Skin Prick Test Results Research Articles

The prevalence and sex difference of allergen sensitization among adult patients with allergic diseases in Shanghai, China.

The worldwide prevalence of allergic diseases has increased during the last few decades, but it is not well known about the sensitization profiles of adult patients in Shanghai. This study aimed to identify the prevalence and sex difference of allergen sensitization among adult with allergic diseases in Shanghai. The sensitization profiles of 7,996 patients (18-60 yrs old) with allergic diseases at our center were retrospectively analyzed, based on the results of skin prick tests. The prevalence of various allergen, age and sex difference of allergen sensitization were investigated. The most common allergens were Dermatophagoides farinae (73.10%), Dermatophagoides pteronyssinus (72.21%) and Blomia tropicalis (53.10%), followed by Blattella germanica (31.18%), Periplaneta americana (27.75%), dog dander (24.96%), mixed molds (17.56%), and shrimp (17.02%). For the patients aged 18-30 yrs, mites and animal dander were most common allergen, whereas cockroaches and mixed molds for those aged over 40 yrs old. As for sex difference, males were more sensitive to Blomia tropicalis, cockroaches and mixed molds. Females were more sensitive to Dermatophagoides farinae and animal dander. The most common allergen in Shanghai are mites, cockroaches, and dog dander. There are sex and age difference on profiles of allergen sensitization.

Single and multiple time-point allergic sensitization during childhood and risk of asthma by age 13.

The relationship between allergic sensitization during childhood and risk of developing asthma remains unclear. To analyze single time-point and temporal patterns of sensitization in childhood in relation to asthma at age 13. Specific IgE (sIgE) level and skin prick test (SPT) toward 22 food allergens and aeroallergens were assessed at 6, 18months, 4, 6, and 13years in children from the high-risk Copenhagen Prospective Studies on Asthma in Childhood2000 (COPSAC2000 ) mother-child cohort. We analyzed the association between single time-point monosensitization, polysensitization, and quantitative assessment of sensitization, that is, sum of all sIgE levels and SPT wheal sizes, against asthma at age 13. In addition, we analyzed the association between three temporal patterns of sensitization: (a) early-transient, (b) late-onset, and (c) persistent sensitization and asthma. Polysensitization status measured by SPT or sIgE was at all single time-points associated with increased risk of asthma at age 13: OR range, SPT=3.0-15.7, and sIgE=2.6-15.7, respectively, whereas monosensitization status was inconsistently associated with asthma. Quantitative assessment of both sIgE and SPT results was associated with asthma at all single time-points: OR range, SPT=1.3-3.6, and sIgE=1.1-1.7. Persistent sensitization, but not early-transient or late-onset sensitization was associated with asthma by age 13: OR [95% CI], SPT=8.9 [2.8-28.23], and sIgE=2.9 [1.1-7.6], respectively. Sensitization to multiple allergens at single time-points, increasing sIgE levels and SPT wheal sizes, and persistent sensitization during childhood were associated with increased risk of asthma at age 13, suggesting the use of quantitative and repetitive sensitization measurements when assessing risk of developing asthma.

Assessment of Inflammatory Biomarkers, Total IgE levels, SNOT-22 scores in Allergic Rhinitis patients

Objectives: The aim of this study is to assess neutrophil-lymphocyte ratio (NLR), mean platelet volume (MPV), platelet-lymphocyte ratio (PLR) and eosinophil-lymphocyte ratio (ELR) of allergic rhinitis patients and compare our findings with healthy controls. We also analyzed the effect of severity of allergic rhinitis on hematological parameters and total IgE levels of the patients. Methods: A total of forty-six patients diagnosed having allergic rhinitis according to Allergic Rhinitis and its Impact on Asthma (ARIA) criteria and forty-six healthy, age and sex-matched subjects were included in this study. The clinical records of the patients were retrospectively analyzed and age, gender, skin prick test results, complete blood counts, total IgE levels and Sino-Nasal Outcome Test (SNOT) 22 scores were recorded for assessment of neutrophil-lymphocyte ratio (NLR), mean platelet volume (MPV), platelet-lymphocyte ratio (PLR) and eosinophil-lymphocyte ratio (ELR) of the patients. Results: Eosinophil count, eosinophil percentage and ELR value of the study group were significantly higher than the control group. (p=0,001, p=0,001, p=0,001 respectively) The cut-off value for ELR was ≥0,105. (sensitivity=0,61, specificity=0,76, AUC=0,703) Total IgE levels of patients with positive skin prick test were significantly higher than patients with negative skin prick test. (p=0,019) The cut-off value for total IgE was ≥63 IU/mL. (sensitivity=0,59, specificity=0,74, AUC=0,706). Conclusion: ELR is a valuable marker for predicting allergic rhinitis. However, it does not correlate with the severity of the disease. Total IgE levels increase in patients with positive skin prick tests. Also, total IgE level does not correlate with the severity of allergic rhinitis.

