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1.
[Frequency of skin reactivity to food allergens in allergic patients].
Camero-Martínez, H, López-García, AI, Rivero-Yeverino, D, Caballero-López, CG, Arana-Muñoz, O, Papaqui-Tapia, S, Rojas-Méndez, IC, Vázquez-Rojas, E
Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993). 2017;(3):291-297
Abstract
BACKGROUND Food allergy is deemed to have a worldwide prevalence ranging from 2 to 10 %. OBJECTIVE To determine the frequency of skin reactivity to food allergens by age groups. METHODS Cross-sectional, descriptive, prolective, observational study. Patients aged from 2 to 64 years with symptoms consistent with allergic disease were included. Skin prick tests were carried out with food allergens. Frequencies and percentages were estimated. RESULTS One-hundred and ninety-one patients were included, out of which 63.4% were females. Mean age was 22.5 years; 19.3 % showed positive skin reactivity to at least one food. Distribution by age group was as follows: preschool children 13.5 %, schoolchildren 24.3 %, adolescents 2.7 % and adults 59.5 %. Diagnoses included allergic rhinitis in 84.3 %, asthma in 19.4 %, urticaria in 14.1 % and atopic dermatitis in 8.4 %. Positive skin reactivity frequency distribution in descending order was: soybeans with 5.2 %, peach with 4.7 %, grapes, orange and apple with 3.6 %, nuts with 3.1 %, pineapple, avocado, tomato and tuna with 2.6 %. CONCLUSION The frequency of skin reactivity to food allergens was similar to that reported in the national and Latin American literature, but sensitization to each specific allergen varied for each age group.
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A comparative analysis of metal allergens associated with dental alloy prostheses and the expression of HLA-DR in gingival tissue.
Zhang, X, Wei, LC, Wu, B, Yu, LY, Wang, XP, Liu, Y
Molecular medicine reports. 2016;(1):91-8
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Abstract
The present study aimed to provide guidance for the selection of prosthodontic materials and the management of patients with a suspected metal allergy. This included a comparison of the sensitivity of patients to alloys used in prescribed metal‑containing prostheses, and correlation analysis between metal allergy and accompanying clinical symptoms of sensitized patients using a patch test. The results from the patch test and metal component analyses were processed to reach a final diagnosis. In the present study, four dental alloys were assessed. Subsequent to polishing the surface of a metal restoration, the components were analyzed using an X‑ray fluorescence microscopy and spectrometry. Immunohistochemical analysis, reverse transcription‑polymerase chain reaction and western blotting were used to detect the expression levels of human leukocyte antigen (HLA)‑DR in gingival tissues affected by alloy restoration, and in normal gingival tissue samples. Positive allergens identified in the patch test were consistent with the components of the metal prostheses. The prevalence of nickel (Ni) allergy was highest (22.8%), and women were significantly more allergic to palladium and Ni than men (P<0.05). The protein and gene expression levels of HLA‑DR in the Ni‑chromium (Cr) prosthesis group were significantly higher, compared with those in the other groups (P<0.01); followed by cobalt‑Cr alloy, gold alloy and titanium alloy. In conclusion, dentists require an understanding of the corrosion and allergy rates of prescribed alloys, in order to reduce the risk of allergic reactions. Patch testing for hypersensitive patients is recommended and caution is required when planning to use different alloys in the mouth.
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Photopatch testing: recommendations for a European photopatch test baseline series.
Gonçalo, M, Ferguson, J, Bonevalle, A, Bruynzeel, DP, Giménez-Arnau, A, Goossens, A, Kerr, A, Lecha, M, Neumann, N, Niklasson, B, et al
Contact dermatitis. 2013;(4):239-43
Abstract
In order to establish a consensus recommendation for performing photopatch testing, a photopatch test taskforce group was established under the joint umbrella of the European Society for Contact Dermatitis and the European Society for Photodermatology in 2000. After proposing the most adequate methodology in 2004 and completing a European multicentre photopatch test study in 2011, this taskforce is recommending a list of photoallergens that should form part of a baseline series for photopatch testing in Europe. It contains mainly ultraviolet filters and drugs, mostly non-steroidal anti-inflammatory drugs. The choice of chemicals was based on the results of a recent multicentre study, previous published cases of photoallergy, and use of the substances in the European market. It is suggested that an extended list of photoallergens should be photopatch tested in selected cases, along with patients' own products. Two contact allergens, cinnamyl alcohol and decyl glucoside, should be simultaneously patch tested in order to clarify photopatch and patch test reactions, respectively, to ketoprofen and methylene bis-benzotriazolyl tetramethylbutylphenol (Tinosorb M™).
