Evaluation of safety and consistency of inhaled allergen extracts in the diagnosis of allergic diseases in children / 中华实用儿科临床杂志

Objective:To investigate the safety and consistency of domestic inhaled allergen extracts in the diagnosis of allergic diseases in children.Methods:Nine thousand five hundred and sixty-three children diagnosed with allergic diseases from September 2018 to June 2020 in Children′s Hospital Affiliated to Capital Institute of Pedia-trics were selected in this study, and all of them were subjected to skin prick test(SPT), and 415 of them were subjected to serum specific IgE (sIgE) test at the same time.The adverse events during SPT were recorded and the consistency of the results between SPT and sIgE test was analyzed.Results:There were 14 cases with adverse events in 9 563 patients, and the overall incidence was 0.15%.The incidence of adverse events was 0.07% (2/2 581 cases) in the 1-5 years old group, 0.19% (12/6 197 cases) in the 6-11 years old and 0 in the 12-17 years old group.The severity of all these events was grade Ⅰ.Out of the 14 cases with adverse events, only 1 case was considered to be related to allergen preparations, with the incidence being 0.01% (1/9 563 cases). The Kappa index showed that the results of dermatophagoides pteronyssinus, dermatophagoides farinae, alternaria and artemisia measured by SPT and sIgE were almost the same.There was high consistency between tree pollens and ragweed ( P<0.01), and moderate consistency between aspergillus fumigatus ( P<0.01). When the results of sIgE were used as the diagnostic criteria, the Youden index for the results of SPT ranged from 0.76 to 0.89, with aspergillus fumigatus (0.76) and tree pollens mixture (0.79) as the lowest.The positive likelihood ratio for most of the inhaled allergens was more than 10 except for tree pollens mixture (7.12) and dermatophagoides farinae (9.10). The negative likelihood ratio for most of the inhaled allergens was less than or equal to 0.1 except for aspergillus fumigatus (0.19). Conclusions:The domestic inhaled allergen extracts had high safety in the clinical application of SPT, and their results of SPT had good consistency with those of serum sIgE, which was conducive to the diagnosis and evaluation of allergic diseases in children.

Clinical characteristics of total IgE in pediatric allergic disease

PURPOSE: Serum total and specific IgE levels have been widely used to diagnose allergic disease. However, it has recently been suggested that serum total IgE does not properly reflect specific IgE. Therefore, we evaluated the clinical significance of serum total IgE in pediatric allergic disease. METHODS: This study included 633 patients who visited Kyungpook National University Children's Hospital between March 2013 and April 2015. We used immunoCAP, an inhalant multiple allergen simultaneous test (MAST), and food MAST to measure specific IgE. We used a skin prick test in some patients and measured serum total IgE, eosinophil count, and serum eosinophil cationic protein in all patients. RESULTS: There was a positive correlation between serum total IgE and antigen level in the inhalant immunoCAP test. Specifically, the sum of immunoCAP levels was highly correlated with serum total IgE (r=0.631, P<0.001). Moreover, there was a positive correlation between serum total IgE and the sum of food immunoCAP levels (r=0.323, P<0.001). Among the food immunoCAP antigens, milk was highly correlated with serum total IgE (r=0.558, P<0.001). There was a positive correlation between serum total IgE and the sum of class levels of inhalant/food MAST tests (r=0.709, P<0.001 and r=0.686, P<0.001, respectively). There was also a positive correlation between serum total IgE and the number of positive skin prick tests (r=0.445, P<0.001). CONCLUSION: Serum total IgE may reflect the sum of serum specific IgE levels in pediatric allergic disease.

A Comparative Study of Skin Prick Test versus Serum-Specific IgE Measurement in Indian Patients with Bronchial Asthma and Allergic Rhinitis.

Background. Skin prick testing (SPT) is the ‘gold standard’ in the assessment of allergic sensitivity to inhalant allergens. Serum-specific immunoglobulin E (SSIgE) measurement is a complementary test. SPT is performed with antigen extracts from India while SSIgE utilises extracts derived from European antigens. Objective. To evaluate the performance of allergic assessment by SSIgE against cockroach, housefly and mosquito aeroallergens which are frequently implicated in driving respiratory allergies in India considering SPT as the ‘gold standard’. Methods. Twenty patients (mean age 28.5 years; range 15-50 years) diagnosed to have bronchial asthma and/or rhinitis underwent SPT. The SSIgE levels were obtained at the same visit. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of SSIgE testing were calculated using SPT as the ‘gold standard’. The correlation between SPT grading and SSIgE levels was also evaluated. Results. The sensitivity of SSIgE testing to each of the 3 aero-allergens was >85%. The PPV of cockroach and mosquito SSIgE was >85%; housefly SSIgE had PPV of 68.7%. The two tests were in agreement in 85% (cockroach), 90% (mosquito) and 55% (housefly). There was a significant correlation between the grades of SPT reactions and SSIgE levels. Conclusions. The SSIgE has higher sensitivity and PPV, but lacks specificity. Higher sensitivity with low specificity leads to increased false positive diagnosis of allergic disease. Unlike allergenic pollens, however, insect antigen extracts from different regions seem to give comparable results, and can thus, reliably be used in the evaluation of allergy.

