Total Serum IgE Levels Research Articles

Hypersensitivity to dipyrone in aspirin-exacerbated respiratory disease patients is associated with urticaria

ObjectiveTo phenotype patients with aspirin-exacerbated respiratory disease (AERD) according to the presence of atopy, urticaria and level of peripheral eosinophils. MethodsThis study included adult asthmatic patients with AERD followed up at a tertiary hospital. They were classified according to atopy and/or urticaria, assessing clinical and laboratorial differences among the groups in order to identify possible aggravating factors of the disease. ResultsWe included 73 patients, 78.1% being female with a mean age of 54.0 years. Severe asthma was observed in 68.5% and respiratory exacerbation with dipyrone in 67.1% of these patients. They had median total serum IgE of 191.6 IU/mL, mean peripheral eosinophils of 718.5 cells/mm3, and 50.7% were atopic. Urticaria was observed in 32.9% of them, and exacerbations were more often triggered by dipyrone (p = .016). Atopic patients were younger than nonatopic patients (p = .023), and had, on average, higher total serum IgE levels (p = .022). We observed a good correlation between asthma severity and peripheral eosinophils count (r2 = 026; p = .021). ConclusionsIn this study, severe asthma was highly prevalent in AERD patients. Likewise, urticaria was quite prevalent and its presence was associated with dipyrone induced hypersensitivity reaction. Atopy was found in half of the patients, with no association with asthma severity. Patients with higher levels of peripheral eosinophils had more severe asthma. Dypirone hypersensitivity may be a marker for concomitant respiratory and cutaneous hypersensitivity reactions.

High serum free IL-18 is associated with decreased omalizumab efficacy: findings from a 2-year omalizumab treatment study

Objective Omalizumab is more effective in severe allergic patients with eosinophilic asthma than those with non-eosinophilic asthma. IL-18, a unique cytokine involved in allergic but non-eosinophilic inflammation, might be associated with the latter condition. We aimed to clarify the roles of IL-18 related pathways in insufficient response to omalizumab treatment. Methods Patients with severe allergic asthma who completed 2-year omalizumab treatments at Kyoto University Hospital were included in this study (UMIN000002389). Associations between pretreatment levels of serum free IL-18 in addition to other mediators and asthma phenotypes including responses to omalizumab treatment were analyzed. Changes in serum free IL-18, periostin and total IgE levels during the treatment were also examined. Results Twenty-seven patients (19 females, average age of 55.7 years) were examined. Fifteen incomplete responders who experienced exacerbations in the second year, were significantly and more frequently obese and showed significantly earlier asthma onset, lower blood eosinophils and more exacerbations before omalizumab treatment than complete responders. Significantly more patients showed high baseline serum free IL-18 levels (≥141 pg/mL, a threshold for the highest tertile) among the incomplete responders than complete responders. Patients with high serum free IL-18 levels shared similar characteristics with incomplete responders, showing significant reductions in serum total IgE levels during omalizumab treatment. Finally, serum free IL-18 levels negatively correlated with serum periostin levels at baseline and in change ratios. Conclusions High baseline serum free IL-18 levels may predict reduced omalizumab efficacy in severe allergic patients with type-2 low asthma, regarding reduction of exacerbations.

ORMDL3/GSDMB genotype as a risk factor for early-onset adult asthma is linked to total serum IgE levels but not to allergic sensitization

BackgroundAn orosomucoid-like 3 (ORMDL3)/gasdermin B (GSDMB) gene locus on chromosome 17q is consistently associated with childhood-onset asthma, which is highly atopic. As some evidence suggests the relationship between asthma and allergic sensitization reflects asthma patient susceptibility to augmented IgE responses driven by common environmental allergens rather than an increased asthma risk after allergen exposure, we aimed to determine any relationships between this locus region and childhood-onset adult asthma with regard to serum total IgE levels or allergic sensitization. MethodsWe conducted a case–control association study using three independent Japanese populations (3869 total adults) and analyzed the ORs for association of rs7216389, an expression quantitative trait locus for ORMDL3/GSDMB, with adult asthma according to onset age. Additionally, associations between the rs7216389 genotype and total serum IgE levels or allergic sensitization was examined. ResultsRs7216389 was associated with both childhood-onset adult asthma (OR for asthmatic patients afflicted at the age of 10 years or younger = 1.61, p = 0.00021) and asthmatic patients with higher levels of total serum IgE (OR for asthmatic patients with IgE ≥1000IU/mL = 1.55, p = 0.0033). In both healthy controls and in the combined healthy and asthmatic individuals, rs7216389 was correlated with increased total serum IgE levels (p < 0.0005), but not allergic sensitization (p > 0.1). ConclusionsORMDL3/GSDMB is an important susceptibility gene for childhood-onset adult asthma in Japanese populations and this association is linked to elevated total serum IgE levels but not to allergic sensitization.

