Serum Specific IgE Research Articles

The long-term efficacy of intra-cervical lymphatic immunotherapy on adults with allergic rhinitis: A randomized controlled study.

The efficacy and safety of the novel immunotherapy method, intra-cervical lymphatic immunotherapy (ICLIT), need to be investigated. Comparing it with subcutaneous immunotherapy (SCIT), we clarified the long-term efficacy and safety of intra-cervical lymphatic immunotherapy on allergic rhinitis (AR), and investigated the improvement of clinical efficacy of the booster injection at 1year after ICLIT treatment. Ninety adult patients with dust mite allergy were randomly divided into 3 groups: 30 in the SCIT group, 30 in the ILCLIT group, and 30 in ICLIT booster group. Changes in total symptom score (TSS), nasal symptom score (TNSS), ocular symptom score (TOSS) and total medication score (TMS) were evaluated in the three groups. Adverse reactions were recorded, and serum dust mite specific IgE (sIgE) and specific IgG4 were assessed in the ICLIT group and ICLIT booster group. TSS, TNSS, TOSS, and TMS scores were significantly lower in the three groups at 36months after treatment (p<0. 05). And at 36months the ICLIT-booster group showed results similar to SCIT and superior to ICLIT (p<0. 05). Serum specific IgE decreased in all three groups at 12 and 36months after treatment, p<0.01. The ICLIT group and the ICLIT booster group showed a significant increase in sIgG4, p<0.01. None of the patients in the three groups had any serious systemic adverse effects during the 3-year follow-up. The ICLIT treatment is effective and safe on AR. One booster injection of allergens at 1year can greatly improve its long-term efficacy. Clinical trial registration number: ChiCTR1800017130.

Long-term efficacy of house dust mite sublingual immunotherapy on clinical and pulmonary function in patients with asthma and allergic rhinitis

BackgroundA previous study reported that house dust mite (HDM) sublingual immunotherapy (SLIT) for 48 weeks was effective as add on treatment for allergic asthma; however, data regarding its long-term efficacy is scarce. ObjectiveThis open-label extension study aimed to evaluate the effect of HDM SLIT on asthma control, pulmonary function, airway inflammation and remodeling throughout the 5-year treatment period. MethodsA total of 140 patients with asthma and allergic rhinitis sensitized to HDM were randomized to receive either drugs alone or drugs plus SLIT for 5 years. Asthma Control Questionnaire (ACQ)-5, Asthma Quality of Life Questionnaire (AQLQ), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), spirometry, quantitative computed tomography, and type 2 biomarkers were assessed. ResultsAn improvement in the ACQ-5, AQLQ, and RQLQ scores was observed in the SLIT group compared with the control group. HDM SLIT increased lung function and reduced the percentage of airway wall area (WA/Ao). The levels of fractional exhaled nitric oxide (FeNO), blood eosinophil, serum specific IgE (s-IgE) for HDM, and total IgE decreased and were sustained during the 5 years. The change in type 2 biomarkers correlated with change in AQLQ score. Based on receiver operating characteristic (ROC) analysis for predicting responders, the area under the ROC curve in FEV1% predicted, WA/Ao, FeNO, and s-IgE was high. Multivariate regression analysis showed that the strongest predictor of responders was FeNO. ConclusionsHDM SLIT continued to provide sustained efficacy, improve lung function, and prevent progression of airway inflammation and remodeling in asthma through to year 5.

Serum levels of specific IgE to cow's milk and its components as predictors of anaphylaxis in Chinese children with cow's milk allergy.

