Positive Allergen Research Articles

The association of allergic sensitization with radiographic sinus opacification.

The relationship between allergic sensitization and radiographic sinus inflammation remains unclear. To determine whether specific allergen sensitization is correlated with sinonasal radiographic opacification. Patients with chronic sinonasal symptoms were selected and included if they had allergy testing and a computed tomography (CT) of the paranasal sinuses. Data regarding demographic characteristics, in vitro allergy test results, and comorbidities were collected. CTs were reviewed, and an overall Lund-Mackay score (LMS) was calculated for each patient. A two-sample t-test was used to compare mean LMS between patients who were sensitized and patients who were not sensitized. A multiple linear regression model was used to determine whether a relationship existed among LMS and allergy results, asthma, nasal polyps, immunoglobulin E (IgE) level, medication usage, in-season versus out-of-season CTs, age, and sex. Significance was determined at an alpha level of 0.05. There were 437 patients included, of whom, 251 had positive specific allergen test results and 186 had negative test results. A total of 282 patients had allergic rhinitis symptoms without a documented diagnosis of sinusitis, and 155 carried a diagnosis of chronic rhinosinusitis. The mean LMS did not differ between patients who were sensitized and patients who were not sensitized (5.56 versus 5.28; p = 0.61). Linear regression demonstrated an increase in LMS in patients with asthma (p = 0.02), male sex (p < 0.01), elevated IgE (p < 0.01), a history of anaphylaxis (p = 0.03), and nasal polyps (p < 0.01). There was a statistically significant decrease in LMS in patients with an in-season CT (p = 0.02). Patients with a positive specific in vitro allergen test result did not have higher overall rates of radiographic sinus inflammation. Asthma, male sex, polyps, elevated IgE, and a history of anaphylaxis were associated with higher LMS.

Correlation between the number of allergen sensitizations and immunoglobulin E: monosensitization vs polysensitization.

The purpose of this study was to determine if total serum immunoglobulin E (IgE) could predict monosensitization compared to polysensitization in patients with allergic rhinitis (AR). This was a retrospective study of a cohort of 1073 patients who underwent allergy testing. Differences in total IgE level between unsensitized, monosensitized, and polysensitized subjects were calculated. Pearson correlation coefficient was calculated to determine whether there was a relationship between total IgE level and the number of positive allergen sensitizations. In addition, allergen sensitization class was calculated for each allergen sensitization and totaled for each patient. Pearson correlation coefficient was calculated to determine the relationship between total IgE level and weighted allergen sensitization by class. There were 159 patients who were monosensitized compared to 492 patients who were polysensitized. Of the monosensitized patients, almost 50% (74) were sensitized to one or both dust mites. Total IgE was higher in polysensitized patients compared to monosensitized compared to controls (p < 0.001). Pearson correlation coefficient between total IgE and number of positive allergen sensitizations was 0.465 (p ≤ 0.001). Pearson correlation coefficient between total IgE and allergen class-weighted sensitizations was 0.529 (p ≤ 0.001). IgE level can be used to predict monosensitization vs polysensitization. There is a moderate correlation between total IgE sensitization and the number of positive allergen sensitizations, as well as allergen class-weighted sensitizations.

Clinical significance of serum allergen sIgE and peripheral blood EOS in patients with chronic sinusitis with nasal polyps

