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Abstract: Globally Ambrosia species (Asteraceae), commonly called ragweed, are recognized to be one of the most problematic groups of invasive weeds and one of the main allergenic genus. Climate and land-use change and air pollution are expected to promote ragweed spread, increase airborne ragweed pollen concentrations (the source of allergens), extend the pollen season, and promote longdistance transport of pollen or sub-pollen particles containing allergens. The allergenicity of pollen itself is going to increase. Likely, all these factors will have meaningful effects in the exacerbation of the sensitization to ragweed pollen and the severity of allergy symptoms. Globally the major health concern regards A. artemisiifolia, because of its very wide global distribution and highly invasive behavior. Together with A. artemisiifolia, also A. trifida and A. psilostachya are species of health concern distributed across different continents, widespread and invasive in several regions. The present review summarizes the characteristics of these species and gives an overview of factors contributing to their allergenicity.

Background: Shellfish allergy is a major cause of food allergy and anaphylaxis worldwide. Several allergenic proteins have been described in the last few years, but the only diagnostic tool that still enables discrimination between allergic and nonallergic sensitized persons is the oral food challenge (OFC). Objective: The aim of this study was to evaluate the usefulness of the nasal allergen provocation test (NAPT) as a diagnostic tool in shellfish allergy. Methods: Forty-five patients with confirmed sensitization to shrimp by a positive skin prick test (SPT) result with a commercial shrimp extract were recruited and classified as sensitized-allergic or sensitized-nonallergic based on current tolerance to shrimp intake, the result of an OFC with a freeze-dried cooked shrimp mixture extract, or a recent history of anaphylaxis induced by shrimp ingestion. These patients and 10 controls not sensitized to shrimp underwent NAPT with a freeze-dried cooked shrimp mixture extract. The response was evaluated using acoustic rhinometry and a visual analog scale. Results: Significant differences (P=.001) were found between the sensitized-allergic group (18/20 positive NAPT, 90%) and both the sensitized-nonallergic group (2/18 positive NAPT, 11.1%) and controls (0/10 positive NAPT). NAPT enables differentiation between allergic and nonallergic persons with a sensitivity of 90%, specificity of 89%, positive predictive value of 90%, and negative predictive value of 89%. Conclusions: Our results indicate that NAPT makes it possible to differentiate between sensitized symptomatic patients and sensitized tolerant patients and could be a valuable diagnostic tool when assessing shrimp allergy.

The growing number of characterized allergen molecules and their use in clinical diagnosis has led to the creation of several allergen databases fulfilling different needs. Those range from systematic allergen nomenclature to clinical diagnosis, including comparison of biochemical properties and immunological and structural characterization. The databases listed in this brief summary have overlapping features and their individual utility will depend on the needs of the user.; Le nombre croissant d’allergènes moléculaires caractérisés et leur utilisation dans le diagnostic clinique ont favorisé la création de plusieurs bases de données répondant à différents besoins. Celles-ci vont de la nomenclature systématique des allergènes au diagnostic clinique en passant par la comparaison des propriétés biochimiques et la caractérisation immunologique et structurelle. Les bases de données énumérées dans ce bref résumé présentent des caractéristiques communes et leur utilité individuelle dépendra des besoins de l’utilisateur.

Background Given the increased popularity of flaxseed in meals, several cases of allergy to these seeds have been reported. Little is known about allergens implicated in hypersensitivity reactions to these seeds. The present work aimed to identify the allergens involved in IgE-mediated reactions in five patients with a clinical history of severe systemic symptoms after flaxseed consumption. Methods Proteins susceptible to be allergens with IgE-binding capacity were purified from flaxseed extract by chromatographic techniques. Their identification was achieved via MALDI-TOF mass spectrometry. Immunoassays were performed using the five allergic patient's era either by testing them individually or as a pool. Results Proteins susceptible to be allergens with IgE-binding capacity were purified from flaxseed extract by chromatographic techniques. Their identification was achieved via MALDI-TOF mass spectrometry. Immunoassays were performed using the five allergic patient's era either by testing them individually or as a pool. Results: Four out of five patients recognized a low-molecular-mass protein (around 13kDa) by immunoblotting of the flaxseed extract, while two patients recognized a protein of approximately 55 kDa. They were identified by mass spectrometry as flaxseed 2S albumin, included into WHO/IUIS allergen nomenclature as Lin u 1,and 11S globulin, respectively. Inhibition assays revealed in vitro IgE-cross-reactivity of Lin u 1 with peanut and cashew nut proteins, while IgE recognition of 11S globulin by patients' sera was partially inhibited by several plant-derived sources. Conclusions Seed storage proteins from flaxseed were involved in the development of severe symptoms in five individuals and exhibited cross-reactivity with other allergenic sources. Besides the severity of flaxseed allergy in patients sensitized to 2S albumin, it is the first time that the 11S globulin is identified as a potential allergen. We consider that these data should be taken into account for a more accurate diagnosis of patients.

Objectives: To determine the usefulness of the in vitro and in vivo methods used in the diagnosis of kiwifruit allergy and to specifically assess the impact of seed proteins on sensitivity. Methods: We performed skin prick tests (SPTs) using various commercial extracts, homemade pulp, and seed extracts and prick-prick tests with kiwifruit on 36 allergic patients. The presence of specific IgE (sIgE) was assessed using the ImmunoCAP (kiwifruit extract), ELISA (Act d 1, Act d 2), ISAC, and FABER assays. Immunoblotting of seed extract was carried out, and a single-blind oral food challenge was performed with whole seeds in seed-sensitized individuals. Results: The prick prick test with kiwifruit demonstrated the highest diagnostic capacity (81.8% sensitivity and 94.1% specificity) among the in vivo tests. The sIgE levels measured using ImmunoCAP (kiwifruit extract) showed a similar sensitivity to that of global ISAC and FABER (63.9%, 59.5%, and 58.3%, respectively). Act d 1 was the major allergen. Sensitization to Act d 1 was associated with positive sIgE results to whole kiwifruit extract detected by ImmunoCAP (P

Urticaria is a distressing dermatologic condition for many. Although the wheals of urticaria are characteristically evanescent, lasting less than 24 hours, patients tend to have recurrent episodes. Hives that last less than 6 weeks are considered acute urticaria. Acute urticaria does not routinely require supplementary work-up because the history often identifies a convincing, inciting allergen. Chronic urticaria is defined as episodes that occur for longer than 6 weeks, and there is often not an easily identifiable trigger. For both acute and chronic urticaria, patients frequently report food as a precipitating cause. For acute urticaria, the foods that are associated with true allergies, such as nuts and shellfish, are the most frequent offenders. The relationship between diet and chronic urticaria is not as firmly defined. Many patients unnecessarily restrict their diets, so it becomes the role of dermatologists to help patients identify if there is a reproducible link between their symptoms and their dietary exposures. The literature suggests that diets free from pseudoallergens and histamine-releasing foods may attenuate urticaria. Supplements such as fats, vitamin D, iron, and flavonoids have also been studied and may diminish symptoms.

