Analysis of serum allergen-specific immunoglobulin E in 3 051 patients with eczema or dermatitis in an allergy clinic / 中华皮肤科杂志

Objective:To analyze measurement results of serum allergen-specific immunoglobulin E (IgE) in patients with eczema/dermatitis.Methods:A retrospective analysis was conducted on serum allergen-specific immunoglobulin E (IgE) levels in 3 051 patients with eczema/dermatitis, who visited the allergy clinic of Huashan Hospital from April 1, 2021 to March 31, 2022. The serum allergen-specific IgE level was detected by using the Phadia allergen detection system, and positive rates of allergens were calculated to determine common inhaled allergens and food allergens in patients with eczema/dermatitis. Comparisons of enumeration data between groups were performed by chi-square test.Results:Among the 3 051 patients with eczema/dermatitis, there were 1 412 with atopic dermatitis and 1 639 were other eczema/dermatitis. Detection of serum allergen-specific IgE showed that 1 629 (53%) patients were positive for allergens, and the number of positive allergen-specific IgEs in each patient was 3.0 ± 1.6. The top 3 common inhaled allergens in patients with eczema/dermatitis were Dermatophagoides farinae (904/1 522, 59%) , Dermatophagoides pteronyssinus (891/1 513, 59%) and Alternaria alternata (206/1 068, 19%) , and the top 3 common food allergens were shrimps (251/1 432, 18%) , egg white (165/992, 17%) and cow milk (149/994, 15%) . Among the 3 051 patients, 25 (1%) were aged < 2 years, 571 (19%) aged 2 - 12 years, 285 (9%) aged 12 - 18 years, and 2 170 (71%) were aged > 18 years. The most common food allergens were both egg white in the age groups of < 2 years and 2 -12 years (77%, 37%, respectively) , and were both shrimps in the age groups of 12 - 18 years and > 18 years (31%, 17%, respectively) . Dermatophagoides pteronyssinus and Dermatophagoides farina were the top 2 common inhaled allergens in all age groups, with the positive rate ranging from 36% to 84%; in addition, the positive rate of molds was relatively high in the age group of 2 - 12 years (mold mixture: 37%; Alternaria alternata: 27%) . From April 2021 to March 2022, the positive rate of outdoor allergens ranged from 10% to 15% among outpatients in every month; the positive rates of tree pollen and grass pollen increased from April 2021, and peaked in October 2021. The patients with atopic dermatitis showed a significantly increased positive rate of allergens (73%) compared with those with other eczema/dermatitis (37%, χ2 = 389.36, P<0.001) , and the rank of common allergens in the patients with atopic dermatitis was basically the same as that in those with eczema/dermatitis. Conclusions:The common allergens were Dermatophagoides farina, Dermatophagoides pteronyssinus and Alternaria alternata in the patients with eczema/dermatitis. Food allergy was more common in infant patients, and inhalation allergy was more common in child, adolescent and adult patients. The positive rate of allergen-specific IgEs was markedly higher in the patients with atopic dermatitis than in those with other eczema/dermatitis.

Analysis of the inhalant allergen spectrum in 4 488 children with allergic rhinitis in Tianjin / 中华实用儿科临床杂志

