Application of scientific criteria to food allergens of public health importance

Scientific criteria for identifying allergenic foods of public health importance (Björkstén, B., Crevel, R., Hischenhuber, C., Løvik, M., Samuels, F., Strobel, S., Taylor, S.L., Wal, J.-M., Ward, R., 2008. Criteria for identifying allergenic foods of public health importance. Regulatory Toxicology and Pharmacology 51(1), 42–52) have been further refined to incorporate an assessment of the strength of available scientific evidence (van Bilsen, J.H., Ronsmans, S., Crevel, R.W., Rona, R.J., Przyrembel, H., Penninks, A.H., Contor, L., Houben, G.F., 2011. Evaluation of scientific criteria for identifying allergenic food of public health importance. Regulatory Toxicology and Pharmacology 60, 281–289). A multi-disciplinary group was invited to critically test the refined approach. They independently evaluated selected publications on coconut, soy and/or peanut allergy, scored them using the newly developed level of evidence criteria, and debated proposed approaches for combining and utilising the scores to measure the overall impact of an allergen in public health impact assessments. The evaluation of selected publications using the modified criteria produced a relatively consistent result across the experts. These refined criteria were judged to be a way forward for the identification of allergenic foods of public health importance, and for prioritisation of allergen risk management and future data gathering. The debate to combine available evidence when assessing whether an allergenic food is of sufficient public health importance to warrant active management led to proposals on how to weight and combine evidence on allergen severity, potency and prevalence. The refined criteria facilitate a debate to find a meaningful sequence of steps to summarise the available information in relation to a food allergen.     

陆丰市变应性鼻炎患者变应原调查分析

目的了解陆丰市变应性鼻炎患者变应原分布情况,为该地区变应性鼻炎的流行病学研究和防治提供依据。方法分析578例陆丰市人民医院五官科门诊部拟诊为变应性鼻炎患者对33种变应原进行皮肤点刺试验的临床资料,并比较不同年龄段及不同性别变应原进行皮肤点刺试验阳性率的差异。结果陆丰市变应性鼻炎患者中,最主要的变应原为屋尘螨(86.86%)和粉尘螨(86.02%),随后依次为海蟹(13.77%)及蟑螂(10.59%),且阳性率随年龄增长呈下降趋势,男女性别间阳性率无显著差异。结论屋尘螨和粉尘螨是陆丰市变应性鼻炎最常见的变应原,采用变应原皮肤点刺试验查找变应原在变应性鼻炎防治中具有重要意义。     

变应性因素与慢性鼻-鼻窦炎的临床相关性研究

目的探讨变应性因素在慢性鼻-鼻窦炎（CRS）发病过程中的作用。方法对194例CRS患者（实验组）进行血清总免疫球蛋白E（TIgE）、特异性免疫球蛋白E（SIgE）定量检测及皮肤点刺试验（SPT）。同时选取190例排外CRS患者作为对照组。结果①实验组屋尘螨、粉尘螨SPT阳性率分别为18．6％、18．6％,与对照组相比,差异均有统计学意义（P〈0．05）。②实验组屋尘螨、粉尘螨、屋尘SIgE阳性率分别为14．9％、16．0％、20．6％,与对照组相比,差异均有统计学意义（P〈0．05）;2组TIgE阳性率相比,差异无统计学意义（P〉0．05）。③屋尘、屋尘螨、粉尘螨SIgE与CRS临床分型均呈负相关（r=-0．176,P=0．014;r=-0．177,P=0．014;r=-0．152,P=0．034）。结论部分变应性因素与CRS的病因及病程有关。     

Laughter elevates the levels of breast-milk melatonin

OBJECTIVE: Patients with atopic eczema (AE) often complain of sleep disturbance. Melatonin is involved in sleep, and the levels of blood melatonin in patients with AE are decreased in comparison to healthy subjects. However, the levels of breast-milk melatonin had only been reported in healthy subjects. Laughter increased natural killer cell activity in blood and free radical-scavenging capacity in saliva in healthy subjects. Thus, the effect of laughter on the levels of breast-milk melatonin was studied in mothers with AE. Moreover, the effect of feeding with breast milk after laughter on allergic responses in infants was studied. METHODS: Forty-eight infants aged 5-6 months were enrolled. All of the infants had AE and were allergic to latex and house dust mite (HDM). Half (n=24) of the mothers of these infants were patients with AE, while another 24 mothers were healthy subjects. The mothers viewed either an 87-min humorous DVD (Modern Times, featuring Charlie Chaplin) or an 87-min nonhumorous weather information DVD at 2000 h. After viewing, breast milk was collected sequentially from 2200, 2400, 0200, 0400 to 0600 h. The levels of breast-milk melatonin were measured. In addition, skin wheal responses to HDM and histamine were studied in infants. RESULTS: Laughter caused by viewing a humorous DVD increased the levels of breast-milk melatonin in both mothers with AE and healthy mothers. In addition, allergic responses to latex and HDM of infants were reduced by feeding with breast milk after laughter of mothers with AE or of healthy mothers. CONCLUSION: Laughter increased the levels of breast-milk melatonin in both mothers with AE and healthy mothers, and feeding infants with increased levels of melatonin-containing milk reduced allergic responses in infants. Thus, laughter of mothers may be helpful in the treatment of infants with AE.     