Background House dust mite (HDM) allergens are major elicitors of allergic reactions worldwide. Objective Identification, characterization, and evaluation of diagnostic utility of a new important HDM allergen was performed. Methods A cDNA coding for a new Dermatophagoides pteronyssinus (Dp) allergen, Der p 37, was isolated from a Dp expression library with allergic patients' IgE antibodies. Recombinant Der p 37 (rDer p 37) expressed in Escherichia coli was purified, then characterized by mass spectrometry, circular dichroism, and IgE reactivity by ImmunoCAP ISAC technology with sera from 111 clinically defined HDM-allergic patients. The allergenic activity of rDer p 37 was studied by basophil activation and CD4+ T-cell responses by carboxyfluorescein diacetate succinimidyl ester dilution assays. Specific antibodies raised against rDer p 37 were used for the ultrastructural localization of Der p 37 in mites by immunogold transmission electron microscopy. Results Der p 37, a 26 kDa allergen with homology to chitin-binding proteins, is immunologically distinct from Der p 15, 18, and 23. It is located in the peritrophic membrane of fecal pellets. Der p 37 reacted with IgE antibodies from a third of HDM-allergic patients and induced specific basophil- and CD4+ T-cell activation. Der p 37 IgE–positive patients had significantly higher IgE levels to major HDM allergens, reacted with more HDM allergens, and had a higher risk (odds ratio = 3.1) of asthma compared to Der p 37–negative patients. Conclusions Der p 37, a new Dp allergen recognized by a third of HDM-allergic patients, may serve as a surrogate marker for severe HDM sensitization and asthma.

Rationale Environmental exposures have been associated with adverse outcomes in COPD. Approximately one third of individuals with COPD have allergic sensitization, but it is unknown whether exposure to allergens in the home are associated with outcomes. Objectives To determine the prevalence and associations of allergen sensitization with exposure to common indoor allergens with symptoms and exacerbation risk in COPD. Methods Allergen sensitization to five common indoor allergens was assessed in former smokers with COPD. Home settled dust was assessed for presence of corresponding allergens. Sensitization and exposure status were determined and associations evaluated in adjusted models with longitudinal outcomes including symptoms, lung function and exacerbations. Interactions were assessed between sensitization/exposure status and lung function. Measurements and Main Results One hundred eighty-three individuals studied were on average 67.3 years old (SD 8.22) with average FEV1 of 53.2 % (SD 17.6%). Seventy-seven percent of participants were exposed to at least one tested allergen, and 17% had sensitization with corresponding allergen exposure. After adjustment, sensitization with exposure was associated with lower lung function (β -8.29, 95% CI -14.80 to -1.77), higher SGRQ (β 6.71, 95% CI 0.17 to 13.25) and higher exacerbation risk (OR 2.31, 95% CI 1.11 to 4.79). Associations appeared to be more pronounced among individuals with lower lung function. Conclusions Allergen exposures are common in COPD and associated with adverse outcomes among those with concomitant allergen sensitization. This study establishes allergens as an important home exposure that potentially could be addressed with comprehensive home environmental modification strategies to improve COPD outcomes.

Asthma and allergic disease result from interactions of environmental exposures and genetics. Vitamin E is one environmental factor that can modify development of allergy early in life and modify responses to allergen after allergen sensitization. Seemingly varied outcomes from vitamin E are consistent with the differential functions of the isoforms of vitamin E. Mechanistic studies demonstrate that the vitamin E isoforms α-tocopherol and γ-tocopherol have opposite functions in regulation of allergic inflammation and development of allergic disease, with α-tocopherol having anti-inflammatory functions and γ-tocopherol having pro-inflammatory functions in allergy and asthma. Moreover, global differences in prevalence of asthma by country may be a result, at least in part, of differences in consumption of these two isoforms of tocopherols. It is critical in clinical and animal studies that measurements of the isoforms of tocopherols be determined in vehicles for the treatments, and in the plasma and/or tissues before and after intervention. As allergic inflammation is modifiable by tocopherol isoforms, differential regulation by tocopherol isoforms provide a foundation for development of interventions to improve lung function in disease and raise the possibility of early life dietary interventions to limit the development of lung disease.

Itaconate is produced from the mitochondrial TCA cycle enzyme aconitase decarboxylase (encoded by immune responsive gene1; Irg1) that exerts immunomodulatory function in myeloid cells. However, the role of the Irg1/itaconate pathway in dendritic cells (DC)-mediated airway inflammation and adaptive immunity to inhaled allergens, which are the primary antigen-presenting cells in allergic asthma, remains largely unknown. House dust mite (HDM)-challenged Irg1-/- mice displayed increases in eosinophilic airway inflammation, mucous cell metaplasia, and Th2 cytokine production with a mechanism involving impaired mite antigen presentations by DC. Adoptive transfer of HDM-pulsed DC from Irg1-deficient mice into naive WT mice induced a similar phenotype of elevated type 2 airway inflammation and allergic sensitization. Untargeted metabolite analysis of HDM-pulsed DC revealed itaconate as one of the most abundant polar metabolites that potentially suppress mitochondrial oxidative damage. Furthermore, the immunomodulatory effect of itaconate was translated in vivo, where intranasal administration of 4-octyl itaconate 4-OI following antigen priming attenuated the manifestations of HDM-induced airway disease and Th2 immune response. Taken together, these data demonstrated for the first time a direct regulatory role of the Irg1/itaconate pathway in DC for the development of type 2 airway inflammation and suggest a possible therapeutic target in modulating allergic asthma.

Immune tolerance to allergens in early-life decreases the risk for asthma in later life. Here we show establishment of stable airway tolerance to the allergen, house dust mite (HDM), by exposing newborn mice repeatedly to a low dose of the allergen. Lung dendritic cells (DCs) from tolerized mice induced a low Th2 response in vitro mirroring impact of tolerance in vivo. In line with our previous finding of increased mitochondrial H2O2 production from lung DCs of mice tolerized to ovalbumin, depletion of mitochondrial H2O2 in MCAT mice abrogated HDM-induced airway tolerance (Tol) with elevated Th2 effector response, airway eosinophilia, and increased airway hyperreactivity. WT-Tol mice displayed a decrease in total, cDC1 and cDC2 subsets in the lung as compared to that in naive mice. In contrast, the lungs of MCAT-Tol mice showed 3-fold higher numbers of cDCs including those of the subsets as compared to that in WT mice. Our study demonstrates an important role of mitochondrial H2O2 in constraining lung DC numbers towards establishment of early-life airway tolerance to allergens.

Provocation tests with allergens play a critical role in differential diagnosis of allergic diseases. The nasal allergen provocation test and the conjunctival allergen provocation test are particularly useful in the diagnosis of allergies with the underlying mechanism involving IgE-dependent reactions. Interestingly, the symptoms typical of both the nasal allergen provocation test and conjunctival allergen provocation test occur during the tests: ocular symptoms during the nasal test and typical nasal symptoms during the conjunctival test. These symptoms provide a picture of the early and late phases of the allergic reaction. Increasing attention is given to the role of the two provocation tests in differential diagnosis of food allergies, and the first studies involving food challenge tests provide a solid foundation for further research in this area.

Background Soybean is the largest source of protein meal worldwide but is an allergen affecting 0.5% of the general population. Soybean contains at least 30 allergens, such as Gly m 1 to Gly m 8, P28 and P34. Soybean allergies can cause allergic symptoms such as asthma, shock and death. Thus, identifying soybean allergens and reducing allergenicity are crucial for solving the problem of soybean allergies. Scope and approach This review summarized the characteristics, structures and epitopes of soybean allergens, especially major allergens (Gly m 4, Gly m 5, Gly m 6, P28 and P34). Various processing techniques to reduce the allergenicity of soybeans were evaluated and compared, including thermal processing, fermentation, high hydrostatic pressure, sprouting, enzyme catalysis, glycosylation and irradiation, etc. Key findings and conclusions Characteristics, structures and epitopes of soybean allergens play important roles in soybean allergenicity. Among the various methods to reduce soybean allergenicity, thermal processing, enzymatic degradation and fermentation are effective in reducing the allergenicity of soybean, resulting for the destruction of epitopes and the reduction of allergens mainly induced by protein degradation. In addition, fermentation strains and metabolites reduce the sensitivity of the body to allergens. Using irradiation to reduce the allergenicity of soybean at safe dosages (≤10 kGy) is difficult. Other processes (e.g., high hydrostatic pressure, glycosylation and sprouting) may work under certain circumstances. A combination of multiple methods is a potential novel method to reduce the allergenicity of soybean.

