Mean IgE Levels Research Articles

Dupilumab as an emerging treatment for refractory allergic fungal rhinosinusitis: a case series and literature review

Background: Allergic Fungal Rhinosinusitis (AFRS) is a chronic, inflammatory, non-invasive fungal disease of the nose, sinuses, and paranasal sinuses. Dupilumab is an emerging biological therapy with promising outcomes in the treatment of patients with refractory AFRS. In this case series, we aimed to assess the effectiveness and safety of dupilumab in the treatment of refractory AFRS. Case description: Our case series included seven patients, all of whom met the inclusion criteria. Of these, four were male (57.1%) and three were female (42.9%). The ages of the patients ranged from 20 to 44 years, with a mean of 30.4. For post-treatment Sinonasal Outcome Test-22 (SNOT-22) scores, six patients (85.7%) reported improvement by one category (two from severe to moderate and four from moderate to mild). Only one patient (14.2%) reported an improvement by two categories (severe to mild). Post-treatment IgE levels ranged from 39 to 590 IU/mL, with a mean of 301.8 IU/mL. There was a significant decrease in the mean IgE level by 93% after dupilumab administration. The average number of surgeries in the included patients ranged from 2 to 4, with a mean of 2.7 surgeries. Post-treatment, none of the patients required revision surgery or steroids after three months of dupilumab therapy. Conclusions: Dupilumab is an emerging biological therapy with promising benefits in the treatment of refractory AFRS. It can be used if functional endoscopic sinus surgery and steroid treatment do not improve symptoms.

Correlation of Smoking Intensity Scores and Total Serum Immunoglobulin E Level in Adult Male Smokers

Background: Exposure to cigarette smoke causes an increase in the T-helper 2 immune response and elevates the formation of IgE by B cells and activation of eosinophils. Objectives: This study aims to determine the correlation between smoking intensity scores measured using the Brinkman Index and total serum Immunoglobulin E level. Methods: The study used an analytical cross-sectional design in a population of adult male smokers according to inclusion and exclusion criteria. This study evaluated the smoking intensity score on total serum Immunoglobulin E expression with control for age, gender, history of atopy, infection, and use of corticosteroids. Serum total IgE levels were examined by immunoradiometric assay using venous blood samples. Data were analyzed using correlation tests and multivariate analysis, linear regression tests with p <0.05 which was significant. Results: The study included 95 samples with a mean sample age of 31.38 ± 1.98 years. The mean Brinkman Index was 103.74 ± 74.47 with a mean total serum IgE level of 247.58 ± 354.58 kU/L. Of the total sample, there were 47 samples (49.5%) who were obese and 26 samples (27.4%) consumed alcohol. The correlation between the Brinkman index and IgE level based on the Spearman correlation test was obtained with a p-value <0.001. Multivariate linear regression analysis showed that the B coefficient value of the Brinkman Index was 0.880 with a p-value of <0.001. Meanwhile, no significant relationship was found between confounding variables and total serum IgE levels. Conclusion: The study found a strong correlation between total serum IgE levels in adult male smokers and the Brinkman Index. The higher the Brinkman Index, the higher the total serum IgE level.

A Cross Sectional Study of Respiratory and Allergy Status in Dairy Workers

ABSTRACT Introduction Workers on dairy farms face exposures to organic dusts and endotoxin. At the same time, a number of studies of farmers have reported a lower prevalence of asthma in farmworkers compared to persons without farm contact. The “hygiene hypothesis” suggests that early life exposures on farms could be protective against allergic disease and asthma. Such protective relationships are less well studied in adult farm workers. Methods A cross-sectional analysis of respiratory function and allergy status was performed in a sample of dairy farm workers (n = 42) and community controls (n = 40). Measures of respiratory status (spirometry, exhaled nitric oxide FeNO, self-reported symptoms) and levels of total and bovine-specific IgE were compared between the groups. Results Prevalence of self-reported asthma and most respiratory symptoms was similar in the two groups, with the exception of increased report of dyspnea among dairy workers. In the dairy workers, level of lung function was not reduced and FeNO was not increased. In unadjusted and adjusted models, dairy work was not associated with reduced lung function or increased airway inflammation. Mean IgE levels did not differ significantly between workers and controls, but elevated bovine-specific IgE was detected only among dairy workers, with an apparent association between elevated bovine IgE and increased FeNO. Conclusion While dairy workers did not demonstrate increased asthma prevalence compared to controls, sensitization to bovine antigen in several workers appeared to be associated with airway inflammation. Occupational health programs for dairy workers should consider the risk of animal allergy as part of respiratory health protection efforts.

