Abstract
BackgroundDespite the well-known fact that acetylsalicylic acid (ASA) can induce anaphylaxis in patients susceptible to wheat-dependent exercise-induced anaphylaxis, few studies have sought to investigate the effects of cofactors on type-1 food allergy and none with ASA and hen’s egg and hen’s egg and alcohol combined.Methods and resultsWe applied the experimental model of ‘passive cutaneous anaphylaxis’ in humans to study whether the absorption kinetics of egg white is altered while being treated with ASA or under the influence of alcohol. Donor sera from four egg allergic patients with specific immunoglobulin E (s-IgE) to ovalbumin (0.1–8.87–19.5–170 kUA/L) were injected intracutaneously into the forearm of 12 healthy volunteers who were then challenged separately to: 1) egg white 2) egg white + ASA and 3) egg white + alcohol. ‘Time to wheal’ and ‘wheal size’ were compared among the three experiments.We saw that ‘time to wheal’ with both ASA (P = 0.001) and alcohol (P = 0.019) added as cofactor significantly decreased compared with baseline.ConclusionIn this passive cutaneous anaphylaxis model, ASA and alcohol affected both reaction time and size of reactions elicited after egg ingestion. This suggests that patients with egg allergy could have faster and more severe reactions during ASA treatment or under alcohol influence.
Highlights
Despite the well-known fact that acetylsalicylic acid (ASA) can induce anaphylaxis in patients susceptible to wheat-dependent exercise-induced anaphylaxis, few studies have sought to investigate the effects of cofactors on type-1 food allergy and none with ASA and hen’s egg and hen’s egg and alcohol combined
Reactivity without cofactors was correlated to donor IgE; none of the 12 recipients reacted with wheals to Donor Sera 1 (DS1) with the lowest s-IgE to ovalbumin and only one recipient to DS2
Adding ASA as cofactor (Fig. 1) decreased the Treact for all six recipients producing a wheal with DS3 at baseline and nine out of the 10 recipients producing a wheal at baseline with DS4
Summary
Despite the well-known fact that acetylsalicylic acid (ASA) can induce anaphylaxis in patients susceptible to wheat-dependent exercise-induced anaphylaxis, few studies have sought to investigate the effects of cofactors on type-1 food allergy and none with ASA and hen’s egg and hen’s egg and alcohol combined. We saw that ‘time to wheal’ with both ASA (P = 0.001) and alcohol (P = 0.019) added as cofactor significantly decreased compared with baseline. Conclusion: In this passive cutaneous anaphylaxis model, ASA and alcohol affected both reaction time and size of reactions elicited after egg ingestion. This suggests that patients with egg allergy could have faster and more severe reactions during ASA treatment or under alcohol influence.
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