Principais agentes sensibilizantes na dermatite de contato alérgica em pacientes de um hospital da região oeste de Santa Catarina / Main sensitizing agents involved in allergic contact dermatitis in patients of a hospital in western Santa Catarina, Brazil

Introdução: A dermatite de contato alérgica (DCA) corresponde a 20% dos casos de dermatite de contato, sendo recorrente em doenças ocupacionais e causa frequente de procura por profissionais dermatologistas e alergistas. Objetivo: Identificar os principais agentes sensibilizantes na dermatite de contato alérgica em um centro especializado em alergia do oeste de Santa Catarina. Metodologia: Trata-se de um estudo do tipo retrospectivo, descritivo, quantitativo e observacional, no qual se realizou a análise por meio de prontuários médicos de 394 pacientes que realizaram o teste de contato por dermatite de contato alérgica no período de 2018 a julho de 2020 no serviço de referência do oeste de Santa Catarina. Os agentes sensibilizantes avaliados no teste de contato foram conforme as baterias padrão (bateria padrão brasileira, bateria de cosméticos e higiene e bateria regional da América Latina). Foram realizadas análises de frequência para as variáveis qualitativas e avaliação da prevalência dos principais agentes sensibilizantes. Além disso, foram relacionados os principais agentes com as variáveis sexo e idade por meio do teste de Qui-quadrado de Pearson. Resultados: Os agentes sensibilizantes mais prevalentes foram: níquel (33,5%), PPD mix (23,2%), perfume mix (22,4%), fragrância mix (22,0%) e cobalto (18,9%). As substâncias mais prevalentes foram o níquel e o PPD mix, que são agentes sensibilizantes usados amplamente no cotidiano dos pacientes. Conclusão: A identificação dos alérgenos através do patch test possibilita aos pacientes a oportunidade de amenizarem a DCA provocada pelos agentes sensibilizantes encontrados.

Introduction: Allergic contact dermatitis (ACD) corresponds to 20% of contact dermatitis cases, being the most common type of occupational skin disease and a common cause of consultation with a dermatologist or allergist. Objective: To identify the main sensitizing agents involved in ACD at a specialized allergy center in western Santa Catarina, a state in the south of Brazil. Methodology: This retrospective, descriptive, quantitative, and observational study involved the review of medical records of all patients who underwent patch testing for ACD from 2018 to July 2020 in the allergy center. The sensitizing agents evaluated in the patch test followed the standard patch series (including the standard Brazilian patch series, cosmetic series, and regional Latin America series). Frequency analyses were performed for qualitative variables and to assess the prevalence of the main sensitizing agents. In addition, the main agents were correlated with sex and age variables using Pearson's chi-square test. Results: The most prevalent sensitizing agents were nickel sulfate (33.5%), PPD mix (23.2%), perfume mix (22.4%), fragrance mix (22.0%), and cobalt chloride (18, 9%). The most prevalent substances were nickel sulfate and PPD mix, which are widely used in patients' daily lives. Conclusion: The identification of allergens via patch testing provides patients with an opportunity to reduce ACD caused by the sensitizing agents identified.

Progress of biomarkers for the efficacy of allergen immunotherapy / 国际儿科学杂志

Allergen immunotherapy（AIT）is currently the etiological treatment for respiratory allergic diseases，which can change the natural course of the disease.However，due to the complexity of patients' autoimmune status，allergy triggers and their complicated relationship with AIT vaccines，there are still about 40% of allergic rhinitis and 10%-20% of asthma patients who respond nonoptimally or even don't show any response to AIT. Thus，searching biomarkers that can evaluate and predict the efficacy of AIT and optimize the AIT strategy has been a major focus and challenge in allergy field.Currently，several serologic biomarkers have been found to be associated with AIT efficacy in vitro，but their value as predictive biomarkers of AIT efficacy needs to be further verified. This article reviews the research progress of serologic candidate biomarkers for AIT efficacy.