Influence of genetic variants and mRNA expression of interleukin IL17A gene in asthma susceptibility

Asthma is a chronic respiratory disease characterized by coughing, wheezing, shortness of breath, chest tightness, overproduction of mucus, and expiratory airflow limitation, which affects >300 million people worldwide. It is triggered by the dynamic interplay of genetic factors and environmental exposure. Th17 cells are an emerging subset of CD4+ T cells, which secrete IL-17A. This proinflammatory cytokine has recently been associated with asthma, autoimmune diseases, and inflammatory disorders. The present case-control study was focused on identifying the involvement of the IL-17A gene in asthma pathogenesis among 150 clinically diagnosed asthma patients and 150 healthy controls (HCs) of South Indian origin. To carry out the study, we aimed to screen the genetic variants of rs2275913G/A and rs8193036C/T and also estimated the serum cytokine levels of the IL-17A cytokine of recruited subjects.Further, we evaluated mRNA expression in selected subjects to correlate with the genetic variants. The results revealed that the mean IL-17A serum levels (161.6 ± 380.1 pg/ml vs. 86.75 ± 90.01 pg/ml) and IgE levels (257.7 ± 133.3 pg/ml vs. 311.2 ± 160.5 pg/ml) in asthma patients were significantly high as compared to healthy controls (p < 0.05). The ROC curves were constructed to compare the cytokine levels of asthma patients and HC, and the area under the curve (AUC) for IL-17A cytokine was 0.64, indicating that the test was satisfactory and significant (95 % CI: 0.575–0.709; p < 0.001). Genotyping of rs2275913G/A polymorphism indicated a 1.6-fold risk (95 % CI-1.02–2.56; p = 0.04) for asthma patients compared to healthy controls, whereas no significant association was observed for rs8193036C/T polymorphism with asthma susceptibility. Under genetic models, GA and AA models showed a protective effect against the disease for rs2275913G/A.In contrast, no statistically significant result was observed among the models of rs8193036C/T when adjusted with age and sex. The mRNA expression levels of the gene were statistically high in patients compared to the HCs, with a 1.8-fold change (p < 0.0001). We conclude that the results indicate IL-17A rs2275913G/A is likely to contribute to protection against the disease, while IL-17A rs8193036C/T shows no association with the disease. However, no correlation was identified in serum cytokine levels concerning genotypes. This comprehensive information in the present study might contribute to developing novel therapeutic strategies for treating inflammatory diseases like asthma. Further studies are warranted to understand the diverse functions of IL-17A concerning its longitudinal stability and its response to clinical interventions with large sample sizes in various ethnicities.

