Multiple Allergen Simultaneous Test Research Articles

Chronic Rhinosinusitis With Nasal Polyps Does Not Affect the Association Between the Nasal Provocation Test and Serum Allergen-Specific Immunoglobulin E Levels

Background and Objectives: This study compared nasal provocation test (NPT) results between groups with and without chronic rhinosinusitis with nasal polyps (CRSwNP) to investigate whether CRSwNP affects the response to the intranasal allergen challenge.Methods: We reviewed the medical records of patients who had undergone the NPT, multiple allergen simultaneous test (MAST), and paranasal sinus computed tomography. Patients were diagnosed with CRSwNP based on findings from nasal endoscopy and paranasal sinus computed tomography. The NPT for house dust mites was conducted, and a positive MAST diagnosis was determined when the levels of immunoglobulin E specific to <i>Dermatophagoides farinae</i> and <i>Dermatophagoides pteronyssinus</i> were equal to or greater than 2 positives or at least 0.70 IU/mL. We statistically analyzed the NPT results and their correlation with MAST outcomes, comparing the CRSwNP group to the non-CRSwNP group.Results: Out of 99 participants, 30 had CRSwNP and 69 did not. There were no significant differences between the groups regarding MAST positivity, eosinophil count, eosinophil cationic protein levels, or responses to intranasal house dust mite challenges. The presence of CRSwNP did not significantly influence the correlation between NPT outcomes and MAST results.Conclusion: The presence of CRSwNP did not influence the outcomes of the NPT or its correlation with the results of the MAST. Additional large-scale, longitudinal studies are warranted to validate these findings.

Insufficiency of Laboratory Data in Reflecting Allergic Rhinitis Severity Based on the Allergic Rhinitis and Its Impact on Asthma Guideline in Korean Patients

Background and Objectives: This retrospective study, conducted at a single tertiary medical center, aimed to investigate the correlation between the severity of allergic rhinitis (AR) based on subjective symptoms and the severity assessed through laboratory data.Methods: In total, 584 patients who were diagnosed with AR by a multiple-allergen simultaneous test were included. Patients were classified into four groups according to the Allergic Rhinitis and its Impact on Asthma (ARIA) classification guideline. The visual analog scale (VAS) score for overall discomfort and laboratory parameters, including the serum total immunoglobulin E (IgE) level and peripheral blood eosinophil count, were evaluated in all patients. An analysis was conducted to examine the differences in VAS scores and laboratory findings among the four groups. Additionally, the correlations between the laboratory findings and VAS score were analyzed.Results: The serum total IgE level and the percentage and count of peripheral blood eosinophils showed no significant differences among the groups. However, the VAS score for overall discomfort exhibited notable between-group differences. The average VAS score was 6.14 (95% confidence interval 5.94–6.34) in the overall group. The mean scores of each group showed a noticeable increasing trend from the mild intermittent group to the mild persistent, moderate to severe intermittent, and moderate to severe persistent groups (p<0.001), although there was no clear correlation between the increase in VAS scores and laboratory parameters.Conclusion: Neither the symptom-based ARIA guideline nor the VAS score correlated with the AR laboratory test measurements. The current laboratory data alone may not be sufficient to reflect the severity of AR based on subjective symptoms.

Allergic Mucin in Allergic Fungal Rhinosinusitis.

A previously healthy 67-year-old man visited the otorhinolaryngologist’s office reporting mucinous nasal secretion, postnasal drip, and right nasal stuffiness for 8 months. On the initial visit, the nasal endoscopy revealed only sparsely pooled mucinous discharge in the right middle meatus with no mass lesion or nasal polyps. A computed tomography image revealed diffusely thickened mucosa of the right maxillary sinus partially filled with a dense secretion showing areas of hyperattenuation in the bone window setting (Figure 1, arrowhead). No focal microcalcifications, bony destructions, or bony remodeling were identified in the maxillary sinus. The patient had serum eosinophilia of 598 eosinophils/μL (9.7% total white blood cells). The radioallergosorbent test showed an elevated total IgE concentration of 915.60 IU/mL and the multiple allergen simultaneous test revealed type I hypersensitization (atopy) to Aspergillus spp. (class 3), Cladosporium spp. (2+), weak sensitization to Penicillium spp. (1+), and none to Alternaria spp.

