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Measurement of specific immunoglobulin E (sIgE) in serum is one of steps in the diagnosis of allergic diseases. This process can be carried out using either single-parameter or multi-parameter tests. In singleplex tests, sIgE is determined for one specific allergen, complete extract or single allergen component. In turn, multipex tests allow simultaneous measurement of sIgE concentration or level for many allergens, both in the form of extracts and allergen components. A variety of validated (IVD) test kits are available for in vitro diagnostics, which differ in both the technique of performance and profile of allergens. We aim to present a summary of the currently available multi-parameter testing for in vitro diagnosis of allergic diseases. [ABSTRACT FROM AUTHOR]

Color is an important food attribute and is often the main factor of choice. Appropriate coloring of food increases its attractiveness, thus affecting consumer preferences and acceptability of food products. Color is one of the most important parameters on the basis of which the quality of food is assessed. The characteristic color of fresh, raw food is due to natural pigments present in plant and animal products. During processing or storage, a natural color loss occurs, which often reduces the attractiveness of the product to consumers. To increase the aesthetic value of food, natural or synthetic dyes are added to it. The use of food dyes to give food a more attractive and appetizing appearance has been used in practice since antiquity. The added dye, although improving the appearance of food, may have a negative impact on the health of the consumer. Although natural dyes are considered safe, they can cause an allergic reaction, including anaphylactic shock. [ABSTRACT FROM AUTHOR]

TSLP, IL-25 and IL-33 are epithelial cytokines and are triggered by, inter alia, damaging factors, viral infections, allergic inflammation and proteases. These cytokines are involved in the pathophysiology of allergic diseases, including asthma and atopic dermatitis, by activating the Th 2 dependent immune response. The role of TSLP and IL-33 in the etiopathogenesis of allergic march is suggested. Finding the relationship between cytokines and the natural history of chronic allergic diseases gives hope for a breakthrough in the assessment of prognosis and possibly the possibility of using new biological drugs in specific disease entities. This publication presents current knowledge about the effect of these cytokines on the course of allergic diseases. Their role as potential biological treatment targets was also discussed. [ABSTRACT FROM AUTHOR]

The cat is one of the most common animals that people keep in their homes. Cat allergens are among the strongest and most common respiratory allergens. They can be found even in public places where cats have never been. Many people, with clinical signs of cat allergies, do not want to get rid of the cat from home, anyway. A hypoallergenic cat that would be a safe alternative to allergy sufferers is sought. Many myths and hypotheses have arisen around the problem of hypoallergenic cats, which have often not been confirmed by any reliable research. The paper attempts to present various theories about cats with low allergenic potential. It has been noted that strategies to reduce the allergenicity of cats focus on attempts to lower the Feld 1 concentration in the saliva of the cat, on its fur and in the animal's environment. Feld 1, the main cat allergen, is widely regarded as a marker molecule for allergy to this animal. This secretory glycoprotein is primarily produced in the sebaceous, salivary and anal glands. Then it is spread on the cat's fur by licking. Along with the fur and exfoliated epidermis, it easily spreads in the environment. Feld 1 is commonly present in house dust and air, both in the presence and absence of an animal in a given place. Among the methods to reduce the concentration of Fel d 1 in cat's saliva, on his fur or in his surroundings, such as cat breed, bathing the animal, proper diet or sensitizing the cat's own Fel d 1 has been described. The most attractive, effective and supported by research appear to be those in which the secretion of active Fel d 1 into the environment is blocked by specific antibodies. This effect can be achieved irreversibly by immunizing the animal with the Fel d 1 antigen, or reversibly by supplementing the cat's diet with avian anti-Fel d 1 antibodies. Both methods seem to be similarly effective, but given the animal's welfare, actions seem to be better whose effects are reversible. It is also worth noting that a cat that secretes less Fel d 1 can be hypoallergenic only for people who are allergic to this allergen, not for people who are allergic to other cat allergens. [ABSTRACT FROM AUTHOR]

The Polish Allergology Society is one of the first to convene a panel of experts, who on March 30, 2020 presented a position on the management of patients with asthma and allergic diseases during the SARSCoV- 2 pandemic. Most of the recommendations and opinions presented in this position remain valid until now. However, the dynamically changing epidemiological situation associated with SARS-CoV-2 infection poses new challenges for physicians in the care of asthma and allergic diseases. Numerous published clinical observations and studies provide new information on asthma and allergic diseases in relation to the COVID-19 pandemic. The current document contains new recommendations in line with available knowledge and taking into account the views of other national and international organizations and societies. [ABSTRACT FROM AUTHOR]

The document prepared by the expert panel of allergy/immunology specialists representing Polish Allergy Society intends to provide allergists with recommendations with respect to proper management of allergic patients during SARS-CoV-2 pandemics. Allergist should aim at reducing patient's social interactions by replacing face-to-face visits with communication via telephone or internet. In parallel allergist is responsible for assuring that the patient is receiving proper care of underlying allergic disease. The experts panel provides eighteen recommendations for management of patients with asthma and allergic diseases during pandemics, indicating that in majority of patients asthma treatment (including inhaled corticosteroids) and allergy treatment should be continued. Specific recommendations for treatment with allergen immunotherapy and with biologics are discussed in details. [ABSTRACT FROM AUTHOR]

Proton pump inhibitors (PPIs) are one of the most commonly used drug groups in clinical practice. Despite the high prevalence of their use, symptoms of hypersensitivity to IPPs are rare and few cases of the occurrence of allergies to drugs from this group have been documented in the available literature. The most often allergic symptoms include urticaria, angioedema and near fatal anaphylaxis. Between the individual drugs of this group there are cross-reactivity reactions. Knowledge- about crossreactivity in this group allow the safe administration of the drugs to patients who require their use. [ABSTRACT FROM AUTHOR]

