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Antecedentes: Existen lineamientos para el diagnóstico de las enfermedades alérgicas y la aplicación de inmunoterapia con alérgenos (ITA).Objetivo: Describir cómo los alergólogos mexicanos diagnostican y tratan con ITA las alergias alimentaria y respiratoria.Métodos: Se encuestó a 227 alergólogos que acudieron a un simposio de inmunoterapia; se indagaron prácticas cotidianas en el diagnóstico de las alergias respiratoria y alimentaria, así como en la forma de aplicar la ITA.Resultados: Los alergólogos utilizan las pruebas cutáneas por punción para el diagnóstico de las alergias respiratorias y alimentarias en 100 y 87.7 % de los casos de una y otra; diagnóstico in vitro mediante determinación de IgE alérgeno-específica en 55.5 y 63 %; y diagnóstico molecular por componentes en 14.1 y 13.2 %. Para los aeroalérgenos, 81 % emplea ITA subcutánea; 77.9 %, ITA sublingual líquida; 1.8 %, ITSL en tabletas; 45 % indicó que estaba dispuesto a emplear tabletas en el futuro. Para los alérgenos de alimentos, la mayoría no utilizaba ITA, aunque 55 % se interesa en la ITA oral y 59 %, en la ITA sublingual.Conclusiones: En términos generales, el diagnóstico y tratamiento de las enfermedades alérgicas se realizan conforme los lineamientos internacionales, además, los alergólogos encuestados mostraron flexibilidad para adoptar nuevos esquemas.

There is little understanding of the mechanisms by which food allergy (FA) develops into persistent disease, or by which symptoms it regresses. Food allergy is a major health problem in developed countries, where the prevalence reaches up to 6% in children and 3% in the adult population.Children with food allergy remission (FAR) and those without FAR below five years of age, were compared 7-10 years with respect to clinical data and expression of glycoprotein A repetitions predominant (GARP) on peripheral blood mononuclear cells.Forty children with FAR and 40 children without FAR at age 7-10, in whom FA was previously diagnosed at age below five years were evaluated. In this prospective study, demographic and clinical data were taken, patients were classified as atopic based on history and serum specific IgE (sIgE) for a specific allergen. Blood samples were obtained from all patients to assess expression of GARP.We observed higher expression of GARP in children with FAR compared to children without FA (p=0.005); optimal cut-off for GARP prediction of the remission was 20.1%. Children with FAR and food-specific IgE in serum had higher expression of GARP compared to children with low food specific IgE (0.35kU/L). Keeping pets at home decreased, and presence of allergic rhinitis increased ORs for high expression of GARP (hGARP) in our patients.hGARP (20.1%) is related with FAR in school children. Allergic rhinitis, and pets at home modify this effect of GARP. Children with allergic rhinitis have less chance of developing remission despite maintaining immune tolerance (hGARP); quite the opposite case with pets at home.

Al·lèrgia; Diagnòstic molecular; Recomanacions Alergia; Diagnóstico molecular; Recomendaciones Allergy; Molecular diagnosis; Recommendations The introduction of molecular diagnosis into routine clinical practice has substantially improved the diagnosis and management of allergic patients by allowing clinicians to precisely identify the allergenic molecule responsible for immunoglobulin E (IgE)-mediated allergies. However, it can be challenging to accurately interpret the results of molecular assays, partly due to the limited evidence base. In this context, a panel of experts with extensive experience in interpreting in vitro measures of total and serum specific IgE reviewed the available scientific evidence. After this review, the panel selected a series of representative case studies to demonstrate how determination of specific and total IgE values and the relationship between them (ratio analysis) can add value to the diagnostic process by more precisely defining the patient’s sensitization profile. Finally, the experts developed a series of recommendations on the clinical application of ratio analysis to optimize and complement the classical approach to allergy diagnosis.

Background Laboratory animal allergy (LAA) has not been sufficiently investigated, although LAA is a relatively common work-related condition and important occupational hazard. Objective This study aimed to evaluate the prevalence of LAA and analyze the diagnostic value of serum specific IgE (sIgE) using the skin prick test (SPT) as a comparative standard. Methods Korean laboratory animal researchers who attended an annual symposium were requested to answer questionnaires regarding demographic characteristics, laboratory animal exposure, and symptoms related to laboratory animal exposure. A total of 213 participants underwent a SPT with mouse and rat epithelial allergen extract. We measured sIgE against rodent urine, epithelium, and serum allergens from 63 participants. SPT outcome served as the comparison method. Results Among 223 participants, 213 had direct/indirect exposure to mice or rats, and 30% and 14% of them complained of allergic symptoms after exposure to mouse and rat, respectively. Sensitization rates were 28% for mouse epithelium and 23% for rat epithelium. Compared to a positive SPT with wheal ≥ 3 mm, presence of sIgE against rodent allergens showed a higher positive predictive value of 87-91% at a cut-off level of 0.35 KUA/L. Agreement between SPT and sIgE test was determined to be fair to moderate. Conclusions Sensitization and allergy to mouse and rat were prevalent among laboratory personnel in Korea. When evaluating cases of potential LAA, the sIgE test can provide added diagnostic value if the skin test is positive. Careful interpretation of two tests is required to accurately diagnose LAA.

To investigate immunoglobulin E (IgE)-mediated hypersensitivity to chlorhexidine (CHX), and association between CHX exposure and serum specific IgE (SIgE) levels, among first-year dental students. Participants completed a questionnaire on medical health, history of allergies/hypersensitivities and CHX exposure. A sample of venous blood (3 mL) was drawn and subjected to SIgE test to CHX; sensitisation defined as SIgE level of ≥0.10 kUA/L. Fifty-eight (98.3%) participants, consisting of 69% (n = 40) female with a mean age of 21, were recruited; three quarters (84%) reported no known health issue, and over half had no history of allergies (57%); less than 20% reported having had exposure to CHX-containing products with the majority from toothpaste (9%) and mouthwash (12%). The CHX SIgE test showed that 8.6% (n = 5) were sensitised. No association between CHX exposure history and the level of SIgE antibody was noted. Although most participants reported no known exposure to CHX, 8.6% showed CHX sensitisation suggesting unknown exposure and the potential risk of developing hypersensitivity and adverse reactions in the future.

Food allergy is common, it can lead to significant morbidity andnegatively impacts on quality of life; therefore, it is vitally important we get the diagnosis right. However, making the diagnosis can be complex. Clinical history is the most important diagnostic tool and subsequent investigation may help confirm the diagnosis. The investigations available to most paediatric departments are skin prick testing and specific IgE so we will focus on these. Within this article we explore the evidence related to targeted testing and how to interpret these within the clinical context.

