Inhalant Allergen Sensitization Research Articles

Optimizing Identification of Allergic Sensitization to Seasonal Inhalant Allergens in the USA: Implications for Constructing Optimal Panels to Evaluate Patients with Allergy

Introduction: While a specific number and type of antigens are recognized to detect perennial inhalant allergies, the optimal number and combination of allergens to reliably identify seasonal allergic sensitization is unclear due to limited national data. This study analyzed aeroallergen testing data from a large US clinical reference laboratory to provide guidance for optimizing seasonal allergen test selection. Methods: The 2019 serum IgE tests for seasonal inhalant allergens were identified from the Quest Diagnostics database. Patients with results for at least 1 of 31 seasonal allergens across 4 allergen classes (11 trees, 7 weeds, 5 grasses, and 8 molds) were analyzed. A step-by-step conditional approach was employed to determine the minimum number and species of allergens needed to identify at least 98% of sensitized patients for each class. Results: Of 88,042 patients tested for ≥1 seasonal allergen, 1.5%, 1.8%, 1.3%, and 1.6% were tested for all trees, weeds, grasses, and molds, respectively. Of those tested for all allergens within a class, 40.4%, 38.6%, 29.5%, and 21.2% were sensitized to at least one tree, weed, grass, or mold allergen, respectively. Identification of ≥98% of sensitized patients within a class required 8 allergens for trees (mountain cedar, maple box elder, walnut, white ash, elm, birch, cottonwood, and hickory/pecan), 5 for weeds (common ragweed short, rough pigweed, English plantain, lamb's quarters/goosefoot, and Russian thistle), 3 for grasses (June/Kentucky blue grass, Johnson grass, and Bermuda grass), and 7 for molds (Alternaria alternata, Aspergillus fumigatus, Mucor racemosus, Epicoccum purpurascens, Penicillium notatum, Helminthosporium halodes, and Fusarium moniliforme). Conclusion: A minimum of 23 antigens is required to optimally detect sensitization to four classes of seasonal allergens (i.e., ≥98% identification). The addition of these allergens to unique perennial allergens (cat, dog, mouse, cockroach, and 2 dust mite species) results in a comprehensive elucidation of inhalant allergen sensitization. This knowledge provides a pivotal guide for clinical laboratories as they construct allergen panels to optimize diagnostic yield.

Endoscopic and Radiologic Central Compartment Disease as Predictors of Perennial Inhalant Allergen Sensitization in Chronic Rhinosinusitis.

Central compartment atopic disease (CCAD) is a recently described variant of chronic rhinosinusitis (CRS) strongly associated with atopy. The association between central compartment disease (CCD) and inhalant allergy is not well established in South-East Asia, where perennial allergic rhinitis is common. The primary objective was to evaluate endoscopic and radiologic CCD as predictors of perennial allergen sensitization in primary CRS. The secondary objective was to compare clinical characteristics of CCAD with other CRS subtypes (CRSwNP and CRSsNP). A retrospective study of consecutive patients with primary CRS who underwent endoscopic sinus surgery at our institution was performed. Allergen sensitization was confirmed by skin or serum testing. Endoscopy records and computed tomography scans of paranasal sinuses were reviewed for CCD. The diagnostic accuracy of endoscopic and radiologic CCD in predicting atopy was calculated. There were 104 patients (43 CCAD, 30 CRSwNP and 31 CRSsNP). Endoscopic CCD was significantly associated with aeroallergen sensitization (odds ratio (OR) 3.99, 95% confidence interval (CI) 1.65-9.67, P = 0.002). Endoscopic CCD predicted atopy with 57% sensitivity, 72% specificity, 69% positive predictive value and positive likelihood ratio of 2.05. Radiologic CCD was not associated with aeroallergen sensitization (OR 0.728, 95%CI 0.292-1.82, P = 0.496). There were more CCAD patients who reported hyposmia (86% vs 42%, P < 0.001) and had anosmia on olfactory testing than CRSsNP (65% vs 14%, P = 0.015). The prevalence of atopy was significantly higher in CCAD than CRSwNP and CRSsNP (70% vs 37% and 42%, P = 0.015 and P = 0.05, respectively). Median serum total immunoglobulin E was higher in CCAD (283 IU/ml) and CRSwNP (127 IU/ml) than CRSsNP (27 IU/ml, P = 0.006 and P = 0.042, respectively). Endoscopic CCD was a better predictor of inhalant allergy than radiologic CCD in primary CRS, in a locale of perennial allergic rhinitis.

