Total IgE Levels Research Articles

Intracutaneous Skin Tests and Serum IgE Levels Cannot Predict the Grade of Anaphylaxis in Patients with Insect Venom Allergies.

BackgroundAllergies against Hymenoptera venoms are a major cause of severe anaphylaxis. Risk assessment for subjects with suspected allergy is difficult because there are currently no biomarkers that predict the likelihood of high-grade anaphylaxis other than several associated comorbidities.ObjectiveWe investigated the relationship between the severity of anaphylaxis and the results of intracutaneous skin tests (ICTs) together with serum levels of tryptase, total IgE, and venom-specific IgE, IgG, and IgG4.MethodsWe performed a retrospective evaluation of 194 patients who presented to a single medical center with allergies to bee venoms (Apis mellifera, Bombus spp.; n=24, 12.4%), vespid venoms (Vespula spp., Vespa spp., Polistes spp.; n=169, 87.1%), or both (n=1, 0.5%).ResultsIndex bee stings occurred earlier in the year than vespid stings, although the latter were reported more frequently overall. On average, subjects who previously experienced grade IV anaphylaxis required higher dosages of venom to yield positive ICTs than those who exhibited lower grade responses. Patients diagnosed with grade IV anaphylaxis exhibited significantly lower levels of venom-specific IgE and IgG and trended toward elevated levels of tryptase. No significant differences in average levels of venom-specific IgG4 and total IgE were observed.ConclusionOur findings reveal that intracutaneous skin testing and levels of venom-specific IgE do not predict the degree of anaphylaxis that develops in patients with venom allergy. Furthermore, the month of the index sting is not a reliable means to differentiate bee from vespid stings in patients presenting with an uncertain history.

The prevalence of ultra-low total IgE level among Egyptian population: impact of age, sex, and socioeconomic class

BackgroundImmunoglobulin E (IgE) is the least prevalent antibody type; it plays a key role in host immunity against parasitic infections and allergic diseases. Association between IgE deficiency and higher malignancy rates has been suggested in many studies.ObjectivesThe goal of our study was to determine the prevalence of ultra-low total IgE levels and their variations according to sex and age among the Egyptian population.MethodologyThis multicenter retrospective cross-sectional study included serum total IgE and CBC records of 1099 children and 993 adults recruited from private and public hospitals in Egypt between 2015 and 2021. Total IgE levels were classified into ultra-low, normal, high, and very high.ResultsOf all included subjects, 0.8% had ultra-low IgE levels and 74.4% had normal IgE levels. High and very high serum total IgE levels were 24.1% and 0.7%, respectively. IgE levels were significantly higher among adults than children 45 (16.5–113.25) IU/ml vs. 20 (10–75) IU/ml; p < 0.001and among private hospital’s patients than the public one (40 (15–98.4) IU/ml vs. 25 (10–98.4) IU/ml; p = 0.002. No significant difference between total IgE serum levels regarding gender (p = 0.825). Total IgE levels were higher among young adults, with a gradual decline among older patients and a peak among the 50 s and 60 s patients. Pearson correlation between IgE and absolute eosinophilic count showed positive correlation but did not reach significant level r = 0.04, p = 0.367.ConclusionAge and socioeconomic class have impacts on total IgE levels with a relatively low prevalence of ultra-low IgE among the Egyptian population.

The adequacy of current diagnostic criteria for making a diagnosis of ABPA.

Currently, there are four different diagnostic criteria systems for allergic bronchopulmonary aspergillosis (ABPA): The Rosenberg-Patterson, Seropositive ABPA (ABPA-S), Central Bronchiectasis and ABPA (ABPA-CB), and the International Society for Human and Animal Mycology (ISHAM) ABPA study group criteria. This study aims to retrospectively compare these four diagnostic criteria in ABPA patients. Patients who were followed up with the diagnosis of ABPA were retrospectively re-evaluated using these four diagnostic criteria, and the superiority of these criteria to each other was determined. A total of 10 ABPA patients were included in the study. Seven patients were diagnosed according to ISHAM ABPA study group diagnostic criteria and six patients according to the Rosenberg-Patterson diagnostic criteria. None of the patients fulfilled the criteria when evaluated individually with ABPA-S and ABPA-CB. Of patients diagnosed by ISHAM, five had a total IgE level above 1000 IU/mL and two had below 1000 IU/mL. We demonstrated that the diagnostic criteria developed by the ISHAM ABPA study group were superior to the others in diagnosing ABPA in cases with a total IgE level above 1000 IU/mL. However, all these criteria seem to be sufficient to diagnose ABPA in patients with a total IgE below 1000 IU/mL. We believe the necessity to demonstrate presence of Aspergillus fumigatus precipitating antibodies or specific IgG positivity should be questioned particularly in patients with radiologic findings compatible with ABPA and a total IgE level below 1000 IU/mL.

