Determination Of IgE Research Articles

B-056 Clinical and Analytical Performance Evaluation of Two Immunoassays for the Detection of Mite Specific Serum IgE for Allergy Diagnosis

Abstract Background IgE-mediated allergic diseases can be considered a modern epidemic, with exponential growth mainly in industrialized countries. Diagnosis is usually based on detailed medical history, physical examination, skin or challenge test and the determination of allergen-specific serum IgE - a laboratory test that has become a high-value tool in the allergy patient's journey over the last three decades. As the identification of specific immunoglobulin E (sIgE) for a given allergen is important to aid in the allergy diagnosis, several methods for detecting IgE in vitro are available worldwide and, in recent years, there have been several improvements in laboratory methodologies bringing greater advances in terms of clinical and analytical performance. The study aims to evaluate the clinical performance and correlation between two different sIgE assays (IMMULITE® 2000 3gAllergy™ and ImmunoCAP) and their concordance with Skin Prick Test (SPT) and clinical history. Methods This prospective study was conducted with approximately 130 consecutive patients who underwent evaluation of allergic diseases in different centers in Brazil. Clinical data, blood samples, and SPT results were collected. With the blood samples, the allergens D1, D2 and D201 were evaluated using both methods (IMMULITE® 2000 3gAllergy™ and ImmunoCAP) and the data were evaluated in a correlation study and clinical concordance analysis. Results Qualitatively evaluating the sIgE results between the two immunoassays, at the cutoff point considered clinically significant (≥ 0.35 KU/L), a total agreement of 95.2% (D1); 95.1% (D2), 91.7% (D201) and 96.8% (Derp2) was observed. Semi-quantitatively evaluating through reactive interpretation, an agreement of 89.5% (D1); 91.06% (D2); 87.60% (D201) and 93.33% (Derp2) was observed. Spearman's correlation between the analytical methods was 0.85 (D1), 0.93 (D2), 0.68 (D201) and 0.76 (Derp2). When compared with the SPT results, a total agreement of 78.7% and 80.1% was obtained for 3gAllergy and ImmunoCAP, respectively, with slightly higher positive agreement for both methods. Conclusions The two methods have good agreement with each other, with greater differences when evaluated quantitatively. However, when compared to clinical history and skin prick test results, both perform very similarly with a few differences that may be caused by the difference in the assay design.

B-044 Development and Evaluation of an Assay for the Detection of Human Total IgE in Serum on the Fully Automated Chemiluminescence Immunoassay Platform - Autolumo® 2000 Plus Analyzer

Abstract Background The escalating prevalence of allergic diseases on a global scale, affecting approximately 20% of the world’s population, has become a significant health concern. Clinical determination of total IgE in serum and plasma is used as an aid to the diagnosis of allergic diseases. The tIgE CLIA Microparticles Kit is a chemiluminescent microparticle immunoassay for the quantitative determination of total IgE concentrations in human serum. This kit, integrated with the AutoLumo® 2000 Plus Analyzer, offers an automated, cutting-edge platform for total IgE detection. This streamlined combination provides clinicians with a reliable tool for comprehensive and efficient allergic diseases diagnosis. Methods The performance of tIgE CLIA Microparticles Kit was evaluated on AutoLumo® A2000 Plus automated chemiluminescence analyzer and compared to a well-characterized platform (Elecsys IgE II on Cobas e601, Roche). This assay is based upon the two-step sandwich method. During detection, the patient sample and the anti-IgE coated microparticles solution were added sequentially. Unbound components were washed off after incubation. The formation of a complex occurred with the subsequent addition of a HRP conjugated anti-IgE antibody solution. The catalysis of chemiluminescent substrates by this complex generated a measurable light signal recorded as RLUs (Relative Light Units). A 2-point calibrator was used to analyze the tIgE antibody concentrations in the serum sample. The limit of blank (LoB), limit of detection (LoD), limit of quantitation (LoQ), accuracy, repeatability, linearity, specificity, on-board stability and real-time stability of the assay kit were evaluated. Serum samples (n=220) that had been previously well characterized were used for method comparisons. Results The tIgE CLIA Microparticles assay demonstrated a measurement range of 5-2500 IU/mL, with LoB, LoD, and LoQ values of ≤3 IU/mL, ≤4 IU/mL, and ≤5 IU/mL, respectively. The accuracy of the assay kit was assessed by trueness and precision following CLSI EP15-A2 and EP5-A2 guidelines. The trueness was evaluated using WHO IRP 11/234 as the reference standard, the estimate %bias between the expected and measured mean value was ≤5%. The average %CV of the intra-run and inter-run precision were 5.00% and 3.24% respectively, with a linearity of R≥0.990. The specificity to tIgE is evident, with no cross-reactivity to IgA, IgG, and IgM (≤100 μg/mL), and minimal interference from rheumatoid factor (RF) and anti-nuclear antibodies (ANA) (<10%). Furthermore, based on the CLSI EP7-A2 guideline, it showed no endogenous interference with bilirubin (30 mg/dL), hemoglobin (250 mg/dL), and triglycerides (3000 mg/dL) and no exogenous interferences with 14 commonly used allergy treatment drugs except Omalizumab (360μg/mL). Notably, the assay remains stable on-board for 28 days and exhibits real-time stability for up to 12 months at 2-8ᵒC. Clinical evaluation, involving 220 samples covering the linearity range of 5.0-2500 IU/mL, reveals a strong correlation (R>0.990) and the bias was within 15% when compared to a reference kit according to the CLSI EP9-A2 guideline. Conclusions Autolumo® Analyzers, in conjunction with the tIgE CLIA Microparticles Assay, presents a fully automated chemiluminescence immunoassay platform for accurate and cost-effective screening to aid allergic diseases diagnostics with excellent specificity, precision, and on-board stability.

