Prick Test Results Research Articles

Skin Prick Test Results and Total IgE Levels of Asthma Patients in Zagazig University Hospital (2015-2019)

Skin Prick Test Results and Total IgE Levels of Asthma Patients in Zagazig University Hospital (2015-2019)

Atopik Dermatit ve Kronik Spontan Ürtikerde Hastalık Aktivite Skoru, Serum Parametreleri ve Deri Prick Testi Arasındaki İlişkinin Araştırılması: Kesitsel Çalışma

Objective: Atopic dermatitis and chronic spontaneous urticaria are allergic skin diseases with recurrent attacks. In this study, disease activity score and laboratory parameters were investigated in patients with atopic dermatitis and chronic spontaneous urticaria. Material and Methods: A total of 68 patients including 33 atopic dermatitis and 35 chronic spontaneous urticaria patients from the dermatology outpatient clinics were enrolled in this study. Serum levels of total immunoglobulin E (IgE), blood eosinophil and basophil counts; prevalence of sensitization to aeroallergens, and disease activity scores were compared between the two groups. Results: A higher eosinophil count in the peripheral blood was observed in atopic dermatitis patients compared to chronic spontaneous urticaria patients. Disease activity scores (SCORAD index) were positively correlated with the eosinophil count and total IgE levels. Furthermore, it was found that the basophil count increased while total IgE levels and SCORAD index scores decreased in the chronic period of the disease. Total IgE levels and SCORAD index scores were higher in atopic dermatitis patients with a positive skin prick test. In chronic spontaneous urticaria patients, it was observed that basophil counts and total IgE levels were correlated, but there was not a correlation between disease activity scores, skin prick test results, and levels of other laboratory parameters. Conclusion: The relationship of serum parameters, especially IgE levels, with the disease activity was found to be significant only in atopic dermatitis.

СЕНСИБИЛИЗАЦИЯ К МОЛЕКУЛЯРНЫМ КОМПОНЕНТАМ АЛЛЕРГЕНА КЛЕЩА ДОМАШНЕЙ ПЫЛИ DER Р1 И DER Р2 У ДЕТЕЙ

Objectives. To establish the molecular profile of sensitization to individual components of the house dust mite allergen (Der p1 and Der p2) in children of Grodno region (Republic of Belarus). Material and methods. We examined 61 children aged from 4 to 17 years with symptoms of allergy associated with house dust mite. sIgE antibodies to the house dust mite allergen components Der p1 and Der p2 were determined by the ImmunoCAP method. Results. sIgE antibodies to at least one molecule of the house dust mite allergen Der p1 and/or Der p 2 were detected in 83.6% of children. sIgE antibodies to Der p1 were found in 75.4% of children, and to Der p2 - in 70.5% of children. sIgE antibodies simultaneously to two molecular components of the dust mite (Der p1 + Der p2) were detected in 62.3% of children. With age, the ratio of Der p1 and Der p2 changes towards the prevalence of Der p2 (p=0.02). It has been found that 9.8% of children have IgE-recognizing Der p1, but not Der p 2, and 6.5% of children have IgE-recognizing Der p2, but not Der p 1. In 16.4% of children with sensitization to a house dust mite no sIgE antibodies to Der p1 and Der p2 were detected. The frequency of sensitization to Der p1 and Der p 2, depending on the degree of skin reactivity, established by the results of skin prick tests with water-salt extracts of house dust mite was as follows: «+» 31.25% and 31.25%, «++» 91,17% and 85.29%, «+++» 80% and 60%, respectively. 9.8% of children with negative skin prick test results (but increased level of sIgE to house dust mite extract) were Der p1-, Der p2- and Der p1 + Der p2-positive in 100% of cases. Conclusions. The allergenic components of house dust mite Der p1 and Der p2 are major in children of Grodno region. A component-resolved diagnostic approach to clarify the profiles of IgE-mediated reactivity in patients with allergy associated with house dust mite will allow to improve and to optimize the therapeutic and diagnostic tactics of managing such patients.

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.

