The Phadiatop test, a new in-vitro test for inhalation allergy

The Phadiatop test, a new in-vitro test for inhalant allergy, was evaluated in relation to a RAST panel, and in comparison with total IgE. In 248 patients, aged 12-64 years, who had been prescribed pulmonary medication in general practice, the Phadiatop, total IgE (PRIST), and specific IgE (RAST) test were carried out with seven inhalant allergens common in the Netherlands. RAST was considered positive at class greater than or equal to 2 and total IgE elevated at values greater than or equal to 200, greater than or equal to 150, and greater than or equal to 100 kU/l in age groups 12-14, 15-16, and 17-64 years respectively. The result of the Phadiatop test is given as positive or negative. The predictive value of the Phadiatop test for one or more positive RAST results was 100% and its predictive value for all RAST results being negative was 97.1%, while these predictive values for total IgE were 84.7% and 71.2% respectively. It is concluded that the Phadiatop test is a valuable test to confirm or exclude sensitization to common inhalant allergens.     

Detection and clinical relevance of a type I allergy with occupational exposure to hexahydrophthalic anhydride and methyltetrahydrophthalic anhydride

Summary Hexahydrophthalic anhydride (HHPA) and methyltetrahydrophthalic anhydride (MTHPA) belong to the group of the acid anhydrides and, among other applications, are used in the production of epoxy resins. These substances are known as potent low-molecular allergens and induce predominantly type I allergies according to Coombs and Gell. We examined 110 employees exposed to HHPA and MTHPA. With all of them a RAST was carried out with the commercially available conjugates of phthalic anhydride (PA) and a skin prick test with 1% and 5% acetonic solutions of PA. In 109 of these sera a radio allergo sorbent test (RAST) was carried out with the not commercially available conjugates of HHPA and of MTHPA. With complaints connected with the workplace the working materials used (HHPA, MTHPA) were also checked by means of the skin prick test. With at least one positive immunological finding (in the RAST and/or skin prick test) in connection with complaints at the workplace, we performed a workplace-related inhalation test under experimental conditions. Specific IgE against acid anhydrides was detected in a total of 17 (15.4%) persons. In the challenge test, six (5.4%) sensitisations were shown to be clinically relevant. On inclusion of borderline positive findings with PA conjugates the RAST produced three false negative and one false positive finding compared with a RAST with HHPA and MTHPA conjugates. With the conjugates of trimellitic anhydride, in no case could specific IgE be detected. The skin prick test led, in comparison with the RAST, to three false positive and three false negative findings. With all clinically relevant sensitisations the skin prick test was regarded as positive. RASTs with conjugates of PA and skin prick tests with native acid anhydrides can, according to our investigations, validly ascertain workplace-related sensitisations to HHPA and MTHPA.     

食物变态反应性疾病原因筛查

目的分析过敏原特异性IgE、IgG在食物变态反应性疾病患者中的意义,为食物变态反应性疾病的防治提供依据。方法采用酶联免疫吸附实验（ELISA）方法检测食物过敏疾病患者血清中总IgE、食物特异性IgE、IgG。IgE检测283例,IgG检测120例。结果食物特异性IgG阳性101例,阳性率84.2%。血清总IgE检测276例,阳性率97.5%;食物特异性IgE阳性90例,阳性率31.8%。特异性IgE检测中鱼过敏原特异性IgE的阳性率最高,为12.0%。特异性IgG检测中蛋清/蛋黄IgG阳性率最高,为55%,其次为蟹35%,牛奶29.2%,虾25%。IgG抗体检测儿童与成人对食物过敏种类上存在明显差异,儿童以蛋清/蛋黄、牛奶为主,成人以蟹、虾为主。结论鱼、甲壳类（蟹、虾）、蛋清/蛋黄、牛奶是食物变态反应性疾病的主要过敏原。血清总IgE、食物特异性IgE、IgG抗体检测是食物变态反应性疾病比较可靠的筛查方法。     

