Specific Allergen Research Articles

Specific aeroallergen sensitization associated with current rhinitis among adults in southwestern Saudi Arabia.

Data about allergic sensitization to rhinitis among adults are limited. The objectives were to explore the prevalence of current rhinitis (CR) and associated specific allergen sensitizations in southwestern Saudi Arabia. A cross-sectional study was conducted on 969 adults in southwestern regions of Saudi Arabia, namely Aseer, Jazan, and Al Baha. From each region, 5 primary health care centers were chosen. The validated Arabic Version of the International Study of Asthma and Allergies in Childhood questionnaire was used. Total immunoglobulin E (IgE) enzyme-linked immunosorbent assay, cytokine enzyme-linked immunosorbent assay (interleukin [IL]-4, IL-10, IL-13, and interferon-γ), aeroallergen-specific IgE immunoassay (a panel of 30 common aeroallergens; 9 indoor and 21 outdoors), and eosinophilic count were assessed. A prevalence of CR of 35.8% (95% confidence interval: 32.8%–38.9%) was found. Regarding outdoor aeroallergens, Mesquite-positive IgE antibodies were higher among CR adults (odds ratio = 1.52, 95% confidence interval: 1.02–2.21) compared to those without CR. The same significant pattern was found with Chenopodium, Ragweed, Pigweed, Russian thistle, Bermuda grass, Timothy grass, and Rye. All indoor aeroallergens were not significantly associated with CR. Total IgE and eosinophil count were significantly higher among adults with CR. In conclusion, CR in southwestern regions of Saudi Arabia is common and of significant public health importance. Aeroallergens that associate with adult sensitization to CR tend to be of the outdoor variety particularly the herbaceous grass and their pollens. The magnitude of CR and its association with exposure to outdoor aeroallergens should be taken into account by health policy decision makers, clinicians, and medical practitioners when diagnosing and treating related conditions.

An innovative approach for better understanding of milk allergy

Introduction: Cow’s milk and its products are popular components of the diet all over the world. Proteins contained in it, such as casein (Bos d 8), α-lactalbumin (Bos d 4), β-lactoglobulin (Bos d 5) and bovine serum albumin (Bos d 6, BSA), can cause troublesome symptoms. Among the proteins mentioned, casein is the most frequent cause of all milk allergies. It is worth mentioning that it is a protein that does not change its properties after thermal and enzymatic treatment. Therefore, casein allergic patients must avoid dairy products in even trace amounts.
 Aim of the study: The aim of the study is to present the benefits of molecular diagnostics of allergy in cow’s milk allergy.
 Description of the state of knowledge: In order to diagnose milk allergy, a medical examination should take place with a clinician who will determine the further steps of diagnosis based on the medical interview. For a complete allergy analysis, molecular diagnostics tests can be used to determine which protein the patient is sensitised to. Such an individual patient’s allergy profile is helpful in developing an appropriate diet.
 Summary: Molecular diagnosis in cow's milk allergy allows to estimate the risk of severe reactions after contact with a specific allergen. On its basis, it is also possible to predict the result of a cow's milk allergen provocation test. By using molecular diagnosis of allergy, it is possible to manage better and control cow's milk allergy in patients.

Extracellular microbial proteases with specificity for plant proteins in food fermentation

Plant-based food products are generating a growing interest as part of the ongoing transition to a primarily plant-based diet, which makes demands to the quality, functionality, and health properties of plant proteins. Microbes used for traditional food fermentations such as lactic acid bacteria (LAB) and fungi (yeasts and molds) carry out enzymatic changes on their protein substrates by which technological and sensorial characteristics can be improved. The literature on extracellular proteases targeting plant proteins, on the other hand, is scattered with only a narrow representation of plants even for traditionally plant-based products. Therefore, this review aims to explore the current state of knowledge regarding the application potential of microbial extracellular proteases targeting plant proteins, with a focus on traditional applied food microbes. Plant proteins are targeted by proteolytic microbes of both animal and plant origins, and their proteases show a wide range of activities. Extracellular microbial proteases can hydrolyze specific protein-based allergens and even reduce the toxicity of plant proteins. Additionally, microbial assisted proteolysis can improve plant protein digestibility by increasing availability of peptides and amino acids. This catabolic process will change the organoleptic characteristics of fermented plant proteins, and the release of bioactive peptides can provide additional functionalities to the plant matrix. The proteolytic activity is determined by the microbial strain, and it can be quite substrate selective, which is why proteases may be overlooked by the prevalent use of casein as substrate in proteolytic screenings. The synergetic effects of LAB and fungal species consortia can facilitate and steer plant protein hydrolysis by which co-fermentation may increase or change the properties of plant protein hydrolysates. Microbes do not necessarily require extracellular proteases because endogenous proteases in a plant-matrix may meet the microbial amino acid requirements. However, extracellular proteases have the potential to provide central properties to diverse food-matrixes by which the full proteolytic potential of food microbes needs to be explored in order to facilitate the development of high-quality plant-based food products.