EFFECT OF SEX ON RESPONSE TO OMALIZUMAB IN PATIENTS WITH ASTHMA

<h3>Introduction</h3> There are sex-related disparities in asthma. Before puberty, males have increased prevalence and severity of asthma compared with females, and this pattern reverses after the onset of puberty. Omalizumab, an IgE antibody, is an effective treatment for allergic asthma, but sex-specific responses have not been studied in detail. <h3>Methods</h3> Post hoc analysis examined data from randomized, placebo-controlled IA05 trial of omalizumab treatment (52 weeks; 75-375 mg sc every 2-4 weeks; N=627; 6 to <12 years, ie children) and open-label, single-arm PROSPERO study (NCT01922037; 48-weeks; N=801; ≥12 years ie adolescents/adults (n=732 ≥18 years); both included patients with moderate-severe allergic asthma. <h3>Results</h3> In IA05/PROSPERO, baseline characteristics of mean age and IgE levels were similar for female and male participants (females 8.4/47.8 versus males 8.6/46.2 years; IgE levels females 463.2/560.3 versus males 472.8/615.0 IU/mL). Asthma exacerbation rates following omalizumab treatment were similar for females and males. In IA05 (children), asthma exacerbation rates were: females - placebo 0.74 versus omalizumab 0.46, males - placebo 0.55 versus omalizumab 0.43, and the interaction test of effect of sex on omalizumab response was not significant (p=0.4821). In PROSPERO (adolescents/adults), asthma exacerbation rates in females were 0.74 versus males 0.77 (p=0.787). Overall safety reported previously for IA05, Lanier JACI 2009;124;1210-6 and PROSPERO, Casale JACI:IP 2019;7(1):156-64. <h3>Conclusions</h3> Despite differences in asthma between females and males, we found no evidence that the effect of omalizumab in children was dependent on sex, and no evidence that the rate of exacerbations was dependent on sex following omalizumab initiation in adolescents/adults.

Effects of curcumin-piperine supplementation on systemic immunity in young women with premenstrual syndrome and dysmenorrhea: A randomized clinical trial

IntroductionPremenstrual syndrome (PMS) and primary dysmenorrhea (PD) are common gynecological complications and there is evidence that inflammation may be an important factor in their etiology. There is a relationship between PMS and PD with susceptibility to allergic disorders. We aimed to assess the effect of curcumin co-administered with piperine on serum IL-10, IL-12 and IgE levels in patients with PD and PMS. Materials and methodsA sample of 80 patients were recruited to this triple-blind, placebo-controlled clinical trial. Participants were randomly allocated to curcumin (n = 40) and control groups (n = 40). Each participant received one capsule (500 mg of curcuminoid plus piperine, or placebo) daily, from 7 days before until 3 days after menstruation for three consecutive menstrual cycles. ResultsSerum IgE, IL-10 and IL-12 levels were quantified by using an ELISA kit. No significant differences were found between the two groups at baseline, including: age, BMI, and dietary intakes (P > 0.05). Curcumin + piperine treatment was associated with a significant reduction in the mean serum levels of IgE [from 223.6 ± 258.7 IU/mL to 161.3 ± 240.7; P = 0.001]; but there were no significant changes in the placebo group (P = 0.12). Serum concentrations of IL-10 and IL-12 before and after the trial period did not differ significantly between the two groups (P > 0.05). ConclusionCurcumin plus piperine might be have positive effect on serum IgE levels with no significant changes on serum IL-10 and IL-12 in healthy young women with PMS and PD. Studies with higher doses and longer durations of treatment with curcumin are required to confirm these findings.

Increased allergic and asthmatic risks in children residing in industrial areas by surveying the pre-inflammatory (IgE, IL-4 and IL-13) biomarkers.

Toxic metal(loid)s can lead to high damages on human. This work was conducted to investigate the levels of metal(loid)s in PM2.5 and a total of 123 male children's (aged 6-9years) blood chosen from different areas in Ahvaz and their association with the pre-inflammatory (Immunoglobulin E and cytokines: IgE, IL-4 and IL-13) responses in serum cells. Six metal(loid)s (arsenic, cadmium, chromium, mercury, nickel and lead) in three regions including industrial (Padad), vehicle traffic (Golestan) and reference (Kianpars) areas were studied. Results showed the concentrations of As, Cr, Cd, Ni and Hg in the ambient air of industrial area (Padad) (P < 0.001), and Pb in vehicle traffic area (Golestan) were higher (p < 0.001). Moreover, the mean levels of IgE (mean = 146.44pg/200landa, P < 0.003), IL-4 (mean = 548.23pg/200landa, P < 0.001) and IL-13 (mean = 53.21pg/200landa, P < 0.001) in Padad were higher than Golestan and Kianpars. Our results suggest that living in industrial areas leads to accelerated synthesis of IgE, IL-4 and IL-13 in blood. The spatial distribution of children's serum IgE, IL-4 and IL-13 concentrations showed an abnormal increase of 240 to 400pg/200landa for IgE, 950 to 1400pg/200landa for IL-4 and 90 to 128pg/200landa for IL-13. Our results indicate children in the industrial area are prone to asthma, allergy, miRNA mutation, and other chronic diseases.

