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Biomedical subjects

Bee Wah Lee

Publications and source records attributed to Bee Wah Lee.

14 recordsLinked to original sources
PubMed2006

Expression of the Blomia tropicalis paramyosin Blo t 11 and its immunodominant peptide in insect cells.

Blo t 11, a dust-mite (Blomia tropicalis) paramyosin, is an allergen with significant IgE reactivity that has potential as a diagnostic/therapeutic reagent for house-dust-mite allergy. The present study describes the successful expression of Blo t 11 and its immunodominant peptide fD in insect cells using a baculovirus expression system. The Blo t 11 and fD genes were cloned into the pMelBacA vector and the resulting vectors were co-transfected into Sf9 insect cells with Bac-N-Blue DNA. Plaque assay was used to select for recombinant virus that was then used to infect High Five insect cells for protein expression. Secreted proteins were harvested by immuno-affinity purification using monoclonal antibodies to Blo t 11. Purified proteins were analysed by immunoblotting, N-terminal sequencing and ELISA. Immunoblot analyses revealed the full-length Blo t 11 cDNA expressed as a minor protein band of approx. 200 kDa and two major protein bands of approx. 60 and 70 kDa. Clones expressing fD cDNA fragment produced a protein of approx. 30 kDa that was confirmed to be fD by N-terminal sequencing. Approx. 4-7.5 mg/l of fD and 1 mg/l of Blo t 11 were obtained by affinity purification. ELISA results showed that human IgE reactivity to these recombinant allergens was lower as compared with that of the native Blo t 11, suggesting that these baculovirus-expressed allergens exhibiting reduced allergenicity could be useful for the development of immunotherapeutic reagents for mite allergy.

Allergens↗
PubMed2006

Food allergy in Asia.

PURPOSE OF REVIEW: Food allergy is increasing in prevalence in Western populations, but little is known about it in Asia. The perception is that the prevalence in this region is low, but is likely to increase with the global increase in allergy. Asia is unique because of the many different cultures and eating habits, with the resulting occurrence of unique food allergens. This review describes the epidemiology and clinical features of food allergy, and introduces some of the unusual food allergens in Asia. RECENT FINDINGS: Recent studies describing the pattern of anaphylaxis and the role of food triggers show that food is an important cause of severe allergic reactions in Asia. Progress has been made on the characterization of unique food allergens from the region. Peanut and tree nuts are rarely the cause of allergic reactions in Asia. The lack of availability of epinephrine auto-injectors in many countries is an important issue that needs to be addressed. SUMMARY: The pattern of food allergy in Asia is unique. Unfortunately, data from many parts of Asia are still lacking. Large, well-designed epidemiological studies are needed so that the scale of the problem can be understood, public awareness can be increased and important food allergens in the region can be identified.

Allergens↗
PubMed2006

Molecular cloning of Blomia tropicalis allergens--a major source of dust mite allergens in the tropics and subtropics.

Allergic asthma, rhinitis, rhinoconjunctivitis and atopic dermatitis are the most common allergic disorders that are caused by the house dust mite (HDM). Beside pyroglyphid mites, the clinical importance of non-pyroglyphid mites has also been increasingly recognized in the recent years. Blomia tropicalis is the most important and ubiquitous mite species in tropical and subtropical regions of the world. Well-standardized and characterized allergens are essential for the diagnosis and therapy of house dust mite allergy as well as for the study of the pathophysiology of allergic disease. With the introduction of molecular biology, a number of house dust mite allergens were obtained by cloning the genes encoding the allergens. To date, seven allergens from Blomia tropicalis have been identified and characterized. Among these, Blo t 5, with unknown function, is the major allergen of Blomia tropicalis, with up to 92% of allergic patients sensitized to it. Native Blo t 5 has been purified and shown to consist of multiple isoforms. With advancing knowledge of these specific allergens, it is anticipated that targeted, effective, diagnostic, efficacious and safe therapeutic modalities would be developed.

Allergens↗
PubMed2006

The epidemiology of paediatric intussusception in Singapore: 1997 to 2004.

