Number Of Skin Prick Tests Research Articles

Allergies and Exercise-Induced Bronchoconstriction in a Youth Academy and Reserve Professional Soccer Team.

A high prevalence of respiratory allergies and exercise-induced bronchoconstriction (EIB) has been reported among endurance athletes. This study was designed to analyze the frequency of sensitization to respiratory allergens and EIB in young soccer players. Prospective cohort design. Youth academy and reserve professional soccer team during the seasons 2012 to 2013 and 2013 to 2014. Eighty-five soccer players (mean age: 20 ± 4 years) participated. Players underwent skin prick tests (SPTs) during the seasons 2012 to 2013 and 2013 to 2014. Spirometry and a eucapnic voluntary hyperpnea test were performed on soccer players during the first season 2012 to 2013 (n = 51) to detect EIB. Two self-administered questionnaires on respiratory history and allergic symptoms (European Community Respiratory Health Survey and Allergy Questionnaire for Athletes) were also distributed during both seasons (n = 59). The number of positive SPTs, exercise-induced respiratory symptoms, presence of asthma, airway obstruction, and EIB. Forty-nine percent of players were sensitized to at least one respiratory allergen, 33% reported an allergic disease, 1 player presented airway obstruction at rest, and 16% presented EIB. Factors predictive of EIB were self-reported exercise-induced symptoms and sensitization to at least 5 allergens. Questioning players about exercise-induced respiratory symptoms and allergies as well as spirometry at the time of the inclusion medical checkup would improve management of respiratory health of soccer players and would constitute inexpensive preliminary screening to select players requiring indirect bronchial provocation test or SPTs. This study showed that despite low frequencies, EIB and allergies are underdiagnosed and undertreated in young soccer players.

Airway hyper-responsiveness to mannitol provides a good evaluation of atopy in childhood asthma.

The relationship between airway hyper-responsiveness (AHR) and atopy has been previously investigated, but there are still some issues to be clarified. The aim of this study was to assess the link between AHR and mannitol and atopy in asthmatic children. We evaluated 44 children with asthma, aged 6-16 years of age, using skin prick tests (SPTs), serum total and specific immunoglobulin E (IgE) levels and the mannitol challenge test (MCT). We found a good correlation between AHR to mannitol and specific IgE against Dermatophagoides pteronissinus (r = -0.66, p < 0.001) and a weak correlation with specific IgE against dog dander (r = -0.33, p = 0.01) and Aspergillus fumigatus (r = -0.23, p = 0.02). Furthermore, we found a weak correlation between AHR to mannitol and serum total IgE (r = -0.30; p = 0.03), the sum of specific IgE to aeroallergens (r = -0.37, p = 0.01) and the number of positive SPTs (r = -0.31, p = 0.02). Measuring AHR with MCT might provide an accurate evaluation of the degree of atopy in children. The patients with a higher degree of atopy were significantly more reactive to mannitol. In clinical practice, these results indicate that children with asthma who are more atopic may require more intensive treatment strategies to reduce AHR.

Characterization of tree allergy prevalence in children younger than 4 years

Characterization of tree allergy prevalence in children younger than 4 years

Associations between asthma and bronchial hyper-responsiveness with allergy and atopy phenotypes in urban black South African teenagers.

To determine asthma and allergy phenotypes in unselected urban black teenagers and to associate bronchial hyper-responsiveness (BHR) with asthma, other atopic diseases and allergen sensitisation. This was a cross-sectional study of 211 urban high-school black children of Xhosa ethnicity. Modified ISAAC questionnaires regarding asthma, eczema and rhinitis were administered. BHR was assessed by methacholine challenge using hand-held nebulisers. Skinprick tests (SPTs) were performed for 8 aeroallergens and 4 food allergens. Asthma was reported in 9%, and 16 % demonstrated BHR. Rhinitis was reported in 48% and eczema in 19%. Asthma was strongly associated with BHR. Asthma was associated with eczema whereas BHR was associated with rhinitis. SPTs were positive in 34% of subjects, aeroallergens in 32%, and food allergens in 5%. The most common sensitivities were to house dust mites (HDM) and German cockroach. BHR was associated with sensitivity to any aeroallergen, cat, HDM, cockroach and bermuda grass. The number of positive SPTs was associated with asthma and BHR. With each level of SPT positivity, there was 40% increased prevalence of asthma and 70% increased prevalence of BHR. The rate of allergen sensitisation in subjects with BHR (72%) was much higher than those without BHR (28%); house dust mite sensitivity was 69% in subjects with BHR and 18% in those without. These are the highest rates of allergen sensitisation in subjects with BHR documented in an African setting and the widest difference in sensitisation rates between subjects with and without BHR.

