Cat Epithelium Research Articles

Depigmented, polymerized cat epithelium extract is safe and improves rhinitis and asthma symptoms in cat allergic patients: A real-world retrospective study.

Cat allergy is often difficult to avoid. Here, we evaluated the safety and effectiveness of a depigmented, polymerized cat epithelium extract (Dpg-pol-cat) for the treatment of allergic rhinoconjunctivitis and asthma. Real-world, retrospective study of patients ≥12 years with cat allergy and moderate to severe allergic rhinitis/rhinoconjunctivitis, with or without asthma, who started allergen immunotherapy (AIT) with Dpg-pol-cat extract during routine visits to the Allergy Department. Safety and effectiveness (improvement in FEV1) of AIT were evaluated. The use of rescue medication and patient perceptions were also assessed. A total of 62 patients were included, of which 34 (54.8%) received at least 12 months of AIT. There were 15 adverse reactions, 8 local and 7 systemic, of which 3 led to AIT discontinuation. Patients with moderate to severe rhinitis decreased from 88.2% at baseline to 29.4% at 12 months (p <0.0001), and patients with moderate asthma decreased from 76.5% to 38.2% (p = 0.0004). FEV1 improved from a mean (SD) of 3188.9 (771.4) ml to 3419.6 (878.4) ml (p = 0.0023). The use of rescue medications for rhinitis decreased from 94.1% to 23.5% (p <0.0001), all patients requiring rescue medications for conjunctivitis (20.6%) were medication free at 12 months, and 97.1% and 92.6% of patients reported improvement in rhinitis and asthma symptoms, respectively. AIT with Dpg-pol-cat extract shows a favorable safety and effectiveness profile in patients with allergic rhinitis/rhinoconjunctivitis, with or without allergic asthma, due to cat allergy, representing a valuable treatment option for these patients.

B-059 Development and Validation of Multiplex Quantitative Allergy Tests based on Automated Flow Fluorescence Immunoassay Analyzer

Abstract Background Serological allergy tests measuring allergen-specific IgE (sIgE) are simpler and safer than skin prick tests, and the results are not influenced by skin condition or human factors. Quantitative detection of sIgE can also aid in evaluating patient allergies and aiding subsequent treatment. Dymind has researched and developed novel quantitative allergy tests based on the automated flow fluorescence immunoassay analyzer system (MF1280), enabling quantitative detection of multiple sIgE in just one test with one sample. Here, we present the performance of tIgE and two specific IgE test kits using the Dymind MF1280 system. Methods This study evaluated the performance of total IgE (tIgE) and two allergen-specific IgE (sIgE) panels of inhalant and food allergens, inhalant allergen panel including d1 (Dermatophagoides pteronyssinus), d2 (Dermatophagoides farina), i6 (Cockroach), e1 (Cat epithelium), e5 (Dog epithelium), w1(Common ragweed), and food allergen panel including f1 (Egg white), f2 (Cow’s milk), f3 (cod), f23 (Crab), 24 (Shrimp), and f27 (beef). Evaluation criteria included precision, linearity, limit of detection (LOD) and method comparison. As clinical performance of 425 clinical samples collected from 2 hospital laboratory in China was evaluated by both of Dymind allergen IgE MF1280 system and Phadia ImmunoCAP. Results The validated linearity of total IgE and sIgE were 2.0-5000.0 IU/mL and 0.1-100.0 IU/mL respectively. The LOD of total IgE and sIgE determined to be 2 IU/mL and 0.1 IU/mL respectively. The precision was evaluated by assaying a low and a high samples of every sIgE assay and the result of d1, d2, i6, e1, e5, w1, f1, f2, f3, f23, f24, f27 were 3.73% / 1.34% (low sample / high sample), 3.26% / 1.95%, 2.18% / 0.87%, 1.31% / 1.40%, 3.63% / 1.13%, 2.84% / 4.76%, 4.50% / 1.53%, 5.97% / 1.64%, 3.46% / 1.11%, 1.58% / 1.73%, 3.77% / 1.28%, 1.78% / 0.96% respectively. The total mean coefficient of measurements was below 7% to ensure high precision in multiplex quantitative analysis. Method comparison of 425 clinical samples between Phadia ImmunoCAP and Dymind allergen IgE showed total concordance rate was over 85% except f2 (over 80%). Conclusions The Dymind Allergen-specific IgE test kits on the automated flow fluorescence immunoassay analyzer system provide fast and accurate in vitro diagnostic detection of tIgE and sIgE for aiding diagnostics specific allergens sensitization and treatment for allergy patients, with good precision and excellent agreement compared to ImmunoCAP. The MF1280 system has advantages including random access, fully automated, multiplex quantitative detection of allergen sIgE with reducing assay time, sample consumption and lower costs.

Point-of-Care Fluorescence Biosensing System for Rapid Multi-Allergen Screening.

