The role of phadiatop in the screening of respiratory allergy

Phadiatop is a new in vitro screening test for respiratory allergy. This test, based on the RAST procedure, detects in serum, the presence of specific IgE to a mixture of common inhalent allergens. Among 70 patients (26 children and 44 adults) consulting for respiratory syndrome, Phadiatop was positive in 31 cases. There were a good correlation between this new test and skin tests (59% for adults and 92% for children), total IgE (70% for adults and 65% for children) and RAST (93% for adults and 96% for children). Phadiatop, with a specificity of 100%, a sensitivity of 82% (76% for adults and 92% for children) and an efficiency of 90% (86% for adults and 96% for children), is a more accurate test than total IgE and could be an excellent in vitro screening test for respiratory allergy.     

Prevalence of intestinal parasites among individuals with allergic skin diseases

The prevalence of intestinal protozoans and helminths in stool samples of individuals with allergic cutaneous symptoms was evaluated to study a possible link between parasites and allergy. Altogether, 218 patients who had chronic urticaria, atopic dermatitis, or pruritus of unknown origin were included in the study. Standard laboratory tests for the detection of allergic etiology were performed for all patients. The presence of intestinal parasites was investigated using microscopy, immunofluorescence, and immunoenzymatic assays. Overall, protozoans and helminths were recovered from the stools of 48 subjects (P = 0.004), 18 of whom were affected with intestinal symptoms (P = 0.023). The presence of Giardia lamblia in the stools was significantly associated with allergic cutaneous manifestations (P = 0.030). In addition, patients with allergy were significantly more likely to have > or = 5 Blastocystis hominis organisms per field (P = 0.046). There was a set of patients with allergic cutaneous diseases in whom the presence of intestinal parasites may not be incidental.     

IgE against food and respiratory allergens in healthy and allergic mothers and their children

IgE against mixtures of common food or respiratory allergens were determined by ELISA in healthy (n = 38) and allergic (n = 62) mothers and their children. Significantly higher level of IgE against respiratory allergens was found in sera of allergic mothers and in cord blood of their children. No correlation between antibody level in maternal and newborn's sera was found; this argues against the transfer of IgE from mother to fetus and points rather to offspring's intrauterine sensitization. Specific IgE level in cord blood was higher in children who developed later allergy than in children who did not. Specific IgE level in colostrum was low both in healthy and allergic mothers; there was no correlation between high concentration of IgE against respiratory allergens in sera of allergic mothers and their colostrum, which does not support the idea of IgE transport from blood to mammary gland. Only slightly increased colostral IgE was detected in allergic mothers whose children manifested allergy later. Allergy of the mother and high level of anti-allergen IgE in her serum and in cord blood are the main predictive factors of future occurrence of allergy in the offspring. A combination of several predictive factors could have higher prognostic value.     

Association of Allergic Symptoms with Dengue Infection and Severity: A Systematic Review and Meta-analysis

The relationship between the severity of dengue infection and allergy is still obscure. We conducted an electronic search across 12 databases for relevant articles reporting allergic symptoms, dengue infection, and dengue classification. These studies were categorized according to dengue severity and allergy symptoms, and a meta-analysis was performed by pooling the studies in each category. Among the included 57 articles, pruritus was the most common allergic sign followed by non-specified allergy and asthma(28.6%, 13%, and 6.5%, respectively). Despite the reported significant association of dengue with pruritus and total Ig E level(P \ 0.05), in comparison with non-dengue cases and healthy controls, there was no association between the different severe dengue group with pruritus, skin allergy, food allergy or asthma. However,removing the largest study revealed a significant association between asthma with dengue hemorrhagic fever(DHF) rather than dengue fever(DF). In comparison with DF, DHF was associated with Ig E positivity. Furthermore, specific-Ig E level was higher in secondary DF rather than primary DF. There was a possible association between allergy symptoms and dengue severity progression. Further studies are needed to clarify this association.     

