Cross-reactivity of pink peppercorn in cashew and pistachio allergic individuals

BACKGROUND: The Pink peppercorn belongs to the same Anacardiaceae family as cashew and pistachio. However, the cross-reactivity of pink peppercorn with cashew and pistachio has yet to be studied. To date, there has been a single case report of anaphylaxis to pink peppercorn in a cashew and pistachio allergic individual. OBJECTIVE: We aim to demonstrate cross-sensitization to pink peppercorn in cashew and/or pistachio allergic children. METHODS: A small descriptive cohort study looking at cross-sensitization of pink peppercorn in cashew and/or pistachio allergic children was conducted. Children with a history of reaction to pistachio and/or cashew nut underwent skin prick tests to the pink peppercorn species Schinus terebinthifolius to determine cross-sensitization. RESULTS: Out of the 21 cashew and/or pistachio allergic subjects, 16 (76.2%) demonstrated cross-sensitization to pink peppercorn. None of the subjects had any knowledge of previous exposure or allergic reactions to pink peppercorn. DISCUSSION: This study demonstrates potential cross-reactivity between pink peppercorn and cashew and pistachio. While an oral food challenge to pink peppercorn would have been important in demonstrating clinical cross-reactivity, this was not performed due to ethical constraints. We hope to increase the awareness of pink peppercorn as a potential and hidden source of allergen and encourage further studies to demonstrate the clinical cross-reactivity and to better delineate the major allergen involved.

Novel strategies in immunotherapy for allergic diseases

Conventional immunotherapy (IT) for optimal control of respiratory and food allergies has been fraught with concerns of efficacy, safety, and tolerability. The development of adjuvants to conventional IT has potentially increased the effectiveness and safety of allergen IT, which may translate into improved clinical outcomes and sustained unresponsiveness even after cessation of therapy. Novel strategies incorporating the successful use of adjuvants such as allergoids, immunostimulatory DNA sequences, monoclonal antibodies, carriers, recombinant proteins, and probiotics have now been described in clinical and murine studies. Future approaches may include fungal compounds, parasitic molecules, vitamin D, and traditional Chinese herbs. More robust comparative clinical trials are needed to evaluate the safety, clinical efficacy, and cost effectiveness of various adjuvants in order to determine ideal candidates in disease-specific and allergen-specific models. Other suggested approaches to further optimize outcomes of IT include early introduction of IT during an optimal window period. Alternative routes of administration of IT to optimize delivery and yet minimize potential side effects require further evaluation for safety and efficacy before they can be recommended.

Knowledge and practice of household mosquito breeding control measures between a dengue hotspot and non-hotspot in Singapore

<p><b>INTRODUCTION</b>The aim of this study was to compare the knowledge and practices of household mosquito-breeding control measures between a dengue hotspot (HS) and a non-hotspot (NHS).</p><p><b>MATERIALS AND METHODS</b>Eight hundred households were randomly sampled from HS and NHS areas, and an National Environment Agency (NEA) questionnaire was administered to heads of the households. Interviewers were blinded to the dengue status of households. We included subjects aged above 16 years, who were communicative and currently living in the household. Chi-square test was used to compare proportions and multiple logistic regression was used to adjust for socio-demographic differences between both areas.</p><p><b>RESULTS</b>The overall response rate was 59.0% (n = 472). There were significant differences in gender, educational level, employment status and housing type between HS and NHS (all P <0.05). NHS residents were less knowledgeable in 6 out of 8 NEA-recommended anti-mosquito breeding actions: changing water in vase/bowls [AOR (adjusted OR), 0.20; CI, 0.08-0.47; P <0.01], adding sand granular insecticide to water [AOR, 0.49; CI, 0.31-0.71; P <0.01], turning over pails when not in use [AOR, 0.39; CI, 0.17-0.89; P = 0.02], removing flower pot/plates [AOR, 0.35; CI, 0.18-0.67; P <0.01], removing water in flower pot/plates [AOR, 0.36; CI, 0.17-0.75; P <0.01] and putting insecticide in roof gutters [AOR 0.36; CI, 0.13-0.98; P = 0.04]. Hotspot residents reported better practice of only 2 out of 8 NEA-recommended mosquito-breeding control measures: changing water in vases or bowls on alternate days [AOR, 2.74; CI, 1.51-4.96; P <0.01] and removing water from flower pot plates on alternate days [AOR, 1.95; CI, 1.01-3.77; P = 0.05].</p><p><b>CONCLUSION</b>More HS residents were knowledgeable and reported practicing mosquito-breeding control measures compared to NHS residents. However, a knowledge-practice gap still existed.</p>