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Pediatric allergy and immunology in Japan
Motohiro Ebisawa1, Sankei Nishima, Hidenori Ohnishi
1Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Sagamihara, Kanagawa, Japan.
Insights
The Japanese Society of Pediatric Allergy and Clinical Immunology has advanced pediatric asthma and food allergy care through guidelines and oral immunotherapy. Recent data suggests a slight decrease in childhood asthma prevalence in Japan.
Area of Science:
- Pediatric Allergy and Clinical Immunology
- Immunology
- Pediatrics
Background:
- The Japanese Society of Pediatric Allergy and Clinical Immunology (JSPACI) was established in 1966 to address the rising prevalence of pediatric allergic diseases in Japan.
- Guidelines for pediatric asthma and food allergy management have been developed and revised by JSPACI since 2000 and 2005, respectively.
- The prevalence of allergic diseases, including wheezing and food allergies, has increased significantly over the past five decades, although recent data indicates a potential decrease in asthma prevalence.
Purpose of the Study:
- To provide an overview of the Japanese Society of Pediatric Allergy and Clinical Immunology's contributions to pediatric allergy and immunology.
- To highlight advancements in the management of pediatric asthma and food allergies in Japan.
- To discuss current research trends in primary immunodeficiency syndromes and immunotherapy.
Main Methods:
- Review of guidelines and training programs established by JSPACI and the Japanese Society of Pediatrics.
- Analysis of prevalence data from surveys on childhood asthma and allergies.
- Examination of trends in the diagnosis and treatment of primary immunodeficiency syndromes.
Main Results:
- JSPACI has developed and regularly revised asthma guidelines since 2000, improving pediatric asthma control.
- Food allergy management guidelines were introduced in 2005, enhancing patient care. Over 50 facilities offer oral immunotherapy for food allergies.
- While asthma prevalence showed a multi-year increase, the latest data from 2012 suggests a slight decrease. Food allergy prevalence is estimated at 5-10% in infants and 1-2% in schoolchildren.
- Research is expanding beyond antibody defects to include acquired and innate immune disorders.
Conclusions:
- The JSPACI plays a crucial role in advancing pediatric allergy and clinical immunology in Japan through guideline development and training.
- Oral immunotherapy is increasingly utilized for food allergies, while research into primary immunodeficiency syndromes is broadening.
- There is a need to re-evaluate and develop subcutaneous and sublingual immunotherapies for environmental allergens like mites and Japanese cedar pollen.
Abstract:
The Japanese Society of Pediatric Allergy and Clinical Immunology (JSPACI) was started in 1966 and currently has 3613 members as of August 1, 2012. The number of pediatricians specializing in allergies who have been certified by the Japanese Society of Allergology is 817. Among these, there are 125 training directors and training facilities for allergy and clinical immunology. The JSPACI first published an asthma guideline specific for children in 2000, and this has been revised every 3 yrs, contributing to better control of pediatric asthma. Food allergy management guidelines were first developed in 2005, which have helped to improve the care of food allergy patients. Among 514 pediatric training programs by the Japanese Society of Pediatrics, there are 312 facilities routinely performing oral food challenges. Among these, there were already 53 facilities performing oral immunotherapy at the end of 2011, treating 1400 cases of food allergy. The prevalence of pediatric allergic diseases has increased in Japan over the past 50 yrs. A number of International Study of Asthma and Allergies in Childhood surveys have been conducted in the past at specific times. The prevalence of wheezing among children aged 13-14 yrs in 2002 was 13.0%. Multi-year surveys found a 1.5- to 2-fold increase every 10 yrs until 2002. However, according to the latest data in 2012, asthma prevalence seems to have slightly decreased in Japan. Food allergy mainly associated with infantile atopic eczema among infants younger than 1 yr of age is the most common form as with other developed countries. The estimated food allergy prevalence based on data from several surveys is 5-10% among infants (0-6 yrs) and 1-2% among schoolchildren (6-15 yrs). A variety of patients suffering from primary deficiency syndrome have been actively analyzed. Previously, antibody defects and well-defined syndromes with immunodeficiency were analyzed, but recent research is focusing on not only acquired immune disorders but also on innate immune disorders. In contrast to the widespread use of oral immunotherapy, one immediate issue is to develop and reassess subcutaneous and sublingual immunotherapies for mite and Japanese cedar pollen antigens that have been disused in Japan since the 1990s.
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