Radioallergosorbent testing for penicillin allergy in family practice.

OBJECTIVES: To determine (a) the prevalence of patients supposedly allergic to penicillin who have a positive radioallergosorbent test (RAST) result for penicillin G or V and (b) the predictive power of family physicians'' clinical judgement that a patient who is supposedly allergic to penicillin will have a positive RAST result. DESIGN: Prospective multicentre cross-sectional observational study. SETTING: Eleven primary care practices in Newfoundland; 10 were in a rural setting. PATIENTS: Of 110 consecutive adult patients with a supposed allergy to penicillin 97 agreed to participate in the study; 92 underwent RAST. INTERVENTIONS: Patients helped physicians complete a questionnaire and had a venous blood sample taken for the RAST. Physicians examined the clinical history and judged whether the patient was likely to have a positive RAST result. MEAN OUTCOME MEASURES: Rates of positive and negative RAST results for penicillin V and G. RESULTS: Of the 92 patients 8 had a positive RAST result and 84 a negative one. The positive predictive power of a "good" clinical history (e.g., urticaria, swollen eyes, tongue or lips, or an anaphylactic reaction witnessed by a physician) was low (10%); the negative predictive power of a "poor" clinical history (e.g., nausea, vomiting, diarrhea, fever, nonspecific rash or fainting) was 92%. CONCLUSIONS: Less than 10% of primary care patients with a supposed allergy to penicillin will have a positive RAST result. In addition, physicians'' predictions of allergy in such patients are imprecise.     

Skin testing versus radioallergosorbent testing for indoor allergens

BACKGROUND: Skin testing (ST) is the most common screening method for allergy evaluation. Measurement of serum specific IgE is also commonly used, but less so by allergists than by other practitioners. The sensitivity and specificity of these testing methods may vary by type of causative allergen and type of allergic manifestation. We compared ST reactivity with serum specific IgE antibodies to common indoor allergens in patients with respiratory allergies. METHODS: 118 patients (3 mo-58 yr, mean 12 yr) with allergic rhinitis and/or bronchial asthma had percutaneous skin testing (PST) supplemented by intradermal testing (ID) with those allergens suspected by history but showed negative PST. The sera were tested blindly for specific IgE antibodies by the radioallergosorbent test (Phadebas RAST). The allergens were D. farinae (118), cockroach (60), cat epithelium (90), and dog epidermal (90). Test results were scored 0-4; ST >/= 2 + and RAST >/= 1 + were considered positive. RESULTS: The two tests were in agreement (i.e., either both positive or both negative) in 52.2% (dog epidermal) to 62.2% (cat epithelium). When RAST was positive, ST was positive in 80% (dog epidermal) to 100% (cockroach mix). When ST was positive, RAST was positive in 16.3% (dog epidermal) to 50.0% (D. farinae). When RAST was negative, ST was positive in 48.5% (cat epithelium) to 69.6% (D. farinae). When ST was negative, RAST was positive in 0% (cockroach) to 5.6% (cat epithelium). The scores of ST and RAST showed weak to moderate correlation (r = 0.24 to 0.54). Regardless of history of symptoms on exposure, ST was superior to RAST in detecting sensitization to cat epithelium and dog epidermal. CONCLUSION: For all four indoor allergens tested, ST was more sensitive than RAST. When both tests were positive, their scores showed poor correlation. Sensitizations to cat epithelium and dog epidermal are common, even in subjects who claimed no direct exposure.     