Cow's milk allergy (CMA) is one of the most common food allergies in young children. As improved diagnostic tools, allergic tests are inconsistent and limited in predicting anaphylaxis. To explore risk factors for anaphylaxis and to determine practical cut-offs for allergic tests in predicting anaphylaxis. This is a prospective cohort study. Children with IgE-mediated CMA were enrolled and divided into three groups (Group 1: non-anaphylaxis; Group 2: GRADE I anaphylaxis; Group 3: GRADE II-IV anaphylaxis that warranted epinephrine). Prick-to-prick tests (PTPs) using fresh cow's milk (CM) were performed. Serum specific IgE (sIgE) against CM and its components, including casein, alpha-lactalbumin, beta-lactoglobulin, and bovine serum albumin were measured. The 90% and 95% positive predictive value (PPV) decision points for predicting anaphylaxis were determined. Potential predictors of anaphylaxis were evaluated in logistic regression models. This study included 134 CMA patients with a median age of 14.4 months. The sensitization rate to any CM component was 89%. Group 3 was more likely to be sensitized to multiple CM components and have higher sIgE levels. The 95% PPV diagnostic decision points of casein-sIgE in predicting anaphylaxis was 13.0 kUA/L. For GRADE II-IV anaphylaxis, casein-sIgE ≥ 54.9 kUA/L could provide a PPV of 88.9%. The elevated casein-sIgE level (OR 14.0, P=0.025) and complicating respiratory allergic diseases (OR 4.8, P=0.022) were independent risk factors for GRADE II-IV anaphylaxis. High casein-sIgE levels are strongly associated with CM anaphylaxis. Detection of casein-sIgE may offer an additional value for the prediction of CM anaphylaxis.

Snail-induced anaphylaxis in patients with underlying Artemisia vulgaris pollinosis: the role of carbohydrates.

The importance of carbohydrates in anaphylaxis has been described with some foods. The current work intends to obtain clinical and immunological evidence of the importance of the O-glycans for IgE binding activity in anaphylactic reactions due to Helix aspersa (HA) ingestión and Artemisia vulgaris (AV) exposition. The studio focused on two cases of IgE-mediated anaphylaxis induced by snail ingestion in patients with underlying rhino-conjunctivitis and asthma due to AV. We performed on both patients: skin prick tests ( SPTs) with HA and AV and with a battery of aeroallergen, controlled nasal challenge and specific IgE to HA and AV, ImmunoCAP ISAC®, and a differential pattern of IgE recognition with SDS-PAGE Immunoblotting (SDSI) when these allergens have suffered an O-deglycosylation procedure. The patients showed positive results in SPTs, nasal challenges, and serum-specific IgE against HA and AV. In patient 1, the SDSI detected several IgE-binding proteins in AV with a molecular mass of 22, 24, and 44 kDa, whereas a band of 12 kDa was detected in HA. On the other hand, patient 2's serum revealed an IgE-binding zone between 75 and 20 kDa in the AV and a band of 24 kDa in the HA. When glycans were removed, patient 1's serum only revealed the AV's 22 and 24 kDa bands, whereas patient 2's serum did not detect any IgE-reactive protein in the HA. Our data suggest that O-glycosylation can be relevant in patients with anaphylaxis due to snails and allergy to Artemisia vulgaris. This new entity representing cross-reactivity between AV and HA could be named Snail-Artemisia Syndrome.

Exposure to ambient fine particulate matter components during pregnancy and early childhood and its association with asthma, allergies, and sensitization in school-age children.

