OBJECTIVETo evaluate the significance of several Dermatophagoides pteronyssinus allergen extracts for skin prick test (SPT) in patients allergic to Dermatophagoides pteronyssinus.

METHODSTwo hundred and nineteen patients enrolled in Peking Union Medical College Hospital underwent SPT and serum specific IgE assay to detect the Dermatophagoides pteronyssinus allergen. Three kinds of house dust mite allergen extracts were used for SPT, including the Dermatophagoides pteronyssinus extract prepared by our laboratory (group A), standardized Dermatophagoides pteronyssinus extract (group B), and mixed extracts of Dermatophagoides pteronyssinus and Dermatophagoides farinae (group C). Human serum specific IgE result was regarded as the reference standard for diagnosis of Dermatophagoides pteronyssinus allergy. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of SPT with the extracts of three groups.

RESULTSSPT results showed that the median wheal diameter of group A, group B, and group C was 0.43, 0.35, and 0.28 cm, respectively, with significant difference among three groups (P<0.05). The difference was significant between group A and B (P<0.01) as well as group A and C (P<0.01), but not between group B and C (P>0.05). There was no local urticaria or systemic allergic reactions following the procedure of SPT. Local reaction was observed in 5 patients and delayed reaction was in 2 patients of group A. As for group B and C, local reaction occurred in 3 cases and delayed reaction in 2 cases in each group. The area under ROC curve of SPT with extract in group A, group B, and group C was 0.765, 0.801, and 0.782, respectively. Based on the detection results of serum specific IgE, the sensitivity of SPT in diagnosis of Dermatophagoides pteronyssinus allergy with extract of group A, group B, and group C was 92.4%, 87.0%, and 81.5%, and the specificity was 60.6%, 73.2%, and 74.8%, respectively.

CONCLUSIONThe Dermatophagoides pteronyssinus extract for SPT prepared by our laboratory offers good sensitivity and specificity comparable to commercially available allergen extracts, and it may be an appropriate candidate for clinical screening and diagnosis of Dermatophagoides pteronyssinus allergy.

Animals ; Antigens, Dermatophagoides ; immunology ; Dermatophagoides pteronyssinus ; immunology ; Female ; Humans ; Male ; ROC Curve ; Sensitivity and Specificity ; Skin Tests ; methods

OBJECTIVETo study the skin prick test (SPT) reactivity to house dust mite allergens in overweight and normal weight children with allergic asthma before and after standard subcutaneous specific immunotherapy.

METHODSTwo hundred and fifteen children with allergic asthma who had positive SPT responses to Dermatophagoides pteronyssinus (DP) and Dermatophagoides farinae (DF) were enrolled. According to the weight index, they were classified into overweight (n=63) and normal weight groups (n=152). Skin indices (SI) to DP and DF were compared between the two groups at 6 months and 1 year after standard subcutaneous specific immunotherapy.

RESULTSThe overweight group had a significantly larger histamine wheal diameter than the normal weight group after controlling the variation in testing time (P<0.05). After controlling the variation in weights, there were significant differences in the SIs to DP and DF before specific immunotherapy and at 6 months and 1 year after specific immunotherapy. At 6 months and 1 year after specific immunotherapy, the SIs to DP and DF were significantly reduced in both groups (P<0.05), and the overweight group had greater decreases in the SIs to DP and DF than the normal weight group.

CONCLUSIONSThe overweight children with allergic asthma have stronger responses to histamine than the normal weight patients. Specific immunotherapy can reduce the reactivity to dust mite allergens in children with allergic asthma. Within one year after specific immunotherapy, the overweight children with allergic asthma have a significantly greater decrease in the reactivity to dust mite allergens than the normal weight patients.