The outcomes of reaction results, forms of tuberculinization, methodologies, essence, and relevance are all described in the scientific research study.

Skin prick test (SPT) is useful in identifying rat and mouse sensitization.To determine the prevalence of rat and mouse sensitization by using local and commercial allergen extracts.Patients with allergic rhinitis or asthma were recruited. SPT of local and commercial rat and mouse allergen extracts were performed. The level of rat and mouse specific IgE (sIgE) was quantified in all patients with positive SPT and randomized patients with negative SPT.Two hundred and thirty patients, 108 male (47%) and median age 14 years (3.2-63.5 years), were enrolled. Rat sensitization by SPT was 11.7% and mouse sensitization was 17.8%. SPT result to local rat and commercial rat allergen extracts were moderately correlated (rs = 0.51, p0.001), while SPT result to local mouse and commercial mouse allergen extracts showed low correlation (rs = 0.38, p0.001). The concordance of SPT results between local rat and commercial rat allergen extracts was 90.4%. Concordance between the local mouse and commercial mouse allergen extracts was 85.2%. When compared with rat and mouse sIgE, the concordance of local rat, commercial rat and commercial mouse allergen extract were80% while that of local mouse was 54.4%. No adverse effect was observed in SPT with any allergen or extract.The prevalence of rat and mouse sensitization was low compared to the study in USA. SPT with local rat and mouse allergen extract was safe and showed good concordance with the SPT result of commercial allergen extracts and rat and mouse sIgE levels.

Background In allergic models, administration of rice that expresses a hybrid peptide consisting of 7 major T cell epitopes of Cry j 1 and Cry j 2 (7Crp), suppressed allergic symptoms, IgE elevation and specific T cell response to Japanese cedar pollen. Objective To evaluate the efficacy and safety of 7Crp-expressing rice in patients with Japanese cedar pollinosis METHODS: A 24-week randomized, double-blind, placebo-controlled study was performed to see the efficacy of 7Crp on allergic symptoms using scoring systems, in which 45 patients were assigned to take either 5 g, 20 g test rice, or placebo daily. A 96-week open study was also conducted to determine its inhibitory effect on serum IgE and T cell proliferative response for Japanese cedar pollen, in which 10 patients consumed 5 g test rice daily. Results No adverse events associated with the test rice occurred, and the intake rate was more than 96%. The test rice did not show suppression of symptoms related to Japanese cedar pollinosis within 24 weeks. However, intake of 5 g test rice led to a significant decrease in T cell response to Japanese cedar pollen during and after the second disperse season in a 96-week open trial, whereas the specific IgE titer remained unchanged. Conclusion Tolerability and safety of 7Crp-expressing rice was accepted. Daily intake of up to 20 g transgenic rice did not provide beneficial effects on Japanese cedar pollinosis within 24 weeks, however, continuous intake of 5 g rice might reduce allergen specific T cell response.

Purpose Despite the vaginal mucosa is able to respond to allergenic stimuli, vaginal allergic responses have been under investigated in clinical practice. Thus, we aimed to identify the most frequent etiological agents responsible for vulvovaginal allergies, the prevalent signs/symptoms, and the diagnostic tests applied in this clinical condition. Methods Literature search was performed on PubMed, Scopus, Scielo, Web of Science, and EMBASE. The study protocol was registered on PROSPERO (CRD42020167238). Studies were divided in two groups depending on allergen exposure route. Due to a significant number of studies correlating allergy to Candida infection, subgroup analysis was included. Results In direct exposure cases, Human Seminal Plasma was the most prevalent allergen, sensitizing 73% of affected women. These women presented localized swelling and burning as prevalent symptoms, affecting 42/68 and 36/68 women, respectively. Cutaneous Prick tests were applied in 58/68 women, either alone or combined with IgE measurements. Regarding cases of indirect/unidentified exposure, house dust mites was the most prevalent allergen (54%), followed by pollen (44%). Predominant symptoms were vulvar pruritus and burning, affecting 67/98 and 52/98 women. Skin prick test was the most prevalent diagnostic method used among different studies. Hypersensitivity toward Candida antigen was present in only half (163/323) of women presenting concomitant allergy and Candida infection. Conclusion From the two types of allergen exposure that can cause vulvovaginal allergic responses, direct contact of the antigen with the vulva and/or vagina was the most prevalent. Still, allergens can also sensitize the vaginal mucosa secondarily to other exposure route, specifically aeroallergens.

Objective. Determining sensitivity to allergens is an essential step in diagnosing children with allergic diseases. Chronic cough has remained poorly understood with causative triggers. The purpose of our study was to shed light on the relationship between sensitization to aeroallergens and chronic cough. Methods. This population-based study examined children (aged 7 years to 13 years) between June and July 2016. The 1,259 children, 72 of whom (5.7%) had a chronic cough, and 1,187 of whom (94.3%) did not (controls), completed the questionnaire, but 1,051 children completed skin prick tests (SPTs) with eight aeroallergens. Results. There were positive SPT results to at least 1 allergen in 549 children (52.2%). Sensitization to house dust mite (HDM) was most common (chronic cough = 46.9 % ; controls = 47.2 % ), followed by pollen (chronic cough = 21.9 % ; controls = 16.5 % ) in both groups, but there was no difference in allergic profile and sensitization to aeroallergen ( P > 0.05 for all comparisons). Multivariable analysis with adjustment for confounding indicated that children who were in sensitization to pollen had an increased risk of chronic cough ( aOR = 2.387 ; 95% CI: 1.115 to 5.111; P = 0.025 ). Multivariable analysis with adjustment for confounding indicated that children who were exposed to current smoking ( aOR = 4.442 ; 95% CI: 1.831 to 10.776; P = 0.001 ) and mold ( aOR = 1.988 ; 95% CI: 1.168 to 3.383; P = 0.011 ) were associated with chronic cough. Conclusion. Sensitization to pollen should be considered as a potential contributing factor to the development of chronic cough in school-aged children.

The number of hospitalisations due to an anaphylactic reaction to food is continuously increasing. Therefore, there is an urgent need to seek effective therapy. Currently, the only way to treat food allergies is to avoid allergens and to administer intramuscular adrenaline if an accidental allergen intake occurs. The only causal therapeutic strategy is specific oral immunotherapy. An increasing amount of data confirms this therapy's effectiveness and safety, but the results remain inconclusive due to the lack of long-term follow-up. In this state-of-the-art review, we briefly summarise the latest placebo-controlled randomised controlled trials on oral immunotherapy (OIT) to treat food allergy. During the paper's review, we asked the following questions: does the therapy permanently increase the amount of allergen consumed without symptoms? Does it significantly increase or decrease the occurrence of severe systemic reactions - requiring the administration of adrenaline or hospitalisation? Many authors describe outcomes such as an increase in the amount of allergen that can be safely ingested; however, significant clinical benefits such as decreased hospitalisations or anaphylaxis incidence are rarely included in the results. To date, there is no unified protocol of therapy, which makes comparisons between studies difficult because of significant differences in types, doses, and routes of administration of the allergen, timeline for up-dosing and maintenance, duration of the therapy, and primary outcomes of OIT.

BACKGROUND Few studies explored the relationship between stasis dermatitis (SD) and allergic contact dermatitis (ACD). OBJECTIVE To examine trends, associations, and clinical relevance of ACD in patients referred for patch testing who had a final SD diagnosis. METHODS Retrospective analysis from 2001 to 2016 of 38,723 patients from the North American Contact Dermatitis Group. RESULTS After patch testing, 303 (0.7%) patients were diagnosed with SD; 46.7% had a concomitant diagnosis of ACD. Patients with vs. without a final SD diagnosis had similar proportions of ≥ 1 positive allergic reaction (59.7% vs. 64.7%; Chi-square, P = 0.0724) but higher odds of allergic reactions to fragrance mix I, bacitracin, quaternium-15, Myroxylon pereirae, benzalkonium chloride, ethyleneurea melamine formaldehyde, diazolidinyl urea, and propylene glycol. The most commonly relevant allergens in patients with final SD diagnosis were fragrance mix I, Myroxylon pereirae, bacitracin, quaternium-15, and formaldehyde. The most common allergen sources were personal care products, topical medications and other health aid products. CONCLUSION Nearly half of patients with a final SD diagnosis were also diagnosed with ACD, supporting the role of patch testing in select SD patients.

