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Neff C, Price M, Cioffi G, Liu Z, Walsh R, Barnholtz-Sloan JS, Walsh KM, Salama AKS, Anders CK, Fecci PE, Ostrom QT. Atopy improves survival and decreases risk of brain metastasis in cutaneous melanoma. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.15.24307061. [PMID: 38798534 PMCID: PMC11118623 DOI: 10.1101/2024.05.15.24307061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Importance Development of new therapies in melanoma has increased survival, and as a result more patients are living to develop brain metastasis (BrM). Identifying patients at increased risk of BrM is therefore of significant public health importance. Objective To determine whether history of atopy is associated with improved survival or reduced incidence of BrM in cutaneous melanoma. Design A retrospective cohort study conducted from June 2022 to March 2024. Setting Population-based in states with Surveillance, Epidemiology and End Results (SEER) supported cancer registries. Participants Individuals (≥65 years) diagnosed with cutaneous melanoma between January 1, 2008 and December 31, 2017 that are participants in traditional Medicare. Exposures Individuals were compared that had history of atopy (allergic rhinitis, atopic dermatitis, asthma, and/or allergic/atopic conjunctivitis) diagnosed prior to melanoma diagnosis, ascertained using ICD-9 or ICD-10 codes in Medicare claims. Main Outcomes and Measures Primary endpoints were diagnosis with a BrM or death during the follow-up period. Associations between atopy and endpoints were assessed using cox proportional hazards models to estimate hazard ratios (HR) and p-values. Results A total of 29,956 cutaneous melanoma cases were identified (median age 76, 60% male and 97% non-Hispanic White). Overall, 7.1% developed BrM during follow up. Among the 35% that had history of atopy, the most common condition was atopic dermatitis (19%). After adjustment for demographic and prognostic factors, atopy was associated with a 16% decrease in death (HR=0.84 [95%CI:0.80-0.87], pFDR<0.001). Among those with non-metastatic disease at time of diagnosis, atopy conferred a 15% decrease in cumulative incidence BrM (HR=0.85 [95%CI: 0.76-0.94], pFDR=0.006), with a 25% decrease associated with atopic dermatitis (HR=0.75 [95%CI:0.65-0.86], pFDR<0.001). Among those with metastatic disease at diagnosis (any metastatic site), only those who received immune checkpoint inhibitors had a survival benefit associated with atopy (HR=0.31, [95%CI:0.15-0.64], p=0.001 vs HR=1.41, [95%CI:0.87-2.27], p=0.165). Conclusions and Relevance Atopy, particularly atopic dermatitis, was significantly associated with improved survival and decreased incidence of BrM. The improved survival associated with these conditions in the context of immunotherapy suggests that these conditions in the elderly may identify those with more robust immune function that may be more responsive to treatment.
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Affiliation(s)
- Corey Neff
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
| | - Mackenzie Price
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
| | - Gino Cioffi
- Trans Divisional Research Program (TDRP) Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute, Bethesda, MD, USA
| | - Zhen Liu
- Department of Biostatistics, Duke University School of Medicine, Durham, NC, USA
| | - Rabina Walsh
- Department of Dermatology, Duke University School of Medicine, Durham, NC, USA
| | - Jill S. Barnholtz-Sloan
- Department of Biostatistics, Duke University School of Medicine, Durham, NC, USA
- Center for Biomedical Informatics & Information Technology (CBIIT), National Cancer Institute, Bethesda, MD, USA
| | - Kyle M. Walsh
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
- The Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, NC, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
| | - April K. S. Salama
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
- Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Carey K. Anders
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
- Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Peter E. Fecci
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
- The Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, NC, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
| | - Quinn T. Ostrom
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
- The Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, NC, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
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Napolitano M, Potestio L, Nocerino M, Patruno C. Considerations for managing elderly patients with atopic dermatitis. Expert Rev Clin Immunol 2024; 20:501-511. [PMID: 38193289 DOI: 10.1080/1744666x.2024.2301967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 12/22/2023] [Indexed: 01/10/2024]
Abstract
INTRODUCTION Atopic dermatitis (AD) diagnosis in elderly is challenging, due to its clinical polymorphism and the lack of diagnostic biomarkers. Moreover, the chronicity of the disease and the complex pathogenetic mechanism, make elderly AD management challenging. AREAS COVERED A narrative review of the current literature was performed using the PubMed, Medline, Embase, and Cochrane Skin databases, by researching the following terms: 'atopic dermatitis,' 'clinical phenotypes,' 'eczema,' 'elderly patients,' 'elderly type atopic dermatitis,' 'eczema clinical presentation.' The aim was to report the current knowledge on pathogenesis, clinical presentation, and treatment options of elderly AD. EXPERT OPINION Elderly type AD has recently been identified as a separate entity, with an increasing prevalence. With aging, both immunosenescence and barrier alterations can cause or modify AD presentation. Moreover, a chronic proinflammatory state (so-called 'inflammaging') is often present in elderly subjects. Older patients with AD may present with peculiar immunophenotypic profile, making AD diagnosis challenging. Similarly, the chronicity of the disease and the complex pathogenetic mechanism, make AD management a challenge. Indeed, systemic therapies for AD are often contraindicated or not tolerated and the management of elderly type AD is often burdened with numerous difficulties, leading to undertreated disease. Even if dupilumab and tralokinumab represent a valuable therapeutic weapon, more data on safety of JAK inhibitors are required.
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Affiliation(s)
- Maddalena Napolitano
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Mariateresa Nocerino
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
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Pawłowicz R, Bożek A, Dor-Wojnarowska A, Rosiek-Biegus M, Kopeć A, Gillert-Smutnicka M, Sobieszczańska M, Nittner-Marszalska M. Elderly Patients and Insect Venom Allergy: Are the Clinical Pictures and Immunological Parameters of Venom Allergy Age-Dependent? Vaccines (Basel) 2024; 12:394. [PMID: 38675776 PMCID: PMC11053896 DOI: 10.3390/vaccines12040394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024] Open
Abstract
Insect venom is one of the most common triggers of anaphylaxis in the elderly population. Venom immunotherapy (VIT) remains the only treatment for Hymenoptera venom allergy (HVA). However, little is known about the differences in indication for VIT in the group of patients aged 60 years and older. The objective of this study was to assess the clinical and diagnostic differences of HVA in elderly patients. The study compared data from patients aged ≥ 60 (N = 132) to data from patients aged from 11 to 60 years (N = 750) in terms of HVA severity, comorbidities, and immunological parameters, namely, intradermal testing (IDT), specific IgE (sIgE) levels against extracts and major allergenic molecules, and serum tryptase level (sBT). The severity of systemic HVA (I-IV Müller scale) did not differ between adults and seniors. However, the severity of cardiovascular reactions (IV) increased with age, while the frequency of respiratory reactions (III) decreased. No differences were found in the immunological parameters of sensitization IDT, venom-specific IgE concentrations, or sIgE against Api m 1, 2, 4, 5, and 10 between patients below and above 60 or 65 years of age. Differences were noted for sIgE against Ves v1 and Ves v5; they were higher and lower, respectively, in seniors. In the seniors group, sBT levels were higher. Elevated tryptase levels, along with the aging process, can represent a risk factor within this age category. Nevertheless, advanced age does not influence the immunological parameters of immediate HVA reactions, nor does it impact the diagnosis of HVA.
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Affiliation(s)
- Robert Pawłowicz
- Clinical Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, Chałbińskiego 1a, 50-368 Wrocław, Poland; (A.D.-W.); (M.R.-B.); (A.K.); (M.N.-M.)
| | - Andrzej Bożek
- Clinical Department of Internal Diseases, Dermatology and Allergology, Medical University of Silesia, Sklodowskiej 10, 41-800 Zabrze, Poland;
| | - Anna Dor-Wojnarowska
- Clinical Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, Chałbińskiego 1a, 50-368 Wrocław, Poland; (A.D.-W.); (M.R.-B.); (A.K.); (M.N.-M.)
| | - Marta Rosiek-Biegus
- Clinical Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, Chałbińskiego 1a, 50-368 Wrocław, Poland; (A.D.-W.); (M.R.-B.); (A.K.); (M.N.-M.)
| | - Agnieszka Kopeć
- Clinical Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, Chałbińskiego 1a, 50-368 Wrocław, Poland; (A.D.-W.); (M.R.-B.); (A.K.); (M.N.-M.)
| | | | - Małgorzata Sobieszczańska
- Clinical Department of Geriatrics, Wroclaw Medical University, Chałbińskiego 1a, 50-368 Wrocław, Poland;
| | - Marita Nittner-Marszalska
- Clinical Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, Chałbińskiego 1a, 50-368 Wrocław, Poland; (A.D.-W.); (M.R.-B.); (A.K.); (M.N.-M.)
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Tsuji S, Adachi Y, Tsuchida A, Hamazaki K, Matsumura K, Inadera H. Association of allergies in children younger than 3 years with levels of maternal intake of n-3 polyunsaturated fatty acids or fish during pregnancy: A nationwide birth cohort study, the Japan Environment and Children's Study. Allergol Int 2024; 73:282-289. [PMID: 38218702 DOI: 10.1016/j.alit.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 11/30/2023] [Accepted: 12/17/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND N-3 polyunsaturated fatty acids (PUFAs) have anti-inflammatory properties and are expected to prevent the onset of allergies. However, epidemiological studies investigating the relationship between child allergies and maternal intake of n-3 PUFAs or fish have yielded inconsistent results. METHODS Following exclusions from a dataset comprising 103,057 records from the Japan Environment and Children's Study, 72,105 participants were divided into five groups according to mothers' intake of n-3 PUFAs or fish during pregnancy to assess the risk of their children being diagnosed with allergy by 3 years old. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for child allergies were calculated using multivariable logistic regression analyses with reference to the lowest intake group. RESULTS Levels of maternal intake of n-3 PUFAs or fish showed inverted associations (i.e., reduced risk) with the incidence of physician-diagnosed allergic rhinoconjunctivitis or parent-reported symptoms of current rhinitis with eye symptoms at different time points and the cumulative incidence from birth to 3 years of age. Inverted associations were also found for current wheeze at 1-<2 years of age and current eczema at 1-<2 and 0-<3 years of age. However, for food allergies, no significant associations were observed in the incidence in each group compared with the lowest intake group at any age. CONCLUSIONS The findings suggest that n-3 PUFA intake during pregnancy may reduce the risk of developing allergic diseases and symptoms in children. In addition, consumption of n-3 PUFAs or fish is very unlikely to increase the risk of allergy given that the results are from a country with high fish consumption. TRIAL REGISTRATION UMIN000030786 https://rctportal.niph.go.jp/detail/um?trial_id=UMIN000030786.
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Affiliation(s)
- Sayaka Tsuji
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Yuichi Adachi
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan; Pediatric Allergy Center, Toyama Red Cross Hospital, Toyama, Japan.
| | - Akiko Tsuchida
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Kei Hamazaki
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, Toyama, Japan; Department of Public Health, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Kenta Matsumura
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Hidekuni Inadera
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
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Losol P, Sokolowska M, Hwang YK, Ogulur I, Mitamura Y, Yazici D, Pat Y, Radzikowska U, Ardicli S, Yoon JE, Choi JP, Kim SH, van de Veen W, Akdis M, Chang YS, Akdis CA. Epithelial Barrier Theory: The Role of Exposome, Microbiome, and Barrier Function in Allergic Diseases. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2023; 15:705-724. [PMID: 37957791 PMCID: PMC10643858 DOI: 10.4168/aair.2023.15.6.705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/18/2023] [Accepted: 10/07/2023] [Indexed: 11/15/2023]
Abstract
Allergic diseases are a major public health problem with increasing prevalence. These immune-mediated diseases are characterized by defective epithelial barriers, which are explained by the epithelial barrier theory and continuously emerging evidence. Environmental exposures (exposome) including global warming, changes and loss of biodiversity, pollution, pathogens, allergens and mites, laundry and dishwasher detergents, surfactants, shampoos, body cleaners and household cleaners, microplastics, nanoparticles, toothpaste, enzymes and emulsifiers in processed foods, and dietary habits are responsible for the mucosal and skin barrier disruption. Exposure to barrier-damaging agents causes epithelial cell injury and barrier damage, colonization of opportunistic pathogens, loss of commensal bacteria, decreased microbiota diversity, bacterial translocation, allergic sensitization, and inflammation in the periepithelial area. Here, we review scientific evidence on the environmental components that impact epithelial barriers and microbiome composition and their influence on asthma and allergic diseases. We also discuss the historical overview of allergic diseases and the evolution of the hygiene hypothesis with theoretical evidence.