Asthma is a heterogeneous disease characterized by chronic airway inflammation. It is defined by the history of respiratory symptoms such as wheeze, shortness of breath, chest tightness and cough that vary over time and in intensity, together with variable expiratory airflow limitation. This disease is a serious global health problem, especially in developed countries. There exist many hypotheses which try to explain reason of asthma development. Epidemiologic studies suggest associations between dietary antioxidants and lipids, especially vegetable oils, and parameters of asthma. It has been hypothesized that decreasing antioxidant and vitamin D deficiency, and an excess of polyunsaturated fatty acids (PUFA) n -6 to n-3 contributes to the development of asthma and severity of its symptoms. It seems that the behavior of a proper diet can reduce the frequency and severity of asthma symptoms. [ABSTRACT FROM AUTHOR]

Introduction. Nonsteroidal anti-inflammatory drugs (NSAIDs) currently occupy a leading position in the frequency of drug-induced hypersensitivity reactions. Aim. The present paper analyses referrals for laboratory tests with regard to determination of NSAIDs-specific IgE as well as the results of these tests. The abovementioned referrals were sent to the Immunological and Allergological Laboratory of the Department of Allergology, Clinical Immunology and Internal Diseases at University Hospital No. 2 in Bydgoszcz between 17.04.2012 and 16.04.2017. Material and methods. The analysis took into account age and sex of patients, number of referrals, the type of drugs for which IgE determination had been ordered, as well as accompanying tests. The obtained results were analyzed for the presence of specific IgE. Results. It was observed that the asIgE determined for NSAIDs accounted for 2.47% of all referrals that had been received by the laboratory. The orders included asIgE for the following drugs: acetylsalicylic acid, paracetamol, ibuprofen, ketoprofen and pyralgine. The most commonly ordered laboratory test was asIgE for aspirin, less often for ketoprofen, ibuprofen, paracetamol and metamizole. Half of the referrals for NSAIDs-specific IgE were combined with referrals for asIgE for other allergens and their mixtures. Only one positive ketoprofen-specific IgE test result was obtained. Conclusions. The analysis of test results suggests non-IgE mediated bases of hypersensitivity symptoms associated with NSAIDs or other undetermined causes not connected with these drugs. [ABSTRACT FROM AUTHOR]

There are a number of unconventional diagnostic methods and laboratory tests whose application in diagnosis of food allergy is sometimes suggested by physicians, dietetitians or advocates of the so called „clinical ecology”, atrenative medicine practicioners and by patients themselves. The results of such tests are not reproductible and there is lack of research to confirm their clinical usefulness in detecting allergies or food intolerance. Among these methods there are both in vitro tests (food-specific IgG testing, microbiome analysis), ex vivo tests (cytotoxic testing) on the samples collected from the patient and in vivo trials (pulse test, iridology, electrodermal tests or VEGA tests). The creators and propagators of these tests maintain that they detect „hidden allergies” which cannot be diagnosed by means of recognized medical tests. It is unnadvisable to apply any of such unconventional and unproved methods in diagnosing food allergy. [ABSTRACT FROM AUTHOR]

Recreational horseback riding is popular and a considerable number of people enjoy horse racing as well. Much is said about occupational allergy in horse breeders, jockeys and veterinarians. However, there are studies that emphasize the relatively high incidence of allergies in people who do not have direct contact with horses. Nowadays commercially available allergen components allow a detailed assessment of the allergic profile of the patient, also in the context of animal allergy. This allows us to explain the many uncertainties associated with allergic patients, and draw conclusions regarding the further course of the disease. This paper describes the known horse allergens, presents the course of allergy to this animal, also in the context of cross-allergies. We examined the use of component resolved diagnosis in the context of horse allergy, showing both advantages and limitations of this method. [ABSTRACT FROM AUTHOR]

Allergy to fur-bearing animals is an important clinical problem. Patients often ask questions about the natural history of their disease, their prognosis and the possibility of coexisting allergies to other animals. Component resolved diagnosis can be a useful tool in response to these and other questions concerning animal allergic patients. In this paper we described in detail the components of dog and cat allergens, taking into account their source, protein families, the clinical relevance and the possibility of a cross-allergy between them. In particular, we highlighted lipocalins, which are the most important family of inhaled mammal allergens. These include major dog allergens (Can f 1-2), cattle (Bos d 2), horse (Equ c 1), rat (Rat n 1), mouse (Mus m 1), guinea pig (Cav p 1), rabbit (Ory c 1) or hamster (Pho p 21). We also attempt to answer the question of how the knowledge about the presence of IgE directed against allergenic components of dog and cat in patient's blood serum can be used in clinical practice. [ABSTRACT FROM AUTHOR]

In the last 10-15 years, we have been dealing with a "second wave" of allergic disease outbreaks caused by food allergies. 60% of cases of food allergy in adults and children are associated with the co-occurrence of inhaled allergy. The structural similarity of proteins, even those of a different origin, is the main factor determining the occurrence of cross-reactions. The article reviews important clinical aspects of food allergy related to cross-reactivity syndromes. [ABSTRACT FROM AUTHOR]

Food allergy is becoming an increasingly grave problem around the world. Every week there are reports of severe anaphylactic reactions to food. Actually, the victims knew about their allergies, avoided dangerous products, but did not realize that the dish that was served to them contained a hidden life-threatening allergen. The aim of the study is to present the current legal situation regarding the duty to provide the buyers with information about the contents of allergens in products. Attention was focused on the existing Regulation of the European Parliament and of the Council (EU), which will be soon put into practice in Poland. It also presents the current situation in chosen developed countries and possible measures to improve the safety and quality of life of people struggling with food allergies. [ABSTRACT FROM AUTHOR]

