ISRN Allergy The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. Atopic Dermatitis: Natural History, Diagnosis, and Treatment Wed, 02 Apr 2014 09:17:29 +0000 Atopic dermatitis is an inflammatory skin disease with early onset and with a lifetime prevalence of approximately 20%. The aetiology of atopic dermatitis is unknown, but the recent discovery of filaggrin mutations holds promise that the progression of atopic dermatitis to asthma in later childhood may be halted. Atopic dermatitis is not always easily manageable and every physician should be familiar with the fundamental aspects of treatment. This paper gives an overview of the natural history, clinical features, and treatment of atopic dermatitis. Simon Francis Thomsen Copyright © 2014 Simon Francis Thomsen. All rights reserved. Female Asthma Has a Negative Effect on Fertility: What Is the Connection? Thu, 27 Mar 2014 14:26:25 +0000 Reproductive changes such as impaired fertility and adverse pregnancy outcomes have been related to female asthma. We recently found that time to pregnancy is prolonged in asthmatic females especially in women with moderate to severe asthma and in those above 30 years of age. Despite their reproductive difficulties the asthmatics ultimately conceived just as many biological children as healthy throughout their reproductive lives. This knowledge therefore raises questions about how asthma affects fertility pathophysiologically. The purpose of this review is to describe the existing knowledge in this field and suggest hypotheses of causal relationships, which may form the basis for future studies in this field. The aim is, in particular, in the literature to examine whether there is any evidence to suggest that the systemic inflammation that characterizes asthma, can affect fertility. The issue is potentially clinically important for asthmatic, infertile individuals and society because treatment of the general systemic inflammation associated with the asthmatic disease combined with hormone stimulation might be the optimal target for an effective infertility therapy, possibly decreasing the need for in vitro fertilization. Elisabeth Juul Gade, Simon Francis Thomsen, Svend Lindenberg, and Vibeke Backer Copyright © 2014 Elisabeth Juul Gade et al. All rights reserved. Respiratory Allergies: A General Overview of Remedies, Delivery Systems, and the Need to Progress Wed, 12 Mar 2014 06:53:38 +0000 The spread of respiratory allergies is increasing in parallel with the alarm of the scientific community. Evidently, our knowledge of the onset mechanisms of these diseases and, as a consequence, of the available remedies is inadequate. This review provides a brief, general description of current therapeutic resources and the state of research with regard to both drugs and medical devices in order to highlight their limits and the urgent need for progress. Increasing the amount of basic biochemical research will improve our knowledge of such onset mechanisms and the potential efficacy of therapeutic preparations. Giuliano Molinari, Giselda Colombo, and Cinzia Celenza Copyright © 2014 Giuliano Molinari et al. All rights reserved. Prevalence of Allergies among University Students: A Study from Ajman, United Arab Emirates Wed, 19 Feb 2014 15:24:37 +0000 Aim. Urbanization and globalization in the Middle East have resulted in drastic environmental changes and increased allergens present in the environment. This study aimed to assess the prevalence of allergies among undergraduate students from a university. Material and Methods. This cross-sectional survey was carried out among undergraduate students of a University at Ajman, UAE. A self-administered questionnaire was used as research instrument for data collection. The demographic data and the allergy characteristics were collected and analyzed using SPSS version 19. Descriptive and inferential statistics were performed. Results. A total of 255 students (33.3% males; 66.7% females) were included. Commonest allergies among the students were allergic conjunctivitis (104 (40.8%)), allergic dermatitis (89 (34.9%)), and eczema (38 (14.9%)). Family history of allergies was strongly associated with occurrence of allergic conjunctivitis and allergic dermatitis. In about 58 (22%) of the students, dust was the most common triggering factor for allergies. Allergies associated with pollen, food, and drugs were less frequent. The distribution of allergies based on gender revealed female preponderance in all types of allergies. Students with allergies reported interference with their daily activities, and academic, social, and extracurricular activities. Conclusions. Allergic conjunctivitis and allergic dermatitis were the frequent allergies reported. Adequate preventive strategies can crumb the prevalence of allergies. Lisha Jenny John, Sharfaa Ahmed, Fiza Anjum, Mohieddin Kebab, Naik Mohammed, Haitham Darwich, Nusaibah Ibraheem, Mohamed Arifulla, and Jayadevan Sreedharan Copyright © 2014 Lisha Jenny John et al. All rights reserved. Complementary Therapies in Allergic Rhinitis Wed, 13 Nov 2013 18:25:39 +0000 Objective. To determine the prevalence