Higher Total Immunoglobulin E Research Articles

Type 2 Biomarkers and Their Clinical Implications in Bronchiectasis: A Prospective Cohort Study

PurposeBronchiectasis is predominantly marked by neutrophilic inflammation. The relevance of type 2 biomarkers in disease severity and exacerbation risk is poorly understood. This study explores the clinical significance of these biomarkers in bronchiectasis patients.MethodsIn a cross-sectional cohort study, bronchiectasis patients, excluding those with asthma or allergic bronchopulmonary aspergillosis, underwent clinical and radiological evaluations. Bronchoalveolar lavage samples were analyzed for cytokines and microbiology. Blood eosinophil count (BEC), serum total immunoglobulin E (IgE), and fractional exhaled nitric oxide (FeNO) were measured during stable disease states. Positive type 2 biomarkers were defined by established thresholds for BEC, total IgE, and FeNO.ResultsAmong 130 patients, 15.3% demonstrated BEC ≥ 300 cells/μL, 26.1% showed elevated FeNO ≥ 25 ppb, and 36.9% had high serum total IgE ≥ 75 kU/L. Approximately 60% had at least one positive type 2 biomarker. The impact on clinical characteristics and disease severity was variable, highlighting BEC and FeNO as reflective of different facets of disease severity and exacerbation risk. The combination of low BEC with high FeNO appeared to indicate a lower risk of exacerbation. However, Pseudomonas aeruginosa colonization and a high neutrophil-to-lymphocyte ratio (NLR ≥ 3.0) were identified as more significant predictors of exacerbation frequency, independent of type 2 biomarker presence.ConclusionsOur study underscores the distinct roles of type 2 biomarkers, highlighting BEC and FeNO, in bronchiectasis for assessing disease severity and predicting exacerbation risk. It advocates for a multi-biomarker strategy, incorporating these with microbiological and clinical assessments, for comprehensive patient management.

Serum vitamin D status in a cohort of infants with food protein‑induced gastrointestinal disease.

Increases in the prevalence of food allergy and vitamin D deficiency have been observed in recent years. The association between vitamin D levels and food allergy remains to be fully elucidated, and research focused on the prevalence of vitamin D insufficiency in infants with food protein-induced gastrointestinal disease in Chengdu, Sichuan is lacking. Thus, the present study aimed to determine the prevalence and clinical characteristics of serum 25 hydroxyvitamin D [25-(OH)D] insufficiency and sufficiency in infants with food protein-induced gastrointestinal disease. The present study also aimed to identify the potential predisposing factors of 25-(OH)D insufficiency. The present retrospective study analyzed data obtained from Chengdu Women's and Children's Central Hospital spanning between June 2021 and February 2022. Children with a confirmed diagnosis of food protein-induced gastrointestinal disease were enrolled in the present study. Blood indicators, including serum 25-(OH)D, serum total immunoglobulin E (IgE), specific IgE against allergens, and hemoglobin were measured during the course of the disease. Clinical characteristics of patients and blood examination results were obtained from the hospital electronic database. A total of 361 patients were included in the study group and 45 healthy individuals were included in the control group. The results of the present study demonstrated that serum 25-(OH)D levels of infants with protein-induced gastrointestinal disease were significantly lower compared with the control group. Notably, female participants with higher serum total IgE levels exhibited insufficient serum 25-(OH)D levels. However, the results of the logistic regression analysis revealed no predisposing factors associated with serum 25-(OH)D insufficiency. In conclusion, infants with food protein-induced gastrointestinal disease may exhibit a higher risk of low serum 25-(OH)D levels and this risk may be greater in females with higher total IgE.

Association of Maternal Asthma and Total Serum Immunoglobulin E levels with Obstetric Complications: The Japan Environment and Children's Study.

