Allergic Type Research Articles

Novel mechanistic insights underlying fungal allergic inflammation.

The worldwide prevalence of asthma and allergic disorders (allergic rhinitis, atopic dermatitis, food allergy) has been steadily rising in recent decades. It is now estimated that up to 20% of the global population is afflicted by an allergic disease, with increasing incidence rates in both high- and low-income countries. The World Allergy Organization estimates that the total economic burden of asthma and allergic rhinitis alone is approximately $21 billion per year. While allergic stimuli are a complex and heterogenous class of inputs including parasites, pollens, food antigens, drugs, and metals, it has become clear that fungi are major drivers of allergic disease, with estimates that fungal sensitization occurs in 20-30% of atopic individuals and up to 80% of asthma patients. Fungi are eukaryotic microorganisms that can be found throughout the world in high abundance in both indoor and outdoor environments. Understanding how and why fungi act as triggers of allergic type 2 inflammation will be crucial for combating this important health problem. In recent years, there have been significant advances in our understanding of fungi-induced type 2 immunity, however there is still much we don't understand, including why fungi have a tendency to induce allergic reactions in the first place. Here, we will discuss how fungi trigger type 2 immune responses and posit why this response has been evolutionarily selected for induction during fungal encounter.

Pattern and Severity of Allergic Rhinitis Correlated with Patient Characteristics: A Rural Hospital-Based Cross-Sectional Study.

Allergic Rhinitis (AR) is rising in incidence in both developed and developing countries. Genetics and epigenetics have a potential role to play. The pattern and severity of AR have implications with regard to choice of treatment, which itself could be related to patient specific genetic and epigenetic factors. Hence, the present study was undertaken to correlate the patient characteristics with AR pattern and severity, in order to understand the pathophysiology of AR. The study also aimed to find out the allergen sensitivity pattern among patients attending a tertiary care centre of rural central India, where climatic variations make it a high prevalence zone. Prospective Observational study on 90 patients with clinically diagnosed Allergic Rhinitis confirmed by Skin Prick Tests. Patient characteristics like demographic data, data relevant to allergen exposure, occupation, family history of atopy and gender; and Disease characteristics like severity (mild, mod-severe), pattern (continuous/ intermittent), type of disease (seasonal/perennial) were noted, analysed and correlation studied. Majority of the patients with AR were in the age group of 15-40 years. Medical students (52%) suffered from moderate to severe type of Allergic Rhinitis, with Persistent disease in approximately 80%. Similarly, 70.59% of farmers had moderate to severe type of the disease, with persistent disease in 70%. In the present study, in clinically diagnosed allergic rhinitis patients, Mite was the commonest allergen found on Skin Prick Test overall and in Medical students, whereas Pollen sensitivity was more common among farmers. 56.66% of the patients had negative family history of atopy. Severity and type of AR depend on allergen exposure. In farmers and medical professionals, persistent and moderate to severe type of disease was more common, as they were persistently exposed to different type of allergens, mites in case of medical professionals and pollens in farmers. Hence, the Disease characteristics, as defined by ARIA guidelines, should not be taken in isolation and management should consider the Patient characteristics for deciding and devising protocols. In the present study, more than 50% patients were without family history of atopy. Hence, the role of various environmental factors, leading to epigenetic changes could be a major contributor in the increase in incidence of allergic rhinitis in recent times. Occurrence of perennial moderate to severe form of disease, in majority of farmers, defies the phenomenon of "Hygiene Hypothesis", focusing on the role of epigenetic changes and various outdoor allergens in the development of allergic rhinitis in them.