Phenotypes of Allergic Asthma: Does In-Vitro Allergy Testing Help Predict Asthma Disease Severity?

Allergy and asthma are often diagnosed concomitantly. Patients with both diagnoses might need to have a more targeted approach to reduce the symptomatic burden and severity of disease. This study was designed to explore the relationship between specific allergen sensitization, and asthma diagnosis and severity with the hypothesis that patients who tested positive to a higher allergy class of response and to more allergens would be more likely to have severe asthma. A retrospective review was performed on 1419 charts that had a positive IgE allergy class blood test between 2014 and 2018. A total of 701 patients had one or more positive tests and a diagnosis of asthma. Patient demographics and pertinent variables including all clinic and ED visits, specific allergy and class of response, and information related to their asthma treatment and severity were recorded. Logistic regression was used to analyze the likelihood of asthma diagnosis, concomitant diagnosis of asthma and allergic rhinitis, and measures of asthma severity. Higher class of response to cat dander 1.24 (1.09, 1.41), dog dander 1.29 (1.13, 1.47), lamb's quarter 1.35 (1.06, 1.70), house dust 1.41 (1.11, 1.82), Cladosporium herbarum 1.35 (1.07, 1.67) or cockroach 1.56 (1.00, 2.44) showed increased odds of hospitalizations. There was a statistically significant difference between the average number of classes for patients with and without asthma (P < .001), and those with and without steroids (P < .001). This study found that positivity to cat dander, dog dander, some fungus, and house dust was associated with more severe asthma.

Dietary fibre in relation to asthma, allergic rhinitis andsensitization from childhood up to adulthood.

BackgroundDietary fibre may reduce the risk of allergy. Our aim was to investigate the association between fibre intake in childhood, asthma, allergic rhinitis and IgE sensitization up to adulthood.MethodsThe individual fibre intake of 2285 participants from the Swedish population‐based birth cohort BAMSE was estimated between 98‐ and 107‐item food frequency questionnaires at ages 8 and 16 years, respectively. At 8, 16 and 24 years, asthma and allergic rhinitis symptoms were assessed by questionnaires, and sensitization to common allergens by serum IgE. Longitudinal associations were analysed by generalized estimating equations, adjusting for potential confounders.ResultsAn inverse overall association was indicated between fibre intake at 8 years and allergic rhinitis symptoms up to 24 years (OR per 5 g/d 0.86; 95% CI 0.77–0.96), particularly in combination with airborne (0.74; 0.62–0.89) and food (0.69; 0.54–0.88) allergen sensitization. Higher fibre intake was also associated with specific allergen sensitization, for example, birch (0.77; 0.67–0.88) and soy (0.68; 0.53–0.87). No association was observed with asthma. Regarding sources, fruit (0.79; 0.67–0.94) and other (potatoes, chips/popcorn, legumes, and nuts, 0.71; 0.50–0.99), but not cereal or vegetable fibre were associated with allergic rhinitis. In additional analyses, including long‐term fibre intake at 8 and 16 years, excluding participants with food‐related allergic symptoms to examine reverse causation, as well as adjusting for antioxidant intake, associations were attenuated and became non‐significant.ConclusionHigher fibre intake in mid‐childhood may be inversely associated with allergic rhinitis and sensitization to specific allergens up to adulthood. However, avoidance of food triggers of allergic symptoms in allergic rhinitis patients may contribute to the protective associations.

