A pilot study on the allergen-specific IgE to molecular components on polysensitized mite allergic asthmatic patients in Guangzhou, China

An investigation of the prevalence and diversity of Anisakis in China: marine food safety implications

Anisakis can cause Anisakiasis in humans if raw or undercooked fish is consumed. Symptoms of infection may include vomiting, acute abdominal symptoms, or allergies. In this study, we collected 187 commercially available marine fish from the Yellow Sea, East China Sea, and South China Sea. Among them, 79 were found positive containing 520 Anisakis worms. The average prevalence rate was found 42% in this investigation. Ninety-two worms from different sea areas were selected and analyzed for identification, revealing the presence of five different species, which are Anisakis pegreffii, Hysterothylacium aduncum, Hysterothylacium zhoushanense, Hysterothylacium amoyense, and Hysterothylacium sp. In the meta-analysis, three databases: PubMed, CNKI, and BaiduXueshu were searched for surveys on the prevalence of Anisakis in Chinese waters from January 2000 to December 2023. A total of 26 studies were included in this analysis of which 25 publications were retrieved from different databases and one being the present study. The pooled prevalence of Anisakis was 45% among commercially available marine fish. Variances in the prevalence of Anisakis were noted among the four seas, with the highest rates in the East China Sea and the Bohai Sea, reaching 53% [0.38; 0.68] and 49% [0.36; 0.62], respectively. The Prevalence of Anisakis infection was significantly higher in astern parts such as Liaoning, Shanghai, and Zhejiang. Analysis of the host fish subgroups revealed that the orders of Anguilliformes, Scombriformes, and Gadiformes had high rates of infection. These findings suggest a significant prevalence of Anisakis, posing an increasing risk of infection for individuals. This study provides impactful information for implementing preventative measures against Anisakis.

The Sensitization Differences of Pollen Allergen Components in Patients with Asthma and/or Rhinitis in Southern China

INTRODUCTION

This study aim to analyzed the main pollen allergen components that cause allergic asthma and/or rhinitis and the cross-reactions between the allergen components.

METHODS

Twenty one allergic rhinitis patients and 23 allergic asthma patients with pollen sensitization from the China Biological Information Repository of Respiratory Diseases were included. All the patients were detected serum pollen allergens components specific immunoglobulin E (sIgE) including Betula verrucosa (Bet v 1, Bet v 2, Bet v 4), Quercus alba (Pla a 1, Pla a 2), Ambrosia elatior (Amb a 1), Artemisia vulgaris (Art v 1, Art v 3, Art v 4), Bermuda grass (Cyn d 1, Cyn d 12), Phleum pratense (Phl p 5, Phl p 1, Phl p 4, Phl p 7, Phl p 12), and cross-reactive carbohydrate determinants.

RESULTS

In patients with asthma, Phl p 4 had the highest positive rate (60.9%), followed by Phl p 1 (43.5%) and Pla a 2 (34.8%), while in patients with rhinitis, Amb a 1 had the highest positive rate (71.4%), followed by Phl p 4 (61.9%) and Pla a 2 (42.9%). Meanwhile, Phl p 1 (43.5%) in asthma patients was higher than that in rhinitis (4.7%, p = 0.03), while Amb a 1 (71.4%) in rhinitis patients was higher than that in asthma (26.1%, p = 0.03). Interestingly, optimal scale analysis show that the severity of both asthma and rhinitis is related to Bet v 4 (Cronbach's Alpha = 95.0%).

CONCLUSIONS

In general, Phl p 4 is the main allergenic component in pollen sensitized asthma patients, while Amb a 1 is the main allergenic component in pollen sensitized rhinitis patients. Sensitization to Bet v 4 may lead to more severe symptoms, and this result may be applied in future clinical precise diagnosis.

A systematic review of allergen cross-reactivity: Translating basic concepts into clinical relevance

Access to the molecular culprits of allergic reactions allows for the leveraging of molecular allergology as a new precision medicine approach-one built on interdisciplinary, basic, and clinical knowledge. Molecular allergology relies on the use of allergen molecules as in vitro tools for the diagnosis and management of allergic patients. It complements the conventional approach based on skin and in vitro allergen extract testing. Major applications of molecular allergology comprise accurate identification of the offending allergen thanks to discrimination between genuine sensitization and allergen cross-reactivity, evaluation of potential severity, patient-tailored choice of the adequate allergen immunotherapy, and prediction of its expected efficacy and safety. Allergen cross-reactivity, defined as the recognition of 2 or more allergen molecules by antibodies or T cells of the same specificity, frequently interferes with allergen extract testing. At the mechanistic level, allergen cross-reactivity depends on the allergen, the host's immune response, and the context of their interaction. The multiplicity of allergen molecules and families adds further difficulty. Understanding allergen cross-reactivity at the immunologic level and translating it into a daily tool for the management of allergic patients is further complicated by the ever-increasing number of characterized allergenic molecules, the lack of dedicated resources, and the need for a personalized, patient-centered approach. Conversely, knowledge sharing paves the way for improved clinical use, innovative diagnostic tools, and further interdisciplinary research. Here, we aimed to provide a comprehensive and unbiased state-of-the art systematic review on allergen cross-reactivity. To optimize learning, we enhanced the review with basic, translational, and clinical definitions, clinical vignettes, and an overview of online allergen databases.