Allergen Differences and Correlation Analysis in Siblings Diagnosed with Respiratory Allergic Diseases

Introduction: Many parents of children with allergies are worried whether their subsequent children will have allergic reactions to the same allergens. Much of the current research on sibling allergens has been focused on twins; however, in real life, very few children are twins. Our study provides an opportunity to initially explore the sensitivity to allergens in siblings diagnosed with respiratory allergic diseases. Methods: Siblings diagnosed with bronchial asthma and/or allergic rhinitis in the Outpatient Department of Allergy Department of Yantai Yuhuangding Hospital from January 2018 to December 2021 were selected. The siblings were divided into elder group and younger group. Data of gender, age, feeding history, serum total IgE (TIgE), absolute eosinophil counts, and allergen-specific IgE (sIgE) were collected and analyzed. The sIgEs of allergens were divided into six categories and analyzed. Results: A total of 98 sibling pairs of patients were included in this study. There were no differences in the positive rates of the different types of allergens, TIgE values, and the absolute eosinophil values between the elder and younger groups and between different genders. Logistic regression analysis indicated that the elder siblings allergic to dust mites, fungi, weed pollens, or food had a statistically significant increased risk of having their younger sibling sensitive to these types of allergens (all p <0.05), and the risk of allergy to dust mites, weed pollens, and tree pollens of younger group increased with age (all p <0.05). Except for the sIgE values of dust mites, the sIgE values of the other allergens were significantly correlated between the two groups (all p <0.05). Conclusion: The positive rates of different allergens were similar between siblings. Elder siblings with dust mites, fungi, weed pollen, or food allergen positivity will have younger siblings sensitive to the same types of allergens.

Recent Advances in Polymer-Based Biosensors for Food Safety Detection.

The excessive use of pesticides and drugs, coupled with environmental pollution, has resulted in the persistence of contaminants on food. These pollutants tend to accumulate in humans through the food chain, posing a significant threat to human health. Therefore, it is crucial to develop rapid, low-cost, portable, and on-site biosensors for detecting food contaminants. Among various biosensors, polymer-based biosensors have emerged as promising probes for detection of food contaminants in recent years, due to their various functions such as target binding, enrichment, and simple signal reading. This paper aims to discuss the characteristics of five types of food pollutants-heavy metals, pesticide residues, pathogenic bacteria, allergens, and antibiotics-and their adverse effects on human health. Additionally, this paper focuses on the principle of polymer-based biosensors and their latest applications in detecting these five types of food contaminants in actual food samples. Furthermore, this review briefly examines the future prospects and challenges of biosensors for food safety detection. The insights provided in this review will facilitate the development of biosensors for food safety detection.

The Prevalence of Atopic Diseases Among Pediatric Food Allergic Patients.

Introduction Food allergy is an immunological reaction that occurs in response to particular proteins in food. As food allergy can affect multiple body organs, symptoms usually include pruritus, urticaria, rash, cough, dyspnea, and wheezing. Atopic diseases are common in patients with food allergies, and multiple significant associations have been made between them. As such, the presence of food allergy in atopic patients can be used as an indicator of disease severity. The aim of this study was to estimate the prevalence of atopic diseases in food allergy patients. Methodology This was a retrospective cohort study that included pediatric patients aged 0-14 with confirmed food allergies between January 2016 and June 2022. Data was retrieved from electronic medical records and included patients' demographics, type of food allergens, symptoms of food allergy, presence of atopic diseases, and the utilization of healthcare services. Categorical variables were reported as frequencies and percentages, with Chi-squared being used for comparison. Results A total of 228 patients were included in the study. Half of them (114, 50%) were diagnosed with an atopic disease. Seventy-four (64.9%) had asthma, 57 (50%) had atopic dermatitis, and 45 (39.5%) had allergic rhinitis. The most common food allergens in atopic patients were eggs and milk products, in 53 (46.4%) and 42 (36.8%), respectively. There was a significant association between allergy to eggs (p=0.0005), bananas (p=0.0242), and strawberries (p=0.0393), and the presence of an atopic disease. No significant difference was found between atopic and non-atopic patients in terms of utilization of outpatient (p=0.09), inpatient (p=0.50), or ER visits (p=0.31) due to food allergy. Conclusion The current study demonstrates the prevalence of atopic disease in patients with food allergies. Although certain foods were associated with the prevalence of atopic diseases, both atopic and non-atopic patients have similar utilization of health care services such as outpatient, inpatient, and ER.

