allergy
Genotype of N-acetyltransferase 2 (NAT2) polymorphism in children with immunoglobulin E-mediated food allergy.

Gawronska-Szklarz B, Pawlik A, Czaja-Bulsa G, Gornik W, Luszawska-Kutrzeba T, Wrzesniewska J.

Department of Pharmacokinetics and Therapeutic Drug Monitoring, Pomeranian Academy of Medicine Szczecin, Poland. gszklarz r1.pam.szczecin.pl

We investigated whether patients with immunoglobulin E-mediated food allergy differed from healthy individuals with regard to genotype of the polymorphic enzyme N -acetyltransferase 2 (NAT2). The genetic polymorphism of acetylation can alter the toxic and therapeutic response to certain xenobiotics and may be also a factor that influences the susceptibility toward certain partly chemically induced diseases. We compared 136 children with immunoglobulin E-mediated food allergy with 123 healthy children. The NAT2 alleles (*4, *5, *6, and *7 ) were determined by polymerase chain reaction-restriction fragment length polymorphism methods with DNA extracted from peripheral blood. A statistically significant increase in the proportion of homozygous slow acetylators (76.5%) was found among patients with food allergy compared with healthy subjects (53.7%; P < .001). There were no homozygous fast acetylators within this group of individuals with severe forms of food allergy. The risk of development of immunoglobulin E-mediated food allergy was almost 3-fold greater in slow acetylators than that in the healthy subjects (odds ratio, 2.8; 95% confidence interval, 1.6 to 4.9). We therefore concluded that the slow acetylation genotype may be an important factor of individual susceptibility to immunoglobulin E-mediated food allergy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11372006&dopt=Abstract allergy medicine



allergy
Prevalence of contact dermatitis among dental personnel in a Swedish rural county.

Ohlson CG, Svensson L, Mossberg B, Hok M.

Department of Occupational and Environmental Medicine, Medical Centre Hospital, Orebro, Sweden. carl-goran.ohlson orebroll.se

The use of acrylate-based polymers in dental care in Sweden has increased dramatically in recent years. Acrylate monomers are sensitizers and can cause contact dermatitis. Allergy to latex, e.g. in rubber gloves, is also an increasing problem in health care and especially in dental care. The aim was to estimate the prevalences of work related allergies in dental personnel in a Swedish county with almost 700 dentists, dental nurses and dental hygienists. A questionnaire was distributed to all dental care units in the county and 98% of the population completed it. Specific allergy was verified with standard patch and prick testing. Work related allergy symptoms were reported by 189 subjects, 28%. The prevalences of acrylate eczema and latex allergy were 3,0% and 3,7% respectively. The prevalence of all work related skin allergy was estimated to 8%. The estimated prevalence of acrylate allergy was close to those of a few other published reports. However, the prevalence of hypersensitivity to latex rubber was lower than those reported from other studies. It is concluded that almost one dental care worker out of ten has a risk of contact dermatitis, unless measures to reduce hazardous exposure have been taken.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11392602&dopt=Abstract allergy medicine



allergy
Higher serum eosinophil cationic protein levels in children with cow's milk allergy.

Hidvegi E, Cserhati E, Kereki E, Arato A.

First Department of Paediatrics, Semmelweis University, Budapest, Hungary.

BACKGROUND: In the pathogenesis of cow's milk allergy, abnormal immunologically mediated reactions play a basic role. Eosinophil activation also participates in the development of several allergies. The purpose of this study was to characterize the degree of this activation by measuring the serum level of eosinophil cationic protein (sECP) and establishing whether it is a useful parameter in monitoring oral cow's milk allergy. METHODS: The sECP level of 35 patients with previously confirmed cow's milk allergy (mean age, 16 months) was evaluated using a fluoroimmunoassay before the cow's milk rechallenge test and at 2 hours and 24 hours after cow's milk challenge. RESULTS: Of the 35 children with previously confirmed cow's milk allergy, 10 had positive clinical reactions after the milk rechallenge test, whereas 25 children had no reaction. The median sECP level of all the patients before the challenge test was significantly higher (12.4 microg/L) than that of the control group (4.3 microg/L) (P < 0.05). Two hours after the challenge, the median sECP of all patients (9.4 microg/L) was lower than the starting values. The median sECP levels were higher in children with positive challenge test results at all time points. However, this difference was not statistically significant. CONCLUSIONS: The normalization of sECP level may indicate the cessation of the cow's milk allergy. Therefore, the measurement of sECP may be helpful in determining the optimal time in which to repeat the challenge test, when the result will more likely be negative. The significant decrease of the sECP level 2 hours after the beginning of milk challenge test may be explained by the fact that this protein is excreted into the intestinal lumen.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11396817&dopt=Abstract allergy medicine