With the steady increase in allergy prevalence worldwide, there is a strong need for novel diagnostic tools for precise, fast, and less invasive testing methods. Herein, a miniatured fluorescence-based biosensing system is developed for the rapid and quantitative detection of allergen-specific immunoglobulin-E. An antibody-based fluorescence assay in a microfluidic-patterned slide, combined with a custom-made portable fluorescence reader for image acquisition and user-friendly software for the data analysis, enables obtaining results for multiple allergens in just ~1 h with only 80 μL of blood serum. The multiplexed detection of common birch, timothy grass, cat epithelia, house dust mite, and dog epithelia shows quantitative IgE-mediated allergic responses to specific allergens in control serum samples with known total IgE concentration. The responses are verified with different control tests and measurements with a commercial fluorescence reader. These results open the door to point-of-care allergy screening for early diagnosis and broader access and for large-scale research in allergies.

Evaluation of Skin Prick Test Results Performed for the Diagnosis of Inhaled Allergens in Konya

Aims: We aimed to determine the distribution of inhaled allergens by evaluating the results of skin prick tests performed on patients with allergic complaints in Konya. Methods: The study included 2351 patients aged 2-18 years who underwent skin prick tests for the diagnosis of inhaled allergens at the Selçuk University Medical Faculty Pediatric Allergy and Immunology Outpatient Clinic between June 1, 2022 and May 31, 2023. Demographic characteristics and skin prick test results of 696 patients with sensitivity to at least one inhaled allergen were retrospectively evaluated. Results: Sensitivity to at least one inhaled allergen was detected in 696 (29.6%) of 2351 patients who underwent skin prick testing for allergic symptoms. The average age of patients with inhaled allergen sensitivity was 10.37 ± 4.14 years. 278 (39.9%) of the patients were girls and 418 (60.1%) were boys. Considering the distribution of inhaled allergens detected by skin prick test, the most frequent allergens were pollen allergens (78.2%), cat epithelium (38.8%) and dog epithelium (33.8%). The most common allergens detected in girls were pollen allergens (77.3%), cat epithelium (38.1%) and house dust mites (37.1%). The most common allergens detected in males were pollen allergens (78.7%), cat epithelium (39.2%) and dog epithelium (34.7%). When allergen sensitivities were evaluated according to gender, sensitivity to house dust mites was more common in girls than in boys. Sensitivity to pollen allergens was most frequently detected in all seasons. Statistically significant differences were detected between house dust mites, pollen allergens, rye, grass mix and cat epithelium sensitivities according to seasons. Conclusion: Our study shows the distribution of inhaled allergens in Konya province. Therefore, we assume that it can contribute to the implementation of environmental measures that can be taken to protect against allergens and thus to the treatment of patients.

Allergen Sensitization and Its Association With Allergic Diseases in the Korean Population: Results From the 2019 Korea National Health and Nutrition Examination Survey.

Allergen exposure is the most potent factor in allergen sensitization, which affects the exacerbation and severity of allergic diseases. Due to industrialization and climate change, the pattern of allergen sensitization has changed over time, and the incidence of allergic diseases has also increased. This study investigated the status of allergen sensitization in the Korean population and its effects on allergic diseases. A total of 2,386 participants aged ≥ 10 years, who underwent 7 specific immunoglobulin E tests for aeroallergens (Dermatophagoides farinae [Der f], dog dander, cat epithelium, birch, oak, Japanese hop, and ragweed), were selected among the participants of the 2019 Korean National Health and Nutrition Examination Survey. We compared the demographic characteristics, combined allergic diseases, and sinusitis symptoms between the atopic and non-atopic groups. The prevalence of allergen sensitization in the general Korean population was 45%, and Der f was the most frequent cause of sensitization (39.9%). The prevalence of sensitization to indoor allergens was highest among teenagers and those belonging to the 20- to 29-year age group (P < 0.001). In contrast, there was a high prevalence of sensitization to outdoor allergens among individuals belonging to the age group of 60-69 years. The prevalence of atopic dermatitis (odds ratio [OR], 2.559; 95% confidence interval [CI], 1.689-3.878), allergic rhinitis (OR, 3.075; 95% CI, 2.426-3.897), and otitis media (OR, 1.481; 95% CI, 1.092-2.007) significantly increased by allergen sensitization. Patients with allergen sensitization were more likely to experience the symptoms of rhinitis and sinusitis. The study findings confirmed that allergen sensitization occurs in approximately half of the general Korean population and affects the prevalence and symptoms of allergic diseases. This suggests that active allergy tests and diagnosis of allergic diseases are necessary in Koreans.

A Case-Control Study Comparing the General Characteristics of Patients with Symptomatic Dermographism and Chronic Spontaneous Urticaria: Is Atopy a Risk Factor for Symptomatic Dermographism?

