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Aim: To examine the associations of physical activity and screen time, a proxy for sedentary behaviour, with fasting and post‐load glucose levels in Singaporean women enrolled in a multi‐ethnic Asian preconception study. Methods: Moderate and vigorous physical activity and screen time (television and other electronic devices) were self‐reported by women enrolled in the S‐PRESTO cohort. Fasting, 30‐min and 120‐min glucose levels before and during a 75‐g oral glucose tolerance test were measured. Associations of physical activity and screen time with glucose levels were analysed using multivariable linear marginal regression. Results: A total of 946 women aged 31.4±3.7 years were examined, of whom 72% were of Chinese, 15.5% were of Malay, 9.3% were of Indian and 3.2% were of mixed ethnicity. A total of 32% of women reported being active, 36% watched television ≥2 h/day and 26% used electronic devices ≥3 h/day. In adjusted models, vigorous, but not moderate, physical activity was associated with lower overall glucose levels, and was associated more strongly with post‐challenge than fasting glucose levels. Compared to women not engaging in vigorous physical activity, those engaging in physical activity ≥75 min/week had lower mean fasting [–0.14 (95% CI –0.28, –0.01) mmol/l], 30‐min [0.35 (95% CI –0.68, –0.02) mmol/l] and 120‐min [–0.53 (95% CI –0.16, –0.90) mmol/l] glucose levels (overall P value=0.05). We found no associations of screen time with glucose levels. Conclusions: Independently of the time spent in non‐vigorous physical activity and using screens, engaging in vigorous physical activity may be a modifiable factor to improve glucose regulation in women of Asian ethnicity who are attempting to conceive. What's new?: Physical inactivity and television time have been associated with insulin resistance and Type 2 diabetes in adults, and with gestational diabetes mellitus in pregnant women.In a preconception cohort study in Singapore in 1000 women trying to conceive, women engaging in ≥75 min/week of vigorous physical activity had lower fasting and post‐load glucose levels than inactive women. Device‐specific screen time was not associated with glucose levels.Engaging in vigorous physical activity may, independently of moderate physical activity and screen time, be a modifiable factor to improve glucose regulation in women of Asian ethnicity attempting to conceive. [ABSTRACT FROM AUTHOR]

Summary: Background: Quantitative magnetic resonance (QMR) has been increasingly used to measure human body composition, but its use and validation in children is limited. Objective: We compared body composition measurement by QMR and air displacement plethysmography (ADP) in preschool children from Singapore's multi‐ethnic Asian population (n = 152; mean ± SD age: 5.0 ± 0.1 years). Methods: Agreements between QMR‐based and ADP‐based fat mass and fat mass index (FMI) were assessed using intraclass correlation coefficient (ICC), reduced major axis regression and Bland–Altman plot analyses. Analyses were stratified for the child's sex. Results: Substantial agreement was observed between QMR‐based and ADP‐based fat mass (ICC: 0.85) and FMI (ICC: 0.82). Reduced major axis regression analysis suggested that QMR measurements were generally lower than ADP measurements. Bland–Altman analysis similarly revealed that QMR‐based fat mass were (mean difference [95% limits of agreement]) −0.5 (−2.1 to +1.1) kg lower than ADP‐based fat mass and QMR‐based FMI were −0.4 (−1.8 to +0.9) kg/m2 lower than ADP‐based FMI. Stratification by offspring sex revealed better agreement of QMR and ADP measurements in girls than in boys. Conclusions: QMR‐based fat mass and FMI showed substantial agreement with, but was generally lower than, ADP‐based measures in young Asian children. [ABSTRACT FROM AUTHOR]