Correlation of Multiple Allergen Simultaneous Test with Nasal Provocation Test of House Dust Mite.

Objectives: Compared with the skin prick test, relationship between the multiple allergen simultaneous test (MAST) and nasal provocation test (NPT) has rarely been evaluated. We evaluated the relationship between the results of the MAST and NPT against house dust mites in the Korean population. Methods: Medical records of patients who underwent both MAST and NPT were reviewed. Positive MAST was diagnosed when the levels of immunoglobulin E (IgE) specific for Dermatophagoides farinae (DF) and Dermatophagoides pteronyssinus (DP) were ≥2 positivity or ≥0.70 IU/ml. During the NPT, changes in subjective symptoms, including nasal obstruction, rhinorrhea, sneezing, itching, ocular discomfort, and peak nasal inspiratory flow (PNIF), were measured. The correlation between NPT and MAST results was statistically analyzed. Results: A total of 96 participants were enrolled in this study: 26 were assigned to the MAST-positive group, and 70 were assigned to the MAST-negative group. Changes in subjective symptoms before and after the nasal allergen challenge were significantly associated with the MAST results. Changes in PNIF before and after the nasal allergen challenge were also significantly associated with the MAST results. We found that a cutoff value of "a subjective total nasal symptom change" of more than 17.5 had a sensitivity of 68.6% and a specificity of 69.2%, while a cutoff value of "a PNIF change" of more than 6.51 had a sensitivity of 67.1% and a specificity of 69.2%. Conclusion: NPT was significantly associated with MAST, and further studies regarding the relationship between NPT using various allergen conditions and MAST are warranted.

Clinical features of chronic fungal rhinosinusitis in Korean geriatric and non-geriatric patients.

Worldwide, the incidence of chronic fungal rhinosinusitis (CFRS) has increased. Although ageing leads to weakening of the immune system, which increases susceptibility to CFRS, the CFRS characteristics in geriatric patients are unclear. Therefore, we comparatively analysed the clinical characteristics of CFRS in geriatric and non-geriatric patients. This retrospective analysis compared the demographics, rhinologic symptoms, multiple allergen simultaneous tests, olfactory function tests, paranasal sinus computed tomography findings, and outcomes of 131 patients with CFRS who underwent functional endoscopic sinus surgery and 131 enrolled patients were divided in geriatric (> 65years) and non-geriatric (≤ 65years) groups. Among the geriatric and non-geriatric participants (n = 65, 49.6% and n = 66, 50.4%, respectively), hypertension and diabetes mellitus were more common in the geriatric group. Demographics, including symptoms, showed no significant intergroup differences. Normosmia and hyposmia were significantly less prevalent, whereas phantosmia and parosmia were more prevalent in the geriatric group than in the non-geriatric group (p = 0.03 and p = 0.01, respectively). Sphenoidal sinus involvement was significantly higher in geriatric patients than in non-geriatric patients (p = 0.02). Based on greater sphenoidal sinus involvement, a deeper anatomical area is more vulnerable to fungal infection in the geriatric group than in the non-geriatric group. Increasing clinicians' awareness of CFRS in geriatric patients with olfactory dysfunction, including phantosmia and parosmia, is important for early intervention.

Association between poly-sensitisation and sensitisation to staphylococcal enterotoxin A and B affecting allergic severity in children.