Cost-effective allergy screening: a retrospective observational study.

Background. Allergies represent a substantial health concern affecting individuals across all age groups. Diagnostic screenings, such as phadiatop and phadiatop infant, are employed to identify specific IgE antibodies associated with allergic reactions. This study delves into the relationship between total IgE levels and screening test outcomes, with the objective of establishing a total IgE threshold capable of predicting the likelihood of negative results in these screenings. Methods. This retrospective observational study included adults and children under 15 years old who underwent total IgE tests in addition to phadiatop and phadiatop infant screenings from January 2018 to December 2022. Exclusion criteria were applied to patients with insufficient serum samples or those whose IgE determinations or screening tests had been invalidated according to standard laboratory protocols. Results. Data analysis uncovered a robust correlation between total IgE levels and screening test outcomes. Additionally, thresholds of 20 UI/mL and 28 UI/mL were pinpointed for total IgE levels, below which the likelihood of obtaining a positive result in phadiatop or phadiatop infant, respectively, significantly decreased. Conclusions. These findings present cost-effective strategies for healthcare practitioners by recommending the initial use of total IgE testing. Subsequently, reflex testing with phadiatop or phadiatop infant, depending on the IgE value, could be considered.

ALLERGIC CONTACT DERMATITIS AND ATOPIC DERMATITIS: HIGHLIGHTS OF THE OVERLAP SYNDROME

Introduction. The combination of atopic dermatitis (AD) with allergic contact dermatitis (ACD) or the occurrence of ACD on the background of atopic dermatitis is called the overlap syndrome. Studies have demonstrated several reasons why patients with AD have a similar or even increased risk of developing ACD compared to those without AD. Allergens and haptens are trigger factors in a group of patients with AD and ACD overlap syndrome. The aim of the study. To confirm the diagnosis of ACD in a group of patients with AD – diagnose the overlap syndrome and analyze which allergens and haptens were the trigger factors in this group. Materials and methods. To confirm IgE-dependent sensitization in atopic dermatitis, skin prick tests or determination of specific IgE in blood serum were performed. Skin patch tests (European series S-1000) were performed to determine the mechanisms of delayed-type hypersensitivity. Results. It was found that the highest specific weight of positive allergic reactions has been recorded in response to the following allergens: ticks, ticks/ambrosia, birch and mold. The absolute majority of patients demonstrated positive specific IgE-dependent sensitization to Dermatophagoides pteronyssinus and Dermatophagoides farinae – 24 (50%), in turn, on Ambrósia – 14 (29.2%), and on Alternaria alternata – 8 (16.7%). Also, the reaction was most often recorded to haptens: cobalt, nickel, formaldehyde, PPD, textile dyes. Deterioration of the clinical course and shortening of AD remission periods were observed due to the formation of ACD against the background of impaired skin barrier function and the presence of chronic immune inflammation. Conclusions. Patients with AD are more often diagnosed with ACD, which predictably worsens the course of AD. Patients with confirmed overlap syndrome "AD + ACD" most often show reactions to haptens: Cobalt, Nikel, Formaldehyde, PPD, Textile dye mix – and in the vast majority to 2 haptens or more in one patient.