Detecting common allergens in dogs with atopic dermatitis in South Korean Provinces using a serological immunoglobulin E-specific allergen test.

Background and Aim:Canine atopic dermatitis (CAD) is a hereditary susceptibility to the development of allergic symptoms in response to repeated exposure to generally innocuous substances known as “allergens.” Allergens can be plants, animals, mold, mites, or milk. At present, serological enzyme-linked immunoassay (ELISA) kits are used for immunoglobulin E (IgE)-specific allergen detection due to their simplicity and accuracy. This study aimed to detect allergens in dogs with CAD and determine how they differ according to season, breed, age, and sex using a serological test in six provinces in South Korea for 12 months. This will allow practitioners to easily understand the risk factors related to CAD.Materials and Methods:In this study, IgE allergen-specific ELISA kits were used. The allergens were detected in serum samples collected from different regions considering season, sex, breed, and age. Allergens were divided into the following Ten categories: 1. Dairy, yeast, and egg, 2. grains, 3. vegetables, 4. meat, 5. seafood, 6. animals, 7. mold, 8. insects, 9. mites, and 10. trees.Results:The percentage of allergens detected in males (54.8%) was higher than that of females (45.2%); 54.2% of allergens occurred in 3-year-old dogs or older. Moreover, regarding frequency, 65.6% of overall allergens occur during autumn; Chungcheongnam-do and Jeollabuk-do showed 20.7% and 20.9%, respectively. Additionally, among allergens categories, notable allergen occurrence was as follows: 38.3% corn; 28.7% potatoes; 22.7% duck; 24.4%,codfish; 31.2% animal wool; 95.6% Aspergillus fumigatus; 31.9% flea; 41.8% oak; and 25.0% sheep’s sorrel grass.Conclusion:This study showcases the frequency of 60 allergens in six provinces detected in dogs with CAD; most likely from food or the environment using serological ELISA kits. Environmental sensitizer results can be considered for humans suffering from allergies to avoid a similar environment. A large-scale study can be performed to evaluate the allergens in the state. However, neither a skin test nor feed analysis was conducted, which is a limitation of this study.

Recent Advances in Electrochemical Sensing Strategies for Food Allergen Detection.

Food allergy has been indicated as the most frequent adverse reaction to food ingredients over the past few years. Since the only way to avoid the occurrence of allergic phenomena is to eliminate allergenic foods, it is essential to have complete and accurate information on the components of foodstuff. In this framework, it is mandatory and crucial to provide fast, cost-effective, affordable, and reliable analysis methods for the screening of specific allergen content in food products. This review reports the research advancements concerning food allergen detection, involving electrochemical biosensors. It focuses on the sensing strategies evidencing different types of recognition elements such as antibodies, nucleic acids, and cells, among others, the nanomaterial role, the several electrochemical techniques involved and last, but not least, the ad hoc electrodic surface modification approaches. Moreover, a selection of the most recent electrochemical sensors for allergen detection are reported and critically analyzed in terms of the sensors’ analytical performances. Finally, advantages, limitations, and potentialities for practical applications of electrochemical biosensors for allergens are discussed.

Development of a Novel Lateral Flow Immunoassay for Detection of Harmful Allergens Found in Dust

