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Tropomyosin has been identified as the major cross-reactive shellfish allergen, but recent studies showed the presence of other clinically relevant allergens. This study aims at determining the allergic immune responses of mice sensitized with raw and boiled shrimp extracts in comparison to recombinant tropomyosin (rTM). Female Balb/c mice were intragastrically sensitized and challenged with raw, boiled shrimp or rTM. Systemic, cellular and humoral allergic responses were compared, while allergenicity of the extracts was also compared by skin prick test (SPT) and immunoblot on shrimp allergic subjects. We showed that rTM and shrimp extracts induced IgE- and Th2-mediated allergic responses in mice, distinguished by remarkable intestinal inflammation in small intestine across all regimens. Notably, boiled shrimp extract exhibited the highest sensitization rate (73.7% of mice developed positive TM-specific IgE response) when compared with raw extract (47.8%) and rTM (34.8%). Mice sensitized with boiled extract manifested the highest allergen-specific IgE and Th2 cytokine responses than the others. Immunoblot results indicated that tropomyosin remained the major allergen in extract-based sensitization and had stronger allergenicity in a heat-treated form comparing to untreated TM, which was in line with the SPT results that boiled extract induced larger wheal size in patients. Hemocyanin and glycogen phosphorylase were also identified as minor allergens associated with manifestation of shrimp allergy. This study shows that boiled extract enhanced sensitization and Th2 responses in agreement with the higher allergenicity of heat-treated TM. This study thus presents three shrimp allergy murine models suitable for mechanistic and intervention studies, and in vivo evidence implies higher effectiveness of boiled extract for the clinical diagnosis of shellfish allergy.

Introduction: This study aimed to analyze the types and distribution characteristics of major inhalant allergens in patients with allergic rhinitis (AR) in Yinchuan, China. Methods: In this cross-sectional study, 2,000 outpatients suspected of having AR were included from 2022 to 2023 at the Department of Otolaryngology-Head and Neck Surgery, General Hospital of Ningxia Medical University. Skin prick tests were performed on the included individuals using 13 common inhalant allergens: house dust mites, dust mites, tropical mites, Artemisia, dog hair, ragweed, cat hair, grass pollen, tree pollen, mold group I, mold group IV, German cockroach (Blattella germanica), and American cockroach (Periplaneta americana). The results of the skin prick tests were summarized, and patients with positive results were grouped by ethnicity, gender, and age to compare the differences in the positive rates of various inhalant allergens between the groups. The number of patients visiting each month was recorded to analyze the temporal variation in the incidence rate and compare the differences in the main inhalant sensitizers among patients in each quarter. Results: Among the 2,000 included patients, there were 1,060 males and 940 females, with an average age of 18.7 years. Among the 2,000 outpatients who underwent allergen skin prick tests, 1,346 cases (67.30%) had positive results. The inhalant allergens were ranked in descending order of positive rates as follows: Artemisia (53.25%), dust mites (51.10%), house dust mites (49.10%), ragweed (45.70%), tropical mites (43.15%), dog hair (19.20%), cat hair (16.05%), American cockroach (12.10%), German cockroach (11.25%), grass pollen (9.15%), tree pollen (7.10%), mold group I (6.10%), and mold group IV (5.05%). There were no statistically significant differences in positive rates between different ethnicities or genders (all p > 0.05). Compared to patients aged 18 years and above, patients under 18 years old had statistically significant differences in positive rates for dust mites, Artemisia, ragweed, mold group I, and German cockroach (all p < 0.05). The seasonal distribution indicated that autumn had the highest number of patient visits in a year (579 cases, 58.95%). Conclusion: Artemisia and dust mites were the major inhalant allergens in patients with suspected AR in Yinchuan, China. The positive rate of inhalant allergen skin prick tests was not correlated with the ethnicity or gender of the local population. Autumn was the season with the highest frequency of visits by patients with suspected AR. [ABSTRACT FROM AUTHOR]

Introduction: Dogs are among the most commonly allergenic pets for children. Data on risk factors for the development of dog allergy are scarce. This study aimed to evaluate the characteristics of children with dog allergy and identify predictors of symptom development with dog exposure. Methods: The study included children with dog allergen sensitization demonstrated by skin prick test (SPT) between September 1, 2019, and December 1, 2022. Demographic, clinical, and laboratory data were collected from the patients' records and interviews with parents. Results: Dog allergen sensitization was detected by SPT in 548 (5.5%) of 9,907 patients. Of these, 507 patients had complete data and were included in the analysis. The patients' median age was 11 (IQR: 8–15) years, 55.8% were male, 97.6% exhibited polysensitization (pollen 75.1%, cat 69.6%), 83.6% had allergic rhinitis, and 46.2% had asthma. Acute dog exposure caused symptoms in 164 patients (32.3%), most commonly sneezing (n = 97) and nasal symptoms (n = 80). Predictors of acute symptoms in dog-sensitized children were male sex (OR: 0.584 [CI: 0.38–0.87]), dog exposure before 1 year of age (OR: 2.35 [CI: 1.18–4.66]), close contact with a dog owner (OR: 2.93 [CI: 1.78–4.8]), and cat allergy (OR: 2.75 [CI: 1.82–4.1]). Conclusion: Approximately one-third of children with dog sensitization developed symptoms after exposure to the dog. Male sex, direct dog exposure before the age of one, close contact with a dog owner, and cat allergy were identified as predictors of dog allergy. [ABSTRACT FROM AUTHOR]

Asthma is a respiratory disorder caused by airway inflammation which may worsen after allergen exposure. Recent cohort studies demonstrate a positive association between skin cancer and asthma or hay fever (allergy to outdoor allergens such as pollen). Nationally-representative data for adults in the United States remains limited. We aimed to characterize skin cancer prevalence among individuals in the United States who have asthma or hay fever. To achieve this aim, we extracted nationwide cross-sectional data from 16,277 adult participants (total survey-weighted sample = 174,765,931) of the Third National Health and Nutrition Examination Survey from 1988 to 1994. This study uses survey-weighted regression to compare the nationwide prevalence of skin cancer among participants with or without a history of asthma or hay fever. Sensitivity analysis examined the influence of sex, 25-hydroxyvitamin D, chronic bronchitis or emphysema, geographical region, urban proximity, and oral glucocorticoid use. Of the included participants, the age-adjusted prevalence of skin cancer was 7.2%, similar to national estimates. Skin cancer prevalence was higher among participants who had asthma with hay fever (adjusted prevalence ratio, 1.79; 95% confidence interval, 1.16, 2.76), but not among participants with asthma only or hay fever only. Similarly, skin cancer prevalence was higher for those with asthma and positive pollen allergen skin prick testing (SPT), but not for those with hay fever and positive pollen SPT. No association was noted between skin cancer and wheezing triggered by pollen. Hay fever or immunoglobulin-E sensitization to pollen may increase skin cancer prevalence among individuals with a history of asthma. [ABSTRACT FROM AUTHOR]

Chronic rhinosinusitis is divided into two groups, which are Chronic rhinosinusitis with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP). The rate of post-surgical recurrence in the CRSwNP is high, and predicting factors are unknown. This study aims to identify and evaluate risk factors associated with treatment-resistant and recurrent CRSwNP. This cross-sectional study evaluates demographic data and atopic risk factors in patients with CRSwNP, including a high IgE level (≥100 U/mL), skin prick test (SPT) for aeroallergens, aspirinexacerbated respiratory disease (AERD), and asthma prevalence. An oral aspirin challenge was performed to diagnose AERD. 191 patients with CRSwNP were enrolled, with 73 patients in the recurrent, and 118 patients in the non-recurrent group. The mean age of the patients in the recurrent group was 45.08±12.05. The mean age of the patients in the non-recurrent group was 42.89±11.73. 49. Asthma prevalence in recurrent- CRSwNP is significantly higher than non-recurrent CRSwNP Asthma severity in recurrent CRSwNP and AERD patients was significantly higher than in nonrecurrent CRSwNP and non-AERD patients. The level of IgE in the recurrent- CRSwNP is higher than non-recurrent CRSwNP. Positive SPT results for tree, weed, and mite allergens were higher in the non-recurrent- CRSwNP group compared to the recurrent CRSwNPgroup. Asthma had a significantly higher difference in AERD compared to non-AERD. The level of IgE in AERD is higher than non-AERD. Recurrent CRSwNP patients and AERD patients had Higher IgE levels. Asthma is more prevalent and more severe in both AERD and recurrent CRSwNP. However, a positive SPT result has been seen higher in non-recurrent CRSwNP. [ABSTRACT FROM AUTHOR]