Occupational allergy to dog among police dog trainers.

This study was aimed to reveal the prevalence of dog allergy and other common allergy and allergic symptoms in police dog trainers. Fifty-six police dog trainers and 150 workers as control group were included in this study. Medical records of dog trainers including respiratory, skin, eye symptoms and physical examinations and skin prick test results are compared with the medical records of control group. Positive SPT to dog was present in 21.4% of dog trainers, whereas the frequency of sensitization to dog in the control group was 1.3% (p minor 0.001). Dog allergy development risk is found 20 times greater in dog trainers than control group. In multiple logistic regression analysis, it was found that atopy was associated with dog allergy likelihood. Sensitization to dog allergens is an important occupational problem for dog trainers.

Efficacy of probiotic supplementary therapy for asthma, allergic rhinitis, and wheeze: a meta-analysis of randomized controlled trials.

Background: Probiotic supplementary therapy to prevent allergic diseases, including asthma in children, has been widely explored in many randomized controlled trials. However, there is conflicting evidence on the effect of probiotic supplementation during pregnancy and infancy to the incidence of asthma and allergic rhinitis. Method: This study was designed to systematically explore the potential effects of probiotic supplementation on the occurrence and development of asthma, wheeze, and allergic rhinitis. Randomized controlled trials were searched in several medical literature data bases. A meta-analysis was undertaken by using the fixed-effects model or the random effects model to calculate the pooled risk of significant heterogeneity. Two writers were designated to perform the study selection and data extraction. The primary outcome was clinically diagnosed asthma; the secondary outcomes included wheeze, allergic rhinitis, and a positive aeroallergen skin-prick test result. Results: Seventeen randomized controlled trials, which composed a total of 5264 children, were analyzed. The pooled data for risk of developing asthma after probiotic supplementation showed no significant reduction compared with controls (risk ratio [RR] 0.86 [95% confidence interval {CI}, 0.73-1.01]; I² = 0%; p = 0.06). A subgroup of strains indicated that Lactobacillus rhamnosus GG supplementation only had a reduction to the occurrence of asthma (RR 0.75 [95% CI, 0.57-0.99]; I² = 11%; p = 0.04). The supplement in the postnatal group had a similar result, but the incorporated data were limited. Meanwhile, it is failed to identify that probiotic supplementary therapy have a clear benefit to the secondary outcomes: wheeze, allergic rhinitis, positive aeroallergen skin-prick test result. Conclusion: This study showed a significant benefit that supplementation with probiotics in pre- and postnatal periods was likely to play an essential strategic role in the prevention of asthma. However, these effects were based on the type of probiotics used, which also need more large-sample and high-quality RCTs to confirm the reliability of this study.

Age at cytomegalovirus, Epstein Barr virus and varicella zoster virus infection and risk of atopy: The Born in Bradford cohort, UK.