Factors Affecting the Duration of Disease in Chronic Urticarial; Single-Center Experience

Chronic urticaria (CU) is characterized by recurrent itchy blisters, angioedema, or both for more than six weeks. We evaluated patients' clinical and demographic characteristics, laboratory results, and factors affecting the disease's duration followed up with the diagnosis of chronic urticaria in our clinic. In our study 101 patients who applied to our outpatient clinic between March and December 2020 were included in the study. Demographic features, comorbid illness of patients, skin prick test results, phadiatop, Total IgE, anti-TPO, vitamin B12, vitamin D, ferritin, complete blood count, autologous serum skin test, urticaria activity score over seven days (UAS7) were examined from hospital records retrospectively. Correlations between variables and their effects on the duration of the disease were statistically investigated. It was observed that the duration of the disease was longer in chronic urticaria patients with anti-TPO positivity (p=0.019). As a result of the multiple regression analysis, it had been determined that the UAS7 value had 2,989 folding effects on the duration of the disease. A positive correlation between the duration of the disease and the UAS7 (r=0,277; p=0,005) was determined. The patients in the study defined as a longer disease duration in the patients with angioedema (p=0,005), dermatographism (p=0,012) and gender of female (p=0,031) Anti-TPO positivity, concomitant angioedema, dermatographism, and higher UAS7 scores predicts that their chronic urticaria will last longer.

The Importance of Nasal Provocation Testing in the Diagnosis of Dermatophagoides pteronyssinus-Induced Allergic Rhinitis.

Allergen identification is the first step for allergen-specific immunotherapy (AIT) of allergic rhinitis (AR). Currently, the diagnosis of AR is based mainly on the positive results of the skin prick test (SPT) and/or serum specific immunoglobulin E (sIgE) measurement. However, the results of these two tests may not always directly correlate with AR. To investigate the importance of nasal provocation testing (NPT) in the diagnosis of Dermatophagoides pteronyssinus (Der p)-induced AR. Rhinitis patients willing to undergo AIT (n = 171) were enrolled. The correlations of Der p SPT, sIgE, NPT, and clinical symptom severity were assessed. NPT-positive responses were more common in patients with higher SPT and sIgE levels. The optimal cut-off value for a NPT-positive response for SPT was 5.5 mm and for sIgE was 2.77 kUA/L, based on the respective receiver operating characteristic (ROC) curves. The area under the curve (AUC) of the ROCs was 0.814 (SPT only) and 0.794 (sIgE only) and increased to 0.828 with the combination of SPT and sIgE. The Der p-NPT concentration was inversely correlated with SPT and sIgE levels (r = -0.477, P < .001, and r = -0.461, P < .001, respectively), but none was correlated with the total nasal symptom score. For patients who are willing to receive Der p AIT, NPT is a useful and safe test to confirm diagnosis prior to treatment initiation, especially in patients with lower levels of Der p SPT (< 5.5 mm) or sIgE (< 2.77 kUA/L).

Correlation between induration diameter of skin prick test result to house dust mite allergen with immunotherapy efficacy

Background: House dust mite (HDM) is one of the most aeroallergen causing allergy diseases. Skin prick test (SPT) is a simple test for hypersensitivity-related IgE. Positivity of house dust mite skin prick test results is essential to start immunotherapy. Objective: This study aimed to investigate the correlation between the induration diameter of skin prick test results to house dust mite allergen with immunotherapy efficacy. Methods: This retrospective study was conducted in the Pediatric allergy and immunology outpatient clinic of Dr. Soetomo General Hospital Surabaya. The medical record was taken from January 1st until December 31st 2020 period. House dust mite allergy was diagnosed based on the positivity of skin prick test to HDM. Immunotherapy efficacy was evaluated with daily symptom score (dSS), daily medication score (DMS), and Combined Symptom and Medication Score (CSMS) at least 3 months after immunotherapy. Age, gender, duration of illness, nutritional status, family history of atopic allergic disease, and other allergic comorbidities were stipulated as confounding variables. Statistical analysis was normality distribution test, wilcoxon rank test, spearman test, and regression analysis. Results: Sixty patients with HDM allergy (33 boys and 27 girls), were included in this study. Significant alteration of dSS, dMS, and CSMS before and after immunotherapy evaluated with wilcoxon rank test result (p=0.000 respectively). There was no correlation of each confounding variable to the induration diameter of SPT. Positive correlation between induration diameter and CSMS score was tested with Spearman test (p=0.003, r= 0.373). Conclusions: Smaller induration diameter of HDM SPT result could be predictive for immunotherapy efficacy.