Impact of the COVID-19 Epidemic on Inhalant Allergen Sensitization in Children

Objective. To explore the impact of non-pharmacological interventions on inhaled allergen sensitization in children during the COVID-19 pandemic. Methods. The positive rate of inhaled allergens, allergens sIgE grade, and multiple sensitization rates before and during the pandemic were analyzed retrospectively in this study. Logistic regression analysis was used to compare the positive rate of allergens before and during the pandemic, using odds ratio (OR) and OR 95% CI to investigate the impact of the pandemic on allergen sensitization. Results. Positive rates of d1 (49.5% vs. 38.5%), d2 (50.2% vs. 32.2%), e2 (10.1% vs. 6.1%), e1 (6.2% vs. 1.7%), mx2 (10.1% vs. 2.7%), sycamore (7.2% vs. 2.1%), w1 (4.0% vs. 1.7%), elm (3.1% vs. 0.6%), w6 (3.0% vs. 1.7%), and u80 (1.3% vs. 0.5%) increased significantly during the COVID-19 pandemic. After adjusting gender, age, season, and other potential influencing factors, the COVID-19 pandemic was found to be a risk factor for the positive rate of d1 (OR = 1.174, 95% CI = 1.015–1.358), d2 (OR = 1.301, 95% CI = 1.093–1.549), e2 (OR = 1.499, 95% CI = 1.280–1.756), mx2 (OR = 3.959, 95% CI = 3.358–4.446), w1 (OR = 1.828, 95% CI = 1.353–2.470, w6 (OR = 1.538, 95% CI = 1.123–2.106)), and u80 (OR = 2.521, 95% CI = 1.413–4.497) (P&lt;0.05). In addition, d1 and d2 allergen sIgE grades increased during the COVID-19 pandemic (d1: χ2 = 9.576, P&lt;0.05; d2: χ2 = 39.063, P&lt;0.05). The proportion of multiple allergies was significantly higher than that before the pandemic, with a statistical significance (χ2 = 1621.815, P&lt;0.05). Conclusion. During the COVID-19 pandemic, non-pharmacological interventions increased the positive rate of both indoor and outdoor allergens in children. The sIgE grade of dust mite allergen and multiple sensitization rates were significantly higher than those before COVID-19.

Complement C1q essential for aeroallergen sensitization via CSF1R+ conventional dendritic cells type 2

Dendritic cells (DCs) are heterogeneous, comprising multiple subsets with unique functional specifications. Our previous work has demonstrated that the specific conventional type 2 DC subset, CSF1R+cDC2s, plays a critical role in sensing aeroallergens. It remains to be understood how CSF1R+cDC2s recognize inhaled allergens. We sought to elucidate the transcriptomic programs and receptor-ligand interactions essential for function of this subset in allergen sensitization. We applied single-cell RNA sequencing to mouse lung DCs. Conventional DC-selective knockout mouse models were employed, and mice were subjected to inhaled allergen sensitization with multiple readouts of asthma pathology. Under the clinical arm of this work, human lung transcriptomic data were integrated with mouse data, and bronchoalveolar lavage (BAL) specimens were collected from subjects undergoing allergen provocation, with samples assayed for C1q. We found that C1q is selectively enriched in lung CSF1R+cDC2s, but not in other lung cDC2 or cDC1 subsets. Depletion of C1q in conventional DCs significantly attenuates allergen sensing and features of asthma. Additionally, we found that C1q binds directly to human dust mite allergen, and the C1q receptor CD91 (LRP1) is required for lung CSF1R+cDC2s to recognize the C1q-allergen complex and induce allergic lung inflammation. Lastly, C1q is enriched in human BAL samples following subsegmental allergen challenge, and human RNA sequencing data demonstrate close homology between lung IGSF21+DCs and mouse CSF1R+cDC2s. C1q is secreted from the CSF1R+cDC2 subset among conventional DCs. Our data indicate that the C1q-LRP1 axis represents a candidate for translational therapeutics in the prevention and suppression of allergic lung inflammation.

