High Atopy Research Articles

Endotype of allergic asthma with airway obstruction in urban children

Black and Hispanic children growing up in disadvantaged urban neighborhoods have the highest rates of asthma and related morbidity in the United States. This study sought to identify specific respiratory phenotypes of health and disease in this population, associations with early life exposures, and molecular patterns of gene expression in nasal epithelial cells that underlie clinical disease. The study population consisted of 442 high-risk urban children who had repeated assessments of wheezing, allergen-specific IgE, and lung function through 10 years of age. Phenotypes were identified by developing temporal trajectories for these data, and then compared to early life exposures and patterns of nasal epithelial gene expression at 11 years of age. Of the 6 identified respiratory phenotypes, a high wheeze, high atopy, low lung function group had the greatest respiratory morbidity. In early life, this group had low exposure to common allergens and high exposure to ergosterol in house dust. While all high-atopy groups were associated with increased expression of a type-2 inflammation gene module in nasal epithelial samples, an epithelium IL-13 response module tracked closely with impaired lung function, and a MUC5AC hypersecretion module was uniquely upregulated in the high wheeze, high atopy, low lung function group. In contrast, a medium wheeze, low atopy group showed altered expression of modules of epithelial integrity, epithelial injury, and antioxidant pathways. In the first decade of life, high-risk urban children develop distinct phenotypes of respiratory health versus disease that link early life environmental exposures to childhood allergic sensitization and asthma. Moreover, unique patterns of airway gene expression demonstrate how specific molecular pathways underlie distinct respiratory phenotypes, including allergic and nonallergic asthma.

Validity and repeatability of the Pediatric Allergy Questionnaire for Athletes (AQUAped) for the screening of atopy.

High atopy prevalence has been reported in athletes. Having an age-specific questionnaire for predicting atopy is important for an optimal management of young athletes. The study objectives were as follows: (i) developing a scoring system for the Pediatric Allergy Questionnaire for Athletes (AQUAped); (ii) identifying the optimal age target within the range 7-14years; (iii) assessing AQUAped validity and repeatability in the identified target population. A total of 133 young athletes (age 7-14years) were recruited. Following a screening visit, the participants filled AQUAped at baseline (T0) and after 7days (T1), concomitantly undergoing skin prick testing. Using atopy as the gold standard (positivity to ≥1 aeroallergen), the 12 core items were scored based on their likelihood ratios, and a total score was calculated. The optimal cut-off was identified based on the Youden's criterion. The repeatability of AQUAped was assessed through the intra-cluster correlation coefficient (ICC). The optimal age target was identified as the largest age range associated with an acceptable cross-validated area under the receiver operating characteristic curve (AUC≥0.70) and an excellent ICC (≥0.75). Forty (30%) children were atopic; the optimal age target was 10-14years (cross-validated AUC=0.70, ICC=0.81). AQUAped total score ranged from -26 to 75, and only 5% of non-atopic children had AQUAped≥24. AQUAped≥2 had 82% specificity, 60% sensitivity, and 74% overall accuracy. Developing and testing a scoring system for AQUAped showed that it is a valid and reliable tool for the screening of atopy in young athletes aged 10-14years.

Comparative prevalence of atopic sensitization in the border areas between Russia and Finland

