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PubMedDate not supplied

The clinical efficacy of in vitro allergen-specific IgE antibody test in the diagnosis of allergic children with asthma.

Asthma is a very common respiratory allergic disease in Taiwan. The aims of this study were to investigate the allergen-sensitized profile and its relationship with serum total IgE levels in allergic asthmatic children in Taiwan. Moreover, the number of allergens to be tested for the most efficient and effective diagnosis of allergic diseases was also examined. Total IgE and IgE specific for a panel of common aeroallergens were assayed in 200 serum samples of asthmatic children using Pharmacia CAP system (Pharmacia, Uppsala, Sweden). House dust mites Der p (Dermatophagoides pteronyssinus), Der f (Dermatophagoides farinae), and Bt (Blomia Tropicalis) had the highest sensitized rates at 82.5%, 82.0%, and 72%, respectively. Candida albican (14.0%) and Bermuda grass (8.0%) were the most common sensitized fungus and pollen in our subjects, respectively. The accumulated sensitized rate (10%) for pollens was lower than those of fungus (21.5%) and house dust allergens (84%). The average serum total IgE of the allergen-negative asthmatic children (n=30) was significantly lower than that of children with at least one allergen sensitized asthma (n=170) (377.9 +/- 123.6 vs. 1117.8 +/- 235.7 IU/ml, p<0.05). The level of total IgE was significantly correlated with the concentrations of mite-specific IgE antibodies, but not with the numbers of allergen sensitized. In addition, the detection rate was 84% when the 4 most common allergens (Der p, Der f, Dog dander, and cockroach) were tested, similar to the result after testing for all 12.

Allergens↗

PubMedDate not supplied

Prevalence of allergen-specific IgE among patients with chronic fatigue syndrome.

The prevalence of atopy among patients having chronic fatigue syndrome (CFS) has been reported to be as high as 80% in published surveys of patients with this syndrome. However, many of the reports relied on self-assessment by patients for the presence of atopy or solely used total immunoglobulin E (IgE) levels to assess the likelihood of atopy. To more critically assess the presence of atopy among patients with CFS, testing was done for total IgE and allergen-specific IgE using the Pharmacia CAP system including 20 common allergens: trees (birch/oak/ash), grass (rye/blue), weeds (common/giant ragweed), molds (Penicillium/Aspergillus/Alternaria), dust mites (Dermatophagoides pteronyssinus/Dermatophagoides farinae), animal dander (cat/dog), and foods (egg white/milk/wheat/corn/peanut/shrimp). Testing of 50 patients having documented CFS indicated that 78% had total IgE < 100 IU/mL, among whom 26% had a positive test for allergen-specific IgE of class I or greater for one or more allergens. Among the 22% of CFS patients having a total IgE > 100 IU/mL, 73% had a positive test for allergen-specific IgE for one or more allergens. The most commonly positive allergens were dust mites (24-26%), whereas molds (0-6%) and foods (0-4%) were rarely positive. The overall frequency of positive results for the presence of allergen-specific IgE among CFS patients was 36%, not significantly different from the normal prevalence of these antibodies in the general population (20-35%). This assessment of the prevalence of allergen-specific IgE antibodies in patients with CFS fails to support a potential association between CFS and atopy.

Allergens↗

PubMedDate not supplied

Recombinant allergens for immunotherapy.

Many of the problems associated with using natural allergenic products for allergy diagnosis and treatment can be overcome using genetically engineered recombinant allergens. Over the past 10 years, the most important allergens from mites, pollens, animal dander, insects, and foods have been cloned, sequenced, and expressed. Allergens have diverse biological functions (they may be enzymes, enzyme inhibitors, lipocalins, or structural proteins). High-level expression systems have been developed to produce recombinant allergens in bacteria, yeast, or insect cells. Recombinant allergens show comparable immunoglobulin E (IgE) antibody binding to natural allergens and show excellent reactivity on skin testing and in in vitro diagnostic tests. Recombinant allergens will enable innovative new strategies for allergen immunotherapy to be developed. These include peptide-based vaccines, engineered hypoallergens with reduced reactivity for IgE antibodies, nucleotide-conjugated vaccines that promote Th1 responses, and the possibility of developing prophylactic allergen vaccines.