Aeroallergen Sensitization, Serum IgE, and Eosinophilia as Predictors of Response to Omalizumab Therapy During the Fall Season Among Children with Persistent Asthma

Perennial aeroallergen sensitization is associated with greater asthma morbidity and is required for treatment with omalizumab. To investigate the predictive relationship between the number of aeroallergen sensitizations, total serum IgE, and serum eosinophil count, and response to omalizumab in children and adolescents with asthma treated during the fall season. This analysis includes inner-city patients with persistent asthma and recent exacerbations aged 6-20 years comprising the placebo- and omalizumab-treated groups in 2 completed randomized clinical trials, the Inner-City Anti-IgE Therapy for Asthma study and the Preventative Omalizumab or Step-Up Therapy for Fall Exacerbations study. Logistic regression modeled the relationship between greater degrees of markers of allergic inflammation and the primary outcome of fall season asthma exacerbations. The analysis included 761 participants who were 62% male and 59% African American with a median age of 10 years. Fall asthma exacerbations were significantly higher in children with greater numbers of aeroallergen-specific sensitizations in the placebo group (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.11-1.60; P < .01), but not in the omalizumab-treated children (OR, 1.08; 95% CI, 0.91-1.28; P= .37), indicating a significant differential effect (P < .01). Likewise, there was a differential effect of omalizumab treatment in children with greater baseline total serum IgE levels (P < .01) or greater baseline serum eosinophil counts (P < .01). Multiple aeroallergen sensitization was the best predictor of response to omalizumab; treated participants sensitized to ≥4 different groups of aeroallergens had a 51% reduction in the odds of a fall exacerbation (OR, 0.49; 95% CI, 0.30-0.81; P < .01). In preventing fall season asthma exacerbations, treatment with omalizumab was most beneficial in children with a greater degree of allergic inflammation.

Association of IL13 genetic polymorphisms with atopic dermatitis: Fine mapping and haplotype analysis

BackgroundAlthough previous studies had reported an important role of interleukin 13 (IL13) and its genetic polymorphisms in atopic dermatitis (AD), many of these previous reports focused on the missense variant rs20541 (Gln144Arg) without fine mapping of the gene region. ObjectiveTo analyze the potential associations of other IL13 variants and their haplotypes with AD and assess total serum immunoglobulin E (IgE) levels. MethodsWe performed fine mapping of single-nucleotide polymorphisms (SNPs) within the IL13 gene in a pilot study of 495 children with AD and 444 healthy controls. Then, we conducted a replication study of 757 children with AD and 1620 healthy controls to evaluate the association between the rs20541 variant of IL13 and AD. ResultsIn the pilot study, the rs20541 and rs1295685 SNPs in the 3ʹ-untranslated region of IL13 had significant associations with AD (P < .001 and .01, respectively). In addition, 2 haplotypes (BL2_ht1 and BL2_ht2), which harbored the significant rs20541 and rs1295685 SNPs, had an association with AD (minimum P = .006). BL2_ht1 and BL2_ht2 had nominal signals associated with the total serum IgE levels (P < .05) but not with the severity of AD (P > .05). In the replication study, rs20541 was associated with the total serum IgE levels but not with the severity of AD. ConclusionAn additional IL13 gene SNP, rs1295685, has a strong linkage disequilibrium with rs20541, and its haplotypes are associated with AD and the total serum IgE levels.

Topical Application of Doxycycline Inhibits Th2 Cell Development Mediated by Langerhans Cells and Exerts a Therapeutic Effect on Atopic Dermatitis