of herbal treatment of allergic rhinitis. Methods. In this prospective study, patients who were diagnosed with perennial allergic rhinitis were questioned about their use of natural products/herbal therapies for their symptoms. Results. In total, 230 patients were enrolled. Overall, 37.3% of the patients stated that they had used natural products/herbal therapies at least once. Women were more likely than men to use herbal supplements (38.3% versus 32.4%). Ten different types of herbal supplements were identified, with stinging nettle (Urtica dioicath), black elderberry (Sambucus nigra), and Spirulina being the most common (12.6%, 6.1%, and 5.7%, resp.). Conclusion. This study found a high prevalence of herbal treatment usage for the relief of allergic rhinitis symptoms in Turkey. The herbal products identified in this study and in the literature are discussed. Ibrahim Sayin, Cemal Cingi, Fatih Oghan, Bahadir Baykal, and Seckin Ulusoy Copyright © 2013 Ibrahim Sayin et al. All rights reserved. Noneczematous Contact Dermatitis Sun, 15 Sep 2013 10:43:53 +0000 Irritant or allergic contact dermatitis usually presents as an eczematous process, clinically characterized by erythematoedematovesicous lesions with intense itching in the acute phase. Such manifestations become erythematous-scaly as the condition progresses to the subacute phase and papular-hyperkeratotic in the chronic phase. Not infrequently, however, contact dermatitis presents with noneczematous features. The reasons underlying this clinical polymorphism lie in the different noxae and contact modalities, as well as in the individual susceptibility and the various targeted cutaneous structures. The most represented forms of non-eczematous contact dermatitis include the erythema multiforme-like, the purpuric, the lichenoid, and the pigmented kinds. These clinical entities must obviously be discerned from the corresponding “pure” dermatitis, which are not associated with contact with exogenous agents. Domenico Bonamonte, Caterina Foti, Michelangelo Vestita, and Gianni Angelini Copyright © 2013 Domenico Bonamonte et al. All rights reserved. Ultrastructural Changes of Airway in Murine Models of Allergy and Diet-Induced Metabolic Syndrome Tue, 10 Sep 2013 15:45:23 +0000 Studying ultrastructural changes could reveal novel pathophysiology of obese-asthmatic condition as existing concepts in asthma pathogenesis are based on the histological changes of the diseased airway. While asthma is defined in functional terms, the potential of electron microscopy (EM) in providing cellular and subcellular detail is underutilized. With this view, we have performed transmission EM in the lungs from allergic mice that show key features of asthma and high-fat- or high-fructose-fed mice that mimicked metabolic syndrome to illustrate the ultrastructural changes. The primary focus was epithelial injury and metaplasia, which are cardinal features of asthma and initiate airway remodeling. EM findings of the allergically inflamed mouse lungs correlate with known features of human asthma such as increased mitochondria in airway smooth muscle, platelet activation and subepithelial myofibroblasts. Interestingly, we found a clear and unambiguous evidence to suggest that ciliated cells can become goblet cells using immunoelectron microscopy. Additionally, we show for the first time the stressed mitochondria in the bronchial epithelia of high-fat- or high-fructose-fed mice even without allergen exposure. These results may stimulate interest in using EM in understanding novel pathological mechanisms for different subtypes of asthma including obese asthma. Geeta Devi Leishangthem, Ulaganathan Mabalirajan, Vijay Pal Singh, Anurag Agrawal, Balaram Ghosh, and Amit Kumar Dinda Copyright © 2013 Geeta Devi Leishangthem et al. All rights reserved. Sustained Elevation of Systemic Oxidative Stress and Inflammation in Exacerbation and Remission of Asthma Thu, 29 Aug 2013 15:14:05 +0000 Oxidative stress has been implicated in the pathogenesis of asthma. We aimed at investigating the biomarkers of oxidative stress, inflammation, and tissue damage in patients with asthma in acute exacerbation and remission. We recruited 18 asthmatics admitted to hospital with acute exacerbation and 18 healthy nonsmoking controls matched for age. We evaluated plasma levels of 8-isoprostane, C-reactive protein (CRP) and total matrix metalloproteinase- (MMP-) 9 by ELISA, and MMP-9 activity by zymographic analysis. Plasma levels of 8-isoprostane and CRP were significantly elevated in acute exacerbation and decreased in remission but remained significantly higher compared to healthy controls. The activities of pro-MMP-9 were also significantly higher in acute exacerbation and decreased in remission but remained significantly higher compared to healthy controls in parallel to plasma levels of total MMP-9. These data suggest that overproduction of MMP-9 along with highly elevated levels of oxidative stress and inflammation is implicated in asthma exacerbation and that measurements of these biomarkers can be a valid index in its management. Judith C. W. Mak, Siu