Allergens↗

PubMed2001

[French multicenter prospective epidemiologic study (ORLI Group) of allergic and lung diseases associated with nasal polyposis].

224 patients presenting with nasal polyposis (NP) were included in a french prospective multicenter study. NP was evaluated by nasal endoscopy and computed tomography. Allergic status was documented using skin prick-tests and/or specific IgE. Pneumologic assessment included spirometry with carbamyl-choline hyper-reactivity test or beta 2 mimetic broncho-dilation test. Minimal follow up period was 1 year. 45% of the whole population were considered as asthmatic. Asthma onset occurred before and after the NP onset in respectively 45.7%, 22.3% and 32% of cases; these two conditions started simultaneously in 32% of patients. Skin prick-tests and/or specific IgE were positive in 32.5% of cases. In most of the cases (80%), patients were polysensitized to house dust mite and/or pollens and/or animal danders and/or fungi. 31% of the population had idiosyncrasy, caused by drugs in general and especially aspirin in 44% of cases. The global population could be divided in two groups according to the occurrence of previous polypectomy or not. The group "polypectomy" and the group "no polypectomy" were similar regarding the frequency, the age of onset, the course and the severity of associated asthma. Familial history (parents, children, brothers and sisters) was of great interest: 58.7% of the patients had one (or more) relative suffering from NP, 43.6% of the patients had one (or more) relative suffering from asthma and 12.2% of the patients had one (or more) relative suffering from idiosyncrasy. These results support a genetic etiology for NP.

Adult↗

PubMed2001

Pattern of sensitization to common environmental allergens amongst atopic Singapore children in the first 3 years of life.

This study was aimed to investigate the sensitization pattern to a range of common allergens in young Singaporean children. A cross-sectional study involving 75 children aged below 3 years was carried out. They presented between December 1995 and April 2000 with symptoms of asthma, rhinitis, eczema, or food allergy. Their levels of allergen-specific serum IgE to a panel of foods (egg white, milk, soy protein, shrimp, wheat and peanut), pet dander, dust mites and cockroaches were measured with Pharmacia CAP System radioallergosorbent test kits. Serum IgE levels greater than 0.35 kU/l represented a positive result. Four children could not be tested with the complete panel because of insufficient serum. The prevalence of sensitization was highest for cow's milk (45.9%) followed by egg white (38.7%), dust mites Dermatophagoides pteronyssinus (31.4%) and Blomia tropicalis (25.5%). Sensitization to ingested allergens was significantly more prevalent in children aged 1 year or younger than in the older children (70.4% of those below 1 year, and 50% of those aged 1-3 years; p < 0.02). Sensitization to inhaled allergens, such as dust mites, was more likely to manifest as respiratory symptoms (allergic rhinitis and asthma), while ingested allergens were associated with gastrointestinal symptoms and eczema (p < 0.001). It was concluded that infants and young children are at high risk of sensitization to common environmental substances. Allergen avoidance is therefore important even in the very young. The prevalence of sensitization to food allergens is higher compared to inhalant allergens in young children.

Allergens↗

PubMed2002

Pediatric allergy and immunology at Siriraj Hospital.

Like other parts of the world, prevalence of childhood allergic diseases in Thailand, particularly of asthma and allergic rhinitis, has risen sharply over the past decade. Epidemiologic studies in this country indicated that allergic sensitization (mainly to house dust mites, cockroaches and cat dander) is the major important risk factor for the development of asthma. House dust mites are the most important source of allergens causing sensitization among allergic Thai children. A nationwide survey indicated that house dust mites are ubiquitous in Thai homes. Despite the authors' earlier finding that mite allergen levels in Thailand (mean group-I allergen level of 11 mcg/g dust), exceeded the recommended international threshold level to induce asthmatic symptoms (10 mcg/g dust), mite allergen levels in homes within the Bangkok area are in the modest range (5 mcg/g dust). With mattresses in Thailand being commonly laid on hardwood surfaces, the authors demonstrated that only top-covering of these mattresses with locally produced mite-impermeable membrane, mite allergens could be substantially reduced. Other active research in pediatric allergy in Thailand include complete surveys of outdoor aeroallergens and research in pharmacologic managements of allergic diseases. The Thailand Registry of Primary Immune Deficiency has recently been established to collect data on patients with these disorders and to improve means for diagnosis and treatment for these unfortunate patients. Finally, with a recent approval for board certification in pediatric allergy and immunology, it is expected that the number of specialists in this field will increase to a sufficient level to provide adequate care for allergic/immunologic children in Thailand.

