Skin Prick Test Reactivity Research Articles

Allerjik rinitli çocuklarda indoor ve outdoor inhalen alerjen prevalansının araştırılması

Objective: The aim of the present study was to determine the prevalence of the aeroallergens sensitivity among children with allergic rhinitis in the province of Istanbul in Turkey, based on skin prick test (SPT) reactivity. Methods: This study, including 729 AR patients with positive SPT, was conducted in three age groups. SPT with extracts including pollens, house dust mites (HDMs), animal dander's (ADs) and molds was performed on these patients. All these patients have a positive reaction to at least one allergen with SPT. Results: The allergen prevalence of 729 patients with positive SPT results was 33% for HDMs, 31% for pollen, 19% for molds and 17% for ADs. The sensitivity to aeroallergens significantly decreased as the age increased (p<0.01). Both outdoor and indoor allergen positivity in preschool children (Group 1) were 89 (43.4%) and in adolescent children (Group 3) were 32 (15.6%), and also sensitivity to allergens significantly decreased according to increase of age (p<0.01). Conclusion: We provided regional allergens profile of children with AR in Istanbul. Avoiding exposure to allergens and finding the best formulation of allergen immunotherapy for AR are important steps in the clinical management of patients.

Early life risk factors for chronic sinusitis: A longitudinal birth cohort study

Chronic sinusitis is a commonly diagnosed condition in adults who frequently present with late-stage disease and irreversible changes to the sinus mucosa. Understanding the natural history of chronic sinusitis is critical in developing therapies designed to prevent or slow the progression of disease. We sought to determine early life risk factors for adult sinusitis in a longitudinal cohort study (Tucson Children's Respiratory Study). Physician-diagnosed sinusitis was reported at age 6. Adult sinusitis between 22 and 32years was defined as self-reported sinusitis plus physician-ordered sinus radiologic films. Atopy was assessed by skin prick test. Individuals were grouped into 4 phenotypes: no sinusitis (n=621), transient childhood sinusitis only (n=57), late-onset adult sinusitis only (n=68), and early onset chronic sinusitis (childhood and adult sinusitis, n=26). Sinusitis was present in 10.8% of children and 12.2% of adults. Childhood sinusitis was the strongest independent risk factor for adult sinusitis (odds ratio=4.2; 95% CI: 2.5-7.1; P<.0001; n=772). Early onset chronic sinusitis was associated with increased serum IgE levels as early as at 9months of age, atopy (assessed by skin prick test reactivity), childhood eczema and allergic rhinitis, frequent childhood colds, maternal asthma, and with increased prevalence of concurrent asthma. No association was found between late-onset adult sinusitis and any of the early life risk factors studied. We identified an early onset chronic sinusitis phenotype associated with a predisposition to viral infections/colds in early life, allergies, and asthma. Elucidation of the molecular mechanisms for this phenotype may lead to future therapies to prevent the progression of the disease into adult sinusitis.

Component-resolved diagnosis in selecting patients for yellowjacket venom immunotherapy

BackgroundVenom immunotherapy is effective in preventing systemic allergic reactions (SARs), but the diagnosis of venom allergy is problematic. ObjectiveTo compare the performance of component-resolved diagnosis and conventional tests in patients referred for venom immunotherapy. MethodsWe measured serum-specific immunoglobulin E to yellowjacket and honeybee venoms (Ves v 1 and Ves v 5 and Api m 1), cross-reactive carbohydrate determinants, serum basal tryptase (ImmunoCAP, ThermoFisher Scientific, Uppsala, Sweden), and skin prick test reactions in 84 patients referred to receive venom immunotherapy. History of SAR and its severity were evaluated. ResultsOf the 78 patients with suspected yellowjacket venom (YJV) allergy, a history of SAR was confirmed in 47 (60%) and 31 (40%) had a non-SAR reaction. The most accurate tests to confirm venom allergy after a SAR were serum-specific immunoglobulin E to yellowjacket whole-venom extract spiked with Ves v 5 (area under the curve 0.87, 95% confidence interval 0.77–0.97, P < .001) and Ves v 5 (area under the curve 0.86, 95% confidence interval 0.76–0.96, P < .001). Sensitization to Ves v 1 was infrequent and its area under the curve was low (0.62, 95% confidence interval 0.47–0.76, P = .106). Sensitivity of the YJV skin prick test was 86%, but its specificity was low at 54%. Double sensitization to yellowjacket and honeybee occurred frequently in skin prick tests. Of the patients without a SAR, 26% showed a positive reaction to YJV in any serum test and 46% showed a positive reaction in skin tests. ConclusionSpecific immunoglobulin E to the YJV spiked with Ves v 5 confirmed the allergy after a SAR. A history of SAR should be confirmed before testing, because venom sensitization is frequent in other types of reactions.