allergy
Effects of cooking methods on peanut allergenicity.

Beyer K, Morrow E, Li XM, Bardina L, Bannon GA, Burks AW, Sampson HA.

The Mount Sinai School of Medicine, Division of Pediatric Allergy & Immunology, One Gustave L. Levy Place, New York, NY 10029-6574, USA.

BACKGROUND: Allergy to peanut is a significant health problem. Interestingly, the prevalence of peanut allergy in China is much lower than that in the United States, despite a high rate of peanut consumption in China. In China, peanuts are commonly fried or boiled, whereas in the United States peanuts are typically dry roasted. OBJECTIVE: The aim of this study was to examine whether the method of preparing peanuts could be a factor in the disparity of allergy prevalence between the 2 countries. METHODS: Two varieties of peanuts grown in the United States were roasted, boiled, or fried. Proteins were analyzed by using SDS-PAGE and immunoblotting. Allergenicity was compared by using immunolabeling with sera from 8 patients with peanut allergy. RESULTS: The protein fractions of both varieties of peanuts were altered to a similar degree by frying or boiling. Compared with roasted peanuts, the relative amount of Ara h 1 was reduced in the fried and boiled preparations, resulting in a significant reduction of IgE-binding intensity. In addition, there was significantly less IgE binding to Ara h 2 and Ara h 3 in fried and boiled peanuts compared with that in roasted peanuts, even though the protein amounts were similar in all 3 preparations. CONCLUSION: The methods of frying or boiling peanuts, as practiced in China, appear to reduce the allergenicity of peanuts compared with the method of dry roasting practiced widely in the United States. Roasting uses higher temperatures that apparently increase the allergenic property of peanut proteins and may help explain the difference in prevalence of peanut allergy observed in the 2 countries.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11398088&dopt=Abstract allergy medicine



allergy
Are children at high familial risk of developing allergy born into a low risk environment? The PIAMA Birth Cohort Study. Prevention and Incidence of Asthma and Mite Allergy.

Wijga A, Smit HA, Brunekreef B, Gerritsen J, Kerkhof M, Koopman LP, Neijens HJ.

National Institute of Public Health and the Environment, Bilthoven, The Netherlands. Alet.Wijga rivm.nl

BACKGROUND: A family history of allergy, reflecting genetic risk factors, increases the risk of developing allergic diseases, but environmental factors, especially those present in early life, also contribute to the actual development of allergic phenomena. OBJECTIVE: To identify differences in lifestyle between allergic and non-allergic parents, which may influence the prevalence of environmental risk factors in their homes. METHODS: Data were collected in a Dutch birth cohort study by postal questionnaire about 2 months before and 3 months after the birth of the child. RESULTS: Of the 3147 infants in the study 1910 (61%) had two non-allergic parents, of 315 infants (10%) only the mother was allergic, of 787 infants (25%) only the father was allergic and 135 (4%) infants had two allergic parents. If both parents were allergic, 53% reported that allergy was taken into consideration when they furnished their home and significantly more of their homes were free of cats and free of cigarette smoke; adjusted odds ratio's for two allergic parents vs. two non-allergic parents were 0.30 (confidence interval (CI) 0.17-0.50) for the presence of cats and 0.46 (CI 0.27-0.75) for smoking in the home. Parental allergy was also associated with having a smooth floor in the baby's bedroom and with postponement of the introduction of fruits and vegetables until the age of 26 weeks. The presence of dogs at home, the prevalence of mothers' smoking during pregnancy and the decision to breast feed were unrelated to parental allergy. CONCLUSION: We conclude that studies on the relationship between allergy in parents and allergy in their offspring should always consider the home environment as a potential confounder. For allergy prevention our results imply that among allergic parents there is awareness and willingness to take measures that reduce exposure to indoor allergens.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11359425&dopt=Abstract allergy medicine



allergy
Provision of allergy care for optimal outcome in the UK.