An Adjuvant-Free Mouse Model Using Skin Sensitization Without Tape-Stripping Followed by Oral Elicitation of Anaphylaxis: A Novel Pre-Clinical Tool for Testing Intrinsic Wheat Allergenicity.

Wheat is a major food allergen per the regulatory bodies of various nations. Hypersensitivity reactions to wheat have been steadily increasing for reasons that are not completely understood. Wheat-allergy models typically use adjuvants to induce sensitization to wheat proteins followed by an intraperitoneal challenge to elicit anaphylaxis. Although these models are very useful, they lack the ability to reveal the intrinsic allergenicity potential of wheat. To improve the mouse model of wheat allergy, we tested the hypothesis that repeated skin application of salt-soluble protein extract (SSPE) from durum wheat will clinically sensitize the mice to oral anaphylaxis to SSPE. Balb/c mice were bred and maintained on a plant-protein-free diet and used in the experiments. Adult female mice were exposed to SSPE once a week for 9 weeks via a solution on intact skin. Sensitization was measured by SSPE-specific IgE (sIgE) antibody and total IgE (tIgE) levels. Oral anaphylaxis was quantified by hypothermic shock response (HSR), and mucosal mast cell response (MMCR) was quantified by measuring MMCP-1 after oral challenge. Using single mouse data, correlation analyses were performed to determine the relationship among the allergenicity readouts. Spleen cytokines were quantified using a protein microarray method. Our results show that (i) repeated skin exposures to SSPE elicited robust increases in the sIgE and tIgE levels; (ii) skin exposure to SSPE was sufficient to sensitize mice for oral anaphylaxis and MMCR; (iii) both HSR and MMCR showed a strong correlation with each other, as well as with sIgE, and a modest correlation with tIgE levels; (iv) selected Th2/Th17/Th1 cytokines were elevated in skin-sensitized mice; and (v) oral allergen-challenged mice showed selective elevation of IL-6 and a panel of chemokines compared to saline-challenged mice. Together, we report the development and characterization of a novel adjuvant-free wheat-allergy mouse model that uses skin sensitization without tape-stripping followed by oral elicitation of anaphylaxis. Furthermore, validation of quantifiable wheat allergenicity readouts makes this model particularly suitable as a pre-clinical testing tool to assess the intrinsic sensitization/oral-anaphylaxis elicitation potential of novel wheat proteins (e.g., processed wheat) and to develop hypo/non-allergenic wheat products.

D-galactose Intake Alleviates Atopic Dermatitis in Mice by Modulating Intestinal Microbiota.

Atopic dermatitis (AD) is one of the most prevalent, chronic and persistent inflammatory skin diseases closely associated with intestinal microbiota. To evaluate the effect of D-galactose intake on AD, we orally administered D-galactose to BALB/c mice whose ears and skin were treated with 2,4-dinitrochlorobenzene (DNCB). D-galactose alleviated DNCB-induced AD-like phenotypes such as redness, scaling/dryness and excoriation. Ear thickness was also decreased by D-galactose administration. Histopathological analysis revealed decreased epidermal thickening, infiltration of immune cells, especially mast cells, in the dermis. Total levels of serum IgE representing the immunological response of AD were decreased by D-galactose administration. Microbiota analysis showed that D-galactose administration restored gut microbiota profiles, which were altered in AD mice, characterized by increased abundance of Bacteroidetes and decreased abundance of Firmicutes. The increased abundance of Bacteroides and the decreased abundance of Prevotella and Ruminococcus were reversed by D-galactose treatment, following improvement of AD. Our results suggest the possible use of D-galactose as a prebiotic to alleviate AD by altering gut microbiota.