我院荨麻疹患儿体外过敏原分析

目的：对本院荨麻疹患儿过敏原情况进行分析探讨。方法：采用免疫球蛋白E测定试剂盒（化学发光法）检测血清总IgE （TIgE）和Phadia公司全自动体外变应原检测系统ImmunoCAP250荧光酶联免疫法检测血清吸入物过敏原过筛查试验（Phadiatop）、食物过敏原过筛查试验（Fx5E）和特异性IgE（SIgE）。结果：193例荨麻疹患儿中,TIgE阳性率为99.3%。Phadiatop、Fx5E总计阳性率为59.8%;Phadiatop、Fx5E阳性率分别为32.1%和49.7%。SIgE显示吸入物过敏原以屋尘、粉尘螨、屋尘螨为主（47.6%）,食物过敏原以牛奶、鸡蛋为主（56.3%,52.6%）。0-3岁年龄段患儿Fx5E阳性率为45.2%,明显高于Phadiatop的阳性率26.2%（P〈0.05）;〉3岁患儿中两者无明显差异（P〈0.05）。结论：荨麻疹患儿多属特应性体质,约60%与第I型变态反应有关;吸入物过敏原主要为屋尘、粉尘螨、屋尘螨,食物过敏原以牛奶、鸡蛋为主;0-3岁患儿食物过敏是其主要因素,而〉3岁患儿食物与吸入物过敏几乎均等存在。     

Immunologically mediated contact urticaria caused by foods in young children with constitutional eczema]

Fifty-two children with atopic dermatitis were investigated with the mixed-food radio-allergosorbent test (RAST) and the skin provocation test 'Skin Application Food Test' (SAFT). The mixed-food RAST is a commercially available test with multiple allergens on one disk. The disk contains 6 common food allergens: cow's milk, egg, peanut, soy, codfish and wheat. The SAFT is a system with which foods are applied to the skin in the state in which they are consumed. This test system is routinely used in our subdivision of Paediatric Dermatology in Sophia Children's Hospital. In some children, atopic dermatitis grew worse after a positive SAFT reaction. In 50% of the 38 children with food allergy a correlation was found between exacerbation/induction of atopic dermatitis and consumption or direct skin contact of foods to which the child was allergic. Due to direct skin contact of foods, atopic dermatitis can grow worse with sudden attacks of pruritus, especially on the hands and in the face. The SAFT imitates the naturally occurring symptoms, is child friendly and easy to perform. The mixed-food RAST can be used as a screening test to identify the children with atopic dermatitis and an atopic immune response to foods, so possibly food allergy. Further investigations of the sensitivity of the target organ (in atopic dermatitis: the skin) and the usefulness of the SAFT are then indicated.     

惠州地区204例儿童慢性荨麻疹血清特异性IgE抗体检测及过敏原分析

目的分析惠州地区儿童慢性荨麻疹患者血清总IgE抗体及特异性IgE抗体水平,了解过敏原分布情况。方法入选2012年1月至2013年12月儿童慢性荨麻疹204例,应用IgE抗体特异性过敏原检测试剂盒(ELISA法)检测血清IgE特异性抗体。结果 204例慢性荨麻疹患儿中总IgE阳性198例,阳性率为97.1%,196例患儿检测出过敏原,阳性率为96.1%,其中食入组主要为蛋黄46例(22.5%),牛奶42例(20.6%),蟹、虾40例(19.6%);吸入组主要为花粉、屋尘、尘螨76例(37.3%),蟑螂52例(25.5%)、猫狗毛发皮屑44例(21.6%)。食入组及吸入组的阳性率无显著性差异(P>0.05)。不同特异性过敏原在各阳性级别均有分布,总IgE均为(+++)级或(++)级。结论多数儿童慢性荨麻疹患者同时出现多种过敏原,其中主要食入因素有蛋黄、牛奶、蟹、虾,主要吸入因素主要为花粉、尘螨、蟑螂、猫狗毛发皮屑。     

Serological examination of IgE- and IgG-specific antibodies to egg protein during influenza virus immunization.

The concentrations of serum IgE (PRIST) and IgE- and IgG-specific antibodies to egg protein were determined in paired sera taken from students who had received influenza virus vaccine. Although persons who gave a history of allergy to egg or to chicken feathers were excluded, 10-16% of vaccinees possessed higher titres of serum IgE and IgE-specific antibody (RAST) to egg white (F1) allergen before vaccination. The titres of IgG-specific antibody to egg protein (ovalbumin and ovomucoid antigens) were negligible, and did not show any significant response after vaccination. In contrast, IgE-specific antibody to F1 allergen rose significantly in a considerable number of the vaccines. The results obtained indicate possible contamination of vaccine products with allergens of egg origin and a potential risk of allergic manifestation after influenza vaccination.     