The European Academy of Allergy and Clinical Immunology (EAACI) has released updated clinical guidelines for the diagnosis and management of IgE-mediated food allergy. The guidelines provide evidence-based recommendations for clinicians treating patients with suspected food allergies. The guidelines emphasize the importance of a detailed clinical history, including dietary history, in reaching an accurate diagnosis. They also outline various diagnostic tests, such as skin prick tests and specific IgE tests, and recommend oral food challenges when necessary. The guidelines also address management strategies, including dietary advice, treatment plans for allergic reactions, and the potential use of immunomodulatory treatments. [Extracted from the article]

Objective: This study aimed to analyze the sensitization rate of different aeroallergens in children of different age, sex, and disease groups, describe the changing trend of different aeroallergens in different ages, and analyze the sensitization risk factors for asthma. Methods: Children (<18 years old) with suspected atopic diseases who visited the Department of Allergy of Children's Hospital Affiliated to Capital Institute of Pediatrics and underwent a skin prick test (SPT) were retrospectively enrolled from January 2019 to November 2021. Results: A total of 5465 patients (3514 boys, 1951 girls; mean age, 7 ± 3 years) were enrolled. Of them, 3703 patients (67.8%) were sensitized to at least one aeroallergen. Before 4 years of age, mold was the most prevalent aeroallergen (103/380 [27.1%]), whereas after 4 years of age, weed pollen was the most prevalent aeroallergen. After 6 years of age, tree pollen became the second most prevalent aeroallergen. After 12 years of age, the sensitization rate of indoor aeroallergens was lower than that of outdoor aeroallergens. Logistic regression showed that sensitization to mold (odds ratio [OR]:1.4, 95% confidence interval (CI): 1.2–1.7, p < 0.001), animal dander (OR: 1.6, 95% CI: 1.4–1.9, p < 0.001), and polysensitization (OR: 1.4, 95% CI: 1.0–1.8, p = 0.038) were potential sensitization risk factors for asthma. Conclusions: Mold is an important allergen in early life. Different kinds of allergens affect different age groups. Patients who are sensitized to mold or animal dander or experience polysensitization should be carefully monitored for asthma risk. [ABSTRACT FROM AUTHOR]

Purpose of Review: Buckwheat (BW) allergy is a significant issue in Asia. This review delves into three types of BW allergy: immediate food allergy; food-dependent, exercise-induced anaphylaxis (FDEIA) as a subset of immediate food allergy; and food protein-induced enterocolitis syndrome (FPIES); by comparing data from Asian and non-Asian countries. Recent Findings: Most studies on BW have been published in Japan and Korea, and only a few studies on the topic have been done outside Asia. To date, seven components of common BW (Fagopyrum esculentum) and four components of Tartary BW (Fagopyrum tartaricum) have been implicated in BW allergy. Although BW-sIgE has limited utility for evaluating immediate BW allergy, Fag e 3-specific IgE, one of the components of common BW, and the skin prick test are diagnostically useful. Summary: The present review aims to shed light on the current state of knowledge, highlight research gaps, and suggest future directions in the management and understanding of BW allergy. [ABSTRACT FROM AUTHOR]

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Abstract Background Skin prick tests (SPTs), or intraepidermal tests, are often the first diagnostic approach for people with a suspected allergy. Together with the clinical history, SPTs allow doctors to draw conclusions on allergies based on the sensitization pattern. The purpose of this study is to investigate the potential cost consequences that would accrue to a Swiss University hospital after the adoption of computer vision-based SPTs. Methods We conducted a cost-consequence analysis from a hospital’s perspective to evaluate the potential cost consequences of using a computer vision-based system to read SPT results. The patient population consisted of individuals who were referred to the allergology department of one of the five university hospitals in Switzerland, Inselspital, whose allergology department averages 100 SPTs a week. We developed an early cost-consequence model comparing two SPT techniques; computer vision-based SPTs conducted with the aid of Nexkin DSPT and standard fully manual SPTs. Probabilistic sensitivity analysis and additional univariate sensitivity analyses were used to account for uncertainty. Results The difference in average cost between the two alternatives from a hospital’s perspective was estimated to be CHF 7 per SPT, in favour of the computer vison-based SPTs. Monte Carlo probabilistic simulation also indicated that SPTs conducted using the computer vision-based system were cost saving compared to standard fully manual SPTs. Sensitivity analyses additionally demonstrated the robustness of the base case result subject to plausible changes in all the input parameters, with parameters representing the costs associated with both SPT techniques having the largest influence on the incremental cost. However, higher sensitization prevalence rates seemed to favour the more accurate standard fully manual SPTs. Conclusion Against the backdrop of rising healthcare costs especially in Switzerland, using computer-aided or (semi) automated diagnostic systems could play an important role in healthcare cost containment efforts. However, results should be taken with caution because of the uncertainty associated with the early nature of our analysis and the specific Swiss context adopted in this study.

Background: Atopic dermatitis (AD) is a multifactorial chronic, frequently recurrent, inflammatory skin condition. The development of IgE-mediated food allergies and food sensitivity are both associated with atopic dermatitis. Cow’s milk allergy (CMA) caused the most common hypersensitivity reaction during childhood; however, the prevalence in adults is around 0.5%. Patients with AD use the Skin Prick Test (SPT) to evaluate the specific sensitization process. Purpose: This study aimed to assess cow's milk allergy among adult AD patients using local allergen extract SPT, standard SPT, and specific IgE (sIgE), as well as evaluating the conformity and relevance of the test results. Methods: Using consecutive sampling technique, the study was conducted twice on 45 adult AD patients with a one-week interval between administrations. Result: Local cow's milk SPT showed 4 positive results, and standard SPT showed 5. No sIgE test was positive. Local SPT was negative for 86.67% of individuals without a history of suspected cow's milk allergies. Standard SPT results were positive for 2.22% of individuals with a history of suspected cow's milk allergies and negative for 86.67% of those without. The relevance between local and standard SPT was shown to be substantial (k = 0.384, p = 0.000). Conclusion: The result of the local cow’s milk SPT and the patient’s history had good conformity, and the relevance with standard SPT was significant in diagnosing cow’s milk allergy among AD patients.

