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Background: Pollen‐food allergy syndrome (PFAS) is caused by the cross‐reaction of the specific IgE to pollen allergens with similar allergens contained in fruits, vegetable, and nuts. The representative allergen responsible for this cross‐reaction is pathogenesis‐related protein (PR)‐10. Specific IgE test using Gly m 4, soybean PR‐10, is widely used to diagnose soy allergy. We aimed to investigate whether the Gly m 4‐specific IgE test is useful for predicting oral allergy symptoms (OAS) to Rosaceae fruits in PFAS caused by Betulaceae pollen sensitization. Methods: Forty‐one patients with suspected PFAS were enrolled. Specific IgE levels were measured against alder pollen, apple, peach, pear, and Gly m 4, and correlation between test results and allergic symptoms was assessed to compare the accuracy of these allergen‐specific IgE tests. Results: Of the 41 patients, 32 were positive for alder pollen‐specific IgE. Of those, 16 showed OAS to at least one of apple, peach, and pear (OAS (+) group), and the rest 16 cases showed no symptoms (OAS (−) group). The Gly m 4‐specific IgE value was significantly higher in the OAS (+) group (p =.014), and the highest in area under the receiver operating characteristics curve. The cut‐off value for detection of the OAS (+) group was 2.65 UA/ml, with a sensitivity of 62.5% and a specificity of 81.3%. Other allergen‐specific IgE values were not significantly different between the two groups. Conclusions: In the subjects sensitized to Betulaceae pollen allergens, the Gly m 4‐specific IgE test is useful for predicting OAS of Rosaceae fruits. [ABSTRACT FROM AUTHOR]

Keywords: exercise; gliadin; non-steroidal anti-inflammatory drugs; prostaglandin; wheat-dependent exercise-induced anaphylaxis EN exercise gliadin non-steroidal anti-inflammatory drugs prostaglandin wheat-dependent exercise-induced anaphylaxis 359 361 3 03/15/23 20230301 NES 230301 Key messages Bread ingestion combined with exercise or aspirin increased the serum level of wheat gliadins. We measured the blood gliadin levels in patients with WDEIA during a challenge test, using a highly sensitive enzyme-linked immunosorbent assay (ELISA) that can specifically detect wheat gliadin.[[2]] As a result, the blood gliadin level increased preceding the allergic symptoms when induced by the combination of wheat ingestion and exercise, while serum gliadin was not detected or remained at a very low level in the case of the wheat ingestion alone. Blood gliadin levels were elevated for 15-120 min after gluten ingestion; however, no enhancing effects were found for aspirin, alcohol, or exercise on blood gliadin levels. [Extracted from the article]

Objectives To clarify the surgical methods and the clinical results of subfascial endoscopic perforator surgery in Japan. Methods This study included 1287 limbs of 1091 patients who underwent subfascial endoscopic perforator surgery in 14 hospitals. Simultaneous saphenous vein treatment was performed in 1079 limbs (83.8%), and 118 limbs (9.2%) had deep venous lesions. The venous clinical severity score was calculated before and 6 to 12 months after surgery. The ulcer healing rate and ulcer recurrence rate were calculated cumulatively. Results Preoperative venous clinical severity score was significantly decreased from 10.0 ± 6.6 to 3.1 ± 3.4 (P < .0001) postoperatively. The primary ulcer healing rate was 96.2% (332/345 C6 limbs) at an average follow-up of 47.7 months, and the ulcer recurrence rate was 12.0% (49/393 C5, C6 limbs) at the average follow-up of 46.0 months after the ulcer healed. Conclusion These results indicate that subfascial endoscopic perforator surgery is an alternative to improve the long-lasting disease severity and/or clinical outcome. [ABSTRACT FROM AUTHOR]

Varicose veins ( VV) in legs are commonly observed in the general global population. However, the prevalence of and risk factors for VV in Japan are not clear. This study aimed at clarifying the risk factors for VV in traditional rural areas of Shimane prefecture. Subjects (113 men and 205 women aged ≥45 years) were recruited from health examinations in those areas in 2012. VV were defined as a reflux of blood in the great and/or small saphenous vein and incompetent perforating veins detected by ultrasonography. Risk factors for VV were analyzed using logistic regression models that included various parameters. We also investigated the possible interaction between standing at work and overweight and calculated the synergistic index. VV were found in 20.1% of the subjects (12.4% of men and 24.4% of women). The previously known risk factors of prolonged upright standing posture during work, higher body mass index ( BMI), female sex, and age were also significant factors for VV. There was a significant combined effect of overweight ( BMI ≥25) and prolonged upright standing posture at work [adjusted odds ratio = 3.42; 95% confidence interval ( CI), 1.07-10.89], although the synergistic effect was not significant [synergistic index = 1.3; 95% CI, 0.2-8.7]. The prevalence of VV in the traditional rural area of Shimane prefecture was comparable to that reported previously in European countries. Our results confirm that exposure to both prolonged standing at work and overweight exacerbate VV development. This finding is useful to develop strategies for VV prevention. [ABSTRACT FROM AUTHOR]

The article presents a study which differentiates two isozymes of coniferyl alcohol dehydrogenase (CADH I and II) from Streptomyces sp. NL15-2K. The study uses gel filtration to identify the apparent molecular masses of CADH I and matrix-assisted laser-desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) to study their subunit molecular masses. Results show that both isozymes are tetramers and they reduced cinnamaldehyde and conifer aldehyde to alcohols in the presence of NADH.

Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a severe IgE-mediated allergic reaction provoked by the combination of wheat-ingestion with intensive physical exercise over the next few hours. Among wheat proteins, ω-5 gliadin, which is one of the components of fast ω-gliadin, has been reported as a major allergen in the anaphylaxis. In this study, we detected IgE-binding epitopes within the primary sequence of ω-5 gliadin using arrays of overlapping peptides synthesized on derivatized cellulose membranes. Sera from four patients with WDEIA having specific IgE to the fast ω-gliadin were used to probe the membrane. Seven epitopes, QQIPQQQ, QQLPQQQ, QQFPQQQ, QQSPEQQ, QQSPQQQ, QQYPQQQ, and PYPP, were detected within the primary sequence of ω-5 gliadin. By using sera of 15 patients, 4 of them, QQIPQQQ, QQFPQQQ, QQSPEQQ, and QQSPQQQ, were found to be dominant epitopes. Mutational analysis of the QQIPQQQ and QQFPQQQ indicated that amino acids at positions Gin¹, Pro4, Gln5, Gln6, and Gln7 were critical for IgE binding. These results will provide a useful tool for developing safer wheat products in addition to diagnostic and immunotherapy techniques for WDEIA. [ABSTRACT FROM AUTHOR]

A 47 years-old woman suffering from baker's asthma for several years developed anaphylaxis when she was walking hard after taking wheat. On the provocation test, neither wheat alone nor exercise alone induced any symptoms. The combination of exercise, wheat and aspirin induced urticaria and marked elevation of blood gliadin levels. According to the high titer of omega-5 gliadin specific IgE in her serum and the result of challenge test, we diagnosed wheat-dependent exercise-induced anaphylaxis (WDEIA). By means of western blotting of soluble and insoluble wheat proteins, we detected several bands which were supposed to be beta-, gamma- and omega-5 gliadin by their relative molecular mass. Wheat gliadins might be causative allergen of both baker's asthma and WDEIA in our case.

Background: Exercise or aspirin intake enhances symptoms by increasing blood gliadin levels in patients with wheat-dependent exercise-induced anaphylaxis (WDEIA). Misoprostol, a synthetic analogue of prostaglandin E1 (PGE1) compensates prostagrandins of which synthesis is inhibited by aspirin and protect the gastrointestinal mucosa. We projected to examine the effect of misoprostol in suppression the allergic symptom and elevation of blood gliadin levels in WDEIA induced by aspirin., Patients and Methods: Two patients with a history of recurrent anaphylaxis associated with wheat ingestion accompanied with exercise, positive specific IgE and/or skin test were enrolled in the provocation test. On the provocation test of WDEIA, wheat ingestion, exercise, aspirin intake were combined on various ways. During the test, the patients' symptom and serum gliadins levels were monitored., Results: Although wheat with exercise did not induce any symptoms, addition of aspirin induced urticaria and elevation of blood gliadin levels in both cases. In case 1, premedication of misoprostol suppressed the urticaria and elevation of blood gliadin levels which were induced by exercise, wheat and aspirin intake. In case 2, premedication of misoprostol suppressed the urticaria and elevation of blood gliadin levels which were induced by wheat and aspirin intake., Conclusion: These findings suggest that a synthetic analogue of PGE1 may suppresses the absorption of the allergen levels and outbreak the allergic symptom induced by aspirin in the patients with WDEIA.

Wheat omega-5 gliadin and a high m.w. glutenin subunit (HMW-glutenin) have been reported as major allergens in wheat-dependent exercise-induced anaphylaxis. A simultaneous detection of specific IgE to epitope sequences of both proteins is considered to be a reliable method for diagnosis of wheat-dependent exercise-induced anaphylaxis. However, the IgE-binding epitope of HMW-glutenin remains unknown. The aim of this study was to determine the IgE-binding epitopes of HMW-glutenin to establish a useful system of identifying patients with wheat-dependent exercise-induced anaphylaxis. For determination of IgE-binding epitopes of HMW-glutenin overlapping peptides were synthesized and reactivities of IgE Abs in the sera of patients to those peptides were analyzed. Three IgE-binding epitopes, QQPGQ, QQPGQGQQ, and QQSGQGQ, were identified within primary sequence of HMW-glutenin. Epitope peptides, which include IgE-binding sequences of omega-5 gliadin and a HMW-glutenin, were synthesized and peptide-specific IgE Abs were measured by CAP-System fluorescent enzyme immunoassay. Twenty-nine of 30 patients with wheat-dependent exercise-induced anaphylaxis had specific IgE Abs to these epitope peptides. None of the 25 sera from healthy subjects reacted to both epitope peptides. Twenty-five patients with atopic dermatitis who had specific IgE to wheat and/or gluten had very low or nonexistent levels of epitope peptide-specific IgE Abs. These results indicated that measurement of IgE levels specific to epitope peptides of omega-5 gliadin and HMW-glutenin is useful as an in vitro diagnostic method for the assessment of patients with wheat-dependent exercise-induced anaphylaxis.