BACKGROUND: Allergic conjunctivitis (AC) is predominantly caused by serum specific-IgE (sIgE)-mediated type I allergy. This study aims to analyze the distribution of sIgE in children with AC, and the concomitant allergic diseases. METHODS: The clinical data from 310 children, diagnosed with AC and admitted to our hospital from January 2017 to January 2019 were retrospectively collected. The children were divided into three groups: infant group (2 months to 1 year old, 91 cases), child group (1 to 3 years old, 112 cases), and preschool group (3 to 6 years old, 107 cases). Children in every group were analyzed for positive rates, the number of positive sIgE types, the distribution of positive inhaling and ingesting allergens and concomitant allergic diseases. RESULTS: The sIgE positive rate of infant was significantly lower than that of the other two groups, and the number of 18.75% sIgE positive species was 1. The number of sIgE positive species in the child group and preschool group was more than 2 (78.30%, 71.15%). The positive rate of sIgE to dust mites, house dust, animal dander, eggs, beef, mutton and mango in the preschool group was significantly higher than the other groups (P

BACKGROUND Wheat extracts containing both water/salt and alcohol soluble proteins may increase extract's accuracy for diagnosing IgE-mediated wheat allergy. OBJECTIVE This study aimed to determine the performance of new invented in-house prepared wheat extracts for skin prick test (SPT). METHODS Children aged 1-18 years with history of immediate wheat allergy were recruited. Four in-house prepared wheat extracts (wheat-Coca-10%EtOH, and 3 new invented extracts, wheat-salt, gliadin, and glutenin) and a commercial wheat extract were used for SPT. Serum specific IgE (sIgE) to wheat and omega-5 (ω-5) gliadin were also determined. Oral food challenge (OFC) with wheat flours was performed in all patients except those with history of wheat-induced anaphylaxis or with recent symptoms within the past 6 months. RESULTS Thirty-one children were recruited. Of those, 14 were excluded from OFC (12 with history of anaphylaxis and 2 with recent symptom). OFC was positive in 8 of 17 children. Of the 5 extracts and sIgE to wheat and ω-5 gliadin, gliadin extract provided the best SPT performance with 84.2% sensitivity, 88.9% specificity, 94.1% positive predictive value (PPV), 72.7% negative predictive value (NPV), 7.59 positive likelihood ratio (LR), 0.18 negative LR, and 85.7% accuracy. CONCLUSIONS Compared to other in-house and commercial wheat extracts and sIgE to wheat and ω-5 gliadin, SPT with an in-house gliadin extract yielded the highest performance for the diagnosis IgE-mediated wheat allergy.

Artemisia and Humulus pollen are the two most important aeroallergens of autumn allergies in North China. Cross-sectional data in 2001 have shown that allergic rhinitis often preceded or occurred at the same time as asthma in patients with autumn pollinosis in North China.We used this cross-sectional data to investigate the association of serum specific IgE (sIgE) levels to Humulus and/or Artemisia pollen with the onset of asthma in patients with autumn pollen-induced allergic rhinitis.1096 patients with autumn pollinosis were face-to-face interviewed and underwent sIgE tests to Artemisia and Humulus. The temporal sequence of allergic rhinitis and asthma was documented. 1013 patients were positive to Artemisia and/or Humulus by sIgE. Multinomial logistic regression and survival analysis were used to examine the potential implication of sIgE levels for the progression of asthma in autumn pollen-induced allergic rhinitis.Of the 1013 participants with a positive sIgE test to Artemisia and/or Humulus, 563 (55.6%) had a history of allergic rhinitis which preceded or occurred at the same time as asthma. 450 (44.4%) had allergic rhinitis alone. After controlling of sex, age at onset of allergic rhinitis, and parental asthma, the risk of developing asthma increased with the levels of sIgE to both Artemisia and Humulus (p0.05). In Kaplan-Meier analysis, IgE classes 5-6 to Humulus or Artemisia increased the risk of asthma development (p0.05).Autumn pollen-induced allergic rhinitis often coexists with seasonal asthma. The incidence of asthma is more pronounced when the sIgE level was higher.

Background: Nut allergies are an increasingly frequent health issue in the pediatric population. Tree nuts (TN) and peanuts are the second cause of food anaphylaxis in Italy. Unfortunately, knowledge of the clinical characteristics of a TN allergy in Italian children is limited. Our study aimed to identify the clinical and allergological characteristics of Italian children with a nut allergy (TN and peanut). Methods: A retrospective observational analysis was performed on the clinical charts of children with a history of nut reaction referred to the allergy unit of the hospital from 2015 to 2019. The studied population was represented by children with a confirmed nut allergy based on positive prick by prick and/or serum-specific IgE to nut plus a positive nut oral food challenge. Demographic, clinical, and allergological features were studied and compared among different nuts. Results: In total, 318 clinical charts were reviewed. Nut allergy was confirmed in 113 patients. Most patients (85/113, 75%) had a familial history of allergy and/or a concomitant allergic disorder (77/113, 68%). Hazelnut and walnut were the more common culprit nuts observed in allergic children. Anaphylaxis was the first clinical manifestation of nut allergy in a high percentage of children (54/113, 48%). The mean age of the first nut reaction was statistically higher with pine nuts. Over 75% of children reported a single nut reaction. During the OFCs, the signs and symptoms involved mainly the gastrointestinal system (82/113, 73%) and resolved spontaneously in most cases. Severe reactions were not frequent (22/113, 19%). Conclusion: To our knowledge, this is the first Italian study that provided a comprehensive characterization of children with a nut allergy. These results are important for clinicians treating children with a nut allergy.

The performance of specific inhalation challenge test (SICT) - reference method in diagnostics of occupational allergy - has some limitations due to health status of a particular patient. Therefore, it is extremely important to identify usefulness of other tests, and the evaluation of diagnostic accuracy of commercially available serum specific immunoglobulin E (sIgE) kits to the most common high molecular weight agents has been launched.The study group comprised 141 subjects - 110 bakers and 31 farmers - with suspicion of occupational airway allergy. All patients underwent evaluation of serum sIgE to occupational allergens with the use of Phadia and Allergopharma kits: in bakers to flour mix and α-amylase, in farmers to epithelium of cow, pig and feathers. Specific inhalation challenge test with workplace allergens performed in all subjects was a reference method for further analysis.Serum specific IgE to flour mix had the highest sensitivity (Phadia - 95.6%, Allergopharma - 88.3%), while its specificity was relatively low (Phadia - 47.8%, Allergopharma - 25%). There were numerous discrepancies between the results of sIgE estimation for particular single allergens (k87, e4, e83), as well as for their mixtures (fx901, fx20, ex71), performed with the kits of both companies (Phadia vs. Allergopharma).Evaluation of serum specific IgE is characterized by inadequate sensitivity, specificity and predictive value to take the place of specific inhalation challenge test in diagnostics of occupational respiratory allergy. Med Pr 2017;68(1):31-43.Test swoistej prowokacji wziewnej – metoda referencyjna w diagnostyce alergii zawodowej – u niektórych chorych nie może być przeprowadzony z powodu przeciwwskazań zdrowotnych. Ponieważ ustalenie rzeczywistej przydatności innych testów jest niezwykle ważne, podjęto badanie, którego celem było określenie trafności i przydatności diagnostycznej dostępnych komercyjnie odczynników do oznaczania alergenowo swoistych przeciwciał immunoglobuliny E (asIgE) w surowicy w diagnostyce IgE-zależnej alergii dróg oddechowych na najczęstsze alergeny pochodzenia roślinnego.Badaniem objęto grupę 141 pacjentów – 110 piekarzy i 31 rolników – z podejrzeniem zawodowej alergii dróg oddechowych. U wszystkich badanych oznaczono asIgE dla alergenów zawodowych w surowicy odczynnikami firm Phadia i Allergopharma: u piekarzy dla mieszaniny mąk i α-amylazy, u rolników dla alergenów naskórka krowy, naskórka świni i mieszaniny piór. Metodę referencyjną do oceny powyższych testów diagnostycznych stanowił wykonany u wszystkich badanych test swoistej prowokacji wziewnej z alergenami z miejsca pracy.Najwyższą czułością charakteryzowały się oznaczenia asIgE dla alergenów mąk (Phadia – 95,6% i Allergopharma – 88,3%), przy stosunkowo niskiej swoistości (Phadia – 47,8% i Allergopharma – 25%). Rozbieżności między wynikami uzyskanymi przy użyciu zestawów Phadia vs Allergopharma dotyczyły oznaczeń asIgE zarówno dla pojedynczych alergenów (k87, e4, e83), jak i mieszanin alergenów (fx901, fx20, ex71).Oznaczanie asIgE w surowicy nie charakteryzuje się wystarczającą czułością, swoistością i wartością predykcyjną, żeby zastąpić test swoistej prowokacji wziewnej w diagnostyce zawodowej alergii dróg oddechowych. Med. Pr. 2017;68(1):31–43.

