Respiratory Allergic Patients Research Articles

Effect of bacteriophages and chamber bitter (Phyllanthus amarus) in combination on Vibrio parahaemolyticus

A Brief Survey of Fungi as Allergen in Respiratory Allergic Patients by Intradermal Skin Sensitivity Test in Terai AreaRachna Chaturvedi and Sushil Chaturvedi

Cockroach allergy in respiratory allergic patients

Cockroach allergy in respiratory allergic patients

Psychological impact of the COVID-19 pandemic on patients with allergic diseases

BackgroundOn March 2020, World Health Organization (WHO) declared COVID-19 to be a pandemic disease. Interactions between allergy-related inflammatory and psychiatric disorders including depression, anxiety, and post-traumatic stress disorder (PTSD) have been documented. Therefore, those who have pre-existing allergic conditions may have an increased psychiatric reaction to the stresses of the COVID-19 pandemic. ObjectiveIdentify the psychological impact of COVID-19 in patients with allergic diseases and determine if these individuals have a greater risk of presenting with post-traumatic stress disorder (PTSD). MethodsIt is a cross-sectional, survey-based study designed to assess the degree of symptoms of depression and the risk of PTSD using the Patient Health Questionnaire (PHQ-9) and the Impact of Event Scale–Revised (IES-R), respectively, in allergic patients. ResultsA total of 4106 surveys were evaluated; 1656 (40.3%) were patients with allergic disease, and 2450 (59.7%) were non-allergic (control) individuals. Of those with allergies, 76.6% had respiratory allergic disease including asthma and allergic rhinitis. Individuals with allergic disease reported higher scores regarding symptoms of PTSD on the IES-R scale (p = 0.052, OR 1.24 CI 0.99–1.55) as well as a higher depression risk score in the PHQ-9 questionnaire (mean 6.82 vs. 5.28) p = 0.000 z = −8.76.The allergy group presented a higher score in the IES-R questionnaire (mean 25.42 vs. 20.59), being more susceptible to presenting PTSD (p = 0.000, z = −7.774).The individuals with allergic conditions were further divided into subgroups of those with respiratory allergies such as allergic rhinitis and asthma vs those with non-respiratory allergies such as drug and food allergy, urticaria and atopic dermatitis. This subgroup analysis compares respiratory versus non-respiratory allergic patients, with similar results on the IES-R (mean 25.87 vs 23.9) p = 0.0124, z = −1.539. There was no significant difference on intrusion (p = 0.061, z = −1.873) and avoidance (p = 0.767, z = −0.297), but in the hyperarousal subscale, patients with respiratory allergy had higher scores (mean 1.15 vs. 0.99) p = 0.013 z = −2.486. ConclusionsPsychological consequences such as depression and reported PTSD are present during the COVID-19 pandemic causing an impact particularly in individuals with allergic diseases. If we acknowledge the impact and how it is affecting our patients, we are able to implement interventions, follow up, and contribute to their overall well-being.

Antimicrobial activity of the lichens Parmotrema andium and Dirinaria applanata

A Brief Survey of Fungi as Allergen in Respiratory Allergic Patients by Intradermal Skin Sensitivity Test in Terai AreaRachna Chaturvedi and Sushil Chaturvedi

Food IgE-Sensitization in Respiratory Allergic Patients in Jakarta

Food allergy and respiratory allergy may co-exist in atopic person. Although both conditions can worsen allergic symptoms, food allergen sensitization has not gain much attention in clinical studies. The aim of this study is to evaluate food IgE sensitization in respiratory allergic patients. This was a cross-sectional study in patients with a history of respiratory allergy in Jakarta, on September to December 2016. Adult asthmatic patients aged 19-60 years were invited to undergo serum specific IgE testing at the Allergy and Immunology Clinic, Cipto Mangunkusumo Hospital, Jakarta. Patients were included if they showed at least one positive skin prick test with environmental allergens. Quantitative determination of specific IgE in serum was carried out by multiple allergosorbent test. Serum specific IgE levels of more than 0.35 kU/L or Class 1 was considered positive. A total of 100 subjects were eligible for analysis; 76% were women. Patients mean age was 38.8 + 12.1 (range 19-59) years old; 62% of the patients have both asthma and allergic rhinitis. There are 46% patients with at least one positive food-IgE sensitization. The most common sensitization was to shrimp (17%), followed by fruit-mix (14%), goat milk (13%), crab (13%), potato (13%), soybean (11%), and strawberry (11%). Significant difference of IgE sensitization was found between house dust mites and crab or shrimp and between cockroach and crab or shrimp. In conclusion food-IgE sensitization in respiratory allergic patients is common. The most common allergens were shrimp, fruit-mix, goat milk, crab, and potato.