Age Distribution↗

PubMedDate not supplied

Skin manifestations in parasite infection.

BACKGROUND: Intestinal parasites stimulate IgE synthesis by their proteinases. Because of their ability to induce IgE production and mast cell degranulation (either directly, e.g. Ascaris, or via specific IgE) it is possible that some parasites induce allergic manifestations. Some parasites may be more allergenic than others due to their allergenicity. Genetic predisposition, nutritional status, and psychosocial variables of the host and the time and degree of allergen exposure may also play an important role. THE AIM: Of our study was to investigate which parasites are more frequently related to the skin manifestations and if atopic background of the host has a role in these skin allergic hives in intestinal parasites. MATERIAL AND METHOD: 55 patients (13 men, mean age 36 years old) infested with digestive parasites were skin prick tested to inhalant allergens (house dust mites, pollens, animal dander) in order to evaluate the atopic status. All patients had allergic skin manifestations (rash and hives) and angioedema due to their intestinal parasites, which remitted after antiparasitic treatment. RESULTS: Forty (73.3%) patients presented angioedema and 15 patients (26.6%) had chronic rash. Patients who were infected with Ascaris had more severe symptoms: more than 2/3 had angioedema, and only one third had chronic rash. More than 2/3 of the patients were infested with Ascaris lumbricoides: 38 patients (69.09%), and only one third were infested with Giardia lamblia: 18 patients (32.72%). Only one third of the patients (17-30.9%) had positive skin prick tests for at least one inhalant allergen. CONCLUSIONS: The parasite most frequently implicated in skin allergic manifestations in our region is Ascaris lumbricoides. Acute angioedema or chronic rash are the major skin manifestations in parasitic infestation. The atopic trait has no importance in the appearance of allergic manifestations in parasitic infestation.

Adult↗

PubMedDate not supplied

Hypersensitivity to molds in New York City in adults who have asthma.

Molds have been linked epidemiologically to asthma as a key aeroallergen in several studies. Other allergens such as cockroach have been linked to asthma in New York City (NYC). To our knowledge, however, the pattern of mold hypersensitivity has never been examined systematically in the NYC area. Thus, we sought to determine the association between mold hypersensitivity and asthma in a large group of ambulatory patients evaluated for allergic disease for the years 1993 through 2001 at a single medical center. Serological testing for mold-specific immunoglobulin E (IgE) as well as IgE specific for other aeroallergens was performed and the associations between allergen-specific IgE and the presence of asthma were examined using bivariate and multivariate analysis. Factor analysis showed that three distinct groupings of aeroallergen-specific IgE existed within the panel of allergens used. Group 1 consisted of cat dander and dust mites (Dermatophagoides farinae). Group 2 consisted of tree, grass, and ragweed pollen. Group 3 consisted of the Deuteromycetes molds, Alternaria tenuis, Aspergillus fumigatus, and Cladosporium herbarum. Patients with asthma had a highly significant increase in the incidence of hypersensitivity to cat/dust mites and to the molds. Multivariate analysis showed that the presence of hypersensitivity to either A. tenuis or C. herbarum had a significant independent association with asthma after adjustment for cat/dust mite hypersensitivity and after adjustment for other clinical factors. On the other hand, pollen hypersensitivity was not associated independently with asthma. Mold hypersensitivity was strongly correlated with hypersensitivity to cat or dust mites in patients who did not have asthma but not in patients who did have asthma. In the NYC area, recent pollen and spore counts show that mold spores are measurable in at least 75% of the year. Thus it is conceivable that mold hypersensitivity plays a contributing and independent role in initiating or perpetuating the allergic response in patients with asthma in the New York area.

Adult↗

PubMedDate not supplied

A multi-allergen ELISA screening method. Comparison with Pharmacia CAP system and Phazet skin prick test.