Milk protein allergy is a major clinical problem. It is usually the first allergy noted in infants. Parents often ask about the effect of elimination diet during pregnancy and breastfeeding on prevention of allergy to milk, as well as whether and how to cow's milk into the diet of a small child. In cow's milk there are about 20 proteins. Each one can be a source of hypersensitivity. Some of them are referred to as major allergens, which can be found in the fraction of whey or casein. Cow's milk protein allergy affects up to 2-3% of newborns. In most cases it spontaneously resolves. Infants affected by non-IgE dependent allergy develop milk tolerance sooner than those with IgE-mediated allergy. The high prevalence of allergy to milk and often unusual or severe symptoms motivate researchers to explain allergy risk factors and find ways to prevent allergy. In this report we discuss the epidemiology and natural course of cow's milk allergy. We also include current opinions on preventing allergy and ways to modify the natural course of the disease. [ABSTRACT FROM AUTHOR]

Introduction. Eczema is a syndrome of polimorphous dermal eruptions in response to inflammation. Contact eczema is an eczema caused by contact with environmental agents, usually irritating chemicals or contact allergens. Aim of the study. The aim of the study was the analysis of epidermal patch tests in contact eczema patients. Material and methods. The study participants included 70 patients with contact eczema, 41 women and 29 men, aged 18-70. The patients underwent physical examination and epidermal patch tests with European Standard Series of allergens using IQ Ultra (Chemotechnique Diagnostics) chamber application system. The patches were applied onto patients' back, in the interscapular region, for 48 hours. After that time, the patches were removed and first readout was made. The second readout was after 72 hours from the moment of patch application. The results were interpreted according to the international patch test results recording system. Results. Positive results of patch tests were obtained from 22 (31.4%) patients. Nickel sulphate was the most frequent sensitizer, with 14 (63.6%) patients showing positive patch tests to that metal. It was followed, in the descending order, by potassium dichromide -- 8 patients (36.3%), cobalt chloride -- 5 (22.7%), PPD -- 3 (13.6%), balsam of Peru -- 2 (9.0%), and fragrance mix I -- 2 patients (9.0%). Single patients (4.5%) were allergic to benzocaine, budesonide, colophony, thiuram mix and cathon CG. Ten patients (45.4%) were positive to more than 1 hapten. Hands were the site most often affected by contact eczema, and this was the case in 22 patients (31.4%). Conclusions. Hands are the sites which are most frequently affected by contact eczema. Metals, in particular nickel, are the most frequent sensitizers in patients with contact eczema. [ABSTRACT FROM AUTHOR]

Anaphylactic reactions caused by bee stings are a common medical problem. The structures and characterization of bee venom allergens have been recently reviewed. Melittin and phospholipase A2, two major components of bee venom are generally thought play an important role in inducing the irritation and allergic reactions associated with the bee stings. Furthermore, recent reports indicate that melittin reduces membrane permeabilization and lyses procariotic as well as eucanoctic cells. This mode of action is responsible for its anti- microbial, anti-tumor and leishmanicidal activities. It has been shown that melittin is capable of inhibiting replication of some viral gene expression. Moreover, honeybee venom has also anti-inflammatory property and can be used in treatment of rheumatoid arthritis. [ABSTRACT FROM AUTHOR]

Food consumption is the second most common cause of anaphylaxis among adults. There have been reported cases after eating seafood, which the most popular are shrimps. The most common allergen of shrimp is tropomyosin. A 22 years-old female experienced dyspnoea, edema of lips, tongue, eyelids and generalized urticaria with pruritus after eating bread with shrimp paste. Also, for 4 years, the patient has symptoms of rhinitis with conjunctivitis during spring and summer months and after eating unprepared apples, nectarines, hazelnuts and walnuts experiences itching of the lips, tongue and throat. The patients provided the results of specific IgE tests which showed positive results for pollen of birch, alder, rye, timothy grass, epidermis of dog, cat, horse, rabbit, egg yolk, shrimp and Alternaria alternata. During the diagnosis, skin prick tests with extracts of food and inhalant allergens were performed. A positive result was for the allergen extract from cat fur, grass mixture, rye, alder, birch, hazel and shrimp. We also established the level of IgE specific to allergen components using the ImmunoCap ISAC method. Allergen-specific IgE was elevated for the shrimp allergen Pen m 4 (sarcoplasmic calcium binding protein), allergens of timothy grass, bermuda grass, birch and cat, as well as cross-reacting allergens of alder, hazel, apple, peach, soy and peanuts. Considering the overall clinical picture the patient was diagnosed with a shrimp allergy and seasonal allergic rhinitis caused by allergy to birch and grasses. The patient was advised to exclude seafood from her diet and provided with adrenaline, steroids and antihistamines. According to our current knowledge, this is the first reported case of anaphylaxis after eating shrimp caused by allergy to Pen m 4. [ABSTRACT FROM AUTHOR]

The oral food challenge remains the most reliable method for confirming or excluding food allergies. The most trustworthy variant is double-blind placebo-controlled food challenge (DBPCFC). In DBPCFC, both the patient and the investigator do not know which sample contains placebo and which is the active sample (verum). DBPCFC should be prepared in such a way that the concentration of the allergen tested in the food administered to the patient is as high as possible, while remaining imperceptible to the patient, and the same ingredients should be used in the active sample and placebo. In addition, meal ingredients, other than those tested, must not cause hypersensitivity symptoms in the patient and the taste, consistency, smell and colour of the food must make it impossible to identify which sample is active and which contains placebo. Self-preparation of recipes for active sample and placebo allows to blind virtually any allergen, but unfortunately it is often fraught with the error of insufficient concealment of the allergen. If the patient recognizes the content of a given food, then the DBPCFC conditions are not met. To avoid setbacks, reduce the preparation time of the sample and increase the likelihood of effective food blinding, one of the validated recipes for active sample and plecebo developed by the research teams can be used. The work presents general guidelines according to which allergens should be blinded. Strategies for the preparation of active and placebo sample are provided, as well as examples of validated recipes available in scientific publications. [ABSTRACT FROM AUTHOR]

