Allergic Type Research Articles

Is it possible to make a diagnosis of raw, heated, and baked egg allergy in children using cutoffs? A systematic review.

The diagnosis of IgE-mediated egg allergy lies both on a compatible clinical history and on the results of skin prick tests (SPTs) and IgEs levels. Both tests have good sensitivity but low specificity. For this reason, oral food challenge (OFC) is the ultimate gold standard for the diagnosis. The aim of this study was to systematically review the literature in order to identify, analyze, and synthesize the predictive value of SPT and specific IgEs both to egg white and to main egg allergens and to review the cutoffs suggested in the literature. A total of 37 articles were included in this systematic review. Studies were grouped according to the degree of cooking of the egg used for OFC, age, and type of allergen used to perform the allergy workup. In children <2 years, raw egg allergy seems very likely when SPTs with egg white extract are ≥4 mm or specific IgEs are ≥1.7 kUA /l. In children ≥2 years, OFC could be avoided when SPTs with egg white extract are ≥10 mm or prick by prick with egg white is ≥14 mm or specific IgE is ≥7.3 kUA /l. Likewise, heated egg allergy can be diagnosed if SPTs with egg white extract are >5 and >11 mm in children <2 and ≥2 years, respectively. Further and better-designed studies are needed to determine the remaining diagnostic cutoff of specific IgE and SPT for heated and baked egg allergy.

De Novo Transcriptome Analysis of Allium cepa L. (Onion) Bulb to Identify Allergens and Epitopes.

Allium cepa (onion) is a diploid plant with one of the largest nuclear genomes among all diploids. Onion is an example of an under-researched crop which has a complex heterozygous genome. There are no allergenic proteins and genomic data available for onions. This study was conducted to establish a transcriptome catalogue of onion bulb that will enable us to study onion related genes involved in medicinal use and allergies. Transcriptome dataset generated from onion bulb using the Illumina HiSeq 2000 technology showed a total of 99,074,309 high quality raw reads (~20 Gb). Based on sequence homology onion genes were categorized into 49 different functional groups. Most of the genes however, were classified under 'unknown' in all three gene ontology categories. Of the categorized genes, 61.2% showed metabolic functions followed by cellular components such as binding, cellular processes; catalytic activity and cell part. With BLASTx top hit analysis, a total of 2,511 homologous allergenic sequences were found, which had 37–100% similarity with 46 different types of allergens existing in the database. From the 46 contigs or allergens, 521 B-cell linear epitopes were identified using BepiPred linear epitope prediction tool. This is the first comprehensive insight into the transcriptome of onion bulb tissue using the NGS technology, which can be used to map IgE epitopes and prediction of structures and functions of various proteins.

Iatrogenic airway injury

### Key points While most anaesthetists use airway devices on a daily basis without apparent complication, they should always be aware of the possibility of injury. Knowledge of these injuries aids prevention and allows timely diagnosis and correct treatment. In this article, we summarize injuries reported from common airway interventions with particular focus on post-intubation tracheal stenosis (PITS). Allergic and irritant type reactions are much less common with single-use face masks than with reusable masks, especially where chemical disinfectants are used in the cleaning process. Soft tissue injuries such as abrasions and ulcers are possible in anaesthetic practice. However, now that prolonged face mask anaesthesia is uncommon, they are more likely to be observed in patients receiving non-invasive ventilation or continuous positive airway pressure. The eye is particularly vulnerable to contact with a face mask and corneal abrasions are possible unless a correctly sized mask is used and continued care is taken. Serious harm from the use of face masks is uncommon and appears to be caused mainly by excessive pressure. This can result either from the face mask itself or from the anaesthetist's hands when performing a jaw thrust manoeuvre and can result in sensory change to the face from pressure to the mental nerve. Likewise pressure to the mandibular branch of the facial nerve can result in paralysis of the muscles of the lower lip and chin. These examples of neuropraxia are rare, occurring only in …

Sensitization pattern affects the asthma risk in Finnish adult population.