A study of allergen detection panel in Guangzhou, southern China based on real-world data from the past 7 years

This study aims to reduce the cost of allergen testing for Guangzhou, China by limiting the number of allergens for which patients are tested, and provide a testing panel to improve diagnostic and therapeutic efficiency. This retrospective study of real-world data from 2012 to 2019 included 39,570 patients with suspected allergies in Guangzhou, southern China. All the patients were tested for one or more of the following allergens serum specific immunoglobulin E (sIgE): Dermatophagoides pteronyssinus, Dermatophagoides farinae, cat dander, dog dander, Artemisia vulgaris, Aspergillus fumigatus, Alternaria alternata, Blattella germanica, egg whites, milk, wheat, peanuts, soybeans, Cancer pagurus, and Penaeus monodon by PhadiaCAP 1000. Totally, only the positive rates of allergens sIgE in D. farinae, D. pteronyssinus, milk, egg whites, B. germanica, C. pagurus, A. alternata, and P. monodon were > 10%, the other allergens were between 4-7%. Moreover, among the allergic diseases, dust mites exhibited the overall highest positive rate, followed by milk and B. germanica. In children, milk was the main allergen, whereas in adults, mites, cockroaches, shrimp, and crab allergens had higher positive rates. The optimal scale analysis shows that the multiple sensitization classification of patients can be divided into three categories: I D. farinae and D. pteronyssinus; II. C. pagurus, P. monodon, and B. germanica; III. Milk and egg whites. Generally, a panel including 4 allergens can detect > 90% of the potential allergy in this local population. In Guangzhou, southern China, D. farinae, milk, B. germanica, and A. alternata as a panel screening allergy for suspected allergic patients was suggested base on this study.

The relationship of D. pteronyssinus allergic component sIgE and sIgG₄ in house dust mite allergic rhinitis or/and allergic asthma patients

Objective: House-dust mite sensitization is an important cause of allergic asthma and/or rhinitis in southern China. This study aimed to analyze the immune effect and relationship between the Dermatophagoides pteronyssinus components specific immunoglobulin E (sIgE) and sIgG₄. Methods: The serum levels of sIgE and sIgG₄ to D. pteronyssinus allergen components Der p 1, 2, 3, 5, 7, 10, and 23 were detected in 112 patients with allergic rhinitis (AR) and/or allergic asthma (AA). Results: Overall, Der p 1 had the highest positive rate of sIgE (72.3%), followed by Der p 2 (65.2%) and Der p 23 (46.4%). Meanwhile, the highest positive rates of sIgG₄ were for Der p 2 (47.3%), Der p 1 (33.0%), and Der p 23 (25.0%). The patients with AR and AA had a higher positive rate (43.4%) of sIgG₄ than that in the patients with AR (42.4%) and the patients with AA (20.4%; p = 0.043). In patients with AR, the positive rate of sIgE in Der p 1 (84.8%) was higher than that in sIgG₄ (42.4%; p = 0.037), but the positive rate of sIgG₄ in Der p 10 (21.2%) was higher than that in sIgE (18.2%; p < 0.001). Most of the patients were positive for sIgE and sIgG₄ of Der p 2 and Der p 10 at the same time. However, positive results for sIgE alone were just found in Der p 7 and Der p 21. Optimal scale analysis showed that Der p 2, Der p 7, and Der p 21 sIgG₄ were closely related to AR and AA (Cronbach α = 0.917). Conclusion: Herein, the D. pteronyssinus allergen components showed different characteristics among the patients with AR, patients with AA, and patients with AR and AA in southern China. Thus, sIgG₄ may be play an important role in allergic reactions.

Matrix Metalloproteinases in Chronic Obstructive Pulmonary Disease

Matrix metalloproteinases (MMPs) are proteolytic enzymes that degrade proteins of the extracellular matrix and the basement membrane. Thus, these enzymes regulate airway remodeling, which is a major pathological feature of chronic obstructive pulmonary disease (COPD). Furthermore, proteolytic destruction in the lungs may lead to loss of elastin and the development of emphysema, which is associated with poor lung function in COPD patients. In this literature review, we describe and appraise evidence from the recent literature regarding the role of different MMPs in COPD, as well as how their activity is regulated by specific tissue inhibitors. Considering the importance of MMPs in COPD pathogenesis, we also discuss MMPs as potential targets for therapeutic intervention in COPD and present evidence from recent clinical trials in this regard.

