Allergic Reactions In Patients Research Articles

Patterns of concomitant allergic reactions in patients suggest cross-sensitization between octylisothiazolinone and methylisothiazolinone.

Recent animal tests have indicated cross-reactivity between methylisothiazolinone (MI), octylisothiazolinone (OIT), and benzisothiazolinone (BIT). To retrospectively analyse concomitant reactions to different isothiazolinones in patients in an occupational dermatology clinic during the ongoing MI contact allergy epidemic. We searched patch test files (January 2012 to February 2017) for patients with allergic reactions to OIT, BIT, and MI, and analysed their patch test results, occupations, exposure, and diagnoses. We found 61 (9.4%) allergic reactions to MI, 19 (2.9%) reactions to OIT and 9 (1.4%) reactions to BIT in a total of 647 consecutively tested patients. Seventeen (89%) of the OIT-positive patients had concomitant reactions to MI, whereas only 3 (33%) BIT-positive patients had allergic reactions to MI. The MI reactions in OIT-positive patients were almost exclusively extreme reactions (+++). Exposure to OIT was identified in 26% of the OIT-positive patients, and 56% of the BIT-positive patients had been exposed to BIT. Allergic reactions to OIT were strongly associated with extreme reactions to MI, which suggests cross-sensitization. In contrast, BIT reactions were mostly independent.

Contrast-induced nephropathy and allergic reaction in patients who were given intravenous contrast material in emergency department.

Contrast-induced nephropathy and allergic reaction in patients who were given intravenous contrast material in emergency department.

Clinical-diagnostic Significance of Recognition of Specific Antibodies in Patients with Allergies to Metal Alloys Used in Prosthetic Dentistry

A comprehensive survey of 226 patients with an allergy to metal alloys applied in the clinic prosthodontics. In this study, the total Immunoglobulin E (IgE), specific IgE- and Immunoglobulin G (IgG) -antibodies to metal ions in serum and in mixed saliva were measured. In the mixed saliva no significant increasing in IgE-antibodies to metal ions has been revealed, IgG-antibodies to gold, cobalt, chromium, nickel, copper, palladium and platinum ions in low titers were defined in elderly patients. To predict the development of allergic reactions in patients with metal alloys prosthetic constructions, specific serum IgG-antibodies to metal ions that characterize the frequency of contact with the allergen were measured. The content of specific IgE-antibodies to metal ions in serum measured to recognize a primary response to allergens (no history of contact with the metal alloys used in prosthetic dentistry). The investigation of specific IgE- and IgG-antibodies to metal ions in serum has shown the largest number of positive tests to copper (11.3%), gold (10.8%), cobalt (9.9%) and nickel ions (9.3%). The verification of clinical and diagnostic significance of revealing specific antibodies to metal ions in patients with allergies to metal alloys used in prosthetic dentistry, showed that the use of these methods is an auxiliary diagnostic tool and it can only be interpreted in conjunction with the results of clinical examination of the patients.

Role of IgE in autoimmunity

There is accumulating evidence to suggest that IgE plays a significant role in autoimmunity. The presence of circulating self-reactive IgE in patients with autoimmune disorders has been long known but, at the same time, largely understudied. However, studies have shown that the increased IgE concentration is not associated with higher prevalence for atopy and allergy in patients with autoimmune diseases, such as systemic lupus erythematosus. IgE-mediated mechanisms are conventionally known to facilitate degranulation of mast cells and basophils and promote TH2 immunity, mechanisms that are not only central to mounting an appropriate defense against parasitic worms, noxious substances, toxins, venoms, and environmental irritants but that also trigger exuberant allergic reactions in patients with allergies. More recently, IgE autoantibodies have been recognized to participate in the self-inflicted damaging immune responses that characterize autoimmunity. Such autoimmune responses include direct damage on tissue-containing autoantigens, activation and migration of basophils to lymph nodes, and, as observed most recently, induction of type 1 interferon responses from plasmacytoid dendritic cells. The importance of IgE as a central pathogenic mechanism in autoimmunity has now been clinically validated by the approval of omalizumab, an anti-IgE mAb, for patients with chronic spontaneous urticaria and for the clinical benefit of patients with bullous pemphigoid. In this review we summarize recent reports describing the prevalence of self-reactive IgE and discuss novel findings that incriminate IgE as central in the pathogenesis of inflammatory autoimmune disorders.

In vitro analysis of volume-reduced washed platelet concentrates stored in bicarbonated Ringer's solution containing less than 5% residual plasma.