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Affiliation(s)
- Purevsuren Losol
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Medical Research Center, Seoul National University, Seoul, Korea
- Department of Molecular Biology and Genetics, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Yu-Kyoung Hwang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Ismail Ogulur
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Yasutaka Mitamura
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Duygu Yazici
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Yagiz Pat
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Urszula Radzikowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Sena Ardicli
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Jeong-Eun Yoon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jun-Pyo Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sae-Hoon Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Medical Research Center, Seoul National University, Seoul, Korea
| | - Willem van de Veen
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Yoon-Seok Chang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Medical Research Center, Seoul National University, Seoul, Korea.
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
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Cao Y, Hao W, Wu Y, Qiao J, Xie M, Jin H, Zhang J, Sun G, Sun H. Epidemiological investigation of emergency infusion adverse drug reactions in Nanjing, China: a prospective cross-sectional study. Expert Opin Drug Saf 2023; 22:871-879. [PMID: 37294710 DOI: 10.1080/14740338.2023.2223945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 04/26/2023] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Little is known about the morbidity and mortality of infusion Adverse drug reactions (ADRs) in the emergency department. We sought to evaluate the epidemiology of emergency infusion ADRs. MATERIALS AND METHODS This was a prospective study of infusion ADRs in the emergency infusion unit (EIU) of a tertiary hospital from 1 January 20201 January 2020, to 31 December 2021w31 December 2021. Emergency infusion ADRs were identified as intravenous drug-related ADRs that the causality was determined using the Naranjo algorithm. The incidence, severity and preventability of these ADRs were assessed using other standard criteria. RESULTS A total of 327 ADRs were recorded for 320 participants, antibiotics were the class of drugs most commonly involved, and 76.15% of ADRs occurred within the first hour. The most common symptoms observed were skin manifestations, accounting for 46.04% of ADRs. Mild reactions accounted for 85.32% based on the Hartwig and Siegel scale. In 89.30% of the reports, the ADRs were evaluated as not preventable based on the modified Schumock and Thornton scale. The causality and severity of ADRs were related to Charlson Comorbidity Index score and age (P < 0.05). CONCLUSION This epidemiological study described the pattern of emergency infusion ADRs in East China in detail. These findings may be useful to compare patterns among different centers.
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Affiliation(s)
- Yun Cao
- Department of Emergency, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - WeiWen Hao
- Department of Emergency, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - YuXuan Wu
- Department of Emergency, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jie Qiao
- Department of Emergency, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Min Xie
- Department of Emergency, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hua Jin
- Department of Emergency, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - JinSong Zhang
- Department of Emergency, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Institute of Poisoning, Nanjing Medical University, Nanjing, P. R. China
| | - GuoZhen Sun
- School of Nursing, Nanjing Medical University, Nanjing, China
- Department of Cardiovascular, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hao Sun
- Department of Emergency, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Institute of Poisoning, Nanjing Medical University, Nanjing, P. R. China
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Sun Y, Wang YX, Mustieles V, Shan Z, Zhang Y, Messerlian C. Blood trihalomethane concentrations and allergic sensitization: A nationwide cross-sectional study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 871:162100. [PMID: 36764558 PMCID: PMC10006400 DOI: 10.1016/j.scitotenv.2023.162100] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/30/2023] [Accepted: 02/04/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Exposure to disinfection by-products has been associated with several allergic diseases, but its association with allergen-specific immunoglobulin E (IgE) antibodies remains inconclusive. METHODS We included 932 U.S. adolescents and 2187 adults from the National Health and Nutrition Examination Survey 2005-2006 who had quantified blood THM concentrations [chloroform (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM), and bromoform (TBM)] and 19 allergen-specific IgE antibodies. The odds ratios (ORs) of allergen-specific sensitization per 2.7-fold increment in blood THM concentrations were estimated by multivariable logistic regression models. RESULTS Blood THM concentrations were unrelated to any allergen-specific sensitization in adults. Among adolescents, however, we found positive associations between blood TCM and chlorinated THMs (Cl-THMs: sum of TCM, BDCM, and DBCM) concentrations and the odds of pet sensitization [OR = 1.28 (95 % CI: 1.05, 1.55) and 1.38 (1.15, 1.65), respectively, per each 2.7-fold increment], between blood BDCM concentrations and the odds of mold [OR = 1.47 (1.24, 1.74)], plant [OR = 1.25 (1.09, 1.43)], pet [OR = 1.27 (1.07, 1.52)], and food sensitization [OR = 1.18 (1.03, 1.36)], and between blood brominated THM (Br-THMs: sum of BDCM, DBCM, and TBM) and total THM (TTHMs: sum of 4 THMs) concentrations and the odds of mold [OR = 1.52 (1.30 1.78) and 1.30 (1.03, 1.65), respectively], dust mite [OR = 1.39 (1.06, 1.82) and 1.45 (1.06, 1.98), respectively], and pet sensitization [OR = 1.42 (1.05, 1.92) and 1.54 (1.19, 1.98), respectively]. CONCLUSION Higher blood concentrations of THMs were associated with a greater risk of allergic sensitization among U.S. adolescents but not in adults.
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Affiliation(s)
- Yang Sun
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Yi-Xin Wang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States.
| | - Vicente Mustieles
- University of Granada, Center for Biomedical Research (CIBM), 18016 Granada, Spain; Instituto de Investigación Biosanitaria Ibs GRANADA, 18016 Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 18016 Granada, Spain
| | - Zhilei Shan
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yu Zhang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Carmen Messerlian
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
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Daniel J, Gupta R, Thangakunam B, Christopher DJ. Undiagnosed Asthma-COPD overlap among patients diagnosed as Asthma and COPD in a referral hospital, India. Heliyon 2023; 9:e14711. [PMID: 37025820 PMCID: PMC10070599 DOI: 10.1016/j.heliyon.2023.e14711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/26/2023] [Accepted: 03/15/2023] [Indexed: 03/29/2023] Open
Abstract
Patients who have features of both Asthma & COPD are now known as Asthma COPD overlap (ACO). Prevalence of ACO based on the Global Initiative for Asthma (GINA) and Global initiative for obstructive lung disease (GOLD) Syndromic Approach is scarce. In this cross-sectional observational study, we recruited physician-diagnosed-pAsthma, pCOPD & pACO by simple random sampling. Clinical features, spirometry, 6-min walk test, Serum Immunoglobulin E, % blood eosinophils and chest x-rays were reviewed. Syndromic approach was applied, and the diagnosis was reclassified accordingly. In all, 877 patients were included (Male = 445, Female = 432). Physician diagnosis for these were: pAsthma-713, pCOPD-157 and pACO-7. They were reclassified using the Syndromic approach as: sAsthma, sCOPD and sACO. The 713 pAsthmatics were reclassified as follows: sAsthma-684 (95.94%), sCOPD-12 (1.68%) and sACO-17 (2.38%). Of the 157 pCOPD patients, 91 (57.96%) were reclassified as sCOPD, 23 (14.6%) as sACO, and 17 (927.38%) as sAsthma. Of the 7 previously diagnosed pACO patients, only 1 (14.28%) was reclassified as sACO, 5 (71.42%) as sAsthma and 1 (14.28%) as sCOPD. sCOPD patients had more exacerbations (52.88% vs 46.34%, p = 0.479), critical care admissions (16.35% vs 7.32%, p = 0.157) and intubations (17.31% vs 9.76%, p = 0.255) compared to sACO patients, the latter had more events than sAsthma patients: exacerbations 46.34% vs 10.11% (p < 0.001), critical care admissions 7.32% vs 1.64% (p = 0.010) and intubations 9.76% vs 1.5% (p < 0.001). The syndromic approach helped us to identify ACO and also more appropriately classified COPD & Asthma. There was a significant difference between physician diagnosis and diagnosis using Syndromic Approach. It revealed considerable misclassification of several Asthmatic and ACO subjects, who could have been denied inhaled corticosteroids, as they were wrongly categorised as COPD by physician diagnosis.
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9
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El Hanache H, Perennec T, Beaumont P, Puillandre E, Schwender D, Louis Donguy F, Froidefond C, Jarlot S, Petit N, Nootens C, Pirson F, Sullerot I, Nicolie B, Van der Brempt X, Morisset M. Food anaphylaxis in the elderly: Analysis of allergy vigilance network data from 2002 to 2021. Clin Exp Allergy 2023; 53:561-572. [PMID: 36811252 DOI: 10.1111/cea.14297] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 01/28/2023] [Accepted: 01/31/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Few studies have focused on food allergies in the elderly, even though it may persist or appear de novo. METHODS We reviewed data for all cases of food-induced anaphylaxis in people age ≥ 60 reported to the French "Allergy Vigilance Network" (RAV) between 2002 and 2021. RAV collates data reported by French-speaking allergists regarding cases of anaphylaxis graded II to IV according to the Ring and Messmer classification. RESULTS In total, 191 cases were reported, with an even sex distribution and mean age was 67.4 years (range 60 to 93). The most frequent allergens were mammalian meat and offal (31 cases, 16.2%), often associated with IgE to α-Gal. Legumes were reported in 26 cases (13.6%), fruits and vegetables in 25 cases (13.1%), shellfish 25 cases (13.1%), nuts 20 cases (10.5%), cereals 18 cases (9.4%), seeds 10 cases (5.2%), fish 8 cases (4.2%) and anisakis 8 cases (4.2%). Severity was grade II in 86 cases (45%), grade III in 98 cases (52%) and grade IV in 6 cases (3%) with one death. Most episodes occurred at home or in a restaurant and in most cases adrenaline was not used to treat the acute episode. Potentially relevant cofactors such as beta-blocker, alcohol or non-steroidal anti-inflammatory drug intake were present in 61% of cases. Chronic cardiomyopathy, present in 11.5% of the population, was associated with greater, grade III or IV reaction severity (OR 3.4; 1.24-10.95). CONCLUSION Anaphylaxis in the elderly has different causes to younger people and requires detailed diagnostic testing and individualized care plans.
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Affiliation(s)
- Hassan El Hanache
- Allergy Unit, Nantes University Hospital, Nantes, France.,Allergy Unit, Angers University Hospital, Angers, France
| | | | | | | | | | | | | | | | - Nicolas Petit
- Allergy unit, Verdun Hospital Center, Verdun, France
| | | | - Françoise Pirson
- Pneumology Unit, Saint-Luc University Clinics, Brussels, Belgium
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10
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King F, Kaczmarczyk R, Zink A, Biedermann T, Brockow K. A new way forward? Examining the potential of quantitative analysis of IgE datasets. ALLERGY, ASTHMA & CLINICAL IMMUNOLOGY 2022; 18:75. [PMID: 35989350 PMCID: PMC9394034 DOI: 10.1186/s13223-022-00717-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/08/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
Allergies constitute an important public health problem, and epidemiological data is crucial to developing strategies for its prevention and therapy. Few population-based studies are available for data on allergies and sensitization. However, as these studies are expensive and time-consuming, novel approaches are searched for.
Objectives
A large monocentric IgE dataset was used to analyse quantitative sensitization data in different age and gender groups and compared the results to available epidemiological data.
Methods
A total of 14,370 patients who sought medical care at the Department for Dermatology and Allergology at the Technical University of Munich, Germany was analysed. Total IgE and sensitization measured in specific IgE levels to common food allergens and aeroallergens were compared between females and males, age groups, and the year of testing (2003–2021).
Results
8283 females (57.6%) and 6087 males (42.4%) were tested. The average number of specific IgE tests per patient was 12.3 ± 11.4. Total IgE increased after birth with age and reached a peak between 4–6 years in males and 10–12 years in females. Males had higher specific IgE for all common aeroallergens (house dust mite, birch, mugwort and timothy grass pollen) and food allergens (milk protein, chicken egg white, peanut, wheat flour, cod) except for cat epithelia. Data closely reflected results of population-based studies in the literature.
Conclusion
This study shows that, despite potential patient and test selection bias, the results of the quantitative IgE-dataset analysis closely reflect results of population-based data. Thus, as large cohorts can be examined with a minute amount of effort, this surrogate method appears promising to supplement epidemiology research.