Molecular Aspects of Allergen-Specific Immunotherapy in Patients with Seasonal Allergic Rhinitis

A systematic review and narrative synthesis of publications was undertaken to analyze the role of component-resolved diagnosis technology in identifying polysensitization for the provision of allergen-specific immunotherapy to patients with seasonal allergic rhinitis. A search of publications was carried out in electronic databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search helped to identify 568 publications, 12 of which were included in this review. Overall, 3302 patients were enrolled. The major finding was that component-resolved diagnostics change the choice of relevant allergens for allergen-specific immunotherapy in at least 50% of cases. Sensitization to allergen components differs with age, type of disease, and overall disease duration. Patients who had both bronchial asthma and allergic rhinitis were sensitized to a larger number of allergens than patients who had bronchial asthma alone.

[Profiles of IgE sensitization to dust mite allergen components in patients with allergic rhinitis and asthma]

Objective:To study the differences and clinical significance of dust mite allergen components in allergic rhinitis（AR） and allergic rhinitis with asthma syndrome（ARAS） patients. Methods:The clinical data of 42 AR patients were retrospectively analyzed and patients were divided into AR and ARAS group. The serum sIgE concentrations of house dust mites were detected by ImmunoCAP system. The allergen components of Der p（Der p 1, Der p 2, Der p 7, Der p 10, Der p 21, Der p 23） and Der f（Der f 1, Der f 2） were analyzed by protein microarray method. The concentration differences of dust mite allergen and its components in AR and ARAS groups were analyzed. Results:Thirty-one cases of AR and 11 cases of ARAS were included. The positive rate of Der p and Der f was 100.0% and 97.6%, respectively. The highest sensitization rates of Der p allergen components were as following: Der p 1（73.8%）, Der f 1（66.7%）, Der f 2（64.3%） and Der p 2（61.9%）. The sensitization rates of Der f 1（100.0% vs 54.8%, P=0.006）, Der p 2（90.9% vs 51.6%, P=0.021） and Der f 2（100.0% vs 51.6%, P=0.004） in ARAS group were significantly higher than those in AR group. The sIgE concentrations of Der p in AR group were significantly lower than those in ARAS group（[7.65±12.15]kUA/L vs[15.20±18.77]kUA/L, P<0.05）. The sIgE concentrations of Der p 1（[5.39±4.61]kUA/L vs[2.03±2.97]kUA/L, P=0.013）, Der p 2（[8.82± 13.58]kUA/L vs[2.78±5.80]kUA/L, P=0.001）, Der p 23（[1.76± 3.88]kUA/L vs[0.28±0.65]kUA/L, P<0.001） was significantly higher in ARAS group than that of AR group. Correlation analysis showed that Der p 1, Der p 2, Der f 1 and Der f 2 had high positive correlation（P<0.01）. The dust mite components sensitization showed a multiple-sensitized mode. 66.7% of the 42 patients were positive for two or more components while it was 58.1% of the AR group and 90.9% of the ARAS group. The sensitization rate of 3 or more components in ARAS group was significantly higher than that in AR group（54.6% vs 29.1%, P<0.05）. Conclusion:The concentration of dust mites allergens in ARAS group is higher than that in AR group. Der p 1, Der f 1, Der p 2 and Der f 2 are the main allergen components with a higher sensitization rate in ARAS group. The concentrations of Der p 1, Der p 2 and Der p 23 were higher in ARAS group. The ARAS group is prone to multi-sensitzed to allergen components.

The Molecular Allergen Recognition Profile in China as Basis for Allergen-Specific Immunotherapy

Approximately 30% of the world population suffers from immunoglobulin-E (IgE)-mediated allergy. IgE-mediated allergy affects the respiratory tract, the skin and the gastrointestinal tract and may lead to life-threatening acute systemic manifestations such as anaphylactic shock. The symptoms of allergy are mediated by IgE-recognition of causative allergen molecules from different allergen sources. Today, molecular allergy diagnosis allows determining the disease-causing allergens to develop allergen-specific concepts for prevention and treatment of allergy. Allergen-specific preventive and therapeutic strategies include allergen avoidance, vaccination, and tolerance induction. The implementation of these preventive and therapeutic strategies requires a detailed knowledge of the relevant allergen molecules affecting a given population. China is the world´s most populous country with around 1.4 billion inhabitants and an estimated number of more than 400 million allergic patients. Research in allergy in China has dramatically increased in the last decade. We summarize in this review article what is known about the dominating allergen sources and allergen molecules in China and what further investigations could be performed to draw a molecular map of IgE sensitization for China as a basis for the implementation of systematic and rational allergen-specific preventive and therapeutic strategies to combat allergic diseases in this country.