Langerhans cells (LCs) polarize the immune milieu towards a T helper type (Th) 1 or Th2 immune response. We investigated the effects of selected tetracyclines on Th cells development mediated by LCs, and their implications for the treatment of atopic dermatitis (AD). Mice were primed with ovalbumin (OVA) peptide-pulsed LCs, which had been treated with each antibiotic, via the hind footpad. After 5 days, the Th1/Th2 cytokine response in the popliteal lymph nodes was investigated by enzyme-linked immunosorbent assay. The expression of cell surface molecules on LCs was investigated using reverse transcriptase polymerase chain reaction. The therapeutic effects of a selected antibiotic on AD-like skin lesions of NC/Nga mice were assessed in terms of the skin severity score, histological changes in the lesioned skin, the serum level of total IgE, and expression of Th1/Th2 cytokines in lymph nodes and skin lesions. Antibiotic-treated, OVA peptide-pulsed LCs inhibited development of Th2 cells but not Th1 cells. This was accompanied by suppression of T-cell immunoglobulin and mucin domain-containing protein (TIM)-4 expression in LCs. Doxycycline had the greatest activity against Staphylococcus aureus strains isolated from skin lesions of patients with AD, and a strong inhibitory effect on Th2 cell development. Doxycycline suppressed the increase in the skin severity score during the acute phase in NC/Nga mice similar to betamethasone. This suppressive effect was associated with a decrease in the serum IgE level and production of Th2 cytokines in auricular lymph node cells and skin lesions. Topical application of doxycycline to AD lesions would act on both superficial S. aureus colonization and epidermal LCs, thus possibly inhibiting the development of Th2 cells in vivo, with benefits for control of acute inflammation in AD.

Diagnostic markers of allergic bronchopulmonary aspergillosis in patients with severe asthma.

Allergic bronchopulmonary aspergillosis (ABPA) is a lung disease in patients with asthma or cystic fibrosis (CF) caused by chronic allergic inflammation to Aspergillus spp. antigens. The role of different immunological mediators in the formation of chronic allergic inflammation in patients with ABPA is not sufficiently explored. This study aimed to investigate serum levels of thymic stromal lymphopoietin (TSLP), thymus and activated chemokine (TARC) as well as IL-8 in patients with ABPA, and to evaluate their diagnostic and monitoring value in the disease. Prospective study included 21 patients with ABPA, 25 patients with severe asthma with fungal sensitisation (SAFS), 37 patients with severe asthma without fungal sensitisation (SAwFS), and 16 healthy people. In patients with ABPA, the serum levels of biomarkers were determined at baseline and after 12weeks of itraconazole therapy. Serum levels of total IgE, Aspergillus-fumigatus-specific IgE, TSLP, TARC, IL-8 were analysed by enzyme-linked immunosorbent assay. In patients with ABPA we established significantly higher serum levels of TARC, IL-8, total IgE, Aspergillus-fumigatus-specific IgE and peripheral blood eosinophil counts, compared to patients with SAwFS. There were no differences in TSLP levels between the examined groups of patients. Serum TARC levels were positively correlated to serum total IgE levels, Afumigatus-specific IgE levels and peripheral blood eosinophil counts and also negatively correlated to lung function (FEV1 ). Longitudinally, serum levels TARC, total IgE and peripheral blood eosinophil counts significant decreased after treatment of ABPA. Thymus and activated chemokine is a useful test in diagnosing and monitoring response to the antifungal treatment of patients with ABPA.

Combined IMIG and Immune Ig Attenuate Allergic Responses in Beagle Dogs.

Background We previously reported attenuation of serum OVA-specific IgE levels and of lymphocyte-derived IL-4, both nominal markers of allergic immunity, following injection of a combination of homologous (mouse) polyclonal anti-idiotypic immunoglobulin (Ig) and immune Ig in BALB/c mice. We predicted this might generalize to other species and using heterologous mixtures of Igs. This was assessed in mice using OVA sensitization in the presence of human Igs as a source of both anti-idiotype Ig and immune Ig and in dogs with peanut butter-induced allergic responses. Methods Eight-week-old BALB/c mice received OVA immunization and 5 weekly injections of immune Ig or anti-idiotype Ig from either homologous (mouse) or heterologous (human) sources. Five-month-old Beagles received weekly topical exposure (on the abdomen) to peanut butter and treatment with pooled dog Ig and dog antirabies immune Ig, or a combination of human IMIG and human anti-Tet. All mice/dogs thereafter received a final allergen challenge, and serum IgG, IgE, and allergen-induced IL-2/IL-4 and IL-31 production in 72 hr cultures was measured. Results In mice attenuation of OVA-induced allergy (IgE-specific Ig and OVA-induced IL-4) was seen using both mouse and human Ig mixtures, without effect on OVA serum IgG or OVA-induced IL-2. Attenuation of concanavalin A- (ConA-) induced IL-4 : IL-2 production and of peanut butter-induced IL-4 and IL-31 was seen in dogs receiving combinations of both heterologous and homologous immune Igs and anti-idiotype Igs, with no decline in IL-2 production. Allergen-specific IgE/IgG was not detectable in dog serum, but there was a trend to lower total serum IgE levels (and decreased IgE : IgG ratios). Conclusion Homologous and heterologous combinations of polyclonal IMIG and immune Ig attenuate allergic responses in mice and dogs. This treatment protocol represents a novel approach which can be adapted for allergic desensitization in veterinary and human use.