Distribution characteristics of sIgE antibodies against four components of egg white in children with egg allergy / 临床检验杂志

Objective To investigate the distribution characteristics of serum sIgE antibodies against four allergenic protein components of egg white in children with egg allergy,and then clarify the clinical application value of single component-resolved diagnostics of egg allergy.Methods Serum samples from 197 children with egg allergy were collected.The levels of serum sIgE antibodies against four major allergenic protein components of egg white,including ovomucin,ovalbumin,ovotransferrin,and lysozyme,were detected by the light-excited chemiluminescence assay(LiCA),and the distribution characteristics of sIgE antibodies were analyzed.Results The positive rates of serum sIgE antibodies against ovalbumin,ovomucin,ovotransferrin,and lysozyme in 197 chlidren with egg allergy were 77.16%(152/197),70.56%(139/197),35.02%(69/197),and 18.27%(36/197),respectively.The positive rate of serum sIgE antibody against both ovomucin and ovalbumin was 30.45%.There was a weak correlation between the levels of sIgE antibodies against egg and the cumulative levels of sIgE antibodies against four allergenic protein components(r=0.266 8,P＜0.05).There were signifi-cant individual differences in the levels of serum sIgE antibodies against four allergenic protein components of egg white in the children with egg allergy.Conclusion There is individual heterogeneity in the levels of serum sIgE antibodies against four components of egg white in the children with egg allergy.The detection of sIgE antibodies against egg white components can distinguish different forms of egg allergies,which is of great value for the accurate diagnosis and precise desensitization of children's egg allergy.

Analysis of serum sIgE to allergens in children with respiratory allergic or infectious diseases / 临床检验杂志

Objective To investigate the distribution of serum allergens in children with respiratory allergic or infectious diseases,and then provide evidence for the prevention and treatment of children's respiratory allergic and infectious diseases.Methods The clinical data of 2 334 children aged 1 to 14 years old(median 5 years)visited Shengjing Hospital Affiliated to China Medical University from April 2019 to June 2022 were retrospectively analyzed.All the children were diagnosed with respiratory allergic or infectious diseases.The Phadia 250 automatic fluorescence enzyme immunoassay system and its supporting detection reagents were used to detect serum sIgE to allergens and statistical analysis was conducted using the GraphPad Prism 8.0 software.Results The positive rates of sIgE to allergens in children with respiratory allergic diseases(n=1 151)and respiratory infectious diseases(n=1 183)were 75.85%and 47.68%,respectively.The main allergen in the children with asthma was a mixture of dust mites(44.18%),followed by a mixture of fungi(40.64%).The main allergens in the children with allergic rhinitis were a mixture of dust mites and weed pollen,both accounting for 52.51%.The common allergen of respiratory infectious diseases was mold mixture(27.81%),followed by a mixture of dust mites(24.77%).The main allergen in children under 7 years old was a mixture of fungi(33.31%).As age increased,the positive rates of allergens in different combinations increased.The positive rates of serum sIgE to dust mite mixture,dander mixture,and weed pollen mixture in children aged≥7 years old were significantly higher than those in children aged≤3 years old and 4-6 years old(P＜0.000 1).The positive rate of serum sIgE to allergens in male patients(64.33%)was significantly higher than that in female patients(56.33%,χ2=14.29,P=0.000 2).Among various disease groups,the levels of sIgE to dust mite mixture and weed pollen mixture were distributed at levels 1-6,with the highest distribution rate at level 6 in allergic rhinitis.Each disease group was associated with one allergen or a combination of two allergens.As the number of allergen combinations increased,the positive rate of sIgE gradually de-creased.The tIgE levels in children with allergic rhinitis were significantly higher than those in children with asthma,upper respiratory tract infection,and lower respiratory tract infection(all P＜0.005).Conclusion Dust mite mixture and mold mixture are common al-lergens in children with asthma,while weed pollen mixture and dust mite mixture are common allergens in children with allergic rhini-tis.As age increases,children become more and more allergic to dust mite,mold,dander,weeds,and pollen.

Analysis of detection results of food-specific IgE and IgG4 in children with allergic diseases / 临床检验杂志

Objective To investigate the clinical significance of the detection of food-specific IgE(fsIgE)and IgG4(fsIgG4)antibod-ies in the diagnosis and treatment of children's allergic diseases.Methods A total of 641 children with allergic diseases visited Hang-zhou Women's Hospital during November 2022 and November 2023 and 100 healthy children during the same period were selected,and the levels of fsIgE and fsIgG4 in their serum samples were detected.Results The total positive rates of fsIgE and fsIgG4 in children with allergic diseases were 37.44%and 90.48%,respectively,which were significantly higher than the 11.00%and 61.00%of healthy children(P＜0.05).The main food allergens in children were milk and eggs.The intensity of fsIgE was concentrated in the 1-2 level and the positive result for a single food was more common.The intensity of fsIgG4 was concentrated in Grade 3 and the positive results for multiple foods were more common.The comparison of the detection results of sIgE and sIgG4 to the same food showed that the posi-tive rate of sIgG4 was significantly higher than that of sIgE(P＜0.05),and the consistency between them was poor(κ＜0.4).There were no significant differences in the positive rates of fsIgE and fsIgG4 between different genders(P＞0.05).The highest positive rate of fsIgE was seen in the infant group and the highest positive rate of fsIgG4 was seen in the childhood group(P＜0.05).The positive rates of sIgE to egg protein,shrimp,crab,and cashew were mainly seen in children with skin diseases(P＜0.05).The positive rates of sIgG4 to egg and milk were mainly seen in children with respiratory diseases(P＜0.05).The positive rates of sIgG4 to shrimp and wheat were mainly seen in children with skin diseases(P＜0.05).Analysis of allergen components showed that the β-lactoglobulin,α-whey protein,and casein in milk and mucin in eggs were important allergenic components.Conclusion Food allergy is an important factor leading to children's allergic diseases.The combined detection of fsIgE and fsIgG4 can provide experimental basis for clinical di-agnosis and treatment as well as personalized dietary guidance of children.