Prior research has shown that specific allergens from house pests, including mice, dust mites, and cockroaches, can lead to worsened symptoms for asthmatic patients. These allergens can be found in indoor environments where dust collects, such as homes, schools, or hospitals. There currently is a need for an accurate, easy-to-use, inexpensive sensor that is capable of detecting and quantifying the amount of these allergens in samples of dust collected in these indoor environments. This sensor would help lead to treatment of pest problems in affected areas and allow for further study of the interaction between these allergens and health outcomes. To create this biosensor, a lateral flow assay has been developed. The developed system uses novel polymer-based materials created by electrospinning. The polymers used in this work include Cellulose Acetate (CA) and Polyvinylpyrrolidone (PVP). Electrospinning is a process where high voltages are used with a syringe pump to create a Taylor cone that sends a polymer jet onto a collector plate. This polymer jet collects on the collector plate as polymer nanofibers, which after aggregation with other nanofibers become a nanofibrous polymer mat. In our work, electrospun polymers have been functionalized for use in traditional portions of a lateral flow immunoassay testing strip. Antibodies encapsulated using polymer processing techniques, and antibodies immobilized onto electrospun polymer material allow for the traditional sandwich detection method when allergen is present. The sandwich detection method makes use of the binding of two antibodies, at different and non-inhibiting binding sites, to a single allergen to cause an observable and measurable color change when the allergen is present. An illustration of the sandwich detection technique is included as the abstract image. One of the antibodies must be immobilized, and the other must be optically labeled for the sandwich to produce a color change. We also have developed a wicking polymer using electrospinning to act as the backbone for our biosensor strips. This is a novel application of electrospun polymers for wicking, and we have worked to characterize and optimize the wicking properties of this material. The use of electrospinning to create functional polymers, which are biocompatible, inexpensive, and relatively safe, poses advantages over the materials typically used in literature, including nitrocellulose, which is a flammability hazard. This novel wicking material has high potential for future use in lateral flow assays and other biosensing techniques that make use of wicking materials. A collaborative group is working to create a phone application that will use the color produced by the strip when a sample is loaded to determine the amount of allergen in the sample and estimate the severity of the indoor environment’s pest problem. The combination of the optical sensor and phone app will enable quantitative measurement of harmful allergens in the dust sample. This will allow the user to take necessary action to remove pests and dust that is worsening asthma symptoms and related health outcomes. Future work in this project includes working to improve the sensitivity of the color change, which will require signal amplification techniques and analysis of different labeling methods. Additionally, the novel wicking material, allergen detection technique, and phone application could be modified to detect other biomolecules of interest for important health, environmental, or related fields. Figure 1

Types of Allergens among Patients Undergoing Skin Allergy Testing in the South Region of Saudi Arabia

Background: Allergy skin testing can help identify the specific causative allergens to confirm the diagnosis and design treatment for Allergic rhinitis. Objective: The study aimed to assess the types of allergens among participants who underwent Skin Allergy Test in the Southern Region of Saudi Arabia. Methods: This retrospective review of hospital records examined the results of the skin prick test from January 2018 to October 2020. Participants who underwent the same panel of allergens were included. Results: Forty-two participants were included. Only one participant (2.4%) showed no response toward any allergen, while the remainder (97.6%) exhibited a positive reaction toward at least one allergen. The highest rates of sensitization were to pollens (83.3%), followed by house dust mites (14.3%), and animal epithelia (28.6%). The most frequent pollens were Bermuda grass (64.3%), followed by Ryegrass (26.2%) and Russian thistle (21.4%). Positive reactions to Dermatophagoides pteronyssinus and Dermatophagoides farinae were observed in 14.3% and 9.5% of participants, respectively. The rates of sensitization to Epithelia of the cats were higher than that to Epithelia of dogs (26.2% vs. 14.3%, respectively). No significant association was detected between the type of aeroallergen and the age or gender of the participants. Conclusions: The most prevalent aeroallergens in the Southern region of Saudi Arabia are pollens, followed by house dust mites and animal epithelia. Sensitization to more than one allergen was common. The use of preventive measures is warranted to reduce sensitization to allergens.

Oral administration of Lactiplantibacillus plantarum NR16 isolated from Kimchi ameliorates murine allergic rhinitis.

Allergic rhinitis (AR) is a type I hypersensitivity mediated by dominant T helper 2 (Th2) response over the Th1 response after re-exposure to a specific allergen. Currently, socio-economic cost evoked by AR is quickly increasing since the prevalence of AR is gradually increasing in all ages worldwide. Several probiotic Lactobacillus strains have been described with potential immunomodulatory effects against type I hypersensitivity such as AR. Thus, the aim of the present work was to characterize basic probiotic property and immunomodulatory role of newly isolated Lactobacillus strains from Kimchi, a traditional fermented Korean food, in AR. Among the identified strains, Lactiplantibacillus plantarum NR16 revealed to be a powerful Th1 inducer since immune cells co-cultured with NR16 produced the highest quantity of interferon-γ (IFN-γ) and interleukin-12 (IL-12) but secreted a low amount of IL-4 invitro. Therefore, NR16 was selected for the following assays conducted with mice with birch pollen-induced AR. Oral administration of NR16 reduced airway hyperresponsiveness and leukocyte infiltration in lesions of mice. In conclusion, oral administration of NR16 may mitigate symptoms of AR by inducing Th1 immune response, which might rebalance Th2/Th1 ratio by decreasing Th2 cytokine production in specific lesions of mucosa.