Implication of serum Nitric oxide and IgE in urinary schistosomiasis: The case of Bamendjing, Cameroon

BackgroundUrinary schistosomiasis (US), also known as bilharziasis is a waterborne parasitic infection most common in rural areas of developing countries. The infection is associated with haematuria but little or nothing is known about its association with other urinary parameters, induction of Nitric Oxide (NO) and IgE production around the Bamendjing Dam an area highly suspected of Schistosoma haematobium infections. The study sought to address this problem for possible future interventions and control. Materials and methodsUrine samples were collected from 301 randomly selected participants and analysed for the presence of S. haematobium using the syringe filtration concentration method. Sera from patients infected with S. haematobium and also from some uninfected individuals were analysed for IgE and NO using ELISA and colorimetric methods respectively. FindingsThe results showed a prevalence of 16.9% (51/301). Sixty percent of the 49 patients with nitrite in their urine, were infected with urinary schistosomiasis (US) (30/49; p = 0.00). Meanwhile only 40% of the 15 patients with bilirubinuria were infected with US (6/15; p = 0.0241). The risk of patients with US having leucocytes and nitrites was high (OR of 1.3 and 1.7 respectively). Total IgE serum levels were significantly higher in patients with US (648.872 ± 223.142) compared to uninfected individuals (275.682 ± 181.674) (p = 0.00). Infected persons had heightened mean NO levels (2,583,617.647 ± 1,100,678.786) than non-infected participants (1,689,766.667 ± 1,163,084.729). Urinary Schistosomiasis in association with urinary parameters had a significant impact on mean IgE levels (F = 4.248, p = 0.022). Patients infected with Urinary Schistosomiasis alone had significantly higher mean total IgE levels than non-infected participants (p = 0.004). ConclusionApart from haematuria, this study has demonstrated that Urinary Schistosomiasis is prevalent among inhabitants around the Bamendjing Dam and results in an increase of other urine parameters such as leucocytes and nitrates and high levels of serum NO and total serum IgE in patients. These parameters are important in the screening of patients for treatment and control of urinary schistosomiasis.

Anaphylaxis in Omani Patients: A Study from a Tertiary Care Center.

ObjectivesAnaphylaxis is an acute and potentially fatal allergic reaction. No studies have yet been conducted to evaluate the spectrum of anaphylactic reactions among Omani patients. As such, this study aimed to describe the clinical features, causes, investigation, and management of anaphylaxis among patients presenting to a tertiary care center in Oman.MethodsThis retrospective study took place between August 2005 and June 2020 at the allergy and immunology clinic of Sultan Qaboos University Hospital, Muscat, Oman. All patients diagnosed with anaphylaxis during the study period were included. Data were collected from electronic medical records.ResultsOne hundred patients were diagnosed with anaphylaxis during the study period. Of these, 52.0% were male. The mean age was 15.9±16.2 years, with 70.0% aged < 18 years old. The eosinophil count ranged from 0.0–16.9 × 109/L, with a mean of 0.8±2.2 × 109/L and a median of 0.3 (0.1–0.6) × 109/L. Total immunoglobulin (Ig) E levels ranged from 25–8706 kIU/L, with a mean of 935.1±1369.5 kIU/L and a median of 500.4 (186.0–972.5) kIU/L. The majority of patients had a family history of allergies (72.0%), and other had concomitant allergic conditions (66.0%). All were prescribed epinephrine (100%). The most common cause of anaphylaxis was food (65.0%). The second most frequent trigger was insect venom (32.0%). Most patients had one category cause (81.0%); two or more causes were present in 12.0% of patients. Clinical symptoms manifested most frequently as cutaneous (92.0%) and respiratory (85.0%). The majority of patients (87.0%) demonstrated the involvement of more than one bodily system. Mean total IgE levels were significantly higher in patients with concomitant presence of other allergic conditions (1193.8 kIU/L) than patients without another concomitant allergic disease (503.6 kIU/L; p =0.030). In addition, concomitant allergic disease is significantly higher in patients < 18 years of age (75.4%) compared to patients > 18 years of age (45.2%; p =0.010).ConclusionsDue to its life-threatening nature, knowledge of the epidemiology and clinical features of anaphylaxis in different populations is necessary to deliver rapid treatment. This study found that the clinical features of anaphylactic patients in Oman were similar to those reported elsewhere. Further research is needed to determine the true incidence of anaphylaxis in Oman to minimize associated morbidity and mortality.

