Allergen Levels Research Articles

Minimizing Indoor Allergen Exposure: What Works?

Allergic rhinitis and asthma morbidity has been linked to indoor allergen exposure. Common indoor allergens include dust mites, cats, dogs, rodents, and cockroaches. These allergens are ubiquitous and often difficult to remove from the home, making long-lasting reduction strategies difficult to achieve. Identifying strategies for reducing the presence of indoor allergens in homes could be utilized to decrease allergic disease burden, improve symptomology, reduce healthcare costs, and improve patients' quality of life. Studies have yielded mixed results with regard to specific environmental control measures in reducing indoor allergen levels and in improving clinical outcomes of allergic disease. In this review, we assess the available evidence of the effectiveness of environmental control measures in reducing indoor allergens and the potential clinical impact of these measures.

Inverse Trend Between Tree Pollen and Fungal Concentrations With Allergic Sensitization Rates in Seoul for 25 Years.

A growing number of individuals are developing allergic diseases due to pollen exposure. Seasonal variations and increased pollen concentrations have occurred with the increased rates of allergic sensitization among both children and adults. Temperature significantly influences pollination, particularly in spring- and early summer-flowering plants, with weather conditions affecting pollen allergen levels. Human activities, including agriculture and deforestation, increase carbon emissions, leading to higher atmospheric CO₂ levels that may enhance allergenic plant productivity. Climate change affects the range of allergenic plant species and length of pollen season. Studies indicate that higher CO₂ and temperature levels are linked to increased pollen concentrations and allergenicity, whereas atmospheric fungal concentrations have declined annually over the past 25 years. Despite more intense precipitation in summer and autumn, the number of rainy days has decreased across all seasons. This concentration of rainfall over shorter periods likely prolongs the dry season and shortens the period of fungal sporulation. Future climate changes, including atmospheric dryness, drought, and desertification could further decrease allergenic fungal sporulation. It remains unclear whether the inverse relationship between pollen and fungal concentrations and distributions directly results from climate change. It is crucial to evaluate the patterns of aeroallergens and their associated health risks.

A comparative study of efficacy and tolerability of bepotastine besilate (1.5%) and olopatadine hydrochloride (0.1%) eye drops in allergic conjunctivitis in a tertiary care hospital of the southern part of India

Background: Allergic conjunctivitis is increasing with the rise in the levels of allergens. Drug therapy is usually needed in addition to avoidance of general allergens to treat this condition. Both bepotastine besilate and olopatadine hydrochloride ophthalmic solutions are newer additions in the treatment of allergic conjunctivitis having dual properties of second-generation antihistaminics along with mast cell stabilizing activity. Aims and Objectives: The aim of the study was to compare the efficacy and tolerability of bepotastine besilate (1.5%) and olopatadine hydrochloride (0.1%) eye drops in patients presenting with allergic conjunctivitis in a tertiary care hospital of Southern part of India. Materials and Methods: Sixty patients who were clinically diagnosed to be suffering from allergic conjunctivitis were selected as participants for the study. They were randomly distributed into two groups consisting of 30 patients each. One group received eye drop bepotastine (1.5%) and the other group received eye drop olopatadine (0.1%), with each patient receiving the medication twice daily for a duration of 2 weeks. During the first visit, all the patients were assessed for the signs and symptoms and subsequently re-assessed at weekly intervals for a period of 2 weeks. They were also advised to report occurrence of any unwanted drug reaction during the weekly follow-up visits. Results: The above study showed the effectiveness of both bepotastine and olopatadine eye drops in decreasing the signs and symptoms of allergic conjunctivitis. Significant clinical improvement was found in all participants, whereas deterioration was found in none of them. Statistically significant improvement of itching and redness of eyes was observed with use of both the study drugs mentioned beforehand. Both the drugs were well tolerated by the patients. Statistically significant reduction of itching and foreign body sensation was found to be more in patients using bepotastine eye drops compared to those using olopatadine eye drops. Only two patients using bepotastine eye drops complained of having a mild burning sensation in eyes. Conclusion: From this study, bepotastine and olopatadine eye drops have been observed to be safe and efficacious in allergic conjunctivitis. Bepotastine eye drop was found to be more efficacious to relieve itching and foreign body sensation compared to that of olopatadine eye drops.

A real-world data analysis of distribution and inconsistency between total serum IgE and allergen-specific IgE results in clinical practice.