There is a large global variation in the sensitization pattern and its association with allergic diseases. In temperate and tropical urban environments, mite monosensitization can be the predominant cause of allergic airway diseases, whereas in other environments, polysensitization is more typical. Sensitization to mite allergens associates with asthma. However, it is suggested that mite sensitization might play a minor role in Northern Europe. The aim of the study was to analyze how sensitization pattern affects the asthma risk in Finnish adults, with a special focus on mites. A population-based case-control data (N=523) from Finnish adult asthma patients with one or two matched controls were used. Asthma was diagnosed based on a typical history of asthmatic symptoms and lung function tests. The allergic sensitization was determined based on skin prick test (SPT) of five mites, three molds, and nine other aeroallergens. Information on demographics was obtained by a questionnaire. The proportion of sensitization to any allergen was 55% in the asthma group and 39% in the control group (P=0.001, OR 2.06, 95% CI=1.35-3.14). Sensitization to animal dander, pollen, or Aspergillus fumigatus was associated with asthma. Polysensitization to more than one allergen types and the number of SPT-positive reactions associated with asthma, whereas sensitization to only one allergen type was not associated with asthma. The large number of sensitizations to several types of allergens distinguishes subjects with asthma. Mite sensitization had little independent association with asthma in Finland.

What makes an allergen?

Allergic diseases are an immune disorder reacting to certain type of allergen(s). Remarkably only a small number of proteins of the plant and animal proteome act as allergens. Therefore, allergens have been clustered according to their common structural, biochemical and functional features. Evidence has accumulated that some allergens possess intrinsic adjuvant properties to stimulate the innate immunity. The adjuvant properties appear to contribute to the allergenicity of the respective proteins, namely the ability to cause allergic sensitization in susceptible subjects or allergic reactions in sensitized individuals. Here, we discuss how allergens interact with the innate immune cells, in particular dendritic cells and epithelial cells, via binding to pattern recognition receptors, exhibiting proteolytic activities and/or inducting type 2 innate lymphoid cells (ILC2), thereby contributing to the sensitization and development of allergic diseases.

Basophil-associated OX40 Ligand Participates in the Initiation of Th2 Responses during Airway Inflammation

Asthma is characterized by increased airway submucosal infiltration of T helper (Th) cells and myeloid cells that co-conspire to sustain a chronic inflammation. While recent studies have demonstrated that the myeloid basophils promote Th2 cells in response to various types of allergens, the underlying mechanisms are poorly understood. Here, we found for the first time that in a mouse model of allergic asthma basophils highly expressed OX40 ligand (OX40L) after activation. Interestingly, blockade of OX40-OX40L interaction suppressed basophils-primed Th2 cell differentiation in vitro and ameliorated ovalbumin (OVA)-induced allergic eosinophilic inflammation mediated by Th2 activation. In accordance, the adoptive transfer of basophils derived from mediastinal lymph nodes (MLN) of OVA-immunized mice triggered a robust Th2 response and eosinophilic inflammation in wild-type mice but largely muted in OX40(-/-) mice and mice receiving OX40L-blocked basophils. Taken together, our results reveal a critical role of OX40L presented by the activated basophils to initiate Th2 responses in an allergic asthma model, implicating OX40-OX40L signaling as a potential therapeutic target in the treatment of allergic airway inflammation.

Analysis of total immunoglobulin E and specific immunoglobulin E of 3,721 patients with allergic disease.

Due to the increase in the prevalence and incidence of allergic diseases, improving the sensitivity and specificity of screening indexes is critical. Total immunoglobulin E (IgE) is a traditional index for judging allergic diseases, while its specificity is relatively poor. Serum-specific IgE (sIgE) is an objective index with high specificity in the diagnosis of allergic diseases. In the present research, the total IgE and sIgE of 3,721 patients with allergic diseases were analyzed to further illuminate the association between them. The data were derived from 3,721 patients. The serum-sIgE to 14 types of common allergens and total IgE were detected. A total of 2,419 cases (65.0%) of 3,721 patients exhibited increasing total IgE and 1,215 patients (32.7%) exhibited positive sIgE. The consistency rate of the two indexes was 60.4%, and the κ-value was 0.28. In 135 patients with normal total IgE, 82.2% exhibited one sIgE positive and 17.8% exhibited two or more sIgE positive. While the number of positive sIgE increased and the detecting level enhanced, the number of positive total IgE markedly increased. Patients (84.1%) with increasing total IgE were associated with positive sIgE, but the increase of total IgE could not be completely explained by the total accumulation of sIgE. Total IgE may play an important role on screening allergic disease while sIgE could be used as crucial evidence for allergy diagnosis. Although the consistency of the two methods was poor, neither total IgE nor sIgE could replace each other. Combining the two indexes with clinical manifestations together will improve the method.

