Apolipoprotein E and functional motor severity in cerebral palsy.

Cerebral palsy is attributed to non-progressive disturbances in the developing fetal or infant brain. The APOE ε4 allele has been associated with poor outcome after brain injury in adults but may be protective among very young children. We conducted this study to explore the hypothesis that the APOE ε4 is associated with lowered severity of cerebral palsy. 158 individuals with CP and their parents were genotyped for APOE. Mean age was 9.1 years; 54% were males. 61% were preterm at birth; 34% less than 30 weeks gestation. 30% of the CP subjects had at least one ε4 allele. There was a trend towards significance for subjects with at least one ε4 allele assigned to the low severity group (p = 0.11). The greater number of ε4 alleles, the more likely an individual was in the low severity CP group (p = 0.12). Individuals with brain injury in the perinatal period were almost 5 times more likely to be in the low severity group (p < 0.01). Family analysis via the TDT supported a protective effect of APOE ε4. Further study is needed to confirm that, in contrast to adults, the APOE ε4 allele appears to confer protection and/or facilitate recovery after brain injury in the fetus or newborn, particularly when that injury occurs around term.

Asian ladybugs (Harmonia axyridis): a new seasonal indoor allergen.

BACKGROUND: Harmonia axyridis, the Asian ladybug (ALB), was repeatedly introduced between 1916 and 1990. These beetles are intolerant to cold and move indoors during the winter. OBJECTIVE: To investigate sensitization to ALB. METHODS: Proteins in ALB extracts were purified by gel filtration and ion exchange chromatography. Purified fractions were screened for IgE antibody using the streptavidin CAP technique in sera from 20 patients with allergy living in ALB-infested houses. Two proteins were fully purified. Serum antibodies were also assessed in sera from 68 adult patients with asthma. RESULTS: Fifteen of the 20 sera had measurable IgE antibody, 7 with high titers, > 10 IU/mL, to ALB extract. The 2 proteins, Har a 1, 10 kd, and Har a 2, 55 kd, bound IgE antibody in 65% and 75% of the sera, respectively. Sequencing revealed a novel N-terminal sequence for Har a 1. Sequencing of Har a 2 demonstrated homology to a dehydrogenase from the red flour beetle. Although sera from 18 of the patients with asthma were positive for IgE antibody to ALB, they were also positive to Blatella germanica. These subjects did not report exposure to H axyridis, and inhibition studies with B germanica blocked > or = 95% of ALB IgE antibody binding. CONCLUSION: Two proteins of ALB have been purified and used to demonstrate that patients exposed to this beetle can develop high-titer IgE antibody. Cross-reactivity with B germanica was found but was significant only among patients primarily exposed to cockroaches. CLINICAL IMPLICATIONS: Asian ladybug has become an important seasonal indoor allergen in the United States.