P. Ho, Alice S. S. Ho, Barbara K. W. Law, Amy H. K. Cheung, James C. M. Ho, Mary S. M. Ip, and Moira M. W. Chan-Yeung Copyright © 2013 Judith C. W. Mak et al. All rights reserved. The Challenge of Delivering Therapeutic Aerosols to Asthma Patients Mon, 05 Aug 2013 11:16:26 +0000 The number of people with asthma continues to grow around the world, and asthma remains a poorly controlled disease despite the availability of management guidelines and highly effective medication. Patient noncompliance with therapy is a major reason for poor asthma control. Patients fail to comply with their asthma regimen for a wide variety of reasons, but incorrect use of inhaler devices is amongst the most common. The pressurised metered-dose inhaler (pMDI) is still the most frequently used device worldwide, but many patients fail to use it correctly, even after repeated tuition. Breath-actuated inhalers are easier to use than pMDIs. The rationale behind inhaler choice should be evidence based rather than empirical. When choosing an inhaler device, it is essential that it is easy to use correctly, dosing is consistent, adequate drug is deposited in both central and peripheral airways, and that drug deposition is independent of airflow. Regular checking of inhalation technique is crucial, as correct inhalation is one of the cornerstones of successful asthma management. Federico Lavorini Copyright © 2013 Federico Lavorini. All rights reserved. Reciprocal Interference of Experimental Dyslipidemia and Food Allergy in the Evolution of Both Diseases Thu, 06 Jun 2013 11:32:10 +0000 Background. Food allergies have been shown to reduce serum triacylglycerol, glucose, cholesterol, and free fatty acid levels in mice. In turn, dyslipidemias, especially dyslipidemias presenting with low levels of HDL cholesterol, are important risk factors for the development of atherosclerosis. However, the consequences of food allergies on dyslipidemia and atherosclerosis have not been fully investigated. Methods. Food allergy was induced using an egg white solution (EWS) in ovalbumin- (OVA-) sensitized C57BL/6 and low-density lipoprotein receptor knockout mice (LDLr−/−) for 5 weeks and was confirmed by the high production of anti-OVA IgE and IgG1 antibodies in both mouse strains. Results. The allergic C57BL/6 mice exhibited EWS aversion that was associated with less visceral fat and high levels of anti-Ova IgE antibodies after 5 weeks of EWS intake compared to controls. However, LDLr−/− allergic mice showed reduced anti-Ova IgE levels that were similar to the nonsensitized group. The LDLr−/− allergic mice also demonstrated a reversal of food aversion and sustained visceral fat after 5 weeks of allergy. Although HDL cholesterol levels were reduced in both sensitized mouse strains, lipid deposition in thoracic and abdominal aorta as well as area and composition of atherosclerotic plaques as unaffected by chronic ingestion of EWS. Conclusion. LDLr−/− mice develop an attenuated food allergy, as they showed a reversal of food aversion and lower IgE production after 5 weeks of induced allergy. The development of atherosclerosis, in turn, was not accelerated in the allergic LDLr−/− group despite the more atherogenic lipid profile. A. C. Gomes-Santos, J. L. Gonçalves, T. R. Fonseca, A. R. Marques, L. P. A. Dourado, D. C. Cara, and J. I. Alvarez-Leite Copyright © 2013 A. C. Gomes-Santos et al. All rights reserved. Identification of T- and B-Cell Subsets That Expand in the Central and Peripheral Lymphoid Organs during the Establishment of Nut Allergy in an Adjuvant-Free Mouse Model Thu, 11 Apr 2013 11:46:47 +0000 Nut allergies are potentially fatal and rarely outgrown for reasons that are not well understood. Phenotype of T- and B-cell subsets that expand during the early stages of nut allergy is largely unknown. Here we studied this problem using a novel mouse model of nut allergy. Mice were rendered hazelnut allergic by a transdermal sensitization/oral elicitation protocol. Using flow cytometry, the T- and B-cell phenotype in the bone marrow (BM), spleen, and the mesenteric lymph node (MLN) of allergic and control mice was analyzed. Nut allergic mice exhibited an expansion of CD4+ CD62L− T cells in BM and spleen; a similar trend was noted in the MLN. There was expansion of CD80+ B cells in BM and spleen and MLN and CD62L− cells in BM and spleen. Interestingly, among CD80+ B cells, significant proportion was CD73− particularly in the MLN. These data demonstrate that during the early establishment of hazelnut allergy there is (i) expansion of CD4+CD62L− T-cell subsets in both the BM and the periphery, (ii) expansion of CD80+ and CD62L− B-cell subsets in BM and the periphery, and (iii) a significant downregulation of CD73 on a subset of B cells in MLN. Babu Gonipeta, David Duriancik, EunJung Kim, Elizabeth Gardner, and Venu Gangur Copyright © 2013 Babu Gonipeta et al. All rights reserved. Innate Immune Responses in House Dust Mite Allergy Thu, 28 Feb 2013 13:22:02 +0000 Sensitizations to house dust mites (HDM) trigger strong exacerbated allergen-induced inflammation of the skin and airways mucosa from atopic subjects