Early inhalant allergen sensitization at component level: an analysis in atopic Dutch children.

Allergic rhinitis is a common respiratory disease in children and sensitization to inhalant allergens plays a significant role in its development. However, limited knowledge exists regarding sensitization profiles of inhalant allergen components in atopic children, particularly in the very young individuals. Understanding these profiles could provide insights into the early development of allergic rhinitis. The objective of this cross-sectional retrospective study was to evaluate the IgE-sensitization profiles to multiple inhalant allergen components and their clinical relevance in Dutch atopic children, with specific focus on children under the age of 4 years. A total of 243 atopic children were included in the study and sensitization profiles were analyzed using multiplex microarray analysis (ISAC). Clinical information was obtained from records of a pediatric allergy outpatient clinic between 2011 and 2020. Specific IgE responses to inhalation allergen components from five allergen sources (grass pollen, tree pollen, house dust mite, cat and dog), were examined. The study encompassed children of different age groups and compared those with and without symptoms. The results demonstrated that sensitization to inhalant allergen components was present in 92% of the cohort. Sensitization was already evident at a young age (87%), including infancy, with a rapid increase in prevalence after 1 year of age. House dust mite emerged as the most predominant sensitizing allergen in early childhood, followed by tree pollen in later years. Sensitization patterns were similar between symptomatic and asymptomatic children, although symptomatic children exhibited higher frequencies and values. The sensitization profiles in very young children were comparable to those of children across all age groups. These findings highlight the presence of sensitization to inhalant allergen components and the early onset of allergic rhinitis before the age of 4, including infancy, in Dutch atopic children. Notable allergen molecules in Dutch atopic children under the age of 4 years include Bet v 1, Fel d 1, Der f 1, Der p 1, Der p 10 and Phl p 4, with house dust mite sensitization being the most common among Dutch infants. Moreover, the prevalence of sensitization to inhalant allergens in this Dutch cohort surpassed that of general European populations, emphasizing the importance of early assessment and management of allergic rhinitis in young atopic children.

Early life sensitization for inhalant allergen develops respiratory allergic diseases : COCOA study

Allergic sensitization differs by age, and tends to develop allergic diseases. This study investigated whether inhalant allergen sensitization develops allergic diseases in general population of Korean children.

Effect of gut microbial composition and diversity on major inhaled allergen sensitization and onset of allergic rhinitis

BackgroundDecreased gut microbiota diversity is associated with gut dysbiosis and causes various diseases, including allergic diseases. We investigated the relationship between gut microbial diversity and sensitization to major inhaled allergens. Furthermore, the relationship of allergic symptom onset with bacterial composition in sensitized individuals was investigated. MethodsThis study included 1092 local residents who had participated in the Iwaki Health Promotion Project in 2016. Blood samples were analyzed to ascertain specific IgE levels against major inhaled allergens (JCP, HD1, Grass-mix, Weed-mix). Nasal symptoms were estimated by questionnaires. Fecal samples were analyzed for bacterial 16S rRNA using next generation sequencing. The diversity index (α-diversity, β-diversity) and the composition of gut microbes in phylum/order levels were compared between patients sensitized or unsensitized to allergen, and symptomatic and asymptomatic groups. ResultsSome α-diversity metrics were significantly decreased in patients who were sensitized to any/all four allergens compared with the unsensitized group. β-diversity differed significantly between those unsensitized and sensitized to all allergens (aged 20–49 years), and between those unsensitized and sensitized to any/all four allergens (aged ≥50 years). The relative abundance of Bacteroidales was significantly lower in the unsensitized than in the sensitized group. The composition and diversity of gut microbiota were similar between the symptomatic and asymptomatic groups. ConclusionsOur results suggest that lack of diversity in gut microbiota has an effect on sensitization to allergens. Bacteroidales in order level may affect sensitization; however, the onset of allergy symptoms was not significantly associated with bacterial composition and diversity.