Characterization of asthma phenotypes in children of the tropics

Determine the main asthma phenotypes in a population of asthmatic children in Cartagena, Colombia. 107 children (7 to 17 years old) with a previous diagnosis of asthma were recruited. Biomarkers of T2 inflammation were evaluated by measuring FeNO, eosinophil count in peripheral blood by hemocytometry, and determination of specific IgE to mite allergens by ELISA. The study was approved by the ethics committee of the University of Cartagena (SGR, Grant BPIN2020000100405). The average age of patients was 10,9 years. 19,6% of the children did not show elevation of any of the T2 inflammation biomarkers evaluated (FeNO<20ppb, eos<300/ul, negative specific IgE), so they were considered patients with non-allergic asthma (non-T2). 71,9% of all patients were sensitized to at least one allergen, this phenotype was considered allergic asthma. 30,8% of the patients presented the three elevated biomarkers (FeNO>20ppb + eos >300/ul + positive specific IgE), this phenotype was classified as high T2 allergic asthma. A moderate correlation (Spearman rho=0,44, p<0,0001) was found between FeNO values and eosinophil counts. In this study, the following phenotypes were found: allergic asthma, high T2 asthma, and non-allergic asthma. Most patients presented a type 2 inflammatory phenotype with allergic sensitization. In addition to the measurement of specific IgE, the use of FeNO and eosinophil count in peripheral blood help to accurately determine those patients with high T2 asthma phenotypes.

Skin tests, serological IgE detection, basophil test—what is available, useful and helps to clarify a mold allergy?

AbstractThe prevalence of sensitization to molds is low in healthy people, but significant in asthmatics. As it has not yet been possible to establish a cause-and-effect relationship between the presence of mold allergens and the occurrence of allergic symptoms, there is a great deal of uncertainty. The update of the S2k guideline “Medical–clinical diagnostics for indoor mold exposure” should help to objectify the topic. Based on the recommendations listed there for the diagnosis of suspected IgE-mediated mold allergy, this article presents the possibilities of skin tests, IgE determinations, and other in vitro test options, but also their limitations in clarifying the cause. Potential possibilities include component-resolved allergy diagnostics, while the limitations include the difficult standardization of test allergen extracts due to the complex allergen source and the insufficient commercial availability of the test extracts. A diagnostic algorithm is presented as a tool for a systematic approach to patients with suspected mold-associated respiratory allergy.

THE ROLE OF IL6 GENE POLYMORPHISM –174C/G IN THE DEVELOPMENT OF RECURRENT BRONCHIAL OBSTRUCTION IN CHILDREN OF EARLY SCHOOL AGE

The purpose of our work was to analyze the polymorphism of the IL6 gene –174C/G in the development of recurrent bronchitis in children of the Uzbek population of preschool age. Material and methods. To achieve this goal, 73 cases of the disease were analyzed, of which group 1 included children with acute obstructive bronchitis (AOB), group 2 - with recurrent bronchial obstruction (RBO) aged 7 to 11 years. Determination of IL-6 and total IgE in blood serum was carried out by enzyme-linked immunosorbent assay using a commercial kit of enzyme-linked immunosorbents. Total genomic DNA was isolated using the DNA-Express kit (Litekh). Single nucleotide polymorphism of the IL-6 gene 174G/C was determined by PCR. Statistical processing of the obtained data was carried out using Microsoft Excel 2013. Differences were considered statistically significant at p &lt; 0.05. Results. A comparative analysis of IL6 and total IgE in AOB and RBO showed a significant increase in IL-6 and an increase in the level of IgE in RBO compared with the AOB group and healthy children. A study of the IL6 –174C/G gene polymorphism showed that the G/G mutacin genotype was observed significantly more often in the group of patients with RBO than in the healthy group. Conclusion: It follows that the main allele G is associated with an increased level of IL-6 expression and is a prognostic factor for the development of RBO in children. The obtained clinical, genetic and immunological results of the study allow us to predict RBR in children.