Objective:To explore the influnces of allergen sIgE and peripheral blood eosinophilic(EOS) on the severity and surgical outcomes in patients with chronic rhinosinusitis with nasal polyps（CRSwNP）. Method:Eighty-nine patients with CRSwNP were enrolled. Before operation, allergen sIgE levels and peripheral blood EOS were detected.All patients were examined paranasal computed tomography(CT). After 3 and 6 months of operation, all patients were examined by nasal endoscopy，Allergen sIgE, peripheral blood EOS, nasal endoscopy score, and CT score were retrospective analyzed. According to the results of allergen sIgE the subjects were divided into two groups: the positive allergens group and negative allergens group. Result:Allergen sIgE were positive in 49 patients(the positive allergens group) and negative in 40 patients(the negative allergens group). The major allergens were Dermatophagoides pteronyssinus（39 patients） and cockroach（16 patients）. Between the positive allergens group and the allergens negative group, there were no statistically significant differences in peripheral blood EOS count and EOS percentage and CT scores and nasal endoscopy scores of 3-month postsurgery(P>0.05). There was signifigant diference in the nasal endoscopy scores of 6- month postsurgery between the two groups(P<0.05). In the 89 patients with CRSwNP, peripheral eosinophil count showed no significant correlation with CT image scores and 3-month postsurgery nasal endoscopy scores and 6-month postsurgery nasal endoscopy scores(r=0.119，0.180，0.126，P>0.05). Blood eosinophil percentage was not significantly correlated to CT image scores and 3-month postsurgery nasal endoscopy scores and 6-month postsurgery nasal endoscopy scores(r=0.167，0.263，0.140，P>0.05). Conclusion:Allergen sIgE has some impacts on postoperative outcomes but has no impact on the severity of CRSwNP. Peripheral eosinophil may not affect the severity and surgical outcomes of CRSwNP.

Association of allergic rhinitis, coronary heart disease, cerebrovascular disease, and all-cause mortality

BackgroundInflammation is implicated in atherosclerotic cardiovascular disease. Allergic diseases also involve a systemic inflammatory state, which may potentiate cardiovascular disease. ObjectiveTo examine the association of allergic rhinitis, coronary heart disease (CHD), cerebrovascular disease (CVD), and all-cause mortality. MethodsWe conducted a retrospective, population-based, matched cohort study comparing the incidence of CHD, CVD, and all-cause mortality from January 1, 1999, through December 31, 2012, in patients with International Classification of Disease, Ninth Revision, documented allergic rhinitis matched 1:1 by age, sex, and ethnicity to a reference cohort without allergic rhinitis within Kaiser Permanente Southern California. Fully adjusted hazard ratios (HRs) were calculated. Further analyses for those with positive environmental allergen specific IgE (sIgE) test results within the allergic rhinitis cohort were also performed. ResultsPatients with physician-diagnosed allergic rhinitis (N = 110, 207 in matched cohort) had significantly lower risk for myocardial infarction (HR, 0.63; 95% confidence interval [CI], 0.59–0.67; P < .001), all CHD (HR, 0.81; 95% CI, 0.78–0.84; P < .001), CVD (HR, 0.67; 95% CI, 0.64–0.70; P < .001), and all-cause mortality (HR, 0.42; 95% CI, 0.40–0.43; P < .001). The results were similar after excluding patients with asthma. Patients with positive sIgE test result also had a decreased risk of all CHD (relative risk [RR], 0.87; 95% CI, 0.79–0.95; P = .003) but no association with cerebrovascular events (RR, 0.89; 95% CI, 0.77–1.02; P = .10) and all-cause mortality (RR, 1.16; 95% CI, 1.00–1.34; P = .06). ConclusionWe found that the presence of allergic rhinitis was associated with decreased CHD, CVD, and all-cause mortality. This decreased risk was more pronounced after excluding patients with asthma. Patients with positive sIgE test results also had decreased risk of CHD.