resulting in atopic dermatitis as well as allergic rhinitis and asthma. Initially, the Th2-biased HDM allergic response was considered to be mediated only by allergen B- and T-cell epitopes to promote allergen-specific IgE production as well as IL-4, IL-5, and IL-13 to recruit inflammatory cells. But this general molecular model of HDM allergenicity must be revisited as a growing literature suggests that stimulations of innate immune activation pathways by HDM allergens offer new answers to the following question: what makes an HDM allergen an allergen? Indeed, HDM is a carrier not only for allergenic proteins but also microbial adjuvant compounds, both of which are able to stimulate innate signaling pathways leading to allergy. This paper will describe the multiple ways used by HDM allergens together with microbial compounds to control the initiation of the allergic response through engagement of innate immunity. Alain Jacquet Copyright © 2013 Alain Jacquet. All rights reserved. Thymic Stromal Lymphopoietin Enhances Th2/Th22 and Reduces IL-17A in Protease-Allergen-Induced Airways Inflammation Thu, 07 Feb 2013 11:14:24 +0000 Background. Thymic stromal lymphopoietin (TSLP) is induced in allergic skin and lung inflammation in man and mice. Methods. Allergic lung inflammation induced by two proteases allergens HDM and papain and a classical allergen ovalbumin was evaluated in vivo in mice deficient for TSLPR. Eosinophil recruitment, Th2 and Th17 cytokine and chemokine levels were determined in bronchoalveolar lavage fluid, lung homogenates and lung mononuclear cells ex vivo. Results. Here we report that mice challenged with house dust mite extract or papain in the absence of TSLPR have a drastic reduction of allergic inflammation with diminished eosinophil recruitment in BAL and lung and reduced mucus overproduction. TSLPR deficient DCs displayed diminished OVA antigen uptake and reduced capacity to activate antigen specific T cells. TSLPR deficient mice had diminished proinflammatory IL-1β, IL-13, and IL-33 chemokines production, while IL-17A, IL-12p40 and IL-10 were increased. Together with impaired Th2 cytokines, IL-17A expressing TCRβ+ T cells were increased, while IL-22 expressing CD4+ T cells were diminished in the lung. Conclusion. Therefore, TSLPR signaling is required for the development of both Th2 and Th22 responses and may restrain IL-17A. TSLP may mediate its effects in part by increasing allergen uptake and processing by DCs resulting in an exacerbated asthma. Dieudonnée Togbe, Louis Fauconnier, Fahima Madouri, Tiffany Marchiol, Pauline Chenuet, Nathalie Rouxel, Aurélie Ledru, François Erard, Valerie Quesniaux, and Bernhard Ryffel Copyright © 2013 Dieudonnée Togbe et al. All rights reserved. The Relationship between Maternal Atopy and Childhood Asthma in Pretoria, South Africa Sun, 27 Jan 2013 14:38:07 +0000 Introduction. Asthma is the commonest chronic condition of children. Diagnosis of this condition remains difficult. Many surrogate markers are used, such as documenting evidence of atopy. Method. A random sample of asthmatic children and their mothers attending the Children’s Chest and Allergy Clinic at Steve Biko Academic Hospital were enrolled. Children were classified as having atopic or nonatopic asthma. Mothers completed a questionnaire to uncover atopic features. Results. Along with their mothers, 64 children with atopic asthma and 36 with nonatopic asthma were studied. The proportion of children with atopic asthma does not differ for mothers with and without a positive SPT (), a history of asthma (), symptoms suggestive of an allergic disease (), or who were considered to be allergic (). The odds ratio of a child having atopic asthma when having a mother with a doctor diagnosed history of asthma is 4.76, but the sensitivity is low (21.9%). Conclusion. The data demonstrates that all maternal allergic or asthmatic associations are poor predictors of childhood atopic asthma. Despite the increased risk of atopic asthma in a child to a mother that has a doctor diagnosis of asthma (OR 4.76 ), this is a poor predictor of atopic asthma (sensitivity 21.9%). Salome Abbott, Piet Becker, and Robin J. Green Copyright © 2013 Salome Abbott et al. All rights reserved. Perinatal Pet Exposure, Faecal Microbiota, and Wheezy Bronchitis: Is There a Connection? Wed, 09 Jan 2013 10:47:59 +0000 Background. The hygiene hypothesis suggests that high hygiene standards have led to an immune dysfunction and an increase in allergic diseases. Farming-related exposures are associated with a decreased risk of asthma. Since the gut microbiota may be a pivotal component in the hygiene hypothesis, we studied whether perinatal exposure to pets, doctor's diagnosed wheezy bronchitis (WB), and compositional changes in the gut microbiota are interrelated among urban infants. Methods. Data were collected prospectively from a mother-infant nutrition study. Data on perinatal pet ownership, WB, and the microbiota composition of faecal samples of the infants assessed by quantitative PCR at 1 month were compared. Results. None of the 30 infants exposed to pets had suffered