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Parker KM, Dang TD, Wijesuriya R, Soriano VX, Lowe AJ, Dharmage SC, Loke P, Tang MLK, Allen KJ, Koplin JJ, Perrett KP, Peters RL. Longitudinal peanut and Ara h 2 specific-IgE, -IgG 4, and -IgG 4/-IgE ratios are associated with the natural resolution of peanut allergy in childhood. Allergy 2024; 79:1868-1880. [PMID: 38720169 DOI: 10.1111/all.16111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/19/2024] [Accepted: 03/12/2024] [Indexed: 07/11/2024]
Abstract
BACKGROUND There are no studies of longitudinal immunoglobulin measurements in a population-based cohort alongside challenge-confirmed peanut allergy outcomes. Little is known about biomarkers for identifying naturally resolving peanut allergy during childhood. OBJECTIVES To measure longitudinal trends in whole peanut and component Ara h 2 sIgE and sIgG4 in the first 10 years of life, in a population cohort of children with challenge-confirmed peanut allergy, and to determine whether peanut-specific immunoglobulin levels or trends are associated with peanut allergy persistence or resolution by 10 years of age. METHODS One-year-old infants with challenge-confirmed peanut allergy (n = 156) from the HealthNuts study (n = 5276) were prospectively followed at ages 4, 6, and 10 years with questionnaires, skin prick tests, oral food challenges, and plasma total-IgE, sIgE and sIgG4 to peanut and Ara h 2. RESULTS Peanut allergy resolved in 33.9% (95% CI = 25.3%, 43.3%) of children by 10 years old with most resolving (97.4%, 95% CI = 86.5%, 99.9%) by 6 years old. Decreasing Ara h 2 sIgE (p = .01) and increasing peanut sIgG4 (p < .001), Ara h 2 sIgG4 (p = .01), peanut sIgG4/sIgE (p < .001) and Ara h 2 sIgG4/sIgE (p < .001) from 1 to 10 years of age were associated with peanut allergy resolution. Peanut sIgE measured at 1 year old had the greatest prognostic value (AUC = 0.75 [95% CI = 0.66, 0.82]); however, no single threshold produced both high sensitivity and specificity. CONCLUSION One third of infant peanut allergy resolved by 10 years of age. Decreasing sIgE and sIgG4 to peanut and Ara h 2 over time were associated with natural resolution of peanut allergy. However, biomarker levels at diagnosis were not strongly associated with the natural history of peanut allergy.
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Affiliation(s)
- Kayla M Parker
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Thanh D Dang
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Rushani Wijesuriya
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Victoria X Soriano
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Adrian J Lowe
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Shyamali C Dharmage
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Paxton Loke
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Monash Children's Hospital, Monash Health, Clayton, Victoria, Australia
| | - Mimi L K Tang
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Katie J Allen
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Jennifer J Koplin
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Child Health Research Centre, University of Queensland, Brisbane, Queensland, Australia
| | - Kirsten P Perrett
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Rachel L Peters
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
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2
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Lee YZ, Kow ASF, Jacquet A, Lee MT, Tham CL. House dust mite allergy in Malaysia: review of research gaps in the current scenario and the way forward. EXPERIMENTAL & APPLIED ACAROLOGY 2023; 91:509-539. [PMID: 37995026 DOI: 10.1007/s10493-023-00857-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/20/2023] [Indexed: 11/24/2023]
Abstract
The prevalence of house dust mite (HDM) allergy, especially in Asian countries with rapid urbanization, has been increasing. House dust mites thrive in places with relatively high humidity. With the combination of climate change, naturally high humidity, and urbanization, tropical countries like Malaysia are becoming a hotspot for HDM allergy fast. With a previously reported sensitization rate of between 60 and 80%, it is a worrying trend for Malaysia. However, due to incomplete and out-of-date data, as seen by the limited study coverage in the past, these numbers do not paint a complete picture of the true HDM allergy scene in Malaysia. This review briefly discusses the HDM fauna, the HDM sensitization rate, the common diagnosis and therapeutic tools for HDM allergy in Malaysia, and makes suggestions for possible improvements in the future. This review also highlights the need of more comprehensive population-based prevalence studies to be done in Malaysia, encompassing the three main HDMs-Dermatophagoides pteronyssinus, Dermatophagoides farinae, and Blomia tropicalis-as the lack of up-to-date studies failed to give a clearer picture on the current scenario of HDM allergy in Malaysia. Future studies will be beneficial to the nation in preparing a better blueprint for the management and treatment of HDM allergy.
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Affiliation(s)
- Yu Zhao Lee
- Office of Postgraduate Studies, UCSI University, 56000, Kuala Lumpur, Malaysia
| | | | - Alain Jacquet
- Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
| | - Ming Tatt Lee
- Faculty of Pharmaceutical Sciences, UCSI University, 56000, Kuala Lumpur, Malaysia
- Graduate Institute of Pharmacology, College of Medicine, National Taiwan University, Taipei, 10051, Taiwan
- Centre of Research for Mental Health and Wellbeing, UCSI University, 56000, Kuala Lumpur, Malaysia
| | - Chau Ling Tham
- Department of Biomedical Science, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia.