Analysis of correlative factors of serum leptin levels in asthmatic patients

Objective: To analysis the correlative factors that probably affect serum leptin levels in asthmatic patients. Methods: Seventy-eight patients with asthma and 29 health controls who were admitted into outpatient clinic of Peking University Third Hospital from April 2014 to December 2015 were consecutively enrolled in our study prospectively. Serum leptin level was measured by enzyme-linked immunosorbent assay (ELISA). The sex, body mass index (BMI), onset age of asthma, allergen detection test, induced sputum cell count and classification, lung function test and asthma control level were recorded. Asthmatic patients were further divided into groups according to these factors and serum leptin levels were compared among groups. Results: Serum leptin levels were not different between asthmatic patients and health controls [(15.0±10.4) vs (15.2±11.7) μg/L, P=0.939]. Female asthmatic patients had significantly higher serum leptin levels than male [(18.2±10.7) vs (7.9±4.8) μg/L, P<0.001]. Asthmatic patients with obesity had significantly higher serum leptin levels than asthmatic patients with overweight, with normal BMI, with underweight and health controls [(29.7±10.8) vs (17.1±11.1), (11.8±7.7), (9.1±0.96), (15.2±11.7) μg/L, all P<0.01]. Serum leptin level was positively related to percentage of induced sputum eosinophil in female asthmatic patients (r=0.331, P=0.032). Onset age of asthma, positive allergen detection, airflow limitation or asthma control level did not affect serum leptin level. Conclusion: Sex and BMI are important factors affecting serum leptin levels in patients with asthma.

Prevalence of Inhalant Allergic Rhinitis in Children with Adenoid Hypertrophy: A Prospective Radioallergosorbent Test (Rast) Study

Introduction:Children with allergic rhinitis are susceptible to adenoidal hypertrophy when compared to children with no allergies. We conducted this study to determine the prevalence of inhalant allergic rhinitis among children aged 2 to 10 years admitted for adenoidectomy by performing radioallergosorbent test (RAST). Material and Methods:75 children who underwent adenoidectomy at Hamad Medical Corporation, Doha, Qatar were recruited prospectively. 41 (54.7%) were males and 34 (45.3%) were females with a mean age of 4.9±4.5 years. Blood samples were collected for total IgE and allergen specific IgE antibodies during preoperative assessment or during intravenous induction for general anesthesia. Results:34 (45.3%) out of 75 children had increased total IgE, 19 (25.3%) had positive allergen specific IgE antibodies and 7 (9.3%) had both positive. Snoring 73 (97.3%) was the most common symptom, followed by mouth breathing 72 (96%), nasal blockage 61 (81.5%), rhinorrhea 34 (45.3%) and sneezing 11 (14.7%). Association of nasal symptoms with total IgE and allergen specific IgE antibodies showed no statistical significance. Association of asthma 29 (38.7%), eczema 10 (13.3%) and family history 31 (41.3%) were also not statistically significant. Conclusion:The result of our study suggests high prevalence of allergy sensitization among children who underwent adenoidectomy but poorly correlated with nasal symptoms. However, snoring and mouth breathing were found to be statistically significant (p=0.01) and specific for adenoid hypertrophy in patients without allergic rhinitis. In addition, nasal blockage is more specific (p=0.02) for with normal total serum IgE levels.

Photo-patch and patch tests in patients with dermatitis over the photo-exposed areas: A study of 101 cases from a tertiary care centre in India.

Many patients with dermatitis over photo-exposed body areas are positive to many contact allergens and have a pre-existing allergic contact dermatitis. This study included patients who presented to a tertiary centre in India with dermatitis on photo-exposed body areas suspected of chronic actinic dermatitis. Their detailed histories were recorded and cutaneous and systemic examinations were performed. Patch testing was done in all the patients and photo-patch testing was carried out in 86 patients. Altogether 101 patients were included (69 males, 32 females). The most common presentation was lichenified hyperpigmented plaques on the photo-exposed sites. Photosensitivity was recorded in 64 (63%) patients and summer exacerbation in 52 (52%). Exposure to the Parthenium hysterophorus weed was recorded in 70 (69%) patients, 27 (26.7%) had a history of hair dye application and 20 (20%) had a history of atopy. Photo-patch test was positive in 11 (12.8%) patients and patch testing was positive in 71 (70%). Parthenium hysterophorus was the most common allergen implicated and was positive in three (4%) photo-patch and 52 (52%) patch tests. Other positive photo-patch test allergens were perfume mix, balsam of Peru, thiuram mix, Compositae mix and promethazine hydrochloride. Other common patch test allergens were parthenolide, colophony, fragrance mix and p-phenylenediamine (PPD) base. In the Indian population parthenium and perfume mix are the most common photoallergens in patients with dermatitis over photo-exposed areas, while parthenium, colophony, fragrance mix and PPD are the common positive allergens.