IgE antibody responses to platinum group metals: a large scale refinery survey.

All 306 South African platinum refinery workers (116 white, 190 coloured) accepted for employment on grounds of absence of evidence of atopy were investigated using the skin prick test and RAST to detect sensitivity to platinum, palladium, and rhodium salts. RAST studies were made for these, together with HSA and DNP-HSA RAST. Of the 306 workers, 38 had a positive skin prick test to the platinum halide salts; of these, one gave a positive reaction to the palladium salt and six to the rhodium salt. There were no isolated positives to the rhodium and palladium halide salts. Total IgE levels were raised in 24 of the 38 (63%) platinum salt prick test positive workers compared with only 43 of the 268 (16%) prick test negative group (p less than 0.001). Positive RASTs were obtained in 62% of those with positive skin tests to the platinum salts. Four of the six giving positive rhodium salt skin tests gave a positive RAST to rhodium salt. Of these, two gave positive RASTS to HSA and all four to DNP-HSA. The palladium salt RAST was negative in the single skin test reactor. In the platinum salt skin test positive group a raised HSA RAST was obtained in 10.5% compared with only 2.5% in the skin negative group. Twenty one per cent of the platinum salt skin positive group had a raised RAST score to DNP-HSA with only 3.5% (4/116) in the skin test negative group, of whom three also had a raised HSA RAST. The latter findings are suggestive of IgE antibody production to new antigenic determinants in HSA produced by conjugation with the platinum salts.     

IgE antibody responses to platinum group metals: a large scale refinery survey

All 306 South African platinum refinery workers (116 white, 190 coloured) accepted for employment on grounds of absence of evidence of atopy were investigated using the skin prick test and RAST to detect sensitivity to platinum, palladium, and rhodium salts. RAST studies were made for these, together with HSA and DNP-HSA RAST. Of the 306 workers, 38 had a positive skin prick test to the platinum halide salts; of these, one gave a positive reaction to the palladium salt and six to the rhodium salt. There were no isolated positives to the rhodium and palladium halide salts. Total IgE levels were raised in 24 of the 38 (63%) platinum salt prick test positive workers compared with only 43 of the 268 (16%) prick test negative group (p less than 0.001). Positive RASTs were obtained in 62% of those with positive skin tests to the platinum salts. Four of the six giving positive rhodium salt skin tests gave a positive RAST to rhodium salt. Of these, two gave positive RASTS to HSA and all four to DNP-HSA. The palladium salt RAST was negative in the single skin test reactor. In the platinum salt skin test positive group a raised HSA RAST was obtained in 10.5% compared with only 2.5% in the skin negative group. Twenty one per cent of the platinum salt skin positive group had a raised RAST score to DNP-HSA with only 3.5% (4/116) in the skin test negative group, of whom three also had a raised HSA RAST. The latter findings are suggestive of IgE antibody production to new antigenic determinants in HSA produced by conjugation with the platinum salts.     