- Natural Medicines and Products Research Laboratory, Institute of Bioscience, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
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3
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Giménez‐Arnau AM, Ribas‐Llauradó C, Mohammad‐Porras N, Deza G, Pujol RM, Gimeno R. IgE and high-affinity IgE receptor in chronic inducible urticaria, pathogenic, and management relevance. Clin Transl Allergy 2022; 12:e12117. [PMID: 35126995 PMCID: PMC8805593 DOI: 10.1002/clt2.12117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/04/2022] [Accepted: 01/09/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND IgE and high-affinity IgE receptor (FcεRI) expression on basophils have been scarcely explored in patients with chronic inducible urticaria (CIndU). OBJECTIVES To investigate baseline serum IgE and FcεRI expression on blood basophils in a large cohort of CIndU patients and its relationship to treatment response. METHODS Baseline total serum IgE and basophil FcεRI expression measured by flow cytometry in 165 patients with CIndU was studied. The relationship of both parameters with the response to antihistamine and anti-IgE (omalizumab) treatment was considered in a subsample of CIndU patients. FcεRI expression in basophils was assessed by mean fluorescence intensity (MFI) and basophil FcεRI standardized density (receptors/cell). RESULTS The median FcεRI expression standardized per density in blood basophils was found significantly higher in patients with CIndU compared to HCs. A positive correlation was found between IgE serum levels and basophil FcεRI expression. Basal FcεRI expression was not related to antihistamine treatment response. However, it was related to omalizumab, and patients responding to omalizumab showed higher basal basophil expression of FcεRI levels. Non-responders to the antihistamine showed significantly higher IgE serum levels. CONCLUSIONS FcεRI receptor overexpression in patients with CIndU shows almost the same pattern than chronic spontaneous urticaria. It seems to be independent of CIndU subtypes. Although additional studies would be welcome, our work highlights the relevance of FcεRI receptor regulation in CIndU supporting autoimmune basophil and mast cell activation and may be a biomarker for response to anti-IgE therapy.
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Affiliation(s)
- Ana M. Giménez‐Arnau
- Department of DermatologyHospital del Mar‐Institut d’Investigacions Mèdiques (IMIM)Universitat Pompeu Fabra de BarcelonaBarcelonaSpain
| | - Clara Ribas‐Llauradó
- Department of DermatologyHospital del Mar‐Institut d’Investigacions Mèdiques (IMIM)Universitat Pompeu Fabra de BarcelonaBarcelonaSpain
- Department of ImmunologyHospital del Mar‐Institut Mar d’Investigacions MèdiquesBarcelonaSpain
| | - Nasser Mohammad‐Porras
- Department of DermatologyHospital del Mar‐Institut d’Investigacions Mèdiques (IMIM)Universitat Pompeu Fabra de BarcelonaBarcelonaSpain
| | - Gustavo Deza
- Department of DermatologyHospital del Mar‐Institut d’Investigacions Mèdiques (IMIM)Universitat Pompeu Fabra de BarcelonaBarcelonaSpain
| | - Ramón M. Pujol
- Department of DermatologyHospital del Mar‐Institut d’Investigacions Mèdiques (IMIM)Universitat Pompeu Fabra de BarcelonaBarcelonaSpain
| | - Ramón Gimeno
- Department of ImmunologyHospital del Mar‐Institut Mar d’Investigacions MèdiquesBarcelonaSpain
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4
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Wong WY, Shipman AR. Athena: Speciality Certificate Examination case - Formulation and Systemic Therapy. Clin Exp Dermatol 2021; 47:1391-1392. [PMID: 34388282 DOI: 10.1111/ced.14881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 07/30/2021] [Accepted: 08/09/2021] [Indexed: 11/30/2022]
Abstract
A 25-year-old man with severe nodulocystic acne vulgaris is reviewed in clinic to start on isotretinoin. He has a background of asthma and peanut allergy. He recently consumed soy-containing food with no allergic reactions. His liver function, renal function and lipids levels are within normal range.
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Affiliation(s)
- W Y Wong
- Department of Dermatology, Portsmouth Hospital, UK
| | - A R Shipman
- Department of Dermatology, Portsmouth Hospital, UK
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5
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Pothirat C, Chaiwong W. Aeroallergen Sensitization and Clinical Characteristics of Subjects with Chronic Rhinitis in Chiang Mai, Thailand: A Twenty-Year Retrospective Study. J Asthma Allergy 2021; 14:789-795. [PMID: 34262297 PMCID: PMC8274822 DOI: 10.2147/jaa.s315081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/16/2021] [Indexed: 11/23/2022] Open
Abstract
Background The prevalence of common aeroallergen sensitization in subjects with AR and clinical comparison between AR and Non-AR (NAR) subjects in Thailand remains limited. The primary objective of this study was to illustrate the prevalence of the common aeroallergen sensitization in AR subjects and the differences in clinical characteristics between AR and NAR subjects. Methods Data were retrospectively collected from all subjects with chronic rhinitis who have visited the Chest and Allergy Clinic in three settings in Chiang Mai, Thailand between January 1998 and December 2018. Clinical characteristics and the result of skin prick test (SPT) to common aeroallergen were collected. Results A total of 2164 subjects with chronic rhinitis were enrolled, SPT was performed in 1001 (46.3%); 655 (65.4%) and 346 (34.6%) were AR and NAR, respectively. Mite mixed was the most frequent aeroallergen sensitization in subjects with AR both without asthma and with asthma (86.4% and 85.6%) followed by cockroach mixed (54.4% and 58.9%), grass pollen (38.9% and 40.4%), animal dander (15.5% and 19.9%), and mold mixed (5.7% and 11.0%). Polysensitization was higher in younger adults compared to middle aged adult and older adult (72.5%, 67.4%, and 58.7%, respectively, p=0.041). The AR subjects had lower age, earlier age of disease onset, and longer duration of disease (32.6±16.3 vs 40.2±15.4 years, 24 (10–36) vs 34 years (22–45), 3 (1–10) vs 2 years (0–5), respectively, p<0.001). The AR subjects also had more asthma, conjunctivitis, and family history of chronic rhinitis (22.3% vs 15.6%, 25.3% vs 4.3%, and 58.0% vs 43.3%, respectively, p<0.05). Conclusion The most common aeroallergen for AR (with and without asthma) was mite mixed followed by cockroach mixed and grass pollen. Polysensitization was significant higher in younger adult than middle aged and older adult. AR was significantly associated with asthma, conjunctivitis and family history of chronic rhinitis compared to NAR.