The response to nasal allergen provocation with grass pollen is reduced inpatients with chronic rhinosinusitis with nasal polyposis and grass sensitization.

The majority of grass pollen-sensitized rhinitis patients develops allergic symptoms when exposed to the causal allergen and shows a positive nasal allergen provocation test (NAPT). Chronic rhinosinusitis with nasal polyposis (CRSwNP) patients, also characterized by eosinophilic inflammation and local IgE production, can suffer from comorbid inhalant allergy, but may show a different response to allergens. We aimed to explore the allergic response to grass pollen allergens by NAPT in grass pollen-sensitized CRSwNP patients. Twelve grass pollen-sensitized CRSwNP patients underwent NAPT with grass pollen and were compared with 12 grass pollen allergic rhinitis patients, 12 control patients and 12 CRSwNP patients without grass pollen sensitization. A positive NAPT was based on change in nasal airflow and symptoms. Further, VAS scores of different symptoms were noted before and after NAPT. Biomarkers such as total IgE, grass pollen-specific IgE and tryptase were measured in serum and nasal secretions. NAPT was positive in 6 of 12 of the grass pollen-sensitized CRSwNP patients, and another four patients developed allergic symptoms not fulfilling the criteria of positivity. In contrast, all patients with allergic rhinitis developed a positive provocation test, whereas in the control group one of the patients and in the non-sensitized CRSwNP group two of the patients developed a positive provocation test. These results show that allergen exposure induces an attenuated clinical response in patients with CRSwNP and sensitization to grass pollen as compared with grass pollen allergic rhinitis patients.

Both exhaled nitric oxide and blood eosinophil count were associated with mild allergic asthma only in non-smokers.

The fractional exhaled nitric oxide (FENO) and the blood eosinophil count (B-eos) are markers of eosinophilic inflammation used in the diagnosis and management of asthma. The relationships between smoking cigarette and both FENO and B-eos are complex and raise questions about the association between these markers and asthma in smokers. To determine the relationships between both FENO and B-eos on one hand and asthma and atopy on the other, according to smoking status. FENO and B-eos were measured in, respectively, 1579 and 1496 of the 1607 middle-aged adults randomly selected from the general population in the cross-sectional ELISABET survey. Allergic asthma was defined as asthma (a self-report of physician-diagnosed asthma, and wheezing in the previous 12months or the use of asthma medications) with atopy (allergic rhinitis or hayfever in the previous 12months, or a previous positive prick test or allergen desensitization therapy). Non-allergic asthma was defined as asthma without atopy. The analysis included 812 (51.4%) never, 473 (30%) former and 294 (18.6%) current smokers. A total of 490 (32%) participants were atopic, 80 (5.1%) had allergic asthma, and 31 (2%) had non-allergic asthma. Only 16.2% (18/111) of asthmatics were treated with glucocorticoid inhalants, suggesting that among them a majority of participants had mild asthma. A positive interaction between smoking status and allergic asthma was observed in multivariate models explaining FENO (P=0.003) and B-eos (P=0.001). Thus, compared to those without allergic asthma, participants with allergic asthma had higher FENO values (+63.4%, 95% CI=[39; 92]) and higher B-eos (+63.2% [38.2; 92.7]) in never and former smokers, but not in current smokers. Lastly, an analysis of receiver-operating characteristic curves showed that each of the two markers was able to discriminate moderately allergic asthma but only in non-smokers. FENO and B-eos were associated with the presence of mild allergic asthma only in non-smokers, not in current smokers. These findings raise questions about the clinical value of FENO and B-eos in smokers.