Background Only a limited number of studies have included objective measures of allergic sensitisation (such as skin-prick test [SPT] and serum specific IgE [sIgE]) when studying time trends in allergic respiratory disease in adults within the current millennium. Methods Five health examination studies of random samples of individuals aged 18-69 years resident in the Copenhagen region were conducted in 1990-1991, 2006-2008, 2010-2011, 2012-2015, and 2016-2017. Allergic sensitisation was defined by sIgE (in 1990-1991, 2006-2008, and, 2012-2015) or SPT (in 2006-2008, 2010-2011, and 2016-2017) to at least one of the allergens: birch, grass, house dust mite, or cat. Allergic rhinitis was defined as sensitisation and self-reported nasal symptoms. Results The age- and sex-standardised prevalence of sIgE-defined sensitisation increased from 16% in 1990-1991, to 26% in 2006-2008, and to 29% in 2012-2015. The age- and sex-standardised prevalence of SPT-defined sensitisation increased from 27% in 2006-2008, to 28% in 2010-2011, and to 32% in 2016-2017. Changes in sIgE-defined and SPT-defined allergic rhinitis showed similar increasing trends. Conclusion The prevalence of allergic sensitisation and allergic rhinitis increased in a general adult Danish population over the last three decades and has thus continued to increase in the current millennium.

durmus, sinem/0000-0002-9272-9098; Uzun, Hafize/0000-0002-1347-8498 WOS:000475757700007 PubMed ID: 31360927 Objective: Eosinophil cationic protein (ECP) plays a significant role in the pathogenesis of atopic diseases such as allergic rhinitis (AR) and asthma. Using saliva as a diagnostic material is a non-invasive, simple method. Analysis of ECP in saliva was shown as an alternative diagnostic contribution in patients with asthma. In this study we aimed to assess a possible association between the levels of salivary ECP and the diagnosis of AR by comparing serum ECP and salivary ECP levels. Methods: Thirty-five allergic rhinitis patients (study group) sensitive to Dermatophagoides farinae (D2) in skin prick test (SPT) and 35 nonallergic, SPT negative, healthy volunteers (control group) were included in the study. Salivary ECP, serum ECP and specific IgE D2 levels were measured. Results: Distribution of age and gender were similar in the study and the control groups (p>0.05). Serum specific IgE D2 levels were significantly higher in the study group compared to the control group (p

The job of cleaning has developed dynamically as a working service, and women constitute the majority of all professional cleaning workers. Cleaners are at an increased risk of work-related asthma (WRA). This study characterizes work-related respiratory symptoms reported by female cleaners, evaluates any associated factors of WRA, and shows diagnostic management of medical certification. The study group comprised 50 professional cleaning women referred to our Occupational Diseases Department due to suspicion of occupational asthma (OA). A questionnaire, skin prick tests, serum specific IgE antibodies, and specific inhalant challenge were performed in all of the participants. Work-related asthma was recognized in 46% of symptomatic cleaners, of whom 15 were considered as having work-exacerbated asthma (WEA) and 8 as having OA. Sensitization to latex and disinfectants played an important role as a causative agent in OA of cleaners.

Food allergies are recognized as a major public health issue, especially in early childhood, with no preventive treatment. The diagnosis of food allergies currently relies on careful study of the patient’s history and diagnostic tests such as the skin prick test (SPT), serum specific IgE (immunoglobulin E) testing and, if indicated, oral food challenges, which are often risky. In this study, a sandwich-type immunocomplex was formed between different food allergens, specific IgE from sera and secondary anti-IgE conjugated with the enzyme horseradish peroxidase. Gold(III) chloride was subsequently added as a visual reader reagent. The color change from red to blue and the associated change in intensity at 550 nm was proportional to the concentration of remaining hydrogen peroxide after decomposition by horseradish peroxidase, which in turn triggers the aggregation of gold nanoparticles generating a blue color with a decrease in intensity at 550 nm. The generation of the visible blue color reports the presence of allergy issues compared to the red color in healthy subjects, and the consequent drop in intensity at 550 nm measures the amount of serum specific IgE, which corroborated the SPT results from the corresponding patients. This multiplexed visual diagnostic system for specific IgE against different food allergens using plasmonic phenomena of the aggregated gold nanoparticles has been a rapid, cheap, sensitive and high through put assay for the detection and determination of the severity of food allergens with a very low sample requirement (5 μl).

Background Diagnosis of Periplaneta americana (American cockroach, ACR) allergy is commonly performed based on clinical history and skin prick test (SPT) or specific serum IgE (sIgE) measurement. The concordance of the findings with the SPT and sIgE results has never been investigated. Objective To compare the results of SPT with commercial ACR-extract (C-ACE) and sIgE measurement, using commercial kit and in-house enzyme-linked immunosorbent assay (ELISA) to the locally produced ACR extract (L-ACE) and native Per a 1, Per a 5, Per a 7, and Per a 9. Methods Sera from 66 individuals clinically diagnosed with chronic allergic rhinitis were included; 46 were positive SPT to C-ACE, and 20 were negative. Specific serum IgE levels were established by using a commercial test kit (ImmunoCap) and an in-house IgE-ELISA Results The percentage the C-ACE SPT-positive cases that were positive by the ImmunoCap-sIgE was 32.6%, indicating low concordance of the 2 assays. With the in-house ELISA, Per a 9 gave the highest sensitivity (98.00%), positive predictive value (PPV; 95.74%), and negative predictive value (NPV; 94.74%) of the sIgE quantification. The correlation coefficients (R) of the L-ACE-SPT and sIgE to L-ACE, Per a 1, Per a 5, Per a 7, and Per a 9 and ImmunoCap sIgE were 0.133, 0.278, 0.419, 0.280, and 0.432, and 0.256, respectively. Conclusion Skin prick test and sIgE measurement using commercial reagents have low concordance. Data of this study showed that sIgE to the native Per a 9 should be considered as an adjunct to the clinical history in diagnosis of ACR sensitization/allergy, particularly when the SPT and the nasal challenge, which is the gold standard method, cannot be performed.

