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PubMedDate not supplied

[Cockroach allergy: a study of its prevalence using skin tests with commercial extracts].

Cockroaches have been increasingly recognized as an important source of indoor allergens. In this study we assessed the prevalence of cockroach sensitization among an outpatient population observed at our Department (155 patients with a mean age of 29 +/- 12 years), based on skin "prick" tests with four commercial cockroach extracts along with a common battery of standardized inhalant allergens. We found a positive wheal to at least one of these four extracts in 27 patients: 26 (96.2%) to Blatta orientalis, 10 (37%) both to Blatella germanica and 1 (3.7%) exclusively to Blatella germanica, with no significant concordance between them. We also observed in patients with cockroach positive skin "prick" test an association with atopy (p < 0.001) and with cutaneous reactivity to other indoor allergens, namely house dust mites (p = 0.02), danders (p = 0.01) and fungi (p = 0.01). These data confirm the higher risk of cockroach sensitization among the atopic population sensitized to indoor allergens. However, the heterogeneity of the positive cutaneous responses obtained in this study, possibly reflecting the incomplete standardization of cockroach extracts, questions the real prevalence and clinical significance of this particular sensitization.

Adolescent↗

PubMed1996

[Allergic children].

Epidemiologic data have shown an increased prevalence (and severity) of atopy related diseases (asthma, eczema and allergic rhinitis) during the post 15-20 years. Atopic respiratory diseases such as allergic rhinitis and asthma represent the effects of an immunological response to allergens, mediated through immunoglobulins E. Development of a clinically significant atopic reaction depends on environmental exposure. The majority of allergic children display positive skin tests to house dust mites, animal danders or pollens. Immediate hypersensitivity to food allergens starts early in life and is most often associated with atopic dermatitis. Allergic reactions to peanuts are generally acute and severe, with an increasing frequency. Parents must be aware of their child's problem and preventive measures must be undertaken very early in life, first at home and later also at school. Family history remains the best predictor of atopy in newborn babies.

Age Factors↗

PubMedDate not supplied

Inhalant allergens: as a cause of respiratory allergy in east Mediterranean area, Turkey.

Inhalant allergens were identified by analyzing the positive skin tests of 614 respiratory allergic patients. The important indoor allergens causing skin test positivity were house dust, Dermatophogoides pteronyssinus, cockroach, mosquito and Dermatophogoides farinea. Johnson grass, cultivated wheat, rye, orchard, and cultivated corn were among important grass pollens. Animal allergens like cow hair, cat and dog dander, bird and chicken feathers and horse hair caused skin test positivity in our allergic patients. Weeds and garden plants were also among important inhalant allergens in this region. Common cocklebur, narcissus, rose, mugworth, and daisy caused skin test positivity in decreasing frequencies. Carob, willow, poplar, olive and cypress pollens were among important inhalant allergens causing skin test positivity that may be important cause of respiratory allergy in this region.

Adolescent↗

PubMed1996

IgE antibodies to Hymenoptera venoms in the serum are common in the general population and are related to indications of atopy.

Determination of Hymenoptera venom (HV)-specific serum IgE antibodies is a useful diagnostic method in patients with systemic anaphylactic reaction (SAR) to Hymenoptera stings. In a general population cohort, we determined the prevalence of SAR and HV-specific IgE antibodies and assessed parameters associated with the latter. A total of 277 voluntarily participating inhabitants of rural Bavaria (Germany) (232 adults, mean age 38.0 years; 45 children, mean age 8.4 years) were investigated for a history of atopic disease or SAR to insect stings; in 258 of these, total IgE and specific IgE antibodies to HV (Apis mellifera, Vespula vulgaris/germanica) and four common aeroallergens (birch pollen, grass pollen, house-dust mite, and cat dander) in the serum were determined. Nine (3.3%) subjects reported SAR to insect stings. In 27.1% of the sera, specific IgE antibodies to HV were found, to bee venom in 24.8%, and to wasp venom in 8.5% (P < 0.0001). Of those exhibiting HV-specific IgE, 7.1% reported SAR to insect stings. A personal history of atopic disease (hay fever, asthma, or atopic eczema) was present in 16.7%, specific IgE to common aeroallergens was found in 32.6%, and total IgE > 100 kU/l was found in 22.5%. Specific serum IgE to HV was significantly associated with male sex (female vs. male, OR = 0.47; CI 0.25-0.86), young age (children vs. adults, OR = 2.80; CI 1.25-6.28), a history of SAR to insect stings (OR = 4.16; CI 1.15-15.03), total sIgE > 100 kU/l (OR = 3.88; CI 1.98-7.60), and specific IgE antibodies to three of the four aeroallergens (grass pollen, OR = 7.24 CI 3.66-14.38; birch pollen, OR = 3.67 CI 1.54-8.81; and house-dust mite, OR = 4.61 CI 2.08-10.32). It is concluded that immunologic sensitization to HV is common in the general population and is associated with atopy-related humoral IgE hyperresponsiveness.