Effect of allergic rhinitis on the outcomes of diode laser dacryocystorhinostomy

PurposeStudies on patients with nasolacrimal duct obstruction have suggested the presence of comorbid allergic rhinitis. This study aimed to investigate the role of allergic rhinitis in the long-term surgical failure of diode laser dacryocystorhinostomy. Materials and methodsA total of 153 patients undergoing diode laser dacryocystorhinostomy between 2013 and 2017 were included in the study. In the consultation and follow-up, a skin prick test, endoscopic nasal examination, and nasal symptom scoring were performed. ResultsA total of 137 patients participated in the follow-up. The nasolacrimal obstruction complaints were completely resolved in 112 patients (81.8%). Of these, eight (7.1%) had positive skin prick tests. The preoperative complaints continued postoperatively in 25 (18.2%) patients. Nasal endoscopy revealed synechiae in one of these patients, whereas no anatomic deformities were observed in the other 24 patients. Of the 25 patients, 21 (84%) had positive skin prick tests. Those patients had signs of allergic rhinitis on endoscopic examination and high nasal symptom scores. There were significant differences in skin prick test results and nasal symptom scores between the two groups (p < 0.05). ConclusionAllergic rhinitis may affect the success of dacryocystorhinostomy in patients with nasolacrimal duct obstruction. To increase the chances of surgical success, besides choosing the appropriate surgical procedure, it may be useful to treat allergic rhinitis pre- and postoperatively.

Prevalence of IgE-Mediated Food Hypersensitivity to Cereals and Beans Based on Skin Prick Test in Children with Celiac Disease.

BACKGROUND Celiac disease is a non-IgE mediated food allergy, which can cause extensive villus atrophy. Because of increased food allergen absorption, there are elevated IgA and IgG antibodies in these patients, so there is a concern about IgE antibody production against wheat and other cereals. METHODS In this study, we evaluated IgE-mediated hypersensitivity to wheat, rice, and other cereals in children with celiac disease. RESULTS 22 patients (50%) had at least one positive skin prick test to food allergens. The most frequent food allergen was peanut (31.8%), followed by wheat (18.2%), corn (9.1%), and rice (4.5%). The results revealed no significant correlation between age, sex, and the results of the skin prick test (p >0.05). The correlation between diagnosis time of celiac disease and results of skin prick test was also not significant statistically (p >0.05). CONCLUSION Because of the high prevalence of IgE mediated hypersensitivity to cereals and beans in children with celiac disease, a skin prick test might be considered in these patients, especially in refractory cases.

The Role of Quantic Molecular Resonance (QMR) in the Treatment of Inferior Turbinate Hypertrophy (ITH): Our Experience With Long-Term Follow-Up in Allergic and Nonallergic Rhinitis Refractory to Medical Therapy. Preliminary Results.

The aim of this study was to assess the long-term effectiveness of quantic molecular resonance (QMR) in the treatment of inferior turbinate hypertrophy (ITH) in allergic and nonallergic rhinitis refractory to medical therapy. This study enrolled 281 patients, 160 males (56.9%) and 121 females (43.1%), mean age 37.8 ± 4.1 years, range 18 to 71. Fifty-four patients have been lost to follow up and have been therefore excluded from the final analysis. Based on skin prick test results, 69 patients were considered allergic (group A) and 158 nonallergic (group B). All subjects underwent before surgery (T0) and 3 (T1), 12 (T2), 24 (T3), and 36 months (T4) after QMR treatment to: 4-phase rhinomanometric examination, nasal endoscopy evaluation, and visual analogue scale to quantify the subjective feelings about nasal obstruction. Subjective and objective parameters showed statistically significant improvement in both groups. Group B parameters not changed during follow-up, while group A showed significant worsening between T1 and subsequent assessments. T4 outcome indicates a better result in nonallergic patients. In accordance with the literature, our preliminary data validate QMR treatment as a successful therapeutic option for nasal obstruction due to ITH. Nonallergic patients had a very good T4 outcome. Allergic patients showed a worsening trend after 1 year probably due to other causes.

Results of Allergic Prick Tests in Patients with Allergic Rhinitis in Edirne

Results of Allergic Prick Tests in Patients with Allergic Rhinitis in Edirne

Peanut oral immunotherapy in a pediatric allergy clinic: Patient factors associated with clinical outcomes