To evaluate the association between maternal asthma (MA) and obstetric complications, while considering subdivided total serum immunoglobulin E (IgE) levels. Data of the participants enrolled in the Japan Environment and Children's Study between 2011 and 2014 were analyzed. In total, 77,131 women with singleton live births at and after 22weeks of gestation were included. MA was defined based on a self-administered questionnaire. Women with MA were stratified based on the quartile of total serum IgE levels during pregnancy as follows: low IgE levels (< 52.40IU/mL), moderate IgE levels (52.40-331.00IU/mL), and high IgE levels (> 331.00IU/mL). The adjusted odds ratios (aORs) for preterm births (PTB), small for gestational age (SGA) infants, gestational diabetes mellitus, and hypertensive disorders of pregnancy (HDP) were calculated using multivariable logistic regression, while considering women without MA as reference and maternal socioeconomic factors as confounders. The aORs for SGA infants and HDP in women with MA and high total serum IgE levels were 1.26 (95% confidence interval [CI], 1.05-1.50) and 1.33 (95% CI, 1.06-1.66), respectively. The aOR for SGA infants among women with MA and moderate total serum IgE levels was 0.85 (95% CI, 0.73-0.99). The aOR for PTB among women with MA and low total serum IgE levels was 1.26 (95% CI, 1.04-1.52). MA with subdivided total serum IgE levels was associated with obstetric complications. Total serum IgE level may be a potential prognostic marker to predict obstetric complications in pregnancies with MA.

The Combination of Serum Total IgE and Blood Eosinophil Levels as a Predictor of Response to Phototherapy Treatment in Patients with Atopic Dermatitis

Atopic dermatitis (AD) is the most common chronic inflammatory skin disease affecting approximately 25% of all people worldwide at some point during their lifetime. Although total serum immunoglobulin E (IgE) and blood eosinophil levels are not elevated in all patients with AD, they have been shown associated with AD severity. This study aimed to investigate whether IgE and blood eosinophil levels correlate with the response to phototherapy treatment, which is a second‐line treatment for moderate‐to‐severe AD, and therefore could be considered a readily available and reliable biomarker that could guide patient management. Eighty‐two patients with AD who received phototherapy at the Sheba Medical Center were retrospectively evaluated for the following: demographic characteristics, serum IgE levels, blood eosinophils count, hospitalization duration, response to phototherapy, and requirement for systemic treatment. Response to phototherapy treatment was assessed by comparing the pre‐ and post‐treatment Investigator’s Global Assessment score for each patient in relation to the aforementioned factors. The total IgE and eosinophil levels were found to be significantly higher in patients who did not respond to phototherapy (p = 0.018 and p = 0.002, accordingly). Serum values of 1780 IU/mL for IgE and 225.0 cells/μL for eosinophils showed maximum sensitivity and specificity as predictive values for treatment response. In conclusion, this study found that high total serum IgE levels and eosinophilia were correlated with a low response to phototherapy. These results suggest that escalating treatment is recommended for patients presenting these clinical features.

Correlation of serum total immunoglobulin E levels, eosinophilia and sensitization to common aero- allergens among asthmatics in Sudan.

Asthma is a chronic inflammatory disorder of pulmonary airways in which many cells and cellular elements play a role. Chronic inflammation is responsible for increased serum total Immunoglobulin E (IgE) levels, specific IgE, and blood eosinophils (B-Eos) count. We aimed in the present study to determine quantitative physiological traits: serum total IgE, and B-Eos count and assess their correlation with skin prick test (SPT) among Sudanese asthmatics, and evaluate these findings with the persistence of developing asthma. 281 subjects; 146 asthmatics and 135 controls were recruited. Pulmonary function tests (PFTs), and SPT for commonly encountered allergens were performed using the standard methods. Serum total IgE was measured using the ELISA technique, and blood smears for B-Eos count were measured using a colter counter. An interview questionnaire was filled out for each individual to determine the duration of the disease, allergic status, and environmental factors. In the majority of asthmatics; Positive SPT response to seven allergens (P &lt; 0.01), the highest exposure allergen was found to be mixed molds (85.3%), and the strongest sensitized allergen was house dust mite (HDM) (P &lt;0.001). Serum total IgE and B-Eos count were highest (P&lt;0.001) having a significant positive SPT response (P&lt;0.001). Conclusion: There is a strong association between sensitization to some allergens and asthma. High serum total IgE levels, and high eosinophil count has been found to be correlated with asthma

Serum total IgE may be a biomarker among chronic pulmonary aspergillosis patients with elevated serum total IgE levels: A cohort study with pathological evaluations.