The Molecule Sensitized Pattern of Atopic Dermatitis Patients Who Co-Sensitized to Shrimp, Cockroaches, Crab and House Dust Mites

This study investigated the molecule sensitized pattern of atopic dermatitis patients who co-sensitized to shrimp, cockroaches, crab and house dust mites allergens and promoted the development of clinical accurate diagnosis and treatment.

Serum levels of specific immunoglobulin E to Dermatophagoides pteronyssinus allergen components in patients with allergic rhinitis or/and asthma

Background: House-dust mites (HDM) allergen is one of the most important allergens in southern China; however, studies on the Dermatophagoides pteronyssinus components are relatively lacking. Objective: This study analyzed the molecular components of D. pteronyssinus in patients with allergic asthma (AS) and/or allergic rhinitis (AR) sensitized to D. pteronyssinus, and aimed to improve HDM immunotherapy in southern China. Methods: Allergen component-resolved diagnosis detection technology was used to detect the serum levels of specific immunoglobulin E (sIgE) to D. pteronyssinus allergen components (Der p 1, 2, 3, 5, 7, 10, and 23) in patients who were sensitized to D. pteronyssinus and with AR (n = 106), AS (n = 144), or AR combined with AS (n = 134). Results: The highest positive rates of D. pteronyssinus components were Der p 1 (94.8%), followed by Der p 2 (77.6%), Der p 23 (62.5%), Der p 7 (34.6%), Der p 5 (17.7%), Der p 10 (12.2%), and Der p 3 (2.6%). Patients with AR+AS had the highest positive rates to Der p 2 (85.8%), Der p 23 (62.7%), Der p 7 (40.3%), Der p 5 (25.0%), and Der p 10 (16.4%). Der p 1 had the highest positive rate in patients with AR (95.3%). The Der p 3 positive rate in patients with AS (6.0%) was higher than that in patients with AR (0.0%, χ² = 6.872, p < 0.05) and patients with AR+AS (0.7%, χ² = 6.063, p < 0.05) Among the patients with AR+AS, 19.1% were co-sensitized to Der p 1, Der p 2, Der p 23, and Der p 7. Interestingly, only one patient with AR was exclusively sensitized to Der p 23. An optimal scale analysis showed that Der p 5, Der p 23, and Der p 7 had strong connection (Cronbach α = 93.7%). Conclusion: Der p 1 and Der p 2 were the main sensitization components of D. pteronyssinus, and patients with AS+AR had the highest positive rate for five of seven D. pteronyssinus allergen components. This research can provide suggestions for personalized HDM-specific immunotherapy in southern China.

Allergen diagnosis strategy: An experimental application of different methods in Guangzhou, Southern China

Different methods have different diagnostic value under diverse clinical conditions. This study was conducted to analyze the clinical practical value of different assays in different situations and to establish the concept of an allergen diagnosis strategy.This study used Phadia CAP, Advan Sure (AdvS), Euroline Camera (ELC), and Allergy Lateral Flow Assay (ALFA) kits to detect allergen specific immunoglobulin E (sIgE) in the sera from 30 allergic asthma patients, with Phadia CAP as the gold standard.This study found high sensitivity for Dermatophagoides pteronyssinus in AdvS (92.6%), ELC (88.9%), and ALFA (85.2%), but poor sensitivity for F. domesticus in all three assays. Furthermore, the AdvS, ELC, and ALFA assays could detect 20, 21, and 8 allergens in one panel, respectively. The combination of the results showed that 93.3% and 46.7% of patients tested positive for ≥5 and ≥10 types of allergens, respectively. All patients who were tested positive for the Marine fish mixture were positive for both Shrimp and Crab. Similarly, patients who were tested positive for Chicken also tested positive for Pork. Optimal scale analysis showed a strong connection between Peanut, Soybean, Wheat, Japanese Hop, Western ragweed, and Oak allergens (Cronbach's α = 91.1%).The ELC assay was more suitable for use in pollen-rich areas, whereas the ALFA assay was easy to establish in areas with poor medical conditions. An allergen diagnosis strategy needs to be considered for use in clinical practice.

Major Pollen Allergen Components and CCD Detection in Bermuda Grass Sensitized Patients in Guangzhou, China

Objective

Bermuda grass pollen is a common inhaled allergen. The aim of this study was to investigate the molecular sensitization patterns to major pollen allergens (Bermuda grass, Mugwort and Timothy grass) and cross-reactive carbohydrate determinants (CCD) in Bermuda grass sensitized patients in southern China.

Methods

Serum specific IgE (sIgE) levels of Bermuda grass allergen components (Cyn d 1 and Cyn d 12), Timothy grass allergen components (Phl p 1, Phl p 4, Phl p 5, Phl p 7 and Phl p 12), Mugwort allergen components (Art v 1, Art v 3 and Art v 4) and CCD were detected in 78 patients sensitized to Bermuda grass via EUROBlotMaster system.

