Positive Skin Prick Test Results Research Articles

The link between early childhood lower airway symptoms, airway hyperresponsiveness, and school-age lung function

BackgroundThe role of early airway hyperresponsiveness (AHR) in the lung function of school-age children is currently unclear. ObjectiveTo conduct a prospective follow-up study of lung function in schoolchildren with a history of lower airway symptoms and AHR to methacholine in early childhood and to compare the findings to schoolchildren with no previous or current lung diseases. We also explored symptoms and markers of type 2 inflammation. MethodsIn 2004 to 2011, data on atopic markers, lung function, and AHR to methacholine were obtained from 193 symptomatic children under 3 years old. In 2016 to 2018, a follow-up sample of 84 children (median age, 11 years; IQR, 11-12) underwent measurements of atopic parameters, lung function, and AHR to methacholine. Moreover, in 2017 to 2018, 40 controls (median age, 11 years; IQR, 9-12) participated in the study. ResultsSchoolchildren with early childhood lower airway symptoms and increased AHR had more frequent blood eosinophilia than their peers without increased AHR and lower prebronchodilator forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity Z-scores than those without increased AHR and controls. Post-bronchodilator values were not significantly different between the two AHR groups. Atopy in early childhood (defined as atopic eczema and at least 1 positive skin prick test result) was associated with subsequent lung function and atopic markers, but not AHR. ConclusionIn symptomatic young children, increased AHR was associated with subsequent obstructive lung function, which appeared reversible by bronchodilation, and blood eosinophilia, indicative of type 2 inflammation.

Incidence of Food allergy among patients with allergic conjunctivitis

The prevalence of ocular allergy is increasing worldwide. Skin prick test is widely recognized as the most reliable method for diagnosing the incriminating allergen as regards type I hypersensitivity reactions. Food allergy results as immunological response to food protein which leads to occurrence of allergic conjunctivitis (AC), allergic rhinitis, asthma, atopic dermatitis, and eosinophilic esophagitis. There is a scarcity of research investigating the association between food allergy and AC. This retrospective cohort study aimed to determine the incidence of food allergy within AC patients and its linkage to disease intensity and to compare the response to sublingual immunotherapy after 4 months of therapy. The study included 240 individuals diagnosed with AC. Of these patients, only 214 (89.16%) cases exhibited positive skin prick test results and showed incidence of food allergy of 29.6 %. After 4 months of sublingual allergen immunotherapy, the total serum IgE level and the grades of severity decreased significantly (p <0.001 for each). On comparing patients with food allergy on sublingual immunotherapy and patients without food allergy and on sublingual immunotherapy, the change in total serum IgE concentration and the grade of severity did not differ among the two groups (p value was 0.63 and 1.00 respectively). In conclusion, food allergies can contribute to the development of AC. Sublingual allergen immunotherapy can be proposed as a promising therapeutic option for AC patients.

Allergic rhinitis in Chinese young adults from the Singapore/Malaysia cross-sectional genetics epidemiology study (SMCGES) cohort: Prevalence, patterns, and epidemiology of allergic rhinitis