Current century has been highlighted with rise in allergic pathology, and environment markedly affects it via epigenetic mechanisms. Allergy research in Russia and Finland has been conducted for many years, of larger scale recorded in the latter, still being maintained over time. Atopy prevalence was studied in the border areas in both countries. The level of total, dietary, inhaled IgE level, as well as dietary and inhalation range were examined. The Phadiatop® radio allergen sorbent test was used (UniCAP 1000 v.2; Pharmacia Upjohn, Uppsala, Sweden), with cut-off point: IgE 110 kUA/l and sIgE 2.5 kUa/l and 0.35 kUA/l. The study was subdivided into 2 stages conducted during 2003 and 2010/2012 timeframe. Stage 1 was performed with children from Finland (n = 344), Russia (n = 427), aged 7—15 years, whereas stage 2 — 180 subjects (Finland, n = 98, Russia, n = 82). Results. It was found that total IgE level was higher in children from Finland. The inhaled sIgE in 2003 and 2010/2012 was higher among children from Finland, p = 0.019 and p = 0.027, showing temporal elevation. In 2003, dietary sIgE was higher among those from Finland (27.6% and 18.3%), p = 0.142, whereas in 2010/2012 it was decreased by 2- and 3-fold in subjects from Finland and Russia, respectively. In 2003, high atopy rate against dust mites, cats, timothy, birch, and dogs was found in Russia, which was increased at stage 2. Such parameter was most evidently elevated for timothy — by 2-fold, p = 0.176, wormwood — by 2-fold, p = 0.312, equine allergens — by 2-fold, p = 0.563, canine allergens — by 1.5-fold, mite — by 1.5-fold, p = 0.220. In 2003, atopy rate in Finland to canine allergens reached 26.5%, timothy — 24.5%, birch — 20.4%, feline allergens — 20.4%. In 2010, it was noted rise in atopy rate mainly to dust mites — by 2-fold, equine allergens — by 2-fold. In 2003, atopy rate in Russia to egg, milk, and wheat prevailed, whereas in Finland it was mostly found against milk, nuts, wheat, eggs, in both cases declined in dynamics. Interestingly, no sensitization to fish in subjects from Russia and Finland was observed at both stages. Finally, at the stage 2 dietary atopy rate was declined in both countries. Differences in atopic sensitization as well as during 7—9 year follow-up observation were preserved between both subject cohorts from Finland and Russia.

Prevention of Food Allergy: The Significance of Early Introduction.

Over the last two decades, the prevalence of food allergies has registered a significant increase in Westernized societies, potentially due to changes in environmental exposure and lifestyle. The pathogenesis of food allergies is complex and includes genetic, epigenetic and environmental factors. New evidence has highlighted the role of the intestinal microbiome in the maintenance of the immune tolerance to foods and the potential pathogenic role of early percutaneous exposure to allergens. The recent increase in food allergy rates has led to a reconsideration of prevention strategies for atopic diseases, mainly targeting the timing of the introduction of solid foods into infants’ diet. Early recommendation for high atopy risk infants to delay the introduction of potential food allergens, such as cow’s milk, egg, and peanut, until after the first year of life, has been rescinded, as emerging evidence has shown that these approaches are not effective in preventing food allergies. More recently, high-quality clinical trials have suggested an opposite approach, which promotes early introduction of potential food allergens into infants’ diet as a means to prevent food allergies. This evidence has led to the production of new guidelines recommending early introduction of peanut as a preventive strategy for peanut allergy. However, clinical trials investigating whether this preventive dietary approach could also apply to other types of food allergens have reported ambiguous results. This review focuses on the latest high-quality evidence from randomized controlled clinical trials examining the timing of solid food introduction as a strategy to prevent food allergies and also discusses the possible implications of early complementary feeding on both the benefits and the total duration of breastfeeding.

Phenotypes favoring fractional exhaled nitric oxide discordance vs guideline-based uncontrolled asthma

BackgroundDespite potential value of identification of allergic inflammation with fractional exhaled nitric oxide (FeNO) in managing asthma, randomized clinical trials have not consistently shown better outcomes compared with guideline management alone. ObjectiveTo assess the effectiveness of FeNO vs non–FeNO-based therapeutic algorithms in managing asthma, and the phenotypic profile associated with FeNO >35 ppb yet well controlled by guidelines, as a potential model to predict better FeNO-based algorithm outcomes. MethodsThis is a randomized controlled study (RCT) in 88 high-risk children with asthma 7 to 18 years of age across 352 visits over a 1-year period. Generalized estimating equations analysis assessed algorithm group differences in outcomes and characteristics associated with higher odds uncontrolled by FeNO alone in the treatment decision algorithm. ResultsThe FeNO treatment algorithm did not show superiority in reducing exacerbations and morbidity (P > .05). Phenotypes that more than doubled the odds FeNO alone identified uncontrolled asthma included adolescence, non-adherence, high atopy (>6+), and baseline FeNO >35 ppb, whereas obesity, FEF25-75% < 65% predicted, and bronchodilator response >10% decreased the odds. Uncontrolled asthma by FeNO alone (F) vs guidelines alone (G) showed overall F/G > 1.0 in adolescents, but <1.0 in younger patients unless the FeNO threshold was reduced to >20 ppb. ConclusionOur study suggests that age and phenotypes play a key role in FeNO discordance compared with the conventional guideline-based uncontrolled asthma. The FeNO-based therapeutic algorithm, if confirmed further, could provide the clinician with an effective asthma management tool. The clinical implication could improve future FeNO-based RCTs and treatment decision algorithms in managing asthma by considering phenotypes and age-dependent FeNO thresholds.