变态反应性皮肤病患者过敏原特异性IgE与总IgE水平分析

目的探讨张家口地区常见3种变态反应性皮肤病患者血清过敏原特异性IgE与总IgE水平分析。方法选取2014年1月-2015年12月诊断急/慢性荨麻疹、湿疹性皮炎、过敏性紫癜3种变态反应性皮肤病患者620例,采用免疫印迹法检测患者血清总IgE、变应原特异性IgE抗体水平,以血清总IgE100IU/ml,或者以血清变应原特异性IgE水平0.35kU/L为阳性,统计分析3种变态反应性皮肤病患者血清特异性IgE与总IgE水平变化,分析常见过敏原分布特征,比较3种皮肤病患者过敏原分布差异。结果入选研究变态反应性皮肤病患者620例,其中,急/慢性荨麻疹260例,湿疹皮炎210例,过敏性紫癜150例。378例(378/620,60.97%)患者血清总IgE水平升高,急/慢性荨麻疹169例(44.71%)、湿疹性皮炎137例(36.24%)、过敏性紫癜72例(19.05%)。血清过敏原特异性IgE阳性患者412例,检出率66.45%(412/620),急/慢性荨麻疹过敏源阳性194例(194/260,74.62%),湿疹性皮炎过敏原阳性168例(168/210,80.00%)、过敏性紫癜109例(109/150,72.67%)。血清过敏原特异性IgE高于总IgE阳性率[(412/620,66.45%)比(378/620,60.97%),χ~2=9.822,P0.05]。常见16种过敏原组合单项中,户尘螨、粉尘螨、春花粉、狗/猫毛皮屑、牛奶、虾6种变应原特异性IgE抗体阳性率在3种皮肤病中比较差异有统计学意义(P0.05)。吸入性过敏原以户尘/粉尘螨、狗/猫毛皮屑阳性率较高,急/慢性荨麻疹、湿疹性皮炎、过敏性紫癜组中阳性率分别为21.43%、14.90%、8.76%;食物性过敏原中,湿疹性皮炎以牛奶阳性率较高,为5.27%,急/慢性荨麻疹以虾/蟹过敏阳性率高,阳性率为10.90%。结论检测变态反应性皮肤病患者血清过敏原特异性IgE与总IgE水平有助于临床合理寻找过敏原,对其进行针对性预防、治疗。     

Castor bean allergy in the upholstery department of a furniture factory.

In this study, undertaken to identify the cause of allergy in several upholstery workers in a furniture factory, the workers were handling several different materials, including glue, silicone spray, upholstery fabrics, and felt. Radio-allergo-sorbent test (RAST) assays showed that sera from sensitised workers contained specific IgE towards the felt; however, further investigations using RAST showed that the allergen was not the felt itself but a contaminant of the felt. The felt was manufactured from sacks, some of which had been used to store castor beans. The sera with raised IgE to the felt also had raised IgE to the castor bean extract. By means of RAST inhibition we confirmed that castor bean allergens in the felt were solely responsible for the raised IgE in the sera. The in-vitro RAST results were found to correlate well with the in-vivo pick tests and clinical symptoms.     

舟山海岛儿童血清过敏原检测分析

目的研究舟山海岛地区过敏性疾病患儿的过敏原分布特点,为临床诊断,治疗及预防提供依据。方法采用酶免疫分析法(ELISA),对患儿的血清样本进行过敏总IgE抗体体外检测呈阳性的475例进行总结分析。结果明确有过敏原的380例(80.00%),其中单一过敏原阳性为87例(18.32%),2种及以上过敏原阳性293例(61.68%)。吸入性过敏原阳性率较高的是螨虫(38.31%)、屋尘(12.21%)、真菌组合(2.53%);食入性过敏原阳性率较高的是鱼类(6.53%)、贝类(6.11%)、豆类(4.21%)。婴幼儿以食物性过敏为主,学龄儿童以吸入性过敏为主。结论螨及鱼类是舟山海岛儿童最常见过敏原,多数患者同时存在多种过敏原。     

The clinical picture is the most important reason to screen for the presence of allergen-specific IgE in children

The presence of allergen-specific IgE in serum is associated with sensitization, but the clinical relevance depends on the patient's history. It supports the diagnosis of an acute allergic response to inhalation or food allergens. The presence of allergen-specific IgE in the serum is not necessary for the diagnosis of asthma, perennial rhinitis or eczema; since allergen avoidance has no beneficial effect in these chronic allergic diseases, one should be critical about the relevance of testing for allergen-specific serum IgE. Screening tests for the presence of allergen-specific serum IgE are frequently used in children; a screening test consists of either 5 inhalant or 5 food allergens and if the test is positive, the laboratory will determine the specific IgE for each of the 5 allergens present in the test. This carries the risk of over-diagnosis if the clinical indication is not clear-cut. Furthermore, in children sensitized to grass pollen, the panel of inhalation and food allergens present in screening tests may lead to serological cross-reactivity with wheat; this increases the number of positive screening tests for food allergens without having clinical relevance. In conclusion, the use of screening tests for the presence of allergen-specific serum IgE should be looked at critically since it may unnecessarily increase the number of allergen-specific IgE tests.     