Active or Passive Exposure to Tobacco Smoking and Allergic Rhinitis, Allergic Dermatitis,and Food Allergy in Adults and Children: A Systematic Review and Meta-Analysis

BackgroundAllergic rhinitis, allergic dermatitis, and food allergy are extremely common diseases, especially among children, and are frequently associated to each other and to asthma. Smoking is a potential risk factor for these conditions, but so far, results from individual studies have been conflicting. The objective of this study was to examine the evidence for an association between active smoking (AS) or passive exposure to secondhand smoke and allergic conditions.ConclusionsWe observed very modest associations between smoking and some allergic diseases among adults. Among children and adolescents, both active and passive exposure to SHS were associated with a modest increased risk for allergic diseases, and passive smoking was associated with an increased risk for food allergy. Additional studies with detailed measurement of exposure and better case definition are needed to further explore the role of smoking in allergic diseases.Please see later in the article for the Editors'' Summary     

Exhaled nitric oxide and nasal tryptase are associated with wheeze,rhinitis and nasal allergy in primary school children

Abstract

Rhinitis and asthma are the most common respiratory diseases in children. We assessed whether airway inflammation markers were associated with nasal allergies and self-reported symptoms of wheeze and rhinitis in 130 children 6–12 year old in an epidemiological context. Independent of sex and age, the fraction of exhaled nitric oxide (FeNO) and nasal mast cell (MC) activation (tryptase ≥?5?ng/mL) were positively associated with wheeze, rhinitis and with nasal allergy. Nasal eosinophil cationic protein (ECP) and exhaled breath condensate (EBC) markers (pH, 8-isoprostane, interleukin-1β) were not associated with symptoms or with nasal allergy. In conclusion, FeNO and nasal tryptase reflect allergic inflammation in the respiratory system.     

Family history of allergy and symptoms of atopic dermatitis

Three hundred sixty five children and hundred thirty nine adults with atopic dermatitis were divided into three groups. Group A included patients with negative family history of allergy; group B--allergy history in one parent or his family; group C--allergy in both parents or their families. It was found that total IgE level was higher in patients of group C in comparison with group A. Similarly, bronchial asthma and/or rhinitis coexisted more frequently, incidence of urticaria was higher and its onset earlier in patients of group C. The results noted in patients of group B occupied middle position between those in group A and group C. Results related to the incidence of RAST positive reactions and multiple sensitivity were similar but the differences were lower. Radioimmunologic assays were performed only in part of the tested patients.     

盐城地区未成年过敏性疾病患者吸入性过敏原IgE检测结果分析

摘要 目的：通过研究分析盐城地区未成年过敏性疾病患者吸入性过敏原特异性IgE检测结果分布变化特点,为过敏性疾病预防和临床诊疗提供科学依据。方法：自2020年1月至2021年3月期间,选择430例未成年(<18岁)过敏性疾病患者,血清检测方法采用欧蒙公司生产的过敏原特异性IgE检测试剂盒。结果：430例患者中,血清过敏原IgE阳性166例(38.60%),其中尘螨和屋尘是主要的吸入性过敏原。血清IgE阳性率男性39%,女性36% (P>0.05),中学组女性阳性率（61.11 %）高于男性（45.83 %）（P<0.05）。不同年龄组间IgE阳性率有统计学差异（P<0.05）,蟑螂、尘螨、霉菌、豚草、屋尘和年龄组间有统计学差异（P<0.05）。不同临床症状与IgE阳性率有统计学差异(P<0.05),其中呼吸道过敏症状组IgE阳性率最高（48.30 %）,不同症状组间主要过敏原都是尘螨。屋尘阳性患者均合并尘螨阳性,其中70.93 %的患者表现出了呼吸道过敏症状。结论：尘螨、屋尘是盐城地区未成年过敏性疾病患者最主要的吸入性过敏原,研究血清过敏原分布,对未成年人过敏性疾病的预防、诊疗具有重要意义。     

Sex-related differences in SLIGRL-induced pruritus in mice

Aims

Pruritus is a common symptom of skin diseases, and is associated with impaired sleep quality and a considerable reduction in the patient's quality of life. Recently, it was reported that there are sex-specific differences in scratching behavior in chronic pruritus patients. Namely, female chronic pruritus patients scratch more and have significantly more scratch lesions than male patients. However, few animal studies have examined sex-related differences in scratching behavior. Thus, the present work investigated sex-related differences in animal pruritus using pruritogens, which are often used to create experimental animal models of itching.

