Rate Of Positive Reactions Research Articles

Patch Testing to Propylene Glycol: The Mayo Clinic Experience.

Propylene glycol (PG) is a solvent, vehicle, and humectant being used increasingly in a wide array of personal care products, cosmetics, and topical medicaments. Propylene glycol is a recognized source of both allergic and irritant contact dermatitis. The aim of the study was to report incidence of positive patch tests to PG at Mayo Clinic. We retrospectively reviewed records of all patients patch tested to PG from January 1997 to December 2016. A total of 11,738 patients underwent patch testing to 5%, 10%, or 20% PG. Of these, 100 (0.85%) tested positive and 41 (0.35%) had irritant reactions. Patients also tested to a mean of 5.6 concomitant positive allergens. The positive reaction rates were 0%, 0.26%, and 1.86% for 5%, 10%, and 20% PG, respectively, increasing with each concentration increase. The irritant reaction rates were 0.95%, 0.24%, and 0.5% for 5%, 10%, and 20% PG, respectively. Propylene glycol is common in skin care products and is associated with both allergic and irritant patch test reactions. Increased concentrations were associated with increased reactions.

Prevalence of allergen sensitization detected by patch tests.

Existing literature on the prevalence of positive reactions to allergens is largely derived from dermatologists who practice at large academic centers. Data from other providers, including allergists who practice in various other settings, is important to assess a more representative and accurate prevalence of contact allergy. To determine the prevalence of contact allergy among individuals with at least one positive patch test result by comparing data for positive patch test reaction rates of common contact allergens from 3 groups based in different practice settings, 2 of which are academic. We retrospectively analyzed patch test results of an academic center (January 1, 2011, to December 4, 2015) and a national contact allergen database (March 1, 2015, to September 1, 2016). Data from a third, academic-based group was obtained separately from the published literature. Logistic regression analysis was used to compare positive reaction rates of the widely available, patch test allergens among the 3 groups. The positive reaction rates for 10 of 36 compared allergens (28%) were significantly higher (p < 0.05) for the national contact allergen database compared with both the academic groups. Positive reaction rates to common allergens used in patch testing may be underreported in the literature. Limitations of our study included the retrospective nature of the study, different date ranges among the three groups, and the absence of all allergens tested by the national contact allergen database.

Reflectance confocal microscopy features of irritant cutaneous reactions to sodium lauryl sulphate in healthy adults

Objective To investigate reflectance confocal microscopy (RCM) features of irritant cutaneous reactions to sodium lauryl sulphate (SLS) in healthy persons aged from 18 to 60 years, to analyze effects of age and gender on cutaneous reactions, and to estimate the value of RCM in objective evaluation of cutaneous reactions. Methods An occlusive patch test was performed on the back of 120 healthy testees with 0.1% and 0.5% SLS solution (0.1% and 0.5% SLS groups) and distilled water (negative control group) for 48 hours. At different time points after the patch removal, clinical evaluation and RCM were performed. Results RCM imaging in the 0.1% and 0.5% SLS groups showed parakeratosis, indistinct structure of the stratum corneum, spongiosis and infiltration of inflammatory cells in the epidermis, and telangiectasia in the papillary dermis. The incidence of RCM features reached the peak until 24 hours after the removal of 0.1% and 0.5% SLS patches, and the incidence of telangiectasia in the dermis was up to 66.7% and 95.0% in the 0.1% and 0.5% SLS groups respectively. At 24 hours after the removal of 0.5% SLS patch, the incidence of spongiosis was significantly lower in the males than in the females (68.9%[42/61] vs. 84.7%[50/59], χ2=4.24, P 0.05) . Clinical evaluation showed that after the removal of 0.1% and 0.5% SLS patches, no significant difference in the incidence of irritant cutaneous reactions was observed between the males and the females or between the testees aged 18-40 years and those aged 41-60 years (all P > 0.05) . There were good correlations between the clinical evaluation results and RCM features. At 24 hours after the removal of 0.1% SLS patch, the correlation coefficient between spongiosis and clinical evaluation results was up to 0.77, so was that between telangiectasia in the dermis and clinical evaluation results (both P < 0.001) . However, at 0.5 hour after the removal of SLS patches, clinical evaluation showed that the positive reaction rates were 2.5% (3/120) and 12.5% (15/120) in the 0.1% and 0.5% SLS groups respectively. In the meantime, there were 17.5% (21/120) and 51.7% (62/120) of testees manifesting more than 2 RCM features in the 0.1% and 0.5% SLS groups respectively, which were more similar to the clinical evaluation results at 24 hours after the removal of SLS patches (34.2%[41/120] and 85.0%[102/120] in the 0.1% and 0.5% SLS groups respectively) compared with the clinical evaluation results at 0.5 hour after the removal of SLS patches. Conclusions Neither gender nor age affects irritant cutaneous reactions to 0.1% and 0.5% SLS. Compared with clinical evaluation, RCM can evaluate cutaneous reactions more objectively and accurately in the early stage of irritant reactions. Key words: Dermatitis, irritant; Sodium dodecyl sulfate; Age factors; Sex factors; Microscopy, confocal