High serum total IgE levels are common in chronic pulmonary aspergillosis. This novel study indicated that serum total IgE is a possible biomarker of the disease activity in the aforementioned condition. Immunofluorescence staining indicated a possible role of IgE in disease pathogenesis.

High Serum Total IgE at Admission Is Associated with Coronary Artery Lesions in Children with Kawasaki Disease.

Kawasaki disease (KD) is associated with allergy. As immunoglobulin E (IgE), a key element of allergic reactions, is related with coronary heart disease, we evaluated the serum total IgE levels, and investigated its clinical relevance in 339 children with KD. These patients were classified as high IgE group and normal IgE group according to the reference value of IgE. Serum IgE levels in the high group (279.76 ± 202.54 IU/mL) significantly increased compared with the normal group (5.51 ± 15.79 IU/mL) (p < 0.001). There were also no significant differences in the frequency of major clinical manifestation between the two groups. The number of patients who developed coronary artery lesions (CALs) was significantly higher in the high group (p = 0.004), and the serum levels of IgE were also markedly higher in the KD patients with CALs than in patients without CALs (p = 0.002). High total serum IgE was an independent prognostic for CALs in the multivariate analysis. In conclusion, serum IgE levels may be associated with CALs in children with KD.

Association between preterm birth and maternal allergy considering IgE level.

The aim of this study was to explore the association between maternal allergies and preterm birth by different total immunoglobulin E (IgE) levels. Data of 81791 pregnant women from the Japan Environment and Children's Study, a prospective birth cohort, were used. Maternal allergic diseases, including a history of bronchial asthma (BA), atopic dermatitis (AD), and allergic rhinitis (AR), were obtained by self-administered questionnaires. Total serum IgE levels were measured at the first trimester and obstetrical outcomes from medical records transcripts were analyzed. The association between maternal allergic disease and obstetric outcome, including threatened abortion, preterm labor, early preterm birth (22-33weeks), and late preterm birth (34-36weeks), were examined by logistic regression. Subgroup analyses were performed by IgE level. Maternal BA and AR were associated with an increased risk of threatened abortion and preterm labor, but high total IgE level was associated with a decreased risk of preterm labor. There was little difference in associations between allergic disease and threatened abortion and preterm labor by total IgE levels. Although there was no significant association between allergic disease and preterm birth, if total IgE was high, AR was significantly associated with a decreased risk of early preterm birth (adjusted odds ratio, 0.60; 95% confidence interval 0.43-0.86). There was significant evidence for differences associated with total IgE levels (P-values for the interaction of the effects of AD and AR on early preterm birth were 0.039 and 0.015, respectively). The effect of allergy on preterm birth might differ depending on the total IgE level.

Effect of omalizumab as add-on therapy to Quality of Life Questionnaire for Korean Asthmatics (KAQLQ) in Korean patients with severe persistent allergic asthma.

Background/AimsOmalizumab is the first biologic known to be effective in patients with severe allergic asthma.MethodsThis study was conducted as a multicenter, single-group, open trial to evaluate the improvement in the quality of life with the additional administration of omalizumab for 24 weeks in Korean patients with severe persistent allergic asthma.ResultsOf the 44 patients, 31.8% were men and the mean age was 49.8 ± 11.8 years. A score improvement of 0.5 points or more in the Quality of Life Questionnaire for Korean Asthmatics (KAQLQ) was noted in 50.0% (22/44) of the patinets. In the improved group, the baseline total immunoglobulin E (IgE) level and the amount of omalizumab used were higher, and the day and night asthma symptoms were more severe, compared to those in the non-improved group. According to the Global Evaluation of Treatment Effectiveness, favorable outcomes were found in 78.6% of patients. The Korean asthma control test (p < 0.005) and forced expiratory volume in 1 second % predicted (FEV1%; p < 0.01) improved significantly in patients who received omalizumab treatment, compared to that at week 0, and the total dose of rescue systemic corticosteroids significantly decreased (p < 0.05). The improved group on KAQLQ showed a significant improvement in FEV1% (p < 0.001).ConclusionsOmalizumab can be considered a biological treatment for Korean patients with severe allergic asthma. It is recommended to consider omalizumab as add-on therapy in patients with high baseline total IgE levels and severe asthma symptoms.

