Allergen-specific IgE Research Articles

IgE Antibody Assay-Based Allergen Database(CLSI-IL/A-37)

There are 8 established allergen databases (IUIS/WHO ANDB, Allergome, AllFam, AllergenOnline, SDAP, COMPARE, IEDB and AllerBase).None of these provide a comprehensive listing of the internationally-accepted nomenclature codes and Linnean system descriptors of the~1000 extract and molecular allergens used world-wide in diagnostic single-and multi-plex IgE antibody assays. The new Diagnostic Allergen DataBase (DADB) has been prepared by an international scientific committee of the Clinical and Laboratory Standards Institute to specifically provide these data together in a readily-searchable Excel database. Using peanut as an example, the DADB lists the allergens’ unique assay working codes (F13), general category (food), principal IgE antibody assay method(s) where the allergen specificity is available, common name (peanut), taxonomical name (Arachis hypogaea), and the NCBI, NPU, LOINC, Allergome and IUIS/WHO descriptor codes for allergens and their assays. The DADB benefits manufacturers of allergen-specific IgE assays by providing unambiguous specificity descriptors. With the DADB, allergen extract manufacturers will have clearly defined specificity targets for allergenic product development. Government regulators will have clarity on the specificity of new allergen reagents that are being submitted for clearance. IgE antibody proficiency testing programs (e.g. CAP) will be able to clearly define the IgE antibody specificities being measured in their challenge sera. The clinician will precisely know the allergen specificity of IgE antibody that is measured in their reference laboratory. Finally, the allergic patient will be assured that their allergic sensitization is being assessed in an assay with a well-characterized allergen reagent.

Cutaneous mastocytosis and allergic diseases in children: A cross-sectional study

BACKGROUND: Mastocytosis is a heterogeneous group of diseases characterized by abnormal accumulation of clonal mast cells in one or more organs. Comorbidities in patients with mastocytosis include IgE-dependent allergies, psychiatric or psychological disorders, and vitamin D deficiency. Despite the clinical similarities between allergies and mastocytosis, only a few European studies have considered these comorbidities.
 AIM: To analyze the frequency of concomitant-allergic diseases in children with cutaneous mastocytosis.
 MATERIALS AND METHODS: Data of 248 children aged 6 months to 17 years who were diagnosed with cutaneous mastocytosis and received outpatient treatment and observation at the Moscow Scientific and Practical Center for Dermatovenereology and Cosmetology between March 2022 and June 2023 were analyzed. Serum levels of total and allergen-specific IgE were analyzed in children with and without allergic diseases. In addition, a positive history of allergy was analyzed in close relatives of children with cutaneous mastocytosis.
 RESULTS: Every third child (36.7%) with cutaneous mastocytosis had a concomitant allergic disease. Relatives of 27.4% of the examined children had allergic diseases. The process was significantly more often accompanied by allergic diseases in children with mastocytomas than in those with maculopapular cutaneous mastocytosis (χ2=45.46; p=0.001). The level of total IgE was not a statistically significant sign of the presence of allergic diseases in cutaneous mastocytosis (χ2=1.161; p=0.3). Allergen-specific IgE was detected in 47.2% of the children with allergic diseases. Among children without signs of food allergy and pollinosis, asymptomatic low and moderate sensitization to any plant product and birch was detected in 26.5%. Sensitization to respiratory allergens was found in 8% of children with cutaneous mastocytosis without allergic diseases.
 CONCLUSIONS: In Russia, this study demonstrated for the first time a high incidence of allergic diseases in children with cutaneous mastocytosis. The results showed that all clinical forms of mastocytosis in children, including cutaneous mastocytosis, should be subjected to interdisciplinary observation and examination. The timely detection of comorbid allergic diseases contributes to the development of individual techniques for the treatment and prevention of complications and anaphylaxis.

Spectra of sensitization to aeroallergens in patients with allergy from the upper chirchik district of the Republic of Uzbekistan