The Clinical Picture of Patients with the Ultra-Extremely Low and Extremely High Total Level of Serum IgE in the Material of the Provincial Hospital in Opole from 2013-2023

Aim: There is growing interest in the importance of low serum total IgE level in the recent years due to data showing its relation to immune system dysfunction syndromes and susceptibility to malignant neoplastic diseases. Material and Method: Within the period 01/01/2013 and 31/08/2023, 13,907 determinations of total serum IgE were performed in the analytical laboratory of the Provincial Hospital in Opole. It should be noted that this research was not a routine one. In the retrospective study presented here, it was decided to compare clinically two groups - those with the ultra-extremely low IgE level (&lt;0.1 U/l), i.e. virtually undetectable, and the extremely high IgE (defined as &gt;10,000 U/l). Results: Women predominated in the group with ultra-extremely low IgE, men in the group with extremely high IgE. Clinically, respiratory conditions predominated in the first group, skin conditions in the second. Immunodeficiencies were more common in the first group, and likewise - to a lesser extent - oncological concerns. Conclusion: We propose that the IgE values &lt;0.1 U/l should be defined as ultra-extremely low (or undetectable), the values between 0.1 and 0.5 as extremely low, and the values between 0.6 and 2.0 as low. Further observations should identify the clinical features and risk of significant health concerns in these individual patient groups.

The utility of in vitro tests in diagnosing immediate hypersensitivity reactions to betalactams: specific IgE determination and the basophil activation test (BAT)

The utility of in vitro tests in diagnosing immediate hypersensitivity reactions to betalactams: specific IgE determination and the basophil activation test (BAT)

The Common Food Allergy in Iraqi Patients with Urticaria

A food allergy is a type of immunological reaction to food that is abnormal. The allergic reaction's symptoms might range from moderate to severe. Itching, swelling of the tongue, vomiting, diarrhea, hives, difficulty breathing, and low blood pressure are some of the symptoms. This can happen anywhere from a few minutes to several hours after exposure. Methods: The included samples of this study were 125 patient with chronic urticaria with age between 20 - 60 years were collected from allergy specialized center of Baghdad/ Ressafa. Determination of food allergen specific IgE in serum of total subjects was done for twenty two of common food allergens. Results: The current results showed that 39/125 of urticarial patients were positive to Beta-Lacto globulin, 29/125 positive to Banana, 21/125 positive to Apple, 14/125 positive to Egg Yolk, 10/125 positive to Sesame, 9/125 positive to Nut-Mix, 7/125 positive to Rice and Potato, 6/125 positive to Egg White, Citrus Mix and Peach, 5/125 positive to Milk and Tomato, 3/125 positive to Wheat Flour and Onion, 2/125 positive to Celery, 1/125 positive to Pea, Pork Meat, Strawberry, Baker’s Yeast, Chicken Meat and Cacao (Chocolate). Conclusions: The most common food allergies concluded in this study were for Beta-Lacto globulin, Banana, Apple, Egg Yolk and Sesame.

The Danger of Disappearing Allergen Skin Test Substances

Allergic diseases affect approximately one-quarter to one-half of the average population under 50 years of age in Central Europe. Due to the high proportion of affected individuals, allergy testing needs to be performed on a large scale, with high sensitivity and specificity at a low cost. Skin tests are the most important diagnostic measure fulfilling these requirements: they can be performed immediately and, quite in contrast to laboratory tests, the results of skin prick tests for the diagnosis of immediate allergy (IgE-mediated: Type I) can be assessed, and discussed with the patients 15–20 minutes later. Patients do not need to be called in for a second appointment to discuss the results of serum-based determination of specific IgE. Recently, we demonstrated that the sensitivity of skin prick tests is superior to the measurement of allergen-specific IgE, even for modern molecular allergens. In T cell mediated allergy of the delayed type (contact dermatitis: Type IV), patch tests read after 48–72 hours are the only available diagnostic measure.