Increased risk of asthma at age 10 years for children sensitized to multiple allergens

BackgroundChildhood sensitization patterns have been previously found to be related to variable risk of early life allergic disease in several birth cohorts. ObjectiveTo determine whether these risks persist into later childhood. MethodsIn the birth cohort of the Wayne County Health, Environment, Allergy and Asthma Longitudinal Study, previous latent class analysis based on sensitization to 10 allergens found the following 4 early life sensitization patterns at age 2 years: “highly sensitized,” “milk/egg dominated,” “peanut and inhalant(s),” and “low to no sensitization.” At an age 10 study-specific visit, children were evaluated by an allergist for current asthma and atopic dermatitis through a physical examination and interviews with the child and parent or guardian. Total and specific immunoglobulin E (IgE), spirometry, and methacholine challenge were also completed. ResultsCompared with children sensitized to none or 1 allergen, children sensitized to 4 or more food and inhalant allergens at age 2 had the highest risk of current asthma (relative risk [RR], 4.42; 95% confidence interval [CI], 2.58-7.59; P < .001) and bronchial hyperresponsiveness (RR, 1.77; 95% CI, 1.29-2.42; P < .001). In addition, they had the highest levels of total IgE (geometric mean, 800 IU/mL; 95% CI, 416-1536) among the 4 groups. Risk of current atopic dermatitis did not depend on pattern of sensitization but remained increased for children with any sensitization (RR, 2.23; 95% CI, 1.40-3.55; P < .001). No differences in spirometry (forced expiratory volume in 1 second, forced expiratory flow between 25% and 75%, and forced expiratory volume in 1 second/forced vital capacity) were identified. ConclusionThe previously reported importance of a specific pattern of sensitization in early life (sensitization to ≥4 inhalant and food allergens) continues to be associated with an increased risk of asthma, bronchial hyperresponsiveness, and high total IgE at age 10 years.

Predictive Value of Radiologic Central Compartment Atopic Disease for Identifying Allergy and Asthma in Pediatric Patients.

Central compartment atopic disease (CCAD) has recently been suggested as a phenotype of chronic rhinosinusitis (CRS). This study aims to investigate the prevalence of the radiologic CCAD phenotype in CRS within a pediatric population and identify its ability to predict comorbid allergy and asthma. Computed tomography and endoscopic examination were conducted on pediatric patients with CRS either with or without nasal polyps. Allergen sensitization was determined with the multiple-allergen simultaneous test and skin prick test. Serum total immunoglobulin E (IgE), peripheral blood eosinophil percentage, and presence of asthma were also evaluated. A total of 82 pediatric patients were enrolled. Overall, 55 (67.1%) of the participants demonstrated aeroallergen sensitization, and 31 (18.9%) of the 164 sides of sinuses were radiologically defined to fit the CCAD phenotype. Patients having CRS with the CCAD phenotype had a higher prevalence of aeroallergen sensitization (87.1% vs 62.4%, P = .008), particularly house dust mite (74.2% vs 53.4%, P = .035), and a higher incidence of asthma (16.1% vs 3.8%, P = .010). Additionally, patients having CRS with the CCAD phenotype demonstrated a high serum total IgE levels (51.6% vs 30.1%, P = .023) in comparison to patients having CRS without CCAD. In pediatric CRS, the radiological CCAD phenotype was associated with allergen sensitization and asthma. Furthermore, the CCAD phenotype was associated with high serum total IgE levels, suggesting allergy etiology should be considered with this type of pediatric patients with CRS.