Skin prick test reactivity to aeroallergens in adult allergy clinic in Thailand: a 12-year retrospective study.

BackgroundThe global prevalence of allergic rhinitis, asthma, and atopic dermatitis has risen significantly over the last 2 decades. Allergic sensitization to aeroallergen is a major risk factor in developing the allergic disease. The prevalence of aeroallergen sensitization varies in different regions and countries.ObjectiveTo determine the prevalence of common aeroallergen sensitization and the atopic status among adult patients.MethodsA cross-sectional, retrospective study. The data were collected from medical records and database of the result of skin prick test of patients who had the allergic symptoms or chronic urticaria in adult allergy clinic, Ramathibodi hospital from January 2004 to December 2015.ResultsA total of 1,516 of patients (female, 1,118 [73.7%]) were enrolled. The mean ages of participants were 41.34 (standard deviation, ±16.5) years. Fifty-eight percent (58%) of patients were diagnosed with allergic rhinitis, 19.7%, 3.2%, and 9.2% with asthma, atopic dermatitis, and chronic urticaria respectively. In the chronic urticaria group, 57.4% underwent the positive skin prick test to common aeroallergens. Mites were responsible for the most common inhaled allergen sensitization in this study as 50.1% of Dermatophagoides pteronyssinus, 32% of Dermatophagoides farinae, and 31.5% of house dust. Cockroach was the second most common aeroallergen sensitization as 32.3% followed by grass pollen, Bermuda (21.1%) and timothy (13.6%). The animal dander, cat and dog, occupied 12.9 and 10% respectively.ConclusionMites were the most common cause of aeroallergen sensitization in all patients followed by cockroach, grass pollen, and animal dander. However, Bermuda sensitization has increased significantly in the last 6 years.

Is the “farm effect” hypothesis still current? Atopy and allergic diseases in rural and urban children in Poland

ABSTRACTObjective: The prevalence of allergic diseases has reached epidemic proportions in the Western world. Although farm-living has been associated with a lower prevalence of asthma and atopy, a marked increase in atopy among rural populations after accession to the European Union has been recently reported in Poland. Here, we aimed to investigate the effect of living environment on the prevalence of atopy and allergic diseases in Polish children. Methods: 400 schoolchildren aged 10–14 years from the capital city (223) and from traditional rural part of the country (177) were recruited from June to November 2011. Data on allergic diseases and symptoms were collected by means of questionnaire and physical examination. Atopy was assessed based on skin prick tests (SPTs) reactivity to inhalant allergens in 350 children. Results: A high discrepancy between the prevalence of allergic symptoms (46.7%) and doctor-diagnosed allergic diseases (25%) was demonstrated (p < 0.0001). Urban children had a higher overall prevalence of allergic diseases and atopy than children living in rural areas, 29.3% versus 17.1% (p = 0.007) and 33.5% versus 20% (p = 0.0045), respectively. However, no significant differences in the rates of particular allergic diseases were noted (p > 0.05). There was higher SPT positivity to trees, grass, corn, weeds, animal dander, and molds in urban children (p < 0.05). Conclusions: Our data support the protective effect of farm-living on the prevalence of atopy and overall allergic diseases, albeit not on particular allergic diseases, in children in Poland. The underlying mechanisms are not identified, but current socioeconomic changes may be responsible.

