Allergic Background Research Articles

38 Young Children With Recurrent Infection and Allergic Background Have Inadequate Baseline Pneumococcal Antibodies

38 Young Children With Recurrent Infection and Allergic Background Have Inadequate Baseline Pneumococcal Antibodies

IgG from Dermatophagoides pteronyssinus (Der p)-atopic individuals modulates non-atopic thymic B cell phenotype (alfa-4/beta-7) and cytokine production (IFN-γ, IL-9, and IL-10) with direct membrane interaction

Studies about thymic B cells are scarce in the literature, but it was suggested that they can exert modulatory and regulatory functions on the immune system. Thymic B cells can play some role in regulating the most frequent allergic background worldwide, the atopy induced by the mite Dermatophagoides pteronyssinus (Der p). Here, we aimed to evaluate if the polyclonal IgG repertoire produced by Der p-atopic individuals can influence the homing and cytokine profile of human thymic B derived from non-atopic children aged less than seven days. With this purpose, we produced polyclonal IgG formulations and cultivated human thymocytes in their presence. We also assessed IgG subclasses and the direct interaction of IgG with thymic B cell membranes. Our results could demonstrate that Der p-atopic IgG could not reduce the expression of α4β7 homing molecule as observed in response to the other IgG formulations and could reduce the frequency of IFN-γ- and IL-9-producing thymic B cells compared to the mock condition. Der p-atopic IgG could also induce thymic IL-10-producing B cells compared to control conditions. The IgG derived from Der p-atopic individuals failed to diminish the population of IL-13-producing thymic B cells, unlike the reduction observed with other IgG formulations when compared to the mock condition. All IgG formulations had similar levels of IgG subclasses and directly interacted with thymic B cell membranes. Finally, we performed experiments using peripheral non-atopic B cells where IgG effects were not observed. In conclusion, our observation demonstrates that IgG induced in allergic individuals can modulate non-atopic thymic B cells, potentially generating thymic B cells prone to allergy development, which seems to not occur in mature B cells.

Plant-produced Der p 2-bearing bioparticles activate Th1/Treg-related activation patterns in dendritic cells irrespective of the allergic background.

Plant-produced Der p 2-bearing bioparticles activate Th1/Treg-related activation patterns in dendritic cells irrespective of the allergic background.

Dermatite de Contato Alérgica Ocupacional a múltiplos agentes num Canalizador

Introduction Contact dermatitis can have an irritating or allergic background and are the most frequently encountered occupational dermatosis. Allergic Contact Dermatitis can be of occupational origin and most often affects the hands, wrists, and forearms. The occupational and clinical history is critical for its diagnosis. The relationship between the symptoms and work, identifying substances that may cause the dermatosis is important to perform epicutaneous tests. The initial stage of treatment consists of evicting the agent, which may include removing the worker from his workplace. Early and appropriate treatment is important to prevent further deterioration and persistence of skin lesions. Case Report 47-year-old man, a plumber for thirty years, and no relevant personal background. About seventeen years ago, he started erythematous, scaly, and fissured lesions on the dorsum of both hands and in the interdigital spaces, which he associated with his professional activity. Initially, he did not wear gloves when working with plastic pipes, glues, sealants, and other rubber and steel materials. With the appearance of the injuries, he began to use them, without improvement. However, he kept the injuries. Dermatology followed it, where it performed the first epicutaneous tests with positivity for the agent Isopropyl-N-Phenyl 4 Phenylenediamine, present in rubbers. Due to continued exposure to the agent present in his workplace, with consequent worsening of the skin lesions, he returned to the consultation. He carried out new epicutaneous tests that revealed new positivities: Paraphenylenediamine, Mixture of Thiurans and Colophony. These agents are present in his work, and the diagnosis of Occupational Allergic Contact Dermatitis was assumed. Discussion/ Conclusion Occupational Allergic Contact Dermatitis is associated with high personal and professional suffering, loss of earning capacity and decreased productivity. Given the multiplicity of sensitized agents, this case was a challenge for Occupational Health, as it was present in various work materials and protective equipment. In this case, it was not possible to leave the workplace, which was not the option accepted by the worker, so the management of the case involved minimizing contact, giving preference to other types of materials, by reducing the time and intensity of exposure, using safer individual protection material, as well as using inner cotton gloves and outer vinyl gloves, in addition to concomitant pharmacological treatment. This case is also positive for other agents due to cross-reactivity, as well as the multiplicity of reactions that was partly caused by the continuous injury to the skin. Keywords: Allergic Contact Dermatitis; Isopropyl-N-Phenyl 4 Phenylenediamine; Paraphenylenediamine; Tiurans; Colophony.