BACKGROUND: Allergic airway diseases caused by hypersensitivity to aeroallergens are the most common manifestation of atopy in children and adults. However, sensitization in the population primarily depends on the allergenic composition of the air environment. Identification of sensitization is a prerequisite for successful treatment of allergic diseases, although the structure of sensitization may have regional characteristics.
 AIM: To study the spectrum of sensitization in people with allergic diseases, namely, allergic rhinitis, bronchial asthma of varying severity, and atopic dermatitis, in the Upperchirchik district of the Tashkent region, which is characterized by a long period of flowering of weeds (wormwood, saltwort, and quinoa, from the end of August to the end of November), cereals (timothy, foxtail, rye, and bluegrass), and herbs (from the end of February to the end of July); the duration of flowering is associated with the peculiarities of climatic and geographic conditions.
 MATERIALS AND METHODS: From January to May 2022, a clinical and allergological examination was conducted on 100 patients with allergic diseases; of these, 38 were children aged 2–18 years (including 20 children with allergic rhinitis, 12 with bronchial asthma, 6 with atopic dermatitis) and 62 were adults (including 32 patients with allergic rhinitis, 13 with bronchial asthma, 17 with atopic dermatitis). To study the total IgE in the blood serum, allergen-specific IgE and standard diagnostic allergens were used for skin testing.
 RESULTS: Among all examined patients, the most frequent were intermittent and persistent forms of allergic rhinitis in 52 (52%), bronchial asthma in 25 (25%), atopic dermatitis in 23 (23%), combination of allergic rhinitis + bronchial asthma in 13 (13%), allergic rhinitis + atopic dermatitis in 12 (12%), and atopic dermatitis + bronchial asthma in 9 (9%) patients. Combined sensitization to pollen and household and food allergens was detected in 90% of the patients, monosensitization to allergens of cereal grasses (meadow Timothy and meadow bluegrass) in 6% and to allergens of weeds (wormwood and quinoa) in 4%. Sensitization to house dust (h1) was detected in 29 children and 51 adults. The frequency of sensitization to food allergens was higher in children than in adults: to cow’s milk allergens in 28.9% of children and 8.1% of adults; to egg allergens in 44.7% of children and 24.2% of adults; and to nut allergens in 38.7% of children and 34.2% of adults.
 CONCLUSION: The spectrum of sensitization to allergens in patients with allergic diseases in the Upperchirchik district of the Tashkent region is characterized by a predominance of sensitization to pollens and household allergens in children and adults, with a significant proportion of polysensitized patients in all age groups.

Relationship between indoor inhalant allergen concentrations, serum IgE, and allergic diseases: A cross-sectional study from the NHANES 2005–2006 program

This research analyzed data from 5106 participants in the National Health and Nutrition Examination Survey 2005–2006 to explore the link between indoor allergen concentrations, serum IgE levels, and allergic diseases. The study found that 14.9% of participants reported having asthma, with significant differences noted in the concentrations of certain indoor allergens, specifically dust dog, mite, and cat allergens, between asthma and non-asthma groups. Furthermore, positivity rates for inhalant allergen-specific IgE and total IgE were higher in the asthma group. However, the correlations between most inhalant allergen IgE, including total IgE, and indoor allergen concentrations were very weak. These findings suggest that the relationship between indoor allergen concentrations and asthma incidence is complex, indicating a potential need for personalized allergen prevention strategies based on disease type and patient sensitization.

TGFβ prevents IgE-mediated allergic disease by restraining T follicular helper 2 differentiation.

Allergic diseases are common, affecting more than 20% of the population. Genetic variants in the TGFβ pathway are strongly associated with atopy. To interrogate the mechanisms underlying this association, we examined patients and mice with Loeys-Dietz syndrome (LDS) who harbor missense mutations in the kinase domain of TGFΒR1/2. We demonstrate that LDS mutations lead to reduced TGFβ signaling and elevated total and allergen-specific IgE, despite the presence of wild-type T regulatory cells in a chimera model. Germinal center activity was enhanced in LDS and characterized by a selective increase in type 2 follicular helper T cells (TFH2). Expression of Pik3cg was increased in LDS TFH cells and associated with reduced levels of the transcriptional repressor SnoN. PI3Kγ/mTOR signaling in LDS naïve CD4+ T cells was elevated after T cell receptor cross-linking, and pharmacologic inhibition of PI3Kγ or mTOR prevented exaggerated TFH2 and antigen-specific IgE responses after oral antigen exposure in an adoptive transfer model. Naïve CD4+ T cells from nonsyndromic allergic individuals also displayed decreased TGFβ signaling, suggesting that our mechanistic discoveries may be broadly relevant to allergic patients in general. Thus, TGFβ plays a conserved, T cell-intrinsic, and nonredundant role in restraining TFH2 development via the PI3Kγ/mTOR pathway and thereby protects against allergic disease.

Probiotic Lactobacillus plantarum GUANKE effectively alleviates allergic rhinitis symptoms by modulating functions of various cytokines and chemokines.