No allergens related to paprika or cayenne respiratory allergy have been identified thus far. We describe a previously healthy 28-year woman who developed work-related rhinoconjunctivitis after four years of kebab-restaurant work. The allergy was studied using skin prick tests, serum specific IgE and nasal provocation tests. Specific IgE protein reactions were studied by Western blot analysis. Paprika, cayenne and curry allergens were identified from the strongest immunoblot bands using tandem mass spectrometry. A positive skin prick test, high specific IgE and positive nasal provocation test confirmed occupational rhinoconjunctivitis from Capsicum spices. Defensin J1 and Vicilin were identified as major paprika and cayenne allergens in this case. Vicilin was detected also from the curry ingredients. Two new occupational respiratory allergens from the Capsicum species were identified. These differ from previously reported bell pepper allergens. We emphasize that substantial spice handling at work poses an allergy risk. Am. J. Ind. Med. 58:791–794, 2015. © 2015 Wiley Periodicals, Inc.

Background Determining whether patients with cow's milk allergy (CMA) can tolerate foods produced with baked milk could provide a better quality of life, a better prognosis, and an option for desensitization. Objectives The aim of this study was to identify which patients over four years of age with persistent CMA could tolerate baked milk, to compare the clinical and laboratory characteristics of reactive and non-reactive groups and to describe their clinical evolution. Materials and methods A cross-sectional study was conducted (January/13 to November/14) that included all the patients followed at a food allergy center who met the inclusion criteria. The patients underwent an oral food challenge (OFC) with a muffin (2.8 g of cow's milk protein). To exclude cow's milk (CM) tolerance, the patients were subsequently challenged with unheated CM. Results Thirty patients met all the inclusion criteria. Fourteen patients (46.7%) were considered non-reactive to baked milk and reactive to unheated CM. When the groups that were reactive and non-reactive to baked milk were compared, no statistically significant differences in clinical features were found. The prick test for α-lactalbumin (p = 0.01) and casein (p = 0.004) and the serum specific IgE for casein (p = 0.05) presented statistical differences. After one year, none of the patients who were reactive to baked milk were ingesting CM, while 28% of the tolerant patients were consuming fresh CM (p = 0.037). Conclusions Baked milk can be tolerated by patients with CMA, especially those with lower levels of casein and α-lactalbumin. This option can improve quality of life and accelerate tolerance.

Bu çalışma ile Samsun ili ve çevresindeki Atopik Dermatitis (AD)’li köpeklerde ilk kez serum spesifik immunoglobin E (IgE) ile alerjen profillerinin belirlenmesi amaçlanmıştır. Değişik ırk, cinsiyet ve yaşlardaki 21 adet köpeğe Favrot Kriterleri ile AD teşhisi konulmuştur. Köpeklere ait serum örnekleri serolojik olarak 20 farklı alerjene spesifik IgE yönünden incelenmiştir. AD’li köpeklerde 20 farklı alerjenin görülme oranlarına cinsiyet, yaş ve beslenme şekillerinin etkisi araştırılmıştır. Samsun ili ve çevresindeki AD’li köpeklerdeki farklı alerjen profilleri arasında en yüksek %95 oranında ev tozu akarı Dermatophagoides farinae seropozitifliği saptanmıştır. Bununla birlikte köpeklerde farklı oranlarda diğer alerjenlere yönelik seropozitiflik saptanmıştır. Dişi köpeklerde erkek köpeklere oranla sadece Ctenocephalides spp. seropozitifliğinin yüksek olduğu istatistiksel olarak tespit edilmiştir (p0,05). Samsun ili ve çevresindeki AD’li köpeklerde ev tozu ile depo akarlarının serum spesifik IgE değerlerinin çok yüksek oranlarda pozitiflik verdiği saptanmıştır. It is aimed to detect allergen determination via serum specific immunoglobulin E (IgE) for the first time in dogs diagnosed as Atopic Dermatitis (AD) from Samsun and vicinity within this present study. Twenty one dogs with different age, breed and gender diagnosed with AD based up on the Favrot’s criteria. Serum samples of the dogs were analyzed by detection of serum specific IgE for determination of 20 different allergens. The effects of gender, age and the feeding routes for those 20 different allergens separately were analyzed. Based up on the grading of the allergens detected in 21 dogs with AD from Samsun and vicinity; results reflects that Dermatophagoides farinae was stated as first degree within a very high seropositivity rate (95%). Moreover, in varying degree of seropositivitiy rates of other allergens were also detected. Females showed statistically (p0.05). Dogs with AD from Samsun and vicinity had very high serum specific IgE levels against to the house dust and storage mites. Keywords: Allergen, Atopic dermatitis, Dog, Samsun, Specific IgE

BACKGROUND: Rhinitis and asthma are linked, but substantial knowledge gaps in this relationship exist. OBJECTIVE: To determine the prevalence of rhinitis and its phenotypes in children and adolescents with asthma, assess symptom severity and medication requirements for rhinitis control, and investigate associations between rhinitis and asthma. METHODS: 749 children with asthma participating in the Asthma Phenotypes in the Inner-City study received baseline evaluations and were managed for 1 year with algorithm-based treatments for rhinitis and asthma. Rhinitis was diagnosed by questionnaire focusing on individual symptoms, and pre-defined phenotypes were determined by combining symptom patterns with skin testing and serum specific IgE. RESULTS: Analyses were done on 619 children with asthma who completed at least 4 of 6 visits. Rhinitis was present in 93.5%, and phenotypes identified at baseline were confirmed during the observation/management year. Perennial allergic rhinitis with seasonal exacerbations (PARSE) was most common (34.2%) and severe. Nonallergic rhinitis was least common (11.3%) and least severe. The majority of children remained symptomatic despite the use of nasal corticosteroids ± oral antihistamines. Rhinitis was worse in difficult-to-control vs. easy-to-control asthma and its seasonal patterns partially corresponded to those of difficult-to-control asthma. CONCLUSION: Rhinitis is almost ubiquitous in urban children with asthma, and its activity tracks that of lower airway disease. PARSE is the most severe phenotype and most likely to be associated with difficult-to-control asthma. This study offers strong support to the concept that rhinitis and asthma represent the manifestations of one disease in two parts of the airways. CAPSULE SUMMARY: Almost all children and adolescents with asthma have rhinitis of various, stable phenotypes based on sensitization and seasonal pattern. Conventional medications control rhinitis symptoms only in a minority. Difficult-to- control asthma is associated with worse rhinitis.