Exposure to fine particulate matter (PM2.5) has been associated with allergic diseases, including asthma. However, information about the effects of specific PM2.5 components is limited. This study aimed to investigate the relationship of exposure to chemical components of PM2.5 during pregnancy and early childhood with the development of asthma, allergies, and sensitization in school-age children. This study included 2,408 children in the second grade of elementary school. Questionnaire surveys of respiratory/allergic symptoms and measurements of serum total IgE and specific IgE levels to house dust mite (HDM) and animal proteins were conducted. Exposures to ambient PM2.5 mass, sulfate (SO42-), nitrate (NO3-), ammonium (NH4+), elemental carbon (EC), and organic carbon (OC) of PM2.5 in participants' residences from conception to age six were estimated using predictive models. Multiple logistic regression analysis was used to analyze the association of respiratory/allergic symptoms and allergen sensitization with estimated exposure concentrations, after adjustment for survey year, sex, season of birth, feeding method during infancy, presence of siblings, history of lower respiratory tract infection, use of childcare facilities, passive smoking, presence of pets, mother's age, history of allergic diseases, smoking during pregnancy, and annual household income. No significant association was found between PM2.5 and its component concentrations and asthma. However, wheezing significantly increased with mean NO3- concentrations during pregnancy (odds ratio of 1.64 [95% confidence interval: 1.10, 2.47] for an interquartile range increase). Significant associations were also found between EC in the second trimester of pregnancy and PM2.5, NO3-, EC, and OC concentrations in early childhood. Higher PM2.5, SO4-, and NH4+ concentrations during the second trimester increased the risk of rhinitis. Sensitizations to HDM and animal proteins were significantly associated with exposure to components such as SO42- and NH4+ during pregnancy but not with postnatal exposure. Exposures to NO3-, EC, and OC during pregnancy and early childhood were associated with wheezing. SO42- and NH4+ exposures during pregnancy were associated with sensitization to HDM and animal proteins. Asthma was not associated with exposure to PM2.5 and its main components at any period.

LONGITUDINAL EVALUATION OF EFFICACY OF SUBLINGUAL IMMUNOTHERAPY IN PEDIATRIC PERENNIAL ALLERGIC RHINITIS USING LABORATORY EXAMINATIONS AND IN VIVO BIOMARKERS

The purpose of this study was to evaluate the efficacy of sublingual immunotherapy (SLIT) with house dust mite (HDM) on pediatric perennial allergic rhinitis (AR) based on longitudinal assessment of nasal symptoms, laboratory examination, and in vivo biomarkers. The subjects included 40 children with perennial AR who had SLIT with HDM for 2 years. Nasal symptoms, medications, skin prick tests, nasal provocation tests, and peripheral blood tests were evaluated before, 6 months, one year and two years after the onset of SLIT. Total nasal symptom scores, prick test wheal diameter, and peripheral blood eosinophil count decreased in 6 months. Total nasal symptom scores continued to decrease from 6 months to 2 years. Symptom-medication scores and nasal provocation test responses decreased in 1 year. Symptom-medication scores continued to decline from 1 to 2 years. Medication scores and nasal eosinophilia decreased in 2 years. Serum specific IgE to HDM slightly increased transiently and decreased in 2 years. The severity of symptoms and specific IgE to HDM at the baseline, and changes of symptoms and specific IgE to HDM during the first six months and first one year of SLIT were correlated with improvement in symptom scores over two years of SLUT. TNSS at baseline was correlated with that at second year. Longitudinal assessment of symptoms, allergen specific IgE, and in vivo biomarkers showed the effectiveness of SLIT. Symptom scores and allergen specific IgE may also be early predictive factors of SLIT efficacy in children with AR.

Analysis of IgE level influencing factors of common allergens for allergic rhinitis in northeastern China

ObjectivesThis thesis aims to provide patients with a preventive and therapeutic basis by analyzing IgE level influencing factors of common allergens for Allergic Rhinitis (AR). MethodMultiple linear regression analysis is made upon questionnaires among 749 cases of AR patients that are divided into 5 age-based groups. Perform serum-specific IgE content testing on patients. ResultsCockroach being an allergen, AR patients’ IgE Level is influenced by allergic history, home-raised plants and animals. For AR patients with mugwort as an allergen, allergy and asthma history could increase IgE level, respectively, β = 4.291 and β = 4.364. If the allergen turns out to be peanut, allergic history would increase the IgE level (β = 0.171), however, the level would be lower in female patients compared with male patients (β = -0.078). For patients with egg as an allergen, allergic history, home-raised plants and animals (pets) would all affect the IgE level, respectively, β = 0.182, β = 0.118 and β = -0.101. ConclusionsIgE level varies according to allergic history, home-raised plants & animals, gender, furniture renewal, asthma, and ages for patients with different allergens including cockroach, mold, mugwort, peanut, egg and crab. For each kind of allergen, the IgE levels react differently to different influencing factors, thus requiring a thorough analysis of each AR patient's allergen and allergenic factors.