Prevalence of Allergic Rhinitis in Patients Diagnosed with Chronic Rhinosinusitis in a Tertiary Care Hospital

Background: Chronic rhinosinusitis (CRS) is an inflammatory disorder of the nose and paranasal sinuses lasting for 12 weeks or longer. Aim: To explore the prevalence of allergic rhinitis and common allergens in chronic rhinosinusitis patients. Methods: The study was conducted in Department of ENT at Dr. Akbar Niazi Teaching Hospital Islamabad from April 2021 to March 2022. On the basis of inclusion criterion, one hundred patients of CRS included in this study. All patients met the diagnostic criteria for CRS through, history, nasoendoscopic examination, and radiological findings. Allergic rhinitis was diagnosed on the basis of skin prick test (SPT). All patients who were operated for CRS were excluded from the study. Results: Male and female ratio was almost equal with slight male predominance. The incidence of polypoidal CRS and non-polypoidal CRS was 52 (52%) and 48 (48%) respectively. Almost two third of polypoidal CRS patients suffered from severe disease based on Nasoendoscopic examination and radiological findings (CT-Scan). The commonest presenting symptoms were nasal discharge and nasal blockage effecting around 92% and 91% patients respectively. Skin prick test (SPT) showed 73% patients were suffering from allergic rhinitis with pet dander being the most common allergen. Conclusion: Chronic Rhinosinusitis is a common disease and majority of patients develop CRS secondary to allergic reaction. Early diagnosis of allergic rhinitis with identification of specific allergens and its management can help in prevention of CRS. Keywords: Allergic rhinitis (AR), Chronic rhinosinusitis (CRS), Sinunasal Polyposis, non-allergic rhinitis, Skin prick test (SPT)

THE USE OF INTRADERMAL SKIN TESTING AND HYPOSENSITIZATION INJECTIONS TO CONTROL SEASONAL DERMATITIS IN GREATER ONE-HORNED RHINOCEROSES (RHINOCEROS UNICORNIS).

Allergic dermatitis was diagnosed in a 25-yr-old female greater one-horned rhinoceros (Rhinoceros unicornis) and her 6-yr-old female offspring by skin biopsy, intradermal skin testing (IDST), and allergen-specific serum IgE testing. Dam and offspring presented with seasonal, erosive, and ulcerative dermatitis affecting the face, legs, and trunk starting at 6 and 2 yr of age, respectively. IDST was performed at the caudal pinnal base using 61 regionally specific allergens. Specific serum allergen responses were detected using Heska's Equine ALLERCEPT® Allergen Panel. Histopathology of the lesions was consistent with an allergic etiology. Injectable allergen-specific immunotherapy was initiated in both animals and within 6 to 18 mon after commencing hyposensitization clinical improvement was noted. This report documents a repeatable methodology for IDST and serological allergen testing for use in rhinoceroses. The hyposensitization protocol detailed here can help guide future treatment protocols.

Immunological Pathomechanisms of Spongiotic Dermatitis in Skin Lesions of Atopic Dermatitis.