Decreased expression of indolamine 2,3-dioxygenase in childhood allergic asthma and its inverse correlation with fractional concentration of exhaled nitric oxide

BackgroundThe tryptophan metabolic pathway mediated by indolamine 2,3-dioxygenase (IDO), a tryptophan-degrading enzyme, plays an important role in controlling the development of allergic inflammation. The fractional concentration of exhaled nitric oxide (FeNO) is closely associated with the allergic state and is extensively used for the clinical evaluation of airway allergic inflammation. Clinical trials have rarely assessed the expression of IDO in childhood allergic asthma and its correlation with FeNO. ObjectiveTo evaluate the IDO level in children with childhood allergic asthma and the relation between IDO levels and FeNO. MethodsThirty children older than 5 years who were diagnosed the first time with allergic asthma were selected from the pediatric outpatient department. Another 30 healthy children were selected as controls. The subjects were evaluated by complete medical history, pulmonary function test results, skin prick test reaction, FeNO concentration test result, eosinophil count, and a disease severity score. Peripheral venous blood and induced sputum were obtained to measure the concentrations of IDO metabolites (ie, tryptophan and kynurenine). ResultsThe IDO levels in the peripheral blood and induced sputum were significantly lower in patients with childhood allergic asthma than in children in the control group. The IDO level was negatively correlated with FeNO but was not significantly correlated with age, sex, blood eosinophil count, or disease severity scale. ConclusionThe expression of IDO was significantly lower in childhood allergic asthma, particularly in children with high FeNO levels. There was no significant relation between IDO levels and asthma severity. Trial RegistrationChinese Clinical Trial Register (www.chictr.org.cn) Identifier: ChiCTR-COC-15006080.

Postpartum airway responsiveness and exacerbation of asthma during pregnancy - a pilot study.

BackgroundAirway responsiveness and inflammation are associated with the clinical manifestations of asthma and the response to pharmacological therapy.ObjectiveTo investigate if airway responsiveness and inflammatory characteristics are related to asthma exacerbations during pregnancy.Materials and methodsIn women with asthma who were prescribed controller medication and monitored closely during pregnancy, the risk of exacerbations was analyzed in relation to postpartum measures of fractional exhaled nitric oxide (FENO), skin prick test reactivity, static and dynamic lung volumes, diffusing capacity for carbon monoxide, bronchial responsiveness to inhaled mannitol, and inflammatory characteristics in induced sputum. Obtained data were analyzed in relation to exacerbation status during pregnancy. The PD15 is defined as the cumulative administered dose causing a 15% decline in forced expiratory volume in the first second (FEV1).ResultsFifty women (mean age ± standard deviation of 32±5 years) were enrolled over an 11-month period and examined on average 4 months postpartum. During pregnancy, 13 women had a total of 16 exacerbations (8 mild and 8 severe). Women with asthma exacerbation during pregnancy had more pronounced airway responsiveness to inhaled mannitol (geometric mean PD15 82 vs 171 mg, p=0.04) and were less likely to be atopic (62% vs 86%, respectively; p=0.04) than the non-exacerbators. No statistically significant difference was found between the 2 groups of women with regard to type of airway inflammation in sputum and fractional exhaled nitric oxide (FENO).ConclusionMore pronounced airway hyperresponsiveness together with nonatopic status appears to characterize women at high risk of exacerbation of asthma during pregnancy.

Effect of Early-Life Geohelminth Infections on the Development of Wheezing at 5 Years of Age.

Exposures to geohelminths during gestation or early childhood may reduce risk of wheezing illness/asthma and atopy during childhood in tropical regions. To investigate the effect of maternal and early childhood geohelminths on development of wheeze/asthma and atopy during the first 5 years of life. A cohort of 2,404 neonates was followed to 5 years of age in a rural district in coastal Ecuador. Data on wheeze were collected by questionnaire and atopy was measured by allergen skin prick test reactivity to 10 allergens at 5 years. Stool samples from mothers and children were examined for geohelminths by microscopy. A total of 2,090 (86.9%) children were evaluated at 5 years. Geohelminths were observed in 45.5% of mothers and in 34.1% of children by 3 years. Wheeze and asthma were reported for 12.6% and 5.7% of children, respectively, whereas 14.0% had skin test reactivity at 5 years. Maternal geohelminths were associated with an increased risk of wheeze (adjusted odds ratio, 1.41; 95% confidence interval, 1.06-1.88), whereas childhood geohelminths over the first 3 years of life were associated with reduced risk of wheeze (adjusted odds ratio, 0.70; 95% confidence interval, 0.52-0.96) and asthma (adjusted odds ratio, 0.60; 95% confidence interval, 0.38-0.94) but not skin prick test reactivity. The effects on wheeze/asthma were greatest with later age of first infection, were observed only in skin test-negative children, but were not associated with parasite burden or specific geohelminths. Although maternal exposures to geohelminths may increase childhood wheeze, childhood geohelminths during the first 3 years may provide protection through a nonallergic mechanism. Registered as an observational study (ISRCTN41239086).

