Statistical analysis of IgE antibodies to the common inhalant allergens in 44,496 sera

A statistical analysis of RAST screening of 44,496 sera, submitted in 1986 and 1987 for routine diagnostic allergic examination, was performed. The sera were tested on a fixed panel of allergens, regardless of the patient's history. The association of a positive RAST with age and month of birth was studied. It was concluded that among the inhalant allergens, house-dust mite was the most frequent sensitizer for all age groups, followed by grass pollen and cat dander. Sensitization to cat dander occurred twice as often as sensitization to dog dander. Among children less than 4 years of age, a different profile of sensitization was found, indoor allergens (mites, animal danders) being more important than outdoor allergens (pollen). Furthermore, we found that children born during December-February had a slightly but significantly greater chance of becoming sensitized to grass pollen compared with children born during September and November (P less than .05). Children born during July-September had a greater chance of becoming sensitized to house dust mite compared with children born during January-March (P less than .05). Finally, it was found that children born during October-December had a greater chance of becoming sensitized to dog dander compared with children born during March-May.     

Environmental and Social Influences on Skin Test Results in Children

Skin tests with 13 inhalant allergens were performed in 788 children with respiratory allergy. Positive reactions were common to animal danders (65%), to grass pollens (55%) and to tree pollens (44%) but rare to moulds (13%) and to house dust mite (12%). Children exposed to cows, dogs or horses at home more often had skin test reactions to these allergens than the children not exposed, but reactions to cat dander occurred as frequently in children exposed to cats at home as to those not exposed. Reactions to three pollens occurred most often in children from upper social classes and from urban areas and reactions to house dust mite occurred most often in children from lower social classes and from rural areas. Children with positive reactions to house dust mite came from larger families than children with negative test results.     

Relationship between aeroallergen and food allergen sensitization in childhood

BACKGROUND: Previous studies measuring the prevalence of allergen sensitization have been relatively small and used small numbers of allergens. To effectively evaluate children with atopic disease, we need an accurate knowledge of which allergens are important. OBJECTIVE: To measure the prevalence of sensitization within a large unselected birth cohort, to examine the associations between sensitization to different allergens and determine whether atopy can be defined by a small panel of allergens. METHODS: The Avon Longitudinal Study of Parents and Children is a population-based birth cohort of 13,638 singletons surviving to 4 weeks of age. The cohort was skin tested at 7 years of age to house dust mite (Dermatophagoides pteronyssinus), grass pollens, cat, peanuts, mixed tree nuts and egg and one of three other panels: animal danders, foods or aeroallergens. Sensitization was defined as a weal diameter of > or =3 mm. The strength of associations between sensitization to different allergens was tested by calculating the odds ratio adjusted for sensitization to D. pteronyssinus and grass pollen and gender. RESULTS: Valid data were obtained from 6412 singletons. Sensitization was most common to aeroallergens: grass pollens (8.5%), D. pteronyssinus (7.8%), cat (4.9%), D. farinae (3.6%), dog (2.7%), horse (1.4%), rabbit (1.4%). Of the foods tested, the most common sensitization was to peanut (1.4%) and mixed tree nuts (1.0%). More than 95% of subjects with sensitization to any of the 29 allergens tested were sensitized to one of grass, D. pteronyssinus or cat allergen. There were strong associations of multiple sensitizations both within and between different allergen classes (pollens, animals, foods, peanut and tree nuts). CONCLUSIONS: Seven-year-old children in the UK are primarily sensitized to aeroallergens, but also to peanuts and tree nuts. There are strong associations between sensitization within allergen groups as well as between allergen groups. Further studies are required to observe whether similar associations are seen with clinical allergy to these allergens.     

Allergen specific IgGd antibodies in dogs with atopic dermatitis as determined by the enzyme linked immunosorbent assay (ELISA).

Allergen specific IgGd antibodies were detected by the enzyme linked immunosorbent assay (ELISA) in 89% of the 62 atopic dogs studied. Antibodies were found most frequently against house dust (47%), human dander (50%), grass pollens (58%) and spring tree pollens (43%). These antibodies were also found in 11 of 20 dogs with atopic symptoms but without immediate skin test reactivity to inhalant allergens. Agreement between the presence of skin reactivity and allergen specific IgGd titres ranged from one of 14 for cat dander to 22 of 34 for house dust. Among dogs with atopic symptoms but without skin test reactivity and specific IgGd titres to the respective allergens, the agreement varied between 28 of 54 for human dander and 67 of 68 for cat dander. In view of the value of the dog as an experimental model of atopic disease in man, further studies of the pathophysiological significance of IgGd antibodies are warranted. In addition, reconsideration of the diagnostic criteria for canine atopic dermatitis, as done by Hanifin & Rajka (1980) in man, seems indicated.     