Analysis of the epidemic characteristics of common allergens in 10 664 patients in Zhengzhou area from 2013 to 2021 / 临床检验杂志

Objective To invesitgate the epidemiological characteristics of common allergens in 10 664 patients with allergic diseases in Zhengzhou area.Methods A total of 10 664 patients visited our hospital and underwent serum allergen screening during January 2013 and August 2021 were selected,and their serum sIgE results were retrospectively analyzed.Results The total positive rate of sIgE to allergens in 10 664 patients was 69.82%.The positive rate of sIgE to inhalant allergens was significantly higher than that to in-gestive allergens(χ2=99.15,P＜0.01).The top three inhalant allergens were grass and tree combination,dust mite combination,and cockroach.The top three ingestive allergens were egg protein,milk,and seafood combination.The positive rate of sIgE to ingestive al-lergens in males was significantly higher than that in females(χ2=8.18,P＜0.01).The highest positive rate of sIgE to ingestive aller-gens was found in the early childhood period(χ2=125.92,P＜0.05).The highest positive rate of sIgE to inhalant allergens was found in the school-age and preschool periods(χ2=283.76,P＜0.01).The proportions of sIgE to cockroach and house dust mite showed a de-creasing trend year by year,while the proportions of sIgE to milk,peanut,lamb,and seafood combination showed an increasing trend year by year.Conclusion The top three inhalant and ingestive allergens in Zhengzhou area are grass and tree combination,dust mite,cockroach and egg protein,milk,seafood combination,respectively.In recent years,the allergies to milk,peanut,lamb,and seafood should be paid attention.

Analysis of external quality assessment results for compound allergen program performed by Shanghai Center for Clinical La-boratory / 临床检验杂志

Objective To evaluate the consistency of testing results for various items in the compound allergen program by conducting external quality assessment scheme.Methods The feedback results of external quality assessment for the compound allergen program performed by Shanghai Center for Clinical Laboratory(SCCL)during 2022 and 2023,including house dust mite,dust mite,cat hair,mugwort,terraced grass,milk,hazelnut,and peanut,were collected and analyzed.Results The compound allergen program was conducted four times,with 104,107,124,and 122 participating laboratories,and the qualification rates were 99.04%,99.07%,99.19%,and 100%,respectively.The specified values of the house dust mite,dust mite,and mugwort items were the same in each group,and the consistency of the results for different reagent groups was relatively high.There was inconsistency in the specified values(negative or positive)of cat hair and milk items between different reagent groups.The consistency of the results among the other rea-gent groups was high,except for the reagent used for detecting compound targets by which the terraced grass,hazelnut,and peanut al-lergens could not be detected.Conclusion The number of participating laboratories in the compound allergen program is gradually in-creasing,and the external quality assessment results of the 8 items covered are good.The overall qualification rate is high,and the con-sistency of reagents from different manufacturers is good.

Detection of sIgE antibodies to allergens in patients with allergic rhinitis in Lishui area / 临床检验杂志