An epidemiological study of food allergy in a regional hospital in Ireland

Food allergy is rapidly becoming a significant burden on the paediatric population of developed countries.[1,2] Type 1 allergy causes much anxiety and leads to some of the very acute and distressing presentations to paediatric A&E. Misconception and fears regarding the use of adrenaline preparations is one of the causative factors, although there is a huge evidence base that shows the safety and effectiveness of these preparations in managing the true and suspected cases of type 1 allergy.[3] In the Paediatric unit in Our Lady of Lourdes Hospital, Drogheda there is an allergy clinic which runs as an out-patient service. Our aim was to establish a database of children who presented to these clinics and record the allergens (both food and aeroallergens) to which they had a positive reaction. We included those that had a positive skin prick test or radioallergosorbent test (RAST), or both. It is only by creating such a database that we can determine both the scale of the problem in our area and the adequacy of services provided. Using this information we could proceed further to audit our services and make any improvements in the future. The aim of the allergy register was to: • Obtain information about 1) the number of children presenting to our allergy clinic and 2) the prevalence of food allergy within this group and the type of allergens (nut, fish, milk, egg). • Determine the number of children with associated atopic conditions (asthma, eczema, hayfever). • Record the nature of reaction to the various allergens. • Record the patients who had been given adrenaline pens so that timely replacements can be provided in the future.

Prospective study in a porcine model of sarcoptes scabiei indicates the association of Th2 and Th17 pathways with the clinical severity of scabies.

BackgroundUnderstanding of scabies immunopathology has been hampered by the inability to undertake longitudinal studies in humans. Pigs are a useful animal model for scabies, and show clinical and immunologic changes similar to those in humans. Crusted scabies can be readily established in pigs by treatment with the glucocorticoid dexamethasone (Dex).Methodology/ Principal FindingsProspective study of 24 pigs in four groups: a) Scabies+/Dex+, b) Scabies+/Dex-, c) Scabies-/Dex+ and d) Scabies-/Dex-. Clinical symptoms were monitored. Histological profiling and transcriptional analysis of skin biopsies was undertaken to compare changes in cell infiltrates and representative cytokines. A range of clinical responses to Sarcoptes scabiei were observed in Dex treated and non-immunosuppressed pigs. An association was confirmed between disease severity and transcription of the Th2 cytokines IL-4 and IL-13, and up-regulation of the Th17 cytokines IL-17 and IL-23 in pigs with crusted scabies. Immunohistochemistry revealed marked infiltration of lymphocytes and mast cells, and strong staining for IL-17.Conclusions/ SignificanceWhile an allergic Th2 type response to scabies has been previously described, these results suggest that IL-17 related pathways may also contribute to immunopathology of crusted scabies. This may lead to new strategies to protect vulnerable subjects from contracting recurrent crusted scabies.

Local allergic rhinitis in elderly patients

BackgroundLocal allergic rhinitis (LAR) is characterized by the production of specific IgE in the nasal mucosa and a positive response to a nasal provocation test in the absence of atopy by conventional measurements. There is no information about LAR in elderly people, just as there is little information about allergic rhinitis (AR) in this age group. ObjectiveTo investigate the prevalence of LAR, AR, and non-AR in elderly patients with rhinitis. MethodsIn 219 patients with a mean (SD) age of 65.81 (5.88), skin prick tests, serum total specific IgE, and nasal provocation tests against common aeroallergens were performed. In addition, nasal specific IgE was measured in the nasal lavage at baseline and after provocation. For monitoring nasal symptoms, a visual analog scale was used. ResultsOf the 219 patients, 46 (21.0%) had LAR, 88 (40.2%) had AR, and 85 (38.8%) were diagnosed as having non-AR. Dermatophagoides pteronyssinus was the main sensitizing aeroallergen in patients with LAR (29 patients [63.0%]) and with AR (48 patients [56.4%]). No significant differences were found between the visual analog scale score and the type of AR (local or nonlocal) and the types of allergens. Clinical responses during the nasal provocation test were associated with significant increases in nasal IgE (Spearman correlation test, R = 0.89, P < .05). Polysensitization was more predominant in patients with AR than in those with LAR (P < .05). ConclusionThe results indicate that LAR and AR are common in elderly patients. However, in this age group, these conditions are often underdiagnosed.

