Positive Allergy Research Articles

Feline atopic dermatitis

Atopy is a highly pruritic skin disease in cats that have positive intradermal test reactions mostly to non - seasonal allergens (house dust mites). It's pathogenesis is unknown, though it is believed that a reaginic antibody exists resemblin IgE. Young cats appear to be predisposed. The most consistent feature of the disease is pruritus, heralding its clinical picture. The four most commonly occurring cutaneous reaction patterns are military dermatitis, eosinophilic granuloma complex lesions, selfinduced alopecia or hypotrichosis and lesionai or nonlesional pruritus of the face, neck and pinnae. The definitive diagnosis of feline atopy requires a positive intradermal allergy test reaction, good flea control, a poor response to a 9 to 13 -week course of a hypoallergenic diet and negative fungal cultures plus skin scrapings for pathogenic mites. The treatment plan may include avoidance of allergens, glucocortidoids (repositol methylprednisolon, dexamethason), ω/3 - ω/6 fatty acid supplements, antihistamines (chlopheniramine, clemastine) and/or mast cell stabilizers (oxatomide) and hyposensitization.

Airway inflammation in sickle cell disease-A translational perspective.

Asthma and sickle cell disease (SCD) are common chronic conditions in children of African ancestry that are characterized by cough, wheeze, and obstructive patterns on pulmonary function. Pulmonary function testing in children with SCD has estimated a prevalence of obstructive lung disease ranging from 13% to 57%, and airway hyper-responsiveness of up to 77%, independent of a diagnosis of asthma. Asthma co-existing with SCD is associated with increased risk of acute chest syndrome (ACS), respiratory symptoms, pain episodes, and death. However, there are inherent differences in the pathophysiology of SCD and asthma. While classic allergic asthma in the general population is associated with a T-helper 2 cell (Th-2 cells) pattern of cell inflammation, increased IgE levels and often positive allergy testing, inflammation in SCD is associated with different inflammatory pathways, involving neutrophilic and monocytic pathways, which have been explored to a limited extent in mouse models and with a dearth of human studies. The current review summarizes the existent literature on sickle cell related airway inflammation and its cross roads with allergic asthma-related inflammation, and discusses the importance of further elucidating and understanding these common and divergent inflammatory pathways in human studies to facilitate development of targeted therapy for children with SCD and pulmonary morbidity.

Biological occupational allergy: Protein microarray for the study of laboratory animal allergy (LAA).

BackgroundLaboratory Animal Allergy (LAA) has been considered a risk for the workers since 1989 by the NIOSH. About one third of the Laboratory Animal Workers (LAWs) can manifest symptoms to LAA as asthma, rhinitis, conjunctivitis and cutaneous reactions. The prevalence of LAA-induced clinical symptoms has been estimated with a great variability (4–44%) also due to the different methodologies applied.ObjectiveEvaluate the prevalence of IgE positivity to mouse and rat allergens in LAWs and assess which factors are predisposing to sensitization among subjects exposed to laboratory animals in the workplace.MethodsOne hundred LAWs were invited to fill out a questionnaire regarding current allergic symptoms, atopic history, home environment, previous and current occupational history. IgE reactivity versus specific allergens was evaluated with ImmunoCAP ISAC.ResultsOut of one hundred LAWs, 18% had a serum susceptibility to mouse and/or rat allergens and 42% reported to have occupational allergy symptoms. Combining the results acquired by ImmunoCAP ISAC and questionnaire, 17% of LAWs have been defined as LAWs-LAA positive since they present a positive IgE response and allergy symptoms, 1% LAWs-LAA sensitized, 25% LAWs-LAA symptomatic and 57% LAWs-LAA negative. Presence of previous allergy symptoms in work and life environment were significantly related to LAWs-LAA positive/sensitized.ConclusionsThe study aimed to define the immunological profile of LAWs using the proteomic array as an innovative approach in the study of environmental and occupational exposure to allergens. We suggested a definition of LAWs-LAA considering serum IgE response and presence of allergy symptoms. The proposed approach has the advantage to provide a standard methodology for evaluating the specific IgE responsiveness to animal allergens in specific workplace also considering the immunological profile of workers referred to exposure in life and occupational environment.