Allergic cross-reactions are a common clinical problem. They are a challenge for both scientists and clinicians working on a daily basis with patients. The current development of molecular biology has allowed for a more precise definition of reactions and mechanisms responsible for the occurrence of allergic cross-reactions. Recent years have also strengthened the importance of specific immunotherapy in the treatment of inhalation allergies, but we still have no conclusiv evidence of their effectiveness and safety in the case of symptoms arising in connection with cross-reactions. In this article, the authors try to explain the basic mechanisms of allergic cross-reactions and methods of treating the symptoms associated with them, especially in the light of the popularity of specific immunotherapy. [ABSTRACT FROM AUTHOR]

The number of people suffering from atopic dermatitis is increasing every year. This disease has a complex etiology, and one of the factors intensifying its symptoms is food hypersensitivity. There are many studies indicating the contribution of food allergies to exacerbations of atopic dermatitis. However, the more accurate role of food allergy in this process leaves much to be explained. It is interesting that there are scientific reports showing a significant improvement in the skin condition of patients with AD after eliminating allergenic foods from their diet. The aim of the work is to collect and systematize knowledge on the common occurrence of AD and food allergy, and the impact of food allergy on the course of AD, based on current domestic and foreign literature. [ABSTRACT FROM AUTHOR]

Allergy to soy is still a big diagnostic and therapeutic problem. It seems that this problem will not lose its significance in the coming years, because soy proteins, mainly due to their prevalence and unique amino acid composition, are still extremely popular in food production, processing and breeding. Allergy to soy is most often manifested clinically as gastrointestinal symptoms, but other ailments are not uncommon. Despite the availability of many diagnostic methods, the diagnosis of soy allergy is not easy. A double-blind placebo-controlled oral provocation test remains the gold standard. However, the future certainly belongs to the molecular methods that allow to assess the sensitivity to specific allergen components, which opens up new possibilities both in predicting the course of natural disease and its treatment, and also in identifying patients at the highest risk of severe anaphylactic reactions. [ABSTRACT FROM AUTHOR]

Commonness of citrus fruits as food products and additives for cosmetics and cleaning products contribute to the increase of the number of people suffering from citrus allergy. Citrus allergens can cause gastrointestinal, respiratory and skin symptoms. Citrus allergens are cross-reactive with many allergens from different sources. This makes diagnostics of citrus allergy problematical and determination of the allergen responsible for allergy symptoms is difficult. The purpose of this article is systematization of information available in literature on citrus allergens, clinical symptoms of citrus allergy, its diagnostics and diagnostics-related problems. [ABSTRACT FROM AUTHOR]

Allergy to house dust mites is the most common cause of perennial allergic rhinitis in Poland. Shrimps, on the other hand, are a rich source of proteins that may be the cause of hypersensitivity. It is known that tropomyosin of house dust mite is highly homologous to the tropomyosin of shrimps. Several dozen mite allergens have been described so far. Over 97% of patients are sensitized to cysteine protease (Der p 1, Der f 1) and members of the NPC2 protein family (Der p 2, Der f 2). Due to relatively small number of patients allergic to other allergen components of house dust mite, the number of commercially available allergen components of house dust mite is still limited. Nevertheless, the number of commercially available allergen components of house dust mite is constantly increasing, and the interpretation of the result can often cause difficulties. In this article we present house dust mite and shrimp allergens that were described so far. The current diagnostic possibilities in sensitization to these allergens are also presented. [ABSTRACT FROM AUTHOR]

Food allergy and chronic psychological stress are growing problems in all developed countries. In clinical practice physicians often encounter patients who report the symptoms of allergy disease being exacerbated by stressful situations. Those subjective observations are confirmed by studies both in humans and in animal models. In this article we discuss the influence of stress on food allergy exacerbations. It is known that in response to stress several immunological mechanisms promote allergic inflammation. The role of stress on increased permeability of the intestinal mucosa and on modulation of the intestinal microflora is discussed. [ABSTRACT FROM AUTHOR]

Introduction. The problem of contact allergy can affect approximately 40% of adults and 20-30% of children and adolescents. Patch tests are the "gold standard" in the diagnosis of contact allergy. In view of the frequent coexistence of allergic diseases and polisensitization, a thorough allergology diagnosis is of great importance. Aim. The aim of this study was to evaluate the prevalence of sensitization to haptens and inhalant and food allergens among patients diagnosed in the direction of contact allergy. Material and methods. In the study a retrospective analysis of medical records of patients diagnosed in the direction of contact allergy was crried out. The inclusion criterion of patients in the study group were performed patch tests with a set of European Series Basic. The study comprised 105 patients, including 82 women aged 18-77 and 23 men aged 19-78. Results. In the test group patients with chronic urticaria (n=32) and allergic contact eczema (n=27) were prevalent. The coexistence of several types of diseases was found in 37.1% of patients. Positive patch tests were obtained in 48% of patients, the prick tests with inhalant allergens in 44% and food allergens in 18% of patients. The strongest sensitizing of haptens were metals, of inhalant allergens: dust mites, weeds and grass, and of food allergens: celery, citrus fruits, rye flour and potatoes. In a significant proportion of patients a cross-sensitization to nickel, chromium and cobalt was frequently observed. Conclusions. Due to the complex etiology of allergic diseases in patients with suspected allergy a detailed diagnostics should be carried out in order to enable identification of allergenic substances and their elimination from the patient's environment. [ABSTRACT FROM AUTHOR]