Canine atopic dermatitis (atopy)

Canine atopic dermatitis is a common clinical entity, characterized by pruritus due to sensitization against common enviromental allergens. It has been proven that there is strong breed predisposition. Genetically programmed dogs overproduct reaginic antibodies (IgE and/or IgGd) after their exposure to airborne allergens (dust mites, epithelia, pollens and molds) which consequently fix themselves to the mast cells of the skin. After reexposure to the same allergens these cells degranulate, with subsequent release of many pharmacologically active substances (histamine, leucotrienes, Prostaglandines etc). However, this is a rather simplistic explanation; the true pathogenesis of atopy is more complicated and still not well understood. Clinical signs first appear between 6 months and 3 years of age. Pruritus, the mainstay of atopy, can be seasonal or perennial. Skin lesions, appearing in later, are attributed to pruritus and/or to secondary complications (staphylococcal pyoderma, seborrhea, dry skin, Malassezia dermatitis). The diagnosis, based on history and clinical findings, necessitates exclusion of other pruritic skin diseases and identification of the offending allergens by using the intradermal test and/or serology (ELISA, RAST). The latter method is diagnostically inferior to intradermal skin test due to the high rate of false positive reactions. Therapeutic options include avoidance of the allergens responsible for sensitization, systemic therapy with glucocorticoids, antihistamines and essential fatty acids in various combinations, topical antipruritic therapy, hyposensitization which is the best therapeutical modality for the perennial form of the disease and management of secondary complications as well as of other concurrent allergic skin diseases, such as food and flea allergy.

Ecological and Public Health Implications of the Discharge of Multidrug-Resistant Bacteria and Physicochemical Contaminants from Treated Wastewater Effluents in the Eastern Cape, South Africa

This study assessed the prevalence of fecal indicator bacteria (FIB) and Vibrio species, as well as the physicochemical qualities of the discharged effluents of two wastewater treatment facilities, in the Eastern Cape, South Africa over a one-year sampling period using standard methods. Bacteriological assessment revealed presumptive E. coli counts ranging from 3 to 1.2 × 105 CFU/100 mL, while counts of Vibrio spp. ranged from 11 to 1.4 × 104 CFU/100 mL. Molecular identification of the isolates by polymerase chain reactions (PCR) yielded positive reaction rates of 76.2% (381/500) and 69.8% (279/400) for E. coli and Vibrio species, respectively. The antibiotic susceptibility profiles of 205 randomly selected PCR-confirmed Vibrio isolates against 18 antibiotics revealed resistance frequencies ranging from 0.5% (imipenem) to 96.1% (penicillin G), based on recommended breakpoint concentrations. About 81% (166/205) of the Vibrio isolates exhibited multidrug resistance (resistance to three or more classes of antibiotics), while nine different antibiotic resistance genes were detected by PCR. The physicochemical qualities of the effluents also ranged as follows: pH (6.5–7.6), temperature (12–27 °C), turbidity (1.5–65.7 mg/L), total dissolved solids (95–171 mg/L), dissolved oxygen (2.1–9.8), electrical conductivity (134–267 µS/cm), free chlorine (0.08–0.72 mg/L), biochemical oxygen demand (0.12–9.81 mg/L), nitrate (1.04–21.5 mg/L), nitrite (0.11–0.76 mg/L), phosphate (1.03–18.3 mg/L) and chemical oxygen demand (27–680 mg/L). The discharged effluents fell short of the regulatory guidelines for some of the parameters assessed. We conclude that the discharged effluents are potential sources of environmental pollution and can contribute to drug resistant bacteria load in the receiving watershed, with the associated ecological and human health risks.