Adolescent↗

PubMed1996

Receiver-operating characteristic (ROC) curves: a fundamental tool for improving the clinical usefulness of in vitro IgE tests.

In order to establish the most efficient thresholds for serum allergen-specific IgE measured by the Pharmacia CAP System, a "second-generation" in vitro method, we evaluated results from 89 subjects with suspected inhalant allergies, using receiver-operating characteristic (ROC) curve analysis. Sera samples were analyzed by the Pharmacia CAP System for specific IgE, the choice of allergens to be tested being based upon the symptoms and clinical history of each patient. Results were analyzed by ROC analysis for the five most representative allergens, cat dander (e1), Dermatophagoides pteronyssinus (d1), Lolium perenne (g5), wall pellitory (W19), and wormwood (w5). The areas under the ROC curves were found to be satisfactory, ranging from 0.931 (e1) to 0.974 (g5) when we excluded w5, which had a significantly smaller area (0.81). To establish the most efficient threshold for each allergen, we calculated the clinical sensitivity, specificity, efficiency, and negative and positive predictive values. The thresholds giving a higher diagnostic efficiency were as follows: 0.40 kUa/l for d1, 0.55 kUa/l for g5, 0.50 for e1, 0.65 kUa/l for w19, and 1.00 kUa/l for w5. It is concluded that quantitative reporting of specific IgE measurement has numerous advantages, but the choice of the positive threshold seems to be a prerequisite for obtaining the optimal clinical efficiency. It is also suggested that a specific threshold should be adopted for each allergen.

Adolescent↗

PubMed1996

The atopy patch test: an increased rate of reactivity in patients who have an air-exposed pattern of atopic eczema.

In a subgroup of patients with atopic eczema (AE), eczematous skin lesions can be induced by epicutaneous testing with aeroallergens (the atopy patch test: APT). An increased frequency of positive APT has been found in AE patients showing a predictive lesional pattern affecting air-exposed skin areas. This study investigates the dose-response of the APT in two different patient groups with AE. Petrolatum preparations of house dust mite, cat dander and grass pollen allergens in four concentrations (500-10,000 protein nitrogen units) were tested epicutaneously in 57 patients with AE, who were prospectively divided in two groups according to whether their AE pattern was with (group I) or without (group II) a predictive distribution. Sixty-nine per cent of patients in group I, and 39% in group II, had positive APT reactions (P = 0.02). The reactions in group I were elicitable with lower allergen concentrations (P = 0.03). A clinically recognizable subgroup of patients with AE showed increased cutaneous sensitivity to aeroallergens.

Adolescent↗

PubMed1997

[Allergen decontamination and public sector].

Reduction of allergen exposure is one way to reduce exacerbations in allergic asthma. According to Danish legislation, the local authorities have to support initiatives which can reduce clinically relevant inhouse allergen exposure. A case of grotesque bureaucracy and ignorance of basic allergological facts is presented. Local administration confused allergy to cat dander with allergy to house dust mite and two appeal boards only reviewed legal aspects, not medical. After inquiry by the ombudsman, the case was reviewed by one appeal board and the patient was granted help. After three years the patient had moved to another district and the case was started all over again. It is recommended that direct contact between physicians should be preferred, in order to avoid misinterpretation of specialist statements. Original documents should always be requested to avoid transcription errors. Local public administration should respect legislation and improve the quality of their medical advisors.