Wstęp: Alergia na orzeszki ziemne należy do kluczowych postaci alergii pokarmowej, szczególnie w populacji wieku rozwojowego. Jest to jedna z najczęstszych przyczyn reakcji anafilaktycznej indukowanej pokarmem, potencjalnie o przebiegu zagrażającym życiu. Stąd poszukuje się lepszych metod i nowych algorytmów diagnostycznych pozwalających na większą trafność i bezpieczeństwo rozpoznania. Aktualnie coraz częściej rozważa się uzupełnienie standardowej diagnostyki alergii na orzeszki ziemne o wykonanie testu aktywacji bazofilów (BAT), z uwagi na jej duże bezpieczeństwo oraz wysoką czułość i swoistość, szczególnie wobec alergenów pokarmowych. Cel: Ocena znaczenia BAT w diagnostyce alergii na orzeszki ziemne. Materiały i Metody: Do badania zakwalifikowano łącznie 80 dzieci: 65 dzieci z uczuleniem na orzeszki ziemne (grupa badana) i 15 dzieci bez uczuleń/lub chorób alergicznych (grupa kontrolna). U wszystkich pacjentów przeprowadzono badanie ankietowe, oznaczono sIgE dla orzeszka ziemnego i jego alergenów oraz przeprowadzono BAT z Ara h i Ara h 2. Po uzyskaniu wyników badań pacjentów kwalifikowano do doustnej próby prowokacji (oral food challenge, OFC) z orzeszkiem ziemnym. Ostateczne rozpoznanie alergii na orzeszki ziemne ustalono zgodnie z obowiązującymi zaleceniami, uwzględniając dane z wywiadu, wyniki badań w kierunku uczulenia oraz OFC. Wyniki poddano analizie statystycznej. Wyniki: Wyniki badań analizowano w następujących grupach: dzieci uczulone, tolerujące orzeszki ziemne (peanut sensitized, but tolerant, PS) (n=23); dzieci, u których nie stwierdzono uczulenia na orzeszki (non-peanut sensitized, non-PS) (n=15); dzieci z alergią na orzeszki ziemne (peanut allergic, PA) (n=42), dzieci bez alergii na orzeszki ziemne (non-peanut allergic, non-PA) (n=38). W grupie PA dodatni wynik BAT stwierdzono u 31 (73,81%) dzieci, w grupie PS u 2 (8,70%) dzieci, a w grupie non-PS u żadnego dziecka (p<0,01). Istotnie statystycznie częściej ujemny wynik stwierdzono w grupie PS (n=16; 69,56%), non-PA (n=28; 73,68%) i kontrolnej (n=12; 80%), niż w grupie PA (n=5; 11,90%) (p<0,01). Stwierdzono istotnie statystycznie wyższe pobudzenie bazofilów w grupie PA w porównaniu do grupy PS i non-PA, zarówno po stymulacji Ara h, jak i Ara h 2 (p<0,01). Włączenie BAT jako kolejnego etapu w diagnostyce alergii na orzeszki ziemne pozwala na zmniejszenie koniecznych do wykonania OFC o 2/3. Podsumowanie: Zastosowanie dodatkowych metod, takich jak ocena BAT, pozwala na zwiększenie trafności rozpoznania alergii na orzeszki ziemne i zmniejszenie ilości OFC koniecznych do ustalenia rozpoznania o 2/3. [ABSTRACT FROM AUTHOR]

Introduction. Cosmetics are the substances commonly used in the contemporary society, however, they develop side effects, reactions of hypersensitivity and even allergy. Beauticians are people who contact with cosmetics particularly often and they are exposed to undesirable effects of cosmetics more often than others. Aim of the study. The aim of the study was to describe the frequency of side effects appearance, reactions of hypersensitivity and allergy to the individual ingredients and metals such as chrome and nickel among the students of cosmetology faculty in Collegium Medicum in Bydgoszcz of Nicolaus Copernicus University in Toruń. Material and methods. In the study take a part 149 students of cosmetology, who fulfilled the questionnaire concerning the appearance of side effects after using the cosmetics. Among the people who noticed such effects, another tests were carried out. Those skins tests dealt with the chosen ingredients which cause the allergy and there were: an aromatic cocktail A, aromatic cocktail P, Balsam of Peru, mertiolat, parabens, formalin, carnation oil, paraphenylenediamine, nickel and chrome. Results. The frequency of side effects after the use of cosmetics was 28,8%. The effects of hypersensitivity were noticed among 16,1%, while an allergy among 2,1% of the tested people. Conclusions. The prevalence of side effects after using cosmetics was similar than general population, and in most cases were not allergy reaction. [ABSTRACT FROM AUTHOR]

Diagnostics of allergic reactions after food consumption cause trouble, especially when allergic reactions cofactors coexist. Introducing the possibility of marking IgE specific to allergen components increase diagnostics possibilities. We present interesting case of patient who was diagnosed due to an interview of several anaphylactic reaction during physical effort after consumption of food like nectarine, apple, plum, grapes, hazelnut, walnut, wheat berry beer. During diagnosis, in the ImmunoCAP ISAC test, an increased level of IgE was found for lipid transfer proteins of walnut, peach, mugwort, plane tree, wheat (Jug r 3, Pru p 3, Art v 3, Pla a 3, Tri a 14). The patient was diagnosed with food-dependent exercise-induced anaphylaxis associated with an allergy to lipid transfer proteins (LTPs). [ABSTRACT FROM AUTHOR]

The relationship between man and horse goes back to prehistoric times. Horses are among the most significant human domesticated animals. Currently, due to mechanization, the role of horses as an economic resource has decreased, but their recreational role is still important. Taking into account frequent contact with humans, they are of great importance as a potential source of allergens, constituting a significant cause of various allergic reactions. The article describes a case of an acute allergic reaction in a patient with bronchial asthma after contact with a horse allergen, which was brought along with the clothing of a person who had contact with the animal. The frequency of allergies, the prevalence and types of allergens as well as anaphylactic reactions to horses are discussed. The application of diagnostics based on allergen components was discussed, as well as component diagnostics performed in the patient in the context of allergy to panallergens from the lipocalin group was described. [ABSTRACT FROM AUTHOR]