Changing analysis of allergic rhinitis inhalant allergen spectrum in Xinjiang region

Objective: To investigate the aeroallergen spectrum in allergic rhinitis in Xinjiang area and analyze its relating factors. Methods: Skin prick test was carried out in 480 cases with allergic rhinitis using 20 inhaled allergens. The major change in recent years with allergic rhinitis and allergen distribution was compared.SPSS 17.0 software was used to analyze the data. Results: Among 480 cases, 406 showed positive reaction. The most common allergens found in patients were chenopodium (61.6%) and mugwort (44.1%), followed by willow(37.7%), maple(37.7%), poplar(30.3%), house dust mite(30.3%), plantain(29.8%), acacia(25.9%), dust mite maple(25.4%), and so on. The rate of positive reaction to only one allergen was 9.6%, of which 21 were mite allergens. The positiverate to allergensin male and female were 84.2% and 85.1%, the distribution of allergens in both sexes did not differ(χ(2)=0.001, P=0.978). The positiverate to allergens in patients aged 21 to 35 years old was 88.6%, in patients aged 36 to 54 years old was 78.4%, the difference was statistically significant(χ(2)=0.258, P<0.01). The positive rate to allergens in Kazakhs was slightly higher than that in other ethnic groups (91.7%). The positive rates to allergens in the Han, Uygur and other ethnic groups were 84.8%, 86.4% and 63.3% respectively, the difference was statistically significant(χ(2)=9.779, P=0.044). Seventy-five point four percent of all allergen-positive patients(306 cases) combined with asthma. Conclusions: The major allergen with allergic rhinitis is chenopodium. Among them, Kazakh allergic positive rate is higher than other ethnic groups.

Contact allergy and intolerance to sulphite compounds: clinical and occupational relevance

Sulphites are widely used as preservatives and antioxidants, e. g., in the food, cosmetic, and pharmaceutical industries. They are known to trigger epidermal sensitizations and associated eczematous contact allergic skin reactions; to identify these, patch testing is performed using sodium disulphite (= sodium metabisulphite; CAS 7681-57-4). In addition to this, inhalation or oral exposure to sulphite can cause the clinical picture of sulphite intolerance, including bronchoconstriction, urticaria, cardiovascular, intestinal, and/or life-threatening anaphylactic reactions, the identification of which requires challenge testing. This review discusses the prevalence of sulphites, their chemical characteristics, statutory regulations and limit values; sulphite-related diseases and their diagnosis; the occupational significance of sulphites as contact allergens in the literature published between 1968 and 2015; and the current incidence of contact sensitizations in the patient collective at a dermatology practice. Individual cases of inhalative occupational sulphite intolerance were also analyzed. A reaction incidence of 3.1% (++ or +++ reaction on day 4) to sodium metabisulphite (1% in Vaseline) was determined in a 10-year collective comprising 780 patients tested at a dermatology practice; in none of these cases was occupational relevance identified. In contrast, the rate of positive test reactions to sulphite was 1.1–4.5% in eight large patch test collectives. Although occupational relevance in the positive test results (depending on selection criteria) was between 0 and 100%, it was predominantly (in six of eight studies) between 5 and 14%. Approximately 50 cases involving occupational allergic contact dermatitis due to sulphite have been published in the literature over the last 45 years, as well as a small number of cases of occupational sulphite intolerance. In summary, epidermal sensitizations to sulphite are rarely of occupational relevance. Despite the wide prevalence of sulphites in the form of preservatives and antioxidants, the low number of cases documented in an occupational dermatological context suggests that occupational sulphite exposure only rarely exists in disease-triggering form.

North American Contact Dermatitis Group Patch Test Results 2013-2014.