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IgE-mediated cross-reactivity among leguminous seed proteins in peanut allergic children.
Ballabio, C, Magni, C, Restani, P, Mottini, M, Fiocchi, A, Tedeschi, G, Duranti, M
Plant foods for human nutrition (Dordrecht, Netherlands). 2010;(4):396-402
Abstract
The immunological cross-reactivity among major protein- and oil-crops, including lupin, lentil, pea, peanut, kidney bean and soybean, has been studied by a combination of in vitro and in vivo experimental approaches: SDS-PAGE separations of legume protein extracts and immuno-blot revelations with 12 peanut-sensitive subjects' sera, Immuno-CAP and Skin Prick tests on the same subjects. The immuno-blotting data showed a wide range of IgE-binding responses both displayed by one subject towards different plant extracts and among subjects. Differences were both quantitative and qualitative. The prevalent responses of most subjects' sera were seen with peanut polypeptides, as expected, as well as with various polypeptides of the other legumes, the most recurrent of which were the basic subunits of the 11S globulins. The distribution of in vivo responses generally paralleled those obtained by in vitro approaches with strong responses elicited by peanut, lentil and pea protein extracts, especially by most sensitive subjects, thus providing a consistent overall set of results. In this work, the comparison of various approaches has allowed us to get an overall broad picture of the immunological cross-reactivities among proteins of widely used different seed species and to hypothesize the role of most conserved specific polypeptides.
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Update on the medical treatment of allergic rhinitis.
Cingi, C, Kayabasoglu, G, Nacar, A
Inflammation & allergy drug targets. 2009;(2):96-103
Abstract
Allergic rhinitis is a global health problem affecting at least 10 to 25 % of the population. So far, numerous classifications and treatment modalities have been described. In the treatment of allergic disorders Pharmacotherapy is the most used therapeutic modality, especially in allergic rhinitis. The first step to successful management is the accurate diagnosis of the type of AR (intermittent or persistent) and assessment of its severity (mild or moderate to severe). Although objective measurements of the nasal airway have great value to evaluate and follow up the cases, in most centers they are not done in routine clinical practice. Allergen avoidance should be the initial step in the management of AR. Oral antihistamines are the first-line therapy for mild to moderate intermittent and mild persistent rhinitis. They are also recommended for moderate/severe persistent rhinitis cases which are uncontrolled on topical intranasal corticosteroids alone. Corticosteroids are well known for their antiinflammatory and anti allergic effects. Topical usage provides topical efficacy while avoiding systemic side effects. Meta-analysis shows that intranasal corticosteroids are superior to antihistamines. They act by suppression of inflammation at multiple points in the inflammatory cascade and reduce all symptoms of rhinitis. A meta-analysis demonstrated that Montelukast was better than placebo, as effective as antihistamines, but less effective than nasal corticosteroids in improving symptoms and QOL in patients with SAR. Good results were reported with subcutaneous and sublingual immunotherapy. Further investigations are promising.