Local specific Immunoglobulin E among patients with nonallergic rhinitis: a systematic review.

Allergen specific immunoglobulin can be present in the nasal mucosa of patients with non-allergic rhinitis (NAR). This condition is defined as local allergic rhinitis. However, the reported presence of nasal specific immunoglobulin E (nspIgE) among NAR is variable. The aim of this review was to summarize the studies which reported the presence of nspIgE among patients diagnosed as NAR. Embase (1947- ) and Medline (1946-) were searched until 6th June 2017. A search strategy was utilized to identify studies on nspIgE among patients with NAR. The target population was patients with symptoms of rhinitis, but negative systemic allergen sensitization. Studies with original data on detectable nspIgE among the NAR population were included. Meta-analysis of single proportions as a weighted probability %(95%CI) was performed. Heterogeneity was explored amongst studies. A search strategy returned 2286 studies and 21 were included. These studies involved 648 participants with NAR. NspIgE was detected using either; 1. nasal secretions, 2. epithelial mucosa sampling, 3. tissue biopsies or 4. In-situ tests. Metaanalysis was performed on studies with nasal secretions. The weighted proportion of detectable nspIgE in nasal secretions within patients with NAR was 10.2 (7.4-13.4) %. Population definitions partly explained variability. Detection of nspIgE was lower in patients without a history suggestive of allergy compared to those with a positive allergic history (0 (0-3.1) % v 19.8 (14.5-25.6) %, p<0.01). NAR with positive allergy history suggests presence of nspIgE. These patients warrant further allergology evaluation to confirm localized nasal allergy, as they benefit from allergy therapy such as immunotherapy.

Allergic sensitization and objective measures of sleep in urban school-aged children with asthma

BackgroundAllergic sensitization is associated with increased child asthma morbidity and decreased pulmonary function. Nocturnal symptoms and/or awakenings typically are measured by self-report from diary data, whereas objective assessments of sleep in child asthma studies are lacking. ObjectiveTo investigate the association between increased allergic sensitization (number of positive allergy test results measured by skin prick test or specific immunoglobulin E) and sleep outcomes (sleep efficiency, sleep duration, and mean number of awakenings measured by actigraphy) in urban schoolchildren with persistent asthma. MethodsOne hundred ninety-six children with persistent asthma (7–9 years old) attending public school in 1 of 4 large urban school districts completed allergy testing during a study clinic visit. Forced expiratory volume in 1 second was monitored at home using a handheld spirometer. Sleep outcomes were measured with a wrist Actiwatch during a 1-month period in the fall and winter seasons. ResultsNumber of positive allergy test results significantly predicted mean sleep efficiency (P = .02), such that children with more positive test results experienced less efficient sleep. Number of positive allergy test results significantly predicted mean number of night awakenings (P = .05), such that children with more positive allergy test results experienced more night awakenings. Variability in forced expiratory volume in 1 second was a significant moderator in the association between number of positive allergy test results and variability in sleep efficiency (P = .04). Racial and ethnic differences in allergic sensitization and sleep outcomes were found between African Americans and Latinos. ConclusionMore positive allergy test results were associated with poorer sleep outcomes measured objectively in this sample of urban children. Implications for environmental control interventions and asthma treatments in different racial and ethnic groups are discussed.

Mycoplasma pneumoniae\u2013Associated Bronchiolitis Obliterans Following Acute Bronchiolitis

The characteristics of Mycoplasma pneumonia (M. pneumoniae)-associated bronchiolitis obliterans (BO) are not well known. We retrospectively reviewed 17 patients with M. pneumoniae–associated BO. All patients had M. pneumoniae–associated acute bronchiolitis prior to the development of BO. In the acute bronchiolitis stage, all patients had fever and cough; six patients also had wheezing and dyspnoea. BO was diagnosed approximately 1.5–8 months later based on clinical manifestations and chest high-resolution computed tomography (HRCT) findings. All patients presented with wheezing and/or dyspnoea at the time of diagnosis of BO. HRCT findings included mosaic attenuation, pronounced air trapping, central bronchiectasis and emphysema, according to disease severity. Lung function tests revealed mild to severe airway obstruction. Fourteen of 17 patients had a greater than 12% increase in forced expiratory volume in 1 second values after taking salbutamol. All patients had positive allergy test results and family or personal history of atopic disease. Four patients had a history of asthma before M. pneumonia bronchiolitis. Asthma was diagnosed before, at the time of or after the diagnosis of BO in 11 cases. M. pneumoniae–associated BO may therefore develop following M. pneumonia bronchiolitis and overlap with asthma.

