Screening of Shuanghuanglian Injection allergenic ingredients based on immune fingerprint / 中国中药杂志

In this paper,immune fingerprint was used to screen the allergenic components of Shuanghuanglian Injection(SHLI) by enzyme-linked immuno sorbent assay(ELISA) combined with HPLC/MS method. ELISA-embedded anti-IgE antibody could successfully adsorb allergens in SHLI and its plasma samples containing drugs through different routes of administration,suggesting that SHLI can induce type I hypersensitivity in rats. HPLC fingerprints and MS map of SHLI and drug-containing plasma samples from different routes of administration before and after anti-IgE antibody adsorption were established. According to the similarity evaluation of HPLC fingerprints and analysis results MS map,the sensitization of traditional Chinese medicine injections can be changed by different administration methods. There were 22 kinds of components that can be adsorbed by specific anti-Ig E antibodies in Shuanghuanglian Injection and its drug-containing plasma,most of them were acids and nitrogen compounds. Based on supramolecular theory,it was inferred that these compounds came from SHLI or body,and may form supramolecular hapten,which results in immunotoxicity and allergic reaction when being used as injection instead of oral liquid. Immune fingerprint is not only used to screen out single component allergen,but also more comprehensive,sensitive and easy to operate. It can provide reference for the future research methods of allergic reaction of traditional Chinese medicine injections.

Preparation of IgE high affinity receptor protein and its biological function identification / 重庆医学

Objective To prepare human alpha segment of high affinity IgE receptor(FcεRIα)protein by genetic engineering technology and to identify its biological function for laying the foundation for further researching the role of FcεRIα in allergic disea-ses.Methods The human FcεRIα gene was obtained by the PCR based accurate synthesis(PAS)method and the prokaryotic ex-pression vector pET-28a(+)was constructed.The FcεRIα was expressed at low temperature induction and the recombinant protein was purified by His tag.The biological function of recombinant human FcεRIα protein was identified by ELISA.Results The hu-man FcεRIα gene was amplified by PAS with a size of approximately 560 bp.The pET-FcεRIα plasmid was correct through the double enzyme digestion and sequencing identification.The human FcεRIα with a molecular weight of approximately 22 000 was in-duced and purified.The recombinant human FcεRIα could effectively detect human serum anti-FcεRIα autoantibody and could com-bined with serum IgE antibodies with high efficiency.Conclusion Human FcεRIα protein is successfully prepared,which prelimina-rily has the ability for detecting the human serum anti-FcεRIα autoantibodies and IgE antibodies,and provides a favorable practical base for further study.

Application of Milk Protein Challenge Test and Serum IgE Antibody Detection in Children with Milk Protein Allergic Diseases / 现代检验医学杂志

Objective To investigate the application effects of milk protein challenge test and serum specific IgE antibody de-tection in children with milk protein allergic diseases.Methods 76 cases of children with milk protein allergic diseases of North Hospital of the People’s Hospital in Urumqi City from January,2013 to December,2015 were treated with milk pro-tein challenge test.The clinical characteristics,results of milk protein challenge test and serum IgE antibody detection,and the value change of routine blood indexes were analysed and compared.Results Diarrhea and hematochezia were the most common clinical features,vomiting,hematemesis and abdominal distention were rare.47 cases (61.8%)showed positive re-sults in milk protein challenge test,and 29 cases (38.2%)showed negative results.42 cases of positive children had delayed allergy,and 5 cases showed rapid allergy.Compared with the negative group,the positive rate of serum specific IgE antibody in positive group didn’t change obviously,the difference was not statistically significant (14.9% vs 6.9%,χ2=0.466,P>0.05).The neutrophil count in positive group was higher after challenge than that of before challenge (t=2.480,P0.05).Conclusion Diarrhea and hematochezia were the most commom disease of digestive tract in children with milk protein allergic diseases.It is necessary to perform milk protein challenge test in clinical practice,however,serum specific IgE antibody is not considered as its diangnosis basis.

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.