Volume-reduced washed platelet (PLT) concentrates (PCs) can prevent circulatory overload and allergic reactions in patients undergoing PLT transfusions. For these reasons, they are in demand for paediatric settings and for patients at risk of circulatory overload. Here, we evaluated the quality of volume-reduced washed PCs stored for 5 days in a novel acetate-free PLT additive solution (PAS) containing glucose and bicarbonate (BRS-A) with <5% residual plasma protein. PCs from two apheresis donations were mixed and divided equally into control and test units. For the test unit (volume-reduced washed PCs), PLTs were washed and stored in 90 ml BRS-A with <5% plasma protein. PLTs in the control unit were stored in 200 ml 100% plasma without any washing manipulations. The in vitro properties of PLTs in both units were compared over a 5-day storage period. The procedure for volume-reduced washed PCs effectively removed >98% plasma protein in 100% plasma PCs and yielded an approximately twofold lower mean volume (91 ml) compared to that observed with the control units. Immediately after washing, the mean PLT concentration of the test units was 20·5 × 10(11) /l, twofold higher than that of the control units. The pH (37°C) levels in the test unit remained above 7·0 for 5 days. Glucose consumption and lactate production rates of the test units on days 1-3 were higher than those of the control units, leading to glucose exhaustion in the test unit by Day 3. Hypotonic shock responses and CD62P and CD42b expression levels in both units were comparable during 5-day storage. Considering the pH buffering capacity of BRS-A, a 90-ml volume may be acceptable for maintaining the in vitro quality of washed PLTs for at least 2 days.

Digitally Analyzed Conjunctival Redness: Does Repeated Conjunctival Provocation Intrinsically Cause Local Desensitization of the Eye?

Background: Allergic reactions in patients with seasonal or perennial rhinoconjunctivitis mediated by airborne allergens can be effectively assessed with the conjunctival provocation test (CPT). The CPT is a fast and easy diagnostic procedure that challenges the ocular mucosa with instillations of allergen solutions into the conjunctival region. This paper aimed to investigate the possible influence of repeated diagnostic CPT procedures on the patient's clinical presentation, i.e. to analyze desensitization effects caused by diagnostic solutions and to show the reproducibility of CPT results. Methods: Treatment progress in 120 placebo-treated patients from 2 immunotherapeutic dose-finding studies was estimated and documented, as based on the CPT which was applied at 4 visits with intervals of 4, 8 and 16 weeks. High-resolution digital photos collected as part of the CPT documentation were analyzed by an external observer and by digital analysis software to determine conjunctival redness, completely independent of the subjectivity of investigators and patients. Results: Two extremal scenarios of the redness changes were considered after provocation with 10,000 standard quality units/ml. A maximal decrease of about 3% (t test: p = 0.0002; U test: p = 0.001) and a minimal decrease of about 1% (t test: p = 0.254; U test: p = 0.431) were found. Conclusions: The observed decrease in conjunctival hyperemia can be explained by local desensitization or by placebo effect. Due to the setup of both studies considered, we could not ascertain how these factors influence the decrease in redness. In order to attribute the observed effects to local conjunctival desensitization with certainty, further pilot studies are needed.

Sodium Cromoglycate Prevents Exacerbation of IgE-Mediated Food-Allergic Reaction Induced by Aspirin in a Rat Model of Egg Allergy

Background: Aspirin (ASP)-facilitated absorption of ingested allergens is considered an exacerbating factor in the development of food allergy. Sodium cromoglycate (SCG) is used for the treatment of atopic dermatitis with food allergy, but the efficacy of SCG in ASP-exacerbated food-allergy reactions is unclear. In this study, we evaluated the effect of SCG on ASP-exacerbated food-allergic reactions, as well as allergen absorption, in egg-allergic model rats. Methods: Plasma concentrations of ovalbumin (OVA) and fluorescein isothiocyanate-labeled dextran (FD-40), a marker for nonspecific-absorption pathways, were measured after oral administration of mixtures of OVA and FD-40 in OVA-unsensitized and OVA-sensitized rats. IgE-mediated allergic reactions were evaluated by measuring changes in rectal temperature and Evans blue dye (EBD) extravasation in the intestine and liver after oral challenge with OVA. The effects of ASP and SCG on such absorption and allergic reactions were also evaluated kinetically. Results: In OVA-sensitized rats, plasma concentrations of OVA and FD-40 were significantly higher than those in unsensitized rats after oral administration. ASP increased the intestinal absorption of OVA and FD-40 via the paracellular pathway, and a lower rectal temperature and higher EBD extravasation were detected in the intestine and liver of OVA-sensitized rats. SCG ameliorated these ASP-facilitated absorptions and allergic reactions in a dose-dependent manner. In particular, high-dose SCG (195.2 μmol/kg) completely inhibited these absorptions and reactions. Conclusion: SCG can prevent ASP-exacerbated allergic reactions in patients with food allergy resulting from inhibition of increases in allergen absorption.