Food Sensitization in Medically Resistant Chronic Rhinosinusitis with or without Nasal Polyposis

Background: Nasal polyposis is a common nasal mass with unknown etiology. It has been assumed that allergy predisposes to polyp formation. Our objective was to compare the prevalence of food sensitization in medically resistant chronic rhinosinusitis patients with or without nasal polyposis. Methods: One hundred and fifty-five patients who fulfilled the inclusion and exclusion criteria were incorporated into this study. The results of their total serum IgE and food-specific IgE levels were examined. Results: The average age was 33 years (± 13) with 96 males and 59 females. The percentage of patients in each group that had a positive result for at least one tested allergen was 84% (88 patients in the sinusitis without polyposis group and 42 patients in nasal polyposis group). Patients without nasal polyposis reacted to an average of 4.6 foodstuffs, whereas patients with nasal polyposis reacted to 4.1. Egg white, sheefish and cherry were the most common type of sensitized food. There were no significant differences in the prevalence, type, number of positive food allergens and class level between the two groups. Conclusions: Food sensitization is common in medically resistant chronic rhinosinusitis. Since food sensitization prevalence, type and severity do not significantly differ between the two groups studied, food atopy is unlikely to be a major factor in nasal polyposis pathogenesis.

Avoidance Behavior against Positive Allergens Detected with a Multiple Allergen Simultaneous Test Immunoblot Assay in Patients with Urticaria: Factors Associated with Avoidance Success/Failure

BackgroundAvoidance behavior against positive allergens detected by using multiple allergen simultaneous test (MAST)-immunoblot assay in patients with urticaria has been rarely reported.ObjectiveWe aimed to assess the avoidance behavior of patients with urticaria against positive allergens detected with a MAST.MethodsOne hundred and one urticaria patients who showed positivity to at least one allergen on a MAST completed a questionnaire regarding their test results. The avoidance behavior of the patients was evaluated, and relevant determining factors of avoidance success/failure were statistically assessed.ResultsWe detected 144 different data (n=51, food allergens; n=17, pollen allergens; and n=76, aeroallergens) from 101 patients with urticaria. The avoidance failure rates were 33.3% for food allergens, 70.6% for pollen allergens, and 30.3% for aeroallergens. The pollen group showed a significantly higher avoidance failure rate than the food and aeroallergen groups (p<0.05). The patients with higher educational levels or more severe urticaria tended to successfully avoid allergens (p<0.05). The monthly household income level and patients' reliability to the test showed borderline correlations (p=0.057 and p=0.075, respectively).ConclusionWe believe that the results of this study could be helpful in predicting avoidance success or failure against allergens in patients with urticaria when clinicians conduct allergen-specific immunoglobulin E tests.

Sensitization pattern to inhalant and food allergens in symptomatic children at first evaluation.

BackgroundData on specific IgE sensitization prevalence in children with allergy-like symptoms seen in the primary care setting are rare. Early diagnosis of allergic diseases is important to prevent clinical manifestations, exacerbations or expansion of allergic diseases to other organ systems. The present study aims to assess the usefulness of early serological diagnosis in children with common allergic symptoms.Methods532 children (<15 years of age), with at least one of ten allergy-like symptoms, from 21 primary care centers in two geographic areas of Italy and Spain were included in the study. Patients were tested with, either Phadiatop® Infant (0–5 years of age) or Phadiatop® and food mix (fx5e) (>5 years of age) to discriminate atopic from non-atopic subjects. A blood sample of atopic subjects was taken for additional 6–26 specific IgE antibody determinations from a predefined panel using the ImmunoCAP® System.Results267 children (50.2 %) were positive in the initial test and were classified as atopic. 14 % were mono-sensitized, 37 % were sensitized to 2–3 allergens and 49 % to more than 3 allergens. The average number of symptoms in the atopic group was 3.3 vs 2.8 in the non-atopic group. The prevalence of sensitization to single allergens was highest for grass and ragweed pollen and house-dust mites (19–28 %). Sensitization to tree allergens was highest for olive tree (16.5 %). Cow’s milk and egg white were the most sensitizing foods (~15 %). Food allergen sensitization predominated in younger children (OR = 2.8) whereas the inverse occurred with inhalant allergens (OR = 2.5 to 5.6). A significant positive correlation between patient age and the number of sensitizations was found.ConclusionsSpecific IgE sensitization in children with allergy-like symptoms is common. Multiple sensitization is predominating. Number of clinical symptoms was higher in the atopic group compared to the non-atopic without a correlation with the number of positive allergens. Age seems to play a crucial role in the development of sensitization with a significant positive correlation between patient age and the number of sensitizations.