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The major grass pollen group 5 allergen from Dactylis glomerata and its C-terminal split product both behave as dimers: implications for allergen standardization.
van Oort, E, Dieker, MC, de Heer, PG, Peltre, G, Aalberse, RC, van Ree, R
International archives of allergy and immunology. 2005;(2):113-22
Abstract
BACKGROUND On SDS-PAGE grass pollen group-5 allergens migrate as a doublet with an apparent molecular mass (M(r)) of 25 kDa. Immunoblot analysis revealed additional group 5 reactivity at double and half this M(r). The aim of this study was to investigate these group 5 molecular entities and to compare their allergenicity and behavior in quantitative immunoassays. METHODS Group-5-specific monoclonal antibodies were produced and used for the development of a group-5-specific sandwich ELISA. Affinity-purified Dac g 5 was separated by SDS-PAGE/Western blotting; individual bands were analyzed by N-terminal sequencing. Size exclusion chromatography (SEC) in conjunction with group-5-specific ELISA, competitive RIA and RAST inhibition were used to analyze the size distribution of Dac g 5. Basophil histamine release assays were used to assess biological activity. RESULTS The lower band of the typical group 5 doublet was identified as a truncated form lacking the typical group 5 N-terminus AD(L)/(A)GY, observed in the upper band. The 12-kDa peptide was shown to be the C-terminal half of Dac g 5 (amino acid 127 onwards). SEC in conjunction with competitive RIA revealed that around 45% of Dac g 5 is represented by the 12-kDa peptide. Both the C-terminal half and the whole allergen dimerize under nondenaturing conditions. In competitive RIA and RAST inhibition both forms are equally well detected. In contrast, the half molecule is poorly recognized in sandwich ELISA and displays negligible biological activity in basophil histamine release tests with purified IgE. CONCLUSIONS These observations stress the need to evaluate the performance of allergen standardization protocols in detail, with special attention to allergen size distribution.
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Comparison of allergen immunotherapy and drug treatment in seasonal rhinoconjunctivitis: a 3-years study.
Giovannini, M, Braccioni, F, Sella, G, Contoli, M, Perri, G, Frati, F, Incorvaia, C
European annals of allergy and clinical immunology. 2005;(2):69-71
Abstract
Drug treatment and specific immunotherapy (SIT) are both effective in seasonal rhinoconjunctivitis, but the former acts only on allergic symptoms while the latter modifies the natural history of the disease. Only a few studies compared the clinical efficacy of the two treatments with contrasting results. We planned a study to compare the efficacy of SIT (15 patients) and drug treatment (15 patients) in moderate to severe seasonal rhinoconjunctivitis caused by sensitization to grass pollen. SIT was performed by a 5-grass extract standardized in IR and absorbed onto calcium phosphate (Phostal, Stallergénes, Antony, France) using the conventional build-up phase in 12 weeks and a maintenance treatment with monthly injection for three years. Drug treatment was done with cetirizine as antihistamine, mometasone furoate as nasal topical steroid, and levocabastine eyedrops. All patients registered during the pollen season their symptoms and drug consumption. After one year 12 of 15 patients treated with SIT had less symptoms and drug consumption in respect to baseline compared to none in drug treated group (p = 0.021) and after three years 15 of 15 were improved in group A compared to one of 15 in group B (p = 0.008). These findings indicate an higher efficacy of SIT in patients with seasonal rhinitis not only in the long term but also in the first year of treatment.
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Allergen challenge and deposition of nedocromil sodium in asthma.
Laube, BL, Lin, TC, Valleteau, A, Dalby, RN, Diemer, FB, Togias, AG
Journal of aerosol medicine : the official journal of the International Society for Aerosols in Medicine. 2002;(4):415-25
Abstract
We examined whether the acute protective effect of nedocromil sodium aerosol could be enhanced by increasing the deposition uniformity of the drug in the lungs of adult patients with allergic asthma. Ten patients with mild-to-moderate asthma were challenged with the same doses of allergen on two occasions in a randomized manner. Thirty minutes before these challenges, patients inhaled 4 mg nedocromil sodium, admixed with the radioisotope (99m)technetium. Radiolabeled drug was inhaled during slow (25.4 +/- 4.6 L/min) and faster (58.0 +/- 7.3 L/min) inhalations from a 700 ml holding chamber. Percent changes in FEV(1) at the same top dose of allergen on the two treatment visits were compared. Lung deposition fraction (LDF) and indices of distribution uniformity, quantified from gamma camera images, were also compared. Acute protection against allergen challenge was similar and complete after slow or faster inspiration of nedocromil sodium. Mean (+/- SD) allergen-induced changes in FEV(1) were -1.05 +/- 2.78% and -0.39 +/- 2.80%, respectively, compared to -26.30 +/- 8.49% on a screening challenge (no drug). Mean LDF was also similar on the two visits, averaging 16.4 +/- 4.6% and 16.1 +/- 7.2% of administered drug, respectively. Distribution of nedocromil sodium was most uniform after slow inspiration, but increased uniformity was not related to enhanced protection. Complete protection against acute bronchoconstriction induced by inhaled allergen can be obtained with 4 mg of nedocromil sodium aerosol, inhaled from a large volume holding chamber, 30 min before the exposure, and at inspiratory flow rates between approximately 20-60 L/min. Protection does not appear to be enhanced by increased uniformity of drug distribution within the lungs.
