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Resumen: El asma grave afecta del 3 al 10% de la población mundial, según estimaciones de la Iniciativa Global para el ASMA (GINA). El asma alérgica es uno de los fenotipos más comunes del asma grave y se caracteriza por una inflamación de tipo 2 provocada por alérgenos y en el que la inmunoglobulina E (IgE) es una mediadora clave, lo que la ha convertido en una diana terapéutica importante. La introducción de las terapias o de los tratamientos biológicos dirigidos ha supuesto la entrada del manejo del asma grave en la era de la medicina de precisión y que el objetivo del tratamiento aspirase a la remisión clínica de la enfermedad. Existe un porcentaje importante de pacientes con asma alérgica grave que no responden a los tratamientos y cuyos síntomas no están controlados. En este documento, un grupo de expertos en el manejo del asma alérgica grave ha revisado y evaluado la evidencia más relevante relativa a la fisiopatología y a los fenotipos del asma grave alérgica, la función de la IgE en la inflamación alérgica, la identificación de alérgenos, las técnicas, biomarcadores y retos diagnósticos y los tratamientos y estrategias disponibles para el manejo de la enfermedad, con un especial foco en los tratamientos biológicos. A partir de esta revisión se han desarrollado unas recomendaciones que han sido validadas a través de un proceso de consenso Delphi con el objetivo de ofrecer mejoras en el manejo del asma alérgica grave a los profesionales implicados e identificar las necesidades no cubiertas en el manejo de esta patología. Abstract: Severe asthma affects 3%-10% of the world's population, according to estimates by the Global Initiative for ASTHMA (GINA). Allergic asthma is one of the most common phenotypes of severe asthma and it is characterized by allergen-induced type 2 inflammation in which immunoglobulin E (IgE) is a key mediator, making it an important therapeutic target. The introduction of targeted biological therapies or treatments has entered the management for severe asthma in the era of precision medicine, and the goal of treatment is clinical remission of the disease. There is a significant percentage of patients with severe allergic asthma who do not respond to treatments and whose symptoms are not controlled. In this paper, a group of experts in the management of severe allergic asthma reviewed and evaluated the most relevant evidence regarding the pathophysiology and phenotypes of severe allergic asthma, the role of IgE in allergic inflammation, allergen identification, techniques, biomarkers and diagnostic challenges, available treatments and strategies for disease management, with a special focus on biological treatments. From this review, recommendations were developed and validated through a Delphi consensus process with the aim of offering improvements in the management of severe allergic asthma to the professionals involved and identifying the unmet needs in the management of this pathology.

Whey is a by-product that represents a cheap source of protein with a high nutritional value, often used to improve food quality. When used as a raw material to produce hypoallergenic infant formulas (HIF), a processing step able to decrease the allergenic potential is required to guarantee their safe use for this purpose. In the present paper, thermal treatments, high hydrostatic pressure (HHP), and enzymatic hydrolysis (EH) were assessed to decrease the antigenicity of whey protein solutions (WPC). For monitoring purposes, a competitive ELISA method, able to detect the major and most allergenic whey protein β-lactoglobulin (BLG), was developed as a first step to evaluate the efficiency of the processes. Results showed that EH together with HHP was the most effective combination to reduce WPC antigenicity. The evaluation method proved useful to monitor the processes and to be employed in the quality control of the final product, to guarantee the efficiency, and in protein antigenicity reduction.