广藿香青枯病点刺和输液接种试验比较研究

目的比较点刺接种法和输液接种法的接种效果。方法采用广藿香苗木分别进行比较点刺和输液接种试验。结果点刺接种法对广藿香小苗和室内试验的接种效果可靠,输液接种法对广藿香大苗和大田试验的接种效果可靠。结论点刺接种法适合广藿香小苗和室内试验,输液接种法适合于广藿香大苗和大田试验。     

腹泻患者粉螨感染调查

目的探讨粉螨致腹泻的发生特点。方法对腹泻患者进行粪螨分离、皮肤挑刺试验、血清总IgE、螨特异性IgE检测。其中粪螨分离采用饱和盐水漂浮法,抗体检测使用ELISA法。结果共检查241例腹泻患者,粪螨阳性率为17.01%(41/241),男、女粪螨阳性率分别为15.86%(23/145)和18.75%(18/96),差异无显著性(χ2=0.34,P>0.05);皮肤挑刺试验"、"、"+"、"±"和"?"者分别占9.13%(22/241)、7.47%(18/241)、5.81%(14/241)、4.98%(12/241)和72.61%(175/241)。粪螨阳性和阴性腹泻患者血清总IgE、螨特异性IgE分别为(165.72±78.55)IU/ml、(132.44±26.80)IU/ml和(145.22±82.47)IU/ml、(67.35±45.28)IU/ml,差异均具显著性(P<0.01)。从事中药材、粮食储藏和加工者粪螨阳性率为26.74%(23/86),其他职业人群粪螨阳性率为11.61%(18/155),差异具显著性(χ2=8.97,P<0.01)。结论粉螨寄生人体肠道可导致粉螨性腹泻,并使患者血清总IgE、螨特异性IgE升高,粉螨浸液皮肤挑刺试验阳性。腹泻患者粉螨感染的发生与所从事的职业有一定关系,但与性别无关。     

BSACI guidelines for the management of drug allergy

These guidelines have been prepared by the Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI) and are intended for allergists and others with a special interest in allergy. As routine or validated tests are not available for the majority of drugs, considerable experience is required for the investigation of allergic drug reactions and to undertake specific drug challenge. A missed or incorrect diagnosis of drug allergy can have serious consequences. Therefore, investigation and management of drug allergy is best carried out in specialist centres with large patient numbers and adequate competence and resources to manage complex cases. The recommendations are evidence-based but where evidence was lacking consensus was reached by the panel of specialists on the committee. The document encompasses epidemiology, risk factors, clinical patterns of drug allergy, diagnosis and treatment procedures. In order to achieve a correct diagnosis we have placed particular emphasis on obtaining an accurate clinical history and on the physical examination, as these are critical to the choice of skin tests and subsequent drug provocation. After the diagnosis of drug allergy has been established, communication of results and patient education are vital components of overall patient management.     

Allergen content of grass pollen preparations for skin prick testing and sublingual immunotherapy

Background:  The allergen content of diagnostics and immunotherapeutics is crucial for effective diagnosis and treatment. The aim of this study was to quantify and compare the allergen content of different grass pollen preparations for skin prick testing and sublingual immunotherapy (SLIT).
Methods:  Five skin prick test (SPT) solutions and 10 sublingual immunotherapeutics were analysed for protein and allergen concentration by Bradford assay, inhibition of IgE-binding to Phleum pratense ImmunoCAPs and content of the main allergen Phl p 5 by two-site enzyme immunoassay. In addition, the grass pollen preparations were compared by sodium dodecyl sulfate–polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting analyses.
Results:  Protein concentrations of SPT solutions ranged from 15 to 427 μg/ml, and Phl p 5 concentrations ranged from 0.15 to 18.3 μg/ml. The ranking of SPT solutions concerning Phl p 5 content and IgE inhibition capacity was the same, and the ranking of protein and allergen content was closely correlated ( r  = 0.9). Protein content of the maintenance doses of the immunotheurapeutics ranged from 5 to 153 μg, Phl p 5 content ranged from 0.2 to 21.6 μg. IgE inhibition capacity of the maintenance doses was closely correlated to their Phl p 5 and protein content. SDS-PAGE and immunoblots confirmed the differences in protein and allergen content.
Conclusions:  Grass pollen preparations for SPT and SLIT varied greatly concerning protein and allergen content. Whereas this result corresponds to previous analyses results of SPT solutions, it was the first comparison of grass pollen immunotherapeutics. For diagnosis and therapy, these differences should be taken into account.