Association between skin prick test of dust mites and serum specific IgE in diagnosis of mite allergy / 中华检验医学杂志

Objective To investigate the association between the results of Dermatophagoides pteronyssinus ( Der p) and Dermatophagoides farinae ( Der f) allergen SPT and serum sIgE in diagnosis of IgE-mediated mite allergy.Methods A total of 166 allergic outpatients with positive expression of serum sIgE of Der p and Der f diagnosed in Beijing Tongren Hospital,the General Hospital of Shenyang Military Region and Guangzhou Institute of Respiratory Disease were enrolled in the study.The SPT was performed by injecting liquid containing the allergen of Der p and Der f.One hundred ninety healthy subjects with negative serum sIgE of Der p and Der f were assigned as controls according to paired design ratio,1 to 1.The sensitivity and specificity of SPT used Der p and Der f allergen were evaluated in the diagnosis of mite allergy.The association between the results of SPT and serum sIgE was analyzed by linear regression method.Results In the allergic group,the positive rates of SPT for Der p and Der f were 98.80％ ( 164/166) and 95.18％ (158/166) respectively.In the control group,the positive rate of STP for Der p and Der f were 2.11％ (4/190) and 1.58％ (3/190) respectively.The SPT results of Der p and Der f showed significant statistical difference between healthy subjects and allergic patients (x2 =285.5,386.3;P＜0.01 ).The sensitivity and specificity of the SPT were 98.80％ (164/166) and 97.89％ (186/190) for Der p and 95.18％ (158/166) and 98.42％ (187/190) for Der f,respectively.There was a significant association between SPT and sIgE with linear correlation analysis( r =0.737,0.708;P ＜ 0.O1 ).Conclusions Both SPT of Der p and Der f is highly sensitive and specific.At the same time,SPT has a significant positive correlation with sIgE.It can be used as an accurate,convenient and fast test in diagnosis of mite allergic diseases.

Prevalencia de sensibilización hacía ácaros y hongos en trabajadores con alergia tipo I / Prevalence of sensibilization to mites and moulds on workers with allergy tipe I

Empleados de oficinas que actualmente trabajan dentro de edificaciones con sistemas cerrados de aire acondicionado, pudiesen estar expuestos a hongos y ácaros en su lugar de trabajo. Las condiciones pudiesen ser peores si estos sistemas no son mantienen de forma apropiada. El Instituto Universitario de Policía Científica de Caracas” (IUPOLC, Venezuela), pudiese ser un ejemplo de esta situación. Analizar la prevalencia de los niveles de IgE Específica en contra de ácaros (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia Tropicalis) y hongos ambientales (Penicillium notatum, Cladosporium herbarum, Aspergillus fumigatus, Alternaria tenuis/alternata) en una población que reporta sintomatología relacionadas con Alergias tipo I (Mediadas por IgE), y que labora en Instituto Universitario de Policía Científica de Caracas, IUPOLC. De la totalidad de trabajadores del edificio del IUPOLC, actualmente 47 empleados reportaron poseer síntomas asociados con Alergias Tipo I al momento de la toma de la muestra para este estudio. Se evaluó los niveles de IgE específica en contra de ácaros y hongos utilizando el sistema de Allergy Screen® de r-biopharm, (Actualmente utilizado en más de 70 países), el cual es un método de fase solida de nitro celulosa. El laboratorio que realizó el estudio está suscrito al esquema de control de calidad externo UK NEQA) (Reino Unido) y además organiza el único sistema disponible para tal fin en Venezuela. 82.98% de los pacientes estudiados presentaron sensibilizaciones en contra de ácaro y/o hongos. 53,19% mostraron valores significativos hacía ácaros; Dentro de ellos el más frecuente fue Blomia tropicalis, (25 casos), seguido Dermatophagoides pteronissynus por Dermatophagoides farinae. Dentro de los hongos los más frecuentes resultaron Cladosporium herbarum (10 casos), Aspergillus fumigatus, (9 casos) Penicillium notatum (4 casos) y Alternaria alternata (1 caso)...