张家口市变态反应性皮肤病患者过敏原临床结果分析

目的分析张家口市常见变态反应性皮肤病患者过敏原种类及分布概况。方法选择2012年10月-2015年8月我院皮肤科诊断变态反应性皮肤病患者580例,使用德国Mediwise公司生产的Alleryscreen系统,采用免疫印迹实验检测患者血清总IgE、变应原特异性IgE水平,以血清总IgE100 IU/ml,或者以血清变应原特异性IgE水平0.35 IU/ml为阳性,统计分析吸入性、食物性变应原阳性率。结果入组变态反应性皮肤病患者580例,急/慢性荨麻疹297例,湿疹皮炎189例,过敏性紫癜94例,其中检出存在过敏原患者312例,检出率53.79%。男性157例(50.32%),女性155例(49.68%),性别比例差异无统计学意义(P0.05)。急/慢性荨麻疹过敏原阳性率55.21%,常见过敏原为户尘螨、粉尘螨、狗/猫毛皮屑;湿疹皮炎过敏原阳性率55.03%,常见过敏原为狗/猫毛皮屑、牛奶、牛羊肉;过敏性紫癜过敏原阳性率46.81%,常见过敏原为狗/猫毛皮屑、户尘螨/粉尘螨、牛羊肉。吸入性过敏原阳性123例,食物性过敏原阳性34例,重叠阳性者155例。吸入性过敏原前四位分别为户尘螨/粉尘螨(25.00%)、狗/猫毛皮屑(20.51%)、蟑螂(10.26%)、矮豚草/蒿(8.02%)。食物性过敏原前四位分别是牛奶(11.86%)、鱼虾蟹(8.97%)、羊肉(6.41%)、鸡蛋(4.81%)。对一类过敏原反应阳性113例,对两类以上过敏原反应阳性199例。结论张家口地区常见的过敏原为户尘螨/粉尘螨、狗/猫毛皮屑、牛奶及蟑螂等,其中吸入性过敏原阳性率高于食物性过敏原;过敏原阳性患者以吸入与食物性重叠存在较为多见,以多种、多组变应原阳性较为常见。     

612例儿童过敏性疾病血清特异性IgE抗体检测分析

摘要:目的　了解郑州市及其周边地区儿童过敏性疾病血清过敏原及其分布状况。方法　采用免疫印迹法检测2014年1月-2014年12月间就诊于医院的612例过敏性疾病儿童血清过敏原,并对结果进行回顾性分析。结果　612例过敏性疾病患儿中,过敏原特异性IgE阳性者363例,阳性率为59.31%。其中吸入性过敏原特异性IgE阳性者214例,阳性率为34.97%,食物性过敏原特异性IgE 阳238例,阳性率为38.89%。特异性IgE阳性者中,吸入组最常见过敏原为蟑螂（142 例,占23.20%）,食物组最常见过敏原为鸡蛋白（108例,17.65%）。特异性IgE检测阳性率最高者为过敏性鼻炎,其次为支气管哮喘。结论　吸入性过敏原和食物性过敏原均是引起郑州市及周边地区儿童过敏性疾病的重要原因,血清过敏原测定有利于了解患者的过敏状态,协助过敏性疾病的诊断。     

Allergy testing possibly useful in children less than 4 years of age with recurrent cough and wheeze

OBJECTIVE: To assess the diagnostic value of measuring allergen-specific IgE antibodies in children less than 4 years of age with recurrent cough and wheeze. DESIGN: Retrospective cohort study. METHOD: The prevalence of specific sensitisation for inhaled and food allergens that can be demonstrated by means of Phadiatop and enzymatic assays was determined on the basis of clinical data on 97 children under four years of age that had been referred to a paediatrician for recurrent cough and wheeze. RESULTS: Measurement of allergen-specific IgE antibodies was performed in 44 (45%) of the 97 patients (58 boys and 39 girls; median age: 13 months). Sensitisation was demonstrated in 15 of 44 patients (34%). Children who were three years old or older or who had eczema or rhinitis apart from colds had a statistically significantly higher chance of having specific antibodies than children who were younger or who did not have these symptoms. CONCLUSION: Measurement of allergen-specific IgE antibodies can also reveal sensitisation in young children with recurrent cough and wheeze. The likelihood of finding specific antibodies was higher in children in whom either the history or the physical examination revealed indications of eczema or rhinitis apart from colds.     

