Breast-feeding is recommended by guidelines in North America and Europe in terms of its protective role against development of allergic diseases including atopic dermatitis. However, some recent epidemiological studies did not support this idea. It should be emphasized that few studies measured immunologically active ingredients in breast milk. Especially in Japan, there have been only retrospective studies about relation between feeding methods and development of atopic dermatitis. We need to conduct prospective studies to investigate relation between breast-feeding and development of atopic dermatitis together with measurement of immunologically active ingredients in breast milk.

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Researches for the pathogenesis in atopic dermatitis have revealed that gene-environment interactions are most important. From the point of genes in pathogenesis like filaggrin mutation, measures like daily skin care against skin barrier dysfunction must be reevaluated, however, cutaneous allergic inflammations are not too much emphasized in that Th2/Th1cytokines, inflammatory cells, chemokines are orchestrated in a complicated fashion.
To prevent atopic dermatitis in childhood from being carried over into adulthood, daily measures must be taken for skin care and anti-inflammatory treatment within acute phase early and intensely enough in order for the eczema not to develop into chronic phase.

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The current state of oral food challenge tests in the pediatric allergy specialists was investigated by a mail questionnaire survey during July and September, 2007. The recovery rate of the questionnaire was 64.4% (480/745). Sixty-six percent of respondents performed oral challenge tests, but only 47.8% of respondents done at least one case of step-wise provocation during April 2006 to March 2007. The most common style of oral food challenge tests was, out-patient or one-day admission setting, open method using boiled eggs, milk, noodles or tofu, 4-5 intakes every 15-30 minutes, and keeping patients in the hospital for around 3 hours after the last intake. Only 41.7% of the respondents obtained a written informed consent from the patients. More than half respondents felt they did not meet the need of patients, but only half of them planned to increase the number of challenge tests. Sixty percent of respondents expected the establishment of a protocol for out-patient challenge test and the improvement of public health insurance.

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Rickets due to vitamin D (VD) deficiency are reported among children with food allergy under the restriction diet. We studied nutritional conditions and VD metabolism in patients with food allergy, especially allergic to fish meats.
Subjects and Methods
We studied 11 cases with food allergy, who visited Morikawa Children's Allergy Clinic or pediatric clinic of JR Sendai Hospital, from January to June, 2007. They showed immediate reactions to fish meat and other various kinds of food, and they were all positive for IgE antibody to various kinds of fish.
We asked the parents about the food restriction other than fish, and examined the patients' nutritional condition, and serum levels of Ca, P, ALP, whole PTH, 1,25(OH)₂D, and 25OHD.
Results and Discussions
In all the subjects, calcium intake was lower than the age matched control standards. Serum 25OHD were in ‘deficient’ levels in 4 out of 11 cases. One of them, who were allergic to and restricted of fish, hen eggs, cow's milk, showed apparent symptoms of rickets due to VD deficiency.
In conclusion, patients with fish allergy, especially in case of multi-allergy, need to take not only adequate VD, but also enough Ca supplementation.

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The patient was a 14-year-old boy who had previously experienced urticaria or anaphylaxis following ingestion of PL granules^®(Salicylamide, acetaminophen, anhydrous caffeine, a methylene disalicylic acid promethazine combination) or ibuprofen in conjunction with Japanese noodles. In February 2008, anaphylaxis occurred while he was playing soccer after eating a school lunch. The school lunch menu consisted of milk, oden (Japanese potaufeu containing Japanese radish, eggs, hanpen (fish paste), konjac (yam paste), carrots, spinach, chikuwa (fish paste)), seaweed mixed rice and fried fish.
His diagnosis was suspected with Food-dependent exercise-induced anaphylaxis due to the wheat because of positive specific IgE antibody (ImmunoCAP^®)to wheat, gluten and his past history. But in challenge test, wheat with exercise elicited no symptoms. So he was given aspirin before wheat, anaphylaxis was induced without exercise.This finding suggested that the symptoms had been elicited by simultaneous ingestion of wheat and a salicylic acid-containing substance, from which wheat-dependent salicylic acid-induced anaphylaxis was diagnosed.

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Background:
The demographic characteristics of asthma patients in Japan are not known in detail. The investigation of regional differences in prevalence of asthma is useful to identify factors that might predispose individuals to asthma.
Methods:
We examined data from the Ministry of Health, Labour and Welfare “Vital Statistics” and “Patient Survey” reports of 1999, 2002, and 2005.
The number of patients with asthma per 1000 population stratified by age, sex and prefecture was analyzed.
Results:
Although the total number of patients with asthma reported in 1999, 2002, and 2005 did not significantly differ, there was a significant increase over time in the number of asthmatic boys aged 0 to 14 years and the number of asthmatic girls aged 0 to 4 years. There were also significant differences in asthma prevalence by prefecture: prevalence was higher in Hokkaido and in the area adjacent to the Sea of Japan in the Tohoku region, and lower in Okinawa prefecture and the Kinki region in 1999, 2002, and 2005.
Conclusion:
In Hokkaido, the prevalence of asthma was consistently high, and consecutively increased, from 1999 through 2005.

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It becomes important evidence to get to know prevalence of a disease, when planning the physiological elucidation of a disease, and health care policies. Until now, there is much asthma in childhood as a junior, and it turns out that there is regional difference and that it is globally higher than an average in the whole country. The epidemiologic survey as a guideline needs to repeat and carry out evaluation of a guideline, evaluation of a medical treatment situation, and evaluation with patient satisfaction with a national level, and the organization will also be needed from now on.

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Factors that influence the risk of asthma can be divided into those that cause the development of asthma and those that trigger asthma symptoms; some do both. The former include host factors and the latter are usually environmental factors. However, the mechanisms whereby they influence the development and expression of asthma are complex and interactive. Early management strategies for asthma can be categorized as follows: “Primary prevention”, “Secondary prevention” and “Early intervention”. Pregnant women and parents of young children should be advised not to smoke as “Primary prevention”. As for “Secondary prevention”, H1- antagonists (antihistamines) interventions cannot be recommended for wide adoption in clinical practice at this time. “Early intervention” can be applied soon after clinical asthma has occurred, with the goals of reducing asthma symptoms and exacerbations safely. Recent studies have shown that the natural course of asthma in young children at high risk for subsequent asthma is not modified with inhaled corticosteroids. Therefore, inhaled corticosteroids cannot be recommended to be used to prevent asthma in high-risk preschool children. The major changes that have been made in Japanese Pediatric Guideline JPGL2008 should be mentioned in this report.

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