Collecting information on influencing factors in developing consistent and high-quality extracts results in accurate diagnosis and effective treatment of type I allergy (IgE mediated). Furthermore, considering that a large number of allergens are currently in practice, any attempt to develop a more effective procedure for preparing extract may be useful. Nowadays, different saline solvents, temperature, incubation time, and PH are being incorporated for preparing allergen extracts. The objective of the current study was to clear and address the commonest of solvent buffers and allied conditions for making extracts of pollens of grasses, trees, and weeds. The literature review was done in Jan 2016 on PubMed and Google Scholar medical search engines without any time limitation. After reading abstracts of 87 articles, finally 37 relevant papers were selected and their full texts were retrieved. In conclusion, 24 full-text papers were recognized appropriate and chosen. The extracted information for papers has been described fully in the text. On the basis of these data, PBS buffer with PH 7.4, temperature of 4 °C and with overnight incubation time, may be the optimized condition in order to have a proper extract for carrying out skin prick tests

Allergic rhinitis remains one of the most pressing problems of modern otorhinolaryngology. Allergic rhinitis is an allergic inflammation of the nasal mucosa characterised by the following symptoms (one or more): stuffiness, rhinorrhoea, nasal itching, sneezing. In recent years the incidence of allergic rhinitis in the economically developed countries has been shown to be close to 40–50%. Allergic rhinitis is now characterised by an early onset, often continuously relapsing course and resistance to antiallergic therapy. Allergic rhinitis has a negative impact on a person’s social and daily activities, mental well-being and general health, regardless of age. Allergic rhinitis significantly reduces job performance, physical and mental activity, communication skills, causes snoring, anxiety, depression, sleep disorders and erectile dysfunction. Studying the mechanisms of the disease provides the basis for a rational therapy that addresses the complex inflammatory response rather than just the symptoms of allergy. Treatment is either in outpatient settings or inpatient – in specialised departments. A recent priority of pharmacotherapy is the use of intranasal corticosteroids, both as basic therapy for allergic rhinitis and as part of a combined regimen. The use of intranasal corticosteroids is considered to be the therapy of choice in allergic rhinitis. The paper demonstrates the efficacy and safety of topical corticosteroids for use in clinical practice. Intranasal corticosteroids have a wide range of reported indications, an extensive evidence base and can be recommended for the treatment of allergic rhinitis. For best result intranasal corticosteroids should be used at first signs of allergic rhinitis onset.

Hazelnut is a widespread nut species, especially present in Europe, that can be consumed raw or roasted thanks to its pleasant taste and nutritional properties. In addition to renowned beneficial properties hazelnuts contain several proteins capable of inducing food allergy in sensitized individuals, including Cor a 2 (a profilin), Cor a 8 (a lipid transfer protein), Cor a 9 (an 11S seed storage globulin, legumin-like), and Cor a 11 (a 7S seed storage globulin, vicilin-like). In the present paper we investigated the effectiveness of autoclave-based treatments in decreasing the allergic potential of hazelnut as assessed by submitting the treated material to an in vivo skin prick test and an in vitro immunoblot analysis, with sera of allergic individuals exposed to the treated food material. This preliminary analysis showed that autoclave treatment preceded by hydration and/or followed by drying seems to be a promising approach and appears to be effective in reducing the allergenicity of hazelnuts in most patients, probably due to the denaturation of most major and minor allergenic proteins. This work opens up the opportunity to produce hypoallergenic hazelnut derivatives that can be tolerated by allergic subjects.

Groundnut is an important global food and oil crop that underpins agriculture-dependent livelihood strategies meeting food, nutrition, and income security. Aflatoxins, pose a major challenge to increased competitiveness of groundnut limiting access to lucrative markets and affecting populations that consume it. Other drivers of low competitiveness include allergens and limited shelf life occasioned by low oleic acid profile in the oil. Thus grain off-takers such as consumers, domestic, and export markets as well as processors need solutions to increase profitability of the grain. There are some technological solutions to these challenges and this review paper highlights advances in crop improvement to enhance groundnut grain quality and nutrient profile for food, nutrition, and economic benefits. Significant advances have been made in setting the stage for marker-assisted allele pyramiding for different aflatoxin resistance mechanisms—in vitro seed colonization, pre-harvest aflatoxin contamination, and aflatoxin production—which, together with pre- and post-harvest management practices, will go a long way in mitigating the aflatoxin menace. A breakthrough in aflatoxin control is in sight with overexpression of antifungal plant defensins, and through host-induced gene silencing in the aflatoxin biosynthetic pathway. Similarly, genomic and biochemical approaches to allergen control are in good progress, with the identification of homologs of the allergen encoding genes and development of monoclonal antibody based ELISA protocol to screen for and quantify major allergens. Double mutation of the allotetraploid homeologous genes, FAD2A and FAD2B, has shown potential for achieving >75% oleic acid as demonstrated among introgression lines. Significant advances have been made in seed systems research to bridge the gap between trait discovery, deployment, and delivery through innovative partnerships and action learning.