Aeropalynological Profile Of Cherepovets And Vologda, The Cities Of Vologda Region, Nw Russia

The article presents data on the composition and seasonal dynamics of airborne pollen in Cherepovets and Vologda. The study was carried out from April 10 to September 30, 2014 and from April 16 to August 31, 2015 in Cherepovets, and from June 3 to September 30, 2019 in Vologda. Pollen data were obtained from the Durham gravimetric samplers. Samples were collected daily. Twenty-one types of pollen have been identified, ten of which are the most common allergenic types (Alnus, Artemisia, Betula, Fraxinus, Salix, Plantago, Poaceae, Quercus, Rumex, Urtica), which account for more than 50% of all pollen that has been registered. The article contains pollen calendars showing two peaks of pollen grain quantity: spring (from last decade of April to May), summer (from the end of June to the middle of July). Betula (30%) and Asteraceae (28%) pollen dominate in the pollen spectrum. Pinus (20%), Plantago (6%) and Poaceae (5%) also play an important role in the regional spectrum. The results show the presence of allergenic pollen from different taxa throughout the study. The proportion of damaged pollen grains is approximately 2%, which corresponds to the norm in natural population in normal condition. This data can become the basis for developing recommendations for reducing the level of pollinosis in the Vologda Region.

A review of current evidence on food allergies during pregnancy.

Food allergy is the reaction of the immune system of the body that occurs after consuming specific foods. During specific physiological ages of pregnancy, women are more prone to different allergic reactions and mostly these reactions may prolong and have long-term effects. The hypersensitivity of different types of allergens is mainly linked with the adversity of reactions. The chances of suffering food allergies in women are greater than in men; women are usually more prone to get allergic to some foods during their specific physiological age of pregnancy. Food allergies are more common in pregnant women as every fifth pregnant woman is affected by some kind of allergy. The specific reasons and evidence of the causes of these food allergies during pregnancies have yet to be explored. A pregnant woman should take a balanced diet and avoid consuming known allergic foods to minimize the risk and complications. This review aimed to broaden the knowledge on food allergies during pregnancies, their onset in the babies, and to make it easy for pregnant women to cope with the complications caused by these food allergies. It also aimed to figure out the certain food that might be responsible for the onset of allergies in women during pregnancy and the effect of these allergies on their babies.

Analysis of Multimorbidity of Moderate to Severe Allergic Rhinitis in Children: A Real-World Study

Introduction: Allergic rhinitis (AR) in children is associated with various comorbidities, posing challenges for treatment and management. There have been few investigations of these multimorbidities in Chinese children with AR. Here, we investigated the prevalence of multimorbidities in children with moderate to severe AR and analyzed the influencing factors using real-world data. Methods: In total, 600 children who visited the outpatient clinic of our hospital and were diagnosed with moderate-severe AR were prospectively enrolled. All children underwent allergen detection and electronic nasopharyngoscopy. Parents or guardians completed a questionnaire that included age, sex, mode of delivery, feeding pattern, and familial history of allergy. The multimorbidities investigated included atopic dermatitis (AD), asthma, allergic conjunctivitis (AC), chronic rhinosinusitis (CRS), adenoid hypertrophy (AH), tonsil hypertrophy (TH), recurrent epistaxis, and recurrent respiratory tract infections (RRTIs). Results: The AR multimorbidities reported in children were as follows: recurrent epistaxis (46.5%), AC (46.3%), AD (40.7%), asthma (22.5%), RRIs (21.3%), CRS (20.5%), AH (19.7%), and TH (12.5%). In univariate logistic regression analysis, age (<6 years), birth mode, familial history of allergy, and single dust mite allergy were associated with AR multimorbidity (p < 0.05). Multivariate logistic regression revealed that a familial history of allergy was an independent risk factor for AC (odds ratio [OR] = 1.539, 95% confidence interval [CI]: 1.104–2.145) and AH (OR = 1.506, 95% CI: 1.000–2.267) (p < 0.05). Age (<6 years) was independently associated with the risk of AD (OR = 1.405, 95% CI: 1.003–1.969) and RRTIs (OR = 1.869, 95% CI: 1.250–2.793) (p < 0.05), cesarean section with AR and CRS risk (OR = 1.678, 95% CI: 1.100–2.561), and single dust mite allergy with asthma (OR = 1.590, 95% CI: 1.040–2.432) and CRS (OR = 1.600, 95% CI: 1.018–2.515) risk (p < 0.05). Further, non-dust mite allergy was independently associated with AR and CRS (OR = 2.056, 95% CI: 1.084–3.899). Conclusion: AR was found to be accompanied by different comorbidities, including both allergic and non-allergic comorbidities, complicating disease treatment. These findings demonstrated that age (<6 years), familial history of allergy, types of allergens, and cesarean section were risk factors for different multimorbidities associated with AR.