Background Shellfish allergy in Singapore is highly prevalent, and shrimp allergy is the most common. Objective This study aims to evaluate the clinical characteristics and immunological phenotype of shellfish allergy in this population. Methods Patients with self-reported shellfish allergy were recruited from outpatient clinics of three large hospitals and from a population survey. Open oral food challenges ( OFC) to glass prawn ( Litopenaeus vannamei) and tiger prawn ( Penaeus monodon) were carried out on all patients except for those who had a history of severe anaphylaxis. Skin prick tests ( SPT) and specific Ig E to crude and recombinant allergens were carried out to evaluate shrimp and dust mite sensitization. Immunoblots were used to assess Ig E-binding proteins. Results The 104 patients recruited were categorized into shellfish allergic ( SA) when OFC was positive or had a history of severe anaphylaxis ( n = 39), shellfish tolerant ( ST) when OFC was negative ( n = 27), and house dust mite positive controls ( HDM+) who were ST ( n = 38). Oral symptoms (87.1%) were the predominant clinical manifestation. Positive challenge doses ranged from 2 to 80 g of cooked shrimp, with 25/52 patients reacting to either one or both shrimps challenged. The presence of specific Ig E to shrimp either by SPT and/or Immuno CAP® assay provided diagnostic test sensitivity of 82% and specificity of 22.2%. The inclusion of specific Ig E to shrimp tropomyosin and Ig E immunoblots with shrimp extracts did not improve the diagnostic proficiency substantially. Conclusions and Clinical Relevance This study highlights the predominance of oral symptoms in shrimp allergy in tropical Asia and that a high provocation dose may be necessary to reveal shrimp allergy. Furthermore, specific Ig E diagnostic tests and immunoblots were of limited use in this population. [ABSTRACT FROM AUTHOR]

Neonates with a family history of atopy are at higher risk for developing wheezing in early life. From a birth cohort of at risk infants (first-degree family with atopic disease), we evaluated the influence of distinct intrinsic immunologic risk factors on wheezing disorders in the first 2 years of life. Cord blood samples were collected from 195 eligible subjects of a birth cohort of 253 subjects. The subjects studied were those who developed wheezing ( n=34) or eczema ( n=29) in the first 2 years of life, and 65 healthy control infants. At the time of thawing the viability of the cells were median 70% (range 67.5%-72.5%). Cytokines from lipopolysaccharide (LPS)-stimulated mononuclear cells were analysed using fluorescent-activated cell sorting-array and their profiles were evaluated using factor analysis. Infants with wheeze were significantly associated with enhanced combined LPS stimulated IL-1β, IL-6, and IL-12/IL-23p40 compared with healthy controls ( P=0.003). This profile was also associated with the increased risk for wheeze at 2 years of age (OR=2.45; 95% CI=1.50-3.93, P=0.001). LPS-stimulated cytokine IL-8 was also significantly higher in the wheeze group compared with healthy controls and eczema ( P=0.003). Intracellular staining showed that monocytes are main producers of IL-6 and IL-8 from cord blood mononuclear cells. Most of the subjects were non-atopic with 3/34 (9%) wheeze and 9/29 (31%) eczema subjects sensitized to the common dietary or inhalant allergens. In infants at genetic risk of atopy, wheeze but not eczema in the first 2 years of life is associated with intrinsic hyperresponsive innate cytokine responses which might predispose infants to wheeze development. Distinct pre-symptomatic hyperresponsive innate immune responses risk factors were found to be associated with early onset wheeze disorders, but not eczema. Cite this as: P. L. Quah, I-C Kuo, C. H. Huang, L. P-C Shek, B. W. Lee and K. Y. Chua, Clinical & Experimental Allergy, 2011 (41) 970-978. [ABSTRACT FROM AUTHOR]