Eighty consecutive subjects, coming to our service as suffering from conjunctivitis and/or rhinitis and/or asthma, were investigated by a new multi-allergen enzymatic screening immunoassay (Profilo, Bio-Allergy, Rome, Italy) regarding to serum specific IgE for groups of inhalant allergens (Dermatophagoides, Parietaria, grasses, trees, animal danders). These groups include allergens which are most frequently responsible of allergy in our country. Indices of diagnostic accuracy of this assay were analyzed in relation to skin prick test (SPT, Phazet, Pharmacia), as in vivo reference test, and Pharmacia CAP System, as in vitro reference test, comparing the results achieved by these tests in the same group of subjects. Profilo showed high significant (p < 0.0005) correlations and satisfactory indices of diagnostic accuracy (sensitivity, specificity, predictive values of positive and negative, and efficiency) for the tested allergens with reference to both Phazet SPT and CAP System. In addition, the method appeared very rapid and simple, so that it could be performed in the physician's office.

Adolescent↗

PubMedDate not supplied

Skin prick testing with standardized extracts from 3 different manufacturers. A comparative randomized study.

The aim of this study was to compare skin reactivity to routine allergen prick test with panels of allergens, supplied by three different manufacturers. The allergens comprised ten aero-allergens commonly used for skin prick test in Northern Europe, and included pollen, dander, house dust mites, and moulds. Two hundred consecutive patients were tested. The methods for standardization of allergen extracts, declaration of allergenic potency, and recommended lancets differed. The equipment were Soluprick SQ (Allergologisk Laboratorium A/S, Denmark) (ALK), Alphatest (Dome/Hollister-Stier, U.K.) (DHS), and Phazet (Pharmacia, Sweden) (PHA). The coefficient of variation for the allergen coated PHA (same lancet was applied twice) was 0.31, and for ALK and DHS allergen extracts 0.13 and 0.18, respectively. The frequencies of patients with positive reactions to the various allergens were generally similar, although DHS appeared to elicit less positive reactions to Timothy, dog, and Dermatophagoides pteronnyssinus. For the individual physician, it may be important to know the allergenic activity of the different allergens in his routine panel compared to the activity in other similar panels.

Adolescent↗

PubMed1992

Inhalant allergens in asthmatic children in Taiwan: comparison evaluation of skin testing, radioallergosorbent test and multiple allergosorbent chemiluminescent assay for specific IgE.

The multiple allergosorbent chemiluminescent assay (MAST-CLA) is a method for measuring total and allergen-specific IgE in human serum by a chemiluminescent immuno-enzymatic system. To compare the results of MAST tests with those of radioallergosorbent (RAST) and skin tests as an adjunct to the diagnosis of inhalant allergens in Taiwan, 195 asthmatic children, aged 5 to 15 years, were studied. All MAST tests had valid positive and negative control threads. The most important allergens in our patients were the two mite species: Dermatophagoid pteronyssinus and Dermatophagoid farinae (87.5% and 82.1%, respectively). There were also large responses (MAST-CLA class > or = 2) to the cockroach mix (28.45%), Alternaria (24.3%), and Eucalyptus (32.6%). The individual efficiency percentage between MAST-CLA and skin tests was D. pteronyssinus 91%, D. farinae 88%, cockroach mix 85%, feather mix 75%, dog dander 64%, Candida 75%, Aspergillus 79%, Alternaria 88%, ragweed mix 62% and Eucalyptus 76%. Comparison of the results of allergen-specific IgE measured by MAST-CLA and RAST were also significantly correlated for all four allergens (D. farinae, Candida, Alternaria and grass mix, r = 0.79-0.92). MAST-CLA was randomly duplicated and proven reproducible in 89% of the tests. Changes between positive and negative results occurred in only 3.6% of the tests. MAST-CLA is a simple in vitro test for specific IgE to 35 allergens, which compares favorably with RAST. It is concluded that MAST-CLA and RAST are similar in their ability to measure allergen-specific IgE, and correlate equally well with skin tests and clinical history in asthmatic children.

Administration, Inhalation↗

PubMed1959

Tetanus: prophylaxis and treatment of the disease.