The inconsistency between serum total IgE (tIgE) and allergen-specific IgE (sIgE) results is often encountered in clinical practice, but the distribution and influencing factors of the inconsistent results have not been fully understood. The aim of this study was to analyze the distribution and inconsistency between tIgE and sIgE test results. A retrospective study, from the electronic medical records of 2139 patients who underwent both tIgE and sIgE tests, from January to December 2023 was reviewed. The tIgE and sIgE results and their distribution, as well as their inconsistency, were analyzed based on sex, age, and disease subgroups. 36.2% of the patients had a positive sIgE, and 43.7% had an elevated tIgE level. sIgE and tIgE results were discordant in nearly 30% of patients, with no difference between genders, while individuals aged over 60 exhibited a significantly higher inconsistency rate than the other age groups, and the inconsistency rate between tIgE and sIgE results was significantly different among different tIgE levels, sIgE grades, positive allergen count and positive allergen types. In addition, patients with chronic urticaria (CU) had a higher inconsistency rate than those with other allergic diseases, but the difference was not statistically significant. The overall inconsistency rate between tIgE and sIgE results was about 30%. The elderly group older than 60 years old is more likely to have inconsistent results, and tIgE level, sIgE level, the number and type of positive allergens also affected the consistency of tIgE and sIgE results.

Assessment of a crustacean allergen in fishery products using a nanomodified label-free voltammetric immunosensing approach

In this work, a label-free immunosensor for the rapid analysis of the crustacean allergen tropomyosin (TPM) is presented. A screen-printed carbon electrode (SPCE) was (bio)modified with oxidized carbon nanotube/manganese(II) ferrite nanomaterial (CNT_O@MnFe2O4) and monoclonal antibodies. The immune interaction with the allergenic protein was detected using a redox probe ([Fe(CN)6]3−/4−) by differential pulse voltammetry. The CNT_O@MnFe2O4 led to a 4-fold increase of the analytical signal compared to the unmodified SPCE, indicating the usefulness of this material in TPM analysis. Moreover, the detection potential was reduced (i.e., closer to 0 V), which increased the selectivity of the sensor even further. The immunosensor enabled a fast analysis time (1 h), providing a limit of detection of 1.6 ng mL−1, and precise results (coefficient of variation = 6.5 %). The analysis of ten commercial foodstuffs was accomplished, and the results were validated with an ELISA assay. The highest TPM concentrations were quantified in shrimp species (M. affinis > P. latisulcatus > P. indicus) and low allergen levels were found in surimi lobster, clam, fresh calamari, and mayonnaise. The simplicity of the sensor makes it a good choice for quality control and food safety assessment in industrial settings.

Assessment of Food Processing Technologies on Allergen Reduction in United States

Purpose: The aim of the study was to analyze the assessment of food processing technologies on allergen reduction in United States. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: Recent advancements in food processing technologies in the U.S. are focusing on reducing allergenicity in food products. Thermal methods are traditionally used, but novel nonthermal techniques, such as high-pressure processing and cold atmospheric plasma, are now being explored for their potential to create hypoallergenic products. These methods aim to modify allergenic proteins without using heat, which can preserve food quality while reducing allergen reactivity. Despite these advancements, ensuring the complete removal of allergens remains challenging, highlighting the ongoing need for robust detection and control strategies​. Unique Contribution to Theory, Practice and Policy: Risk assessment theory, health belief model (HBM) & diffusion of innovations theory may be used to anchor future studies on analyze the assessment of food processing technologies on allergen reduction in United States. Implementing advanced food processing technologies focused on allergen reduction can revolutionize industry practices. Regulatory bodies could use empirical data from these assessments to set more precise guidelines and safety standards for allergen levels in food products.