Adolescent ; Animals ; Asthma ; immunology ; therapy ; Child ; Child, Preschool ; Dermatophagoides farinae ; immunology ; Dermatophagoides pteronyssinus ; immunology ; Female ; Humans ; Immunotherapy ; Male ; Overweight ; immunology ; Pyroglyphidae ; immunology ; Skin Tests

OBJECTIVE: To evaluate the efficacy and safety of subcutaneous immunotherapy with a standardized Dermatophagoides pteronyssinus extract for allergic rhinitis. METHOD: Sixty-eight patients with allergic rhinitis who received specific immunotherapy with a standardized dermatophagoides pteronyssinus extract were enrolled in this study. The clinical symptoms and signs were scored before and 2 years after treatment. Side effects were registered. Symptom and side effect scores were assessed to evaluate the clinical efficacy and safety. RESULT: There was a significant difference (P < 0.01) in symptom and medication scores between the two groups tow years after treatment. The patients had fewer symptoms and lower intake of medication. No severe systemic reactions were registered. CONCLUSION Immunotherapy with a standardized dermatophagoides pteronyssinus extract is effective and safe to treat patients clinically sensitive to this allergen.
Allergens ; therapeutic use ; Animals ; Dermatophagoides pteronyssinus ; immunology ; Female ; Humans ; Immunotherapy ; methods ; Male ; Rhinitis, Allergic ; therapy

OBJECTIVE: To study the therapeutic effects of the specific immunotherapy (SIT) on allergic rhinitis and allergic rhinitis combined bronchial asthma. METHED: All patients were classified into allergic rhinitis group (AR group) with 32 patients and allergic rhinitis combined bronchial asthma group (AR+BA group) with 32 patients. Another health control group with 32 cases was designed as well. The allergens,symptom scores and therapeutic effects of the former two-group patients were analysis, and the serums of all three-group cases were extracted to evaluate the specific Immunoglobin E(sIgE), Interleukin-4 (IL-4). The SPSS13. 0 package was applied to conduct t-test and chi-square test, and the difference of P<0. 05 was regarded as statistical significance. RESULT: The main allergens of 64 patients were dermatophagoides farinae and dermatophagoides pteronyssinus. The improvement of symptom scores before and after SIT was statistical significant with P<0. 05. Although total effective rate reached 100% , AR group was superior than AR+BA group in term of the efficacy comparison, and P<0. 05 indicated the statistical significance. The serum sIgE, IL-4 values of three groups were brought into comparison, and P<0. 05 indicated the statistical significance of the difference. CONCLUSION The SIT on the AR, AR+BA is a safe and effective treatment, but different disease responds diversely. The long-term treatment course is recommended.
Allergens ; immunology ; Animals ; Asthma ; therapy ; Dermatophagoides farinae ; immunology ; Dermatophagoides pteronyssinus ; immunology ; Humans ; Immunoglobulin E ; blood ; Immunotherapy ; Interleukin-4 ; blood ; Rhinitis, Allergic ; therapy ; Treatment Outcome

Many allergists are currently focusing on the development of new diagnostic tools, and are attempting to improve both the sensitivity and specificity. A multiple allergen simultaneous test-chemiluminescent assay (MAST-CLA) is one of the most popular diagnostic tools used in the Republic of Korea. However, there remains controversy among allergists with regard to the cut-off point for a positive result. The present study was conducted in order to determine the validity of MAST-CLA as compared with that of the skin prick test, with particular emphasis on arthropod allergens, on the basis of percentage agreement rates and k-values, and also to suggest the optimal positive cutoff points using receiver operating characteristic (ROC) curves. The study was conducted with 97 subjects (54 men, 43 women). Optimal individual cut-off points were calculated as follows; class II for Dermatophagoides farinae, class I for Dermatophagoides pteronyssinus, and trace for a cockroach mix. These findings suggest that attempting to apply optimal individual cut-off points will be a good way of improving diagnostic tests, particularly MAST-CLA.
Adult ; Allergens/*immunology ; Animals ; Antigens, Dermatophagoides/*immunology ; Chemiluminescent Measurements/*methods/standards ; Cockroaches/chemistry ; Dermatophagoides farinae/chemistry ; Dermatophagoides pteronyssinus/chemistry ; Female ; Humans ; Hypersensitivity/*diagnosis/immunology ; Insect Proteins/*immunology ; Male ; *ROC Curve ; Skin Tests/methods