Leucopenia associated with metamizole: a case-control study.

The aim of this study was to identify possible risk factors for the development of leucopenia associated with metamizole use. A retrospective case-control study was performed. Cases of metamizole-associated leucopenia managed at a single centre (2005-2013) were characterised and compared with matched controls who took metamizole without developing complications. Fifty-seven cases and 139 controls were identified. Of the cases, 32 were postoperative and these were compared to age-, sex- and ward-matched postoperative controls (n = 64). The remaining cases (n = 25) were compared to sex-matched, non-postoperative controls (n = 75). The number of patients with a positive allergy history was higher among postoperative cases than controls (p = 0.004) as was the number with previous leucopenic episodes (p = 0.03). The prevalence of diagnosed hepatitis C infection was 9% among all cases compared with 1% among all controls (p = 0.005). The use of concomitant cytostatic agents (even at immunosuppressive doses) was significantly higher among non-postoperative cases than controls (p = 0.011). There was no association between renal function and the development of leucopenia. A history of allergies, previous leucopenic episodes, hepatitis C infection and concomitant cytostatic agents are possible risk factors for leucopenia associated with metamizole use.

The Role of Oxidative Stress in the Clinical Manifestations of Childhood Asthma

ABSTRACTIntroduction: The significance of oxidative stress in pathogenesis of childhood asthma was recognized, but its role in the clinical manifestations of disease is still unclear. Materials and Methods: The study was conducted in 96 asthmatic children. The urinary biomarker of oxidative stress, 8-oxo-7,8-dihydro-2-deoxyguanosine (8-oxodG/creatinine) was determined by using HPLC-MS/MS. ELISA was performed to measure myeloperoxidase (MPO) and Cu,Zn- superoxide dismutase (Cu,Zn-SOD) in serum. Results: Logistic regression analysis revealed that female gender, tobacco smoke exposure, and increased 8-oxodG/creatinine were associated with risk for intermittent asthma, while the positive allergy test and increased Cu,Zn-SOD were associated with eczema in asthmatic children. Higher MPO (p = 0.033), and percent of granulocytes (p = 0.030) were found in severe persistent asthma in comparison to intermittent or mild persistent asthma. Conclusion: The main findings that TSE-induced oxidative stress is a risk for intermittent asthma and eczema may be clinically significant for the disease prevention and therapeutic improvements.

Kronik Kabızlığı Olan Çocuklarda Besin Allerjisinin Rolü

Objective: We aimed to evaluate the role of food allergies in the etiology of constipation in children who presented with chronic constipation. We investigated the effects of the allergens on constipation by eliminating the relevant allergen from diet in cases with positive food allergy testing in the study. Materials and Methods: The study included 75 patients aged 6 months-10 years with functional constipation. The severity of constipation was assessed with the constipation symptom score. Food-specific IgE levels were evaluated in the sera while skin prick and atopy patch tests were performed by using milk, egg white, egg yolk, wheat, and soybean in all patients. For the patients with positive test results, the allergen was eliminated from the diet over 2 months. Two months later, these patients were re-evaluated by using the constipation symptom score. Results: There was a female predominance (62.7%) in the study group. The mean age was 4.69±0.295 (mean±SD) years. The mean duration of constipation was 24±2 (mean±SD) months. The atopy patch test was positive in 4 of the 75 (5.3%) patients. Atopy patch test positivity was found for egg white and yolk in the first patient, wheat and soy in the second, wheat alone in the third, and soy alone in the fourth. The skin prick test was found to be negative in all four patients. Food mixed specific IgE levels were positive in three of the four patients with a positive atopy patch test (2.31kU/L, 2.35 kU/L, 0.1 kU/L and 1.16 kU/L, respectively). When patients were reevaluated after an elimination diet by using the constipation symptom score, the symptom score had improved in only one patient, the one with soy allergy. Conclusion: Our findings support that food allergy has no role in chronic constipation. The atopy patch test did not make an additional contribution to the diagnosis of food allergy.