Evaluation of levels of absolute eosinophil count in blood and serum IgE in patients with Atopic dermatitis

Background: Atopic dermatitis is a chronic relapsing disease of the skin, common in infants and children. Defects in the function of skin barrier, reoccurring skin infections and allergen sensitization are associated. Features: itch, rash on extensors and face, lichenification in flexures, family or personal history of atopic diseases. In this study, the relation between severity of AD, serum IgE levels & AEC in blood is found out. Materials and Methods: Our case control study was done in the Department of Dermatology, Venereology and Leprosy, Shadan Institute of Medical Sciences, Hyderabad from October 2019-October 2020. A total of 50 patients, of all age groups, with atopic dermatitis visiting the hospital were enrolled. 50 age matched healthy controls were also included. Inclusion criteria: Age range: 6 months to 40 years. Exclusion criteria: Patients receiving any systemic drug (homeopathic, ayurvedic, unani and allopathic),oral contraceptives, hormonal therapies. Patients who are immunocompromised, pregnant, lactating, with cancer, systemic and autoimmune diseases Method: A thorough clinical history inclusive of age of onset, personal and family history of atopic diseases, duration of illness is taken. Physical examination was done to find the severity (SCORAD index) and the body surface area involved (Wallace’s Rule of Nine). Blood tests were done to find the AEC values and IgE levels in each patient. Result: The onset of disease was seen in patients from 4 months of age to 20 years with an average of 4.8 years. Out of the 50 patients in the study, males and females were 19 and 31 respectively. In patients with AD, the mean AEC was 673 and the mean IgE levels were 301.9 whereas in controls, it was 125 and 31 respectively. Thus, the laboratory workup showed raised values in majority patients with AD. Conclusion: The study showed that AEC and serum IgE levels had a correlation with the severity of atopic dermatitis. History of allergic

Comparison of Blood and Tissue Eosinophil Count and Blood IgE in Patients with Chronic Sinusitis and Nasal Polyps.

Background The inflammatory mucosa of the sinus cavities is called sinusitis and is divided into various types based on its appearance and sign. Chronic rhinosinusitis is an inflammatory-infectious disease that involves the frontal, sphenoid, ethmoid, and maxillary sinuses. Chronic sinusitis is a multifactorial disease and the range of causes varies from environmental factors to genetic factors. The purpose of this study was to compare blood and tissue eosinophils and serum IgE levels in patients with chronic sinusitis with nasal polyp in Vali-e-Asr hospital in 1397. Methods In this descriptive-analytical study, the population under study included those with chronic sinusitis referred to Birjand Valiasr Hospital in 1397.3 cc of blood samples were taken 1 day before surgery to evaluate eosinophil counts and serum IgE levels. Also, samples taken from patients during surgery were counted, and then, 100 cells were counted, and eosinophil counts and percentages were calculated. The data were entered into the SPSS software after data collection. Results This study was performed on 70 patients with chronic rhinosinusitis which included 43 men (61.4%) and 27 women (38.6%) with mean age of 39.11 ± 13 13.72 years. There was no significant difference between sex of patients and mean serum IgE level (P < 0.05). The mean percentage of eosinophils in blood samples and tissues of patients with chronic sinusitis was significantly increased with the increase in CT scan (P < 0.05). Conclusions Tissue or blood eosinophilia was not observed in patients with chronic rhinosinusitis. Also, the mean eosinophil percentage of blood and tissue increased significantly in patients with increased scanning computed tomography (P < 0.05).