Association between serum immunoglobulin E levels and knee osteoarthritis in Korean adults

The objective of this study was to examine whether osteoarthritis (OA) in the knees was associated with total immunoglobulin E (IgE), allergen-specific IgE, or allergic sensitizations in a nationally representative population. The study population comprised of 785 adults aged 50 years or more in the Korea National Health and Nutrition Examination Survey 2010. OA was diagnosed as radiographic (rOA) and symptomatic osteoarthritis (sxOA). We performed multivariable logistic regression analyses to investigate relationships of OA in a knee with serum total IgE, allergen (Dermatophagoides farinae, cockroach, and dog allergens)-specific IgE, and allergic sensitizations. Participants with the highest tertile of the total IgE had 92% and 242% increased risk of knee rOA and sxOA, respectively. Those with D.farinae-specific IgE had 2.2 times increased risk of knee sxOA compared to the lowest tertile. Participants with high total IgE (>150kU/L) had a 60% increased risk of knee rOA. Those with D.farinae-specific sensitization (>0.35kU/L) had 2.0 times increased risk of knee sxOA in compared to those without sensitization. Population-attributable fractions of knee rOA caused by high total IgE and knee sxOA caused by D.farinae-specific sensitization were 9.8% and 15.3%, respectively. Total IgE and D.farinae-specific IgE were significantly associated with OA in knees of Korean adults. High total IgE and D.farinae-specific sensitization were also associated with their OA.

Study of atopic multimorbidity in subjects with rhinitis using multiplex allergen component analysis

BackgroundRhinitis is a common problem within the population. Many subjects with rhinitis also have atopic multimorbidity, such as asthma and eczema. The purpose of this investigation was to compare subjects with only rhinitis to those that have rhinitis, asthma and/or eczema in relation to immunoglobulin E (IgE) sensitization, inflammatory markers, family history, lung function and body mass index (BMI).MethodsA total of 216 adult subjects with rhinitis from the European Community Respiratory Health Survey II were investigated with multiplex component allergen analysis (103 allergen components), total IgE, C-reactive protein, eosinophilic cationic protein, fractional exhaled nitric oxide and spirometry. Rhinitis, eczema, asthma and parental allergy were questionnaire-assessed.ResultsOf the 216 participants with rhinitis, 89 also had asthma and/or eczema. Participants with rhinitis that also had asthma or eczema were more likely to be IgE-sensitized (3.44, odds ratio, OR: 95% CI 1.62–7.30, adjusted for sex, age, mother’s allergy, total IgE and forced expiratory volume (FEV1)). The number of IgE-positive components was independently associated with atopic multimorbidity (1.11, OR: 95% Cl 1.01–1.21) adjusted for sex, age, mother’s allergy, total IgE and FEV1. When analysing different types of sensitization, the strongest association with atopic multimorbidity was found in participants that were IgE-sensitized both to perennial and seasonal allergens (4.50, OR: 95% CI 1.61–12.5). Maternal allergy (2.75, OR: 95% CI 1.15–4.46), high total IgE (2.38, OR: 95% CI 1.21–4.67) and lower FEV1 (0.73, OR: 95% CI 0.58–0.93) were also independently associated with atopic multimorbidity, while no association was found with any of the other inflammatory markers.ConclusionIgE polysensitization, to perennial and seasonal allergens, and levels of total IgE seem to be the main determinants of atopic multimorbidity in subjects with rhinitis. This indicates that disease-modifying treatment that targets IgE sensitization may be of value when decreasing the risk of developing atopic multimorbidity.

