allergy
[Allergy and lung function in school children]

[Article in Polish]

Jedrychowski W, Flak E, Mroz E.

Katedra Epidemiologii i Medycyny Zapobiegawczej CM UJ w Krakowie. myjedryc cyf-kr.edu.pl

In order to measure the effect of allergy on the lung function among schoolchildren a cross-sectional study has been performed in 1048 children of 10-11 year age who attended the grammar schools in Krakow. The lung function was assessed by the following spirometric indices: VC, FVC, FEV0.5, FEV0.75, FEV1, FEF25-75%, FEF0.2-1.2, PEFR while the data on allergy diagnosed clinically by physician was obtained by self-administered questionnaires from the parents of children. For those of the children who had the allergic skin test performed a search in medical records has been carried out. The frequency of allergy diagnosed clinically (without skin tests) was higher in boys (22.3%) than in girls (18.4%) and the same differences have been found for allergy confirmed by skin testing (15.7% vs. 9.3%). Except for VC and FVC, all adjusted mean values of spirometric indices were significantly lower in allergic than in non-allergic group of children. Regression coefficient of spirometric indices were related inversely with the presence of allergy. The greatest effects of allergy (without skin tests) have been observed on PEFR (-180 ml), FEF0.2-1.2 (-171 ml), FEF25-75% (-121 ml) and for FEV0.75 (-69 ml) and FEV1 (-68 ml). The smallest differences were found for VC and FVC. The additional series of analysis done in the subgroup of children without attacks of dyspnea with wheezing or wheezing independent from colds or respiratory infections confirmed the results obtained in the total study sample. The prevalence of obstructive syndrome, defined as FEV1/FVC < 80%, was 4.5% in the total sample, however, only 2.9% in non-allergic children, 7.2% in children in whom allergy was diagnosed by physicians and 8.5% among those children among whom allergy was diagnosed by allergic skin tests.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10321095&dopt=Abstract allergy medicine



allergy
A comparison of skin prick tests, intradermal skin tests, and RASTs in the diagnosis of cat allergy.

Wood RA, Phipatanakul W, Hamilton RG, Eggleston PA.

Department of Pediatrics, Division of Allergy and Immunology, and the Department of Medicine, Division of Allergy and Immunology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.

BACKGROUND: Skin testing and RASTs are the most commonly used methods for the diagnosis of allergy. Questions remain, however, as to the accuracy of these tests, particularly with regard to the role of intradermal skin tests (IDSTs) in the evaluation of respiratory allergy. OBJECTIVE: The purpose of this study was to determine the predictive value of skin prick tests (SPTs), IDSTs, and RASTs in the diagnosis of cat allergy. METHODS: Patients were challenged with a well-characterized cat exposure model after evaluation by history, SPTs, IDSTs (if SPT results were negative), and RASTs. All patients were evaluated with respect to their upper respiratory responses, although only those patients with asthma were included in the analysis of lower airway responses. Challenge results were considered positive if the mean upper respiratory symptom score was 0.5 or more, the mean lower respiratory symptom score was 0.4 or more, or the maximum fall in FEV1 value was 15% or more. RESULTS: One hundred twenty patients were evaluated. SPT values were positive in 81 patients; of the remaining 39 patients, IDST values were positive in 26 patients. RASTs were performed in 89 patients; the values were positive in 45 of 51 patients with a positive SPT value and were negative in all patients with a negative SPT value. When any positive challenge outcome was considered, positive challenge results were seen in 38 of 41 patients with a positive SPT score, in 10 of 39 patients with a negative SPT score, in 6 of 26 patients with a positive IDST score, in 4 of 13 patients with a negative IDST score, in 27 of 27 patients with a positive RAST score, and in 12 of 44 patients with a negative RAST score. CONCLUSION: Although both SPT and RAST values exhibited excellent efficiency in the diagnosis of cat allergy, IDST scores added little to the diagnostic evaluation.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10329809&dopt=Abstract allergy medicine



allergy
Correlation of lymphocyte proliferating cell nuclear antigen expression with dietary cow's milk antigen load in infants with allergy to cow's milk.

Papadopoulos NG, Syrigou EI, Bossios A, Manou O, Gourgiotis D, Saxoni-Papageorgiou P.