Test di attivazione dei basofili (BAT): quale utilità nella diagnostica dell'allergia a veleno di imenotteri?

BACKGROUND: The diagnosis of Hymenoptera venom allergy (HVA) relies on detailed anamnesis, skin tests and determination of specific IgE (sIgE) with extractive and molecular allergens of Apidae and Vespidae. In many patients, however, multiple venoms sIgE positivity is detected and it is not always possible to clearly determine the primary sensitization or whether there is true double sensitization, and therefore to prescribe a proper venom-specific immunotherapy (VIT). In these cases, the in vitro sIgE inhibition test can add valuable information. However, this test requires extensive experience and has some limitations in case of low sIgE values and in case of high levels of sIgE anti-cross reactive carbohydrate determinants (CCD). Recently, the use of basophil activation test (BAT) has been recommended in order to identify the primary sensitization in subjects in which molecular testing and/or sIgE inhibition have been inconclusive. Aim of the study was to evaluate the usefulness of BAT in a selected cohort of subjects who experienced allergic reactions following hymenoptera sting, history suggestive of Vespid sting and inconclusive sIgE assay.METHODS: Nineteen subjects with allergic reactions following hymenoptera sting (17 with systemic reactions and two with extensive local reactions) were studied. Of those, six patients showed multiple sIgE positivity for Vespidae and positivity sIgE for Apis mellifera (Apis m) and anti-CCD (5/6) too; six patients complained reactions after hymenoptera sting but with negativity of Apis m and Vespidae sIgE (≤0.10 kU/L), and seven patients showed very low sIgE levels (0.11-0.84 kU/L) for extractive and/or molecular Vespidae allergens. In all subjects, the following were performed: the sIgE assay for Vespula sp, Polistes dominulus (Polistes d), Vespa crabro, Apis m, Ves v 1, Ves v 5 and Pol d 5 (ImmunoCAP 1000, Thermofisher Scientific), and BAT in which extractive venoms of Vespula sp (BAG2-I3) and Polistes d (BAG2-I77), (Bühlmann Laboratories AG), were used for basophil stimulation. The response, measured as percentage of activated basophils (CD63+) at the different venom concentrations, was evaluated by cytofluorimetric method with FACSCanto™ II (Becton Dickinson). The sIgE inhibition assay was performed by overnight incubation at 4 °C of serum with venom extract in solution (Anallergo), at decreasing concentrations of 300, 30, 3 and 0.3 µg/mL, followed by sIgE assay.RESULTS: BAT detected the primary sensitizer in 6/19 (32%) subjects including one with negative sIgE and three with very low sIgE, while sIgE assay identified the primary sensitizer in 5/19 (26%) including four concordant with BAT. BAT in 6/19 (32%) cases allowed diagnosis of dual sensitization, of which half (3/6) confirmed by inhibition test, five concordant with sIgE assay by molecular technique, and one with negative sIgE. In one of seven cases of dual sensitization evidenced by molecular testing, BAT was decisive and in one case negative. In 2/7 (29%) patients with negative sIgE for molecular allergens, BAT was positive for Vespula sp (in one of these, similar activation was obtained for Vespula sp and Polistes d at different venom concentrations).CONCLUSIONS: This study proved that BAT is useful in confirming true double sensitizations and slightly more sensitive than molecular testing in identifying single sensitization to Vespidae venom, both in cases with negative sIgE (≤ 0.10 kU/l), and in subjects with multiple positivities for Vespidae, even where anti-CCD antibodies are present. These data, therefore, confirm the importance of combining multiple laboratory methods for precision diagnosis of HVA and more accurate choice of VIT.