Clinical Characteristics of Atopic Dermatitis in Korean School-Aged Children and Adolescents According to Onset Age and Severity

BackgroundAtopic dermatitis (AD) is a heterogeneous disease with different age of onset, disease course, clinical symptoms, severity, and risk of comorbidity. The characteristics of children with AD also vary by age or country. However, little is known about the clinical characteristics of AD in Korean school-aged children and adolescents. Furthermore, there are few studies on phenotypic differences according to onset age. This study aimed to explore the clinical characteristics and phenotypes according to onset age and severity of AD in children and adolescents in Korea.MethodsAD patients aged 6–18 years who presented to 18 hospitals nationwide were surveyed. The patients were examined for disease severity by pediatric allergy specialists, and data on history of other allergic diseases, familial allergy history, onset age, trigger factors, lesion sites, treatment history and quality of life were collected. The results of the patient’s allergy test were also analyzed. The patients were classified into infancy-onset (< 2 years of age), preschool-onset (2–5 years of age), and childhood-onset (≥ 6 years of age) groups. Study population was analyzed for clinical features according to onset-age groups and severity groups.ResultsA total of 258 patients with a mean age of 10.62 ± 3.18 years were included in the study. Infancy-onset group accounted for about 60% of all patients and presented significantly more other allergic diseases, such as allergic rhinitis and asthma (P = 0.002 and P = 0.001, respectively). Food allergy symptoms and diagnoses were highly relevant to both earlier onset and more severe group. Inhalant allergen sensitization was significantly associated with both infancy-onset group and severe group (P = 0.012 and P = 0.024, respectively). A family history of food allergies was significantly associated with infancy-onset group (P = 0.036). Severe group was significantly associated with a family history of AD, especially a paternal history of AD (P = 0.048 and P = 0.004, respectively). Facial (periorbital, ear, and cheek) lesions, periauricular fissures, hand/foot eczema, and xerosis were associated with infancy-onset group. The earlier the onset of AD, the poorer the quality of life (P = 0.038). Systemic immunosuppressants were used in only 9.6% of the patients in the severe group.ConclusionThis study analyzed the clinical features of AD in Korean children and adolescents through a multicenter nationwide study and demonstrated the phenotypic differences according to onset age and severity. Considering the findings that the early-onset group is more severe and accompanied by more systemic allergic diseases, early management should be emphasized in young children and infants.

Effects of Exposure to Indoor Fine Particulate Matter on Atopic Dermatitis in Children.