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Affiliation(s)
- Chaicharn Pothirat
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Warawut Chaiwong
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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6
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Altrichter S, Fok JS, Jiao Q, Kolkhir P, Pyatilova P, Romero SM, Scheffel J, Siebenhaar F, Steinert C, Terhorst-Molawi D, Xiang YK, Church MK, Maurer M. Total IgE as a Marker for Chronic Spontaneous Urticaria. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2021; 13:206-218. [PMID: 33474856 PMCID: PMC7840871 DOI: 10.4168/aair.2021.13.2.206] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/13/2020] [Accepted: 11/14/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Immunoglobulin E (IgE) and its receptor, FcɛRI, importantly contribute to the pathophysiology of chronic spontaneous urticaria (CSU). Recent findings point to a possible role of total IgE as a marker of CSU disease activity, endotypes, and responses to treatment. The evidence in support of total IgE included in the diagnostic workup of patients with CSU has not yet been reviewed. METHODS Publications were searched via PubMed. The search terms used were "chronic urticaria" and "total IgE." Studies were screened by titles and abstracts, and 141 were used in the review. RESULTS CSU patients frequently had elevated total IgE serum levels (up to 50%), but normal or very low total IgE levels also occurred. High total IgE may represent high disease activity, longer disease duration, high chance of responding to omalizumab treatment, quick relapse after stopping omalizumab, and lower chance of responding to cyclosporine. Low IgE, in contrast, may suggest Type IIb autoimmune CSU, poor response to treatment with omalizumab and a better chance to benefits from cyclosporine treatment. Furthermore, IgE in different CSU cohorts may have different physicochemical properties that could explain differences in treatment responses to IgE-directed therapies. CONCLUSION The results of our review suggest that total IgE is a valuable marker for CSU, and we recommend its assessment in the routine diagnostic workup of CSU patients.
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Affiliation(s)
- Sabine Altrichter
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Jie Shen Fok
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Respiratory Medicine, Box Hill Hospital, Melbourne, Victoria, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Qingqing Jiao
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Pavel Kolkhir
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Division of Immune-Mediated Skin Diseases, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Polina Pyatilova
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Dermatology and Venereology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Sherezade Moñino Romero
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Jörg Scheffel
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Frank Siebenhaar
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Carolin Steinert
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Freie Universität Berlin, Berlin, Germany
| | - Dorothea Terhorst-Molawi
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Yi Kui Xiang
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Martin K Church
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Marcus Maurer
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
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7
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Jung JH, Kim GE, Park M, Kim SY, Kim MJ, Lee YJ, Kim YH, Kim KW, Sohn MH. Changes in allergen sensitization in children with allergic diseases in the 1980 to 2019. ALLERGY ASTHMA & RESPIRATORY DISEASE 2021. [DOI: 10.4168/aard.2021.9.4.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Jae Hwa Jung
- Department of Pediatrics, Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Ga Eun Kim
- Department of Pediatrics, Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Mireu Park
- Department of Pediatrics, Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Soo Yeon Kim
- Department of Pediatrics, Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Min Jung Kim
- Department of Pediatrics, Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Ju Lee
- Department of Pediatrics, Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Yoon Hee Kim
- Department of Pediatrics, Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Won Kim
- Department of Pediatrics, Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Myung Hyun Sohn
- Department of Pediatrics, Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
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8