Latex anaphylaxis and occupational contact dermatitis developed in the same individual: A case report

According to the Gell-Coombs classification, latex causes two types of allergic reaction: IgE-mediated allergic reaction Type I hypersensitivity, and T lymphocyte-mediated or Type IV hypersensitivity. IgE-mediated latex reaction causes mastocytic and basophilic degranulation and contact urticaria, asthma and anaphylaxis.

Impact of food allergy on health-related quality of life: A case report of 2 patients with adult-onset IgE mediated food allergy.

Food allergy incidence is increasing, and reactions can be life-threatening. Food allergies significantly impact patients' and families' quality of life (QoL). Here, we describe two cases with adult-onset IgEmediated food allergy impacting their physical and psychological health and affecting their quality of life. Patient 1: A 29-year-old lady, previously healthy, presented with a history of sneezing, shortness of breath, and eye and lip swelling shortly after drinking cow milk at the age of 28 years. She had multiple episodes of similar symptoms after consumption of dairy products. A positive blood test confirmed Cow's Milk allergy (Table 1). She was very anxious and concerned about accidental exposure and even avoided serving milk to her children. She scored 5.2/7 on the Food Allergy Quality of Life Questionnaire-Adult Form (FAQLQ-AF). The patient currently avoids dairy products and carries Adrenaline autoinjectable (AAI), with no reported anaphylaxis. Patient 2: A 46-year-old man with a history of type 2 DM was evaluated for recurrent urticaria. Further history revealed recurrent episodes of urticaria and angioedema for the past few years one to two hours after wheat intake; the most recent episode was typical for anaphylaxis, and he denied any exercise or presence of other co-factors. Allergy testing confirmed wheat allergy (Table 1). He scored 4.9/7 on FAQLQ-AF. He was concerned about having another anaphylaxis. He was instructed to avoid wheat and to carry AAI, after which no further attacks were reported. Identifying the food allergens for both patients alleviates some of their anxiety. Moreover, having an AAI on hand and training on how and when to use it led to increased safety feeling, although initially, they were hesitant to carry AAI. Continuous assessment will be carried out during clinic visits to ensure improved QoL. Several factors affect the extent of food allergy's impact on patients' QoL, like age, type, and number of food allergens. Physicians must be aware of the psychological burdens faced by adults with food allergies and implement strategies to address and improve patients' QoL through counseling, proper education, and psychotherapy if needed.

Dupilumab improves long-term outcomes in patients with uncontrolled, moderate-to-severe GINA-based type 2 asthma, irrespective of allergic status.