This review draws comparisons between wheat-dependent exercise-induced anaphylaxis (WDEIA) and other food-dependent exercise-induced anaphylaxis (FDEIAs) and discusses the importance of co-factors in its pathophysiology. FDEIA remains an enigmatic condition since it was first described 30 years ago. The sporadic and unpredictable nature of its reactions has puzzled clinicians and scientists for decades, but recent studies on WDEIA have enlightened us about the pathophysiology of this condition. The identification of defined allergic epitopes such as Tri a 19, α-gliadin, β-gliadin and γ-gliadin in WDEIA enables it to become the perfect model for studying FDEIA, but WDEIA is by no means a unique condition. On a larger scale, FDEIA represents a crucial link between IgE-mediated and anaphylactoid reactions and provides supportive evidence for the concept of 'summation anaphylaxis' and the need to overcome the 'allergen threshold'. Future work should focus on identifying more of the FDEIA epitopes and understanding their distinct molecular properties. The development of a biomarker in order to identify patients susceptible to co-factor influences would be invaluable.

RESUMO Teste de contato atopico com aeroalergenos: uma ferramenta promissora no diagnostico da dermatite atopica 1 Servico de Alergia, Hospital Sao Zacharias, Rio de Janeiro, RJ. 2 Hospital Geral de Nova Iguacu, Nova Iguacu, RJ. 3 Servico de Imunologia, Hospital Universitario Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ. 4 FDA Allergenic. Artigo Original Braz J Allergy Immunol. 2013;1(1):65-70. Atopy patch test with aeroallergens: a promising tool in the diagnosis of atopic dermatitis Sergio Duarte Dortas Junior, MD, MSc1,2, Soloni Afra Pires Levy, MD1, Andrea Huguenim Silva Pires, MD, MSc1, Augusto Tiaqui Abe, MD1, Solange Oliveira Rodrigues Valle, MD, PhD1,3, Vilma Perez Coelho, MD1, Ludwig Ruppert Hahnstadt, MSc4, Alfeu Tavares Franca, MD, PhD1,3 Objetivos: Avaliar a padronizacao do metodo com relacao a concentracao do aeroalergeno, tempo de oclusao, de interpretacao; e determinar a especificidade e a sensibilidade do teste de contato alergico (TCA) em relacao ao teste por puntura e a dosagem de IgE especifica, na verificacao da sensibilizacao a acaros em criancas com dermatite atopica (DA). Metodos: Foram selecionadas 72 criancas com idade entre 2 e 12 anos, acompanhadas no ambulatorio de alergia do Hospital Sao Zacharias. Estas foram submetidas a teste de puntura, dosagem de IgEs especificas e TCA para acaros (Dermatophagoides pteronyssinus, Dermatophagoides farinae e Blomia tropicalis). Os testes foram realizados em 3 grupos: (1) DA com ou sem rinite e asma, (2) Rinite e/ou asma sem DA, (3) Saudaveis (controle). Resultados: No grupo 1, 40% dos pacientes apresentaram reacao positiva. A sensibilidade foi maior nos pacientes com maior tempo de exposicao (48 h e 72 h). No grupo 2, o TCA foi mais especifico que sensivel para todos os extratos, com aumento da sensibilidade quanto maior o tempo de exposicao (72 h). No grupo 3, apenas 8,3% apresentaram positividade a algum aeroalergeno do TCA. Conclusao: O TCA mostrou ter valor diagnostico em relacao as reacoes de fase tardia a acaros (D. pteronyssinus, D. farinae e B. tropicalis), com elevada especificidade. Ele demonstrou ser um teste confiavel quando comparado aos resultados do grupo controle. Descritores: Dermatite atopica, teste de contato atopico, acaros. Objectives: To evaluate the standardization of the atopy patch test (APT) with regard to concentration of aeroallergens, occlusion time, and interpretation, and to determine the specificity and sensitivity of the method in relation to prick test and serum specific IgE determination in the investigation of dust mite sensitization in children with atopic dermatitis (AD). Methods: Seventytwo children, ranging from 2 to 12 years of age, were selected among those receiving care at the allergy outpatient clinic of Sao Zacharias Hospital. Children underwent skin prick testing, specific IgE measurements, and APT for mites (Dermatophagoides pteronyssinus, Dermatophagoides farinae, and Blomia tropicalis). Tests were performed in three groups: (1) AD with or without rhinitis and asthma; (2) rhinitis and/or asthma without AD; (3) healthy individuals (controls). Results: In group 1, 40% of the patients presented positive reactions. Sensitivity was higher in patients with longer exposure times (48 h and 72 h). In group 2, APT was more specific than sensitive for all extracts, with increasing sensitivity associated with longer times of exposure (72 h). In group 3, only 8.3% of the individuals were positive to any aeroallergen on APT. Conclusion: APT seems to have diagnostic value in identifying late phase reactions to mites (D. pteronyssinus, D. farinae, and B. tropicalis), with high specificity, and proved to be a reliable test when compared with the results obtained for controls.

Background Childhood food allergy is a serious health problem. However, little is known about the frequency and manner in which it is currently diagnosed. Objective To describe parent report of physician practices in the diagnosis of pediatric food allergy. Methods Data from children with food allergy were identified for analysis from a representative survey administered in US households with children from June 2009 to February 2010. Analyses were performed at the level of the allergy. Demographic characteristics, symptom prevalence, and diagnostic methods were calculated as weighted proportions. Adjusted models were estimated to examine the association of reaction history and allergenic food with odds of physician diagnosis and testing. Results Food allergies (n = 3,218) to 9 common allergens were reported among 2,355 children in a sample of 38,480. We found that 70.4% of reported food allergy was diagnosed by a physician. Among physician-diagnosed food allergy, 32.6% was not evaluated with diagnostic testing, 47.3% was assessed with a skin prick test, 39.9% with a serum specific IgE test, and 20.2% with an oral food challenge. Odds of physician diagnosis and testing were significantly higher for severe versus mild/moderate food allergy. Urticaria and angioedema were not reported as symptoms in 40.7% and 34.6% of severe food allergies, respectively. Conclusion Thirty percent of parent-reported food allergies in this study were not diagnosed by a physician. One in 5 physician-diagnosed allergies was evaluated with oral food challenge. Understanding parent report of practices in food allergy provides insight into ways in which to streamline the diagnosis and management of care.

Food allergy is a common medical problem in infants, children and teenagers. With a good history, appropriate allergy tests and some training, food allergy is relatively easy to diagnose. A correct diagnosis can allow the child to avoid the relevant allergens and reduce their risk of experiencing further allergic reactions. They and their families can also be taught how to recognize and manage any future reactions. This is important as allergenic foods can precipitate anaphylaxis, particularly in children with co-existing asthma. This article will provide a description of how to diagnose and manage infants, children and teenagers with possible food allergy.