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11
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Biomarkers to Predict Response to Inhaled Corticosteroids and Long-Acting Muscarinic Antagonists in Adolescents and Adults with Mild Persistent Asthma. Ann Am Thorac Soc 2022; 19:372-380. [PMID: 34793687 PMCID: PMC8937224 DOI: 10.1513/annalsats.202105-613oc] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Rationale: Whether biomarkers can be used to predict response to inhaled corticosteroids (ICS) or long-acting muscarinic antagonists (LAMA) in mild persistent asthma is unclear. Objectives: In a prespecified exploratory analysis of a randomized clinical trial of 295 participants 12 years of age or older with uncontrolled mild persistent asthma, we sought to identify biomarkers of treatment response after 12 weeks of ICS (mometasone, 200 μg or 220 μg twice/d), LAMA (tiotropium, 5 μg/d), or placebo in adults (⩾18 yr) and adolescents (12-17 yr) separately. Methods: The primary outcome was a composite outcome of asthma control (treatment failure, asthma control days, and forced expiratory volume in 1 second [FEV1]). Analyses examined type 2 inflammatory biomarkers and physiologic biomarkers. We assessed the area under the receiver operating characteristic curve (AUC) for response to ICS and LAMA (each versus placebo). An AUC of 0.5 suggests no discrimination, 0.7-0.8 is considered acceptable, more than 0.8-0.9 is considered excellent, and more than 0.9 is considered outstanding. Results: In 237 adults, sputum and blood eosinophil levels and fractional exhaled nitric oxide (FeNO) each predicted ICS response (AUCs: 0.61 [95% confidence interval (CI), 0.53-0.69], 0.64 [95% CI, 0.56-0.72], and 0.62 [95% CI, 0.54-0.70], respectively; all P < 0.01); the AUC for blood eosinophil levels and FeNO together was 0.66 (95% CI, 0.58-0.74; P < 0.001). In 58 adolescents, the number of positive aeroallergens and total serum immunoglobulin E each predicted ICS response (AUCs: 0.69 [95% CI, 0.52-0.85] and 0.73 [95% CI, 0.58-0.87], respectively; both P < 0.03); the AUC for both together was 0.73 (95% CI, 0.58-0.87; P = 0.003). After ipratropium bromide, FEV1 reversibility predicted LAMA response in adults (AUC: 0.61 [95% CI, 0.53-0.69], P = 0.007) but not in adolescents. Conclusions: The AUCs of the type 2 inflammatory biomarkers and physiological biomarkers we examined may not be high enough to confidently identify individuals with asthma who respond to ICS and LAMA. However, our findings indicate that the biomarkers that predict response to ICS or LAMA may differ in adults versus adolescents with uncontrolled mild persistent asthma. Prospective, biomarker-stratified clinical trials are needed to confirm these findings and to identify first-line controllers tailored for each population.
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12
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Chen B, Yang J, Song Y, Zhang D, Hao F. Skin Immunosenescence and Type 2 Inflammation: A Mini-Review With an Inflammaging Perspective. Front Cell Dev Biol 2022; 10:835675. [PMID: 35281103 PMCID: PMC8908007 DOI: 10.3389/fcell.2022.835675] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
Skin-resident stromal cells, including keratinocytes, fibroblasts, adipocytes, and immune cells including Langerhans cells, dendritic cells, T cells, and innate lymphoid cells, and their functional products work in concert to ensure the realization of skin barrier immunity. However, aging-induced immunosenescence predisposes the elderly to pruritic dermatoses, including type 2 inflammation-mediated. Inflammaging, characterized by chronic low level of pro-inflammatory cytokines released from senescent cells with the senescence-associated secretory phenotype (SASP), may drive immunosenescence and tangle with type 2 inflammatory dermatoses. The present mini-review summarizes current evidence on immunosenescence and type 2 inflammation in the skin and further focuses on future needs from an inflammaging perspective to clarify their complexity.
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Affiliation(s)
- Bangtao Chen
- Department of Dermatology, Chongqing University Three Gorges Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Jing Yang
- Department of Dermatology, Chongqing University Three Gorges Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Yao Song
- Department of Dermatology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Daojun Zhang
- Department of Dermatology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fei Hao
- Department of Dermatology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Fei Hao,
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13
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Yokoi H, Matsumoto Y, Kawada M, Sakurai H, Saito K. Pollen Allergy Screening with Allergen-Specific and Total Immunoglobulin E Titers. ALLERGY & RHINOLOGY 2022; 13:21526575221079260. [PMID: 35359700 PMCID: PMC8961393 DOI: 10.1177/21526575221079260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Allergic rhinitis is a typical type I hypersensitivity reaction, commonly
caused by inhalant allergens. Accurate identification of the causative
antigen is important for rapid diagnosis and treatment initiation. Objective This study examined the efficiency of serum-based allergen-specific
immunoglobulin E and total immunoglobulin E antibody titers in screening for
pollen allergy. We also examined the effect of cross-reactive carbohydrate
determinants on specific immunoglobulin E titers in screening for pollen
allergy, one of the causes of false positivity in specific immunoglobulin E
measurements. Methods A questionnaire was used to evaluate the symptoms of pollinosis among
participants who underwent a medical examination. One hundred and thirty-two
participants reported pollen allergy symptoms and 127 reported an absence of
symptoms. Specific immunoglobulin E levels were measured using the AlaSTAT
3g Allergy method. Seventeen components, including four types of
cross-reactive carbohydrate determinant-specific immunoglobulin E
antibodies, were measured and evaluated comparatively. Results The sensitivity and specificity of the tests in predicting the presence or
absence of pollen allergy were analyzed. The values of the areas under the
curves for immunoglobulin E antibody levels against cedar, cypress, orchard
grass, and ragweed pollen were 0.87, 0.82, 0.63, and 0.56, respectively. A
cross-reactive carbohydrate determinant-related false-positive effect on the
pollen specific immunoglobulin E titer was noted in pollen screening. Conclusion Cedar pollen-specific immunoglobulin E titers showed sufficient accuracy for
use in pollen allergy screening. The study of cross-reactive carbohydrate
determinants suggested that subjects who tested positive for pollen often
had false-positive results due to the impact of cross-reactive carbohydrate
determinants.
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Affiliation(s)
- Hidenori Yokoi
- Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, Tokyo Japan
| | - Yuma Matsumoto
- Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, Tokyo Japan
| | - Michitsugu Kawada
- Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, Tokyo Japan
| | - Hiroyuki Sakurai
- Department of Pharmacology, Kyorin University School of Medicine, Tokyo Japan
| | - Koichiro Saito
- Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, Tokyo Japan
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14
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Tsolakis N, Jacinto T, Janson C, Borres M, Malinovschi A, Alving K. Relationship between longitudinal changes in type-2 inflammation, immunoglobulin E sensitization, and clinical outcomes in young asthmatics. Clin Transl Allergy 2021; 11:e12066. [PMID: 34582101 PMCID: PMC9083004 DOI: 10.1002/clt2.12066] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 08/25/2021] [Accepted: 09/16/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Asthma is a heterogeneous condition where biomarkers may be of considerable advantage in diagnosis and therapy monitoring. However, the changes in asthma biomarkers and immunoglobulin E (IgE) over the course of life has not been extensively investigated. OBJECTIVE To study longitudinal changes in type-2 inflammatory biomarkers, IgE, and clinical outcomes, and the association between these changes, in young asthmatics. METHODS Asthmatics (age 10-35 years, n = 253) were examined at baseline and at a follow-up visit, 43 [23-65] (median [range]) months later. Subjects were analyzed using the multi-allergen tests Phadiatop and fx5 (ImmunoCAP) and grouped based on the baseline allergen-specific IgE antibody (sIgE) concentration: <0.10, 0.10-0.34, and ≥0.35 kUA /L. The relationship between changes (Δ values) in type-2 biomarkers (individualized fraction of exhaled nitric oxide [FeNO%], blood eosinophil [B-Eos] count, total IgE [tIgE] and sIgE, lung function [% predicted forced expiratory volume in 1 second (FEV1 ) and FEV1 /forced vital capacity (FVC)], and Asthma Control Test [ACT]) score were determined. RESULTS At follow up, FEV1 and FEV1 /FVC had decreased (93.6% vs. 95.8%, and 93.4% vs. 94.7% of predicted, respectively [p < 0.001 both]), whereas ACT score had increased (21.6 vs. 20.6, p = 0.001). A significant decline in lung function was seen in subjects with sIgE ≥ 0.10 kUA/L, but not in those with undetectable sIgE (<0.10 kUA /L). Furthermore, tIgE and sIgE declined over time (p < 0.001 all) whereas FeNO% and B-Eos count were not significantly changed. In univariate analysis, significant negative correlations between ∆B-Eos count and ∆FeNO%, on one hand, and changes in lung function, on the other hand, were seen, and multivariate analysis showed an independent relationship between ΔFeNO%, and ΔFEV1 (p < 0.05) and ΔFEV1 /FVC% (p < 0.01). Sex-specific analysis showed that the independent association between ΔFeNO%, and ΔFEV1 remained only in females (p = 0.005), and there was a significant interaction with sex (p = 0.02). CONCLUSION In young asthmatics, IgE levels declined over 43 months, whereas FeNO and B-Eos remained unchanged. In spite of improved asthma control, an accelerated lung function decline was seen in patients with detectable sIgE at baseline, and the decline correlated with changes in type-2 biomarkers. Particularly, the increase in individualized FeNO associated independently with decline in FEV1 in females.
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Affiliation(s)
- Nikolaos Tsolakis
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | | | - Magnus Borres
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,ImmunoDiagnostics, Thermo Fisher Scientific, Uppsala, Sweden
| | | | - Kjell Alving
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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15
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Altaii HA, Al-Tae FMD. Investigation of Serum Total IgE and Eosinophil Levels in Different Allergic Diseases Together with the Study of Their Correlations with Various Possible Allergens in Mosul City. Immunol Invest 2020; 51:567-587. [PMID: 33283561 DOI: 10.1080/08820139.2020.1853154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Serum total IgE (tIgE) is frequently used in the diagnosis of allergic diseases in Mosul city and Iraq. However, neither normal nor elevated levels can exclude or confirm the diagnosis of these diseases. Here, we tried to evaluate the validity of tIgE in the diagnosis of allergic asthma(AS), allergic rhinitis(AR) and atopic dermatitis(AD) in a sample of Mosul population, to set up an optimum cut-off value for diagnosis of these diseases and to study its correlation with different parameters that might affect its level. 38 patients with AS, 27 with AR, 46 with AD and 45 healthy controls were included in this study. tIgE were determined by ELISA and compared between allergic diseases and controls. Blood eosinophilia was ascertained and correlated with tIgE levels. The geometric means of tIgE were 316.87 IU/ml (95% CI: 234.69 to 427.82) in AS, 262.07 IU/ml (95% CI:174.24 to 394.18) in AR and 270.48 IU/ml (95% CI:202.57 to 361.16) in AD compared to 16.90 IU/ml (95% CI:12.32 to 23.18) in healthy controls. tIgE in allergic diseases was significantly increased in comparison to healthy controls (P <.0001). Female gender influenced tIgE in AS, but not in AR or AD. tIgE predominated in younger age groups; however, no significant difference was found between younger and older groups. Optimum values for tIgE with best discriminative accuracy were 77 IU/ml for AS and 81 IU/ml for AR and AD. Eosinophils count appeared to be a useful adjunct, and correlate well with tIgE in the diagnosis of allergic diseases.