Currently, the prevalence of allergic rhinitis (AR) remains high and there is a great need to develop better and safer ways to alleviate AR symptoms. The Lactobacillus plantarum GUANKE probiotic was reported as an immunomodulator through maintaining Th1/Th2 balance. This study aimed to determine the efficacy of GUANKE in AR subjects. Adults aged from 18 to 60 years old and previously suffered from AR were recruited and received GUANKE probiotics treatment for 4 weeks. The questionnaires of Total nasal symptom scores (TNSS), total non-nasal symptom score (TNNSS), and rhinitis control assessment test (RCAT) were used to assess the effectiveness before and after treatment. The serum allergen-specific IgE and cytokines were also determined at baseline and after 4 weeks of probiotics administration. The results showed that TNSS and TNNSS were significantly reduced and the RCAT score was significantly increased compared to baseline. The sub-symptom score of rhinorrhea, itching, sneezing, and tearing in each questionnaire also showed significant changes, and the serum IgE level was markedly decreased. We further measured inflammatory-related proteins in serum and found that a total of 20 proteins (6 upregulated and 14 downregulated) were significantly changed compared to baseline, including IL-4, IL-7, IL-20, IL-33, CXCL1, CXCL5, CXCL6, CXCL11, CCL4, CCL23, TGF-alpha, LAP-TGF-beta-1, MMP-1, MMP-10, AXIN1, NT-3, OSM, SCF, CD6, and NRTN. Enrichment analysis showed that these significantly altered proteins were mainly enriched in cytokine and chemokine-related signaling pathways. Taken together, this study demonstrated the Lactobacillus plantarum GUANKE can serve as an effective immunobiotic for the treatment of AR, which is realized through maintaining the Th1/Th2 balance by modulating the functions of various cytokines and chemokines.

Clinical features of adult patients with allergic parotitis

BackgroundAllergic parotitis (AP), due to its non-specific symptoms, frequently poses a diagnostic challenge, leading to cases being overlooked or misdiagnosed by clinicians. ObjectiveThis study aimed to elucidate detailed clinical characteristics and common diagnostic indicators of AP. MethodsA comprehensive review and analysis of medical records was conducted from patients diagnosed with AP, encompassing demographic, clinical, and laboratory data, at the Affiliated Stomatological Hospital of Nanjing Medical University between January 2019 and March 2022. ResultsThe study enrolled 17 patients, evidenced by an average age of 36.00 ± 12.95 years. Common presentations of AP among the patients included notable symptoms such as parotid gland swelling, associated pain, and xerostomia. Ten patients had other atopic diseases. Palpation revealed the affected parotid glands to be soft and nodular, with an elevated local skin temperature. The unstimulated whole saliva flow rate was decreased. Ultrasonography demonstrated increased volume, reduced echo heterogeneity, and lymph node enlargement in the affected parotid glands. All cases observed increased serum salivary amylase and total IgE levels. Investigation of food allergens and inhaled allergen-specific IgE showed that all patients had suspected food allergies. Food provocation tests (FPT) induced AP in 13 cases, confirming the role of food allergens. ConclusionFood allergens are involved in the etiology of AP, underscoring the importance of comprehensive clinical evaluation, including symptoms, signs, and confirmatory auxiliary tests, such as FPT, for accurate diagnosis and differentiation from other salivary gland pathologies.

LONGITUDINAL EVALUATION OF EFFICACY OF SUBLINGUAL IMMUNOTHERAPY IN PEDIATRIC PERENNIAL ALLERGIC RHINITIS USING LABORATORY EXAMINATIONS AND IN VIVO BIOMARKERS

The purpose of this study was to evaluate the efficacy of sublingual immunotherapy (SLIT) with house dust mite (HDM) on pediatric perennial allergic rhinitis (AR) based on longitudinal assessment of nasal symptoms, laboratory examination, and in vivo biomarkers. The subjects included 40 children with perennial AR who had SLIT with HDM for 2 years. Nasal symptoms, medications, skin prick tests, nasal provocation tests, and peripheral blood tests were evaluated before, 6 months, one year and two years after the onset of SLIT. Total nasal symptom scores, prick test wheal diameter, and peripheral blood eosinophil count decreased in 6 months. Total nasal symptom scores continued to decrease from 6 months to 2 years. Symptom-medication scores and nasal provocation test responses decreased in 1 year. Symptom-medication scores continued to decline from 1 to 2 years. Medication scores and nasal eosinophilia decreased in 2 years. Serum specific IgE to HDM slightly increased transiently and decreased in 2 years. The severity of symptoms and specific IgE to HDM at the baseline, and changes of symptoms and specific IgE to HDM during the first six months and first one year of SLIT were correlated with improvement in symptom scores over two years of SLUT. TNSS at baseline was correlated with that at second year. Longitudinal assessment of symptoms, allergen specific IgE, and in vivo biomarkers showed the effectiveness of SLIT. Symptom scores and allergen specific IgE may also be early predictive factors of SLIT efficacy in children with AR.