Impact of cytokines genes polymorphisms and their serum levels on childhood asthma in Egyptian population

BackgroundAsthma is chronic immune-mediated airway inflammation, and it is affected by a complex network of interacting cytokines. To date, the exact role of each cytokine and its genetic polymorphisms in childhood asthma development and its severity has remained poorly understood. The purpose of this study was to explore potential roles of four cytokine genes polymorphism and serum levels l [(T helper-2 (Th2) cytokine); Interleukin-4 (IL-4) 590, (Th3 cytokine); and transforming growth factor β1 (TGF-β1) 509T; (Th17) including tumor necrosis factor-alpha (TNF-α), and IL17A rs8193036] in childhood asthma risk and control in Egyptian children, for the 1st time. Materials and methodsThis case-control study included two children subgroups; Group1 included 216 non-asthmatic controls and (Group 2) 216 cases diagnosed with asthma (clinically and spirometry-based) were classified as controlled, partly controlled, and uncontrolled. Polymorphisms of TGF-β1-509, IL-4 590, and TNF-α-308 genes were detected using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). IL-17 was genotyped using tetra-primer amplification refractory mutation system polymerase chain reaction (ARMS-PCR). Serum cytokines levels were measured by enzyme-linked immunosorbent assay (ELISA). ResultsSerum total IgE, TGF-β1, IL4, TNF-α, and IL17A levels were significantly higher in asthmatic compared to controls. Also, significant increases in serum total IgE, IL-4, TGF-β1, and TNF-α levels are combined with poor asthma control, while no significant IL17A changes. There were significant changes of IL-4-590, TNF-α-308, and IL17A genotypes and allele distributions between asthmatic and controls groups as well as different asthma control levels; while no impact of TGF-β1 SNP on asthma risk and control level. Four cytokines SNPs affected their serum levels among asthmatic patients. ConclusionThere are impacts of cytokine gene polymorphisms (IL-4-590, TNF-α-308, and IL17A); but not TGF-β1 on asthma susceptibility and poor asthma control in Egyptian children.

Cytokine TGFβ Gene Polymorphism in Asthma: TGF-Related SNP Analysis Enhances the Prediction of Disease Diagnosis (A Case-Control Study With Multivariable Data-Mining Model Development).

IntroductionTGF-β and its receptors play a crucial role in asthma pathogenesis and bronchial remodeling in the course of the disease. TGF-β1, TGF-β2, and TGF-β3 isoforms are responsible for chronic inflammation, bronchial hyperreactivity, myofibroblast activation, fibrosis, bronchial remodeling, and change the expression of approximately 1000 genes in asthma. TGF-β SNPs are associated with the elevated plasma level of TGF-β1, an increased level of total IgE, and an increased risk of remodeling of bronchi.MethodsThe analysis of selected TGF-β1, TGF-β2, TGF-β3-related single-nucleotide polymorphisms (SNP) was conducted on 652 DNA samples with an application of the MassARRAY® using the mass spectrometry (MALDI-TOF MS). Dataset was randomly split into training (80%) and validation sets (20%). For both asthma diagnosis and severity prediction, the C5.0 modelling with hyperparameter optimization was conducted on: clinical and SNP data (Clinical+TGF), only clinical (OnlyClinical) and minimum redundancy feature selection set (MRMR). Area under ROC (AUCROC) curves were compared using DeLong’s test.ResultsMinor allele carriers (MACs) in SNP rs2009112 [OR=1.85 (95%CI:1.11-3.1), p=0.016], rs2796821 [OR=1.72 (95%CI:1.1-2.69), p=0.017] and rs2796822 [OR=1.71 (95%CI:1.07-2.71), p=0.022] demonstrated an increased odds of severe asthma. Clinical+TGF model presented better diagnostic potential than OnlyClinical model in both training (p=0.0009) and validation (AUCROC=0.87 vs. 0.80,p=0.0052). At the same time, the MRMR model was not worse than the Clinical+TGF model (p=0.3607 on the training set, p=0.1590 on the validation set), while it was better in comparison with the Only Clinical model (p=0.0010 on the training set, p=0.0235 on validation set, AUCROC=0.85 vs. 0.87). On validation set Clinical+TGF model allowed for asthma diagnosis prediction with 88.4% sensitivity and 73.8% specificity.DiscussionDerived predictive models suggest the analysis of selected SNPs in TGF-β genes in combination with clinical factors could predict asthma diagnosis with high sensitivity and specificity, however, the benefit of SNP analysis in severity prediction was not shown.