The xMAP food allergen detection assay (xMAP FADA) is an advanced multiplex immunoassay with multiple antibodies for each of 15 target food allergens and gluten, allowing for signal confirmation and antigenic profiling to occur in a single analysis. Botanicals used as spices are complex matrices for allergen analysis because they can exhibit inherent cross-reactivity with antibodies employed by the assays. Preliminary examinations of botanicals revealed chili peppers to have notably high levels of cross-reactivity with Brazil nut and hazelnut antibody bead sets in the xMAP FADA. This in-depth investigation of 29 pre-ground and whole chili peppers indicated Brazil nut and hazelnut cross-reactivity to be consistent among most members of genusCapsicum, although cross-reactive signals generated by chili peppers were distinguishable from signals indicative of target allergen detection. Using the requirements that complementary antibodies used in the assay generated positive responses and that the various secondary end points were characteristic of the target analytes, xMAP FADA reactivity to chilis of the genus Capsicum was categorized as cross-reactivity instead of confirmed detection of target allergenic foods.

Sarcoplasmic calcium-binding protein is a stable allergen in Scylla paramamosain and named Scy p 4. To explore the importance of linear epitopes in the immunoglobulin G (IgG)/immunoglobulin E (IgE)-binding capacity of Scy p 4, chemical denaturants were used to destroy the structure. Scy p 4 was reduced with dithiothreitol and subsequently alkylated with iodoacetamide (IAA). Furthermore, the structural analysis indicated that IAA-Scy p 4 was an unstructured protein. The inhibition enzyme-linked immunosorbent assay showed that IAA-Scy p 4 could inhibit the binding of Scy p 4 to sensitize serum, with inhibition rates reached 55%. Moreover, the linear mimotopes of Scy p 4 were predicted in silico. Three linear epitopes were verified by serological tests and named L-Scy p 4-1 (AA76-91), L-Scy p 4-2 (AA111-125), and L-Scy p 4-3 (AA137-146). Overall, these data provide an understanding of the relationship between the structure and allergenicity about Scy p 4, and the identified linear epitopes can be used for diagnosis and food processing of shellfish allergy.

The detection of allergenic proteins and the influence of processing on the structure and antigenicity of these proteins are relevant topics. Using commercial enzyme-linked immunosorbent assay kits, this study aimed to evaluate the degradation profiles of milk, egg and soy proteins during the processing of semisweet biscuits. The formulations were baked under different conditions according to a complete factorial experiment that included a three-level temperature factor and a six-level time factor. β-lactoglobulin and egg white proteins were severely degraded, the degradation of casein was intermediate, and soy proteins were the most stable. Complete allergen protein degradation was found under only the extreme baking conditions, which resulted in products that were not sensorily acceptable. Residual levels of the proteins were detected after baking, indicating that this thermal processing reduced but did not eliminate the antigenicity of these proteins; thus, baking cannot be considered a strategy to protect allergic consumers.

Purpose: to study the changes in quantitative values and functional activity of immunocompetent cells on application of glucoseminylmuramildipeptide in children with allergen-induced phenotype of bronchial asthma.We have performed an integrated assessment of parameters of innate and acquired immunity in 60 children at the age of 3-11 years old with allergen-induced bronchial asthma (BA) with mild clinical course of disease, and in 30 healthy children of the same age. BA phenotypes were verified in accordance with PRACTALL international consensus report (2008). Study exclusion criteria were: severe course of bronchial asthma and application of immunocorrecting therapy during preceding six months. We conducted a prospective parallel open study of the effect of glucoseminylmuramildipeptide on the parameters of immunocompetent cells during three months with division into two control groups by random sampling technique on the basis of therapy being performed. To analyze the venous blood cells, we used flow cytofluorometer COULTER EPICS XL by Beckman Coulter Inc. Cytokine levels were determined using immunoenzyme method with reagents by R&D Diagnostics Inc (USA) and IgE – with reagents by Alkor Bio Company (St. Petersburg), production of cytokines – using reagents by Vektor-Best (Novosibirsk). Statistical processing of data was performed using Statistica 10 program with significance level p < 0.05, assessment of correlations by Spearman correlation analysis, multidimensional correlation analysis with V.P. Terentyev’s method of correlation pleiades (1959) and testing for normal distribution of characteristic values (Shapiro–Wilk). The scope of our study permitted to evaluate its findings with accuracy 95-99%.The changes of the adaptive response system in children with allergen-induced phenotype of BA were characterized by the intensified proliferation, suppression of negative regulation processes, activation of synthesis of Th2-profile cytokines, and intensified synthesis of IgE.The identified impairments of availability, functional activity of immunocompetent cells and cytokine production were preserved in application of inhaled corticosteroids therapy, with further decreasing of IFNγ synthesis.Application of glucoseminylmuramildipeptide in children with BA provided for reduction of spontaneous and mitogen-induced production of IL-4 and correction of deviated structural and functional characteristics of immunocompetent cells.Incorporation of glucoseminylmuramildipeptide into therapeutic regimens for allergen-induced phenotype of BA in children promoted normalization of parameters of the cellular component of immune system, amelioration of Th1/Th2-imbalance, increase of Th1 activity, and adequate spontaneous and induced production of IFNγ by peripheral blood cells.

Peanut (Arachis hypogaea) allergen powder-dnfp (Palforzia™; hereafter referred to as PTAH), is the first oral immunotherapy approved in the USA and European Commission for mitigating allergic reactions in children aged 4–17 years with peanut allergy. In the pivotal phase 3 studies in patients with peanut allergy, relative to placebo, PTAH significantly desensitized to peanut protein and reduced severity of allergic reactions to accidental peanut exposure, together with improvements in food allergy-related quality of life. The clinical benefits of PTAH were maintained with continued treatment for up to 2 years. Most adverse events with PTAH, including systemic allergic reactions, were of mild to moderate severity. Frequency and severity of adverse events decreased with continued treatment. Peanut allergy is a major growing health problem worldwide. Current management of peanut allergy includes strict peanut avoidance and management of acute allergic reactions. With various routes of immunotherapy being investigated as a potential treatment option, peanut (Arachis hypogaea) allergen powder-dnfp (Palforzia™; hereafter referred to as PTAH) is the first oral immunotherapy approved for children aged 4–17 years with peanut allergy. In children with peanut allergy, PTAH increased desensitization to peanut protein and reduced severity of allergic symptoms relative to placebo. Patients treated with PTAH also reported improvements in food allergy-related quality of life. Adverse events seen with PTAH, including systemic allergic reactions, are generally mild or moderate in severity. PTAH is a novel effective treatment option for mitigating allergic symptoms in children with peanut allergy.

Molecular diagnostics makes it possible to determine true and cross-reactivity differentially, which is of great clinical importance not only for the diagnosis of the true spectrum of sensitization, but also for the reasonable choice of pathogenetic therapy and prediction of the effectiveness and risks associated with allergen-specific immunotherapy (ASIT). Several clinical cases are presented as examples demonstrating the clarifying nature of molecular allergodiagnostics. In the first case, the detection of primary sensitization, which was conducted using ASIT with a causally significant allergen, led to the elimination of not only respiratory but also skin symptoms. In other clinical cases, patients had similar anamnesis and data from skin and laboratory studies. To clarify the indications for ASIT, correct choice of a therapeutic allergen and method of its administration, and the prognosis of the effectiveness of ASIT, it is necessary to identify the primary allergenic source that causes IgE-mediated sensitization. For this purpose, the patients were recommended to undergo laboratory diagnostic examinations to clarify the spectrum of sensitization. Component allergodiagnostics of ImmunoCAP made it possible to develop an individual management strategy for these patients.