Assessment of tolerance of a new product (gluten-free grain snack) in children with food allergy to gluten

The development of a technological scheme for the production of cereal snacks based on the extrusion process with preliminary enzymatic treatment of wheat flour and the use of hydrolysate as a partial replacement for gluten-free raw materials is an urgent task. The use of gluten-free cereal snacks in the diet opens up new possibilities for dietary therapy in patients suffering from various manifestations of food allergy to gluten, making their diet more diverse and meeting their individual needs. The purpose of the research was to clinically evaluate the tolerance of gluten-free cereal snacks in children with PA to gluten. Material and methods. The study included 21 patients (male and female) aged 3 to 17 years with a diagnosed food allergy, including gluten. All children received gluten-free cereal snacks according to their age: children from 3 to 7 years old (n=11) received 50 g (176 kcal) daily, and children aged 8 to 17 years old (n=10) received 100 g (352 kcal) daily for 14 days, in addition to a non-specific hypoallergenic diet excluding highly allergenic foods. On the first day of the study, the patients or one of their parents evaluated the organoleptic properties of the presented product (taste, color, smell) using a 5-point scale (1 - very bad, 5 - excellent), according to a specially designed questionnaire. The assessment of clinical symptoms over time related to skin, gastrointestinal tract, and nervous system was conducted using a second questionnaire, where parents kept a daily «observation log» reflecting the child's well-being and condition, as well as adverse events associated with taking the product. Clinical safety parameters were assessed based on the dynamics of complete blood count and blood immunological parameters (total IgE, specific IgE, and IgG4 antibodies to the studied allergens) at the beginning and end of the consumption period. Results. Daily examinations and patient questionnaires revealed no adverse reactions to the product. No significant differences in body weight were observed at the end of the study (p>0.05). In the results of clinical and immunological blood analysis before and after consuming gluten-free cereal snacks, no significant deviations were observed in the form of an increase in eosinophil count, total IgE, allergen-specific IgE and IgG4 antibodies in peripheral blood. This suggests a favorable clinical safety profile of the proposed product. Conclusion. The study found that consumption of the new product (gluten-free cereal snacks) was well-tolerated by children aged 3 to 17 years with various manifestations of food allergy: no adverse effects of the product or exacerbations of the underlying disease were observed during the 14-day period of gluten-free cereal snack consumption. Therefore, the studied gluten-free cereal snacks can be recommended for children aged 3 to 17 years with various manifestations of gluten FA, in combination with a gluten free diet.

Allergen-specific immunoglobulin-Es for dermatitis in the Japanese native Noma horses.

Noma horses are native Japanese horses. Health checkups revealed that many Noma horses developed dermatitis during summer, which subsided in winter. Seasonal development and signs of itching, suggestive of allergic dermatitis, were observed. In this study, allergen-specific IgE was measured using blood samples collected from 15 Noma horses in summer and winter to identify allergens highly associated with dermatitis. The presence of dermatitis in the subject individuals was recorded during blood sample collection. White blood cell and eosinophil counts, serum total IgE concentration, and serum allergen-specific IgE units (ARUs) were measured. White blood cell and eosinophil counts were significantly higher in horses with dermatitis in summer compared to winter. On the other hand, there was no significant difference in serum total IgE concentration regardless of the presence of dermatitis or the season. Horses with dermatitis in summer showed higher ARUs derived from red ants, horseflies, biting midges, cockroaches, deerflies, and mosquitoes than those in winter. These ARUs were positively correlated with white blood cell and eosinophil counts. The factor analysis results suggested that sensitization to some insects, such as mosquitoes and deerflies, may be a cause of dermatitis. In conclusion, insect-derived allergens could be associated with the onset of dermatitis in Noma horses.

Clinical relevance of cluster analysis in phenotyping allergic rhinitis in the paediatric population of the Kuyavian-Pomeranian voivodeship, Poland.