BackgroundThe prevalence of allergic diseases has increased in recent decades, but the causes remain unclear. Changes in the epidemiology of childhood infections could have contributed, but the current evidence is inconclusive. This study aims to investigate whether age at cytomegalovirus (CMV), Epstein‐Barr virus (EBV) or varicella zoster virus (VZV) infection is associated with the development of atopy.MethodsA total of 2559 children were enrolled in the Born in Bradford Allergy and Infection Study. Serum samples collected at 12 and 24 months were tested for CMV‐IgG, EBV‐IgG and VZV‐IgG for 1000 children to establish age at infection. Skin prick testing (SPT) was conducted at age 4 years.ResultsSerology and SPT results were available for 740 children. Of these, 135 (18%) were atopic. In girls, there was a strong association of CMV infection in the second year with increased odds of atopy (adjusted OR 4.38, 95% CI 1.87‐10.29) but this was not observed in boys. Age at EBV or VZV infection was not associated with risk of atopy in unadjusted analysis, but there was effect modification by sex; girls infected with VZV in the second year of life had increased odds of atopy (adjusted OR 2.85, 95% CI 1.29‐6.30).ConclusionsOur results highlight potential sex‐specific effects of age at CMV infection and age at VZV infection on risk of atopy, which provide insight into the mechanisms involved in the development of atopy.

A Comprehensive Analysis of Skin Prick Test Results from Giresun Region

Amaç: Giresun’da prick testi yapılmış hastalarda pozitiflik oranını saptamak ve alerjenlerin yaş, cinsiyet, başvuru tanısı ve mevsimlere göre dağılımını incelemek.Yöntemler: Çalışmaya 12 aylık periyotta deri prick testi yapılan 330 hasta dahil edildi. Test sonuçları retrospektif olarak incelenerek yaşları, cinsiyetleri, ön tanıları, testin hangi mevsimde yapıldığı ve prick testi sonuçları kaydedildi. Pediatrik ve yetişkin hastalar arasında test pozitifliği ve çoklu alerjen pozitifliği açısından karşılaştırma yapıldı.Bulgular: Test yapılan 330 hastadan 92 (%27,9) ’si alerjik rinit, 73 (%22,1) ’ü ürtiker, 59 (%17,9) ‘u kronik öksürük, 50 (%15,1) ‘si kronik pruritus, 25 (%7,6) ’i atopik dermatit, 25 (%7,6) ’i kontakt dermatit ve 6 (%1,8) ‘sı anjionörotik ödem hastasıydı. En sık test pozitifliği sırasıyla anjionörotik ödem (%83,3) alerjik rinit hastalarında (%65,2) bulundu. Hastaların 106 (%66,7)’sında akar pozitifliği (ev tozu ve depo akarları), 44 (%27,7)’ünde çayır ve ot poleni duyarlılığı, 43 (%27)’ünde ise ağaç poleni duyarlılığı saptandı. Alerjik rinit hastalarında en sık ev tozu akarları [D. Pteronyssnus- 33 hasta (%55) ve D. Farinae- 30 hasta (%50)] alerjisi olduğu saptandı. Pediatrik hastalarda en yüksek test pozitifliği alerjik rinit (%72,7) ve atopik dermatit (%50) hastalarındaydı. Çocuk ve yetişkinlerin test pozitifliği ve çoklu alerjen pozitifliği oranları benzerdi (sırasıyla, X2= 0.417, p=0.519 ve X2= 0.383, p=0.536). Sonuç: Giresun’da en sık prick test endikasyonu olarak saptadığımız ön tanı alerjik rinit idi. En yüksek test pozitifliği anjionörotik ödem ve alerjik rinit hastalarındaydı. En sık reaksiyon saptanan alerjen ise ev tozu akarlarıydı.

Reassessing the Risks of MMR Vaccination for Egg-Allergic Patients Referred by Healthcare Workers; a Clinical Paradigm