Lack of autoantibodies against collagen and related proteins in collagenous colitis

IntroductionCollagenous colitis (CC) is a common cause of chronic diarrhea and is characterized by a subepithelial thickened collagen layer in the colonic mucosa.It shares many of the characteristics found in autoimmune diseases, but no autoantibodies have been identified. In CC, an imbalance in collagen turnover is evident. The purpose of the present study was to investigate whether any collagen-associated autoantibodies or other antibodies such as TPO and ASCA were present, and if levels of total IgE were increased.MethodsSera from women with active CC were analysed with ELISA for detection of autoantibodies against collagen type III and IV (Col III and IV), matrix metalloproteinase-9 (MMP-9), tissue inhibitors of metalloproteinase-1 (TIMP-1) and tenascin-C (TNC). Sera were also analysed for TPO, ASCA and total IgE. Healthy female blood donors served as controls. The cut-off value in the control group was defined as relative units > 97.5th percentile.ResultsSixty-six women were included (mean age 60 years; range 31–74, mean disease duration 6 years; range 1–22). No autoantibody was significantly overexpressed in the CC population compared to controls. The mean disease duration was lower (p = 0.03) in the subjects who expressed collagen-associated autoantibodies (3.7 years; range 1–14), compared to those who did not (6.4 years; range 1–22). Treatment with budesonide was not associated with any of these autoantibodies.ConclusionNo increased presence of the investigated antibodies could be found in the present study of CC. Neither could antibodies against ASCA or TPO, or elevated levels of IgE, be found. Consequently, no association was found between CC and these proteins, even though this may not be generalizable to other compounds in the collagen layer.

Association of Soil-Transmitted Helminths Infection with Total Serum Immunoglobulin E Levels and Total Eosinophils in Elementary School Students in Medan

BACKGROUND: Soil-transmitted helminths infection is widespread in tropical and subtropical areas. More than 267 million preschool-aged children and more than 568 million school-age children live in areas where this parasite is transmitted intensively and requires treatment and prevention. People at risk are preschool children, school-aged children, reproductive age women, and adults in certain high-risk occupations, such as tea pickers or miners. Worm infections often infect elementary schoolchildren because at this time, children have many activities and are often in direct contact with a dirty environment so that it can cause children not to pay attention to personal hygiene. AIM: This study aimed to determine the association of STH infection with total serum IgE levels and eosinophil counts in elementary school students in Medan. METHODS: This cross-sectional study was conducted on 65 elementary school students at Medan orphanage who met inclusion and exclusion criteria. Examination of STH infection was carried out using Kato-Katz method, and blood tests were performed to assess total serum IgE and blood eosinophils counts. Univariate and bivariate analysis was performed to determine the association of STH infection with total serum IgE levels and eosinophil counts in these students using Pearson correlation test and Chi-square. RESULTS: Of the 65 elementary school students in the orphanage who were willing to have their routine blood and feces checked, 36 boys (55.3%) and 29 girls (44.6%), 39 children were infected with STH (60%). The most common infections were Ascaris lumbricoides (26.1%), Trichuris trichiura (18.4%), and mixed infections (15.3%) with an average of mild infection intensity. The results of the analysis showed that there was no significant association between STH infection and eosinophils counts (p = 0.582, 95% confidence interval, OR 1.3). In addition, there was also no significant association of STH infection with total serum IgE levels (p = 0.883, 95% confidence interval, OR 63.6). CONCLUSION: In this study, there was no association between STH infection with eosinophils counts and total serum immunoglobulin E levels in elementary school students in Medan.

Evaluation of Serum IL-33, IL-5 and Trace Elements Levels among Asthmatic Patients

The precise relationship between interleukins-33 and IL-5, as well as some trace elements and asthma, is unknown. The target of research was to compare and link the above-mentioned serological parameters in asthmatic patients and healthy controls. In 69 asthmatic patients and 35 healthy controls, serum levels of IL-33, IL-5, zinc, copper, iron, total IgE, Forced expiratory volume (FEV) and Forced expiratory volume (FEV) were compared. Spirometry was used to assess the (FEV) and (FVC) in asthmatic patients, as well as their age and body mass index (BMI). When asthmatic patients were matched to controls, mean levels of IL-33, IL-5, and total IgE appeared highly significant difference (p &lt; 0.001). There was a substantial decline in zinc levels in the asthmatic group, but no significant drop in Copper levels. There was also a statistically significant difference in high Iron mean levels among asthmatic patients. In addition, the findings revealed a significant positive correlation between Iron and IgE levels in patients and the levels of (IL-33 and IL-5), plus a significant negative correlation with Zinc levels. Only Copper had no relationship with the interleukins studied. IL-33, also known as IL-5, is a novel inflammatory marker implicated in asthma progression by interacting with IgE, Zinc, Iron, but not Copper levels. As a result, it could be a one-of-a-kind therapeutic target in these patients.