Allergic rhinitis (AR) is the most common allergic disease in the world, and additionally, its prevalence is successively increasing. Children with AR constitute a heterogeneous group of patients differing both in the course of AR and in the frequency of asthma coexistence. It is possible to identify children with AR at risk of a more severe course of the disease by analysing the potential family, environmental and clinical factors related to the development of the disease; the findings will help identify patients with a higher risk of developing asthma in the future, and who will benefit the most from early allergen-specific immunotherapy. Evaluation of clinical relevance of cluster analysis in phenotyping AR based on an analysis of selected clinical and environmental factors. The study sample was 80 children (7-17 y.o.) with AR, including 28 children with associated asthma. The effects of AR symptoms on the patients daily functioning, skin prick tests (Allergopharma), allergen-specific IgE for airborne allergens (Biocheck GmbH), total cholesterol, cholesterol high-density lipoprotein (HDL), cholesterol low-density lipoprotein (LDL), triglyceride levels in the blood (ARCHITECTcSystem), FeNO and nNO concentrations (HypAir FeNO Medisoft) and results of methacholine challenge test (Lungtest 1000Ispa) were analysed. Four clusters of patients with AR were extracted, differing in the incidence and severity of AR symptoms and the coincidence of asthma. Most of the children from cluster 1 (n = 24; 85.71%) and cluster 2 (n = 15; 78.95%) had persistent AR, while most of the children from cluster 3 (n = 11; 73.33%) and cluster 4 (n = 14; 77.78%) had intermittent AR. The co-occurrence of asthma was significantly higher in cluster 1 than in other clusters (p = 0.0002). Children in clusters 3 and 4 reported a lower impact of AR symptoms on daily functioning (p = 0.0153). Children in cluster 1 had significantly more often an abnormally high total cholesterol level (p = 0.033) and in cluster 4 significantly more often abnormally high triglyceride levels (p = 0.009) were observed. Patients in cluster 2 were significantly less likely to have abnormal high LDL levels (p = 0.015). Children with AR from the Kuyavian-Pomeranian voivodeship differing in the course of AR, the frequency of coexistence of asthma, and occurrence of lipid parameter abnormalities.

Chemical chaperone TUDCA selectively inhibits production of allergen-specific IgE in a low-dose model of allergy.

The cellular response to endoplasmic reticulum (ER) stress accompanies plasma cell maturation and is one of triggers and cofactors of the local inflammatory response. Chemical chaperones, low-molecular substances that eliminate pathological ER stress, are proposed as means of treating pathologies associated with ER stress. The aim of this study was to evaluate the effect and mechanisms of influence of chemical chaperones on the humoral response in a low-dose model of allergy. The allergic immune response was induced in BALB/c mice by repeated administration of ovalbumin at a dose of 100 ng for 6 weeks. Some animals were injected with both the antigen and the chemical chaperones, TUDCA (tauroursodeoxycholic acid) or 4-PBA (4-phenylbutyrate). Administration of TUDCA, but not 4-PBA, suppressed production of allergen-specific IgE (a 2.5-fold decrease in titer). None of the chemical chaperones affected the production of specific IgG1. The effect of TUDCA was associated with suppression of the switch to IgE synthesis in regional lymph nodes. This phenomenon was associated with suppressed expression of genes encoding cytokines involved in type 2 immune response, especially Il4 and Il9, which in turn could be caused by suppression of IL-33 release. In addition, TUDCA significantly suppressed expression of the cytokine APRIL, and to a lesser extent, BAFF. Thus, TUDCA inhibition of the allergy-specific IgE production is due to suppression of the release of IL-33 and a decrease in the production of type 2 immune response cytokines, as well as suppression of the expression of the cytokines APRIL and BAFF.

RAST, Inmunoblot, Immunocap and ISAC in food allergy

skin tests; Sensitization; IgE-mediated allergy; allergenic extract. After the discovery of IgE, technological advances have provided new laboratory tools for the quantification of allergen-specific IgE antibodies in serum and on the surface of basophils-mast cells. In vitro testing offers numerous advantages: accurate quantitation, lack of drug interference, safety, and long-term storage of samples. Quantitative immunoassays for IgE antibodies can be an adjunct to skin testing. The allergen reagent in solid phase (allergosorbent) or liquid is the main component of the assay that confers specificity to the IgE antibody test. It is the most complex and highly variable reagent in IgE antibody assays. The choice to use diagnostic recombinants on a single rather than multiple platforms is made on a case-by-case basis (considering prior history and clinical profile) and in an allergen-dependent manner. Although most food allergies are limited to a small number of possible triggers, these foods are very complex when evaluating their allergenic potential. The possibility of fractionating the allergen and understanding some of its components as potentially important to define the risk of clinical reaction, cross-reactivity, or persistence of allergy, opened a new era in the field of allergy, called molecular allergy. The identification of the allergenic component responsible for the reactions is an important tool to confirm the information and severity of the symptoms, natural history of the disease, possibility of cross-reactivity and clinical symptoms (allergy markers).