Prevalence of atopy in children with hypertrophic tonsil and recurrent/chronic tonsillitis

The incidence of allergic diseases is increasing every day. Many studies have been conducted to investigate the relationship between many diseases and the presence of atopy. However, there is not enough publication about the presence of atopy and a similar relationship between tonsil diseases. The aim of this study was to determine how hypertrophic, recurrent / chronic tonsils are affected by the presence of atopy. Study was conducted by produced from the thesis of Atopy Prevalence in Hypertrophic Tonsil and Recurrent / Chronic Tonsillitis Children. This study was carried out in Azerbaijan, Neriman Nerimanov Medical University, Department of Ear-Nose-Throat, on the children under the age of 15 years (minimum 2, largest 15 years, mean age 6.3). Tonsillectomy was diagnosed as recurrent / chronic tonsillitis or tonsillar hypertrophy and the first 50 patients were included in the study group and discussed with the literature. In our study, the presence of atopy in 50 children between the ages of 2-15 with tonsillar hypertrophy and recurrent / chronic tonsillitis was investigated. In 27 patients with advanced hypertrophic tendencies 7 (25.9%), in 23 patients with recurrent / chronic tonsillitis, atopy was detected in 1 (4.3%) and the difference was statistically significant. Serum total IgE levels were higher in patients with hypertrophic tonsil than patients with recurrent / chronic tonsillitis. This difference seems to be related to the high atopy rate seen in the hypertrophic tonsil group. As a result of these evaluations, it can be predicted that atopic patients may have hypertrophy in tonsils and atopy may be present in patients with tonsillar hypertrophy. Thus, tonsils may be one of the allergic organs such as lower respiratory tract, nose, skin, eye.

Persistent asthma phenotype related with late-onset, high atopy, and low socioeconomic status in school-aged Korean children

BackgroundTreatment guidelines for asthma have been established based on asthma severity; there are limitations in the identification of underlying pathophysiology and prediction of prognosis in heterogeneous phenotypes of asthma. Although the complex interactions between environmental and genetic factors affect the development and progression of asthma, studies on asthma phenotypes considering environmental factors are limited. This study aimed to identify asthma phenotypes using latent class analysis including environmental factors in school-age children.MethodsWe included 235 children (6–8 years) with parent-reported, physician-diagnosed asthma from the Children’s HEalth and Environmental Research (CHEER) study, which is a 4-year prospective follow-up study with 2-year intervals. At every survey, pulmonary function tests, methacholine challenge tests and blood tests with questionnaire were conducted.ResultsFour asthma phenotypes were identified. Cluster 1 (22% of children) was characterized by high prevalence of atopy and mild symptoms; subjects in cluster 2 (17%) consisted of less atopy and normal lung function, but intermittent troublesome; cluster 3 (29%) experienced late-onset atopic troublesome asthma with decreased lung function in combination with low socioeconomic status; and cluster 4 was associated with early-onset and less-atopic infrequent asthma.ConclusionsLate-onset, high atopy, and low socioeconomic status are associated with troublesome persistent asthma phenotype in school-age children. Environmental factors might be implicated in the clinical heterogeneity of asthma. Asthma phenotypes considering diverse factors might be more helpful in the identification of asthma pathogenesis and its prevention.

Asthma susceptibility variants are more strongly associated with clinically similar subgroups