Diagnosis of food allergy is often very difficult. Patients report numerous symptoms that are sometimes difficult to associate with a specific kind of food. Despite the development of immunological diagnostic methods, most importantly the increasing availability of component resolved diagnosis, in vivo tests, in particular oral challenge tests, are necessary to reliably assess the actual course of the patient's symptoms. Food challenges are time-consuming and often difficult to prepare. For this reason, other alternative diagnostic methods are being sought, such as various skin prick test modifications. These methods raise numerous controversies and doubts in clinicians. In particular many concerns are gathered with the diagnosis of IgE-independent reactions. Atopy patch tests raised hopes in this area, but it turned out that their specificity is limited and the interpretation of the result difficult. In this article we present practical aspects of conducting in vivo diagnosis in patients suspected of food allergies. Based on literature data and own observations, we explaine what are the limitations of in vivo diagnostic tests and how the patient's diagnostic procedure can be improved. [ABSTRACT FROM AUTHOR]

Primary Immunodeficiencies (PIDs) are more common than we think. The most common PNO, is isolated IgA deficiency, occurs in the Caucasian population with a frequency of 1:500. These deficiencies are the result of one or more parts of the immune system missing, weakened or not working properly. Allergy also results from an abnormality in the immune system, so it is assumed to be associated with Primary Immunodeficiencies. It has been shown that allergies are more common in patients with PID, and it has been proven that allergy symptoms may precede or even mask symptoms of PID, making diagnosis difficult, which is associated with a delay in the correct diagnosis of deficiency and a worse prognosis for these patients. [ABSTRACT FROM AUTHOR]

The medical case described below is a challenge for doctors of many specialties. A young woman suffering from an oncological disease, a severe form of atopic dermatitis, a multi-serious allergy and, additionally, bronchial asthma is a patient who requires careful medical, nursing and psychological care. The variable picture of the disease basically excluded the patient from everyday, normal functioning. In-depth allergological diagnostics allowed for introducing safe products into the patient's diet and avoiding severe anaphylactic reactions. [ABSTRACT FROM AUTHOR]

It is estimated that about 27% of the saliva proteins are derived from blood. Due to the specificity of food allergies, saliva seems to be extremely reliable material for laboratory tests, with high clinical usefulness. This material is easily available and simple to collect by various techniques, including using standardized saliva collection tubes. Available literature data show that currently used saliva collection methods do not have a significant impact on the results of measured laboratory parameters, including total IgE concentration. The results for IgE specific for various food allergens in saliva compared to the values measured in serum also seem promising, although a small number of studies available in the literature limits conclusion. Saliva seems to be a good material for diagnosis food allergies, although this subject certainly requires further research. [ABSTRACT FROM AUTHOR]

Introduction. Allergy to hymenoptera venom is a significant clinical problem. Allergen-specific immunotherapy is an effective method of treatment of bee venom allergy. Unfortunately, in course of immunotherapy some adverse anaphylactic reactions with a broad range of symptoms may appear. Case report. A 31-year old woman in June 2016 underwent anaphylactic shock after being stung by a bee. Intradermal tests with bee venom turned out positive. Total IgE concentration was 79,08 kU/l; allergen-specific IgE to bee venom (sIgE) <0,35 kU/l (class 0); allergen- -specific IgE to bee venom (sIgE) 11,81 kU/l (class 3). The patient was qualified to allergen-specific immunotherapy. In the period between July and December 2017, the patient received a maintenance dose of bee venom six times. No topical nor general complications were reported. In January 2018 the patient reported for a follow-up to receive the 7th maintenance dose. Symptoms of anaphylactic shock appeared around 10 minutes after administration of 100 μg Venomenhal bee. Successful shock management treatment was applied, with adrenaline being administered twice. The woman was in premenstrual period, she stopped taking contraceptive pills while in menstrual cycle preceding the vaccine. No other factors possibly aggravating the course of allergic reactions were reported. [ABSTRACT FROM AUTHOR]

Panallergens are proteins commonly found in nature. Although they are present in unrelated organisms, they perform a similar function in them. Panallergens have highly conserved amino acid sequence regions and a similar three-dimensional structure, and thus meet the requirements for cross-recognition by IgE. Some of them are pathogenesis- releted proteins produced in plant tissues as a result of biotic and abiotic environmental stress. The article describes the most important panallergen families described so far. [ABSTRACT FROM AUTHOR]

Antibody determination is the basis for making a diagnosis in many diseases. Everyday physicians of various specialties determine specific antibodies in their patients. Every new discovered antibody that is characterized by high sensitivity and specificity is always of great interest. The article presents information on the most commonly made mistakes when performing these diagnostic tests. Despite big significance of those tests and their wider use, there is lack of a practical guide in literature, which would allow for systematization of basic clinical knowledge about them, especially in the scope of differential diagnosis. Sometimes these tests happen to be performed routinely, and a negative result is the basis for excluding the diagnosis of a particular disease entity, despite its presence. Antibodies are immunoglobulins, which are characterized by their specific properties. There are specific indications when the total concentrations of individual immunoglobulin classes should be determined and whether the patient produces them at all or their production is disturbed. We should also acquire the knowledge of which medications may affect their concentration, and in some cases, assess their concentration together with the total protein concentration and the γ-globulin fraction in which antibodies are contained. This part of the article discusses the basic definitions related to disorders of antibody synthesis, factors affecting antibody concentration and differential diagnosis. [ABSTRACT FROM AUTHOR]