Background: Egg allergy for the Measles-Mumps-Rubella (MMR) vaccine is still the cause of concern for many healthcare workers and families due to reactions such as anaphylaxis. Objectives: This study aimed to reassess the risk of MMR vaccination in infants with egg allergy referred by healthcare workers. Methods: This cross-sectional observational study was performed in a university-affiliated hospital in Istanbul, Turkey, between March 2017 and September 2018. The study patients were one-year-old infants who were candidates for MMR vaccination, and referred to our outpatient allergy clinic by healthcare workers due to egg allergy. The children were diagnosed with egg allergy by a pediatric allergist and then received the MMR vaccine. Results: Among 50 children aged one year, 19 (38%) were female, and 31 (62%) were male. The diagnosis was atopic dermatitis in 29 (58%) patients, urticaria in 18 (36%) patients, angioedema in 2 (4%) patients, and anaphylaxis in one (2%) patient. Fourteen (28%) patients had both egg and cow’s milk allergy. Four (8%) patients had egg, cow’s milk, and wheat allergy. The total IgE level was 119.80 ± 213.43 IU/mL. Specific IgE levels for egg white were positive in 37 patients. Specific IgE levels for egg white were 15.26 ± 29.64 kU/L. Skin prick test results were positive for egg allergens in 35 patients with a mean diameter of 3.12 ± 2.18 mm for egg yolk and 3.27 ± 2.62 mm for egg white. None of the patients with egg allergy developed anaphylactic reaction and only one patient had urticaria within 5 min after vaccination. There was no correlation between specific IgE levels for egg white and diagnosis of the patients. Conclusions: MMR vaccine administration to children with egg allergy is safe. Life-threatening reactions to the MMR vaccine in patients with egg-allergy are very rare. It seems in cases of hypersensitivity reactions such as acute anaphylaxis events, the MMR vaccine needs to be administered in a hospital under the supervision of a pediatric allergist.

Predictive fiberoptic endoscopic findings of upper airway in children with allergic rhinitis

ObjectiveTo determine predictive fiberoptic findings of upper airway in children with allergic rhinitis. Method129 children had fiberoptic evaluation of nasal cavity, pharynx and larynx. They were divided into allergic rhinitis group and normal group based on skin prick test results. All video recordings were randomly reviewed by three independent national board-certified otolaryngologists who were blinded to the clinical details and outcomes of the participants’ allergy testing. Each physician assessed and documented 10-item questionnaire. Intra-rater, inter-rater reliability and correlation between items and allergic status was calculated. ResultsIntra-rater reliability was moderate to perfect for all physicians on all items (kappa = 0.578–0.962). Inferior turbinate hypertrophy (κ = 0.714, p = 0.02), middle turbinate hypertrophy (κ = 0.728, p = 0.01), discoloration of inferior turbinate (κ = 0.685, p = 0.01), adenoid hypertrophy (κ = 0.662, p = 0.02) had good inter-rater reliability and these findings were predictive of allergic rhinitis. Adenoid hypertrophy was less encountered in allergic rhinitis. All other endoscopic findings beyond the nasal cavity were not predictive for allergic rhinitis in children. ConclusionNasal cavity findings including inferior turbinate hypertrophy, middle turbinate hypertrophy, discoloration of inferior turbinate and adenoid tissue assessment rather than pharyngolaryngeal findings are predictive of allergic rhinitis in children.

Efficacy and Safety of Sesame Oral Immunotherapy—A Real-World, Single-Center Study

The presence of sesame in Western diet is increasing, making its avoidance by sesame-allergic patients more challenging. To report the efficacy and safety of sesame oral immunotherapy (OIT). Sixty patients aged 4 years or older, diagnosed as sesame-allergic on the basis of a positive oral food challenge, were consecutively enrolled into OIT between November 2014 and November 2017. Fifteen patients with sesame allergy, based on a positive oral food challenge or a recent immediate reaction, and a positive skin prick test result or specific IgE, continued sesame elimination and served as observational controls. Immunologic parameters were measured in a subset (OIT, n= 16; controls, n= 11) at the start and end of the study. Fully desensitized patients continued daily consumption of 1200 mg sesame protein and challenged with 4000 mg after more than 6 months. Fifty-three OIT-treated patients (88.4%) were fully desensitized to sesame, compared with 0% of controls. Four additional patients (total 57 of 60= 95%) were desensitized to more than 1000 mg protein. Reactions occurred in 4.7% of hospital doses and 1.9% of home doses. Epinephrine-treated reactions occurred in 16.7% of patients for hospital and 8.3% for home doses. Significant decreases in rSes i 1 IgE (P= .007) and basophil reactivity (P= .001) and increases in sesame and rSes i 1 IgG4 (P= .001) occurred in OIT-treated patients but not in controls. Forty-seven patients desensitized to 4000 mg were evaluated more than 6 months after reaching maintenance. Only mild reactions were reported during maintenance, and all passed the 4000-mg challenge. Sesame-OIT is an effective alternative to sesame avoidance in allergic patients. The potential for adverse events necessitates its performance in specialized centers.