Accumulating evidence suggests that Staphylococcus aureus plays a significant role as a disease modifier in upper and lower airway diseases. We aimed to assess the association between staphylococcal enterotoxins (SEs) with allergic diseases and the degree of allergen sensitisation in children, which remains unclear. We retrospectively reviewed the medical records of 455 patients aged 3-18years between March 2018 and March 2022. Clinical history and demographic data were obtained. The baseline study included paranasal sinus X-ray scan, multiple allergen simultaneous test, and ImmunoCAP® for measuring serum total and specific immunoglobulin E (IgE) levels to allergens and staphylococcal enterotoxin A and B (SEA and SEB). The mean age was 9.77 ± 4.3years. 133 patients (29.2%) were sensitised to one inhalant allergen, and 188 patients (41.3%) showed polysensitisation. Patients sensitised to SEs showed higher total and specific IgE levels and total eosinophil counts compared to non-SE-sensitised patients. Sensitisation to SEs is closely associated with polysensitisation to inhalant allergens and allergic multimorbidity. When the SE-IgE value was 0.35 or higher, the odds ratio for allergen polysensitisation was significantly higher than when the SE-IgE value was lower than 0.35. Association between polysensitisation and sensitisation to SEs in children shows the higher the specific IgE levels for SEs, the higher the likelihood of polysensitisation. Considering the relationship between polysensitisation, high IgE levels, and the severity of allergic morbidity, sensitisation to SEs is thought to be related to allergy severity.

Multiple allergen simultaneous test is useful in assessing allergen sensitization and its geographic variations by the Geographic Information System-based approach

Multiple allergen simultaneous test is useful in assessing allergen sensitization and its geographic variations by the Geographic Information System-based approach

Optical Analysis of Nasal Endoscopic Images From a Patient With Severe Acute Respiratory Syndrome Coronavirus 2

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide; a simple diagnostic test is becoming increasingly important. Polymerase chain reaction tests of nasal swab samples are expensive and time-consuming. Detailed observation of the nasal cavity is required. No nasal endoscopic study regarding patients with SARS-CoV-2 has been published. Here, we compared endoscopic images of normal subjects and patients with allergic rhinitis (AR) to images from a patient with confirmed SARS-CoV-2 infection. Nasal cavity endoscopic images (of the inferior turbinate) were compared using the hue, saturation, and luminance (HSL) color system of Matrox Design Assistant, version 5.0. The multiple allergen simultaneous test was used to distinguish normal subjects from patients with AR. HSL patterns were compared among images. We enrolled 14 normal subjects and patients with AR and 1 patient with confirmed SARS-CoV-2 infection. The inferior turbinates of normal subjects and patients with AR were smooth and uniform, while those of the patient with SARS-CoV-2 were scratched and stretched. Although additional data are needed, optical analysis of nasal endoscopy images may be useful to screen for SARS-CoV-2 infection. This imaging method is rapid, non-invasive, and inexpensive.

Comparison of Intradermal Skin Test and Multiple Allergen Simultaneous Test Results in Canine Atopic Dermatitis

Hyeyeon Nam, Taesik Yun, Yunhoi Koo, Dohee Lee, Yeon Chae, Jooyoung Park, Dongjoon Choi, Hakhyun Kim, Mhan-Pyo Yang, Byeong-Teck Kang. J Vet Clin 2021;38:120-6. https://doi.org/10.17555/jvc.2021.38.3.120

Differential Correlations among Allergy Tests According to Indoor Allergens in Allergic Rhinitis

Several allergy tests are used for the diagnosis of allergic rhinitis; however, few studies have reported a direct comparison of the skin prick test (SPT), multiple allergen simultaneous test (MAST), and ImmunoCAP according to specific allergens. This study aimed to evaluate the correlations between each test and allergic rhinitis symptoms and to evaluate the correlations of the MAST and ImmunoCAP with the SPT for representative indoor allergens in Korea. Electronic medical charts were retrospectively reviewed, and 698 patients with allergic rhinitis who had performed SPT, MAST, and ImmunoCAP were enrolled. Correlations between each allergy test for 4 representative indoor allergens and the symptoms of allergic rhinitis were analyzed. Agreements of the MAST and ImmunoCAP with the SPT were compared according to each allergen. The SPT showed higher correlations with allergic rhinitis symptoms for 4 indoor allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, cat, and dog allergens) than the MAST or ImmunoCAP. In comparison between the MAST and SPT, the least correlation was observed for the dog allergen, whereas between the ImmunoCAP and SPT, the least correlation was observed for the cat allergen. The correlation between the ImmunoCAP and SPT was higher than that between the MAST and SPT for the dog allergen, whereas no significant differences were noted for other allergens. Overall, the SPT showed a higher correlation with allergic rhinitis symptoms than the MAST or ImmunoCAP for 4 indoor allergens. ImmunoCAP showed similar reactivity to MAST; however, it showed better positivity with dog allergen in patients who were reactive to the allergen in the SPT. Care should be taken while evaluating dog allergen sensitization using the MAST.