Background The role of probiotics in allergy prevention remains uncertain but has been shown in some studies to have a possible protective effect on eczema. Objective We aimed to assess the effect of probiotic supplementation in the first 6 months of life on eczema and allergic sensitization at 1 year of age in Asian infants at risk of allergic disease. Methods A double-blind, placebo-controlled randomized clinical trial involving 253 infants with a family history of allergic disease was carried out. Infants received at least 60 mL of commercially available cow's milk formula with or without probiotic supplementation [ Bifidobacterium longum (BL999) 1 × 107 colony forming unit (CFU)/g and Lactobacillus rhamnosus (LPR) 2 × 107 CFU/g] daily for the first 6 months. Clinical evaluation was performed at 1, 3, 6 and 12 months of age, with serum total IgE measurement and skin prick tests conducted at the 12-month visit. The primary and secondary end-points were eczema and allergen sensitization, respectively. Results The incidence of eczema in the probiotic (22%) group was similar to that in the placebo group (25%) ( P=0.53). The median Scoring Atopic Dermatitis score at 12 months was 17.10 (9.74) in the probiotic group and 11.60 (8.40) in the placebo group ( P=0.17). The prevalence of allergen sensitization showed no difference (probiotic=24% vs. placebo=19%, P=0.26). The total IgE geometric mean (95% confidence interval) was 18.76 (12.54–24.98) kU/L in the probiotic group and 23.13 (16.01–30.24) kU/L in the placebo group ( P=0.15). Atopic eczema (with sensitization) in the probiotic (7.3%) group was comparable to the placebo group (5.8%) ( P=0.86). Conclusion Early life administration of a cow's milk formula supplemented with probiotics showed no effect on prevention of eczema or allergen sensitization in the first year of life in Asian infants at risk of allergic disease. Further work is needed to determine whether timing of supplementation, dose and probiotic strain are important considerations. [ABSTRACT FROM AUTHOR]

The liver is the major organ for the metabolism of homocysteine (Hcy) and production of insulin-like growth factor 1 (IGF-1). Hcy metabolism and IGF-1 synthesis may be impaired in chronic liver diseases. The study investigated the regulatory effect of a Chinese herbal suppository, Vitalliver, on Hcy and IGF-1, as well as their relationship in patients with hepatitis B infection. Forty patients with chronic hepatitis B virus (HBV) infection without cirrhosis, 25 males and 15 females, were observed for changes in Hcy and IGF-1 after the administration of Vitalliver (one nightly) for a period of 3 months. Serum levels of Hcy, IGF-1 and IGFBP-3 were measured at baseline, and at 1 month and 3 months after treatment. Vitalliver reduced Hcy levels significantly ( p = 0.001) from 9.7 ± 2.8 to 9.0 ± 2.1 µmol/L after treatment of 3 months. Furthermore, the IGF-1 levels increased significantly ( p < 0.001) from 170.2 ± 81.8 to 212.8 ± 80.9 ng/mL at 1 month and 187.5 ± 72.3 ng/mL at 3 months ( p = 0.001) after treatment. In conclusion, it is speculated Vitalliver may have a self-regulatory effect on the release of IGF-1 in HBV patients without liver cirrhosis. Copyright © 2005 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Cow milk allergy (CMA) is one of the most common food allergies in childhood. Patients with CMA present with a wide range of immunoglobulin (Ig)E- and non-IgE-mediated clinical syndromes. Limited information is known about the specific humoral and cellular responses to cow milk proteins in these various forms of CMA.The aim of the study was to determine IgE, IgA, IgG1 and IgG4 antibody levels and lymphocyte proliferative responses to the major cow milk allergens in patients with IgE- and non-IgE-mediated CMA.One hundred and forty cow milk allergic patients, 6 months to 22 years of age, were included in the study. One hundred and thirteen patients had IgE-mediated CMA, 11 had milk protein-induced enterocolitis syndrome and 16 had allergic eosinophilic gastroenteritis. Twenty-one patients without food allergy, 8 months to 18 years of age, served as controls. Serum IgE, IgA, IgG1 and IgG4 antibodies toα-,β-, andκ-casein,α-lactalbumin andβ-lactoglobulin were measured using enzyme-linked immunosorbent assays. For a subset of these patients, we performed lymphocyte proliferation assays to the various milk allergens.Patients with IgE-mediated CMA had higher specific IgE concentrations to casein compared with whey proteins (P < 0.001). In this group of patients, there was a positive correlation between IgE levels and levels of the other isotypes for all four milk proteins (P < 0.001). In general, the caseins were the more allergenic and antigenic proteins in all groups of patients. Patients with enterocolitis syndrome produced less milk protein-specific IgG4 (P < 0.05) and had a trend for higher IgA antibody levels when compared to the control group. Lymphocyte proliferative responses in all groups with CMA were significantly higher than controls (P < 0.05), although this response was similar in patients with IgE- and non-IgE-mediated CMA.There is a distinct pattern of humoral antibody response in the different forms of CMA. Patients with IgE-mediated CMA have an elevated polyisotypic response to cow milk protein. The relative lack of specific IgG4 production in patients with enterocolitis syndrome may be involved in the pathogenesis of the disease. In general, caseins appear to be the predominant allergen in patients with CMA. [ABSTRACT FROM AUTHOR]