Objective To investigate the distribution characteristics of inhalant and ingestive allergens in patients with allergic rhinitis(AR)in Lishui area,and then provide evidences for the clinical diagnosis,treatment and prevention of AR.Methods The detection data of serum sIgE antibodies to allergens from 1 610 patients with suspected AR visited the Department of Otolaryngology of Lishui Central Hospital during January 2020 and December 2022 were collected,and the distribution characteristics of various allergen spectra in AR patients were further analyzed.Results A total of 1 020 patients were diagnosed with AR and the positive rate of serum sIgE an-tibodies to allergens was 63.35%.The positive rate(66.59%)in male AR patients was significantly higher than that in females(59.48%,P＜0.01).The main allergen among AR patients in Lishui area was house dust mite.The top five inhalant allergens were house dust mite(77.94%),mixed mold(10.20%),cat dander(9.22%),tree pollen(5.88%),and dog dander(3.43%).The top five ingestive allergens were milk(23.33%),crab(7.75%),cashew nut(6.67%),shrimp(4.41%),and egg protein(3.33%).The positive rates of serum sIgE antibodies to milk,crab,and shrimp in males were significantly higher than that in females(P＜0.05).There were significant differences in the positive rates of serum sIgE antibodies to house dust mite,mulberry tree,cockroach,tree pol-len,and grass pollen among different age groups(P＜0.05).The positive rates of serum sIgE antibodies to egg protein,milk,crab,and amaranth were significantly different(P＜0.05).There were seasonal differences in the positive rates of serum sIgE antibodies to house dust mite,mulberry,mixed mold,tree pollen,and grass pollen(P＜0.05).Conclusion The allergens of AR patients in Lishui area are diverse and complex,and are affected by factors such as gender,age and season.

Effects of allergens on the expression of IL-18, IL-18-binding protein a and IL-18 receptor α by peripheral blood CD4 + Th17 cells of patients with allergic rhinitis / 中华微生物学和免疫学杂志

Objective:To investigate the expression of IL-18, IL-18-binding protein a(IL-18BPa) and IL-18 receptor α(IL-18Rα) by peripheral blood CD4 + Th17 cells of patients with allergic rhinitis (AR) and the effects of allergens on their expression. Methods:This study enrolled 45 outpatients with AR and 23 healthy control subjects receiving physical examination in the First Affiliated Hospital of Jinzhou Medical University from October 2019 to September 2020. According to the results of skin prick test, the 45 patients were divided into two groups: AR group with positive results (24 cases) and nAR group with negative results (21 cases). Blood samples of them were collected. Flow cytometry was used to analyze the effects of allergens on the expression of IL-18, IL-18BPa and IL-18Rα at protein level by peripheral blood CD4 + Th17 cells. The level of IL-17A in plasma was measured by Bioplex system, and its correlation with the percentage of IL-18 + Th17 cells was analyzed. Results:Compared with the healthy control group, the AR group showed increased ratios of CD4 + Th17 and IL-18 + Th17 cells ( P<0.01), decreased ratio of IL-18BPa + Th17 cells ( P<0.01), enhanced mean fluorescence intensity (MFI) of IL-18BPa ( P<0.01) and reduced MFI of IL-18Rα ( P<0.01); the nAR group showed enhanced MFI of IL-18BPa ( P<0.000 1) and reduced MFI of IL-18Rα ( P<0.000 1). The ratio of IL-18 + Th17 cells and the MFI of IL-18Rα in the AR group were higher than those in the nAR group ( P<0.05, P<0.01). House dust mite extract and Platanus pollen extract induced the expression of IL-18 and IL-18BPa by CD4 + Th17 cells of AR patients ( P<0.05). Moreover, house dust mite extract directly induced the CD4 + Th17 cells isolated from the healthy control subjects to express IL-18 and IL-18R ( P<0.05). Compared with healthy control subjects, AR patients had higher level of IL-17A in plasma and it was moderately correlated with the ratio of IL-18 + Th17 cells ( P<0.05). Conclusions:Allergens may be involved in the pathogenesis of AR by inducing blood CD4 + Th17 cells to express IL-18 and IL-18Rα.

Progress in the application of AIT in allergic airway diseases / 中国临床药理学与治疗学

Allergen specific immunotherapy (AIT) is to identify the patient's allergen, give the patient repeated exposure to the allergen extract, and gradually increase the concentration and dose until the target maintenance dose is reached, so that the patient can develop tolerance to the allergen, which is the only treatment that can regulate the pathogenesis of allergic diseases and change its natural course. In recent years, domestic and foreign scholars have made great progress in the clinical practice and research field of AIT. This article reviewed the relevant progress of the mechanism, efficacy and drug administration of AIT.

