Analysis of food allergen spectrums in food anaphylaxis in Guangzhou / 国际检验医学杂志

Objective To analyse distribution of age and gender characteristics of specific IgG(sIgG)antibodies and specific IgE (sIgE)antibodies of 13 types of food allergens in patients with food anaphylaxis,and to explore the relationship between sIgG and sIgE in food anaphylaxis.Methods 314 cases of patients from 2009 to 2012 were selected as subjects,and divided into underage group(1 63 cases)and adult group(1 5 1 cases).Serum sIgG of 13 types of food allergens were detected by using enzyme linked immu-nosorbent assay,serum sIgE of these food allergens were detected by using immune capture.Results 80.25% of the patients were sIgG-positive,and no obvious gender differences were found;while the positive rates of sIgG in the underage group(94.48%)were higher than that in the adult group(64.90%),there were statistically significant differences(P < 0.05 ).34.39% of the patients were sIgE-positive.The positive rates of sIgE in male patients(40.68%)were higher than that in female patients(26.28%),and that in the underage group(55.21%)were also higher than that in the adults group(1 1.92%),there were statistically significant differences(P <0.05).Conclusion The total positive rates and its distribution characteristics of sIgG and sIgE of same food aller-gens were obviously different.Food anaphylaxis might be associated with age,gender,food types and individual diversity.

Lidocaine anaphylaxis and lidocaine-specific immunoglobulin E measurement

Although local anesthetics can cause adverse drug reactions (ADRs), most ADRs to local anesthetics are from vasovagal, toxic, or anxiety reactions, while immunoglobulin E (IgE)-mediated anaphylaxis is extremely rare. We report a case of IgE-mediated anaphylactic reaction to lidocaine. A 27-year-old male patient who had two episodes of anaphylactic reactions after local injection of lidocaine was referred to our clinic for the safe use of local anesthetics for the subsequent dental procedure. Skin prick and intradermal tests were performed with amide local anesthetics; lidocaine, bupivacaine, mepivacaine, and ropivacaine. Lidocaine and mepivacaine showed positive response in prick test, and lidocaine, mepivacaine, and bupivacaine showed positive reactions in intradermal test. Only ropivacaine showed negative response both in prick and in intradermal test, and the patient was successfully treated with it. To detect serum-specific IgE, we prepared lidocaine-human serum albumin (HSA) conjugate. Enzyme-linked immunosorbent assay result showed high level of specific IgE to lidocaine-HSA conjugate in serum of the patient. This case suggests that local anesthetics can elicit specific IgE-mediated allergic reactions, and both skin prick and intradermal test should be performed in case of suspected IgE-mediated allergic response to local anesthetics.

Clinical Significance of Food-specific IgE Antibody Testsin Food Protein-induced Proctocolitis / 대한소아소화기영양학회지

PURPOSE: The aim of this study was to determine the clinical significance of food-specific IgE antibody tests in detecting triggering antigens in food protein-induced proctocolitis (FPIPC). METHODS: Between February 2006 and May 2007, data from 16 consecutive FPIPC patients that underwent MAST and Uni-CAP tests on initial visits, were reviewed. The endoscopic criterion used for establishing a diagnosis of FPIPC was an increase in the number of eosinophils in the lamina propria (> or =60 per 10 high power fields). Offending foods were suspected clinically based on elimination and challenge testing to mother or patient diets with the following five highly allergenic foods: dairy products, eggs, nuts and soybean, fish and shellfish, and wheat and buckwheat. We compared the results of initial MAST or Uni-CAP tests with clinically suspected offending foods. RESULTS: For the 16 FPIPC patients, MAST tests showed positive results in 2 patients (12.5%), and Uni-CAP tests showed positive results in 3 patients (18.8%). Through clinical elimination and challenge, the 33 offending foods were identified: 7 fish and shellfish (21.2%), 6 eggs (18.2%), 6 wheat and buckwheat (18.2%), 4 dairy products (12.1%), 3 soybean (9.1%), 3 pork (9.1%), 2 nuts (6.1%), 1 beef (3.0%), and 1 mushroom (3.0%). Clinically suspected offending foods and MAST and Uni-CAP test results were found to be correlated in 1 patient (6.7%) each. CONCLUSION: Food specific IgE antibody tests are inappropriate for predicting offending foods in FPIPC. Clinical food elimination and challenge testing provide useful means of detecting offending foods.