BackgroundAdditional information is needed to inform optimal patient selection, expected outcomes, and treatment end points for clinical peanut oral immunotherapy (OIT). ObjectiveTo provide insight into the optimal patient selection, expected outcomes, and treatment end points for clinical peanut oral immunotherapy by analyzing a real-world peanut OIT cohort. MethodsRecords were reviewed for 174 children undergoing peanut OIT at a pediatric allergy clinic. Patient age, peanut skin prick test results, and peanut-specific immunoglobulin E (sIgE) results, with inclusion of additional foods in OIT, were analyzed for correlations with OIT outcomes. ResultsTo date, 144 patients have achieved maintenance dosing, 50 of whom transitioned to ad lib twice-weekly peanut ingestion. A total of 30 discontinued OIT. In addition, 47 patients who underwent multifood OIT had no significant difference in reactions (FDR-adjusted P = .48) or time-to-reach maintenance (FDR-adjusted P = .48) compared with those on peanut OIT alone. Age at initiation inversely correlated with achievement of maintenance: 92% of patients 0.5 to less than 5 years, 81% of those 5 to less than 11 years, and 70% of those 11 to less than 18 years reached and continued maintenance (P = .01). Baseline peanut-sIgE level positively correlated with number of reactions during updosing (P < .001) and maintenance (P = .005), though it was not significantly different in patients achieving successful maintenance vs those who discontinued OIT (P = .09). Furthermore, 66% of patients experienced greater than or equal to 1 adverse reaction during OIT. Of those on ad lib peanut ingestion, 2 reported mild reactions after lapses in peanut consumption. ConclusionClinical peanut OIT has similar outcomes to research protocols. OIT can be successful in older children and those with high peanut-sIgE levels, though these factors affect outcomes. Clinical and laboratory criteria can guide successful transition to intermittent ad lib peanut consumption.

High Histamine Control Concentration Leads to False Negative Allergy Skin Testing.

Allergy skin test reliability depends on the reagents and controls selected. Histamine is used at 1 mg/ml and 6 mg/ml concentration but few studies address the rationale for selecting one versus the other and how this may impact diagnostic accuracy. To determine the rate of false negative allergen skin tests responses between UniTest PC (using the 1 mg/mL histamine) and Quintip devices (using 6 mg/mL) for 4 common aeroallergens. Subjects aged 18-65 with symptoms of allergy to cat and/or ragweed received skin testing with 4 aeroallergens (dust mite mix, timothy grass, ragweed, cat), histamine and control diluent. Those individuals who tested positive to cat or ragweed with one skin prick test (SPT) device but not the other then proceeded to nasal allergen challenge (NAC). The primary outcomes were the aeroallergen false negative rates and sensitivities of the skin test devices followed by nasal allergen (NAC). Twenty-five individuals were recruited and underwent a total of 300 SPTs. SPT to allergens (ragweed, dust mite, cat, and timothy grass) resulted in a statistically significant difference in wheal size among the two skin testing devices (p value <0.0001, 0.0001, 0.0006, and 0.0053 respectively). Six NAC procedures were performed to cat/ragweed and 5 of 6 (83% were positive). The overall allergen sensitivity rate for UniTest and Quintip were 97% and 78% respectively with most false negatives due to the use of 6 mg/ml histamine control reagent. Our study shows that 6 mg/ml concentration of histamine control reagent may contribute to a false interpretation of aeroallergen skin prick test results.

Sensitization against Fungi in Patients with Airway Allergies over 20 Years in Germany

Background: Fungal spores are ubiquitous allergens. Severe forms of asthma are particularly highly associated with fungal sensitization. National and international asthma guidelines recommend the implementation of allergen immunotherapy if indicated. Thus, detection and treatment of relevant allergies are key components of primary care of these patients. Objectives: The aims of the study were (i) to investigate trends in the prevalence of sensitization to twelve fungi in central Germany over the last 20 years and (ii) to dissect specific sensitization patterns among the 3 most important fungi: Aspergillus, Alternaria, and Cladosporium. Methods: This single-center study evaluated skin prick test (SPT) results of 3,358 patients with suspected airway allergies over a period of 20 years (1998–2017). Results: While 19.2% of all study patients had positive test results to at least 1 of the 3 fungi (Alternaria, Aspergillus, or Cladosporium) in the first study decade, this rate increased to 22.5% in the second decade. Slight increases in sensitization rates to almost all fungi were observed over the 20-year period. In the last decade, polysensitization to Alternaria, Aspergillus, and Cladosporium increased significantly. Sensitization to fungi is age-dependent and peaks in the age-group of 21–40 years during the second decade. Conclusion: Fungi are relevant allergens for perennial and seasonal allergy symptoms. We currently recommend including Aspergillus, Alternaria, and Cladosporium in the standard series of SPTs for airway allergies.

Clinical History Matters, Skin Prick Test (SPT) Results are Not the Be-All and End-All for Allergy Diagnosis

Clinical History Matters, Skin Prick Test (SPT) Results are Not the Be-All and End-All for Allergy Diagnosis

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.