Provocation tests

Oral provocation tests involve the supervised administration of suspected foods in increasing doses to evaluate a patient's allergic condition. Acknowledged as the superior method for diagnosing food allergies, it surpasses results from specific IgE serum or prick tests, which indicate sensitization but not necessarily allergy. The test is indicated in cases of diagnostic uncertainty, assessment of natural or induced tolerance, or cross-reactivity risks. Three types of tests exist: open, single-blind, and double-blind with a placebo. While the latter two reduce anxiety, open tests are more practical for children under three.

The Hydrogel Based Allergen-Coated Gold Nanoparticles for Topical Administration: A Possible Epicutaneous Immunotherapy in Pollen-Sensitized Mice?

ABSTRACT Background The rapid uptake of antigens by antigen-presenting cells (APCs) and their migration to draining lymph nodes in the initial hours after antigen administration in epicutaneous allergen specific immunotherapy (EPIT) prompted us to investigate whether the topical administration of allergens without patch application could alleviate allergy in pollen-sensitized mice. We evaluated the immunotherapeutic effect of topically administering hydrogel-based Gold nanoparticles (AuNPs) loaded with a total extract of Platanus orientalis pollen (Pla. ext (50 μg)-AuNPs) on intact skin. Methods Mice sensitized to P. orientalis pollen were divided into three groups and treated with Pla. ext (50 μg)-AuNPs: 1) patch with Pla. ext (50 μg)-AuNPs, 2) patch with Pla. ext (50 μg)-AuNPs in combination with hydrogel, and 3) topical application of Pla. ext (50 μg)-AuNPs in combination with hydrogel. The immunotherapeutic effects were evaluated by measuring serum specific and total IgE antibodies, total cell and eosinophil count in nasopharyngeal lavage fluid, cytokines in the supernatants of re-stimulated splenocytes by the total extract, and histological examination of lung and nasal mucosa. Results Topical administration of Pla. ext (50 μg)-AuNPs, like patch-based administration, significantly downregulated specific and total IgE and IL-4 production, promoted secretion of IFN-γ and IL-10, markedly reduced the number of inflammatory cells, particularly eosinophils, in nasopharyngeal lavage fluid (p < .05), and inhibited inflammation and pathological damage in lung and nasal mucosa. Conclusion Our results suggest that topical administration of AuNPs loaded with P. orientalis total pollen extract on intact skin could be a potential application for EPIT in the P. orientalis pollen -sensitized mice.

Skin test (Skin Prick Test) in food allergy

Skin tests, also known as prick tests, in food allergies are restricted to IgE-mediated food allergies, with results that barely indicate sensitization to a certain food and do not necessarily suggest food allergy. The clinical context of the patient is the decisive point before performing any type of food allergy skin test; Contextualizing and relating the patient's clinical picture with the immunological mechanism of IgE-mediated allergies will allow a better selection of the allergy test for each case. Positive tests should be interpreted more carefully, and consider that during early childhood it is common that several patients may have negative specific serum IgE tests in the blood for food allergens compared to those performed on the skin, which are positive. Skin testing can be carried out with standardized strata of foods, but they are not always available for all foods and some are very unstable. Skin tests can even be performed with raw foods, using the prick to prick technique to perform the puncture with fresh foods (especially fruits or vegetables) or other products that are not commercially available. The skin prick test is a test where, after having placed the allergenic extract in drops or with fresh food itself, the puncture must be carried out with a standardized lancet.