The role of the nasal allergen provocation test in local allergic rhinitis cases: a preliminary report.

IntroductionThe current state of knowledge is that allergic rhinitis can occur in two forms. One is allergic rhinitis as a manifestation of a systemic allergy with systemic atopy and positive results of skin prick tests or sIgE tests. The other is local allergic rhinitis (LAR) as a local allergic reaction affecting only the nasal mucosa without systemic atopy.AimTo attempt to assess the usefulness of the nasal allergen provocation test for the purposes of differential diagnosis and the qualification of LAR patients for therapy.Material and methodsThe subjects in the study were a group of 6 adults diagnosed with LAR on the basis of their medical history and the results of nasal allergen provocation tests, with the allergens being house dust mites (Dermatophagoides pteronyssinus, Dermatophagoides farinae). The methods adopted in the study were a point-based rating scale as a measure of nasal/extranasal complaints and active anterior rhinomanometry.ResultsSignificant differences (p < 0.05) were observed, using the subjective rating scale, in relation to registered nasal and extranasal complaints in the early phase of the allergic reaction. Similarly, the rhinomanometry method revealed significant differences in nasal resistance values before and after the administration of an allergen.ConclusionsThe nasal allergen provocation test is the only testing tool that objectively measures the degree of the patient’s allergic reactions and is useful in qualifying LAR patients for further therapy.

Hypoallergenic diet may control refractory epilepsy in allergic children: A quasi experimental study

Recent data has suggested a definitive role for inflammatory processes in the pathophysiology of epilepsy. In this study we hypothesized that food allergies, as chronic inflammatory processes, underlie the pathophysiology of refractory idiopathic epilepsy and investigated whether food elimination diets may assist in managing refractory epilepsy. The study was conducted on 34 patients up to 16 years of age with refractory convulsions who attended the Allergy Outpatient Clinic, Mofid Children Hospital between 2015 and 2016 with youngest and oldest participants at ages of 3 months and 16 years old, respectively. The participants were categorized into three groups according to the results of skin prick test and serum specific IgE measurements. Elimination diets were instituted for the patients with non IgE-mediated and mixed food allergies. The study was conducted for a period of 12 weeks. The participants were assessed for at least 50% reduction in number of seizures following the intervention. There was a significant reduction in number of seizures (p < 0.001) following the intervention. Seventeen patients (50%) did not experience any seizures after 8 weeks of treatment and 12 patients (35%) had a significant (51–99%) decrease in the number of their seizures. Five patients did not show any changes in their daily seizure frequency. The obtained data suggest that food allergy may play a role in triggering refractory epilepsies and their adequate response to treatment. A trial of elimination diet showed more than 50% seizure reduction in more than 85% of the children studied. However, we believe these results are preliminary and they motivate a fully controlled study in the future.

Serum Levels of Interleukin-10 and Tumor Growth Factor-β1 in Children With Eosinophilic Gastrointestinal Disorders Compared to Control Groups

Background: Eosinophilic Gastrointestinal Disorders (EGID) are a heterogeneous group of gastrointestinal disorders, associated with an increase of the eosinophils in the gastrointestinal mucosal tissue. Regulatory T cells (Tregs), as a subset of T cells, have a proven prominent role in immunopathology and protection against allergic diseases. Also, they appear to play a role in EGID pathogenesis. In the present study, serum levels of Tumor Growth Factor (TGF)-β and interleukin (IL)-10 were measured in patients with EGID compared to patients with Gastroesophageal Reflux Disease (GERD) and healthy subjects.Materials and Methods: A total of 34 patients with EGID, 23 with GERD, and 25 healthy controls were included in the study. The diagnoses of EGID and GERD were made based on the patients’ clinical symptoms, endoscopic findings, and biopsy confirmation. A questionnaire of demographic information, allergy history, as well as endoscopic-pathological and skin prick test results were completed and performed. The serum levels of TGF-β and IL-10 were measured using the ELISA method. Results: Family history of allergic disorders in patients with EGID or GERD was significantly high compared to healthy controls (P=0.010, P=0.005, respectively). There was a statistically significant increase in serum levels of TGF-β1 (P=0.025), but no significant difference was observed in serum level of IL-10 among three groups. However, the serum level of IL-10 was significantly high in a subgroup of patients with upper gastrointestinal eosinophilic involvement compared to the healthy controls (P=0.018).Conclusion: Significant increase in the serum level of IL-10 and TGF- β might be due to the Tregs dysfunction in EGID patients. Further studies should determine the role of Tregs in the pathogenesis of EGID.