Clinical Characteristics of Angioedema With Eosinophilia

Angioedema with eosinophilia (AE) is a very rare allergy disease, case reports of which have been published sporadically since 1984. Here, we retrospectively analyzed the clinical features of 10 AE patients in Korea. Nine of the 10 subjects were young females, ranging from 23 to 38 years old. Twenty percent of the subjects had episodic-type AE with high serum IgM and eosinophil counts, while 80% were non-episodic type with normal serum IgM levels but high eosinophil counts. All patients had used systemic corticosteroids to control AE. One patient with refractory episodic-type AE was treated with anti-IgE antibody. This is the first study to evaluate the clinical characteristics of AE in a Korean population.

Clinical Characteristics of Angioedema With Eosinophilia

Angioedema with eosinophilia (AE) is a very rare allergy disease, case reports of which have been published sporadically since 1984. Here, we retrospectively analyzed the clinical features of 10 AE patients in Korea. Nine of the 10 subjects were young females, ranging from 23 to 38 years old. Twenty percent of the subjects had episodic-type AE with high serum IgM and eosinophil counts, while 80% were non-episodic type with normal serum IgM levels but high eosinophil counts. All patients had used systemic corticosteroids to control AE. One patient with refractory episodic-type AE was treated with anti-IgE antibody. This is the first study to evaluate the clinical characteristics of AE in a Korean population.

What Taiwan contributes to the world of allergy and clinical immunology?

In commemorate the 9th Asia Pacific Congress of Allergy, Asthma, and Clinical Immunology (APCAACI) in Taipei, Taiwan in November this year, some of the seminar works and contributions by the researchers from Taiwan to the advance in the field of allergy and clinical immunology, such as DNA vaccine, traditional Chinese medicine, anti-IgE antibody, and personalized medicine for severe drug allergic reaction, are summarized in this special review.

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 Features of Allergic Bronchopulmonary Aspergillosis in Korea

Allergic bronchopulmonary aspergillosis (ABPA) is a complex disease, triggered by a hypersensitivity reaction to the allergen Aspergillus fumigatus. This disease occurs frequently in patients with cystic fibrosis and severe asthma in Western countries, with a prevalence of 2%-15%. However, there have been only a few case reports in Korea. We investigated the clinical and immunological features of patients with ABPA. Ten adult patients diagnosed with ABPA, according to Greenberger's criteria, were analyzed during the period January 2001 to December 2010 in a tertiary hospital. Skin-prick tests, pulmonary function tests, and high-resolution computed tomography (HRCT) were performed, and total serum IgE and A. fumigatus-specific IgE were measured. The patient cohort consisted of men who were middle-aged (median, 62.5; range, 19.0-79.0 years) at the diagnosis of ABPA with a long duration of asthma (median, 15.0; range, 1-48 years). Approximately 40% of the patients had a history of pulmonary tuberculosis more than 10 years prior to the study (median 23.5; range, 10.0-31.0 years) accompanied by severe obstructive lung function and radiological post-tuberculous destructive lung lesions. These patients also tended to have increased levels of immunologic parameters, such as total eosinophil count, total IgE, and A. fumigates-specific IgE, compared to those without tuberculosis sequels. Two patients with steroid-dependent asthma were treated with anti-IgE therapy and showed good responses. We report the clinical features of 10 ABPA patients, including 4 with histories of post-tuberculosis destructive lesions. Furthermore, anti-IgE antibody therapy may be an alternative strategy in cases of steroid-dependent ABPA.

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.

Papel de los anticuerpos en la urticaria autoinmune / Antibodies role in autoimmune urticaria

Autoimmune urticaria occurs in patients in whom there are functional autoantibodies directed against FcepsilonR1 and IgE. The antibodies concerned are of subtypes IgG1 and IgG3. It is generally more severe and treatment-resistant. The significance of diagnosing autoimmune urticaria is that patients can be offered an explanation for an otherwise unremitting and puzzling condition. It also opens up the prospect of effective treatment by immunomodulatory treatment in selected patients with autoimmune urticaria. The utologous serum skin test is used as a screening test for autoimmune urticaria. The sensitivity and specificity are about 80% respectively. The diagnosis can be confirmed by demonstrating release of histamine from target basophils or dermal mast cells. Treatment of autoimmune urticaria involves the use of low sedation H1 antihistamines in licensed dosages. Off-label dosages are used if the condition is still poorly controlled. Prednisolone can be used in acute and severe flare-ups. Immunomodulatory treatment with cyclosporin can be considered in recalcitrant cases.