GA2LEN skin test study III: Minimum battery of test inhalent allergens needed in epidemiological studies in patients

Background:  The number of allergens to be tested in order to identify sensitized patients is important in order to have the most cost-effective approach in epidemiological studies.
Objective:  To define the minimal number and the type of skin prick test (SPT) allergens required to identify a patient as sensitized using results of the new Pan-European GA²LEN skin prick test study.
Method:  In a large Pan-European multicenter (17 centers in 14 countries) patient based study, a standardized panel of 18 allergens has been prick tested using a standardized procedure. Conditional approach allowed to determine the allergens selection.
Result:  Among the 3034 patients involved, 1996 (68.2%) were sensitized to at least one allergen. Overall, eight allergens (grass pollen, Dermatophagoides pteronyssinu s, birch pollen, cat dander, Artemisia , olive pollen, Blatella and Alternaria ) allowed to identified more than 95% of sensitized subjects. However, differences were observed between countries, two allergens being sufficient for Switzerland (grass pollen and cat dander) as opposed to nine for France (grass pollen, Dermatophagoides pteronyssinu s, olive pollen, cat dander, Blatella , cypress, dog dander, alder and [Artemisia or Alternaria]). According to country, up to 13 allergens were needed to identify all sensitized subjects.
Conclusion:  Eight to ten allergens allowed the identification of the majority of sensitized subjects. For clinical care of individual patients, the whole battery of 18 allergens is needed to appropriately assess sensitization across Europe.     

Classification of allergens by positive percentage agreement and cluster analysis based on specific IgE antibodies in asthmatic children]

Classification and characterization of allergens is important because allergic patients are sensitized by a variety of allergens. One hundred and sixty-one sera from asthmatic children were investigated for specific IgE antibodies against 35 allergens including 20 inhalants and 15 foods by means of the MAST method. We assessed the allergenic properties of the allergens based on positive percentage agreement and cluster analysis. There was a high positive percentage agreement of specific IgE antibodies between house dust and Dermatophagoides spp., a relatively high agreement between 5 molds, cat and dog epithelium, mugwort and wormwood and 5 grasses. Among the food allergens, the positive percentage agreements were relatively high, especially between cow's milk, casein, cheese, and between 3 cereal grains. In the cluster analysis, house dust and Dermatophagoides spp. made a big cluster; therefore 32 allergens except house dust and mites were analyzed. From the results of the cluster analysis, the major cluster consisted of (1) ragweed, (2) mugwort and wormwood, (3) timothy, sweet vernal, velvet and cultivated rye, (4) wheat, barley and rice, (5) molds, (6) cow's milk, casein, soybean and cheese, (7) shrimp and crab, (8) egg white, (9) Japanese cedar, (10) dog epithelium, (11) cat epithelium. The cluster of grass pollens and cereal grains made one cluster. These results tend to confirm the presence of species cross-reactivities within the major classes of allergens.     

IgE immune response to Ginkgo biloba pollen.