This study aimed to investigate the short-term effect of exposure to indoor fine particulate matter (PM2.5) on atopic dermatitis (AD) symptoms in children. Sixty-four children (40 boys and 24 girls) with moderate-to-severe AD, aged under 18 years were enrolled in the study. They were followed up from February 2019 through November 2020. Exposure to indoor PM2.5 in each household of the enrolled children and their AD symptoms were measured daily. The generalized linear mixed model was utilized for statistical analysis. Subdivision analysis was performed by stratifying the patients by age, sex, season, severity, the presence of family allergic diseases, sensitization, and indoor environment conditions including temperature and relative humidity. A total of 9,321 person-days of AD symptom data were collected. The average PM2.5 concentration was 28.7 ± 24.3 µg/m3, with the highest value in winter (47.1 ± 29.6 µg/m3). The overall effect of PM2.5 on AD symptoms was not statistically significant. However, an increase of 10 µg/m3 in indoor PM2.5 concentration increased AD symptom scores by 16.5% (95% CI: 6.5, 27.5) in spring and12.6% (95% CI: 4.3, 21.5) in winter, 6.7% (95% CI: 2.3, 11.3) at indoor temperatures of <25.5 °C, and by 15.0% (95% CI: 3.5, 27.7) with no use of an air purifier. The harmful effect of PM2.5 in boys, in children aged ≥6 years, and in children with inhalant allergen sensitization was significant, showing an increase in AD symptoms of 4.9% (95% CI: 1.4, 8.6), 12.0% (95% CI: 5.3, 19.1), and 7.0% (95% CI: 1.9, 12.3) per 10 µg/m3 of PM2.5, respectively. Furthermore, children with inhalant allergen sensitization plus severe symptoms (SCORing Atopic Dermatitis, SCORAD ≥ 30.7, median value) showed more harmful effects from exposure to PM2.5 (15.7% (95% CI: 4.5, 28.1) increase in AD symptom scores per 10 µg/m3 of PM2.5 increase). Indoor exposure to PM2.5 exacerbated AD symptoms in children in spring, winter, and at indoor temperatures of < 25.5 °C. In particular, this harmful effect was prominent in children with inhalant allergen sensitization and severe symptoms. Minimizing exposure to indoor PM2.5 is needed for the proper management of AD.

A population-based study on associations of stool microbiota with atopic diseases in school-age children

Infants with less diverse gut microbiota seem to have higher risks of atopic diseases in early life, but any associations at school age are unclear. This study sought to examine the associations of diversity, relative abundance, and functional pathways of stool microbiota with atopic diseases in school-age children. We performed a cross-sectional study within an existing population-based prospective cohort among 1440 children 10 years of age. On stool samples, 16S ribosomal RNA gene sequencing was performed, and taxonomic and functional tables were produced. Physician-diagnosed eczema, allergy, and asthma were measured by questionnaires, allergic sensitization by skin prick tests, and lung function by spirometry. The α-diversity of stool microbiota was associated with a decreased risk of eczema (odds ratio [OR], 0.98; 95% CI, 0.97, 1.00), and β-diversity was associated with physician-diagnosed inhalant allergy (R2= 0.001; P= .047). Lachnospiraceae, Ruminococcaceae_UCG-005, and Christensenellaceae_R-7_group species were associated with decreased risks of eczema, inhalant allergic sensitization, and physician-diagnosed inhalant allergy (OR range, 0.88-0.94; 95% CI range, 0.79-0.96 to 0.88-0.98), while Agathobacter species were associated with an increased risk of physician-diagnosed inhalant allergy (OR, 1.23; 95% CI, 1.08-1.42). Functional pathways related to heme and terpenoid biosynthesis were associated with decreased risks of physician-diagnosed inhalant allergy and asthma (OR range, 0.89-0.86; 95% CI range, 0.80-0.99 to 0.73-1.02). No associations of stool microbiota with lung function were observed. The diversity, relative abundance and functional pathways of stool microbiota were most consistently associated with physician-diagnosed inhalant allergy in school-age children and less consistently with other atopic diseases.

Maternal iron status during early pregnancy and school‐age, lung function, asthma, and allergy: The Generation R Study

BackgroundIron deficiency during early life could affect the developing lung and immune system, and influence child's respiratory or allergy outcomes in later life.ObjectiveTo examine the associations of maternal iron status during early pregnancy with child's lung function, asthma, inhalant allergic sensitization, and physician‐diagnosed inhalant allergy at school‐age.MethodsIn a population‐based cohort study, among 3825 mother–child pairs, ferritin, transferrin concentrations, and transferrin saturation were measured from maternal venous blood samples during early pregnancy. In children at the age of 10 years, spirometry was used to determine child's lung function, current asthma and physician‐diagnosed inhalant allergy were assessed by questionnaires, and inhalant allergic sensitization was measured by skin prick tests. We used multivariable regression models to examine the associations.ResultsAfter adjustment for gestational age at maternal iron status measurement and sociodemographic or lifestyle‐related confounders, a higher maternal transferrin concentration was associated with a higher risk of physician‐diagnosed inhalant allergy (odds ratio [95% confidence interval]: 1.13 [1.01 to1.26]), but not with lung function, asthma, or inhalant allergic sensitization. This association did not attenuate after further adjustment for maternal hemoglobin levels or early growth factors. We observed no consistent association of maternal ferritin concentrations or transferrin saturation with child's respiratory or allergy outcomes.ConclusionHigher maternal transferrin concentrations during pregnancy, reflecting lower serum iron levels, were associated with an increased risk of child's physician‐diagnosed inhalant allergy but not lung outcomes. Underlying mechanisms and clinical implications need to be explored.