from WB by 24 months, whereas 15 of the 99 (15%) nonexposed infants had had WB (). The counts of Bifidobacterium longum were higher in samples () from nonwheezing infants with pet exposure compared to those () in wheezing infants without pet exposure (8.59/10.44 versus 5.94/9.86, resp. (median/upper limit of range, bacteria(log)/g of stool); ). B. breve was more abundant in the wheezing infants (). Merja Nermes, Katri Niinivirta, Lotta Nylund, Kirsi Laitinen, Jaakko Matomäki, Seppo Salminen, and Erika Isolauri Copyright © 2013 Merja Nermes et al. All rights reserved. Effect of Activated Charcoal Fibers on the Survival of the House Dust Mite, Dermatophagoides pteronyssinus: A Pilot Study Wed, 24 Oct 2012 10:12:36 +0000 House dust mites produce potent allergens that exacerbate asthma in sensitized patients, whom are recommended to practice allergen avoidance within their home environment. We tested the effect of activated charcoal impregnated fibers on house dust mite survival. One hundred live adult house dust mites (Dermatophagoides pteronyssinus) were added to eight culture dishes preequilibrated at room temperature () and 70% humidity () containing house dust mite food and active charcoal fibers. At 10 minute intervals, live and dead house dust mites were counted. All house dust mites instantly attached to the activated charcoal fibers and started to shrink almost immediately. There were no live house dust mites present as early as 40 minutes in some dishes while after 190 minutes all house dust mites were dead. In conclusion, activated charcoal fibers, if incorporated into bedding items, have the potential to control house dust mites in the indoor environment. Hae-Seon Nam, Sun-Hwa Lee, Young-Jin Choi, Joon-Soo Park, Moon-Kyun Cho, Sang-Han Lee, Julian Crane, and Robert Siebers Copyright © 2012 Hae-Seon Nam et al. All rights reserved. Conditions Associated with Childhood Asthma in North Texas Mon, 24 Sep 2012 09:19:38 +0000 Introduction. The purpose of this study was to identify significant associations between asthma diagnosis, comorbid conditions, and social problems in children. Method. This study explored data collected in a unique, regional survey of children’s health in north Texas originally administered in 2009 to a random sample of 21,530 households with children from 0 to 14 years of age. Descriptive statistics were compiled for the subsample of children with asthma, associations of interest were identified, and strengths of relevant associations were calculated. Results. The prevalence of asthma in school-aged children in the target area is 19–25%, which exceeds both national and state values. Statistically significant associations were found between asthma and allergies, sleep problems, and tonsillectomy. Significant associations were identified between asthma and school absences, academic problems, and behavior problems in school. There was a significantly greater prevalence of obesity/overweight among children with asthma than without asthma. Discussion. Children with asthma are at high risk for impairment in multiple dimensions. Thorough assessment, including comprehensive medical, social, and environmental histories, is critical in management of pediatric asthma. Patricia Newcomb and Alaina Cyr Copyright © 2012 Patricia Newcomb and Alaina Cyr. All rights reserved. Hormonal Link to Autoimmune Allergies Wed, 22 Aug 2012 09:17:30 +0000 IgE recognition of autoantigens might augment allergic inflammation in the absence of exogenous allergen exposure. Among allergy and autoimmunity, there is disproportionate representation of males before puberty and females after puberty, suggesting a role for sex hormones. Hormone allergy is an allergic reaction where the offending allergens are one's own hormones. It is an immune reaction to the hormones, which can interfere with the normal function of the hormones. It can occur perimenstrually in women along with the variation in menstrual cycle. The perimenstrual allergies are about the cyclic abundance of the hormone causing a cyclic expression of allergic symptoms. The inflammatory mechanisms of allergic reactions to hormone allergens, which are intrinsic to the body, are the same as the mechanisms of allergic reactions to external allergens. Shilpa Shah Copyright © 2012 Shilpa Shah. All rights reserved. Alternative Treatment for Asthma: Case Study of Success of Traditional Chinese Medicine Treatment of Children from Urban Areas with Different Levels of Environmental Pollution Thu, 09 Aug 2012 13:51:18 +0000 The present study examined efficacy of traditional Chinese medicine (TCM) treatment in Dutch children with asthma in areas with differing air pollution. The study results indicate that TCM treatment of children living in more polluted urban area is less successful then that of children living in cleaner air area. Helen Kopnina Copyright © 2012 Helen Kopnina. All rights reserved. Clinical and Immunological Changes of Immunotherapy in Patients with Atopic Dermatitis: Randomized Controlled Trial Wed, 07 Mar 2012 13:03:46 +0000 Background. Immunotherapy has proven to be an useful tool in the management of allergic respiratory diseases; however, little has been studied in atopic dermatitis. Objective. To evaluate the clinical and immunological impact of immunotherapy with mites allergen extracts in atopic dermatitis. Methods. Patients with atopic dermatitis were assigned with computer-generated randomization to either of the following groups: (a) controls received only topical treatment with steroids and/or tacrolimus and (b) actively treated patients received topical treatment plus immunotherapy. Levels of serum total IgE, mites-specific IgE and IgG4 were assessed at study start and after one year of immunotherapy. Results. 