Patch testing is the most important diagnostic tool for the assessment of allergic contact dermatitis. This study documents the North American Contact Dermatitis Group (NACDG) patch testing results from January 1, 2013, to December 31, 2014. At 13 centers in North America, patients were tested in a standardized manner with a screening series of 70 allergens. Data were manually verified and entered into a central database. Descriptive frequencies were calculated, and trends were analyzed using χ test. A total of 4871 patients were tested. There were 3255 patients (66.8%) who had at least 1 positive reaction and 2412 patients (49.5%) who were ultimately determined to have a primary diagnosis of allergic contact dermatitis. A total of 434 patients (8.9%) had occupationally related skin disease. There were 9726 positive allergic reactions. Compared with the previous reporting periods (2011-2012 and 2001-2012, including at least three 2-year cycles), positive reaction rates for the top 25 screening allergens statistically increased for 2 allergens: methylchloroisothiazolinone/methylisothiazolinone (6.4%; risk ratios, 1.26 [1.07-1.50] and 2.08 [1.84-2.37]) and hydroxyethyl methacrylate (2.6%; risk ratios, 1.34 [1.02-1.76] and 1.23 [1.00-1.51]). Methylisothiazolinone, which was added to the screening series for this 2013-2014 cycle, had the third highest positive reaction rate of allergens tested (10.9%). Four other newly added allergen preparations-formaldehyde 2% (7%), diphenylguanidine (3.8%), propylene glycol 100% (2.8%), and benzophenone-4 (2.1%)-all had reaction rates greater than 2%. Twenty-one percent of tested patients had at least 1 relevant allergic reaction to an allergen not on the NACDG series; 14.6% of these were occupationally related. The T.R.U.E. TEST (SmartPractice Denmark, Hillerød, Denmark) would have hypothetically missed one quarter to one third of reactions detected by the NACDG screening series. These results confirm that the epidemic of sensitivity to methylisothiazolinone previously documented in Europe is also occurring in North America. Patch testing with allergens beyond a standard screening tray is necessary for the complete evaluation of occupational and nonoccupational allergic contact dermatitis.

Prevalence of Preservatives Across All Product Types in the Contact Allergen Management Program.

Preservatives are known causes of allergic contact dermatitis. The aim of this study was to determine the prevalence of preservatives in each product category in the Contact Allergen Management Program and compare prevalence with reported rates of allergic contact dermatitis. Contact Allergen Management Program product information was queried based on the 53 approved preservatives for cosmetic products by the European Union and Association of Southeast Asian Nations plus 5 additional preservatives used in US products. Phenoxyethanol and parabens were the most common preservatives with 23.9% of products containing phenoxyethanol and 20.75% of products containing parabens. Methylisothiazolinone (MI) was found in 12.9% of products, most commonly in hair care and household products. Preservatives like MI and methylchloroisothiazolinone (MCI) that are both common in products and have a high incidence of allergic contact dermatitis are of greatest concern as contact allergy hazards. Phenoxyethanol and parabens are common and have weak sensitizing power, making them preferred preservatives. Evaluating the prevalence of preservatives provides important information on allergen exposures. Using current positive reaction rates, the risk of sensitization to a given preservative can be more accurately estimated and may affect the use of certain preservatives by industry in the future.

Systematic selection of solvent mixtures for non-aqueous redox flow batteries – vanadium acetylacetonate as a model system

Employing solvent mixtures in the electrolyte of non-aqueous redox flow batteries can increase energy density and efficiency. In this paper, active species solubility, electrolyte conductivity, and redox reaction rates were examined systematically among a number of binary and ternary mixtures, consisting of acetonitrile and 5 polar aprotic co-solvents to identify mixtures with enhanced active species solubility and redox reaction rates. Although we used vanadium acetylacetonate as a model, the methodologies presented here are applicable when evaluating solvent mixtures for other active species. Our approach is distinctive in that it elucidated the trade-offs in desirable properties that are necessary when solvent mixtures are used for non-aqueous redox flow batteries. We found that in a vanadium acetylacetonate–based non-aqueous redox flow battery, the use of an 84/16vol% acetonitrile/1,3-dioxolane binary solvent mixture resulted in an increase in the positive and negative sides reaction rates compared to that observed with pure acetonitrile. This binary mixture resulted in an improvement in reaction rate with no decrease in energy density and is a promising solvent system for other active species used for non-aqueous flow batteries.