Description of allergic phenotype in patients with eosinophilic oesophagitis: management protocol proposal

There is a profile of patient with eosinophilic oesophagitis and atopic background, marked by the existence of IgE-mediated sensitizations. Our aim is to report the observed sensitivities to environmental and food allergens and panallergens in patients with eosinophilic oesophagitis with atopic background as well as characterizing other markers or analytical parameters. We suspect that the prevalence of sensitization to panallergens will be high and this will probably be relevant in terms of the onset and clinical course of the disease. We collated clinical and analytical data from 160 adult patients with a reported diagnosis of eosinophilic oesophagitis. These patients were studied between 1 January 2012 and 31 December 2020. During an initial visit skin tests were performed with full batteries of routine aero-allergens and foodstuffs. Patients were subsequently referred for blood test and determination of specific IgE, blood count and total IgE (in all cases), as well as eosinophilic cation protein and IMMUNOISAC in the centres in which this was available. We were able to detect a broad spectrum of sensitizations to environmental, foodstuffs and panallergens. The most common allergic disease was rhinoconjuntivitis. The sensitizations observed to foodstuffs were atypical for the adult population and were not responsible for manifestations compatible with immediate allergy. An important percentage of patients presented seasonal worsening of choking symptoms. We should be able to identify patients with eosinophilic oesophagitis and atopic background. Identifying this phenomenon would enable giving dietary and environmental recommendations as well as more specific and effective treatments to our patients.

Production of a Ric c3 hypo-allergen with no IgE binding or anaphylactogenic activity.

Several studies have been carried out to expand the use of Ricinus communis L. castor bean (Ricinus communis L castor bean.). This oilseed finds appropriate conditions for its development in Brazil, with more than 700 applications. The main allergens of this plant are Ric c1 and Ric c3, that cross-react with various aeroallergens and food allergens such as peanuts, soybeans, corn, and wheat. This study aimed to determine the effect of mutations in Ric c3 amino acid residues known to affect IgE binding and allergy challenges. Based on the Ric c3 structure, B-cell epitopes, and amino acid involved in IgE binding, we produce recombinant mutant protein, mrRic c3, secreted from E. coli. Strategic glutamic acid residues in IgE-biding regions were changed by Leucine. The allergenicity of mrRic c3 was evaluated by determination of IgE, IgG1, and total IgG in immunized Balb/c mice and by degranulation assays of mast cells isolated from Wistar rats. The mrRic c3 presented a percentage of mast cell degranulation close to that seen in the negative control, and the immunization of mice with mrRic c3 presented lower levels of IgE and IgG1 than the group treated with the protein without mutations. The mutant mrRic c3 had an altered structure and reduced ability to stimulate pro-inflammatory responses and bind IgE but retained its ability to induce blocking antibodies. Thus, producing a hypoallergenic mutant allergen (mrRic c3) may be essential in developing new AIT strategies.

Популяционное исследование распространенности целиакии среди школьников г. Москвы

Objective. Examination of schoolchildren in Moscow using a specially designed questionnaire to identify children at risk of developing celiac disease. Patients and methods. The study enrolled 3070 Moscow schoolchildren aged 7–18 years old. Serological and genetic examinations were performed in 42 children at risk for celiac disease, including determination of IgA and IgE to wheat, IgA and IgG to tissue transglutaminase, and IgA to endomysium. Molecular HLA testing for alleles that predispose to celiac disease was conducted. Endoscopic and morphological diagnostics were performed when indicated. Results. The risk group for celiac disease amounted to 10.2% of all schoolchildren surveyed. According to the results of the questionnaire, children in the risk group significantly more often had abdominal pain, excess gas, bloating, flatulence, dyspeptic complaints (diarrhea, constipation, vomiting), asthma attacks or other forms of allergies, headache, joint or body pain, fatigue and weakness, mood swings, depression, anxiety, or episodes of emotional arousal. Changes in height, weight, delayed physical or sexual development, dental enamel defects, and skin rashes were also noted. Of the 42 children in the risk group, the DQ2 heterodimer was detected in 13 (31%) children, the DQ8 heterodimer – in 2 (4.8%), and a combination of DQ2 and DQ8 heterodimers – in 1 (2.4%). Thus, characteristic HLA haplotypes were identified in 38% of the examined children. Three children had IgA antibodies to tissue transglutaminase (at &gt;10 norm) and IgA anti-endomysium antibody titers. Conclusion. The method of questioning by means of a specially designed questionnaire for school-age children allows to identify individuals at risk of developing celiac disease. According to serological, genetic, endoscopic, and morphological investigations, the incidence of celiac disease among children at risk was 7.1%. The prevalence of celiac disease among school-age children in Moscow corresponds to global trends, amounting to 0.7%. Key words: questionnaire, gluten-free diet, cereals, gluten intolerance, celiac disease, children