BACKGROUND Tyrophagus putresecentiae is an important mite species in rural and urban environments, causing sensitization and allergic disease. While evidence suggests that microRNAs (miRNAs) may regulate the expression of allergen-encoding genes, no study has directly investigated this possibility. Here, this gap was addressed by profiling miRNAs and elucidating their target allergen messenger RNAs (mRNAs) in this mite species. METHODS Small RNA and transcriptome libraries were constructed for eggs, larvae, nymphs, and adults. After deep miRNA and whole-transcriptome sequencing were performed, the miRNA and allergen-encoding mRNA regulatory networks were explored. RESULTS A total of 540 miRNAs were identified, including 155 with expression levels differing significantly across the four mite developmental stages (p

Allergic rhinitis and asthma are highly related to indoor and outdoor allergens. A common weed, Chenopodium album is one of these outdoor aero-allergens. In the literature, data about specific characteristics of children with C. Album sensitization is limited. In this study, we aimed to evaluate demographic and clinical characteristics of patients with Chenopodium album sensitization in a cross-sectional study. The patients and two control groups included in the study were found to be sensitized to Chenopodium album following skin prick tests in an allergy clinic over a period of one year. The patients and control groups completed a questionnaire consisting of items regarding demographics and clinical characteristics. The frequency of Chenopodium album sensitizationwas 9.4% (47/502). The distribution of these patients diagnoses was: 48.9% allergic rhinoconjunctivitis (ARC), 19.1% allergic rhinitis (AR), 12.8% ARC + asthma, 8.5% asthma, 4.3% asthma + AR. Allergic rhinoconjunctivitis was statistically higher than in the control groups (P: 0.008, P: 0.001). Allergic rhinitis symptoms and ocular symptoms occurred together in 51% during the pollination period of Chenopodium album, whereas 17% of the patients were asymptomatic between August-September. Forty percent of the patients had accompanying sensitization to animal dander (cat and/or dog dander), which was statistically high compared to control group 1 (P: 0.001). In conclusion, Chenopodium album sensitization is highly related to rhinoconjunctivitis. Children with ocular symptoms must be evaluated for Chenopodium album sensitization. These children can also be expected to have a high animal dander sensitization rate.

The house dust mite is the most common cause of allergic diseases, and TLR4 acts as an overarching receptor for allergic responses. This study aimed to identify novel allergen binding to TLR4 in house dust mites and unveil its unique role in allergic responses. Der p 38 was purified and characterized by liquid chromatography tandem mass spectrometry–based peptide mapping. Biolayer interferometry and structure modeling unveiled TLR4-binding activity and the structure of recombinant Der p 38. The allergenicity of Der p 38 was confirmed by a skin prick test, and basophil activation and dot blot assays. The skin prick test identified 24 out of 45 allergic subjects (53.3%) as Der p 38+ subjects. Der p 38–augmented CD203c expression was noted in the basophils of Der p 38+ allergic subjects. In animal experiments with wild-type and TLR4 knockout BALB/c mice, Der p 38 administration induced the infiltration of neutrophils as well as eosinophils and exhibited clinical features similar to asthma via TLR4 activation. Persistent Der p 38 administration induced severe neutrophil inflammation. Der p 38 directly suppressed the apoptosis of allergic neutrophils and eosinophils, and enhanced cytokine production in human bronchial epithelial cells, inhibiting neutrophil apoptosis. The mechanisms involved TLR4, LYN, PI3K, AKT, ERK, and NF-κB. These findings may contribute to a deep understanding of Der p 38 as a bridge allergen between eosinophilic and neutrophilic inflammation in the pathogenic mechanisms of allergy.

The skin is a complex organ, harboring multiple cell types, including resident immune cells. Change in skin homeostasis can lead to the development of several inflammatory skin conditions, in particular different categories of allergic skin diseases such as Atopic Dermatitis (AD) and Allergic Contact Dermatitis (ACD). ACD is an acute skin inflammation, characterized by the onset of eczematous lesions at the contact site with the allergen (called hapten), and driven by a type 1/17 immune response. AD is a chronic skin inflammation with a type 2 immune signature, characterized by the development of skin dryness and eczematous lesions that can affect the entire body in the most severe cases. Importantly, these two diseases are strongly associated with itch. Itch in the skin is primarily encoded by specialized neuronal cell types called nociceptors/pruriceptors. In this review on neuro-immune interactions in allergic skin disease, we will detail the diversity of nociceptors and pruriceptors in the skin and focus on the particular role of such neurons in pruritus and as master regulators of the associated immune response to allergens.

Wenting Luo,&ast; Shuwen Yang,&ast; Huimin Huang, Liting Wu, Zhangkai J Cheng, Peiyan Zheng, Jinping Zheng, Baoqing Sun Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Baoqing Sun; Jinping Zheng Email sunbaoqing@vip.163.com; 18928868238@163.comObjective: Peanut is one of the most frequently reported allergens causing severe allergies in western countries. In China, however, there have been few reports of severe allergies caused by peanuts. We investigated the peanut allergen components sensitization and cross-reaction with pollen allergen in Chinese Southerners with allergic rhinitis and/or asthma.Methods: Total IgE (tIgE) and specific IgE (sIgE) antibodies against Ara h 1, Ara h 8, Juglans pollen, Platanus pollen, birch pollen, Bet v 1, Bet v 4, and cross-reactive carbohydrate determinant (CCD) of 58 allergic patients, of whom 33 were peanut-sIgE positive and 25 were negative, were detected by the ImmunoCAP system. The relationships between peanut allergen and pollen allergens were analyzed.Results: A 9.1% (3/33) of the patients with peanut sensitization were sensitized to Ara h 8, while 21.2% (7/33) were sensitized to Ara h 1. The peanut-sensitized group had significantly higher positive rates for sIgE antibodies against CCD (69.7% vs 4.0%), Juglans pollen (87.9% vs 12.0%), Platanus pollen (90.9% vs 16.0%), and birch pollen (60.6% vs 4.0%) than the peanut tolerance group (all P < 0.05). Spearman correlation showed that peanut-sIgE were significantly correlated with sIgE to CCD (rs=0.859), Juglans pollen (rs=0.772), Platanus pollen (rs=0.838) and birch pollen (rs=0.816).Conclusion: The majority of patients sensitized to peanut allergen in Southern China tested positive for multiple pollen allergens. Peanut sensitization was highly correlated with Platanus, Juglans, and birch pollen sensitization, which suggested there may be cross-reactions between peanut and pollen allergens. Clinicians should pay attention to distinguish diagnosis in clinical peanut allergy diagnosis and treatment.Keywords: peanut sensitization, pollen allergen, specific IgE, cross-reactivity, CCD

Allergic Rhinitis is one of the most common disease causing much debility and loss of efficiency of an individual. Allergic rhinitis can occur continuously or intermittently throughout the year by an allergen to which the individual is more or less always exposed, characterized by sudden attack of sneezing, swelling of nasal mucosa, profuse watery discharge, itching of eyes and lachrymation. This study is to know the effectiveness of Homoeopathic medicines in the treatment of Allergic Rhinitis.