BackgroundAllergic rhinitis (AR) is characterized by the occurrence of at least 2 symptoms of nasal itching, nasal blockage, rhinorrhea, and sneezing, when not afflicted with a cold or flu, with defined atopic sensitization demonstrated by skin prick test or specific IgE responses. Besides the detriment to standard of living and economic burden of AR, both multicentre and single-cohort studies have observed an increase in AR prevalence in Asia over time. MethodsIn total, 12 872 individuals, with mean age 22.1 years (SD = 4.8), were recruited from universities in Singapore and Malaysia. Each participant provided epidemiological data based on an investigator-administered questionnaire adapted from the validated International Study of Allergies and Asthma in Childhood (ISAAC) protocol, and atopy status was determined using a skin prick test (SPT) performed by qualified staff. AR was diagnosed according to Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines and a positive SPT result. ResultsSensitization (determined by SPT) to either Blomia tropicalis or Dermatophagoides pteronyssinus was prevalent in 66.5% of the cohort. Current rhinitis (manifesting ≥2 rhinitis symptoms, within the past 12 months) was observed in 48.9% of our population, while AR, which included atopy status, was estimated at 39.4%. Sneezing and rhinorrhea were the most common symptoms among AR cases. AR prevalence decreased with increasing age (OR: 0.979; 95% CI: 0.969–0.989), while male gender (OR: 2.053; 95% CI: 1.839–2.294), and a parental history of allergic diseases (OR: 2.750; 95% CI: 2.284–3.316) were significant risk factors for AR. Upon adjustment for age, gender, and parental history, housing type (OR: 0.632; 95% CI: 0.543–0.736) and income level (>$6000 vs <$2000; OR: 2.461; 95% CI: 2.058–2.947) remained as significant risk factors for AR, while ever having kept a pet (OR: 1.167; 95% CI: 1.025–1.328) emerged as a risk factor. Conflicting results were obtained for indicators of sedentary lifestyle: frequent physical activity (OR: 1.394; 95% CI: 1.150–1.694) and increased duration spent using the TV/computer (OR: 1.224; 95% CI: 1.006–1.489) both increased the risk of AR. Lastly, we used the Quality of Diet based on Glycaemic Index Score (QDGIS) to assess the Glycaemic Index (GI) level of overall diet. We identified lower GI level of overall diet as a protective factor against AR manifestation (OR: 0.682; 95% CI: 0.577–0.807). ConclusionWhile the previously established non-modifiable risk factors for AR were present in our study population, the identification of modifiable risk factors, such as TV/computer usage, and dietary habits, opens a new area for research, both in the areas of gene-environment interaction, and management of AR.

Early life exposures and development of allergic disease in infants with familial risk: Results from ongoing probiotic intervention trials.

We search revision of risk determinants of the ongoing allergy epidemic. Children numbering 433 born to mothers with allergic disease or sensitisation were selected from the three ongoing probiotic intervention trials for this case-control study. Children who developed atopic eczema or food allergy, had positive skinprick test results or had been prescribed inhaled corticosteroids by the age of 2 years were identified as cases (n=231), while children without allergic manifestations were the healthy controls (n=202). The data on early environmental exposures were collected from prospectively documented study records. The statistical analyses were adjusted for potential confounders. Determinants associated with the increased risk of atopic eczema were lower maternal prepregnancy BMI (aOR 0.15, 95% CI: 0.037-0.54) and maternal intrapartum antibiotic treatment (aOR 2.21, 95% CI 1.20-4.10), the latter also linked to obstructive respiratory symptoms (aOR 3.87, 95% CI 1.07-14.06). The risk of allergic sensitisation was associated with lower maternal prepegnancy BMI (aOR 0.18, 95% CI 0.43-0.79) and intrapartum antibiotic treatment (aOR 2.13, 95% CI 1.07-4.22). Based on our demonstrations, interventions such as personalised diets, can be optimised for specific subgroups and definite risk periods.

Diagnostic Value of a Novel Eosinophil Cationic Protein-Myeloperoxidase Test Paper Before and After Treatment for Allergic Rhinitis.

PurposeTo develop and evaluate the effectiveness/clinical application of an eosinophil cationic protein-myeloperoxidase (ECP-MPO) test paper before and after treatment in patients with allergic rhinitis (AR).Patients and MethodsWe included 40 controls and 106 AR patients who were enrolled in the Allergy Clinic of Renmin Hospital of Wuhan University. Total IgE, specific IgE and skin prick test (SPT) were detected in all participants. AR patients were treated with oral cetirizine hydrochloride for 14 days. The ECP-MPO test paper results, nasal secretion smear and eosinophil counts, rhinoconjunctivitis total nasal symptom score (TNSS), quality of life questionnaire (RQLQ), visual analogue scale (VAS), serum Th1/Th2/Th17 cytokine, and chemokine data were collected pre- and post-treatment. ECP concentrations in nasal secretions were assessed by ELISA. Pearson correlation test and Kappa consistency test were used for statistical analysis.ResultsThe post-treatment colour grade of the ECP-MPO test paper was lower in AR patients than the pre-treatment grade. The chromogenic grade correlated positively with the ECP concentration and the eosinophil count in nasal secretions both before and after treatment. Positive ECP-MPO test paper results were consistent with positive SPT, Der p-IgE and Der f-IgE result (Kappa values, 0.843, 0.810, 0.795, respectively). The pre- and post-treatment chromogenic grades correlated positively with the TNSS (r1=0·691; r2=0·539), RQLQ (r1=0·783; r2=0·625), and VAS (r1=0·703; r2=0·682) scores in AR patients.ConclusionThe ECP-MPO test paper can effectively detect ECP in nasal secretions, and its results are consistent with those from the SPT, Der p-IgE and Der f-IgE result. Its chromogenic grade can reflect the symptom severity and specific cytokine and chemokine levels in AR patients.

