allergy
In vitro testing in pediatric food allergy.

Herr TM, Cook PR, Highfill G.

Division of Otolaryngology, University of Missouri School of Medicine, Columbia, USA.

Food allergies are an important cause of morbidity in the pediatric population. We used a questionnaire to assess the value of in vitro testing in evaluating children for food allergy. The patient population was divided into two groups: those who tested positive (Class I or greater) for food allergy (combined food/inhalant allergy or food allergy alone) and those who tested negative for food allergy (inhalant only or negative test). Although we recognize that a significant proportion of food allergies may not be IgE-mediated, for the purposes of this study we considered a patient food allergy--positive if in vitro testing was positive and food allergy--negative if testing was negative. Thirty-eight of 77 patients tested (49%) were positive for food allergies. Those with food allergies did not have pretreatment scores significantly different from those of patients negative for food allergies (55 vs. 65, p = 0.11). Similarly, we detected no statistically significant difference between the symptom-improvement scores of the two groups (37 vs. 40, p = 0.57). We conclude that in vitro testing for food allergies is warranted in children with allergic symptoms, for several reasons: The prevalence of IgE-mediated food allergy in children may be higher than previously thought, and children with food allergies experience the same severity of symptoms as those without. It must be remembered that in vitro testing only detects IgE levels, and therefore a negative test does not mean that the patient does not have food allergies. However, when positive, in vitro testing gives the physician the opportunity to modify the treatment plan, helping avoid time-consuming and demanding oral food challenges. Our questionnaire also showed that food allergy and non-food allergy patients had similar pretreatment and posttreatment symptom scores.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9949358&dopt=Abstract allergy medicine



allergy
[IgE levels in cord blood in an area of the Veneto region]

[Article in Italian]

Tenderini ML, Ravagnan P, Galliani EA, Faggian D, Plebani M, Acerbi E, Martini G, De Lazzari F.

Servizio di Immunoematologia, Azienda Ospedaliera, Padova.

BACKGROUND: Cord blood IgE levels have been studied as a possible marker of allergy in infants but few studies are available in our Region. The aim of this paper was to test IgE levels in cord blood of 60 consecutive newborns in a restricted area of Veneto, to correlate cord blood IgE levels with family history of allergy and to verify the risk of contamination from mother's blood. METHODS: Cord blood was obtained from 60 consecutive newborns. Immunoglobulin levels (IgG, IgA, IgM, and IgE) were measured in cord blood of newborns and in serum of all mothers. Family history for allergy was previously investigated from the mothers. RESULTS: IgE were detectable in cord blood of 5 newborns but only 2 of them had positive family history for allergy which was pointed out in 11/60. In one of these cases the contamination of sample from mother's blood was postulated. IgG levels in newborn cord blood were higher than in mothers' blood and it was not related with IgE levels or other investigated factors. CONCLUSIONS: Only 6.6% of newborns in a restricted area of Veneto region have detectable IgE in cord blood whereas 18.3% of them have positive family history for allergy. Measurable levels of IgE in cord blood are not related with positive family history of allergy and are rarely influenced by mothers' blood contamination.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9842212&dopt=Abstract allergy medicine



allergy
Induction of allergy to new aeroallergens during specific immunotherapy (SIT) in grass pollen sensitive patients.

Obtulowicz K, Cichocka-Jarosz E.

Fac. of Medicine, Department of Industrial Allergology, Cracow, Poland.

In the group of 50 patients suffering from grass pollen allergy and successfully treated with SIT for three consecutive years, we observed in 5 persons after the end of this treatment the induction of allergy to new allergens (to weeds, mites or tree) manifested by the change of the symptoms season. The induction of the new kind of allergy was confirmed by revealing of the positive skin prick tests to new allergens and by an increase of the specific IgE serum level to them. Despite disappearance of the symptoms of the illness during grass pollen season in all 5 patients we noted the higher total IgE as well as specific to grasses IgE serum level, in comparison to the value at the start of SIT. In the paper the possible mechanisms of this phenomenon are discussed, which seems to be not connected with the natural development of allergy and which confirms once more that during SIT individual changes in humoral and cellular immunity of the patient take place, sometimes very difficult to be predicted. They may among others switch clinical profile of allergy, what indicates that patient during SIT should be under the careful immunological supervision.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9846194&dopt=Abstract allergy medicine



allergy
Joint Task Force Algorithm and Annotations for Diagnosis and Management of Rhinitis.

Dykewicz MS, Fineman S, Nicklas R, Lee R, Blessing-Moore J, Li JT, Bernstein IL, Berger W, Spector S, Schuller D.

Department of Internal Medicine, Saint Louis University School of Medicine, Missouri, USA.

The algorithm and text annotations in this document are intended to assist clinical decision making about patients who present with symptoms of rhinitis. This document complements the Executive Summary of Joint Task Force Practice Parameters for Diagnosis and Management of Rhinitis (Ann Allergy, Asthma, Immunol 1998; 81:463-468) and Diagnosis and Management of Rhinitis: Complete Guidelines of the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology (Ann Allergy, Asthma, Immunol 1998;81:478-578). The Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology is co-sponsored by the American Academy of Allergy, Asthma and Immunology, the American College of Allergy, Asthma and Immunology and the Joint Council of Allergy, Asthma and Immunology.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9860025&dopt=Abstract allergy medicine



allergy
[Latex allergy in health services workers]

[Article in Polish]

Obtulowicz K, Kotlinowska T, Stobiecki M, Wyczolkowski M, Mazurkiewicz A.