Background Peas contain comparatively high levels of protein. With the recent trend for the development of alternative, high-protein food sources, pea flour, pea protein concentrate, and pea protein isolate have been incorporated into an increasing number of foods. Marketing materials sometimes claim that peas are hypoallergenic. Among the legume family, peanuts and soybeans are considered as commonly allergenic and regulations in many countries require special labeling and manufacturing control measures for foods containing peanuts or soybeans or ingredients derived from those two legumes. Peas are also legumes but are not on the lists of priority allergenic foods, so special labeling and manufacturing control measures are not needed for peas or pea-based ingredients. The increasing use of high-protein, pea-based ingredients in processed foods may necessitate further review of the placement of peas on the lists of priority allergenic foods. Additionally, peas are definitely allergenic and should not be marketed as hypoallergenic. Scope and approach The clinical allergy literature was searched for publications describing allergic reactions to peas, including both garden peas and field peas. The identification and characteristics of pea proteins are reviewed. The potential cross-reactivity of pea proteins with known allergens from peanut and soybean is assessed using a bioinformatics comparison. Key findings and conclusions Allergies to both garden peas and field peas are well documented. As consumer exposure to pea protein increases, an increase in allergies to peas should also be anticipated. Several allergenic proteins have been identified among the pea protein fractions. Pis s 1, a vicilin in the globulin fraction, appears to be the immunodominant allergen but additional studies on pea allergens are warranted. Pis s 2, a convicilin from the globulin fraction, is also identified as a pea allergen. The albumin fraction contains the two less well characterized allergenic albumin protein(s) known as PA1 and PA2. Furthermore, a non-specific lipid transfer protein (nsLTP), a member of the pathogenesis-related protein family (PR14) involved in plant defenses has been identified as an allergen. Strikingly, pea seeds do not contain the classical type of 2S albumin proteins, with the conserved Cys motif, of high allergenic potency found in peanut (such as Ara h 2, 6, and 7), soybean (Gly m 8), and certain tree nuts, e.g. Ber e 1 in Brazil nut, Ana o 3 in cashew, and Jug r 1 in walnut. The effects of processing on the allergenicity of peas have not been thoroughly evaluated, although some evidence indicates that the allergenicity of peas can be reduced by blanching for at least some pea-allergic individuals and that the pea albumin allergens have some limited heat stability.

Objective To investigate the changes of basophil activation before and after treatment of children with allergic rhinitis and its clinical significance. Methods A total of 18 children with moderate to severe persistent allergic rhinitis in the acute phase were included as the subjects of this study. Based on the conventional therapy for allergic rhinitis, 2 mL of anticoagulated peripheral blood was taken before the treatment (acute phase) and after the remission of clinical symptoms and signs (remission period), respectively. Inhalant allergen stimulation was performed in vitro and basophil activation status (expressions of CD63 and CD203c) was detected by flow cytometry so as to analyze the changes of basophil activation before and after treatment. Results 1. The mean value of VAS score in children with allergic rhinitis before treatment was 8 (6, 9), while that in the post-treatment remission period was 2 (0, 3.2). The symptoms were greatly improved after treatment and the VAS score was decreased significantly. The differences were statistically significant (P Conclusion According to the published basic and clinical researches, basophils may be important immune cells involved in allergic rhinitis. Basophil activation test can be used as an effective tool for allergen detection. The dynamic observation of basophil activation can provide an immunological basis for the clinical control of allergic rhinitis.

BACKGROUND Data on the sensitization pattern and clinical characteristics of pediatric vernal keratoconjunctivitis (VKC) are scary in Central Africa. This chronic form of allergic conjunctivitis affects the quality of school life and work productivity. There is no study that shows the breadth of vernal keratoconjunctivitis in our setting. PURPOSE To describe the clinical characteristics of vernal keratoconjunctivitis in Kinshasa, to evaluate the sensitization profile and associated factors. METHODS A total of 400 children with vernal keratoconjunctivitis underwent a clinical examination and a skin prick test (SPT) for 10 allergens. Dermatophagoides pteronyssinus, Blomia tropicalis and cockroach were the most common allergens in 52, 1 %, 18, 8% and 13% respectively among sensitized children and 66, 4% showed polysensitization. RESULTS The main symptoms were itchy eyes 45%, brownish discoloration conjunctiva 17%, red eyes 12, 2%, eyelids rubbing 11, 5%, tearing 8, 7% and photophobia 5, 5%.The limbic form was predominant with 54%, followed by palpebral form 26% and mixed form 20%. The most common complications were superficial punctate keratitis 17, 2%, shield ulcer 1, 5%, corneal plaque 1, 3% and corneal erosion 1%. CONCLUSION This study outlines that 34, 5% of children attending the outpatient Ophthalmology Department in two hospitals of Kinshasa for vernal keratoconjunctivitis disease had a positive skin prick test to at least one allergen, in particular for Dermatophagoides pteronyssinus, Blomia tropicalis and cockroach.

BACKGROUND Recent trends in the sensitization of construction workers show a decrease in potassium dichromate and an increase in epoxy resin sensitization. OBJECTIVES To present the trends of occupational contact allergy of construction workers in Greece from 2009 to 2018. METHODS We retrospectively reviewed the files of patients with eczema patch tested in our Contact Dermatitis Clinic who were construction workers. RESULTS A total of 191 construction workers initially reported contact dermatitis. Of these, 138 had occupation-relevant allergic contact dermatitis (ACD) or irritant contact dermatitis (ICD). All patients were men. After being patch tested, 98 (71.0%) were diagnosed with ACD and 40 with ICD. Median duration of occupation till onset of ACD was 2 years (interquartile range [IQR] 0.8-7). The hands were the most common location for ACD (73.5%), followed by the trunk (39.8%), the legs (38.8%), and the face (11.2%). Of the patients, 74.6% had lesions affecting multiple body sites. Potassium dichromate (67%) was the most frequent allergen, followed by thiuram mix (37.4%) and cobalt chloride (31.8%). Sensitization to epoxy resins was lower (12.1%). CONCLUSION The sensitization pattern of Greek construction workers does not follow the trends in Central or Northern Europe, rather sharing attributes with less industrialized countries.

Fungi are rich sources of biologically active natural compounds, which are used in the manufacturing of wide range of clinically important drugs. Alternaria is a fungal genus that belongs to family Pleosporaceae, and has been known as a promising secondary metabolites producer. However the same fungus showed harmful pathogenicity against different plants causing crops economical losses, and is a common allergen in humans, growing indoors and causing hay fever or hypersensitivity reactions. Alternaria is a multicultural fungal genus widely distributing in soil and organic matter. It includes saprophytic, endophytic and pathogenic species. This review aims to briefly summarize the structurally different metabolites produced by Alternaria fungi, as well as their occurrences, biological activities and functions.

The review of literature presents the current data about the antioxidant system of the respiratory tract. The localization of the components and functioning of the enzyme link of antioxidant defense in the respiratory tract are described. The protein content of the bronchoalveolar lavage is characterized. The changes in the content of various proteins in the bronchoalveolar lavage fluid after exposure to an allergen in patients with bronchial asthma are presented. There were shown the function and localization of non-enzymatic bioantioxidants of lung fluid. The characteristics, synthesis induction and physiological role in the respiratory tract of the antioxidant enzyme of lung fluid — extracellular superoxide dismutase were considered in detail., В обзоре литературы изложены современные данные об антиоксидантной системе респираторного тракта. Показаны локализация компонентов и функционирование ферментного звена антиоксидантной системы в респираторном тракте. Дана характеристика протеинового состава жидкости бронхоальвеолярного лаважа. Представлено изменение содержания различных протеинов в жидкости бронхоальвеолярного лаважа после воздействия аллергеном у больных бронхиальной астмой. Показаны функции и локализация неферментных биоантиоксидантов бронхоальвеолярного секрета. Подробно рассмотрены характеристика, индукция синтеза и физиологическая роль в респираторном тракте антиоксидантного фермента бронхоальвеолярного секрета — экстрацеллюлярной супероксиддисмутазы., В огляді літератури викладені сучасні дані щодо антиоксидантної системи респіраторного тракту. Показана локалізація компонентів і функціонування ферментної ланки антиоксидантної системи в респіраторному тракті. Викладена характеристика протеїнового складу рідини бронхоальвеолярного лаважу. Представлено зміни вмісту різних протеїнів у рідині бронхоальвеолярного лаважу після впливу алергена у хворих на бронхіальну астму. Показано функції й локалізацію неферментних біоантиоксидантів бронхоальвеолярного секрету. Докладно розглянуті характеристика, індукція синтезу й фізіологічна роль у респіраторному тракті антиоксидантного ферменту бронхоальвеолярного секрету — екстрацелюлярної супероксиддисмутази.