Sensitization to food and pollen allergens and their implication for travelers with respiratory allergies

Respiratory allergies, i.e. asthma and allergic rhinitis, are typically induced by inhalant allergens such as house dust mite allergens. During travel, these persons may also be exposed to other type of allergens that potentially trigger hypersensitivity reactions. However, sensitization pattern of respiratory allergic patients to allergens associated with traveling (such as peanut, sea food, and grass pollens) is not known. The aim of this study was to evaluate allergen sensitization pattern among adult patients with respiratory allergies. A cross-sectional study was done in respiratory allergic patients between September and December 2016. Adult asthmatic patients aged 19 to 60 years were invited to undergo skin prick test at the Allergy and Immunology Clinic, Cipto Mangunkusumo Hospital, Jakarta. A total of 105 cases were enrolled; 80 (76.2%) were women. Sixty-two patients (59%) had both asthma and allergic rhinitis. Sensitization to food allergens was mostly found to shrimp (36.2%), egg (33.3%), crab (30.5%), peanut (28.6%) and tuna (28.6%), while sensitization to grass pollens was found in 11.4% patients. As conclusion, about 72.4% people with a history of asthma or allergic rhinitis triggered by the house dust mites are also sensitive to at least one food allergen and 11.4% was sensitive to grass pollens. These allergens are potential inducers of allergic symptoms when traveling or holiday, especially during air-travel (peanut allergy) or spring season (pollen allergy).

Skin prick test analysis reveals cross-sensitization to tomato profilin and grass pollen in nasobronchialallergic patients with history of tomato food allergy.

The association between grass pollen sensitization and food allergy to tomato is of great interest. We report here, the first such study in Indian population. We investigated 246 allergic rhinitis / asthma patients by diagnostic case history and skin prick test (SPT); grass pollen mix, tomato extract and purified tomato profilin were used for SPT. Tomato profilin was purified by affinity chromatography, and analyzed by HPLC (95% purity) and SDS-PAGE (14 kDa). We observed that 38% of the patients had sensitization to both grass pollen and tomato fruit, of which 92% were sensitized to tomato profilin. Among patients with a history of food allergy to tomato fruit, the association was more pronounced (66%). Tomato profilin appears to be an important cross-sensitizing panallergen in respiratory allergic patients in the Indian subcontinent.

Identification of airborne pollens in Delhi

Aims: To quantify and identify the pollen grains in the atmosphere of Delhi. Settings and Design: The study was conducted at the National Centre of Respiratory Allergy, Asthma and Immunology, Vallabhbhai Patel Chest Institute (VPCI), University of Delhi, Delhi, India. Subjects and Methods: The study was conducted for 2 months at VPCI, University of Delhi (North Campus), Delhi. Pollen grains were collected on a daily basis using 24-h Burkard (UK) volumetric air sampler. Trapped pollen film was stained with a fuchsin stain that is protected with a cover slip and examined under a light microscope. Identification was done with the help of manuals for pollen identification. Statistical Analysis Used: Data analysis was done by Microsoft Excel 2007. Results: In this study period (April and May 2017), a total of 10,858/m3 pollens were counted; of these, 7758/m3 pollens of 34 species of trees, weeds, and grasses were identified. Overall, Juniper sp. (1385/m3) pollen of tree was found to be the most dominant pollen, followed by Cannabis sativa (726/m3), Pooideae grasses (e.g. Poa sp., Lolium perenne, Dactylis glomerata) (654/m3), Cynodon dactylon (509/m3), Amaranthus sp. (506/m3), Artemisia sp. (460/m3), Cassia sp. (447/m3), Chenopodium album (412/m3), Helenium autumnale (381/m3), and Parthenium (301/m3). Juniper sp. (1310/m3) pollens in April 2017 and C. sativa (421/m3) pollens in May 2017 have shown their dominance. Conclusions: In our study, various pollens of different plant species were counted and identified in this short study period. The common pollens found were Juniper sp., C. sativa, Pooideae grasses (e.g. Poa sp., Lolium perenne, Dactylis glomerata), C. dactylon, Amaranthus sp., C. album, H. autumnale, Parthenium, and Artemisia sp. in 2 months. This short study may be helpful for the respiratory allergic patients to protect themselves by pollens.