Objective:To investigate the types and characteristics of inhalant allergens in children with allergic rhinitis (AR) in Tianjin, and to provide foundation for the prevention and treatment of AR in children.Methods:The data of 4 488 patients with AR at the Pediatric Asthma and Allergy Clinic of the Second Hospital of Tianjin Medical University from March 2016 to February 2022 were collected and analyzed retrospectively in this study.The distribution features of inhalant allergens in AR children were explored.The relationship between the positive results of inhalant allergens and the gender, age and other comorbid allergic diseases was discussed.Serum allergen-specific immunoglobulin E (sIgE) was determined using the UniCAP100 system(fluorescent enzyme-linked immunoassay). Enumeration data were expressed as the number of cases and percentage (%), and data were compared between groups by χ2 test. Results:(1)In the serum of 4 488 AR patients, 3 116 cases were positive for inhalant allergens, with a positive rate of 69.43%.There were 28.47%(887/3 116) AR patients positive for 1 allergen, 25.22%(786/3 116) positive for 2 allergens, 19.67%(613/3 116) positive for 3 allergens, and 26.64%(830/3 116) positive for 4 or more allergens.The most common inhalant allergens were moulds (45.72%, 2 052/4 488), followed by dermatophagoides farinae (34.71%, 1 558/4 488), mugwort (33.95%, 313/922), dermatophagoides pteronyssinus (31.13%, 1 397/4 488), and ragweed (30.97%, 227/733). (2)The positive rates of inhalant allergens in preschool, school age and adolescent groups were 56.15%(1 132/2 016), 79.26%(1 624/2 049) and 85.11%(360/423), respectively ( χ2=309.72, P<0.001). The most common inhalant allergen in the preschool and school age groups was moulds (40.23%, 50.85%). In the adolescent group, dermatophagoides farina (56.74%) was the predominant inhalant allergen, followed by dermatophagoides pteronyssinus (53.66%) and moulds (47.04%). There were significant differences in the types of positive inhalant allergens among the 3 groups ( χ2=466.99, P<0.001). Children in the preschool group were mostly positive for single allergens, while those in the school age and adolescent groups were positive for 4 or more inhalant allergens.(3)The positive rate of inhalant allergens in boys reached 73.28%(2 139/2 919), significantly higher than that in girls (62.40%, 979/1 569) ( χ2=58.28, P<0.001). The top 3 common inhalant allergens in boys and girls were moulds, dermatophagoides farinae, and dermatophagoides pteronyssinus.There were significant differences in the types of positive inhalant allergens between boys and girls ( χ2=75.02, P<0.001). About 20.78% of the girls were positive for single allergens, and 20.45% of the boys were positive for 4 or more allergens.(4)The AR group complicated with asthma and atopic dermatitis had the highest positive rate (79.21%)of inhalant allergens, followed by AR patients with asthma (73.67%), AR patients with atopic dermatitis (61.05%) and AR patients (57.05%) successively.There were significant differences between the groups ( χ2=178.57, P<0.001). Conclusions:The main inhalant allergens in AR children in Tianjin are moulds, dermatophagoides farinae, mugwort, dermatophagoides pteronyssinus, and ragweed.The distribution characteristics of inhalant allergens vary with the age, gender and combined allergic diseases.Allergens should be detected for AR children as soon as possible, so as to prevent AR in advance, reduce drug use, and provide evidence for specific allergen immunotherapy.

Inter-Laboratory Comparison of Multi-Allergen-Specific Immunoglobulin E Screening Assay Using Polycheck Allergy Diagnostic / 임상검사와정도관리

BACKGROUND: Currently there is no external proficiency testing program for allergen-specific immunoglobulin E assays (sIgE) in Korea. The aim of this study was to evaluate the accuracy of sIgE performed in different laboratories in Korea using Polycheck Allergy Diagnostic (Biocheck GmbH, Germany) or simply ‘Polycheck’ and to further perform an inter-laboratory comparison of sIgE. METHODS: Three inter-laboratory trials were undertaken from June 2016 to December 2017 at nine institutions. Serum samples obtained from three patients who had a history of positive Polycheck results were used in each trial. A total of 59 allergens were evaluated from the standard panel, inhalation panel, and food panel. The acceptable rates (%) of classes 0–6 of the results were calculated using three different criteria, including the consensus of 80% participants of the College of American Pathologists (CAP), the most frequent value (MFV), and the Overall Misclassification Index Score (OMIS). RESULTS: The proportion of laboratories that showed acceptable results for CAP criteria, MFV, and OMIS were around 93.0%–97.7%, 66.3%–76.0%, and 0.1–1.3, respectively, in each trial. Under-performing institutes showed consistently higher (49/68, 72.1%) or lower (19/68, 27.9%) than acceptable results for all criteria. CONCLUSIONS: This is the first study evaluating the inter-laboratory variation of sIgE in Korea using various criteria. It was found that the acceptable rate could be altered based on changes in these criteria. These findings might be useful for the inter-laboratory comparison of sIgE in Korea in the future as well.