Introduction: At present, allergic diseases are some of the most common chronic diseases affecting all spheres of human life. The only form of causative treatment of allergic diseases, apart from elimination of the sensitizing factor, is the specific allergen immunotherapy. The symptoms of allergic diseases can cause a number of consequences, including reduction of patient activity, negatively affect social relationships, ways of spending free time, and also cause sleep disorders. Assessing the quality of life in allergic diseases provides us with knowledge of the patient’s psychological and social functioning, and is a valuable addition to the review of the effectiveness of treatment for allergic diseases, allowing us to assess the patient’s overall well-being. Aim of the study: The aim of the study was to evaluate the quality of life of patients using specific allergen immunotherapy. Material and methods: 128 subjects were included in the study, but 100 questionnaires were used for the analysis. The study group was comprised of patients undergoing specific allergen immunotherapy over the age of 18 years. In this paper a diagnostic survey was used as a research method. The tools used are the standard questionnaire SF-36 and the questionnaire survey. Results: In the present study, it was observed that the overall quality of life of people affected by allergic diseases, as measured by the SF-36 questionnaire, can be assessed as quite good. Respondents subjected to specific allergen immunotherapy consider this method of treatment positively influencing their health as they reduce the symptoms of allergies. As many as 91% of the respondents think that specific immunotherapy affects them to reduce the symptoms of allergies. It has also been shown that the length of therapy has no effect on reducing the symptoms of allergies. Conclusions: The overall quality of life of patients is quite good, best evaluated in the domains of physical fitness, limitation of activity caused by emotional problems and changes in health status. Researchers positively evaluate the effect of immunotherapy on their health as it reduces the symptoms of allergies. Respondents have little knowledge about how to prevent exposure to allergens. Despite a positive assessment of the effectiveness of immunotherapy, the vast majority of respondents feel the need for additional antihistamines.

Since the discovery that Der p 1 is a cysteine protease, the role of proteolytic activity in allergic sensitization has been explored. There are many allergens with proteolytic activity; however, exposure from dust mites is not limited to allergens. In this paper, genomic, transcriptomic and proteomic data on Dermatophagoides pteronyssinus (DP) was mined for information regarding the complete degradome of this house dust mite. D. pteronyssinus has more proteases than the closely related Acari, Dermatophagoides farinae (DF) and Sarcoptes scabiei (SS). The group of proteases in D. pteronyssinus is found to be more highly transcribed than the norm for this species. The distribution of protease types is dominated by the cysteine proteases like Der p 1 that account for about half of protease transcription by abundance, and Der p 1 in particular accounts for 22% of the total protease transcripts. In an analysis of protease stability, the group of allergens (Der p 1, Der p 3, Der p 6, and Der p 9) is found to be more stable than the mean. It is also statistically demonstrated that the protease allergens are simultaneously more highly expressed and more stable than the group of D. pteronyssinus proteases being examined, consistent with common assumptions about allergens in general. There are several significant non-allergen outliers from the normal group of proteases with high expression and high stability that should be examined for IgE binding. This paper compiles the first holistic picture of the D. pteronyssinus degradome to which humans may be exposed.