Clinical characteristics and cytokine profiles of central-compartment-type chronic rhinosinusitis.

The clinical characteristics of central-compartment-type chronic rhinosinusitis (CRS) in East Asian individuals are not clear. We sought to investigate the clinical features and the cytokine profiles of central-compartment-type CRS in our patient group. Adult patients diagnosed with bilateral CRS were recruited, and patients who had previously undergone sinus surgery and pansinusitis (Lund-Mackay scores >23) were excluded. Central-compartment-type CRS was defined by both endoscopic and radiological features. The symptoms, inhalant allergen sensitization status, endoscopic findings, and radiological assessments were recorded and compared between patients with central-compartment-type CRS and other types of CRS. We also examined the extent of tissue eosinophilia and specific cytokine protein levels (eosinophil cationic protein [ECP], myeloperoxidase [MPO], immunoglobulin E [IgE], interleukin [IL]-4, IL-5, and IL-13) in the sinonasal tissues. Central-compartment-type CRS was found in 16 (23.9%) patients, and non-central-compartment-type CRS was found in 51 (76.1%) patients. Hyposmia or anosmia as the major symptom was more common in the central-compartment-type CRS group. The numbers of eosinophils in tissue and serum were significantly higher in the central-compartment-type CRS patients. The presence of allergen sensitization was not significantly different between groups. The levels of IL-5 and IL-13 were increased in middle turbinate tissues of patients with central-compartment-type CRS. Central-compartment-type CRS was associated with hyposmia or anosmia, eosinophilic subtypes, and elevated levels of IL-5 and IL-13 in middle turbinate tissues but not necessarily correlated with allergic disease in our patients.

The Role of Allergen Sensitivity on Pityriasis Alba

Objective: Pityriasis alba is mostly seen in individuals with a history of atopy, although it may occur in non-atopic individuals. Despite many hypothesis, no certain etiologic factor for pitryriasis alba has been determined. We aimed to investigate the roles of environmental factors, inhalant and food allergy sensitization in its etiopathogenesis. Methods: We noted patients’ and controls’ age, gender, education level of parents, xerosis, hand soap type, bathing frequency, bath water temperature, wind condition in the location, using sun screen cream, sun exposure time, results of inhalant allergen and food allergen testing. Inhalant allergy test was carried out through a skin prick test for children older than two years, and a food allergy test was carried out through prick to prick test for children of all ages. Results: The findings showed that there were significant relationships between pityriasis alba and xerosis, inhalant allergen sensitization (p&lt;0.0001, p=0.009, respectively). Conclusion: We conclude that xerosis and inhalant allergen sensitization are associated with pityriasis alba. Therefore, we think that clinicians should suggest moisturizers to patients with pityriasis alba and make their inhalant allergy tests in clinical follow-up of patients.