Gastrointestinal manifestations, spectrum and frequency of sensitization to food allergens in Kyiv’s adult citizens with allergic rhinitis: a cross-sectional study

Background. Food allergy affects 1–3 % of adults worldwide. More than 160 foods can cause allergic reactions. Food allergy may precede and stimulate allergic rhinitis. Aim of the study was to assess the spectrum and frequency of sensitization to food allergens in patients with allergic rhinitis from Kyiv, Ukraine. Materials and me­thods. The investigation was conducted as a cross-sectional study. One hundred and seventy-five Kyiv adult patients with allergic rhinitis were enrolled in the trial. Sensitization to allergens and their components was determined by skin prick tests and in vitro detection of allergen specific IgE by ELISA in blood serum — a multicomponent Allergy Explorer2 ALEX2 test. Results. It was shown that sensitization to following inhalant allergens was predominant: to timothy grass — in 50.3 %, to ragweed — in 48.6 %, to birch — in 44 %, to wormwood — in 24 %, to Alternaria alternata mold — in 15.4 % of patients. One hundred and thirty-one (74.9 %) participants have co-sensitization to at least one food allergen, among them 77 (58.8 %) had gastrointestinal symptoms. Sensitization to following food allergens was predominant: to hazelnut — 27.5 %, apple — 26.3 %, peanut — 21.7 %, celery — 14.3 %, soy — 13.1 %, carp — 11.4 %, kiwi — 9.1 %, crab — 9.1 %, codfish — 8.6 %, oyster — 8.6 %, peach — 8 %, lobster — 8 %, carrot — 7.4 %, anisakis — 6.3 %, prawn — 6.3 %, tiger prawn — 5.7 %, to beef — 5.1 % of cases. It was found that the frequency of sensitization to cross-reactive proteins PR-10 was 20.5 % (95% confidence interval (CI); 9.7–33.9 %) in patients with allergic rhinitis without food co-sensitization comparing to 51.1 % (95% CI; 42.5–59.7 %) in participants with both allergic rhinitis and food co-sensitization, p < 0.001; to nsLTP — 2.3 % (95% CI; 0–8.9 %) and 19.8 % (95% CI; 13.4–27.2 %), respectively, p = 0.011. Conclusions. Among Kyiv adult patients with allergic rhinitis, approximately three quarters have food co-sensitization that may be the cause of gastrointestinal symptoms and exacerbations of allergic rhinitis after consuming vegetables, fruits and nuts due to cross-reactivity with inhalant allergens. This should be considered when manage such patients.

Exploring the Autoimmune Pathogenesis in Severe Asthma

Introduction: Severe asthma has a poor response to hormone therapy and a poor level of control, so the discovery of new pathogenetic mechanisms is important for diagnosing and treating severe asthma. IL-35 may play a protective role in autoimmune diseases by directly or indirectly inhibiting the secretion of IL-17, which is an important proinflammatory factor involved in the occurrence and development of autoimmune diseases. The autologous serum skin test (ASST) is a good sensitivity and specificity screening test for autoimmune functional autoantibodies. We compared the levels of IL-35 and IL-17 in serum samples, the positive rate of ASST, the level of exhaled nitric oxide (FeNO), and the atopic constitution in patients with severe asthma to those with mild-to-moderate asthma so as to explore the possible autoimmune pathogenesis of severe asthma. Methods: Patients with mild-to-moderate and severe asthma were enrolled. Their age, gender, smoking history, family history of asthma, history of allergic rhinitis, positive allergen results, serum total IgE (TlgE), allergen-specific IgE (slgE), routine blood, ASST results, and FeNO test results were compared and analyzed. The IL-35 and IL-17 levels in serum samples from both groups were measured by enzyme-linked immunosorbent assay for comparison and analysis. The SPSS 22.0 software package was used for statistical analysis. Results: A total of 50 patients with mild-to-moderate asthma and 31 patients with severe asthma were included in this study. The proportion of patients with a history of smoking and a family history of asthma was significantly higher in the severe asthma group compared to the mild-to-moderate asthma group (all p < 0.05); the number of positive allergen tests was significantly lower in patients with severe asthma compared to those with mild-to-moderate asthma (p < 0.001). The rate of positive ASST was significantly higher in patients with severe asthma than in patients with mild-to-moderate asthma (p < 0.05). Serum IL-17 levels were significantly higher in patients with severe asthma than in patients with mild-to-moderate asthma (p < 0.05), but serum IL-35 level between the two group was not significantly different (p = 0.113). ASST-positive patients had a statistically significant increase in the risk of developing severe asthma, while patients with allergen positive were less likely to develop severe asthma (positive ASST: OR = 5.277, p = 0.024; allergen positivity: OR = 0.123, p = 0.001). Conclusions: IL-35 has a weaker inhibitory effect on high IL-17 expression in patients with severe asthma, and the rate of positive ASST was significantly higher in patients with severe asthma, which all suggested the possibility of autoimmune pathogenesis in patients with severe asthma.