INTRODUCTION: Asthma is one of the most common chronic noncommunicable diseases. Aeroallergens are often implicated in the pathogenesis of allergic rhinitis (AR) and bronchial asthma (BA). Identification of the most prevalent aeroallergens, to which the patients are sensitized, plays an important role in the diagnosis and treatment of BA. Among various diagnostic tests for detecting sensitizing allergens, the skin prick test (SPT) is a useful method to demonstrate hypersensitivity to a specific antigen. METHODOLOGY: This was a hospital-based cross-sectional observational study carried out on BA patients attending our institute during the year 2020–2021. BA patients of both sex and age between 18 and 65 years, diagnosed according to the latest GINA guidelines and gave written informed consent were included in the study. After recruitment, the participant’s detailed medical history and sociodemographic data were obtained. Total eosinophil count (TEC), serum immunoglobulin E (S. IgE), X-ray PNS, chest X-ray, and other investigations as required were done. SPT was done using 63 antigens, which included 20 pollens, 8 fungi, 5 insects, 8 dusts, 4 dander, 2 dust mites, 2 feathers, and 14 food allergens. RESULTS: Six thousand and three hundred SPTs were performed with a total of 63 allergens using the modified SPT technique. Of the 100 patients enrolled, 71% were diagnosed as BA and 29% as BA with AR. Among the study population, 44% were females and 56% were males. The majority was constituted of young adults, aged 21–30 years. More than half of the patients (68%) had their duration of disease between 1 and 5 years. Seventy percent patients reported seasonal variation in symptoms, and spring season was associated with maximum allergic exacerbations followed by winter. Significant positive reaction (≥2+) in SPT was found in 89% of patients, whereas 11% tested negative for all allergens. pollens were the most common aeroallergen group identified, whereas feathers and food allergens were the least common in the present study. Among pollen, Prosopis juliflora was the most common (24%) pollen-causing sensitization closely followed by Holoptelea integrifolia (17%) and Gynandropsis gynandra (18%). Female cockroach (37%) and mosquito (37%) were the most common insects to which the majority of the population were sensitized. Dermatophagoides farinae was accounting for 23% of positive reactions in the study population. Alternaria tenuis was the most common fungus to which 6% of the patients tested positive. House dust (17%) was the most common dust subgroup associated with positive SPT. Among danders, buffalo dander (8%) was observed to be the most common sensitizer followed by dog dander (6%). The pigeon feather was the most common feather identified. A strong positive correlation was observed between S. IgE and the number of allergens that tested positive (r = 0.489; P < 0.0001) and a strong positive correlation was observed between serum TEC and the number of allergens that tested positive (r = 0.430; P < 0.0001). CONCLUSION: Our study identified pollen as the most common sensitizing aeroallergen followed by insects. Such studies, conducted from time to time, shed light on the changing trends of the commonly prevalent allergens in a particular area. The identification of offending allergens for a patient also explores treatment options such as allergen-specific immunotherapy.

Background: Skin prick tests (SPTs), or intraepidermal tests, are often the first diagnostic approach for people with a suspected allergy. Together with the clinical history, SPTs allow doctors to draw conclusions on allergies based on the sensitization pattern. The purpose of this study is to investigate the potential cost consequences that would accrue to a Swiss University hospital after the adoption of computer vision-based SPTs. Methods: We conducted a cost-consequence analysis from a hospital's perspective to evaluate the potential cost consequences of using a computer vision-based system to read SPT results. The patient population consisted of individuals who were referred to the allergology department of one of the five university hospitals in Switzerland, Inselspital, whose allergology department averages 100 SPTs a week. We developed an early cost-consequence model comparing two SPT techniques; computer vision-based SPTs conducted with the aid of Nexkin DSPT and standard fully manual SPTs. Probabilistic sensitivity analysis and additional univariate sensitivity analyses were used to account for uncertainty. Results: The difference in average cost between the two alternatives from a hospital's perspective was estimated to be CHF 7 per SPT, in favour of the computer vison-based SPTs. Monte Carlo probabilistic simulation also indicated that SPTs conducted using the computer vision-based system were cost saving compared to standard fully manual SPTs. Sensitivity analyses additionally demonstrated the robustness of the base case result subject to plausible changes in all the input parameters, with parameters representing the costs associated with both SPT techniques having the largest influence on the incremental cost. However, higher sensitization prevalence rates seemed to favour the more accurate standard fully manual SPTs. Conclusion: Against the backdrop of rising healthcare costs especially in Switzerland, using computer-aided or (semi) automated diagnostic systems could play an important role in healthcare cost containment efforts. However, results should be taken with caution because of the uncertainty associated with the early nature of our analysis and the specific Swiss context adopted in this study. [ABSTRACT FROM AUTHOR]

Chronic urticaria is wheals, angioedema, or both that lasts longer than 6 weeks. Chronic urticaria, though uncommon, can have a negative impact on a patient's quality of life. The pathomechanism of chronic urticaria is unknown, but it is linked to a variety of immunological factors, which can also be linked to a variety of comorbidities. Chronic urticaria is treated primarily with second-generation Hi antihistamines. This was a retrospective descriptive study involving chronic urticaria patients from the Dermatology and Venereology Polyclinic RSUD Dr. Moewardi Surakarta from January 2018 to December 2021. This study included 45 chronic urticaria patients. The majority (73.33%) of the sample is female, with 26,67% patients belonging to age group 51-60 years. Up to 53.33% of patients are private employees. In 16 patients, the skin prick test (SPT) was positive, all of whom were allergic to ≥1 food allergens. Tomatoes, peanuts, and egg yolks are the food allergens that most frequently produce positive results. Twelve patients (26.67%) had a history of allergies, with cold allergy being the most common (17.78%). 15 (33.33%) of the patients had co-morbidities, with cavities being the most common (15.56%). Up to 91.11% patients received second-generation antihistamine-Hi (cetirizine 10 mg) alone or in combination with other drugs, while four patients received only topical moisturizer. Characteristics of chronic urticaria patients at the Dermatology and Venereology Polyclinic of RSUD Dr. Moewardi Surakarta are similar to globally. [ABSTRACT FROM AUTHOR]

Purpose: Our aim was to evaluate the accuracy of a combined airway inflammatory biomarker assessment in diagnosing asthma in elite water sports athletes. Methods: Members of the Hungarian Olympic and Junior Swim Team and elite athletes from other aquatic disciplines were assessed for asthma by objective lung function measurements, and blood eosinophil count (BEC), serum total immunoglobulin E (IgE), fractional exhaled nitric oxide (FENO) measurements, and skin prick testing were performed. A scoring system from BEC, FENO, serum IgE, and skin test positivity was constructed by dichotomizing the variables and assigning a score of 1 if the variable is elevated. These scores were summed to produce a final composite score ranging from0 to 4. Results: A total of 48 participants were enrolled (age 21 ± 4 yr, 42% male), of which 22 were diagnosed with asthma. Serum total IgE and FENO levels were higher in asthmatic individuals (68 [27-176] vs 24 [1-43], P = 0.01; 20 [17-26] vs 15 [11-22], P = 0.02), and positive prick test was also more frequent (55% vs 8%, P < 0.01). Asthmatic participants had higher composite variable scores (2 [1-3] vs 1 [0-1], P = 0.02). Receiver operating characteristic analysis showed that total IgE, FENO, and composite variable were suitable for identifying asthmatic participants (area under the curve = 0.72, P = 0.01; 0.70, P = 0.02, and 0.69, P = 0.03). A composite score of >2 reached a specificity of 96.2%, a sensitivity of 36.4%, and a likelihood ratio of 9.5. Logistic regression model revealed a strong association between the composite variable and the asthma diagnosis (OR = 2.71, 95% confidence interval = 1.17-6.23, P = 0.02). Conclusions: Our data highlight the diagnostic value of combined assessment of Th2-type inflammation in elite water sports athletes. The proposed scoring system may be helpful in ruling in asthma in this population upon clinical suspicion. [ABSTRACT FROM AUTHOR]

Introduction: Prick‐to‐prick (PTP) test with fresh food is accepted as a reliable tool for measuring sensitization to fruits and vegetables. Not all fruits and vegetables are available throughout the year. The objective of this study was to investigate whether skin prick test (SPT) performed with frozen juice of fruits and vegetables (FJFV) is a good alternative to PTP tests performed with fresh fruits and vegetables (FFV). Methods: Adult patients suspected of having a food allergy to fruits and/or vegetables were included. A questionnaire was used to score symptoms after consumption of apple, kiwi, peach, tomato, and carrot. SPTs with FJFV, and PTP tests with FFV were performed. Intra‐class correlation coefficients (ICC) between the SPT and PTP test results were calculated. The sensitivity and specificity of both diagnostic tests towards food allergen specific symptoms (FASS) were calculated. Results: Thirty‐six patients were included. FASS was positive in 75% for apple, 53% for kiwi, 44% for peach, 25% for tomato, and 22% for carrot. ICC between SPT and PTP test results were moderate for apple (0.72) and kiwi (0.71), strong for peach (0.75) and tomato (0.89), and very strong for carrot (0.94). Sensitivity was equal for the SPT and PTP tests for apple (0.93), peach (0.81), and carrot (1.00), and comparable for kiwi (0.50 resp. 0.70), and tomato (0.44 resp. 0.56). Specificity was equal for apple (0.33), peach (0.15), and carrot (0.41), and comparable for kiwi (0.29 resp. 0.21) and tomato (0.80 resp. 0.72). Conclusions: Results of SPT with FJFV and PTP test with FFV are comparable. SPT with FJFV is a good alternative in the daily practice of the allergists. [ABSTRACT FROM AUTHOR]