A Demographics Analysis of IgE- and Non-IgE-mediated Food Allergies in Children

Background: There are three broad types of food allergies, including IgE-mediated reactions, non-IgE-mediated reactions, and mixed reactions. The onset of IgE-mediated food allergies is usually rapid and can sometimes lead to serious illness. Non-IgE-mediated and mixed types of food allergies can cause significant morbidity as a result of chronic disease. Objectives: This study aimed to compare various types of food allergies and discuss the basis of their different presentations. Methods: This study was conducted on children aged 2 - 12 years old with signs or symptoms of food allergy in the allergy clinics of Azad University Hospitals, Tehran, Iran, from January 2019 to January 2020. Food allergy was evaluated in these patients by careful history, physical exam, skin prick test, and atopy patch test. Results: A positive family history of atopy was detected in the first-degree relatives of 82 (63%) patients. All the children were exclusively breastfed at the beginning. A total of 61 patients had positive skin prick test (SPT), and 68 patients had positive atopy patch test (APT) results. Among food allergens, a significant correlation was detected between positive atopic patch test results and hypersensitivity reactions to cow’s milk (P value = 0.001), beef (0.002), and tomato (0.04). There was the same significant correlation between positive skin prick test results, allergens, and wheat (P value = 0.01). Conclusions: Although skin prick and atopy patch tests may help identify the culprit foods, oral food challenges are the mainstay of the diagnosis.

Comparative characteristics of methods of allergological examination for house dust mite allergy in children with bronchial asthma and allergic rhinitis

Objective. To determine the diagnostic significance of methods of allergological diagnostics: skin prick tests (SPT), quantitative determination of specific immunoglobulin E (sIgE) and nasal provocative test (NPT) in children with allergy to house dust mites (HDM) diagnosed with allergic rhinitis (AR) or AR in combination with asthma. &#x0D; Methods. Patients underwent a targeted history taking for possible domestic sensitization, SPT with HDM allergens, NPT with HDM, and sIgE to HDM allergens was determined by the ImmunoCAP method. &#x0D; Results. The statistical processing group included 109 children (67 boys, 42 girls, aged 5 to 17,9 years (mean age 8,9±2,52 years)), in whom sensitization to HDM was confirmed by at least one of the methods used in the study. A higher sensitivity of SPT then of sIgE was determined (96,3% and 81,6%, respectively). According to SPT and sIgE results, sensitization to both types of mites (D. pteronyssinus and D. farinae) is more common than isolated. Coincidence of positive results of SPT and sIgE was obtained in 84 cases (77,1%). &#x0D; Conclusion. SPT can be considered as the first line of investigation. The use of a complex of examination methods is necessary to determine the role of sensitization to HDM, if NPT is taken as the «gold» standard of diagnosis.

Characteristics of Atopic Dermatitis Patients who Underwent Skin Prick Test

Background: Skin prick test (SPT) is indicated in type I hypersensitivity reactions (rapid type), among which is Atopic Dermatitis (AD). However, the results of SPT for the tested allergens are not always accompanied by history of known allergens in AD patients. Purpose: To identify the characteristics of AD patients who underwent SPT. Methods: This was a descriptive retrospective study to determine the demographics, allergy history, SPT results, and positive and negative clinical relevance in AD patients treated at Allergy Immunology Division of Dermatology and Venerology Outpatient Clinic Dr. Soetomo General Academic Hospital Surabaya-Indonesia from January 2017 to December 2019. Results: A total of 284 AD patients were included. The adult age group (20-59 years) predominated the AD patient’s visit every year with 58 patients (60.42%), 47 patients (46.08%), and 65 patients (75.58%) in 2017, 2018, and 2019, respectively. Only 60 AD patients underwent SPT, where most patients were allergic to dust with 30 patients (50.0%). House dust mite (HDM) allergen had the highest percentage of positive SPT result with 41 patients (63.3%). The greatest clinical relevance was found in cat fur allergen, where all patients (100.0%) had clinical relevance to their SPT result. Conclusion: This study shows that most AD patients were in adult age group and had a history of dust allergy. The highest percentage of positive SPT result was found in HDM allergen and the greatest clinical relevance was found in cat fur allergen.