Increasing Prevalence of the Sensitization to Cat/Dog Allergens in Korea

BACKGROUND: Recently, the number of domestic pets has increased. As a consequence, sensitization to animal allergens, such as cat or dog allergens, has become a problem. OBJECTIVE: We studied the annual trends of sensitization to cats or dogs, and the characteristics of the patients. METHODS: We retrospectively analyzed the medical records of 7,469 patients who visited a dermatology clinic and underwent an allergic profile test, from January 2011 to December 2015. Specific immunoglobulin E (IgE) levels to cat or dog antibody greater than 3.50 IU/ml were regarded as positive results. RESULTS: In all, 274 patients showed significant increase in levels of specific IgE antibody to dog, and 307 revealed increase in levels of of specific IgE antibody to cat. The prevalence of these specific IgEs increased from 2011 to 2015. Independent risks for sensitization to cat allergens were sensitization to dog, but not to house dust, Dermatophagoides pteronyssinus, and D. farinae. Independent risks for sensitization to dog allergens were sensitization to cat, but not to house dust, D. pteronyssinus, and D. farinae. Total IgE level was not related to specific IgE level against either cats or dogs. CONCLUSION: In conclusion, the prevalence of sensitization to cat or dog has increased. Sensitization to cat or dog is related to each other, but is irrelevant to the total IgE level.

The clinical value of China Savin pollen extract used for skin prick test / 临床耳鼻咽喉头颈外科杂志

The aim of this study is to evaluate the effectiveness and safety of China Savin pollen extract which was used for skin prick test (SPT) in the diagnosis of China Savin pollen allergy. Patients with diagnosis of allergic diseases were collected from Allergy Department of Peking Union Medical College Hospital. All patients were given SPT with China Savin pollen extract, and the mean wheal diameter (MWD) was measured after 15 minutes. Receiver operating characteristic curve (ROC) analysis was performed based on the results of serum specific immunoglobulin E (sIgE). The effectiveness of SPT in the diagnosis of China Savin pollen allergy was evaluated under different diagnostic cutoff values. Adverse events were also recorded to evaluate the safety. A total of 1 029 patients were enrolled in this study without drop out case. There were 1 007 patients in full analysis set (FAS) and 765 patients in per protocol analysis set (PPS). The elimination rate was 25.66%. The area under the ROC curve of FAS is 0.814 (95%: 0.788-0.839); which of PPS is 0.829 (95%: 0.801-0.857). Based on the ROC curve of PPS, the optimal and the 95% specificity diagnostic cutoff values of MWD were 3.25 mm and 4.75 mm respectively. Based on different diagnostic cutoff value (3.00, 3.25 and 4.75 mm), the sensitivities of SPT with China Savin pollen extract were 0.740 0 (95%: 0.701 6-0.778 4), 0.700 (95%: 0.659 8-0.740 2) and 0.532 (95%: 0.488 3-0.575 7) respectively, whereas the specificity was gradually increased in sequence, which was 0.769 8 (95%: 0.719 1-0.820 5), 0.826 4 (95%: 0.780 8-0.872 0) and 0.950 9 (95%: 0.924 9-0.976 9) respectively. There were 7 adverse events observed among 6 patients (rate: 0.583%, 6/1 029). The manifestation was mild. There was no severe adverse event. SPT with China Savin pollen extract is an effective and safe tool for the diagnosis of China Savin pollen allergy. The effectiveness of diagnosis could be improved based on integration of medical history and different diagnostic threshold values of SPT.

Development and Performance Evaluation of External Quality Controls for Allergen-Specific Immunoglobulin E Tests

BACKGROUND: Many companies have developed different methods and products for allergen-specific immunoglobulin E (IgE) tests. Because there is no standardised reference method, external quality assessment (EQA) is important for allergen-specific IgE test to ensure the comparability and reliability of the results from different laboratories. We prepared specimens for EQA of allergen-specific IgE tests and evaluated their stability. METHODS: Four pooled sera with 24 selected allergen-specific IgE levels were prepared and stored at −80℃. The stability of allergen-specific IgE levels was assessed on days 1, 7, and 14 at −20℃, 2℃ to 8℃, and 20℃ to 25℃, and then after 3 months at −80℃. Mock proficiency tests were performed with the four sets of prepared external quality controls for six laboratories, using the commercial multiple allergen simultaneous test (MAST) methodology. RESULTS: About 150 specimens (650 µL each) for EQA were prepared; randomly selected specimens showed similar IgE levels for the 24 allergens (±1 class). The levels of allergen-specific IgE remained stable throughout the study period (P>0.05). Although mock survey results from six laboratories using four MAST assays revealed some variability with a difference (2–3 class), no consistent differences were observed through the allergens or MAST methods. Qualitative results from the mock survey showed 85.4% (cut-off of class 1) and 81.3% (cut-off of class 2) concordance with the results from ImmunoCAP (Phadia, Sweden). CONCLUSIONS: The pooled sera prepared for allergen-specific IgE tests might be adequate and useful for EQA.