Risk of Developing Asthma After Lower Respiratory Tract Infections with Respiratory Syncytial Virus During Childhood

Background: Recent studies indicate causal relationship between infection by respiratory syncytial virus (RSV) and bronchial asthma. We evaluated the incidence of bronchial asthma in children with RSV positive infection early in their childhood in a nation-wide cohort study. Methods: Children (aged between one month and 15 years) were evaluated for the presence of RSV infection when they presented with one or more acute respiratory tract infection symptoms (fever, cough, cold and wheezing) in a major tertiary care hospital in the Kingdom of Bahrain during a period of seven years. RSV detection was done using nasopharyngeal secretion (NPS) samples by direct antigen detection immunofluorescence technique. Number of children who were later diagnosed with asthma was recorded. Serum IgE levels were estimated. Risk of developing bronchial asthma is represented using relative risk (RR) [95% CI]. Children with asthma without prior RSV infection from the same population formed the historical control. Results: A total of 3782 children diagnosed with respiratory tract infection were recruited. We observed that RSV infection at younger age (during infancy) and severe infection were significantly associated with asthmatic episodes RR [95% CI]: 7 [5.5, 8.2]. Additionally, asthmatics with prior RSV infection had significantly higher total IgE levels (167 ± 37 IU/ml) compared to those without RSV infection (92 ±17 IU/ml). Mean (SD) age of children developing asthma with prior RSV infection was 0.7 (0.42) years compared to the historical control [6.8 (3.8) years] and was statistically significant. Conclusion: Infants with RSV infection have an increased risk of developing bronchial asthma later in the childhood. The more severe the RSV infection, the greater is the severity of bronchial asthma as indicted by serum IgE levels. Asthma in children with RSV infection occurs at much younger age compared to those without RSV infection.

A Study on Correlation of Serum IGE Levels with Diagnosis and Management of Bronchial Asthma in Children

Introduction: Traditional methods for identifying atopic individuals in allergy and respiratory illness studies include the responsiveness of allergy skin tests, serum IgE levels, and peripheral blood eosinophilia. Objectives: The main objective of the study is to find the association between Raised Serum IgE levels and bronchial asthma in children. Material and methods: This cross sectional study was conducted in Mayo Hospital Lahore during May 2021 till November 2021. The data was collected from 140 patients of age range 2 to 12 years. The doctor conducted a thorough examination of each patient, after which the required paperwork was completed. Results: 140 patients provided the data for this study. Gender, a family history of asthma, breastfeeding exclusively for the first six months, or living in a residential setting were not shown to have a significant impact on the amount of total serum IgE. Higher total serum IgE levels in asthmatics and older age groups, cigarette smoke exposure, and higher eosinophil counts are correlated. Asthmatics had higher IgE levels. Conclusion: It is concluded that there is a correlation between total serum IgE levels and a child's propensity for wheeze and early sensitivity to local aeroallergens. Allergy in children can be accurately predicted by measuring the serum total IgE level.

Значення поліморфізму тол-подібного рецептора-2 в розвитку сенсибілізації до кліщів домашнього пилу в дітей із атопічним дерматитом

Atopic dermatitis is a chronic recurrent inflammatory skin disease that affects 5-20% of children. Airborne allergens derived from house dust mites can cause atopic dermatitis. TLR2 play an important role in the recognition of house dust mite allergens. Purpose - to investigate the prevalence of sensitization to house dust mites in children with atopic dermatitis and the role of TLR2 rs4696480 polymorphism in the development of sensitivity to house dust mites. Materials and methods. The study included 100 patients with atopic dermatitis. Genotyping of the polymorphism TLR2 rs4696480 was performed in the patient group using real-time PCR. Measurements of sIgE to dust mites were performed by Western blotting according to the manufacturer’s protocol (Simesta-Medivis, Ukraine-Germany). Results. Sensitization to house dust mites was found in 48% of children. Children with elevated levels of specific IgE to dust mites had a significantly higher SCORAD index than patients without sensitization (p&lt;0.001). In the group of children sensitized to house dust mites, there were significantly higher levels of total IgE (p&lt;0.001) and a longer course of the disease (p&lt;0.05). There was no statistically significant difference in the distribution of genotypes depending on the presence of sensitization to dust mites (OR=1.250 (0.481-3.245) for AA and AT; OR=2.125 (0.715-6.315) for AA and TT). Conclusions. This study showed that the susceptibility to dust mites among children with atopic dermatitis is 48%. The presence of susceptibility to house dust mites affects the severity of the disease. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local ethics committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author. Key words: TLR2, house dust mites, atopic dermatitis, children.