Allergic fungal airway diseases: analysis of data in asthma patient register

Introduction. Allergy to microscopic fungi (micromycetes), which can colonize the respiratory tract, is associated with an eosinophilic endotype of inflammation and severe disease course. Among the hallmarks of fungal allergy, experts identify fixed airways obstruction, bronchiectasis, and fibrosis. Currently, there has been proposed the term “allergic fungal airways disease” (AFAD), which combines various clinical phenotypes, which pathogenesis is based on IgE-mediated allergic reaction against fungal spores colonizing the respiratory tract. According to this approach, the AFAD group includes severe asthma with fungal sensitization and allergic bronchopulmonary aspergillosis (ABPA). A promising direction in AFAD treatment implies the use of genetically engineered biological drugs against T-2 inflammation. The aim of the study was to evaluate the prevalence ofAspergillusspp. sensitization and allergic bronchopulmonaryAspergillosis in patients with asthma.&#x0D; Materials and methods. A retrospective single-center registry study was conducted in the I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russian Federation. The study included 523 patients with asthma of varying severity. The level of total and specific blood serum IgE against aeroallergens, includingAspergillusspp., was analyzed by enzyme immunoassay. The diagnosis of asthma was established in accordance with the recommendations of the GINA working group and the Clinical recommendations of the Ministry of Health of the Russian Federation, fungal sensitization and ABPA — in accordance with the recommendations of the ISHAM working group.Results. During the examination of patients with asthma, sensitization toAspergillusspp. recorded in 16.6% cases, severe asthma with sensitization toAspergillusspp. — in 7.4%, ABPA — in 6.1%. In patients with allergic asthma, the prevalence of sensitization toAspergillusspp. was 22%, severe asthma with sensitization toAspergillusspp. — 10.1%, ABLA — 8.1%. Among patients with ABPA, females (64%) aged 40 years and older prevailed. The major clinical manifestations of ABPA were presented as cough (96%) and shortness of breath (76%), CT scan radiological changes were in a form of bronchiectasis (72%).&#x0D; Conclusion. A high prevalence of sensitization toAspergillusspp. in patients with asthma was found. It is necessary to includeAspergillusspp. into the list of tested allergens while examining patients with chronic lung diseases for timely detection of AFAD and prescription of proper anti-inflammatory or antimycotic therapy.

Nanofluidic point-of-care IgE test for subtropical grass pollen for rapid diagnosis of allergic rhinitis

BackgroundWidening of subtropical climate zones globally and increasing grass-pollen exposure provide the impetus for developing a more precise and accessible diagnosis of allergy. ObjectiveTo evaluate the utility of recombinant allergen components of Panicoideae and Chloridoideae pollens for specific IgE testing in a rapid, point-of-care device. MethodsRecombinant (r) Pas n 1 and Cyn d 1 were expressed, purified, and tested in the nanofluidic device for measuring serum specific IgE (spIgE) in a well-characterized Australian cohort. Concentrations and classes of spIgE to rPas n 1 and rCyn d 1, and total IgE were compared with skin prick test results and spIgE with grass pollen. ResultsCorrelations between commercial and academic laboratories for 21 sera were high for rPas n 1 spIgE (r = 0.695) and total IgE (r = 0.945). Higher spIgE to rPas n 1 and rCyn d 1 fluorescence was detected in the patients with grass-pollen allergy and with clinician-diagnosed allergic rhinitis (n = 134) than in participants with other allergies (n = 49) or no allergies (n = 23). Correlation between spIgE concentrations to rPas n 1 (r = 0.679) and rCyn d 1 (r = 0.548), with Bahia and Bermuda grass-pollen spIgE, respectively, was highly significant (p<0.0001). The positive/negative predictive agreements of spIgE classes for rPas n 1 (73%/82.5%) and rCyn d 1 (67.8%/66.3%) between the nanofluidic and ImmunoCAP measurements for Bahia and Bermuda grass pollen, respectively, were substantial. ConclusionPoint-of-care nanofluidic tests for spIgE to rPas n 1 and rCyn d 1 could increase access to more precise clinical diagnosis for patients with allergies in subtropical regions.