Mite allergen levels and fungal counts in children's bedding in four widely separated towns in Japan

We evaluated the relationships between children's housing, earthquake or tsunami damage affecting children, prevalence of allergic diseases, and levels of mite allergens and fungi on children's bedding after the Great East Japan Earthquake in four municipalities in Japan. We surveyed 464 children in Ishinomaki, 254 in Kami, 614 in Iwanuma, and 300 in Oiso whose parents or guardians had completed the International Study of Asthma and Allergies in Childhood questionnaire. We measured the levels of Dermatophagoides 1 allergens (Der 1) (Dermatophagoidespteronyssinus and Dermatophagoides farinae) on children's mattresses or futons and fungal counts (Aspergillus and yeast) between 2016 and 2018. Earthquake damage was significantly greater in Ishinomaki than in the other three municipalities. There were no differences in the prevalence of allergic disease among the four municipalities. Der 1 levels were significantly higher in Ishinomaki than in Iwanuma, but there were no differences among Oiso, Iwanuma, and Kami. Der 1 levels in children with asthma in Iwanuma and with allergic rhinitis in Kami were significantly higher than in those without these conditions. Total fungal counts and Aspergillus counts were highest in Kami and lowest in Oiso. Der 1 levels were significantly correlated with fungal counts in Kami and Iwanuma, but not in Ishinomaki or Oiso. Both Der 1 levels and total fungal counts in Ishinomaki were greater than those in other three municipalities. Housing and allergen-avoidance strategies varied among the four municipalities. Mite allergen and fungal levels in these Japanese municipalities might have been affected by the earthquake and tsunami, and these changes might have affected the prevalence of allergic diseases in children.

Effect of Addition of Tannin Extract from Underutilized Resources on Allergenic Proteins, Color and Textural Properties of Egg White Gels.

Tannins, present in numerous plants, exhibit a binding affinity for proteins. In this study, we aimed to exploit this property to reduce the concentration of allergenic egg white proteins. Tannins were extracted, using hot water, from the lyophilized powder of underutilized resources, such as chestnut inner skin (CIS), young persimmon fruit (YPF), and bayberry leaves (BBLs). These extracts were then incorporated into an egg white solution (EWS) to generate an egg white gel (EWG). Allergen reduction efficacy was assessed using electrophoresis and ELISA. Our findings revealed a substantial reduction in allergenic proteins across all EWGs containing a 50% tannin extract. Notably, CIS and BBL exhibited exceptional efficacy in reducing low allergen levels. The addition of tannin extract resulted in an increase in the total polyphenol content of the EWG, with the order of effectiveness being CIS > YPF > BBL. Minimal color alteration was observed in the BBL-infused EWG compared to the other sources. Additionally, the introduction of tannin extract heightened the hardness stress, with BBL demonstrating the most significant effect, followed by CIS and YPF. In conclusion, incorporating tannin extract during EWG preparation was found to decrease the concentration of allergenic proteins while enhancing antioxidant properties and hardness stress, with BBL being particularly effective in preventing color changes in EWG.

CYBER-PHYSICAL SYSTEM FOR MONITORING THE ENVIRONMENT FOR ALLERGENS USING GEOLOCATION DATA

The task of creating a cyber-physical system for monitoring the environment for allergens is relevant. Therefore, our study is devoted to the development of a method and a cyber-physical system for monitoring the environment for allergens using geolocation data. The developed cyber-physical system for monitoring the environment for allergens not only uses the available information on the activity of pollen sources in a given region, but also measures the concentration of pollen in the air in real time, which helps to monitor the level of pollen in the region where the user is located, and, taking into account the user's geolocation data, provides him with useful information for route planning to avoid staying in high-risk areas. Collecting and analyzing geolocation data allows you to track changes in the distribution of allergens over time and in space. This can be useful for understanding trends in allergenic reactions and for developing effective allergy management strategies. The cyber-physical system for monitoring the environment for allergens is useful for people with allergies by providing them with accessible and up-to-date information about the environment and the risks of allergic reactions, allowing them to better plan their activities and avoid areas with high levels of plant pollen concentration. Such a cyber-physical system enables an individualized approach to each user, taking into account their unique problems by performing allergen filtering. This allows for effective and personalized allergy management solutions. The proposed cyber-physical system can create a valuable database with allergic reactions and predictions that will be used to improve the methods of diagnosis, treatment and management of allergies. The proposed cyber-physical system can be used for global monitoring of pollen and allergen levels in different parts of the world. This will allow us to identify global trends in the distribution of allergens and develop effective strategies for managing allergies at the global level.

Nasal allergen-neutralizing antibodies correlate closely with tolerated intranasal allergen challenge dose following grass pollen subcutaneous immunotherapy in patients with local allergic rhinitis.