Adult↗

PubMed1997

[Environmental allergens and allergic diseases].

Prevalence of allergic diseases in Japan has been increasing these 30 years. About 3%/5% of adult/ child general population are suffering from bronchial asthma these days. Housedust-mite, pollen, fungi and food have been identified as causative allergen. But recent change of life style in Japan is thought as the most important cause of increase of allergic diseases, such as change from life in wooden houses to concrete buildings. A full-day air-conditioning is comfortable not only for residents but also for microorganisms such as mite and fungi. Therefore, chance to expose to these allergens has been increasing. It is well-known that mite allergen is the most important causative allergen of bronchial asthma. Allergen analysis made us possible to measure the amount of allergen contents in our environment. It is known that 2 micrograms of Der 1 allergen of mite per 1 g of dust is enough to sensitize the host and 10 micrograms per 1 g dust can induce asthma attack. As mite allergens are rich in a sleeping mattress, asthma patients with mite allergy sometimes get asthma attack during sleeping at night. Pet dander such as cat and hamster are also popular causative allergens of asthma. About 30% of asthma patients show positive immediate skin response to these allergens. Releasing the pet from patients' home sometimes brought immediate relief from their symptoms.

Adolescent↗

PubMed1996

Comparison between two automated systems to determine specific IgE: CAP and ELItest.

BACKGROUND AND OBJECTIVE: The ELItest is a newly developed system to measure specific IgE based on allergen bound to paper rings and an alkaline phosphatase conjugated second antibody detection system. It was compared to the CAP system, a method based on allergen conjugated to an encapsulated cellulose polymer and a beta-galactosidase conjugated fluorescence detection system. METHODS: Sera of 300 patients with positive history and positive skin-prick tests to common allergens (birch, timothy-grass, cat dander, dermatophagoides ptronyssinus, wasp venom) and 30 negative controls were tested in both systems. Serial dilutions of high titre sera were measured; inter- and intraassay coefficients of variation (cv) were determined. RESULTS: The CAP system proved to be more sensitive (92.3%) compared to ELItest (84%) but marginally less specific (94.7% for CAP versus 96.7% for ELItest). Intraassay cv were slightly lower in the ELItest (7.2% CAP versus 6.4% ELItest), whereas the interassay cv was roughly twice as high for ELItest (20.1%) than for the CAP system (11.4%). Linearity over an 8-fold dilution was good in both tests (r2 0.979 ELItest versus 0.996 CAP), although ELItest levelled off at higher allergen concentrations. Similarly, correlation analysis between both systems revealed that ELItest consistently measured lower values, especially at higher concentrations of specific IgE. The slope of the linear regression line of a log/log plot of measured IgE concentrations was significantly lower than 1 in birch, cat and wasp; the y-intersect was significantly lower than 0 in all analysed allergens. CONCLUSION: These results suggest that the ELItest system for the measurement of specific IgE is not quite as reproducible and sensitive as the CAP system but slightly more specific, and that higher concentrations of specific IgE are measured lower in the ELItest. One potential reason might be that the amount of allergen bound to a paper ring might be smaller than that bound to a cellulose polymer, but further experiments are necessary to prove this hypothesis.

Adolescent↗

PubMed1997

Allergen content in dust from homes and schools in northern Norway in relation to sensitization and allergy symptoms in schoolchildren.