The B Cell Response and Formation of Allergenic and Anti-Allergenic Antibodies in Food Allergy.

Food allergies are a growing public health concern worldwide, especially in children and young adults. Allergen-specific IgE plays a central role in the pathogenesis of food allergies, but their titers poorly correlate with allergy development. Host immune systems yield allergen-specific immunoglobulin (Ig)A, IgE and IgG subclasses with low or high affinities and differential Fc N-glycosylation patterns that can affect the allergic reaction to food in multiple ways. High-affinity IgE is required to induce strong mast cell activation eventually leading to allergic anaphylaxis, while low-affinity IgE can even inhibit the development of clinically relevant allergic symptoms. IgA and IgG antibodies can inhibit IgE-mediated mast cell activation through various mechanisms, thereby protecting IgE-positive individuals from allergy development. The production of IgE and IgG with differential allergenic potential seems to be affected by the signaling strength of individual B cell receptors, and by cytokines from T cells. This review provides an overview of the diversity of the B cell response and the diverse roles of antibodies in food allergy.

Allergic sensitization does not influence advancement or survival in oral cancer

A history of allergies has been said to be associated with a lower risk of head and neck cancer compared to the general population. However, it is not known whether having an allergic sensitization influences the prognosis and advancement of cancer disease. Thus, the aim of the study was to investigate the relationship between allergic sensitization and oral cancer advancement and patient survival. Allergen-specific IgE antibodies were investigated by ImmunoCAP™ Rapid in consecutive 80 patients with oral cancer. ImmunoCAP Rapid system tests a mix of representative inhalant allergens such as birch, timothy grass, mugwort, house dust mite, cat, dog, cockroach, olive (pollen), wall pellitory and mold. Eighty patients met the inclusion criteria for the study. Fifteen patients (19%) had positive ImmunoCAP test. There was no statistically significant difference in primary tumour size (T-stage) between groups (60% in allergy vs 68% in non-allergy had T1–T2 stage and 40% vs 32% T3–T4, respectively, p = 0.570). 27% of patients with allergy had nodal metastases compared with 37% of patients without allergy (p = 0.557). Both groups had comparable short-term survival. In conclusion, allergic sensitization does not seem to influence either the advancement or the short-term survival of patients with oral squamous cell carcinoma.

Analysis on epidemiological characteristics of allergens with allergic skin diseases in a hospital in Beijing City from 2017 to 2021

Objectives: In order to provide valuable information for the diagnosis and treatment of dermatitis, the prevalence rate and trend changes of common allergens in patients with allergic skin diseases in Beijing City were investigated and analyzed. Methods: This study was a retrospective data collection study. A total of 2 822 patients diagnosed with moderate to severe atopic dermatitis with allergen examinations were collected from Peking University First Hospital from 2017 to 2021, most of them were adults, and 83%(2 340/2 822) were over 18 years old. The ImmunoCAP fluorescent enzyme-linked immunoassay system was used to quantify specific IgE. The positive rate of each allergen was counted according to age, gender and year. The epidemiological characteristics and trends were analyzed. Results: In the past five years, 22 503 allergen-specific IgE test data were collected, and the positive rate of allergens in 40%(1 122/2 822) of the 2 822 patients was mainly multiple sensitization, the positive rate of allergens and multiple sensitization rates were the highest in people aged 13-18 years old. The 2 822 patients were dominated by inhaled allergens, and the highest positive rate was inhaled mixture (29.3%). The top five positive rates of inhaled allergens were Dermatophagoides farina (26.7%), Dermatophagoides pteronyssinus (25.5%), Mugwort (23.9%), Birch pollen (19.2%) and Siberian cocklebur (18.2%). The top five positive rates of food allergens were shrimp (15.2%), peanut (14.8%), sesame (14.7%), wheat (13.2%) and milk (13.1%). Analysis of the positive rate of allergens in different age groups showed except for the positive rate of birch pollen peaked at 3-12 years old, other inhaled allergens were the highest food allergens in 13-18 years old. Among food allergens, the positive rates of fx5, milk, egg and wheat were the highest in <3 years old, the positive rate decreased gradually with age, and the positive rate of other food allergens peaked at 13-18 years old, and the shrimp and crab was the highest in adult. The positive rate of various allergens in the 2 822 patients showed little difference between male and female and the male was slightly higher than female. In the past five years, the positive rate of allergens has been on the rise. The changes of inhaled allergens in cat/dog hair dander, Dermatophagoides farina and cicadas were large, while the positive rate of food allergens was stable. Conclusions: The etiology of the allergic skin diseases is complex, which may be related to allergen exposure, heredity, immunity, environmental factors, abnormal skin barrier function, etc. This study showed the distribution of allergens in patients with allergic skin diseases in Beijing City to a certain extent. It provided epidemiological data and clinical evidence for the prevention and treatment of allergic diseases.