Administration of BNT162b2 mRNA COVID-19 vaccine to subjects with various allergic backgrounds.

The mRNA-based COVID-19 vaccine was introduced to the general public in December 2020. Shortly thereafter, safety concerns were raised due to the reporting of allergic reactions. Allergy-related disorders were suspected to be significant risk factors and the excipient polyethylene glycol was suggested to be a robust allergen. This is a retrospective study analysis. Subjects with putative risk factors for severe allergic reactions to the Pfizer-BioNTech BNT162b2 vaccine were referred for vaccination under observation at the Unit of Allergy and Clinical Immunology. Data was collected for each subject, including demographic details, medical history and previous reactions to any allergen. When appropriate, skin tests were done prior to vaccination. A total of 346 subjects received 623 vaccine doses under observation. The study included patients with various allergy-related disorders (n=290) and those with allergy to a previous COVID-19 vaccine dose (n=56). Both groups showed female predominance (78% and 88%, p=NS). Patients without reactions to previous doses reported more drug allergy (80% vs. 39%, p<0.001) and previous anaphylaxis (64% vs. 14%, p<0.001). There was no difference in sensitivity to other allergens, including polyethylene glycol. Under observation, mild allergic reactions were noted in 13 individuals characterized by female gender (100%), a history of anaphylaxis (69%) and drug allergy (62%). In 7 subjects, allergy was treated with antihistamines while others recovered spontaneously. Our study demonstrates that vaccination under specialist-supervision is a powerful tool for reducing over-diagnosis of systemic reactions and for rapid and reliable collection of vaccine safety data.

A Dermocosmetic Significantly Reduces the Frequency and Intensity of Facial Skin Intolerability and Sensitivity in Subjects with Skin Intolerant to Skin Care Products and Sensitive Skin.

Intolerance to dermocosmetics is frequent in subjects with allergic contact dermatitis (ACD). A dermocosmetic (DC) was developed to restore the natural skin barrier, to reduce skin inflammation and to improve sensitive skin in ACD. To assess the benefit of a DC in subjects with an allergic background and intolerance to cosmetic care, or with sensitive skin. In this open-label study, 107 subjects above 16 years of age applied DC on the face twice a day for 28 days. Assessments at Days 0, 14 and 28, included skin sensitivity, stinging test, local tolerance, transepidermal water loss (TEWL), skin hydration, inflammatory biomarkers (IL-1α, IL-1RA, PGE2) using tape stripping and subject satisfaction. 88% were women and mean age was 42.0±15.0 years. Skin sensitivity at inclusion scored 5.9±0.35; 46% had ACD, 95% skin irritation, 92% sensitive skin and 88% intolerance to cosmetics. A significant (p<0.0001) 85% decrease of frequency and intensity of the composite score was observed at both endpoints. Stinging scores significantly (p<0.0001) decreased from 3.9 at baseline to 2.4 at Day 14 and 1.4 at Day 28; 77% and 81% of subjects reported improved skin reactivity at Day 14 and Day 28, respectively. Similar improvements were noted in the frequency and intensity of irritation, erythema, stinging, burning and discomfort. TEWL, skin hydration and inflammatory biomarker levels significantly (p<0.0001) improved. Overall subject satisfaction (85%) and tolerance (investigators: 99%, subjects: 97%) were high. DC significantly reduced the frequency and intensity of facial skin intolerability and sensitivity in subjects with skin intolerant to skin care products. NCT05487937.

