Development and evaluation of light-initiated chemiluminescent assay for quantitation of milk-specific IgG 4 antibody in human serum / 临床检验杂志

Objective@#To develop and evaluate a beads-based light-initiated chemiluminescent assay (LICA) for quantitation of cow milk component (Bos d 5) specific IgG 4 antibody in human serum. @*Methods@#The sIgG 4 -LICA was performed by incubated serum samples with biotinylated allergens, emission beads coated with mouse anti-human IgG 4 antibody and streptavidin-coated sensitizer beads. The reaction conditions of sIgG 4 -LICA were optimized and the analytical performance was evaluated. @*Results@#The precision of intra-assay, within-day and inter-assay (coefficient of variation) were 1.78% to 3.13%, 6.65% to 8.41% and 7.94% to 12.30%, respectively. The functional sensitivity of this assay was 4.71 ng/mL. For the linear range, the sIgG 4 -LICA had a good linear relationship within the range between 28.13 and 1 800 ng/mL, and the linear regression equation was Y=0.98X-1.31(r 2 =0.997). Maximum dilution limit was 1∶64. The disturbing rates measured by adding hemoglobin, triacylglycerol, total bilirubin, acid resistance and biotin to human sera with different concentrations of Bos d 5 sIgG 4 were from -6.38% to 8.60%. @*Conclusions@#The sIgG 4 -LICA introduced in this study was demonstrated to have effective performance for quantitation of allergen-specific IgG 4 and can meet the need of clinical requirement.

Immunologic Evaluation of Patients with Cefotetan-Induced Anaphylaxis

Cefotetan is a commonly prescribed second-generation cephalosporin that acts against a wide range of bacteria. However, cefotetan-induced hypersensitivity has rarely been reported. We report 2 cases of cefotetan-induced anaphylaxis with immunologic evaluation. The first case was a 70-year-old asthmatic woman who had dyspnea and hypotension during administration of cefotetan, in which high serum-specific IgE to cefotetan-human serum albumin (HSA) conjugate was detected by enzyme-linked immunosorbent assay. The second case was a 63-year-old asthmatic woman who complained of chest tightness and dyspnea during cefotetan infusion, in which high serum-specific IgG1 and IgG4 with no serum specific IgE to cefotetan-HSA conjugate was detected. The basophil activation test using basophils from the patient showed a significant up-regulation of CD63 with the addition of anti-IgG4 antibody compared with that in non-atopic healthy controls. In conclusion, cefotetan can induce anaphylaxis, which may involve both IgE- and IgG4-mediated responses in the pathogenic mechanism.

Antigen Specific IgG4 in Patients with Gastrointestinal Complaints.

Aims: To find the antigen specific IgG4 in patients with gastrointestinal complaints and in control group, to demonstrate suitability of detection of IgG4 by using antigen panel. Place and Duration of Study: Laboratory Management and Consultancy, Riga, Latvia, October 2012 - February 2013. Methodology: The study included 147 patients (46 men, 101 women, aged from 1 to 76) with different complaints regarding gastrointestinal habitus. Antigen specific IgG4 analysis by using regional adopted antigen panel was executed. Results: Almost all patients with gastrointestinal complaints -141 out of 147-have at least 2nd level antibodies, while in control group 15 out of 24 have 2nd level of antibodies. Conclusion: IgG4 antigen specific antibody tests by panels could be used as a screening tool for food intolerance detection.

Clinical application of the detection of sIgE and sIgG4 in children with allergic diseases / 国际检验医学杂志

Objective To explore the clinical application value of the detection of sIgE and sIgG4 in children with allergic asthma and allergic rhinitis .Methods The levels of sIgE and sIgG4 of allergic asthma group (n=85) ,allergic rhinitis group (n=72) and control group (n=60) were respectively detected by ELISA .The diagnostic efficiency of sIgE and sIgG4 were analyzed by using ROC curve .Results Before treatment ,the serum levels of sIgE and sIgG4 of allergic asthma group and allergic rhinitis group were remarkably higher than those of control group (P< 0 .01) .After 6 -month treatment ,the serum sIgE levels of allergic asthma group and allergic rhinitis group significantly decreased ,and the serum sIgG4 levels significantly increased (P< 0 .01) .For the combined detection of sIgE and sIgG4 ,the diagnostic sensitivities of allergic asthma and allergic rhinitis were 90 .6% (77/85) and 84 .7% (61/72) respectively ,and the diagnostic specificities of allergic asthma and allergic rhinitis were 81 .2% (69/85) and 76 .4%(55/72) respectively .Conclusion The serum sIgE and sIgG4 are good indicators for the diagnosis of allergic diseases .