УЛААНБААТАР ХОТЫН ХАРШЛЫН РИНИТТЭЙ 3-12 НАСТАЙ ХҮҮХДЭД ИЙЛДСИЙН ӨВӨРМӨЦ ИММУНОГЛОБУЛИН Е ТОДОРХОЙЛСОН ҮР ДҮН / Шинэ санаа Шинэ нээлт

@#BACKGROUND. In our country, the allergic rhinitis spreads through 23,5% of adults and asthma spreads through 20.9% of children. The allergic rhinitis causes rhinosinusitis, rhino polypus, inflammation of respiratory tract, middle ear infection, breath with mouth, insomnia or sleepless and losing of life quality. Therefore it affects badly on children’s focusing and grades. Aim: To detect the specific immunoglobulin E for 3-12 years old children with allergic rhinitis. Goals: 1. To detect the specific immunoglobulin E for 3-12 years old children with allergic rhinitis , to take a skin test from 7-12 years old children 2. to detect the specific immunoglobulin E for 20 children of control group METHODS. We did an otolaryngologic examination and took an anamnesis of “Allergic rhinitis and its impact on asthma” that from the international organization. We detected the specific immunoglobulin E with aeroallergens and 40 types of food allergens for 3-6 years old 20 children with allergic rhinitis and 20 healthy control group children in their peripheral blood by using Agnito BIO Lc, the allergic panel from Taiwan. Did skin test with positive and negative control for 7-12 years old 20 children by 40 types of diagnosing devices that from Allergopharma /from German/, Lofarma /from Italy/ firms. We produced the study results and did statistic information on SPSS 23 program. RESULTS. We did the allergic test in peripheral blood of 3-6 years old children following the standard of allergen-specific IgE and produced the results. 3 of them /19 children/were sensitive for epidermis of dog, cat and horse /15.7%/. All of them were sensitive for ground plants /100%/, 12 of them/63,1%/ were very sensitive/32+/ for mugwort, and 16 /84,2%/of them were sensitive for herbs, 14 /73,6%/ of them were sensitive for other allergens such as resin, candida. And 6 /31,5%/ of them were sensitive for mites. 8 of them were sensitive for food allergens additionally /42,1%/.12 of 17 children who had a skin test were sensitive for mugwort /70,5%/, 9 of them were sensitive for trees/aspen, hus, pinaster/ /52,9%/. There was any sensitiveness for house dust and container dust mite for 7-12 years old 17 children. It shows that there might be immunity for this age. CONCLUSION. The boys with allergic rhinitis were more than girls about 61,1%. It shows that the allergic rhinitis occurs in boys more than girls.3-6 children were sensitive /97,2%/ for ground plantsand sIgE level 7.26±5.18. 7-12 years old 20children were sensitive for herbs and mugwort more /94,1%/.

Clinical characteristics in patients with allergic rhinitis and nonallergic rhinitis in Guangzhou / 中国耳鼻咽喉头颈外科

OBJECTIVE To obtain and compare the clinical characteristics in patients with allergic rhinitis(AR) and nonallergic rhinitis(NAR) and investigate the trends in the proportion of AR and NAR in recent 10 years in Guangzhou. METHODS 5486 patients with nasal hyper-reactivity symptoms were divided into the AR group and NAR group. Clinical data including gender, age distribution and seasonality were analyzed. RESULTS The trends in the proportion of AR and NAR during the past decade did not change significantly. Male made up the majority of AR patients and NAR patients and AR patients were significantly younger than NAR patients. Male AR patients were significantly younger than females, while there were no significant difference in the age distribution among the male NAR patients and female ones. As the age increasing, the proportion of AR and NAR patients in overall study population present opposite tendency. The main onset season in AR was summer and in NAR was winter in Guangzhou city. CONCLUSION There were significant differences between AR and NAR in age, gender and seasonality. However, the trends in the proportion of AR and NAR in recent 10 years did not change significantly in Guangzhou.

