote an inappropriate immune response to dietary allergens is limited. Sensitization through the skin in early life is considered to be a key event. Food allergy results from a dysregulated type 2 response to food allergens, characterized by enhanced levels of IgE, IL-4, IL-5 and IL-13 with infiltration of mast cells, eosinophils and basophils during acute reactions. Recent data implies a possible role of innate lymphoid cells (ILCs) in driving food allergy. ILCs represent a group of lymphocytes that lack specific, recombined antigen receptors. They contribute to immune responses not only through the release of cytokines and other mediators, but also by responding to cytokines produced by activated cells in their local microenvironment. Due to their localization at barrier surfaces of the airways, gut and skin, ILCs form a link between the innate and adaptive immunity. This review summarizes recent evidences on how skin and gastrointestinal mucosal immune system contribute to both homeostasis and the development of food allergy, as well as the involvement of ILCs towards inflammatory processes and regulatory mechanisms.

Background: Allergen immunotherapy(AIT) is an effective treatment for allergic rhinitis, asthma and venom allergy. Compliance is essential for AIT to obtain maximal benefit as it is a long term treatment. Objective: We aimed to evaluate the real life compliance of children with subcutaneous immunotherapy(SCIT) and tried to document the factors associated. Additionally how COVID-19 pandemic effected the compliance of the patients and the reasons of drop-outs were also evaluated. Method: Patients diagnosed with allergic rhinitis, allergic asthma or venom allergy and treated with SCIT between 2012 September, 2020 July were analyzed. Results: The study population comprised of 201 children (66,7% male) with a median (interquartile range) age of 12,8(9,4-15,2) years during the first injection of SCIT. The overall compliance rate before COVID-19 pandemic was 86,1%. Short AIT follow up time and venom allergy were found to be risk factors for drop out. The leading causes of drop outs were moving to another city/country(32,1%), improvement of symptoms(17,8%), ineffectiveness(14,2%) and adverse reactions(14,2%). During COVID-19 pandemic, among 108 patients receiving AIT, 31(28,7%) dropped out the therapy. The most frequent reasons for drop-outs were fear of being infected with COVID-19(35,4%) and thinking that the AIT practise stopped due to COVID-19 pandemic(29%). Male gender and older age were found to be the independent risk factors for drop out. Conclusion: The real life compliance in children was higher than in adults. Nearly one third of children dropped out during COVID-19 pandemic. Male gender and older age are associated with AIT drop out during COVID-19 pandemic.