SPECTRUM OF CAUSATIVELY RELEVANT AEROALLERGENS OF SOUTHERN UKRAINE WHICH PROVOKE ALLERGIC REACTION IN PATIENTS WITH POLLINOSIS ON THE EXAMPLE OF KHERSON REGION

The aim: the analysis of spectrum of causatively relevant aeroallergens of southern Ukraine which provoke allergic reaction in patients with pollinosis. Materials and methods: ambulatory medical records data and skin prick-testing results of 477 patients afflicted with pollinosis in Kherson (250 women - 52,41 % and 227 men - 47,59 %) aged from 19 to 66 years old (38,05±0,45) have been analyzed retrospectively. Results: all patients revealed clinical implications mainly during the September-October period. Clinically 151 patients (31,66%) showed severe and 326 (68,34%) moderate to severe clinical progression. Composite family plants (composites) proved to be the most widespread plants (69,76 %) among all pollen aeroallergens of Kherson region. Weeds and sunflower showed the highest percentage among composites: Ambrosia topped to 79,87 %, Helianthus (sunflower)- 75,68 %, Artemisia - 42,98 %, and Cyclachaena (sump weed) - 36,48 %. Wild and cultivated grains' aeroallergens toped to 28,22 %. Among them the sensibility to Lolium perenne (19,28 %), Festuca pratensis (17,82 %), Dactylis glomerata (17,82 %) has been noticed more often. Tree aeroallergens topped to 2,03 %. Conclusions: The third wave of pollen formation (September-October period) appeared to be the most significant and clinically hard for Kherson region. According to the specific allergologic research data, allergens of the composite family plants, among which pollen of Ambrosia, Helianthus, Artemisia and Cyclachaena cause more frequent sensibility, turned to be the most widespread causatively relevant aeroallergens in Kherson region which provoke allergic reaction in patients with pollinosis. The second place was taken by wild and cultivated grains' aeroallergens, among which sensibility to Lolium perenne, Festuca pratensis, Dactylis glomerata proved to be the most common.

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.

Oral Immunotherapy and Basophil and Mast Cell Reactivity in Food Allergy.

Basophil activation tests (BATs) can closely monitor, in vitro, a patient’s propensity to develop type I hypersensitivity reactions. Because of their high specificity and sensitivity, BATs have become promising diagnostic tools, especially in cases with equivocal clinical histories, skin prick test results, and/or levels of specific IgE to allergen extracts. BATs also are useful as tools for monitoring the effects of treatment, since oral immunotherapy (OIT) studies report a diminution in patients’ basophil responsiveness over the course of OIT. This review will discuss the BAT findings obtained before, during, and after OIT for food allergy. We will mainly focus on the association of basophil responsiveness, and alterations in basophil surface markers, with clinical outcomes and other clinical features, such as blood levels of specific IgG and IgE antibodies. The detailed analysis of these correlations will ultimately facilitate the use of BATs, along with other blood biomarkers, to differentiate short-term desensitization versus sustained unresponsiveness and to improve treatment protocols. Given the critical anatomic location of mast cells adjacent to the many IgE+ plasma cells found in the gastrointestinal tissues of allergic individuals, we will also discuss the role of gastrointestinal mast cells in manifestations of food allergies.

Correlation of skin prick testing to environmental allergens

BackgroundTo diagnose and adequately treat allergies, identification of sensitizing allergens is crucial. Skin prick or serum immunoglobulin E testing determines sensitization to potential allergens. Consensus varies regarding degree of cross-reactivity between aeroallergens. ObjectiveTo quantify correlations between aeroallergen skin prick test results. MethodsA total of 11,832 patients’ quantitative skin prick test results and basic characteristics were obtained from a tertiary academic center’s electronic medical record and deidentified. Data were analyzed using Spearman’s rank correlation coefficients to detect nonlinear associations between wheal sizes of skin prick test results. ResultsThe highest correlation among grasses was 0.903 (fescue and red top). Of note, 13 more grass pairs had correlation more than 0.8, and 19 had correlation between 0.7 and 0.8. The Northern grass comparative results are from a satellite clinic that tested more grasses than the main clinic, in which only Kentucky blue and Bermuda were tested (correlation 0.768; n = 9348). Highest correlation among weeds was 0.74 (lambs quarter and pigweed). In addition, 6 more weed pairs had correlation more than 0.7. Highest correlation among trees was 0.724 (palm and alder) and 6 more tree pairs had correlation more than 0.7. Highest correlation among molds was 0.711 (Helminthosporium and Epicoccum). Dust mite correlation between Dermatophagoides farinae and Dermatophagoides pteronyssinus was 0.848 (n = 10,022). ConclusionThis study confirmed the expected high degrees of correlation not only between skin prick test results of related environmental allergens but also between less closely related Northern grasses and Bermuda grass. This has implications for simplification of testing and immunotherapy protocols in the future.