BACKGROUND: The ginkgo (Ginkgo biloba L.) continues to be planted as a shade tree in preference to other species in Seoul, Korea. The proportion of ginkgo to total shade trees was 43.2% in 1998, but the allergenic characteristics of ginkgo pollen has not been elucidated. OBJECTIVES: This study was undertaken to obtain information regarding the skin reactivity rate to ginkgo pollen in a population of Korean subjects with respiratory allergy. Possible ginkgo pollen allergens and the cross-reactivity of ginkgo pollen with other prevalent pollens were also examined. METHODS: Four hundred and forty-seven patients with asthma and/or allergic rhinitis were skin prick tested with extract of ginkgo pollen (1:20 wt/vol). Of these patients, positive skin responders (A/H ratio > or =2+) were selected for ELISA and immunoblot experiments. RESULTS: A total of 21 patients (4.7%) showed skin reactivity (A/H ratio > or =2+) to ginkgo pollen in the skin prick test. They were also cosensitized to many other tree, grass, and weed pollens. Sixteen (76%) of the 21 positive skin responders showed specific IgE responses to ginkgo pollen in ELISA. In inhibitory ELISA, IgE binding to ginkgo pollen was inhibited by more than 80% by oak, ryegrass, mugwort, and ragweed; and 34% by hop Japanese; and 10% by rBet v 2 at 10 microg/mL. In immunoblot, 10 out of 21 sera (48%) reacted to the 15-kD protein of ginkgo pollen, 9 (43%) to 33-35 kD, and 8 (38%) to 36-38 kD. In inhibitory immunoblot, IgE binding to ginkgo pollen proteins was almost completely inhibited by oak, ryegrass, mugwort and ragweed, but only partially by hop Japanese and rBet v 2. CONCLUSION: The skin reactivity rate to ginkgo pollen is approximately 4.7% in a population of Korean subjects with respiratory allergy. Since ginkgo pollen has a high cross-reactivity with other prevalent pollens, it could cause clinical symptoms during its pollen season by cross-reacting with the IgE produced in response to other pollens in patients sensitized to multiple pollens.     

Atopic features of cough variant asthma and classic asthma with wheezing

Background Cough variant asthma is a phenotype of asthma solely presenting with coughing. It involves airway inflammation and remodelling as does classic asthma with wheezing, and a subset of patients may progress to classic asthma. The atopic features of cough variant asthma remain unclear. Objective To compare atopic features between patients with cough variant asthma and those with classic asthma, and to examine the possible correlation of these features with the future development of wheezing in the former group. Methods Total and specific IgE levels of seven common aeroallergens [house dust mite (HDM), Gramineae/Japanese cedar/weed pollens, moulds, cat/dog dander] were examined in 74 cough variant asthma patients and in 115 classic asthma patients of varying severity. Forty of the former patients were prospectively observed for 2 years to determine whether cough variant asthma progressed to classic asthma despite inhaled corticosteroid treatment. Results Patients with classic asthma had higher total IgE (P<0.0001), larger numbers of sensitized allergens (P=0.03), and higher rates of sensitization to dog dander (24% vs. 3%, P<0.0001), HDM (46% vs. 28%, P=0.02), and moulds (17% vs. 7%, P=0.047) than did patients with cough variant asthma. Wheezing developed in six (15%) patients with cough variant asthma, who were sensitized to larger numbers of allergens (P=0.02) and had higher rates of sensitization to HDM (P=0.01) and dog dander (P=0.02) than the 34 patients in whom wheezing did not develop. Among the patients with classic asthma, total and specific IgE variables were similar in the subgroup with mild disease (n=60) and the subgroup with moderate‐to‐severe disease (n=55), as reported previously. Conclusions Atopy may be related to the development of wheezing in patients with cough variant asthma. To prevent the progression of cough variant asthma to classic asthma, avoidance of relevant allergens may be essential.     

2475例过敏患者过敏原分析

收集2475例过敏患者资料,观察过敏原的变化和皮肤点刺试验与sIgE的结果.过敏患者对狗、猫、真菌2、虾过敏逐年递增(P＜0.01);对胶乳和真菌1过敏在2001～2004年逐年递增,2005年稍减少(P＜0.01);对草本、螨过敏2002年起逐年递增;对树花粉、鸡蛋、牛奶过敏5年中变化不明显(P＞0.05).患者对螨过敏与年龄有关(P＜0.01),以20～40岁最明显,40～60岁男性最低.患者对真菌2过敏也与年龄有关(P＜0.01);对狗、猫、胶乳、真菌1、树花粉、草本、鸡蛋、牛奶、虾的过敏与患者年龄无关(P＞0.05).5年来单个过敏原过敏患者逐渐减少,患者过敏原个数明显增加(P＜0.01).吸入过敏患者皮试与sIgE相关,r=0.467.食物过敏患者皮试和sIgE结果的相关性差.总的皮试和sIgE的符合率为77.7%.     