The Editor takes a closer look at some of this month's articles

The Editor takes a closer look at some of this month's articles

Patch test results in children and adolescents. Study from the Santa Casa de Belo Horizonte Dermatology Clinic, Brazil, from 2003 to 2010

BACKGROUNDPatch testing is an efficient method to identify the allergen responsible for allergic contact dermatitis.OBJECTIVETo evaluate the results of patch tests in children and adolescents comparing these two age groups' results.METHODSCross-sectional study to assess patch test results of 125 children and adolescents aged 1-19 years, with suspected allergic contact dermatitis, in a dermatology clinic in Brazil. Two Brazilian standardized series were used.RESULTSSeventy four (59.2%) patients had "at least one positive reaction" to the patch test. Among these positive tests, 77.0% were deemed relevant. The most frequent allergens were nickel (36.8%), thimerosal (18.4%), tosylamide formaldehyde resin (6.8%), neomycin (6.4%), cobalt (4.0%) and fragrance mix I (4.0%). The most frequent positive tests came from adolescents (p=0.0014) and females (p=0.0002). There was no relevant statistical difference concerning contact sensitizations among patients with or without atopic history. However, there were significant differences regarding sensitization to nickel (p=0.029) and thimerosal (p=0.042) between the two age groups under study, while adolescents were the most affected.CONCLUSIONNickel and fragrances were the only positive (and relevant) allergens in children. Nickel and tosylamide formaldehyde resin were the most frequent and relevant allergens among adolescents.

A clinical evaluation of skin disorders of lower limb amputation sites.

Amputee patients commonly experience skin problems that may result in social, mental, and economic difficulties. The purpose of this study was to evaluate the incidence of dermatological disorders and identify potential causes and symptomatic patterns among a population of lower limb amputees. Seventy lower limb amputees were enrolled. Complete examinations were performed by a dermatologist, who diagnosed and documented any skin disorders observed and recorded demographic characteristics of each patient. Mycological and bacteriological swabs were collected from the skin at the amputation site for culture analysis. In patients with suspected disease, patch tests were performed. Of the 70 patients, 58 (82.9%) were male and 12 (17.1%) female. Vascular insufficiency due to diabetes (n = 38, 54.3%) and trauma (n = 16, 22.9%) were the most common reasons for amputation. Skin problems were observed in 49 (70%) cases, and positive allergen reactions occurred in 16 (45.7%) of the 35 contact dermatitis cases. Fungal infection occurred in two patients and bacterial infection in seven. Seventy percent of the lower limb amputee patients in this cohort exhibited skin problems. This high percentage indicates that skin problems may reduce patients' quality of life. A multidisciplinary approach to the treatment of patients who have undergone amputation and early recognition and treatment of symptoms are therefore of critical importance.

Serum indolamine 2,3 dioxygenase as a marker in the evaluation of allergic rhinitis.