The efficacy of allergen-immunotherapy in patients with pollen allergy in the Central and Western regions of Ukraine considering the specifics of their sensitization

Various sorts of weed plants with allergenic properties are extended on the territory of Ukraine. Weed’s distribution has regional characteristics. Clinically significant weed allergens are found in pollen from wormwood, ragweed, quinoa, plantain, and thistle. The main treatment for hay fever is allergen immunotherapy. The modern development of molecular diagnostics makes it possible to clearly identify the main allergen of weed pollen and, on this basis, offer the patient a personalized choice of allergen immunotherapy with the possibility of predicting its effectiveness. In order to determine the characteristics of sensitization to weeds in patients of the Central and Western regions of Ukraine and to evaluate the effectiveness of sublingual allergen immunotherapy (SLIT), 1.400 patients from 3 to 65 years of age were examined in these regions. Patients were evaluated general laboratory and instrumental studies, skin prick-tests (SPT), level total serum and specific IgE and component studies. A two-year course of immunotherapy was performed using sublingual allergens of wormwood and ragweed. Evaluation of the effectiveness of SLIT was performed using a visual analogue scale (VAS). According to the results of the study, positive SPT for mugwort was detected 1.2 times more often among patients in the western regions compared with the central regions. Regarding sensitization to ragweed, on the contrary, it was 3.2 times more often observed in patients of the central region. Component diagnostic data confirmed the results of SPT. Patients taking SLIT showed significantly lower VAS (P &lt; 0.05) compared with patients receiving symptomatic therapy. The regional characteristics of sensitization to various types of weeds were found. Latent sensitization to ragweed is increasingly found in patients in the western regions of Ukraine. Use in patients with AR and/or BA SLIT with standardized allergens is an effective and safe treatment method that allows you to quickly control symptoms.&#x0D;

Gender, prick test size and rAra h 2 sIgE level may predict the eliciting dose in patients with peanut allergy: Evidence from the Mirabel survey.

Peanut allergy management is based on active avoidance and access to emergency treatment including self-injectable adrenaline. Knowing the dose at which a patient is likely to react is crucial for risk assessment and could significantly improve management by integrating a personalized approach. To develop a threshold dose distribution curve model from routinely collected data. The MIRABEL survey is an observational study of 785 patients with peanut allergy/sensitization conducted in France, Belgium and Luxemburg. The current analysis included the 238 participants for whom medical and oral food challenge data were available. Several statistical models (Kaplan-Meier, Cox model, Weibull and Lognormal with predictive factors, basic Weibull and Lognormal) were compared to select the best model and predictive factor combination associated with the threshold doses. Inferences were made with a Bayesian approach. Patients were mainly children (mean age: 9years [IQR: 6-11]; 87% < 16years) and males (62%). Median Ara h2 s IgE was of 8kUA/L [IQR: 1-55] and median skin prick test size of 10mm [IQR: 7-13]. OFC was positive in 204 patients (86%). The median threshold dose was of 67mg of peanut protein [IQR: 16-244]. The dose at which 1% of the patients are likely to react with objective symptoms was 0.26 [0.03; 2.24] mg of peanut protein. Gender, size of the skin prick test (SPT) and Ara h 2 specific IgE level had a significant impact on the threshold dose distribution curve. The Cox model was the most effective to predict threshold doses with this combination of factors. Girls react to lower doses than boys with a beta coefficient associated to the risk and a 95% credible interval of 0.44 [0.04; 0.77]. The higher the size of the SPT and the Ara h 2 specific IgE level are, the higher the risk of reacting to a small amount of peanut, with beta coefficients associated to the risk and 95% credible intervals of 0.05 [0.02; 0.08] and 0.01 [0.01; 0.02], respectively. According to the model, routinely collected data could be used to estimate the threshold dose. The consequences could be the identification of high-risk patients who are susceptible to react to small amounts of peanut and a personalized management of peanut allergy integrating the risk of allergic reaction. Limitations of this study are that assessors of OFC outcome were aware of SPT and Arah2 results, and a further validation study is required to confirm the predictive value of these parameters.