Introduction: Symptomatic dermographism (SDerm) is the most common chronic inducible urticaria (CIndU) subtype. There is still limited information in the literature about clinical features, triggering factors, and accompanying comorbidities of SDerm. The aim of this study was to compare the clinical features and laboratory data of patients with SDerm and chronic spontaneous urticaria (CSU). Methods: The clinical features and laboratory data of patients with SDerm and CSU were compared retrospectively. The laboratory data and general characteristic features of the patients were obtained from the medical records. Results: The study included a total of 361 patients (CSU: 220, SDerm: 141). The rates of asthma (odds ratio [OR]: 1.79, p = 0.036), allergic rhinitis (OR: 6.03, p < 0.001), and thyroid disease (OR: 1.78, p = 0.039) were higher in patients with SDerm. The disease duration (median 12 months, p < 0.001) and regular antihistamine use (OR: 0.31, p < 0.001) were lower in patients with SDerm. Total IgE level (median: 193, p < 0.001), thyroid antibody positivity (OR: 1.93, p = 0.039), and atopy (OR: 8.81, p < 0.001) were higher in patients with SDerm. Dermatophagoides pteronyssinus (OR: 17.72, p < 0.001), Dermatophagoides farinae (OR: 17.20, p < 0.001), grass pollen (OR: 2.50, p < 0.026), cat epithelium (OR: 3.68, p < 0.023), and cockroach (OR: 4.93, p < 0.009) allergen positivity rates were higher in patients with SDerm. Conclusion: Atopic diseases such as asthma and allergic rhinitis and the sensitization rate to aeroallergens seem to be higher in patients with SDerm than in patients with CSU. The results of this study should be supported by multicenter studies of patients from different geographical regions.

Study on sIgE distribution characteristics and the sensitization pattern of allergen in 1 161 patients with allergic diseases of respiratory tract in northwest China

Objective: To explore the allergen map of patients with allergic diseases in northwest China, to investigate the distribution characteristics of serum specific Immunoglobulin E (sIgE) in different ages, genders, diseases and the sensitization patterns of allergens. Methods: This study is a cross-sectional study, a total of 1 161 patients with confirmed respiratory allergic diseases were selected retrospectively from outpatient or inpatient department of Gansu Provincial People's Hospital, Gansu Provincial Maternity and Child Care Hospital, General Hospital of Ningxia Medical University, Yinchuan Maternal and Child Health Care Hospital, Xijing Hospital, Air Force Military Medical University and Tumor Hospital of Inner Mongolia Autonomous Region from June 2019 to October 2022. HAIKE ALLEOS 2000 fluorescent magnetic particle chemiluminescence method was used to quantify their serum for 12 inhaled allergen-specific IgE. Chi square test or Fisher's exact test were used for comparison between count data groups (Bonferroni correction was used for further pairwise comparison in multiple groups, two-sided P<0.05/3=0.017 considered that the difference was statistically significant). Pearson correlation analysis was used for correlation of continuous numerical variables. Results: The positive detection rate of sIgE in 1 161 patients was 66.8%(776/1 161). The three highest positive rate of inhaled allergen were mugwort(599/1 161, 51.6%), French chrysanthemum(565/1 161, 48.7%) and dandelion(412/1 161, 35.5%). In different age groups, the highest positive rate of sIgE was 7-18 age group(379/513, 73.9%) while the lowest positive rate was 4-6 age group(222/370, 60.0%), the difference between groups was statistically significant(χ2=21.177, P<0.001). The sensitization peak of mugwort, French chrysanthemum, plantain, timothy, birch, dermatophagoides pteronyssinus, dermatophagoides farinae, cat epithelium, dog epithelium and German cockroach appeared in 7-18 age group. In different disease groups, the highest positive rate of sIgE was allergic rhinitis with asthma group (500/717, 69.7%) while the lowest positive rate was asthma group (76/144, 52.8%), the difference between groups was statistically significant(χ2=15.563, P<0.001). In different gender groups, the positive rate of sIgE in male (503/711, 70.7%) was higher than in female (273/450, 60.7%), the difference between groups was statistically significant(χ2=12.630, P<0.001). The multiple-sensitization rate was 86.9%(674/776) and the double-sensitization rate was 16.8%(130/776) in sIgE positive patients. Pearson correlation results showed that there was an extremely strong correlation between dandelion and French chrysanthemum(r=0.93,P<0.001). There was a strong correlation between mugwort and French chrysanthemum(r=0.64,P<0.001). In the co-sensitization analysis, the number of patients sensitized by mugwort, French chrysanthemum, dandelion, plantain and timothy accounted for 25.2%(170/674)of the total number of multiple sensitization. The number of patients sensitized by mugwort, French chrysanthemum and dandelion accounted for 58.3%(393/674)of the total number of multiple sensitization. The number of patients sensitized by mugwort, French chrysanthemum, dandelion and plantain accounted for 35.6%(240/674) of the total number of multiple sensitization. Conclusion: Mugwort, French chrysanthemum, dandelion are the major inhaled allergens in northwest China. The positive rate of sIgE was different in different ages, diseases and genders. The multiple-sensitization rate of allergen was high and there was a certain positive correlation between pollen allergen-specific IgE pairwise, suggesting that there may exist co-sensitization or cross-reactions among allergens.