Allergic rhinitis occurs on exposure to a known allergen and is correlated with a positive skin test and physical examination results. Tryptophan is a substrate of many important proteins, e.g., indolamine 2,3 dioxygenase (IDO). IDO, an immunomodulator, is a metabolic enzyme induced by immune activation. It has a significant role in allergic reactions. T-helper 2 cell is proposed to affect the expression of IDO. To evaluate IDO levels in patients with allergic rhinitis compared with controls and its relationship to the severity of allergic rhinitis. This case-control study included 20 patients who were atopic and with allergic rhinitis who attended the allergy clinic of Ain Shams University Hospitals. Twenty age- and sex-matched patients who were not atopic were included as controls. An allergic rhinitis diagnosis was made according to the Allergic Rhinitis and its Impact on Asthma document. Complete history taking, physical examination, skin-prick test, complete blood cell count, erythrocyte sedimentation rate, total serum immunoglobulin E (IgE), IDO concentration, and nasal smear for eosinophils were done for the patients. There was a significant increase in IDO levels in allergic rhinitis in comparison with subjects without allergy (p < 0.001). IDO was positively correlated with total IgE levels (p < 0.037). There was an insignificant relationship among IDO levels and age, sex, duration of the disease, severity score, nasal and blood eosinophilia, and number of positive allergens. IDO plays an important role in patients with atopic symptomatic allergic rhinitis, especially with increased levels of IgE. There is no relationship between IDO levels and severity of disease.

Reactivity and evolution of 4022 patch tests in Chilean patients with contact dermatitis

Allergic Contact Dermatitis is a classic delayed hypersensitivity reaction. To study the reactivity and evolution in Chilean patients by gender, using the standard European patch test. The results of the European standard patch test applied to 4,022 patients aged 1 to 93 years (64% female) with Allergic Contact Dermatitis, diagnosed between January 1995 and August 2011, were retrospectively analyzed. From a total of 4,022 patients, 2,439 (60.6%) had a positive reaction. Among reactive patients, 1,854 (76.04%) were female and 584 (23.96%) male. The most common positive allergens were nickel (35.3%), cobalt (15.1%), fragrance mix (14%), chromium (8.7%) and balsam of Peru (8.5%). In females, nickel was the most common reactive antigen (34.28%), and in males, fragrance mix (15.7%). During the period 2003-2011, an increased reactivity to nickel (26.6%) and a decreased reactivity to p-phenylenediamine (29.6%) and fragrance (42.8%), was observed. Fragrance mix is the most common reactive allergen in males and the third for females. Nickel is the leading allergen in the female group and the second of importance for males, making it the most significant allergen for the Chilean population. We also observed that the reactivity of some allergens evolves and varies over time.

Prevalence of Inhalant and Food Allergies after Skin Prick Testing in Patients with Resistant Allergic Rhinitis in Warm Humid Weather

Result: The population under study was almost equally distributed between both genders with minimal female predominance, 312 (52%). Age distribution of positive allergens was almost equally distributed among each decade from 10 to 50 years. Two hundred fifty-eight (43%) were found to have another associated allergic comorbid condition; bronchial asthma was the most common, 186 (31%). Dermatophagoides pteronyssinus was the most commonly encountered positive aeroallergen found in 252 (42%), while Walnut was found as the most prevalent food allergen 48 (8%).