Principais sensibilizantes em pacientes idosos e não idosos com dermatite de contato

Aims: To evaluate the prevalence of the main allergens found in allergic contact dermatitis among elderly and non-elderly patients.Methods: Retrospective study of the medical records of patients clinically diagnosed with contact dermatitis treated from August 2000 to January 2012 at the Allergy Outpatient Clinic of Marília Medical School and at an Allergy and Dermatology private clinic in Marília, state of São Paulo, Brazil. The inclusion criteria were clinical diagnosis of contact dermatitis, patch test performed during the study period, and no treatment with systemic corticosteroids or any other immunosuppressants. Age, sex, history of other types of allergy and allergens used were assessed. The patch test results were read 48 hours and 72 hours after application of the test chambers.Results: A total of 362 patients were included in the study: 60 elderly patients (aged 60 years or older) and 302 non-elderly patients. In addition to contact dermatitis, other types of allergies were observed in 20 (33.3%) of elderly patients and in 113 (37.4%) of non-elderly patients (p=0.54). There were 162 positive reactions on the patch test among elderly patients and 738 positive reactions among non-elderly patients (p=0.24). Strong positive reactions were present in 41 (68.3%) elderly patients and in 156 (51.6%) non-elderly patients (p=0.02). Strong and very strong positive reactions, when assessed together, were detected in 44 (73.3%) elderly patients and in 214 (70.8%) non-elderly patients (p=0.69). The most common allergens were nickel sulfate (in 33.3% of elderly and 38% of non-elderly patients) and fragrance mix (in 25% of elderly and 27.8% of non-elderly patients), with no statistical difference between the groups.Conclusions: There was a high rate of positive reactions on the patch test among patients with contact dermatitis, with no difference between elderly and non-elderly individuals, and the most common allergens were nickel sulfate and fragrance mix. Therefore, it is important that allergy to nickel and fragrances be included in the etiologic investigation of contact dermatitis, regardless of age.

The Association of Race/Ethnicity and Patch Test Results: North American Contact Dermatitis Group, 1998-2006.

The North American Contact Dermatitis Group patch tests patients with suspected allergic contact dermatitis (ACD) to a broad series of screening allergens and publishes periodic reports. We have previously reported on the association of race and ethnicity with the rates of positive responses to standard patch test allergens. This report extends those observations. The aim of the study was to report the North American Contact Dermatitis Group patch testing results from January 1, 1998, to December 31, 2006, comparing the frequency of positive reactions between white and black subjects. Standardized patch testing with 45 allergens was used at 13 centers in North America. χ analysis of results in black subjects as compared with whites was examined. A total of 19,457 patients were tested; 92.9% (17,803) were white and 7.1% (1,360) were black. The final diagnoses of ACD (whites, 45.9%; blacks, 43.6%) and irritant contact dermatitis (13.0%/13.3%) were similar in the 2 groups. The diagnosis of atopic dermatitis was less common in the white patients (8.9%) as compared with the black patients (13.3%). Positive patch test reactions rates were similar for most allergens. However, statistically, blacks reacted more frequently to p-phenylenediamine (7.0% vs 4.4%, P < 0.001), bacitracin (11.6% vs 8.3%, P = 0.0004), as well as specific rubber accelerators mercaptobenzothiazole (2.7% vs 1.8%), thiuram (6.2% vs 4.3%), and mercapto mix (1.9% vs 0.8%, P < 0.001). Whites had an increase in positive reactions to fragrances (12.12% vs 6.77%, P < 0.0001), formaldehyde (9.25% vs 5.45%, P < 0.0001), and some formaldehyde releaser preservatives used in personal care products and textile resins (9.80% vs 6.18%, P < 0.0001). There were statistically different rates of positive patch test reactions to specific allergens between black and white patients suspected of having ACD. The etiology of these differences is unclear but probably relates to culturally determined exposure patterns rather than genetic differences.