Previous research has shown greater efficacy of dupilumab in patients with uncontrolled asthma and type 2 inflammation. We analyzed dupilumab's efficacy in patients from the TRAVERSE study with or without evidence of allergic asthma and type 2 inflammation per current GINA guidelines (≥150 eosinophils/μL or FeNO ≥20 ppb). All patients aged ≥12 years who rolled over from the placebo-controlled QUEST study (NCT02414854) to TRAVERSE (NCT02134028) received add-on dupilumab 300 mg every 2 weeks for up to 96 weeks. We assessed annualized severe asthma exacerbation rates (AERs) and changes from parent-study baseline (PSBL) in pre-bronchodilator FEV1 and 5-item asthma control questionnaire (ACQ-5) score in patients with moderate-to-severe type 2 asthma with and without evidence of allergic asthma at PSBL. In TRAVERSE, dupilumab consistently reduced AER across all subgroups. By Week 96, dupilumab increased pre-bronchodilator FEV1 from PSBL by 0.35-0.41 L in patients receiving placebo during QUEST (placebo/dupilumab) and 0.34-0.44 L in those receiving dupilumab during QUEST (dupilumab/dupilumab) with an allergic phenotype at baseline. In patients without evidence of allergic asthma, pre-bronchodilator FEV1 improved by 0.38-0.41 L and 0.33-0.37 L, respectively. By Week 48, ACQ-5 scores decreased from PSBL by 1.63-1.69 (placebo/dupilumab) and 1.74-1.81 (dupilumab/dupilumab) points across subgroups with allergic asthma, and 1.75-1.83 (placebo/dupilumab) and 1.78-1.86 (dupilumab/dupilumab) in those without. Long-term treatment with dupilumab reduced exacerbation rates and improved lung function and asthma control in patients with asthma with type 2 inflammation as per current GINA guidance and irrespective of evidence of allergic asthma.

Lossy mode resonance-based optical immunosensor towards detecting gliadin in aqueous solutions

The development of accurate, intuitive, and easy-to-handle devices to detect different types of allergens is on the rise, as these are useful tools to guarantee consumer safety, which should be a priority for any food industry. Gliadin, one of the main proteins present in gluten, is the one responsible for triggering the immune system to produce autoantibodies in celiac disease, the most dangerous pathology related to gluten. Lossy Mode Resonance (LMR) based biosensors are lately known as a promising sensing technology and its implementation on planar waveguides has been shown to result in manageable, sustainable and robust structures. In this work, an LMR based microfluidic biosensor for gliadin detection is proposed, by coating a coverslip with Titanium Dioxide (TiO2) by Atomic Layer Deposition (ALD) to generate the resonance phenomena and functionalizing the sensor surface with anti-gliadin antibody (AGA) through covalent bond. The sensor was exposed to different gliadin concentrations in ultrapure water, in the range of 0.1–100 ppm with an accuracy of ±0.14 ppm, for a sensitivity of 1.35 ppm/ml. The calibration curve was obtained from the experimental data corresponding to three repetitions of the assay and a limit of detection (LOD) of 0.05 ppm was achieved. Moreover, the sensor was exposed to commercial flour samples, some of them labeled as gluten free (GF) and the response agreed with the expected results according to product label. Biosensor specificity to gliadin was demonstrated by injecting chicken egg white albumin without obtaining any significant response.

Acute coronary syndrome caused by allergic reaction (Kounis syndrome): a literature review