Grass pollen allergens globally: the contribution of subtropical grasses to burden of allergic respiratory diseases

Grass pollens of the temperate (Pooideae) subfamily and subtropical subfamilies of grasses are major aeroallergen sources worldwide. The subtropical Chloridoideae (e.g. Cynodon dactylon; Bermuda grass) and Panicoideae (e.g. Paspalum notatum; Bahia grass) species are abundant in parts of Africa, India, Asia, Australia and the Americas, where a large and increasing proportion of the world's population abide. These grasses are phylogenetically and ecologically distinct from temperate grasses. With the advent of global warming, it is conceivable that the geographic distribution of subtropical grasses and the contribution of their pollen to the burden of allergic rhinitis and asthma will increase. This review aims to provide a comprehensive synthesis of the current global knowledge of (i) regional variation in allergic sensitivity to subtropical grass pollens, (ii) molecular allergenic components of subtropical grass pollens and (iii) allergic responses to subtropical grass pollen allergens in relevant populations. Patients from subtropical regions of the world show higher allergic sensitivity to grass pollens of Chloridoideae and Panicoideae grasses, than to temperate grass pollens. The group 1 allergens are amongst the allergen components of subtropical grass pollens, but the group 5 allergens, by which temperate grass pollen extracts are standardized for allergen content, appear to be absent from both subfamilies of subtropical grasses. Whilst there are shared allergenic components and antigenic determinants, there are additional clinically relevant subfamily‐specific differences, at T‐ and B‐cell levels, between pollen allergens of subtropical and temperate grasses. Differential immune recognition of subtropical grass pollens is likely to impact upon the efficacy of allergen immunotherapy of patients who are primarily sensitized to subtropical grass pollens. The literature reviewed herein highlights the clinical need to standardize allergen preparations for both types of subtropical grass pollens to achieve optimal diagnosis and treatment of patients with allergic respiratory disease in subtropical regions of the world.     

Allergy and allergy-like symptoms in 1,050 medical students

During a 10-year period 1,050 medical students were questioned regarding allergy and allergy-like symptoms and 612 of them underwent skin prick tests with dog, cat, timothy and birch allergens. Symptoms of eczema, asthma or non-infectious rhinitis, past or current, or current reactions to pollen, furred animals, dust, mould or food were reported by 46% of the students. Three per cent reported present eczema of the flexure type and a further 8% reported past symptoms of the same kind. Current contact e zema was reported by 7% and past contact eczema by a further 3%. Daily treatment with ointments was reported by 52% of the students with current flexure eczema and by 17% with current contact eczema. Current asthma was reported by 5% and past asthma by a further 3%. Of those with current asthma, 88% were allergic to pollens and/or furred animals and 57% used anti-asthmatic drugs for at least 2 weeks/year. Current allergic symptoms in the nose and/or eyes were reported by 29% and a further 2% reported past symptoms. Of those with current symptoms 64% were allergic to pollens and/or furred animals, as judged by the history and skin tests. Almost 60% of the students with pollen allergy used anti-allergic drugs for at least 2 weeks/year. Allergy to pollens was reported by 17%, to animals by 12%, to house dust by 10%, to moulds by 2% and to foods by 15%. Allergy reported and confirmed by a prick test was found in 8% against birch, 6% against timothy, 10% against cat and 5% against dog.(ABSTRACT TRUNCATED AT 250 WORDS)     

Comparative degree and type of sensitization to common indoor and outdoor allergens in subjects with allergic rhinitis and/or asthma

Background and objectives The determinants of variability in the clinical expression of atopy are still to be documented. The goals of this study were to determine, in subjects with a clinical diagnosis of symptomatic asthma or rhinitis, what is the possible contribution of different types of indoor and outdoor allergens to the development of their disease, by looking at the prevalence and degree of sensitization to these allergens according to age and gender. Subjects and methods We analysed allergy skin prick tests to common airborne indoor and outdoor allergens in 3371 consecutive patients, grouped according to diagnosis of allergic asthma, rhinitis, or both. For each of these three groups, we calculated the prevalence of sensitization to indoor/outdoor allergens, the atopic index (Al), the number of positive responses to allergy skin prick test and the mean wheal diameter (MWD) of these responses. Results The prevalence of atopy and the values of Al and MWD peaked in subjects aged 16 to 25 years, declining afterwards; in subjects ± 18 years old, atopic indices were slightly higher in men than in women. In atopic subjects, the prevalence of sensitization was, in decreasing order: housedust (84.2%), cat hair-epithelium (76.5%), dog hair-dander (63.0%), house dust mite (54.2%), grasses (51.9%), trees (47.2%) and ragweed pollens (44.9%) and finally, moulds (25.4%). Among subjects sensitized only to outdoor allergens (n= 195), 73.8% had a rhinitis, 11.8% had asthma and 14.4% had both diagnoses; for those sensitized only to indoor allergens (n= 710), these values were respeetively 48.6, 24.5 and 26.9%, and for those sensitized to both indoor and outdoor allergens (n= 1793), the comparable values were 55.5, 14.6 and 29.9%. Conclusion These data show that in our population of subjects with respiratory allergic symptoms, indoor allergen sensitization is strongly associated with asthma, while exclusive sensitization to pollens is associated primarily with rhinitis. Sensitization was more prevalent for indoor allergens than for outdoor allergens in all groups determined according to diagnosis or age. Indices of atopy were higher in men in the group ± 18 years old. Prevalence and degree of sensitization were shown to peak in young adults, regardless of the allergen, and to diminish with age. This study stresses the role of indoor allergens in the development of asthma and shows the variability of allergic manifestations according to the type of sensitization.     