Comparison of inhalant allergen sensitization between children, adolescents, and adults with asthma and allergic rhinitis

Purpose: Inhalant allergens are known as a major factor for respiratory allergic diseases. There are many differences in sensitization rates of inhalant allergens, depending on the environment and demographic factors. This study aimed to compare the cross-sec tional differences in sensitivity patterns to inhalant allergen between children, adolescents, and adults. Methods: We analyzed the results of 449 patients with asthma or allergic rhinitis who underwent the inhalant allergen skin prick test at our university hospital in 2016. The subjects were classified 5 groups according to age: children (≤12 years), adolescents (13-17 years), young adults (18-30 years), middle adults (31-64 years), and elderly group (≥65 years). Positive responses skin prick test for allergens were defined as allergen-to-histamine wheal ratio ≥1. Results: The sensitization rate (SR) to house dust mites (HDM) was 52.1% on average, showing the highest SR in all groups, espe cially in children (64.2%). Children and adolescents showed high SRs to cockroach along with tree pollen, animal fur, and adults showed high SR to weed pollen along with them. Among the tree pollen, the SRs to oak, alder, birch, and beech were high in all groups; in children, the SR to plain and willow tended to be high, and in adults the SR to hazel was high. SRs to Timothy pollen (9.9%) and Alternaria (8.6%) tended to be higher in children than in the other groups. Conclusion: Although HDM is still the major allergen in children and adults with respiratory allergy, our study suggests various dif ferences in the sensitization pattern to inhalant allergens according to age even in the same area. Further studies are needed to ex plain these differences in sensitization patterns. (Allergy Asthma Respir Dis 2021;9:148-155)

Atopic dermatitis, inhalant allergy and food allergy: A paediatric approach.

Food and inhalant allergens have also been identified as potential trigger factors of atopic dermatitis symptoms. Here we aimed to investigate relationships between atopic dermatitis and inhalant-food allergen sensitization in Turkish children with atopic dermatitis. We included 70 patients (42 male, 28 female) with atopic dermatitis and 45 controls (30 male, 15 female) with no atopy, no atopy familial history, no atopy clinical findings no atopic dermatitis. We noted patients' and controls' age, gender, passive smoking exposure, atopy, xerosis, bath water temperature, shower gel type, clothes detergent type, blood hemoglobin, blood eosinophil count, blood eosinophil percent, values of serum immunoglobulin E, serum immunoglobulin A, serum immunoglobulin G, serum immunoglobulin M, results of inhalant allergen, and food allergen testing. We found that nine cases had inhalant allergen sensitization and 21 cases had food allergen sensitization. There were significant relationships between cases and controls in terms of count of eosinophil and percent of eosinophil (P = .008, P = .009, respectively). Humoral and cellular allergen-specific immune responses to food and inhalant allergens can be detected in patients with atopic dermatitis. Accordingly, we believe that blood eosinophil count and percent are more valuable laboratory parameters than serum total IgE for following patients with atopic dermatitis.

Associations of Plasma Fatty Acid Patterns during Pregnancy with Respiratory and Allergy Outcomes at School Age.

Fatty acids might play a role in asthma and allergy development as they can modulate immune responses. We examined among 4260 mother-child pairs participating in a population-based cohort the associations of maternal plasma fatty acid patterns during pregnancy with a child’s respiratory and allergy outcomes at school-age. In mid-pregnancy, 22 individual fatty acids were measured from maternal blood. Three patterns were previously identified by principal component analysis: A ‘high n-6 polyunsaturated fatty acid (PUFA)’, a ‘monounsaturated and saturated fatty acid’, and a ‘high n-3 PUFA’ pattern. At the age of 10 years, a child’s lung function was assessed by spirometry, current asthma and physician-diagnosed inhalant allergy by questionnaire, and inhalant allergic sensitization by skin prick tests. A higher ‘high n-6 PUFA’ pattern was associated with a higher forced expiratory volume in 1 s/forced vital capacity and forced expiratory flow after exhaling 75% of forced vital capacity (Z-score difference (95% CI) 0.04 (0, 0.07) and 0.04 (0.01, 0.07), respectively, per SD increase in the fatty acid pattern). We observed no associations of maternal fatty acid patterns with a child’s asthma or allergy outcomes. Our results showed limited associations of maternal patterns of high n-6 PUFA concentrations in pregnancy with a better lung function in school-aged children.

Maternal Vitamin D Levels during Late Pregnancy and Risk of Allergic Diseases and Sensitization during the First Year of Life-A Birth Cohort Study.