Nadwrażliwość na pokarmy u niemowląt karmionych wyłącznie piersią – analiza wyników badań alergologicznych oraz najczęściej uczulających alergenów pokarmowych

IntroductionThe incidence of adverse reactions induced by food proteins in infants exclusively breastfed is poorly understood. The predominant view is that in the pathogenesis of hypersensitivity to food, IgE-mediated mechanisms prevail; the most common food allergen is cow's milk protein. AimThe aim of the study was to determine the prevalence of hypersensitivity to food in infants exclusively breastfed with symptoms suggestive of hypersensitivity to food and to identify the most common food allergens responsible for hypersensitivity in IgE-mediated and non-IgE-mediated mechanisms. Patients and MethodsThe study involved 106 infants exclusively breastfed up to 6 months of age, in whom allergy tests were performed due to atopic eczema and/or symptoms from gastrointestinal tract. All patients underwent testing for IgE-mediated and non-IgE-mediated allergy. ResultsNon-IgE-mediated reactions dominated in breastfed infants with positive allergy tests results. Only positive results of APT were found in 68.9% (n=73) of patients. IgE-mediated sensitization was found in 3.8% of children (n=4), mixed type of hypersensitivity affected 6.6% (n=7) of infants. It has been found that in the group of children with positive sIgE panel (n=11), allergy to cow's milk protein fractions (n=9) was most frequent. The most common allergens responsible for non-IgE-mediated hypersensitivity in the study infants were egg yolk (55.7% children; n=59), then egg white (51.9%, n=55), cow's milk (33.0%; n=35), wheat flour (27.4%, n=29) and soybeans (26.0%, n=28). ConclusionOn the basis of own research results, it can be assumed that non-IgE-mediated hypersensitivity to food dominates in infants exclusively breastfed, and the most common food allergen responsible for the clinical response is hen's egg, then cow's milk and wheat.

Analiza zależności między wywiadem rodzinnym a występowaniem nadwrażliwości na pokarmy u niemowląt karmionych wyłącznie piersią w wieku do 6. miesiąca życia

IntroductionThe literature describes an association between a positive family history of allergic diseases and the incidence of allergies in children. AimThe aim of the study was to evaluate the influence of the family history of allergy on the incidence of hypersensitivity to food in infants exclusively breastfed up to 6 months of age. Materials and methodsThe study involved 106 infants exclusively breastfed up to 6 months of age, in whom due to atopic eczema and/ or symptoms of gastrointestinal tract allergy tests were conducted. The family history includes allergies with immediate family members, parents and siblings. All the patients were diagnosed for IgE-mediated and non-IgE-mediated food allergy. The statistical analysis was performed. ResultsIn infants with positive allergy test results (n=84), 34 patients (40.5%) were affected by the family history of allergic diseases. In the group with IgE-mediated sensitization, family history of allergic diseases affected 50.0%; in children with non-IgE-mediated hypersensitivity to food – 39.7%; in children with the mixed type – 42.9%. In the group of patients who did not show hypersensitivity to the allergens examined, family history of atopy affected 36.4% of infants. In our study, in infants exclusively breastfed up to 6 months of age there was no association between the prevalence of hypersensitivity to food and the family history of atopy. ConclusionOn the basis of own research results and reports of other authors it can be assumed that genetic factors are not significant in the development of non-IgE-mediated hypersensitivity to food in young children.