OBJECTIVE: We aimed to analyze the quality of life (QOL) in adults with allergic rhinitis according to the sensitization profile for relevant aeroallergens in Northern China, investigate the proportion of patients with coexisting asthma, and explore the correlation between QOL of rhinitis patients and the specific IgE level to the causative allergen. METHOD: One hundred and sixty-four allergic rhinitis patients participated in this study, whose clinical history, results of intradermal skin test and serum specific IgE levels to common aeroallergens in North China were collected. QOL was evaluated using the rhinoconjunctivitis quality of life questionnaire (RQLQ). RESULT: QOL of rhinitis patients was worse in those sensitized to tree pollens or weed pollens than those sensitized to house dust mites in Northern China. The proportion of patients with co-existing asthma was lower in tree pollen group than in house dust mite group or weed pollen group, and there was no significant difference between house dust mite group and weed pollen group. There was no significant correlation between QOL of rhinitis patients and the specific IgE level to the causative allergen. CONCLUSION In our study group, QOL of patients with allergic rhinitis varied with the allergen responsible for symptoms, but was not influenced by the specific IgE level to relevant allergen. The proportion of patients with co-existing asthma also varied with different pollen allergens. Rhinitis patients sensitized to weed pollens might be more likely to suffer from asthma than those sensitized to tree pollens.
Adult ; Allergens ; immunology ; Animals ; Asthma ; China ; Dermatophagoides pteronyssinus ; Humans ; Immunoglobulin E ; blood ; Pollen ; Pyroglyphidae ; Quality of Life ; Rhinitis, Allergic ; physiopathology

OBJECTIVETo construct a vector encoding T-cell epitopes of major allergen group 1 of Dermatophagoides pteronyssinus as a vaccine delivered by MHC class II pathway.

METHODSThe nucleotide sequences of the 3 target genes were synthesized, including TAT, IhC and the recombinant fragment of Der p 1 encoding 3 T-cell epitopes. After amplification of the 3 target fragments by PCR and digestion with corresponding restriction endonucleases, the recombinant gene TAT-IhC-Der p 1-3T was ligated using T4 DNA ligase and inserted into the prokaryotic expression vector pET28a(+) to construct the recombinant plasmid pET-28a(+)-TAT-IhC-Der p 1-3T, which was confirmed by digestion with restriction endonucleases and sequencing. The recombinant vector was transformed into E. coli strain BL21 (DE3) and induced with IPTG, and the induced protein TAT-IhC-Der p 1-3T was detected by SDS-PAGE. After purification, the recombinant protein was confirmed by Western blotting and its allergenicity tested using IgE-binding assay.

RESULTSThe recombinant plasmid pET-28a-TAT-IhC-Der p 1-3T was successfully constructed as confirmed by restriction endonuclease digestion and sequencing and the expression of the recombinant protein TAT-IhC-Der p 1-3T was induced in E. coli. Western blotting verified successfull purification of the target protein, which showed a stronger IgE-binding ability than Der p 1.

CONCLUSIONWe successfully constructed a recombinant expression vector pET-28a-TAT-IhC-Der p 1-3T expressing a T-cell epitope vaccine delivered by MHC II pathway with strong IgE-binding ability, which provides a basis for further study on specific immunotherapy via MHC class II pathway.

Allergens ; immunology ; Animals ; Antigens, Dermatophagoides ; immunology ; Arthropod Proteins ; immunology ; Base Sequence ; Cloning, Molecular ; Cysteine Endopeptidases ; immunology ; Dermatophagoides pteronyssinus ; Epitopes, T-Lymphocyte ; Escherichia coli ; Gene Expression ; Genes, MHC Class II ; Genetic Vectors ; Plasmids ; Polymerase Chain Reaction ; Recombinant Proteins ; immunology ; Vaccines ; immunology

We attempted to investigate the correlation between the severity of atopic dermatitis (AD) in children and the indoor level of house dust mite (HDM) allergens. Ninety-five patients (31.1 +/- 19.5 months of age) with AD were enrolled in this study, and serum specific IgE against Dermatophagoides pteronyssinus and D. farinae was measured. The severity of AD was assessed using the visual analogue scale on the same day of house dust collection. Living rooms and mattresses where the child usually slept were vacuumed for 2 minutes and concentrations of Der f 1 were measured by enzyme-linked immunosorbent assay. The skin symptoms were more severe in patients with Der f 1 concentrations in living room > 2 microg/g dust than < or = 2 microg/g dust (P = 0.018). This difference was noted in AD patients without sensitization to HDM (P = 0.004), but not in patients with sensitization. There was no difference in symptom severity according to Der f 1 concentrations in mattresses (P = 0.062). The severity of skin symptoms is associated with indoor concentrations of HDM in children with AD, and it is likely to act as nonspecific irritants as well as allergens in AD skin lesions.
Adolescent ; Animals ; Antigens, Dermatophagoides/*analysis ; Beds/parasitology ; Child ; Child, Preschool ; Dermatitis, Atopic/*diagnosis/pathology ; Dermatophagoides farinae/immunology ; Dermatophagoides pteronyssinus/immunology ; *Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoglobulin E/blood ; Infant ; Male ; Severity of Illness Index