Quantitative Assessment of Serum Specific IgE in the Diagnosis of Echinococcus granulosus

Quantitative Assessment of Serum Specific IgE in the Diagnosis of Echinococcus granulosus

Dust mite component Analysis: Identifying key allergens components for effective immunotherapy in allergic rhinitis

BackgroundThe aim of this study was to examine the frequency of sensitization to house dust mite (HDM) components among allergic rhinitis patients receiving subcutaneous immunotherapy (SCIT), and to assess the correlation between SCIT efficacy and specific IgE (sIgE) levels for allergenic HDM components. MethodsSerum samples and clinical data were collected from 38 allergic rhinitis patients receiving HDM-SCIT at baseline and after 1 year of treatment. Effective treatment was defined as a therapeutic index (TI) of at least 50% after 1 year. Cytokine levels were analyzed using commercial ELISA kits, while serum total and specific IgE levels were determined by the fluoroenzymeimmunoassay technique. The ALLEOS 2000 magnetic particle chemiluminescence system was used to measure sIgE levels for Der f, Der p 1, Der p 2, Der p 10, and Der p 23. ResultsAllergic rhinitis patients undergoing HDM-SCIT had a high rate of allergic sensitization to the HDM major allergens Der p (100%), Der f (100%), Der p 1 (94.74%), Der p 2 (94.74%), and Der p 23 (36.84%). Patients who responded to SCIT had higher levels of IgE for HDM components at baseline, while those with ineffective treatment showed an opposite performance, particularly for Der p 1 (P＜0.05). After 1 year of treatment, effective and ineffective patients showed opposite trends in sIgE for dust mite components (decreased in effective patients, increased in ineffective patients). HDM-SCIT led to a significant reduction in IL-2, IL-4, IL-6, and EOS% (P＜0.05). IgE for Der p, Der f, Der p 1, Der p 2, and HDM sIgE were significantly positively correlated (P < 0.001). The correlation heatmap analysis based on changes in values reveals a negative correlation between CSMS score changes and sIgE for Der f and Der p 1, and a positive correlation with IL-2, IL-10, and TNF (P < 0.05). ConclusionsThe molecular sensitization profiles during HDM-SCIT are variable and relate to treatment efficacy. Molecular diagnosis can assist allergists in identifying patients eligible for HDM-SCIT, thereby enhancing the treatment's clinical efficacy. Serum cytokine levels of IL-2, IL-4, IL-6，and EOS% may serve as useful biomarkers for monitoring HDM-SCIT efficacy.

The Common Food Allergy in Iraqi Patients with Urticaria

A food allergy is a type of immunological reaction to food that is abnormal. The allergic reaction's symptoms might range from moderate to severe. Itching, swelling of the tongue, vomiting, diarrhea, hives, difficulty breathing, and low blood pressure are some of the symptoms. This can happen anywhere from a few minutes to several hours after exposure. Methods: The included samples of this study were 125 patient with chronic urticaria with age between 20 - 60 years were collected from allergy specialized center of Baghdad/ Ressafa. Determination of food allergen specific IgE in serum of total subjects was done for twenty two of common food allergens. Results: The current results showed that 39/125 of urticarial patients were positive to Beta-Lacto globulin, 29/125 positive to Banana, 21/125 positive to Apple, 14/125 positive to Egg Yolk, 10/125 positive to Sesame, 9/125 positive to Nut-Mix, 7/125 positive to Rice and Potato, 6/125 positive to Egg White, Citrus Mix and Peach, 5/125 positive to Milk and Tomato, 3/125 positive to Wheat Flour and Onion, 2/125 positive to Celery, 1/125 positive to Pea, Pork Meat, Strawberry, Baker’s Yeast, Chicken Meat and Cacao (Chocolate). Conclusions: The most common food allergies concluded in this study were for Beta-Lacto globulin, Banana, Apple, Egg Yolk and Sesame.