Office employees that actually work inside buildings with air-conditioned closed systems are well known to be exposed to fungi and storage mites in their workplace. The conditions could be worst when those systems aren’t properly maintained. The “Instituto Universitario de Policía Científica de Caracas” (IUPOLC, Venezuela) could be an example for that situation. AIM: To evaluate the prevalence of sensitization to moulds and mites though Specific IgE levels determinations, on workers of the IUPOLC that presented clinical symptoms associated with allergy type I at the moment of the study. From the total population of workers of the IPUOLC facility, actually 47 employees of IUPOLC presented one or more clinical symptoms associated with allergy at the moment of the study. The level of serum-specific IgE to mites and moulds were evaluated, using the Allergy Screen® r-biopharm methodology enzymatic solid phase method in nitro-cellulose in all subjects (Actually used in more than 70 countries). The Laboratory that performed the tests is actually subscribed to the UK NEQAS (United Kingdom National External Quality Assessment Service), and also they organize the only Allergy External Quality Scheme available in Venezuela. 82.98% of the patients analyzed presented one or more increased values for mites or molds. 53,2% resulted with positive values for Mites; the most frequent mites involved on the population were Blomia tropicalis, (with 25 cases), Dermatophagoides pteronissynus and Dermatophagoides farinae. On molds the most frequent sensibilizations resulted on Cladosporium herbarum (10 cases), Aspergillus fumigatus, (9 cases) Penicillium notatum (4 cases) and last Alternaria alternata (1 case). This study suggests an important role of fungi and mites as occupational allergens for IUPOLC workers. The prevalence of allergic symptoms among employees of IUPOLC was relatively high...

Relationship between Serum Specific IgE and Allergen Skin Test in Allergic Patients of Wuhan Area / 华中科技大学学报（医学）（英德文版）

In order to study the relationship between serum specific IgE (sIgE) and allergen skin test, allergen skin tests and detections of sIgE in 220 allergic patients of Wuhan area were analyzed.The coherent rate of the two methods was beyond 70 % (P＜0.01). It was concluded that the in vitro and in vivo detection methods of allergens have a high coherence and can be used as the effective ways to diagnose the allergic diseases in clinical practice.

Evaluation of multi-allergen dipstick (Allergodip(R)) as a screening test in allergy patients / 천식및알레르기

BACKGROUND AND OBJECTIVE: The Allergodip(R) multi-allergen screening test is a simple method for measuring serum-specific IgE to common inhalant allergens simultaneously. The dipstick contains nine separate allergen pads including D. pteronyssinus, Alternaria, cat epithelium, dog epithelium, English plantain, mugwort, birch, rye and six-grass mixture pollen extracts, as well as positive and negative controls. This study was performed in order to evaluate sensitivity and specificity of this test in comparison to skin prick test. MATERIALS AND METHOD: We compared the results obtained by skin prick test (PT) to those obtained by Allergodip(R) test (AT) in 30 patients with various allergic diseases. The skin reactivity was presented as allergen to histamine ratio (A/H) and results of the AT test were assessed visually and classified into Allergodip(R) class 0-4. RESULTS: Compared with PT, results of AT gave a sensitivity of 55.3% and a specificity of 93.8% when the A/H > OR = 3 was considered a positive response for PT. The agreement rate between positive PT and positive AT to each antigen was 82.6% in D. pteronyssinus, 82.9% in Alternaria, 71.1% in dog epithelium, 57.2% in mugwort pollen, 57.2% in birch pollen, 49.9% in grasses mixture pollen, 23.6% in cat epithelium and 6.7% in rye grass pollen, respectively. Significant correlations were noted between PT and AT classes in D. pteronyssinus, Alternaria, dog epithelium, mugwort pollen, birch pollen, and in grasses mixture pollen (p < 0.05, respectively), but not in cat epithelium or rye grass pollen. CONCLUSION: We concluded that Allergodip(R) test is useful in screening serum-specific IgE antibodies against multiple allergens at one time.

Clinical features of mold asthma sensitive to Alternaria spp / 알레르기

It has been suggested that Alternaria is the most prevalent fungal allergen based upon previous reports of airborne spore survey and allergy skin prick test. In order to observe the clinical features of Alternaria-sensitive asthmatic patients, and to evaluate a diagnostic value of allergy skin prick lest, serum specific IgE antibody, and bronchoprovocation test to Alternaria antigen, we performed allergy skin prick test with two sources of Alternaria antigens as well as 80 common inhalant and food allergens, and serum specific IgE antibody was determined by Ala-STAT(DPC, USA). To confirm bronchial sensitization, bronchoprovocation test with Alternaria alternata antigen from Allergophama (Germany) was performed on 15 asthmatic subjects sensitized to any of Alternaria spp. antigen, and compared between positive and negative responders. Eleven among 15 patients showed early (7) or dual (4) asthmatic responses. Four (36.4%) of 11 positive responders showed an positive response to one kind of Alternaria antigen on skin prick test. Four (36.3%) of them had a positive response to only Alternaria antigen with all negative responses to other fungal allergens. Seven (63.6%) of them showed positive responses to other fungal allergens such as Fusarium spp., Cladosporium spp., Aspergillus spp. All except one of 11 positive responders had high specific IgE antibody to Alternaria alternata on AlaSTAT. These results suggest that more than two sources of Alternaria spp. antigen should be used for screenig a causative fungal allergen. Determination of serum specific IgE can be helpful to complete the sensitivity of skin prick test in case of asthmatic patients sensitized to Alternaria antigen. Further studies will be needed to evaluate allergenic relationships with other fungal allergens appearing cocurrently on skin prick test.