Determination of antibody presence is the basis for making a diagnosis in many diseases. Physicians determine specific antibodies in their patients on a daily basis. Of great interest is every new discovered particle which is characterized by high sensitivity and specificity. This article discusses the most commonly made mistakes during the diagnosis with the use of antibodies. Despite big significance of these tests and their wider use, there is lack of a practical guide in literature, which would allow for systematization of basic clinical knowledge about them, especially in the scope of differential diagnosis. Routine antibody determination commonly leads to diagnostic mistakes and negative result is the basis for the exclusion of a diagnosis of a particular disease entity, despite its presence. Antibodies are immunoglobulins, one of the most important proteins of the immune system and they are characterized by their specific properties. Particular indications exist concerning determination of the total concentration levels of specific classes of immunoglobulins. It should be noted that there are situations in which the body does not produce antibodies or their production is disturbed. We should also acquire the knowledge of which medications may affect their concentrations, assess their concentration together with total protein concentration and γ-globulin fraction, within which the antibodies are contained. The article following discusses the clinically relevant properties of antibodies. [ABSTRACT FROM AUTHOR]

Autoimmune lymphoproliferative syndrome (ALPS) is a genetic disease with autosomal dominant inheritance, qualified as a primary immunodeficiency. Clinical manifestations in ALPS are a consequence of inappropriate apoptosis, that is programmed cell death. The main clinical symptoms include chronic lymphoproliferation, manifested by lymphadenopathy and splenomegaly, the occurrence of autoimmune disorders, especially peripheral blood cytopenia and a tendency to cancerous transformation, mainly the development of lymphomas. A characteristic feature of ALPS is the lack of genotype-phenotype correlation, which may cause completely different clinical manifestation of the disease in individual family members. Consequently, a genetically determined disease is not suspected for a long time or at all. ALPS is still a little-known syndrome, and the diagnosis is significantly lower than its actual occurrence. Patients are referred to many different specialists who treat only the current symptoms, often not very effectively, because they do not understand the underlying disease. That is why it is important to spread the knowledge about this difficult syndrome. [ABSTRACT FROM AUTHOR]

Facial edema is undoubtedly a symptom that causes both the patient and the doctor to be afraid of severe consequences that can even lead to death. Often, the underlying cause of the disease is unexplained, patients are struggling with relapses, and doctors remain helpless. Therefore, detailed diagnostics is important, which will explain the causes and protect against the consequences of the ailment. The following case report presents another, extremely rare cause of face edema. [ABSTRACT FROM AUTHOR]

Introduction. The prevalence of shellfish allergy depends on the climate zone and the population. It is assumed that about 0.5-2.5% of the general population is allergic to shrimps. The best-characterized allergens are tropomyosin, arginine kinase, sarcoplasmic calcium-binding protein and hemocyanin. Case report. The patient, 28 year old male, was admitted in July 2017 to the Department of Allergology to diagnose the cause of anaphylactic reaction which occurred 3 months prior to the hospitalization after consumption of king prawns. Immediately after the meal the patient developed pruritus and generalized urticaria as well as swelling of the hands and face. Next the patient developed vast urticaria on limbs and trunk, followed by tachycardia and hypotension. During the diagnosis, the patient underwentskin prick tests with extracts of food and inhalant allergens, including standardized shrimp allergen extract - with a positive result for D. pteronyssinus and D. farinae, grass, weeds, cat dander, hazel, birch and alder, but negative for all food allergens tested, including shrimp. The prick by prick tests performed with fresh royal shrimp (both raw and cooked) yielded strongly positive results. The concentration of IgE specific to shrimp allergen was elevated - 5.25 kU/l, while the concentration of IgE of shrimp tropomiosin was negative (ImmunoCap). In addition, elevated concentrations of IgE specific for D. pteronyssinus were found 9.86 kU/l, D. farinae 7.90 kU/l, grass 19.09 kU/l, cat's dander 2.94 kU/l. We also established the level of IgE specific to allergen components using the ImmunoCap ISAC method. Allergen-specific IgE was not elevated to any shrimp allergens available in ImmunoCap ISAC: n Pen m1 (tropomyosin), n Pen m2 (arginine kinase) and n Pen m4 (calcium binding sarcoplasmic protein). Conclusions. On the basis of conducted examinations the patient was diagnosed with a shrimp allergy. The applied molecular diagnostics did not explain which allergen component the patient is allergic to. It is possible that the patient is allergic to hemocyanin, which can also cross-react with house dust mite allergens, but confirmation of this diagnosis requires further investigation. [ABSTRACT FROM AUTHOR]

Diagnosis of allergic diseases is one of the most difficult in medicine. Detailed gathering of a medical history, especially if it concerns food allergy is a big challenge, among others due to the amount and variety of food intake, the presence of cofactors, or the use of food additives. The problem is also the presence of the so-called hidden allergens. Diagnostic process is also complicated by the lack of precise research tools, which are characterized by 100% sensitivity and specificity. Each of the methods used has its limitations, and the negative result is not the basis for the exclusion of allergies. The article presents problems that may be encountered by a doctor diagnosing allergic diseases. The authors hope that it will be helpful, especially in those patients whose clinical manifestations do not correlate with the results of the tests. The more so that allergic diseases are an increasing problem that affects not only the patient himself, but they also constitute a social and economical problem. The symptoms of allergic diseases are so troublesome for patients that they have been combined into one disease entity known as: allergic irritability syndrome. [ABSTRACT FROM AUTHOR]