Heart Rate Variability in Subjects with Severe Allergic Background Undergoing COVID-19 Vaccination

Anti-Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) vaccination is the world's most important strategy for stopping the pandemic. Vaccination challenges the body's immune response and can be complicated by hypersensitivity reactions. The autonomic nervous system can modulate the inflammatory immune response, therefore constituting a potential marker to characterize individuals at high risk of hypersensitivity reactions. Autonomic nervous system functionality was assessed through measurement of the heart rate variability (HRV) in subjects with a history of severe allergic reactions and 12 control subjects. HRV parameters included the mean electrocardiograph RR interval and the standard deviation of all normal R-R intervals (SDNN). All measurements were performed immediately before the anti-SARS-CoV-2 vaccination. The median RR variability was lower in the study than in the control group: 687 ms (645-759) vs. 821 ms (759-902); p = 0.02. The SDNN was lower in the study group than in the control group: 32 ms (23-36) vs. 50 ms (43-55); p < 0.01. No correlation was found between age and the SDNN. Autonomic nervous system activity is unbalanced in people with a severe allergy background.

Lyophilized amniotic membrane for corneal ulcer and post operative cross‐linking

AbstractPatients with progressive keratoconus, especially in the early part of life, may benefit from crosslinking to accelerate the polymerization of corneal collagen, thus increasing the biomechanical strength of the cornea. The reference crosslinking protocol, recognized as the most effective in stabilizing the disease, corresponds to a classic crosslinking protocol with de‐epithelialization (epi off). This technique is pro‐inflammatory in patients who often have associated allergic keratoconjunctivitis. It is also painful postoperatively despite the systematic application of a dressing lens since it requires corneal de‐epithelialisation. The allergic background can lead to delays in healing with postoperative infections. Amniotic membranes have already been used in post refractive surgery. Their application in post‐crosslinking protocol epi off, directly on the patient's cornea without suture under a therapeutic contact lens, would reduce the intensity of pain after the procedure, complications such as infectious keratitis, sterile infiltrates, superficial or deep haze, aseptic corneal necrosis (thinning and fibrosis, perforation described), endothelial damage due to probable excessive free radical toxicity (reversible corneal decompensation or requiring a corneal graft), delayed epithelial healing (association of dry syndrome or blepharitis) and viral reactivation (Herpes Simplex virus or HSV). The amniotic membrane by its anti‐angiogenic, healing, anti‐inflammatory and anti‐infectious properties seems to have a decrease in post‐operative pain and an acceleration of corneal epithelial healing as in superficial corneal ulcers.

Spatio-temporal modeling of airborne pollen concentrations

Keywords: Pollen, Machine Learning, Allergic Disease Abstract Background and aim High concentrations of airborne pollen trigger seasonal allergies and possibly severe adverse respiratory and cardiovascular health events. Predicting pollen concentration accurately is valuable for epidemiological studies to determine the effects on cardiovascular, respiratory, and cognitive health. We aimed to develop a spatiotemporal land-use regression model for pollen, predicting daily concentrations at a fine spatial resolution of 1x1km across Switzerland between 2003 and 2020. Methods Daily pollen concentrations for hazel, alder, ash, birch, and grasses were available from 14 sites. We considered a range of spatial (elevation, tree type), temporal (date, season, month, week and day of the year, national daily pollen concentration) and spatiotemporal predictors (wind speed, wind direction, temperature, precipitation, relative humidity, satellite-observed Normalized Difference Vegetation Index (NDVI), and land-use (CLC, Landsat satellite) to explain variation in total pollen concentration for five specific pollen species. We applied a range of feature engineering techniques to encode categorical variables (land-use) and fill in missing values (Landsat). We applied a random forest model with 5-fold cross-validation. Results The median grass pollen concentration was 24 pollen/m3 (P5-P95 range 0-187 pollen/m3) during the main grass pollen season (May-July for all years). Preliminary results of a model predicting grass pollen concentration achieved an overall R2 of 0.74 and a root mean squared error (RMSE) of 24.12 pollen/m3 (cross-validation). Temperature, humidity, wind speed, NDVI, Landsat, average national daily pollen concentration and date features were the most important predictors for grass pollen concentration. Conclusions Building upon national observed pollen concentrations and using random forest machine learning, these spatiotemporal pollen models will serve to estimate individual residential pollen exposure. Resulting estimates will enable us to study respiratory and cardiovascular mortality and hospital admissions using historical data from the Swiss National Cohort and the Swiss Federal Office of Statistics.