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Allergies to cross-reactive plant proteins. Latex-fruit syndrome is comparable with pollen-food allergy syndrome.
Yagami, T
International archives of allergy and immunology. 2002;(4):271-9
Abstract
Both latex-fruit syndrome and oral allergy syndrome concomitant with pollinosis (pollen-food allergy syndrome) are considered to be caused by cross-reactivity between sensitizers and symptom elicitors. The cross-reactive food allergens relevant to these syndromes are mostly sensitive to heat and digestive enzymes. Such a vulnerable antigen cannot sensitize people perorally but provokes allergic reactions in already sensitized patients based on its cross-reactivity to the corresponding sensitizer. These types of food allergens are often called incomplete food allergens or nonsensitizing elicitors. Their features contrast with those of complete food allergens that have the capacity for peroral sensitization as well as symptom elicitation. Although highly antigenic and cross-reactive, carbohydrate epitopes do not generally elicit allergic reactions and often disturb in vitro IgE tests. Recent research has revealed that some of the cross-reactive allergens responsible for the two syndromes are proteins related to the defense responses of higher plants. Plant defense-related proteins are relatively conserved in the course of evolution and can supply cross-reactive epitopes. It is important to note that various stresses can stimulate the expression of these proteins, which implies that allergens increase in plants under stressful conditions like severe growing situations and exposure to some kinds of chemicals. Because defense-related proteins usually provide a plant with resistance to stresses, varieties that are apt to intensively induce such proteins are agriculturally valuable. Less toxic substances that cause crops to express defensive proteins are being investigated as a new type of agrochemical. Moreover, some defense-related proteins are going to be constantly produced in genetically modified plants. Even though these proteins can be useful agriculturally, their allergenicity should be evaluated carefully.
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Nedocromil sodium 2% ophthalmic solution for the treatment of ragweed pollen seasonal allergic conjunctivitis.
Blumenthal, MN, Schwartz, RH, Kaiser, H
Ocular immunology and inflammation. 2000;(3):159-67
Abstract
PURPOSE To determine the efficacy and safety of nedocromil sodium 2% ophthalmic solution in the treatment of seasonal allergic conjunctivitis. METHODS A combined analysis of two multicenter, randomized, comparative, double-masked, placebo-controlled clinical trials involving 261 patients diagnosed with seasonal allergic conjunctivitis was used. Patients were randomly assigned to receive either topical 2% nedocromil sodium or placebo twice daily for eight weeks. Diary card scores and clinician assessments of allergic symptoms were recorded throughout the study; efficacy was determined by comparing symptom severity at the peak pollen period with symptom severity at baseline. Clinician and patient evaluations of treatment effectiveness were used as secondary measurements of efficacy. RESULTS Patients treated with nedocromil sodium experienced improvement in allergy symptoms, with reductions in the summary symptom score, itch, redness, conjunctival injection, and conjunctival edema significantly (p<0.05) greater than those observed in the patients treated with placebo. Clinicians' and patients' opinions of nedocromil sodium treatment effectiveness were significantly (p<0.02) superior to those of placebo treatment effectiveness. CONCLUSION Nedocromil sodium is effective in the management of seasonal allergic conjunctivitis.