The increasing incidence rate of allergic diseases has attracted global attention, and these diseases greatly threaten children′s health. The common pathogenesis of allergic diseases is the specific IgE- or cell-mediated immune response to common inhalant or food allergens. Epidemiological investigation, analysis of fecal flora, and clinical studies all suggest that the development and progression of allergic diseases are closely related to the early disturbance of intestinal flora. Probiotics can regulate intestinal immune response, increase the barrier function of epithelial cells, inhibit the adhesion and colonization of pathogenic bacteria, and thus restore or reconstruct normal intestinal flora. With the increasing understanding of allergic diseases, the effect of probiotics in the prevention and treatment of such diseases will be taken more and more seriously.
Child ; Humans ; Hypersensitivity ; drug therapy ; immunology ; microbiology ; prevention & control ; Intestines ; immunology ; microbiology ; Probiotics ; administration & dosage

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome associated with anticonvulsant drugs is a rare but potentially life-threatening disease that occurs in response to arene oxide producing anticonvulsant such as phenytoin and carbamazepine. There have been many reports of cross reactivity among the anticonvulsants upon first exposure to the offending drugs. However, there has been few data describing the development of DRESS syndrome after switching medication from previously well-tolerated phenytoin to carbamazepine, and the induction of hypersensitivity to phenytoin by DRESS to carbamazepine. We experienced a case of a 40-yr-old man who had uncontrolled seizure that led to the change of medication from the long-term used phenytoin to carbamazepine. He developed DRESS syndrome after changing the drugs. We stopped carbamazepine and restored phenytoin for seizure control, but his clinical manifestations progressively worsened and he recovered only when both drugs were discontinued. Patch tests with several anticonvulsants showed positive reactions to both carbamazepine and phenytoin. Our case suggests that hypersensitivity to a previously tolerated anticonvulsant can be induced by DRESS to another anticonvulsant, and that the patch test may be a useful method for detecting cross-reactive drugs in anticonvulsant-associated DRESS syndrome.
Syndrome ; Skin/drug effects/immunology/pathology ; Phenytoin/immunology ; Male ; Humans ; Drug Hypersensitivity/*immunology ; Drug Eruptions/etiology/*immunology ; Carbamazepine/*adverse effects ; Anticonvulsants/adverse effects ; Adult

OBJECTIVETo explore a new experimental method for screening of allergens in post-market traditional Chinese medicine injections by confirming allergens in Huachansu injection.

METHODFirst of all, the serum of patients allergic to Huachansu injection were collected, at the same time, the dubious allergen was conjugated to bovine serum albumin (BSA) by EDC coupling procedure to form complete antigen (BNP-BSA), which makes it possible to reproduce the allergic reaction of Huachansu injection in vitro. The histamine liberation ratio, the level of TNF-alpha and Histamine released from RBL-2H3 mast cell were detected; the above data were compared with those obtained in vivo.

RESULTThe difference of the histamine liberation ratio, the levels of TNF-alpha and histamine of the resibufogenin-BSA group, group of patients allergic to Huachansu injection were not significant compared with those of normal control group. However, there were significant difference in those data among the cinobufagin-BSA group, the blank control and normal control group (P<0.05).

CONCLUSIONThe allergen in the serum collected from patients allergic to Huachansu injection is resibufogenin.

Allergens ; adverse effects ; immunology ; Amphibian Venoms ; adverse effects ; immunology ; Animals ; Anura ; Bufanolides ; adverse effects ; immunology ; Drug Hypersensitivity ; immunology ; Histamine Release ; Humans ; Mast Cells ; immunology ; Medicine, Chinese Traditional

Diagnostic methods for drug allergy include the patient's history, in vivo skin test, in vitro laboratory test, and provocation test. However, the history is often not reliable, procedures for in vivo and in vitro tests are not standardized, and provocation tests are sometimes harmful to patients. Generally, skin prick and intradermal tests are useful for immediate reactions; in contrast, patch test and delayed reading of both skin prick and intradermal tests are helpful for delayed reactions. A drug provocation test is the gold standard for both responses, and it is necessary to be aware of exact indications and contraindications with appropriate drugs, doses, and intervals. To date, several methods have been developed to detect culprit agents for drug hypersensitivity reactions, but they are neither completely well validated nor standardized. Based on this awareness and necessity, the Korean Academy of Asthma, Allergy and Clinical Immunology launched the Standardization Committee to review the international guidelines and the literature, and then developed the consensus report on the procedures and applications of diagnostic tests for drug allergy.
Allergy and Immunology ; Asthma ; Consensus ; Diagnostic Tests, Routine* ; Drug Hypersensitivity* ; Humans ; Hypersensitivity ; In Vitro Techniques ; Intradermal Tests ; Patch Tests ; Skin ; Skin Tests