Eosinophilia and potential antibody cross-reactivity between parasites in a child with pinworm and immune dysregulation: a case report

BackgroundIntestinal parasitic infections are common in humans, especially among young children. These conditions are often asymptomatic and self-limiting, and diagnosis is mainly based on the search for ova and parasites in the stools since serology may be biased due to cross reactivity between parasites. Pinworm is common in children and is not usually associated with hypereosinophilia; adhesive-tape test is the gold standard testing for the microscopic detection of Enterobious vermicularis (Ev) eggs.Case presentationA 13-year-old boy was referred due to a self-resolving episode of vomiting and palpebral oedema after dinner, together with a history of chronic rhinitis, chronic cough, absolute IgA deficiency and Hashimoto’s thyroiditis and hypereosinophilia (higher value = 3140/µl). On evaluation we detected only palpable thyroid and hypertrophic nasal turbinates. Food allergy was excluded, but skin prick tests showed sensitization to house dust mites and cat epithelium and spirometry showed a marked obstructive pattern with positive bronchodilation test prompting the diagnosis of asthma for which maintenance inhaled treatment was started. Chest x-ray and abdomen ultrasound were negative. Further blood testing showed positive IgG anti-Echinococcus spp. and Strongyloides stercoralis and positive IgE for Ascaris, while Ev were detected both by the adhesive tape test and stool examination, so that we made a final diagnosis of pinworm infection. Three months after adequate treatment with pyrantel pamoate the adhesive-tape test turned out negative and blood testing showed a normal eosinophil count. The child later developed also type 1 diabetes.ConclusionsWe suggest the need to investigate for enterobiasis in children with hypereosinophilia and to consider autoimmunity as a potential confounding factor when interpreting serology for helminths.

Thermo-SPT: A new skin prick test evaluation framework based on low-cost, portable smartphone thermography.

Although the skin prick test (SPT) is a reliable procedure to confirm IgE-dependent allergic sensitization in patients, the interpretation of the test is still performed manually, resulting in an error-prone procedure for the diagnosis of allergic diseases. To design and implement an innovative SPT evaluation framework using a low-cost, portable smartphone thermography, named Thermo-SPT, to significantly improve the accuracy and reliability of SPT outcomes. Thermographical images were captured every 60 s for a duration of 0 to 15 min using the FLIR One app, and then analysed with the FLIR Tool® . The definition of 'Skin Sensitization Region' area was introduced to analyse the time-lapse thermal changes in skin reactions over several time periods during the SPT. The Allergic Sensitization Index (ASI) and Min-Max Scaler Index (MMS) formulae were also developed to optimize the identification of the peak allergic response time point through the thermal assessment (TA) of allergic rhinitis patients. In these experimental trials, a statistically significant increase in temperature was detected from the fifth minute of TA for all tested aeroallergens (all values ). An increase was observed in the number of false-positive cases, where patients with clinical symptoms not consistent with SPT were evaluated as positive on TA assessment, specifically for patients diagnosed with Phleum pratense and Dermatophagoides pteronyssinus. Our proposed technique, the MMS, has demonstrated improved accuracy in identifying P. pratense and D. pteronyssinus compared with other SPT evaluation metrics, specifically starting from the fifth minute. For patients diagnosed with Cat epithelium, although not statistically significant initially, an increasing trend was determined in the results at the 15 min (ΔT (T15 - T0 ), ; ASIT15 , ). This proposed SPT evaluation framework utilizing a low-cost, smartphone-based thermographical imaging technique can enhance the interpretability of allergic responses during the SPT, potentially reducing the need for extensive manual interpretation experience as standard SPTs.

Prevalence of common sensitizing aeroallergens in patients with atopic dermatitis.

Atopic dermatitis (AD), a skin disease burden worldwide, is a complex, multifactorial, chronic inflammatory disease. Prevalence of AD is increasing in developing countries and identifying the causative allergens is a major challenge. Aeroallergens are shown to aggravate atopic dermatitis. Explore the prevalence of aeroallergens sensitization in patients with AD and its possible relation with AD severity. Cross-sectional study of 132 patients diagnosed to have atopic dermatitis. Atopy was detected by serum specific IgE to a panel of the most encountered aeroallergens. From the 132 patients, elevated specific IgE was detected in 72.7% from which 59.1% were mild and 86.4% are moderate/severe as well as 15.9% are mono-sensitized and 54.5% are poly-sensitized with poly-sensitization being more in severe cases compared to mild cases (68.2% vs 4.5%). Regarding specific IgE to different aeroallergens, the most prevalent were Dermatophagoides pteronyssinus (50%), followed by Dermatophagoides farinae (34.1%), Birch pollen (20.5%), cat epithelium (18.2%) Regweed (15.9%), and Cockroach (9.1%). However, moderate to severe cases were more sensitized to candida (p=0.012), mix grass pollen (p=0.002), ragweed (0.00), mite (p=0.037) and cat epithelium (p=0.007). Dermatophagoides pteronyssinus, Dermatophagoides farinae, Birch pollen, cat epithelium Regweed and Cockroach are the most frequent sensitizing aeroallergens in atopic dermatitis.