Association of self-reported allergic rhinitis with dengue severity: A case-control study

BackgroundThe severity of dengue infection has been reportedly associated with patients’ allergic reactions. To further elucidate the role of allergy in dengue severity, we conducted a matched case-control study to assess the association between allergic background and dengue shock syndrome. MethodsThis is a matched case-control study that was carried out in the Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam from January to December 2017. Dengue infection was determined by non-structure protein 1 (NS1) diagnostic quick test or anti-dengue antibodies (IgM). The total and dengue-specific IgE levels were measured using ELISA. Patients’ demographics, clinical, and allergic profiles were collected using a structured questionnaire. ResultsA total of 572 dengue patients with positive NS1 (92.7%) or IgM antibodies (7.3%) results were included in this study. Of these patients, 143 patients developed dengue shock syndrome (case group) while the other 429 patients did not (control group). None of the baseline characteristics including age, sex, or being overweight was significantly different between the two groups (p>0.05). In multivariable analysis, having a history of dengue infection (OR=3.35, 95% CI: 1.8–6.17, p<0.001) and allergic rhinitis (OR=1.95, 95% CI: 1.11–3.4, p = 0.019) were found to be associated with dengue shock syndrome. Higher levels of dengue-specific IgE were not associated with worse outcomes in patients with allergies (p = 0.204) or allergic rhinitis (p = 0.284). ConclusionDengue patients presenting with a history of a previous dengue infection or allergic rhinitis should be considered high-risk patients for the development of dengue shock syndrome.

Unusual ascites post laparoscopic cholecystectomy in old patient: Case report and review of the literature.

IntroductionAscites that precede laparoscopic cholecystectomy is an infrequent event. Its actual mechanism is not identified, but an inflammatory or allergic peritoneal reaction has been proposed. It can a life-threatening or an acute serious condition; for instance, the bile duct or other visceral injuries are eliminated.Case presentationWe present a 83 years old, medically free, who presented with fever and right upper quadrant pain. Diagnosed with severe acute calculus cholecystitis. Diagnostic laparoscopy and laparoscopic cholecystectomy were done, with copious irrigation of the abdomen. Postoperatively, patient started to had tense with moderate tenderness abdomen. Drain output showed clear ascites fluid. Postoperative ascites culture returned back as negative. Ascites treated conservatively with fluid restriction and furosemide. As per our knowledge, this is the fourth case that was reported in the literature of medicine.DiscussionThis was a particular case related to ascites which emerged without any known cause. The medical history of a powerful allergic background is can be the reason for transudative ascites that take place following an uneventful, occasional laparoscopic cholecystectomy. There was a presumed abnormal peritoneal or allergic reaction to the diathermy. No specific aetiological aspect was known irrespective of an extensive search being carried out.ConclusionIn cases of idiopathic post-laparoscopic ascites, general care and support is needed and fluid restriction and possible diuretic might be needed with no need for surgical intervention. Further studies are recommended for understanding of the pathophysiology of the disease.

