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Previous studies provide evidence for an association between modifications of the gut microbiota in early life and the development of food allergies. We studied the faecal microbiota composition (16S rRNA gene amplicon sequencing) and faecal microbiome functionality (metaproteomics) in a cohort of 40 infants diagnosed with cow's milk allergy (CMA) when entering the study. Some of the infants showed outgrowth of CMA after 12 months, while others did not. Faecal microbiota composition of infants was analysed directly after CMA diagnosis (baseline) as well as 6 and 12 months after entering the study. The aim was to gain insight on gut microbiome parameters in relation to outgrowth of CMA. The results of this study show that microbiome differences related to outgrowth of CMA can be mainly identified at the taxonomic level of the 16S rRNA gene, and to a lesser extent at the protein-based microbial taxonomy and functional protein level. At the 16S rRNA gene level outgrowth of CMA is characterized by lower relative abundance of Lachnospiraceae at baseline and lower Bacteroidaceae at visit 12 months. [ABSTRACT FROM AUTHOR]

Background: Skin prick test (SPT) or Phadiatop, a multi-allergen IgE screening test, was used as a tool for detecting aeroallergen sensitization. Objective: To compare SPT and Phadiatop as a tool for diagnosis allergic rhinitis (AR) using the nasal provocation test (NPT) as a comparative standard. Methods: Children aged 5-18 years with rhinitis symptoms more than 6 times in the past year were enrolled. SPT to 13 common aeroallergens, serum for Phadiatop, and NPT to Dermatophagoides pteronyssinus (Der p) were performed. NPT to mixed cockroach (CR) were performed in children who had CR sensitization and negative NPT to Der p. Children who had a disagreement between the result of SPT and Phadiatop or having negative results were evaluated for specific IgE (sIgE) to common aeroallergens. Results: One hundred-forty children were enrolled with the mean age of 9.8 ± 3 years, 56% were male. Of 92 children (65.7%) with positive SPT to any aeroallergens, 88 children (95.6%) were sensitized to house dust mite (HDM). NPT showed positive results in 97 children (69.3%). Of 48 children who showed negative SPT, 4 children (8.3%) had sIgE to aeroallergens but NPT was positive in 1 child. Eighty-eight children (62.9%) had positive tests for Phadiatop and 4 (4.5%) of them had negative results for NPT to Der p. Among 52 children who had negative results for Phadiatop, 4 children (7.6%) had sIgE to aeroallergens but NPT was positive in 2 children (3.8%). SPT and Phadiatop showed 94.2% agreement: with Kappa 0.876, p < 0.001. Using NPT as a comparative standard for diagnosis for AR, SPT showed a sensitivity of 89.6% and specificity of 88.3% and Phadiatop provided the sensitivity of 88.6% and specificity of 95.3%. Conclusions: SPT to aeroallergen and Phadiatop have good and comparable sensitivity and specificity for the diagnosis of AR in children. [ABSTRACT FROM AUTHOR]

Objective: To determine usefulness of basophil activation test [BAT] in diagnosis of immediate betalactam [BL] allergy, and compare the role of diagnosis BAT with standard testing, skin test [ST], and drug provocation test [DPT] in patients with history suspected of drug allergy in Thailand. Materials and Methods: Cross-sectional study of 􀏐ifteen patients with an history of immediate hypersensitivity reactions to common BL drug group, at Ramathibodi Hospital between 2010 and 2012. All subjects underwent ST, and DPT if ST was negative. BAT was done in all patients. Results: Fifteen patients (10 children and 5 adult), including seven male and eight female cases with history of highly indicated immediate type allergic reactions to beta lactam were examined. Five presented with anaphylaxis and 10 with urticarial rash/angioedema. From 􀏐ifteen patients, eight patients were con􀏐irmed allergic to BL, where four had ST positivity, and four had positive DPT. The present study found one patient with severe anaphylaxis that had negative ST, but could not undergo DPT due to underlying diseases. The alternative test BAT yielded positive result. Four of the eight patients were con􀏐irmed as BL allergic patients with positive BAT (50%). None of the patients with negative drug testing had positive BAT. Estimated sensitivity of ST was similar to BAT at 50%, while speci􀏐icity of BAT in the present study was 100%. The result yielded higher sensitivity, such as 62%, when we combined both tests together (ST and BAT). The authors observed BAT positive results in 75% of patients with positive ST, and 25% of patients positive DPT. Conclusion: BAT has an advantage in patients contraindicated to perform DPT. Moreover, BAT can avoid the risk of reproducible reactions from in vivo testing, especially in high-risk patients allergic to BL. BAT is a promising alternate investigation tool ensuring patients' safety. [ABSTRACT FROM AUTHOR]

Aim To determine the outcomes of juvenile idiopathic arthritis ( JIA) in Thai children. Methods A retrospective cohort study. All JIA patients in a rheumatology clinic, Ramathibodi Hospital, between July 1997 and December 2012 were enrolled. The patient data were reviewed from medical records. At the most recent follow-up visit, patient outcomes were assessed in three aspects: disease status, functional outcomes and structural damage. Results Of 168 patients, 158 (94.0%) were assessed in disease status and functional outcomes, with 114 patients (67.9%) assessed in three aspects over 4 years of disease. The most common JIA category was systemic JIA ( SJIA) (33.8%), followed by enthesitis-related arthritis ( ERA) (24.8%), oligoarthritis (18.5%), rheumatoid factor ( RF)-negative polyarthritis (15.3%), RF-positive polyarthritis (7.6%) and one undifferentiated arthritis. SJIA had the highest remission rate due to early diagnosis and prompt treatment compared to other categories, whereas RF-positive polyarthritis carried the worst prognosis in three aspects, followed by ERA. Moreover, ERA patients had the highest failure rate in conventional therapy, half of whom had combined treatment with biologic agents and presence of human leukocyte antigen ( HLA)-B27 was a predictor for biologic treatment in ERA patients. In addition, disease duration > 2 years or failure of conventional therapy was a predictor of structural bone damage. Conclusions SJIA had the highest remission rate, whereas RF-positive polyarthritis had the worst outcome in three aspects. Prolonged disease duration or failure of conventional therapy was a predictor of structural bone damage, while HLA-B27 was a predictor for biologic treatment in ERA patients. [ABSTRACT FROM AUTHOR]