Usefulness of antigen-specific IgE probability curves derived from the 3gAllergy assay in diagnosing egg, cow's milk, and wheat allergies

BackgroundSpecific IgE (sIgE) antibody detection using the Siemens IMMULITE® 3gAllergy™ (3gAllergy) assay have not been sufficiently examined for the diagnosis of food allergy. The aim of this study was to evaluate the utility of measuring sIgE levels using the 3gAllergy assay to diagnose allergic reactions to egg, milk, and wheat. MethodsThis retrospective study was conducted on patients with diagnosed or suspected allergies to egg, milk and wheat. Patients were divided into two groups according to their clinical reactivity to these allergens based on oral food challenge outcomes and/or convincing histories of immediate reaction to causative food(s). The sIgE levels were measured using 3gAllergy and ImmunoCAP. Predicted probability curves were estimated using logistic regression analysis. ResultsWe analyzed 1561 patients, ages 0–19 y (egg = 436, milk = 499, wheat = 626). The sIgE levels determined using 3gAllergy correlated with those of ImmunoCAP, classifying 355 patients as symptomatic: egg = 149, milk = 123, wheat = 83. 3gAllergy sIgE levels were significantly higher in symptomatic than in asymptomatic patients (P < 0.0001). Predictive probability for positive food allergy was significantly increased and correlated with increased sIgE levels. The cut-offs for allergic reaction with 95% predictive probability as determined by the 3gAllergy probability curves were different from those of ImmunoCAP. ConclusionsMeasurements of sIgE against egg, milk, and wheat as determined by 3gAllergy may be used as a tool to facilitate the diagnosis of food allergy in subjects with suspected food allergies. However, these probability curves should not be applied interchangeably between different assays.

Introduction of peanuts in younger siblings of children with peanut allergy: a prospective, double-blinded assessment of risk, of diagnostic tests, and an analysis of patient preferences.

The prevalence of peanut allergy in younger siblings of children with peanut allergy has been reported between 7% and 8.5%, but the anaphylactic risk at the time of introduction is currently unknown, which limits our ability to best counsel parents on this issue. To determine the risk of anaphylaxis and working parameters of allergy testing in this context. One hundred and fifty-four peanut-naïve younger siblings of peanut-allergic children underwent double-blinded skin testing, followed by parent-led peanut introduction. Questionnaires were dispensed to parents to investigate preferences with regard to peanut introduction in this subgroup. Eight participants (5.2%) presented unequivocal IgE-mediated reactions to peanut upon introduction, including five anaphylaxes. These participants were significantly older compared to the rest of the cohort (median 4.0 vs 1.9years, P=0.04). The negative predictive value of skin prick test with peanut extract and peanut butter and of specific IgE was 99%, 100%, and 100%, respectively. Six peanut-tolerant participants had positive peanut allergy tests. The option of introducing at home without prior skin testing was associated with high levels of anxiety (median 8.4 on 10-point Likert scale) when compared to supervised introduction (median 3.8, P<0.0001) or home introduction after negative skin test (median 4.3, P<0.0001). There is an increased risk of anaphylaxis upon peanut introduction in siblings of children with peanut allergy, and parents are reluctant to introduce at home without testing. Allergy testing prior to introduction is negative in over 90% of cases and carries a high negative predictive value.

Diagnostic procedure after an immediate hypersensitivity reaction in the operating room

The diagnosis of a perioperative allergic reaction is based on clinical features associated with a suggestive timeline, the exclusion of other diagnoses, elevated concentrations of degranulation markers (histamine, tryptase), and positive allergy assessments (skin tests, specific IgE). After initiating appropriate treatment, the anesthesiologist should take blood samples to measure histamine and tryptase concentrations just after the reaction and repeat them 1-2hours later to validate the diagnosis of immediate hypersensitivity. A delayed measurement of basal tryptase is useful to rule out mastocytosis and to interpret moderate tryptase levels. The anesthesiologist must inform the patient of the reaction to obtain adhesion and consent to subsequent investigations and must record the timing of the reaction and of the blood sampling, the possible causal agents, and the treatment administered. These data must be shared with the laboratory and the allergist. An adverse drug reaction report must be filed. The gold standard for allergy assessment is skin testing. These tests should be done in an appropriate facility, with experienced staff and in compliance with current guidelines. Specific IgE assays and cellular assays can help when clinical features and skin tests are discordant. Provocation tests are sometimes required. After allergy assessment, the safest protocol for subsequent anesthesia is determined in collaboration with the anesthesiologist. The patient must be informed and carry an allergy alert card.

