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PubMed2005

Impact of children's respiratory allergies on caregivers.

BACKGROUND: Despite the great attention that has been paid to HRQoL in children with respiratory allergy, few studies have addressed this aspect in relation to caregivers. The aim of our study was to evaluate the impact of childhood respiratory allergies on caregivers by means of a new method. METHODS: 119 parents of children suffering from allergies (75 suffering from asthma and 44 suffering from rhinitis) were recruited from three Italian Allergy Units. Parents were asked to complete the Disease Impact On Caregiver (DIOC), a new non disease specific questionnaire, validated on the Italian population. The questionnaire consists of 31 items grouped in four factors (Performance, Personal gratification, Psychophysical endurance, Socio-emotional domain) and covers the life aspects that could be affected by the assistance duties towards an ill family member. RESULTS: Child's asthma resulted to have a worse impact on many aspects of a parents' life than rhinitis. Differences resulted to be statistically significant in 19 aspects out of the 31 assessed. The worse impact of asthma versus rhinitis was confirmed in the following domains: Performance (24.0 +/- 18.2 vs 11.5 +/- 17.8), Personal gratification (26.3 +/- 20.5 vs 12.1 +/- 16.5) and Psychophysical endurance (35.0 +/- 24.8 vs 18.8 +/- 21.7). In the Socio-emotional domain no difference emerged. CONCLUSIONS: Compared to parents of rhinitics, parents of asthmatic children appear to be more compromised in their resistance to stress, mood, emotional stability, amount of spare time and leisure activities. Our results suggest the need of giving the due attention to these problems both in clinical practice and in research, in order to avoid possible interferences of the caregiver's distress in the optimization of treatment outcome.

Adult↗
PubMed1990

Symptoms of respiratory allergies are worse in subjects with coexisting food sensitization.

Food sensitization was evaluated in 78 subjects with respiratory allergies, both by skin tests with commercial and fresh allergens, and by specific IgE determination. On the basis of the presence or absence of the latter the population was divided into two groups. The group with food-specific IgE showed more severe features of respiratory allergy, including a greater number of positive skin tests and specific IgE determinations, more class 3 and 4 reactions, and more symptoms. The hypothesis that early food sensitization can predispose to severe inhalant allergy is discussed.

Adult↗
PubMed2002

Urban air pollution and respiratory allergy.

Evidence suggests that urbanization with its high levels of vehicle emissions, and westernized lifestyle are linked to the rising incidence of pollen-induced respiratory allergy seen in most industrialized countries. Moreover, the increase in respiratory allergy parallels an increase in outdoor and indoor air pollution. Although the role played by outdoor pollutants in allergic sensitization of airways has yet to be elucidated, it is well established that outdoor pollution exacerbates respiratory symptoms in atopic subjects. This review focuses on the evidence implicating outdoor pollution in pollen-related respiratory diseases. Acute and chronic exposure to such components of air pollution as sulphur dioxide, nitrogen dioxide, ozone and respirable particulate matter (isolated or in various combinations) enhances airway responsiveness to aeroallergens in atopic subjects. By attaching to the surface of pollen grains and of plant-derived paucimicronic particles, pollutants can modify the morphology of these antigen-carrying agents and alter their allergenic potential. In addition, by inducing airway inflammation, which increases airway epithelial permeability, pollutants overcome the mucosal barrier and so "prime" allergen-induced responses. Lastly, air pollutants such as diesel exhaust particulates can also facilitate the immunoglobulin (Ig)E response that leads to pollinosis symptoms in atopic individuals.

Air Pollution↗
PubMed1990

Parietaria: an unrecognized cause of respiratory allergy in the United States.

Parietaria is considered the ragweed of the Old World. There are no prior reports of respiratory allergy due to Parietaria (P.) in North America. Following the identification of a lead case, 100 grass-sensitive patients who suffered from seasonal respiratory allergy were skin tested to P. judaica (P.j.) and P. officinalis (P.o.). Eight percent reacted. Five of 42 females (12%) and three of 58 males (5%) demonstrated skin test reactivity to extracts of P.j. and P.o. All reacted to P.j. There was a greater incidence (P less than .05) and reaction size (P less than .05) in females.

Adolescent↗
PubMed1976

The relationship of the house-dust mite to respiratory allergy.