Background. Allergen-specific immunotherapy as elimination procedures is the only method of treatment and prevention of allergic disorders formation and exacerbation of clinical symptoms. One of the approaches to molecular diagnosis is choice of allergen for allergen-specific immunotherapy (ASIT). The purpose of our study was to identify possible reasons of failure of ASIT with pollen allergens (predominantly weeds) in children with seasonal allergic rhinitis (hay fever) and/or bronchial asthma based on studying hypersensitivity to the allergens, analysis of anamnestic data. Materials and methods. Allergy skin prick tests were conducted to 192 children (middle age 9.8 ± 2.7 years) with the seasonal symptoms of rhinitis and/or bronchial asthma according to standard methodology with pollen allergens of Immunolog Ltd (Vinnytsia). We evaluated positive results as 5 mm and higher diameter of papula/hyperemia. The anamnestic survey was carried out in 52 patients by means of the questionnaire that contained questions about cross allergy (pollen-food, oral allergy syndrome), concomitant pathology of upper respiratory tract and effectiveness of АSІТ, which is elaborated by us. Results. The skin prick tests show that in 192 patients, who have hay fever, ragweed, sunflower sensibilization predominates (56 and 58 %, correspondingly). About 10–20 % of children are sensitive to cereals (ryegrass, fescue). To the allergens of poplar, acacia, couch-grass, oak, mint, nettle, walnut, the positive reactions of prick tests were observed in 3–7 children, that is 1.5–3.6 %. According to our results, 23 % of patients had sensibilization to 5 and more pollen allergens. 52 % of children had concomitant food allergy, 15 % of patients have reactions of the lips, oral cavity when using certain products, mostly tomatoes, nuts, seeds (they were diagnosed oral allergy syndrome). Also, one third of children have varying degrees of adenoid hypertrophy, tonsils hypertrophy, allergic rhinitis is complicated by sinusitis in 13 % of cases. Children received 3 to 4 courses of preseason subcutaneous ASIT (December to May) according to classic scheme. The vast majority of children got mixed extracts of ragweed, cyclachaena, mugwort, quinoa, sunflower (90 %). One allergen (ragweed or sunflower) has been used only in 6 children (10 %). We detected that 1/5 children had no clinical effect, the symptoms of hay fever were not diminished or changed their temporal frames. 82 % of patients without effect of ASIT had cross plant-food allergy (oral allergy syndrome). Conclusion. Before the beginning of АSІТ in children with hay fever, the doctor must define a high-risk group in relation to its possible ineffectiveness. We suggest taking into account children with sensitization to 4 and more pollen allergens, with the presence of oral allergic syndrome, concomitant pathology of ENT organs, in particular, adenoid hypertrophy, chronic sinusitis. Such children are recommended to make a profile of molecular allergy diagnostics to determine the specific immunoglobulines Е to the major and minor allergens. Component resolved molecular allergy diagnostics maybe also helpful in estimation the risk of systemic (anaphylactic) reactions in children with cross reactivity (pollen-food allergy) and in improvement of preventive measures, in particular, in patients with oral allergy syndrome.

Pollen allergies are responsible for a considerable global public health burden, and understanding exposure is critical to addressing the health impacts. Atmospheric pollen counts are routinely used as a predictor of risk; however, immune responses are triggered by specific proteins known as allergens, which occur both within and on the surface of the pollen grain. The ratio between atmospheric pollen counts and allergen concentrations (‘pollen potency’) has been shown to be inconsistent, with potentially important implications for pollen monitoring practice. Despite this, there has been no previous synthesis of the literature and our understanding of the factors that influence pollen potency remains poor. We conducted a scoping review with the aim of deriving a current understanding of: (a) the factors that influence pollen potency; (b) its variation through time, between taxa and by location; and (c) the implications for pollen monitoring practice. Our synthesis found that pollen potency is highly variable within and between seasons, and between locations; however, much of this variability remains unexplained and has not been deeply investigated. We found no predictable pollen potency patterns relating to taxon, geography or time, and inconclusive evidence regarding possible driving factors. With respect to human health, the studies in our synthesis generally reported larger associations between atmospheric allergen loads and allergy symptoms than whole pollen counts. This suggests that pollen potency influences public health risk; however, the evidence base remains limited. Further research is needed to better understand both pollen potency variability and its implications for health.

The article presents literature data and therapeutic experience on the use of oral provocation tests. They are considered to be the golden standard for the diagnosis of food allergy and provide an opportunity not only to confirm the pre­sence of the condition, but also to determine the level of to­lerance to the product and to monitor the effectiveness of food desensitization. The risks and indications for oral provocation tests are presented. Difficulties in the results interpretation have also been evaluated. In particular, information about the fact that the mild, subjective, or atypical symptoms of food allergy are most complicated in the evaluation, as they can not only indicate the beginning of the development of serious reactions, but also be the result of the influence of emotional factors. The individual approach to choosing the dose of the food allergen and the interval between its administration during oral provocation tests was described. Our therapeutic experience confirms that symptoms during oral provocation tests predominantly occur after the administration of the allergen in higher doses. And, accordingly, at higher doses, as a rule, there were more severe symptoms of food allergy. A short time interval between the administration of an allergen (less than 30 minutes) can complicate the interpretation of the results and compromise the test. The article presents a clinical case of the oral provocation test in a 7-month-old child, which confirmed the presence of allergy to cow’s milk proteins. This case allows us to trace the peculiarities of the diagnostic investigation and the method of conducting the test at an early age using infant formulas (standard adapted milk and formula with complete protein hydrolysis).

Immunoglobulin E (IgE) is a well-known key factor in allergic airway disease; however, its central role in non-allergic airway inflammation is often underestimated. In some airway diseases, IgE is produced as a result of allergic sensitization. However, in others, IgE production occurs despite the lack of a specific allergen. Although multiple pathways contribute to the production of IgE in airway disease, it is its activity in mediating the inflammatory response that is associated with disease. Therefore, an understanding of IgE as the unifying component of upper and lower airway diseases has important implications for both diagnosis and treatment. Understanding the role of IgE in each upper and lower airway disease highlights its potential utility as a diagnostic marker and therapeutic target. Further classification of these diseases by whether they are IgE mediated or non–IgE mediated, rather than by the existence of an underlying allergic component, accounts for both systemic and localized IgE activity. Improvements in diagnostic methodologies and standardization of clinical practices with this classification in mind can help identify patients with IgE-mediated diseases. In doing so, this group of patients can receive optimal care through targeted anti-IgE therapeutics, which have already demonstrated efficacy across numerous IgE-mediated upper and lower airway diseases.

Animal blood is a by-product, which can be utilized in a value-adding way instead of being wasted. Allergen substitution is a good possibility especially for a substance that is difficult to substitute, such as milk. Blood plasma is a fluid with high protein content without blood (iron) taste and colour, so it is similar to milk in several ways. While investigating the substitution of milk, it is advisable to investigate the substitution of sugar as well because a lot of consumers who exclude milk from their diet find the glycaemic index and energy content of foods important. The investigated model food is a simple, homogeneous matrix: vanilla custard with milk and with and without sugar and vanilla custard with blood plasma and with and without sugar. Colour, pH and rheological attributes of custard sample groups were measured. According to the results the used protein source as well as sweetener significantly determine the colour, pH and texture of the final product. However, colour and pH are easy to change with other components (food colours, acidity regulators) and the effect of milk and sugar substitution on rheological attributes might not be possible to detect without instrumental analysis.