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

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

Multiple Allergen Simultaneous Test-Immunoblot Assay for Immunoglobulin E Detection in Patients with Isolated Allergic Conjunctivitis.

We aimed to investigate the immunoglobulin E (IgE) detection rate and allergen patterns in patients with isolated allergic conjunctivitis using the multiple allergen simultaneous test (MAST)-immunoblot assay. A total of 120 patients with allergic conjunctivitis and no associated rhinitis, asthma, or dermatitis underwent the MAST-immunoblot assay to measure serum total IgE (TIgE) and serum specific IgE (SIgE) against 57 allergens. Patients were classified into subgroups based on the season when the eye symptoms were exacerbated, and TIgE and SIgE positivity. Differences between sex and age groups were also analyzed. Of the 120 patients, 57.5% (69 patients) and 69.2% (83 patients) were positive for TIgE (≥100 IU/mL) and SIgE (≥0.7 IU/mL), respectively. The allergens that most frequently triggered sensitization in the study population were Dermatophagoides farinae, Dermatophagoides pteronyssinus, Tyrophagus putrescentiae, Alternaria, and house dust. House dust mites, such as D. farinae and D. pteronyssinus, showed the highest detection rates regardless of the season. Men had a higher positive rate for TIgE than women, whereas a higher rate of sensitization, detected as SIgE positivity, was seen in younger patients. In conclusion, MAST-immunoblot assay can detect sensitizing allergens in patients with isolated allergic conjunctivitis.

Non-association between low vitamin d levels and aeroallergen-positivity evaluated using multiple allergen simultaneous test in Korean adults

BackgroundStudies on the association between vitamin D levels and allergen sensitization have reported conflicting results. We aimed to evaluate the association between low vitamin D levels and sensitization to 59 aeroallergens in Korean adults.MethodsWe retrospectively reviewed serum 25-hydroxyvitamin D (25[OH]D) measurements of participants (n = 57,467) in a healthcare center between May 2003 and June 2020. Serum 25(OH)D levels were categorized as follows: severe deficiency (< 10 ng/mL), deficiency (10 to < 20 ng/mL), insufficiency (20 to < 30 ng/mL), and sufficiency (≥ 30 ng/mL). Among all subjects, 1277 simultaneously underwent the multiple allergen simultaneous test. Multiple linear and logistic regression analyses were used to estimate coefficients and odds ratios (ORs) with 95% confidence interval (CI) for the association between serum vitamin D deficiency and aeroallergen sensitization after adjustment for potential confounders. Subgroup analyses were conducted for the types of aeroallergen (house dust mites, pollens, animal dander, foods, cockroach, and fungus).ResultsVitamin D deficiency, defined as serum 25(OH)D level < 20 ng/mL, was noted in 56.4% of participants. There were significant differences in serum 25(OH)D levels according to sex, age, season, and bone mineral density (all P < 0.001). In multiple linear regression analyses, serum 25(OH)D levels were significantly lower in young subjects (adjusted coefficient [95% CI], 0.188 [0.101, 0.275]) and during winter (− 4.114 [− 6.528, − 1.699]). However, no significant association was observed between serum 25(OH)D levels and allergen sensitization (adjusted coefficients [95% CI], − 0.211 [− 1.989, 1.567], P = 0.816). In multivariate logistic regression analyses, male sex, young age, and winter season were significant risk factors for vitamin D deficiency. However, allergen sensitization showed no significant association with 25(OD)D levels after adjusting for confounders (adjusted OR [95% CI], 1.037 [0.642, 1.674] in insufficiency; 0.910 [0.573, 1.445] in deficiency; 0.869 [0.298, 2.539] in severe deficiency groups, P for trend = 0.334). There were consistent findings across subgroups regarding type of aeroallergen sensitized.ConclusionVitamin D deficiency was prevalent but was not significantly associated with aeroallergen sensitization in Korean adults. To the best of our knowledge, this is the first large-scale study to evaluate the association between vitamin D deficiency and sensitization to 59 different aeroallergens.