Racial/ethnic disparities in minority children with total IgE level >1,300 IU/ml

Immunoglobulin E (IgE) is important in the pathophysiology of allergic disease. The risk of asthma and other allergic diseases varies by population with Puerto Ricans carrying the highest burden of any population in the United States. Total IgE is used for dosing the biologic therapy omalizumab, with an upper limit of 1,300 IU/mL for pediatric patients. However, the clinical relevance of high total IgE level is controversial. Our current study sought to characterize those patients with total IgE >1,300 IU/ml from various racial/ethnic minority populations as this could represent a barrier to care and therapeutic options. We analyzed total IgE measurements available from 1,994 Puerto Rican and 1,447 Mexican American patients and 1,488 African American patients from the GALA2 and SAGE2 studies for those whose IgE level was >1,300 IU/ml. We found a high number of Puerto Rican children (217/1,994, 10.9%) have IgE >1,300, as compared to 64/1,447 or 4.4% of Mexican American (chi-squared 45.8, p<0.001) and 86/1,488 or 5.8% of African American children (chi-squared 27.3, p<0.001). Mexican Americans and African Americans were not significantly different (chi-squared 2.5, p=0.113). We further characterize these patients’ clinical phenotypes with respect to asthma and atopic dermatitis. An unusually high number of Puerto Rican children have very high IgE levels, the cause of which is not currently known. These children would not be considered as candidates for omalizumab therapy, representing a racial/ethnic disparity to care and therapeutic options.

Immunological Factors Associated with Adult Asthma in the Aseer Region, Southwestern Saudi Arabia

Background: The prevalence of asthma is on the rise in Saudi Arabia. Data regarding the immunological profile of asthma in adults in the Aseer region, in southwestern Saudi Arabia, have not been well studied. Objectives: Our aim was to study the immunological factors associated with sensitization to asthma among adults in the Aseer region. Methods: A cross-sectional study with a nested case control design in a 1:1 ratio was conducted on a sample of adults attending primary health care centers in the Aseer region. The study used a validated Arabic version of the International study of asthma and allergies in childhood (ISAAC) questionnaire. The presence of wheezing in the past 12 months was used as a proxy for bronchial asthma. Matched age and sex controls were selected. Both groups were tested for complete blood count (CBC), total and differential white blood cell (WBC) count including eosinophils, total immunoglobulin E (IgE) measurement, allergen-specific immunoglobulin E (IgE), and cytokine levels. Results: The present study included 110 cases and 157 age- and sex-matched controls. Rye wheat was found to be a significant outdoor sensitizing agent ((odds ratio) OR = 5.23, 95% CI: 1.06–25.69). Indoors, house dust mites Dermatophagoides petronyssinus (OR = 2.04, 95% CI: 1.04–3.99) and Dermatophagoides farinae (OR = 2.50, 95% CI: 1.09–5.75) were significant. Higher total IgE (OR = 1.84, 95% CI: 1.10–3.06) and eosinophil levels (OR = 2.85, 95% CI: 1.14–7.15) were significantly associated with adult bronchial asthma in Aseer. On the other hand, the role of cytokines was not significant. Conclusions: In the present study, certain environmental agents were found to be important with regards to sensitization to bronchial asthma in adults. Knowledge about these sensitization agents should be disseminated to health providers and treating physicians in order to enhance preventive environmental control measures and asthma management. Asthma-treating physicians in the region should be alerted to the use of targeted biological therapies in selected asthmatics with difficult-to-control courses.

Specific IL-5 snp is associated with high serum IL-5 levels and higher eosinophil counts among iraqi asthmatic children

Objective: Interleukin-5 (IL-5) is a cytokine known to play major role in the regulation of eosinophil formation, maturation, recruitment, and survival. Hence, an increased production of IL-5 may be contributed to the pathogenesis of eosinophil-dependent inflammatory diseases such as asthma. Methods: A total of 85 children, including 59 males and 26 females with asthma with ages between 1 year and 16 years, attended the Respiratory Clinic at Karbala pediatric hospital, with a nonasthmatic children group which have the same age and gender. Restriction fragment length polymerase chain reaction was performed to determine IL-5 C-703T genetic polymorphisms. Total immunoglobulin E (IgE) level was measured using the EUROIMMUN IgE ELISA kit and serum IL-5 levels using Elabscience ELISA kit. The absolute eosinophil count was measured by five differential automated hematology analyzers and confirmed by the examination of peripheral blood smear. Results: The TT genotype of IL-5 C-703T polymorphism was associated with asthmatic children (P: 0.033). In addition, TT genotype was associated with increase of serum IL-5 levels and high absolute eosinophil count (P = 0.008 and 0.021, respectively). Whereas, CT genotype of IL-5 C-703T was found to be associated with high total serum IgE (P

Rationale for the autologous serum skin test in acute versus chronic urticaria.