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Williams F, Ponsford M, El-Shanawany T, Macdonald L, Jolles S, Williams P. Improved anaphylaxis referral rates to specialized services from an Emergency Department. Clin Exp Allergy 2020; 50:973-976. [PMID: 32474954 DOI: 10.1111/cea.13673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 05/17/2020] [Accepted: 05/18/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Fiona Williams
- Department of Immunology & Allergy, University Hospital of Wales, Cardiff, UK
| | - Mark Ponsford
- Department of Immunology & Allergy, University Hospital of Wales, Cardiff, UK
| | - Tariq El-Shanawany
- Department of Immunology & Allergy, University Hospital of Wales, Cardiff, UK
| | - Lyndsey Macdonald
- Department of Accident & Emergency, University Hospital of Wales, Cardiff, UK
| | - Stephen Jolles
- Department of Immunology & Allergy, University Hospital of Wales, Cardiff, UK
| | - Paul Williams
- Department of Immunology & Allergy, University Hospital of Wales, Cardiff, UK
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9
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Chan CJ, Yong YS, Song AAL, Abdul Rahim R, In LLA, Lim RLH. Lactococcus lactis harbouring Ara h 2.02 alleviates allergen-specific Th2-associated responses in sensitized mice. J Appl Microbiol 2019; 128:862-874. [PMID: 31758869 DOI: 10.1111/jam.14524] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 10/28/2019] [Accepted: 11/19/2019] [Indexed: 12/21/2022]
Abstract
AIM To study the prophylactic effect of recombinant Lactococcus lactis (rLl) harbouring Ara h 2.02 peanut allergen, in sensitized and challenged mice. METHODS AND RESULTS Ara h 2.02 cDNA was cloned into pNZ8048 for heterologous expression in L. lactis. The purified recombinant allergen showed IgE binding comparable with native Ara h 2. Balb/c mice were fed with either recombinant (rLl), nonrecombinant L. lactis (Ll) or NaHCO3 (Sham) prior to sensitization and challenged with rAra h 2.02, whereas the baseline group was only fed with Ll. Allergen-specific immunoglobulin and splenocyte cytokines responses were determined for each mouse. Mice fed with either Ll or rLl showed significant alleviation of IgE and IgG1 compared to the Sham group. Despite no significant decrease in Th2 (IL-4, IL-13, IL-6) or increase in Th1 (IFN-γ) cytokines, both groups showed lower IL-10 level, while the IL-4 : IFN-γ ratio was significantly lower for rLl compared to Ll group. CONCLUSIONS Oral administration of rLl harbouring Ara h 2.02 demonstrated alleviation of Th2-associated responses in allergen-challenged mice and a possible added allergen-specific prophylactic effect. SIGNIFICANCE AND IMPACT OF THE STUDY Ara h 2.02 coupled with the intrinsic properties of probiotic L. lactis as a delivery vehicle can be explored for the development of a commercially scalable vaccine.
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Affiliation(s)
- C J Chan
- Faculty of Applied Sciences, UCSI University, UCSI Heights, Cheras, Kuala Lumpur, Malaysia
| | - Y S Yong
- Faculty of Applied Sciences, UCSI University, UCSI Heights, Cheras, Kuala Lumpur, Malaysia
| | - A A L Song
- Department of Microbiology, Faculty of Biotechnology and Biomolecular Sciences, University Putra Malaysia, UPM Serdang, Selangor, Malaysia
| | - R Abdul Rahim
- Department of Cell and Molecular Biology, Faculty of Biotechnology and Biomolecular Sciences, University Putra Malaysia, UPM Serdang, Selangor, Malaysia
| | - L L A In
- Faculty of Applied Sciences, UCSI University, UCSI Heights, Cheras, Kuala Lumpur, Malaysia
| | - R L H Lim
- Faculty of Applied Sciences, UCSI University, UCSI Heights, Cheras, Kuala Lumpur, Malaysia
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10
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Park DJ, Lee J, Kim SY, Kwon HJ, Lee HK, Kim Y. Evaluation of AdvanSure AlloScreen Max Panel With 92 Different Allergens for Detecting Allergen-Specific IgE. Am J Clin Pathol 2019; 151:628-637. [PMID: 30984971 DOI: 10.1093/ajcp/aqz023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The objective of this study was to examine the performance of AdvanSure AlloScreen Max with 92 different allergens compared to Polycheck Allergy and ImmunoCAP. The relationship of serum IgE concentration with the number and the highest class/level of positive allergen-specific IgEs was also examined. METHODS A total of 406 serum samples were included in this study. Discrepant cases between AdvanSure AlloScreen Max and Polycheck Allergy underwent ImmunoCAP testing for allergen-specific IgE. RESULTS Total agreement of the two multiple allergen simultaneous tests (MAST) was 92.5%. Compared to ImmunoCAP, total agreement rate was higher with AdvanSure AlloScreen Max (60.8%) than that with Polycheck Allergy (39.2%). Serum IgE concentration showed a significant and positive correlation with the number and the highest class/level of positive allergen-specific IgEs. CONCLUSIONS A MAST assay panel containing as many allergens as possible would be more helpful in the allergen screening for patients with high serum IgE concentration.