Cutaneous Delayed-Type Hypersensitivity to Surfactants

Repeated and prolonged use of surfactants can cause irritant as well as allergic contact dermatitis. This study reports the frequency of positive patch test results to surfactants tested on the North American Contact Dermatitis Group screening series including cocamidopropyl betaine (CAPB), amidoamine (AA), dimethylaminopropylamine (DMAPA), oleamidopropyl dimethylamine (OPD), and cocamide diethanolamide (CDEA), and correlations of positive reactions between CAPB and the other surfactants. This was a retrospective analysis of 10 877 patients patch tested between 2009 and 2014 to the surfactants CAPB, AA, DMAPA, OPD, and CDEA. Frequencies of positive reactions to these surfactants were calculated, and trends of reactivity between the surfactants analyzed. The OPD had the highest rate of positive patch reactions (2.3%) followed by DMAPA (1.7%), and CAPB (1.4%). The AA and CDEA had the lowest rate of positive reactions (0.8%). There was a high degree of overlap in positive patch tests between the surfactants. The CDEA was the least likely to coreact with another surfactant.

SEROLOGICAL EVIDENCE OF EXPOSURE TO &lt;italic&gt;Anaplasma phagocytophilum&lt;/italic&gt; IN HORSES FROM THE RIO DE JANEIRO STATE MOUNTED POLICE BRED IN THE URBAN ZONE

&lt;title&gt;Abstract&lt;/title&gt;&lt;p&gt;&lt;italic&gt;Anaplasma phagocytophilum&lt;/italic&gt; is an emergent hemoparasite in regions where ticks are regularly found. In order to investigate the rate of anti-&lt;italic&gt;A. phagocytophilum&lt;/italic&gt; antibody in horses of the Mounted Police of Rio de Janeiro state and therefore the presence of this agent, 41 horses from the Cavalry Squadron (CS) and 50 from the Regiment of Mounted Police (RMP) were selected. For the serologic diagnosis the Indirect Fluorescent Antibody test was performed. In the present work, among 91 equine sera samples anti-&lt;italic&gt;A. phagocytophilum&lt;/italic&gt; antibodies, with titer ≥ 1:80, were detected in 11 animals (12%), being five (5%) from males and six (7%) females, with no statistical difference. The adult animals with ages varying between five and 14 years presented the highest rate of positive reaction, although antibodies were detected in animals of all ages. We did not observe statistic differences in relation to the presence of anti-&lt;italic&gt;A. phagocytophilum&lt;/italic&gt; antibodies among the animals bred in the CS and RMP. The presence of anti-&lt;italic&gt;A.phagocytophilim&lt;/italic&gt; antibodies in horses of the Mounted Police with no clinical signs is indicative that the parasite is present in the enzootic form among the horses of the urban area. The circulation of the parasite among the animals is not dependent of the presence of tick infestations.&lt;/p&gt;

Lettuce contact allergy.

Lettuce (Lactuca sativa L.) and its varieties are important vegetable crops worldwide. They are also well-known, rarely reported, causes of contact allergy. As lettuce allergens and extracts are not commercially available, the allergy may be underdiagnosed. The aims of this article are to present new data on lettuce contact allergy and review the literature. Lettuce is weakly allergenic, and occupational cases are mainly reported. Using aimed patch testing in Compositae-allergic patients, two recent Danish studies showed prevalence rates of positive lettuce reactions of 11% and 22%. The majority of cases are non-occupational, and may partly be caused by cross-reactivity. The sesquiterpene lactone mix seems to be a poor screening agent for lettuce contact allergy, as the prevalence of positive reactions is significantly higher in non-occupationally sensitized patients. Because of the easy degradability of lettuce allergens, it is recommended to patch test with freshly cut lettuce stem and supplement this with Compositae mix. As contact urticaria and protein contact dermatitis may present as dermatitis, it is important to perform prick-to-prick tests, and possibly scratch patch tests as well. Any person who is occupationally exposed to lettuce for longer periods, especially atopics, amateur gardeners, and persons keeping lettuce-eating pets, is potentially at risk of developing lettuce contact allergy.

Screening for serum biomarkers in patients with chronic hepatitis B with hepatitis B surface antigen seroclearance, following pegylated interferon alpha therapy.