Meat allergy: II–Effects of food processing and enzymatic digestion on the allergenicity of bovine and ovine meats.

This study was designed to evaluate whether peptic treatment of BSA and OSA affects their allergenicity and to evaluate the effect of technological treatments of meat for infant feeding on the allergenicity of these proteins.

Twelve children (8 males and 14 females) suffering from atopic dermatitis (AD), aged 12 months to 4.33 years (mean age 2.21 +/? 1.05 years).

Children suffering from atopic dermatitis (AD), (AD), clinically reactive and SPT-positive to beef, underwent skin prick testing (SPT) and radioallergosorbent test (RAST) with BSA and OSA, before and after peptic treatment. They were tested also with commercially available homogenized bovine meat (HBM) and with freeze-dried bovine (FDBM) and ovine (FDOM) meats. Peptic digestion of BSA and OSA was carried out in a Dubnoff's water bath containing 0.05 mg/ml of pepsin. SPT and RAST were performed for 1 mg/ml of BSA and OSA digested 5 minutes, 2 hours and 4 hours with pepsin; homogenized bovine meat, and FDBM and FDOM. SPT results were expressed as diameters (in mm) of the wheal obtained after SPT; a diameter > or = 3 mm was considered as positive. RAST was considered positive for IgE values 5 > UI/ml.

SPT to native BSA and OSA were positive in all patients. Only 2 of the 12 children were SPT-positive to HBM, FDBM, and FDOM. After digestion, SPTs and were positive as follows: for BSA, 4/12 after 5 minutes peptic treatment, 2/12 after 2 hours and 2/12 after 4 hours; for OSA, 3/12 after 5 minutes peptic treatment, none after 2 and 4 hours. None of RASTs was positive after peptic attack.

Both proteolytic digestion and technological treatment reduced the allergenic potential of meat products.     

海口地区138例哮喘患儿血清总IgE水平及过敏原检测分析

目的:探讨海口地区哮喘患儿血清中总IgE水平及主要过敏原种类。方法:采用德国欧蒙印迹法分别检测138例哮喘患儿及40例健康儿童的过敏原种类,并采用美国贝克曼化学发光仪DXI800检测血清中总IgE含量。结果:40例健康儿童血清总IgE含量为116.29±91.60μg/L,过敏原检测均为阴性;138例哮喘患儿总IgE的含量为2 126.17±1 942.69μg/L,138例哮喘患儿总IgE阳性率为73.2%,总IgE水平明显高于对照组过敏原阳性率68.1%(P<0.01),且大多数患儿被多种过敏原致敏。吸入组最高为屋尘57例,其次为屋尘螨/粉尘螨46例;食入组最高为虾20例,其次为鸡蛋白、蟹。结论:通过对哮喘患儿测定血清总IgE水平,并结合过敏原的测定,可了解患儿过敏的变应原,寻找病因,尽量避免接触此类过敏原,减少发病。     

164例儿童过敏性疾病血清过敏原检测分析

目的:探讨血清过敏原检测在儿童过敏性疾病中的意义。方法:对164例过敏性疾病儿童的血清过敏原检测结果进行回顾分析。结果:164例患过敏性疾病患儿中147例血清总IgE阳性,阳性率为89.6%。吸入组阳性率70.7%,食物组阳性率18.9%,混合阳性率18.9%。过敏原检测阳性率最高者为荨麻疹,其次支气管哮喘、过敏性鼻炎及湿疹。检出的阳性过敏原中,吸入组最常见为户尘螨(116例,占70.7%),食物组最常见为虾蟹(31例,占18.9%)。结论:吸入性过敏原和食物过敏原均是引起儿童过敏性疾病的重要原因。血清过敏原测定有利于了解患者的过敏状态,协助过敏性疾病的诊断,为过敏性疾病制定环境干预措施和免疫治疗方案提供可靠依据。