BACKGROUND: Previous studies have shown a high prevalence of atopic diseases among school children in the community of Sør-Varanger. Moreover, animal dander followed by pollen and house dust mite, were the most common allergens in skin prick tests. OBJECTIVE: To assess the allergen content in homes (living-rooms and mattresses) and classrooms of children living in an arctic area at 70 degrees. The presence of allergens in homes and schools and their relationship to atopy was of particular interest. METHODS: Dust samples from 38 homes and seven schools in northern Norway were collected by vacuum cleaning. The presence of allergens of dog, birch, timothy, Cladosporium herbarum, codfish and hen egg-white was investigated by radio-allergosorbent test (RAST) inhibition and the presence of major allergens of cat Felis domesticus (Fel d I) and house dust mites (HDM) Dermatophagoides pteronyssinus (Der p I) and Dermatophagoides farinae (Der f I) by enzyme-linked immunosorbent assay (ELISA). RESULTS: Mattresses contained significantly more dust per unit area than living-rooms and classrooms. No statistically significant differences in allergen content for dog, birch, timothy. Cladosporium, codfish and hen egg-white were seen between HDM-sensitized and non-atopic children. Most dust samples contained dog allergens with the highest allergenic activity found in living-rooms of those keeping dogs. An increased level of Fel d I was detected in only one of 38 samples from living-rooms (this family kept a cat) and in 25 of 38 samples from mattresses with ranges from 24 to 84 ng/m2. The highest concentrations were found in mattresses of children keeping cats. Increased levels (> or = 25 ng/m2) of Der p I were found only in homes and virtually only in mattresses of HDM-sensitized children. An increased level of Der f I was found in only one case, i.e. in the mattress of an HDM-sensitized child where additionally Der p I and HDMs were demonstrated microscopically. When relating Der p I to HDM-sensitization an odds ratio of more than 16 (95% CI: 1.6-394.3) was found. All extracts from living-rooms included codfish allergens. Low RAST inhibition values were detected for hen egg-white. Cladosporium, birch and timothy pollen in most samples. Furthermore, the study demonstrated that dust from schools was relatively free of allergens. CONCLUSION: Previous findings indicating that the main allergen exposure problem in this geographical area is that of pet allergens were confirmed.

Allergens↗

PubMed1997

Comparative degree and type of sensitization to common indoor and outdoor allergens in subjects with allergic rhinitis and/or asthma.

BACKGROUND AND OBJECTIVES: The determinants of variability in the clinical expression of atopy are still to be documented. The goals of this study were to determine, in subjects with a clinical diagnosis of symptomatic asthma or rhinitis, what is the possible contribution of different types of indoor and outdoor allergens to the development of their disease, by looking at the prevalence and degree of sensitization to these allergens according to age and gender. SUBJECTS AND METHODS: We analysed allergy skin prick tests to common airborne indoor and outdoor allergens in 3371 consecutive patients, grouped according to diagnosis of allergic asthma, rhinitis, or both. For each of these three groups, we calculated the prevalence of sensitization to indoor/outdoor allergens, the atopic index (AI), the number of positive responses to allergy skin prick test and the mean wheal diameter (MWD) of these responses. RESULTS: The prevalence of atopy and the values of AI and MWD peaked in subjects aged 16 to 25 years, declining afterwards; in subjects > or = 18 years old, atopic indices were slightly higher in men than in women. In atopic subjects, the prevalence of sensitization was, in decreasing order, housedust (84.2%), cat hair-epithelium (76.5%), dog hair-dander (63.0%), house dust mite (54.2%), grasses (51.9%), trees (47.2%) and ragweed pollens (44.9%) and finally, moulds (25.4%). Among subjects sensitized only to outdoor allergens (n = 195). 73.8% had a rhinitis, 11.8% had asthma and 14.4% had both diagnoses; for those sensitized only to indoor allergens (n = 710), these values were respectively 48.6, 24.5 and 26.9%, and for those sensitized to both indoor and outdoor allergens (n = 1793), the comparable values were 55.5, 14.6 and 29.9%. CONCLUSION: These data show that in our population of subjects with respiratory allergic symptoms, indoor allergen sensitization is strongly associated with asthma, while exclusive sensitization to pollens is associated primarily with rhinitis. Sensitization was more prevalent for indoor allergens than for outdoor allergens in all groups determined according to diagnosis or age. Indices of atopy were higher in men in the group > or = 18 years old. Prevalence and degree of sensitization were shown to peak in young adults, regardless of the allergen, and to diminish with age. This study stresses the role of indoor allergens in the development of asthma and shows the variability of allergic manifestations according to the type of sensitization.