Methacholine and adenosine 5′‐monophosphate (AMP) responsiveness, and the presence and degree of atopy in children with asthma

The relationship between atopy and bronchial hyperresponsiveness (BHR), both key features of asthma, remains to be clarified. BHR is commonly evaluated by bronchial challenges using direct and indirect stimuli. The aim of this study was to investigate the degree of BHR to methacholine (direct stimulus) and adenosine 5'-monophosphate (AMP) (indirect stimulus) according to the presence and degree of atopy in children with asthma. We performed a retrospective analysis of data from 120 children presenting with a diagnosis of asthma. These children were characterized by skin-prick tests (SPTs), spirometry and bronchial challenges with methacholine and AMP. Atopy was defined by at least one positive reaction to SPTs, and its degree was measured using serum total IgE levels, number of positive SPTs and atopic scores (sum of graded wheal size). A provocative concentration causing a 20% decline in FEV(1) (PC(20) ) was determined for each challenge. Patients with atopy(n=94) had a significantly lower AMP PC(20) than non-atopic patients (n=26), whereas methacholine PC(20) was not different between the two groups. Among the patients with atopy, there was no association between methacholine PC(20) and any atopy parameter. In contrast, a significant association was found between AMP PC(20) and the degree of atopy reflected in serum total IgE, number of positive SPTs and atopic scores (anova trend test, p=0.002, 0.001, 0.003, respectively). AMP responsiveness was associated with the presence and degree of atopy, whereas such a relationship was not observed for methacholine responsiveness. These findings suggest that atopic status may be better reflected by bronchial responsiveness assessed by AMP than by methacholine.

Association between short sleep duration and the risk of sensitization to food and aero allergens in rural Chinese adolescents

Both long and short sleep duration have been associated with obesity, cardiovascular disease, and diabetes. However, there have been no previous studies investigating the potential relationship between altered sleep duration and allergen sensitization. To explore the association between sleep duration and sensitization to food and aeroallergens. This study includes 1534 rural Chinese adolescent twins aged 12-21 years who completed standard sleep questionnaires and skin prick tests (SPTs) to nine food and five aeroallergens. Total sleep time was defined as the interval from bedtime to wake-up time minus sleep latency. Sensitization was defined as having at least one positive SPT. Compared with individuals with the highest (third) tertile of sleep duration, those who slept less were more likely to be sensitized to any food allergen with odds ratios (ORs) of 1.9 [95% confidence interval (CI): 1.3-2.7] and 1.4 (95% CI: 1.0-1.9) for the first and second tertiles (trend test P(trend)=3×10(-4)), respectively. The corresponding ORs for sensitization to any aeroallergen were 1.5 (95% CI: 1.1-2.0) and 1.3 (95% CI: 1.0-1.7) (P(trend)=8×10(-3)). These associations were independent of percent body fat. In addition, we observed a significant dose-response association between the number of positive SPTs and percentage of shortest sleep duration (first tertile) (P(trend)=1×10(-3)). In this sample of relatively lean rural Chinese adolescents, we found that short sleep duration was associated with increasing risk of sensitization to food and aeroallergens, independent of percent body fat. Longitudinal studies are needed to further determine the temporal and causal relationships. If short sleep duration indeed is one of the risk factors for allergic sensitization, the global burden of allergic diseases could be dramatically reduced by providing appropriate guidance on sleep duration for youth.

Bronchial hyperresponsiveness to methacholine and adenosine 5′-monophosphate, and the presence and degree of atopy in young children with asthma

Bronchial hyperresponsiveness (BHR) is a characteristic feature of asthma, and is usually measured by bronchial challenges using direct or indirect stimuli. The relationship between atopy and BHR remains to be clarified, particularly in a population selected for asthma. Furthermore, data for young children are limited, although asthma frequently occurs in early childhood. The aim of this study was to investigate methacholine (direct stimulus) and adenosine 5'-monophosphate (AMP) (indirect stimulus) responsiveness according to the presence and degree of atopy in young children with asthma. A retrospective analysis of data from 122 preschool children (median age [range]: 5.3 years [4.0-6.8]) presenting with the diagnosis of asthma was performed. These children were characterized by skin-prick tests (SPTs) and bronchial challenges with methacholine and AMP, using a modified auscultation method. The end-point concentration, resulting in audible wheezing and/or oxygen desaturation, was determined for each challenge. Atopy was defined by at least one positive reaction to SPTs, and its degree was assessed using serum total IgE levels, number of positive SPTs, and atopic scores (sum of graded weal size). Atopic patients (n=97) had a significantly lower AMP end-point concentration than non-atopic patients (n=25), whereas the methacholine end-point concentration was not different between the two groups. Among the atopic patients, there was no association between the methacholine end-point concentration and any of the atopy parameters. By contrast, a significant association was found between the AMP end-point concentration and the degree of atopy reflected in serum total IgE and atopic scores (χ² test for trend, P=0.001, 0.003, respectively). Young children with atopic asthma had a significantly greater AMP responsiveness than those with non-atopic asthma, whereas methacholine responsiveness was not significantly different between the two groups. The degree of atopy appeared to be an important factor in AMP responsiveness, but not in methacholine responsiveness, and thus might be a marker of airway inflammation in asthma.