Local allergic rhinitis (LAR) is defined by chronic nasal symptoms, absence of atopy, positive nasal allergen challenge (NAC) and a good response to subcutaneous allergen immunotherapy (SCIT). We sought to investigate SCIT capacity to induce local and systemic blocking antibodies in LAR patients. A RDBPC study of grass SCIT was performed, with participants receiving either SCIT (Group A; n = 10) or placebo (Group B; n = 14) in the first 6 months. Both groups subsequently received SCIT for 12 months at Year 2. Nasal and serum antibodies (IgG4, IgA1 and IgA2) and their inhibitory capacity were measured at multiple timepoints. The allergen concentration tolerated increased significantly at 6 months (Group A; p = .047) and 24 months (Group B; p = .049) compared with baseline and persisted until the end of the study. Induction of serum sIgA1 to Phl p was seen in Groups A and B, albeit the former being induced earlier (1.71-fold, p = .027). A significant induction in sIgG4 to Phl p 1 and 5 was observed in serum of Group A (p = .047 and p = .0039) and sIgA2 to Phl p in Group B (p = .032 and p = .0098) at 18 and 24 months, respectively. Both local and systemic blocking antibodies can inhibit allergen-IgE complexes binding to CD23 on B cells, and this correlated with level of allergen tolerated intra-nasally in Group A (serum; 𝜌 = -.47, p = .0006, nasal; 𝜌 = -.38, p = .0294). Grass pollen SCIT induced functional systemic blocking antibodies that correlate with the concentration of allergen tolerated following NAC, highlighting their potential as a biomarker of SCIT in LAR.

The prevalence of IgE positivity, environmental factors, and clinical implications associated with mite species in allergic patients in Taiwan.

Allergic diseases are a growing public health concern with increasing prevalence and severity. Allergens play significant roles in triggering immune responses and the development of allergic reactions. Investigate the presence and clinical significance of dust mites, storage mites, and predatory mite Cheyletus eruditus(Ce) in household environments. A survey of household dust was performed to determine mite occurrence and analyze influencing factors, an analysis of the correlation between mite species and allergic symptoms, and basophil activation triggered by mite allergens. Cross-reactivity between Ce and house dust mites was assessed. The high appearance rate of mite species in households of Taiwan was Dermatophagoides pteronyssinus (Dp) and D. farinae(Df). Environmental factors such as pet keeping, vacuum cleaner usage, air conditioner usage, proximity to the kitchen, cleaning frequency, and protein concentration in beds were shown to influence mite prevalence. The appearance of Dp and Df significantly increased the occurrence of airway and nasal symptoms, while the presence of Ce was strongly correlated with skin symptoms. The activation of basophils and the correlation between specific IgE levels and allergic symptoms in response to Ce exposure were demonstrated. The presence of Ce was associated with elevated levels of allergens in bedding. The IgE adsorption between mite species was demonstrated suggesting cross-reactivity between the Ce and Dp was limited. Presence of Ce is associated with elevated levels of major mite allergens in beddings. Allergenicity of Ce was confirmed by IgE reactivity and basophil activation regarding mite infestation as a potential cause of skin-related allergy.

Investigating Allergies to Cow Milk, Peanut, and Egg in Children and Their Associations With the Severity of Atopic Dermatitis

Objectives: Atopic dermatitis (AD) is a risk factor for children’s onset of food allergy. This study explores the frequency of food allergies among children with AD and their relationship with the severity of the disease. Methods: This analytical and cross-sectional study was conducted on 48 children under the age of 14 years who were diagnosed with AD. The patients were divided into three groups according to age as follows: Younger than 2 years, between 2 and 7 years, and between 7 and 14 years. Serum immunoglobulin E level of food-specified allergen was measured. Then, the children were categorized into three groups for comparison based on AD severity, food allergy type, and frequency. Results: The frequency of allergy to egg, peanut, and cow milk was 66.7%, 37.5%, and 18.8%, respectively, in the patients. Boys have more allergies to peanuts (46.2%) than girls (27.3%). Egg allergy is prevalent among both genders (girls 63.6% and boys 69.2%). Allergy to cow milk was higher in the age group under 2 years (23.1%). Half of the children between 7-14 years old had an allergy to peanuts (50%). Over half of the children in all age groups had egg protein allergies. The patients with mild and moderate AD had more allergies (25.0%) to cow milk compared to severe AD patients (6.2%). Discussion: This study indicated that food allergy is common in patients with AD, and nearly two-thirds of the patients were allergic to one foodstuff. Meanwhile, allergy to eggs was more common among the patients compared to other foodstuffs.