Sensitization rate of Trichophyton spp. allergen in various allergic diseases and identification of its allergens with immunoblotting / 천식및알레르기

BACKGROUND: Trichophyton is one of the most common genera of dermatophytes. It has been reported that Trichophyton spp. might be one of the causative allergens in patients with asthma, rhinitis, urticaria and angioedema. OBJECTIVES: To analyze the sensitization rate of Trichophyton, to determine serum specific IgE antibody, and to confirm Trichophyton as a causative antigen in patients with allergic diseases. METHODS: A total of 1,806 patients were enrolled in this study. Skin prick test was performed with 50 common inhalant allergens and 20 food allergens. Serum specific IgE antibodies were determined by ELISA using Trichophyton mentagrophytes antigen in 60 patients among positive skin responders to Trichophyton antigens and in 20 controls. For evaluation of cross-reactivity between Trichophyton and other fungal species, competitive ELISA inhibition test was performed. SDS-PAGE and IgE-immunoblot analysis using T. mentagrophytes antigen were applied in 7 patients with high specific IgE titers. RESULTS: 102 patients (5.7%) showed positive response to T. mentagrophytes on skin prick test, and six patients showed isolated positive responses. Serum specific IgE increased according to skin reactivity (p<0.05). SDS-PAGE and IgE-immunoblot showed 10 IgE-binding components (11, 17, 27, 32, 35, 38, 42, 48, 49, 51 kDa) within Trichophyton extracts. Trichophyton-ELISA inhibition test showed dose-dependent inhibitions with additions of Trichophyton antigens, while minimal inhibitions were noted with additions of Fusarium, Alternaria, Aspergillus and Clados- porium. CONCLUSIONS: Trichophyton could induce IgE sensitization in allergy patients. The sensitization rate on skin prick test was 5.7%. Trichophyton antigen should be included in skin prick test battery to screen causative agents for allergy patients.

Relationship Between IgE-Mediated Basophil Histamine Releasability and Airway Hyperresponsiveness or Atopy Markers in Atopic Children / 소아알레르기및호흡기학회지

BACKGROUND: Our previous data suggested that IgE-mediated histamine release from basophil was elevated in the atopic asthmatic children. Basophil may play an important role in the development of the IgE-dependent, late phase response in allergen induced airway disease. So the existence of enhanced basophil histamine release in asthma could promote airway reactivity and obstruction. PURPOSE: The purpose of this study is to determine the relationship between IgE-mediated basophil histamine releasability (BHR) and airway hyperresponsiveness or markers of atopy in atopic children. METHODS: Twelve atopic asthmatics and four healthy atopics who were sensitive to D.p and D.f were selected. Their median age was 11.2 years old, their mean serum IgE level was 897+/-276 IU/mL and mean total eosinophil count was 536+/-71/mm3. Total eosinophil counts, total IgE, D.p and D.f-specific IgE, pulmonary function test, and methacholine provocation test were performed. IgE-mediated basophil histamine release by D.f allergen and goat-antihuman IgE antibody were measured by automated fluorometric assay. The relationship between histamine release and airway hyperresponsiveness or atopic markers was investigated. RESULTS: PC20 inversely correlated with anti-IgE antibody-mediated BHR (r=-0.50, P<0.05). Serum total IgE concentration correlated with anti-IgE antibody-mediated BHR (r=0.54, P<0.05). Serum concentrations of specific IgE to D.p correlated with anti-IgE antibody-mediated BHR (r=0.66, P<0.05). PC20 correlated correlated with FEF25-75% (r=0.75, P<0.05) and inversely with the total eosinophil counts (r=-0.69, P< 0.01). CONCLUSION: IgE-mediated basophil histamine releasability is inversely correlated with airway hyperresponsiveness, and correlated with total or specific-IgE in atopic children. These findings suggest that basophil histamine releasability is easy and useful method of diagnosis and monitoring response to treatment in atopic disease.