Prediction of Food Sensitization in Children with Atopic Dermatitis Based on Disease Severity and Epidermal Layer Impairment

Plain Language SummaryThe study has revealed notable associations between food sensitizations (FSs) and the disease severity as well as epidermal barrier impairment in children with atopic dermatitis (AD). Specifically, the findings indicate that children with AD who were sensitized to higher numbers of food allergens (FAs) had higher SCORAD scores and greater epidermal barrier impairment. In addition, SCORAD score and stratum corneum hydration (SCH) levels at lesional skin could be predictive factors for FS in children with AD. The findings of this study suggest that clinicians should consider screening for food sensitization in children with moderate-severe AD and/or low SCH levels at lesional skins.

The Value of Current Laboratory Tests in Diagnosing Food, Venom, and Drug Allergies.

An accurate diagnosis of IgE-mediated allergies is necessary to inform risk management for severe allergic reactions including anaphylaxis for food, venom, and drug allergies. The most widely available laboratory test for allergy is serum-specific IgE testing, which is routinely used for food allergy and insect sting allergy. Testing for specific IgE is limited by high sensitivity and low specificity, resulting in concern regarding overdiagnosis. Testing of allergen components has led to improved diagnosis for some food and venom allergens. Additional options for laboratory tests, such as epitope analysis, basophil activation, and mast cell activation, are being investigated for their potential to optimize diagnosis and provide predictors for reaction severity and treatment response. In contrast, laboratory testing for drug allergy is more limited because to date, there are no well-validated commercial assays in the United States. Furthermore, it is important to diagnose delayed reactions to medications, because these also significantly affect decision-making regarding therapeutic options for infectious disorders. Reliable tests for both immediate and delayed drug hypersensitivity are much needed, because drug allergy labels can significantly limit treatment options for patients. Research in this area is emerging.

B-058 Development and Evaluation of the Assay for Detection of Human Specific IgE Against Animal Dander Allergens on a Fully Automated Chemiluminescence Immunoassay Platform—Autolumo® A2000 Plus

Abstract Background The detection of specific IgE is a key method for diagnosing allergic diseases. An accurate, user friendly and cost-effective way to clinically diagnosing allergies is beneficial for the patients. Our detection kit together with the Autolumo A2000 Plus chemiluminescence fully automated platform provide a new and more effective (40 minutes) way for detection of specific IgE with simple operation, high sensitivity and specificity. Methods The Animal Dander Allergen Mix Assay kit detects specific IgE against cat dander (E1), horse dander (E3), cow dander (E4) and dog dander (E5). Performance evaluation of the animal dander mix, E1, E3, E4 and E5 assay kits for the detection of specific IgE in serum was performed on our automated chemiluminescence platform (Autolumo A2000 Plus) and compared to a well-characterized platform (ImmunoCAP, Phadia). During detection, magnetic particle suspension, antigen solution, patient sample, and enzyme conjugate were added sequentially. A streptavidin-biotinylated antigen-sIgE antibody-anti-IgE-HRP conjugate complex is formed, wherein the amount of the anti-IgE-HRP conjugate is positively correlated to the amount of sIgE antibodies in the patient sample. After the substrate is added, the HRP catalyze the chemical reaction to generate a recordable signal in the form of light. The intensities of the light were obtained by using a chemiluminescence quantitative analyzer, and the standard curve was generated according to the 7-point calibration, and then the sIgE antibody concentrations in the serum sample were analyzed. The overall agreement, method comparison, precision, linearity, and stability of our mixed and single assay kits were evaluated using serum samples (n &amp;gt; 140) that had been characterized with Phadia. Results The overall agreement for the animal dander mix assay is 91.84%, with the average intra-run and inter-run precision to be 1.97% and 4.21% respectively. The limit of blank (LoB) and limit of detection (LoD) for the animal dander mix assay is 0.019 kU/L and 0.045 kU/L respectively. The sensitivity for our single E1, E3, E4, and E5 assays are 97%, 85.6%, 70.8%, and 80.2%, respectively. All single assays have a specificity &amp;gt;90%, total precision &amp;lt;5% CV, and a linearity with R2 &amp;gt; 0.999. The LoB, LoD and recommended LoQ for all single assays are 0.019 kU/L, 0.037 kU/L, and 0.1 kU/L respectively. The average signal drifts after 10 days incubation in 37C is less than 10% indicating the assays are stable. Conclusion Autolumo A2000 Plus is a fully automated chemiluminescence Immunoassay platform that provides accurate and cost-effective screening for allergy diagnostics with excellent overall agreement, precision, and stability.