Eight Aeroallergen Skin Extracts May Be the Optimal Panel for Allergic Rhinitis Patients in Central China

Background: The prevalence of allergic rhinitis (AR) is increasing rapidly in Central China. The skin prick test (SPT) is the standard tool with which to determine the allergen sensitization status in AR patients. Changes in allergen sensitization patterns have been observed within countries and regions due to geographical and seasonal variations. Objective: The aim of this study was to evaluate the profile of SPT reactivity to different aeroallergens in AR patients and to suggest a minimal panel of allergens to detect sensitized patients in Central China. Methods: From January 2015 to December 2016, patients who presented to Tongji Hospital with suspected AR were tested with the same panel of 19 aeroallergens. The results of SPT were analyzed to determine the minimum test battery panel necessary to cover 99% of the cases of SPT sensitization in different age subgroups. Results: A total of 2,416 patients (male:female ratio 1.2:1) were enrolled in our study with an average age of 22.0 years. The overall rate of sensitization to any allergen was 79.0%, and 64.3% of the subjects were monosensitized. The highest sensitized rate was found in the subgroup aged 14-18 years (92.0%), followed by the subgroups of 6-14 years (86.4%), >18 years (75.6%), and ≤6 years (74.9%). The most common sensitization was to Dermatophagoides farinae (71.1%). Testing with 8 allergens (D. pteronyssinus, D. farinae, Platanus, Artemisia, Cryptomeria, Blatella germanica, Humulus, and Alternaria) was sufficient to identify over 99% of the sensitized patients. Conclusion: An SPT panel covering 8 allergen extracts was able to detect almost all sensitized patients suffering from AR symptoms in Central China.

Sesame allergy in adults: Investigation and outcomes of oral food challenges

Sesame (Sesamum indicum) allergy is the most common seed allergy and has been increasingly reported worldwide. [1] Gangur V. Kelly C. Navuluri L. Sesame allergy: a growing food allergy of global proportions?. Ann Allergy Asthma Immunol. 2005; 95: 4-11 Abstract Full Text PDF PubMed Google Scholar The variation in prevalence between populations is likely due to different food habits and awareness. Similar to peanut, immunoglobulin E (IgE)-mediated sesame allergy begins early in life (usually before 2 years of age) and persists in 80% of patients. [2] Cohen A. Goldberg M. Levy B. et al. Sesame food allergy and sensitization in children: the natural history and long-term follow-up. Pediatr Allergy Immunol. 2007; 18: 217-223 Crossref PubMed Scopus (78) Google Scholar Clinical manifestations range from mucocutaneous, respiratory, and gastrointestinal manifestations to life-threatening systemic anaphylaxis. Therefore, accurate diagnosis of sesame allergy is crucial but the value of skin prick tests (SPTs) and sesame-specific IgE (sIgE) has been questioned. Previous studies, largely performed in children, have suggested that neither test sufficiently predicts true allergy as determined by oral food challenges (OFCs). 3 Kanny G. De Hauteclocque C. Moneret-Vautrin D.A. Sesame seed and sesame seed oil contain masked allergens of growing importance. Allergy. 1996; 51: 952-957 Crossref PubMed Scopus (116) Google Scholar , 4 Leduc V. Moneret-Vautrin D.A. Tzen J.T. et al. Identification of oleosins as major allergens in sesame seed allergic patients. Allergy. 2006; 61: 349-356 Crossref PubMed Scopus (144) Google Scholar , 5 Permaul P. Stutius L.M. Sheehan W.J. et al. Sesame allergy: role of specific IgE and skin-prick testing in predicting food challenge results. Allergy Asthma Proc. 2009; 30: 643-648 Crossref PubMed Scopus (30) Google Scholar This is of particular concern because anaphylaxis has been reported in adult patients with negative SPT reactions and sIgE levels. [3] Kanny G. De Hauteclocque C. Moneret-Vautrin D.A. Sesame seed and sesame seed oil contain masked allergens of growing importance. Allergy. 1996; 51: 952-957 Crossref PubMed Scopus (116) Google Scholar We performed a retrospective evaluation of the utility of SPT, sIgE, and other clinical parameters in predicting sesame allergy confirmed by OFC reactions in adults.