Intradermal testing and serum allergen-specific IgE-testing in cats with naturally occurring feline bronchial disease.

While feline asthma (FA) is considered to be of allergic origin, the etiology of feline chronic bronchitis (CB) to date is unknown. Aim of the study was to compare the results of intradermal testing (IDT) and serum testing for allergen-specific immunoglobulin E (SAT) in cats diagnosed with FA and CB. Twenty-seven client-owned cats with clinical signs, suggestive of feline inflammatory bronchial disease (FBD) were prospectively enrolled in the study. Patients were assigned to 3 groups based on results of bronchoalveolar-lavage-fluid (BALF)-cytology: FA (n=8), CB (n=10), or cats with a physiological BALF cytology (PB; n=9). A standardized IDT for 27 allergens was performed in all cats. In addition, allergen-specific IgE was measured in serum samples using an FcεRIα-ELISA. The number of positive reactions in both tests was compared between groups, and agreement between test results of both tests was evaluated. Regarding the number of positive reactions, no statistically significant difference was detected between groups in IDT (p=0.65) and SAT (p=0.51). When comparing the 2 test systems, a weak correlation was found for the allergens Tyrophagus putrescentiae (k=0.256), Dermatophagoides farinae (k=0.276), and rye (k=0.273). The most commonly observed reactions were to house dust mites, storage mites, rye and nettle in IDT and to sheep sorrel, storage mites, and house dust mites in SAT. IDT and SAT in cats with feline inflammatory bronchial disease (FBD) cannot be used interchangeably for allergen detection. Sensitization to environmental allergens can occur in cats with and without airway inflammation. Therefore, a positive test result should always be assessed in context with clinical signs and allergen exposure.

Influence of Cordyceps militaris-fermented grain substrate extracts on alleviating food allergy in mice

BackgroundCordyceps militaris is recognized as a tonic in traditional Chinese medicine, and there have been documented findings on the anti-allergic properties of its extract derived from the fruiting body. Due to the limited availability of wild C. militaris, a specialized grain substrate has been devised for the solid-state fermentation of its fruiting bodies. However, the fermented grain substrate is considered waste and usually used as feeds for animals. To achieve the sustainable development goals, C. militaris-fermented grain substrate (CFGS) was collected to prepare CFGS extracts. Further, the anti-allergic properties of these extracts were assessed with the aim of exploring novel applications. MethodsThe water extract and ethanol extract of CFGS were prepared, and their potential in alleviating allergic enteritis was assessed in mice with food allergy. Assessment of immunomodulatory effects included the measurement of serum antibodies and splenic cytokines. Additionally, influence of extracts on gut microbiota composition was examined through sequencing analysis of 16S rRNA gene from freshly collected feces of the mice. ResultsDaily administration of the water and ethanol extracts, at doses of 50 or 250 mg/kg body weight, demonstrated a notable alleviation of allergic diarrhea and enteritis. This was accompanied by a decrease in mast cell infiltration in the duodenum and a reduction in allergen-specific IgE production in the serum. Both extracts led to a significant decrease in IL-4 secretion. Conversely, there was an increase in IFN-γ, IL-10, and TGF-β secretion from splenocytes. Remarkably, allergic mice exhibited a distinct fecal microbiota profile compared to that of normal mice. Intriguingly, the administration of these extracts had varying effects on the fecal microbiota. ConclusionTaken together, these findings collectively indicate the potential of CFGS extracts as promising candidates for functional foods. These extracts show promise in managing allergic enteritis and modulating gut microbiota.