Predominance of mite allergy over allergy to pollens and animal danders in a farming population

The prevalence of IgE-mediated hypersensitivity to respiratory allergens, including Lepidoglyphus destructor (a storage mite) and Dermatophagoides pteronyssinus , was studied in a rural population of Gotland, a Swedish island in the Baltic Sea. A sample of 440 farmers underwent examination, comprising skin-prick tests (animal danders, pollens, moulds, house dust mite and wheat) and blood sampling for radio-allergosorbent tests (RAST) (birch, Timothy grass, dog, D. pteronyssinus, Cladosporium and L. destructor ). The highest prevalence of positive skin-prick tests was noted for D. pteronyssinus (6.0%). Low prevalences of positive skin-prick tests, 0.7-2.7%, were found for pollens, animal danders and moulds. Among the tested allergens, D. pteronyssinus and L. destructor yielded the highest prevalences of positive RAST results, namely 5.2 and 6.8%, respectively. Most farmers with allergy to pollens and animal danders had symptoms both from the upper and lower airways and from the eyes. Among farmers with both asthma and rhinoconjunctivitis, the prevalence of positive RAST results for L. destructor and D. pteronyssinus were similar. The present study clearly demonstrates that mites are by far the most important allergens in the farming population on Gotland, whereas otherwise common allergens such as pollen and animal danders are clearly less significant.     

Salsola pollen as a predominant cause of respiratory allergies in Kuwait.

BACKGROUND: Respiratory allergies are common in Kuwait, and the role of certain allergens has been previously documented. OBJECTIVE: To evaluate the results of skin prick tests to a range of allergens that were considered relevant to the vegetation surveys and aerobiological studies performed in Kuwait. METHOD: New patients attending our center during August 2002 to February 2003 with asthma or allergic rhinitis underwent skin prick tests to a battery of allergens. RESULTS: A total of 451 patients aged 5 to 60 years (mean age, 29.5 years) were tested. Of these patients, 403 (89.4%) had a positive test result to at least one allergen and were considered allergic. A total of 76.7% of the allergic patients had a positive reaction to Salsola pollen, with a mean wheal diameter of 8.25 mm (median, 8 mm). Chenopodium album was positive in 57.6% and Bermuda grass was positive in 38.2% of the allergic cases. Indoor allergens seemed to play a lesser role than pollens: Dermatophagoides pteronyssinus was positive in only 37.5%, and American and German cockroaches were positive in 33.2% and 22.3%, respectively. All the allergens other than Salsola elicited a mean wheal diameter of less than 6.25 mm (median, < or = 6 mm). CONCLUSIONS: Indoor allergens seem to play a lesser role in respiratory allergies in Kuwait. Most allergic patients become sensitized to pollens; the strongest and most frequent reaction is from Salsola pollen. Salsola imbricata is found growing extensively in most areas of the country, flowering mainly in autumn, when the most common pollen is of the Chenopod-Amaranth type and when most patients with seasonal allergic rhinitis become symptomatic.     