The Use of Diets in the Diagnosis and Treatment of Common Gastrointestinal Diseases in Dogs and Cats.

The nutritional health of dogs and cats is important to pet owners around the world. Nutrition is inextricably linked to the health of the gastrointestinal system and vice versa. Gastrointestinal signs, such as vomiting, diarrhea, anorexia, or weight loss, are one of the most common reasons that dog and cat owners make non-routine appointments with veterinarians. Those patients are evaluated systematically to identify and/or rule out the causes of the symptoms. Some causes of chronic diarrhea are within the gastrointestinal tract while others are secondary to pathogenic factors outside the digestive system. Some useful biomarkers of chronic intestinal disease (enteropathy) exist in serum and feces. After determination that the clinical signs are due to primary gastrointestinal disease and that there is no parasitism, specific diets are used for at least two weeks. There are several types of diets for pets with chronic enteropathies. There are limited ingredient diets and hydrolyzed protein diets with reduced levels of allergens. There are also highly digestible and fiber-enhanced diets. Some diets contain probiotics and/or prebiotics. If symptoms do not improve and the patient is stable, a diet from a different class may be tried. For chronic enteropathies, the prognosis is generally good for symptom resolution or at least improvement. However, if interventions with novel diets do not ameliorate the symptoms of chronic enteropathy, then antibiotic, anti-inflammatory, or immunosuppressant therapy or further, more invasive diagnostics such as taking an intestinal biopsy, may be indicated. Pancreatitis is a common gastrointestinal disease in dogs and cats and patients may present with mild to severe disease. Many patients with mild to moderate disease can be successfully treated with early supportive care, including feeding a low-fat diet. A novel pharmaceutical, fuzapladib (Panoquell-CA1) looks very promising for treating more severe forms of acute pancreatitis in dogs. Maintenance on a low-fat diet may prevent pancreatitis in at-risk dogs. Future advances in medicine will allow pet owners and veterinarians to use dietary management to maximize the health of their dogs and cats.

Correlation between immunoglobulin index level and disease severity and clinical manifestations in children with atopic dermatitis as a chronic inflammatory.

It was to analyze the clinical characteristics of atopic dermatitis (AD) in children and its relationship with immunoglobulin (IgG, IgA, IgM, IgE) levels. 400 children with AD in the dermatology clinic of Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital(SCMC-FMU) were the study subjects, and 200 normal children were enrolled as the blank control. The clinical data of the included children were collected, and the serum immunoglobulin levels and other related indicators were measured. The results showed that the IgE level was higher observably in group A when we compared it with group A0, the IgE level was much higher in group B in comparison to group B0, group C showed higher IgE level C than in group C0, and it was the same case in groups D and D0(P < 0.05). The IgM level was decreased greatly in group C than that in normal children in group C0 (P < 0.05), but showed no visible difference among other groups (P > 0.05). The O-SCORAD scores of groups A, B, C, and D were significantly positively correlated with IgE level (P < 0.05). No great correlation was observed between skin dryness and IgE-specific allergen, IgG, IgA, IgM, and IgE levels in groups A - D (P > 0.05). Immunoglobulin deficiency was present in AD children compared with normal children, and IgE could be used as an efficient indicator to assess the severity of AD in children.

ENVIRONMENTAL ALLERGENS AND ASTHMA

Exposure to inhalant allergens is associated with allergen-specific sensitization, a risk factor for the development of bronchial asthma, along with genetic and environmental factors. Early life exposure to mites increases the risk of sensitization and development of asthma in high-risk children. The same would occur with cat allergen levels inside the house and increased risk of sensitization in preschool and school. On the other hand, early contact with multiple microorganisms contributes to preventive immunomodulation by inducing tolerance to allergens. Climate change has been shown to increase the potency of allergenic pollens and the severity of exposure to fungi, which could partly explain the increase in allergic diseases in recent years. There is much evidence regarding exposure to allergens in sensitized asthmatic children and asthma exacerbation. It is essential to know which allergens the patient is sensitized to in order to implement environmental avoidance measures. This article summarizes an update on the mechanisms of sensitization to inhalant allergens in asthmatic children and its relationship with climate change and asthma severity. The main prevention measures, environmental control and the role of immunotherapy are also presented.