Aeroallergen Sensitization Predominates in Children with Atopic Dermatitis

Abstract Background: Children with atopic dermatitis (AD) suffer from frequent flare-ups. Correct identification of allergens responsible for flare-ups is important in managing AD. Suspecting food allergens as culprits may result in unnecessary food restrictions which adversely affect the growth of these children. In view of this fact, we aimed to assess the allergen sensitization pattern of children with AD in Sri Lanka. Objective: The objective is to assess the food and aeroallergen sensitization pattern of children with AD. Materials and Methods: This study was conducted among 100 consecutive patients refereed to the dermatology clinics of a specialized children’s hospital and a tertiary care hospital with the clinical diagnosis of AD. Age ranged from 1 to 18 years. All underwent a Skin prick test (SPT), using prick test solutions for house dust mite Dermatophagoids pteronyssinus (HDM-DP), Aspergillus fumigatus (AF), cat epithelia (CE), cow’s milk (CM), egg white (EW), and peanut. Results: Of 100 patients 53.0% had positive SPT for HDM-DP. 15.0% were positive for CE, 9.0% positive for AF. All above three are aeroallergens, food allergen sensitivities were 9.0% for CM, 2.0% for EW, and 1.0% for peanuts. It is of note that the wheal size of HDM-DP SPT showed a very strong correlation with the age of the subject (R 2 = 0.0723, P = 0.007). Conclusion: Aeroallergen sensitization predominate over food allergen sensitization in children with AD. HDM and CE were the most common aeroallergen sensitivities. The wheal size of HDM-DP had a very strong positive correlation with age.

A new way forward? Examining the potential of quantitative analysis of IgE datasets

BackgroundAllergies constitute an important public health problem, and epidemiological data is crucial to developing strategies for its prevention and therapy. Few population-based studies are available for data on allergies and sensitization. However, as these studies are expensive and time-consuming, novel approaches are searched for.ObjectivesA large monocentric IgE dataset was used to analyse quantitative sensitization data in different age and gender groups and compared the results to available epidemiological data.MethodsA total of 14,370 patients who sought medical care at the Department for Dermatology and Allergology at the Technical University of Munich, Germany was analysed. Total IgE and sensitization measured in specific IgE levels to common food allergens and aeroallergens were compared between females and males, age groups, and the year of testing (2003–2021).Results8283 females (57.6%) and 6087 males (42.4%) were tested. The average number of specific IgE tests per patient was 12.3 ± 11.4. Total IgE increased after birth with age and reached a peak between 4–6 years in males and 10–12 years in females. Males had higher specific IgE for all common aeroallergens (house dust mite, birch, mugwort and timothy grass pollen) and food allergens (milk protein, chicken egg white, peanut, wheat flour, cod) except for cat epithelia. Data closely reflected results of population-based studies in the literature.ConclusionThis study shows that, despite potential patient and test selection bias, the results of the quantitative IgE-dataset analysis closely reflect results of population-based data. Thus, as large cohorts can be examined with a minute amount of effort, this surrogate method appears promising to supplement epidemiology research.