Correlation analysis of pediatric allergic rhinitis symptoms with house dust-mite-specific IgE and the household environment dust mites allergens / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore the correlation of allergic rhinitis symptoms in preschool children with the household environment dust mites and house dust-mite-specific IgE, as to provide theoretical basis for pediatric allergic disease prevention and control work. METHODS The children with rhinitis who was born in the Second People's Hospital of Wuhu were selected in this study. When the children were 3 or 4 years old, they were followed up. The allergic rhinitis symptoms integral of the children were evaluated, the household environment dust samples of the children were collected. The content of dermatophagoides pteronyssinus allergen components 1(Der p1) and dermatophagoides farinae allergen components 1(Der f1) in dust samples were determined by the method of enzyme-linked immunosorbent(ELIEA). The children house dust-mite-specific serum IgE(sIgE) level was also examined. RESULTS Pediatric allergic rhinitis symptoms had a positive correlation with dermatophagoides pteronyssinus sIgE and dermatophagoides farinae sIgE(P0.05). CONCLUSION The allergic rhinitis symptoms of the children are positively correlated with household environment dust mites and dust mites specific IgE. That indicated the severity of allergic rhinitis symptom in children may be determined by detecting specific IgE levels. The prevention of allergic disease and improvement the quality of life of the allergic children can be done by strengthening the health education of dust mites and decreasing the content of bedroom environment dust mites.

Analysis on the allergens specific IgE in patients with allergic diseases / 国际检验医学杂志

Objective To explore the positive distribution characteristics of common allergen specific immunoglobulin E(slgE)in patients with suspected allergy in the Affiliated Zhongshan Hospital of Sun Yat-sen University.Methods Fluorescence enzyme linked immunosorbent assay was used to detect the serum sIgE antibody of 1 884 patients with suspected allergy diseases,including four kinds of inhalant allergens combinations (dust mites,mold,animal skin,pollen)and four kinds of food allergens combinations (seafood,cereals,meat,dairy products)from March to October 2014.The slgE expression situation of different allergen,different gender and age in allergic patients were compared.Results The slgE positive rates of dust mites,animal fur,mildew,pollen in in-haled allergens were 73.9%,8.5%,6.5%,4.0%.The positive rates of seafood,dairy products,cereals,meat in food allergens were 47.8%,31.5%,23.0%,8.5%.The slgE positive rate of patients with allergic diseases who were allergic to two kinds or more mixed allergens was up to 82.0%,and often allergic to dust mites and animal fur.The slgE positive rate of different gender had no significant difference (P >0.05).The slgE positive rate decreased as age increased.Conclusion Dust mites are the main inhalant al-lergens combination,seafood,dairy products and cereals are the main food allergens combinations.Patients with allergic disease are allergic mixed allergens.SlgE positive rate decreases with increasing age.

Distribution characteristics and clinical significance of specific immunoglobulin E of 29 kinds of food and inhalation allergens in atopic dermatitis children / 中华实用儿科临床杂志