Choosing and consuming food in a restaurant, the guest (consumer) also participates in the creation of experience. This experience should be positive and be a pleasure for all senses in order for the guest to return to the same hospitality facility. However, for people who are allergic to foods, the choice and consumption of food in hospitality facilities can turn to negative experience, lead to fear, and even to negative or fatal reactions and consequences. That is exactly what can make successful business difficult for the hospitality facility, given that the number of food allergens is increasing every day as well as the number of guests with such problems. The paper has a task to examine the challenges faced by hospitality facilities in the area of the city of Novi Sad, to which they can respond, and to which they would like to respond when allergens are concerned.

Abstract The number of studies on patch-test results in children and adolescents has gradually increased in recent years, thus stimulating reviews. This paper is a systematic review of a 15-year period devoted to studying the issue. Variations pertaining to the number and age groups of tested children and/or adolescents, the number of subjects with atopy/atopic dermatitis history, the quantity, type and concentrations of the tested substances, the test technique and type of data regarding clinical relevance, must all be considered in evaluating these studies, as they make it harder to formulate conclusions. The most common allergens in children were nickel, thimerosal, cobalt, fragrance, lanolin and neomycin. In adolescents, they were nickel, thimerosal, cobalt, fragrance, potassium dichromate, and Myroxylon pereirae. Knowledge of this matter aids health professionals in planning preventive programs aimed at improving children's quality of life and ensuring that their future prospects are not undermined.

Objective: Identification of common allergens by skin prick test in patients of united airway disease. Materials and Methods: Skin prick test was performed in 60 patients of United Airway Disease to identify the common allergens. A total of 62 allergens consisting of 36 types of pollen, 5 fungi, 4 insects, 8 type of dusts, 4 dander, 3 fabrics, Dust mite and Parthenium leaves were tested. Result: Most common allergens were Dust mite (60%) followed by Parthenium leaves (45%), insects (18.75%), pollen (14.81%), dust allergens (8.51%), fabrics (8.33%), fungi (5.66%), dander (5%). Most common insect allergens were cockroach (female) (30%), cockroach (male) (23.33%). Common pollens were Ricinus communis (28.33%), Amaranthus spinosus (28.33%), Parthenium hysterophorus (26.66%), Eucalyptus tereticornis (26.66%) and Cynodon dactylon (25%). Common dust allergens were house dust (21.66%), paper dust (11.66%) and cotton mill dust (10%). Among fabrics kapok cotton (13.33%) showed maximum positivity. Among fungi Aspergillus fumigatus (10%) followed by A. niger (6.66%) were most common. In animal dander group common ones were cat dander followed by dog dander. Conclusion: In conclusion it can be said that the knowledge drawn by above study will help to treat patients by immunotherapy or avoidance strategy.

The prevalence of food allergy has increased over the last decades and consequently the food labeling policies have improved over the time in different countries to regulate allergen presence in foods. In particular, Reg 1169 in EU mandates the labelling of 14 allergens whenever intentionally added to foods, but the inadvertent contamination by allergens still remains an uncovered topic. In order to warn consumers on the risk of cross-contamination occurring in certain categories of foods, a precautionary allergen labelling system has been put in place by food industries on a voluntary basis. In order to reduce the overuse of precautionary allergen labelling (PAL), reference doses and action limits have been proposed by the Voluntary Incidental Trace Allergen Labelling VITAL project representing a guide in this jeopardizing scenario. Development of sensitive and reliable mass spectrometry methods are therefore of paramount importance in this regard to check the contamination levels in foods. In this paper we describe the development of a time-managed multiple reaction monitoring (MRM) method based on a triple quadrupole platform for milk and egg quantification in processed food. The method was in house validated and allowed to achieve levels of proteins lower than 0.2 mg of total milk and egg proteins, respectively, in cookies, challenging the doses recommended by VITAL. The method was finally applied to cookies labeled as milk and egg-free. This method could represent, in perspective, a promising tool to be implemented along the food chain to detect even tiny amounts of allergens contaminating food commodities.