Investigation of 14 Food Allergen-Specific IgG Antibodies in 1299 Children

By analyzing 14 food allergen-specific IgG antibodies in 1299 children residing in Henan province of China, we aimed to gain a preliminary understanding of food intolerance in children living in this region. Specific IgG antibodies for 14 food allergens were semi-quantitatively detected in the sera of subjects using enzyme-linked immunosorbent assays. The total positive rate for food allergen IgG antibodies was 99.9%. Of the 14 food allergens tested, sera most frequently tested positive for specific IgG antibodies for the following five food allergens, listed from the highest positive rate to the lowest: egg, milk, soybean, cod, and crab. The total positive rate for each food allergen-specific IgG antibody showed no statistically significant gender-based differences (p > 0.05), nor did the total positive rate for IgG antibodies for all the types of food allergens (p > 0.05). The positive rates of allergen-specific IgG antibodies for milk, beef, chicken, pork, mushrooms, and eggs (p < 0.05) showed a statistically significant difference between the 0- to 3-year-old and 4- to 11-year-old groups. Food intolerance is prevalent in children.

Occupational anaphylaxis--an EAACI task force consensus statement.

Anaphylaxis is a systemic allergic reaction, potentially life-threatening that can be due to nonoccupational or, less commonly, to occupational triggers. Occupational anaphylaxis (OcAn) could be defined as anaphylaxis arising out of triggers and conditions attributable to a particular work environment. Hymenoptera stings and natural rubber latex are the commonest triggers of OcAn. Other triggers include food, medications, insect/mammal/snake bites, and chemicals. The underlying mechanisms of anaphylactic reactions due to occupational exposure are usually IgE-mediated and less frequently non-IgE-mediated allergy or nonallergic. Some aspects of work-related allergen exposure, such as route and frequency of exposure, type of allergens, and cofactors may explain the variability of symptoms in contrast to the nonoccupational setting. When assessing OcAn, both confirmation of the diagnosis of anaphylactic reaction and identification of the trigger are required. Prevention of further episodes is important and is based on removal from further exposure. Workers with a history of OcAn should immediately be provided with a written emergency management plan and an adrenaline auto-injector and educated to its use. Immunotherapy is recommended only for OcAn due to Hymenoptera stings.

The Frequency of Allergic Rhinosinusitis in Patients Referred to Ear, Nose Throat Clinic due to Chronic Rhinosinusitis

The Frequency of Allergic Rhinosinusitis in Patients Referred to Ear, Nose Throat Clinic due to Chronic Rhinosinusitis With respect to importance of chronic rhinosinusitis, especially its allergic type among 150 referent patients to ENT (Ear & Nose & Throat) clinic with taking the history of disease and accurate clinical examination and recording the results of total serum (IgE) and eosinophil of peripheral blood, the patients with allergic and non- allergic cases were identified and the cases in which it was not possible to diagnose accurately by these methods they were reported under title of suspicious to allergic symptom where among these patients, about 45% of them were diagnosed with allergic case. And at the same time, the relationship was explored and determined among asthma, conjunctivitis, and eczema with allergic type of disease in which these types of diseases were seen clearly further in allergic rhinosinusitis than in its non- allergic type.

Assessment of sensitivity to common aeroallergens in a Tunisian population

Allergic diseases are common in clinical practice and are considered by the World Health Organization (WHO) as an important health problem (Liu et al. 2010).Worldwide, about 500 million people are affected (15%) with a prevalence of 20-30% in developed countries (Laaidi et al. 2009). This study aimed to identify the major aeroallergens and their prevalence in a population of patients living in a polluted oasis situated in the southwest of Tunisia. A total of 67 patients were admitted to the Department of Pneumology and Oto-rhino-laryngology at Gafsa Hospital between August 2007 and September 2008. They were invited to a health examination including skin-prick test, blood sampling and assessment of specific IgE to several common aeroallergens. Of the 67 patients, only 39 were sensitive to allergens (58.20%), 23 of whom were sensitive to more than one type of allergen (58.97%). The most common aeroallergens were tree and grass pollen (32.96%), followed by animal dander (19.78%), mites (17.58%), herbaceous pollen (12.08%), mould (6.59%), latex (6.59%) and cockroaches (4.39%). Although this study was limited to a modest target population of patients, we did observe significant results that highlight the most frequently detected allergens in the region of Gafsa. These results are in agreement with reports from other studies conducted in other areas.