Atopic dermatitis (AD) is a chronic pruritic skin disease with a complex pathogenesis underlying its heterogeneous clinical phenotypes and endotypes. The skin manifestation of AD reflects the cytokine milieu of a type-2-dominant immunity axis induced by genetic predisposition, innate immunity dysregulation, epidermal barrier defects, and allergic inflammation. However, the detailed pathomechanism of eczematous dermatitis, which is the principal characteristic of AD, remains unclear. This review examines previous studies demonstrating research progress in this area and considers the immunological pathomechanism of “spongiotic dermatitis”, which is the histopathological hallmark of eczematous dermatitis. Studies in this field have revealed the importance of IgE-mediated delayed-type hypersensitivity, the Fas/Fas-ligand system, and cell-mediated cytotoxicity in inducing the apoptosis of keratinocytes in spongiotic dermatitis. Recent studies have demonstrated that, together with infiltrating CD4 T cells, IgE-expressing dendritic cells (i.e., inflammatory dendritic epidermal cells and Langerhans cells) that capture specific allergens (i.e., house dust mites) are present in the spongiotic epidermis of lichenified eczema in patients with IgE-allergic AD. These findings suggest that IgE-mediated delayed-type hypersensitivity plays a pivotal role in the pathogenesis of spongiotic dermatitis in the skin lesions of AD.

Factors Associated with Non-adherence to Specific Allergen Immunotherapy in Management of Respiratory Allergy

Non-adherence to specific allergen immunotherapy is a major hurdle faced by the allergist, contributing to poor clinical outcomes. To assess the independent association of various factors with non-adherence to specific allergen immunotherapy. Fifty consecutive (non-adherent) and control (adherent) subjects receiving specific allergen immunotherapy were included in the study and various factors related to non-adherence including socio-demographic, clinical and immunotherapy related variables were compared between the two groups by univariate and multivariate analysis. On univariate analysis, gender, allergic conjunctivitis, family history, progression of disease, perception of immunotherapy, medicine requirement, and the pattern of missed doses greater than two in the last 10, 20 and 30 doses were found to be significantly associated with non-adherence. On multivariate analysis, independent association was observed with allergic conjunctivitis, family history, perception of immunotherapy, missed doses greater than two in the last 10 doses of immunotherapy and medicine requirement. The independent factors associated with non-adherence may vary between different settings and countries. There is a need for developing individual case holding programmes to improve clinical outcomes in patients receiving specific allergen immunotherapy.

Lactobacillus gasseri MG4247 and Lacticaseibacillus paracasei MG4272 and MG4577 Modulate Allergic Inflammatory Response in RAW 264.7 and RBL-2H3 cells.

Allergic inflammation refers to a hyperimmune reaction that causes hypersensitivity responses such as hives, itchiness, runny nose, and cough due to specific allergens. Allergic diseases are known to be influenced by the diversity and distribution of intestinal microbiota, and Lactobacill is known to relieve allergic symptoms by modulating cytokines secreted by T helper type 1 (Th1)/Th2 cells. This study was designed to investigate the effects of Lactobacillus gasseri MG4247 and Lacticaseibacillus paracasei MG4272, MG4577, and MG4657 on levels of pro-inflammatory cytokines and proteins associated with allergic symptoms in RAW 264.7 macrophages, and RBL-2H3 mast cells, as well as their probiotic properties. MG4247, MG4272, and MG4577 significantly reduced tumor necrosis factor-α and interleukin (IL)-6 levels in LPS-induced RAW 264.7 macrophages, and markedly decreased IL-4, IL-5, and IL-13 levels and STAT6 phosphorylation in DNP-IgE/HSA sensitized RBL-2H3 mast cells. Furthermore, MG4247, MG4272, and MG4577 tolerated the acidic condition with pepsin and basic condition with bile salt, and showed a high adhesion rate (≥ 73.9%). In safety evaluation, MG4247, MG4272, and MG4577 showed no hemolytic or bile salt hydrolase activity and no cytotoxicity to HT-29 cells (≥ 96.7%). Hence, MG4272, MG4272, and MG4577 can be used as candidate probiotic strains to relieve cytokines associated with allergic inflammation. Supplementary InformationThe online version contains supplementary material available at 10.1007/s12602-022-09950-4.

Unraveling the Pathogenesis of Asthma and Chronic Obstructive Pulmonary Disease Overlap: Focusing on Epigenetic Mechanisms.