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Affiliation(s)
- Hiyam A Altaii
- Department of Biology, College of Science, University of Mosul, Mosul, Iraq
| | - Firas M D Al-Tae
- Department of Microbiology and Immunology, College of Medicine, University of Mosul, Mosul, Iraq
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16
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González-Pérez R, Poza-Guedes P, Pineda F, Forstenlechner P, Castillo M, Mederos-Luís E, Aumayr M, Matheu V, Alava-Cruz C, Sánchez-Machín I. Mite Molecular Profile in the Th2-Polarized Moderate-to-Severe Persistent Asthma Endotype Subjected to High Allergen Exposure. Int Arch Allergy Immunol 2020; 182:21-31. [PMID: 32927455 DOI: 10.1159/000510118] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/10/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The association among the IgE responses to prevailing groups of house dust mite (HDM) allergens in the concurrent asthma phenotypes has not been determined. OBJECTIVE The aim of the present study lays on a component-resolved diagnosis (CRD) model to investigate the mite molecular signature in subjects with type-2 inflammation asthma. METHODS We selected patients showing a clinically relevant sensitization to HDMs with moderate-to-severe persistent asthma. Skin prick test (SPT) with standardized mite extracts, a broad customized CRD serum sIgE panel including 9 Dermatophagoides pteronyssinus allergens and the related protein allergenic characterization, was investigated in all serum samples. RESULTS Ninety out of 93 (96.77%) patients with a positive SPT to HDM showed a concordant sIgE (≥0.35 kUA/L) to the crude extract of D. pteronyssinus. Major allergens (Der p 2, Der p 23, and Der p 1) were present in >70% of all subjects, with mid-tier allergens (Der p 5, Der p 7, and Der p 21) reaching up to 51% in the present cohort. A complex pleomorphic repertoire of HDM molecules recognized by IgE was depicted, including 38 distinct profiles. CONCLUSIONS AND CLINICAL RELEVANCE The proposed CRD panel approach, containing the most prevalent HDM allergens, appeared to be sufficient to obtain a precise D. pteronyssinus molecular diagnosis in asthmatics with a climate-dependent high-mite allergen exposure and coexisting sensitization. A dominant role of both major and mid-tier allergens has been confirmed in moderate and severe persistent asthmatics with the preponderant Th2-high endotype.
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Affiliation(s)
- Ruperto González-Pérez
- Allergy Department, Hospital Universitario de Canarias, Tenerife, Spain, .,Severe Asthma Unit, Hospital Universitario de Canarias, Tenerife, Spain,
| | - Paloma Poza-Guedes
- Allergy Department, Hospital Universitario de Canarias, Tenerife, Spain.,Severe Asthma Unit, Hospital Universitario de Canarias, Tenerife, Spain
| | | | | | | | | | | | - Víctor Matheu
- Allergy Department, Hospital Universitario de Canarias, Tenerife, Spain
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17
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Kim JY, Rhee CS, Cho SH, Choe G, Kim DY, Han DH. House Dust Mite Sublingual Immunotherapy in Children Versus Adults With Allergic Rhinitis. Am J Rhinol Allergy 2020; 35:9-16. [DOI: 10.1177/1945892420931713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background There are only a few studies in which the clinical efficacy of SLIT has been compared between children and adults. In addition, there is a lack of research on other factors, associated with the treatment, including immunological parameters and quality of life (QOL). Objective To compare the effects of sublingual immunotherapy (SLIT) in adults and children on various factors: clinical efficacy, quality of life (QOL), satisfaction, immunological parameters, and adverse events. Methods Subjects who were sensitized to house dust mites and treated with SLIT for at least 2 years were enrolled. Seventy patients who completed questionnaires measuring nasal symptoms and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores and underwent serologic tests for immunological parameters at initial, 1-year, and 2-year follow-up were selected and divided into two groups based on age: a child group (age 4–12 years, n = 44) and an adult group (age 19–59 years, n = 26). Results The Total Nasal Symptom Score (TNSS) was significantly decreased after 2 years of SLIT in both the child and adult groups ( p < 0.001, both); however, changes in TNSS from baseline did not significantly differ between the two groups ( p = 0.365). More patients in adult group were satisfied with SLIT than those in child group ( p = 0.050), and changes in RQLQ score from baseline tended to be larger in adult group ( p = 0.089). The levels of immunological parameters at baseline were significantly higher in the child group than in the adult group; however, changes in the levels of these parameters were not significantly different. Conclusion Although more adult patients were satisfied with SLIT, the clinical effects of SLIT on nasal symptoms were comparable between child and adult groups. Despite different immunological values at baseline between the two groups, changing patterns of immunological parameters did not differ.
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Affiliation(s)
- Jin Youp Kim
- Department of Otorhinolaryngology, Armed Forces Capital Hospital, Seongnam, Korea
| | - Chae-Seo Rhee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
- Graduate School of Immunology, Seoul National University College of Medicine, Seoul, Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Biomedical Research Center, Seoul, Korea
- Sensory Organ Research Institute, Seoul National University Biomedical Research Center, Seoul, Korea
| | - Seong H. Cho
- Division of Allergy and Immunology, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Goun Choe
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Dong-Young Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Doo Hee Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
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18
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Whiteside S, Chin A, Tripathi G, Dharmani-Khan P, Markova M, Keslova P, Sedlacek P, Geddes MN, Lewis V, Modi M, Kalra A, Dabas R, Akhter A, Larratt L, van Slyke T, Brandwein J, Spellman SR, Leigh R, Daly A, Khan FM, Storek J. Curability and transferability of atopy with allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 2020; 55:1282-1289. [PMID: 32231249 DOI: 10.1038/s41409-020-0876-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 03/07/2020] [Accepted: 03/16/2020] [Indexed: 12/29/2022]
Abstract
Atopy is excessive production of IgE in response to allergens. We evaluated in patients undergoing allogeneic hematopoietic cell transplantation (HCT) the following hypotheses: (1) Atopy is "curable" in atopic patients receiving HCT from a nonatopic donor (D-R+), and (2) Atopy is transferable from atopic donors to nonatopic recipients (D+R-). Atopic patients with atopic donors (D+R+) and non-atopic patients with non-atopic donors (D-R-) served as controls. We measured levels of multiallergen-specific IgE (A-IgE, atopy defined as ≥0.35 kUA/L) in sera from 54 patients and their donors pre HCT and from the patients at ≥2 years post HCT. Only 7/12 (58%) D- R+ patients became nonatopic after HCT. Only 1/11 (9%) D+R- patients became atopic. Eleven of 13 (85%) D-R- patients remained nonatopic. Unexpectedly, 11/18 (61%) D+R+ patients became nonatopic. In conclusion, contrary to our hypothesis and previous reports, the "cure" of atopy may occur in only some D-R+ patients and the transfer of atopy may occur rarely. The "cure" may not be necessarily due to the exchange of atopic for nonatopic immune system, as the "cure" may also occur in D+R+ patients.
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Affiliation(s)
| | - Alex Chin
- University of Calgary, Calgary, AB, Canada.,Alberta Public Laboratories, Calgary, AB, Canada
| | - Gaurav Tripathi
- University of Calgary, Calgary, AB, Canada.,Alberta Health Services, Calgary and Edmonton, AB, Canada
| | - Poonam Dharmani-Khan
- University of Calgary, Calgary, AB, Canada.,Alberta Health Services, Calgary and Edmonton, AB, Canada
| | - Marketa Markova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Petra Keslova
- 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Petr Sedlacek
- 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Michelle N Geddes
- University of Calgary, Calgary, AB, Canada.,Alberta Health Services, Calgary and Edmonton, AB, Canada
| | - Victor Lewis
- University of Calgary, Calgary, AB, Canada.,Alberta Health Services, Calgary and Edmonton, AB, Canada
| | | | - Amit Kalra
- University of Calgary, Calgary, AB, Canada
| | - Rosy Dabas
- University of Calgary, Calgary, AB, Canada
| | | | - Loree Larratt
- Alberta Health Services, Calgary and Edmonton, AB, Canada.,University of Alberta, Edmonton, AB, Canada
| | - Tiffany van Slyke
- Alberta Health Services, Calgary and Edmonton, AB, Canada.,University of Alberta, Edmonton, AB, Canada
| | - Joseph Brandwein
- Alberta Health Services, Calgary and Edmonton, AB, Canada.,University of Alberta, Edmonton, AB, Canada
| | - Stephen R Spellman
- Immunobiology Research, Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA
| | - Richard Leigh
- University of Calgary, Calgary, AB, Canada.,Alberta Health Services, Calgary and Edmonton, AB, Canada
| | - Andrew Daly
- University of Calgary, Calgary, AB, Canada.,Alberta Health Services, Calgary and Edmonton, AB, Canada
| | - Faisal M Khan
- University of Calgary, Calgary, AB, Canada.,Alberta Public Laboratories, Calgary, AB, Canada
| | - Jan Storek
- University of Calgary, Calgary, AB, Canada.,Alberta Health Services, Calgary and Edmonton, AB, Canada
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19
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Carvalho V, Olej B, Rodrigo de Moraes J, Boechat JL. Mometasone furoate is not superior to saline for chronic rhinitis in the elderly. World Allergy Organ J 2019; 12:100064. [PMID: 31641400 PMCID: PMC6796772 DOI: 10.1016/j.waojou.2019.100064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 08/30/2019] [Accepted: 09/16/2019] [Indexed: 11/16/2022] Open
Abstract
Introduction Prevalence of diseases associated with ageing is rising; among these are the rhinologic problems. Chronic rhinitis appears as one of the most common worrisome nasal disorders in this age group. At the same time, the allergic form diminishes because of the immunosenescence. Objective This study aimed to evaluate the effect of a corticosteroid nasal spray (mometasone furoate) over nasal patency and the severity of rhinitis and its impacts on quality of life as compared with the saline nasal spray. Methods This open label-trial randomized subjects ≥60y with chronic rhinitis (allergic and nonallergic rhinitis) with mometasone spray 100mcg/d and isotonic saline nasal spray or saline alone for two weeks. The primary endpoint was the improvement in nasal patency evaluated by the peak nasal inspiratory flow (PNIF). Secondary outcomes included the severity of symptoms and the quality of life assessed by a visual analogic scale (VAS) and the sinonasal outcome test (SNOT-22), respectively. Results Forty patients underwent randomization, in equal number in each group of treatment, either with allergic (AR) and nonallergic rhinitis (NAR). At week 2, the mean PNIF score was 79.5 in the corticosteroid (CE) plus saline group and 82.0 in the saline group (p = 0.37). Also, SNOT-22 and VAS were not improved with the addition of mometasone furoate. Conclusions Treatment with mometasone furoate nasal spray plus isotonic saline is not superior to saline alone in elderly patients with rhinitis in respect of improving nasal patency, quality of life, and reducing the intensity of symptoms. Trial registration The trial is registered at the Brazilian Clinical Trials Registry (ReBEC) #RBR-498bnq. Registered 05 July 2017.
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Affiliation(s)
- Victor Carvalho
- Unidade de Pesquisa Clínica, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense. Rua Marquês do Paraná, 303, 4º andar, Niterói, 24033-900, Rio de Janeiro, Brazil
| | - Beni Olej
- Unidade de Pesquisa Clínica, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense. Rua Marquês do Paraná, 303, 4º andar, Niterói, 24033-900, Rio de Janeiro, Brazil
| | - José Rodrigo de Moraes
- Instituto de Matemática e Estatística, Universidade Federal Fluminense. Rua Professor Marcos Waldemar de Freitas Reis, Campus do Gragoatá, Niterói, Rio de Janeiro, Brazil
| | - Jose Laerte Boechat
- Departamento de Alergia e Imunologia, Faculdade de Medicina, Universidade Federal Fluminense. Rua Marquês do Paraná, 303, 2º andar, Niterói, Rio de Janeiro, Brazil
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He H, Li R, Choi S, Zhou L, Pavel A, Estrada YD, Krueger JG, Guttman-Yassky E. Increased cardiovascular and atherosclerosis markers in blood of older patients with atopic dermatitis. Ann Allergy Asthma Immunol 2019; 124:70-78. [PMID: 31622668 DOI: 10.1016/j.anai.2019.10.013] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 10/02/2019] [Accepted: 10/06/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) is associated with increased systemic inflammation and cardiovascular risk. Although previous studies have found increased inflammatory proteins in the blood of patients with AD, detailed comparison among patients with AD of different ages is unavailable. OBJECTIVE To characterize the blood proteomic signature of patients with AD as a function of age. METHODS We used the OLINK high-throughput proteomic assay to measure serum inflammatory and cardiovascular risk proteins in 71 patients with moderate to severe AD from 3 age groups (18-40 years old [n = 26], 41-60 years old [n = 24], and >60 years old [n = 21]) compared with 37 age-matched controls. Total and allergen-specific serum IgEs were also measured. RESULTS When we compared patients with AD from 3 different age groups with their respective controls, we identified a total of 172 differentially expressed proteins. TH2 chemokines (CCL13, CCL17) were consistently elevated in patients with AD across all ages (P < .05), whereas TH1 (CXCL10) and TH17 (KYNU, CCL20) markers incrementally increased with age in both patients with AD and healthy subjects. Elderly patients with AD (>60 years old) exhibited striking upregulation of key proinflammatory proteins, including markers of atherosclerosis (CCL4, CCL7, SORT1), cardiovascular risk (GDF15, MPO, ST2), cell adhesion (CDH3), and apoptosis (FAS; all P < .05) compared with younger patients with AD and age-matched controls. We also found that total and allergen-specific serum IgEs decreased significantly with age in patients with AD (P < .05). CONCLUSION Elderly patients with AD had increased levels of systemic inflammatory markers, including those associated with cardiovascular and atherosclerosis risk, which may explain their increased incidence of cardiovascular disease. This finding suggests that older patients with AD may benefit from cardiovascular disease screening and prevention.