Objective To investigate the distribution characteristics in the positive ratio distribution of serum allergen specific immunoglobulin E (sIgE) in atopic dermatitis children with multiple sensitization factors,which could help to assess the atopic condition and offer recommendation for the avoidance of allergens.Methods A total of 90 children with atopic dermatitis were enrolled(male 66,female 24,aged 0.3-16.1 years).All the patients were divided into 3 groups according to the patients' age:0-3 years old group (48 patients),4-7 years old group (31 patients),8-16 years old group (11 patients).The serum sIgE levels of 29 kinds of food and inhalation allergens in each patient were detected by the UniCAP 250 quantified IgE measurement system.Results The positive ratio of each food allergen in all the patients were as follows:55.6％ (50/90 cases) for egg white,42.2％ (38/90 cases) for milk,32.2％ (29/90 cases) for egg yolk,12.2％ (11/90 cases) for shrimp,11.1％ (10/90 cases) for crab,7.8％ (7/90 cases) for chicken,4.4％ (4/90 cases) for fish,54.4％ (49/90 cases) for wheat,37.8％ (34/90 cases) for peanut,34.4％ (31/90 cases) for soybean,33.3％ (30/90 cases) for tomato and 28.9％ (26/90 cases) for peach.The positive ratio of each inhalation allergen in all the patients were as follows:51.1％ (46/90 cases) for house dust,45.6％ (41/90 cases) for alternaria alternata,41.1％ (37/90 cases) for dermatophagoides pteronyssinus,40％ (36/90 cases) for dermatophagoides farinae,33.3％ (30/90 cases) for dog dander,28.9％ (26/90 cases) for cockroach,27.8％ (25/90 cases) for cat dander,21.9％ (19/90 cases) for blomia tropicalis,36.7％ (33/90 cases) for ambrosia elatior,34.4％ (31/90 cases) for white ash,32.2％ (29/90 cases) for london plane,32.2％ (29/90 cases) for artemisia vulgaris,31.1％ (28/90 cases) for common silver birch,27.8％ (25/90 cases) for willow,25.6％ (23/90 cases) for mountain juniper,25.6％ (23/90 cases) for humulus scandens and 25.6％ (23/90 cases) for chenopodium album.The positive ratios of sIgE for egg white,milk,egg yolk of patients in the 0-3 years old group were higher than those in the 4-7 years old group and 8-16 years old group (x2 =29.27,15.98,18.58,all P ＜ 0.05).The positive ratios of sIgE for dermatophagoides pteronyssinus,dermatophagoides farinae,blomia tropicalis,cat dander,mountain juniper,humulus scandens of patients in the 8-16 years old group were higher than those in the 0-3 years old group and 4-7 years old group (x2 =12.94,14.31,7.77,7.65,9.41,6.93,all P ＜ 0.05).The positive ratios of sIgE for food allergens and animal dander in the patients of diagnosed as atopic dermatitis alone were higher than those of diagnosed as atopic dermatitis combined with asthma or allergic rhinitis.The positive ratios of sIgE for common inhalation allergens in the patients diagnosed as atopic dermatitis alone were lower than those diagnosed as atopic dermatitis combined with asthma or allergic rhinitis.Conclusions Allergens such as animal protein,house dust,mites and molds are the main sensitization allergens for atopic dermatitis children with multiple sensitization factors.Atopic dermatitis children in 0-3 years old group often presented sensitiveto food allergens,while those in 8-16 years old group are more commonly sensitive to inhalation allergens.Patients diagnosed as atopic dermatitis alone are often presented sensitive to food allergens and animal dander,while those diagnosed with asthma or allergic rhinitis are more commonly sensitive to inhalant allergens.

Distribution characteristics and clinical significance of specific immunoglobulin E in asthmatic and allergic rhinitis children with multiple sensitization factors / 中华实用儿科临床杂志

Objective To evaluate the distribution characteristics of the positive ratio of serum allergen specific IgE (sIgE) in asthmatic and allergic rhinitis children with multiple sensitization factors,which may be beneficial for recommendations on the avoidance of allergen and assessment of atopic disease.Methods A total of 128 children with asthma and allergic rhinitis were enrolled(93 male,35 female,aged from 1.5 to 16.1 years old,and the average age was 7 years and 8 months).All of the patients were presented as positive allergic screening test results for 2 or more kinds of allergen when evaluated.Eighty-seven patients were diagnosed as asthma combined with allergic rhinitis,while 38 cases with allergic rhinitis and 3 cases with asthma.The serum sIgE levels to 29 kinds of inhalant allergens and food allergens for each patients were detected by the UniCAP250 quantified IgE measurement system.Results The positive ratios of each inhalant allergen for all the patients were as follows:67％ for House dust,61％ for Dermatophagoides pteronyssinus,59％ for Dermatophagoides farinae,50％ for Alternaria alternata,42％ for Blomia tropicalis,29％ for Cat dander,23 ％ for Dog dander,11％ for Cockroach,32％ for Artemisia vulgaris,29％ for Humulus scandens,28％ for White ash,26％ for Ambrosia elatior,24％ for Willow,24％ for Mountain juniper,24％ for London plane,24％ for Humulus scandens,22％ for Chenopodium album and 20％ for Common silver birch; the positive ratios of each food allergen were as follows:25％ for Milk,25％ for Egg white,7％ for Shrimp,6％ for Crab,6％ for Egg yolk,4％ for Chicken,2％for Fish,31％ for Wheat,20％ for Peanut,17％ for Soybean,27％ for Peach and 21％ for Tomato.Sixty-five patients with positive results to food allergens were divided into food allergen sensitization group while the other 53 patients for food allergen non-sensitization group.The positive ratios of different inhalant allergens such as Dog dander,Alternaria alternate,Common silver birch,Mountain juniper,London plane,Willow,White ash,Ambrosia elatior,Artemisia vulgaris,Chenopodium album,Humulus scandens of children in the food allergen sensitization group were 35.4％,60.0％,39.7％,41.5％,43.1％,43.1％,46.2％,43.1％,55.4％,40.0％,44.6％,which were higher than those in the food allergen non-sensitization group(11.1％,39.7％,1.6％,6.3％,4.8％,4.8％,9.5％,7.9％,7.9％,3.2％,3.2％,respectively,all P ＜ 0.05).The positive ratios of Dermatophagoides pteronyssinus,Dermatophagoides farinae and House dust in the food allergen non-sensitization group were 69.8％,69.8％,76.2％,respectively,which were higher than those in the food allergen sensitization group (52.3％,49.2％,58.5％,respectively,all P ＜ 0.05).Eightytwo point eight percent of the children with asthma combined with allergic rhinitis and 73.7％ of the children with allergic rhinitis were sensitive to 3 or more kinds of inhalant allergens.Conclusions Inhalant allergens such as house dust,mites and molds were the main sensitization allergen for asthmatic and allergic rhinitis children with multiple sensitization factors.The asthmatic and allergic rhinitis children with food allergens sensitization often presented sensitive to animal dander,molds and outdoor inhalant allergens,while those without food allergens sensitization were more commonly sensitive to indoor allergens.