Alternative to In Vivo Tests During the COVID-19 Pandemic: Multiple Allergen Simultaneous Tests as a Useful First Screening.

In allergy diagnosis we sometimes find some clinical or logistic limitations to be able to carry out in vivo tests, so the detection of serum allergic-specific IgE could be an alternative as a first screening step. Here, we compare the results from the routine diagnostic tools and multiple allergen simultaneous tests to detect inhalant allergen sensitization. Thirty-two subjects with a positive ImmunoCAP Phadiatop screening were included, evaluating the accuracy of their diagnosis using (1) specific IgE determination by ImmunoCAP and (2) MAST EUROLINE Immunoblot. The MAST method showed a high agreement and correlation with the ImmunoCAP system for Derma-tophagoides pteronyssinus, cat dander, orchard grass and Alternaria alternata. Of the subjects, 94% were sensitized to at least one of the allergens using MAST EUROLINE immunoblot, whereas 79% of individuals with a positive Phadiatop went undetected when we analyzed only the 4 allergens mentioned before. The study showed the usefulness of MAST EUROLINE immunoblot for screening detection of specific IgE antibodies directed against a broad spectrum of inhalant allergens as a first screening tool. Furthermore, its performance is not affected by the possible in vivo test limitations and avoids the arbitrary selection of allergenic sources for evaluation, which may lead to incorrect patients' diagnosis and management.

Changes in allergen sensitization in children with allergic diseases in the 1980 to 2019

Purpose: Allergen sensitization is constantly changing, and understanding these changes can help manage and prevent allergic diseases. This research analyzed and compared the changes in allergen sensitization in children diagnosed with allergic diseases us-ing the skin test and the multiple allergen simultaneous test. Methods: We retrospectively analyzed the data on children who were diagnosed with allergic diseases and received immunother-apy at Yonsei Medical Center from 1980 to 1998 and they were screened for allergen sensitization at Severance Hospital from 2005 to 2019. Results: Between 1980 and 1998, and between 2005 and 2019, data on 3,205 (male, 70.3%; mean age, 7.2±2.9 years) and 15,318 children (male, 62.8%; mean age, 8.8±4.5 years) were analyzed. The sensitized allergens that appeared in the 1980-1998 included Dermatophagoides farinae (91.0%), Dermatophagoides pteronyssinus (76.3%), cockroach (13.5%), and Alternaria (11.5%), in order of frequency; further, the sensitized allergens that appeared in the 2005-2019 included D. farinae (45.0%), D. pteronyssinus (39.6%), cat dander (12.2%), and dog dander (9.1%), in order of frequency. D. farinae and D. pteronyssinus demonstrated the highest sensitization rates, although the rates decreased gradually. The sensitization to cat dander and dog dander showed a growing trend, and sensiti-zation to Humulus japonicus, Candida, and cockroach decreased after 2005. Conclusion: Over the past 40 years, the allergen sensitization in Korean children with allergic diseases has increased. These changes reflect lifestyle and environmental changes and influence allergic disease management approaches. Thus, changes in allergic sensi-tization should be monitored continuously. (Allergy Asthma Respir Dis 2021;9:208-215)

Correlations Between the Adenotonsillar Microbiome and Clinical Characteristics of Pediatric Patients With Snoring.