Results

Compared with CCD-positive patients, those with negative CCD results had significant higher positive rates of Cyn d 1 (47.8% vs 14.5%), Phl p 1 (26.1% vs 7.3%), Phl p 12 (21.7% vs 3.6%) and Art v 4 (26.1% vs 3.6%) (all p < 0.05). Patients <18 years old had the highest positive rate of Cyn d 1 (40.7%). Additionally, rhinitis patients had the highest positive rate of Cyn d 1 (60.0%), and all patients with Cyn d 12 sensitization (17.2%) were asthmatic patients. Optimal scale analysis showed that Phl p 1 and Cyn d 1 were closely related (Cronbach’s alpha = 85.1%).

Conclusion

The highest positive rate of pollen allergen components was Cyn d 1 in Bermuda grass sensitized patients in southern China. Most patients were sensitized to CCD alone, and CCD may have less interference in the detection of Cyn d 1, Art v 4, Phl p 1 and Phl p 12. The sensitization patterns of pollen allergen components varied in different ages and diseases, and the diagnostic strategy of pollen allergen needs to be considered in the future.

Sensitisation of severe asthma in different occupations: A multicentre study in China

OBJECTIVE

This was the first multicentre study assessing the sensitisation patterns in patients with severe asthma by different occupations as well as different regions of China, and aimed to provide evidence for the prevention of sensitised patients with severe asthma.

METHODS

A total of 676 adults were included and assigned to three cohorts. Cohort A was comprised of severe asthma patients without smoking (n = 454), cohort B comprised severe asthmatic patients who were ex-smokers (n = 149), and cohort C comprised non-asthma individuals (n = 73). All study subjects underwent testing of serum sIgE level of house dusts mix (hx2), foods mix (fx5), moulds mix (mx2), tree pollen mix (tx4) and weed pollen mix (wx5) simultaneously.

RESULTS

Overall, the positive rates of hx2, fx5, mx2, tx4 and wx5 were 37.6%, 11.9%, 16.6%, 9.0% and 9.5% in severe asthmatic patients, respectively. Comparing cohort A with cohort B, the hx2 positive rates in cohort A were higher in fulltime homemaker (30.0% vs. 0.0%) and medical staff (40.0% vs. 0.0%, P < 0.05). However, the mx2 positive rates in cohort B were higher in businessman (30.0% vs. 7.0%) and the tx4 positive rates in cohort B were higher in drivers (35.7% vs. 0.0%, P < 0.05). The optimal scale analysis showed that severe asthmatic patients who work indoor were more prone to be allergic to house dusts (Cronbach's alpha = 76.4%).

CONCLUSION

Patients with severe asthma in different occupations exhibited different sensitisation patterns. Avoid being contact with house dust and application of indoor air purifier should be considered for severe asthma patients.

Increased MMP8 Levels in Atopic Chronic Obstructive Pulmonary Disease: A Study Testing Multiple Immune Factors in Atopic and Non-Atopic Patients

Objective

The aim of this study was to analyse the level of serum matrix metalloproteinases (MMPs) in atopic and non-atopic COPD patients, providing guidance for clinical practice and theory for atopic COPD.

Methods

Blood samples from 50 adult male patients with COPD, including 17 atopic and 33 non-atopic patients, were submitted for detection of MMP8, MMP9, surfactant associated protein D (SPD), noradrenaline (NE), leukotriene (LT) B4, recombinant proteoglycan (PRG4), Phadiatop sIgE, and tIgE levels. Patients’ Modified Medical Research Council Dyspnea Scale (mMRC), COPD Assessment Test (CAT), pulmonary function test results, FeNO, blood cell ratio and induced sputum were collected.

Results

The level of serum tIgE in patients with atopic COPD [1876.00 kU/l (760.50, 5347.00)] was significantly higher than in patients with non-atopic COPD [377.00 kU/l (93.50, 581.50), P < 0.001]. The MMP8 levels in atopic COPD (1600 ± 1181 ng/mL) were significantly higher than in non-atopic COPD (973.3 ±921.5 ng/mL, P = 0.0494), but there was no significant difference in MMP9, SPD, NE, LTB4, and PRG4 levels between the two groups. In atopic COPD patients, the rate of leukocyte (r_s = 0.63, P < 0.001) and neutrophil (r_s = 0.54, P < 0.05) were positively correlated with MMP8 levels, while lymphocyte rate was negatively correlated with MMP8 (r_s = −0.70, P < 0.001) and MMP9 levels (r_s = −0.54, P < 0.05). Optimal scale analysis showed that NE was most closely related to the basophil rate from induced sputum and FeNO levels (Cronbach’s alpha = 85.1%). Interestingly, all atopic COPD patients with mMRC ≥2, CAT ≥ 10, and CCQ ≥16 exhibited MMP8 levels >1000 ng/mL.