1. The house-dust mite is a potent and important allergen. 2. 11.2% of patients with perennial respiratory allergy are allergic to the mite allergen and not to the various dust allergens. 3. 39.6% of the patients allergic to the allergens of house-dust are allergic to the allergen of the house-dust mites. 4. 23.7% of patients allergic to the allergens of house-dust are not allergic to the allergen of the house-dust mite. 5. 25.2% of patients with perennial respiratory allergy are not allergic to either the house-dust or mite allergens. 6. Endo, Center, or both dusts were negative in 222 cases, or 36.4%. 7.house-dust mites were negative in 297 cases, or 48.9%. 8. Positive intracutaneous skin tests with house-dust mite extract correlated with only 60.5% of the patients. Negative skin tests correlated with 67.3% of the patients.

Adrenocorticotropic Hormone↗
PubMed1988

Health and socioeconomic consequences of occupational respiratory allergies: a pilot study using workers' compensation data.

Growing evidence suggests that individuals with occupational allergies have long-term health and employment problems. Workers' compensation claims for allergic respiratory disease allowed in Ontario 1975-1981 were reviewed for demographic, risk factor, and exposure data. Diagnoses listed in these 244 claims were reassessed for consistency with criteria for occupational respiratory allergies. Twenty-eight percent of the 154 claimants who met the criteria were granted a permanent disability award from the workers' compensation board (WCB). In response to a questionnaire mailed 2-8 years after claim allowance, 77% of those traced reported improvement, but 59% still required medication and 85% still suffered symptoms. Seventy-six percent of claimants left their employer. Seventy-five percent of those who left did so due to their allergic condition; 95% suffered long-term income loss. The unemployment rate for this cohort was 36%, well above that for the general population. Older workers with longer duration of symptoms and longer duration of exposure prior to the claim had the worst prognoses. The data were consistent with previous studies in suggesting that occupational respiratory allergies may result in serious health and socioeconomic consequences. Exploring the feasibility, acceptability, and potential usefulness of WCB data, it is suggested that this source merits further consideration both for descriptive as well as prognostic studies.

Canada↗
PubMed2003

[Anti-IgE and future treatments for respiratory allergies].

Immediate hypersensitivity remains the fundamental mechanism of respiratory allergy, emphasizing the importance of the antigen-immunoglobulin (IgE) reaction. Development of innovating treatments has naturally centered on a search for compounds inhibiting the IgE response, in particular anti-IgE antibodies. Humanized anti-IgE antibodies have been recently developed for administration in humans. These antibodies are designed to form complexes with circulating IgE which can be eliminated. The first trials have demonstrated an efficacy in allergic asthma, expressed by a significant decrease in consumption of systemic steroids in severe asthma. Other work has also showed a lower number of hospitalizations for acute asthma. Other therapeutic approaches have focused on limiting the production of IgE by an effect on the auxiliary lymphocyte balance, or more generally, by inhibiting the Th2 response while favoring the Th1 response. Early results obtained with anti-IL-5 were disappointing since the decrease in the eosinophilic response was not associated with any alteration in bronchial hyperreactivity. Administration of IL-12 has given similar results but the first trials with nebulized anti-IL-4 are more promising.

Antibodies, Anti-Idiotypic↗
PubMed2005

Respiratory allergy to the indoor ant (Monomorium pharaonis) not related to sting allergy.

BACKGROUND: Many studies are available on systemic reactions to ant sting, but few have described the direct role of ants in respiratory allergy. The nonstinging house ant, Monomorium pharaonis (pharaoh ant), is a highly infesting species in indoor environments. OBJECTIVE: To determine whether the pharaoh ant is an indoor source of aeroallergens. METHODS: Two patients with asthma who lived in homes with ant infestation were enrolled. Pharaoh ants were collected at the patients' homes, and crude extracts were prepared. Skin prick tests with ant extracts were performed. Specific IgE to pharaoh ant was measured by enzyme-linked immunosorbent assay (ELISA), and the allergenic components were determined by using immunoblot analysis. Cross-reactivity among pharaoh ant, imported fire ant, Pachycondyla chinensis ant, and other indoor allergens was evaluated by ELISA inhibition tests. Specific bronchial challenge testing was performed using pharaoh ant extracts. RESULTS: Both patients had positive skin test reactions to pharaoh ant extract and high levels of specific IgE antibodies to pharaoh ant. The ELISA inhibition test results demonstrated significant inhibition by pharaoh ant; however, P. chinensis, cockroach, and house dust mite showed no inhibition of the IgE binding to pharaoh ant. Two important IgE-binding components, 9.4 and 34 kDa, were identified by using immunoblot analysis. Pharaoh ant bronchial challenge test results showed typical early asthmatic reactions in 1 patient and dual asthmatic reactions in the other patient. CONCLUSIONS: Ants can induce IgE-mediated bronchoconstriction regardless of sting in sensitized patients. Ants should be taken into consideration as a cause of respiratory allergy in patients living in homes with visual evidence of infestation.