Objective: Genome-wide association studies (GWAS) identified single nucleotide polymorphisms (SNPs) reproducibly associated with asthma. This study evaluated whether GWAS-nominated SNPs are more strongly associated with asthma patients sharing the same clinical characteristics in order to refine the role of recently identified genes. Methods: Analyses were performed in unrelated French Canadian subjects (566 cases and 416 controls) with data collected on lung function, blood cell counts, atopy, disease history and medication. Previously defined asthma subgroups were used for analysis: 1) older patients with low atopy and low lung function, 2) high atopy, 3) young non-smoking women and 4) high smoking history. Allele frequencies of 68 GWAS-nominated SNPs were compared between controls and cases or controls and subgroups of cases defined by cluster analysis. Results: Twelve GWAS-nominated SNPs demonstrated evidence of replication (p value < 0.05) for association with asthma. In phenotypically similar asthma patients, rs10197862, located in IL1RL1/IL18R1, was the most strongly associated SNP with the high atopy subgroup (p = 0.0009). SNPs located at the IL33 and the STARD3/PGAP3 loci were also associated with the high atopy subgroup. Two SNPs, rs1544791 (PDE4D) and rs3806932 (TSLP), were more strongly associated with the high smoking history subgroup than with asthma or any other subgroups. All 10 SNPs that replicated for asthma per se and within subgroups had lower p values in subgroups. Moreover, 12 SNPs were only replicated in a subgroup. Conclusion: This study shows that the majority of GWAS-nominated SNPs are more strongly associated with homogeneous subgroups of asthma than broadly defined asthma.

Atopic dermatitis phenotype with early onset and high serum IL-13 is linked to the new development of bronchial hyperresponsiveness in school children.

Atopic dermatitis (AD) is characterized by a heterogeneous clinical spectrum, and some forms of AD are associated with the initial steps of allergic march. The aims of this study were to determine AD phenotypes in school-age children and investigate their associations with the allergic march in each cluster. We included 242 children (6-8 years) with current AD from the Children's HEalth and Environmental Research study, a 4-year prospective follow-up study with 2-year survey intervals. Latent class analysis was used. Serum IL-13 and thymic stromal lymphopoietin (TSLP) levels at the time of enrollment were measured using ELISA. We identified four current AD phenotypes in children, characterized as 'early onset with low atopy' (26.4% of the sample; group 1), 'early onset with high atopy and high eosinophil percentages' (48.3%; group 2), 'late onset with low atopy' (9.9%; group 3), and 'late onset with high atopy and normal eosinophils' (15.3%; group 4). Although groups 2 and 4 demonstrated high atopic burden, children in group 2 showed the persistence of AD and eosinophilia associated with a high prevalence of new cases of bronchial hyper-responsiveness and asthma symptoms during follow-up. The serum IL-13 level was significantly increased in the early-onset AD groups, but there was no significant difference in the serum TSLP levels across all four groups. An allergic march-associated AD phenotype exists that is characterized by early onset of AD with its persistence, increased serum IL-13 levels, high atopy, and a persistently increased blood eosinophil percentage.

Effect of Prenatal Maternal Trait Anxiety on Atopic Dermatitis and Immunoglobulin E Level: Cocoa Study

U E S D A Y 855 Phenotypes of Atopic Dermatitis in School Children Eun Lee, Si Hyeon Lee, Ji-Won Kwon, Song I. Yang, MD, Young Ho Jung, MD, Hyung-Young Kim, Ju-Hee Seo, MD, Byoung-Ju Kim, MD, PhD, Hyo-Bin Kim, MD, PhD, So Yeon Lee, MD, PhD, HoJang Kwon, MD PhD, Soo-Jong Hong, MD, PhD; Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine, Asan Institute for Life Sciences, University of ulsan College of Medicine, Department of Pediatrics, Bundang CHA Medical Center, CHA University College of Medicine, Childhood Asthma Atopy Center, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea, Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Department of Pediatrics, Korea Cancer Center Hospital, Seoul, South Korea, Department of Pediatrics, Hae-undae Paik Hospital, Inje University College of Medicine, Busan, South Korea, Department of Pediatrics,Inje University Sanggye Paik Hospital, Seoul, South Korea, Department of Pediatrics, Hallym University College of Medicine, Seoul, South Korea, Dankook University, Cheonan. RATIONALE: Atopic dermatitis (AD) develops from a complex interplay between environmental and immunologic factors incomplete understanding of its pathophysiology. AD is characterized by heterogeneous features in its onset and severity. The aim was to define the distinct phenotypes of AD children aged 6 to 13 years. METHODS: 242 children diagnosed with AD ever and AD symptoms during the last 12 months were included from the first survey of Children’s Health and Environmental Research survey (n52491). Variables such as personal characteristics, age at onset of AD, treatment during the last 12 months, number of positive skin prick tests (SPTs), total serum IgE levels and eosinophil were included. After 4 years, lung function tests, methacholine provocation tests, and blood test including IgE and eosinophil were performed. RESULTS: We identified 4 AD phenotypes. Class types were characterized as ‘‘early onset with low atopy’’ (26.4% of sample, Group 1), ‘‘early onset with high atopy’’ (48.3%, Group 2), ‘‘late onset with low atopy’’ (9.9%, Group 3), ‘‘intermediate onset with high atopy’’ (15.3%, Group 4). At 4 year follow-up, although group 2 and 4 showed persistently elevated IgE levels, only group 2 showed persistently elevated eosinophil level, increased prevalence of new onset of bronchial hyper-responsiveness (BHR) (13.5%) and new diagnosis of asthma (8.5%), and higher positive SPTs, compared to group 4. CONCLUSIONS: The LCA revealed four distinct AD phenotypes in school children. Cluster analysis of ADmay lead to a better understanding of the pathophysiology of AD, a better prediction of the prognosis, and furthermore, an ideal application of personalized therapy in future.