Clinical application of examination of specific IgG4 to food allergens / 临床检验杂志

Objective To investigate the clinical application of examination of specific IgG4 to food allergens.Methods Specific IgG4 as well as specific IgE to ten kinds of food allergens in sera of 51 patients with chronic eczema was examined by ELISA.Results Food allergen specific IgG4 was positive in 35 patients (68.6%) and food allergen specific IgE was positive in 45 patients(88.2%)of the 51 cases (P

Trichophyton and asthma: specific IgE, IgG1 and IgG4 determination / 천식및알레르기

BACKGROUND AND OBJECTIVE: Trichophyton may be the causative allergen in patients with severe asthma. This study was performed in order to confirm Trichophyton as a causative antigen in asthmatic patients in Korea and to understand the pathogenic mechanism of Trichophyton- induced asthma. MATERIALS AND METHOD: Two groups of 33 asthmatic patients sensitized to Trichophyton anti- gen were enrolled. Group I included 12 patients showing positive results on Trichophyton bron- choprovocation test(BPT), group II included 21 patients showing negative results on Trichophyton-BPT, and group III included 19 controls showing negative results to Trichophyton antigen on skin prick test. Allergy skin prick test including Trichophyton as well as common inhalant allergens was done. To confirm bronchial sensitivity, BPT with Trichophyton extract was performed. Serum specific IgE, IgG1 and IgG4 antibodies by ELISA were done using Trichophyton mentagrophytes antigen and then compared with specific IgE results by RIA using Trichophyton tonsurans. RESULTS: Although there were no significant differences in asthmatic duration, total eosinophil count and skin reactivity(p>0.05, respectively), significant difference was noted in methacholine PC20 (p<0.05) between group I and II. There were no significant differences in specific IgE and IgG4 level between group I and group II (p<0.05). Specific IgE and IgG4 levels were significantly higher in group I than in group III (p<0.05, respectively). Two of group I patients had high specific IgG4 without specific IgE. There was no relationship between skin reactivity to Trichophyton mentagrophytes and specific IgE level. Positive predictive value of RIA for Trichophyton BPT was higher than that of ELISA. CONCLUSION: These results suggest that Trichophyton inhalation induces bronchoconstriction by IgE mediated mechanism. Trichophyton antigen should be included in skin prick test battery to screen causative agents for asthmatic patients. Further studies will be needed to evaluate the roles of specific IgG in Trichophyton-asthma.

Clinical features of anaphylaxis patients caused by Pachycondyla chinensis / 천식및알레르기

BACKGROUND AND OBJECTIVE: There have been a few cases of anaphylaxis caused by a sting from Pachycondyla chinensis (PC). This study was conducted to observe clinical features of seven PC-induced anaphylaxis patients, and to evaluate the role of serum specific IgE and IgG4 antibodies. MATERIAL AND METHOD: Seven patients with PC-induced anaphylaxis and 15 unexposed heal- thy controls were enrolled. PC was collected at patients' home and prepared as PC extract. Four patients had complained of bee and wasp sting anaphylaxis. Serum specific IgE and specific IgG4 antibodies were detected by ELISA. Positive cut-off value for specific IgE and specific IgG4 was decided as mean plus 2xS.D. of absorbance value of controls. RESULTS: There were six(86%) female subjects and one male subject. Five(71%) patients resided in Kyoung-Ki do. Four(57%) patients had positive allergy skin prick test to ant antigen. Four (57%) patients had other allergic diseases such as asthma, urticaria and allergic rhinitis. Four(57%) patients had experienced anaphylaxis after bee and wasp sting. All patients had positive serum specific IgE and six(86%) patients had positive serum specific IgG4. CONCLUSION: IgE-mediated reaction contributed to development of PC-induced anaphylaxis. Specific IgG4 does not seem to have a protective role in PC-induced anaphylaxis patients. Further studies will be needed to evaluate a possible cross-reactivity between ant, and bee venoms.

The early changes of humoral immune response after rush immunotherapy with Dermatophagoides farinae (D.f) and Dermatophagoides pteronyssinus (D.p) in house dust mite sensitive asthmatic children / 천식및알레르기

PURPOSE: Rush immunotherapy (RIT) with house dust mite may be effective to treat house dust mite allergic disease, but the mechanisms are not clear. Considerable attention has been devoted to the IgG subclass in relation to clinical outcome. Usually, conventional immunotherapy with D.f and D.p is followed early on by a rise in allergen-specific IgG1 with a gradual decline over time and slow rise in allergen-specific IgG4. Some investigators have implicated that IgG4 is a more important blocking antibody than IgG1 in RIT. But there is no consistent data on the early changes of allergen-specific IgG1 or IgG4. To inves- tigate the alteration of humoral immunity in the mechanism of early phase of RIT, the D.f -specific IgE, IgG1, and IgG4 levels of the RIT group were compared with that of the con- trol group with asthma. METHOD: The RIT group included 17 D.f and D.p-sensitized asthmatic children, who had received RIT with D.f and D.p, and the control group included 15 D.f and D.p-sensitized asthmatic children who had not received RIT. They received RIT to mite for just over 8 weeks until maintenance was achieved. The symptom scores of asthma, skin reactivity to D.f (allergen/histamine ratio), RIT changes of D.f-specific IgE, IgG1, and IgG4 levels were compared before and 8 weeks after for the two groups. D.f-specific IgE, IgG1, and IgG4 levels were measured by ELISA. RESULTS: The symptom scores and the skin reactivity to D.f decreased significantly 8 weeks after RIT. D.f-specific IgG1 levels increased significantly 8 weeks after RIT in the RIT group but not in the control group. But D.f-specific IgE and D.f- specific IgG4 levels did not change 8 weeks after RIT in either of the two groups. CONCLUSION: D.f-specific IgG1 production was increased in the early phase of RIT. These findings suggest that the early clinical changes after RIT may be linked to the early increase of IgG1 blocking antibody.