House dust mite and cockroach exposure are strong risk factors for positive allergy skin test responses in the Childhood Asthma Management Program

BACKGROUND: Children with asthma have a high prevalence of environmental allergies, especially to indoor allergens. The relationships of exposure to indoor allergens (dust mites, cat, dog, cockroach, and molds) and other host factors to allergy sensitization have not been evaluated simultaneously in a large cohort. OBJECTIVES: We studied 1041 children aged 5 to 12 years with mild-to-moderate asthma to determine risk factors associated with having positive allergy skin test responses to indoor allergens. Also, we described, compared, and contrasted 6 allergens in the home environments of these children from 8 North American cities. METHODS: Data were used from baseline visits of the Childhood Asthma Management Program. Patients' sensitivities to house dust mites (Dermatophagoides farinae and Dermatophagoides pteronyssinus), cats, dogs, cockroaches, and molds were examined for relationships to demographic variables, home dust allergen exposures, number of other positive allergy skin test responses, total serum IgE levels, and smoking in the home. RESULTS: San Diego (78.5%) and Toronto (59.3%) had the topmost percentages of homes with moderate-to-high house dust mite levels. Boston (21.5%), St Louis (16.3%), and Baltimore (13.4%) had the highest percentages of homes with detectable levels of cockroach allergen. For house dust mites, the higher the level of allergen exposure, the more likely patients were to have positive allergy skin test responses, with relative odds of 9.0 (95% confidence interval, 5.4-15.1) for those exposed to high mite levels (>10.0 microg/g dust) relative to those unexposed. Even exposure to low levels of mite allergen (0.020-2.0 microg/g) was found to be a significant risk factor for sensitization. For cockroach allergen, those with detectable home exposure were more likely to have positive skin test responses (relative odds, 2.2; 95% confidence interval, 1.3-3.8) than those with undetectable exposure. In contrast, levels of exposure to cat, dog, and mold allergens were not related to sensitization rates. For cat allergen, this may reflect lower rates of cat ownership among highly sensitized subjects. Furthermore, the number of allergy skin test responses that were positive, excluding the test for the outcome of interest for each model, and total serum IgE levels were strong independent predictors of sensitization. CONCLUSIONS: Levels of exposure determined by house dust analysis are important determinants of sensitization for dust mite and cockroach allergen. This relationship was not demonstrable for cat, dog, or mold allergens, possibly because of confounding factors. For all allergens studied, the degree of atopy, determined by the total number of positive skin test responses or by total serum IgE levels, is an important contributing risk factor for sensitization.     

Is it important to perform pollen skin prick tests in the season?

BACKGROUND: Seasonal exposure to pollens causes the characteristic symptoms of respiratory allergy as well as an increase in specific IgE levels and inflammatory mediator release. However, little is known about the effect of natural allergen exposure on the skin test reactivity of patients with seasonal allergy. OBJECTIVE: The aim of this study was to investigate the monthly variation in skin test reactions with pollen allergens during pollen season and its relation to pollen counts. METHODS: Fifteen subjects with seasonal allergic rhinitis and/or asthma (4 male, 11 female) between the ages of 13 and 52 (mean 33.9 +/- 2.9) who lived in Ankara, Turkey were selected for this study. Patients were monitored from the beginning of March to the end of September 1997, and skin prick tests were performed using 5 grass, 12 tree, and 5 weed pollen allergen extracts every month. Atmospheric pollen grains were counted in the Ankara area between January and December, 1997. RESULTS: There were small but statistically significant increases in tree pollen-induced wheal sizes in May when compared with other months (P < 0.05). Skin test reactivity was correlated with tree pollen counts (r = 0.978, P < 0.05). There was not a significant difference in skin test reactivity to grass and weed pollens between months. CONCLUSIONS: Although skin test reactivity may be slightly greater to tree pollen during the tree pollen season, the timing of skin testing is not a critical determinant in patients with pollen allergy.     

Species specific grass pollen sensitivity: diagnosis and treatment with single grass species Allpyral vaccines

Skin test titrations and nasal provocation tests in sixty patients with hay fever showed specific reactions to extracts of individual grass species. There was, however, no correlation between skin and nasal sensitivity. Repeat testing after treatment with Allpyral vaccines consisting of only the grass species to which the nasal reaction was most severe, or only one of several pollens to which reactions were equally severe, showed marked diminution of skin and nasal sensitivity not only to the single pollen used for immuno-therapy but to all five common pollens used in the Allpyral grass mix. Clinical results seemed much improved as compared with results in the same year for Allpyral five grass mix vaccines, especially in the case of patients treated with Timothy, rye, or cocksfoot. It was concluded that these three grasses were to be preferred for treatment in England, and that these grasses contain common allergens.     