Residual profiles and health risk of indoor allergens in China

Exposure to indoor allergens is a principal risk factor for allergic diseases. However, most of the previous studies on indoor allergens focused on very limited kinds of allergens in China. Knowledge of the simultaneous exposure to multiple allergens is still lacking. In this study, the residual profiles of 8 allergens were investigated in 166 dust samples from 11 cities in China. The house dust mite allergens including Der p 1, Der f 1, and Der 2 were detected in the range of <0.02–283.83 μg/g dust. The concentrations of dog allergen Can f 1 and cat allergen Fel d 1 varied widely, from <0.84–22,896.46 μg/g dust for Can f 1 and from <0.02–6298.96 μg/g dust for Fel d 1. Cockroach allergen Bla g 2 was detected in 68% of the samples but at a low level with a maximum of 9.44 μg/g dust. Comparatively low detection frequencies were found for mouse allergen Mus m 1 as 37% and for fungi allergen Asp f 2 as 24%. The frequency of cleaning sheets/bedding was negatively correlated to the levels of house dust mite allergens. The presence of pets indoors was associated with higher levels of pet allergens and lower levels of house dust mite allergens and cockroach allergen. Risk evaluation reveals that at least 4 allergens were found in more than 80% of the rooms and more than 2 allergens with median/high risk were detected in 42% of the rooms, indicating that simultaneous exposure to multiple allergens is prevalent in China.

Comprehensive characterization and detection of nut allergens in bakery foods using Q-TOF mass spectrometry and bioinformatics

Abstract Food allergy is a growing health issue worldwide and the demand for sensitive, robust and high-throughput analytical methods is rising. In recent years, mass spectrometry-based methods have been established for multiple food allergen detection. In the present study, a novel method was developed for the simultaneous detection of almond, cashew, peanut, and walnut allergens in bakery foods using liquid chromatography–mass spectrometry. Proteins unique to these four ingredients were extracted, followed by trypsin digestion, quadrupole time-of-flight (Q-TOF) mass spectrometry and bioinformatics analysis. The raw data were processed by de-novo sequencing module plus PEAKS DB (database search) module of the PEAKS software to screen peptides specific to each nut species. The thermal stability and uniqueness of these candidate peptides were further verified using triple quadrupole mass spectrometry (QQQ-MS) in multiple reaction monitoring (MRM) mode. Each nut species was represented by four peptides, all of which were validated for label-free quantification (LFQ). Calibration curves were constructed with good linearity and correlation coefficient (r2) greater than 0.99. The limits of detection (LODs) were determined to range from 0.11 to 0.31 mg/kg, and were compared with the reference doses proposed by Voluntary Incidental Trace Allergen Labelling (VITAL). The recoveries of the developed method in incurred bakery food matrices ranged from 72.5% to 92.1% with relative standard deviations (RSD) of &amp;lt;5.2%. The detection of undeclared allergens in commercial bakery food samples confirmed the presence of these allergens. In conclusion, this method provides insight into the qualitative and quantitative detection of trace levels of nut allergens in bakery foods.

Assessment of Contact Allergens in "Hypoallergenic" Athletic Shoes by Mass Spectrometry.

Background: Identification of athletic shoes for patients with contact allergy is difficult. Company reports of allergen content are often incorrect. Objectives: To determine whether chemical analysis of 4 athletic shoes, previously reported to be free of the most common contact allergens, contain quantifiable allergen levels. Methods: Samples from the uppers and insoles of 4 shoes believed to be free of common allergens were assessed by mass spectrometry. A total of 4 rubber accelerators and 2 adhesives were directly quantified and additional 7 rubber accelerators were assessed using semiquantitative measures. Results: Aside from carbamates (assayed as 59 ppm zinc in insoles) in SeaVee's Sixty-Six sneakers, para-tertiarybutylphenol formaldehyde resin (PTBFR) (assayed as 7.6 ppm paratertiary butylphenol or 4-tertiary butylphenol [4TBP] in uppers) in Allbirds Tree Runners and rosin (assayed as 628 ppm sodium abietate in uppers) and carbamates (24 ppm zinc in uppers) in Saucony Jazz sneakers, these shoes had low levels of all allergens assayed in this study. Tom's Carlo sneakers contained rosin (127 ppm sodium abietate in insoles), PTBFR (6.5 ppm 4TBP in uppers), and carbamates (112 ppm sodium abietate in insoles) but had low levels of all other assayed allergens. Conclusions: Although identifying allergen-free shoes is challenging, the results of this analysis will help patch testing physicians recommend athletic shoes to patients with specific allergies.