Adolescent↗

PubMed1977

[Value of the nose provocation test in the allergic patient. A comparative study of the correlation skin inhalation, and lung tests provoked with various allergens].

The authors make a comparative study in 55 CNLSD children and 10 healthy children. In all those children, provocation tests were performed as wel at the level of the skin, as at the level of the lung and nose. The provocation tests were performed with the following allergens: house dust, mites, human dander and pollen, and with histamine. Only in the control group (10 healthy children) no lung provocations with histamine were done. From the investigation follows that skin tests are not always reliable. Furthermore, in many cases a nose provocation test (combination of aerosole. Furthermore, in many cases a nose provocation test (combination of aerosol provocation with a allergen and PAR rhinomanometry) can replace a lung provocation test.

Allergens↗

PubMed1997

Prevalence of skin reactions to aeroallergens in asthmatics of Puerto Rico.

In Puerto Rico, although a high prevalence of asthma has been reported, the sensitization rates to aeroallergens in these patients is unknown. The purpose of this study using a case control design, was to determine and compare the rates of sensitization to common aeroallergens in an asthmatic population of 576 asthmatics and 144 healthy controls. A skin prick test was conducted using standardized extracts of Dermatophagoides farinae (Df) and D. pteronyssinus (Dp), house dust (HD), cat hair and epithelium (CT), dog hair and dander (DG), grass pollen mix (PG), tree pollen mix (PT), weed pollen mix (PW), Aspergillus mix (AM), mold mixes A (MA) and B (MB), Periplaneta americana (PA) and Alternaria-Hormodendrum mix (AH). In addition, an extract from the domestic mite Blomia tropicalis (Bt) was also used. A wheal > or = 3 mm2 was considered a positive reaction. In addition, a standardized questionnaire was administered and a preliminary domestic mite identification survey was conducted. The analysis of the data showed that 85.8% of the asthmatics had at least one positive reaction and 61.6% of them had positive skin reactions to atleast one mite species. Asthmatics reacted to domestic mites 6.19 times more than the control group (p < 0.0001) and was the largest significant difference found in this study for any allergen tested. Preliminary identification of the acarologic fauna in southern Puerto Rico demonstrated that Blomia tropicalis, Dermatophagoides pteronyssinus, D. farinae and E. maynei are the dominant domestic mite species found in homes of asthmatic individuals. These results demonstrate that domestic mites are a very important source of sensitizing aeroallergens for asthmatic patients in Puerto Rico. Based upon the mite survey, Blomia tropicalis plays an important role in allergic sensitization, in addition to Dermatophagoides pteronyssinus and D. farinae. The skin prevalence to pollens and to molds may not reflect the true prevalence of sensitization to these allergens. Pollen identification and counts, and a survey of microflora of Puerto Rico are needed in order to identify and validate important allergens that eventually could be incorporated into a more appropriate panel for testing sensitization in susceptible individuals.

Adolescent↗

PubMed1998

Immunization with purified natural and recombinant allergens induces mouse IgG1 antibodies that recognize similar epitopes as human IgE and inhibit the human IgE-allergen interaction and allergen-induced basophil degranulation.

Molecular characterization of allergens by recombinant DNA technology has made rapid progress in the recent few years. In the present study we immunized mice with aluminum hydroxide-adsorbed purified recombinant major timothy grass pollen allergens (rPhl p 1, rPhl p 2, rPhl p 5), dog albumin, a major animal dander allergen, and proteins with low (beta-lactoglobulin) or no (ribulose diphosphate carboxylase) allergenic potential in humans. Allergens that bind high levels of IgE in humans (Phl p 1, Phl p 5, dog albumin) induced high IgE and IgG1 levels in mice, whereas proteins with little or no allergenic activity in humans failed to induce significant IgE and IgG1 levels in mice. Continuous immunization for a period of 27 wk resulted in the production of mouse IgG1 Abs that recognized recombinant allergen fragments/epitopes defined by IgE Abs of allergic patients. As a consequence, allergen-specific mouse Abs strongly inhibited human IgE binding to the allergens and suppressed the allergen-induced histamine release from human basophils. In summary, our data indicate that 1) the allergenic potency of a protein may be related to its overall immunogenicity and 2) prolonged immunization with single purified recombinant allergens induces protective IgG Abs. The presented experimental in vivo/in vitro system allows the evaluation of Ag preparations (e.g., recombinant allergens) to be used for immunotherapy in humans.