Primary versus secondary immunoglobulin E sensitization to soy and wheat in the Multi-Centre Allergy Study cohort

Background IgE sensitization to soy and wheat is classified as ‘primary’ when generated by food ingestion and ‘secondary’ when it as a consequence of primary sensitization to cross‐reacting pollen antigens via inhalation. The age‐specific relevance of these categories of sensitization throughout childhood is unknown. Objective To monitor the natural course of IgE sensitization against common food allergens in childhood in relation to sensitization against cross‐reactive airborne allergens. Methods The German Multi‐Centre Allergy Study with follow‐up from birth to age 13 recruited initially 1314 children. IgE antibody levels against cow's milk, hen's egg, soy, wheat, mites, cat and dog dander, birch and grass pollens were tested. Longitudinal data were analysed from the 273 children with sera obtained at age 2, 5, 7 and 10 years of age. Results The point prevalence of sensitization (>1.0 kU/L) to milk and egg allergens progressively decreased from about 4% at 2 years to <1% at 10 years. By contrast, the prevalence of IgE to wheat and soy progressively increased with age, from 2% to 7% (soy) and from 2% to 9% (wheat). At 10 years of age, IgE to grass pollen was detected in 97% and 98% of the children reacting against soy and wheat, respectively; IgE to birch pollen was observed in 86% and 82% of the children reacting against soy and wheat, respectively. Early IgE sensitization to soy or wheat preceded that to grass or birch pollen in only 4% and 8% of participants sensitized to soy and wheat, respectively. Conclusion IgE sensitization to soy and wheat is relatively uncommon and mostly primary in early infancy, more frequent and mostly secondary to pollen sensitization at school age. Clinical Implications Awareness should be raised to avoid unnecessary diet restrictions due to the high frequency of clinically irrelevant, secondary sensitization to soy and wheat in schoolchildren with pollinosis.     

Cupressaceae pollinosis in the Madrid area

Background There is no previous report of Cupressaceae pollinosis in the Madrid area. Objective To ascertain the presence of Cupressaceae pollinosis in the Madrid area. Methods Thirty-six patients were studied who had winter pollinosis symptoms and a positive skin test to C. arizonica. They were skin tested with C. sempervirens (Abeiló, Madrid), C. arizonica (in-house extract) and other common inhalant allergens (Abeiló). Total IgE was measured and specific IgE to C. arizonica, C. sempervirens and J. sabinoides was determined. Results Six of the patients were only sensitized to Cupressaceae pollens, whereas 30 patients had also sensitivity to other pollens (oleaceae 28, plantain 27, grasses 25, chenopodium 25, compositae 23, Parietaria 9) and 18 patients were also sensitized to other inhalant allergens (animals 17, mites 4, moulds 2). Conclusion These results confirm the existence of allergy to Cupressaceae pollens in Madrid (Spain).     

Sensitization to Lolium multiflorum grass pollen in pollinosis patients: evaluation of allergenic fractions recognized by specific IgE antibodies

BACKGROUND: Lolium multiflorum (Lm) pollen allergens are the major causative agents for rhinoconjunctivitis in Southern Brazil. There have been no studies about the sensitization and allergenic cross-reactivity between Lm and other grass pollens. We evaluated the sensitization of Brazilian pollinosis patients to Lm pollen allergens through skin prick test (SPT) and immunoassays (ELISA and immunoblot). METHODS: Serum samples from 60 patients with pollinosis and positive SPT to grass pollen extracts (Lm+ group), 30 patients with negative SPT to grass pollen, but positive SPT to mite extracts (Lm- group), and 30 nonatopic subjects (NA group) were tested by SPT, ELISA, and immunoblot using Lm extract. Inhibition immunoassays with Lolium perenne (Lp), mixed grass (Gmix) and Lm extracts were also performed. RESULTS: A high concordance was found between the Gmix and Lm extracts in SPT. Positivity rates in SPT were also highly concordant with IgE-ELISA results. The assay was able to detect Lm-specific IgE in >95% of Lm+ patients. A significant self- and cross-inhibition was observed in IgE-ELISA, reflecting a high cross-reactivity between the grass pollen allergens. Immunoblot revealed 13 IgE-binding Lm fractions, from which the bands 28-30 kDa and 31-34 kDa were recognized by >90% of Lm+ patients. CONCLUSION: Lm-specific IgE antibodies are highly cross-reactive with pollen proteins from other grass species. The results indicate that Lm extracts could be used in both SPT and ELISA for a more specific evaluation of IgE responses to Lm grass pollen in Brazilian pollinosis patients.