Asthma and COPD overlap (ACO) is characterized by patients presenting with persistent airflow limitation and features of both asthma and COPD. It is associated with a higher frequency and severity of exacerbations, a faster lung function decline, and a higher healthcare cost. Systemic inflammation in COPD and asthma is driven by type 1 T helper (Th1) and Th2 immune responses, respectively, both of which may contribute to airway remodeling in ACO. ACO-related biomarkers can be classified into four categories: neutrophil-mediated inflammation, Th2 cell responses, arachidonic acid-eicosanoids pathway, and metabolites. Gene–environment interactions are key contributors to the complexity of ACO and are regulated by epigenetic mechanisms, including DNA methylation, histone modifications, and non-coding RNAs. Thus, this review focuses on the link between epigenetics and ACO, and outlines the following: (I) inheriting epigenotypes without change with environmental stimuli, or epigenetic changes in response to long-term exposure to inhaled particles plus intermittent exposure to specific allergens; (II) epigenetic markers distinguishing ACO from COPD and asthma; (III) potential epigenetic drugs that can reverse oxidative stress, glucocorticoid insensitivity, and cell injury. Improved understanding of the epigenetic regulations holds great value to give deeper insight into the mechanisms, and clarify their implications for biomedical research in ACO.

Peculiarities of the etiological spectrum of household allergens

The aim of the study was to study the range of substances that cause respiratory sensitization in adults and children living in Dnipro as of 2019.&#x0D; Materials and research methods. Enzyme-linked immunosorbent assay was used to study the serum of venous blood, which determined the specific IgE of up to 9 allergens that are most common in the home. Kits for quantification of allergen-specific IgE from Vitrotest Specific-IgE, Ukraine were used. Conducted allergy diagnosis for 380 people with certain features of allergy history of various types of allergies, who went to the laboratory to specify the etiological root cause of their disease.&#x0D; Research results. As a result of the analysis of the received data the distribution of allergens on their prevalence among the population of Dnipro was established. The degree of hypersensitivity to each specific allergen and their ability to cross-react with each other was determined. Among the allergens of the household panel, the most dangerous were allergens of molds, which caused a sensitization reaction in 292 people, which was 76.8 % of all surveyed. The top three (in prevalence) of household allergens included: cat epithelium, which caused sensitization in 125 people (32.9 %) and Derm mite. Farinae, sensitivity to which was found in 117 patients (30.7 %). The share of inadequately strong allergopathological reactions is one third of all examined and prevails in people with sensitization to allergic agents of the household panel such as cat epithelium, Derm mite. Farinae and Derm. Pteronyssinus. Hyperractivity to fungi of the genus Candida and mold has been found in 9–12 % of people. The lowest severity of sensitization was observed in the epithelium of the dog and house dust, and low sensitivity in the reactivity structure of allergopathological reactions was observed for allergens of the epidermal group (down and feathers of poultry) and cockroaches. The development of cross-reactions took place between allergens of epidermal origin: there was a hypersensitivity to the hair and epithelium of dogs and cats (r=0.94, P˂0.01), poultry feathers and cockroaches (r=0.99, P˂0.01). This association of cross-reactions is possible, given the theory of minor and major proteins, and is due to their similarity: the similarity of the inclusion in the allergen structures of specific forms of molecules inherent in both allergic agents that may have allergy-stimulating effects.&#x0D; Conclusions. Cross-linking between several types of related allergens is the best way to further investigate this issue. It makes sense to include in the laboratory study a molecular method for the determination of major and minor proteins in the case of the greatest relationship to determine not only a specific allergen as an etiological factor, but also a specific sensitizing protein that is part of them. This is of great importance for subsequent immunotherapy when the removal of only one (major) protein agent can reduce the risk of susceptibility reactions to several types of allergens

The Added Value of Patch Testing Beyond the Baseline Tray.