IgE antibody in serum-detection and diagnostic significance as a biomarker in patients with uncontrolled asthma

Background: The presence of atopy increases the probability that a patient with respiratory symptoms has allergic asthma but this is not specific for asthma nor is it present in all asthma phenotypes. Atopic status can be identified by skin prick testing or level of serum IgE. Ig E is a tissue bound molecule found in serum in equilibrium with that bound to mast cells and basophils. The aim of this study was to evaluate the levels of serum total IgE in patients with uncontrolled asthma and test the significance of serum IgE as a biomarker/predictor of severity for uncontrolled asthma. Materials and Methods: A simple random sampling of 55 patients in the age group of 5 to 63 years with 19 males and 36 females over two groups of 45 cases with uncontrolled asthma and 10 controls of controlled asthma were included in the study. Clinical examination, spirometry and serum IgE levels were measured. Results: The level of serum IgE was high in 80 % of the total study population with as high as 88.8% in the uncontrolled asthma group and 40 % in the controlled group. The mean serum IgE level in uncontrolled asthma patients were 2222 IU/L, while in the control group it was 1224 IU/L. Conclusions: The high levels of serum IgE in uncontrolled asthma patients clearly indicates the definite correlation between higher IgE levels and uncontrolled asthma and demonstrates an inverse relationship with serum IgE levels and FEV1 %. Keywords: Allergy; Asthma; Atopy; Gina; Serum IgE.

A 12 weeks, randomized and double-blind evaluation of the efficacy of oral supplements of probiotics (Lactogut and Lactogut Kidz) on atopic dermatitis in adults and children

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The primary objective of the study was to evaluate the efficacy and safety of oral probiotics in the treatment of atopic dermatitis (AD) using the scoring atopic dermatitis (SCORAD) index, serum IgE levels and absolute eosinophil count (AEC). The secondary objective of the study was to determine the association of oral probiotic therapy and improvement in AD using global photographs, dermoscopic images (fotofinder) and individual patient satisfaction.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This was a randomized, double-blind study conducted on 70 patients (20 adults and 50 children) with moderate to severe AD. The participants were randomized into control arm and treatment arm. The treatment arm received conventional and probiotic therapy and only conventional therapy was provided to the control arm. The research was carried out in five visits. For each visit, SCORAD was calculated and response compared using clinical and videodermoscopic images. Patient satisfaction was documented using a quality of life questionnaire during each visit.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Across the treatment arm, the mean serum IgE levels were greatly decreased in contrast to the control arm over the 12 weeks period. SCORAD score was significantly lowered in the treatment arm (55.20%) compared with 18.95% in the control arm. Dermoscopic assessment, global photographic assessment and patient satisfaction in the treatment arm showed statistically significant improvement in AD compared to the control arm.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The decrease in SCORAD scores demonstrated strong associations with the use of probiotics in patients with AD as an adjunct to conventional therapy. Thus, in both adults and children suffering from moderate to severe AD, probiotic supplement can be administered effectively as an adjunct therapy.&lt;/p&gt;&lt;p class="abstract"&gt; &lt;/p&gt;

A Study on Serum Immunoglooubin E levels as a marker in childhood asthma

Background: Asthma is a chronic inflammatory of the lungs which causes bronchial hyperresponsiveness and reversible airway obstruction. The disease predominantly affects the children. Bronchial asthma is manifested in response to external trigger of allergens. The most important risk factor is atopy, which produces high amount of IgE, the aim of this study is to evaluate serum IgE levels as a marker for the disease activity and study the correlation with the severity of bronchial asthma. Methods: A prospective study was conducted in peadiatrics department of the tertiary care hospital from March 2019 to February 2019. Children between 6-12yrs admitted with clinical features of asthma as per GINA guidelines was included in the study. IgE levels were taken at the time of the initial presentation. Results: The study showed that all the participants 100% who presented with clinical features suggestive of asthma had high IgE levels irrespective of age, sex and severity of asthma. The mean IgE levels in females were more than males. As the severity of asthma increased the mean IgE levels also increased. Conclusion: The study conclude that the IgE levels are independent of age and sex. IgE levels are directly proportional to severity of asthma.

Ingrained Insight into Nasal Polyposis; Role of Human Papillomavirus: An Indian Study.