Role of Vitamin D &amp; Immunoglobulins E in patients of Seasonal Allergic Conjunctivitis

Introduction: Allergic conjunctivitis is in fact a bunch of diseases affecting the visual surface and is usually related with type1 hypersensitivity reactions. Two acute disorders, seasonal allergic conjunctivitis and perennial allergic conjunctivitis, exist, as do 3 chronic illnesses, vernal keratoconjunctivitis, atopic keratoconjunctivitis, and giant papillary conjunctivitis. Seasonal allergic conjunctivitis is related with seasonal hypersensitivities that ordinarily happen amid the spring and summer months, and in some cases amid the fall. Exposure to dust, grass and other airborne allergens causes seasonal allergic conjunctivitis. Low levels of vitamin D somewhat related to allergic disorders. This study show a relationship between Serum vitamin D and Immunoglobulin’s E in patients of seasonal allergic conjunctivitis Objective: To evaluate serum vitamin D and serum total immunoglobulin E levels in patients with seasonal allergic conjunctivitis (SAC). Material and Methods Study design: quantitative cross sectional Duration: Six months i.e. 1st September 2021 to 28th February 2022 Data Collection procedure: A cross sectional study was conducted on 100 patients. The study was conducted in Holy Family Hospital Rawalpindi. Ethical approval was taken from ethical committee. An educated consent was taken from the participants. 60 patients in this study presented with seasonal allergic conjunctivitis and 40 healthy normal persons were included. Serum vitamin D and serum total IgE levels were calculated. Results: The average age of the participant in this study was in between 30-50 years of age. In SAC group 40 were males and 20 females. Group two healthy normal consist of 25 males and 15 females. There is a significant decrease of vitamin D level in patients who were diagnosed seasonal allergic conjunctivitis and IgE levels were high when compared to normal healthy group Conclusion: In conclusion, we demonstrated lower plasma vitamin D levels in patients with SAC compared with the control bunch. To conclude a certain association between vitamin D status and allergic conjunctivitis, both multicenter larger case arrangement and further studies examining the impacts of vitamin D supplementation ought to be performed in the long run. Keywords: Vitamin D, seasonal allergic conjunctivitis, IgE, Allergy

Bullous pemphigoid and milia: prevalence and clinical laboratory findings in a Brazilian sample

BackgroundBullous pemphigoid (BP) associated with milia lesions has been increasingly reported, but its prevalence has not been reported in a Brazilian BP population yet. ObjectivesTo describe the occurrence and clinical-laboratorial findings of BP-milia association in a southeastern Brazilian sample. MethodsA descriptive study based on the medical charts of 102 BP patients was accomplished. Clinical and laboratory data of BP-milia patients were compiled. Total serum IgE measurements, immunoblot assays based on basement membrane zone antigens, and HLA-DQ alleles typing were performed. ResultsMilia was evident in 8 (7.8%) BP patients, five males, aged between 46 and 88 years. Increased total IgE levels were determined in 7 (87.5%) of the eight patients. In five of eight patients, immunoblotting showed IgG reactivity against the BP180-NC16a domain but not against collagen VII or laminin-332; it also revealed reactivity against the BP180 C-terminal domain or LAD-1, or both in four of them. The HLA-DQB1*03:01 and HLA-DQA1*05:05 alleles were identified in three of five BP-milia patients. Moreover, three of five cases presented the HLA-DQB1*06 allelic group. Study limitationsHLA determination was performed in five patients. ConclusionsMilia formation in BP patients seems to be less uncommon than previously admitted. Laboratory data revealed increased IgE; autoantibodies against the BP180 C-terminal domain or LAD-1, or both; and the HLA-DQB1*06 allelic group, described for the BP-milia association. Careful determination of antibodies against basement membrane zone molecules and HLA characterization in different populations may provide further insights into this association.