Профіль сенсибілізації до алергенних компонентів у пацієнтів з респіраторною алергічною патологією

Abstract. Respiratory allergic diseases, which include allergic rhinitis and bronchial asthma, are a serious medical and social problem worldwide due to their high prevalence and negative impact on the quality of life of the relevant category of patients. The development of respiratory allergy pathology is usually caused by inhaled allergens, which are divided into seasonal: tree, grass or weed pollen, as well as year-round — house dust mites, mold, pet epithelium. But at the same time, respiratory manifestations of allergic pathology are often combined with its non-respiratory manifestations, which affects the profile of sensitization of patients to various allergens and requires a personalized approach to specific allergy diagnostics and immunotherapy. The aim of this study was to study the profile of sensitization to the components of various allergens in patients with respiratory allergic pathology. Materials and methods. The results of a multiplex study (determination of specific IgE to 112 allergenic proteins using the ImmunoCap ISAC test system) in 291 patients who applied to the Clinic of Allergology and Immunology “Forpost” with signs of respiratory allergic pathology were analyzed. Results. Among the seasonal allergens, the most frequent causes of sensitization were spring tree proteins (PR10) — Bet v1, timothy and meadow grasses Phl p1, and ragweed Amb a1. Among year-round allergens, sensitization to the major allergenic component of cats — uteroglobin Fel d1, major components of house dust mites and mold fungi Alternaria alternata was most often detected. Among the allergenic proteins of dogs, sensitization to urinary kallikrein Can f5 was most common. The vast majority of examined patients also had sensitization to food allergens of three main groups of proteins — thermolabile proteins (PR10), lipid transport proteins (LTP), or tropomyosin. Conclusions. In the structure of sensitization among adult patients, the main components of pollen allergens of spring trees (Bet v1), meadow grasses (Phl p1) and ragweed (Amb a1) play an important role. Year-round allergens include cat allergens (Fel d1), house dust mites (Der р1, Der f1, Der p2, Der f2) and Alternaria alternata mold (Alt a1). In patients with hypersensitivity to dog and house dust mite allergens, it is necessary to determine the presence of antibodies to such important components as Can f5 and Der p23. Sensitization to minor components of allergens was detected much less often, however, the appropriate determination of antibodies to them is also important, as it affects the choice of patient treatment tactics. Sensitization to food products in persons with respiratory allergic diseases is due to cross-properties of inhaled and food allergens due to PR10, LTP and tropomyosin molecules.

Allergic rhinitis caused by plant pollen in adolescents

Background. Allergic rhinitis is caused by grass pollen is a common problem in the world. The symptoms of this disease can varied on the age of the patient. &#x0D; Aim: to identify the etiology and analyze the clinic of allergic rhinitis in adolescents. &#x0D; Methods. An allergic examination was carried out in 96 patients with allergic rhinitis signs who were treated at MEGI MC, which included the study of an allergic history and setting of scarification tests, determination of IgE, comparison of clinical manifestations and detection of sensitization to pollen of various plants in adolescents with allergic rhinitis. &#x0D; Results. The prevailing share of girls was 65.4%. The etiological factors were tree pollen in 28.6% of cases (in 27 patients), weeds — 12.4% (12 people), meadow grasses — 10.6% (10 people), meadow and weeds — 8.3 % (8 people), a combination of trees, meadow and weeds — 6.4% (6 people) and trees and meadow grasses — 4.7% (4 people). &#x0D; Conclusion. Typical clinical manifestations consist of light and middle rhinitis — 71 people (94%), conjunctivitis — 45 people (58.8%), rhinosinusitis — 22 people (28.6%), bronchial asthma — 10 people (10.4%).

DOES RACE IMPACT THE RELATIONSHIPS BETWEEN FENO AND CLINICAL CHARACTERISTICS OF ASTHMA AND ALLERGIC DISORDERS?