Peculiarities of the etiological spectrum of household allergens

The aim of the study was to study the range of substances that cause respiratory sensitization in adults and children living in Dnipro as of 2019.&#x0D; Materials and research methods. Enzyme-linked immunosorbent assay was used to study the serum of venous blood, which determined the specific IgE of up to 9 allergens that are most common in the home. Kits for quantification of allergen-specific IgE from Vitrotest Specific-IgE, Ukraine were used. Conducted allergy diagnosis for 380 people with certain features of allergy history of various types of allergies, who went to the laboratory to specify the etiological root cause of their disease.&#x0D; Research results. As a result of the analysis of the received data the distribution of allergens on their prevalence among the population of Dnipro was established. The degree of hypersensitivity to each specific allergen and their ability to cross-react with each other was determined. Among the allergens of the household panel, the most dangerous were allergens of molds, which caused a sensitization reaction in 292 people, which was 76.8 % of all surveyed. The top three (in prevalence) of household allergens included: cat epithelium, which caused sensitization in 125 people (32.9 %) and Derm mite. Farinae, sensitivity to which was found in 117 patients (30.7 %). The share of inadequately strong allergopathological reactions is one third of all examined and prevails in people with sensitization to allergic agents of the household panel such as cat epithelium, Derm mite. Farinae and Derm. Pteronyssinus. Hyperractivity to fungi of the genus Candida and mold has been found in 9–12 % of people. The lowest severity of sensitization was observed in the epithelium of the dog and house dust, and low sensitivity in the reactivity structure of allergopathological reactions was observed for allergens of the epidermal group (down and feathers of poultry) and cockroaches. The development of cross-reactions took place between allergens of epidermal origin: there was a hypersensitivity to the hair and epithelium of dogs and cats (r=0.94, P˂0.01), poultry feathers and cockroaches (r=0.99, P˂0.01). This association of cross-reactions is possible, given the theory of minor and major proteins, and is due to their similarity: the similarity of the inclusion in the allergen structures of specific forms of molecules inherent in both allergic agents that may have allergy-stimulating effects.&#x0D; Conclusions. Cross-linking between several types of related allergens is the best way to further investigate this issue. It makes sense to include in the laboratory study a molecular method for the determination of major and minor proteins in the case of the greatest relationship to determine not only a specific allergen as an etiological factor, but also a specific sensitizing protein that is part of them. This is of great importance for subsequent immunotherapy when the removal of only one (major) protein agent can reduce the risk of susceptibility reactions to several types of allergens

Allergens sensitization among children with allergic diseases in Shanghai, China: age and sex difference

BackgroundThe distribution of allergens has geographic characteristics. Local epidemiological data provides evidence-based strategies for the prevention and management of allergic diseases. Age and sex differences may exist in the prevalence of sensitivity to various allergens. We investigated the distribution of common allergens in allergic children in Shanghai, southeastern China.Methods39,926 children 1 month to 18 years of age diagnosed with allergic diseases were tested for the presence of serum-specific Immunoglobulins E (sIgE) to 17 allergens common to this region, using a reversed enzyme allergosorbent test.Results25,757 (64.5%) of the subjects showed elevated sIgE to at least one of the tested allergens. House mite and dust mite were the most common aeroallergens, while egg and milk were the most common food allergens. The most common aeroallergens and food allergens were similar among each allergic disease. By age-group analysis, the positive rates of aeroallergens were higher at older age. Several peaks of sensitization to food allergens were observed in children between 1 and 3 years of age for eggs, milk, nut, crab and shrimp. In addition, the sensitization to beef and mango was highest in children 3–6 years of age. The rate of positive sIgE detection was higher in males than females for all the tested allergens except cockroach, trees and beef. Considering the interplay between sex and ages and other related components (including season, monthly temperature, humidity, air quality index, test rate of patients), the sIgE positive rates of the main aeroallergens increased with age, while the main food allergens decreased; males are more sensitive to several aeroallergens (including dust mite, house mite, cat epithelium, dog epithelium and mulberry).ConclusionsHouse mite, dust mite, milk, and egg are major allergens in Shanghai. Children at younger age are more sensitive to food allergens, while increasing overall prevalence of sensitization can be found with increasing age. Boys have higher positive rates of sIgE responses than girls. Knowledge of the prevalence of allergen sensitization in different age groups and sex may help facilitate diagnosis and intervention efforts to mitigate the impact of allergic diseases in this large geographical region. This approach may be extrapolated to other regions.

Analysis of inhaled allergen spectrum characteristics of allergic rhinitis in 5 019 cases in Xinjiang area

Objective: To analyze the characteristics of allergen spectrum in patients with allergic rhinitis (AR) in Xinjiang area in recent 13 years. Methods: The skin prick test (SPT) results of 5 019 AR patients from 2007 to 2019 were retrospectively summarized, and 14 allergens of different age, gender and race were analyzed. Results: The distribution of 14 allergens was significantly different in different years, the difference was significant (P<0.05). The top three positive rates of 14 allergens were quinoa 48.2% (2 398/4 970), plantain 33.3% (1 221/3 667), and Artemisia 33.1% (1 647/4 974). There was no significant difference in the positive rate of dog epithelium between different genders and ages (χ²=0.041, P>0.05; χ²=3.8, P>0.05), the difference of other allergen in positive rates was statistically significant (all P<0.05). The positive rates of Alternaria Alternata (χ²=7.3), Penicillium Sp. (χ²=0.3), Cat Epithelium (χ²=3.1), Dust Mite (χ²=1.4), Acaroid Mite (χ²=0.5) and Cockroach (χ²=2.9) had no significant difference among different races (all P>0.05). The positive rates of other eight allergens including Artemisia Vulgaris (χ²=64.9), Chenopodium (χ²=204.1), Artemisiifolia (χ²=72.4), Plantain (χ²=87.8), Phleum Pratense L(χ²=55.4), Robinia Pseudoacacia (χ²=67.8), Canis Familiari (χ²=70.8), Dog Epithelium (χ²=15.7) were significantly different among different races (all P<0.05). Conclusion: The distribution of allergens in Xinjiang area changes with time, the main allergens are mainly herbaceous, and the distribution of allergens in patients with AR is different in gender, age and race.