ObjectivesFew studies have reported combined analyses of the microbiome of the adenoids and tonsils in pediatric patients with snoring, and correlations of the adenotonsillar microbiome with clinical characteristics have not been evaluated to date. The aim of this study was to characterize the adenotonsillar microbiome and to determine its correlations with the subjective symptoms of pediatric patients with snoring and with levels of regional mucosal immune molecules.MethodsTwenty-four children who underwent tonsillectomy with adenoidectomy owing to snoring were enrolled in this cross-sectional study conducted between August 2017 and December 2018. The microbiome of the adenoids and tonsils was characterized, and its alpha- and beta-diversity was determined. Clinical characteristics, including subjective discomfort during sleep (assessed using the obstructive sleep apnea-18 questionnaire), the presence of allergic rhinitis, concentrations of heat shock protein (Hsp)27, Hsp70, and interleukin-8 (IL-8) in lavage fluids, and white blood cell (WBC) counts, were measured.ResultsAt the phylum level, the microbiome was not significantly different between the adenoids and tonsils; the alpha and beta indices were likewise not significantly different between these two regions. The alpha-diversity of the entire adenotonsillar microbiome was associated with sex, emotional stress, and IL-8 levels in the tonsil lavage fluids. Beta-diversity was associated with Hsp27 levels in the tonsil lavage fluids and WBC counts. Multiple allergen simultaneous test results were not significant, although total serum immunoglobulin E levels were significantly associated with the beta-diversity of the adenotonsillar microbiome.ConclusionThe data reported herein suggest, for the first time, that the adenotonsillar microbiome interacts with the regional mucosal immune system. The observed association of the microbiome with subjective discomfort is a novel finding that warrants further investigation.

A Comparison of Multiple Allergen Simultaneous Tests Using Allergen-Specific IgE Concentration and Intradermal Skin Tests in Atopic Horses With Pollen Allergy

Intradermal tests (IDTs) and measurement of specific immunoglobulin E class (sIgE) levels in sera are the most common and reliable methods used in allergological clinical practice. The purpose of this study was to explore the sensitization of pollen allergy in atopic horses with pollinosis and to assess the diagnostic value of the multiple allergen simultaneous tests (MASTs) compared with that of the IDT. Twenty-one Malopolski horses with typical skin hypersensitivity symptoms during pollen seasons were enrolled. Intradermal tests were performed, and allergen-specific IgE concentrations in sera were measured using a monoclonal anti-IgE antibody to pollens of grass, weeds, trees, and cultivated plants. The highest sensitization rate was for Secale cereale (IDT, 76%; MAST, 66.7%), grass (IDT, 71%; MAST, 57%), and Brassica napus (IDT, 52.4%; MAST, 57%). Receiver operating characteristic (ROC) curve analysis and the area under the ROC curve (AUC) showed that Betula spp., Alnus spp., and Corylus spp. had the highest AUC at 0.854, followed by Secale cereale (AUC = 0.796), Plantago lanceolata (AUC = 0.726), Brassica napus (AUC = 0.704), and a grass allergen mixture (AUC = 0.695). The mean AUC for all allergens was 0.712 (0.604–0.867). The overall sensitivity of the sIgE plant horse panel was 78% (range, 68%–90%), the specificity was 86.3% (range, 64%–100%), and the accuracy was 79% (range, 64%–87%). Statistical kappa (κ) agreement between the MAST and IDT was reached for tree (κ = 0.767), rye (κ = 0.687), colza (κ = 0.671), and grass (κ = 0.664) pollen. The MAST showed a favorable agreement with the IDT and can be used for the detection of sIgE in atopic horses with pollinosis.

Comparison of the clinical characteristics of bilateral and unilateral fungal balls in Korea.