Nasal polyposis (NP) are benign lesion of nasal cavity, affecting up to 1-4% of population. It is known to have up to 70% recurrence rate. The underlying pathophysiology is still undetermined. Recent literatures have thrown light on the viral aetiology for NP. To our knowledge this is the first Indian study done, that aims to evaluate the prevalence of Human papillomavirus (HPV) in NP. It was a prospective case control study done among 40 individuals with NP and 40 healthy controls in a tertiary care centre. All the patients were subjected to routine clinical evaluation, investigations prior to proposed surgeries. The mucosal samples after the surgery were subjected to HPV DNA analysis by RT-PCR. Among the cases, the male to female ratio was 1.3:1. The mean age of patients with NP was 39 ± 14.6. The mean serum IgE levels among the case were 154IU/ml and was significantly higher as compared to controls. Other inflammatory markers such as absolute eosinophil count, erythrocyte sedimentation rate, and neutrophil to leukocyte ration were found to be not significant. There was no HPV DNA detected among both case as well as controls. There seems to be strong association of IgE and NP, suggesting an IgE mediated pathway for its Causation. There is no association of HPV in NP.

The Effects of Smoking on IgE, Oxidative Stress and Haemoglobin Concentration.

Background:Smoking is a well-known related factor for many health problems in a human being through different ways of exposure. Objectives:Thie aim of the study was to examine the effects of different types of cigarette smoking on hemoglobin level, high sensitive C-Reactive Protein (hsCRP), Malondialdehyde (MDA), and IgE levels in healthy adult subjects. Methods:One hundred seventy-one healthy adult females and males were included in this study. They divided into four groups: cigarette, shisha, passive smokers, and non-smokers groups. Serum samples from all groups analyzed for hemoglobin, hsCRP, IgE, and malondialdehyde level. Results:The mean MDA, IgE, and hemoglobin levels significantly increased in both smokers (cigarette and Shisha groups) and passive smokers than in non-smokers group (p<0.05). The hsCRP levels were significantly increased (p<0.05) in cigarette and Shisha smokers compared to non-smokers. At the same time, there was a non-significant relationship between passive smoker in comparison to non-smokers (p>0.05). Conclusion:This study concluded that smoking, including cigarette and shisha, even passive smoking harmed health through increasing Malondialdehyde, serum IgE and hs-CRP levels in the body.

The relationship between serum vitamin D levels and childhood atopic dermatitis

Aim: We aimed to evaluate serum vitamin D levels among children who have atopic dermatitis (AD) and to determine relationship with its clinical features and laboratory.Material and Methods: One hundred twenty children (66 B, 54 G) with AD, aged between 1-16 years, followed up from Pediatric Allergy Outpatient Clinic were enrolled. Family history of atopy, comorbid allergic diseases, allergy skin prick tests, serum total peripheral blood eosinophil counts, IgG, IgA, IgM, IgE levels, were recorded. AD severity was determined by using Scoring Atopic Dermatitis (SCORAD) index. The serum 25(OH)D vitamin levels were studied with HPLC method.Results: The mean serum total IgE level was 557 ± 425.3kU/L and mean blood eosinophil count was 557 ± 425.3 mm3. The meanserum 25(OH) vitamin D level was 28.42 ± 10.56 ng/ml. One of the patients (0.83%) had severe vitamin D deficiency, 16 (13.3%) had deficiency and 55 (45.8%) had insufficiency. Serum vitamin D level was normal in 48 (40 %) patients. According to SCORAD index, mean serum vitamin D level was higher in patients with mild AD (32.18 ± 7.91 ng/ml) than in patients with moderate disease(28.79 ± 11.02 ng/ml) or in patients with severe AD (23.78 ± 8.92 ng/ml)(p0,05).Serum 25(OH)D levels were inversely correlated with SCORAD index values (r =-0.273, p= 0.003). Conclusions: In this study, we showed a reverse correlation between serum 25(OH)D vitamin level and atopic dermatitis severity. Vitamin D deficiency should be thought in unresponsive AD cases.

Vitamin D and Serum Immunoglobulin E Levels in Allergic Rhinitis: A Case-control Study from Pakistan.