Clinical relevance of skin prick test in atopic dermatitis patients at allergy immunology division dermatovenerology outpatient clinic Dr. Soetomo general academic teaching hospital Surabaya

Background: Positive specific IgE tests, including skin prick test (SPT), for several food allergens are frequently found in atopic dermatitis (AD) patients, most of which have no clinical relevance and are associated only with atopy. This study aimed to determine the allergic history of AD patients who were subjected to SPT and to determine its clinical relevance. This is a descriptive retrospective study on AD patients who were subjected to SPT from 2017 to 2019 using secondary data. Allergy history, SPT results, and its clinical relevance were collected and analyzed. From a total of 284 AD patients, only 60 patients who were subjected to SPT. Most of the patients had dust allergy (50.0%) and house dust mite (HDM) allergen also had the highest positive SPT result (63.3%). Furthermore, the highest clinical relevance was found in HDM allergen (93.3%). This study shows that most AD patients were allergic to dust. The highest positive SPT result was found in HDM allergen, where ultimately this allergen also had the highest clinical relevance.

Investigating the association of atopy and aeroallergen sensitization and chronic spontaneous urticaria

IntroductionChronic spontaneous urticaria (CSU) is a common skin allergic reaction with an unknown mechanism. There is inadequate evidence to support the role of aeroallergen sensitization in CSU.AimThe present study was conducted to investigate the association between the aeroallergen sensitivity and CSU.Material and methodsIn this cross-sectional study, 91 patients with CSU were recruited. Information on demographic characteristics was collected. The skin prick test (SPT) for most prevalent aeroallergens and pulmonary function test (PFT) were performed and the results were clinically matched to investigate the allergic rhinitis (AR) and asthma. Total serum immunoglobulin E (IgE) concentration was analysed in the subjects for the presence of atopy.ResultsNinety one patients (75 of them were females) were enrolled in the study (with a mean age of 36.90 ±12.93 years). SPT result was positive in 75 (82.4%) subjects. Weeds (67 cases, 73.6%), trees (61 cases, 67%), and dust mites (55 cases, 60.4%) were the most common pollens in the positive SPT samples. Thirty-seven (40.7%) of the patients had allergic rhinitis. There was a statistically significant association between the presence of AR and positive SPT result (p = 0.002). Eight patients had allergic asthma and 45 (49.4%) of the patients had a total serum IgE level of more than 100 IU/ml.ConclusionsOur results indicated a clear association between the presence of aeroallergen sensitivity and development of CSU. AR exists as a co-morbidity of CSU.