Objective: To determine the effect of a partially hydrolysed formula on genetically predisposed children, with respect to the development of atopic clinical manifestations and in vitro testing of serum IgE levels (total and milk-specific).Methods: One hundred and ten infants were randomly assigned to receive either partially hydrolysed formula or standard infant formula, and were prospectively monitored from birth for clinical atopic symptoms and serum IgE levels.Results: Eczema occurred less frequently in infants receiving partially hydrolysed formula. This was significant (P < 0.05) at 3, 6, 9, 12, 18 and 24 months. However, the significance decreased with time, although it almost reached statistical significance at 30 months by the Kaplan-Meier survival function (log-rank statistic, 3.46; P = 0.063). Although wheezing occurred less frequently in infants receiving partially hydrolysed formula, compared to those receiving standard infant formula, the difference did not reach statistical significance (P > 0.05).Conclusions: Exclusive feeding of hypoallergenic milk formula in the first 4 months of life has a protective effect in terms of the development of atopic dermatitis in the first 2 years of life, compared to feeding with cow's milk formula. [ABSTRACT FROM AUTHOR]

Background: Asthma and atopy are complex genetic traits, influenced by the interaction of multiple genes and environmental factors. Linkage of these traits to chromosome 5q31–33 has been shown in other populations, but has not been well studied in the Chinese. We studied linkage between asthma and atopy with markers on chromosome 5q31–33 in the Singapore Chinese. This region contains many candidate genes, including the cytokine gene cluster. Methods: We recruited 88 Chinese families with at least two affected offspring, totaling 373 subjects, with 125 and 119 sib-pairs for atopy and asthma, respectively. All individuals were genotyped with 19 polymorphic microsatellite markers spanning a distance of 41 cM along chromosome 5q31–33. Affected sib-pair and multipoint linkage analysis was performed. Results: There was evidence for linkage of the asthma and atopy phenotypes with three markers, D5S2110, D5S2011, and D5S412 (P values of 0.001 to 0.00001). Multipoint analysis further substantiated this (nonparametric linkage scores of 1.8–2.9). These findings suggest that susceptibility genes for asthma and atopy are found in this region in the Chinese. Conclusions: This study has shown linkage of atopy and asthma to chromosome 5q31–33 in a heterogeneous Chinese population. These findings further substantiate the notion that chromosome 5q31–33 contains “universally” important susceptibility genes for these traits. [ABSTRACT FROM AUTHOR]

Investigates the relationship between the frequency of the Ile50Val polymorphism genotype and the atopy in ethnic groups in Singapore. Frequency distribution of interleukin-4 receptor Ile/Val genotypes in normal controls and atopic individuals; Role of cycle sequencing in confirming the accuracy of genotyping.

Discusses a study which examined the association of the R576 allele of the alpha subunit of interleukin-4 receptor with atopy. Subjects and methods; Information on an allele-specific-polymerase chain reaction; Comparison of the allele frequency for R576 in Chinese and Caucasian populations.

A correction to the article "Identification of shared and unique immunoglobulin E epitopes of the highly conserved tropomyosins in Blomia tropicalis and Dermatophagoides pteronyssinus in the previous issue is presented.