Allergens↗

PubMed1998

[Health effects of airborne pollutants, particularly in swine confinement stalls, from the viewpoint of occupational medicine].

From the point of view of occupational respiratory medicine, an overview on potential health effects of airborne pollutants particularly in swine confinement houses is presented. Airway diseases are the most frequent occupational disorders among farmers in many countries around the world including Germany. Due to various methodological reasons, epidemiological studies in farming populations are more difficult to perform than among non-farmers. Major constituents of swine confinement dust include bacteria, endotoxin, mites, fungal spores, and animal dander. Gaseous pollutants include ammonia, methane, and hydrogen sulfide. In a variety of cross-sectional studies, high prevalences of respiratory symptoms and non-obstructive (and obstructive) bronchitis and Organic Dust Toxic Syndrome have been reported in pig farmers. Nasal and bronchial provocation challenges with swine confinement dust include influx of neutrophils and other inflammatory cells as well as mediators. In cross-sectional and longitudinal studies, endotoxin turns out as the probably most relevant parameter associated with lung function impairment. Further studies are clearly needed focusing on the prognosis of non-obstructive bronchitis in swine farmers and on health effects of reducing airborne contaminants in swine confinement houses.

Adolescent↗

PubMed1998

Allergy in the airway.

BACKGROUND: Airway disease is responsible for significant morbidity worldwide and the role of allergies in the cause and persistence of airway symptoms is becoming increasingly appreciated. OBJECTIVE: The exposure of the airway to allergens depends on the size of inhaled particles. Common allergens encountered in Australia include grass pollens, house dust mites and animal danders and sensitivity to each leads to a different clinical pattern of disease. The diagnosis of allergy requires a history of symptoms related to exposure to an allergen, together with detection of allergen-specific IgE. The evidence for the role of allergens in contributing to allergic airway disease is extensive. DISCUSSION: Airway allergies are an important factor in the genesis of asthma and allergic rhinitis. There is increasing evidence that modification of exposure to allergens can improve allergic symptoms and may prevent allergic diseases. Methods of allergen avoidance are discussed.

Allergens↗

PubMed1998

[Specific immunotherapy--past--present--future].

Specific immunotherapy or hyposensitization has been used extensively for almost 90 years as a specific treatment of IgE-mediated allergic diseases. In hayfever and allergic asthma due to house-dust mites and animal danders (especially cat) immunotherapy is highly effective and used worldwide. The term "local immunotherapy" stands for topical administration of specific IT in allergic disorders and includes local nasal, bronchial, oral and sublingual immunotherapy. Today bronchial and oral IT can not yet be recommended for clinical practice. Local nasal IT may be indicated in carefully selected adult patients with rhinitis caused by grass- and Parietaria-pollen allergy. Sublingual (swallow) IT with pollen (Grass/Parietaria) and mite extracts can be recommended in adult patients with allergic rhinitis.

Adult↗

PubMed1998

Assessment of the indoor environment in respiratory allergy.

Many types of allergens may be present in the indoor environment and may lead to sensitization and respiratory allergy. Common indoor allergens include dust mites, animal dander, cockroach exposure and molds. Exposure to indoor pollutants, such as tobacco smoke, wood-burning stoves or fireplaces and chemical sprays, can precipitate and exacerbate symptoms. An allergic reaction in the airways caused by natural exposure to allergens has been shown to lead to an increase in inflammatory reaction, increased airway hyperresponsiveness and increased eosinophils in bronchoalveolar lavage. Other research has demonstrated that asthma symptoms correlate with levels of domestic dust mite and cockroach exposure. In the case of dust mites, ending exposure results in symptomatic relief.

Air Pollution, Indoor↗