Chronic hepatitis B (CHB) is one of the most common infectious disease worldwide and a leading cause of death. Hepatitis B surface antigen (HBsAg) has previously been proven to be a steady biomarker that may be used to predict clinical outcomes. The amount of circulating HBsAg has been reported to reflect the number of infected hepatocytes. An advantage of pegylated interferon alpha (peg-IFN-α) is that as a finite course of therapy, it can potentially lead to sustained disease remission in subsequent decades. HBsAg seroclearance can reportedly be achieved in some hepatitis B patients treated with peg-IFN-α; this is a major advantage of IFN-α, as compared with nucleoside analogue treatment. In the present study, a random phage display peptide library was used to screen for potential serum peptide biomarkers in predicting which patients with CHB would exhibit HBsAg seroclearance, following 48 weeks of peg-IFN-α therapy. A total of 30 patients with CHB who achieved HBsAg seroclearance following peg-IFN-α therapy and an additional 30 age-, gender-, hepatitis B e antigen (HBeAg) status- and hepatitis B virus genotype-matched patients with CHB without HBsAg seroclearance following peg-IFN-α therapy, were enrolled as a discovery cohort. In the discovery/screening phase, 17/20 of the randomly selected phage clones, exhibited a specific reaction with purified sera immunoglobulin G from the HBsAg clearance group, and 13/17 positive phage clones came from the same phage clone, with the inserted peptide sequence ETCRASCINESA (named IFNC1). In the validation phase, phage-ELISA results showed that the positive reaction rate of the IFNC1 peptide phage clone was 92.0% with the HBsAg seroclearance group (n=50), which was significantly higher, as compared with the randomly selected HBsAg non-clearance group (12.0%, n=50) and the healthy control group (8.0%, n=50). In conclusion, the newly identified mimic peptide IFNC1 showed a high predictive validity HBsAg seroclearance in patients with CHB, following peg-IFN-α therapy. Therefore IFNC1 may be a potential serum biomarker, which could be used to predict the treatment outcomes of peg-IFN-α therapy.

Food hypersensitivity in adult patients with atopic dermatitis in Korea.

It is known that atopic dermatitis (AD) is associated with food or environmental allergens and increased levels of serum IgE. However, the role of hypersensitivity to food antigens in adult patients remains controversial. To evaluate the association between food hypersensitivity and AD in 126 adult Korean participants. Patients with AD were assessed for a previous history of food hypersensitivity that aggravated the symptoms of AD. Blood samples were taken from the patients to measure food allergen-specific IgE. Based on history and laboratory results, open oral food challenge (OFC) tests were performed. Of 126 participants, 33 (26.2%) claimed to have experienced previous food hypersensitivity. Both pork and wheat (n=5 each) were the main foods mentioned, followed by beef (n=4) and shellfish (n=3). We found that 20 participants (15.9%) had raised levels of food-specific IgE, with beef (n=7), pork (n=6), milk (n=5) and wheat (n=5) being the most common (some patients had more than one). However, when the open OFC tests were conducted in 48 participants with self-reported food hypersensitivity or raised levels of food-specific IgE, only one showed a positive reaction; this participant had a previous history of pork consumption exacerbating AD. Although some participants claimed to have a history of AD aggravation related to food intake, when an open OFC test was conducted, few of them had positive results. Our study result indicates that there is a positive reaction rate of only 0.79% for adults. We therefore conclude that adults are less sensitive than children with regard to the association between AD and food hypersensitivity.

Combination of phage display and SEREX for screening early lung cancer associated antigens

