Timothy grass pollen sensitization in asthmatic egyptian children

Background: Allergic diseases are considered a major problem for healthcare systems in both developed and developing countries. Longitudinal epidemiologic studies have shown an increased prevalence of sensitization to common allergens, and increased prevalence of asthma, atopic dermatitis, food allergy, and allergic rhinitis in children. The increase in allergies is a phenomenon that is being observed in all fast-developing countries. For a long time, science has taken as a starting point that solely a genetic predisposition is a precondition for the development of an allergy. Today, knowledge of environmental factors that can alter genes or the transcription of genes in the cells, has improved

Aim of the Work: We aimed to investigate the rate of sensitization to Timothy grass pollen in a group of asthmatic Egyptian children in relation to other markers of disease expression. Our ultimate objective was to add information to the map of aeroallergen sensitization in our country

Patients and Methods: This analytical cross sectional study was conducted on children with bronchial asthma following up at the Pediatric Allergy and Immunology Clinic, Children's Hospital, Ain Shams University in the period from September 2017 to March 2018. The sample included 100 asthmatic patients who were enrolled consecutively. Patients were classified into intermittent and persistent Asthma according to the 2009 VA/DoD asthma management guidelines

Results: The current study revealed a high frequency of Timothy grass pollen [TGP] sensitization representing 61% of the studied sample. The diameter of wheal in sensitized children ranged between 3-7 mm with a median [IQR] of 4 [3- 4]. None of our subjects had wheal diameter >/= 8 mm, which denotes severe reaction. In our study, Patients with persistent asthma were more prone to be TGP sensitized [80.3%] than those with intermittent asthma [19.7%]. Sensitized children with persistent asthma showed larger wheal diameter [median= 4 mm, range: 4-7 mm] than those with intermittent asthma who showed smaller diameter [median= 3.5 mm, range: 3-4 mm]

Conclusion: Sensitization to TGP might point a persistent phenotype of pediatric asthma and may be linked to severity and need to step up and/or add on therapeutic options

Fish sensitization in a group of allergic Egyptian children

There are no published data on fish allergy in Egypt. We sought to screen for the frequency of fish sensitization in a group of atopic Egyptian infants and children in relation to their demographic and phenotypic data. We consecutively enrolled 87 allergic children; 1-15 years old [median 5.0 yr]. The study measurements included clinical evaluation for the site and duration of allergy, possible precipitating factors, and family history of allergy as well as skin prick testing with a commercial fish extract, and serum fish specific and total IgE estimation. Twelve subjects [13.8%] were sensitized to fish as evidenced by positive skin prick test [SPT] results; five [41.7%] of them gave a history suggestive of fish allergy compared to two [2.7%] of the non-sensitized children [p=0.00]. The SPT results did not vary significantly with age, gender, family history of atopy, or serum total or fish specific IgE [SpIgE]. Fish sensitization does not seem to be rare in atopic children in Egypt. It can be associated with any clinical form of allergy and the causal relationship needs meticulous evaluation. Wider scale population-based studies are needed to assess the prevalence of fish allergy and its clinical correlates in our country

Sesame seed sensitization in a group of atopic Egyptian children

Background: There are no published data on the prevalence of sesame allergy/sensitization in Egypt

Objective: In this pilot study, we thought to estimate the frequency of sesame seed sensitization in a group of atopic Egyptian infants and children

Methods: We consecutively enrolled 90 patients with physician diagnosed allergic disease. The study measurements included clinical evaluation for the site and duration of allergy, history suggestive of sesame seed allergy, and family history of allergy, as well as skin prick testing [SPT] using a commercial sesame extract, and serum sesame specific IgE [SpIgE] estimation

Results: None of the studied patients reported symptoms suggestive of sesame seed allergy. Nevertheless, two children [2.2%] showed positive SPT response to sesame [wheal diameter >/= 3 mm above the negative control]. Only one of them had a wheal diameter which exceeded that of the histamine control. The serum sesame SpIgE exceeded 0.35 IU/ml in all subjects [range = 0.35 - 3.0 IU/ml; median [IQR] = 0.9 [0.6] IU/ml]. Serum sesame SpIgE was significantly increased in patients with history of recurrent urticaria [p=0.03]

Conclusion: Sesame seed sensitization is not uncommon in atopic Egyptian children. It can be associated with any clinical form of allergy and the causal relationship needs meticulous evaluation. Wider scale population-based studies are needed to assess the prevalence of sesame allergy and its clinical correlates in our country

value of cord serum interferon-gamma estimation in the prediction of first year allergies

Background: it was previously assumed that interferon-gamma [IFN-[gamma]] underexpression in newly born infants could be a risk factor for atopic diseases

Objective: we sought to investigate the value of cord serum IFN-[gamma] in the prediction of infantile allergy and its possible correlations with other relevant markers

Methods: eighty mother-newborn pairs were enrolled consecutively at delivery. The family history of allergy was inquired about and then cord blood was tested for eosinophil and basophil counts and serum total IgE, IgD, and IFN-[gamma]. The infants were followed up for one year for subsequent development of allergic disorders

Results: twenty-eight infants [35%] developed first year allergies, of whom 19 [68%] had a positive family history of atopy. Atopic dermatitis constituted 57% of the forms of allergy detected. Cord serum IFN-[gamma] concentration at birth was significantly lower in infants who developed allergies during the first year of life [2.8 +/- 2 pg/ml] as compared to those who did not [13.6 +/- 6.1 pg/ml, p<0.05]. Only 11 cord serum samples [14%] contained detectable levels of total IgE. However, 64% of neonates with measurable cord serum IgE developed allergy subsequently. Cord serum IgD concentrations were below the detection limit [5 mg/L] of the method employed. Cord blood basophil, eosinophil and total leucocytic counts were negatively correlated to cord serum IFN [gamma] levels

Conclusions: our findings imply that the family history of atopy is still the most important predictor of allergy. Estimation of cord serum IFN-[gamma] in genetically predisposed babies might raise the predictive value