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Affiliation(s)
- Helen He
- Department of Dermatology, Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Randall Li
- Department of Dermatology, Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Seulah Choi
- Department of Dermatology, Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Lisa Zhou
- Department of Dermatology, Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ana Pavel
- Department of Dermatology, Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Yeriel D Estrada
- Department of Dermatology, Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, New York
| | - James G Krueger
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, New York
| | - Emma Guttman-Yassky
- Department of Dermatology, Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, New York.
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Williamson S, Merritt J, De Benedetto A. Atopic dermatitis in the elderly: a review of clinical and pathophysiological hallmarks. Br J Dermatol 2019; 182:47-54. [PMID: 30895603 DOI: 10.1111/bjd.17896] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a multifactorial and complex disease, characterized by an impaired skin barrier function and abnormal immune response. Many elderly patients present with pruritus and xerosis to dermatology, allergy and primary care clinics, and there is a lack of information available to clinicians regarding the proper diagnosis and management of these patients. Although the elderly are described as having a distinct presentation of AD and important comorbidities, most investigations and clinical care guidelines pertaining to AD do not include patients aged 60 years and older as a separate group from younger adults. OBJECTIVES To summarize current information on pathophysiology, diagnosis and management of AD in the elderly population and identify areas of insufficient information to be explored in future investigations. METHODS We carried out a systematic review of published literature, which assessed changes in the skin barrier and immune function with ageing and current information available for physicians to use in the diagnosis and treatment of AD in elderly patients. RESULTS Many age-related changes overlap with key hallmarks observed in AD, most notably a decline in skin barrier function, dysregulation of the innate immune system, and skewing of adaptive immunity to a type-2 T helper cell response, in addition to increased Staphylococcus aureus infection. CONCLUSIONS While general physiological alterations with ageing overlap with key features of AD, a research gap exists regarding specific ageing-related changes in AD disease development. More knowledge about AD in the elderly is needed to establish firm diagnostic and treatment methodologies. What's already known about this topic? Atopic dermatitis (AD) is a common inflammatory skin disease that causes significant burden worldwide. Recently, elderly patients have been considered a subgroup of patients with distinct AD manifestation. Limited studies have characterized the clinical presentation and role of IgE-mediated allergy in elderly patients with AD. What does this study add? This review offers a summary of age-related skin and immune alterations that correspond to pathogenic changes noted in patients with AD. The role of itch, environmental factors and skin microbiota in AD disease presentation in ageing patients is explored.
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Affiliation(s)
- S Williamson
- Department of Dermatology, College of Medicine, University of Florida, Gainesville, FL, U.S.A
| | - J Merritt
- Department of Dermatology, College of Medicine, University of Florida, Gainesville, FL, U.S.A
| | - A De Benedetto
- Department of Dermatology, College of Medicine, University of Florida, Gainesville, FL, U.S.A
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Forcelini CM, Ramos M, Santos IFD, Brackmann G, Bernardon LG, Corbellini APZ, Perin BV. The influence of allergic rhinoconjunctivitis on migraine disability in children. ARQUIVOS DE NEURO-PSIQUIATRIA 2019; 77:418-423. [PMID: 31314844 DOI: 10.1590/0004-282x20190058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 04/03/2019] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Migraine is a common condition in the pediatric population and causes a significant impact on the quality of life. Atopic disorders are some of the migraine comorbidities. We hypothesized that allergic rhinitis could aggravate migraine in the pediatric population. METHODS This cross-sectional study consecutively evaluated 90 pediatric outpatients (46 children 6-12 years of age; 44 adolescents up to 18 years of age) who sought medical assistance because of migraine at a general neurology clinic in Passo Fundo, RS, Brazil. They, and their parents, were given three questionnaires, to evaluate the diagnosis of current allergic rhinitis, allergic rhinoconjunctivitis and seasonal allergic rhinitis, as well as the disability caused by headache (ISAAC - International Study of Asthma and Allergies in Childhood; CARATkids - Control of Allergic Rhinitis and Asthma Test for Children; PedMIDAS - Pediatric Migraine Disability Assessment). The study was approved by the local ethics committee. RESULTS According to the ISAAC questionnaire, children with current allergic rhinoconjunctivitis in the last year showed higher scores on the PedMIDAS than those patients without atopy (median and interquartile range 26 [10-58] vs. 5 [1-13], p = 0.008). A significant positive correlation of CARATkids scores with PedMIDAS scores was found (p = 0.007, rho = 0.39). After including other putative predictors of migraine disability (age, body mass index, time since onset of migraine) in a multiple regression analysis, only the scores on the CARATkids remained a significant independent variable correlated with PedMIDAS scores (p = 0.001; R = 0.55; R2 = 0.30). CONCLUSIONS Current allergic rhinoconjunctivitis is related to enhanced disability caused by headache in childhood migraine.
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Affiliation(s)
| | - Matheus Ramos
- Universidade de Passo Fundo, Faculdade de Medicina, Passo Fundo, RS, Brasil
| | | | - Gabriela Brackmann
- Universidade de Passo Fundo, Faculdade de Medicina, Passo Fundo, RS, Brasil
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Age-specific changes in the molecular phenotype of patients with moderate-to-severe atopic dermatitis. J Allergy Clin Immunol 2019; 144:144-156. [DOI: 10.1016/j.jaci.2019.01.015] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 01/04/2019] [Accepted: 01/17/2019] [Indexed: 12/31/2022]
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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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Wei J, Jaleel T, MacLeod AS, Ji JS. Inverted U-shaped relationship between vitamin D and ever-reported eczema in US adults. Allergy 2019; 74:964-975. [PMID: 30589434 DOI: 10.1111/all.13708] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 11/12/2018] [Accepted: 11/26/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Eczema is a skin condition which affects up to 10% to 20% of people worldwide. Previous literature finds that low vitamin D levels may be a risk factor for eczema, but the association is not clear. METHODS We used the cross-sectional data from U.S. National Health and Nutrition Examination Survey 2005-2006. Adults were defined as 20 years and older. The association between eczema and serum 25-hydroxyvitamin D [25(OH)D] was estimated using multivariate logistic regression models adjusted for patient demographics, lifestyle variables, stress, and medical comorbidities. Restricted cubic spline analyses were performed to explore nonlinear relationship. We also stratified by race. RESULTS A total of 3921 adults were included in the analysis. The prevalence of ever-report of eczema was 7.94% in US adults. Reports of eczema were higher in people with higher socioeconomic status, depressive symptoms, previous history of asthma and hay fever, female, sampled in summer, and nonHispanic white. The logistic regression found higher odds ratio of eczema in vitamin D deficiency group (<50 nmol/L) compared to sufficiency group (>75 nmol/L) (OR = 1.81, 95% CI: 1.09-3.01, P = 0.02). The spline analysis found an inverted U-shaped relationship between eczema and serum 25(OH)D level. Eczema risk reached the highest at around 45 nmol/L, with decreasing risk in both directions away from this value. This relationship was absent in nonHispanic black population. CONCLUSION Vitamin D is associated with reports of eczema in nonHispanic white population, but not in the nonHispanic black population in the United States.
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Affiliation(s)
- Jia Wei
- Environmental Research Center Duke Kunshan University Kunshan China
| | - Tarannum Jaleel
- Department of Dermatology Duke University Medical Center Durham North Carolina
| | - Amanda S. MacLeod
- Department of Dermatology Duke University Medical Center Durham North Carolina
| | - John S. Ji
- Environmental Research Center Duke Kunshan University Kunshan China
- Nicholas School of the Environment Duke University Durham North Carolina
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Suh MJ, Park JA, Chang SW, Kim JH, Lee KH, Hong SC, Lee HS, Kang JW. Chronological changes in rhinitis symptoms present in school-aged children with allergic sensitization. PLoS One 2019; 14:e0210840. [PMID: 30653594 PMCID: PMC6336313 DOI: 10.1371/journal.pone.0210840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 01/02/2019] [Indexed: 11/30/2022] Open
Abstract
Introduction It is difficult to accurately predict the natural course of allergic rhinitis (AR), because it is affected by a wide variety of environmental influences, as well as genetic predisposition. Considering the high prevalence of allergic rhinitis in children and adolescents, caregivers should be given appropriate information regarding the disease course. This study aimed to understand the prognosis of allergic rhinitis by examining the relationship between allergic sensitization and rhinitis symptoms during this developmental period. Methods This cross-sectional study included 1069 children aged 9–16 years from the Korean International Study of Asthma and Allergies in Childhood Survey database who had completed health questionnaires, and for whom skin prick test results were available. Data were collected during May 2016. The distribution of sensitization and allergic symptoms was compared by age groups (elementary, middle, and high school). Data were analyzed using linear-by-linear analysis. Results Sensitization to at least one tested allergen differed by age (59.2%, 58.3%, 68.2%, in elementary, middle, and high school students, respectively; p = 0.025), and seasonal allergen sensitization (35.0%, 37.1%, 53.9%, respectively) increased with age (p < 0.001). Conversely, the proportion of rhinitis symptoms among sensitized children decreased as age increased (58.80%, 52.90%, 49.70%, respectively; p = 0.047). However, the rate of non-allergic rhinitis was age-independent. Conclusion With increasing age during childhood and adolescence, symptomatic allergic rhinitis decreases; thus, subclinical allergic rhinitis increases. This suggests that the symptoms of later-sensitized children are less clearly manifested, or that the symptoms reduce as previously sensitized children mature. This should be clarified further in a longitudinal study.
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Affiliation(s)
- Michelle J. Suh
- Department of Otorhinolaryngology, Jeju National University School of Medicine, Jeju, South Korea
| | - Jin A. Park
- Department of Otorhinolaryngology, Jeju National University School of Medicine, Jeju, South Korea
| | - Suk Won Chang
- Department of Otorhinolaryngology, Jeju National University School of Medicine, Jeju, South Korea
| | - Jeong Hong Kim
- Department of Otorhinolaryngology, Jeju National University School of Medicine, Jeju, South Korea
- The Environmental Health Center (Atopic Dermatitis and Allergic Rhinitis), Jeju National University, Jeju, South Korea
| | - Keun-Hwa Lee
- The Environmental Health Center (Atopic Dermatitis and Allergic Rhinitis), Jeju National University, Jeju, South Korea
| | - Seong-Chul Hong
- The Environmental Health Center (Atopic Dermatitis and Allergic Rhinitis), Jeju National University, Jeju, South Korea
| | - Hye-Sook Lee
- The Environmental Health Center (Atopic Dermatitis and Allergic Rhinitis), Jeju National University, Jeju, South Korea
| | - Ju Wan Kang
- Department of Otorhinolaryngology, Jeju National University School of Medicine, Jeju, South Korea
- The Environmental Health Center (Atopic Dermatitis and Allergic Rhinitis), Jeju National University, Jeju, South Korea
- * E-mail:
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Hong SD, Ryu G, Seo MY, Jeong JI, Kim HY, Chung SK, Dhong HJ. Optimal cutoff values of allergen-specific immunoglobulin E to house dust mites and animal dander based on skin-prick test results: Analysis in 16,209 patients with allergic rhinitis. Am J Rhinol Allergy 2018; 32:23-26. [PMID: 29336285 DOI: 10.2500/ajra.2018.32.4483] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The most common tests for allergen sensitization in patients with allergic rhinitis are the skin-prick test (SPT) and an in vitro test to detect serum specific immunoglobulin E (sIgE). However, in vitro allergen test results were interpreted dichotomically as positive or negative at a threshold of 0.35 kU/L of sIgE, regardless of the patient characteristics or antigen types. OBJECTIVE The purpose of this study was to determine the cutoff value for sIgE in house-dust mites and animal dander, and to analyze differences in cutoff value according to age and gender. METHODS A total of 16,209 patients with more than one allergic rhinitis symptom who underwent both SPT and serum sIgE testing were retrospectively evaluated between March 2008 and May 2012. There were 9374 male (57.8%) and 6835 female (42.2%) patients. The mean age was 31.8 years (range, 2-89 years). The criterion standard for allergen sensitization was defined as a wheal of >3 mm or an allergen-to-histamine ratio of ≥1 in SPT results. The Youden index was used to calculate the cutoff value of sIgE. RESULTS Cutoff values of sIgE for Dermatophagoides pteronyssinus, Dermatophagoides farinae, cat, and dog were 0.69, 1.16, 0.13, and 0.45 kU/L, respectively. The cutoff value of sIgE changed according to age for D. pteronyssinus and D. farinae but not for cat and dog allergens. When categorizing according to age group, the cutoff values of sIgE for D. pteronyssinus and D. farinae had a tendency to decrease with age. There was no significant difference in cutoff value according to gender. CONCLUSION The cutoff value for sIgE differed for each antigen and changed with age. Physicians should select the proper cutoff value for sIgE for appropriate criteria according to antigen and patient age rather than using a uniform cutoff value.