To screen out effective lung cancer associated antigens for early diagnosis in order to improve the level of early diagnosis. A T7 phage display cDNA library of human early lung cancer was developed. And then differential phage clones were picked out to be sequenced and bioinformatically analyzed. With the 8 screened differential phage clones a lung cancer associated antigen microarray was established to evaluate the single or combined roles of all the selected antigens in the diagnosis of lung cancer by the reaction of the antigens plus serum from normal subjects and patients with lung cancer, respectively. The titer of the constructed cDNA library was 3.71×10 (6); pfu/ml and the number of phage was 1.11×10 (6); pfu, with a recombination rate of cDNA library over 90%. Nine differential phage clones were initially screened out, but the genes of two antigens (A42 and A83) were found the same. Bioinformatics analyses showed that the genes of the 8 antigens were known before and they were all proven to be related with tumor except A64. The positive reaction rates of the 8 antigens with serum from lung cancer patients were significantly higher than that with serum from normal subjects (Ps<0.05). When keeping specificity no less than 60%, the sensitivity of each antigen in predicting lung cancer alone was under 70% and the areas under curve (AUC) of the antigens were all under 0.8. However, when all the antigens were combined to detect lung cancer, the sensitivity and specificity was 90.8% and 94.1%, respectively, and AUC reached up to 0.969. A T7 phage display cDNA library with a good quality of capacity, recombination rate and representativeness of human early lung cancer was successfully developed, and 8 lung cancer associated antigens were screened out. A combination of the 8 antigens can greatly improve their value to diagnose lung cancer with a higher sensitivity and specificity (both above 90%)．

Clinical availability of component-resolved diagnosis using microarray technology in atopic dermatitis.

BackgroundVarious allergens play a role in the elicitation or exacerbation of eczematous skin lesions in atopic dermatitis (AD), and much research effort has been focused on improving diagnostic tests to identify causative allergens.ObjectiveThe purpose of this study was to evaluate the diagnostic effectiveness of a newly introduced microarray-based specific immunoglobulin E detection assay, ImmunoCAP ISAC, for use in AD patients.MethodsThe serum samples of 25 AD patients were tested by using ISAC and a multiple allergen simultaneous test-enzyme immunoassay (MAST-EIA). In addition, 10 of the 25 patients underwent skin prick testing (SPT). The positive reaction rates to allergens in each test and the agreements, sensitivities, and specificities of ISAC and MAST-EIA were evaluated versus the SPT results.ResultsFor ISAC versus SPT, the overall results were as follows: sensitivity, 90.0%; specificity, 98.2%; positive predictive value (PPV), 90.0%; and negative predictive value (NPV), 98.2%. The total agreement and κ value for ISAC versus SPT were 96.9% and 0.882, respectively. For MAST-EIA versus SPT, the sensitivity was 80.0%, specificity 92.7%, PPV 66.7%, and NPV 96.2%. The total agreement and κ value for MAST-EIA versus SPT were 90.8% and 0.672, respectively. The overall agreement between the ISAC and MAST-EIA results was 88%.ConclusionThe ISAC results in AD correlated well with the SPT results, and compared favorably to the MAST-EIA results. This study demonstrates the potential of ISAC as a convenient allergic diagnostic method in AD patients.

Trends in patch-test results and allergen changes in the standard series: A Mayo Clinic 5-year retrospective review (January 1, 2006, to December 31, 2010)

Patch testing is essential for identification of culprits causing allergic contact dermatitis. We sought to identify trends and allergen changes in our standard series during 2006 to 2010, compared with our previous report (2001-2005). We conducted a retrospective review of patch-test results. A total of 3115 patients were tested with a mean of 73.0 allergens. Since our prior report, 8allergens were added to the standard series; 14 were deleted. Significantly higher rates of allergic positive reaction were documented for carba mix, 3%, and Disperse Orange 3, 1%. Rates were lower for 10 allergens: neomycin sulfate, 20%; gold sodium thiosulfate, 0.5%; hexahydro-1,3,5-tris(2-hydroxyethyl)triazine, 1%; disperse blue 124, 1%; disperse blue 106, 1%; diazolidinyl urea, 1%; hexylresorcinol, 0.25%; diazolidinyl urea, 1% aqueous; 2-bromo-2-nitropropane-1,3-diol, 0.25%; and lidocaine, 5%. Many final patch-test readings for many allergens were categorized as mild reactions (erythema only). Overall allergenicity and irritancy rates declined significantly since our prior report. Results were generally comparable with those in a North American Contact Dermatitis Group report from 2005 to 2006. This was a retrospective study; there is a lack of long-term follow-up. Since our previous report, our standard series composition has changed, and overall rates of allergenicity and irritancy have decreased. Notably, many final patch-test readings showed mild reactions.