Gabrielė Žūkaitė1, Rasa Šimoniūtytė2, Agnė Baliūnaitė1 1Lithuanian University of Health Sciences, Faculty of Medicine, Kaunas, Lithuania 2Vilnius City Clinical Hospital, Department of Internal Medicine, Vilnius, Lithuania Abstract Background. Kounis syndrome is a cardiac pathology manifested by angina pectoris or myocardial infarction caused by an acute allergic reaction. There are three types of this syndrome: type 1 is caused by coronary artery spasm and patients are without risk factors, type 2 is allergic myocardial infarction and type 3 is caused by stent thrombosis or restenosis. The main clinical symptoms are chest pain, rash, hypotension and shortness of breath. Aim: to select and analyze the latest diagnostic and treatment recommendations for Kounis syndrome based on the experience of foreign researchers and to discuss the etiology, pathogenesis and clinical symptoms. Material and methods. A systematic review of the medical literature was performed using databases of PubMed, Elsevier, Google Scholar, and guidelines of European Society of Cardiology. The search was performed using the following keywords and their combinations in English: Kounis syndrome, vasospastic angina, MINOCA, syndrome X, acute coronary syndrome, allergy induced angina pectoris, allergy induced myocardial infarction. Results: The main diagnostic principles are based on clinical symptoms, laboratory blood tests (troponin I), ECG, coronary artery angiography and echocardiography. The treatment of this syndrome depends on the type, but the most important thing is to stop the progression of the allergic reaction and myocardial ischaemia. Conclusion. The prognosis of Kounis syndrome is favorable and most patients make a full recovery. Serious complications are rare. Kounis syndrome still remains a rarely diagnosed disease, because there is still a lack of guidelines on how to properly treat and diagnose this syndrome. Keywords: Kounis syndrome, acute coronary syndrome, allergy, vasospastic angina. Full article https://doi.org/10.53453/ms.2023.2.17

Sensitization pattern to environmental allergens in a Japanese population.

We previously described the prevalence of allergen-specific IgE in a general population of Japanese adults. We sought to elucidate allergen sensitization patterns in this population. Serum samples had been obtained from 800 blood donors aged 20 to 59 years and living in Tokyo, Japan, in 2005 and stored in the Japanese Red Cross Society. These samples were examined for IgE levels, total and specific for 23 allergens or allergen sources correlated with allergic airway diseases using the ImmunoCAP method. Exploratory and confirmatory factor analyses were performed to uncover the relationship among allergen-specific IgE based on their titers. Hierarchical cluster analysis was executed using Ward's method based on standardized factor scores identified through factor analysis. Exploratory factor analysis revealed 6 categories of allergen-specific IgE: specific to 2 types of animals (insects and Dermatophagoides pteronyssinus/animal dander), 2 types of pollens (group 1 [Japanese cedar and cypress] and group 2 [alder, grass, and weeds]), and 2 types of microorganisms (fungi and commensal microorganisms on the skin). The Japanese population was categorized into 3 clusters: (A) nonatopic type, (B) house dust mite-dominant sensitization type, and (C) panatopic type. The panatopic group could be further classified into 2 subclusters positive and negative for fungal sensitization. This study demonstrated that a Japanese population could be divided into 3 clusters according to the sensitization pattern to 6 types of allergens.

Molecular Mechanisms of Scombroid Food Poisoning.

Scombroid food poisoning (SFP) is a foodborne disease that develops after consumption of fresh fish and, rarely, seafood that has fine organoleptic characteristics but contains a large amount of exogenous histamine. SFP, like other food pseudo-allergic reactions (FPA), is a disorder that is clinically identical to allergic reactions type I, but there are many differences in their pathogenesis. To date, SFP has been widespread throughout the world and is an urgent problem, although exact epidemiological data on incidence varies greatly. The need to distinguish SFP from true IgE-associated allergy to fish and seafood is one of the most difficult examples of the differential diagnosis of allergic conditions. The most important difference is the absence of an IgE response in SFP. The pathogenesis of SFP includes a complex system of interactions between the body and chemical triggers such as exogenous histamine, other biogenic amines, cis-urocanic acid, salicylates, and other histamine liberators. Because of the wide range of molecular pathways involved in this process, it is critical to understand their differences. This may help predict and prevent poor outcomes in patients and contribute to the development of adequate hygienic rules and regulations for seafood product safety. Despite the vast and lengthy history of research on SFP mechanisms, there are still many blank spots in our understanding of this condition. The goals of this review are to differentiate various molecular mechanisms of SFP and describe methods of hygienic regulation of some biogenic amines that influence the concentration of histamine in the human body and play an important role in the mechanism of SFP.