β-Blocker premedication does not increase the frequency of allergic reactions from coronary CT angiography: Results from the Advanced Cardiovascular Imaging Consortium

Backgroundβ-Blockers are often used for heart rate control during coronary CT angiography (CTA). Increased frequency and severity of allergic reactions to radiocontrast media (RCM) have been reported with concomitant use of β-blockers. ObjectivesThe objectives of this study were to determine whether there is a higher incidence of allergic reactions to low-osmolar nonionic RCM in patients undergoing coronary CTA with concomitant β-blockers and to define the overall incidence and severity of allergic reactions in patients undergoing coronary CTA with and without a history of allergy to RCM. MethodsPatients undergoing coronary CTA at 47 institutions participating in the Advanced Cardiovascular Imaging Consortium registry were analyzed. The incidence and severity of allergic reactions were compared between those patients who did and those who did not receive β-blockers, as well as in subgroups of patients with and without a history of prior allergy to RCM. ResultsThe incidence of allergic reaction in patients who received β-blockers was 45 of 23,867 (0.19%) compared with those who did not receive β-blockers, which was 9 of 5232 (0.17%; P = .84; odds ratio = 1.1). Of the patients with history of allergy to RCM, 4 of 706 patients (0.6%) on β-blockers experienced allergic reactions compared to 1 of 77 patients (1.3%) without β-blockers (P = .40; odds ratio = 0.43). Conclusionsβ-Blocker pretreatment had no effect on the frequency or severity of allergic reaction in patients undergoing coronary CTA, even in patients with a past history of allergy to RCM.

Food Allergies: The Basics

IgE-associated food allergy affects approximately 3% of the population and has severe effects on the daily life of patients—manifestations occur not only in the gastrointestinal tract but also affect other organ systems. Birth cohort studies have shown that allergic sensitization to food allergens develops early in childhood. Mechanisms of pathogenesis include cross-linking of mast cell– and basophil-bound IgE and immediate release of inflammatory mediators, as well as late-phase and chronic allergic inflammation, resulting from T-cell, basophil, and eosinophil activation. Researchers have begun to characterize the molecular features of food allergens and have developed chip-based assays for multiple allergens. These have provided information about cross-reactivity among different sources of food allergens, identified disease-causing food allergens, and helped us to estimate the severity and types of allergic reactions in patients. Importantly, learning about the structure of disease-causing food allergens has allowed researchers to engineer synthetic and recombinant vaccines.

Significance of 40-, 45-, and 48-kDa Proteins in the Moderate-to-Severe Clinical Symptoms of Buckwheat Allergy.

PurposeThis study was aimed to investigate the relationship between the allergen components and moderate-to-severe allergic reactions in patients with buckwheat allergy.MethodsFifteen patients with a history of buckwheat ingestion and a buckwheat specific IgE level≥0.35 kU/L were enrolled. They were divided into 2 groups according to clinical severity scores, with 0-1 being asymptomatic-to-mild and 2-4 being moderate-to-severe symptoms. Immunoblotting was performed to investigate IgE reactivity toward buckwheat allergens and to measure intensity of each component by using a reflective densitometer.ResultsThe proportions of positive band to the 16 kDa (62.5% vs 0%, P=0.026) and 40-50 kDa (87.5% vs 28.6%, P=0.041) buckwheat allergens in the grade 2-4 group were higher than those in grade 0-1 group. The level of buckwheat specific IgE of grade 2-4 group was higher than that of grade 0-1 group (41.3 kU/L vs 5.5 kU/L, P=0.037). The median optical densities (ODs) of IgE antibody binding to 40-50 kDa protein were higher in the grade 2-4 group, compared with those in the grade 0-1 group (130% OD vs 60.8% OD, P=0.037).ConclusionsThe 40-50 kDa protein is implicated as an important allergen to predict moderate-to-severe clinical symptoms in Korean children with buckwheat allergy.

Shuxuetong injection-based on nested case-control study of blood through injection suspect allergic reaction influencing factors

To understand the real world Shuxuetong injection suspicious allergic factors. National 18 hospitals of the hospital information system using Shuxuetong data, using design methods retrospective nested case-control, and contrast using Shuxuetong after the occurrence of allergic reactions in patients with non-allergic patients differences in age, gender, admission illness, allergies, etc. Based on available data, indicate suspicious allergies affect Shuxuetong factors may be hospitalized illness, solvent, single dose, concomitant medications. When using Shuxuetong for critically ill patients should use caution and pay attention to solvents, dose, combination therapy of choice clinically. Conclusions of this study need further study to be verified.