Air Pollution, Indoor↗
PubMed1990

[The assessment of the incidence of food allergy or intolerance in patients with respiratory allergy].

In this study we have evaluated the possible relationship between food allergens and hypersensitivity to grass pollens. One hundred-thirty patients with grass pollen pollinosis and symptoms probably related to adverse reaction to foods were selected. Skin prick test for food allergens was positive in 79 patients (60.7%) Statistical analysis using chi-square test showed a high significant relationship between grass pollen and nuts, peanuts, beans and peas (p less than 0.0001). Elimination diet and challenge test allowed us to identify the responsible foods in 61 out 79 patients (77.2%). Twelve patients were affected by food allergy (challenge test, skin prick test and RAST positive and concordant); 49 patients suffered from intolerance. Possible causes of this high relationship are discussed.

Adolescent↗
PubMed1976

Incidence of respiratory allergy not increased after anesthesia in infancy.

A 12-year follow-up study of children who had had operations with general anesthesia in infancy and of nonhospitalized children of the same age showed almost identical incidences of respiratory allergy in the test and control groups. General anesthesia in infacy does not predispose to respiratory allergies in childhood.

Adolescent↗
PubMed2004

[Value of skin prick test and atopy patch test in mite-induced respiratory allergy and/or atopic eczema/dermatitis syndrome].

AIM: The atopy patch test (APT) was introduced to assess sensitization to inhalant allergens in patients with atopic/eczema dermatitis syndrome (AEDS), but its diagnostic role in subjects with respiratory allergy is scantly investigated. We sought to evaluate the response to APT and to skin prick tests (SPT) with mite extracts in subjects with persistent respiratory symptoms (rhinoconjunctivitis, rhinosinusitis, asthma), with AEDS, and with both the diseases. METHODS: Eighty-nine patients were included in the study, 75 (84.3%) children and 14 (15.7%) adults, 54 (60.7%) males and 35 (39.3%) females (median age 5.4 years). They were divided in 3 groups, respectively formed by 47 (mean age 12.3+/-11.6 years), 15 (mean age 2.2+/-2.5 years), and 27 (mean age 6.2+/-6.3 years) subjects, according to the presence of only respiratory symptoms, only AEDS, or both, and underwent to usual SPT with mite extracts and to APTs done by mite extract in Finn chambers and removed after 48 hours, with readings after 20 minutes and 24 hours. RESULTS: Of the 89 patients, 24 showed a positive SPT and 69 a positive APT; in 17 both SPT and APT were positive, while 13 were negative to the 2 tests. The APT was more frequently positive than SPT not only in the 2 groups with AEDS -- 32/42 (86.5%) vs 8/42 (21.6%) -- but also in the group with only respiratory symptoms -- 37/47 (78.7%) vs 16/47 (34%). CONCLUSION: These results confirm the high value of APT in patients with mite-induced AEDS and suggest that its routine use might improve also the diagnosis of respiratory allergy to house dust mites.

Adult↗
PubMed2001

Segregation analysis of asthma and respiratory allergy in population-based samples of families.

Class A regressive multiple logistic segregation models with a sibling covariate were used to investigate the underlying determinants of asthma and respiratory allergy (defined from specific IgE levels to inhaled allergens) in the randomly recruited Caucasian families from the Genetic Analysis Workshop 12 asthma data sets--Perth, Busselton, and Southampton. For asthma, both a purely multifactorial model and a major gene (dominant or recessive) model with multifactorial effects fitted the data. For respiratory allergy, a dominant, dominant with multifactorial effects and a purely multifactorial model all fitted the data. However, homogeneity of the three studies was rejected for both traits indicating that the three populations are significantly different and should be analyzed separately. This finding has implications for the meta-analysis of asthma linkage studies.

Adult↗
PubMed1999

Respiratory allergy to mushroom spores: not well recognized, but relevant.