Allergic diseases are the most common chronic illness in childhood. Findings from developed countries have reported associations between Vitamin D levels during pregnancy and offspring allergy risk. This prospective cohort study aimed to determine the associations between maternal Vitamin D levels during late pregnancy and allergic diseases in Malaysian infants during the first year of life. Serum 25(OH)D concentrations of 380 pregnant women in the third trimester were measured using a chemiluminescent immunoassay. Children’s allergic outcomes were assessed at 3, 6, and 12 months based on parental reports. Specific IgE antibodies against food and inhalant allergens were measured in infants at 12 months of age. A total of 43.2% pregnant women were Vitamin D deficient (<30 nmol/L) and 56.8% were nondeficient (≥30 nmol/L). A total of 27.6% of the infants had eczema, 6.1% had wheeze, 27.4% had food sensitization, 10.8% had inhalant allergen sensitization, and 3.8% had IgE-mediated food allergy during the first year of life. Compared with the nondeficient group, maternal Vitamin D deficiency in late pregnancy was not associated with any allergic outcomes after adjustment for potential confounding factors. In conclusion, the present study does not support an association between maternal Vitamin D levels in late pregnancy and allergic outcomes during the first year of life.

Comparison of inhalant allergen sensitization in children, adolescents and adults with asthma and allergic rhinitis

Comparison of inhalant allergen sensitization in children, adolescents and adults with asthma and allergic rhinitis

Atopy is predictive of a decreased need for hospitalization for coronavirus disease 2019

Atopy is predictive of a decreased need for hospitalization for coronavirus disease 2019

Food and inhaled allergen sensitization range in children with atopyrelated gastrointestinal manifestations

The gastrointestinal tract is a barrier to the penetration of allergens into the organism and can be one of the shock organs of the development of allergic inflammation. The diagnosis of gastrointestinal manifestations of allergies is not given due attention, since their clinical symptoms are not pathognomonic, but are identical to diseases of the gastrointestinal tract of various genesis. The aim: to study the features of the structural and functional state of the gastrointestinal tract and the spectrum of sensitization to food and inhalation allergens of children with gastrointestinal manifestations of atopy. The analysis of medical histories of children with gastrointestinal manifestations of allergies aged from 1 to 18 years (n = 28), who were treated at the Regional children's allergological center in Krasnoyarsk, was performed. All patients underwent a specific allergological examination (allergological history, determination of the concentration of total IgE, specific IgE to food and inhalation allergens). The assessment of the state of the gastrointestinal tract was carried out taking into account complaints, anamnesis, objective examination and the results of esophagogastroduodenoscopy. It is established that gastrointestinal manifestations of atopy were most often combined with dermatorespiratory manifestations of allergy in the form of allergic rhinitis, atopic bronchial asthma and atopic dermatitis. Among the lesions of the gastrointestinal tract with the highest frequency of occurrence, changes in the nature of the stool (diarrhea, constipation) and the presence of symptoms of inflammation of the gastrointestinal tract-gastroesophageal reflux, gastritis, bulbitis, duodenitis, were determined. According to the results of esophagogastroduodenoscopy, gastritis and cardia insufficiency were most often determined. According to the results of the analysis of the concentration of total IgE in the blood serum, the increased level was determined in 42,8% of cases, the average value of total IgE in the blood serum in patients with atopic genesis of allergies was 140,9 IU/ml. These data evidence that the immunopathological basis for triggering allergic inflammation of the gastrointestinal tract may be based not only on atopic mechanisms. Based on the analysis of specific IgE concentrations, the characteristics of the spectrum of sensitization to food and inhalant allergens of children with gastrointestinal manifestations of atopy were determined. The most significant allergens were: food – flour mix; pollen – mixed of trees; domestic – perennial mixed. Thus, when conducting a specific allergological examination of children with atopy, it is necessary to take into account the systemic nature of the process and pay special attention to assessing the state of the gastrointestinal tract, as one of the shock organs in the development of allergic inflammation.