IntroductionAutologous serum skin test (ASST) is a rapid, in-vivo clinical test to detect functional autoantibodies in patients with chronic spontaneous urticaria (CSU), but the rationale for its use in acute urticaria (AU) is unknown.AimTo evaluate the efficacy of ASST among patients with AU or CSU.Material and methodsTreatment-naïve adult (age ≥ 18 years) patients with a diagnosis of AU (< 6 weeks’ duration) and CSU were enrolled prospectively in a cross-sectional study. Healthy age- and sex-matched subjects served as controls. Besides a detailed history and physical examination, ASST, total immunoglobulin E (IgE), freeT3 (fT3), freeT4 (fT4), anti-thyroglobulin, and anti-TPO levels were assessed in all subjects.ResultsOf 101 subjects, mean age was 34.35 ±12.68 years and the study comprised 58.4% of females with no difference between AU (n = 27), CSU (n = 46), and control groups (n = 28). The ratio of positivity in ASST was similar between AU (25.9%) and CSU groups (21.7%), but higher than in controls (10.7%, p = 0.33 for all). The ratio of patients with high total IgE levels (> 100 IU/ml) in AU (85.2%) and CSU (65.2%) groups was similar (p = 0.06), but significantly higher than in the control group (10.7%) (p< 0.001 and p< 0.001). The CSU group had significantly higher abnormal thyroid test results (45.7%) than AU (14.8%) and control groups (3.6%) (p = 0.01 and p< 0.001), whereas patients with clinically diagnosed thyroiditis were only in the CSU group (6.5%). In logistic regression analysis, there was no relation found among the possible risk factors for ASST, even if analysed separately as AU, CSU and control groups.ConclusionsEven though thyroid function test levels were found to be related with CSU, and total IgE was associated with urticaria, ASST was found to be of importance. This study confirms that ASST was insufficient to demonstrate autoimmunity and acute-chronic urticaria nature. Further tests indicating auto-antibodies in AU and CSU are needed.

Evaluation of Sensitivity Toward Storage Mites and House Dust Mites Among Nasobronchial Allergic Patients of Kolkata, India

House dust mites (HDMs) are the major constituents of house dust (HD). HD and HDM sensitization is well documented worldwide. Storage mite (SM) sensitization is presently lacking from India. The present study evaluated the sensitization of both HDM and SM among 372 allergic rhinitis patients reported to the Allergy and Asthma Research Center of Kolkata metropolitan, India. HD samples were collected from the patients' home and analyzed for the major constituent mites. HD and six constituent mites Dermatophagoides pteronyssinus (DP), Dermatophagoides farina Hughes (Acari: Pyroglyphidae) (DF), Blomia tropicalis (BT), Acarus siro Linnaeus (Acari: Acaridae) (AS), Lepidoglyphus destructor (LD), and Tyrophagus putrescentiae (Schrank) (Acari: Acaridae) (TP) are tested for the allergenic potential through Skin Prick Test (SPT). Three SMs, namely AS, LD, and TP, were newly included in the mite SPT extract for the first time in Kolkata. In total, 330 patients showed significant positive SPT toward any one allergen tested. HD was the major elicitor exhibiting 92.42% response. Individuals of age group 15-40 were the worst sufferers. DF showed the highest sensitization (87.87%) among the dust mites. The SMs also contributed significantly to prove their sensitizing potential. SPT rates for AS, LD, and TP were 33, 25, and 18%, respectively. SPT grades and total Immunoglobulin E (IgE) were positively correlated for each of the allergens. Most of the patients were multi-sensitized (95%) and represented markedly high total IgE levels (>500 IU/ml). Three SMs proved to be significant allergens for the studied population. The sensitization toward these SMs is first time reported from India and can be recommended for inclusion of routine SPT for better outcome in the future.