Ewan PW.

Allergy and Clinical Immunology Clinic, Box 40, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, UK.

Allergy is common and the prevalence has increased substantially in the last 2-3 decades. There has been a particular increase in severe allergic disease, including anaphylaxis, food, drug and latex rubber allergy. Provision of allergy services in the NHS is extremely poor and there is a huge unmet need. Allergy is a full speciality, but there are few consultants and few trainees. Whilst other specialists have a role in the management of allergy, it is no longer adequate to devolve most of allergy care to them. Provision of allergy care must be lead by allergy specialists so that adequate standards of care can be achieved. The lack of care leads to morbidity, mortality and substantial cost to the NHS, much of which is avoidable. There is an urgent need for the creation of more consultant posts in allergy and this requires recognition by Trust Managers, Regional Commissioners and the Department of Health.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11359639&dopt=Abstract allergy medicine



allergy
Recombinant allergens Pru av 1 and Pru av 4 and a newly identified lipid transfer protein in the in vitro diagnosis of cherry allergy.

Scheurer S, Pastorello EA, Wangorsch A, Kastner M, Haustein D, Vieths S.

Department of Allergology, Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, D-63225 Langen, Germany.

BACKGROUND: In central and northern Europe food allergy to fruits of the Rosaceae family is strongly associated with birch pollinosis because of the existence of IgE cross-reactive homologous allergens in birch pollen and food. By contrast, in the Mediterranean population allergic reactions to these fruits frequently are not related to birch pollen allergy and are predominantly elicited by lipid transfer proteins (LTPs). OBJECTIVE: We sought to determine the prevalence of IgE sensitization to the recombinant cherry allergens Pru av 1 and Pru av 4 in comparison with cherry extract within a representative group of patients who were allergic to cherries recruited in Germany and to compare the relevance of IgE to cherry LTPs in Italian patients. METHODS: Recombinant Pru av 1 and rPru av 4 were available from earlier studies. The cDNA of the cherry LTPs was obtained by using a PCR-cloning strategy. The protein was expressed in Escherichia coli and purified by means of metal chelate affinity chromatography. Sera from 101 German patients with birch pollinosis and oral allergy syndrome to cherry and sera from 7 Italian patients with cherry allergy were investigated by using enzyme allergosorbent tests for IgE reactivity with cherry extract, rPru av 1, rPru av 4, and the recombinant cherry LTP. Inhibition experiments were performed to compare the IgE reactivity of natural and recombinant cherry LTPs and to investigate potential cross-reactivity with birch pollen allergens. RESULTS: The LTP from cherry comprises 91 amino acids and a 26 amino acid signal peptide. The mature cherry LTP shows high amino acid sequence identity with allergenic LTPs from peach (Pru p 3, 88%), apricot (Pru ar 3, 86%), and maize (Zea m 14, 59%) and displays no IgE cross-reactivity with birch pollen. The IgE prevalences in the German patients were as follows: LTP, 3 of 101 (3%); rPru av 1, 97 of 101 (96.0%); rPru av 4, 16 of 101 (16.2%); and cherry extract, 98 of 101 (97%). All 7 Italian patients had IgE against the cherry LTP. CONCLUSIONS: Recombinant allergens are useful tools for a more accurate in vitro IgE-based diagnosis of cherry allergy. Taken together, they mimic the allergenic activity of cherry extract, having slightly higher biologic activity. Sensitization to the cherry LTP is relevant for a minority of patients recruited in Germany, but our data indicate that it may be a major allergen in Italy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11295665&dopt=Abstract allergy medicine