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Affiliation(s)
- Dong Jin Park
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul
| | - Jehoon Lee
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul
| | - Soo-Young Kim
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul
| | - Hi Jeong Kwon
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul
| | - Hae Kyung Lee
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul
| | - Yeongsic Kim
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul
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11
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Zhang Z, Cai Z, Hou Y, Hu J, He Y, Chen J, Ji K. Enhanced sensitivity of capture IgE‑ELISA based on a recombinant Der f 1/2 fusion protein for the detection of IgE antibodies targeting house dust mite allergens. Mol Med Rep 2019; 19:3497-3504. [PMID: 30896856 PMCID: PMC6472038 DOI: 10.3892/mmr.2019.10050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 03/06/2019] [Indexed: 12/20/2022] Open
Abstract
The detection of allergen‑specific immunoglobulin (Ig)E is an important method for the diagnosis of IgE‑mediated allergic diseases. The sensitivity of the indirect IgE‑ELISA method against allergen extracts is limited by interference from high IgG titers and low quantities of effectual allergen components in extracts. To overcome these limitations, a novel capture IgE‑ELISA based on a recombinant Der f 1/Der f 2 fusion protein (rDer f 1/2) was developed to enhance the sensitivity to IgEs that bind allergens from the house dust mite (HDM) species Dermatophagoides farina. pET28‑Der f 1/2 was constructed and expressed in Escherichia coli BL21 (DE3) pLysS. The purified fusion protein was evaluated by IgE western blotting, IgE dot blotting and indirect IgE‑ELISA. Capture‑ELISA was performed by coating wells with omalizumab and incubating in series with sera, biotinylated Der f 1/2, horseradish peroxidase‑conjugated streptavidin and 3,3,5,5‑tetramethylbenzidine. The relative sensitivities of indirect‑ELISA and capture‑ELISA for HDM allergen‑specific IgE binding were determined; sera from non‑allergic individuals were used as the control group. rDer f 1/2 was expressed in the form of inclusion bodies comprising refolded protein, which were then purified. It exhibited increased IgE‑specific binding (24/28, 85.8%) than rDer f 1 (21/28, 75.0%) or rDer f 2 (22/28, 78.6%) with HDM‑allergic sera. Furthermore, in a random sample of HDM‑allergic sera (n=71), capture‑ELISA (71/71, 100%) was more sensitive than indirect‑ELISA (68/71, 95.8%) for the detection of HDM‑specific IgEs (P<0.01), indicating that this novel method may be useful for the diagnosis of HDM allergy.
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Affiliation(s)
- Zhen Zhang
- Department of Biochemistry and Molecular Biology, Health Science Center of Shenzhen University, Shenzhen, Guangdong 518035, P.R. China
| | - Zelang Cai
- Department of Biochemistry and Molecular Biology, Health Science Center of Shenzhen University, Shenzhen, Guangdong 518035, P.R. China
| | - Yibo Hou
- Department of Biochemistry and Molecular Biology, Health Science Center of Shenzhen University, Shenzhen, Guangdong 518035, P.R. China
| | - Jiayun Hu
- Department of Biochemistry and Molecular Biology, Health Science Center of Shenzhen University, Shenzhen, Guangdong 518035, P.R. China
| | - Yongshen He
- Department of Biochemistry and Molecular Biology, Health Science Center of Shenzhen University, Shenzhen, Guangdong 518035, P.R. China
| | - Jiajie Chen
- Department of Biochemistry and Molecular Biology, Health Science Center of Shenzhen University, Shenzhen, Guangdong 518035, P.R. China
| | - Kunmei Ji
- Department of Biochemistry and Molecular Biology, Health Science Center of Shenzhen University, Shenzhen, Guangdong 518035, P.R. China
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12
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Joo Chan C, Richardo T, Lim RLH. Current Trend in Immunotherapy for Peanut Allergy. Int Rev Immunol 2019; 37:279-290. [DOI: 10.1080/08830185.2018.1509967] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Chong Joo Chan
- Department of Biotechnology, Faculty of Applied Sciences, UCSI University, Cheras, Kuala Lumpur, Malaysia
| | - Timmy Richardo
- Department of Biomedicine, Indonesia International Institute for Life Sciences (i3L), Jakarta, Indonesia
| | - Renee Lay Hong Lim
- Department of Biotechnology, Faculty of Applied Sciences, UCSI University, Cheras, Kuala Lumpur, Malaysia
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13
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Popescu FD, Vieru M. Precision medicine allergy immunoassay methods for assessing immunoglobulin E sensitization to aeroallergen molecules. World J Methodol 2018; 8:17-36. [PMID: 30519536 PMCID: PMC6275558 DOI: 10.5662/wjm.v8.i3.17] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 08/17/2018] [Accepted: 10/09/2018] [Indexed: 02/06/2023] Open
Abstract
Molecular-based allergy diagnosis for the in vitro assessment of a patient immunoglobulin E (IgE) sensitization profile at the molecular level uses allergen molecules (also referred to as allergen components), which may be well-defined, highly purified, natural allergen components or recombinant allergens. Modern immunoassay methods used for the detection of specific IgE against aeroallergen components are either singleplex (such as the fluorescence enzyme immunoassay with capsulated cellulose polymer solid-phase coupled allergens, the enzyme-enhanced chemiluminescence immunoassay and the reversed enzyme allergosorbent test, with liquid-phase allergens), multiparameter (such as the line blot immunoassay for defined partial allergen diagnostics with allergen components coating membrane strips) or multiplex (such as the microarray-based immunoassay on immuno solid-phase allergen chip, and the two new multiplex nanotechnology-based immunoassays: the patient-friendly allergen nano-bead array, and the macroarray nanotechnology-based immunoassay used as a molecular allergy explorer). The precision medicine diagnostic work-up may be organized as an integrated “U-shape” approach, with a “top-down” approach (from symptoms to molecules) and a “bottom-up” approach (from molecules to clinical implications), as needed in selected patients. The comprehensive and accurate IgE sensitization molecular profiling, with identification of the relevant allergens, is indicated within the framework of a detailed patient’s clinical history to distinguish genuine IgE sensitization from sensitization due to cross-reactivity (especially in polysensitized patients), to assess unclear symptoms and unsatisfactory response to treatment, to reveal unexpected sensitizations, and to improve assessment of severity and risk aspects in some patients. Practical approaches, such as anamnesis molecular thinking, laboratory molecular thinking and postmolecular anamnesis, are sometimes applied. The component-resolved diagnosis of the specific IgE repertoire has a key impact on optimal decisions making for prophylactic and specific immunotherapeutic strategies tailored for the individual patient.