Investigating the Level of Vitamin E, C and Superoxide Dismutase in Patients with Allergic Asthma and Allergic Asthma with Helminths Infection

The aim of this study was to investigate the relationship of antioxidant activity, vitamin E, vitamin C and superoxide dismutase with the severity of allergic asthma by estimating their level in the patients’ sera, as well as evaluating their association with the level of total and specific serum IgE in allergic asthmatics and allergic asthmatics with helminths infection. The study applied on 180 subjects divided into three groups, 100 patients with allergic asthma and 50 patients having allergic asthma with helminths infection. The group of patients included 50 males and 100 females age 15-60 years. The control group comprised of 30 healthy individuals, included 14 males and 16 females age range 16-60 years. For each participant, the medical history was considered; the total and specific IgE levels, vitamin E, vitamin C and superoxide dismutase levels were determined in the patient’s sera using ELISA technique. The present study has demonstrated an increased level in serum total IgE in the patients’ groups (allergic asthma group and allergic asthma with helminths) compare to the control group, mean 374.54 IU/mL; 472.24 IU/mL; 29.21 IU/mL respectively. The level differences among the three groups are highly significant when compared statistically

Elevated serum KL-6 in pediatric asthma exacerbation: a proof of alveolar injury

Background: Asthma is one of the most popular chronic diseases in children. It is defined as a complicated inflammatory disorder in which the patient suffers from chronic and persistent inflammation of the airways. The sialylated glycoprotein Krebs von den Lungen-6 (KL-6), one of the lung epithelium-specific proteins, has been recognized as a significant biomarker which directly associates with interstitial lung disease (ILD) pathogenesis, indicating the extent of damage and regeneration of type II pneumocytes. Objective: the aim of this study is to investigate the degree of alveolar damage in asthmatic children with acute exacerbation as reflected by serum KL-6 levels. Methods: This cross-sectional controlled study included 50 patients with acute asthma exacerbation diagnosed as per the GINA guidelines definition and 50 age- and sex-matched healthy children as controls. Spirometry was done for all participants. Serum KL-6 level was estimated by Enzyme Linked Immunosorbent Assay (ELISA), and total serum IgE level was measured via the electrochemiluminescence technology. Results: The asthma patients included 35 (70%) males and 15 (30%) females with mean age of 10.76 ±1.9 years. Forty-seven patients (94%) had a positive family history of bronchial asthma and 32 (64%) had other atopic manifestations The mean serum KL-6 level in patients was more than double the mean level of the control group (115.79 vs 55.64). No significant relation was observed between KL-6 serum level and age, family history of asthma, seasonal variation, or atopic manifestation among the cases. Serum total IgE levels were significantly higher in cases compared to controls (P<0.05). Conclusion: Serum KL-6 levels in pediatric asthma patients may be a useful diagnostic tool for detecting and monitoring the severity of airway inflammation. The use of serum KL-6 alone may help to differentiate between asthmatic patients in exacerbation and healthy controls.

Metabolomic Analysis Reveals Distinct Profiles in the Plasma and Urine Associated with IgE Reactions in Childhood Asthma.

Several metabolomics studies have identified altered metabolic pathways that are related to asthma. However, an integrative analysis of the metabolic responses across blood and urine for a comprehensive framework of asthma in early childhood remains lacking. Fifty-four age-matched children with asthma (n = 28) and healthy controls (n = 26) were enrolled. Metabolome analysis of the plasma and urine samples was performed using 1H-nuclear magnetic resonance (NMR) spectroscopy coupled with partial least-squares discriminant analysis (PLS-DA). Integrated analysis of blood and urine metabolic profiling related to IgE reactions for childhood asthma was investigated. A significantly higher plasma histidine level was found, in parallel with lower urinary 1-methylnicotinamide and trimethylamine N-oxide (TMAO) levels, in children with asthma compared to healthy controls. Compared to children without allergic sensitization, 11 (92%) plasma metabolites and 8 (80%) urinary metabolites were found to be significantly different in children with IgE and food sensitization respectively. There were significant correlations between the plasma 3-hydroxybutyric acid and excreted volumes of the hydroxy acids, which were strongly correlated to plasma leucine and valine levels. Urine N-phenylacetylglycine, a microbial-host co-metabolite, was strongly correlated with total serum and food allergen-specific IgE levels. Plasma pyruvate and urine valine, leucine, and isoleucine degradation metabolisms were significantly associated with allergic sensitization for childhood asthma. In conclusion, blood and urine metabolome reflect different metabolic pathways in allergic reactions. Plasma pyruvate metabolism to acetic acid appears to be associated with serum IgE production, whereas urine branched-chain amino acid metabolism primarily reflects food allergic reactions against allergies.