Medical and social assessment of the quality of life of a family with a child suffering from food allergy

Food allergy (FA) is a health problem that adversely affect the quality of life of children and their family members. The purpose of the study was to assess the quality of life in families with children affected FA. Material and methods. A cross-sectional study was conducted in a group of 75 children with a confirmed FA (at the age of Me 4.9 years [1.3; 7.1]). One of the caregivers of the child was asked to complete the Russian version of a specialized questionnaire «The Food hypersensitivity famiLy ImPact, FLIP» for assessing the life quality of families with children affected FA. Results. Diet organization is the main concern affecting quality of life, while the daily life of the family and the emotional sphere are less impacted. Age, type of food allergens and clinical manifestations do not significantly contribute the life quality indicators. Hypersensitivity to several food is statistically associated with changes in everyday life and emotions. Non-compliance with the diet is associated with a lower impact of FA on quality of life. 56% of respondents worried about the nutritional value of child's diet and 49.3% of caregivers reported that a child's FA significantly impacted grocery shopping behaviors (reading labels, etc.). At the same time, 73.3% noted that child's FA does not affect the diet of other family members. Also, 33.3% of the parents experienced anxiety due to child's FA and 38.7% are worried that FA might stay persistent. 30.7% of respondents are afraid of accidental consuming of allergenic products. Conclusion. The acquired results indicate the importance of quality of life assessment for understanding the social aspects of FA. Strategies to improve the quality of life include the development of informational and educational programs both for parents and patients. In order to estimate impact of FA to life quality from the patient's perspective further development of questionnaires adapted for children and adolescents is necessary.

Allergic adverse reactions in children following tuberculosis chemotherapy

Introduction. Tolerability of anti-TB chemotherapy in children is an urgent problem. The study is devoted to the characteristics of adverse reactions (AR) of an aller-gic type (allergic and toxic-allergic) and the factors con-tributing to their occurrence. Materials and methods. The retrospective study included 146 children aged 0 to 14 years with respiratory TB who received TB chemo-therapy, including 22 children with multidrug-resistant agent contact (MDR-TB). The spectrum of clinical and laboratory manifestations of АRs, frequency, risk factors were studied. Results. ARswith an allergic component were observed in 54 (37.0%) children, among them allergic in 32 (21.9%) and toxic-allergic in 22 (15.1%). The most common allergic reaction was asymptomatic eosinophilia (81.2%), in other cases, a combination of eosinophilia with dermatitis or only skin manifestations. A mild degree of eosinophilia prevailed, but in 3 patients it was severe (more than 20% of eosinophils in the leuk-ogram). In toxic-allergic reactions, signs of allergy were combined with an increase in liver enzymes in 59.0% of children, less often with other disorders. It was found that the early age of children, complicated course of TB, MDR-TB regimen, hyperergic skin tests do not increase the chance of developing allergic ARs. A burdened aller-gic history increases the chance of allergic АR to anti-TB drugs 2.8 times, and the presence of a primary affect in the lung 3.1 times. Temporary discontinuation or re-placement of drugs was required much more often in toxic-allergic reactions — 40.9% than in allergic ones — 18.7% (р &lt;0.05). Allergic and toxic-allergic reactions were reversible. Conclusion. In the development of АRs to anti-TB drugs in children, the allergic factor is of sig-nificant importance. The creation of laboratory methods for diagnosing allergic reactions to anti-TB drugs would be useful

Erythrodermic Atopic Dermatitis Associated with Dust Mite and Alternaria alternata in an Eight-Year-Old Child: A Case Report