Fungal Pollution in the Homes of Respiratory Allergic Patients in Mashhad City, Northeast Iran

Background: Fungal spores are ubiquitous constituents indoors and outdoors and are now generally identified as important causes of respiratory allergies.Objectives: This study aims to evaluate the frequency and prevalence of allergens with fungal origin at homes of allergic patients with respiratory symptoms in the city of Mashhad, Iran.Methods: In this cross-sectional study, a group of patients with allergic rhinitis (n = 50) were selected based on positive skin prick test. Healthy volunteers with no respiratory allergy were included in control group with the same age as diseased group. Samples from nasal cavity and different parts of bedroom were collected and cultured. The fungal agents were recognized by conventional mycological methods based on the cultural and microscopic appearance as properties.Results: Colonization with fungi was obtained in 26% - 64% and 86-98% of the patient and healthy groups, respectively. Among all species isolated from specimens of the patients, A.flavus was dominant which followed by A. niger, Penicillium and Cladosporium whereas the most commonly isolated fungi from the whole specimens of healthy subjects were A. flavus, A. fumigatus, A. niger, Penicillium, Yeast, Alternaria and Cladosporium. Conclusions: Fungi can be hazardous for health. Furthermore, prevention of fungal spores’ growth is important, and also identifying and determining the most common allergen fungi are key steps to provide the necessary recommendations to the patients in controlling and preventing disease.

Serum specific IgE responses to inhalant allergens sensitization

Background: Serum specific immunoglobulin E (ssIgE) sensitization to common inhalant allergens has not been studied in Indonesia. This study aimed to evaluate specific IgE production of common inhalant allergens in patients with asthma and/or allergic rhinitis in Jakarta, Indonesia.Methods: This was a cross-sectional study in adult patients with respiratory allergy from September to December 2016 at Cipto Mangunkusumo Hospital, Jakarta. Patients were included if they showed at least one positive skin prick test (SPT) to environmental allergens. Serum specific IgE was assayed by using multiple allergosorbent methods. Inhalant allergens tested were dust mites, pollen, cockroach, animal dander, and mould. Serum IgE level more than 0.35 kU/L was considered positive.Results: One hundred subjects were enrolled (76% women). Dust mites made up 75% of sensitization, followed by cat/dog (31%), cockroach (27%), pollen (24%), and mould (6%). Almost all patients sensitized to cockroach, pollen, cat/dog epithelia and mould were also co-sensitized with dust mites. Twenty two percent of patients were negative to all tested allergens.Conclusion: IgE-sensitization to inhalant allergens varies widely in respiratory allergic patients. House dust and storage mites are the most common allergens. About one-fifth of the subjects did not show specific-IgE sensitization. Thus, this test should always be combined with SPT to diagnose allergy.

P062 Modulation of allergen specific IgE and IgG4 responses after sublingual immunotherapy in respiratory allergic patients

P062 Modulation of allergen specific IgE and IgG4 responses after sublingual immunotherapy in respiratory allergic patients

A Study on T Regulatory Cells in Patients with Respiratory Allergies in Zagazig University Allergy and Immunology Unit

Background: A positive autologous serum skin test (ASST) reflects the presence of anti-FceRI and/or anti-IgE autoantibodies and used to show autoimmunity in cases with respiratory allergies. Impaired CD4+CD25 high FoxP3+ T regulatory cell activity can cause autoimmune diseases and allergy. Objective: To investigate the association between respiratory allergies and CD4+CD25 high FoxP3+ T regulatory T cell count and re-evaluate the significance of ASST reactivity in respiratory allergy patients and healthy controls. Methodology: 16 patients with persistent asthma, 14 seasonal allergic rhinitis patients and 30 control subjects were included. ASST and measurement of FoxP3+ regulatory T cell count was performed in all subjects. Results: ASST was positive in 18/30 (60%) respiratory allergic patients and none of control subjects. FoxP3+Treg cell count was lower in respiratory allergic patients than control subjects with negative correlation with disease severity. Conclusion: Respiratory allergic patients have lower level of FoxP3+ regulatory T cell than normal individuals. A positive ASST response found in respiratory diseases patients suggests that it may occur as a result of some inflammatory events during the diseases process and could be related to disease activity .