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Affiliation(s)
- Sang Duk Hong
- From the Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Gwanghui Ryu
- From the Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Min Young Seo
- From the Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jong In Jeong
- Department of Otorhinolaryngology, Keimyung University College of Medicine, Daegu, South Korea
| | - Hyo Yeol Kim
- From the Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seung-Kyu Chung
- From the Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hun-Jong Dhong
- From the Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Sharma M, Khaitan T, Raman S, Jain R, Kabiraj A. Determination of Serum IgE and Eosinophils as a Diagnostic Indicator in Allergic Rhinitis. Indian J Otolaryngol Head Neck Surg 2018; 71:1957-1961. [PMID: 31763276 DOI: 10.1007/s12070-018-1383-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 04/27/2018] [Indexed: 10/17/2022] Open
Abstract
Allergic Rhinitis is a chronic, inflammatory disease induced by an IgE-mediated reaction and identified clinically by the presence of symptoms of nasal discharge, itching, sneezing and nasal congestion. The aim and objectives of the study was to determine serum IgE and eosinophil levels in patients with allergic rhinitis and healthy controls, men and women, different age groups and to establish a correlation between serum IgE and eosinophil. A retrospective study was conducted in the outpatient department of ENT in ICARE institute of medical sciences and research, Haldia during the time span of March 2016 to February 2017. A total of 155 subjects (113 cases and 42 controls, 74 men and 81 women) of age 1 month-75 years were selected for the study. Blood samples obtained were analyzed to determine serum IgE and eosinophil levels and the results were subjected to statistical analysis using STATA 12 software. The mean values and standard deviation of the serum log IgE and eosinophil levels in cases and healthy controls, men and women, various age groups were obtained and tabulated using paired t test and MV test. Pearson's correlation was performed to establish a relationship between serum log IgE and eosinophil levels. The mean values of serum log IgE and eosinophil levels were found to be higher in cases (log IgE-5.65, IgE-814.36 IU/ml, eosinophil-4.49%) when compared to controls (log IgE-4.43, IgE-96.62 IU/ml, eosinophil-2.36%). Men predominance was seen in mean serum log IgE levels (IgE-1018.5 IU/ml, log IgE-5.92) whereas women predominance in mean eosinophil counts (4.96%) in allergic rhinitis. A weakly positive correlation of 0.194 was established between serum log IgE and eosinophil levels. Estimation of serum IgE and eosinophil can serve as a simple, non-invasive and reliable investigative tool in the diagnosis of allergic rhinitis.
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Affiliation(s)
- Manuprita Sharma
- 1Department of ENT, ICARE Institute of Medical Sciences and Research, Haldia, West Bengal 721645 India
| | - Tanya Khaitan
- 2Department of Oral Medicine and Radiology, Dental Institute, RIMS, Ranchi, Jharkhand 834009 India
| | - Santosh Raman
- 3Department of ENT, Mata Gujri Memorial Medical College, Kishanganj, Bihar 855108 India
| | - Ritika Jain
- 4Centre for Development Studies, Trivandrum, 695011 India
| | - Arpita Kabiraj
- Department of Oral Pathology and Microbiology, Index Institute of Dental Sciences, Indore, Madhya Pradesh 452016 India
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Kang IH, Jeong KH, Lee MH, Shin MK. Atopic labial pigmentation: a new diagnostic feature in Asian patients with atopic dermatitis. Int J Dermatol 2018; 57:817-821. [DOI: 10.1111/ijd.14010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 03/22/2018] [Accepted: 04/02/2018] [Indexed: 01/15/2023]
Affiliation(s)
- In-Hye Kang
- Department of Dermatology; School of Medicine; Kyung Hee University; Seoul Korea
| | - Ki-Heon Jeong
- Department of Dermatology; School of Medicine; Kyung Hee University; Seoul Korea
| | - Mu-Hyoung Lee
- Department of Dermatology; School of Medicine; Kyung Hee University; Seoul Korea
| | - Min-Kyung Shin
- Department of Dermatology; School of Medicine; Kyung Hee University; Seoul Korea
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Yanagisawa S, Ichinose M. Definition and diagnosis of asthma-COPD overlap (ACO). Allergol Int 2018; 67:172-178. [PMID: 29433946 DOI: 10.1016/j.alit.2018.01.002] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 12/04/2017] [Indexed: 01/15/2023] Open
Abstract
It is now widely recognized that asthma and COPD can coexist as asthma-COPD overlap (ACO), but the preliminary attempts at providing universal guidelines for the diagnosis of ACO still need to be improved. We believe that a case can be made for devising guidelines for the diagnosis of this increasingly common disease that are specific to Japan. In this paper, we present our consensus-based description of ACO which we believe is realistic for use in our country. In addition, we cite the scientific evidence for our own "objective" features used to develop the criteria for COPD and asthma diagnosis. We acknowledge that they will need to be validated and updated over time, but hope the results will encourage further research on the characteristics and treatment of this commonly encountered clinical problem.
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Affiliation(s)
- Satoru Yanagisawa
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masakazu Ichinose
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
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Shrestha SK, Drews A, Sharma L, Pant S, Shrestha S, Neopane A. Relationship between total serum immunoglobulin E levels, fractional exhaled breath nitric oxide levels and absolute blood eosinophil counts in atopic and non-atopic asthma: a controlled comparative study. J Breath Res 2018; 12:026009. [PMID: 29068321 DOI: 10.1088/1752-7163/aa95da] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Asthma is a prevalent non-communicable disease both in low- and high-income countries, including Nepal. Total serum immunoglobulin E levels and peripheral blood absolute eosinophil counts are known inflammatory markers of asthma. Fractional exhaled nitric oxide measurement in breath has also been proposed as a non-invasive biomarker to assess eosinophilic airway inflammation. This study explores the correlation between these three variables with the intent that one may replace the other in resource-limited setups. APPROACH This prospective controlled trial evaluated 314 subjects with and without asthma, with the asthma group sub-divided into atopic and non-atopic categories. Total serum immunoglobulin E level, absolute eosinophil count in peripheral blood and fractional exhaled nitric oxide level were measured in all categories. RESULTS The geometric mean of immunoglobulin E levels, absolute eosinophil count and fractional exhaled nitric oxide were 221.07 ± 774.55 IU/mL, 214 ± 360/uL and 37 ± 49 ppb in the asthma group and 59.13 ± 174.32 IU/mL, 164 ± 137/uL and 12 ± 21 ppb in the control group, respectively. Significantly higher levels were seen in the asthma group for total serum immunoglobulin E (p < 0.001), AEC (p = 0.002) and FENO (p < 0.001) levels. Total serum immunoglobulin E levels, absolute eosinophil count and fractional exhaled nitric oxide were 436.79 ± 822.40 IU/mL, 269 ± 395/uL and 76 ± 52 ppb in atopic asthma group. Similarly, total serum immunoglobulin E levels, absolute eosinophil count and fractional exhaled nitric oxide were 131.17 ± 692.96 IU/mL, 182 ± 328/uL and 23 ± 22.5 ppb in non-atopic asthma group. Significantly higher levels were seen in all three variables: tIgE (p < 0.001), AEC (p = 0.008) and FENO (p < 0.001). A moderate degree of positive correlation was identified between tIgE and FENO50 (Spearman's rho = 0.461) and tIgE and AEC (Spearman's rho = 0.315) with only small correlation between FENO50 and AEC (Spearman's rho = 0.299). SIGNIFICANCE tIgE levels, FENO50 and AEC levels are higher in asthma, specifically in the atopic phenotype, as compared to normal. Total serum IgE levels have moderate correlation with FENO50 and AEC but FENO50 and AEC are weakly correlated.
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Affiliation(s)
- S K Shrestha
- Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal, PO Box. No. 21266
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D'Apolito M, Campanozzi A, Giardino I, Pettoello-Mantovani M. Levels of inflammatory cytokines from peripheral blood mononuclear cells of children with cow's milk protein allergy. Turk Arch Pediatr 2017; 52:208-212. [PMID: 29483800 DOI: 10.5152/turkpediatriars.2017.6290] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 11/03/2017] [Indexed: 12/19/2022]
Abstract
Aim The aim of the study was to investigate the level of cytokines in cultures of cow's milk protein- stimulated peripheral blood mononuclear cells of patients with cow's milk protein allergy. Material and Methods Eleven children with cow's milk protein allergy and 11 non-allergic controls were studied. Their peripheral blood mononuclear cells were cultured alone and in the presence of cow's milk α-lactalbumin; β-lactoglobulin; αS 1, αS 2, β, and κ-casein fraction mixtures; and a cow's protein mixture from whole milk. Production of cytokines, tumor necrosis factor-α, interleukin-10, and interleukin-12 were determined in culture supernatants. Results In cow's milk protein-stimulated peripheral blood mononuclear cell cultures of children with cow's milk protein allergy, tumor necrosis factor-α, interleukin-10, and interleukin-12 production was significantly higher than in non-allergic controls (p<0.05). No difference in cytokine production was found between cultures obtained from unstimulated peripheral blood mononuclear cell cultures of both cow's milk protein allergy and non-allergic controls. Conclusions The findings of this preliminary study align with data from the literature suggesting that the investigation of tumor necrosis factor-α, interleukin-10, and interleukin-12 in cow's milk protein-stimulated peripheral blood mononuclear cell cultures of children may be taken in further consideration to explore whether they might have a predictive role for cow's milk protein allergy. Further studies are therefore needed to extensively investigate this issue.
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Affiliation(s)
- Maria D'Apolito
- Pediatric Research Center, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Angelo Campanozzi
- Pediatric Research Center, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Ida Giardino
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Massimo Pettoello-Mantovani
- Pediatric Research Center, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.,University Pediatric Unit, Department of Pediatrics, Scientific Institute "Casa Sollievo della Sofferenza", University of Foggia, Italy.,European Paediatric Association/Union of National Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany
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Dutta S, Mondal P, Saha NC, Moitra S, Podder S, Ghosh A, Saha GK. Role of offending out-door aero-allergen and CD14 C(-159)T polymorphism in development and severity of asthma in a Kolkata patient population. Afr Health Sci 2017; 17:1101-1109. [PMID: 29937881 PMCID: PMC5870296 DOI: 10.4314/ahs.v17i4.18] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective Present study involved identification of offending out-door aero-allergens and associated genetic pathway in nasso-bronchial asthma among Kolkata population. Methods Skin-prick test was done among 950 asthmatic patients against 11 common aero-allergens and total serum IgE concentration was measured. PCR-RFLP was done in patients and non-asthmatic control (n=220 in each) to characterize functional polymorphism, C(-159)T, of CD14, a positional candidate gene for allergy. Association of genetic polymorphisms was made with clinico-pathological conditions. Results We identified Cocos nucifera as the most common aero-allergen sensitizer among atopic patients in Kolkata. Patients with childhood-onset asthma were significantly more sensitive towards aero-allergens and had significantly higher serum IgE level than those of adult-onset (p< 0.0001). No significant difference was found in distribution of SNP genotypes of CD14 among case and control (p=0.178). However among patients, frequency of C allele is significantly higher in childhood-onset group than that of adult-onset and concordantly in former CC genotype was associated with significant higher level of serum IgE than CT and TT. Conclusion In Kolkata, pollen is a common out-door aero-allergen and Cocos nucifera is predominant among pollens. Childhood-onset and adult-onset of asthma showed significant difference in allergen sensitivity as well as genetic background with respect to CD14 polymorphism.