<h3>Introduction</h3> Fractional exhaled nitric oxide (FeNO) is an adjunctive tool for asthma management. It is also elevated in atopic patients without asthma. We sought to evaluate whether race modifies the association of FeNO with indicators of allergy and asthma. <h3>Methods</h3> Children attending a scheduled 10 year visit as part of the WHEALS (Wayne County Health Environment Allergy and Asthma Longitudinal Study) birth cohort were included, with analysis restricted to participants whose reported race was Black or White. The 10 year visit included determination of allergic rhinitis (AR), atopic dermatitis (AD), asthma, food allergy (FA), spirometry, methacholine challenge, total IgE, eosinophil count, and allergen sensitization. <h3>Results</h3> 459 children (75.4% Black, mean age 10.2 years) had sufficient data for analysis. Children with current asthma, AR, AD, FA, or sensitization to common foods or inhalant allergen had higher FeNO (p <0.001 for each). Black children had higher FeNO levels (p=0.002). Following adjustment for other variables including allergic disorders and atopy, race had no significant association with FeNO (p=0.094). Following adjustment, race was a significant effect modifier only for the association between PC20 and FeNO (p=0.007), where an association of higher FeNO with bronchial hyperresponsiveness was found amongst Black children. <h3>Conclusion</h3> Our data reflects a diverse population with higher levels of FeNO in Black children compared to White children, largely explained by a higher prevalence of allergic disorders and atopy. Although the association between PC20 and FeNO was modified by race, a potential limitation was that we could not conduct a methacholine challenge in all children.

Allergen Profile of London Plane Tree Pollen: Clinical and Molecular Pattern in Central Spain.

Platanus acerifolia (London plane tree) is a deciduous tree of the Platanaceae family. Sensitization to this plant varies with geography. Madrid, located in central Spain, has one of the highest London plane tree pollen concentration levels on the Iberian Peninsula. We evaluated both the clinical characteristics and the molecular sensitization pattern of patients with allergy to London plane tree pollen in the region of Madrid. Thirty-eight patients allergic to London plane tree pollen were selected according to their clinical symptoms and positive results in skin prick testing and/or specific IgE determination. Serum was collected, and allergen components were evaluated using immunodetection techniques as well as ImmunoCAP. The IgE-binding proteins detected were identified and characterized using mass spectrometry. Analysis of serum samples from allergic patients revealed 9 IgE-binding bands in London plane tree pollen extract. Among these, the 45-kDa protein, which corresponded to Pla a 2, was detected in 76.3% of patients. However, the 18-kDa (Pla a 1) and 9-kDa (Pla a 3) bands were detected in 44.7% and 23.7% of sera, respectively. These results were confirmed using purified proteins. Characterization of the allergen revealed the 27-kDa protein to be glutathione-S-transferase. The molecular profile of patients sensitized to London plane tree pollen differs from that reported in studies from other locations. In the population we studied, the prevalence of Pla a 2 was higher than that of Pla a 1 and Pla a 3. In addition, the minor allergen previously referred to as Pla a 4 was characterized as glutathione-S-transferase.

Skin symptoms in veterinary assistant staff and veterinarians: A cross-sectional study.

Veterinary assistants and veterinarians are at an increased risk of developing an occupational skin disease, for example, irritant/allergic contact dermatitis, contact urticaria and hand eczema (HE). We aimed to investigate the prevalence of skin problems and the influence of predisposing factors especially among veterinary assistants. We conducted a cross-sectional study among veterinary assistant staff (n= 103) and veterinarians (n= 19). A questionnaire, specific IgE determination and photographs of hands were evaluated for skin symptoms. Logistic regression models assessed predisposing factors. Over 50% (n= 62/122) of our study population reported hand eczema (HE) in the last 12 months (1-year prevalence). Twenty-seven subjects reported redness and contact urticaria directly after animal contact, 35 had a positive history of allergic contact dermatitis. HE was associated with (i) increased frequency of hand washing (11-15 times per day; OR 4.15, confidence interval [CI] 95% 1.18-14.6, p= 0.027, univariate model) and (ii) unprotected contact to fluids and tensides >5 times per day (OR 4.56, CI 95% 1.53-13.6, multivariate model). We observed a high prevalence of self-reported HE among staff in veterinary practices. Excessive hand washing, unprotected contact with irritants and long-term glove use should be avoided.