Comparison of the Effects of Breast Milk Feeding with Maternal Restriction and Hypoallergenic Milk Feeding on the Acquisition of Tolerance to Cow Milk / 소아알레르기및호흡기학회지

PURPOSE: The aim of this study was to compare the effects of breast milk (BM) feeding with those of maternal cow milk (CM) restriction and extensively hydrolyzed CM formula feeding on the duration of CM allergy as well as changes in specific immunoglobulin E (IgE) levels in infants with CM allergy. METHODS: Children diagnosed with CM allergy before 12 months age and BM fed were included retrospectively. CM allergy was diagnosed by CM specific IgE over 0.35 kU/L and 1) obvious clinical symptoms, 2) a suspicious history with positive provocation test, or 3) CM specific IgE over the 95% positive predictive value and subsequent documented report of clinical symptoms. The patients were classified into three groups by feeding regimen: BM group, extensively hydrolyzed formula (eHF) group, or mixed feeding (MF) group. Analysis of the groups regarding the duration of food allergy and changes in CM specific IgE was then performed. RESULTS: Forty-six children were included. Twenty-four children were in the BM group, 13 children were in the eHF group, and 9 children comprised the MF group. Thirteen patients reached tolerance. The means of the tolerance age were 69.7+/-5.4 months in the BM group, 36.6+/-4.6 months in the eHF group, and 38.2+/-7.9 months in the MF group. The survival curves of tolerance showed significant difference among the three groups (P=0.04). CM specific IgE levels measured at a second time period were 9.6 kU/L (interquartile range, 3.6-44.2) in the BM group, 2.0 kU/L (1.0-18.0) in the eHF group, and 4.8 kU/L (0.2-10.4) in the MF group (P=0.04). CONCLUSION: Feeding regimen influences the duration of CM allergy. Exclusively BM-fed children achieved tolerance later than eHF-fed children. Prospective and randomized controlled studies are required.

Distribution of Specific Immunoglobulin E and Total Immunoglobulin E in Children with Respiratory Allergic Disease / 实用儿科临床杂志