Purpose of review Diagnostic decision points for food allergen-specific serum IgE concentration and for skin prick test results have been established for several foods, reducing the requirement for food challenges in a number of patients. Many patients, however, still need to undergo oral food challenges because their food-specific IgE level is in the undefined range. In addition, diagnostic decision points could not be established for several foods. It appears that measurement of serum specific IgE concentrations to individual allergens is superior to determination of specific IgE to the crude food extract containing allergenic and nonallergenic proteins. This review will outline recent advantages in characterization of food allergens as well as the relevance of this knowledge for use in recently developed protein microarray technology. Recent findings Protein microarrays have been developed to profile allergen-specific IgE antibodies from human serum with the advantage of screening hundreds of allergens in parallel using minute amounts of blood. This technology, however, requires prior knowledge of the proteins to be studied. The identification and characterization of clinically relevant allergens have increased dramatically within the last several years. Relevant new allergens have been identified, especially in tree nuts and seeds. Interestingly, most of these allergens belong to the same family of seed storage proteins. In addition, known food allergens have been further characterized and IgE-binding sites have been determined. Moreover, 'informative' peptides shown to be predictive for the persistence of food allergy have been identified. Summary The combination of food allergen characterization and protein or peptide microarray technology will enable us to develop improved diagnostic tools in food allergy.

Background: The positive and negative predictive values of specific IgE to penicillins are not well established for penicillin hypersensitivity. One reason may be that serum IgE levels to penicillin diminish over time. The objective in this study was to investigate variations in serum half-life (T1/2) for specific IgE to penicillins (s-IgE) and to evaluate the outcome of penicillin challenges in patients with previous but not present specific IgE to penicillins. Methods: Two subgroups were investigated. All included patients had a history of penicillin allergy with reported symptoms such as urticaria/angioedema or unclassified cutaneous rash. T1/2 of specific IgE to penicillins was calculated based on sera from 29 patients with repeated measurements of s-IgE. Twenty-two patients with a previous positive s-IgE was followed and challenged with penicillin when IgE had become negative. Results: The T1/2 for s-IgE varied between the 26 patients with decreasing s-IgE from 1.6 months to 76.4 months and 52% had a T1/2 of less than a year. The three patients with stable and increasing IgE-values showed T1/2 approaching infinity A total of 29 challenges with β-lactams were performed. Four different patterns were seen when evaluating the clinical reaction to challenge (positive/negative) and post-challenge boost of s-IgE (yes/no). Eight (36.4%) had negative challenge and negative post-challenge s-IgE, eight (36.4%) negative challenge, but positive post-challenge s-IgE levels. 3 (13.6%) had positive challenge and positive post-challenge s-IgE whereas 3 (13.6%) were challenge positive, but had negative post-challenge s-IgE. Conclusion: Specific IgE to penicillins declines over time stressing the importance of a close time relation between diagnostic work-up and clinical reaction. Reversal of previously positive s-IgE may still be associated with positive penicillin challenges and/or re-boostering of s-IgE to positivity.

An accurate diagnosis of aeroallergen sensitization is pivotal to clinical practice and research. Given the recent technological advances in analyzing serum allergen-specific IgE, the question of which testing method, skin or serum testing, is superior in diagnosing allergic sensitization must be readdressed, as well as their value in predicting clinical disease. This review article provides a detailed summary of recent studies addressing these questions. Conclusively, most studies show substantial discordance between serum-specific IgE and skin testing results, suggesting that the two testing methods compliment each other and cannot be used interchangeably. On average, using only one testing method may misdiagnose every fourth allergically sensitized patient as non-sensitized. In addition, depending on the allergen tested, skin prick testing and serum-specific IgE testing appear to be the methods of choice in predicting outcomes of experimental allergen challenge, while intradermal testing is less contributory.

Aim: Allergen immunotherapy (AIT) is indicated in IgE-mediated respiratory allergy. Recently, it has been reported that serum-specific IgE (sIgE) levels >10 kU/l may predict AIT efficacy in adults with allergic rhinitis. The aim of the present preliminary study was to investigate whether this cut-off could also be associated with perception of effective AIT in children with allergic asthma and/or rhinitis due to house dust mites (HDM). Methods: A total of 31 allergic children (17 males; mean age of 12.5 years) with levels of serum sIgE to HDM >10 kU/l were evaluated. Eight allergic children (five males; mean age of 13.4 years) with levels of serum sIgE to HDM 6 VAS. Severity of nasal symptoms was assessed by nasal VAS, and asthma control was evaluated by asthma control test; both were considered before and after AIT. Results: All children (but one) with sIgE >10 kU/l perceived AIT efficacy, whereas only one child with sIgE 10 kU/l (p < 0.001 for both). Conclusion: Allergen-sIgE assessment before AIT prescription might represent a useful tool to individuate potential responders.

Exposure to house dust has been associated with asthma in adults, and this is commonly interpreted as a direct immunologic response to dust-mite allergens in those who are IgE sensitized to house dust-mite. Mattress house dust-mite concentrations were measured in a population-based sample of 2890 adults aged between 27 and 56 years living in 22 centers in 10 countries. Generalized linear mixed models were employed to explore the association of respiratory symptoms with house dust-mite concentrations, adjusting for individual and household confounders. There was no overall association of respiratory outcomes with measured house dust-mite concentrations, even in those who reported they had symptoms on exposure to dust and those who had physician-diagnosed asthma. However, there was a positive association of high serum specific IgE levels to HDM (3.5 kUA /l) with mattress house dust-mite concentrations and a negative association of sensitization to cat with increasing house dust-mite concentrations. In conclusion, there was no evidence that respiratory symptoms in adults were associated with exposure to house dust-mite allergen in the mattress, but an association of house mite with strong sensitization was observed.

Arslan, Serhat/0000-0002-2110-8489 WOS: 000328082800023 In horses, allergic disease has been implicated in the pathophysiology of atopic dermatitis, recurrent urticaria, and recurrent airway obstruction. With the present study, it is aimed to give information about allergens which determined in Thoroughbred stallions with detecting serum IgE. 18 Thoroughbred stallions averaged 11 years old were included in the study. Fifteen single and five mix allergens were checked for allergen-specific IgE. English plantain (Plantago lanceolata), Birch/Alder/Hazel and Micropolyspora faeni/Thermoactinomyces were detected as quite allergic to six Thoroughbred stallions at total. Consequently, assays detect equine IgE, can be an effortless method in determining allergens in horses.

Background Peach allergy is regarded as one of the most important fresh fruit allergies. Data are available on the state-of-the-art diagnosis, including food challenges, and a component-resolved diagnosis. However, the roles played by different peach allergens with respect to symptom severity are not completely understood. Objective To evaluate the role of serum specific IgE to peach and recombinant allergens in the diagnosis of peach allergies in Italian children. Methods Forty-four children with peach allergy confirmed by a placebo-controlled food challenge were divided into 2 groups based on their symptom severity: patients with mild oral allergy syndrome (OAS) and patients with systemic symptoms (SS). The presence of specific IgE to peach and rPru p 1, rPru p 3, and rPru p 4 was determined. Results The presence of specific IgE to Pru p 4 and Pru p 1 was found significantly more frequently in patients with OAS, whereas specific IgE to Pru p 3 was not found significantly more frequently in patients with SS. Only anti-rPru p 4 IgE levels were significantly higher in patients with OAS, whereas no significant differences were found in anti-rPru p 1 and anti-rPru p 3 IgE levels between patients with OAS compared with patients with SS. Conclusion In Italian children with peach allergies, the presence of specific IgE to Pru p 3 is not associated with SS, and the levels of specific IgE to Pru p 3 do not correlate with the severity of the reactions.