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Affiliation(s)
- Florin-Dan Popescu
- Department of Allergology, “Carol Davila” University of Medicine and Pharmacy, Bucharest 022441, Romania
- Department of Allergology and Clinical Immunology, “Nicolae Malaxa” Clinical Hospital, Bucharest 022441, Romania
| | - Mariana Vieru
- Department of Allergology, “Carol Davila” University of Medicine and Pharmacy, Bucharest 022441, Romania
- Department of Allergology and Clinical Immunology, “Nicolae Malaxa” Clinical Hospital, Bucharest 022441, Romania
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14
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Rim JH, Park BG, Kim JH, Kim HS. Comparison and clinical utility evaluation of four multiple allergen simultaneous tests including two newly introduced fully automated analyzers. Pract Lab Med 2016; 4:50-61. [PMID: 28856193 PMCID: PMC5574498 DOI: 10.1016/j.plabm.2016.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 12/16/2015] [Accepted: 01/19/2016] [Indexed: 11/29/2022] Open
Abstract
Background We compared the diagnostic performances of two newly introduced fully automated multiple allergen simultaneous tests (MAST) analyzers with two conventional MAST assays. Methods The serum samples from a total of 53 and 104 patients were tested for food panels and inhalant panels, respectively, in four analyzers including AdvanSure AlloScreen (LG Life Science, Korea), AdvanSure Allostation Smart II (LG Life Science), PROTIA Allergy-Q (ProteomeTech, Korea), and RIDA Allergy Screen (R-Biopharm, Germany). We compared not only the total agreement percentages but also positive propensities among four analyzers. Results Evaluation of AdvanSure Allostation Smart II as upgraded version of AdvanSure AlloScreen revealed good concordance with total agreement percentages of 93.0% and 92.2% in food and inhalant panel, respectively. Comparisons of AdvanSure Allostation Smart II or PROTIA Allergy-Q with RIDA Allergy Screen also showed good concordance performance with positive propensities of two new analyzers for common allergens (Dermatophagoides farina and Dermatophagoides pteronyssinus). The changes of cut-off level resulted in various total agreement percentage fluctuations among allergens by different analyzers, although current cut-off level of class 2 appeared to be generally suitable. Conclusions AdvanSure Allostation Smart II and PROTIA Allergy-Q presented favorable agreement performances with RIDA Allergy Screen, although positive propensities were noticed in common allergens. Two new multiple allergen simultaneous tests (MAST) analyzers are evaluated. AdvanSure Smart II and PROTIA presented favorable agreement performance with RIDA. Positive propensity of new assays for D. farina and D. pteronyssinus was noticed. The changes of cut-off level resulted in total agreement percentage fluctuations.
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Affiliation(s)
- John Hoon Rim
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Medicine, Yonsei University Graduate School of Medicine, Seoul, Republic of Korea
| | - Borae G Park
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jeong-Ho Kim
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyon-Suk Kim
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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15
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Williams P, Önell A, Baldracchini F, Hui V, Jolles S, El-Shanawany T. Evaluation of a novel automated allergy microarray platform compared with three other allergy test methods. Clin Exp Immunol 2016; 184:1-10. [PMID: 26437695 DOI: 10.1111/cei.12721] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2015] [Indexed: 02/01/2023] Open
Abstract
Microarray platforms, enabling simultaneous measurement of many allergens with a small serum sample, are potentially powerful tools in allergy diagnostics. We report here the first study comparing a fully automated microarray system, the Microtest allergy system, with a manual microarray platform, Immuno-Solid phase Allergen Chip (ISAC), and two well-established singleplex allergy tests, skin prick test (SPT) and ImmunoCAP, all tested on the same patients. One hundred and three adult allergic patients attending the allergy clinic were included into the study. All patients were tested with four allergy test methods (SPT, ImmunoCAP, Microtest and ISAC 112) and a total of 3485 pairwise test results were analysed and compared. The four methods showed comparable results with a positive/negative agreement of 81-88% for any pair of test methods compared, which is in line with data in the literature. The most prevalent allergens (cat, dog, mite, timothy, birch and peanut) and their individual allergen components revealed an agreement between methods with correlation coefficients between 0·73 and 0·95. All four methods revealed deviating individual patient results for a minority of patients. These results indicate that microarray platforms are efficient and useful tools to characterize the specific immunoglobulin (Ig)E profile of allergic patients using a small volume of serum sample. The results produced by the Microtest system were in agreement with diagnostic tests in current use. Further data collection and evaluation are needed for other populations, geographical regions and allergens.