Objective To study the distribution of sepecific immunoglobulin E(SIgE) and its relationship with the total immunoglo-(bulin) E(TIgE) in children with respiratory allergic disease.Methods Serum SIgE was measured in 209 children with asthma,allergic rhinitis,cough variant asthma and asthmatic bronchitis by Pharmacia UniCAP100E system.The SIgE included the SIgE antibodies to fx5E(egg albumen,milk,fish,wheat,peanut,soybean),hx2(house dust,dermatophagoides culinae,dermatophagoides pteronyssinus,cockroach),ex1(scurf of cat,horse,cow and dog),mx1(penicillium notatum,helminthosporium halodes,aspergillums furngatits,alternaria allcrnata,),f23(crab),f14(shrimp),w14(amaranthaceae),T21(cajeput) and i8(moth).Serum TIgE was also detected in 132 patients.Results 1.The positive detection rate of SIgE in patients aged from 3 to 14 years were 72.81% which were higher than that of aged from 40 days to 3 years old(57.89%).2.The SIgE detection rate of fx5E,hx2 and ex1 were 81.8%,32.73% and 16.36% respectively in patients aged from 40 days to 3 years old;but that of hx2,fx5E,i8,w14,f24 and ex1 were 78.31%,48.19%,24.10%,24.10%,15.66% and 15.66% respectively in patients aged from 3 to 14 years.3.The positive detection rate of SIgE was related with that of TIgE.The detection rate of combined SIgE and the TIgE was 83.33%.Conclusions 1.The lower detection rate of SIgE in patients aged from 40 days to 3 years may be due to the wheezing in infants partially induced by the acute infection and congenital airway disease.2.The most common allergens in children aged from 40 days to 3 years were fx5E,hx2 and ex1.But that of patients aged from 3 to 14 years were hx2,fx5E,i8,w14,f24 and ex1.3.The combined detection of the SIgE and the TIgE may increase the positive rate and diagnose the patients with respiratory allergic disease effectively.

Combined Use of Allergen Skin Prick Test and Specific Immunoglobulin E Antibody on Allergen Diagnosis in Asthmatic Children / 实用儿科临床杂志

Objective To analyze the advantages of combined analysis of allergen skin prick test(SPT)and phadiatop/specific IgE antibody on the allergen diagnosis in asthmatic children.Methods Inhalant allergen SPT and Phadiatop test were done in 57 asthmatic children.Thirty-three cases of those asthmatic children were measured serum specific IgE antibody against dermatophagoids pteronyssinus.Results Dermatophagoids,molds and pets were the main inhalant allengens in asthmatic children.The positive rates of SPT and Pha-(diatop) in 57 asthmatic children were 86% and 79%,respectively,and the consistence rate between SPT and Phadiatop was 86%.Five cases with negative Phadiatop were confirmed to have molds allergy via SPT and molds specific IgE test.The consistence rate of dermatophagoids pteronyssinus SPT and specific IgE was 97%.Conclusion It is helped to improve the sensitivity and specificity of allergen diagnosis in asthmatic children when doctors combined analyze the results of allergen skin prick test and specific IgE test.

Detection Rate of Allergen-Specific IgE by Multiple Antigen Simultaneous Test-Immunoblot Assay / 대한진단검사의학회지

BACKGROUND: A new multiple antigen simultaneous test (MAST) has recently been introduced that is simple, rapid, and economical, and requires a small amount of serum samples. We evaluated the MAST-immunoblot assay (AllergyScreen; R-Biopharm, Darmstadt, Germany) for its specific antigen detection rate, and the results were interpreted based on the cut-off levels of classes 0.5, 1.0, 2.0, and 3.0 and correlated with clinical information. METHODS: A total of 166 allergic patients were tested by AllergyScreen (AS) for 10 specific allergens and the results were compared with skin prick test (SPT, cut-off=2+) or specific IgE (cut-off=class 1) on Uni-CAP system (uCAP). Thirty-five healthy subjects considered as truly negative for all allergens were also tested by AS to get the best cut-off level using the receiver operating characteristics (ROC) curve analysis and to evaluate its clinical specificity. RESULTS: The sensitivities (AS/uCAP, 73-31% and AS/SPT, 27-63%), specificities (AS/uCAP, 89-100% and AS/SP, 81-97%), and agreements (AS/uCAP 71-82% and AS/SPT 77-80%) varied with the cut-offm levels used and allergens tested. The overall linear regression equation was Y=0.69X+0.10, R=0.81 (P0.5 class and efficiency was 82% (AS/uCAP) and 75% (AS/ SPT). However, 25 (71%) of the healthy subjects showed positive reactions (0.6-4.0 class) to at least one allergen. CONCLUSIONS: Using an appropriate cut-off, AS/uCAP showed the sensitivity, specificity, and agreement at an acceptable level, and similar or better results compared with previous reports on MAST/ SPT. The AS can be an efficient way of testing for specific allergens in the clinical laboratory or at the physician's office. But, in view of the positive reactions in the healthy subjects, a class of less than 4.0 on AS must be integrated with clinical information for an appropriate data interpretation.