Conclusion

In general, tIgE and MMP8 levels were higher in atopic COPD patients than in non-atopic patients. NE levels were closely correlated with the basophil rate of induced sputum and FeNO levels, which may play an important role in the pathogenesis and development of atopic COPD.

Molecular allergen sensitization of Aspergillus fumigatus between allergic bronchopulmonary aspergillosis and A fumigatus-sensitized asthma in Guangzhou, Southern China

Background

Few studies have assessed the sensitization of mycotic allergens and Aspergillus fumigatus molecular allergens. This study aimed to investigate the relationships of A fumigatus components and mycotic allergens in allergic bronchopulmonary aspergillosis (ABPA) patients and A fumigatus (Af)‐sensitized asthma patients.

Methods

Serum sIgE levels of Penicillium chrysogenum, Cladosporium herbarum, Mucor racemosus, Candida albicans, Alternaria alternata, Helminthosporium halodes, and A fumigatus allergen components (Asp f 1, Asp f 2, Asp f 3, Asp f 4, and Asp f 6) were measured via the ImmunoCAP assay in 18 ABPA and 54 Af‐sensitized asthma patients in Guangzhou city, China.

Results

94.44% of ABPA patients and 87.04% of Af‐sensitized asthma patients were co‐sensitized to at least one other fungal allergen. The positive rates of Asp f 1 (88.89% vs 59.26%, P < .05), Asp f 2 (66.67% vs 33.33%, P < .05), Asp f 4 (61.11% vs 33.33%, P < .05), and Asp f 6 (66.67% vs 14.81%, P < .001) in ABPA patients were higher than those in Af‐sensitized asthma patients. IgE levels of Asp f 1 (P < .05), Asp f 4 (P < .05), and Asp f 6 (P < .001) were higher in ABPA patients than in Af‐sensitized asthma patients. Optimal scale analysis showed that ABPA was more relevant to Af components (Cronbach's alpha = 90.7%).

Conclusion

The A fumigatus components and their relationships with various mycotic allergens were different in ABPA and Af‐sensitized asthma patients. This finding may help local doctors in the diagnosis and immunotherapy of fungal allergies.

The Role of Der p 23 Sensitization: An Analysis of 474 Patients Sensitized to Mite

INTRODUCTION

House dust mite contains several allergen components and causes perennial allergy. Lately, a new major allergen, Der p 23, was described with relatively high sensitization rates in different European Countries. In addition, Der p 23 is supposed to cause asthmatic disease.

OBJECTIVE

We would like to question the prevalence and clinical impact of specific immunoglobulin E to Der p 23 in a large patient sample in southern Bavaria, Germany.

METHODS

474 patients from southern Bavaria, who visited the allergy department within the Department of Oto-Rhino-Laryngology of a university hospital, with sensitization to Dermatophagoides pteronyssinus were retrospectively compared regarding their sensitization profile to Der p 1, Der p 2, and Der p 23 and their clinical characteristics.

RESULTS

Among D. pteronyssinus-sensitized patients, the overall sensitization rate to Der p 23 was 42% in southern Bavaria. Most likely, patients were simultaneously sensitized to Der p 1, Der p 2, and Der p 23. Der p 23-sensitized patients reported more frequently asthma and showed higher prevalence of poly-sensitization towards 3 additional allergen groups and higher prevalence of double-sensitization to Der p 1 and Der p 2 compared to patients with missing sensitization to Der p 23. Considering the results of allergen provocation tests, neither IgE sensitization against Der p 23 nor levels of specific immunoglobulin E to Der p 23 allow a clear prediction of the clinical relevance of the sensitization.

CONCLUSION

With a sensitization rate of 42%, Der p 23 closely misses the criterion of a major allergen in our southern Bavarian patient collective. A higher prevalence of polysensitization and self-reported asthma was the only clinical feature found in Der p 23-sensitized patients.

Personalized medicine for asthma in tropical regions

PURPOSE OF REVIEW

Precision medicine could help to improve diagnosis and treatment of asthma; however, in the tropics there are special conditions to be considered for applying this strategy. In this review, we analyze recent advances of precision allergology in tropical regions, highlighting its limitations and needs in high-admixed populations living under environments with high exposure to house dust mites and helminth infections.

RECENT FINDINGS

Advances have been made regarding the genetic characterization of the great diversity of populations living in the tropics. Genes involved in shared biological pathways between immune responses to nematodes and the allergic responses suggested new mechanisms of predisposition. Genome wide association studies of asthma are progressively focusing on some highly replicated genes such as those in chromosome 17q31-13, which have been also replicated in African ancestry populations. Some diagnostic difficulties, because of the endemicity of helminth infections, are now more evident in the context of phenotype definition.