BACKGROUND: Although basidiospores are a major component of the air spora in many parts of the world, their clinical significance as triggers of respiratory allergy has rarely been demonstrated. Therefore, the class of basidiomycetes as an aeroallergen is not well known. OBJECTIVE: To demonstrate a cause and effect relationship between respiratory allergy and basidiospores, we illustrate this case report of a 38-year-old housewife. METHODS: Skin prick test, immunoblot, and active anterior rhinomanometry were used as diagnostic tools to verify specific reactivity of a Pleurotus pulmonalis spore extract. Two atopic subjects served as controls. RESULTS: The skin prick test positive study subject reacted with subjective and objective signs including a significant drop of the FEV1 by nasal challenge at a concentration of 0.1 mg/mL of the Pleurotus spore extract while both controls were negative even at a higher test concentration. IgE-immunoblot revealed several distinct bands in the serum of the Pleurotus-sensitized subject. CONCLUSION: Spores of Pleurotus pulmonalis, a common mushroom of the fungal class of basidiomycetes, can cause specific, IgE-mediated acute rhinoconjuncivitis and asthma in sensitized individuals.

Adult↗
PubMed2000

Chironomid potent allergens causing respiratory allergy in children.

Generally speaking, chironomids contain potent inhalant allergens. The skin prick tests with chironomid crude extract (Chironomus (C.) calipterus) were positive in 20 out of 25 children with respiratory allergy. The skin prick tests with house dust mite crude extract (Dermatophagoides pteronyssinus) were positive in 3 of these 20 chironomoid positive skin tests. Chironomid-specific IgE-ELISA were demonstrated in the sera of 17 (85%) of the chironomid skin positive patients. These 17 patients gave negative skin prick test to house dust mite crude extract. It is concluded that chironomid allergens should be considered when dealing with human respiratory allergy caused by arthropods.

Adolescent↗
PubMed1992

Prevalence of respiratory allergy in a platinum refinery.

In a cross-sectional study, 65 workers in the chemical industry with exposure to platinum salts were investigated with regard to the prevalence to allergic respiratory tract diseases. A respiratory questionnaire, a skin-prick test with K2PtCl6 and environmental allergens, determination of total IgE, platinum-specific IgE and histamine release in basophilic granulocytes and lung function tests were applied before and after a Monday shift and after a Friday shift. Work-related symptoms of respiratory allergy were present in 23% of all workers, but were significantly more frequent in the most exposed group in the platinum refinery (52.4%). Of all workers, 18.7% had a positive skin-prick test with platinum salt. As compared to the other workers, the workers with work-related symptoms of respiratory allergy had significantly more positive skin-prick tests (64.3%) and a higher total IgE and platinum-specific IgE; they did not, however, show higher histamine release. In the course of the week, a significant fall in lung function, namely in FEV1 and FEF25, was recorded in the group of workers with work-related symptoms.

Adult↗
PubMedDate not supplied

The efficacy of sublingual immunotherapy for respiratory allergy is not affected by different dosage regimens in the induction phase.

BACKGROUND: Sublingual administration of allergens is a safe and effective alternative to subcutaneous immunotherapy in patients with respiratory allergies. A drawback to this therapeutic approach is the relatively long and complex management of the induction phase. AIM OF THE STUDY: To determine whether different induction regimens affect the outcome of sublingual immunotherapy. METHODS AND RESULTS: Adult and pediatric patients with allergic rhinoconjunctivitis and/or asthma were included in the study. Ten subjects served as controls and received symptomatic treatments. Forty-three subjects were allocated to sublingual immunotherapy, with three different induction protocols (8-, 15- and 20-day, respectively). Symptom and medication scores, skin test results and (in asthmatic patients) FEV1 values were monitored for two years. Adverse effects were recorded. All induction regimens produced a significant improvement in symptom and medication usage (p < 0.0001); skin test scores decreased (p < 0.0001) and FEV1 improved (p < 0.05). In contrast, symptom and skin test scores did not significantly change in controls. No relevant adverse effects were observed with any of the induction regimens. CONCLUSIONS: For patients with respiratory allergies, sublingual immunotherapy with an 8-day induction protocol is safe and effective. Our results encourage the usage of shorter induction regimens, which produce better compliance with this therapy.

Administration, Sublingual↗
PubMed1983

[Reflex therapy in respiratory allergy].

The immune system and factors probably involved in respiratory allergies in certain subjects examined. Subjects were grouped according to age and sex and treated using both conventional methods, specific acupuncture and a placebo. The statistically evaluated results give an encouraging insight into the application of acupuncture within this delicate and complex field of human pathology.

Acupuncture Therapy↗