Zakladu Alergologii Przemyslowej Katedry Medycyny Pracy i Chorob Srodowiskowych Uniwersytetu Jagiellonskiego.

The studies were performed in 20 workers from the Health Service (13 women and 7 men in the age 25-57) suffering from hand urticaria (6 persons) and hand dermatitis (14 persons) suspected of the allergy to latex gloves. In all patients the familial and personal predispositions to allergy were evaluated by the anamnesis, the estimation of total IgE serum level and the skin prick tests (SPT) with inhalant allergens. The latex allergy was diagnosed by SPT and contact test with standardized extract of the natural latex allergen in the concentration 1000 PNU/ml (Nexter-Allergopharma) and by estimation of specific to latex IgE serum level. In addition to this, contact tests with glove's material as well European standard contact allergens (Hermal) were done and the one with antiseptic substances to which the patient was exposed at his work. The allergy type I to latex gloves was confirmed in all 6 cases with contact urticaria. The SPT with standard extract of the natural latex was more valuable than latex specific IgE in the serum. Contact allergy (type IV) to latex gloves was confirmed in 10 from 14 suspected cases. In the next 4 the allergy to antiseptic substances was the reasons of the illness. The allergy to latex gloves appears more often in women. No case showed the familial predisposition to allergy and only 4 patients additionally suffered from the allergy to pollen and mites. Moreover in both groups of patients we showed the presence of the additional contact allergy to different allergens (to metals and antiseptic substances).

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9825659&dopt=Abstract allergy medicine



allergy
Monocyte chemotactic protein expression in allergy and non-allergy-associated chronic sinusitis.

Wright ED, Frenkiel S, Ghaffar O, al-Ghamdi K, Luster A, Miotto D, Hamid Q.

Meakins-Christie Laboratories, Montreal.

OBJECTIVE: Chronic sinusitis (CS) is characterized by inflammatory mucosal thickening and polyp formation with a predominantly eosinophilic infiltrate. Chemokines are a novel group of inflammatory mediators capable of attracting specific inflammatory cell populations. Monocyte chemotactic proteins (MCP) are a subfamily of chemokines (MCP-1, MCP-2, MCP-3, and MCP-4) that share a number of functional properties including chemotactic activity for eosinophils. The purpose of this study was to investigate the expression of the MCP family of chemokines in allergy and non-allergy-associated chronic sinusitis using the technique of immunocytochemistry. METHOD: We examined the expression of MCP-1, MCP-3, and MCP-4 in biopsies from the ethmoid sinuses of patients with CS and normal controls. RESULTS: MCPs were localized to the epithelial cells and a subset of inflammatory cells within the mucosa. The expression of both MCP-3 and MCP-4 immunoreactivity were significantly increased in patients with both allergy and non-allergy-associated CS compared to normal controls (p < .001). There was no significant difference in the expression of MCP-1 in nasal biopsies from individuals with CS and normals. The level of expression of MCP-3 and MCP-4 correlated with eosinophil (p < .001) and CD4-positive T-cell infiltrate (p < .001) but not with CD8-positive T-cell infiltration. CONCLUSIONS: Our data suggest biologic redundancy in the expression of eosinophil chemoattractants in CS and a potential role for MCP-3 and MCP-4, but not MCP-1, in the pathophysiology of this disorder. Further, chemokines may be a common link between the eosinophilia of allergy-associated and non-allergy-associated CS, a finding that may have therapeutic implications.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9800627&dopt=Abstract allergy medicine



allergy
IgE antibodies to prohevein, hevein, and rubber elongation factor in children with latex allergy.

Ylitalo L, Alenius H, Turjanmaa K, Palosuo T, Reunala T.

Department of Dermatology, Tampere University Hospital, Finland.

BACKGROUND: Prohevein (Hev b 6.01) and hevein (Hev b 6.02) have been shown to be major IgE-binding allergens in health care workers and other adult patients allergic to natural rubber latex (NRL). Rubber elongation factor (REF; Hev b 1) and the 23/27 kd NRL allergen (Hev b 3) are characteristic of children with latex allergy who have spina bifida and other children requiring multiple operations at an early age. In addition, there are children with latex allergy and no history of multiple operations in whom sensitizing allergens are not known. OBJECTIVES: We studied IgE antibodies to NRL allergens in children with latex allergy who had not undergone surgery and compared the findings with those in children with latex allergy and a history of multiple operations. METHODS: Sera from 30 children with latex allergy who had not undergone surgery, 12 children with latex allergy with a history of multiple operations, and 19 control children without evidence of NRL allergy were examined. Immunoblotting was used to study IgE binding to NRL proteins, and purified prohevein, hevein, and REF were used in ELISA to measure specific IgE antibodies. RESULTS: In immunoblotting, sera from 21 (70%) children who had not undergone surgery and from 4 (33%) children with a history of multiple operations showed IgE binding to a 20-kd protein band (known to contain prohevein), and 9 (30%) and 8 (67%) sera, respectively, to a 14-kd protein band (known to contain REF). In ELISA, sera from 26 (86%) children who had not undergone surgery and from 7 (58%) children with a history of multiple operations had IgE antibodies to prohevein and 19 (63%) and 7 (58%) sera, respectively, to hevein. Eight (27%) sera from the children who had not undergone surgery had IgE antibodies to REF in contrast to 8 (67%) sera from children with a history of multiple operations. CONCLUSIONS: The IgE antibody pattern differs between children with latex allergy who had not undergone surgery and those with a history of multiple operations. The major allergens in children with no history of surgery appear to be prohevein and hevein and not REF, a finding that agrees well with that reported for health care workers with allergy to latex.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9802376&dopt=Abstract allergy medicine