Pollen sensitization among Egyptian patients with respiratory allergic diseases.

Pollen is responsible for seasonal allergies, such as allergic rhino-conjunctivitis (AR), and has become a growing public health concern. Climate change affects the range of allergenic species as well as the timing and length of the pollen season. In Egypt, data on pollinosis are scarce. This study aimed to identify the most prevalent pollen causing allergies among Egyptian patients with respiratory allergies. A total of 200 patients with respiratory allergic diseases, allergic rhinitis and/or bronchial asthma (BA), were included. Medical history taking and physical examinations were conducted on each patient. Complete blood count (CBC), total immunoglobulin E (IgE) determination, spirometry, specific IgE, and skin prick tests (SPTs) for common aeroallergens and food were performed. Of the 200 patients, 106 (53%) were females. The age of study subjects ranged 16-66 years (mean ± SD, 34.42 ± 13.0), and 65% were living in urban areas. Grass pollen, mainly from Timothy grass and maize, were the most prevalent allergens (28.5%). Timothy grass was the most common type of pollen in patients with AR (28.3 %). Elder pollen was more prevalent among asthmatic patients (P = 0.004). Bermuda grass was statistically more prevalent in rural than in urban areas (P = 0.008). Maize was linked to uncontrolled BA, whereas Timothy grass was the most prevalent among patients with moderate/severe AR. Forty-three patients had oral allergy syndrome; oranges and tomatoes were the most cross-reactive food allergies (12% and 11.5%, respectively). Exacerbation of allergic symptoms was noted during January, December, March, and June. In conclusion, pollen plays a substantial role in affecting patients with respiratory allergies in Egypt. Grass pollen is the most prevalent type of pollen, especially in urban areas.

Prevalence of work-related asthma among Egyptian farmers in Great Cairo.

Work related asthma (WRA) refers to asthma induced by exposure to sensitizing agents and/or irritants in the workplace leaving health and economic consequences. Early diagnosis can improve the prognosis of WRA permitting sometimes full recovery. This study aimed to assess the prevalence of WRA among Egyptian adult agriculture workers. A multi-center cross sectional study included 150 adult workers from 4 different farms, during the period from 2019 and 2021. All participants were subjected to full medical history, clinical examination, chest x-ray, skin prick test and CBC to detect absolute eosinophilic count. Spirometry with post bronchodilatation test (reversibility test) at the farm (in the day of insecticide aerosol and without aerosol) and after a week off the farm was also done. Age, median ± SD, was 37.67 ± 9.75 years, duration of farming occupation was 21.84 ± 10.18 years. Of the 150 participants, 11 had WRA. Of these, 6 had allergic occupational asthma, 3/11 had work exacerbated asthma and only 2/11 had irritant occupational asthma. Of the allergic subjects, 7.3% tested positive to mixed pollens, 4.7% to Alternaria, 2% to penicillium and 2% to the farm pollens. The onset of respiratory symptoms was 13.45 ± 6.93 months after start working in the farm. A statistical significance was observed between WRA and non-WRA individuals regarding age, duration of farming occupation and asthma symptoms during workday (P < 0.001). There was a statistical significance between WRA group and non-WRA group regarding FEV1, FEV1/FVC ratio carried out at work, during holidays and during spraying (P < 0.001). Absolute eosinophilic count, mean among WRA group was 0.55 ± 0.13 (×103cells/mm3) with significance between WRA and non-WRA (P= 0.001). Farming occupation may cause WRA, therefore, more attention should be given to minimize exposure and risk of inducing WRA.

Comparison of COVID-19 characteristics in Egyptian patients according to their Toll-Like Receptor-4 (Asp299Gly) polymorphism.

Background: Toll-like receptor (TLR)-4 plays a vital role in recognizing viral particles, activating the innate immune system, and producing pro-inflammatory cytokines. Objectives: This cross-sectional study aimed to compare COVID-19 severity, progression, and fate according to TLR-4 (Asp299Gly) polymorphism in Egyptian patients. Methods: A total of 145 COVID-19 patients were included in this study. TLR-4 (Asp299Gly) genotyping was done using the PCR restriction fragment length polymorphism (PCR-RFLP) approach. Results: The most commonly encountered TLR-4 genotype in relation to the amino acid at position 299 was the wild-type AA (73.1%); meanwhile, the homozygous mutant GG genotype (8.3%) was the least encountered. At hospital admission, 85.8% of the AA group had free (with no ground glass opacities) chest computed tomography (CT) examination, and 16.0% were asymptomatic. On the other hand, of the AG and GG groups, 81.5% and 83.3%, respectively showed bilateral ground-glass opacities in chest CT, as well as 25.9% and 75.0%, respectively were dyspneic. Values of the total leucocytic count, C-reactive protein (CRP), ferritin, and D dimer increased in the AAAG>GG sequence. ICU admission (83.3%) and in-hospital death (33.3%) rates were significantly higher in the GG group. Conclusions: In COVID-19 patients, the TLR-4 mutant G allele may be associated with a more aggressive disease course and in-hospital death. New therapeutic alternatives could be aimed at this area.

Prevalence of confirmed immunoglobulin E-mediated food allergy among adult Egyptian patients.

Food allergy (FA) represents an increasing social and economic health problem. Prevalence of food allergy differs from one country to another depending on genetic and environmental as well as feeding habits of each country. Estimate the prevalence of confirmed immunoglobulin E-mediated food allergy (FA) among adult Egyptian patients and identify its possible risk factors. A total of 2081 adult subjects were randomly selected from the Allergy outpatient clinic at Ain Shams university hospitals. Patients who disclosed food adverse complaints (probable food allergy group) were further subjected to a detailed questionnaire, complete blood cell count, total immunoglobulin E level, skin prick test and /or specific immunoglobulin E test for common food allergens, and oral food challenge with the culprit food. Patients were classified into confirmed food allergy and no food allergy groups depending on the results of oral food challenge test. Out of the 2081 adults, 100 subjects had self-reported food adverse complaints, and of them, 45 (45%) had confirmed diagnosis of FA. Thirty four (75.6%) confirmed FA patients were females with mean age ± SD of (38.02 ± 13.08) years, five patients (11.1%) had persistent childhood FA, 11 (24.4 %) had family history of atopy, five (11.1%) had associated atopic diseases and 24 (53.3%) were polysensitized. Female gender, young age and exercise were found to be risk factors for confirmed FA (OR: 1.766, 1.4, and 1.9 respectively). Cutaneous manifestations were the most common presentation of confirmed FA patients in the form of urticaria 40/45 (88.9%) and angioedema 18/45 (40%). The most common food allergen was milk, banana, fish, tomato, strawberry and eggs. In conclusion, IgE mediated food allergy is a noticeable health problem among adult Egyptians, particularly adult females and young age groups.