Skin testing: a survey of allergists

In the allergist's office, skin testing remains the central way to confirm allergic response. Although anecdotal data suggest widely varying practices in skin testing by allergists, the diversity and relative frequency of these practices have not been documented. To determine the extent of the diversity in skin testing practices among allergists. A questionnaire was sent via the Internet to all physician members and fellows of the American College of Allergy, Asthma and Immunology who practice in the United States. This survey explored choice of extract concentrations, skin test device, number and type of tests, method for interpretation and documentation of skin test results, and quality assurance procedures used. Overall, a significant degree of variability was reported with regard to number of skin tests performed, extract concentrations, skin test devices, interpretation and documentation of results, and quality assurance procedures. The average number of skin prick tests performed ranged from 5.09 (grasses) to 10.9 (trees), whereas the average number of intradermal tests performed ranged from 2.03 (grasses) to 5.6 (perennial). The allergen extract concentrations used for intradermal testing varied widely. Expressed as a dilution of the concentrated extracts, 20.8% use 1:100 dilutions, 10.3% use 1:500 dilutions, and 59.4% use 1:1,000 dilutions. Significant variability also occurred regarding devices and the technique with which the devices were used. Most clinicians (92.1%) used the most concentrated extract available for skin prick testing. For reporting the results of skin testing, 53.8% used a 0 to 4+ scale, and only 28.3% measured orthogonal diameters. Of those using a 0 to 4+ scale, two thirds related the results to the size of the histamine control. Quality assurance testing was reportedly performed by 61.2% of responders. However, less than 10% of responders used an objective test protocol for this purpose. This survey highlights some of the areas that allergists can improve on in the use and reporting of skin tests.

Relationship of maternal skin test responses to infant cord-blood progenitor cytokine receptor expression

Rationale Increasingly, focus has turned toward the perinatal period as critical for development of atopy and atopic disease. Based on previous findings of impaired cord blood T helper-cell (Lancet 1999;353:196) and CD34+ progenitor maturational responses (J Allergy Clin Immunol 1999;104:370) in atopic at-risk infants, we examined the relationship between maternal atopy, as measured by the number of positive skin prick tests (SPT), and cytokine receptor expression on CD34+ cord blood progenitors. Methods Patients from two separate cohorts were examined – the Allergy Prevention Program cohort from Australia and a small, ongoing birth cohort from Hamilton, Ontario. CD34+/CD45+ cord blood mononuclear cells were analyzed using flow cytometry for IL-3, IL-5 and GM-CSF receptor expression. Maternal SPT were performed to standard allergen extracts. Results Data available on 64 subjects (6 from Hamilton, 58 from Australia) revealed a significant inverse relationship between GM-CSFRα and IL-5Rα and the number of positive maternal SPT in both cohorts: Hamilton cohort r=−0.857 ( P=0.029); Australian cohort r=−0.293 ( P=0.026). In the Hamilton cohort, a positive correlation was found between IL-3Rα and positive maternal SPT r=0.848 ( P=0.033). Conclusions Infant cord blood progenitor IL-5Rα and GM-CSFRα are negatively associated with the number of maternal SPT, while IL-3Rα is positively associated with SPT. These findings are consistent with the concept of a relative immaturity of hemopoietic progenitors in the cord blood of infants at risk of developing atopy, and point out the potential predictive capacity of cord blood progenitors for atopic disease

Sensitization to environmental antigens in asthmatic children from a central Italian area

This study was designed to evaluate the frequency of respiratory allergens in different age groups of asthmatic atopic children in the Chieti-Pescara area. We examined a pediatric population (507 children) aged between 1 to 17 years (mean 6.62±2.9). All the children were submitted to a panel of skin prick tests (SPT) for 12 common aeroallergens: Grass Pollens (G.), Parietaria (P.), Olive (O.), Artemisia (A.), Ragweed (R.), Dermatophagoides Pteronyssinus and Dermatophagoides Farinae (D.P. & D.F.), Cat and Dog dander (C.D.), Feathers (F.), Alternaria (Al.), Aspergillus (As.). All the subjects gave positive result to one or more allergens. The population was subdivided in to 4 groups according to their age (Group A: 1–3 years; Group B: 4–6 years; Group C: 7–9 years; Group D: 10–17 years). In each age group, we determined the number of subjects with 1, 2, 3, 4 or 5 and more than 5 positive SPT and the prevalence of positive SPT for different allergens. We found that 74% of 507 patients showed positive reaction to Dermatophagoides Pt, 71% to Dermatophagoides Fa, 45% to Grass, 23% to Parietaria, 21% to Olive, 17% to Artemisia, 17% to Cat's or Dog's danders, 13% to Alternaria, 5.9% to Ragweed, 5.9% to Feathers, and 4% to Aspergillus. In addition we detected that 12% of children examined were monosensitized; 56% were sensitized to 2 or 3 allergens; 22% were sensitized to 4 or 5 allergens, and then 8% were polysensitized to >5 allergens. The allergy to grass pollens and to house dust mites was the most frequent in monosensitized. In the older patients, we found an increase in number of positives SPT to several allergens, and an increase in the frequency of Gr., P. and O. allergy, while the house dust mites sensitization remained constant in all groups and represented the dominant cause of asthmatic symptoms in this population. Our data confirm the importance of age in determining a respiratory polysensitization. In conclusion, our data suggest that house dust mites (D.P. and D.F.) and grass pollens are the most common allergens in asthmatic children of the Chieti-Pescara area.