Immunodepressive and pathogenetic mechanisms in infectious allergy

The incidence of infectious allergy has been growing mainly due to infection with Staphylococcus aureus, Streptococcus pneumoniae, Klebsiella pneumoniae, with enhancing allergic background by yeast-like fungi of the genus Candida. The frequency of infection has currently become a threat without tending to decline. Undoubtedly, Staphylococcus aureus is a pathogenic species producing highly powerful exotoxins exerting properties of cytolysin capable of disrupting the integrity of any cell wall, destroying epithelial cells, damaging mucous membranes in any organ, including the intestines, wherein it becomes accumulated at any location of staphylococcal inflammation. At the same time, almost 90% of cases of allergic reactions are diagnosed with atopic dermatitis because IgE level in some cases of infectious allergy is increased. The mechanism of the pathogenetic action of reagins is realized by re-binding of antigens to IgE fixed on mast cell and basophil surface resulting in FcR1 cross-linking and release of vasoactive mediators responsible for developing early phase of allergy. IgE concentrations, accounting for only 0.002% of the total blood immunoglobulins in an apparently healthy person, may remain low in atopic bronchial asthma, atopic dermatitis, allergic rhinoconjunctivitis, etc. IgE level is increased not only in atopy, but also in oncopathology, autoimmune diseases, whole body cooling and IgA deficiency. In allergic reactions, an increased level in the extracellular pool of various receptor structures is recorded. Of interest is a comparative analysis of the ratio between frequency of IgE reactions and CD23 shedding in infectious allergies of various etiology. The aim of the study is to establish a role of the CD23 extracellular pool in pathogenetic mechanisms of infectious allergy. There were examined 678 subjects who were at apparently healthy state at the time of the examination, including 545 females and 133 males, as well as 1481 patients with verified infectious allergy who live in the Arkhangelsk Region. It has been established that patients with staphylococcal infection had markedly aggravated symptom complex of pathological reactions linked to anemia, neutropenia and deficiency of phagocytic protection. Pathological reactions in infectious allergies are accompanied by sharply increased level of sCD23 with its abnormally high concentrations ( 200 ng/ml) found in 51.7% of cases paralleled by increased level of serum IL-10 and reagins in 21.43 and 35.7% cases, respectively, along with phagocytic defense deficit observed in 85.7% as well as accumulation of CEC in 92.86%. A parallel increase in level of sCD23 and IgE is associated with increased percentage of T helpers, cytotoxic T lymphocytes, activated T cells expressing IL-2 receptor, along with upregulated of the MHC II molecules.

Loss of isoprenylation significantly reduces IgE mediated mast cell activation

Abstract Allergic disease is the 6th leading cause of chronic illness in the US and accounts for billions of dollars in healthcare costs annually. Mast cells are tissue resident innate immune cells linked to allergic disease and activated by IgE and other ligands. Upon activation they release histamine, cytokines, chemokines, proteases, and lipid mediators evoking allergic symptoms. New ways of targeting mast cells could greatly benefit allergic disease therapy. Previous findings showed repurposing of statin drugs, such as Fluvastatin, reduced allergic symptoms in vitro and in vivo. We found that Fluvastatin suppresses IgE-mediated mast cell activation by inhibiting isoprenylation of proteins. However, statin effects were dependent on genetic background. To avert genetic background dependency, we tested the hypothesis that a dual farnesyl and geranylgeranyl transferase inhibitor (FGTI 2734) would suppress allergic disease withoutgenetic background limitations. We show that FGTI 2734 reduced IgE-mediated degranulation and cytokine production by bone marrow derived mast cells from multiple genetic backgrounds. Similarly, FGTI 2734 also suppressed IgE-mediated anaphylaxis on multiple genetic backgrounds. These in vivo effects extended to an allergic asthma model, in which FGTI 2734 inhibited pulmonary inflammation. Finally, we show that FGTI-2734 can significantly reduce IgE-induced cytokine production from human skin mast cells. These data show that dual farnesyl and geranylgeranyl transferase inhibitors may be an effective therapeutic treatment for mast cell-associated diseases. Supported by NIH (1RO1AI101153)

Successful Desensitization to mRNA COVID-19 Vaccine in a Case Series of Patients With a History of Anaphylaxis to the First Vaccine Dose.