Comparison of IgE-binding components between 2 house dust mites in adult allergic patients

Purpose: This study investigated the differences in the profile of IgE-binding components between Dermatophagoides pteronyssinus (Dp) and Dermatophagoides farina (Df) in respiratory allergic patients sensitized to Dp/Df. Methods: Eighteen patients with respiratory allergic diseases having higher levels of serum specific IgE to Df compared to those to Dp (> twice) were enrolled. IgE-immunoblot analysis using Dp and Df extracts were used to compare the IgE binding components. Study subjects were classified into 2 groups according to the results of IgE-immunoblot analysis: 6 subjects having IgE-binding components to group 1 and 2 allergens (group B) and 12 subjects not having them (group A). Results: Group A subjects were older (47.92± 8.51 vs. 35.50± 11.10, P = 0.039) and males were dominant (75% vs. 0% P = 0.009). IgEimmunoblot analysis demonstrated that all the group B subjects had IgE bindings to 2 major components, 14 and 25 kDa, while group A subjects had IgE bindings to high-molecular weight components ranging from 60–98 kDa. The enzyme-linked immunosorbent assay inhibition test showed a significant inhibition with additions of Df, not with Dp in group B subjects. Serum specific IgE levels to Dp and Df were significantly higher in group B than in group A, while its ratio (Df to Dp) was significantly higher in group A. No differences were noted in clinical parameters, total IgE, or eosinophil cationic protein levels. Conclusion: Heterogeneity of IgE binding patterns to Dp and Df extracts was noted according to the ratio of serum specific IgE (Df/ Dp). (Allergy Asthma Respir Dis 2016;4:199-204)

Enhanced glucocorticoid‐induced leucine zipper in dendritic cells induces allergen‐specific regulatory CD4+T‐cells in respiratory allergies

Respiratory allergies rely on a defect of IL-10-secreting regulatory CD4(+) T-cells (IL-10-Tregs ) leading to excessive Th2-biased immune responses to allergens. According to clinical data, the restoration of allergen-specific IL-10-Tregs is required to control respiratory allergies and cure patients. The discovery of mechanisms involved in the generation of IL-10-Tregs will thus help to provide effective treatments. We previously demonstrated that dendritic cells (DCs) expressing high levels of the glucocorticoid-induced leucine zipper protein (GILZ) generate antigen-specific IL-10-Tregs . We suspect a defective expression of GILZ in the DCs of respiratory allergic patients and speculate that increasing its expression might restore immune tolerance against allergens through the induction of IL-10-Tregs . We assessed GILZ expression in blood DCs of patients and healthy nonallergic donors by qPCR. We compared the ability of patients' DCs to induce allergen-specific IL-10-Tregs before and after an in vivo up-regulation of GILZ expression by steroid administration, steroids being inducers of GILZ. We report lower levels of GILZ in DCs of respiratory allergic patients that return to normal levels after steroid administration. We show that patients' DCs with increased levels of GILZ generate allergen-specific IL-10-Tregs again. We further confirm unequivocally that GILZ is required in patients' DCs to activate these IL-10-Tregs . This proof of concept study shows that the re-establishment of GILZ expression in patients' DCs to normal levels restores their capacity to activate allergen-specific IL-10-Tregs . We thus highlight the up-regulation of GILZ in DCs as a new interventional approach to restore the immune tolerance to allergens.

Changes in allergen sensitization over the last 30 years in Korea respiratory allergic patients: a single-center.