Distribution and clinical significance of allergens in children with adenoid hypertrophy in Wuxi district / 中国现代医生

Objective To study the distribution and clinical significance of allergens in children with adenoid hypertrophy.Methods The allergen detection results of 223 children with adenoid hypertrophy admitted to the Department of Otolaryngology,the Wuxi Second People's Hospital from January 2021 to October 2022 were retrospectively analyzed,while 43 children without adenoid hypertrophy were set as the control group.The allergy test results were compared between the two groups for difference.Results The positive rate of total allergens in adenoid hypertrophy group was 54.7%.The positive rate of total allergens in the control group was 27.9%.The difference was statistically significant(P<0.05).In the adenoid hypertrophy group,the positive rate of inhaled allergens was 41.3%,mainly mites/dusts and molds.The positive rate of ingested allergens was 32.3%,mainly milk and egg white.The adenoid hypertrophy group was divided according to age.The positive rate of total allergens was 54.0%in the 2-7 year old group.The positive rate of total allergens in the 8-14 year old group was 55.7%.There was no significant difference between the two groups(P>0.05).Conclusion Allergen stimulation is one of the causes of adenoid hypertrophy.Mite,mold,milk and egg white are common allergens in children with adenoid hypertrophy in Wuxi.The effect of allergen stimulation on adenoid hypertrophy did not decrease with age.Therefore,the detection of serum allergens can help to understand the specific allergens of children and provide direction for the non-surgical treatment of children with adenoid hypertrophy.

Detection of serum allergens in children with allergic rhinitis in Hangzhou / 中国现代医生

@#Objective To analyze the distribution of common allergens in children with allergic rhinitis(AR)in Hangzhou,and to provide reference for its prevention and treatment.Methods From January 2020 to December 2022,13 521 children who were diagnosed with AR and underwent in vitro serum specific immunoglobulin E(sIgE)detection in Affiliated Hangzhou First People's Hospital,School of Medicine,Westlake University were selected as the research objects.The positive rates of allergens in children with AR of different genders,ages and seasons were compared.Results Among 13 521 children,the positive rate of sIgE was 54.49%(7367/13 521),of which 64.82%were allergic to only one allergen.Among the 19 common allergens,the top three overall positive rates were household dust mite(44.27%),milk(14.62%),and mixed grass(4.82%).The positive rates of allergens of house dust mites,cat hair dander,mulberry,mold combination,tree pollen combination,amaranth,cockroach,milk,shrimp,crab,pineapple,shellfish and mango in male children were significantly higher than those in female children(P<0.05).The positive rates of allergens of house dust mite,mixed grass,cat hair dander,mulberry,mold combination,egg white,shrimp,crab,pineapple,cashew nuts and shellfish in different age groups were statistically significant(P<0.05).July and August were the two months with the highest allergen positive rate.The allergen positive rates of house dust mite,dog and cat hair dander were the highest in summer,and the allergen positive rate of plants was consistent with the flowering season.The sIgE concentration of house dust mite(77.87%)was mainly grade 3 and above.The sIgE concentration of other allergens was mainly grade 1 and 2.Conclusion Dust mites and milk are the most common allergens in children with AR in Hangzhou,and the distribution of allergens varies with gender,age and season.Allergen detection can provide a more accurate plan for the diagnosis,prevention and treatment of AR.

Valoración del impacto de la legislación argentina sobre alérgenos alimentarios: cinco años de una travesía con aciertos y desafíos / Assessment of the impact of the argentine legislation on food allergens: five years of a journey with successes and challenges / Avaliação do impacto da legislação argentina sobre alérgenos alimentares: cinco anos de uma caminho de desafios e sucessos

Resumen Las alergias alimentarias representan un problema de salud pública. La declaración de alérgenos en el rótulo implicó un avance fundamental para la gestión del riesgo, ya que evitar el alimento desencadenante mediante el rotulado adecuado constituye actualmente una medida insustituible de cuidado para la población susceptible. Se realizó una valoración del impacto de la legislación nacional en referencia a la declaración de alérgenos alimentarios entre 2017 y 2022. Se utilizaron los motores de búsqueda interna de la Administración Nacional de Medicamentos, Alimentos y Tecnología Médica (ANMAT) para los retiros de productos alimenticios del mercado y se contrastó como herramienta de medición indirecta para la valoración del impacto de la implementación del Artículo 235 séptimo del Código Alimentario Nacional (CAA). Se analizaron 43 productos (galletitas, fideos, chocolates, alimentos a base de vegetales). El 53,5% (23 sobre un total de 43) presentaba declaración de alérgenos. El 70% de los mismos (16 sobre un total de 23) fueron categorizados "con inconsistencias" y el 14% (6 productos de 43) utilizaba etiquetado precautorio. El paradigma reactivo del control de alimentos sobresalió por sobre el de las auditorías, los programas de monitoreo y, en suma, sobre los programas de prevención, ya que el sistema se activó fundamentalmente por la vía reactiva de las denuncias. Esto representó un 72% de los productos categorizados.