Identifying the heterogeneity of young adult rhinitis through cluster analysis in the Isle of Wight birth cohort

Rhinitis affects many young adults and often shows comorbidity with asthma. We hypothesized that young adult rhinitis, like asthma, exhibits clinical heterogeneity identifiable by means of cluster analysis. Participants in the Isle of Wight birth cohort (n = 1456) were assessed at 1, 2, 4, 10, and 18 years of age. Cluster analysis was performed on those with rhinitis at age 18 years (n = 468) by using 13 variables defining clinical characteristics. Four clusters were identified. Patients in cluster 1 (n = 128 [27.4%]; ie, moderate childhood-onset rhinitis) had high atopy and eczema prevalence and high total IgE levels but low asthma prevalence. They showed the best lung function at 18 years of age, with normal fraction of exhaled nitric oxide (Feno), low bronchial hyperresponsiveness (BHR), and low bronchodilator reversibility (BDR) but high rhinitis symptoms and treatment. Patients in cluster 2 (n = 199 [42.5%]; ie, mild-adolescence-onset female rhinitis) had the lowest prevalence of comorbid atopy, asthma, and eczema. They had normal lung function and low BHR, BDR, Feno values, and total IgE levels plus low rhinitis symptoms, severity, and treatment. Patients in cluster 3 (n = 59 [12.6%]; ie, severe earliest-onset rhinitis with asthma) had the youngest rhinitis onset plus the highest comorbid asthma (of simultaneous onset) and atopy. They showed the most obstructed lung function with high BHR, BDR, and Feno values plus high rhinitis symptoms, severity, and treatment. Patient 4 in cluster 4 (n = 82 [17.5%]; ie, moderate childhood-onset male rhinitis with asthma) had high atopy, intermediate asthma, and low eczema. They had impaired lung function with high Feno values and total IgE levels but intermediate BHR and BDR. They had moderate rhinitis symptoms. Clinically distinctive adolescent rhinitis clusters are apparent with varying sex and asthma associations plus differing rhinitis severity and treatment needs.

The diversity of young adult wheeze: a cluster analysis in a longitudinal birth cohort

Cluster analyses have enhanced understanding of the heterogeneity of both paediatric and adult wheezing. However, while adolescence represents an important transitional phase, the nature of young adult wheeze has yet to be clearly characterised. To use cluster analysis to define, for the first time, clinically relevant young adult wheeze clusters in a longitudinal birth cohort. K-means cluster analysis was undertaken among 309 currently wheezing subjects at 18 years in the Isle of Wight birth cohort (N=1456). Thirteen disease-characterising clustering variables at 18 years were used. Resulting clusters were then further characterised by severity indices plus potential risk factors for wheeze development throughout the 1st 18 years of life. Six wheeze clusters were identified. Cluster 1 (12.3%) male-early-childhood-onset-atopic-wheeze-with-normal-lung-function had male predominance, normal spirometry, low bronchodilator reversibility (BDR), intermediate bronchial hyper-responsiveness (BHR), high atopy prevalence and more admissions. Cluster 2 (24.2%) early-childhood-onset-wheeze-with-intermediate-lung-function had no specific sex association, intermediate spirometry, BDR, BHR, more significant BTS step therapy and admissions. Cluster 3 (9.7%) female-early-childhood-onset-atopic-wheeze-with-impaired-lung-function showed female predominance, high allergic disease comorbidity, more severe BDR and BHR, greatest airflow obstruction, high smoking prevalence, higher symptom severity and admissions. Cluster 4 (19.4%) female-undiagnosed-wheezers had adolescent-onset non-atopic wheeze, low BDR and BHR, impaired but non-obstructed spirometry, high symptom frequency and highest smoking prevalence. Cluster 5 (24.6%) female-late-childhood-onset-wheeze-with-normal-lung-function showed no specific atopy association, normal spirometry, low BDR, BHR and symptom severity. Cluster 6 (9.7%) male-late-childhood-onset-atopic-wheeze-with-impaired-lung-function had high atopy and rhinitis prevalence, increased BDR and BHR, moderately impaired spirometry, high symptom severity and higher BTS step therapy. Young adult wheeze is diverse and can be classified into distinct clusters. More severe clusters merit attention and are associated with childhood onset, atopy, impaired lung function and in some, smoking. Smoking-associated undiagnosed wheezers also merit recognition. Better understanding of young adult wheeze could facilitate better later adult respiratory health.