Efficacy and Safety of Sublingual Immunotherapy using a Combination of Dermatophagoides Pteronyssinus and Blomia Tropicalis Extracts in Patients with Allergic Rhinitis: A Randomized, Double-Blind, Placebo-Controlled Trial

The aim of this study was to evaluate the safety and efficacy of sublingual immunotherapy (SLIT) with extracts of Dermatophagoides pteronyssinus and Blomia tropicalis in patients with moderate/severe persistent allergic rhinitis (AR). Methods: This was a double-blind, randomized, placebo-controlled trial of SLIT for the treatment of house dust mite-induced AR. A total of 65 patients, aged between 12 and 60 years, were treated for 12 months and randomized into two groups: SLIT and placebo. The SLIT group received a combination of extracts containing Dermatophagoides pteronyssinus and Blomia tropicalis allergens. All had their sensitization confirmed by skin prick test or serum-specific IgE. Total Nasal Symptom Score, RQLQ quality of life questionnaire, current treatment, and need for medication to control symptoms were recorded during the study. Total serum IgE, serum specific IgE, and IgG4 levels to Der p 1 and Blo t were assessed at baseline, 6 and 12 months after treatment. Results: There was no significant difference in the number of adverse events between groups. The SLIT group showed a significant reduction in the consumption of antihistamines to control symptoms (p &lt; 0.0001) when compared to placebo. There was no significant change in serum total IgE, serum specific IgE, and IgG4 to both allergens when comparing the SLIT and placebo groups. Conclusion: After one year, SLIT using a dose of 1 mcg of Der p 1/day and 753 UBE of Blo t/day proved to be effective and safe in controlling AR exacerbations.

Fungal allergen sensitization: Prevalence, risk factors, and geographic variation in the United States

Many fungal species are associated with the pathogenesis of allergic disease, yet most epidemiologic studies on IgE-mediated fungal sensitization have only included a few species. We investigated fungal allergen sensitization prevalence, risk factors, and geographic variation in the United States. From 2014 to 2019, a total of 7,912,504 serum-specific IgE (sIgE) test results for 17 fungal species were measured in 1,651,203 patients aged 0-85 years by a US-wide clinical laboratory. Fungal sensitization prevalence, patterns, and relationship with demographic characteristics, clinical diagnoses, and geographic regions were analyzed. Twenty-two percent of patients were positive (sIgE>0.10 kUA/L) to at least 1 fungal allergen; 13.7% were positive to >2 fungal allergens. Fungal species-specific positivity rates ranged 7.4-18.6% and were highest for Candida albicans (18.6%), Alternaria alternata (16.6%), Stemphylium herbarum (14.9%), and Aspergillus fumigatus (14.2%). Other fungi that were frequently tested had relatively low positivity rates (eg,Cladosporium herbarum 11.1%, Penicillium chrysogenum 10.7%). Independent risk factors for test positivity for all fungal species included male sex, teen age (highest in those aged 10-19 years), atopic dermatitis, and asthma. Fungal sensitization was generally higher in urban areas and ecoregions composed predominantly of grasslands and prairies compared to woodlands and forest, although there was greater variation in sensitization risk to different fungi in different ecoregions. Independent risk factors for fungal sensitization include male sex, teen ages, atopic dermatitis, asthma, and ecoregion.