Reactivity to allergenic food contaminants: A study on products on the market.

The frequency and severity of reactions in food-allergic consumers exposed to unintentional food allergen contamination during production is unknown. To warn allergic consumers, it has been suggested for pre-packaged foods to be precautionary labelled when the food allergen contamination may exceed the amount to which 1%-5% of the population could react (ED01-ED05). ED01 for hazelnut and milk have been estimated at 0.1 and 0.2mg, respectively, by the Voluntary Incidental Trace Allergen Labelling (VITAL) initiative. The respective reference doses recommended by the FAO/WHO Codex consultation are 3 and 2mg. We evaluated the reactivity to potential traces of milk and hazelnut allergens in allergen-free pre-packaged products by children affected by severe allergies to milk and hazelnuts. Oral Food Challenges with commercially available hazelnut-free wafer biscuits and milk-free chocolate pralines were administered to patients with severe food allergies to hazelnut and cow's milk, respectively. Contamination levels of milk or hazelnut allergens were measured using chromatographic separation interfaced with triple quadrupole mass spectrometry. No hazelnut allergic patient showed allergic reactions to exposure to biscuits, nor any milk allergic patient displayed allergic reactions to the dark chocolate praline. While no hazelnut trace was detected in biscuits, the praline was found to be contaminated by milk at concentrations ranging between 8 and 35mg total protein/kg food. In our dose model, these amounts exceeded 1.5-10 times the VITAL ED01 and reached the threshold suggested by the FAO/WHO Codex consultation. Upon the consumption of food products available on the market, many patients with severe food allergies tolerate significantly higher doses of allergen than reference doses indicated in the VITAL system used for precautionary allergen labelling. These doses support the safety of the FAO/WHO recommended reference doses.

High plasma IL-6 levels may enhance the adverse effects of mouse allergen exposure in urban schools on asthma morbidity in children

Few data on the relationships between environmental exposures, asthma morbidity, and systemic IL-6 inflammation exist. We sought to determine whether baseline plasma IL-6 level is associated with increased asthma morbidity in children exposed to mouse allergen in inner-city classrooms. Data from the longitudinal School Inner-City Asthma Studies of 215 children with asthma, aged 4 to 14 years and recruited from urban elementary schools, were analyzed. Given the unknown threshold of IL-6 risk levels and skewness of the distribution, the children were stratified into tertiles as follows: low baseline IL-6 level (<0.013 pg/mL), moderate baseline IL-6 level (0.013-0.302 pg/mL), and high baseline IL-6 level (>0.302 pg/mL). Relationships between plasma IL-6 level and body mass index (BMI) percentile, inflammatory markers, lung function, mouse allergen exposure, and asthma outcomes were assessed. Cross-sectional analysis demonstrated that increasing IL-6 level was associated with higher BMI percentile (P< .0001), C-reactive protein level (P= .0006), and blood neutrophil count (P= .0024). IL-6 was not associated with type 2 inflammatory markers, including blood eosinophil count, allergic sensitization, or fractional exhaled nitric oxide level. Longitudinal analysis showed that children with high IL-6 levels had a higher number of days with asthma symptoms than did those children with moderate (incidence rate ratio= 1.74 [95% CI= 1.10-2.77]; P= .0187) or low (incidence rate ratio=1.83 [95% CI= 1.21-2.77]; P= .0043) IL-6 levels. Children with high IL-6 levels who were exposed to increasing levels of mouse allergen exhibited lower ratios of FEV1 value to forced vital capacity than did children with moderate IL-6 levels (β= -0.0044 [95% CI= -0.0073 to -0.0015]; pairwise interaction P= .0028) or low IL-6 levels (β= -0.0042 [95% CI= - 0.0070 to -0.0013]; pairwise interaction P= .0039). Inner-city children with asthma and high plasma IL-6 levels are more likely to have an increased BMI, elevated C-reactive protein level, elevated blood neutrophil count, and greater asthma symptoms. High IL-6 level appears to increase susceptibility to the effects of classroom exposure to mouse allergen on lung function in urban children.