The patch test is the standard for diagnosing allergic contact dermatitis. Standardized trays allow the examination of the most prevalent allergens, whereas customized trays are more appropriate for addressing specific allergens and require expertise. They are therefore usually performed in specialized clinics. We assessed the results of 4355 patch tests performed between 2012 and 2020 in a contact dermatitis clinic located in a large tertiary medical center. All patients were tested using the European baseline series and additional trays as clinically indicated. We assessed the frequency of relevant positive reactions outside the European baseline series. We then examined the added value and number of tests (NNTs) that need to be performed to elicit one relevant positive reaction per tray and common allergens. Nine hundred fifty-four patients (21.9%) had 1 or more positive relevant reactions; 43.3% tested positive for an allergen outside the European baseline series (OEBS). The acrylate and fragrance trays were highly represented among the positive and relevant reactions OEBS with NNTs of 4.4 and 6.8, respectively. 2-Hydroxyethyl methacrylate is the most prevalent allergen OEBS and is considered a marker for acrylate sensitivity with a high rate of cross-reactions and concordance rate of 85%, justifying its addition to the EBS in 2018. Other highly represented allergens include chloramphenicol, 2-hydroxyethyl acrylate, and Amerchol L-101, a lanolin derivative. The cosmetics and textile trays, although often tested, have relatively low added values of 3.7% and 2.3%, respectively. Surprisingly, the cutaneous adverse drug reaction series tray (CAD-1000) yielded no positive reactions, whereas testing the patients' medication yielded positive results in 10.9% of the cases. Expanded patch testing is crucial to accurately diagnose allergic contact dermatitis and almost doubles the number of patients with relevant positive reactions. Acrylate sensitivity is an emerging epidemic with a high positive reaction rate and low NNT, as is sensitivity to the allergens in the fragrance tray. 2-Hydroxyethyl methacrylate is a reliable marker for acrylate sensitivity with a concordance rate of 85%. Chloramphenicol is a common culprit and should be added to the standard tray in countries with a high usage rate. A low NNT was also observed when testing the patients' own cosmetics and medications; this should, therefore, be encouraged. The textile tray yielded a relatively high NNT; however, it should be performed when clinically indicated in the absence of a reliable marker in the EBS.

A comprehensive comparison between ISAC and ALEX2 multiplex test systems.

Diagnosis of type I hypersensitivity is based on anamnesis, provocation as well as blood- and skin testing. Multiplex specific IgE (sIgE) testing enables determination of sIgE antibodies against multiple recombinant or purified natural allergen components. The aim of this study was to evaluate the performance of the novel ALEX2® (Allergy Explorer, ALEX2 test introduced on the market November 2019) multiplex platform and to compare it with the ImmunoCAP ISAC® test system. Serum samples of 49 patients, routinely determined with ISAC, were selected based on positive results covering in total most of the 112 ISAC components. Cohen's kappa, negative percent agreement (NPA), and positive percent agreement (PPA) of ALEX2 data compared to ISAC data (as a non-reference standard) were computed for those allergen components present on both platforms (n=103). Furthermore, in some samples sIgE results against allergen extracts and/or -components tested with either ImmunoCAP® (ThermoFisher) or IMMULITE® (Siemens) were available and compared to ALEX2 results. The overall agreement between ISAC and ALEX2 common allergen components was 94%. NPA and PPA were respectively 95 and 90%. Kappa values differed for specific allergen groups and varied between 0.60 and 0.92 showing moderate to almost perfect agreement. Of the qualitative discrepancies between ALEX2 and ISAC, 59% were related to weak positive results i.e. results under 1 kUA/L or 1 ISU, respectively. The method comparison between ISAC and ALEX2 multiplex tests showed a high concordance for those allergen components present on both platforms.

Simultaneous quantification of specific food allergen proteins using a fluorescent multiplex array

The aim was to develop a fluorescent multiplex array for simultaneously measuring regulated food allergens using specific allergen protein molecules from peanut, tree nut, cow’s milk, egg, soy, fish, shellfish, sesame, mustard and celery. Microspheres coupled to specific monoclonal antibodies were used for allergen detection, with purified allergens as reference standards.Standard curves for 17 allergens covered a 5-log dynamic range. Intra- and inter-assay acceptance criteria were within 70–130% recovery and a CV of ≤15%. Food reference materials contained high levels of their respective major allergens (2000–175,000 µg/g), Similar high allergen levels were found in 10 selected foods analysed using a 9-plex array. Egg, milk, peanut, hazelnut and walnut allergens were detectable in chocolate bars with incurred allergens at 3, 10, 30, and 100 ppm. The multiplex array is an efficient tool for measuring specific food allergens, with applications for risk assessment and standardization of therapeutic products for food allergy.