Abstract Food allergies represent a public health problem. The declaration of allergens on the label implied a fundamental advance for risk management, since avoiding the triggering food through proper labelling is currently an irreplaceable measure of care for the susceptible population. An assessment of the impact of the national legislation was carried out in reference to the declaration of food allergens between 2017 and 2022. The ANMAT internal search engines were used for the withdrawals of food products from the market and contrastlised as an indirect measurement tool for the impact assessment of the implementation of Section 235 seventh of the Argentine Food Code (CAA, for its acronym in Spanish). Forty-three products (biscuits, noodles, chocolates, vegetable-based foods) were analysed. The allergen declaration was present in 53.5% (23 out of a total of 43). Some inconsistencies were present in 70% of them (16 out of a total of 23) and 14% (6 products out of 43) used precautionary labelling. The reactive paradigm of food control stood out above that of audits, monitoring programmes and, in short, prevention programmes, since the system was activated fundamentally through the reactive route of complaints. This represented 72% of the categorised products.

Resumo As alergias alimentares representam um problema de saúde pública. A declaração de alérgenos no rótulo envolveu um avanço fundamental para a gestão do risco, visto que evitar os alimentos que desencadeiam as alergias, por meio de uma rotulagem adequada, é atualmente uma medida insubstituível de cuidado para a população suscetível. Foi realizada uma avaliação do impacto da legislação nacional referida à declaração de alérgenos alimentares entre 2017 e 2022. Os motores de busca interna da ANMAT (Administração Nacional de Medicamentos, Alimentos e Tecnologia Médica) foram utilizados para as retiradas de produtos alimentares do mercado e contrastados como uma ferramenta indireta de medição para a avaliação do impacto da aplicação do artigo 235 sétimo, do CAA (Código Alimentar Nacional). Foram analisados 43 produtos (biscoitos, macarrão, chocolates, alimentos à base de vegetais). 53,5% (23 de um total de 43) apresentavam declaração de alérgenos, 70% deles (16 de um total de 23) foram categorizados "com inconsistências" e 14% (6 produtos de 43) utilizavam rotulagem de precaução. Destacou-se o paradigma "reativo" do controle de alimentos por sobre o controle das auditorias, dos programas de monitoramento e, em resumo, dos programas de prevenção, visto que o sistema foi ativado fundamentalmente pela via reativa das reclamações. Isso representou 72% dos produtos categorizados.

The progress of combined therapy of omalizumab and allergen immunotherapy in children with moderate to severe allergic asthma / 国际儿科学杂志

Allergen immunotherapy(AIT)is considered the treatment capable of modifying the natural history of allergic respiratory disorders.The adverse reactions associated with AIT limit its clinical use in moderate to severe allergic asthma.Omalizumab is currently approved for the treatment of allergic asthma, chronic spontaneous urticaria, allergic rhinitis and other allergic diseases.A few trials have demonstrated the clinical efficacy of AIT and omalizumab combination therapy in children with moderate to severe allergic asthma.This review summarizes the research progress, mechanisma and application of omalizumab combined with AIT in children with moderate to severe allergic asthma.

Interpretation of managing food allergy: Global Allergy and Asthma European Network guideline (2022) / 中华实用儿科临床杂志

Food allergy is one of the most common chronic non-infectious diseases in many countries and regions, which affects 2%-4% of children and adults.Its prevalence is on the rise worldwide.In 2022, the Global Allergy and Asthma European Network (GA 2LEN) proposed recommendations on managing food allergy to people at different age groups.This review aims to interpret the recommendations, clinical practice, precautions, evidence gaps and research priorities of food allergy management based on the GA 2LEN guideline 2022, thus providing reference for clinical management of food allergy.

Basic research on toxin of Solenopsis invicta / 药学实践与服务

Solenopsis invicta is a kind of invasive pest that causes serious damage to local agriculture, environment, and human health. They attack mainly with venom within stingers. Those who are allergic to the venom would suffer a systemic anaphylaxis, even fatal shock, after being stinged by these ants. Many studies reveal that their venom is mainly composed by water, insoluble alkaloids and trace proteins, within which alkaloids are the main cause of burning sensation and blisters, while allergic reactions are caused by proteins or peptides. The research progress of toxic substances in the venom of Solenopsis invicta as well as the roles and functions of each component were reviewed in this paper.

Progress on mechanisms and clinical application of allergen immunotherapy / 国际儿科学杂志

Allergen immunotherapy(AIT)is an effective treatment for allergic diseases that have been used for more than a century.At present, AIT is administered in two main ways: subcutaneous immunotherapy(SCIT)and sublingual immunotherapy(SLIT), which aims to induce immune tolerance to allergens and provide long-term clinical benefit to patients.The effectiveness of AIT has been confirmed and the research on its mechanism has been deepened, and AIT combined with biological agents has been widely used in clinical practice.