Main methods

Acute pruritus was induced in ICR mice by a single intradermal injection of histamine, 4-methylhistamine, serotonin, compound 48/80, substance P (SP), or the proteinase-activated receptor-2 (PAR-2)-activating peptide SLIGRL-NH₂. Chronic pruritus was induced by 5 weeks of the repeated application of 2,4,6-trinitro-1-chlorobenzene (TNCB) to BALB/c mice.

Key findings

Female mice showed significantly higher scratching counts in SLIGRL-NH₂-induced pruritus than male mice. Conversely, there was no obvious sex-related difference in scratching behavior for the other pruritogens examined.

Significance

These results indicate that sex-related differences may exist in the pruritogen-responsive neurons that transmit the itch signal induced by SLIGRL-NH₂, but not by histamine or 5-HT.     

儿童过敏性结膜炎与变应性鼻炎的相关性及鼻眼联合防治效果分析

目的：探讨儿童过敏性结膜炎与变应性鼻炎的相关性研究及鼻眼联合防治的临床效果。方法：回顾性分析300 例儿童过敏性 结膜炎与310 例儿童变应性鼻炎患者的临床资料,对儿童过敏性结膜炎与变应性鼻炎的相关性进行分析后将所有患儿随机均分 为对照组与观察组,对照组采用常规点眼的方法进行治疗,观察组则采用鼻朗喷鼻联合人工泪液点眼进行治疗。比较两组临床疗 效及不良反应情况。结果：（1）300 例过敏性结膜炎患儿中,50 例（16.67%）并发变应性鼻炎;310 例变应性鼻炎患儿中,59 例 （19.03%）并发过敏性结膜炎（P＞0.05）;（2）109 例同时并发两种疾病患儿中,均进行眼结膜与鼻粘膜的刮片检查嗜酸性粒细胞, 其中60 例（55.05%）结膜刮片与67 例（61.47%）鼻粘膜刮片检测到嗜酸性粒细胞（P＞0.05）;（3）两组治疗前后BUT 及角膜荧光素 染色评分、症状评分、临床总有效率比较差异明显（P＜0.05）。结论：儿童过敏性结膜炎与变应性鼻炎具有一定的相关性;鼻朗喷鼻 联合人工泪液点眼治疗儿童合并变应性鼻炎的临床疗效显著。     

Epidemiologic studies on allergic diseases among rural and urban school children in Poland

451 rural children (group I) and 2000 urban children (group II) aged 10-16 years from Toruń province were inquired by a questionnaire to their parents or guardians. 9.09% of children in the country and 13.45% of those living in the city of Toruń suffered from hypersensitivity disorders; bronchial asthma was reported in 2.22% and 3.05% of cases, allergic rhinitis--in 3.77% and 7.15%, allergic conjunctivitis--in 1.33% and 2.75%, allergic edema--in 0.44% and 0.60%, urticaria--in 1.55% and 3.50%, and infantile eczema--in 0.44% and 2.10% of cases, respectively. The pollinosis prevalence rate was 2.00% in group I and 1.85% in group II. At least 2 various forms of hypersensitivity coexisted in 30.48% of allergic urban children (64.86% of patients with pollinosis among them); infantile eczema preceded allergic rhinitis and bronchial asthma symptoms in 6.29% and 11.47% of cases, respectively, while allergic rhinitis occurred before the onset of bronchial asthma in 24.59% of asthmatic children. 37.10% of individuals with positive family history of allergic conditions also fell ill with some diseases of this nature, while in those with negative family history allergy occurred only in 10.22% of cases. From environmental factors mother's diseases during pregnancy, bottle feeding and a regular diet during the first year of life, frequent respiratory infections in the early childhood and poor living conditions increased the risk of allergic diseases or aggravated their course in the population examined.     