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Kim H, Ellis AK, Fischer D, Noseworthy M, Olivenstein R, Chapman KR, Lee J. Asthma biomarkers in the age of biologics. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2017; 13:48. [PMID: 29176991 PMCID: PMC5691861 DOI: 10.1186/s13223-017-0219-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 10/25/2017] [Indexed: 02/08/2023]
Abstract
The heterogeneous nature of asthma has been understood for decades, but the precise categorization of asthma has taken on new clinical importance in the era of specific biologic therapy. The simple categories of allergic and non-allergic asthma have given way to more precise phenotypes that hint at underlying biologic mechanisms of variable airflow limitation and airways inflammation. Understanding these mechanisms is of particular importance for the approximately 10% of patients with severe asthma. Biomarkers that aid in phenotyping allow physicians to "personalize" treatment with targeted biologic agents. Unfortunately, testing for these biomarkers is not routine in patients whose asthma is refractory to standard therapy. Scientific advances in the recognition of sensitive and specific biomarkers are steadily outpacing the clinical availability of reliable and non-invasive assessment methods designed for the prompt and specific diagnosis, classification, treatment, and monitoring of severe asthma patients. This article provides a practical overview of current biomarkers and testing methods for prompt, effective management of patients with severe asthma that is refractory to standard therapy.
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Affiliation(s)
- Harold Kim
- Division of Clinical Immunology & Allergy, Department of Medicine, Western University, 1151 Richmond St, London, ON N6A 5C1 Canada
- Division of Clinical Immunology & Allergy, Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Anne K. Ellis
- Division of Allergy & Immunology, Department of Medicine, Queen’s University, 15 Arch Street, Kingston, ON K7L 3N6 Canada
- Department of Biomedical and Molecular Sciences, School of Medicine, Queen’s University, Kingston, ON Canada
| | - David Fischer
- Division of Clinical Immunology & Allergy, Department of Medicine, Western University, 1151 Richmond St, London, ON N6A 5C1 Canada
- Canadian Society of Allergy and Clinical Immunology, P.O. Box 51045, Orleans, ON K1E 3W4 Canada
| | - Mary Noseworthy
- Alberta Children’s Hospital, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4 Canada
| | - Ron Olivenstein
- Division of Respiratory Medicine, Faculty of Medicine, McGill University, 3605 Rue De la Montagne, Montreal, QC H3G 2M1 Canada
- Acute Care Division, Montreal Chest Institute, 1001 Décarie Blvd, Montreal, QC H4A 3J1 Canada
| | - Kenneth R. Chapman
- Asthma and Airway Centre, Toronto Western Hospital, University Health Network, 399 Bathurst Street, Toronto, ON M5T 2S8 Canada
- Division of Respirology, Department of Medicine, University of Toronto, 1 King’s College Circle, #3172, Toronto, ON M5S 1A8 Canada
| | - Jason Lee
- Toronto Allergy and Asthma Centre, 123 Edward St, Toronto, ON M5G 1E2 Canada
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, 30 Bond St, Toronto, ON M5B 1W8 Canada
- Department of Surgery, School of Medicine, University of Toronto, 1 King’s College Circle, #3172, Toronto, ON M5S 1A8 Canada
- Evidence Based Medical Educator Inc., 123 Edward St., Suite 920, Toronto, ON M5G 1E2 Canada
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Abstract
Recent studies suggest that allergic rhinitis is highly prevalent in the elderly population, but is underdiagnosed and undertreated. This review article briefly introduces allergic rhinitis in the elderly (epidemiology and pathophysiology) and identifies the main goals of treatment in these patients with respect to age-related physiological factors, comorbid conditions and polypharmacy. The primary focus of the article is a narrative review of the literature concerning the different types of treatment options in elderly patients aged 60+ years (pharmacological therapy and allergen-specific immunotherapy). The main management trend for allergic rhinitis in elderly patients is the same as the trend in young patients. Second-generation antihistamines and nasal glucocorticosteroids are also the first-line therapies in seniors. In a few trials, allergen-specific immunotherapy for grass pollen or house dust mites has been shown to be effective and safe in patients aged 60 years or older with allergic rhinitis. In conclusion, undertreatment of allergic rhinitis in the elderly is a reality. Pharmacological treatment is quite similar in both older and younger patients with allergic rhinitis.
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Nam YH, Lee SK. Comparison between skin prick test and serum immunoglobulin E by CAP system to inhalant allergens. Ann Allergy Asthma Immunol 2017; 118:608-613. [PMID: 28477791 DOI: 10.1016/j.anai.2017.03.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 03/07/2017] [Accepted: 03/10/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Skin prick tests (SPTs) and measurements of serum specific immunoglobulin E (sIgE) antibodies are the most commonly used diagnostic tools for confirming sensitization. However, disagreement between the tests has been observed. OBJECTIVE To compare SPT and the CAP system for diagnosis of sensitization to common inhalant allergens. METHODS Subjects included 2,635 patients 10 to 90 years old who underwent analyses by SPT and CAP at the Dong-A University Hospital (Busan, Korea) from June 2011 through May 2016. The 2 test results were compared for 17 inhalant allergens. RESULTS Agreement between the SPT and sIgE level was 75.3%. Overall agreement was moderate (κ = 0.59), with strong agreement for house dust mites and birch (κ > 0.7) and weak agreement for Tyrophagus putrescentiae and dog (κ < 0.3). When CAP was compared with SPT as the reference, the sensitivity was 75.8% and the specificity was 75.2%. Mean wheal size by SPT showed a positive correlation with sIgE levels (r = 0.59), which decreased with age. CONCLUSION There was a discrepancy between SPT and CAP for diagnosing allergic sensitization among inhalant allergens. The allergic sensitization and correlation between the tests decreased with age. Cautious interpretation of the clinical relevance of allergen sensitization based on SPT and CAP results is required, especially in older patients.
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Affiliation(s)
- Young-Hee Nam
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea
| | - Soo-Keol Lee
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea.
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Peters MC, Nguyen MLT, Dunican EM. Biomarkers of Airway Type-2 Inflammation and Integrating Complex Phenotypes to Endotypes in Asthma. Curr Allergy Asthma Rep 2017; 16:71. [PMID: 27613654 DOI: 10.1007/s11882-016-0651-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW Over the past decade, the most important advance in the field of asthma has been the widespread recognition that asthma is a heterogeneous disease driven by multiple molecular processes. RECENT FINDINGS The most well-established molecular mechanism in asthma is increased airway type-2 inflammation, and consequently, non-invasive biomarkers of increased airway type-2 inflammation, such as blood eosinophil counts or blood periostin levels, have proven important in stratifying asthma patients in clinical trials of type-2 cytokine inhibitors. However, it remains ambiguous how well these non-invasive biomarkers represent airway measures of type-2 inflammation in asthma. As a result, the utility of these biomarkers to assist with asthma management or as research tools to better understand asthma pathogenesis remains unclear. This article reviews primary data assessing biomarkers of airway type-2 inflammation in asthma and describes how the use of biomarkers can advance a precision medicine approach to asthma treatment.
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Affiliation(s)
- Michael C Peters
- The Airway Clinical Research Center, University of California, Box 0130, 505 Parnassus Avenue, San Francisco, CA, 94143, USA. .,Division of Pulmonary and Critical Care Medicine, University of California, Box 0130, 505 Parnassus Avenue, San Francisco, CA, 94143, USA. .,Cardiovascular Research Institute, University of California, Box 0130, 505 Parnassus Avenue, San Francisco, CA, 94143, USA.
| | | | - Eleanor M Dunican
- The Airway Clinical Research Center, University of California, Box 0130, 505 Parnassus Avenue, San Francisco, CA, 94143, USA.,Division of Pulmonary and Critical Care Medicine, University of California, Box 0130, 505 Parnassus Avenue, San Francisco, CA, 94143, USA.,Cardiovascular Research Institute, University of California, Box 0130, 505 Parnassus Avenue, San Francisco, CA, 94143, USA
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Labib M, Sargent EH, Kelley SO. Electrochemical Methods for the Analysis of Clinically Relevant Biomolecules. Chem Rev 2016; 116:9001-90. [DOI: 10.1021/acs.chemrev.6b00220] [Citation(s) in RCA: 555] [Impact Index Per Article: 69.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Mahmoud Labib
- Department
of Pharmaceutical Sciences, University of Toronto, Toronto, Ontario M5S 3M2, Canada
| | | | - Shana O. Kelley
- Department
of Pharmaceutical Sciences, University of Toronto, Toronto, Ontario M5S 3M2, Canada
- Institute
of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario M5S 3G4, Canada
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Tanei R, Hasegawa Y. Atopic dermatitis in older adults: A viewpoint from geriatric dermatology. Geriatr Gerontol Int 2016; 16 Suppl 1:75-86. [DOI: 10.1111/ggi.12771] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Ryoji Tanei
- Department of Dermatology; Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology; Itabashi Tokyo Japan
| | - Yasuko Hasegawa
- Department of Geriatric Pathology; Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology; Itabashi Tokyo Japan
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Odongo L, Mulyowa G, Goebeler M, Trautmann A. Bet v 1- and Bet v 2-Associated Plant Food Sensitization in Uganda and Germany: Differences and Similarities. Int Arch Allergy Immunol 2015; 167:264-9. [PMID: 26437181 DOI: 10.1159/000439533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 08/17/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Birch pollen allergy and concomitant plant food sensitization are well documented in Europe. However, there are currently no data available on pollen-associated plant food sensitization or even pollen allergy in tropical Africa. Our study aimed to investigate Bet v 1- and Bet v 2-associated plant food sensitization in atopic patients from Uganda and compare it with sensitization rates in German patients. METHODS Sera from 83 Ugandan and 97 German atopic patients were analysed using UniCAP100™ for allergen-specific IgE against the birch tree pollen allergens Bet v 1 and Bet v 2 as well as the plant foods hazelnut, apple, kiwi, pea, peach, cherry, litchi, peanut, and soy. RESULTS As expected, sensitization to Bet v 1 and cross-reactive plant food allergens was more common in German atopic patients. In contrast, the prevalence of sensitization against Bet v 2 was remarkably similar in Ugandan and German patients. Interestingly, in Ugandan patients we found IgE-mediated sensitization against plant foods such as hazelnut, pea, peach, cherry, and litchi that are neither cultivated nor consumed in Uganda. CONCLUSIONS For Ugandan atopic patients, sensitization against the Bet v 2 allergen (a plant profilin) may explain cross-reactivity to several plant foods which are not consumed in Uganda. Additionally, it is probable that sensitization of Ugandan atopics to alder pollen (Alnus acuminata, plant family Betulaceae) caused serological cross-reactivity with Betula verrucosa-related allergens.