Results from the 5-year SQ grass sublingual immunotherapy tablet asthma prevention (GAP) trial in children with grass pollen allergy

Allergy immunotherapy targets the immunological cause of allergic rhinoconjunctivitis and allergic asthma and has the potential to alter the natural course of allergic disease. The primary objective was to investigate the effect of the SQ grass sublingual immunotherapy tablet compared with placebo on the risk of developing asthma. A total of 812 children (5-12years), with a clinically relevant history of grass pollen allergic rhinoconjunctivitis and no medical history or signs of asthma, were included in the randomized, double-blind, placebo-controlled trial, comprising 3years of treatment and 2years of follow-up. There was no difference in time to onset of asthma, defined by prespecified asthma criteria relying on documented reversible impairment of lung function (primary endpoint). Treatment with the SQ grass sublingual immunotherapy tablet significantly reduced the risk of experiencing asthma symptoms or using asthma medication at the end of trial (odds ratio=0.66, P<.036), during the 2-year posttreatment follow-up, and during the entire 5-year trial period. Also, grass allergic rhinoconjunctivitis symptoms were 22% to 30% reduced (P<.005 for all 5years). At the end of the trial, the use of allergic rhinoconjunctivitis pharmacotherapy was significantly less (27% relative difference to placebo, P<.001). Total IgE, grass pollen-specific IgE, and skin prick test reactivity to grass pollen were all reduced compared to placebo. Treatment with the SQ grass sublingual immunotherapy tablet reduced the risk of experiencing asthma symptoms and using asthma medication, and had a positive, long-term clinical effect on rhinoconjunctivitis symptoms and medication use but did not show an effect on the time to onset of asthma.

Natural history of skin prick test reactivity: A 20-year prospective study of a random population sample of children and adolescents

BackgroundAllergic reactions to airborne allergens may have important consequences for affected individuals and are believed to be unstable through life, although evidence from longitudinal studies is limited. ObjectiveTo assess changes in skin prick reactivity during 20 years in a random population sample of children and adolescents in relation to symptoms of rhinitis. MethodsA total of 983 individuals, aged 7 to 17 years, were randomly selected in 1986 and invited to 4 examinations during a 20-year period. During each examination, a skin prick test was performed using common local aeroallergens (ie, birch, grass, mugwort, horse, dog, cat, house dust mite [Dermatophagoides pteronyssinus and Dermatophagoides farinae] and 2 molds [Alternaria iridis and Cladosporium herbarum]). ResultsThe prevalence of allergy to any tested allergen peaked at the ages of 13 to 23 years. Rates of sensitization were variable. In the group of individuals tested more than once (n = 592), 16% developed sensitization during the study period and 9% became desensitized. In the group of individuals tested at all 4 examinations (n = 148), 34% developed sensitization and 22% became desensitized. In the group who developed sensitization, 55% had rhinitis, 17% had asthma, and 70% had eczema. In the group who became desensitized, 30% had rhinitis, 10% had asthma, and 50% had eczema. ConclusionThis 20-year prospective study found that sensitization is common, but its prevalence in individuals is also variable over time. Furthermore, through puberty and early adulthood a large number of individuals develop sensitization and a smaller number become desensitized. In addition, we found that symptoms of rhinitis rarely preceded sensitization.

Birth decade affects the sensitization pattern and asthma risk in Finnish adult population.

We have previously shown that sensitizations to several types of allergens distinguish subjects with and without adult-onset asthma in Finland. The aim was to analyze how age affects sensitization and asthma risk. We used previous population-based case-control data (N=456) from Finnish adult asthma patients with one or two matched controls. Asthma was diagnosed based on a typical history of asthmatic symptoms and lung function tests. Allergic sensitization was determined by skin prick test (SPT) to 17 aeroallergens. Information on demographics was obtained by a questionnaire. Sensitization to more than one allergen type and the number of positive SPT reactions associated with younger age and asthma. Atopic subjects aged 65 and above were characterized by sensitization to only one to two allergens, with very few animal danders and without an association with asthma. Multiple sensitizations and animal dander sensitization are more common among Finnish asthmatic adults aged under 56 than among older asthmatics. Cohort studies are needed to understand timing of host-environmental interactions behind this.