Bronchial asthma in hay fever

The author diagnosed cough, emphysema and the symptoms characteristic for the bronchial asthma in 43% of patients with seasonal allergy (rhinitis, conjunctivitis) to pollens. Such symptoms were more frequent (51% of cases) in patients allergic to the grass pollens with coexisting hypersensitivity to Compositae family. Asthmatic symptoms in patients allergic only to grass pollens were seen in 38%. The author suggests that prolonged exposition in the inhalatory allergens (from two to four-five months) plays an important role in asthma onset in such patients. It rather delays than accelerates admittance to allergic clinics.     

儿童过敏性紫癜发病的危险因素研究

为了探讨儿童过敏性紫癜发病的危险因素,本研究选取了2015年7月至2017年6月在本院治疗的过敏性紫癜患儿118例作为观察组研究对象,同时选取健康正常儿童120例作为对照组,调查分析两组微生物感染、食物过敏、药物过敏史等资料,同时观察治疗疗效。研究显示,观察组的幽门螺杆菌(Hp)、肺炎支原体、链球菌感染率和螨虫阳性率分别为61.02%、16.10%、10.17%和13.56%,明显高于对照组(p<0.05);观察组对牛奶、鸡蛋、虾过敏的比例分别为9.32%、11.02%和8.47%,明显高于对照组(p<0.05);观察组有药物过敏史、家中饲养猫、狗等动物、家中近3个月装修的比例为22.88%、45.76%和17.80%,明显高于对照组(p<0.05);Logistic回归分析显示,Hp感染是发生过敏性紫癜的危险因素(OR=1.613, p<0.05);Hp感染和无Hp感染患者治疗疗效差异比较无统计学意义(p>0.05)。本研究表明,Hp感染可能是儿童过敏性紫癜发生的影响因素,但Hp感染对治疗疗效无明显影响。     

Aberrant structures of fecal bacterial community in allergic infants profiled by 16S rRNA gene pyrosequencing

We investigated the correlation between fecal bacteria composition in early infancy and the prevalence of allergic diseases in late infancy. The fecal microbiota in the first 2?months was profiled using the 16S rRNA V6 short-tag sequences in the community and statistically compared between two groups of subjects who did and did not show allergic symptoms in the first 2?years (n?=?11 vs. 11). In the allergic group, genus Bacteroides at 1?month and genera Propionibacterium and Klebsiella at 2?months were more abundant, and genera Acinetobacter and Clostridium at 1?month were less abundant than in the nonallergic group. Allergic infants who showed high colonization of Bacteroides and/or Klebsiella showed less colonization of Clostridium perfringens/butyricum, suggesting antagonism between these bacterial groups in the gastrointestinal tract. It was also remarkable that the relative abundance of total Proteobacteria, excluding genus Klebsiella, was significantly lower in the allergic than in the nonallergic group at the age of 1?month. These results indicate that pyrosequence-based 16S rRNA gene profiling is valid to find the intestinal microbiotal disorder that correlates with allergy development in later life.     

急性呼吸道感染患儿白细胞计数、内毒素、C 反应蛋白水平变化及 临床意义

目的:探讨急性呼吸道感染患儿白细胞(WBC)计数、血清内毒素(ET)、C反应蛋白(CRP)水平变化及临床应用价值。方法:对急性呼吸道感染组106例患儿(细菌感染组62例、病毒感染组44例)进行WBC计数、血清ET、CRP水平等指标进行检测,并与正常对照组的40例健康儿童进行比较分析。结果:急性呼吸道感染组患儿WBC计数、血清ET、CRP水平均显著高于正常对照组,差异具有统计学意义(P<0.05或P<0.01);血清ET、CRP水平对诊断脓毒症的敏感性差异无显著性(P>0.05),均显著高于WBC计数,差异具有统计学意义(P<0.05);WBC计数特异性显著高于ET、CRP水平,ET水平特异性显著低于CRP,差异均具有统计学意义(P<0.05);细菌感染组患儿血清ET、CRP水平显著高于病毒感染组,差异具有统计学意义(P<0.05),而两组间WBC计数差异不显著(P>0.05)。结论:测定WBC计数、ET、CRP对急性呼吸道感染患儿具有一定的诊断价值。     