P>Background: Very little is known regarding the global variations in the prevalence of food allergies. The EuroPrevall-INCO project has been developed to evaluate the prevalence of food allergies in China, India and Russia using the standardized methodology of the EuroPrevall protocol used for studies in the European Union. The epidemiological surveys of the project were designed to estimate variations in the prevalence of food allergy and exposure to known or suspected risk factors for food allergy and to compare the data with different European countries. Methods: Random samples of primary schoolchildren were recruited from urban and rural regions of China, Russia and India for screening to ascertain possible adverse reactions to foods. Cases and controls were then selected to answer a detailed questionnaire designed to evaluate the possible risk factors of food allergies. Objective evidence of sensitisation including skin-prick test and serum specific IgE measurement was also collected. Results: More than 37 000 children from the three participating countries have been screened. The response rates for the screening phase ranged from 83% to 95%. More than 3000 cases and controls were studied in the second phase of the study. Furthur confirmation of food allergies by double blind food challenge was conducted. Conclusions: This will be the first comparative study of the epidemiology of food allergies in China, India, and Russia using the same standardized methodology. The findings of these surveys will complement the data obtained from Europe and provide insights into the development of food allergy.

BACKGROUND: Goat's milk (GM) allergy not associated with allergy to cow's milk (CM) is a rare disorder. Caseins have been implicated has the major allergens eliciting symptoms. METHODS: We report the case of a 27 years-old female patient that experienced two episodes of urticaria related to ingestion of goat's cheese (GC). She tolerated CM, dairy products and sheep cheese. Skin prick tests were performed with GM, CM, bovine casein and alpha -lactalbumin and fresh milk and GC. Serum specific IgE to GM, CM and its fractions, and GM and CM immunobloting assays with inhibition were also evaluated. RESULTS: Skin tests were positive to GM and GC and negative to CM. GM immunoblot showed an IgE-binding 14 kDa band that was totally inhibited after serum pre-incubation with GM. CONCLUSIONS: Allergens other than casein can be involved in allergy to GM. Even small quantities of protein can elicit symptoms.

Results In 16 patients (42.1%) with negative serum specific IgE tests for both fungi and HDM, total IgE ( 76.1 + 64.7 KU/L) was significantly lower than in 14(36.8%) patients with positive serum specific IgE tests for fungi (730.1 + 948.41 KU/L) and in 16 patients (42.1%). with positive serum specific IgE tests for HDM (783.5 + 854.1 KU/L), respectively. In patients with negative serum specific IgE tests for both fungi and HDM, FEV1 % predicted (95.9 + 19.2 %) was significantly higher than in patients with positive serum specific IgE tests for fungi (75.5 + 24.2 % )and in patients with positive serum specific IgE tests for HDM (76.7 + 27.3 % ), respectively. In patients with negative serum specific IgE tests for both fungi and HDM, PC20 (2.61 + 1.32 mg/ml) was significantly higher than in patients with positive serum specific IgE tests for fungi (2.23 + 2.05 mg/ml) and in patients with positive serum specific IgE tests for HDM (1.34 + 1.12 mg/ml), respectively.

Background Anaphylaxis after the first exposure to a food allergen is uncommon unless a cross-reaction is present. Objective To investigate a possible relationship between the fruit Cyphomandra betacea Sendth (commonly known as tamarillo) and the wood of Triplochiton scleroxylon (obeche) in a patient with allergic occupational bronchial asthma due to obeche wood who began to experience anaphylaxis episodes after eating tamarillo. Methods A 33-year-old carpenter exposed to obeche wood in his occupation was initially seen with rhinitis and bronchial asthma. The causal relationship of these symptoms to obeche wood exposure was investigated by means of peak flow monitoring and bronchial inhalation testing. Furthermore, the patient had 2 acute episodes of anaphylaxis a few minutes after eating salad containing tamarillo. He had never tasted tamarillo before. The allergologic study included skin prick tests, serum specific IgE determinations, bronchial challenges, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and immunoblotting. Results Results of skin prick tests with common aeroallergens were negative. Strong skin prick test responses were obtained with obeche and tamarillo. Results of bronchial challenge testing with obeche extract were positive. In tamarillo extract, a 28-kDa band appeared as the most relevant IgE-binding antigen. A similar band of 28 kDa happens to be frequently detected in obeche-allergic patients. Conclusion To our knowledge, this is the first reported case of anaphylaxis to tamarillo presented in a patient allergic to obeche, which raises the question of a new cross-reactivity antigen.

Contact with pine processionary caterpillar (Thaumetopoea pityocampa) induces dermatitis usually located in exposed areas through a toxic-irritative mechanism. Over the last few years an immediate hypersensitivity mechanism have mainly been demonstrated in adult patients. However, there are few studies carried out in children. Objective To evaluate a group of 16 children who experienced allergic reactions after exposure to pine processionary caterpillar. Patients and methods All patients underwent allergy testing through skin prick test. Serum specific IgE determination was performed by EAST technique. The molecular mass of the IgE –binding bands was studied by SDS-PAGE Immunoblotting. Results Skin prick test with the caterpillar extract was positive in all patients. Specific IgE was positive (higher than 0.35 kU/L) in 15 patients’ sera. Western blotting showed several IgE-binding bands with molecular mass values ranging from 17.5 to 168 kDa. Electrophoretic mobility of some of the relevant allergens was related to the conditions of sample preparation (reduced or non-reduced). Conclusions The results of this study demonstrate the existence of an allergic IgE-mediated mechanism caused by pine processionary caterpillar proteins. Airborne urticating hairs of this animal should be considered as seasonal inhalant allergen, which is able to induce allergic pathologies in children who frequent pine areas.

Background There have been a few reports of hypersensitivity reactions to Ranitidine and cross-reactivities between H2-receptor antagonists. The pathogenic mechanisms of H2 receptor antagonist induced hypersensitivity reactions are not understood. The purpose of this study was to observe the clinical characteristics of the patients with Ranitidine anaphylaxis and investigate the pathogenic mechanisms with detection of serum specific IgE antibody to Ranitidine-HSA conjugate. Methods Ten patients with anaphylaxis to Ranitidine were enrolled from Ajou University Hospital and Seoul National University Bundang Hospital. Skin prick test (SPT) using Ranitidine extract were performed in 7 patients. Serum specific IgE and G1 antibodies were detected by ELISA using Ranitidine-HSA conjugate. The study subjects were divided into 2 groups according to the presence of serum specific IgE antibody to Ranitidine-HSA conjugate: 3 subjects had high serum specific IgE (Group I) and 7 subjects showed negative results (Group II), when positive cut off value was determined from mean + 3 SD of absorbance values of healthy controls. Results Six (60%) were female and 9 (90%) were atopics. 6 (86%) patients had positive responses to ranitidine on SPT, however, high serum specific IgE to Ranitidine-HSA conjugate was detected in only 3 patients (30%), while serum specific IgG1 was detectable in one patient (10%). There were no significant differences in clinical characteristics including age, sex, atopy and serum total IgE level between group I and II. Conclusions We confirmed the presence of serum specific IgE to Ranitidine-HSA conjugate by ELISA, suggesting that IgE mediated response is a major pathogenic mechanism of Ranitidine induced anaphylaxis. Further studies will be needed to investigate other immunologic and non-immunologic mechanisms and cross-reactivity among other H2 receptor antagonists.