Аllergic sensitization in children with atopic dermatitis in the first 2 years of life according to the results of skin tests

Atopic dermatitis (AD) is associated with food allergies (FA), which frequency and structure varies from region. The objective of the research was to determine the structure of FA in children (<2 years) with AD and to analyze age-specific sensitization. Methods. 79 children with AD aged 2-24 months were examined (Russia, Moscow). Skin prick tests (SPT) with food allergens were used to determine sensitization, if necessary additional SPT with aeroallergens were performed. Results. 51.9% of patients had hypersensitivity to at least 1 allergen. Positive SPT for egg were detected in 38.0%, cow's milk - in 27.8%, fish - in 10.1%. Allergy to fish occurred predominantly in the 2nd year of life (35.0% vs 4.8, p=0.02). Soy, peanuts, and nuts were detected in less than 5% of patients. At 2-6 months of age, sensitization was found in 36.4%, and after 6 months in 57.9% (p=0.08). In the group with FA before 6 months of age (n=8), 7 patients were sensitized to egg and 6 to milk. The prevalence of milk and egg allergy did not differ between exclusively breastfed and formula-fed children. Hypersensitivity to allergens was found in 4 of 10 breastfeeding patients, for compared to 3 of 11 exclusive formula-feeding patients (p=0.66). Acute allergic reactions were reported in 6.3% of patients with AD, which was 12.2% of children with FA. Triggers were egg (n=5) and fish (n=4). Anaphylaxis did not occur until 6 months of age. The frequency of severe reactions was about the same in children 1st and 2nd years of age (p=0.64). SPT urticaria size, defined in points (max=4), did not differ between children 2-24 months of age. Egg and nut allergens showed the maximum skin reaction: medians were 3 [2; 4] and 1.5 [0.75; 2.5] points. Milk allergens caused significantly less reaction compared with egg (p<0.01). These differences were absent when comparing reactions to individual milk serum fraction proteins and reactions to egg. Hypersensitivity to non-food allergens was found in 41.5% of children with FA (21.5% of children with AD), mainly sensitization to cat epithelium, birch, house dust and dog epithelium was detected. Conclusion. Sensitization to milk proteins and eggs is the leading since 2 months of age, without differences in relation to the age of the infant and the type of feeding. In all cases of moderate AD, SCT is applicable in children 0-2 years of age, with practically no age restrictions.

Sensibilization Spectrum in Preschool Children with Atopic Dermatitis

Background. Atopic dermatitis (AD) is an allergodermathosis that is widespread in children and adult populations. Sensibilization to food allergens prevails in children of early age, and to airborne allergens in older age. Impairments of skin barrier lead to increase in Staphylococcus aureus colonization and finally aggravate the course of AD and the sensibilization level.Objective. The aim of the study is to estimate the sensibilization spectrum in 3-6 years old children with AD and its correlation with severity.Methods. It was cross sectional study with two independent cohorts of 3-6 years old children with and without (healthy) AD. Estimation of sensibilization spectrum and revealing of correlation with disease severity were performed.Results. The study includes 106 children aged 4.4 ± 1.2 year (58.5% boys and 41.5% girls). Polysensibilization was revealed in 28.3% of children. According to our data: 3-6 years old children with AD most often had sensibilization to the cat epithelium (34.9%), cow's milk proteins (22.6%), Dermatophagoides pteronyssinus mite (16.0%). Sensibilization to enterotoxins of Staphylococcus aureus was revealed in 7.5% children. We have recorded weak positive correlation between the AD severity and the level of specific IgE to airborne and food allergens. There was no statistically significant correlation between the AD severity and the level of specific IgE to Staphylococcus aureus enterotoxins A and B. Conclusion. The most common sensibilization type among 3-6 years old children with AD was one to airborne allergens. Sensibilization to the cat epithelium prevails among airborne allergens, to the cow's milk proteins — among food allergens. The weak positive correlation between the AD severity and the level of specific IgE to airborne and food allergens was revealed. The weak negative correlation with the level of specific IgE to Staphylococcus aureus enterotoxins A and B was revealed, thus the data was statistically insignificant.