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Affiliation(s)
- P Williams
- Department of Immunology, University Hospital of Wales, Cardiff
| | | | | | | | - S Jolles
- Department of Immunology, University Hospital of Wales, Cardiff
| | - T El-Shanawany
- Department of Immunology, University Hospital of Wales, Cardiff
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16
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Wasp venom allergy screening with recombinant allergen testing. Diagnostic performance of rPol d 5 and rVes v 5 for differentiating sensitization to Vespula and Polistes subspecies. Clin Chim Acta 2016; 453:170-3. [DOI: 10.1016/j.cca.2015.12.026] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 12/15/2015] [Accepted: 12/19/2015] [Indexed: 11/19/2022]
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17
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Comparison of three multiple allergen simultaneous tests: RIDA allergy screen, MAST optigen, and polycheck allergy. BIOMED RESEARCH INTERNATIONAL 2012; 2013:340513. [PMID: 23484110 PMCID: PMC3591101 DOI: 10.1155/2013/340513] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 11/14/2012] [Accepted: 11/19/2012] [Indexed: 01/23/2023]
Abstract
We compared the performances of 3 Multiple Allergen Simultaneous Test (MAST) assays: RIDA Allergy Screen (R-Biopharm, Darmstadt, Germany), MAST Optigen allergy system (Hitachi Chemical Diagnostics, Mountain View, CA), and Polycheck Allergy (Biocheck GmbH, Munster, Germany). Forty sera that tested positive with the RIDA Allergy Screen (20 for food and 20 for inhalant panel) were subjected to MAST Optigen and Polycheck Allergy. For 26 available sera with discrepant results, 62 ImmunoCAP allergen-specific IgE tests (Pharmacia Diagnostics, Uppsala, Sweden) were performed. Percent agreements (kappa value) were 87.6% (0.59) and 91.3% (0.60) between RIDA and MAST; 89.9% (0.55) and 88.3% (0.46) between RIDA and Polycheck; and 86.8% (0.51) and 90.6% (0.61) between MAST and Polycheck. Compared with ImmunoCAP, agreements (kappa value) of inhalant and food panels were 51.7% (0.04) and 33.3% (−0.38) for RIDA; 60.7% (0.27) and 81.8% (0.59) for MAST; and 65.5% (0.26) and 45.5% (0.07) for Polycheck. The agreements between RIDA, MAST, and Polycheck and ImmunoCAP-positivity were 45.7%, 88.2%, and 28.6%, respectively, and the agreements for ImmunoCAP-negativity were 37.0%, 51.9%, and 88.9%. MAST Optigen showed better agreement with ImmunoCAP than other assays in the food panel. Better sensitivity of MAST Optigen and better specificity of Polycheck Allergy were suspected.
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18
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Oh EJ, Lee SA, Lim J, Park YJ, Han K, Kim Y. [Detection of allergen specific IgE by AdvanSure Allergy Screen test]. Korean J Lab Med 2010; 30:420-31. [PMID: 20805716 DOI: 10.3343/kjlm.2010.30.4.420] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND In vitro serum allergen-specific IgE tests have been routinely used in the clinical diagnosis of allergic diseases. We evaluated the clinical usefulness of a newly introduced multiple antigen screen test, Advansure Allergy Screen (LG Life Science, Korea) (LG-Screen) for the detection of allergen specific IgE. METHODS A total of 180 sera (80 for inhalant and 100 for food panels) were tested by LG-Screen and RIDA Allergy Screen (R-biopharm, Germany) (RIDA-Screen) assays. According to the 58-60 specific allergens or allergen groups, the positive rates and agreement rates were analyzed using the cut off levels of class 2. For the quantitation of total IgE and specific IgE, nephelometry and ImmunoCAP test were performed in the sera showing discrepant results between the two allergy screen assays. RESULTS The agreement rate and kappa value (k) of total IgE between the two allergy screen assays was 73.9% and 0.333. LG-Screen showed higher agreement rate with nephelometry than RIDA-Screen. The positive rates to common outdoor inhalant and food allergens were significantly higher in RIDA-Screen. Overall agreement rate of specific IgE between the two allergy screen assays for 58 allergens was 86.7% (6,086/7,020) (k, 0.293). In samples showing discrepant results between the two allergy screen assays, concordance rate of allergy screen assay with ImmunoCAP assay was 70.9% (449/633) for LG-Screen (k, 0.585) and 29.1% (184/633) for RIDA-Screen (k, -0.303). CONCLUSIONS LG-Screen showed a favorable agreement with RIDA-Screen and ImmunoCAP assays, and it could be used for the detection of allergen specific IgE in the clinical laboratory.