Screening instrument to identify skin prick test-negative patients with asthma and/or rhinitis.

To the best of our knowledge, there is no prediction tool for determining respiratory allergy in patients with asthma and/or rhinitis. As such, this study aimed to develop an instrument for identifying skin prick test (SPT)-negative patients with asthma and/or rhinitis. This cross-sectional study screened 510 consecutive patients diagnosed with asthma and/or rhinitis between November 2009 and May 2011 in Ankara, Turkey. A structured questionnaire was the screening tool that was administered during the initial visit by the treating specialist and compared with a SPT result. All 15 variables were analysed using the logistic regression model to obtain β values (a score) for each variable. Each variable had a score, and scores were summed up to obtain final score for each patient. The study included 363 patients, of which 165 (45.5%) were SPT positive. The final model included 13 variables. The lowest and highest scores were -21 and 26. A total score of 5.5 had sensitivity of 63% and specificity of 80%. The area under the receiver operating characteristic curve was 0.78. The histogram of the total scores for the study population was bimodal. We designed a highly specific 13-item instrument for identifying SPT-negative patients. It may be used in middle income countries where allergy testing is expensive, not reimbursed or few allergy clinics are available. We think that our idea is interesting, that needs further research.

Chronological changes in rhinitis symptoms present in school-aged children with allergic sensitization.

IntroductionIt is difficult to accurately predict the natural course of allergic rhinitis (AR), because it is affected by a wide variety of environmental influences, as well as genetic predisposition. Considering the high prevalence of allergic rhinitis in children and adolescents, caregivers should be given appropriate information regarding the disease course. This study aimed to understand the prognosis of allergic rhinitis by examining the relationship between allergic sensitization and rhinitis symptoms during this developmental period.MethodsThis cross-sectional study included 1069 children aged 9–16 years from the Korean International Study of Asthma and Allergies in Childhood Survey database who had completed health questionnaires, and for whom skin prick test results were available. Data were collected during May 2016. The distribution of sensitization and allergic symptoms was compared by age groups (elementary, middle, and high school). Data were analyzed using linear-by-linear analysis.ResultsSensitization to at least one tested allergen differed by age (59.2%, 58.3%, 68.2%, in elementary, middle, and high school students, respectively; p = 0.025), and seasonal allergen sensitization (35.0%, 37.1%, 53.9%, respectively) increased with age (p < 0.001). Conversely, the proportion of rhinitis symptoms among sensitized children decreased as age increased (58.80%, 52.90%, 49.70%, respectively; p = 0.047). However, the rate of non-allergic rhinitis was age-independent.ConclusionWith increasing age during childhood and adolescence, symptomatic allergic rhinitis decreases; thus, subclinical allergic rhinitis increases. This suggests that the symptoms of later-sensitized children are less clearly manifested, or that the symptoms reduce as previously sensitized children mature. This should be clarified further in a longitudinal study.

Evaluation of periostin level for predicting severity and chronicity of childhood atopic dermatitis.