INTRODUCTION: The world's first rotavirus vaccine, Rotashield or RRV-TV, was registered in the US in 1998, but withdrawn within a year because of an observed association with intussusception (IS). Surveillance for IS has consequently become important in safety monitoring of new-generation rotavirus vaccines during development. Post-marketing surveillance is also important, and requires the availability of local baseline epidemiology data on IS. MATERIALS AND METHODS: An eight-year study of IS in children under 2 years of age in Singapore was performed by retrospective review of admissions to KK Women's and Children's Hospital, the main paediatric hospital, from 1997 to 2001, followed by prospective surveillance of all hospitals from 2001 to 2004, using the case definition of the Brighton Collaboration Intussusception Working Group. RESULTS: The average IS incidence was 60 per 100,000 in under-ones, and 32 per 100,000 in under-twos, with a downward trend between 1999 and 2004. Ninety-two per cent of subjects were aged below one year, with 51% aged 6 months to 11 months. The mean age at which IS occurred increased from 6.4 months to 12.5 months over the study period. The male-to-female ratio was 1.3:1. No trend in IS numbers was observed over different months of the year. CONCLUSION: IS in Singapore shows no seasonality, but has demonstrated a trend of decreasing incidence in recent years. While highest in the first year of life, the risk of IS is increasing in the second year of life. Males have a slightly higher risk.

Child, Preschool↗
PubMed2005

Evaluation of RIX4414, a live, attenuated rotavirus vaccine, in a randomized, double-blind, placebo-controlled phase 2 trial involving 2464 Singaporean infants.

BACKGROUND: At present, no rotavirus vaccine is commercially available for use worldwide. Hence, a live, attenuated monovalent vaccine was developed with human strain RIX4414 (G1P1A P[8] specificity). Vaccination trials involving infants are ongoing in developed and developing countries. METHODS: This study was a randomized, double-blind, placebo-controlled trial conducted at pediatric hospitals and polyclinics in Singapore for the evaluation of the immunogenicity, reactogenicity, and efficacy of 2 oral doses of RIX4414. In total, 2464 healthy infants (who were 11-17 weeks old when the first dose was administered, which is in accordance with the local immunization schedule) were enrolled to receive RIX4414 at 3 concentrations of virus (10(4.7), 10(5.2), or 10(6.1) focus-forming units) or placebo at 1-month intervals, concomitantly with routinely administered infant vaccines. RESULTS: The RIX4414 vaccine was highly immunogenic, and virtually all vaccine recipients (98%-100%) experienced "vaccine take" (i.e., a combined immunogenicity end point based on seroconversion and/or shedding of RIX4414 in postvaccination stool samples) after receipt of 2 doses at all 3 dosage levels. Depending on the virus concentration, the anti-rotavirus IgA seroconversion rate varied from 76% (95% confidence interval [CI], 68%-83%) to 91% (95% CI, 85%-95%). Two doses of RIX4414 were well tolerated, with no increase in high fever, severe diarrhea, or vomiting after either dose or with increased viral concentration, compared with placebo. There was no observed interference with routine vaccinations of infants when RIX4414 was coadministered. The calculated efficacy of RIX4414 against rotavirus gastroenteritis was 82% (P = .046); however, this result was considered to be of limited conclusive value because of the low number of rotavirus gastroenteritis episodes identified during the follow-up period. CONCLUSIONS: The live, attenuated rotavirus vaccine (RIX4414) was well tolerated and highly immunogenic in Singaporean infants. The immunogenicity of routinely administered infant vaccines was not impaired by concomitant administration of RIX4414 vaccine.

Administration, Oral↗
PubMed2005

Prevalence of allergy-related symptoms in Singaporean children in the second year of life.

This study describes the cross-sectional prevalence of symptoms associated with eczema (chronic itchy rash), asthma (wheeze), and allergic rhinitis (rhinoconjunctivitis) in 1026 subjects between 18.5 and 23 months old (median age is 21 months) in Singapore. The first 2 yr cumulative prevalence of chronic itchy rash, wheeze, and rhinoconjunctivitis were 22.1% (n=227), 22.9% (n=235), and 8.4% (n=86) respectively. In total, 42.2% (414 of 979) reported ever having any of these symptoms. Eczema, although prevalent, was diagnosed only in 34.4% (n=78) of children with chronic itchy rash. Children with this eczematous rash were also more prone to wheeze (cOR=2.0, 95% CI: 1.2-3.0) and rhinoconjunctivitis (cOR=2.0, 95% CI: 1.4-2.8). Similarly, subjects who reported rhinoconjunctivitis and chronic itchy rash were 2.4 times (95% CI: 1.6-3.6) and 1.4 times (95% CI: 1.0-2.0) more at risk of wheezing respectively. Family history of allergy was a significant risk factor for chronic itchy rash (aOR=1.8, 95% CI: 1.3-2.4) and wheeze (aOR=1.7, 95% CI: 1.3-2.4). Thus, symptoms related to allergy were already prevalent during the second year of life. Significant proportions of these symptoms are likely to be due to true atopy as strong relationship with familial history and comorbidity with other potential allergic symptoms were observed.