Detection of serum allergen-specific IgE antibody and analysis of epidemiological characteristics in 19 744 patients with type Ⅰ allergic diseases / 国际检验医学杂志

Objective To analyze the detection results and distribution characteristics of serum allergen-specific immunoglobulin(Ig)E in patients with type Ⅰ allergic diseases(hereinafter referred as allergic disea-ses)in Chengdu area,and to provide epidemiological data and diagnostic basis for the prevention and treat-ment of allergic diseases.Methods A total of 19 744 patients diagnosed with allergen-specific IgE antibody screening in Sichuan Academy of Medical Sciences·Sichuan Provincial People's Hospital from September 2018 to December 2022 were included in this study.The serum level of allergen-specific IgE antibody was de-tected by enzyme-linked immunosorbent rapid test strip technology.According to different age,gender,season and disease groups,the positive results of specific allergens were counted,and the distribution characteristics and rules of specific allergens were analyzed.Results Among the 19 744 patients with allergic diseases,8 406 were positive for allergen-specific IgE,and the positive rate was 42.57%.The main inhaled allergens were house dust mites(15.17%),house dust(10.86%)and cat dander(4.04%).Milk(2.26%),beef(1.68%)and egg white(0.86%)were the main food allergens.The positive rate of inhaled allergens was higher than that of food allergens(P<0.05).The positive rate of male was higher than that of female(P<0.05).The positive rate of allergens in patients aged 10-<18 years was the highest,and the main allergens were house dust mites,house dust and cat dander.The positive rate of allergens was the highest in autumn,followed by spring and winter,and the lowest in summer.The main allergens were house dust mites,house dust and cat dander.The positive rates of allergens in different types of allergic diseases were as follows:allergic rhinitis>allergic asthma>eczema>others>allergic purpura>urticaria.There were significant differences in all aller-gens except cod,crab,mango and peanut among different diseases(P<0.05).Conclusion The characteristics of patients with allergic disease in Chengdu area are as follows:inhaled allergens are the main allergens;males have a higher allerger positive rate;the majority of patients were 10-<18 years old;patients are prone to dis-ease in autumn;allergic rhinitis was the most common.This can provide a reference for the prevention and treatment of allergic diseases in this area.

Application of Omalizumab combined with allergen immunotherapy in the treatment of allergic asthma in children / 中华实用儿科临床杂志