Allergy and Clinical Immunology Laboratory, 2nd Department of Pediatrics, University of Athens, Greece. ngp soton.ac.uk

BACKGROUND: Controversial results have been reported on the participation and diagnostic value of lymphocyte reactivity in cow's milk (CM) allergy. In this study, we used a specific nuclear marker to evaluate lymphocyte proliferation in IgE-mediated CM allergy in infants, and examine its relation with diets containing different CM antigen loads. METHODS: Infants with IgE-mediated CM allergy, as assessed by open provocation and RAST, were grouped according to their exclusive diet, either CM formulae, breast feeding, or hydrolysed whey formulae. A group of non-atopic infants receiving CM was also examined. Lymphocyte proliferation to beta-lactoglobulin was evaluated by quantitation of the proliferating cell nuclear antigen (PCNA) expression in peripheral blood mononuclear cells, by flow cytometry. Immunophenotypic surface markers were also examined. RESULTS: A marked difference of PCNA expression between CM-fed allergic infants and healthy controls was observed (p<0.001). In this setting, PCNA expression >/=10% was highly specific and sensitive as a marker of CM allergy in CM-fed infants. Moreover, a significant correlation (p<0.001) between antigen load and PCNA was established in CM-allergic infants under different diets, higher values obtained with increasing antigen loads. In addition, within the group fed hydrolyzed formulae, low-molecular-weight products resulted in marginally lower PCNA expression than higher-molecular-weight formulae. No differences in immunophenotype were found, with the exception of a higher CD23 expression in the breast-fed group. CONCLUSIONS: PCNA could be a useful marker in the assessment of lymphocyte proliferation to CM antigens. Low CM antigen diets are related with reduced lymphocyte reactivity, which may partly explain the clinical benefit observed with such diets.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10341323&dopt=Abstract allergy medicine



allergy
Prevalence of food allergy in 137 latex-allergic patients.

Kim KT, Hussain H.

Allergy, Asthma, and Respiratory Care Center, Inc., Long Beach, California, USA.

There have been reports of increased prevalence of certain food allergies in patients with Type I latex allergy (LA). A detailed food allergy history was obtained from 137 patients with LA. Latex allergy was defined by positive history of IgE mediated reactions to contact with latex and positive skin prick test to latex and/or positive in vitro test (AlaSTAT and/or Pharmacia CAP). Food allergy was diagnosed by a convincing history of possible IgE mediated symptoms occurring within 60 minutes of ingestion. We identified 49 potential allergic reactions to foods in 29 (21.1%) patients. Foods responsible for these reactions include banana 9 (18.3%), avocado 8 (16.3%), shellfish 6 (12.2%), fish 4 (8.1%), kiwi 6 (12.2%), tomato 3 (6.1%), watermelon, peach, carrot 2 (4.1%) each, and apple, chestnut, cherry, coconut, apricot, strawberry, loquat, one (2.0%) each. Reactions to foods included local mouth irritation, angioedema, urticaria, asthma, nausea, vomiting, diarrhea, rhinitis, or anaphylaxis. Our study confirms the earlier reports of increased prevalence of food allergies in patients with LA. We also report increased prevalence of shellfish and fish allergy not previously reported. The nature of cross reacting epitopes or independent sensitization between latex and these foods is not clear.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10209685&dopt=Abstract allergy medicine



allergy
[Analysis of food allergy incidence in children up to 5 years of age in the Wielikopolska region]

[Article in Polish]

Hofman T.

Centrum Alergologii w Poznaniu.

The aim of this study was found the most frequent food allergens and analysis of food allergy incidence in children with food allergy from region Wielkopolska. 78 children in age from 2 months to 5 years of life with the first symptoms of food allergy: gastrointestinals symptoms and atopic dermatitis was examined. The specific IgE using the immunoenzymatic Quidel and AlaSTAT method to wheat, peanut, hazel nut, tomato, soya been, cow milk, egg, corn, orange and cod was percentage of the lymphocytes ThCD4+ in peripheral blood of allergy children was estimated. The normal results ranging from 29-42%. During the analysis established that in children from region Wielkopolska the most frequent allergen in each age was cow milk. Allergy to wheat found in 50% children with food allergy. It was observed increase allergy to new products as soya been, corn and nuts which are the more frequent used in our region. The causes apparent the food allergy among the children in age to 5 years are: so early given the cow's milk and other foreign protein to diet of infants, and infections the intestinal, airways and urine tracts. It is necessary breast-feeding the infants minimum up to 6 months of life and varying light diet without a big amounts of cow's milk or other foreign proteins during lactation and pregnancy. About a half of patients had a decreased number of lymphocytes T CD4+. Among the causes of food allergy the most important are in 40% the genetic factors but in 60% the infections factors and feedings defects.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10101520&dopt=Abstract allergy medicine



allergy
Prevalence of peanut and tree nut allergy in the US determined by a random digit dial telephone survey.