Personalized approach to diagnostics and therapy of patients with psoriasis

Establishing causal relationship between allergy and psoriasis and determining appropriate sensitization profile may guide clinicians in terms of specific allergological diagnostics and personalized therapy. Our purpose was to study the occurrence of food allergy and certain sensitization profile to food allergens in patients with psoriasis, in order to establish new approaches to specific diagnosis and treatment of the disorder.The study involved patients with psoriasis vulgaris (n = 51) aged 18 to 66 years. The control group included practically healthy people matched by sex and age (n = 19). All the patients underwent allergological examination: collection of allergic history, determination of total immunoglobulin E (IgE) and eosinophilic cationic protein concentration in blood serum by means of indirect immunofluorescence analysis using Thermo Scientific Multiskan FC semi-automatic analyzer. The sensitization profiles to food and pollen allergens were also studied. Calculation and analysis of these data was carried out using Statistica 8.0 software package.Concentration of total immunoglobulin E in blood serum in the group of patients with psoriasis was 57.9 IU/ml (31.6-135.1) compared to control group, with 45.1 IU/ml (23.4-144.0). The levels of serum eosinophilic cationic protein was 8.6 ng/ml (4.6-20.3) in the patients with psoriasis, being 7.9 ng/ml (4.6-27.1) in controls. When studying the spectrum of sensitization to food allergens in patients with psoriasis, some specific features were revealed. E.g., sensitization to cow’s milk was detected in 33.3% (n = 17); to beef, in 39.2% of cases (n = 20), to whole chicken egg – 29.4% (n = 15), to chicken, in 39.2% (n = 20); to wheat flour, 37.2% (n = 19); to rye flour, in 31.4% (n = 16); to rice and buckwheat, 21.6% (n = 11), to yeast, in 23.5% of the patients (n = 12). Upon administration of individual elimination diet for 1 month, we observed a decrease or complete regression of itching, decreased severity of infiltration, hyperemia and peeling in the foci of psoriatic skin lesions in 68% of the cases. Normal concentration of total immunoglobulin E and eosinophilic cationic protein in blood serum of patients with psoriasis combined with positive results of skin-prick tests and elimination effect presumes a participation of non-atopic immune pathologies when triggering allergy in psoriatic disease.

The Clinical Implications of Aspergillus Fumigatus Sensitization in Difficult-To-Treat Asthma Patients

Fungal sensitivity has been associated with severe asthma outcomes. However, the clinical implication of Aspergillus fumigatus sensitization in difficult-to-treat (or difficult) asthma is unclear. To characterize the clinical implications of A fumigatus sensitization in a large difficult asthma cohort. Participants who underwent both skin prick and specific IgE testing to A fumigatus (n= 318) from the longitudinal real-life Wessex AsThma CoHort of difficult asthma, United Kingdom, were characterized by A fumigatus sensitization (either positive skin prick test result or specific IgE) and allergic bronchopulmonary aspergillosis status using clinical/pathophysiological disease measures. A fumigatus sensitization was found in 23.9% (76 of 318) of patients with difficult asthma. Compared with A fumigatus nonsensitized subjects, those with sensitization were significantly more often male (50% vs 31%), older (58 years) with longer asthma duration (33 years), higher maintenance oral corticosteroid (39.7%) and asthma biologic use (27.6%), raised current/maximum log10 total IgE+1 (2.43/2.72 IU/L), worse prebronchodilator airflow obstruction (FEV1 62.2% predicted, FEV1/forced vital capacity 61.2%, forced expiratory flow between 25% and 75% exhalation 30.9% predicted), and frequent radiological bronchiectasis (40%), but had less psychophysiologic comorbidities. Allergic bronchopulmonary aspergillosis diagnosis was associated with higher treatment needs and stronger eosinophilic signals. Factors independently associated with A fumigatus sensitization in difficult asthma included maintenance oral corticosteroid use (odds ratio [OR], 3.34) and maximum log10 total IgE+1 (OR, 4.30), whereas for allergic bronchopulmonary aspergillosis included maintenance oral corticosteroid use (OR, 6.98), maximum log10 total IgE+1 (OR, 4.65), and radiological bronchiectasis (OR, 4.08). A fumigatus sensitization in difficult asthma identifies a more severe form of airways disease associated with greater morbidity, treatment need, and airways dysfunction/damage, but fewer psychophysiologic comorbidities. Screening of A fumigatus status should be an early element in the comprehensive assessment of patients with difficult asthma.

Learning early about peanut-triggered food protein‐induced enterocolitis syndrome