Management of Food Allergy to Fish with Oral Immunotherapy: A Pediatric Case Report.

Fish allergy represents a persistent allergic disorder that usually does not improve spontaneously. Because neither fully effective therapeutic strategy nor truly curative approaches are currently available for food allergy, we report herein a case of fish allergy in a 11-year-old male patient treated with Oral Immunotherapy (OIT). The patient at the age of 4 years, for the first time, experienced immediate urticaria and angioedema, rhinitis, cough, and dyspnea after ingestion of both salmon and codfish. Skin prick test, specific IgE, and oral food challenge (OFC) were positive for both salmon and codfish. Therefore, positive allergy tests and challenge confirmed allergy to fish. The patient underwent oral administration of increasing doses of the offending food. He was initially treated by OIT using dehydrated codfish. When the dosage of 1 g was achieved and tolerated by the patient, a desensitization regimen was continued through the administration of cooked codfish. At the end of the protocol, the patient achieved desensitization also confirmed by negative OFC with fish. This case suggests that OIT could be used for treatment of food allergy caused by fish with successful results.

Non-immediate hypersensitivity reactions to beta-lactam antibiotics in children - our 10-year experience in allergy work-up.

BackgroundNon‐immediate reactions to beta‐lactam antibiotics (BL) occur more than one hour after drug administration, and the most common manifestations are maculopapular exanthemas and delayed‐appearing urticaria and/or angioedema. Infections can lead to skin eruptions and mimic drug hypersensitivity reactions (DHR), if a drug is taken at the same time. The most of children are labeled as ‘drug allergic’ after considering only the clinical history.ObjectiveTo diagnose/detect a hypersensitivity or an infection which mimic DHR in children with non‐immediate reactions to BL MethodsA prospective survey was conducted in a group of 1026 children with histories of non‐immediate reactions to BL by performing patch tests, skin tests, and in case of negative results, drug provocation tests (DPTs). In 300 children, a study was performed to detect infections by viruses or Mycoplasma pneumoniae.ResultsUrticaria and maculopapular exanthemas were the most reported non‐immediate reactions. Only 76 (7.4%) of 1026 children had confirmed non‐immediate hypersensitivity reactions to BL. Fifty‐seven children had positive delayed‐reading intradermal tests (18 of these with a positive patch test). Nineteen children had positive DPT. Sixty‐six of 300 children had positive tests for viruses or Mycoplasma pneumoniae and 2 of them had a positive allergy work‐up.ConclusionsA diagnostic work‐up should be performed in all children with non‐immediate reactions to BL, to remove a false label of hypersensitivity. Even though only 57 (5.5%) of 1026 children displayed positive responses to delayed‐reading intradermal tests to BL, such tests appear to be useful in order to reduce the risk for positive DPTs.

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Detection of specific immunoglobulin E antibodies toward common airborne allergens, peanut, wheat, and latex in solvent/detergent-treated pooled plasma.

Allergic transfusion reactions (ATRs) present with a broad range of symptoms probably caused by mediators released from mast cells and basophil granulocytes upon activation. Passive immunoglobulin (Ig)E sensitization may yield clinical symptoms and positive allergy tests. Unexpected findings of IgE antibodies in pooled solvent/detergent (S/D)-treated plasma (Octaplas, Octapharma) during routine analysis initiated an investigation of serum proteins. Consecutive batches of S/D-plasma transfused during September 2014 through March 2015 were investigated for IgE, IgG, IgA IgM, C3, C4, haptoglobin, anti-nuclear antibodies (ANAs), and red blood cell (RBC) antibodies. During the study period, 4203 S/D-plasma units were transfused. Nineteen (14 Octaplas A and five Octaplas AB) of 20 batches of S/D-plasma were included, representing 99.9% of total number of plasma units. A total of 0.4% of units and five batches reported ATRs. Concentrations of total IgE higher than expected values in adults (<120 kU/L) were observed in 18 of the 19 (95%) batches investigated (median concentration [quartiles], 161 [133-183]). Specific IgE antibodies (expected < 0.35 kilounits antigen [kUA]/L) against house dust mite (2.52 [1.01-5.09]), timothy (2.83 [2.48-3.24]), cat (1.13 [0.58-1.52]), dog (0.83 [0.50-1.05]), mugwort (0.69 [0.53-0.97]), birch (0.62 [0.28-0.92]), peanut (0.52 [0.29-075]), wheat (0.46 [0.33-0.69]), and latex (0.32 [0.21-0.53]) were also detected. IgG, IgA, IgM, C3, C4, and haptoglobin were within or below normal ranges. No RBC antibodies were observed, but 18% of batches showed low levels of ANA (anti-RNP). Specific IgE antibodies against airborne allergens, food allergens, and latex were detected in S/D-treated pooled plasma.