Clinical Significance of Cytoplasmic IgE-Positive Mast Cells in Eosinophilic Chronic Rhinosinusitis.

Cross-linking of antigen-specific IgE bound to the high-affinity IgE receptor (FcεRI) on the surface of mast cells with multivalent antigens results in the release of mediators and development of type 2 inflammation. FcεRI expression and IgE synthesis are, therefore, critical for type 2 inflammatory disease development. In an attempt to clarify the relationship between eosinophilic chronic rhinosinusitis (ECRS) and mast cell infiltration, we analyzed mast cell infiltration at lesion sites and determined its clinical significance. Mast cells are positive for c-kit, and IgE in uncinated tissues (UT) and nasal polyps (NP) were examined by immunohistochemistry. The number of positive cells and clinicopathological factors were analyzed. Patients with ECRS exhibited high levels of total IgE serum levels and elevated peripheral blood eosinophil ratios. As a result, the number of mast cells with membranes positive for c-kit and IgE increased significantly in lesions forming NP. Therefore, we classified IgE-positive mast cells into two groups: membrane IgE-positive cells and cytoplasmic IgE-positive cells. The amount of membrane IgE-positive mast cells was significantly increased in moderate ECRS. A positive correlation was found between the membrane IgE-positive cells and the radiological severity score, the ratio of eosinophils, and the total serum IgE level. The number of cytoplasmic IgE-positive mast cells was significantly increased in moderate and severe ECRS. A positive correlation was observed between the cytoplasmic IgE-positive cells and the radiological severity score, the ratio of eosinophils in the blood, and the total IgE level. These results suggest that the process of mast cell internalization of antigens via the IgE receptor is involved in ECRS pathogenesis.

Correlation between Total Serum Immunoglobulin E (IgE) and Absolute Eosinophil Count (AEC) in Allergic Diseases In Children

Allergy, is a clinical expression of soluble factors like IgE, histamine or eosinophils found in serum or plasma of such patients. The products that are responsible for allergy are called as Allergens. Allergens normally induce IgE production which leads to type 1 hypersensitivity response on subsequent exposure to the same allergen. The target organs are mostly nose, lung, skin and gastrointestinal tract. Atopy is also considered as a triad of Atopic dermatitis, allergic rhinitis and bronchial asthma. Raised serum IgE and AEC are proven indicators of allergic phenomenon. Various studies show relationship between serum Immunoglobulin E level and total eosinophil count in population suffering from allergic diseases. Serum total Immunoglobulin E, total eosinophil count and specific IgE are all helpful for the diagnosis and treatment of allergic diseases. Objectives: 1.To Evaluate Serum Total IgE level in Children with allergic diseases.2. To Evaluate Absolute Eosinophil Count (AEC) in children with allergic diseases.3. To Correlate Serum Total Immunoglobulin E Level and Absolute Eosinophil Count (AEC) with allergic diseases. Methodology: Cross sectional study with 100 children in the age group 2-12 years with nasopharyngeal allergies (like bronchial asthma and atopic rhinitis) and skin allergies (like atopic dermatitis, urticaria) ,eye allergies were enrolled and serum IgE levels and AEC levels was done. Results: In present study Absolute eosinophil count was raised in 58% of cases Serum IgE was raised in 54% of cases. In present study, of 58% cases with raised Absolute eosinophil count 81% (47 cases) showed raised serum IgE levels. Conclusion: Absolute eosinophil count and serum Total IgE has been considered as a significant marker of allergic state and can be used as a marker of allergic response in atopic individuals. Raised serum IgE and AEC are more in nasobronchial allergy as compare to other systemic allergies. The elevated level of serum Total IgE and Absolute Eosinophil Count both shows Significant Correlation thus can be considered as a dependable laboratory investigation in diagnosing and categorizing allergic diseases.

