Comparison of allergenic properties of salmon (Oncorhynchus nerka) between landlocked and anadromous species.

BACKGROUND: Salmon is one of the most widely consumed seafoods in Japan and many other countries around the world. Due to the confirmed cases of salmon-induced allergy, the food sanitation law in Japan stipulates salmon as one of the specific food items for which labeling is recommended when used as an ingredient of processed foods. However, trout, the landlocked form of anadromous salmon, is not subject to the allergen-labeling requirements, even though both populations belong to a single species. Since no supporting data have been demonstrated to make a clear distinction between these two populations in terms of allergenicity, we comparatively examined their allergenic properties using sera from patients allergic to fish. METHODS: Extracts of Oncorhynchus nerka from different habitats were obtained: kokanee (landlocked) and red salmon (anadromous). Control extracts were derived from four other species. This study focused on the (1) IgE-binding capacity of the fish extracts in patients' sera (n = 50), (2) ELISA inhibition test (n = 6), and (3) inhibition immunoblot test (n = 8) between the kokanee and red salmon. RESULTS: The extracts from kokanee and red salmon showed the highest correlation with each other in terms of the IgE-binding capacity, and showed complete (100%) reciprocal cross-inhibition in the ELISA inhibition test. On immunoblotting, there was no marked difference in the staining pattern between the two extracts, and each IgE-binding band gradually disappeared when the patients' sera were preincubated with the counterpart antigen in a dose-dependent manner. CONCLUSIONS: These results suggest that kokanee has similar allergenic properties to red salmon.

Short-term efficacy of tacrolimus ointment and impact on quality of life.

BACKGROUND: Topical calcineurin inhibitor (TCI) was reported to be an effective therapeutic agent for patients with atopic dermatitis (AD), for not only improving clinical findings but also for reducing pruritus. Recently in Japan tacrolimus ointment (0.03%) as a TCI was approved for use in children aged > or =2 years. There have been no reports, however, on the impact of TCI on quality of life (QOL) in pediatric AD in Japan. The purpose of the present study was therefore to evaluate the efficacy of tacrolimus ointment (0.03%) in the short-term and the impact on patient QOL. METHODS: A total of 30 pediatric patients with AD, whose skin problems were not sufficiently controlled by mid-high potency topical glucocorticosteroids, were enrolled. Efficacy was assessed on score of cutaneous findings, pruritus, sleeping disorder, and QOL. RESULTS: Three patients discontinued because of skin burning (n = 1), generalized herpes infection (n = 1), and feeling of lack of efficacy (n = 1), leaving a final total of 27 patients who were evaluated. Significant improvements in clinical findings, pruritus, and sleeplessness were observed within 1 week of treatment and consequently each QOL category was also improved. These improvements continued for the duration of the study. CONCLUSIONS: Tacrolimus ointment therapy is rapidly effective for not only clinical symptoms (cutaneous findings, pruritus and sleeplessness) but also in QOL of AD pediatric patients aged > or =2 years.

Allergen-specific T-cell response in patients with phenytoin hypersensitivity; simultaneous analysis of proliferation and cytokine production by carboxyfluorescein succinimidyl ester (CFSE) dilution assay.

BACKGROUND: Phenytoin can induce diversified adverse reactions including generalized eruptions and the hypersensitivity syndrome. Delayed-type allergic mechanisms have been postulated to underlie these reactions. The tests most widely used to detect T-cell sensitization to drugs are the patch test and the lymphocyte transformation test (LTT), but their sensitivity is not sufficient. Simultaneous assessment of both the frequencies and the cytokine-producing phenotypes of allergen-specific T cells has become possible with the recently introduced carboxyfluorescein succinimidyl ester (CFSE) assay. METHODS: Seven patients who presented with phenytoin-induced maculopapular exanthema with and without fever were included in this study. Peripheral blood mononuclear cells (PBMCs) were labeled with CFSE and cultured with phenytoin for seven days. The cells were stained with anti-CD4 and cytokine-specific monoclonal antibodies (MoAbs), and analyzed with FACSCalibur. RESULTS: The phenytoin-specific proliferation of CD4+ cells in patients was significantly higher than in the four controls exposed to phenytoin, and in seven healthy children with no previous phenytoin intake. A significant difference in the percentages of CD4+ IFN-gamma+ cells between patients and the seven healthy children was observed. The sensitivity and specificity of proliferation were 100% and 90.9%, and those of IFN-gamma secretion were 71.4% and 100%, respectively. CONCLUSIONS: Phenytoin-specific proliferation may be detected with greater sensitivity by the CFSE dilution assay than the conventional LTT. The assay revealed that both CD4+ and CD4- T cells proliferated and produced IFN-gamma and TNF-alpha after stimulation with phenytoin. The CFSE dilution assay might be useful for the diagnosis and understanding of drug hypersensitivity.