Keratosis pilaris and filaggrin loss‐of‐function mutations in patients with atopic dermatitis – Results of a Finnish cross‐sectional study

Keratosis pilaris (KP) associates with epidermal barrier defects in atopic dermatitis (AD) but its role in disease severity and concomitant atopic diseases seems to vary between populations. We performed a cross‐sectional observational study with 502 randomly selected AD patients of a Finnish tertiary health care center. At a single clinical examination, disease severity (Rajka Langeland severity score and EASI), clinical signs and patient history were evaluated and total IgE levels and frequent filaggrin (FLG) loss‐of‐function mutations were investigated. There was no link with disease severity (p = 0.649, 95% CI 0.569–0.654), asthma (p = 0.230, 95% CI 0.206–0.281) or atopic sensitization (p = 0.351, 95% CI 0.309–0.392). Keratosis pilaris was significantly associated with palmar hyperlinearity (p < 0.000, 95% CI 0.000–0.006, OR 4.664, 95% CI 2.072–10.496) and the filaggrin loss‐of‐function mutation 2282del4 (p < 0.000, 95% CI 0.000–0.009, OR 4.917, 95%CI 1.961–12.330). The prevalence of KP in the cohort was generally low and KP seems to be infrequent in Finnish AD patients. This may be explained by the fact that the tested FLG loss‐of‐function mutations are rarer in the Finnish population compared for example, with central Europe or Asia. Mutations in other locations of the FLG gene or other genes of the epidermal barrier may play a more important role.

Implication of serum Nitric oxide and IgE in urinary schistosomiasis: The case of Bamendjing, Cameroon

BackgroundUrinary schistosomiasis (US), also known as bilharziasis is a waterborne parasitic infection most common in rural areas of developing countries. The infection is associated with haematuria but little or nothing is known about its association with other urinary parameters, induction of Nitric Oxide (NO) and IgE production around the Bamendjing Dam an area highly suspected of Schistosoma haematobium infections. The study sought to address this problem for possible future interventions and control. Materials and methodsUrine samples were collected from 301 randomly selected participants and analysed for the presence of S. haematobium using the syringe filtration concentration method. Sera from patients infected with S. haematobium and also from some uninfected individuals were analysed for IgE and NO using ELISA and colorimetric methods respectively. FindingsThe results showed a prevalence of 16.9% (51/301). Sixty percent of the 49 patients with nitrite in their urine, were infected with urinary schistosomiasis (US) (30/49; p = 0.00). Meanwhile only 40% of the 15 patients with bilirubinuria were infected with US (6/15; p = 0.0241). The risk of patients with US having leucocytes and nitrites was high (OR of 1.3 and 1.7 respectively). Total IgE serum levels were significantly higher in patients with US (648.872 ± 223.142) compared to uninfected individuals (275.682 ± 181.674) (p = 0.00). Infected persons had heightened mean NO levels (2,583,617.647 ± 1,100,678.786) than non-infected participants (1,689,766.667 ± 1,163,084.729). Urinary Schistosomiasis in association with urinary parameters had a significant impact on mean IgE levels (F = 4.248, p = 0.022). Patients infected with Urinary Schistosomiasis alone had significantly higher mean total IgE levels than non-infected participants (p = 0.004). ConclusionApart from haematuria, this study has demonstrated that Urinary Schistosomiasis is prevalent among inhabitants around the Bamendjing Dam and results in an increase of other urine parameters such as leucocytes and nitrates and high levels of serum NO and total serum IgE in patients. These parameters are important in the screening of patients for treatment and control of urinary schistosomiasis.

House Dust Mite Exposure through Human Milk and Dust: What Matters for Child Allergy Risk?

Allergies are major noncommunicable diseases associated with significant morbidity, reduced quality of life, and high healthcare costs. Despite decades of research, it is still unknown if early-life exposure to indoor allergens plays a role in the development of IgE-mediated allergy and asthma. The objective of this study is to contribute to the identification of early-life risk factors for developing allergy. We addressed whether two different sources of house dust mite Der p 1 allergen exposure during early life, i.e., human milk and dust, have different relationships with IgE levels and asthma outcomes in children. We performed longitudinal analyses in 249 mother–child pairs using data from the PIAMA birth cohort. Asthma symptoms and serum total and specific IgE levels in children were available for the first 16 years of life. Der p 1 levels were measured in human milk and dust samples from infant mattresses. We observed that infant exposure to Der p 1 through human milk was associated with an increased risk of having high levels of serum IgE (top tertile > 150 kU/mL) in childhood as compared to infants exposed to human milk with undetectable Der p 1 [adjusted OR (95% CI) 1.83 (1.05–3.20) p = 0.0294]. The Der p 1 content in infant mattress dust was not associated with increased IgE levels in childhood. The risk of asthma and Der p 1 sensitization was neither associated with Der p 1 in human milk nor with Der p 1 in dust. In conclusion, high levels of IgE in childhood were associated with Der p 1 exposure through human milk but not exposure from mattress dust. This observation suggests that human milk is a source of Der p 1 exposure that is relevant to allergy development and fosters the need for research on the determinants of Der p 1 levels in human milk.

