Comparison of two disposable plastic skin test devices with the bifurcated needle for epicutaneous allergy testing

Early Pollen Sensitization in Children Is Dependent upon Regional Aeroallergen Exposure

Introduction. Aeroallergen sensitization occurs at an earlier age than previously noted. The purpose of this paper was to identify which pollens cause early sensitization in young children presenting with rhinitis symptoms. Methods. This paper was a retrospective analysis of skin test results from 2- to 8-year-old patients presenting with a history consistent with allergic rhinitis. Patients were tested to aeroallergens common to the Great Basin along with a histamine and saline control. Pollen counts were obtained from a Reno, NV-certified counting station. Results. 123 children less than 8 years of age were identified. Over 50% of these children were sensitized to at least one aeroallergen. Chemopodaciae, timothy, alfalfa, black walnut, olive, mountain cedar and willow were predominating sensitizing aeroallergens of the Great Basin Region. Pollen counts were notable for a early spring peak for the tree season, grass season in May and weed season in August. Pollen levels continued to November at low levels. Discussion. Aeroallergens causing early sensitization differed from those which had predominately been reported in other regions of the United States. Pediatric allergists should consider performing a local review of sensitizing aeroallergens in their region to assist with identification and management of allergic rhinitis in their youngest patients. Please make style changes as appropriate.

DNA-vaccination via tattooing induces stronger humoral and cellular immune responses than intramuscular delivery supported by molecular adjuvants

Tattooing is one of a number of DNA delivery methods which results in an efficient expression of an introduced gene in the epidermal and dermal layers of the skin. The tattoo procedure causes many minor mechanical injuries followed by hemorrhage, necrosis, inflammation and regeneration of the skin and thus non-specifically stimulates the immune system. DNA vaccines delivered by tattooing have been shown to induce higher specific humoral and cellular immune responses than intramuscularly injected DNA. In this study, we focused on the comparison of DNA immunization protocols using different routes of administrations of DNA (intradermal tattoo versus intramuscular injection) and molecular adjuvants (cardiotoxin pre-treatment or GM-CSF DNA co-delivery). For this comparison we used the major capsid protein L1 of human papillomavirus type 16 as a model antigen. L1-specific immune responses were detected after three and four immunizations with 50 μg plasmid DNA. Cardiotoxin pretreatment or GM-CSF DNA co-delivery substantially enhanced the efficacy of DNA vaccine delivered intramuscularly by needle injection but had virtually no effect on the intradermal tattoo vaccination. The promoting effect of both adjuvants was more pronounced after three rather than four immunizations. However, three DNA tattoo immunizations without any adjuvant induced significantly higher L1-specific humoral immune responses than three or even four intramuscular DNA injections supported by molecular adjuvants. Tattooing also elicited significantly higher L1-specific cellular immune responses than intramuscularly delivered DNA in combination with adjuvants. In addition, the lymphocytes of mice treated with the tattoo device proliferated more strongly after mitogen stimulation suggesting the presence of inflammatory responses after tattooing. The tattoo delivery of DNA is a cost-effective method that may be used in laboratory conditions when more rapid and more robust immune responses are required.

A pilot study of distraction for adolescents during allergy testing

PURPOSE

This pilot study describes pain and anxiety associated with allergy testing; tests distraction, specifically self-selected distraction; and examines the relationship between pain, anxiety, and engagement with distraction.

DESIGN AND METHODS

An experimental design was used with a convenience sample of 32 adolescents from an allergist's office randomly assigned to three groups. Pain was measured by the adolescent pediatric pain tool (APPT) and FACES scale.

RESULTS

No differences in pain ratings were found among the groups. Less pain was associated with lower anxiety and greater engagement with distraction. Greater engagement with distraction occurred with less anxiety.

PRACTICE IMPLICATIONS

Knowledge about allergy testing pain, anxiety, and engagement with distraction can assist nurses in preparing adolescents for this procedure.

Comparison of standard and modified SPT method

BACKGROUND

The aim of our study was to compare clinical significance and economical factors of commonly used standard skin prick tests (SPT) method with new, modified and more handy way of performing SPT.

METHODS

Twenty-one subjects [with an average age of 23 years (SD +/- 2.72)] with known sensitivity to examined allergen extracts were tested with histamine, negative control solution and standard allergen extracts (Allergopharma, Reinbeck, Germany). SPT were applied to the volar surface of randomly assigned forearm with two methods: standard technique using lancet needle to prick the epidermis under small drop of extract and tested method using lancet needle which was dipped in extract before prick. In this method all extracts were placed in marked, small, plastic chambers.

RESULTS

Mean wheal to histamine was 5.49 (standard method) and 5.01 (modified method). There was no statistical difference between the standard and modified method for size of wheal to histamine (P = 0.654) and to allergen extracts (n = 36, P = 0.824, Wilcoxon test). Economical analysis revealed that examined SPT technique is cheaper than standard method.

CONCLUSION

Examined method may be considered to be an alternative for performing SPT as it is safe, cheaper and more convenient than standard technique.

SUMMARY STATEMENT

Comparison of standard and modified SPT method revealed the new method to be more economical.

A comparison of two skin test methodologies and allergens from two different manufacturers

BACKGROUND

Skin prick tests (SPTs) are a frequently used method for evaluation of atopy. A variety of standard allergen preparations are available, together with a number of different methods of application.

OBJECTIVE

The objective of this study was to compare SPT reactivity 1) using Soluprick SQ allergens (ALK Allergologisk Laboratorium A/S, Hørsholm, Denmark) and Bayer allergens [Bayer Corporation, West Haven, CT], and 2) using two common methods of application, a standard prick lancet and a Quintest, both produced by Bayer.

METHODS

SPTs were undertaken on 22 adult volunteers (mean age 40 years, 17 female, 5 male). Wheal size was recorded as mean diameters (mm) and area (mm2).

RESULTS

Bayer allergens produced larger mean diameters and areas to dust mites than ALK allergens, with the differences significant when allergens were applied with the lancet. There was a tendency for the ALK cat allergen to produce larger reactions than the Bayer product. The method of application also influenced the wheal size, with the lancet producing significantly larger mean diameters than the Quintest for the histamine and allergens from both manufacturers, except the ALK cat allergen. There were similar differences between methods of application for reactions measured as an area.

CONCLUSIONS

SPTs that use different allergens or different methods of application will not provide comparable assessments of atopy.