青霉素过敏人群IL-18血清浓度以及启动子区基因多态性研究

目的：探讨青霉素类抗生素过敏反应与IL-18及其基因多态性的关系。方法：采用ELISA方法检测50例正常对照和67例过敏患者血清中IL-18水平,PCR-SSP法检测IL-18启动子区多态性位点的基因型。结果：青霉素过敏组IL-18血清浓度显著高于正常对照组（P〈0.01）,且随着皮试反应程度的增强,IL-18浓度也随之升高;青霉素过敏病人IL-18-607位点A等位基因出现频率显著高于对照组（P〈0.01）,CA＋CC基因型降低了青霉素过敏发生的风险性[2=5.868,P〈0.05,OR=3.910,95%Cl（1.225,12.478）]。不同基因型患者血清中IL-18浓度无显著性差异。结论：青霉素过敏反应与IL-18升高有关,IL-18基因启动子区-607C/A位点多态性与青霉素过敏显著相关。     

Evaluation of the age of onset of respiratory allergic symptomatology

Summary In order to evaluate the age of ouset of respiratory allergic symptoms we examined 2315 patients (656 children and 1659 adults) coming to our clinic as out patients. Each patient underwent the following diagnostic tests: anamnestic and clinical examination, skin-tests for the most common allergens and, when requested, Radioallergosorbent test (RAST) and specific and non specific BPT.We selected 278 children and 673 adults for whom it was possible to establish (on the basis of precise anamnestic considerations) the age at which the respiratory symptoms first appeared.Among these, 300 reacted only toParietaria pollen, 58 only to grass pollen, 420 only to house-dust mite, and 173 were not allergic.Patients reacting to multiple allergens were excluded from the analysis.The results of our study show a significant precocity of the onset of symptoms related to allergic sensitization to mites with peak level at 5 years.On the other hand, the onset of pollen-related symptoms was later on (peak level at 20–25 years forParietaria pollen and 30–35 years for grass pollen). For non allergic patients we did not find a definite age of onset.     

High rates of detection of respiratory viruses in tonsillar tissues from children with chronic adenotonsillar disease

Chronic tonsillar diseases are an important health problem, leading to large numbers of surgical procedures worldwide. Little is known about pathogenesis of these diseases. In order to investigate the role of respiratory viruses in chronic adenotonsillar diseases, we developed a cross-sectional study to determine the rates of viral detections of common respiratory viruses detected by TaqMan real time PCR (qPCR) in nasopharyngeal secretions, tonsillar tissues and peripheral blood from 121 children with chronic tonsillar diseases, without symptoms of acute respiratory infections. At least one respiratory virus was detected in 97.5% of patients. The viral co-infection rate was 69.5%. The most frequently detected viruses were human adenovirus in 47.1%, human enterovirus in 40.5%, human rhinovirus in 38%, human bocavirus in 29.8%, human metapneumovirus in 17.4% and human respiratory syncytial virus in 15.7%. Results of qPCR varied widely between sample sites: human adenovirus, human bocavirus and human enterovirus were predominantly detected in tissues, while human rhinovirus was more frequently detected in secretions. Rates of virus detection were remarkably high in tonsil tissues: over 85% in adenoids and close to 70% in palatine tonsils. In addition, overall virus detection rates were higher in more hypertrophic than in smaller adenoids (p = 0.05), and in the particular case of human enteroviruses, they were detected more frequently (p = 0.05) in larger palatine tonsils than in smaller ones. While persistence/latency of DNA viruses in tonsillar tissues has been documented, such is not the case of RNA viruses. Respiratory viruses are highly prevalent in adenoids and palatine tonsils of patients with chronic tonsillar diseases, and persistence of these viruses in tonsils may stimulate chronic inflammation and play a role in the pathogenesis of these diseases.