Atopic Dermatitis (AD) is a chronic inflammatory condition of the skin characterised by itching, recurrent lesions, and lichenification. Erythroderma also known as generalised exfoliative dermatitis, is characterised by erythema that covers more than 90% of the body’s surface. These erythematic lesions are much more prone to infection. In present case, an eight-year-old girl presented with a chief complaint of rashes all over the body with severe itching from two years presented to the Allergy and Asthma Centre. She had positive history of atopy and multiple septicaemia-related hospitalisations since last two years. Skin biopsy leads the diagnosis of Spongiotic Dermatitis consistent with Erythroderma secondary to AD. Multiple allergies, including those to dust mites (DP der p2, p21, DF der f2) and Alternaria alternata (alt 1), were identified by Component-Resolved Diagnosis (CRD). Cyclosporin’s, Omalizumab (a monoclonal antibody against immunoglobulin E), and allergen-specific sublingual immunotherapy were given for the management and all gave excellent results in the patient. AD can be properly diagnosed and treated in its early stages, breaking the cycle that leads to severe erythroderma. To fully comprehend the molecular and immunological genesis of these allergic types, more research is required.

Significance of total and specific IgE in asthma of Iraqi adult patients

A case-control retrospective study was conducted during January – June 2019 on 104 patients with asthma (50 females and 54 males) and 111 non-asthmatic healthy subjects matched patients for gender (54 females and 57 males) to assess role of total and specific IgE serum levels in patho-physiology of disease using ELISA and multiplex immunoblot kits. The mean age ± standard deviation of asthma patients was 37.9 ± 12.1 years, while it was lower among control (35.9 ± 10.5 years), but the difference was not significant. Males and females were similarly distributed among asthma cases (48.1 and 51.9%, respectively) and control (48.6 and 51.4%, respectively). Most of asthma cases were observed to have mild disease (49%), followed by moderate and severe asthma (93.4 and 11.5%, respectively). It was also observed that 51.9% of patients had a family history of asthma. With respect to allergen type, 21.2% of asthma cases were seropositive for mixed types of allergens. Median level of total IgE was significantly (p &lt; 0.001(elevated in sera of asthma cases (204.1 ng/ml) compared to control subjects (163.3 ng/ml). The level positively paralleled the severity of disease. The highest level was observed in severe cases (244.9ng/ml, while the lowest level was recorded in mild cases (189.7 ng/ml). The level of specific IgE showed some variations among asthma cases distributed according to the type of allergen, the highest median was recorded in seronegative cases (215.2 ng/ml), while a lowest level was observed in cases seropositive for animal dander (189.3 ng/ml). Logistic regression analysis revealed that total asthma patients, as well as male and female cases were at an increased risk to develop asthma episodes due to elevated serum level of IgE.ROC analysis demonstrated that elevated serum level of IgE occupied a significant (p = 0.001) area under curve (AUC), which was 0.828. In conclusion, the present study confirms the significant role of total and specific IgE in patho-physiology of bronchial asthma and its correlation with disease severity and allergen type in adults

Drug-Induced Rhinitis: Narrative Review.

Rhinitis, one of the most common inflammatory conditions of the nasal mucosa, is known to affect a large proportion of people worldwide. It is generally classified into allergic and non-allergic types and both are associated with several unpleasant symptoms. Several medications prescribed for different medical conditions can cause unpleasant rhinitis as an adverse effect, which is known as drug-induced non-allergic rhinitis. The aims of this article were to review the literature to identify drugs that could induce rhinitis, prevalence of drug-induced rhinitis, and the associated pathogenic mechanisms if known. Literature search screening for eligible papers published up to December 31st, 2021, in Medline (via PubMed) and Embase was conducted. The search included the following combination of keywords and terms: rhinitis, sneezing, congestion, allergic, non-allergic, rhinorrhea, vasomotor, medication, drug-induced. The review findings suggest that 12 subtypes of drugs potentially could induce rhinitis. Based on their mechanisms of action, the pathogenic causes for the induction of rhinitis have been recognized for some drugs, while others remain unknown. Awareness of the list of drugs that reportedly induce non-allergic nasal symptoms, along with taking the patient's medication history, is important in the diagnosis of rhinitis.