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Affiliation(s)
- Leo Odongo
- Department of Dermatology, University Hospital Mbarara, Mbarara, Uganda
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Nakano-Tahara M, Terao M, Nishioka M, Kitaba S, Murota H, Katayama I. T Helper 2 Polarization in Senile Erythroderma with Elevated Levels of TARC and IgE. Dermatology 2015; 230:62-9. [DOI: 10.1159/000366502] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 08/07/2014] [Indexed: 11/19/2022] Open
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Jang HM, Yeo GS, Kim JH, Hwang CY, Hyun JE, Kim SS, Kang YH, Jung DI. Prevalence of serum allergen-specific immunoglobulin E for canine atopic dermatitis in Korea. J Biomed Res 2014. [DOI: 10.12729/jbr.2014.15.4.162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Factors associated with Culicoides Obsoletus complex spp.-specific IgE reactivity in Icelandic horses and Shetland ponies. Vet J 2014; 201:395-400. [DOI: 10.1016/j.tvjl.2014.04.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 04/04/2014] [Accepted: 04/30/2014] [Indexed: 11/18/2022]
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Linabery AM, Prizment AE, Anderson KE, Cerhan JR, Poynter JN, Ross JA. Allergic diseases and risk of hematopoietic malignancies in a cohort of postmenopausal women: a report from the Iowa Women's Health Study. Cancer Epidemiol Biomarkers Prev 2014; 23:1903-12. [PMID: 24962839 DOI: 10.1158/1055-9965.epi-14-0423] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Allergic diseases signify immune dysregulation attributable to underlying genetics and environmental exposures. Associations between various allergies and hematopoietic cancers have been observed, albeit inconsistently; however, few prospective studies have examined the risk, and even fewer among older adults. METHODS We examined risk of incident hematopoietic cancers in those reporting allergic diseases in a population-based cohort of 22,601 older women (Iowa Women's Health Study). Self-reported allergic status, including asthma, hay fever, eczema, and/or other allergies, was determined via questionnaire in 1997 (mean age, 72 years; range, 63-81 years). Incident cancers were ascertained by linkage with the Iowa Cancer Registry from 1997 to 2011. Cox proportional hazards regression was performed to estimate multivariate-adjusted HR and 95% confidence intervals (CI) for myeloid (N = 177) and lymphoid (N = 437) malignancies, respectively. RESULTS Allergic diseases were not associated with risk of myeloid (HR, 1.00; 95% CI, 0.72-1.37) or lymphoid (HR, 0.99; 95% CI, 0.81-1.22) malignancies overall, or for most allergic and malignant subtypes examined. Self-reported asthma was positively associated with development of myelodysplastic syndrome (MDS; HR, 2.00; 95% CI, 0.93-4.32). In addition, there was a 30% to 40% decrease in risk of both lymphoid and myeloid cancers in those reporting rural residences but no association in those reporting urban residences; the interaction between residence and allergy was statistically significant for lymphoid malignancies (Pinteraction = 0.05). CONCLUSIONS AND IMPACT These results suggest that asthma may contribute to the pathogenesis of MDS, a finding consistent with the chronic antigen stimulation hypothesis. Susceptibility differences by location of residence are concordant with the hygiene hypothesis and merit additional exploration.
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Affiliation(s)
- Amy M Linabery
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota. Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.
| | - Anna E Prizment
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Kristin E Anderson
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - James R Cerhan
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Jenny N Poynter
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota. Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Julie A Ross
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota. Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
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Nandi S, Aditya G, Chowdhury I, Das A, Saha GK. Chironomid midges as allergens: evidence from two species from West Bengal, Kolkata, India. Indian J Med Res 2014; 139:921-6. [PMID: 25109727 PMCID: PMC4165005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND & OBJECTIVES Arthropods of different taxonomic identity including chironomid midges are known to induce allergic response in humans. The present study was done to access two common chironomid species Chironomus circumdatus and Polypedilum nubifer for their sensitizing potential as an allergen in atopic patients and controls. METHODS Following preparation of allergenic extracts of the two chironomid species separately, 198 atopic patients attending an allergy clinic and 50 age matched controls were tested along with a routine panel of allergens to assess sensitization. RESULTS The skin prick test (SPT) results revealed that 189 of the 198 patients (95.4%) demonstrated sensitization to both the chironomid species. Higher levels of total IgE was observed in atopic subjects than in the control group. INTERPRETATION & CONCLUSIONS The results suggest that the chironomid midges Chironomus circumdatus and Polypedilum nubifer can elicit sensitization in humans. A potential risk for allergic reactions by susceptible individuals exists due to these chironomid species, owing to their abundance and chances of contact with human beings. Further studies may be initiated to characterize the nature of the allergens and to assess their clinical relevance.
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Affiliation(s)
- Soumi Nandi
- Department of Zoology, University of Calcutta, Kolkata, India
| | - Gautam Aditya
- Department of Zoology, University of Calcutta, Kolkata, India,Department of Zoology, The University of Burdwan, Burdwan, India
| | | | - Arijit Das
- Rittik Allergy & Asthma Treatment Centre, Kolkata, India
| | - Goutam K. Saha
- Department of Zoology, University of Calcutta, Kolkata, India,Reprint requests: Dr Goutam K. Saha, Department of Zoology, University of Calcutta 35, Ballygunge Circular Road, Kolkata 700 019, India e-mail:
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Prevalence of allergic sensitization in the United States: results from the National Health and Nutrition Examination Survey (NHANES) 2005-2006. J Allergy Clin Immunol 2014; 134:350-9. [PMID: 24522093 DOI: 10.1016/j.jaci.2013.12.1071] [Citation(s) in RCA: 238] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 12/06/2013] [Accepted: 12/11/2013] [Indexed: 12/31/2022]
Abstract
BACKGROUND Allergic sensitization is an important risk factor for the development of atopic disease. The National Health and Nutrition Examination Survey (NHANES) 2005-2006 provides the most comprehensive information on IgE-mediated sensitization in the general US population. OBJECTIVE We investigated clustering, sociodemographic, and regional patterns of allergic sensitization and examined risk factors associated with IgE-mediated sensitization. METHODS Data for this cross-sectional analysis were obtained from NHANES 2005-2006. Participants aged 1 year or older (n = 9440) were tested for serum specific IgEs (sIgEs) to inhalant and food allergens; participants 6 years or older were tested for 19 sIgEs, and children aged 1 to 5 years were tested for 9 sIgEs. Serum samples were analyzed by using the ImmunoCAP System. Information on demographics and participants' characteristics was collected by means of questionnaire. RESULTS Of the study population aged 6 years and older, 44.6% had detectable sIgEs, whereas 36.2% of children aged 1 to 5 years were sensitized to 1 or more allergens. Allergen-specific IgEs clustered into 7 groups that might have largely reflected biological cross-reactivity. Although sensitization to individual allergens and allergen types showed regional variation, the overall prevalence of sensitization did not differ across census regions, except in early childhood. In multivariate modeling young age, male sex, non-Hispanic black race/ethnicity, geographic location (census region), and reported pet avoidance measures were most consistently associated with IgE-mediated sensitization. CONCLUSIONS The overall prevalence of allergic sensitization does not vary across US census regions, except in early life, although allergen-specific sensitization differs based on sociodemographic and regional factors. Biological cross-reactivity might be an important but not the sole contributor to the clustering of allergen-specific IgEs.
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Kim EJ, Kwon JW, Lim YM, Yoon D, Seo JH, Chang WS, Kim HY, Park JW, Cho SH, Hong SJ, Lee JS. Assessment of Total/Specific IgE Levels Against 7 Inhalant Allergens in Children Aged 3 to 6 Years in Seoul, Korea. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2013; 5:162-9. [PMID: 23638315 PMCID: PMC3636451 DOI: 10.4168/aair.2013.5.3.162] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Revised: 08/17/2012] [Accepted: 09/26/2012] [Indexed: 11/20/2022]
Abstract
PURPOSE Childhood allergies are a serious problem, as they may lead to lifetime chronic disease. Determination of total and specific IgE levels is known to be a diagnostic tool for allergic sensitization; however, IgE levels are affected by various factors, such as age, sex, ethnicity, and geographic area. Thus, we evaluated the distribution of total and specific serum IgE levels against seven inhalant allergens in preschool children and examined their association with allergic diseases in Seoul, Korea. METHODS Total/specific serum IgE determination and skin prick tests for seven common allergens were performed on 509 children aged 3 to 6 years from 16 child care centers in Seoul, Korea. Demographic characteristics were surveyed from parents using a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. A diagnosis of atopic dermatitis was made by physicians. RESULTS The geometric mean of total IgE was 80.48±3.80 kU/L in preschool children. IgE levels were higher in boys (boys, 102.34±3.52 kU/L; girls, 62.37±3.93 kU/L; P<0.001) and atopic subjects (atopic, 158.00±3.35 kU/L; non-atopic, 52.75±3.44 kU/L; P<0.001). An increased prevalence of atopy was associated with a high monthly household income (P=0.004) and higher maternal education level (above university-level education; P=0.009), as well as increased total IgE levels (P=0.036). Physician-diagnosed atopic dermatitis was associated with sensitization to inhalant allergens. CONCLUSIONS Total IgE levels were very high as compared with those in previous reports from other countries. The most common sensitized allergen was Dermatophagoides farinae, and the positive response rate peaked at age 3 years and was maintained thereafter, particularly in boys. Specific IgE levels for seven inhalant allergens varied with age in preschool children. Although further investigations are needed with a broad range of ages and various allergens, the distribution of the total and specific serum IgE levels in preschool children might help to serve as a reference value to diagnose atopy.
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Affiliation(s)
- Eun-Jin Kim
- Allergy TF, Department of Immunology and Pathology, Korea National Institute of Health, Cheongwon, Korea
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48
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Potaczek DP, Kabesch M. Current concepts of IgE regulation and impact of genetic determinants. Clin Exp Allergy 2013; 42:852-71. [PMID: 22909159 DOI: 10.1111/j.1365-2222.2011.03953.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Immunoglobulin E (IgE) mediated immune responses seem to be directed against parasites and neoplasms, but are best known for their involvement in allergies. The IgE network is tightly controlled at different levels as outlined in this review. Genetic determinants were suspected to influence IgE regulation and IgE levels considerably for many years. Linkage and candidate gene studies suggested a number of loci and genes to correlate with total serum IgE levels, and recently genome-wide association studies (GWAS) provided the power to identify genetic determinants for total serum IgE levels: 1q23 (FCER1A), 5q31 (RAD50, IL13, IL4), 12q13 (STAT6), 6p21.3 (HLA-DRB1) and 16p12 (IL4R, IL21R). In this review, we analyse the potential role of these GWAS hits in the IgE network and suggest mechanisms of how genes and genetic variants in these loci may influence IgE regulation.
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Affiliation(s)
- D P Potaczek
- Department of Pediatric Pneumology, Allergy and Neonatology, Hannover Medical School, Hannover, Germany
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Abstract
Asthma in the adult patient is a complex clinical syndrome. Multiple patient phenotypes and subphenotypes exist that contribute to disease heterogeneity. Whether adult asthma begins in utero, develops in childhood, or manifests for the first time in adulthood is not completely understood, nor are the mechanisms fully delineated. In this chapter, we update definitions that apply to this group, emphasize epidemiologic factors and pathogenic mechanisms, diagnosis, therapeutic options, and controversies regarding drug safety. Finally, we provide a brief discussion of biomarker technologies and novel therapies with the potential to impact adult-onset asthma outcomes.
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Affiliation(s)
- Amir A Zeki
- UC Davis School of Medicine, Davis, CA, USA.
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Lee S, Ahn K, Paik HY, Chung SJ. Serum immunoglobulin E (IgE) levels and dietary intake of Korean infants and young children with atopic dermatitis. Nutr Res Pract 2012. [PMID: 23198022 PMCID: PMC3506874 DOI: 10.4162/nrp.2012.6.5.429] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Atopic dermatitis (AD) has become a serious epidemic in Korean children. We aimed to investigate the association between vitamin C, E and other nutrients, and serum total IgE/specific IgE levels in children with AD. A total of 119 children (0-24 mo) diagnosed with AD were recruited for this cross-sectional study from a medical center in Seoul. A 24 h recall was used to assess dietary intakes. Serum total and six food-allergen specific IgE levels were measured by CAP-FEIA. Serum vitamin E was also measured but only in 25 out of the total 119 participants. Multiple linear regression analysis was performed to estimate the coefficients between serum IgE levels and dietary intake as well as serum vitamin E. Serum vitamin E levels showed a significantly inverse association with serum total IgE and all specific IgE levels (P < 0.05). Fat intake was inversely related with specific-IgEs for egg whites, milk, buck wheat, soy, and peanuts (P < 0.05). Positive associations were found between carbohydrate (CHO) intake and total IgE and specific IgEs to egg whites, milk, soy, and peanuts (P < 0.05). Vitamin C, E and n-3/n-6 fatty acids were not related with serum total IgE and specific IgE levels except for the association between buck wheat and vitamin E. In addition, there were no significant differences between males and females in dietary intake and serum IgE levels by student's t-test. Although dietary vitamin E showed no association with serum IgE levels, serum vitamin E drew a significant inverse relationship with serum IgE levels. The evidence seems to suggest that vitamin E may possibly lower total and specific-IgEs in children with AD, and that it is important to maintain a relatively high serum vitamin E level in children with AD.
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Affiliation(s)
- Sangeun Lee
- Department of Foods and Nutrition, Kookmin University, 861-1, Jeongneung-dong, Seongbuk-gu, Seoul 136-702, Korea. ; Department of Food and Nutrition, Seoul National University, Seoul 151-742, Korea
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