PurposeDetermining the culprit allergen is important for the diagnosis and management of allergic diseases. The skin prick test (SPT) has been widely used to identify culprit allergens. Skin reactivity to allergens has changed due to changes in lifestyle and outdoor environments. Therefore, the aim of the present paper was to examine changes in allergen sensitization in Korea.MethodsWe enrolled 1,135 patients with respiratory allergic diseases who were diagnosed at Severance Hospital from January 2010 to December 2011. SPTs were performed with inhalant allergens, and were compared to our previous studies of the SPTs in the 1980s and the 1990s.ResultsIn the 2010s, the SPT positive rate of allergic rhinitis or allergic conjunctivitis was higher than asthma without allergic rhinitis or allergic conjunctivitis. The SPT positive rate was decreased by increments of age (P value <0.01). Skin reactivity to tree pollens was significantly increased to 36.4% in the 2010s from 19.0% in the 1990s and 8.8% in the 1980s. Among tree pollens, skin reactivity to oak (4.7%->14.4%), birch (7.1%->13.6%), alder (6.3%->13.4%) and pine (2.9%->14.3%) was significantly increased in the 2010s compared with the 1990s, respectively. Current skin reactivity to grass pollens (13.9%) and weed pollens (27.0%) has significantly decreased since the 1990s (20.3%, 40.9%, respectively). Skin reactivity to house dust mites showed no difference between the 1990s (55.2%) and the 2010s (55.6%). Skin reactivity to dog (27.3%->20.7%) and cockroach (25.3%->12.3%) have significantly decreased in the 2010s in comparison with the 1990s.ConclusionsIn light of the above results, we revealed the changes in skin reactivity to inhalant allergens that have occurred in Korean allergic patients over the past three decades. Since outdoor environmental factors such as the amount of pollen, global warming and plant distribution causes the changes in skin reactivity, further study and continuous close observation will be needed.

Aerobiological, clinical, and immunobiochemical studies on Alstonia scholaris pollen from eastern India

Alstonia scholaris or Indian devil tree is a common, evergreen, tropical tree of the Apocynaceae family. The objectives of this study were (a) to observe the seasonal variation of A. scholaris pollen in the atmosphere of an industrial and rural area of West Bengal, India by conducting a 2-year aerobiological survey with a Burkard personal volumetric sampler, (b) to study its allergenicity in the local population by in vivo (skin-prick test) and in vitro tests (enzyme-linked immunosorbent assay and dot blotting), (c) to identify the immunoglobulin E (IgE)-binding proteins present in the pollen extract (sodium dodecyl sulphate-polyacrylamide gel electrophoresis and immunoblotting), (d) to study its chemical composition. A. scholaris pollen were present in the air from September until November. They contained 14.3% carbohydrate, 9.2% lipid, and 4.3% protein. Among 140 respiratory allergic local patients, 28.57% showed positive skin reaction to A. scholaris pollen extract. Twelve protein bands in the range of 94.4-13.3kDa were observed in the pollen extract. Seven IgE-binding proteins were found. Among them, one component of 29.9kDa was the most important in A. scholaris pollen extract. This component could be purified and would be helpful in the diagnosis and therapy of A. scholaris pollen-susceptible patients.

Prevalence of Fungal Allergens in Respiratory Allergic Patients in Ahvaz City, Southwest Iran

Background: Fungi are ubiquitous in our environment and they are one of the important causes of allergic diseases. Identification of the most common aeroallergens to which patients are sensitized in a specific area is important in the diagnosis and treatment of allergic rhinitis. Objectives: The purpose of this study was to determine the prevalence of skin reactivity to common fungal allergens and total IgE in patients with allergic rhinitis in Ahvaz city. Patients and Methods: In this cross sectional study, 295 volunteers with the signs and symptoms of allergic diseases who referred to the Khuzestan Jahad Daneshgahi Medical Center in Ahvaz during 2010 were investigated. All patients were subjected to skin prick test (SPT) with common allergenic extracts. Data were analyzed by SPSS-18 software using Chi square test. Results: Seventy subjects, comprising 23.7% of the study group had positive skin test to at least one of the fungal allergens. The prevalence rate of sensitivity to fungal allergens was as follow: Cephalosporin 11.5%; mold mix 9.8%; Penicillium mix 9.5%; Alternaria mix 8.1%; and Aspergillus 5.1%. Mean total IgE in patients with SPT was significantly higher than in patients without any positive skin prick test (251 vs. 125 IU/mL, P = 0.001). There was no statistical difference in the prevalence of sensitization to these allergens between two sexes; whereas, 15-35 age groups had significantly higher rates of allergy to fungal allergens (P =0.047). Conclusions: Fungal sensitization is a relatively common finding among patients with allergic rhinitis. Elimination or reduction of mold exposure in allergic patients is of special consideration and measures to reduce environmental factors which facilitate mold growth and proliferation are very important.