31 patients in the active group and 29 in the control group completed the study. Symptoms and medication scores were significantly reduced in the active group after six months. Three patients in the control group showed new sensitizations to mites, while 3 patients in the active group showed neosensitization to shrimp with negative oral food challenge. We observed significant increase of mites-specific IgG4 levels in active group. Conclusion. Specific allergen immunotherapy induced a tolerogenic IgG4 response to mite allergens associated with favorable clinical effects in atopic dermatitis patients. Jorge Mario SΓ‘nchez Caraballo and Ricardo Cardona Villa Copyright © 2012 Jorge Mario Sánchez Caraballo and Ricardo Cardona Villa. All rights reserved. Unscrambling Egg Allergy: The Diagnostic Value of Specific IgE Concentrations and Skin Prick Tests for Ovomucoid and Egg White in the Management of Children with Hen’s Egg Allergy Thu, 09 Feb 2012 10:18:53 +0000 Resolution of egg allergy occurs in the majority of egg allergic children. Positive specific IgE antibodies to ovomucoid (OVM) have been suggested to be of greater predictive value for persistent egg allergy than specific IgE to egg white. The performance of OVM-specific IgE antibody levels in a cohort of children referred for a routine egg challenge was compared with egg white specific IgE levels in predicting a positive egg challenge. 24/47 subjects had persistent egg allergy. Receiver operating characteristic analysis showed that OVM-specific IgE testing was the most useful test for the diagnosis of persistent egg allergy. The optimal decision points for the prediction of persistent egg allergy were >0.35 kUA/L for specific IgE levels to both EW and OVM, and ≥3 mm for SPT. Children with specific IgE levels suggestive of persistent egg allergy need not be subject to an egg provocation challenge, reducing both costs and risks to the child. D. E. Marriage, M. Erlewyn-Lajeunesse, D. J. Unsworth, and A. J. Henderson Copyright Β© 2012 D. E. Marriage et al. All rights reserved. Epicutaneous Immunotherapy Compared with Sublingual Immunotherapy in Mice Sensitized to Pollen (Phleum pratense) Thu, 02 Feb 2012 14:12:10 +0000 Background. The aim of this study was to compare the efficacy of epicutaneous immunotherapy (EPIT) to sublingual immunotherapy (SLIT) in a model of mice sensitized to Phleum pratense pollen. Methods. BALB/c mice were sensitized by sub-cutaneous route to pollen protein extract mixed treated for 8 weeks, using sham, EPIT, or SLIT. Measurements involved the serological response and cytokine profile from reactivated splenocytes, plethysmography after aerosol challenge to pollen, cell, and cytokine contents in the bronchoalveolar lavages (BALs). Results. After immunotherapy, sIgE was significantly decreased in the treated groups compared to sham (𝑃<0.001), whereas sIgG2a increased with EPIT and SLIT (𝑃<0.001 and 𝑃<0.005 versus sham). Reactivated splenocytes secreted higher levels of Th2 cytokines with sham (𝑃<0.01). Penh values were higher in sham than EPIT and SLIT. Eosinophil recruitment in BAL was significantly reduced only by EPIT (𝑃<0.01). Conclusion. In this model of mice sensitized to pollen, EPIT was at least as efficient as SLIT. Lucie Mondoulet, Vincent Dioszeghy, Mélanie Ligouis, Véronique Dhelft, Emilie Puteaux, Christophe Dupont, and Pierre-Henri Benhamou Copyright © 2012 Lucie Mondoulet et al. All rights reserved. The Relationship of Allergy Severity to Depressive and Anxious Symptomatology: The Role of Attitude toward Illness Thu, 12 Jan 2012 13:28:39 +0000 The current study examined the relationship between self-reported allergy severity, depressive and anxious symptoms, and attitude toward illness in adolescents and young adults (AYAs) with allergies. Participants were 214 undergraduate students between the ages of 17–25 years with self-reported allergies. Participants completed the Center for Epidemiological Studies Depression Scale (CES-D), the Zung Self-Rating Anxiety Scale (SAS), and the Child Attitude Toward Illness Scale (CATIS) as measures of depressive symptoms, anxious symptoms, and attitude toward illness, respectively. Using the bootstrapping method, results revealed that attitude toward illness mediated the relationship between self-reported disease severity and depressive and anxious symptoms. Results of the current study suggest that attitude toward illness is one pathway by which subjective disease severity impacts psychological functioning