Multivariate Asthma Phenotypes in Adults: The Quebec City Case-Control Asthma Cohort

Background and Objectives: Asthma is a heterogeneous disease where patient severity can be classified according to various models based on numerous variables. Large collections of well-phenotyped subjects are needed to find distinct clusters of patients for personalized medicine and future genetic studies. The objective of this study is to describe the collection of the Quebec City Case-Control Asthma Cohort and to identify homogeneous subgroups of asthma patients based on clinical characteristics. Methods: This cohort is part of an ongoing project initiated in 2007 to elucidate the genetic basis of asthma. All subjects are randomly recruited at the same site following advertisements. Subjects are unrelated French Canadian white adults 18 years of age or older. Each participant underwent a spirometry, methacholine challenge, and allergy skin-prick tests. Blood was collected for DNA, cell counts and total serum IgE measurements. So far, 982 subjects have been recruited and classified as cases (n = 566) or controls (n = 416). We performed factor and cluster analyses on collected phenotypes from this set to identify subgroups of phenotypically similar asthmatic patients. Results: Factor analysis with 13 variables led to the selection of five factors: lung function, numbers of allergens, blood eosinophil percentage, smoking status and age. K-means cluster analysis on the reduced dataset produced four significantly different groups with the following characteristics: smoking history, low atopy and low lung function, high atopy, and young non-smoking with average atopy. Conclusions: The Quebec City Case-Control Asthma Cohort is a new resource for local and collaborative clinical and genetic research on asthma. This new collection reveals distinct multivariate phenotypes of adult asthma that are likely to be important for future genetic studies and targeted therapies.

Is Asthma Caused by Atopy (Positive Skin Prick Tests)? Epidemiologic Evidence Suggests a Negative Answer

In this paper we shortly discuss epidemiological data on the relationship between asthma and atopy according to recent personal and literature epidemiological publications. The coexistence in several subjects of asthma (and of other "atopic" diseases) and IgE hyperproduction generated the dogma that these two biological conditions are mainly genetic in origin and are linked by a strong casual relationship. In the last decades atopy increased at 5-10 % annual rate and at present atopy prevalence, although variable in different countries, reaches somewhere the prevalence of more than 60 %. Similarly, asthma prevalence increased in the last decades, especially so in western and English speaking countries, reaching in certain countries prevalence values higher than 40 %. For these reasons, although certainly dependent on a genetic predisposition, atopy and asthma can nowadays be considered to be largely determined by environmental factors. Moreover, the analysis of epidemiological data derived from studies conducted worldwide, showed that the prevalence of the two conditions were clearly not correlated so that in certain countries with a 50-60% prevalence of atopy asthma prevalence is lower than 2-6 %, while in other countries asthma prevalence is double than atopy prevalence. Further, in countries with high atopy, the prevalence this conditions is high both in asthmatics and in normal subjects and in the places where asthma prevalence reaches high levels this condition is high both in atopic and non atopic people. In conclusion, epidemiological data show that environmental factors affecting asthma prevalence are different from those affecting atopy prevalence and that subjects bearing one of the two conditions don't show any preferential tendency to develop the other one. From aetiological and pathogenetic point of view asthma and atopy appear to be independent conditions We therefore believe that the association between asthma and atopy demonstrated in almost all the "population studies" (atopy prevalence has always been found 20-30 % higher in asthmatics than in non asthmatic subjects) doesn't prove the existence of a "causal" relationship between the two conditions: this could be a kind of association without causative meaning as is the association between blond hair and blue eyes which in no way can be considered a prove that one of the two conditions is the cause of the other.