SUMMARY

The clinical impact of the advances in precision medicine for asthma in the tropics is still limited and mainly related to component resolved diagnosis. More basic and clinical research is needed to identify genetic, epigenetic, or other biologic markers that allow and accurate definition of phenotypes and endotypes of this heterogeneous disease. This will substantially improve the selection of personalized treatments.

IgE and IgG4 responses to shrimp allergen tropomyosin and its epitopes in patients from coastal areas of northern China

Sensitization to allergens and their peptides varies among patients due to geographical or ethnic differences. The present study aimed to investigate immunoglobulin (Ig)E and IgG₄ responses to tropomyosin and its peptides in shrimp allergic patients from northern China. A total of 92 subjects were studied, including 35 shrimp allergic patients, 29 patients with house dust mite (HDM) and/or cockroach allergic patients and 28 healthy volunteers. Serum IgE and IgG₄ antibodies to recombinant shrimp tropomyosin (rPen a 1) and its peptides were measured by means of a light-initiated chemiluminescent assay. A total of 9 major sequential epitopes of Pen a 1 reported in the literature were synthesized. Of 35 shrimp allergic patients, 25 (71.4%) had positive Pen 1-specific IgE (sIgE) antibodies and 22 (62.9%) contained measurable rPen a 1-specific IgG₄ (sIgG₄) antibodies. A strong IgG₄ response accompanied the presence of IgE to Pen a 1. None of the patients with HDM and/or cockroach allergy demonstrated IgE reactivity to rPen a 1. The reaction frequency of IgE binding epitope was 20–48%, while that of IgG₄ binding epitope was 63.6–3.9%. The IgE and IgG₄ recognition patterns of the tropomyosin peptides demonstrated high interpatient heterogeneity. Diversity of IgE binding epitopes was positively correlated with Pen a 1 sIgE levels. In the study population, tropomyosin was a major allergen recognized by the majority of shrimp allergic patients, which is consistent with previous reports. However, none of the 9 epitopes are major (reaction frequency >50%) IgE-binding regions, indicating the epitopes profile may be different in other regions.

Identifying Potential Co-Sensitization and Cross-Reactivity Patterns Based on Component-Resolved Diagnosis

BACKGROUND

Component-Resolved diagnosis (CRD) can help to establish immunoglobulin E (IgE) sensitization profiles and potential risks and determines whether specific IgE is the result of primary sensitization or cross-reactivity, especially for those who are polysensitized.

METHODS

We recruited 432 patients with mite-sensitized respiratory allergic diseases to study the co-sensitization and cross-reactivity of the 17 allergen components in Guangdong Province, China, using the CRD method and to describe the potential association between allergen components.

RESULTS

Among the 432 patients, serum specific immunoglobulin E of the 17 components were tested by EUROIMMUN system. Der p 1 (81.48%), Der f 2 (77.78%), Der f 1 (74.07%), Der p 2 (66.20%) and Der p 23 (54.63%) were the main sensitized components in patients with mite-sensitized respiratory allergy, while the components of cockroach, crab, and shrimp had a lower positive rate. In the crude extract allergen-positive samples, Der f 2 (91.06%) and Der f 1 (86.72%) were the major sensitized components of Der f, while Der p 1 (94.52%), Der p 2 (78.36%), Der p 23 (63.29%) were the major sensitized components of Der p, And other components of Der p such as Der p 7 (34.25%), Der p 5 (17.81%), Der p 10 (12.05%), Der p 3 (1.92%) were all below 50.00%. Blo t 5 (54.55%) was one of the major components of Blo t. The positive rates of all Bla g components were as follows, rBla g 2 (15.56%) >rBla g 5 (8.89%) >rBla g 4 (4.44%) >rBla g 1 (1.11%). The positive rate of the only available pen a 1 component was 9.43%. Using hierarchical cluster and optimal scale analysis, 17 components can be roughly divided into 5 different sensitization clusters. Also, from the results of the Venn diagram, the allergen component in each cluster has a high proportion of co-sensitization and cross-reactivity. Regardless of age, total IgE levels, and disease type factors, similar sensitization profiles were observed for each component in the same category based on hierarchical clustering analysis.

CONCLUSIONS

Epidemiological data on allergen components causing allergic symptoms can be further understood using CRD. Der p 1, Der p 2, Der p 23, Der f 1, Der f 2 as the primary sensitizing component of the study cohort. The positive rate for Blo t 5 was 28.01% for all populations and 54.45% for Blo t-positive samples. In addition, CRD allows us to identify more potential allergen associations such as common sensitivities and cross-reactions between component proteins. Based on these results, we suggest that when patients are identified as sensitized to a particular allergen, clinicians can pay more attention to other allergy components that are closely related to it.