Animal blood is a by-product, which can be utilized in a value-adding way instead of being wasted. Allergen substitution is an obvious possibility because many properties of blood plasma are similar to egg white. Techno-functional and sensory attributes (water activity, moisture content, colour and texture related properties) were measured by instrumental methods. The allergenic egg powder can be substituted by non-allergenic blood plasma powder in sponge cakes, but the change in the ingredient has an effect on hardness and tolerating compressive stress until the breaking. In the case of water activity and moisture content, sponge cakes with blood plasma were as desirable as sponge cakes with egg.

Статья посвящена обсуждению проблемы распространения аллергических заболеваний среди детей раннего и младшего возраста. Гастроинтестинальные нарушения младенческого возраста, вызванные рядом аллергенов, но чаще всего контактом с белками коровьего молока, являются одной из самых частых и самых сложных клинических проблем для врача-педиатра. Особое внимание в данной статье уделяется так называемым не-IgE-опосредованным формам аллергии к белкам коровьего молока, то есть таким формам аллергии, при которых происходит поражение эпителия пищеварительного тракта ребенка при отсутствии каких-либо кожных и/или респираторных проявлений. Часть этих форм аллергии сопровождаются гемоколитическим синдромом, который является тревожным сигналом, или так называемым «красным флажком», для педиатров и семейных врачей и требует внимания, дифференциальной диагностики и грамотной адекватной терапии. Существенным (а в ряде случаев и единственным) компонентом такой терапии является элиминация аллергена из рациона ребенка или кормящей матери ­и/или назначение заменителя грудного молока, не содержащего причинно-значимый аллерген. С этой целью согласно рекомендациям Европейской академии аллергологии и клинической иммунологии для детей, находящихся на искусственном вскармливании, предлагается использовать либо смеси с глубоким гидролизом белка как смеси первого выбора, либо аминокислотные формулы, но только при непереносимости смесей на основе глубокого гидролиза белковой молекулы.

The study was a prospective, double-blind, placebo-controlled trial with patients diagnosed with LAR to HDMs and with concomitant asthma who underwent a 12-month treatment course of SLIT for HDM allergies. Seventeen patients were randomized to SLIT with the use of allergen extracts ofiD. pteronyssinus/iandiD. farinae/i(50/50%) in SQ-HDM SLIT tablets and 15 patients were randomized to the placebo group. The total rhinitis score (TRSS), total asthma symptom score (TASS), combined total symptom score (TSS), total medication score (TMS), and FEV1 were analyzed.bResults/b: In the final analysis, 16 patients who received SLIT and 14 who received placebo who completed the study protocol were included. Significant reductions in TRSS, TASS, TSS, and TMS after 12 months of treatment were observed in patients after SLIT (ip/i lt; 0.05). A significant increase in the mean FEV1 between baseline and after 12 months of therapy was observed in the study, withip/i = 0.03 in the study group.bConclusion/b: SLIT can improve nasal and bronchial symptoms and reduce symptomatic treatment in patients with LAR and asthma and with hyperresponsiveness to HDMs.

Background: Allergic rhinitis (AR) is characterized by chronic inflammation of the nasal mucosa. T-helper 2 lymphocytes, neutrophils, and eosinophils play an active role during the late-phase immune response after exposure to allergen.Objective: We aimed to investigate the usefulness of inflammatory parameters of neutro-phil-to-lymphocyte ratio (NLR), eosinophil-to-neutrophil ratio (ENR), and eosinophil-to-lymphocyte ratio (ELR) as markers for distinction between intermittent and persistent allergic rhinitis.Material and Methods: This was a double-center, retrospective study. Patients were enrolled after diagnosed with AR according to the Allergic Rhinitis and Its Impact on Asthma guide-lines. Individuals with an active infection were excluded. A cohort of healthy subjects acted as a control group. NLR, ENR, and ELR were calculated using the results obtained from the patients’ complete blood count. Descriptive statistical analysis was performed for all studied variables.Results: In all, 205 AR patients and 49 healthy individuals were included. AR patients had sig-nificantly higher levels of absolute eosinophils, ENR, and ELR, and significantly lower levels of NLR than the healthy controls (P < 0.05). A total of 160 (78%) patients with persistent AR had significantly higher levels of absolute eosinophils, ENR, and ELR, and significantly lower levels of NLR than patients with intermittent AR (P < 0.05). Conclusion: Currently, classification of severity of AR is based on the patient’s anamnesis. It has been shown in this study that serum eosinophil levels in persistent AR patients could be used as traceable parameters in evaluating severity of the disease by looking at the propor-tions of ENR and ELR. We anticipate that in the future this issue would be supported by a larger number of studies.

Background Food allergy is a major public health concern all over the world. Data are lacking on the number of affected children, severity of food allergy, and burden of the disease. Objectives The current research aims at exploring the most common sensitization patterns of food allergy as well as collecting data on clinical presentation among pediatrics. Methods The sensitization pattern of the most common 21 food allergens through ImmunoLINE IgE Nutritional assay as well as total serum IgE test were assessed. The assessment was conducted on a group of 188 children aged from one to five years who visited the pediatric outpatient clinic of Suez Canal University hospital. Results One or more specific allergen components related IgE antibodies were found in 74.5% of the study participants. The mean level of total IgE in serum was 122.86 ±72.93 IU/ml. In addition, the percentage of children who were diagnosed with food allergy reached 22.3% whereas the percentage of those who were confirmed with food allergy was 4.3%. Furthermore, Egg yolk was represented as the most frequently food allergen with a percentage of 27.7% whereas egg white and cow milk amounted to 23.4%. Conclusion Most of the children were found to be poly-sensitized. The frequent food allergies confirmed via ImmunoLINE IgE Nutritional assay were caused by cow's milk and egg yolk allergens.

Background:Results of surveys report that allergists use a wide range of doses for allergy immunotherapy; however, results of randomized, double-blind, placebo controlled studies suggest that the range of the optimum effective dosing is relatively narrow.Objective:To review studies that established effective or less than fully effective doses for allergy immunotherapy.Methods:Studies were reviewed that established effective and ineffective subcutaneous and sublingual immunotherapy doses. Only those studies that expressed dosing in terms of the content of a major allergen in the maintenance doses were included in defining effective and ineffective doses.Results:Studies were identified that showed effective doses for subcutaneous injection, established in randomized, double-blind, placebo controlled trials, for short ragweed, timothy grass, house-dust mites, cat and dog dander, birch, and Alternaria. For short ragweed, timothy grass, Dermatophagoides pteronyssinus, and cat and dog dander, less-effective doses were determined, along with effective doses; the less-effective doses were only one-fifth to one-tenth less in allergen content than were the effective doses. Effective doses of cockroach and all fungal extracts except Alternaria have not been established. Information is available on the mean major allergen content of U.S. standardized and a few nonstandardized extracts, which allows the information on effective and ineffective dosing to be used in prescribing subcutaneous allergy immunotherapy. With sublingual allergy immunotherapy, all the approved tablets had multidose studies that determined the optimal dose. For the U.S. liquid extracts, to my knowledge, there are no studies to define effective doses except for ragweed.Conclusions:Although a wide range of doses are prescribed by U.S. allergists, analysis of available data suggests that effective doses fall within a narrow range and that use of doses one-fifth or one-tenth of the effective doses may sacrifice most or all of the potential efficacy of the treatment.