Cleansing and debridement is paramount in dealing with tetanus-prone wounds (severe crushing injuries, piercing wounds, blisters and burns are outstanding examples, particularly if contaminated with dirt, grass or other debris). Prophylaxis then is relatively easy in persons who have been actively immunized by toxoid injections. For them, a "booster" injection is indicated. Use of antitoxin, however, is hazardous, whether for prophylaxis or for treatment of the disease. Since it may in itself cause severe disease, including anaphylactic reaction and serum sickness, decision to use it must be weighed against the possibility of the development of tetanus in each case. To prepare for use of it, careful history should be taken, with particular reference to sensitivity to horse dander. Dermal tests, and perhaps ophthalmic tests, for sensitivity to the serum should be carried out. Even the tests may be hazardous and precautions should be taken accordingly. If it is decided that the use of antitoxin is necessary even though the patient is sensitive to the material, desensitization must be carried out promptly, with adequate preparation for severe reaction. There is experimental evidence that antibiotics of the tetracycline group, given soon after injury, may have prophylactic effect against tetanus.

Anaphylaxis↗

PubMed1992

[Quality control in the allergy laboratory--4 years "Allergy Ring Trial" in Austria].

In 1988 the Austrian Society for Allergology and Immunology initiated an external quality control program for the in vitro allergy diagnosis. In 12 mailings, 62 sera from allergic patients were sent to selected laboratories in order to determine total and antigen specific IgE according to the laboratory-specific methods. The values for total IgE varied considerably (73.9% were within +/- 1 SD, 94.3% within +/- 2 SD and 99.1% within +/- 2 SD, but only 0.9% beyond that). Sources of error were mainly attributable to inappropriate equipment and low quality reagents, but also bad test performance, with respect to personnel and the routines. In contrast, antigen specific IgE against pollen, mites, moulds, insect venoms, animal danders, drugs, parasites, environmental and food antigens revealed quite homogeneous results. Out of 1492 data, only 46 (3.1%) had to be declared as "wrong", and the variability of the RAST-classes was low. Whereas the quality of the reagents from all the different suppliers was not absolutely reliable at the beginning of the study, it improved considerably with time, as consequence of our complaints. The comparability of the methods for detecting total-IgE were non-satisfactory, whereas those for antigen specific IgE were generally good. The variety of methods employed (radio- and enzyme immunologic, fluoro- and nephelometric methods, etc.) should entail appropriate consequences, especially critical comparisons within one and the same laboratory; in addition, international standardization of the "normal" values should replace company-standards, and quality control programs for each test system before it is marketed should be mandatory. Our results confirm, that external control should be obligatory for any laboratory.(ABSTRACT TRUNCATED AT 250 WORDS)

Allergens↗

PubMed1992

Indoor air pollution.

This article summarizes the health effects of indoor air pollutants and the modalities available to control them. The pollutants discussed include active and passive exposure to tobacco smoke; combustion products of carbon monoxide; nitrogen dioxide; products of biofuels, including wood and coal; biologic agents leading to immune responses, such as house dust mites, cockroaches, fungi, animal dander, and urine; biologic agents associated with infection such as Legionella and tuberculosis; formaldehyde; and volatile organic compounds. An approach to assessing building-related illness and "tight building" syndrome is presented. Finally, the article reviews recent data on hospital-related asthma and exposures to potential respiratory hazards such as antineoplastic agents, anesthetic gases, and ethylene oxide.

Air Pollutants↗

PubMed1978

A review of allergic respiratory disease in laboratory animal workers.

There is increased recognition of hypersensitivity lung disease among workers with laboratory animals as an occupational disease. Symptoms of asthma in 44 of 78 workers with laboratory animal dander allergy reflected the serious consequences of this occupational ailment. Affected employee profiles induced family history of atopy; immediate (Type I) allergic reaction; symptoms of rhinitis, asthma, and cough; hypersensitivity to one or more species, most often rats, mice, and rabbits. Diagnosis depends on history and physical, radiologic, and laboratory examinations, including skin tests with relevant antigens. Control and treatment depend on environmental change (reemployment or reduction of antigen contact); mechanical devices (masks and filters); chemotherapy (bronchodilators, steroids), prophylaxis and immunotherapy (hyposensitization). Standardization of medico-legal criteria covering occupational asthma is needed.