Dissociation between skin test reactivity and anti-aeroallergen IgE: Determinants among urban Brazilian children.

BackgroundThe dissociation between specific IgE and skin prick test reactivity to aeroallergens, a common finding in populations living in low and middle-income countries, has important implications for the diagnosis and treatment of allergic diseases. Few studies have investigated the determinants of this dissociation. In the present study, we explored potential factors explaining this dissociation in children living in an urban area of Northeast Brazil, focusing in particular on factors associated with poor hygiene.MethodsOf 1445 children from low income communities, investigated for risk factors of allergies, we studied 481 with specific IgE antibodies to any of Blomia tropicalis, Dermatophagoides pteronyssinus, Periplaneta americana and Blatella germanica allergens. Data on demographic, environmental and social exposures were collected by questionnaire; serum IgG and stool examinations were done to detect current or past infections with viral, bacterial, protozoan and intestinal helminth pathogens. We measured atopy by skin prick testing (SPT) and specific IgE (sIgE) to aerollergens in serum (by ImmunoCAP). SIgE reactivity to B. tropicalis extract depleted of carbohydrates was measured by an in-house ELISA. Total IgE was measured by in house capture ELISA. SNPs were typed using Illumina Omni 2.5.ResultsNegative skin prick tests in the presence of specific IgE antibodies were frequent. Factors independently associated with a reduced frequency of positive skin prick tests were large number of siblings, the presence of IgG to herpes simplex virus, Ascaris lumbricoides and Trichuris trichiura infections, living in neighborhoods with infrequent garbage collection, presence of rodents and cats in the household and sIgE reactivity to glycosylated B. tropicalis allergens. Also, SNP on IGHE (rs61737468) was negatively associated with SPT reactivity.ConclusionsA variety of factors were found to be associated with decreased frequency of SPT such as unhygienic living conditions, infections, total IgE, IgE response to glycosylated allergens and genetic polymorphisms, indicating that multiple mechanisms may be involved. Our data, showing that exposures to an unhygienic environment and childhood infections modulate immediate allergen skin test reactivity, provide support for the “hygiene hypothesis”.

Diagnosis of red meat allergy with antigen-specific IgE tests in serum

Red meat allergy is a tick-associated hypersensitivity reaction to galactose-α-1,3-galactose (α-gal) and is characterized by anaphylaxis, angioedema, urticaria and/or gastrointestinal symptoms occurring 3–6 hours after ingesting red meat such as beef, pork, or lamb. Diagnosis of red meat allergy is challenging due to the unusually long delay in symptom onset and poor sensitivity of skin prick tests with commercial meat extracts. The primary diagnostic tools available for this disease are quantification of α-gal-, beef-, pork-, and/or lamb-specific IgE in serum, however the diagnostic performance of these tests has not been reported. Using patient data for n=135 patients with red meat allergy and n=37 controls, we found that measurement of α-gal-specific IgE using the bovine thyroglobulin (bTG) ImmunoCAP method had the best overall sensitivity (100%) and specificity (92.3%) for diagnosis of red meat allergy. Measuring α-gal-specific IgE using the streptavidin (SA)-CAP technique or beef- or pork-specific IgE using ImmunoCAP were also effective tests with high sensitivities (89–92%) and variable specificities (65–82%). Lamb-specific IgE and total IgE had essentially no diagnostic value for red meat allergy. Positive and negative predictive values mirrored these trends. Taken together, these findings indicate that the α-gal-specific IgE test by bTG ImmunoCAP is the most useful for establishing a diagnosis of red meat allergy, although α-gal-specific IgE by SA-CAP and beef- and pork-specific IgE by ImmunoCAP are also effective tests.

Opisthorchis felineus negatively associates with skin test reactivity in Russia-EuroPrevall-International Cooperation study.