IntroductionPeriostin has some effects on the pathogenesis of atopic dermatitis (AD) via release of pro-inflammatory cytokines and chemokines from activated keratinocytes and it is related to chronicity of skin lesions.AimTo evaluate the relationship between plasma periostin levels and severity and chronicity of AD in children.Material and methodsThe study population consisted of 29 children with atopic dermatitis without concomitant allergic disease such as asthma or allergic rhinitis and 31 healthy controls. Data of demographic features, serum eosinophil, total IgE and skin prick test results were collected through the patient’s medical records. The severity of the disease was assessed by the SCORAD index. Serum periostin levels were measured with a human periostin ELISA kit.ResultsThe mean ages of the AD patients and the control group participants were 80.7 ±52.8 and 90.3 ±41.6 months, respectively. Mean plasma periostin levels were 63.0 ±19.0 ng/ml in AD patients, and 23.6 ±7.3 in healthy controls, and there was a statistically significant difference between the two groups (p = 0.001). Plasma periostin level did not vary according to total IgE or serum eosinophil count (p > 0.05). Age of onset and duration of symptoms also were not correlated with plasma periostin levels. Although there was a positive relationship between plasma periostin level and the SCORAD index of patients, it was not statistically significant (r = 0.19, p > 0.05).ConclusionsThis study showed that plasma periostin levels were increased in children with atopic dermatitis. Periostin may have a partial role in the pathogenesis of atopic dermatitis, but it is not associated with severity or chronicity in children with atopic dermatitis.

Can evaluation of specific immunoglobulin E serum concentrations of antibodies to aeroallergens in atopic dermatitis patients replace skin prick tests method in clinical practice?

IntroductionPositive skin prick tests (SPT) results with protein allergens are the minor Hanifin and Rajka’s atopic dermatitis (AD) criterion. In adults, they mainly concern aeroallergens. The inflammation of skin often prevents SPT, but does not exclude the assessment of serous specific immunoglobulin E (sIgE) concentrations.AimTo assess usefulness of testing AD patients to aeroallergens with SPT and sIgE concentrations, and the correlation of these results and the clinical AD course.Material and methodsIn 286 AD patients, total IgE and sIgE (14 aeroallergens) were measured. SPTs were performed with 17 aeroallergens. The AD severity was determined depending on the concurrent co-existence of asthma, allergic rhinitis, extensive skin flares and severe itching.Results59.1% and 66.1% of patients have had positive results of sIgE and SPT, respectively (p > 0.05). The concentration of total IgE has positively correlated with the number of positive sIgE results (rho = 0.588, p < 0.001) and their intensity (rho = 0.592, p < 0.001). Among the patients with at least one high positive sIgE score, severe AD patients have been dominant (59.8% vs. 40.2%, p < 0.04). Among the patients with positive results without any high scores, the percentages are 21.6 and 78.4, respectively (p < 0.001).ConclusionsThe compatibility of SPT results and IgE concentrations indicates that the two methods equally assess aeroallergy in AD patients. The assessment of sIgE concentrations is especially advisable in patients with an elevated total IgE level. The obtained results may suggest that presence of a high specific IgE level of antibodies to aeroallergens may be the factor predicting a severe clinical AD course.

Skin prick test results to food allergens in patients with allergic rhinitis

Aim: The role of food allergy in etiology of allergic rhinitis (AR) has not been well established. Allergic rhinitis may be a component of other atopic disorders. So it is difficult to assess the true prevalence of food induced allergic rhinitis. The aim of this study is to evaluate the skin prick test (SPT) results for some food allergens in allergic rhinitis patients. Material and Methods: A total of 31 items SPT results of 110 patients diagnosed with allergic rhinitis including food allergens and inhalant allergens were evaluated retrospectively. Chi-square test was used for statistical analysis. P value < 0.05 was considered as statistically significant. Results: Out of all patients 76.4% had positive reaction to at least one allergen while 23.6% had negative SPT to all allergens. Sixty point nine % of patients had positive result for at least one food allergen and 67.5% for at least one inhalant allergen. Nine point one % of patients had positive test results for only food allergens. The most common positively detected food allergens were flours (rye, barley, oat flour) and peanut. Positive test results for cow’s milk was higher in patients under 18 years of age. Also positive test results to egg and cow’s milk were statistically significantly higher in patients with atopic status than non - atopic. Conclusion: According to our study findings, allergic rhinitis patients may have uncertain sensitivity to cereal flours. It seems that; independently from allergic rhinitis, atopic status is the main condition in patients with cow’s milk and egg allergies.