IntroductionAllergic rhinitis (AR) is the most common non-infectious rhinitis and is associated with sneezing, cough, and flu-like symptoms. The exact pathophysiology of AR remains uncertain. The deficiency of vitamin D3 has been documented as a probable cause of allergic conditions due to its role in immunomodulation. The aim of this study was to evaluate the role of vitamin D3 deficiency in allergic rhinitis.MethodsThis case-control study was conducted with 50 patients of AR and 50 healthy individuals. Serum immunoglobulin (Ig) E and vitamin D3 levels were measured in all study participants. Data were analyzed using SPSS v. 21.0 (IBM Corp., Armonk, NY).ResultsMean serum IgE levels in the AR group were 553.5 ± 53.9 IU/L as compared to 219.4 ± 32.1 IU/L in the control group (p <0.0001). AR patients had mean serum vitamin D levels of 14.8 ± 7.4 ng/mL as compared to 19.1 ± 6.6 ng/mL in the control group (p=0.002). Only 10% of participants in the AR group had adequate serum vitamin D levels as compared to 26% in the controls (p=0.08).ConclusionVitamin D deficiency was present in both study groups. The AR group had significantly lower mean levels of serum vitamin D than the control group. However, upon stratification, the differences were insignificant.

Refractory asthma phenotyping based on immunoglobulin E levels and eosinophilic counts: A real life study.

Asthma is an inflammatory heterogeneous disease with variable severity. The serum IgE level and Eosinophilic count have been used as biomarkers to define treatment strategies with biological agents in severe refractory asthma. The aim of this study is to determine the concurrence of high eosinophil count and elevated serum IgE levels in patients with severe refractory asthma. A retrospective cross-sectional real-life study was conducted on patients attending adult refractory asthma outpatient clinic between 2015 and 2018. Serum total IgE level and blood EOS count on matched dates with spirometry and Asthma Control Test (ACT) scores were collected. All data were obtained while patients were not on biological agents. A total of 142 patients with severe refractory asthma were included. The mean age was 43 years, mean eosinophilic count 564 cells/μL and mean serum IgE levels of 520 IU/ml. There was a significant correlation between serum IgE level and eosinophilic count. Serum IgE and eosinophilic count were concurrently elevated in 110 patients (78%). The patients were further categorized into four subgroups. Group A: IgE 30-100 IU/mL and EOS 150-300 cells/μL (7.3%), Group B: IgE >100 IU/mL and EOS 150-300 cells/μL (19.1%), Group C: IgE 30-100 IU/mL and EOS >300 cells/μL (14.5%) and Group D: IgE >100 IU/mL, EOS >300 cells/μL (59.1%). The majority of severe refractory asthma patients exhibits both elevated serum IgE level and eosinophilic counts.

Vitamin D: A Silent Cofactor for Allergic Rhinitis

Introduction &#x0D; Allergic rhinitis affects around 50% of atopies in India. Vitamin D is related to both humoral and cell mediated immunity and its receptors are found in inflammatory mediators. This study was conducted to assess any possible association between Allergic rhinitis and serum Vitamin D.&#x0D; Materials and Methods&#x0D; A cross sectional study was conducted amongst 41patients with Allergic rhinitis as per ARIA guidelines attending the Otolaryngology outpatient Department of a peripheral tertiary care hospital. Vitamin D levels were assessed in patients with allergic rhinitis in terms of serum Ig-E level and absolute blood eosinophil count (ABEC).&#x0D; Results&#x0D; Among 41 patients, 31 patients (75.6%) had deficiency of vitamin D with mean Vitamin D level of 14.87±1.56ng/ml (normal vitamin D level-30-100ng/ml and low &lt;20ng/ml), mean serum Ig-E level was 1040±303.83Iu/ml (normal-1.90-170 IU/ml by CLIA method) and mean ABEC 1226.77±397.89 (normal-30-350/ml).&#x0D; Conclusion&#x0D; Low serum Vitamin D is common in Allergic rhinitis patients. Low serum Vitamin D seems to be a significant cofactor in aetiopathogenesis of Allergic rhinitis in most of the cases.