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Affiliation(s)
- Eun Jee Oh
- Department of Laboratory Medicine, School of Medicine, the Catholic University of Korea, Seoul, Korea
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19
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Khan S, Holding S, Doré P, Sewell C. Pitfalls in the diagnosis of latex allergy. Allergol Int 2010; 59:305-308. [PMID: 20657167 DOI: 10.2332/allergolint.09-oa-0154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2009] [Accepted: 03/23/2010] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Screening patients for latex allergy prior to surgery is an important but intensive procedure. The appropriate testing strategy for diagnosing latex (Hevea brasiliensis) allergy involves in-vitro specific IgE or skin prick testing. The sensitivity and specificity of both tests are influenced by patient-specific factors or manufacturing processes that alter the clinically relevant allergens in skin testing solutions. METHODS Total IgE and latex-specific IgE testing was introduced as a screening test. Skin prick testing was done on patients with a high probability of latex allergy and negative specific IgE with total IgE <100 kU/L. SDS-PAGE was done on the non-ammoniated latex (NAL) and newly introduced ammoniated latex (AL) reagents for the clinically relevant allergens. RESULTS 51 patients had a total IgE <100 (range, 2.8-99.0 kU/L), and 10% had a positive skin test. 60% of positive skin tests would have been missed with lower total IgE cut-offs of 50 kU/L (6% of referrals). SDS-PAGE of the NAL solution showed 3 prominent bands with molecular weights of approximately 20, 24 and 42 kDa that correlated with Hev b 6, Hev b 3 and Hev b 7/13, respectively. In contrast, the AL solution showed 3 very faint higher molecular weights bands that did not correlate with clinically relevant antigens. CONCLUSIONS Increasing the cut-off value of total IgE for allergen-specific IgE testing increased the sensitivity of the specific IgE test. The NAL reagent had a greater number of clinically significant allergens at higher concentrations than AL, which may have implications for the clinical sensitivity of the newer AL reagent.
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Affiliation(s)
- Sujoy Khan
- Path Links Immunology, Scunthorpe General Hospital, Scunthorpe, United Kingdom; Department of Immunology, Hull Royal Infirmary, University of Hull, Hull, United Kingdom.
| | - Steve Holding
- Department of Immunology, Hull Royal Infirmary, University of Hull, Hull, United Kingdom; Post graduate Medical Institute, University of Hull, Hull, United Kingdom
| | - Philip Doré
- Department of Immunology, Hull Royal Infirmary, University of Hull, Hull, United Kingdom; Hull York Medical School, University of Hull, Hull, United Kingdom
| | - Carrock Sewell
- Path Links Immunology, Scunthorpe General Hospital, Scunthorpe, United Kingdom; Hull York Medical School, University of Hull, Hull, United Kingdom
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20
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Current World Literature. Curr Opin Allergy Clin Immunol 2009; 9:386-90. [DOI: 10.1097/aci.0b013e32832eb836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Sporik R, Henderson J, Hourihane JO. Clinical Immunology Review Series: An approach to the patient with allergy in childhood. Clin Exp Immunol 2009; 155:378-86. [PMID: 19141124 DOI: 10.1111/j.1365-2249.2008.03852.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Allergic conditions are common, with asthma being the most common chronic illness in childhood in most developed countries. Some 80% of asthmatic children are sensitized to aeroallergens, usually indoor animal dander and house dust mite. Some 80% of asthmatics also have rhinitis. Rhinitis and eczema receive less medical attention than asthma, but they can cause longterm morbidity and have substantial direct and indirect economic costs. Food allergy and anaphylaxis are increasingly recognised and are usually easily diagnosed and managed.Clinicians can use in vivo and in vitro measurements of allergen-specific immunoglobulin E to better time reintroduction of implicated foods. Specific parenteral and sublingual immunotherapy is widely practiced internationally but is uncommon in the UK. It may alter the natural history of aeroallergen reactive diseases in the upper and lower airways. Specific oral tolerance induction represents the current cutting edge in clinical allergy research. It remands resource intensive at present and cannot be adopted into routine clinical practice at this time.
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Affiliation(s)
- R Sporik
- Royal Cornwall Hospital, Truro, Cornwall, UK
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Abstract
Patients with urticaria make up a large proportion of the referrals to allergy clinics. There are many causes of urticaria and it is the clinical history which is most important when attempting to identify potential causes; however, urticaria is very often idiopathic. In a small minority of patients urticaria may be a symptom of a serious underlying medical illness or the allergic symptoms may progress to cause systemic reactions, and it is important to identify these patients and to remember that severe urticaria is a distressing and disabling condition. This review will discuss classification, investigation and treatment of urticaria and will consider some of the more unusual types of urticaria that may be encountered in the out-patient clinic.
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Affiliation(s)
- S J Deacock
- Royal Surrey County Hospital NHS Trust, Guildford, Surrey, UK.
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El-Shanawany T, Williams PE, Jolles S. Clinical immunology review series: an approach to the patient with anaphylaxis. Clin Exp Immunol 2008; 153:1-9. [PMID: 18577027 DOI: 10.1111/j.1365-2249.2008.03694.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Anaphylaxis is a severe, life-threatening, generalized or systemic hypersensitivity reaction. While there is agreement as to this definition of anaphylaxis, the clinical presentation is often variable and it is not uncommon for there to be debate after the event as to whether anaphylaxis had actually occurred. The management of anaphylaxis falls into two distinct phases: (1) emergency treatment and resuscitation of a patient with acute anaphylaxis and (2) the search for a cause for the event and the formulation of a plan to prevent and treat possible further episodes of anaphylaxis. Both aspects are important in preventing death from anaphylaxis and are covered in this review.
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Affiliation(s)
- T El-Shanawany
- Department of Biochemistry and Immunology, University Hospital of Wales, Cardiff, UK.
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