(1) Peanut allergy is associated with high risk of anaphylaxis which could be prevented by oral immunotherapy. Patients eligible for immunotherapy are selected on the basis of a food challenge, although currently the assessment of antibodies against main peanut molecules (Ara h 1, 2, 3 and 6) is thought to be another option. (2) The current study assessed the relationship between the mentioned antibodies, challenge outcomes, skin tests and some other parameters in peanut-sensitized children. It involved 74 children, divided into two groups, based on their response to a food challenge. (3) Both groups differed in results of skin tests, levels of component-specific antibodies and peanut exposure history. The antibody levels were then used to calculate thresholds for prediction of challenge results or symptom severity. While the antibody-based challenge prediction revealed statistical significance, it failed in cases of severe symptoms. Furthermore, no significant correlation was observed between antibody levels, symptom-eliciting doses and the risk of severe anaphylaxis. Although in some patients it could result from interference with IgG4, the latter would not be a universal explanation of this phenomenon. (4) Despite some limitations, antibody-based screening may be an alternative to the food challenge, although its clinical relevance still requires further studies. [ABSTRACT FROM AUTHOR]

This article discusses the diagnostic accuracy of skin prick tests (SPT), food-specific IgE, and component testing for IgE-mediated peanut, egg, milk, and wheat allergy. The study, conducted in Singapore, aimed to examine the diagnostic accuracies of these tests in children who had undergone an oral food challenge (OFC). The results showed that SPT and food-specific IgE had high sensitivity, while component testing had high specificity. However, the diagnostic accuracies varied depending on the food and patient population tested. The study provides valuable information for clinicians in Singapore to better stratify the risk of OFCs and improve the care of children with food allergies. [Extracted from the article]

Jingjing He,1– 3 Jing Gao,1– 3 Yan Zhao,4 Shuai Chen1,3 1Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361003, People’s Republic of China; 2Teaching Hospital of Fujian Medical University, Xiamen, 361003, People’s Republic of China; 3Xiamen Key Laboratory of Otolaryngology Head and Neck Surgery, Xiamen, 361003, People’s Republic of China; 4Army 73rd Group Military Hospital, Chenggong Hospital Affiliated to Xiamen University, Xiamen, 361000, People’s Republic of ChinaCorrespondence: Shuai Chen, Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Xiamen University, School of Medicine, No. 55, Zhenhai Road, Siming District, Xiamen, 361005, People’s Republic of China, Email chenshuai@xmu.edu.cn Yan Zhao, Army 73rd group military hospital, Chenggong Hospital Affiliated to Xiamen University, No. 92-96, Wenyuan Road, Siming District, Xiamen, 361000, People’s Republic of China, Email 46330926@qq.comBackground: Allergic rhinitis (AR) is a chronic inflammatory disease of the nasal mucosa. However, few studies focus on the distributional characteristics of allergens in AR patients in Southern Fujian Province, China.Methods: A skin prick test (SPT) was performed and eight common allergens including Dermatophagoides farinae (Df), Dermatophagoides pteronyssinus (Dpt), weeds, animal dander, molds, cockroaches, and mangoes were chosen.Results: The positive reactions rate to the allergens was 65.79% in 6689 patients in Southern Fujian Province. Positive reactions to Df and Dpt had a negative association with age, whereas positive reactions to cockroach and weed had a positive association with age. A linear trend analysis demonstrated a significant positive relationship between positive reactions to various allergens from 2016 to 2019. Positive reactions to Df and Dpt were both correlated with the season. Positive reactions to Df, Dpt, cockroach and weed were related to disease duration and positive reactions to cockroach were correlated with city residence. Multivariate analysis revealed that male positive reactions gradually decreased with age (≤ 60), in contrast to female (≤ 60) positive reactions. Statistical difference was observed between the genders with regard to AR incidence from 2016 to 2019. The positive rate of skin tests was highest in summer in men, whereas in women it was lowest in summer. The gender composition ratios of positive cases in Xiamen, Zhangzhou, and Quanzhou cities differed significantly. The proportion of patients with positive reactions to the allergens in the three cities decreased with age. The highest proportions of patients with positive reactions all occurred during summer in the three cities. Furthermore, there were statistically significant differences in the age composition ratios across the seasons.Conclusion: This study analyzed the distributional characteristics of AR allergens in Southern Fujian Province, China. These findings will inform specific immunotherapy for AR patients.Keywords: allergic rhinitis, allergen, skin prick test, Southern Fujian Province in China

Aims: We aimed to determine the distribution of inhaled allergens by evaluating the results of skin prick tests performed on patients with allergic complaints in Konya. Methods: The study included 2351 patients aged 2-18 years who underwent skin prick tests for the diagnosis of inhaled allergens at the Selçuk University Medical Faculty Pediatric Allergy and Immunology Outpatient Clinic between June 1, 2022 and May 31, 2023. Demographic characteristics and skin prick test results of 696 patients with sensitivity to at least one inhaled allergen were retrospectively evaluated. Results: Sensitivity to at least one inhaled allergen was detected in 696 (29.6%) of 2351 patients who underwent skin prick testing for allergic symptoms. The average age of patients with inhaled allergen sensitivity was 10.37 ± 4.14 years. 278 (39.9%) of the patients were girls and 418 (60.1%) were boys. Considering the distribution of inhaled allergens detected by skin prick test, the most frequent allergens were pollen allergens (78.2%), cat epithelium (38.8%) and dog epithelium (33.8%). The most common allergens detected in girls were pollen allergens (77.3%), cat epithelium (38.1%) and house dust mites (37.1%). The most common allergens detected in males were pollen allergens (78.7%), cat epithelium (39.2%) and dog epithelium (34.7%). When allergen sensitivities were evaluated according to gender, sensitivity to house dust mites was more common in girls than in boys. Sensitivity to pollen allergens was most frequently detected in all seasons. Statistically significant differences were detected between house dust mites, pollen allergens, rye, grass mix and cat epithelium sensitivities according to seasons. Conclusion: Our study shows the distribution of inhaled allergens in Konya province. Therefore, we assume that it can contribute to the implementation of environmental measures that can be taken to protect against allergens and thus to the treatment of patients.