Assessment of Ceruloplasmin, Hemopexin, and Haptoglobin in Asthmatic Children

BACKGROUND: Ceruloplasmin (Cp), haptoglobin, and hemopexin play a role in iron homeostasis and may function to modulate the systemic inflammatory response and be involved in tissue repair. We hypothesized that these proteins could be biological markers for bronchial asthma that reflect the involvement of iron oxidative stress in asthma pathogenesis.&#x0D; AIM: Evaluation of serum levels of proteins involved in iron homeostasis (Cp, hemopexin, and haptoglobin) in asthmatic children and their correlation to pulmonary functions.&#x0D; MATERIALS AND METHODS: Sixty moderate to severe persistent asthmatic children aged 6–13 years were included (30 during attacks and 30 in-between attacks). Thirty healthy matched controls were also recruited. All children were subjected to history taking, clinical evaluation and assessment of complete blood picture, serum levels of Cp, haptoglobin, hemopexin, and total IgE. Pulmonary function tests were assessed for all patients.&#x0D; RESULTS: Serum Cp and haptoglobin were significantly elevated in asthmatic children between attacks (448.04 ± 386.79), (993.33 ± 554.56) compared to controls (168.42 ± 13.46), (473.33 ± 350.3), (p = 0.0002, p &lt; 0.0001) and to asthmatics during exacerbations (288.8 ± 219.6), (620 ± 467.86), (p = 0.014, p = 0.006). Serum hemopexin was significantly higher in asthmatics between attacks (509.33 ± 341.51) compared to controls (296.67 ± 158.38) (p &lt; 0.003) but no significant difference compared to acute exacerbations (477.33 ± 396.6). No significant correlations were found between any of the assessed protein levels and pulmonary functions. Hemoglobin concentration was significantly higher among stable asthmatics compared to acute exacerbation and control groups.&#x0D; CONCLUSION: Cp, haptoglobin, and hemopexin can be used as a panel of non-invasive biomarkers that reflect the involvement of iron oxidative stress in asthma pathogenesis.

Soy Skin Prick Test in Patients with Physician-Diagnosed Atopic Disorders

Abstract Background Soy protein is an important component of soybeans and is one the 8 most significant food allergens. Yet, the prevalence of soy allergy in the pediatric population is not well defined. Objectives To evaluate the incidence of IgE mediated soy protein sensitization among children with clinical manifestation of atopic disorders by the use of skin prick test (SPT) for soy protein. Methods Two hundred patients with atopic manifestations attending the Pediatric Allergy and Immunology Clinic at the Pediatric Department of Ain shams University, were recruited between January 2017 till January 2018. They were subjected to SPT to soy protein, measurement of total serum IgE and eosinophilic count in the peripheral blood. Results Of the 200 patients, 108 (54%) were males and 92 (46%) were females with a male to female ratio of 1.17:1. Their ages ranged between 2 years and 15 years (mean±SD; 6.0±33.3 years). Seven patients (3.5%) had positive skin prick test to soy protein. The mean value for the absolute eosinophilic count was 0.4x109/L. The median for the total serum IgE level was 50 IU/L. According to age, the highest percentage of soy protein sensitivity was elicited among patients less than 3 years (57.14%), followed by those between 3 to 6 years (28.5%) and those between 6 and 15 years (14.28%). A positive family history of atopy was recorded in 122 (61%) of all cases. In terms of gender, incidence of soya sensitivity was higher among males than females but with no statistical difference. Although the most common allergic manifestations of all studied patients were respiratory (83%), and atopic dermatitis (22.5%), yet positive SPT to soy proteins was elicited in 43% in allergic rhinitis cases, in 29% of asthma patients, in 14% of patients with combined asthma and allergic rhinitis, and 14.3% of patients having eczema. Conclusion Soy protein sensitization is not uncommon in children especially in those with atopic manifestations. Large scale studies are needed to evaluate the actual incidence of soy protein hypersensitivity in children.

Effect of pre-acupuncture intervention on serum IgE and cutaneous phosphorylated tyrosine-protein kinase expression in rats with urticaria