BackgroundCoronavirus disease 2109 (COVID-19) vaccines have recently been approved to curb the global pandemic. The risk of allergic reactions to the vaccine polyethylene glycol (PEG) component has raised significant public concern. Desensitization is suggested in cases of vaccine related hypersensitivity reactions. After comprehensive literature review on the topic, our aim was to establish a safe and effective desensitization protocol for patients with suspected or confirmed immediate type hypersensitivity reactions to the COVID-19 vaccine.MethodsParticipants were referred to the McGill University Health Center (MUHC) Allergy-Immunology department for clinical evaluation following a reported reaction to their first dose of Moderna® mRNA-1273 or Pfizer-BioNTech® BNT162b2 vaccines. They underwent skin prick testing (SPT) with higher and lower molecular weight (MW) PEG and polysorbate 80, as per published protocols. Their second dose was administered following a desensitization protocol consisting of multiple dose-administration steps followed by a 60-min observation period.ResultsAmong a cohort of 142 patients with an increased risk for allergic reactions to the COVID-19 vaccines, six individuals were selected to undergo desensitization. All were female with allergic background including chronic spontaneous urticaria, anaphylaxis to medications, and/or vaccines. The main symptom after their first dose was difficulty swallowing with lightheadedness or immediate urticaria, angioedema, and/or dizziness. Two patients had positive skin testing. One patient was on chronic antihistamines which resulted in an inconclusive PEG skin test and the skin testing was negative for the three other patients. During the desensitization, two patients reported cutaneous symptoms of an immediate reaction and were managed with antihistamines. One of these patients also complained of ear pressure and had a drop in her systolic blood pressure, treated with intravenous fluids.ConclusionThis study suggests that some individuals with an immediate-type hypersensitivity reaction to their first dose of mRNA COVID-19 vaccine may safely receive their second dose using a desensitization protocol. The success of this desensitization protocol is a step forward in the fight against COVID-19, allowing more individuals to be immunized.

C5 and SRGAP3 Polymorphisms Are Linked to Paediatric Allergic Asthma in the Italian Population.

Asthma is a complex and heterogeneous disease, caused by the interaction between genetic and environmental factors with a predominant allergic background in children. The role of specific genes in asthmatic bronchial reactivity is still not clear, probably because of the many common pathways shared with other allergic disorders. This study is focused on 11 SNPs possibly related to asthma that were previously identified in a GWAS study. The genetic variability of these SNPs has been analysed in a population of 773 Italian healthy controls, and the presence of an association between the polymorphisms and the asthma onset was evaluated performing genotyping analysis on 108 children affected with asthma compared with the controls. Moreover, a pool of 171 patients with only allergic rhinoconjunctivitis has been included in the case–control analysis. The comparison of allele frequencies in asthmatic patients versus healthy controls identified two SNPs—rs1162394 (p = 0.019) and rs25681 (p = 0.044)—associated with the asthmatic condition, which were not differentially distributed in the rhinoconjunctivitis group. The rs25681 SNP, together with three other SNPs, also resulted in not being homogenously distributed in the Italian population. The significantly higher frequency of the rs25681 and rs1162394 SNPs (located, respectively, in the C5 and SRGAP3 genes) in the asthmatic population suggests an involvement of these genes in the asthmatic context, playing a role in increasing the inflammatory condition that may influence asthma onset and clinical course.

The effect of allergy and asthma as a comorbidity on the susceptibility and outcomes of COVID-19.