Complex relationships between vitamin D and allergic sensitization among Puerto Rican 2-year-old children

BackgroundIn the United States, Puerto Ricans have a higher prevalence of asthma than other Latino ethnicities. Low vitamin D levels for children living in northern climates could be a factor. ObjectiveTo assess serum 25-hydroxyvitamin D [25(OH)D] distributions (a marker of vitamin D) and associations among vitamin D, allergic sensitization, early wheeze, and home/demographic factors. MethodsPuerto Rican infants born in New York City, with a maternal history of atopy, were enrolled in a birth cohort. Blood was collected at age 2 years (n = 154; 82 males and 72 females). Serum 25(OH)D and immunoglobulin E (IgE) (indoor allergen-specific and total) were determined using immunoassays. Home/demographic characteristics and respiratory symptoms were assessed by questionnaire. ResultsThe median concentration of 25(OH)D was 22.6 ng/mL; 32% were at risk of deficiency or inadequacy (<12 or 12–19 ng/mL). Serum 25(OH)D levels were lower in the heating (a surrogate for less sun exposure in colder months) compared with nonheating (26.1 vs 22.7 ng/mL, P = .02) season, but were not associated with allergen-specific IgE levels or with level of acculturation (measured by maternal birthplace). However, low 25(OH)D levels (below median) were associated with high total IgE >100 IU/mL (P = .01). Also, 25(OH)D concentrations differed between children who attended daycare and those who did not (21.8 vs 24.5 ng/mL; t test, P = .02). Serum 25(OH)D was not associated with wheeze or asthma by 2 years of age (P = .43). ConclusionVitamin D deficiency, possibly linked with allergic pathways, may partially explain the trajectory for disproportionate asthma burden among Puerto Ricans, especially those born and raised in colder climates.

Identification of atopic dermatitis phenotypes with good responses to probiotics (Lactobacillus plantarum CJLP133) in children.

The therapeutic effect of probiotics in atopic dermatitis (AD) remains controversial and varies according to the individual patient. We aimed to identify a population of AD patients with a good clinical response to probiotic treatment. We recruited 76 children with a median age of 7.1 years who suffered from moderate to severe AD. After a 2-week washout period, all patients were given Lactobacillus plantarum CJLP133 at a dosage of 1×1010 colony-forming units once a day for 12 weeks. We measured eosinophil counts in the peripheral blood, the proportion of CD4+CD25+Foxp3+ regulatory T (Treg) cells in CD4+ T cells, serum total immunoglobulin E (IgE) levels, and specific IgE against common allergens before the start of the treatment (T1) and at discontinuation (T2). Responders were defined as patients with at least a 30% reduction in the SCORing of AD (SCORAD) index after treatment. There were 36 responders and 40 non-responders after probiotic treatment. The median SCORAD was reduced from 29.5 (range 20.6-46.3) at T1 to 16.4 (range 6.3-30.8) at T2 in the responder group (P<0.001). In multivariable logistic regression analysis, a good clinical response was significantly associated with high total IgE levels (aOR 5.1, 95% CI 1.1-23.6), increased expression of transforming growth factor (TGF)-β (aOR 4.6, 95% CI 1.3-15.9), and a high proportion of Treg cells in CD4+ T cells (aOR 3.7, 95% CI 1.1-12.7) at T1. In the responder group, the proportion of Treg cells was significantly increased after 12 weeks of treatment (P=0.004), while TGF-β mRNA expression was decreased (P=0.017). Our results suggest that a subgroup of patients with a specific AD phenotype showing an immunologically active state (high total IgE, increased expression of TGF-β, high numbers of Treg cells) may benefit from probiotic treatment with L. plantarum CJLP133.