To observe the effect of acupuncture on serum IgE level, the degranulation of mast cells, the release of histamine and serotonin, and the expressions of phosphorylated tyrosine-protein kinase Lyn and Syk (p-Lyn, p-Syk) in skin tissue in rats with urticaria, as well as analyze the mechanism of acupuncture in the prevention and the treatment of urticaria. SD male rats were randomly divided into normal control, model control, medication and acupuncture groups (n＝10 in each group). The anti-ovalbumin serum was used to establish urticaria model. Rats of the medication group received gastric lavage of Loratadine (0.1 mg/100 g). In the acupuncture group, bilateral "Xuehai" (SP10) and "Quchi" (LI11) were punctured perpendicularly, about 2 to 4 mm in depth, and the needles were retained for 30 min. The treatment was given consecutively for 14 days in the two treatment groups. H．E. staining was adopted to observe the morphological changes of skin tissue, ELISA to determine the total IgE level in serum, the toluidine blue staining to observe the degranulation of mast cells in local skin tissue and the immunohistochemistry to determine the expressions of histamine and serotonin as well as the the expressions of p-Lyn and p-Syk. Compared with the normal control group, the epidermis of the model control group was significantly thickened, the dermis was swollen, the inflammatory infiltration of small vessels was serious and the mast cells were swollen and deformed, with blurred edge and exfoliated granules. Additionally, in the model control group, the serum IgE level was significantly higher (P<0.05), the expressions of histamine and serotonin, as well as p-Lyn and p-Syk proteins in local skin tissue were significantly increased (P<0.05). Compared with the model control group, in the acupuncture group and the medication group, the epidermis was slightly thickened, the dermis got slightly edema, the inflammatory cells were presented occasionally and the degranulation of mast cells were reduced. Besides, the serum IgE level was significantly decreased (P<0.05), the expressions of histamine and serotonin, as well as the p-Lyn and p-Syk were significantly reduced (P<0.05). There was no significant difference in each index between the acupuncture group and the medication group (P>0.05). Acupuncture at LI11 and SP10 is applicable in the treatment of urticaria. This therapy inhibits the type Ⅰ hypersensitivity and the mast cell degranulation, which may be related to the regulation of p-Lyn and p-Syk protein expressions in the locus coeruleus skin tissue.

Occurrence of +874T/A gene polymorphism of interferon-gamma in Iraqi atopic patients

Traditionally, asthma, atopic dermatitis and allergic rhinitis, in addition to food allergy, categorized as atopic diseases, the term allergy refer to immediate hypersensitivity which used to describe the combined immediate and late phase reactions. This study aimed to determine serum total IgE level, eosinophil count, and serum level of IFN-γ, in relation to the age of atopic patients and genotyping of the IFN-γ gene at +874 T/A in relation to serum IFN-γ level. As well as comparing of IFN-γ concentrations of atopic patients according to genotypes in atopic patients and apparently healthy control. The studied groups were 25 apparently healthy controls and 75 atopic patients (25 asthma patients, 25 allergic rhinitis patients and 25 atopic dermatitis patients). The obtained results showed that, the prevalence of atopic diseases occurred in the age group between 21 and 40 (second group) are more than the age group less than 21 (first group) and the age group of more than 40, third group (p = .0001). Moreover, total IgE is significantly increased in the three atopic groups compare to control (P < .001) and IgE in all age groups is significantly high. The high eosinophil count was seen in patients of atopic subjects than in apparently healthy control (P < .01). Asthma and allergic rhinitis eosinophil count is significantly high in first and second groups but not in third age group and atopic dermatitis eosinophil count is low in atopic dermatitis in all age groups. Furthermore, significant decrease in serum IFN-γ levels was observed in asthmatic patients, slightly decrease in allergic rhinitis and slightly increase in dermatitis patients. TA genotype was higher frequency in control, allergic rhinitis and atopic dermatitis groups than AA and TT, in asthmatics, AA was higher than TA and TT. There was no deviation on Hardy-Weinberg equilibrium, non-significant difference between observed and expected genotypes. Also non-significant association was observed between genotypes in all studied groups according to odd ratio and fisher exact probability. This study concluded that the prevalence of atopic diseases occurred in the age group between 21 and 40 years more than the age group less than 21 years and the age group of more than 40 years. The age can affect some parameters of immune system in atopic patients namely IgE level, eosinophil count and IFN-γ. However, there is no relationship between +874 T/A IFN-γ genotypes and atopic diseases development risk in Iraqi atopic patients.

Clinical relevance of eosinophils, basophils, serum total IgE level, allergen-specific IgE, and clinical features in atopic dermatitis.