Helicobacter Pylori Infection and Gastroesophageal Reflux in Asthmatic Children

The aim of this article is to investigate the prevalence of Helicobacter pylori (HP) infection, frequency of gastroesophageal reflux (GER), existence of atopy and levels of serum immunoglobulin E (IgE) in children with bronchial asthma. One hundred and thirty seven children who were diagnosed as bronchial asthma and/or wheezy child aged between 1 and 17 years were enrolled into the study. Peripheral venous blood samples were obtained to determine the total IgE and HP IgG antibody levels. GER was evaluated by the scintigraphic method and the presence of atopy was investigated by skin prick test. The study was conducted in 86 (62.8%) boys and 51 (37.2%) girls. HP IgG antibody levels were found negative in 125 (91.2%) and positive in 12 (8.8%) cases. GER was detected in 73 (53.7%) of the children. Forty-one (37.3%) children were accepted as atopic according to skin prick test results. The average total IgE levels of the participants was 168.89 +/- 270.76 IU/ml. A significant difference could not be determined related to GER, atopy frequency and serum IgE levels between the cases who had HP antibody positivity or not. The present findings suggest that the rate of HP antibody positivity is low in patients with bronchial asthma and a significant difference could not be determined in GER, and atopy between patients with positive and negative HP antibodies. High atopy frequency found in our patient group raises the question of whether allergic diseases can be protective against fecal-oral infectious diseases.

Genetic variation in the beta subunit of the high affinity IgE receptor and atopy and asthma

Genetic variation in the beta subunit of the high affinity IgE receptor and atopy and asthma

Interdigital dermatitis: sentinel skin damage in hairdressers.

In the course of a cohort study, 2275 hair-dressing apprentices were examined a median of 6 weeks after the start of their training in the years 1992. 1993 and 1994. Skin changes were noted in 821 (36%). The site most often affected was the interdigital web space (664 of those with skin changes: 81%). The proportion of participants with a high atopy score and previous hand and flexural dermatitis was larger in the subset with interdigital dermatitis than in healthy persons, but was particularly elevated in those affected by dermatitis involving other sites. Interdigital dermatitis can be regarded as a potential precursor of more severe hand dermatitis in hairdressers, and probably of irritant hand dermatitis in wet work occupations in general. Thus, it is an important sentinel for secondary prevention. e.g. regular and thorough application of emollients.

Highly atopic children: Formation of IgE antibody to food protein, especially peanut

Highly atopic infants often form IgE antibodies toward multiple food protein in the first 2 years of life. They begin producing IgE antibody to inhalant allergens between the first and second year of life. We hypothesized that highly atopic children would be at significant risk of sensitization to peanut. We defined high atopy as serum IgE ≥10 times 1 SD from normal plus multiple positive RASTs. In this study we have characterized the immunologic status of 141 patients by measuring total serum IgE and specific IgE to several allergens, including peanut. These data demonstrated that, independent of clinical history, a positive RAST to peanut was more common in the highly atopic category compared to the low atopy category. Significantly more patients who were highly atopic and had a positive peanut RAST had a positive RAST for egg or milk compared to low atopic patients. More significantly, 33 of the patients had never knowingly received peanut, yet 21 (63.6%) had a positive RAST for peanut, whereas seven (21.2%) had a peanut antibody in the highest RAST category. All these seven patients were considered highly atopic according to the definition above, and three were younger than 2 years of age. These results suggest that highly atopic infants are at special risk for sensitization to peanut, even when they have never received peanut, and that characterization of immunologic sensitization to milk, egg, and peanut will identify the highly atopic infant. At present, it is not clear how these infants became sensitized, but they likely correspond to infants who have been reported as having a reaction to peanut on first known exposure.

Synthesis of Human IgE in vitro in Normals and High IgE Atopy

Synthesis of Human IgE in vitro in Normals and High IgE Atopy