Peach allergy is particularly common in the Mediterranean countries, but in other parts of the Europe, including Poland, this is a growing problem. The main peach allergen is the non-specific, low molecular weight lipid transfer protein (LTP) Pru p 3, belonging to the prolamin superfamily, mainly found in the peach skin. The most common clinical manifestation of peach allergy is oral allergy syndrome (OAS), which occurs in 79% of peach allergic patients. The diagnostic gold standard in peach allergy remains the double blind placebo controlled food challenge (DBPCFC). The future lies with molecular diagnostics, which is becoming more and more popular nowadays. It enables precise determination of allergic components to which a patient is hypersensitive. It has crucial in predicting the patient's allergic disease's natural course, and is useful in identifying patients with higher risk of anaphylactic reactions. [ABSTRACT FROM AUTHOR]

Macrophage activation syndrome (MAS) is a reactive form of haemophagocytic lymphohistiocytosis (HLH). The mechanisms causing the disease include activation and proliferation of macrophages, which is associated with symptoms of systemic inflammatory reaction, enlargement of organs and cytopenia due to hemophagocytosis of hematopoietic cells. MAS may develop in the course of systemic connective tissue diseases, most commonly in juvenile idiopathic arthritis, Still's disease and systemic lupus erythematosus. In clinical image is characterized by persistent fever despite the use of antibiotics, hepatosplenomegaly, lymph node enlargement, rash, neurological symptoms, hepatic and myocardial insufficiency are observed. It is a serious, life-threatening and potentially fatal complication. Therefore, proper diagnostic process and providing optimal treatment is crucial. In the diagnostic process the HScore scale can be used to assess the probability of MAS occurrence in a patient. In the case of MAS secondary to systemic connective tissue diseases, the treatment should be considered individually depending on the underlying disease, triggering factor and the severity of symptoms. The first line of treatment are intravenous glucocorticosteroids. In case of ineffective treatment, cyclosporin A, intravenous immunoglobulin, etoposide, plasmapheresis, anti-thymocyte globulin, granulocyte-macrophage colony-stimulating factor (GM-CSF) as well as biological treatment are used. [ABSTRACT FROM AUTHOR]

Introduction. Examination of IgE levels specific to allergen components is indicated in patients with anaphylaxis of unclear cause. Case report. A 27 year old male underwent diagnosis because of recurrent allergic reactions, occurring only after physical exertion, without any specific cause. Patient had 3 episodes of anaphylaxis in the last 3 years, always due to food and physical exercise. The first reaction occurred after consumption of kiwi, the second and third after meals, which were consumed by the patient regularly, without any side effects. Methods. During the diagnostics, the patient underwent skin prick tests (SPT) with selected inhaled and food allergens, prick by prick tests with selected fruits and vegetables. IgE levels specific to allergen components were determined using ImmunoCap ISAC. Patient performed exercise provocation test, with and without proceeding food challenge. Results. SPT were positive with the following allergens: weed, poplar, alder, birch, Artemisia vulgaris, tomato, banana. Prick by prick tests were positive for peach. In the ImmunoCap ISAC we found elevated IgE levels specific to birch Bet v 1, allergens belonging to the LTP family (Ara h1, Cor 8, Jug r 3, Pru p 3, Art v 3, Pla 3) and Mal d 1, Pru p 1, and Act d 2. Food-exercise challenges, both without and with suspected allergen consumption, were negative. Conclusions. The clinical pattern of allergic disease, its heterogeneous course, and co-occurrence of cofactors necessary to induce anaphylaxis may suggest that in this case LTP-allergy is the source of symptoms. [ABSTRACT FROM AUTHOR]

Overweight and obesit, as well as allergies, represent a growing problem in all developed countries. An interesting issue is the impact of these health problems on one another. At present, a characteristic phenotype of asthma associated with obesity is distinguished. There is plenty of evidence that weight loss results in improved bronchial asthma control. What is more, weight gain can aggravate the course of asthma. Adipose tissue is immunologically active, which may be an important factor in the development of allergies. It is known that allergic inflammation is promoted by some cytokines and interleukins. Weight gain results in an increase of levels of Il-6, leptin, TNF-alpha. Il-6 and leptin influence the decrease in T-regs activity. The relationship between asthma and obesity is evident, but does diet affect the development of other atopic diseases? In this article we attempt to answer this question based on the latest publications. [ABSTRACT FROM AUTHOR]

Wheat-dependent exercise induced anaphylaxis (WDEIA), caused by sensitization to omega-5 gliadin is an important clinical problem. The study presents an interesting case of WDEIA and highlights the role of component resolved diagnosis and challenge tests in establishing the proper diagnosis. Patient, 55, male, was diagnosed due to recurrent episodes of anaphylaxis, with generalized urticaria, accompanying hypotension and loss of consciousness. The symptoms occurred every 2-3 months. In the course of diagnosis we performed skin prick tests (SPT) with inhalant and food allergens. We also established the concentration of total IgE, specific IgE to Dermatophagoides pteronyssinus, Dermatophagoides farinae, bee and wasp venom, gluten, wheat and rye flour and the level of IgE specific to allergen components using ImmunoCap ISAC. Patient also performed exercise provocation test on an empty stomach and after eating bread. SPT were positive with wheat flour (4/25 mm) and rye flour (4/5 mm). The concentration of allergen-specific IgE against wheat flour (before exercise provocation test) was 0.18 IU/ml and rye flour 1.06 IU/ml, after provocation test 0.18 IU/ml and 1.21 IU/ml respectively. ImmunoCap ISAC reveled elevated level of IgE specific to wheat allergen component rTri 19 (omega-5-gliadin) - 2.4 ISU-E and to timothy nPhl p4 (berberine bridge enzyme) - 2.5 ISU-E. Exercise provocation test on an empty stomach was negative, with no disturbing symptoms. Exercise provocation test after consumption of bread was positive, with hypotension and generalized whole skin urticaria. Based on the clinical history of the disease, results of provocation test and immunological examination, the patient was diagnosed with wheat- dependent exercise induced anaphylaxis. [ABSTRACT FROM AUTHOR]