Mast cells and basophils are multifunctional effector cells that contain abundant secretory granules in their cytoplasm. Both cell types are involved in a variety of inflammatory and immune events, producing an array of inflammatory mediators, such as cytokines. The aim of the study was to examine whether isoquercitrin modulates allergic and inflammatory reactions in the human basophilic KU812 cells and to elucidate its influence on the phosphorylation of mitogen-activated protein kinase (MAPK) and nuclear factor (NF)-κB activation. The KU812 cells were stimulated with phorbol-12-myristate 13-acetate plus the calcium ionophore A23187 (PMACI). The inhibitory effects of isoquercitrin on the productions of histamine and pro-inflammatory cytokines in the stimulated KU812 cells were measured using cytokine-specific enzyme-linked immunosorbent (ELISA) assays. Western blotting analysis was used to assess the effects of isoquercitrin on the MAPKs and NF-κB protein levels. Our results indicated that the isoquercitrin treatment of PMACI-stimulated KU812 cells significantly reduced the production of histamine and the pro-inflammatory cytokines, such as interleukin (IL)-6, IL-8, IL-1β, and tumor necrosis factor (TNF)-α. The treated cells exhibited decreased phosphorylation of extracellular signal-regulated kinase (ERK), revealing the role of ERK MAPK in isoquercitrin-mediated allergy inhibition. Furthermore, isoquercitrin suppressed the PMACI-mediated activation of NF-κB in the human basophil cells. In conclusion, the results from the present study provide insights into the potential therapeutic use of isoquercitrin for the treatment of inflammatory and allergic reactions.
Basophils ; drug effects ; immunology ; Cytokines ; genetics ; immunology ; Down-Regulation ; drug effects ; Extracellular Signal-Regulated MAP Kinases ; genetics ; immunology ; Histamine ; immunology ; Humans ; Hypersensitivity ; drug therapy ; genetics ; immunology ; NF-kappa B ; genetics ; immunology ; Quercetin ; analogs & derivatives ; pharmacology

Ascorbic Acid ; adverse effects ; immunology ; Child, Preschool ; Drug Hypersensitivity ; etiology ; Family ; Female ; Humans ; Male

Aspirin and food additives are known to induce bronchoconstriction, angioedema or urticaria in susceptible patients. To evaluate the incidence of hypersensitivity to aspirin and food additives, 36 subjects with bronchial asthma, 33 of whom were non-allergic asthmatics and 3 were allergic asthmatics who had a history of aspirin sensitivity, were challenged orally with six compounds: acetylsalicylic acid (ASA), sodium bisulfite, tartrazine, sodium benzoate, 4-hydroxy benzoic acid, and monosodium L-glutamate. Significant bronchoconstrictions were found in 15 (41.7%) of the 36 subjects tested. Eight of the 15 subjects showed positive asthmatic responses to the aspirin, two showed asthmatic responses to the food additives, and five responded to both aspirin and the food additives. It is suggested that ASA and food additives could be causes of clinically significant bronchoconstriction in moderately severe non-allergic asthmatic patients.
Adolescent ; Adult ; Aged ; Aspirin/*immunology ; Asthma/*immunology ; Bronchial Provocation Tests/*methods ; Drug Hypersensitivity/*immunology ; Female ; Food Additives/*adverse effects ; Human ; Male ; Middle Age

Aspirin and food additives are known to induce bronchoconstriction, angioedema or urticaria in susceptible patients. To evaluate the incidence of hypersensitivity to aspirin and food additives, 36 subjects with bronchial asthma, 33 of whom were non-allergic asthmatics and 3 were allergic asthmatics who had a history of aspirin sensitivity, were challenged orally with six compounds: acetylsalicylic acid (ASA), sodium bisulfite, tartrazine, sodium benzoate, 4-hydroxy benzoic acid, and monosodium L-glutamate. Significant bronchoconstrictions were found in 15 (41.7%) of the 36 subjects tested. Eight of the 15 subjects showed positive asthmatic responses to the aspirin, two showed asthmatic responses to the food additives, and five responded to both aspirin and the food additives. It is suggested that ASA and food additives could be causes of clinically significant bronchoconstriction in moderately severe non-allergic asthmatic patients.
Adolescent ; Adult ; Aged ; Aspirin/*immunology ; Asthma/*immunology ; Bronchial Provocation Tests/*methods ; Drug Hypersensitivity/*immunology ; Female ; Food Additives/*adverse effects ; Human ; Male ; Middle Age