Objective:To analyze the efficacy and safety of Omalizumab (OMA) combined with allergen immunotherapy (AIT) on children with allergic asthma.Methods:Clinical data of 43 children with allergic asthma from the Second Hospital of Tianjin Medical University between August 2018 and October 2022, who were managed by OMA combined with double mite subcutaneous immunotherapy (SCIT) were retrospectively analyzed, including 30 males and 13 females with the age of 5-15 years.Twenty children with allergic asthma who were managed by the monotherapy for SCIT during the same period, including 16 males and 4 females with the age of 4-13 years were included in the control group(group1: conventional immunotherapy; group2: cluster immunotherapy). Among the 43 cases managed by OMA combined with SCIT, 20 were treated with OMA, followed by AIT (OMA-AIT group), and 23 were treated with AIT, followed by OMA (AIT-OMA group). Notably, 6 cases in AIT-OMA group who were additionally given OMA due to the difficulty in increasing doses were subgrouped in AO1 group, and 17 who were additionally given OMA due to poor control of asthma or comorbidities during the course of AIT and frequent adverse events were subgrouped in AO2 group.The number of asthma exacerbations within 1 year and during the combination therapy, the Childhood Asthma Control Test/Asthma Control Test (C-ACT/ACT) findings, the Visual Analogue Scale (VAS) for grading rhinitis, inhaled corticosteroid (ICS) dosage converted to budesonide equivalent, the Total Medication Score (TMS), comorbidities, lung function [percent-predicted forced expiratory volume in 1 second(FEV 1% pred), percent-predicted peak expiratory flow(PEF%pred), percent-predicted maximal mild-expiratory flow(MMEF%pred)], exhaled nitric oxide (FeNO), completion of the initial SCIT and adverse effects [local adverse reactions (LRs) and systemic adverse reactions (SRs)] were analyzed for assessing the efficacy and safety of OMA combined with AIT on children with allergic asthma.The t-test of two independent samples was used for comparison of measurement data that followed normal distribution.Wilcoxon′s test was used for non-normally distributed between-group comparisons.The χ2 test was used for the between-group comparison of counting data. Results:(1)Baseline comparison showed that the male ratio (17/20 cases vs.13/23 cases) and the proportion of moderate-to-severe persistent asthma (18/20 cases vs.18/23 cases) in the OMA-AIT group were significantly higher than those of the AIT-OMA group (all P<0.05). (2)Efficacy: ①In OMA-AIT group, all children reached the AIT maintenance treatment stage successfully after combination therapy.At the maintenance treatment stage, the C-ACT/ACT, VAS and TMS scores(26.0±1.25 vs.24.55±2.28, 1.50±1.24 vs.2.55±1.70, 3.60±1.47 vs.5.45±1.19)were significantly improved from baseline(all P<0.05). There were no significant differences in lung function indexes FEV 1%pred, PEF%pred, and MMEF%pred ( P>0.05), and FeNO level did not change significantly than baseline.After the combination treatment, ICS dosage significantly decreased from 240.00 (160.00, 380.00) μg/d at baseline to 140.00 (80.00, 300.00) μg/d ( P<0.05). Comorbidities, including allergic rhinitis, food allergy, atopic dermatitis and angioedema were improved.Five cases (25.00%) had once asthma exacerbation during the treatment.The duration of maintenance dose of conventional (22.70±7.10 vs.15.20±1.32) and cluster immunotherapy (13.00±4.97 vs.7.30±1.06) were longer than those of the corresponding control group(all P<0.05). ②AIT-OMA group: In AO1 group, the C-ACT/ACT score were improved from baseline( P<0.05), and VAS score, TMS score decreased from 3.00(1.75, 3.00), (4.67±1.97) points at baseline to 1.00(0, 1.00), (2.83±1.60) points by the maintenance dose in AO1 group (all P<0.05). There were no significant differences in the FEV 1%pred, PEF%pred, MMEF%pred and FeNO compared with baseline in AO1 group.ICS dosage in AO1 group significantly decreased from (180.00±78.99) μg/d at baseline to (88.88±26.23) μg/d ( P<0.05). In AO2 group, the C-ACT/ACT, VAS and TMS scores at the completion of OMA treatment[26.53±0.94 vs.25.06±2.05, 1.00 (0, 2.00) vs.2.00(2.00, 3.50), 3.41±0.94 vs.5.53±1.23]were significantly improved from baseline (all P<0.05). PEF%pred[(106.47±22.37)% vs.(94.47±26.39)%] significantly increased than baseline ( P<0.05), and the remaining lung function indexes and FeNO were not significantly improved.ICS dosage significantly decreased from 240.00(160.00, 400.00) μg/d at baseline to 80.00 (20.00, 160.00) μg/d ( P<0.05). During the combination treatment, 1 case (5.88%) had once asthma exacerbation, and all 8 cases with food allergy or atopic dermatitis or conjunctivitis had improved comorbidities.(3)Safety: adverse events during OMA injection were not reported.①In OMA-AIT group, a total of 165 OMA injections were performed in the initial treatment stage of the conventional immunotherapy group, with 13 (7.88%) reported LRs and 2 (1.21%) grade-1 SRs.A total of 143 OMA injections were performed in the initial treatment stage of the cluster immunotherapy group, with 19(13.29%) reported LRs and none of SRs.②In AIT-OMA group, there were 6 cases of adverse events in the initial treatment stage of AIT who were successfully reached the maintenance treatment stage after the addition of OMA in AO1 group.In AO2 group, children who were additionally given OMA due to adverse events in the maintenance treatment phase did not report adverse events during the combination therapy. Conclusions:OMA combined with AIT not only expands the scope of AIT, improves allergic and asthma symptoms in children, reduces the use of drugs, but also enhance the safety of AIT and compliance, reduces adverse events during AIT treatment, and even shortens the time of initial treatment.

Research progress and clinical application of allergen nasal provocation test / 临床耳鼻咽喉头颈外科杂志

The allergen nasal provocation testing（NPT）, in which allergens are applied directly to the nasal mucosa under standard and controlled conditions to provoke the main symptoms of allergic rhinitis（AR）, reproduces the response of the upper respiratory tract to natural exposure to allergens under controlled conditions and is the only test currently available to confirm nasal reactivity to allergens. It is invaluable in studying the mechanisms of AR and in assessing the response to novel anti-allergic treatments. The test may play an increasingly important role in clinical practice, especially in the identification of local AR, the diagnosis of occupational AR, the clarification of the composition of allergens, the assessment of the efficacy of AR treatment and the selection of candidates undergoing allergen immunotherapy. This article reviewed the application of NPT in the diagnosis of allergic and non-allergic rhinitis, and also introduces the indications, contraindications, advantages and limitations of NPT in evaluating nasal response.