Food allergy (FA) has become a common global public health issue, with a growing prevalence in the modern world and a significant impact on the lives of patients, their families, and caregivers. It affects every area of life and is associated with elevated costs. Food allergy is an adverse immune reaction that occurs in response to a given food. The symptoms vary from mild to severe and can lead to anaphylaxis. This is why it is important to focus on the factors influencing the occurrence of food allergies, specific diagnostic methods, effective therapies, and especially prevention. Recently, many guidelines have emphasized the impact of introducing specific foods into a child's diet at an early age in order to prevent food allergies. Childhood allergies vary with age. In infants, the most common allergy is to cow's milk. Later in life, peanut allergy is more frequently diagnosed. Numerous common childhood allergies can be outgrown by adulthood. Adults can also develop new IgE-mediated FA. The gold standard for diagnosis is the oral provocation test. Skin prick tests, specific IgE measurements, and component-resolved diagnostic techniques are helpful in the diagnosis. Multiple different approaches are being tried as possible treatments, such as immunotherapy or monoclonal antibodies. This article focuses on the prevention and quality of life of allergic patients. This article aims to systematize the latest knowledge and highlight the differences between food allergies in pediatric and adult populations. [ABSTRACT FROM AUTHOR]

Meniere's Disease is a rare ear disorder that can cause severe morbidity to the patient and has no definitive treatment to date. Endolymphatic hydrops is the critical event. Though symptomatology is well understood, the exact etiology of Endolymphatic hydrops attack is still unclear. Twenty-five consecutive patients of Meniere's Disease diagnosed in the Vertigo clinic aged 12 to 70 years were included. Their allergic status was evaluated using a skin prick test. Allergic and non-allergic patients were then identified. Comparison between the two groups was made to identify the effect of allergy on the severity of symptoms using vertigo scales, Functional level scale, Dizziness handicap index, and Pure tone average staging. The prevalence of allergy among Meniere's Disease patients was 56%. The most common allergen found in our study was tyrophagus(n = 8). Polysensitization was more common(n = 12). Airborne allergens were more common than food allergens. There was no significant relationship between the severity scales and the allergen positivity status (p > 0.05). The prevalence of allergy is more among patients with Meniere's Disease. The Endolymphatic sac is allergy prone. The occurrence of endolymphatic hydrops may be due to a cross-reaction of allergen-induced IgE antibodies to self-antigen. Management of the specific allergen may help decrease symptomatology in these patients. Allergen-specific therapies have a promising role in the treatment of allergic conditions and provide a long-term symptom-free period in affected individuals. This can be applied in patients with Meniere's Disease having associated allergic features based on their skin prick test results. [ABSTRACT FROM AUTHOR]

Objective: We aimed to determine the distribution of inhaled allergens by evaluating the results of skin prick tests performed on patients with allergic complaints in Konya. Material and Methods: The study included 2351 patients aged 218 years who underwent skin prick tests for the diagnosis of inhaled allergens at the Selçuk University Medical Faculty Pediatric Allergy and Immunology Outpatient Clinic between June 1, 2022, and May 31, 2023. The demographic characteristics and skin prick test results of 696 patients with sensitivity to at least one inhaled allergen were retrospectively evaluated. Results: Sensitivity to at least one inhaled allergen was detected in 696 (29.6%) of 2351 patients who underwent skin prick testing for allergic symptoms. The mean age of patients with inhaled allergen sensitivity was 10.37 ± 4.14 years. 278 (39.9%) of the patients were girls, and 418 (60.1%) were boys. Considering the distribution of inhaled allergens detected by the skin prick test, the most frequent allergens were pollen allergens (78.2%), cat epithelium (38.8%), and dog epithelium (33.8%). The most common allergens detected in girls were pollen allergens (77.3%), cat epithelium (38.1%) and house dust mites (37.1%). The most common allergens detected in males were pollen allergens (78.7%), cat epithelium (39.2%), and dog epithelium (34.7%). Sensitivity to house dust mites was more prevalent in girls than boys. Sensitivity to pollen allergens was most frequently detected in all seasons. Significant differences were detected between house dust mites, pollen allergens, rye, and cat epithelium sensitivities according to seasons. Conclusion: Our study shows the distribution of inhaled allergens in Konya province. Therefore, we assume that it can contribute to the implementation of environmental measures that can be taken to protect against allergens and, thus, to the treatment of patients. [ABSTRACT FROM AUTHOR]

A review of the latest publications in food allergy over the past couple of years confirmed that food allergy is a major public health concern, affecting about 8% of children and 10% of adults in developed countries. The prevalence of food allergy varies around the world, with the increase being driven mainly by environmental factors, possibly together with genetic susceptibility to environmental changes. A precise diagnosis of food allergy is extremely important. Both new tests (eg, the basophil activation test) and improved optimization of information provided by existing tests (eg, the skin prick test and measurement of specific IgE level) can contribute to improving the accuracy and patients' comfort of food allergy diagnosis. Understanding the underlying immune mechanisms is fundamental to designing allergen-specific treatments that can be safe and effective in the long term. New discoveries of the immune response to food allergens, including T-cell and B-cell responses, have emerged. Novel therapeutic approaches are being trialed at various stages of development as attempts to allow for more active intervention to treat food allergy. Prevention is key to reducing the increase in prevalence. Early introduction of allergenic foods seems to be the most effective intervention, but others are being studied, and will, it is hoped, lead to modification of the epidemiologic trajectory of food allergy over time. [ABSTRACT FROM AUTHOR]

Abstract Introduction Prick‐to‐prick (PTP) test with fresh food is accepted as a reliable tool for measuring sensitization to fruits and vegetables. Not all fruits and vegetables are available throughout the year. The objective of this study was to investigate whether skin prick test (SPT) performed with frozen juice of fruits and vegetables (FJFV) is a good alternative to PTP tests performed with fresh fruits and vegetables (FFV). Methods Adult patients suspected of having a food allergy to fruits and/or vegetables were included. A questionnaire was used to score symptoms after consumption of apple, kiwi, peach, tomato, and carrot. SPTs with FJFV, and PTP tests with FFV were performed. Intra‐class correlation coefficients (ICC) between the SPT and PTP test results were calculated. The sensitivity and specificity of both diagnostic tests towards food allergen specific symptoms (FASS) were calculated. Results Thirty‐six patients were included. FASS was positive in 75% for apple, 53% for kiwi, 44% for peach, 25% for tomato, and 22% for carrot. ICC between SPT and PTP test results were moderate for apple (0.72) and kiwi (0.71), strong for peach (0.75) and tomato (0.89), and very strong for carrot (0.94). Sensitivity was equal for the SPT and PTP tests for apple (0.93), peach (0.81), and carrot (1.00), and comparable for kiwi (0.50 resp. 0.70), and tomato (0.44 resp. 0.56). Specificity was equal for apple (0.33), peach (0.15), and carrot (0.41), and comparable for kiwi (0.29 resp. 0.21) and tomato (0.80 resp. 0.72). Conclusions Results of SPT with FJFV and PTP test with FFV are comparable. SPT with FJFV is a good alternative in the daily practice of the allergists.

The global application of the skin prick test (SPT) is attributed to the low costs, easy execution, and in vivo approach. Still, the healthcare professionals’ technique and the lancet shape may challenge the standardization of the method. Thus, we investigated the influence of the shape of the lancet and the applied weight on the wheal size of SPT. Two allergic and one non-allergic individual were tested with allergens (Dermatophagoides pteronyssinus and Phleum pratense) and histamine solution (positive control), respectively. Horizontally (HS) and diagonally (DS) shouldered lancets with the same tip length (1 mm) were tested under two different conditions: either 60 g or 120 g weight pressure. The wheal size induced by the 4 different combinations was measured. The higher-weight device (120 g) induced a significantly larger and less variable wheal response with the tested allergens and histamine. However, the shape of the lancet affected the wheal size more than the applied weight. The least variable response was measured to histamine for the horizontal-shouldered lancet combined with the higher weight, whereas the same lancet with the lower weight resulted in a significant number of false negative results.