OBJECTIVETo investigate the mechanism(s) of penicillins allergic reaction.

METHODSThe radioallergosorbent test (RAST) was used to detect 9 specific IgE antibodies, including major antigenic determinants: benzylpenicilloyl (BPO), ampicilloyl (APO), amoxicilloyl (AXO), phenoxomethylpenicilloyl (PVO) and flucloxacilloyl (FLUO), and minor antigenic determinants: benzylpenicillanyl (BPA), amoxicillanyl (AXA), 6-aminopenicillanic (APA) and phenoxomethylpenicillany (PVA), in the sera of 32 penicillin allergic patients. The relationship between specific IgE antibodies and penicillins chemical structures was studied by radioallergosorbent inhibition test.

RESULTSNineteen of 32 patients (59.4%) were RAST positive, among whom, five cases were positive only to one or two antigenic minor determinants, and three cases were positive only to one or three major antigenic determinants. The remaining 11 patients were positive not only to major antigenic determinants but also minor antigenic determinants. In 9 specific IgE antibodies, the positive rate of PVA-IgE was the highest (34.38%), followed by BPO-IgE (31.25%). The positive rate of FLUO-IgE was the lowest (15.63%). Of the total patient group, 53.13% were positive to one or more minor antigenic determinants, while 37.5% (12/32) were positive to one or more major antigenic determinants. The percentage of patients with urticarial reactions who were positive to minor antigenic determinants (63.16%) was significantly higher than observed in the anaphylactic shock group (38.5%, P < 0.05).

CONCLUSIONSThe minor antigenic determinant was important in allergic reaction. The combining sites of the specific IgE antibodies were likely to be the side-chain of drug or the overwhelming drug molecule.

Adolescent ; Adult ; Aged ; Antibodies ; blood ; Drug Hypersensitivity ; immunology ; Epitopes ; immunology ; Female ; Humans ; Immunoglobulin E ; blood ; Male ; Middle Aged ; Penicillins ; immunology ; Radioallergosorbent Test

Allergic asthma is thought to arise from an imbalance of immune regulation, which is characterized by the production of large quantities of IgE antibodies by B cells and a decrease of the interferon-γ/interleukin-4 (Th1/Th2) ratio. Certain immunomodulatory components and Chinese herbal formulae have been used in traditional herbal medicine for thousands of years. However, there are few studies performing evidence-based Chinese medicine (CM) research on the mechanisms and effificacy of these drugs in allergic asthma. This review aims to explore the roles of Chinese herbal formulae and herb-derived compounds in experimental research models of allergic asthma. We screened published modern CM research results on the experimental effects of Chinese herbal formulae and herb-derived bioactive compounds for allergic asthma and their possible underlying mechanisms in English language articles from the PubMed and the Google Scholar databases with the keywords allergic asthma, experimental model and Chinese herbal medicine. We found 22 Chinese herb species and 31 herb-derived anti-asthmatic compounds as well as 12 Chinese herbal formulae which showed a reduction of airway hyperresponsiveness, allergen-specifific immunoglobulin E, inflflammatory cell infifiltration and a regulation of Th1 and Th2 cytokines in vivo, in vitro and ex vivo, respectively. Chinese herbal formulae and herbderived bioactive compounds exhibit immunomodulatory, anti-inflflammatory and anti-asthma activities in different experimental models and their various mechanisms of action are being investigated in modern CM research with genomics, proteomics and metabolomics technologies, which will lead to a new era in the development of new drug discovery for allergic asthma in CM.
Animals ; Asthma ; complications ; drug therapy ; immunology ; Disease Models, Animal ; Drugs, Chinese Herbal ; therapeutic use ; Homeostasis ; Hypersensitivity ; complications ; drug therapy ; immunology ; Immunologic Factors ; therapeutic use