Background: Food protein‐induced enterocolitis syndrome (FPIES) is a non-immunoglobulin E mediated food allergy that typically presents with repetitive emesis and may be associated with lethargy, marked pallor, hypotension, hypothermia, and/or diarrhea. Although many foods are known to cause FPIES, peanut-triggered FPIES is emerging due to changes in the feeding practice guidelines, which recommends early peanut introduction in infants. Objective: We aimed to characterize peanut-triggered acute FPIES cases in our pediatric population and to describe their attributes, treatment, and outcomes. We hypothesized that increases in the incidence of peanut-triggered FPIES coincided with implementation of the guidelines for early peanut introduction. Methods: A retrospective chart review was conducted of pediatric patients who presented to Phoenix Children’s Hospital Emergency Department and subspecialty clinics during a 6-year period (January 2013 to September 2019). Results: Thirty-three cases of patients with acute FPIES were identified, five of which were peanut triggered. In those patients with peanut-triggered FPIES, the median age for peanut introduction was 7 months (range, 5‐24 months). Two patients had positive peanut skin-prick test results. All five cases were identified in the past 2 years (2018 to 2019). No peanut-triggered reactions were documented in the preceding 4-year period (2013 to 2017). Conclusion: Peanut may be an emerging trigger of acute FPIES, coinciding with an earlier introduction of peanut in the infant diet after implementation of the new addendum guidelines for the prevention of peanut allergy. Oats and rice were the most common triggers of acute FPIES in our cohort. Further study will help clarify the significance and reproducibility of these findings.

Clinical characteristics of asymptomatic allergen sensitization with nasal septal deviation, often misdiagnosed as allergic rhinitis.

Allergic rhinitis (AR) is often defined based on symptoms accompanied by a positive allergen sensitivity test result. However, a positive skin prick test (SPT) does not always imply the occurrence of clinical symptoms. If an asymptomatic allergen-sensitized patient has nasal septal deviation (DSN) that could cause nasal obstruction, the condition could easily be confused with typical symptomatic AR. This study investigated the clinical and laboratory characteristics of asymptomatic allergen-sensitization with septal deviation (ASSD). Patients from a nationwide AR cohort study, conducted in 8 university hospitals, were investigated. AR was diagnosed when there were at least 1 rhinitis symptom with a positive SPT result. The ASSD group included patients who had severe nasal obstruction with few other symptoms and a positive SPT, along with septal deviation. Clinical and laboratory characteristics were compared between the ASSD group and the true AR group. In total, 728 patients were included. The average age was 32.2 ± 12.7 and 66% of the patients had DSN. SPT indicated that ASSD patients were less sensitized to house dust mite (p = 0.019 for Dp and p = 0.021 for Df). There was a significant sex difference: the male-to-female ratio was higher in the ASSD than in the AR group (3.59 vs. 1.77, p = 0.012). However, no statistically significant differences in age, family history, and body mass index were found. ASSD can mimic AR. When dealing with allergen-sensitized patients with a predominant symptom of nasal obstruction, DSN might also be considered before confirming a diagnosis of AR.

Cross-reactivity in Skin Prick Test Results of Members Within Pooideae Subfamily.

ObjectiveMolecular similarities of grass pollen antigens have led to the view that cross-reactivity exists within members of the Pooideae subfamily of grasses. This has resulted in testing for only the most antigenically representative member of Pooideae, Timothy grass (Phleum pratense), despite little literature to support the claim that Phleum is the most representative member or that in vitro cross-reactivity correlates with in vivo cross-reactivity. The aim of the study was to determine if patients with allergic rhinitis symptoms and positive skin prick test results to meadow fescue (Festuca pratensis) also have positive results to Timothy grass.Study DesignRetrospective cross-sectional study.SettingTertiary care center in middle Missouri.MethodsA retrospective chart review identified patients ≥12 years old with a diagnosis of allergic rhinitis who underwent skin prick testing between March 2016 and July 2018, by using a search with CPT code 95004 (Current Procedural Terminology). Positive skin prick test results were based on wheal produced ≥3 mm than the negative control.ResultsAfter review of 2182 charts, 1587 patients met criteria to test for Phleum and Festuca. In total, 1239 patients had a positive result for Phleum or Festuca. Of these, 479 (38.6%) tested positive for Festuca alone, while 342 (27.6%) and 418 (33.7%) tested positive for Phleum alone and Phleum+Festuca, respectively.ConclusionClinical cross-reactivity among Pooideae members may not be as complete as traditionally thought. P pratense may not be the most antigenically representative subfamily member, and other grasses may need to be included in skin prick testing.