Systematic Review of Omalizumab for the Treatment of Chronic Rhinosinusitis

S A T U R D A Y 174 Omalizumab for the Treatment of Chronic Rhinosinusitis: A Multi-Disciplinary Practice Review Shaun Kilty, MD, FRCSC, Andrea Lasso, Stephanie Santucci, RN, William H. Yang, MD; Ottawa Hospital Research Institute, Ottawa, ON, Canada, Division of Otolaryngology-Head and Neck Surgery, The University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada, Allergy and Asthma Research Centre, Ottawa, ON, Canada, University of Ottawa Medical School, Ottawa, ON, Canada. RATIONALE: Recently, anti-IgE monoclonal antibody has emerged as a potential therapy for CRS. However, to date evidence for its efficacy in this patient population is sparse. The purpose of this study is to evaluate the clinical treatment effect of omalizumab therapy for patients with recalcitrant CRS treated in a multi-disciplinary clinic. METHODS: The charts of 194 patients on omalizumabwere reviewed. 21 patients diagnosed with CRS and having failed surgical and/or medical therapy were identified. Data extraction was performed and targeted demographic details, asthma, environmental allergy and CRS specific disease related data including self-reported major symptom improvement. Nonparametric data was analysed with the Mann-Whitney test and binary data was analysed with Fisher’s exact test. RESULTS: Themean treatment durationwas17months.Themost common skin test positive environmental allergens were dust mites (100%) and cats (65%). 75% of the cohort had CRS with polyps. Six patients (30%) had AERD.Themeanpolyp score decreased from1.8 to 1.0 (p50.106). From the time of treatment initiation to the last omalizumab treatment dose, patients reported a mean 59% improvement in their olfaction, a mean 70.4% improvement in facial pain, a mean 78.2% improvement in nasal obstruction and a mean 68.1% improvement in the symptom of rhinorrhea. Patients reported a mean overall improvement in their sinus symptoms of 74.1%. CONCLUSIONS: Omalizumab therapy provided a substantial improvement in the self-reported major symptom control for patients with recalcitrant CRS and asthma. Awell-designed comparative study is needed to further assess its effectiveness in the CRS population.

Allergen Specific IgE Response Is Similar in HIV-1 Seropositive and Seronegative Adults: Implications for HAART Induced Th2 to Th1 Switching

FEBRUARY 2015 AB8 Abstracts S A T U R D A Y 24 Allergen Specific IgE Response Is Similar in HIV-1 Seropositive and Seronegative Adults: Implications for HAART Induced Th2 to Th1 Switching Mili Shum, MD, Ashlei Mathew, MD, Maja Nowakowski, PhD, Hamid Moallem, MD, Tamar A. Smith-Norowitz, PhD, Helen G. Durkin, PhD, Rauno O. Joks, MD, FAAAAI; State University of New York Downstate Medical Center, Brooklyn, NY, Center for Allergy and Asthma Research, State University of New York Downstate Medical Center, Brooklyn, NY, Center for Allergy and Asthma Research at SUNY Downstate Medical Center, Brooklyn, NY, SUNY Downstate Medical Center, Brooklyn, NY, Center for Allergy and Asthma Research, SUNY Downstate, Brooklyn, NY. RATIONALE: Advanced HIV disease has been associated with Th2 mediated IgE responses, including IgE anti-HIV, and decreased atopy. The effect of HAART (highly active antiretroviral therapy) on Th2 mediated allergic IgE responses has not been determined. METHODS: Retrospective chart review was performed for adults seen in Allergy clinic at University Hospital of Brooklyn during 7/2000 to 5/2014. Subjects included HIV-1 patients on HAART and a control group consisting of HIV-1 seronegative patients (age and sex matched with a clinical visit in the samemonth). Total and allergen specific serum IgE was determined by ImmunoCAP assay; Skin prick test (SPT, Dermapik) for aeroallergens was performed using the Dermapik method. A mixed linear model was constructed for each dependent variable (IgE, no. of positive allergy results). Fixed factors were HIV status and gender; age was introduced as a linear covariate; matched pair ID was introduced as a random factor. RESULTS: Seventy-four subjects were analyzed with equal number of subjects in each group. HIV-1 seropositive subjects on HAART and controls had similar total serum IgE of 90.95 IU/ml and 144.54 IU/ml respectively (p50.23) and similar numbers of positive allergen specific IgE responses of 3.34 and 4.06, respectively (p50.28). CONCLUSIONS: These findings suggest there is limited effect of HAART on Th2 to Th1 switching.