Maloney JM, Rudengren M, Ahlstedt S, Bock SA, Sampson HA. J Allergy Clin Immunol . 2008;122(1): 145–151 PURPOSE OF THE STUDY. The authors of this study sought to determine the usefulness of peanut-, tree nut–, and seed-specific immunoglobulin E (IgE) measurements for the diagnosis of symptomatic allergies and to learn more about the relationships among these foods. STUDY POPULATION. Children and adults ( N = 324) referred to a private allergy practice and to an academic center allergy clinic for evaluation of suspected IgE-mediated peanut, tree nut, or seed (sesame seed, mustard seed, poppy seed, rapeseed, and cottonseed) hypersensitivity were enrolled in …

(RAST) inhibition technique (6). It appeared that F. elastica only weakly inhibited IgE binding to F. benjamina, whereas F. benjamina completely inhibited IgE-binding to F. elastica. This taken together with our findings suggest that F. elastica has only one cross-reacting 12 kDa IgE-binding band. This study demonstrated that the best source of F. benjamina allergens is the sap extract and that the allergens in the sap are species-specific except for the 12 kDa band.

Background Local allergic rhinitis (LAR) is characterized by negative skin testing and serum specific IgE. Diagnosis is based on nasal provocation test (NPT), very sensitive but time-consuming, and/or presence of local synthesis of specific IgE (sIgE) which shows low sensitivity (22%). The aim of the study was to evaluate the presence of specific D. pteronyssinus (DP) activation of basophils by basophil activation test (BAT) in subjects with confirmed LAR. Methods BAT was performed in 43 subjects: 16 with confirmed LAR (positive NPT with DP, negative skin testing and sIgE to DP), 13 with allergic rhinitis (AR)(positive NPT with DP, positive skin testing and sIgE to DP) and 14 healthy controls (negative NPT, negative skin testing and sIgE to DP). To demonstrate a specific IgE mechanism of basophil activation, BAT with wortmannin pre-treatment was performed in four LAR patients. Results BAT with DP was positive in 85% of AR patients and 50% of LAR subjects. BAT showed a substantial correlation with NPT in AR subjects (kappa index: 0.78, p=0.0001). The positive responses of the 4 LAR samples that underwent BAT with wortmannin became negative when this substance was added to the assay. Conclusions

Background Skin prick tests (SPTs) has relatively a good correlation with allergen-specific IgE against house dust mites (HDM) and pollens, whereas their correlation to fungi remains low. We aimed to investigate the correlation between results of serum specific IgE and SPTs for HDM or fungi in patients with chronic lower respiratory symptoms. The clinical difference between serum fungus or HDM-specific IgE-positive and –negative groups was also examined.

Background Microarray technique is promising in allergy diagnosis. The aim of this study was to compare SPT with specific-IgE by microarray in a group of patients with rhinitis. Methods Cross-sectional study, 101 participants with rhinitis diagnosed according to ARIA (89.1% with asthma); age range 6 to 15 years. SPT was done with Dermatophagoides pteronyssinus (Dp), Blattella germanica (Bg), cat and dog allergenic extracts (IPI ASAC Brasil); a mean wheal diameter of ≥2 mm greater than the negative control was considered positive. Sera were analysed for allergen specific IgE antibodies to Dp (Der p 1, Der p 2), Bg (Bla g 1, Bla g 2, Bla g 4, Bla g 5), cat (Fel d 1, Fel d 2) and dog (Can f 1, Can f 2) allergens using a microarray system (ImmunoCAP ISAC, PMD, Austria), considered positive ≥0.3 ISU (ISAC standardized units). Categorical variables were shown as percentage and differences between the 2 methods verified by chi-square test; P < 0.05 was considered significant. Results SPT was positive to Dp in 88.1% whereas ISAC was positive to Der p 1 in 74.2% (P < 0.001) and Der p 2 in 73.3% (P < 0.01) respectively. Sensitivity of SPT was 97% and specificity was 38%. The remaining allergens caused less SPT reactions (cockroach 25.7%, cat 22.8%, dog 27.7%) and these were associated with lower detection of specific-IgE by ISAC respectively Bla g 1 (0.9%, P = 0.09), Bla g 2 (0%), Bla g 4 (0%), Bla g 5 (0.9%, P = 0.55); Fel d 1 (16.8%, P < 0.01), Fel d 2 (0.9%, P = 0.06); Can f 1 (4.9%, P = 0.53), Can f 2 (2.9%, P < 0.001). Conclusions SPT remains the favored method to detect IgE-mediated sensitivity to aeroallergens. SPT was highly sensitive for Dp though less specific in comparison with the IgE microarray to Der p 1 and Der p 2 allergens.

Background Although history taking is primary method in the diagnosis of bee venom allergy, serum specific IgE detection is critical to identify causative bee and assess the effect of immunotherapy. Component-resolved diagnosis (CRD) in allergy has been used for its high sensitivity and specificity in many allergy diseases caused by food, cat, birch, and grass pollens. The purposes of this study are to evaluate diagnostic value of serum specific IgE to 3 bee venom component allergens and observe the changes of allergen specific IgE during bee venom immunotherapy. Methods Fifty-six bee venom anaphylaxis patients receiving bee venom immunotherapy were recruited from Ajou University Hospital. Clinical manifestations and serum specific IgE levels to bee venoms and component allergen (rApi m1 of Apidae, rVes v5 and rPol d5 of Vespidae) measured by using ImmunoCAP (Phadia, Sweden) were analyzed retrospectively. Results Thirty-five (62.5%) patients were male and 33 (73.3%) were atopics. Their mean age was 44.9 ± 13.8 years ranged from 11 to 73 years. Local reactions were found in 13 (23.2%) patients, while systemic reactions, in 43 (76.8%) patients. The most frequent manifestation was anaphylaxis which were severe (37.5%) and moderate (39.3%) manifestations followed by urticaria and angioedema. Yellow Jacket (80.8%) was the most prevalent bee followed by yellow hornet, white faced hornet, honey bee and paper wasp at the time of diagnosis with concurrent sensitization in both Apidae and Vespidae at 70.9% patients. The positive predictive value (PPV) of serum specific IgE levels to rVes v5 and rPol d5 were 85.7 and 87.5%, and they significantly correlated with conventional serum specific IgE level (r = 0.762 and r = 0.757, respectively), however, PPV of rApi m1 was only 34.8% at the time of initial diagnosis. After 3 years of bee venom immunotherapy, all kinds of bee venom specific IgE levels tended to decline compared to those collected before allergen immunotherapy, especially in component specific IgE to Vespidae. Conclusions Yellow jacket sting and male gender may be risk factors for bee venom allergy in Korea. Component allergen specific IgE to Vespidae, not Apidae had a diagnostic and monitoring value comparable to conventional specific IgE in bee venom allergy.