A Novel Method for Total IgE Purification from Human Serum.

For Ab purification, high-affinity chromatography is commonly used. This technique results in high-purity Abs, but it requires highly specific knowledge and equipment. Commercial kits for purification of IgE are not available. Therefore, we established a (to our knowledge) novel method for the purification of total IgE from human serum. Sera from 19 allergic and nonallergic patients were included. After depletion of polyclonal IgG, total serum IgE was captured using anti-human IgE Abs coupled to beads, eluted from the beads, and incubated with protein G-coupled beads to increase the final purity. Purity analysis and Ab detection were performed by Western blot. Total serum IgE and purified IgE concentrations were analyzed using ELISA. To determine their functionality, primary human mast cells were sensitized with purified IgE and activated with anti-IgE or a relevant allergen. CD63+ expression and histamine release were used as readout parameters. Concentrations of purified total IgE corresponded with the levels of total serum IgE. Minor fractions of IgE remained attached to the beads, confirming an effective elution of IgE Abs. Only minimal amounts of IgG were found in the purified IgE fractions, confirming a high purity of IgE. Mast cells sensitized with purified IgE and subsequent activation with anti-IgE Ab or a relevant allergen showed increased expression of CD63+ and increased histamine release. This (to our knowledge) novel method represents a highly effective and widely accessible approach for purification of human serum IgE, which can improve the use of IgE-based in vivo and in vitro models and contribute to allergy research.

CHARACTERIZATION OF CONSULTATIONS REQUESTED FOR PATIENTS WITH ELEVATED BLOOD EOSINOPHILS: A TERTIARY IMMUNOLOGY AND ALLERGY CLINIC EXPERIENCE

Objective: Blood eosinophilia has become a common laboratory abnormality and its characterization poses a dilemma for physicians. As a result, physicians often consult specialists in immunology and allergy in order to evaluate patients with high eosinophils, with the general assumption of an underlying allergic or immunologic cause. However, there is little data in the literature regarding consultations requested from immunology and allergy clinics because of eosinophilia. This study aimed to evaluate the clinical and demographic characteristics of patients who were consulted to the allergy clinic because of eosinophilia and detail the etiologies of eosinophilia. Methods: The medical records of 1366 patients consulted to the allergy clinic were evaluated retrospectively, and the data of 143 patients who were consulted for eosinophilia were investigated. Results: The median (range) eosinophil count was 2456 cells/ mm3 (520-42920). 86 (60.1%) patients were classified as mild (500 to 1500 cells/mm3 ), 44 (30.8%) patients as moderate (1500 to 5000 cells/mm3 ), and 13 (9.1%) patients as severe (≥5000 cells/ mm3 ) eosinophilia. The most frequently consulted departments were chest diseases (37.1%), internal medicine (34.2%), and dermatology (14.7%), respectively. While the most common clinical symptoms at presentation were cough, dyspnea, pruritus, rhinitis, and gastrointestinal symptoms, 49 (34.3%) patients were asymptomatic. The mean±SD vitamin B12 and tryptase levels were 424.2±240.5 pg/mL, and 4.48±1.76 ng/mL, respectively. The median total IgE level was 150 IU/mL (1.5-9464). Atopy was&nbsp;identified in 26.6% (n=38) of the patients. Among 143 eosinophilia patients, there were no patients diagnosed with myeloproliferative or lymphocytic variants of hypereosinophilic syndrome (HES), eight patients were diagnosed with idiopathic HES. While the most common underlying causes were asthma (n=38) and allergic rhinitis (n=20), 30 patients had non-allergic causes. Conclusion: Although parasitic infections and allergic diseases are the first etiologies that come to mind when eosinophilia is detected in a patient, a specific anamnesis and advanced diagnostic tests for differential should be performed in order to detect other underlying or accompanying conditions apart from these diseases.