Changes in Indoor Insecticide Residue Levels after Adopting an Integrated Pest Management Program to Control German Cockroach Infestations in an Apartment Building

Insecticide use in homes leads to human exposure to insecticide residues that persist in the environment. Integrated pest management (IPM) programs have been known to be more environmentally friendly for managing German cockroach (Blattella germanica L.) infestations, but their effect on indoor insecticide residue levels are not well understood. An IPM program consisting of applying cockroach gel baits and placing insect sticky traps as the primary treatment methods were implemented. Floor wipe samples were collected from the bedroom and kitchen floors of 69 apartments with German cockroach infestations at 0 months and again at 12 months from 49 of the 69 apartments sampled at 0 months. Levels of 18 insecticide residues were measured. The mean insecticide residue concentration per apartment decreased by 74% after 12 months. The number of insecticides detected per apartment decreased from 2.5 ± 0.2 to 1.5 ± 0.2 (mean ± standard error). Indoxacarb residue was only detected in two apartments at 12 months despite the fact that an average of 32 ± 4 g 0.6% indoxacarb gel bait was applied per apartment. IPM implementation can result in significant reduction in the insecticide residue concentrations and number of detected insecticides in floor dust samples.

Allergen sensitization pattern of allergic adults and children in southern China: a survey based on real life data

Background

Allergic diseases are increasing yearly. We aimed to evaluate the difference in allergen sensitization pattern between adults and children in southern China by analyzing a large sample size of real-life data, and to provide the evidence for formulating the prevention and management strategies.

Methods

Retrospective analysis was conducted on 39,813 serum allergen-specific IgE (sIgE) results collected in southern China from January to December in 2017. Sensitization patterns and how these allergens could lead to the allergic diseases were analyzed for adults and children respectively. The difference of allergen positive rate between groups was calculated using the Chi square test.

Results

The top five most sensitized allergens in southern China were house dust mite (28.1%), cockroach (24.3%), shrimp (19.2%), crab (15.5%) and egg white (9.9%). While cockroach had the highest positive rate in adults (29.2%), the most sensitized allergen in children was house dust mite (29.7%). The positive rates of egg white and cow’s milk in children were higher than in adults for the whole year (p < 0.001); whereas for adults, the positive rate to cockroach, shrimp and crab were higher than in children (p < 0.001). The positive rate of house dust mite in coastal cities (32.4%) was higher than that in landlocked cities (24.0%) in children, but in adults, the rate in landlocked cities (31.1%) was higher than that in coastal cities (25.3%). Optimal scaling analysis showed that the sIgEs of crab and shrimp had the closest correlation with cockroach-sIgE (Cronbach’s α = 0.891). The positive rate to mold allergens increased from summer to autumn, reaching its plateau in October (6.2%). Patients with skin diseases were found to receive the highest sIgE prescription from doctors (56.9%).

Conclusions

Doctors tend to prescribe more sIgE tests for patients with skin disorders in southern China. In addition to house dust mite, cockroach was found to be another important allergen. Adults with multiple sensitization always showed co-sensitization with shrimp, crab and house dust mite. These should be taken into consideration when giving allergen avoidance advice to patients.

Electronic supplementary material

The online version of this article (10.1186/s13223-019-0357-y) contains supplementary material, which is available to authorized users.

Co-sensitization and cross-reactivity of Blomia tropicalis with two Dermatophagoides species in Guangzhou, China

Background

Contradictory results have been reported previously in the analyses of cross‐reactivity among Blomia tropicalis (Blo t), Dermatophagoides pteronyssinus (Der p), and Dermatophagoides farinae (Der f). This study aims to investigate the characteristics of co‐sensitization and the IgE cross‐reactivity among them and attempts to identify whether patients are sensitized to Blo t due to cross‐reaction or true sensitization.

Methods

Specific IgE (sIgE) in the sera from 1497 allergenic patients was determined by ImmunoCAP. Cross‐reactivity was analyzed and determined by sIgE inhibition with 21 sera samples.

Results

Around 85.50% of patients were sensitized to Der p, 85.37% of patients were sensitized to Der f, and 71.54% of patients were sensitized to Blo t. Further, 70.14% of patients were co‐sensitized to Blo t, Der p, and Der f, and only seven patients were sensitized solely to Blo t. With increasing sIgE levels for Blo t, the positive rates of severe‐level (class 5‐6) co‐sensitization to Der p or Der f significantly increased. Blo t was moderately associated with Der p and Der f, with correlation coefficients of 0.6998 and 0.6782, respectively. Der p and Der f inhibited IgE binding to Blo t more strongly than Blo t inhibited IgE binding to Der p or Der f in the patient groups C_{Blo t} < C_{Der p} and C_{Blo t} < C_{Der f}.

Conclusions

This study has established valuable information about the co‐sensitization and cross‐reactivity of Blo t with two Dermatophagoides species (Der p and Der f) and helps to provide adequate diagnosis and treatment of the mite‐allergic patients.