Most studies on the relationship between helminth infections and atopic disorders have been conducted in (sub)tropical developing countries where exposure to multiple parasites and lifestyle can confound the relationship. We aimed to study the relationship between infection with the fish-borne helminth Opishorchis felineus and specific IgE, skin prick testing, and atopic symptoms in Western Siberia, with lifestyle and hygiene standards of a developed country. Schoolchildren aged 7-11 years were sampled from one urban and two rural regions. Skin prick tests (SPT) and specific IgE (sIgE) against food and aeroallergens were measured, and data on allergic symptoms and on demographic and socioeconomic factors were collected by questionnaire. Diagnosis of opisthorchiasis was based on PCR performed on stool samples. Of the 732 children included, 34.9% had opisthorchiasis. The sensitization to any allergen when estimated by positive SPT was 12.8%, while much higher, 24.0%, when measured by sIgE. Atopic symptoms in the past year (flexural eczema and/or rhinoconjunctivitis) were reported in 12.4% of the children. SPT was positively related to flexural eczema and rhinoconjunctivitis, but not to wheezing. Opisthorchiasis showed association with lower SPT response, as well as borderline association with low IgE reactivity to any allergen. However, the effect of opisthorchiasis on SPT response was not mediated by IgE, suggesting that opisthorchiasis influences SPT response through another mechanism. Opisthorchiasis also showed borderline association with lower atopic symptoms. There is a negative association between a chronic helminth infection and skin prick test reactivity even in a developed country.

Prevalence of aeroallergens in patients of bronchial asthma and/or allergic rhinitis in India based on skin prick test reactivity

Background: Exposures to various aeroallergens play a crucial role in the pathogenesis of bronchial asthma (BA) and allergic rhinitis (AR). On the basis of climate change, the prevalence of aeroallergens may vary in different regions. AIMS: The aim of the study was to determine the prevalence of the sensitivity to aeroallergens among patients with BA and/or AR based on skin prick test (SPT) reactivity in India. Settings And Design: This study was conducted at National Centre of Respiratory Allergy, Asthma and Immunology and Department of Respiratory Allergy and Applied Immunology, (Department of Respiratory Medicine), Vallabhbhai Patel Chest Institute, University of Delhi, Delhi-110007 (India). Subjects And Methods: A total of 4835 patients were screened from the Outpatient Department of institute during the period of August 2008 to July 2016. Out of 4835 patients, 4263 patients were performed SPT consisting of 2361 (55.38%) males and 1902 (44.62%) females, with a mean age of 30.06 years were included in the study. Diagnosis of BA and AR was made according to the GINA and ARIA guidelines, respectively. SPT was done with 58 different types of aeroallergens, which included grass pollens, weed pollens, tree pollens, dust, fungi, insects, kapok cotton, wool, and silk antigens. Statistical Analysis Used: Data analysis was done using Excel 2007. Results: Significant skin positive reaction (2 + and above) against aeroallergens were found in 1993 (46.77%) participants including 422 (9.9%) BA patients, 570 (13.37%) AR patients, and 1001 (23.48%) of both BA/AR. The younger adults aged 20–29 years were the foremost commonly affected group with 626 (14.68%) significant skin-positive patients. Among individual allergens, most common aeroallergen was mosquito (30.89%) and least common was Ehretia (0.37%). Conclusions: In different states of India, the mosquito was found the most common sensitizing allergen in BA and/or AR patients. Sensitization was the most common in the younger age group (20–29 years) patients.

Mechanisms, safety and efficacy of a B cell epitope-based vaccine for immunotherapy of grass pollen allergy