in AYAs with allergies. Elizabeth S. Molzon, Kristina I. Suorsa, Stephanie E. Hullmann, Jamie L. Ryan, and Larry L. Mullins Copyright © 2011 Elizabeth S. Molzon et al. All rights reserved. Do Other Components of Bedding Dust Affect Sensitisation to House Dust Mites? Wed, 11 Jan 2012 15:24:04 +0000 Bedding dust is a mixture of many components, of which the house dust mite (HDM) allergen, Der p 1, is the most allergenic. There has been little work to investigate the effect of other bedding dust components on HDM sensitisation. The objective of the study was to determine the effect of endotoxin in bedding dust on the allergic response in HDM-sensitised individuals. Twenty-nine house dust mite-sensitised adults were skin prick and allergen patch tested against a sterile solution of their own bedding dust and against a solution containing the same concentration of Der p 1 as the bedding solution for comparison. There was no significant difference in wheal size between the diluted house dust mite solution and the bedding dust in spite of their high levels of endotoxin. Symptomatic subjects had larger, but not statistically significant, responses to commercial house dust mite solution than asymptomatic subjects. Allergen patch test responses were negative in 22/29 of subjects using either bedding dust solutions or comparable diluted house dust mite solutions. An individual's own bedding dust does not appear to contain factors that enhance skin prick test or atopy patch test responses to house dust mites. Claire Smith, Thorsten Stanley, Julian Crane, and Robert Siebers Copyright © 2011 Claire Smith et al. All rights reserved. Measurement of Horse Allergen (Equ cx) in Schools Wed, 04 Jan 2012 15:53:46 +0000 Background. The presence of horse allergen in public places is not well-known, unlike for instance cat and dog allergens, which have been studied extensively. The aim was to investigate the presence of horse allergen in schools and to what extent the influence of number of children with regular horse contact have on indoor allergen levels. Methods. Petri dishes were used to collect airborne dust samples during one week in classrooms. In some cases, vacuumed dust samples were also collected. All samples were extracted, frozen and analysed for Equ cx content shortly after sampling, and some were re-analysed six years later with a more sensitive ELISA assay. Results. Horse allergen levels were significantly higher in classrooms, in which many children had horse contact, regardless of sampling method. Allergen levels in extracts from Petri dish samples, which had been kept frozen, dropped about 53% over a six-year period. Conclusion. Horse allergen was present in classrooms and levels were higher in classrooms where many children had regular horse contact in their leisure time. This suggests that transfer of allergens takes place via contaminated clothing. Measures should be taken to minimize possible transfer and deposition of allergens in pet-free environments, such as schools. Anne-Sophie Merritt, Gunnel Emenius, Lena Elfman, and Greta Smedje Copyright Β© 2011 Anne-Sophie Merritt et al. All rights reserved. Airway Epithelium in Atopic and Nonatopic Asthma: Similarities and Differences Thu, 29 Dec 2011 17:19:00 +0000 Asthma is an inflammatory disorder of the airways, and the airway epithelium has the central role in its pathogenesis. In general, the airway inflammation is characterised by the infiltration of the epithelium and submucosa by a range of inflammatory cells driven largely by Th-2 lymphocytes, eosinophils, and mast cells. The pathogenic mechanisms of nonatopic asthma in comparison to its atopic counterpart have always been a subject of debate. Although clinically are two distinct entities, more similarities than differences have been observed between the two in terms of immunopathogenesis, underlying IgE mechanisms, and so on. in a number of previous studies. More information has become available in recent years comparing the ultrastructure of the epithelium in these two types of asthma. A comparison of airway epithelium in atopic and nonatopic asthma is presented here from the available information in the literature. Similarities outnumber the differences, until we unravel the mystery surrounding these two important phenotypes of asthma in more detail. Prathap Pillai, Chris J. Corrigan, and Sun Ying Copyright © 2011 Prathap Pillai et al. All rights reserved. Th2 Cytokine Levels Distort the Association of IL-10 and IFN-𝛾 with Allergic Phenotypes Wed, 28 Dec 2011 13:58:18 +0000 The expression of allergic phenotypes involves complex inter-relationships among several Th2 and Th1 cytokines as well as the regulator cytokine interleukin (IL)-10. These direct or indirect interrelationships may distort the true associations of cytokine responses with these phenotypes. In this study, we aimed to clarify the effects of the regulatory cytokine IL-10 and Th1 cytokine interferon-gamma (IFN-𝛾) on allergic phenotypes after adjusting for the correlations with Th2 cytokines. After adjusting for Th2 cytokines, IL-10 and IFN-𝛾 were protective against atopy. Adjusted