The coronavirus disease 2019 (COVID-19) pandemic causes an overwhelming number of hospitalization and deaths with a significant socioeconomic impact. The vast majority of studies indicate that asthma and allergic diseases do not represent a risk factor for COVID-19 susceptibility nor cause a more severe course of disease. This raises the opportunity to investigate the underlying mechanisms of the interaction between an allergic background and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The majority of patients with asthma, atopic dermatitis, allergic rhinitis, chronic rhinosinusitis, food allergies and drug allergies exhibit an over-expression of type 2 immune and inflammatory pathways with the contribution of epithelial cells, innate lymphoid cells, dendritic cells, T cells, eosinophils, mast cells, basophils, and the type 2 cytokines interleukin (IL)-4, IL-5, IL-9, IL-13, and IL-31. The potential impact of type 2 inflammation-related allergic diseases on susceptibility to COVID-19 and severity of its course have been reported. In this review, the prevalence of asthma and other common allergic diseases in COVID-19 patients is addressed. Moreover, the impact of allergic and non-allergic asthma with different severity and control status, currently available asthma treatments such as inhaled and oral corticosteroids, short- and long-acting β2 agonists, leukotriene receptor antagonists and biologicals on the outcome of COVID-19 patients is reviewed. In addition, possible protective mechanisms of asthma and type 2 inflammation on COVID-19 infection, such as the expression of SARS-CoV-2 entry receptors, antiviral activity of eosinophils and cross-reactive T-cell epitopes, are discussed. Potential interactions of other allergic diseases with COVID-19 are postulated, including recommendations for their management.

Efficacy of a rational algorithm to assess allergy risk in patients receiving the BNT162b2 vaccine

Among 6146 hospital employees, 118 subjects with severe allergic background were identified through a screening questionnaire and stratified into 3 groups (Low-risk (LR), Intermediate (IR) and High-risk (HR) group), based on their allergic anamnesis.Data reports on hypersensitivity reactions (HypR) have been collected in both allergic and non-allergic subjects. Seventeen patients (14%) in the allergic population had a HypR after the first, the second or both doses. Skin manifestations were the most frequent ones. Allergic events were more frequent in HR (35%) than IR (10%; p = 0.005) or LR (0%; p = 0.074) subjects. No patient had anaphylaxis. All patients completed the vaccination schedule.13 HypR occurred in patients without severe allergic background (13/6028, 0,2%) including one (1/6148, 0.016% of total population) WAO grade-4 anaphylaxis.Our data suggest that BNT162b2 mRNA Covid-19 vaccine is relatively safe also in patients with severe allergic background; however, some precautions are required for high-risk patients.

Епідеміологія кліщових та поєднаних із ними харчових алергій серед дитячого населення Рівненської області

Актуальність. Визначальним при вивченні ризиків розвитку в дітей поєднаних кліщових і харчових алергій є їх епідеміологічна нестабільність у світі, країні, Рівненській області зокрема внаслідок зростання тригерного навантаження, одним із найбільш потужних чинників якого є алергени кліщів побутового пилу. Мета дослідження — проведення епідеміологічного моніторингу особливостей взаємного впливу кліщових та харчових алергій на імунологічні механізми серед дітей Рівненської області та контамінації середовища життєдіяльності людини кліщами побутового пилу. Матеріали та методи. За період 2007–2017 рр. амбулаторно та санітарно-паразитологічно обстежено 410 вогнищ харчових алергій у різних вікових групах із дослідженням акарофауни в них. Результати. У зразках побутового пилу з вогнищ харчових та кліщових алергій визначено представників 8 видів 4 родин алергенних кліщів, із них паразитологічно й імунологічно встановлений патогенний вплив видів Dermatophagoides pteronyssinus, Dermatophagoides farinae, Acarus siro та Glycyphagus domesticus на сенсибілізацію дитячого населення. У 91 % дітей 0–3 років діагностована лише харчова IgE-опосередкована алергія, вплив кліщів побутового пилу на алергічні процеси не доведений. Зі збільшенням віку сенсибілізованих дітей спостерігалось зростання лабораторно ідентифікованих IgE-залежних харчових алергій — від 68 % у групі 3–6 років до 88 % у підлітків 10–14 років, переважно полівалентного типу. Аналогічно від 32 % дітей 3–6 років до 54 % підлітків 10–14 років мали встановлену й підтверджену кліщову алергію, що вказує на роль кліщів побутового пилу у формуванні й підтримці генералізованих форм атопічних реакцій. Висновки. Епідеміологічна ситуація серед дитячого населення території Рівненської області з харчових і кліщових алергій визначена як нестабільна; здійснений ситуаційний аналіз імунологічного стану дитячого населення віком 0–14 років із кліщових та харчових алергій, прослідкована роль стану забруднення навколишнього середовища кліщами побутового пилу як фактора створення високого алергізуючого фону.