Bottom-up, end-user based feed, and food analysis through smartphone quantification of lateral flow assays (LFA) has the potential to cause a paradigm shift in testing capabilities. However, most developed devices do not test the presence of and implications of inter-phone variation. Much discussion remains regarding optimum color space for smartphone colorimetric analyses and, an in-depth comparison of color space performance is missing. Moreover, a light-shielding box is often used to avoid variations caused by background illumination while the use of such a bulky add-on may be avoidable through image background correction. Here, quantification performance of individual channels of RGB, HSV, and LAB color space and ΔRGB was determined for color and color intensity variation using pH strips, filter paper with dropped nanoparticles, and colored solutions. LAB and HSV color space channels never outperformed the best RGB channels in any test. Background correction avoided measurement variation if no direct sunlight was used and functioned more efficiently outside a light-shielding box (prediction errors < 5%/35% for color/color intensity change). The system was validated using various phones for quantification of major allergens (i.e., gluten in buffer, bovine milk in goat milk and goat cheese), and, pH in soil extracts with commercial pH strips and LFA. Inter-phone variation was significant for LFA quantification but low using pH strips (prediction errors < 10% for all six phones compared). Thus, assays based on color change hold the strongest promise for end-user adapted smartphone diagnostics.

In recent years occupational skin and respiratory diseases have been more and more frequently diagnosed in small production and service enterprises. The awareness of occupational exposure and its possible health effects among their workers and employers is not sufficient. Beauty salons, in addition to hairdressers and beauticians, frequently employ manicurists and pedicurists. The workers often happen to perform various activities interchangeably. The health status of beauty salons workers has rarely been assessed. The most numerous reports concern hairdressers. In this occupational group, the occurrence of skin lesions induced by wet work and frequent allergy to metals, hair dyes and bleaches and perm solutions has been emphasized, while information about health hazards for being a manicurist or pedicurist in beauty salons is seldom reported. The aim of this paper is to present professional activities (manicure and pedicure, methods of nail stylization), occupational exposure and literature data on work-related adverse health effects in manicurists and pedicurists. Wet work and exposure to solvents, fragrances, resins, metals, gum, detergents may cause skin disorders (contact dermatitis, urticaria, angioedema, photodermatoses), conjunctivitis, anaphylaxis, respiratory tract diseases, including asthma. The discussed occupations are also associated with the increased incidence of bacterial (particularly purulent), viral and fungal infections and cancer. Med Pr 2013;64(4):579–591

Apart from medication to control asthmatic inflammation, the education of patients and parents is the most important therapeutic step in achieving asthma control and normal life. This is a critical, but sadly often neglected, activity. It can be stated with certainty that an asthmatic who does not know the information outlined in this paper will never be free of asthma symptoms. Education is important at every visit, and is not time consuming or difficult to perform. This plan is easy to remember and use.

Objective: To study skin sensitivity to various allergens in patients of nasobronchial allergy. Materials and Methods: 2880 skin prick tests with 60 allergens were performed in 48 patients of nasobronchial allergy. Results: Most common offending allergens were insects (21.2%), followed by dusts (12.0%), pollens (7.8%), animal dander (3.1%), and fungi (1.3%). The common insect antigen were locust female (33.3%) followed by locust male (25%), grasshopper (20.8%), cricket (16.7%), cockroach female (16.7%) and cockroach male (14.6%). Common dust allergens were house dust, wheat dust, cotton mill and paper dust. Among pollens, Amaranthus spinosus, Argemone mexicana, Adhatoda vasica, Ailanthus and Cannabis were found to be common allergens. In animal danders common offending allergens were cow dander and dog dander. Among fungi Aspergillus fumigatus, Aspergillus flavus, Alternaria teneis and Fusarium sodani were common allergens. Patients of bronchial asthma had associated allergic rhinitis in 80% cases. Conclusion: Common allergens in patients of nasobronchial allergy were identified. The data may prove useful in of allergen avoidance and immunotherapy in these patients.