Sensitization according to skin prick testings in atopic patients with asthma or rhinitis at 24 allergy clinics in Northern Europe and Asia

Skin prick tests (SPT) were performed on 2113 atopic patients (407 children and 1 706 adults) with asthma and/or rhinitis at 24 allergy clinics in Iceland, Norway, Denmark, Sweden, Estonia, Lithuania and Russia. Test extracts were Dermatophagoides pteronyssinus ( D . pteronyssinus), Dermatophagoides farinae [D. farinae), cat, dog, horse, birch, timothy, mugwort, Cladosporium, Alternaria, cockroach, chironomids (red mosquito larvae, RML) and shrimp. Among the allergens, timothy followed by cat, birch and dog gave the highest number of positive SPT. Positive SPT with house dust mites (HDM), furred animals, RML and Cladosporium were more common in asthmatics than in patients with rhinitis; birch and timothy more common in patients with rhinitis. Sensitization against D. pteronyssinus, horse, timothy and Cladosporium was more common in men than in women. Although the general sensitization pattern of the atopic patients at the participating centers showed similarities, there were also significant differences between centers. Positive SPT with furred animals were most prevalent in Northern and Central Sweden and St Petersburg, and least common in Siberia and Denmark. Pollen allergy was most common in Novosibirsk and on the west coast of Sweden, and less common in Vladivostok. Sensitization against HDM was most common in Lithuania and least prevalent in Northern Sweden and Finland. Insect allergens gave the most positive reactions in St Petersburg and the least positive reaction in Novosibirsk. Sensitization against multiple allergens was found in 74% of the patients and a mono-allergy in 26%. The degree of atopy was higher in males than in females and higher in asthmatics than in patients with rhinitis. The month of birth of the patients did not influence significantly the test results. It is concluded that although the sensitization pattern shows similarities in different regions, it is also influenced to some extent by residence as well as by diagnosis, sex and age of the patients.

The Diagnostic Value of Skin-Prick Tests in Dermographic Individuals

Fifty-five patients displaying significant dermographic wheals, who presented with respiratory or food allergy symptoms, were investigated prospectively. Fifty-five additional patients presenting with similar clinical histories as the study group but without dermographism were used as controls. Total serum IgE and skin-prick tests (SPT) to 30 common allergens were performed on all subjects. Specific IgE (RAST) was determined only in those whose history did not correlate with the skin-test results. Allergens that gave a positive reaction were retested with extra care to exert minimal pressure. No statistically significant difference was found in the percentage of positive SPT reactors when comparing dermographic patients and controls (chi 2 test). No significant difference was found when the number of positive SPT (mean values) was compared between dermographic subjects and controls (t-test). However, when the values of mild positive SPT (1+ to 2+) were compared between the two groups, there was a significant difference only on the first performance of SPT in dermographic individuals (P less than 0.05, t-test). Our findings demonstrate that SPT can be reliable even in the presence of dermographism. False positive results are occasionally observed when the reactions are mild, but careful repetition of positive SPT might eliminate this problem.

Effect of maternal avoidance of eggs, cow's milk and fish during lactation upon allergic manifestations in infants.

Atopic/allergic manifestations and skin-prick tests (SPT) to egg white, cow's milk (CM) and fish were evaluated during the first 18 months of life in two matched groups of infants with a family history of atopy/allergy. In one group (n = 65) the mothers had a diet free from eggs, CM and fish during the first 3 months postpartum, whereas the mothers in the other group (n = 50) consumed an ordinary diet. The diet of the infants was similar in both groups, i.e. CM was not supplied until 6 months of age, and eggs and fish not until 9 months of age. The incidence of atopic dermatitis was significantly lower in the maternal diet group during the first 6 months postpartum (10.8 and 28%, respectively) but not after that age. Other atopic/allergic manifestations did not differ and the number of positive SPT to egg white, CM or fish at 9 months of age was similar in both groups.