ABSTRACT
The prevalence of respiratory allergies, especially those induced by fungi such as Alternaria alternata, has dramatically increased over the past decade. This increase has caused major health problems worldwide. This study aimed to investigate the role of A.alternata in the etiology of allergic asthma, by using the skin prick test and assessment of IgE specific to the fungus in the patient's sera. This study enrolled 202 patients with allergic asthma, aged 12 to 83 years. Participants included 40.1% males and 59.9% females who were enrolled after recording demographic information. A skin prick test with the whole cell extract of A. alternata was performed on the epidermis of the patients' forearms. Histamine and normal saline were used as positive and negative controls, respectively. Serum levels of IgE specific for A.alternata were measured for all patients using the ImmunoCAP Phadiatop method in which the specific A. alternata allergen cocktail that connected to the solid phase reacted to IgE antibodies in each patient's sera. Data were analyzed by analysis of variance and chi-square tests. Among 202 patients with allergic asthma, 14 [6.93%] had mild asthma, 73 [36.10%] were moderate asthmatics and 115 [56.90%] had severe asthma. In total, 14 [6.93%] patients were positive for both the skin test and IgE specific to A. alternata, 35 [17.33%] had negative specific IgE and positive skin test results, and 36 [17.82%] had a positive specific IgE and negative skin test. A total of 117 [57.92%] patients were negative for both tests. The results of this study showed the presence of IgE specific for A. alternate in 50 of 202 [24.75%] patients diagnosed with allergic asthma. The skin prick test was successfully used as a screening test. The results were further confirmed
ABSTRACT
Introduction: Rabies is a fatal disease and has a threatening risk for the public health. Immunosuppression is related to a wide variety of diseases. It is recommended that immunosuppressed patients receive the full post exposure vaccination, concerning that the immune response may be inadequate. The aim of this study is to determine the level of rabies neutralizing antibody in immunosuppressed patients after receiving rabies post-exposure prophylaxis. Consequently we assess the efficiency of antibody level in immunosuppressed patients admitted at Pasteur Institute of Iran. The study was performed at Pasteur Institute of Iran. Data related to immunosuppressed patients, doses of anti-rabies vaccine and serum, and level of rabies neutralizing antibody titer collected from the patients admitted to the Prevention and Treatment of Rabies Center, Department of Vaccination at Pasteur Institute of Iran, during 2008 to 2010. Subjects who received chemotherapy, immunosuppressive drugs, and chronic renal failure were included in this study. Results: Twenty two cases were evaluated. The Immunosuppressed state was related to cancer [in 8 cases], 4 cases of hematologic disorders, 6 cases of autoimmune disease, and 4 cases of chronic renal failure or kidney transplant. Mean age of 46.45 +/- 21.5 year. All cases received HRIG serum [human rabies immunoglobulin] plus PVRV [Purified Vero cell rabies vaccine]. The level of rabies neutralizing antibody was checked two weeks after the last dose of vaccine. Mean level of rabies neutralizing antibody was 12.07 +/- 6.72 IU/ml. All cases achieved minimum protective level of antibody which is = 0.5 IU/ml. The amount of the antibody level had no relation to age or kind of immunosuppressive disease of patients. Conclusion: It is recommended that Rabies-exposed immunosuppressed patients receive rabies post exposure prophylaxes. We have to be cautious about the cases who have not achieved the appropriate level of rabies antibody. Keywords: Post-exposure rabies prophylaxis, Immunosuppressed patients, Rabies neutralizing antibody