Objective To investigate the distribution characteristics of inhaled allergens in children with allergic rhinitis (AR) and asthma in Chongqing. Methods A cross-sectional study was conducted on 9 420 children with AR and asthma who underwent inhaled allergen skin prick test (SPT) in our department from January 2021 to September 2022 in Chongqing.According to the clinical diagnosis, these children were divided into the AR group (n=2 217) and the asthma group (n=7 023).Chi-square test was used to compare the detection rate of inhaled allergen SPT in 2 groups of children and the difference in the detection rate of inhaled allergen SPT between the 2 groups in terms of gender, age group and season, respectively. Results The detection rate of inhaled allergen SPT was 71.6% in the AR group and 57.9% in the asthma group (Chi-square=132.664, P < 0.001).The primary inhalant allergens in the 2 groups were dust mites (65.4%, 50.3%), house dust mites (65.0%, 50.4%), cockroach (10.2%, 7.9%), cat hair (8.3%, 6.0%), and corn pollen (6.5%, 6.1%), and children accepted test mainly had dual (57.1%/54.7%) and triple (22.2%/20.8%) inhaled allergens.In the AR group, the detection rate of inhaled allergens was higher in boys than that in girls (Chi-square=7.011, P=0.008), and the gender difference only appeared in the asthma group for the detection rate of cockroach (Chi-square=21.671, P < 0.001).In the AR group, the highest detection rates for dust mites and house dust mites happened in summer, while the highest detection rates for duck hair happened in spring; In the asthma group, the summer witnessed the highest detection rates for dust mites and house dust mites and the spring experienced the highest detection rates for corn, birch pollen and dog hair.The detection rate of inhaled allergens in children with AR and asthma was increased with age, and the detection rate of inhaled allergens in the AR group aged 1~10 years was higher than that in the asthma group of the same age group. Conclusion The inhaled allergens of children with AR and asthma in Chongqing are mainly from indoor sources.AR is dominated by perennial inhaled allergens compared with asthma, and the trends of the distribution for inhaled allergens in AR and asthma were similar.

The European Academy of Allergy and Clinical Immunology (EAACI) is updating the Guidelines on Food Allergy Diagnosis. We aimed to undertake a systematic review of the literature with meta‐analyses to assess the accuracy of diagnostic tests for IgE‐mediated food allergy. We searched three databases (Cochrane CENTRAL (Trials), MEDLINE (OVID) and Embase (OVID)) for diagnostic test accuracy studies published between 1 October 2012 and 30 June 2021 according to a previously published protocol (CRD42021259186). We independently screened abstracts, extracted data from full texts and assessed risk of bias with QUADRAS 2 tool in duplicate. Meta‐analyses were undertaken for food‐test combinations for which three or more studies were available. A total of 149 studies comprising 24,489 patients met the inclusion criteria and they were generally heterogeneous. 60.4% of studies were in children ≤12 years of age, 54.3% were undertaken in Europe, ≥95% were conducted in a specialized paediatric or allergy clinical setting and all included oral food challenge in at least a percentage of enrolled patients, in 21.5% double‐blind placebo‐controlled food challenges. Skin prick test (SPT) with fresh cow's milk and raw egg had high sensitivity (90% and 94%) for milk and cooked egg allergies. Specific IgE (sIgE) to individual components had high specificity: Ara h 2‐sIgE had 92%, Cor a 14‐sIgE 95%, Ana o 3‐sIgE 94%, casein‐sIgE 93%, ovomucoid‐sIgE 92/91% for the diagnosis of peanut, hazelnut, cashew, cow's milk and raw/cooked egg allergies, respectively. The basophil activation test (BAT) was highly specific for the diagnosis of peanut (90%) and sesame (93%) allergies. In conclusion, SPT and specific IgE to extracts had high sensitivity whereas specific IgE to components and BAT had high specificity to support the diagnosis of individual food allergies. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the effect of response intensity of allergen skin prick test (SPT) on symptom severity and long-term efficacy of dust mite subcutaneous immunotherapy (SCIT) in allergic rhinitis (AR). Methods: AR Patients diagnosed with dust mite allergy and completed 3 years of SCIT were collected and classified into three groups: grade 2 (SPT of + +), grade 3 (SPT of + + +) and grade 4 (SPT of + + + +). Comparisons between groups were performed to examine the associations of SPT categories and symptom severity and the long-term efficacy of SCIT in AR. Results: 181 AR patients were included. There was no significant difference in the baseline TNSS, SMS, RQLQ and VAS, and particularly to symptom severity grading among three SPT grade groups (P > 0.05). The moderate–severe AR was more likely to be smoking and accompany with asthma and had higher prevalence of sensitization to cockroach, mixed grass and tree pollen than mild AR (P < 0.05). Prevalence of sensitization to cockroach, mixed grass, ragweed and animal dander was increased in AR patients with asthma and allergic conjunctivitis (P < 0.05). Furthermore, after 3 years of SCIT, no statistical differences in TNSS, SMS, RQLQ, VAS and long-term efficacy were observed among the three SPT grade groups (P > 0.05). Similarly, long-term outcomes of patients with different SPT grades did not differ among different clinical characteristics and different efficacy determination criteria (P > 0.05). Conclusions: The SPT response intensity cannot be used as an objective evaluation index for symptom severity and the long-term efficacy of SCIT in AR patients. [ABSTRACT FROM AUTHOR]

Objective: Although skin prick tests (SPTs) are generally considered safe, limited studies have specifically evaluated reactions related to SPTs with all allergens. In contrast to these studies, our aim is to exclusively evaluate systemic reaction (SR) occurrences with food allergens during SPTs in children. Materials and Methods: All patients who underwent skin prick and/or prick-to-prick (PtoP) tests with food allergens at our clinic between January 2010 and January 2020 were included in the study. The occurrence of SR during SPTs was evaluated based on patient records. Results: The study included 1852 patients, with 57% males and a median age of 31 months (1-210). Skin tests were most commonly conducted for the indication of atopic dermatitis (29.3%). During the study, 11.2% had repeat SPTs for tolerance and a new allergy diagnosis. No local reactions or SRs occurred during SPTs. Among those with PtoP tests, 3 patients (0.16%) experienced SRs—1 had anaphylaxis (0.05%), the rest had angioedema. Legumes and sea bass caused these reactions. In patients with severe index reactions and those who underwent PtoP testing, SR development was significantly higher (P < .001 for both), and anaphylaxis occurrence was significantly higher among those undergoing PtoP testing compared to prick testing alone (P = .03). Conclusion: The prevalence of both SR and anaphylaxis due to SPT with food allergens was found to be quite low in children. However, it is important to consider the possibility of SR development before conducting SPT with food allergens, especially in patients who will undergo the PtoP test and those with severe index reactions. [ABSTRACT FROM AUTHOR]

This study aims to evaluate the sensitization distribution of aeroallergens in patients with allergic conjunctivitis (AC) living in a temperate subhumid region and to describe the prevalence in a Mexican cohort. A total of 761 patient records were revisited, including the results of the skin prick test (SPT) for 45 aeroallergens. We found 292 patients with AC and a positive SPT in a 5-year period. The most frequent aeroallergens include dust mites (69.2% for Dermatophagoides pteronyssinus and 47.6% for Dermatophagoides farinae), trees (36% for cypress and 22.6% for ash), animals (33.9% for dogs and 26.7% for cats), and grasses (21.2% for Paspalum notalum and 19.9% for Poa pratensis). Among the studied population, a prevalence of 38.4% for the disease was calculated. House dust mites were responsible for most sensitizations found in the studied population. There is a high prevalence of AC in the selected cohort during the period studied. [ABSTRACT FROM AUTHOR]

This European Academy of Allergy and Clinical Immunology guideline provides recommendations for diagnosing IgE‐mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Food allergy diagnosis starts with an allergy‐focused clinical history followed by tests to determine IgE sensitization, such as serum allergen‐specific IgE (sIgE) and skin prick test (SPT), and the basophil activation test (BAT), if available. Evidence for IgE sensitization should be sought for any suspected foods. The diagnosis of allergy to some foods, such as peanut and cashew nut, is well supported by SPT and serum sIgE, whereas there are less data and the performance of these tests is poorer for other foods, such as wheat and soya. The measurement of sIgE to allergen components such as Ara h 2 from peanut, Cor a 14 from hazelnut and Ana o 3 from cashew can be useful to further support the diagnosis, especially in pollen‐sensitized individuals. BAT to peanut and sesame can be used additionally. The reference standard for food allergy diagnosis is the oral food challenge (OFC). OFC should be performed in equivocal cases. For practical reasons, open challenges are suitable in most cases. Reassessment of food allergic children with allergy tests and/or OFCs periodically over time will enable reintroduction of food into the diet in the case of spontaneous acquisition of oral tolerance. [ABSTRACT FROM AUTHOR]