中药过敏反应文献分析与认知情况问卷调查

目的：增强人们对中药知识及使用的认知程度，合理使用，减少中药的不良反应。方法：首先通过检索中国知网数据库中常用中药注射剂中引起过敏反应报告较多的病例，对患者一般情况及过敏反应类型等进行统计并整理结果；其次对广州市在住居民进行中药过敏反应认知情况问卷调查，并对有效问卷相关内容进行统计分析。结果：在检索到的中药注射剂所致过敏病例1352例中，I型超敏反应占94.75%；男性和成人分别占54.22%和74.56%。在问卷调查中共回收有效问卷268份，对使用中药初次过敏的认识仅为10.77%，55.38%的人数为不清楚；对中药使用较多的女性占64.62%；使用中药原因认为有效及副作用少的分别占42.93%、51.52%。结论：临床药物过敏类型中不可忽视I型或与I型类似的类过敏反应的反生；提高人们对中药的认知程度，中药是国宝，但要注意选择适合的剂型，正确、合理使用，保证用药的安全性。 Objective: To enhance people’s cognition for traditional Chinese medicine knowledge and use, reasonable use, reduce the adverse reaction of traditional Chinese medicine. Methods: First, re-trieve traditional Chinese medicine injections which are commonly used and caused lots of allergic reactions cases in the report by the China National Knowledge Infrastructure, statistic data about the patient’s general situation and allergic reaction type and so on, and sort result; second, investigate Guangzhou residents perceptions of Chinese medicine allergic reaction, and make a careful analysis of related contents in the valid questionnaires. Results: Retrieve 1352 allergic cases were caused by traditional Chinese medicine injection, the effective rates of type I immune hypersensitivity reactions, males and adults were 94.75%, 54.22% and 74.56% respectively. In 268 effective questionnaires, the effective rates were 10.77% for the first time allergy which was caused by using traditional Chinese medicine, 55.38% residents were not clear; women which often used traditional Chinese medicine made up 64.62%; it accounted for 42.93%, 51.52% respectively because traditional Chinese medicine were effective and less side effects to use it. Conclusion: In the allergy type of clinical drug, type I allergic reaction or anaphylactoid can not be neglected. Improve people’s cognition of the traditional Chinese medicine, traditional Chinese medicine is a national treasure, but it should pay attention to choose the suitable dosage forms, correct and reasonable use, guarantee the safety of medication.

Association between fraction of exhaled nitrous oxide, bronchodilator response and inhaled corticosteroid type.

Fraction of exhaled nitrous oxide (FeNO) is a known marker of airway inflammation and a topic of recent investigation for asthma control in children. To investigate the relationship among FeNO and bronchodilator response measured by spirometry and types of inhaled corticosteroids (ICS). A one-year review of children tested with spirometry and FeNO in a regional pediatric asthma centre was conducted. A total of 183 children were included (mean [± SD] age 12.8 ± 2.8 years). Fluticasone was used most commonly (n=66 [36.1%]), followed by ciclesonide (n=50 [27.3%]). Most children (n=73 [39.9%]) had moderate persistent asthma. Increased FeNO was associated with percent change in forced expiratory volume in 1 s (FEV1) after bronchodilator adjusted for allergic rhinitis, parental smoking and ICS type (B=0.08 [95% CI 0.04 to 0.12]; P<0.001). Similarly, FeNO was associated with percent change in forced expiratory flow at 25% to 75% of the pulmonary volume (FEF25-75) after bronchodilator adjusted for parental smoking and ICS type (B=0.13 [95% CI 0.01 to 0.24]; P=0.03). FeNO accounted for only 16% and 9% of the variability in FEV1 and FEF25-75, respectively. Mean-adjusted FeNO was lowest in fluticasone users compared with no ICS (mean difference 18.6 parts per billion [ppb] [95% CI 1.0 to 36.2]) and there was no difference in adjusted FeNO level between ciclesonide and no ICS (5.9 ppb [95% CI -9.0 to 20.8]). FeNO levels correlated with bronchodilator response in a regional pediatric asthma centre. However, FeNO accounted for only 16% and 9% of the variability in FEV1 and FEF25-75, respectively. Mean adjusted FeNO varied according to ICS type, suggesting a difference in relative efficacy between ICS beyond their dose equivalents.

Characterization of low molecular weight allergens from English walnut (Juglans regia).

Although English walnut is a commonly allergenic tree nut, walnut allergens have been poorly characterized to date. The objective of this work was to characterize the natural, low molecular weight (LMW) allergens from walnut. A protocol was developed to purify LMW allergens (specifically 2S albumins) from English walnuts. In addition to 2S albumins, a series of peptides from the N-terminal region of the 7S seed storage globulin proprotein were also identified and characterized. These peptides comprised a four-cysteine motif (C-X-X-X-C-X10-12-C-X-X-X-C) repeated throughout the 7S N-terminal region. Upon IgE immunoblotting, 3/11 and 5/11 sera from walnut-allergic subjects showed IgE reactivity to the 7S N-terminal fragments and 2S albumin, respectively. The mature 7S protein and the newly described 7S N-terminal peptides represent two distinct types of allergens. Because the proteolytic processing of 7S globulins has not been elucidated in many edible plant species, similar protein fragments may be present in other nuts and seeds.