Sicherer SH, Munoz-Furlong A, Burks AW, Sampson HA.

Elliot and Roslyn Jaffe Food Allergy Institute, Division of Allergy and Immunology, Department of Pediatrics, Mount Sinai School of Medicine, New York, New York, USA.

BACKGROUND: Allergy to peanuts and tree nuts (TNs) is one of the leading causes of fatal and near-fatal food-induced allergic reactions. These allergies can be lifelong and appear to be increasing in prevalence. Despite the seriousness of these allergies, the prevalence of peanut and TN allergy in the general population is unknown. OBJECTIVE: We sought to determine the prevalence of peanut and TN allergy among the general population of the United States. METHODS: We used a nationwide, cross-sectional, random digit dial telephone survey with a standardized questionnaire. RESULTS: A total of 4374 households contacted by telephone participated (participation rate, 67%), representing 12,032 individuals. Peanut or TN allergy was self-reported in 164 individuals (1.4%; 95% confidence interval [CI], 1.2%-1.6%) in 151 households (3.5%; 95% CI, 2.9%-4.0%). The prevalence of reported allergy in adults (1.6%) was higher than that found in children under 18 years of age (0.6%). In 131 individuals, details of the reactions were obtained. When applying criteria requiring reactions to be typical of IgE-mediated reactions (hives, angioedema, wheezing, throat tightness, vomiting, and diarrhea) within an hour of ingestion, 10% of these subjects were excluded. Among the remaining 118 subjects, allergic reactions involved 1 organ system (skin, respiratory, or gastrointestinal systems) in 50 subjects, 2 in 45 subjects, and all 3 in 23 subjects. Forty-five percent of these 118 respondents reported more than 5 lifetime reactions. Only 53% of these 118 subjects ever saw a physician for the allergic reaction, and only 7% had self-injectable epinephrine available at the time of the interview. The prevalence of peanut and TN allergy was adjusted by assuming that 10% of the remaining 33 subjects without a description of their reactions would also be excluded and correcting for a 7% false-positive rate for the survey instrument. A final "corrected" prevalence estimate of 1.1% (95% CI, 1.0%-1.4%) was obtained. CONCLUSIONS: Peanut and/or TN allergy affects approximately 1.1% of the general population, or about 3 million Americans, representing a significant health concern. Despite the severity of reactions, about half of the subjects never sought an evaluation by a physician, and only a few had epinephrine available for emergency use.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10200001&dopt=Abstract allergy medicine



allergy
[Cytokine production of peripheral mononuclear cells in HD-mite-allergic rhinitis patients]

[Article in Japanese]

Ishii K, Asakura K, Kataura A.

Department of Otolaryngology, Sapporo Medical University.

To elucidate the role of cytokines in the pathogenesis of allergic rhinitis, the proliferative response and cytokine production of peripheral mononuclear cells (PMNC) following stimulation with mite-antigen were evaluated in HD-mite-allergic rhinitis patients (mite-allergy group), non-HD-mite pollinosis patients (non-mite-allergy group) and normal subjects (normal group). The proliferative response of PMNC to PHA stimulation was not different among the groups, whereas that to mite-antigen stimulation was significantly higher in the mite-allergy group than in the normal group. Production of both IL-4 and IL-5 from PMNC after stimulation with mite-antigen was significantly higher in the mite-allergy group than in the normal group. Production of IFN-gamma from PMNC after antigen stimulation was significantly increased in both the mite-allergy and normal groups. The ratio of IFN-gamma to IL-4 synthesis was significantly higher in the normal group than in the mite-allergy group. This study revealed cytokine synthesis from PMNC after the antigen-stimulation was predominantly Th2-cytokines in patients with HD-mite-allergic rhinitis.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10067323&dopt=Abstract allergy medicine