Titanium Hypersensitivity: A Clinical Study

Titanium implants are extensively used to replace the missing natural teeth in prosthodontics. However, allergic reactions to titanium in dentistry has not received its due attention. Literature reports sensitivity to titanium ranging from 0.6 to 5% of the general population. The allergic reactions in patients who are sensitive to titanium ranges from type I to IV with symptoms ran­ ging from vague pain, skin rashes to implant failure. The aim of this study was to evaluate the presence of titanium allergy by anamnesis and examination of subjects using titanium dioxide 0.5% in patch test methodology. A sample size of four hundred healthy subjects with no previous history of immunosuppression were included. Titanium dioxide 0.5% concentration in petrolatum was used to conduct the patch test. A history of allergy to any other allergen was recorded as a part of the study. Under the limitations of this study, it was concluded that, titanium can induce hypersensitivity response in susceptible patients. From this study it was observed that the hypersensitivity reactions to titanium was 0.3% in all the subjects tested. It was also observed that the individuals with a prior history of allergy to other known allergens were more susceptible to allergic reactions to titanium. Limitations of the study was the absence of a wider age group of population for this study. Future research is recommended by considering a wider age group of population and a long­term follow­up of patients.

IgE and IgG epitope mapping by microarray peptide-immunoassay reveals the importance and diversity of the immune response to the IgG3 equine immunoglobulin

The presence of whole horse IgG in therapeutic snake antivenom preparations of high purity is a contamination that can cause IgE-mediated allergic reactions in patients. In this study, the immunodominant IgE and IgG-binding epitopes in horse heavy chain IgG3 were mapped using arrays of overlapping peptides synthesized directly onto activated cellulose membranes. Pooled human sera from patients with and without horse antivenom allergies were used to probe the membrane. We have demonstrated that, for both cases, individuals produce antibodies to epitopes of sequential amino acids of horse heavy chain IgG3, although the signal strength and specificity appear to be distinct between the two groups of patients. A single region was found to contain the dominant allergic IgE epitope. The critical residues involved in the binding of human IgE to the epitope were determined to include four hydrophobic amino acids followed by polar and charged residues that formed a coil structure. This is the first study to describe the specific amino acid sequences involved with the immune recognition of human IgG and IgE to horse antivenom.

HLA-DRB1*07:01 Is Associated With Asparaginase Allergies In Children With Acute Lymphoblastic Leukemia

HLA-DRB1*07:01 Is Associated With Asparaginase Allergies In Children With Acute Lymphoblastic Leukemia

Development of an indirect competitive immunoassay for walnut protein component in food

Among food allergens, walnut is a frequent cause of adverse food reactions in allergic patients. In this study, the walnut allergen protein 2S albumin precursor (Jug r 1) cDNA was synthesised and cloned into the pGEX-6P-1 expression vector. The recombinant plasmids were transformed into Escherichia coli (E. coli) BL21(DE3) pLys for expression of protein Jug r 1. Polyclonal antibodies were prepared against the expressed purified Jug r 1 protein. An indirect competitive enzyme-linked immunosorbent assay (ELISA) for the detection and quantification of walnut soluble proteins in processed foods was developed using the prepared polyclonal antibodies. The developed ELISA had a high specificity, walnut protein standard solution at 2.2ng/mL [inhibition concentration (IC80) of the competitive test] was clearly identified by the ELISA. The mean recoveries ranged from 86% to 112%. The coefficient of variation (CV) for the 4 model foods was 6.4–8.7%.