Animals↗

PubMed2004

[Passive smoking, atopy and respiratory health in schoolchildren].

Aim of the study was to verify the hypothesis that the effect of passive smoking exposure on the occurrence of respiratory symptoms and diseases is higher in children with increased individual susceptibility defined on the basis of occurrence of symptoms of atopy. Project was performed as the cross-sectional epidemiological study which comprised population of 1,534 children attending primary schools in Swietochłowice, Kedzierzyn-Koźle, Pszczyna and Kielce. On the basis of standard questionnaire an information regarding occurrence of wheezing, attacks of dyspnea with wheezing, asthma and spastic bronchitis was collected. Atopy in child was defined on the basis of occurrence of symptoms of allergy to at least one of the following allergens: house dust mites, animal dander, pollens or symptoms of food allergy confirmed by physician's diagnosis. Exposure to tobacco smoke was assessed also on the basis of the information regarding smoking given by the parents in the questionnaire. The effect of interaction atopy * passive smoking was assessed on the basis of variable called "interaction" which had three levels: level A: when exposure to passive smoking and atopy = 0, level B: when exposure to passive smoking or atopy =1 and level C: when exposure to passive smoking and atopy =1. The results of our study revealed that statistically significant relationship between interaction atopy * passive smoking on the occurrence of analyses symptoms and diseases. The occurrence of symptom/disease increased with the presence of either atopy or exposure to passive smoking and was the highest when atopy and exposure to passive smoking was present. The results of simple analyses were conformed by multivariate analyses. The results of our study suggest that the effect of environmental exposures could be higher in children with atopy.

Asthma↗

PubMed2005

[What environmental measures should be taken for the treatment of atopic dermatitis in children and the prevention of other atopic manifestations?].

The association of atopic dermatitis, asthma and allergy is frequent. Hence, it is logical to imagine that eviction of the main indoor allergens (dust mites, animal danders) would have a preventive effect on the onset and progression of atopic dermatitis and the risk of asthma. Recent epidemiological studies are generally negative with regard to primary and also secondary and tertiary prevention. Only one study appeared positive; it combined eviction of food allergens and of indoor allergens during the first year of life. Other studies are warranted to assess the interest and efficacy of eviction of inhalant allergens in atopic dermatitis.

Child↗

PubMed2005

Evaluation of the phadiatop test in the diagnosis of allergic sensitization in a general adult population.

BACKGROUND: Phadiatop is a commercially available qualitative serological test employed for screening of allergic sensitization in patients with suspected allergic diseases. AIM: The study evaluated the diagnostic accuracy of Phadiatop for the diagnosis of allergic sensitization in a general adult population. METHODS: A total of 469 subjects from the population of A-Estrada (Spain) were selected by age-stratified random sampling (age range, 18-92 years). Phadiatop test (Uni-CAP method) was performed in serum samples from 465 of these subjects. Skin prick tests to a panel of 13 relevant aeroallergens in the studied area (including mites, pollens, moulds, and animal dander) were employed as the reference diagnostic procedure. Subjects with at least a positive skin prick test (> or =4 mm, n= 120) were considered to have allergic sensitization. RESULTS: Phadiatop sensitivity was 70.8% (95% CI 61.7-78.6%), specificity 90.7% (95% CI 87.0-93.5%), positive predictive value 72.6% (95% CI 63.5-80.3%), negative predictive value 89.9% (95% CI 86.2-92.8%), global accuracy 85.6% (95% CI 82.0-88.6%), negative likelihood ratio 0.3 (95% CI 0.2-0.4), and positive likelihood ratio 7.6 (95% CI 5.4-10.8). A high proportion of false-positive Phadiatop cases showed (a) increased total serum IgE levels, (b) significant alcohol consumption, and (c) small-sized (below the diagnostic cut-off) wheal reactions on SPT. A high proportion of false-negative Phadiatop cases showed exclusive storage mite sensitization. Sensitivity and positive predictive value of Phadiatop were somewhat higher among individuals with a history of nasal or bronchial symptoms. CONCLUSIONS: Phadiatop is a valuable tool for the diagnosis of allergic sensitization in a general adult population. However, limitations of the test should be taken into account in similar surveys.

Adolescent↗