levels of IL-10 and IFN-𝛾 stimulated with house-dust mite (HDM) were significantly lower in atopics than non-atopics, for IL-10 adjusting for IL-5 (𝑃=0.002), IL-13 (𝑃=0.012), IL-9 (𝑃=0.016), and IL-4 (𝑃=0.043), and for IFN-𝛾 adjusting for IL-5 (𝑃=0.005), IL-13 (𝑃=0.005), and IL-9 (𝑃=0.037). IL-10 and IFN-𝛾 levels stimulated with phytohaemagglutinin (PHA) and staphylococcal enterotoxin B (SEB) exhibited a similar pattern. The adjusted levels of IL-10 and IFN-𝛾 stimulated with HDM, PHA or SEB were all significantly negatively correlated with total serum IgE, except for IFN-𝛾 stimulated with SEB. Levels of Th2 cytokines distort the associations of IL-10 and IFN-𝛾 with allergic phenotypes. Removing the covariance with Th2 cytokines, both IL-10 and IFN-𝛾 were protective against atopy. Guicheng Zhang, Catherine M. Hayden, Jack Goldblatt, Patrick Holt, and Peter N. Le SouΓ«f Copyright © 2011 Guicheng Zhang et al. All rights reserved. Histone Deacetylase Inhibition and Dietary Short-Chain Fatty Acids Mon, 26 Dec 2011 08:11:19 +0000 Changes in diet can also have dramatic effects on the composition of gut microbiota. Commensal bacteria of the gastrointestinal tract are critical regulators of health and disease by protecting against pathogen encounter whilst also maintaining immune tolerance to certain allergens. Moreover, consumption of fibre and vegetables typical of a non-Western diet generates substantial quantities of short-chain fatty acids (SCFAs) which have potent anti-inflammatory properties. Dietary interventions such as probiotic supplementation have been investigated for their pleiotropic effects on microbiota composition and immune function. Probiotics may restore intestinal dysbiosis and improve clinical disease through elevated SCFA levels in the intestine. Although the precise mechanisms by which such dietary factors mediate these effects, SCFA metabolites such as butyrate also function as histone deacetylase inhibitors (HDACi), that can act on the epigenome through chromatin remodeling changes. The aim of this review is to provide an overview of HDAC enzymes and to discuss the biological effects of HDACi. Further, we discuss the important relationship between diet and the balance between health and disease and how novel dietary interventions such as probiotics could be alternative approach for the prevention and/or treatment of chronic inflammatory disease through modulation of the intestinal microbiome. Paul V. Licciardi, Katherine Ververis, and Tom C. Karagiannis Copyright © 2011 Paul V. Licciardi et al. All rights reserved. Prolonged Antigen Ingestion by Sensitized Mice Ameliorates Airway Inflammation Thu, 01 Dec 2011 16:03:06 +0000 Food allergy frequently precedes or coexists with respiratory allergy, and although restriction of contacts with the allergen is the elected clinical procedure, oral immunotherapy (OIT) has proven to be surprisingly efficient in clinical trials. We investigated whether prolonged restriction and voluntary exposure of previously sensitized (immunized) mice to ovalbumin (OVA) in the drinking water would alter subsequent responses to bronchial (aerosol) challenge with OVA. We found a significant suppression of bronchial inflammation, with marked reduction of eosinophils. IL-4, CCL-2, and CCL-11 are not associated with elevation in IL-10 production or Foxp3 expression, with only minor digestive symptoms. Maria de Lourdes Meirelles Noviello, Nathália Vieira Batista, Luana Pereira Antunes Dourado, and Denise Carmona Cara Copyright © 2011 Maria de Lourdes Meirelles Noviello et al. All rights reserved. The Characterization of the Repertoire of Wheat Antigens and Peptides Involved in the Humoral Immune Responses in Patients with Gluten Sensitivity and Crohn's Disease Thu, 27 Oct 2011 16:04:33 +0000 Intestinal T cells from gluten sensitivity/celiac disease patients respond to a heterogeneous array of peptides. Our study extended this heterogeneity to humoral immune response to various wheat proteins and peptides in patients with gluten sensitivity or Crohn’s disease. IgG and IgA antibodies in sera from those patients and healthy control subjects were measured against an array of wheat antigens and peptides. In gluten-sensitive patients, IgG reacted most against transglutaminase, prodynorphin, wheat extract, and 𝛼-, 𝛾-, and πœ”-gliadin; IgA reacted most against wheat then transglutaminase, glutenin, and other peptides. In the sera of Crohn’s disease patients, IgG reacted most against wheat and wheat germ agglutinin then transglutaminase, prodynorphin, 𝛼-, and 𝛾-gliadin; IgA reacted foremost against prodynorphin then transglutaminase and 𝛼-gliadin. These results showed a substantial heterogeneity in the magnitude of IgG and IgA response against various wheat antigens and peptides. Measurements of IgG and IgA antibodies against such an array of wheat peptides and antigens can enhance the sensitivity and specificity of serological assays for gluten sensitivity and celiac disease and may also detect silent celiac disease or its overlap with inflammatory bowel disease. Aristo Vojdani Copyright © 2011 Aristo Vojdani. All rights reserved.