To confirm local production of IgE, and evaluate role of immunoglobulins on eosinophil activation in nasal polyp (NP) tissue, we measured IgG, IgA, secretory IgA(sIgA), total (tIgE) and specific IgE (sIgE) to Dermatophagoides pteronyssinus(DP) by ELISA in NP tissue homogenates from 51 subjects. They were classified according to skin reactivity to DP: group I, 15 highly atopic subjects; group II, 18 weakly atopic subjects; and group III, 18 non-atopic subjects. Eosinophil cationic protein (ECP) level was measured by CAP system. Highest level of DP-sIgE was noted in group I, followed by group II and III (p<0.05). Nine (60%) of group I and 4 (22%) of group II subjects had detectable level of DP-sIgE with no significant differences in IgA, sIgA, and IgG. All of NP tissue had eosinophilic infiltration with no significant difference in activated eosinophil count or ECP level among 3 groups. A significant correlation was noted between EG2+ cell count and tIgE (r=0.55, p<0.05), and DP-sIgE level (r=0.60, p<0.05). A significant correlation was also noted between ECP and IgG (r=0.51, p<0.05) and DP-sIgE level (r=0.47, p<0.05) with no significant correlation with IgA or sIgA. These results suggest that DP-sIgE was detectable in NP tissue from weakly atopic subjects as well as highly atopic subjects. IgG and sIgE may have potential roles in eosinophil degranulation in NP tissue.
Blood Proteins/analysis ; Cell Degranulation/immunology ; Dermatophagoides pteronyssinus/immunology ; Eosinophil Granule Proteins ; Eosinophils/immunology ; Humans ; Immunoglobulin A/analysis/immunology ; Immunoglobulin E/analysis/immunology ; Immunoglobulin G/analysis/immunology ; Immunoglobulins/analysis/*immunology ; Nasal Polyps/*immunology/pathology ; *Ribonucleases

BACKGROUND: Total IgE levels in allergic patients tend to be higher than those in healthy individuals. We evaluated the usefulness of total IgE levels in predicting positive results of allergen specific IgEs in multiple allergen simultaneous tests. METHODS: A total of 133 patients with allergic symptoms were evaluated. Allergen specific IgEs were detected using 3 different kits: Allergy screen (R-biopharm, Germany), AdvanSure Allergy Screen (LG Life Science, Korea) and Polycheck allergy (Biocheck Co., Germany). Total IgE was measured by turbidoimmunometric assay (LX-2200, Eiken Chemical Co., Japan). The patients were divided into high (> or =170 IU/mL) and low (<170 IU/mL) groups of total IgE level, and the positive rates and number of positive allergen specific IgEs were evaluated in each group. Positive concordance rates among different kits were also evaluated. RESULTS: High total IgE group showed significantly higher positive rates and number of positive allergen specific IgEs in all of the 3 test kits used compared to low total IgE group. Only two of the allergens, Dermatophagoides farinae and Dermatophagoides pteronyssinus had positive concordance rates of > or =50%. Allergen specific IgEs to these two allergens showed good correlation with total IgE (correlation coefficients >0.5). CONCLUSIONS: Total IgE appears to be useful in predicting positive results in allergen specific IgE tests to common allergens. The specific IgEs to D. farinae and D. pteronyssinus showed good correlation with total IgE. However, for other allergens, significant differences were observed among different test kits, and the standardization of allergens in multiple allergen simultaneous tests is needed.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Allergens/*immunology ; Animals ; Child ; Child, Preschool ; Dermatophagoides farinae/immunology ; Dermatophagoides pteronyssinus/immunology ; Female ; Humans ; Hypersensitivity, Immediate/*diagnosis ; Immunoglobulin E/*blood ; Male ; Middle Aged ; Predictive Value of Tests ; Reagent Kits, Diagnostic ; Republic of Korea