Aeroallergen sensitisation patterns of children aged 5 years and younger with asthma and/or allergic rhinitis in Istanbul

Aim of the studyThe purpose of the study was to determine the aeroallergen sensitisation patterns of children aged 5 years and younger with asthma (AS) and/or allergic rhinitis (AR) in Istanbul, Turkey. MethodsThis cross-sectional observational study was conducted between January and December 2018 in the outpatient clinic of a hospital department of pediatric allergy. Patients, who had regular outpatient controls, full clinical and laboratory records, positive skin prick test results, and were willing to participate in the study, were included. ResultsIn total, 148 children aged 5 years or younger who had positive skin prick test results were included in the study. The male/female ratio and the mean age at onset of symptoms were 87/61 and 2.13±1.33 (0.4–4.5) years, respectively. Of the 148 patients, 63 (42.6%) had AS, 11 (7.4%) AR, and 74 (50.0%) had both AS and AR. The age of the patients, age at symptom onset, male/female ratio, number of allergen sensitivities, total IgE levels, total eosinophil levels, and skin prick test results for aeroallergens did not differ between the patients with AS, AR, and AS+AR. House dust mite (HDM) was the most common aeroallergen in patients, while the cockroach was the least common aeroallergen. The severity of asthma and control levels were not found to be associated with aeroallergen sensitisation in children. ConclusionOne out of every four atopic children aged 5 years or younger is sensitised to aeroallergens. The most common sensitisation is to house dust mites. Weed aeroallergen may be related to severity of asthma in children aged 5 years or younger in Istanbul. We speculate that HDM and weed allergens could be used in the diagnostic or treatment strategies for the management of asthmatic children aged 5 years or younger.

Allergy status in children with adenoid hypertrophy with and without serous otitis media

Introduction: Serous otitis media (SOM) is one of the most common diseases of children which can lead to hearing loss and imbalance in many cases. Objective: To evaluate the relationship between allergy status and SOM in children with adenoid hypertrophy and whether affected by age group. Materials and Methods: This cross-sectional study was conducted on 103 children aged 1-15 years with grade III or IV adenoid hypertrophy (± SOM) who referred to ear, nose, and throat (ENT) clinic. Additionally, children were divided into two subgroups based on age category of below and above seven years. The allergy status in children with and without SOM was compared by measuring the total immunoglobulin E (IgE) level, serum eosinophil level and skin prick test (SPT). Results: There was no difference in prevalence of mean absolute eosinophil count (127.3 versus 141.3 eosinophils/ µL, respectively) (P=0.63), mean total IgE level (68.2 versus 140 IU/L, respectively; P=0.119) and positive SPT results (23.5% versus 28.4%, respectively; P=0.551) between children with adenoid hypertrophy (± SOM). Conclusion: It seems absolute eosinophil count, total IgE level and positive SPT results have no significant role in SOM of children with adenoid hypertrophy and maybe other factors are implicated in its occurrence.

Comparison of allergens and symptoms in patients with allergic rhinitis between 1990s and 2010s

BackgroundThe prevalence of allergic rhinitis (AR), an environment- and lifestyle-dependent condition, has been constantly increasing in Korea. Although the environment and lifestyle of the Korean people have recently undergone rapid changes, corresponding changes in the characteristics of AR patients have not been well documented. Therefore, we aimed to outline the changes in allergens and clinical manifestations of AR in Korean patients from the 1990s and 2010s.MethodsWe reviewed 1447 and 3388 AR patients who visited the same tertiary hospital in the 1990s and 2010s, respectively. All patients were diagnosed with AR based on the presence of characteristic symptoms, positive skin prick test results, and answered a symptom questionnaire at the time of visit. We compared differences in the allergens and results of the symptom questionnaire between the two sets of patients.ResultsWhen compared with the 1990s, the rate of sensitization to house dust mites, cockroaches, Aspergillus, Alternaria, and tree pollen significantly increased and that to cat fur significantly decreased in patients from the 2010s (all P < 0.05). Male predominance was observed with two peaks in the age distribution of patients from the 2010s. The proportion of patients with moderate-to-severe nasal obstruction and itching of the nose/eye increased (each P < 0.05) and that of patients with minor symptoms such as olfactory disturbances, cough, sore throat, and fatigue also increased (all P < 0.01) in the 2010s.ConclusionsAllergen reactivity and type and symptom severity in Korean AR patients significantly varied between the 1990s and 2010s. Our results may therefore be helpful for patient counseling and management.