BackgroundWe have developed a recombinant B cell epitope-based vaccine (BM32) for allergen-specific immunotherapy (AIT) of grass pollen allergy. The vaccine contains recombinant fusion proteins consisting of allergen-derived peptides and the hepatitis B surface protein domain preS as immunological carrier. MethodsWe conducted a randomized, double-blind, placebo-controlled AIT study to determine safety, clinical efficacy and immunological mechanism of three subcutaneous injections of three BM32 doses adsorbed to aluminum hydroxide versus aluminum hydroxide (placebo) applied monthly to grass pollen allergic patients (n=70). Primary efficacy endpoint was the difference in total nasal symptom score (TNSS) through grass pollen chamber exposure before treatment and 4weeks after the last injection. Secondary clinical endpoints were total ocular symptom score (TOSS) and allergen-specific skin response evaluated by titrated skin prick testing (SPT) at the same time points. Treatment-related side effects were evaluated as safety endpoints. Changes in allergen-specific antibody, cellular and cytokine responses were measured in patients before and after treatment. ResultsSixty-eight patients completed the trial. TNSS significantly decreased with mean changes of −1.41 (BM32/20μg) (P=0.03) and −1.34 (BM32/40μg) (P=0.003) whereas mean changes in the BM32/10μg and placebo group were not significant. TOSS and SPT reactions showed a dose-dependent decrease. No systemic immediate type side effects were observed. Only few grade 1 systemic late phase reactions occurred in BM32 treated patients. The number of local injection site reactions was similar in actively and placebo-treated patients. BM32 induced highly significant allergen-specific IgG responses (P<0.0001) but no allergen-specific IgE. Allergen-induced basophil activation was reduced in BM32 treated patients and addition of therapy-induced IgG significantly suppressed T cell activation (P=0.0063). ConclusionThe B cell epitope-based recombinant grass pollen allergy vaccine BM32 is well tolerated and few doses are sufficient to suppress immediate allergic reactions as well as allergen-specific T cell responses via a selective induction of allergen-specific IgG antibodies. (ClinicalTrials.gov number, NCT01445002.)

The association between hypovitaminosis D and pediatric allergic diseases: A Korean nationwide population-based study.

There is still considerable disagreement regarding the role of vitamin D in the development or exacerbation of allergic diseases. To investigate the association between serum vitamin D levels and recent symptoms of allergic diseases in elementary schoolchildren. A nationwide cross-sectional survey was conducted in children ages 6-7 years from 45 randomly selected elementary schools. The presence of atopic dermatitis (AD) or asthma was defined as medical treatment of children for AD or asthma within 12 months of the survey. The presence of allergic rhinitis (AR) was defined as medical treatment for AR during the past 12 months and a positive skin test response. Current AD was defined as confirmed eczema on physical examination. Serum 25-hydroxyvitamin D (25[OH]D) was measured by chemiluminescent immunoassay. Questionnaire data and blood samples were collected from 3720 children. The overall prevalence rates of vitamin D insufficiency (20-29 ng/mL) and deficiency (<20 ng/mL) were 64.0% and 18.4%, respectively. For a 1 ng/mL decrease in 25(OH)D, the adjusted odds ratio (aOR) for AR was 1.020 (95% confidence interval [CI], 1.002-1.040) and the aOR for current AD was 1.027 (95% CI, 1.006-1.047). For each 1 ng/mL decrease in 25(OH)D, the aOR for positive skin-prick test reactivity was 1.013 (95% CI, 1.000-1.027). No significant association between vitamin D level and the prevalence of asthma was observed. A high prevalence of vitamin D deficiency and insufficiency was found in Korean elementary schoolchildren, and low vitamin D levels were associated with recent symptoms of AD and AR.

Profils de sensibilisation cutanée aux allergènes respiratoires des patients de la ville de Tétouan (Nord Ouest du Maroc)

The prevalence of respiratory allergies is increasing and is a serious global health problem. The objective of the study was to determine the prevalence of skin sensitization to inhalant allergens in patients consulting for respiratory allergy, to identify the main allergens involved and to evaluate the profile of skin prick-test reactivity related to sex, age and season. This retrospective study included 379 patients consulting during 2009-2012 in three private medical offices of Tetouan. Of the 379 patients, 39.6% were monosensitized and 60.4% polysensitized. The percentages of polysensitized patients were higher in patients exhibiting rhinoconjunctivitis and astma-rhinoconjunctivitis than in subjects with asthma. The prevalence of symptoms according to sex showed no significant difference (P=0.64). Regarding age, a significant difference was observed in the case of rhinoconjunctivitis (P<0.01), while asthma and asthma-rhinoconjunctivitis showed no significant difference. Sensitization to house dust mites was the most frequent followed by grasses, olives and Parietaria. The multiple correspondence analyses (ACM) showed that patients under 20-years of age with asthma and asthma-rhinoconjunctivitis profile are more associated with sensitization to mites during the spring and autumn. The 20-49-year age group was represented mainly by polysensitized patients with rhinoconjunctivitis. Sensitization to mites ranks first in Tetouan followed by the percentage of sensitized patients to grass pollen and olive. The ACM showed that the house dust mite asthma seems to affect more children and adolescents while the 20-49 year age of polysensitized group suffers significantly rhinoconjunctivitis.