Associations between Pollen Counts, Pollutants, and Asthma-Related Hospital Admissions in a High-Density Indian Metropolis

Background. The seasonal pattern of asthma-related hospitalization has often been correlated with ambient allergen/pollutant levels. Objective. To examine the relationship between asthma-related hospital admissions (ARHA) and outdoor pollen, spore, and pollutant levels for adult patients in a densely populated Indian megacity Kolkata. Methods. ARHA data were obtained from two major teaching hospitals of the city. Pollen and spores causing allergic sensitization were identified by skin prick tests (SPTs) among respiratory allergic subjects (N = 1353). Outdoor concentrations of aeroallergens were determined using a Burkard sampler for five consecutive years (2004–2009). Levels of NO2, SO2, suspended particulate matters (SPMs), and respirable particulate matters (RPMs) were made available by West Bengal Pollution Control Board (WBPCB, Government of West Bengal). Poisson multivariate Poisson regression (with adjustments for overdispersion) was used to model the data. Results. We found that ARHA in Kolkata increased with predictable regularity in March and September, while remaining low in January and July. SPT showed highly positive skin reactions with grass/weed and palm pollens in respiratory allergic patients, while Aspergilli spores also evoked good sensitivity. In our regression model, the airborne pollen types, Cheno-Amaranthaceae and Cyperaceae, and the inorganic pollutant, SO2 and RPM, were significantly associated with ARHA (p < .05).Conclusion. ARHA in the megacity of Kolkata shows two seasonal peaks that can be correlated with outdoor grass/weed pollen and RPM concentrations. In contrast, the city’s ambient fungal spore counts were not found to be significantly associated.

Airborne load of Cassia pollen in West Bengal, eastern India: its atmospheric variation and health impact

A Burkard personal volumetric sampler was used at Sriniketan, a town about 150km northwest of Calcutta, in the state of West Bengal, in eastern India to record the frequency of three common airborne Cassia pollen types, Cassia tora, Cassia occidentalis, and Cassia fistula for two consecutive years (2004-2006). Correlation was made between the meteorological factors and the pollen concentration in the atmosphere. The study reports Cassia pollinosis by in vivo skin prick test in respiratory allergic patients. The highest positive reactions were exhibited by C. tora (34.7%), C. fistula (33.3%), and C. occidentalis (28.5%). The allergic potential of these was investigated by in vitro enzyme linked immunosorbent assay test. Their protein components were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, in the range of 15.8-81.5kDa. In C. occidentalis and C. fistula, 11 bands were found, while it was 10 in C. tora. The results show that the Cassia pollen occur significantly in the atmosphere with the potential to elicit an allergic response in susceptible patients.

Outdoor airborne fungal spora load in a suburb of Kolkata, India: its variation, meteorological determinants and health impact

Our objective was to conduct an aeromycological and health survey (2002–2007) in a suburban area near Kolkata, India, with the aim of achieving the following goals: (i) to prepare a fungal spore calendar, (ii) to determine the influence of different meteorological parameters, and (iii) to study the respiratory health status of local population in relation to allergy. Airborne fungal spores from more than 50 taxa were found, of which at least 15 were allergenic. The spore-concentration increased during early-winter and rainy season, and diminished during late-winter and mid-summer. Species-specific fluctuations had substantial influences from several meteorological parameters. The suburban area was found to be considerably contaminated with numerous allergenic air-spora, which caused health risk to the local population. Males were more susceptible to respiratory disorders irrespective of their age. In general, respiratory allergic patients in the 20–40 year age-group showed more frequent health problems due to aeroallergens. A positive correlation was found between the respiratory allergy cases and the air-spora concentrations.