Asthma↗
PubMed2005

Viewpoint: are doctors responsible for the increase in allergic diseases?

There is no exact explanation for the increase in allergic diseases that occurred since the last two decades. An increased allergen exposure and/or a decreased bacterial load cannot explain the phenomenon completely. Other causal factors that rose at the beginning of the 1980s must be taken into consideration. Important changes at that time in our management of children were the worldwide switch from aspirin to paracetamol, the introduction of broad-spectrum antibiotics such as cephalosporins and the advice to avoid dust and pets in newborns from allergic families. General application of these new approaches, in itself or in combination, might be responsible, at least in part, for the increase of allergic diseases in children.

Allergens↗
PubMed2004

Central nervous system side effects of first- and second-generation antihistamines in school children with perennial allergic rhinitis: a randomized, double-blind, placebo-controlled comparative study.

OBJECTIVE: Allergic rhinitis is common and on the rise. Antihistamines are the mainstay of treatment and are the most commonly prescribed drugs in Singapore. Treatment-related sedation and its effect on cognition are a major concern. First- and second-generation antihistamines show varying degrees of sedation, but to date, objective studies in children are lacking. The objective of this study was to assess the sedating effect of cetirizine (second-generation antihistamine) and chlorpheniramine (first-generation antihistamine) compared with placebo using an objective neurophysiological test. METHODS: This was a prospective, double-blind, placebo-controlled, randomized, single-dose, 3-way crossover study. Twenty-four children aged 7 to 14 years with allergic rhinitis completed the study. All children were randomly allocated to medication sequences and received 3 different drugs on 3 different days, at least 1 week apart. The P300 event-related potential was used as an objective test of sedation. Subjective assessment was by a visual analog scale. RESULTS: Chlorpheniramine and cetirizine increased P300 latency when compared with baseline. No significant increase was obtained with placebo. The significant increase in P300 latency was not accompanied by significant change in subjective somnolence as measured by the visual analog scale. CONCLUSION: We have shown that cetirizine has sedative properties in children. The lack of correlation between P300 latency and the visual analog scale indicates that sedation induced by these drugs may not be subjectively noted.

Adolescent↗
PubMed2004

Secondary household transmission of SARS, Singapore.

Secondary household transmission of severe acute respiratory syndrome (SARS) was studied in 114 households involving 417 contacts. The attack rate was low (6.2%). Occupation of the index case was the factor that most influenced household transmission (adjusted hazard ratio for healthcare workers 0.157; 95% confidence interval 0.042 to 0.588).

Adolescent↗
PubMed2003

Identification of the major allergenic components in Blomia tropicalis and the relevance of the specific IgE in asthmatic patients.

BACKGROUND: Blomia tropicalis has been reported to be a clinically important allergen in house dust. High prevalence of sensitization to B. tropicalis has been noted in asthmatic patients in Taiwan; however, the allergenic components and its impact on asthmatic patients remain to be clarified. OBJECTIVE: To analyze the prevalence of IgE against B. tropicalis and each allergenic component in asthmatic patients. METHODS: A series of recombinant allergenic components were used for skin tests. The B. tropicalis specific IgE in the serum were measured using the Pharmacia CAP System and immunoblot analysis. RESULTS: A total of 131 patients were included in this study: 44% of these 131 patients were allergic to B. tropicalis, 43% of the 80 B. tropicalis-sensitive patients were allergic to Blo t 5, and 75% of the 65 Blo t 5-sensitive patients were allergic to Blo t 5 fragment 3 (Blo t 5 70-117). The sera IgE binding activity to B. tropicalis was repeatedly tested after Dermatophagoides pteronyssinus absorption, and results showed that most patients were concurrently sensitized to D. pteronyssinus and B. tropicalis. In addition, in 2 (18%) of 11 patients, the B. tropicalis sensitization was caused by the cross-reactivity of D. pteronyssinus. CONCLUSION: A high prevalence of B. tropicalis sensitization was detected in our asthmatic patients, and most of them were concurrently sensitized to D. pteronyssinus and B. tropicalis. The major allergenic component and its IgE binding fragments in Blo t 5 have been identified. These allergenic components can be used for the allergenic determination in B. tropicalis and for further immunotherapy.

Adolescent↗
PubMed2003

An extensive study of human IgE cross-reactivity of Blo t 5 and Der p 5.