Occupational Allergies in Dentistry: A Cross-Sectional Study in a Group of French Dentists

Background: Dentists have a high risk of developing occupational allergies due to their repeated exposure to many professional allergens. The aim of this cross-sectional study was to assess occupation-related allergies in a group of French dentists and to determine the main associated risk factors. Methods: A self-administered questionnaire about allergies, particularly occupational allergies, was published online in a private group dedicated to French dentists. Results: Data from 584 French dentists were collected; 50.3% of the respondents presented allergies and 13.4% presented occupation-related allergies. Regarding professional allergens, natural rubber latex, cleaning products, and resins were the most frequently incriminated substances. Temporary interruption of activity was reported by 10.3% of individuals suffering from occupational allergies. Almost 65% of them used different reliever medications for the management of acute exacerbations, but maintenance treatment was implemented in only 34.6% of cases. Having a general allergy was the first predictor of occupational allergies with an odds ratio of 7.49. Conclusions: The frequency and the impact of occupational allergies were significant among our study population of French dentists, particularly in those with an associated allergic background. Education and prevention programs are key measures to minimize risk.

Persistent diarrhea as manifestation of gastrointestinal food allergy in young children: diagnostic possibilities

Persistent diarrhea can be a sign of a number of medical conditions, including a gastrointestinal food allergy. Diagnosis in childhood is not very informative, since allergic diseases at this age often have a non-IgE-dependent mechanism of development. Objective. To study the diagnostic value of the fecal eosinophilic neurotoxin test for the diagnosis of gastrointestinal food allergy in young children with persistent diarrhea. Material and methods. The authors examined 70 young children (from 1 month to 3 years) with persistent diarrhea and 20 conditionally healthy children of the same age without burdened allergic background. They determined fecal eosinophilic neurotoxin levels in all children. The children were divided into 2 groups according to the results of this examination: Group with normal level of neurotoxin and Group with increased level of neurotoxin. Results. The physical development of children with persistent diarrhea with high levels of eosinophilic neurotoxin is often assessed as low or very low. With persistent diarrhea, blood and mucus in the stool was significantly more often detected in children with a high level of eosinophilic neurotoxin. Persistent diarrhea with an increased level of eosinophilic neurotoxin, was significantly more often combined with atopic dermatitis reflecting its allergic nature. The total IgE test turned out to be a highly specific marker of the allergic nature of persistent diarrhea, however, it has a low sensitivity and it is positive only in 26.3% of children with an increased eosinophilic neurotoxin. This fact confirms the non-IgE dependent pathogenetic mechanisms of gastrointestinal allergy. Conclusion: The study demonstrated a high differential diagnostic value of the eosinophilic neurotoxin test in the feces of children with persistent diarrhea. The authors revealed a statistical interconnection of a high level of eosinophilic neurotoxin and other markers of allergy. The results obtained substantiate the advisability of the eosinophilic neurotoxin test as a non-invasive method in the diagnosis of gastrointestinal food allergy.