La urticaria autoinmune aparece en pacientes que generan autoanticuerpos funcionales contra el FcepsilonR1 y la IgE. Los anticuerpos involucrados pertenecen al subtipo IgG1 e IgG3. Generalmente es una forma de urticaria más grave y resistente al tratamiento. La importancia de diagnosticar urticaria autoinmune radica en que al hacerlo los enfermos pueden recibir una explicación acerca de una enfermedad desconcertante y que habitualmente no remite. En casos seleccionados de urticaria autoinmune también se abre un espectro de tratamientos eficaces que incluyen terapias inmunomuduladoras. La prueba de suero autólogo se utiliza como estudio de rastreo para esta patología. La sensibilidad y especificidad son cercanas al 80%. El diagnóstico puede confirmarse mediante la demostración de liberación de histamina de basófilos o células cebadas de dermis. El tratamiento de la urticaria autoinmune consiste en la utilización de antihistamínicos H1 con escaso efecto sedante en las dosis recomendadas. Las dosis superiores a las habituales se utilizan en pacientes en quienes la enfermedad se controla escasamente. En casos agudos y durante las exacerbaciones puede administrarse prednisolona. El tratamiento inmunomodulador con ciclosporina puede considerarse en casos refractarios.

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.

Effects of Exercise on IgE Antibody Production of Type I Allergic Reaction in Mice and Rats / 日本温泉気候物理医学会雑誌

The present study was carried out on mice and rats to examine the effects of running and swimming on immune responses, particularly IgE antibody and hemagglutinin (HA) production. In the experiment with running mice, four-week old mice were divided into four groups. The first group of mice started running at the age of four weeks (E4 group), the second group started running at the age of seven weeks (E7 group), the third group started running at the age of 10 weeks (E10 group), and the fourth group was a control that received no treatment. In the experiment protocol, each group was subjected to running exercise until the age of 13 weeks. Each group of mice was forced to run at a speed of 15m/min on a flat floor with no slope for 60min a day. In the E4 group, IgE antibody production was suppressed without affecting HA production. In the E7 and E10 groups, neither IgE antibody production nor HA production was affected. In the experiment with swimming rats, seven-week old rats were divided into two groups: the swim group and the control group. The swim group was forced to swim for five days for three 15-min sessions a day loaded with an iron ring weighing 3% of the body weight. The control received no treatment. In the swim group, IgE antibody production was suppressed without affecting HA production. From these results, it might be concluded that running exercise and swimming exercise from early childhood will provide favorable influences on some asthmatic diseases by suppressing IgE antibody production.

Sputum induction method for studying total IgE levels in atopics asthamtic patients / 천식및알레르기

BACKGROUND: IgE antibodies have been considered to play an important role in the pathogenesis of atapic asthma. However, there have been only few studies on the role of IgE in airway secretion in the pathogenesis of bronchial asthma. This might be partly due to difficulty in sampling of airway seceretion from asthmatic patients. Recently, sputum induction method by inhalation of nebulized hypertonic saline was developed, and proved to be valid and useful method for obtaining airway secretion from asthmatic patients for studying airway inflammation. OBJECTIVE AND METHOD: To evaluate the usefulness of sputum induction method for studying IgE antibodies in airway secretion from atopic asthmatic patients, total IgE levels in induced sputum from 54 atopic asthmatics were measured by enzyme-linked immunosorbent assay(ELISA) and tried to find an association with sputum eosinophilia. RESULT: Total IgE levels in induced sputum were significantly higher in atopic asthmatic patients(1.27+82.066 IU/ml) than in controls(0.203+0.291 IUgmP)(p5% of 200 counted leukocytes). There was a significant correlation of total IgE levels between induced sputum and serum in atopic asthmatic patients(r=0.60, p<0.05). Total IgE levels in induced sputum(1.278+ 2.066) were significantly higher than saliva sample(0.504 + 1.111 IU/ml) from atopic asthmatic patients(p<0.05). CONCLUSION: These results suggest that total IgE levels are increased in the induced sputum of atopic asthmat,ic patients and sputum induction method is a useful tool for studying IgE antibodies in airway secretion from asthmatic patients.