The prevalence of house dust mite (HDM) allergy, especially in Asian countries with rapid urbanization, has been increasing. House dust mites thrive in places with relatively high humidity. With the combination of climate change, naturally high humidity, and urbanization, tropical countries like Malaysia are becoming a hotspot for HDM allergy fast. With a previously reported sensitization rate of between 60 and 80%, it is a worrying trend for Malaysia. However, due to incomplete and out-of-date data, as seen by the limited study coverage in the past, these numbers do not paint a complete picture of the true HDM allergy scene in Malaysia. This review briefly discusses the HDM fauna, the HDM sensitization rate, the common diagnosis and therapeutic tools for HDM allergy in Malaysia, and makes suggestions for possible improvements in the future. This review also highlights the need of more comprehensive population-based prevalence studies to be done in Malaysia, encompassing the three main HDMs—Dermatophagoides pteronyssinus, Dermatophagoides farinae, and Blomia tropicalis—as the lack of up-to-date studies failed to give a clearer picture on the current scenario of HDM allergy in Malaysia. Future studies will be beneficial to the nation in preparing a better blueprint for the management and treatment of HDM allergy. [ABSTRACT FROM AUTHOR]

Background: Research on reported food-related triggers of atopic disease in South Asian adults is lacking despite the region’s large population and the global significance of allergic diseases. Objectives: The study aimed to identify prevalent local food items and assess allergic sensitization rates to potential trigger foods for atopic diseases via skin prick and specific IgE testing. Methods: The study began with a pilot survey of 100 subjects recruited from 4 hospitals in Hyderabad, India, focusing on foods perceived to relate to asthma, allergic rhinitis, atopic dermatitis, urticaria, and gastrointestinal allergic symptoms. A subsequent main study evaluated 2010 participants, 1754 of whom were diagnosed with an aforementioned atopic disease and who reported allergic symptoms related to any of 77 foods identified in the pilot study. Ultimately 1622 patients who consented to skin prick and specific IgE testing and who reported at least 1 food item triggering allergic diseases were included in the final analysis. Results: Among 1622 patients (average age, 42.6 ± 12.9 years; 55.5% male), asthma was the most commonly diagnosed atopic disease (26.4%), with itching and rash being frequently reported symptoms (22.7%). Notably, 94.9% of patients had total serum IgE > 144 kU/L. Chickpea, cabbage, eggplant, walnut, cumin, and betel leaf were the most commonly reported trigger foods. Conclusion: In this sample of South Indian adults diagnosed with allergic disease, reported food triggers were most commonly local dietary staples, while reported reactions to priority allergens like peanut and sesame were conspicuously absent. Observed concordance between patient-reported food triggers and sensitization to reported food triggers was low, highlighting the need for improved clinical evaluation of suspected triggers.

Topical corticosteroid (TC) abuse is a common, worldwide, problem. One of the recent emerging concerns is the adulteration of TC in fairness cream. The presence of TC in skin-whitening cosmetic creams can be detected by high-performance liquid chromatography (HPLC). Since HPLC is expensive, time-taking and not easily available, we suggest the use of histamine wheal test as a simple and inexpensive test to detect the presence of topical steroids in fairness cream.

Topical corticosteroid (TC) abuse is a common, worldwide, problem. One of the recent emerging concerns is the adulteration of TC in fairness cream. The presence of TC in skin‑whitening cosmetic creams can be detected by high‑performance liquid chromatography (HPLC). Since HPLC is expensive, time‑taking and not easily available, we suggest the use of histamine wheal test as a simple and inexpensive test to detect the presence of topical steroids in fairness cream. [ABSTRACT FROM AUTHOR]

Objectives: This study represents the first attempt in understanding the prevalence of common allergens in Kashan, based on the clinical data i.e., demographic statistics and available SPTs collected.Methods: In a retrospective cross-sectional study on 10,000 patients referred to Kashan Asthma and Allergy Clinic from 2006 to 2016, clinical information was extracted through electronic records. Considering risk factors including a family history of atopy, symptoms, smoking, and suitability of sleeping materials, sensitization to 17 aeroallergens was evaluated using SPT.Results: About 44.6% of patients had simultaneous allergic rhinitis and asthma, while 21.2% suffered concurrently from ocular allergy. The most prevalent outdoor sensitization was against weed pollens (62.3%), specially Salsola kali (69.9%), mixed extracts of Chenopodium album and Amaranthus retroflexus (58.3%) from Chenopodiaceae family, followed by grasses (44.6%), and trees (35.5%). For indoor allergens, cockroach (32.5%) was the most prevalent aeroallergen, followed by mites (27.1%), mold (23.4%), and animal dander (20.64%).Conclusion: The study showed that reaction to SPT is generally high in Kashan, especially towards weed pollens of the Chenopodiaceae family. Despite her dry climate, the living style in Kashan has traditionally been inclined to keep indoor spaces humid throughout the year and therefore more prone to such indoor aeroallergens as cockroaches, mites, and fungi infestations.

Aim:The skin prick test (SPT) is the standard tool for determining respiratory allergen sensitizations. Different allergen sensitization patterns have been observed within countries and regions according to geographical and seasonal variations. This study aims to identify the sensitization pattern of children in different age groups and to define the minimum number and type of allergen extracts in an SPT to detect a sensitized child.Materials and Methods:This retrospective study was conducted in the Outpatient Clinic of the Pediatric Allergy, Immunology, and Pulmonology Unit of a tertiary Children’s Hospital from October 2019 to December 2020. Children aged between 2 and 18 years suspected of inhalant allergy with the presence of clinically relevant symptoms were included. The results of SPT were collected from medical records to determine the optimal panel to cover 95% of the sensitized children.Results:A total of 1821 patients with SPT results were evaluated. Forty-three patients (2.4%) were excluded from the study because some allergen extracts did not apply. Consequently, 1778 children (male/female ratio of 1.33) were included in the study. The median age (interquartile range) was 8 years (2-18). The most common sensitizations were to grasses (Lolium perenne and Poa pratensis), trees (Olea europaea and Fraxinus excelsior), cereals (Avena sativa and Hordeum vulgare), animal dander (cat and dog), and weeds (Plantago lanceolata and Ambrosia artemisiifolia). The rate of sensitization tended to increase with age. Applying an SPT that included six allergen extracts for 2-5 years, five for 6-11 years, and four for 12-18 years was sufficient to identify 95% of sensitized children.Conclusion:A test panel with six allergen extracts was sufficient to identify most of the sensitized children and adolescents suspected of allergy and had clinically relevant symptoms. An SPT with fewer allergen sources was required to detect older sensitized children than younger children.