BACKGROUND: Dual sensitization by Blomia tropicalis and Dermatophagoides pteronyssinus mites is common in tropical and subtropical countries. The human IgE cross-reactivity between clinical important group 5 allergens, Blo t 5 and Der p 5, remains controversial. OBJECTIVE: This study was undertaken to assess the levels of the IgE cross-reactivity between Blo t 5 and Der p 5 by using sera from a large cohort of asthmatic children in subtropical and tropical countries. METHODS: Purified recombinant Blo t 5 and Der p 5 were produced in Pichia pastoris and tested against sera from 195 asthmatic children. The IgE cross-reactivity was examined by direct, inhibitory and competitive human IgE enzyme-linked immunosorbent assay as well as skin prick tests. RESULTS: The Blo t 5 IgE responses were 91.8% (134 of 146) and 73.5% (36 of 49) for Taiwanese and Malaysian sera, respectively. The Blo t 5 specific IgE titers were significantly higher than those of Der p 5 (P <.02). The correlation of IgE reactivity between Blo t 5 and Der p 5 was low, and only limited cross-reactivity was observed. This was further confirmed by the dose-response inhibition studies. Skin prick tests performed on asthmatic children in Thailand also showed differential IgE response to Blo t 5 and Der p 5. CONCLUSION: By using a large panel of asthmatic sera and a combination of in vitro and in vivo assays, the major allergen of B tropicalis in tropical and subtropical regions, Blo t 5, exhibits low levels of IgE cross-reactivity with homologous Der p 5. These findings suggest that highly specific clinical reagents are necessary for precise diagnosis and immunotherapeutic treatment of sensitization to group 5 mite allergens.

Adolescent↗
PubMed2003

Comparative study of the reactogenicity of a three-component acellular pertussis vaccine and whole-cell pertussis vaccine administered to healthy Singaporean infants.

The objective of this study was to assess and compare the reactogenicity of GlaxoSmithKline (GSK) Biologicals' diphtheria-tetanus-tricomponent acellular pertussis vaccine (DTPa) and the locally used combined diphtheria-tetanus-whole-cell pertussis vaccine (DTPw) as a primary vaccination course in healthy infants at the age of 3, 4 and 5 months. A phase IV, single-blinded, randomized comparative clinical study involved one hundred and eighty healthy infants with two study groups in a 2:1 ratio to receive either DTPa or DTPw vaccine which were administered intramuscularly at the right anterior-lateral aspect of the thigh. The incidence and intensity of local solicited symptoms such as pain, redness and swelling at injection site and general solicited symptoms such as fever and fussiness were evaluated. Serious adverse events were followed for one month after each vaccination. The overall incidence of local and general symptoms was significantly higher in the group receiving locally used DTPw vaccine as compared to the group receiving GSK DTPa vaccine. Solicited local symptoms, pain (47.4% vs 15.1%), redness (95.9% vs 84.9%) and swelling (46.2% vs 18.5%), were reported more frequently in the group receiving DTPw vaccine than in the group receiving DTPa vaccine. Fever (> or = 37.5 degrees C) (52% vs 14.6%) and fussiness (60.8% vs 33.6%) were also more commonly reported in the DTPw group. There were six serious adverse events reported (4 with DTPw and 2 with DTPa). None of them related to the study vaccines, as considered by the investigators. Thus it was found that GSK Biologicals' DTPa vaccine was significantly less reactogenic as compared to the locally used DTPw vaccine manufactured by Commonwealth Serum Laboratories when administered as a 3-dose primary vaccination course to healthy infants at the age of 3, 4 and 5 months in Singapore.

Diphtheria-Tetanus-Pertussis Vaccine↗
PubMed2002

A comparison of safety, tolerability and immunogenicity of Oka/Merck varicella vaccine and VARILRIX in healthy children.

This study compared safety, tolerability, and immunogenicity of the Oka/Merck varicella vaccine and VARILRIX [Oka-RIT strain SmithKline Beecham Biologicals] in healthy children 12-24 months of age. Subjects were randomized in this double blind study to receive either a single dose of Oka/Merck varicella vaccine, (approximately 50,000 plaque forming units (PFU), Group A or approximately 16,000 PFU, Group B) or 1 dose of VARILRIX, (approximately 40,000 PFU/dose, Group C). Safety profiles in each treatment group were similar. The proportions of subjects achieving a 6-week postvaccination titer> or = 5 gpELISA units in Groups A, B or C were 97.1, 95.2 and 85.6%, respectively.

Antibodies, Viral↗