The advances of allergen component detection in IgE-mediated food allergy / 中华预防医学杂志

There are many types in food allergy, and the most common is mediated by IgE. Currently, the diagnosis of food allergy mainly relied on skin prick test and serum specific IgE of allergen extract, which can not identify cross-sensitization. Component-resolved diagnosis (CRD) can identify the major allergen components and cross-components of food allergens, which plays an important role in dietary guidance, prognosis monitoring and diagnosis of special types of IgE-mediated food allergy. This article enumerates clinical characteristics of the IgE-mediated common food allergies, such as milk, egg and seafood allergy, and special type of food allergy, such as cat pork syndrome, oral allergy syndrome, α-gal syndrome and food-dependent exercise-induced anaphylaxis, summarizes the advances of CRD in these types of IgE-mediated food allergy, in order to provide an evidence for the diagnosis, treatment and prevention of IgE-mediated food allergy.

Comparative analysis of serum IgE detected by ImmunoCAP and EUROLine assays / 医学研究生学报

Objective The diagnosis of allergic diseases mainly relies on the allergen skin test or in vitro specific IgE test. This study was to explore the diagnostic efficiency of EUROLine and its application in southern China by reference to the standard method of the immunoenzymatic capsulated hydrophilic carrier polymer (ImmunoCAP).Methods Using the EUROLine system, we examined 12 common specific IgEs (sIgE) from 283 patients with multiple sensitizations in the First Affiliated Hospital of Guangzhou Medical University, including cockroach (i6), dog dander (e2), cat dander (e1), Mugwort (w6), ragweed (w1), dust mites (ds1), chicken protein (f1), milk (f2), crab (f23), shrimp (f24), peanut (f13) and soybean (f14).Results EUROLine showed that house dust mite allergens were the main aeroallergens in southern China, with a positive rate of 66.3%, while egg white had the highest positive rate (53.2%) in food allergens. The overall rate of the allergens detected by EUROLine was consistent to that of ImmunoCAP by 60.8%-90.1%, the positive rate by 63.3%-93.6%, and the negative rate by 54.5%-95.2%. The Kappa value of EUROLine was 0.203-0.702 in detecting each allergen and >0.6 with cat hair, egg white, peanut, milk and mugwort. The rank correlation coefficient between ImmunoCAP and EUROLine was >0.7 for dust mite combination, cat hair, mugwort, egg white, milk, peanut and crab allergens, with the highest consistency rate for egg white (93.17% \[191/205\]), the lowest for shrimp (70.83% \[170/240\]), and an overall consistency rate of 82.68% (1542/1865).Conclusion The EUROLine system has a high diagnostic performance, and it is inexpensive, efficient and applicable in the detection of allergens in southern China.

Allergy-related evidences in relation to serum IgE: data from the China state key laboratory of respiratory disease, 2008-2013 / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the serum total IgE (tIgE) and specific IgE (sIgE) to common allergens among allergic patients in Guangzhou, China.</p><p><b>METHODS</b>7 085 patients were examined for tIgE and sIgE to 15 allergens, based on the protocols of reversed enzyme allergosorbent test and the sandwich enzyme-linked immunosorbent assay.</p><p><b>RESULTS</b>3 758 (53.04%) patients tested positive for tIgE, and 4 640 (65.49%) for sIgE. Der pteronyssinus, Der farinae, eggs, and cow's milk were the most common allergens leading to higher positive rates of sIgE responses. Several peaks of sensitization were: Der pteronyssinus, Der farinae, and Blomia tropicalis at age 10-12; cow's milk at age below 3; eggs at age 4-6. The mean level and positive rate of tIgE tended to increase in subjects sensitized to more allergens. Sensitization to Der pteronyssinus (OR, 1.6; P<0.05), Der farinae (OR, 1.5; P<0.05), Blomia tropicalis (OR, 1.4; P<0.05), Blattella germanica (OR, 1.5; P<0.05), cow's milk (OR, 1.3; P<0.05), and soy beans (OR, 2.0; P<0.05) were independently correlated with allergy-related conditions in preliminary diagnosis.</p><p><b>CONCLUSION</b>The major allergens in Guangzhou include Der pteronyssinus, Der farinae, cow's milk, and eggs. Sensitization to these allergens appears to be predictors of allergy-related disorder.</p>

Prevalence of sensitivity to cockroach allergens and IgE cross-reactivity between cockroach and house dust mite allergens in Chinese patients with allergic rhinitis and asthma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Cockroaches are an important indoor allergen source causing allergic rhinitis and asthma. The aim of this study was to investigate the cockroach prevalence in mainland of China and the cross-reactivity of IgE between cockroach and house dust mite allergen in Chinese patients.</p><p><b>METHODS</b>The cockroach sensitization pattern was based on a skin prick test (SPT) obtained from a national multicenter prevalence study, in which 6304 patients from 25 allergy centers across China participated. Factors, including different regions of China, age, gender and the correlations between the American and German cockroaches and house dust mite Der p were investigated. Eighteen out of 1236 clinical sera from south China were selected to perform the cross-inhibition assay between house dust mites and cockroaches.</p><p><b>RESULTS</b>Totally 25.7% of patients were SPT positive to the American cockroach (Periplaneta Americana, Per a) and 18.7% SPT positive to the German cockroach (Blattella germanica, Bla g). The prevalence of positive cockroach SPT was higher in southern than in northern China, higher in adults than in children, and higher in males than in females. Patients had relatively low levels of cockroach SPT reactions, mainly class 1 or 2. Of the SPT positive cockroach patients, 88% were also SPT positive to house dust mite (Dermatophagoides pteronyssinus, Der p). An IgE cross-inhibition study confirmed that Der p sensitization could cause false positive SPT reactions against cockroach.</p><p><b>CONCLUSIONS</b>A relatively high prevalence of cockroach sensitivity was found in mainland of China. However, a cross-inhibition study showed that only a small number of patients appear to have Bla g and/or Per a as primary sensitizing source. The importance of cockroaches as a risk factor for sensitization and triggers of allergic symptoms in mainland of China needs to be further investigated.</p>