Signaling pathways activated by a protease allergen in basophils.

Allergic diseases represent a significant burden in industrialized countries, but why and how the immune system responds to allergens remain largely unknown. Because many clinically significant allergens have proteolytic activity, and many helminths express proteases that are necessary for their life cycles, host mechanisms likely have evolved to detect the proteolytic activity of helminth proteases, which may be incidentally activated by protease allergens. A cysteine protease, papain, is a prototypic protease allergen that can directly activate basophils and mast cells, leading to the production of cytokines, including IL-4, characteristic of the type 2 immune response. The mechanism of papain's immunogenic activity remains unknown. Here we have characterized the cellular response activated by papain in basophils. We find that papain-induced IL-4 production requires calcium flux and activation of PI3K and nuclear factor of activated T cells. Interestingly, papain-induced IL-4 production was dependent on the immunoreceptor tyrosine-based activation motif (ITAM) adaptor protein Fc receptor γ-chain, even though the canonical ITAM signaling was not activated by papain. Collectively, these data characterize the downstream signaling pathway activated by a protease allergen in basophils.

Innate lymphoid cells and cytokines of the novel subtypes of helper T cells in asthma.

BackgroundIn this study, the expression of interleukin-9 (IL-9), IL-17, IL-22, and IL-25 genes that might be the potential predisposing factors for asthma as well as count of innate lymphoid cells (ILCs) as another source of inflammatory cytokines have been evaluated.ObjectiveThe aim of this study was to evaluate the expression of newly identified helper T cells signature cytokines and amount of ILCs.MethodsBlood and sputum samples from 23 patients with moderate to severe asthma and 23 healthy volunteers were collected. The types of allergens to which our patients were sensitive were defined using immunoblotting method. Gene expression of studied cytokines was evaluated using quantitative transcription-polymerase chain reaction and ILCs were counted by the flow cytometry method.ResultsIn this research, the gene expressions of IL-9, IL-17, IL-22, and IL-25 were significantly higher in asthmatics, especially in the severe form of the disease. This increase was even higher in serum samples compared with sputum samples. Counting ILCs revealed their increase in comparison with normal people.ConclusionWe showed the importance of IL-25, IL-22, IL-17, and IL-9 cytokines in patients with asthma as their expression levels are increased and these increase are correlated with the severity of the disease. We also showed that the increased amount of ILCs in asthmatics could confirm their potential role in the immunopathogenesis of asthma as another source of inflammatory cytokines.

Prevalence of various types of allergens in ocular allergic conditions of patients from Pokhara, Nepal

Introduction: Ocular allergic conditions are mostly recurrent and the drugs prescribed, especially corticosteroids, have serious side effects. Therefore, when maximal tolerated topical and systemic medications are unable to control allergic conjunctivitis, a skin prick test for allergens should be conducted and patients should be taught to avoid these allergens. Objective: To find out the prevalence of common allergens inciting ocular allergic diseases in Nepal. Subjects and methods: A total of 13,376 skin prick tests were performed on 76 patients suffering from different chronic recurrent ocular allergic conjunctivitis with 176 common allergens (pollens, fungi, insects, dusts, danders, fabrics/ feathers, food, parthenium leaves, tobacco and mite). Buffer saline was used as a negative control while histamine acid phosphate was used as a positive control. Grading of the skin prick test reaction was done by comparison to the histamine positive control. Only markedly positive reactions were considered positive. Relevant data were entered into the excel spreadsheet and analyzed with the Stata-12 commercial package. The association between allergic conditions and socio-demographic, environmental and other co-variates were tested by the chi-square test. Results: The common offenders found in the study were mite (42.11 %) followed by fabrics/ feathers (20.39 %), dusts (18.18 %), pollen (17.05 %), non-juicy food (15.02 %), dander (13.60 %), juicy food (11.64 %) and fungus (9.87 %), and tobacco (6.58 %), parthenium leaves (5.26 %) and insects (3.17 %) were less common offenders. Conclusions: All ocular allergy patients should undergo skin prick tests to find out the allergens causing their allergy and then receive specific immunological treatment (SIT). DOI: http://dx.doi.org/10.3126/nepjoph.v6i1.10759 Nepal J Ophthalmol 2014; 6 (2): 6-23