Fungal rhinosinusitis occurs in different forms depending on race and region. While allergic fungal rhinosinusitis is common in Caucasians, fungal ball (FB) is more common in Asians. However, most cases are reported as unilateral, and clinical data on bilateral FB (BFB) are rare. Therefore, the purpose of this study was to analyze and to compare the clinical characteristics of BFB and unilateral FB (UFB) in Koreans. We retrospectively analyzed medical records and computed tomography (CT) images of 434 patients diagnosed with FB. The patients were divided into two groups: BFB and UFB. Demographic data, multiple allergen simultaneous test including total or specific immunoglobulin E (IgE) levels, symptoms, CT findings, treatment, and outcomes were analyzed. Among the patients, 26 had BFB and 408 had UFB. Hypertension was noted in 61.5% of the BFB and 39% of the UBF individuals (p = 0.023). While total IgE levels were similar between the two groups, Dermatophagoides pteronyssinus (p = 0.004), Cladosporium (p = 0.017), and Aspergillus-specific IgE positivity (p = 0.025) were significantly higher in the BFB than in the UFB group. Not only symptoms such as postnasal drip (p = 0.013), mucopurulent rhinorrhea (p = 0.009), and foul odor (p = 0.037), but also sphenoid sinus involvement on CT images were more common in the BFB than in the UFB group (p = 0.011). Patients with BFB in Korea showed more common hypertension and symptoms of foul odor, mucopurulent rhinorrhea, and postnasal drip with allergy positivity compared to those with UFB. Therefore, understanding clinical characteristics of BFB will allow clinicians to approach BFB more appropriately.

A Comparison of Intradermal Skin Testing and Serum Insect Allergen-specific IgE Determination in Horses With Insect Bite Hypersensitivity From 2008 to 2016

New techniques in equine veterinary allergy testing include multiple allergen simultaneous tests (MASTs) that cover insect bite hypersensitivity (IBH), respiratory and atopic allergic diseases. The in vivo intradermal test (IDT) method is one of the most widely used techniques in veterinary practice, but recently, in vitro methods have been introduced as possible alternatives. This study was designed to assess the correlation between IDTs and MASTs based on IgE determination in serum. The study was performed on Malopolski breed horses with IBH (n = 26). IDTs were performed, and allergen-specific IgE serum concentrations were measured using a monoclonal anti-IgE antibody during the years 2008–2016. An allergen panel containing Tabanus spp., Culicoides nubeculosus, mosquito (Culex spp.), Simulium equinum, and Stomoxys calcitrans was used. This study shows good agreement and correlation (correlation coefficient rho, 0.413–0.589) between the two tests for four (Tabanus spp, Culicoides nubeculosus, Culex spp., Simulium equinum) of the five tested allergens in horses with IBH. The overall sensitivity (Se) of the allergen-specific IgE insect horse panel was 72.6% (range, 30.8%–91.3%), the specificity (Sp) was 63.6% (range, 50%–70.1%), and the accuracy (Acc) was 73.3% (range, 48%–88.5%) compared with IDTs. This study found good agreement and correlation between IDTs and serological MASTs based on monoclonal antibodies for most of the determined allergens for horses with IBH.

NASAL EOSINOPHIL CORRELATION WITH AEROALLERGEN SENSITIZATION IN CHILDREN

Introduction Identification of eosinophil leukocytes within the nasal mucosa and corresponding eosinophilia of the nasal secretions are common place findings in allergic rhinitis patients. We thought that sensitization to specific allergens would affect the results of the nasal eosinophil test. Therefore, we compared aeroallergen sensitization and nasal eosinophil counts in children with rhinitis. Methods This study was conducted in 285 children under 18 years of age with acute or chronic rhinitis, who had had nasal eosinophil examinations and been tested for aeroallergens with the multiple allergen simultaneous test between March 2013 and February 2016 at the allergy clinic in a tertiary referral hospital. We retrospectively reviewed the patients’ medical and laboratory records and classified them according to the results of sensitization to each allergen to determine the association between nasal eosinophils and 18 aeroallergens. Results A total of 245 children were enrolled in this study. The children's mean age was 7.9 years and the male to female ratio was 1.75. Of the cases, 175 (71.4%) patients were sensitized to at least one of the 18 aeroallergens. In those sensitized, the mean percentage of nasal eosinophilia was 9.26%. There were significant differences in the percentage of nasal eosinophils between the groups sensitized and non-sensitized to aeroallergens (pAlternaria alternata among the 18 aeroallergens, showed the greatest mean percentage of nasal eosinophils (27.9%). Conclusions Nasal eosinophilia was significantly associated with sensitization to aeroallergens. In particular, patients sensitized to Alternaria alternata are more likely to have nasal eosinophilia.