INTRODUCTION: The role of inhaled and swallowed aeroallergens in treatment outcomes of adult patients with eosinophilic esophagitis (EoE) is unclear. We hypothesized that the pollen season contributes to the failure of the 6-food elimination diet (SFED) in EoE. METHODS: We compared outcomes of patients with EoE who underwent SFED during vs outside of the pollen season. Consecutive adult patients with EoE who underwent SFED and skin prick test (SPT) for birch and grass pollen were included. Individual pollen sensitization and pollen count data were analyzed to define whether each patient had been assessed during or outside of the pollen season after SFED. All patients had active EoE (≥15 eosinophils/high-power field) before SFED and adhered to the diet under the supervision of a dietitian. RESULTS: Fifty-eight patients were included, 62.0%had positive SPT for birch and/or grass, whereas 37.9% had negative SPT. Overall, SFED response was 56.9% (95% confidence interval, 44.1%-68.8%). When stratifying response according to whether the assessment had been performed during or outside of the pollen season, patients sensitized to pollens showed significantly lower response to SFED during compared with outside of the pollen season (21.4% vs 77.3%; P = 0.003). In addition, during the pollen season, patients with pollen sensitization had significantly lower response to SFED compared with those without sensitization (21.4% vs 77.8%; P = 0.01). DISCUSSION: Pollens may have a role in sustaining esophageal eosinophilia in sensitized adults with EoE despite avoidance of trigger foods. The SPT for pollens may identify patients less likely to respond to the diet during the pollen season. [ABSTRACT FROM AUTHOR]

Introduction: Airborne fungi induce allergic symptoms in 3–10% of the population worldwide. To better prevent and manage fungi-related allergic diseases, it is essential to identify the genus and the distribution profile of airborne fungi. Methods: With this purpose in mind, we carried out a 12-month volumetric sampling study to monitor the airborne fungi and retrospectively analyzed the sensitization profile of four dominant fungi (Cladosporium, Alternaria, Aspergillus, and Penicillium) among respiratory allergies during the same study period in Wuhan, China. Results: A total of 29 different fungal genuses were identified, and the peak fungal concentration period was found to be in September and October, followed by May and June. The most prevalent fungi in this area were Cladosporium (36.36%), Ustilago (20.12%), and Alternaria (13.87%). In addition, the skin prick test data from 1,365 respiratory allergies patients showed that 202 (14.80%) of them were sensitized to fungi. The sensitization rates to Cladosporium, Alternaria, Aspergillus, and Penicillium were 11.72%, 4.69%, 1.98%, and 4.76%, respectively. The seasonal fluctuation of Alternaria and Aspergillus correlated with their sensitization rates. Among the fungal sensitized patients, 76 (37.62%) were sensitized to two or more kinds of fungi. The serum-specific IgE tests suggested low to high correlations existed between these fungi; however, these correlations were not found between fungi and other allergens. Conclusion: Our study provides the distribution profile and reveals the clinical significance of the airborne fungi in Wuhan, which will facilitate the precise management of fungal allergy. [ABSTRACT FROM AUTHOR]

Objective: To find the frequency of a positive skin prick test (SPT) in patients that experienced chronic tympanic membrane perforation (TMP). Materials and Methods: Thai patients aged 18 years or older who experienced chronic TMP and presented at the Otorhinolaryngology Outpatient Unit, Siriraj Hospital, were recruited and underwent a SPT covering 18 kinds of indoor and outdoor allergens. Patients with active middle ear disease or conditions that made them unsuitable for the SPT and pregnant patients were excluded. Results: Forty-five participants were enrolled in the present study. The frequency of a positive SPT was 33.3%. Among the positive SPT group, 80% had polysensitization. Dermatophagoides pteronyssinus (mite Dp) was the most frequent positive allergen at 66.7%. The most common cause of chronic TMP in the present study was trauma. The patients' demographic profiles in the positive and negative SPT groups showed no statistically significant differences. Conclusion: The frequency of allergy in the chronic TMP population in the present study was close to that of the normal population. Overall, the present study population had positive sensitization only to indoor allergens. [ABSTRACT FROM AUTHOR]

Background: Allergic disorders and asthma, both allergic and non-allergic, are the noncommunicable diseases with the earliest onset. Their burden is growing, especially in low- and middle-income countries (LMICs) where allergic rhinitis (AR) and asthma are the most prevalent chronic diseases seen in childhood. Asthma was formerly considered to be uncommon in children in LMIC settings, but studies indicate that the burden of childhood asthma in these areas is large and comparable to those in high income countries (HIC). The prevalence of asthma in African children, as assessed by self-reported questionnaires in the International Study of Asthma and Allergies in Childhood (ISAAC) III study, is higher than the global average. Moreover, the prevalence of childhood asthma in LMICs is increasing, in contrast to HIC settings where it has stabilized or is decreasing. Materials and Methods: This is a prospective study and observational study was conducted in the Department of Pediatrics at Tertiary Care Teaching Hospital over a period of 1 year. The skin-prick test (SPT) results from very young children with the diagnosis of asthma (2 years) who were referred for testing for aeroallergen sensitization were analyzed within the last 4 years. All children had a history of at least three wheezing attacks with good response to bronchodilators and had been diagnosed with asthma by their referring physicians. Of the entire study group, 90 were skin-prick tested with a standard panel consisting of aeroallergens (full panel group) and children were tested only with a mixture of house dust mite allergens (house-dust mite group), based on the decision of the physician evaluating them at the time. Result: The total number of the patients included in the study was 90 patients, of the 59 (65.6%) male and 31 (34.4%) female. The study group is divided into three age groups, 2-4 Years (31.1%), 5- 7 Years (44.5%) and 8-10 Years (24. 4%).The frequency of each group. Out of 90 children in the study, 63 children were found sensitive to at least one aeroallergen and 27 were no sensitivity for all aeroallergens. Out of the 38 males (60.3%) and 25 (39.7) female sensitive to at least one of the aeroallergens and 17 (62.9%) male and 10 (37.1%) female was no sensitivity for all aeroallergens. Moreover, 28 (44.4%) of patients with positive tests were in the age group 5-7 years and 20 (31.7%) were in the age group of 8-10 Yrs. Only 15 (23.8%) were found in the age group 24 years. The highest prevalence of positive skin reaction was recorded for mite allergens among them Dermatophytosis pteronyssinus (49.2%), D. farinae (33.3%). Conclusion: The majority of children with asthma have positive skin prick tests for 1 or more of aeroallergens. House dust mite was the most common positivity aeroallergens. However, there was no statistically significant association of positive skin prick test with asthma control. [ABSTRACT FROM AUTHOR]

Introduction: Specific immunoglobulins E (sIgE) are important parameters for the estimation of severity of allergic diseases. Aim: To determine the relationship between the concentration of specific IgE antibodies in serum and types of asthma. Material and methods: The concentration of sIgE antibodies against allergens Dermatophagoides pteronyssinus, cat dander, timothy grass, and Alternaria alternata were determined in the serum of 4077 respondents randomly selected from 8 regions (ECAP study). The positive results of sIgE (≥ 0.35 IU/ml or ≥ 0.7 IU/ml) were correlated to clinical diagnosis (types of asthma, skin-prick tests). Results: sIgE antibodies against any allergen were detected in 9.9% (classes 1-6)/7.6% (classes 2-6) of healthy respondents. Comparing sIgE antibodies of respondents with intermittent asthma to sIgE antibodies of respondents with persistent asthma, no statistically significant differences were identified. Relating to allergens of D. ptero nyssinus, cat dander, and A. alternata, sIgE antibodies were more frequently detected in respondents with atopic asthma and a negative skin-prick test as compared to healthy respondents with a negative skin-prick test (p < 0.005 to p < 0.001). Relating to allergens of D. pteronyssinus, cat dander, and timothy grass, sIgE antibodies were more frequently detected in respondents with atopic asthma and a weakly positive skin-prick test as compared to healthy respondents with weakly positive skin-prick test (p < 0.05 to p < 0.001). Conclusions: Regarding subjects with a negative or weakly positive skin test, when sIgE antibodies to the same allergen are detected, asthma is much more likely to occur. [ABSTRACT FROM AUTHOR]

Complementary to conventional testing that is based on allergen extracts, molecular allergy diagnosis reduces the need for oral food challenges (OFCs) in food allergy diagnosis. Keywords: allergy; diagnosis; microarray; molecular allergy diagnosis; peanut; skin prick test; specific IgE EN allergy diagnosis microarray molecular allergy diagnosis peanut skin prick test specific IgE 1041 1044 4 10/09/23 20231001 NES 231001 Key Messages We evaluated diagnostic accuracy of ALEX SP 2 sp microarray for peanut allergy in a Turkish population. We, therefore, conclude that SPT, in combination with sIgE to Ara h 2 and Ara h 6 are a highly sensitive and specific approach to diagnose allergy to peanuts. Allergy, diagnosis, microarray, molecular allergy diagnosis, peanut, skin prick test, specific IgE. [Extracted from the article]

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