ENose breath prints as a surrogate biomarker for classifying patients with asthma by atopy

Electronic noses (eNoses) are emerging point-of-care tools that may help in the subphenotyping of chronic respiratory diseases such as asthma. We aimed to investigate whether eNoses can classify atopy in pediatric and adult patients with asthma. Participants with asthma and/or wheezing from 4 independent cohorts were included; BreathCloud participants (n= 429), Unbiased Biomarkers in Prediction of Respiratory Disease Outcomes adults (n= 96), Unbiased Biomarkers in Prediction of Respiratory Disease Outcomes pediatric participants (n= 100), and Pharmacogenetics of Asthma Medication in Children: Medication with Anti-Inflammatory Effects 2 participants (n= 30). Atopy was defined as a positive skin prick test result (≥3 mm) and/or a positive specific IgE level (≥0.35 kU/L) for common allergens. Exhaled breath profiles were measured by using either an integrated eNose platform or the SpiroNose. Data were divided into 2 training and 2 validation sets according to the technology used. Supervised data analysis involved the use of 3 different machine learning algorithms to classify patients with atopic versus nonatopic asthma with reporting of areas under the receiver operating characteristic curves as a measure of model performance. In addition, an unsupervised approach was performed by using a bayesian network to reveal data-driven relationships between eNose volatile organic compound profiles and asthma characteristics. Breath profiles of 655 participants (n= 601 adults and school-aged children with asthma and 54 preschool children with wheezing [68.2% of whom were atopic]) were included in this study. Machine learning models utilizing volatile organic compound profiles discriminated between atopic and nonatopic participants with areas under the receiver operating characteristic curves of at least 0.84 and 0.72 in the training and validation sets, respectively. The unsupervised approach revealed that breath profiles classifying atopy are not confounded by other patient characteristics. eNoses accurately detect atopy in individuals with asthma and wheezing in cohorts with different age groups and could be used in asthma phenotyping.

Comparative Study of Food Allergies in Children from China, India, and Russia: The EuroPrevall-INCO Surveys

A clear understanding of the differences in the epidemiology of food allergy between rural and urban populations may provide insights into the causes of increasing prevalence of food allergy in the developed world. We used a standardized methodology to determine the prevalence and types of food-specific allergic sensitization and food allergies in schoolchildren from urban and rural regions of China, Russia, and India. The current study is a multicenter epidemiological survey of children recruited from 5 cities in China (Hong Kong and Guangzhou), Russia (Tomsk), and India (Bengaluru and Mysore) and 1 rural county in Southern China (Shaoguan). A total of 35,549 children aged 6 to 11 years from 3 countries participated in this survey. Random samples of children from 3 countries were first screened by the EuroPrevall screening questionnaire. Children with and without a history of adverse reactions to foods were then recruited for the subsequent case-control comparative studies. We determined the prevalence rates of food-specific IgE sensitization and food allergies using the predefined criteria. The prevalence rates of food-specific IgE sensitization (≥0.7 kU/L) to at least 1 food were 16.6% in Hong Kong, 7.0% in Guangzhou, 16.8% in rural Shaoguan, 8.0% in Tomsk, and 19.1% in India. Using a definition of probable food allergy as reporting allergic symptoms within 2 hours of ingestion of a specific food plus the presence of allergic sensitization to the specific food (positive IgE and/or positive skin prick test result), the prevalence of food allergy was highest in Hong Kong (1.50%), intermediate in Russia (0.87%), and lowest in Guangzhou (0.21%), Shaoguan (0.69%), and India (0.14%). For children recruited from Hong Kong, both sensitization and food allergy were significantly higher in children who were born and raised in Hong Kong when compared with those who were born in mainland China and migrated to Hong Kong, highlighting the importance of early-life exposures in affecting the subsequent development of food sensitization and food allergy. There are wide variations in the prevalence of food-specific IgE sensitization and food allergy in the 3 participating countries. Food allergy appears to be less common when compared with developed countries. The variations in the prevalence of food allergen sensitization cannot be explained by the differences in the degree of urbanization. Despite the high prevalence of food-specific IgE sensitization in India and rural China, food allergy is still extremely uncommon. In addition to IgE sensitization, other factors must play important roles resulting in the clinical manifestations of food allergies.