Laboratory screening test with inhalant and food allergens in atopic Brazilian children and adolescents: a performance

The Phadiatop Infant® (PhInf) is a panel developed to assess allergic sensitization (immunoglobulin E [IgE]) in children aged &lt;5 years and combines inhalant and food allergens. The test has not been evaluated outside Europe. This is a cross-sectional study conducted at 11 pediatric allergy centers to evaluate PhInf as an allergic disease screening method in Brazilian children. Children as controls and patients (aged 6 months–18 years) were grouped according to their primary disease and age group. PhInf and specific serum IgE (sIgE) screening was performed for Dermatophagoides pteronyssinus (DP), cat and dog epithelia, a mix of grasses and pollens, eggs, cow’s milk, peanuts, and shrimp. Values ≥ 0.35 kUA/L (or PAU/L) were considered positive. A total of 470 children and adolescents, which included 385 patients and 85 controls, participated in the study (47.7% boys, average age: 6.3 years). In all, 72.6% of the participants had positive PhInf test (n = 341), with a higher proportion of those having food allergy (92.6%), atopic dermatitis (91.9%), and those aged &gt;13 years having allergy (95%). The PhInf and sIgE agreement between patients (Kappa = 0.94, P &lt; 0.001) and controls (Kappa = 0.84, P &lt; 0.001) was high. PhInf and DP agreement in patients aged &gt;13 years was excellent (Kappa = 0.936, P &lt; 0.001). Compared with sIgE dosage, PhInf had high sensitivity (97%) and specificity (93%). Positivity of PhInf test in this population was high and had an excellent correlation with the allergens comprising the panel. It is a useful method for screening children suspected of having allergic diseases in a non-European country.

Association Between 25(ОН)D Concentration and Atopic Dermatitis and Its Severity Children Aged from 3 to 6 Years: Cross Sectional Study

Background. The association between the vitamin D provision for children and the atopic dermatitis (AD) development and severity is not clearly determined.Objective. The aim of the study was to compare 25(OH)D serum concentration in children with AD and in healthy peers with association analysis of 25(OH)D with disease severity and allergen sensibilization.Methods. The study included children aged from 3 to 6 years with AD and their healthy peers. Vitamin D provision was estimated via 25(OH)D serum concentration determined by chemiluminescent microparticle immunoassay. Vitamin D deficiency was established at 25(OH)D concentration 20 ng/ml, insufficiency — 21–29 ng/ml. Sensibilization to airborne (Dermatophagoides pteronyssinus, Dermatophagoides farinae, cat epithelium and dandruff) and food (cow's milk and chicken egg proteins) allergens was determined by IgE concentration revealed via immunofluorescence.Results. The 25(OH)D serum concentration in children with AD (n = 106) was lower than in their healthy peers (n = 40), median (interquartile range) — 26.5 ng/ml (19.0–35.3) and 32.4 ng/ml (27.9–37.5) respectively (p = 0.012). Meanwhile, vitamin D insufficiency/deficiency according to 25(OH)D concentration was revealed in more than half patients (58%) with AD and in every third child (37%) from control group (OR — 3.5, 95% CI — 1.6–7.5). It was also revealed that 25(OH)D concentration was lower in patients with moderate course of AD (in comparison to mild) as well as in children sensibilized to airborne and/or food allergens.Conclusion. The vitamin D provision in preschool children is associated with AD, its severity and the presence of sensibilization to airborne and/or food allergens.

Is the allergic reaction to Aspergillus a contraindication for biological therapy in severe asthma?

Abstract Introduction: According to the available speciality data, a study from the Netherlands has proven that 24% of patients are in Stage 4–5 of the Global Initiative for Asthma guide (GINA) treatment. Among them, 17% have difficult-to-treat asthma and only 3.7% have severe asthma. Patients with severe asthma have a poor prognosis, with numerous exacerbations that are usually severe. Therefore, add-on biological treatments used for eligible patients may change the outcome. Case report: A 56-year-old female patient, diagnosed 10 years ago with asthma, without professional exposure, treated at home with maximal inhalation treatment, with multiple exacerbations and therefore multiple admissions to the hospital, one of which in the intensive care unit where she received endotracheal intubation and mechanical ventilation, is admitted to the hospital for persistent dyspnoea at rest, wheezing and chest tightness. Investigations revealed obstructive ventilatory dysfunction with a decreased value of forced expiratory volume (FEV1) by 37.57% and a reversibility ratio of 156%. Radiography results indicated absence of acute pleuropulmonary lesions; white blood cells (WBC) at 13,550 and eosinophils at 5566/µL; and 4.107% confirmed immunoglobulin E (IgE)-mediated allergy. The score for asthma control test (ACT) taken on 26 April 2018 was −8 and total IgE was 513 UI/L. Allergology evaluation results did not indicate allergies at prick test. Specific IgE was done for allergy for cat epithelium, guinea pig, rabbit, Penicillium notatum, Cladosporium herbarum and Aspergillus fumigates. Negative fungal test after bronchoscopy was performed to exclude pulmonary Aspergillosis. Omalizumab at 900 mg/month treatment was started. The outcome after 1 year showed no exacerbations, no admissions and no systemic corticotherapy usage. Discussion: Allergic reaction to Aspergillus does not overlap with the diagnosis of pulmonary Aspergillosis; the condition is rather associated with immunosuppression and with a poor outcome. Severe asthma with prolonged progression and multiple risk factors must be treated with maximal therapy.