Efficacy of intramuscular BCG polysaccharide nucleotide on mild to moderate bronchial asthma accompanied with allergic rhinitis: a randomized, double blind, placebo-controlled study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Atopy is a state of allergy to common antigens and is founded on an immune disturbance of exuberant Th2 activity and IgE production. There is also epidemiological and experimental evidence that exposure to mycobacteria has the potential to suppress the development of asthma or atopy. Since Th1 and Th2 immune mechanisms are significantly antagonistic, it is hypothesized that mycobacterial exposure may moderate atopic disease by modification of immune responses.</p><p><b>METHODS</b>One hundred and twenty mild to moderate persistent asthmatics accompanied with allergic rhinitis were randomly divided into four groups with one injection every other day for 18 times for group A with 1 ml of normal saline, B with 0.5 mg of Bacillus Calmette-Guérin polysaccharide nucleotide (BCG-PSN) and C with 1 mg of BCG-PSN, 36 times for group D with 0.5 mg of BCG-PSN. Markers for the severity of asthma and rhinitis including the amount of inhaled corticosteriod, bronchodilator and oral H1 blocker-loratidine being used to obtain optimal symptomatic control, symptom scores of asthma and allergic rhinitis, peak expiratory flow (PEF), histamine provocative dose that produces at least a 20% change in forced expiratory volume with in 1 second (PD20-FEV1), blood IgE levels as well as dermatophagoides pteronysinus (DP) and dermatophagoides farinae (DF) skin prick test were measured every visit for 6 months.</p><p><b>RESULTS</b>There were no differences for symptom scores of asthma, daily use of bronchodilator, PEF, PD20-FEV1, blood IgE as well as DF and DP skin prick test among the four groups. Score for allergic rhinitis decreased significantly in groups B, C and D on day 36 and 72 as compared with group A (P < 0.05). Score for allergic rhinitis increased after day 72 in group B and C while it was significantly lower in group D (P < 0.05). The patients in group D used less amount of inhaled beclomethosone than other groups (P < 0.05) from day 72 after the treatment to day 180. Oral loratadine consumption in groups B, C and D was significantly less on day 36 and 72 as compared with their baseline and group A after the treatment (P < 0.05). Group D maintained significantly lower dosage of oral loratadine until day 150 comparing with its baseline and group A.</p><p><b>CONCLUSIONS</b>BCG-PSN has a symptomatic effect on allergic rhinitis. BCG-PSN may reduce the dosage of non-sedative H1 blocker loratadine as well as the dosage of inhaled beclomethosone in the treatment of mild to moderate asthma and allergic rhinitis.</p>

House dust mite allergen (Derp1 and Blot5) levels in asthmatics' home in Hongkong / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To measure Derp1 and Blot5 allergen levels in asthmatics' homes in Hongkong.</p><p><b>METHODS</b>Seventy houses were enrolled for a mite indoor environment study. Dust samples were obtained from two sites of each patients' house: bed and floor. Derp1 and Blot5 levels were quantified by a two-site monoclonal antibody-based ELISA technique.</p><p><b>RESULTS</b>The levels of Derp1 allergens found in bed (geometric mean (GM) 3.43 microg/g of dust; 95%CI, 1.89-4.96 microg/g) and on the floor (GM 1.12 microg/g of dust; 95%CI, 0.71-1.53 microg/g) indicated significant differences (P=0.005). However, the levels of Blot5 allergens found in bed (GM 19.00 microg/g of dust; 95%CI, 0.89-38.90 microg/g) and on the floor (GM 6.14 microg/g of dust; 95%CI, 0.40-11.90 microg/g) showed no statistically significant difference. In addition, in regards to the exposure index for Derp1 and Blot5 allergens found in bed and on the floor, 17.6% in bed and 8.6% on the floor had levels of Blot5 > or = 10 microg/g of dust, higher than those obtained for Derp1 (7.2% and 0% in bed and on the floor respectively, P<0.05); higher percentages in bed and on the floor (25.0% and 35.7%) were observed for levels of Blot5 = 0 microg/g of dust as compared with Derp1 in bed and on the floor (4.3% and 14.5% respectively, P<0.05).</p><p><b>CONCLUSIONS</b>Derp1 and Blot5 are the major allergens found in this regional study, Blot5 is a more potent allergen in Hongkong, probably reflecting the high level of exposure to Blomia tropicalis (Bt). Bt and Dermatophagoides pteronyssinus (Dp) allergens should be included for precise diagnosis and effective immuno-therapeutic treatment of mite allergy in Hongkong.</p>