Natural rubber producing plants: An overview

Currently, Hevea brasiliensis has been only one resource for commercial natural rubber production. Rubber tree, H. brasiliensis (Willd. ex A. Juss.) Muell. Arg., commonly known as the Brazilian rubber tree is native to the Amazon River basin. Attempts to develop alternative sources of natural rubber have been made at various times and no fewer than eight botanical families, 300 genera and 2500 species have been found to produce natural rubber in their latex. Only two species, in addition to the Para rubber tree, are known to produce large amounts of rubber with high molecular weight: a shrub named guayule ( Parthenium argentatum Gray) and the Russian dandelion ( Taraxacum koksaghyz ). These plants were considered sufficiently promising as alternative rubber sources that several research programs have been conducted on these plants, especially during World War II. Hevea rubber has been an undeniably beneficial commodity for the past 100 years. The superior qualities of the natural elastomers produced by this tree have never been surpassed by any of the synthetic products. Parthenium argentatum (guayule) is an industrial crop, which is the best potential source of latex suitable for use in medical products, gloves etc., which does not cause allergic reactions in patients suffering from Type 1 latex allergy. The dandelion rubber will be tested for use in a variety of applications, but primarily for use in tires. Researchers hope the project will lead to the production of the country's first dandelion rubber commercial facility in the next five years. By 2020, they hope the plant will be producing 60 million pounds of natural rubber. Other alternative rubber producing plants like lettuce ( Lactuca serriola ) and fig tree ( Ficus bengalensis ); have not yet been sufficiently studied to establish their usability. The ideal rubber-producing crop would be fast growing plant species that can grow in any type of land across the world. The major objective of this review was to provide the information about cultivation, genetics and breeding aspects of Hevea and also other natural rubber producing species for alternative source of latex production in the near future. Keywords : Alternative rubber sources, biotechnology, breeding, Hevea brasiliensis, Parthenium argentatum, Taraxacum koksaghyz, Ficus bengalensis, Lactuca serriola African Journal of Biotechnology Vol. 12(12), pp. 1297-1310

Perplexing cases of allergy to salami

Perplexing cases of allergy to salami

Allergische Transfusionsreaktionen bei einer Patientin mit multiplen Nahrungsmittelallergien

A 13-year-old girl with an osteosarcoma was treated by surgery and chemotherapy. During three transfusions of apheresis platelet concentrates allergic reactions occurred, partly in spite of premedication with an antihistamine and a corticoid. As the patient declared to be allergic to some foods, in-vitro tests for allergen-specific IgE antibodies were performed and showed markedly positive results for specific IgE to carrot and celery, less so to hazelnut, peanut and a lot of other food antigens. The donor of one of the unsuitable platelet concentrates remembered when questioned, that he had eaten carrots and chocolate with hazelnuts during the evening before platelet donation. Two washed platelet concentrates were transfused without any problem. Furthermore, transfusions of nine red blood cell concentrates and one unit of virus-inactivated frozen pooled plasma were well tolerated. Patients should be asked for allergies previous to transfusions to be alert to allergic reactions in patients with a positive history of food or drug allergies. If premedication with antihistamines does not prevent severe allergic transfusion reactions, transfusion of washed platelet concentrates and of virus-inactivated frozen pooled plasma can be considered.

Comparison of allergic reactions to pegasparaginase given intravenously versus intramuscularly

Pegasparaginase (PEG) is important for treatment of Acute Lymphoblastic Leukemia (ALL). Despite conjugation to polyethylene glycol to reduce immunogenicity, allergic reactions still occur and may be severe. Traditionally, PEG is given via intramuscular (IM) injection but recent protocols have shown it can be safely given intravenously (IV), which may be preferred by patients. There is a potential concern that the IV route may result in more severe allergic reactions due to immediate exposure to reactive antibodies in the blood, which is delayed after IM administration. The purpose of our study is to compare the severity and incidence of allergic reactions with IV versus IM PEG. We are unaware of any prior studies examining this. We reviewed all patients with ALL diagnosed from 2005 to 2010 inclusive who received PEG and had an allergic reaction. Reactions were graded using both common toxicity criteria (CTC) 3.0 and 4.0. Allergic reactions were seen in 17 of 186 (9%) newly diagnosed patients receiving IM PEG and 4 of 11 (36%) receiving IV PEG; P = 0.019. The severity of reaction was not increased with IV versus IM. Allergic reactions occurred more frequently in high-risk patients (14 of 85; 16%) versus standard risk (7 of 112; 6%), P = 0.034. There appears to be an increased incidence of allergic reactions in patients who receive IV PEG compared with IM although the severity is similar. In addition high-risk patients appear to have more allergic reactions than standard risk.

Detection of the allergenic celery protein component (Api g 1.01) in foods by immunoassay

Among food allergens, celery is a frequent cause for adverse food reactions in allergic patients. In this study, the celery allergen protein Api g 1.01 RNA was amplified by RT-PCR and cloned into the pET-32a expression vector. The recombinant plasmid was transformed into E.coli BL21(DE3) pLys for the expression of protein Api g 1.01. Monoclonal antibodies were prepared against the expressed purified Api g 1.01 protein. A sandwich enzyme-linked immunosorbent assay (ELISA) for the detection and quantification of celery soluble proteins in processed foods was developed using the prepared monoclonal antibodies. The developed ELISA had a high specificity, although it showed slight cross-reactivity to carrot. The limit of quantification (LOQ) was 0.28 μg/mL (equivalent to 5.6 μg whole celery protein/g food sample). The recovery ranged from 83 to 115%, whereas coefficients of variation were 6.7–8.9%.