BackgroundAtopic dermatitis (AD) is an inflammatory disease with diverse clinical features. Although AD is diagnosed mainly by clinical features, the laboratory abnormalities can be found in most patients and may be of diagnostic value. However, few studies have been performed on the clinical significance of laboratory abnormalities in adult and adolescent AD.MethodsAdult and adolescent patients with AD were included in this study. The questionnaire and dermatological examination were completed by investigators. Laboratory tests included complete blood count, serum total IgE, and allergen‐specific IgE.ResultsA total of 473 patients were recruited and 396 of them were diagnosed as AD. Increased serum total IgE level, peripheral eosinophils, and basophils were seen more frequently in AD patients than in non‐AD patients (P < .05). Positive aeroallergens were seen more in AD patients than in non‐AD patients (P < .05). Both total serum IgE level (R = .286, P < .001) and peripheral eosinophils (R = .444, P < .001) significantly correlated with EASI score. Serum total IgE level and extrinsic type AD decreased with age. Patients with elevated serum total IgE are more likely to have a personal history of atopic diseases (P = .014). AD‐associated symptoms (such as flexural dermatitis, white dermographism, and anterior neck folds) are more frequently observed in AD patients with high serum IgE or eosinophilia (P < .05).ConclusionThe serum total IgE level, allergen‐specific IgE, peripheral eosinophils, and basophils are important for the diagnosis of AD. And they are associated with the severity, age groups, and clinical manifestations.

Bifidobacterium infantis Relieves Allergic Asthma in Mice by Regulating Th1/Th2.

BackgroundBifidobacteria are among the probiotics used in treating intestinal diseases and are rarely used for allergic asthma treatment. The present study investigated the mechanism of B. infantis in treating allergic asthma in mice.Material/MethodsA total of 40 male Balb/c mice were randomized into control, ovalbumin (OVA), montelukast (Mon), and B. infantis (B10) groups, and allergic asthma was induced in the OVA, Mon, and B10 groups. Airway reactivity was measured on day 29 by methacholine at various doses. The numbers of total cells and inflammatory cells in bronchoalveolar lavage fluid (BALF) were counted by blood cell counter and Diff-Quik staining. Hematoxylin-eosin (HE) staining was performed to observe inflammatory cell infiltration in lung tissues. Total IgE and OVA-specific IgE in serum were measured by ELISA. Mucin 5AC expression was detected by Western blot to evaluate airway obstruction. The levels of Th1 (IFN-γ, IL-2) and Th2 (IL-4, IL-5, IL-13) cytokines in BALF and tissues were detected by ELISA and qRT-PCR, respectively.ResultsThe mice in the OVA group had airway hyperreactivity, while the symptoms in the B10 group and Mon group were effectively relieved. B10 reduced the number of inflammatory cells in BALF as well as inflammatory cell infiltration in tissues. Moreover, the levels of total serum IgE, OVA-specific IgE, and Mucin 5AC were increased in the OVA group, but were reduced in the Mon group and B10 group. B. infantis increased the levels of Th1 cytokines and decreased those of Th2 cytokines.ConclusionsB. infantis can reduce the infiltration of inflammatory cells induced by OVA-specific antibodies in mice. B. infantis has therapeutic effects on allergic asthma by promoting Th1 and inhibiting Th2 immune responses.

The Th2 adjuvant activity of indoor dust is dependent upon Dectin-1

Indoor dust (ID) contains environmental agents that promote T helper 2 (Th2) responses to inhaled allergens through a tumor necrosis factor (TNF)-dependent pathway. The main components of ID responsible for inducing Th2 responses are unknown. Here, we investigated if the Th2 adjuvant activity of ID is mediated by ligands for Dectin-1, a C-type lectin receptor that recognizes microbe-derived β-glucans. Using a cell reporter assay, we screened ID samples for bioactive Dectin-1 ligands. Using an ID-mediated asthma model, we compared allergic airway inflammation (airway eosinophilia, serum total IgE levels), TNF levels in bronchoalveolar lavage fluid (BALF), and airway hyperreactivity (AHR) in wild type (WT) and Dectin-1-deficient (Clec7a−/−) mice. ID samples contained bioactive Dectin-1 ligands that activated nuclear factor kappa B signaling. In an ID-mediated asthma model, allergic airway inflammation was diminished in Clec7a−/− mice compared to WT mice, as demonstrated by decreased total airway cells, airway eosinophils and serum total IgE levels following allergen challenge. In contrast, allergen-induced AHR was similar in WT and Clec7a−/− mice. Following acute exposure to ID, Clec7a−/− mice had significantly decreased TNF levels in BALF compared to WT mice. In Clec7a−/− mice, addition of TNF during sensitization with ID and allergen restored airway eosinophilia upon allergen challenge. Dectin-1 signaling is required for the Th2 adjuvant activity of ID, possibly by inducing TNF production during airway sensitization to inhaled allergens. Collectively, these findings suggest that Dectin-1 ligands within the indoor environment may contribute to asthma development by promoting allergic airway sensitization.