The Role of Helminth Infection and Environment in the Development of Allergy: A Prospective Study of Newly-Arrived Ethiopian Immigrants in Israel.

Helminth infection may be protective against allergy and account for the low prevalence of allergy in developing countries. We studied prospectively the prevalence of allergy in Ethiopian immigrants with heavy helminth infection on arrival in Israel, and again after a year of adjustment to an urban industrialized setting, to explore the roles of helminth infection, changed environment and background immunity on the manifestations of allergy. 126 newly arrived Ethiopian immigrants were studied at baseline and 115 after a year of follow up in Israel. Allergic symptoms, Skin prick tests (SPT), Tuberculin (PPD) skin tests, stool and blood samples were obtained for determining parasites, blood IgE and eosinophil levels, respectively. Anti-helminthic therapy was offered to the entire infected individuals, but only 50/108 (46.3%) took the medication. At baseline, there was a significant negative association between helminth infection and allergy, 4/18 (22.2%) of uninfected participants were allergic compared to 7/108 (6.5%) of helminth-infected participants (p = 0.028), as well as between helminth infection and SPT reactivity, 12/18 (66.6%) of uninfected participants compared to 43/108 (39.8%) of helminth-infected participants (p = 0.033). After one year, a significant general increase in allergy and SPT was observed. While only 11/126 (8.7%) were allergic at baseline, 30/115 (26.1%) became allergic at follow-up (p<0.0001), and while 55/126 (43.7%) were SPT+ at baseline, 79/115 (68.7%) became SPT+ at follow-up (p<0.001). A twofold increase in allergen sensitization was also observed after one year in Israel, particularly for dust mites, grasses and olive tree (p<0.001). These results show that: a) Helminth infection is significantly associated with low allergy and low SPT reactivity; b) One year after immigration to Israel, allergy and SPT reactivity increased significantly in all immigrants; c) Higher increases in positive SPT and allergy were observed after a year in the group that remained infected with helminths, even though they had a lowered helminth load; d) The reasons for the increased allergy one year after immigration needs further investigation but probably reflects the combined influence of the decreased helminth load and novel environmental factors.

Latex-Fruit Anaphylaxis from Persimmon

Background: Despite rare reports of persimmon anaphylaxis, the association of persimmon with natural rubber latex is low or undetermined, and latex-fruit syndrome presenting with anaphylaxis caused by persimmon has not been reported. Methods: Allergy skin testing were performed for aeroallergens, persimmon and plant foods, including those implicated in the latex-fruit syndrome and local fruits. Results: Strongly positive prick by prick and skin prick tests reactions in response to persimmon fruit, plant foods with known cross-reactivity with latex and latex were demonstrated. Conclusion: Our patient showed strongly positive allergy skin testing in response to persimmon fruit, specific plant foods with reported cross-reactivity with latex and latex. Although specific IgE for persimmon fruit and RAST inhibition latex immunoCAP are not available in our country We observed strongly positive reactions selectively towards the particular plant foods that contain class I chitinases, B-1,3-gluconase, profilin and patatin-like protein. Furthermore persimmon contains profilin, a cross reactive allergen to natural rubber latex. Total IgE was high and an IgE-mediated reaction was confirmed by immediate reactions.