Atopic dermatitis (AD) is a chronic, relapsing, inflammatory skin disease. Children with AD tend to have a higher prevalence of food allergies. This study investigated the clinical significance of food sensitization in AD patients. A total of 266 AD patients participated in this study. The prevalence of food sensitization and clinically relevant sensitization were compared in the subjects according to their age and AD severity. Sera from all patients were analyzed for food-specific IgE levels using the Pharmacia CAP System FEIA. The serum specific IgE levels for egg, milk, peanut and soybean were measured. Patients were regarded as sensitized to the food if their food-specific IgE levels were above 0.35 kUA/L. Also the food-specific IgE levels, the so-called diagnostic decision point, which is recommended as the clinically relevant level, for clinical food allergy, as suggested by Sampson et al, was used as an alternative method. From the measurement of food-specific IgE antibodies of the four foods, egg was the most highly sensitized and the main causative allergenic food in children with AD. The positive rates of specific IgE to the four major food allergens, and the prevalences of clinically relevant food sensitization, were higher for all foods tested in the group less than 1 year of age, and were significantly higher in moderate to severe AD compared to mild AD in infants and young children. In summary, presence of food specific IgE is prevalent in infants and young children with AD, and clinically relevant food sensitization is important in Korean infants and children with moderate to severe AD.
Child, Preschool ; Dermatitis, Atopic/*immunology ; Egg Hypersensitivity/epidemiology ; Female ; Food Hypersensitivity/diagnosis/*epidemiology ; Humans ; Immunoglobulin E/blood ; Infant ; Male ; Milk Hypersensitivity/epidemiology ; Peanut Hypersensitivity/epidemiology ; Soybeans/immunology

OBJECTIVEFood allergy as one of social health problems has gained more attention of people. However, few reports on prognosis of food allergy, the relation between infant food allergy and other allergic diseases, and factors affecting prognoses of infant food allergy in China. The present study was designed to investigate the evolution of infancy food allergy and to explore predicting factors of the tolerance to these foods and factors of other allergic diseases to provide a clue for managing children with food allergy reasonably and to improve their prognoses.

METHODSTotally 119 children with food allergy during infancy, who were diagnosed in the Department of Primary Child Care, Children's Hospital, Chongqing University of Medical Sciences from January 2000 to June 2003, were studied retrospectively by analyzing the follow-up data before March 2004. The occurrence of food tolerance and other allergic diseases were counted. Kaplan-Meier methods were used to calculate the cumulative tolerance probability. And the predicting factors of persistent food allergy and influential factors of other allergic diseases were analyzed by unconditional Logistic regression models.

RESULTSThe cumulative tolerance probabilities of cow's milk and egg were 42% and 31% one year after diagnosis respectively, 63% and 62% 2 years later, 77% and 80% 3 years later, and 100% after 4 years. And the severity of skin prick test reactions to cow's milk and egg was the predicting factor for persisting hypersensitivity to cow's milk and egg (OR = 2.535, 95% CI: 1.159-5.543; OR = 2.654, 95% CI: 1.302-5.410, P < 0.05). Thirteen cases presented with hypersensitivity to other foods (15.6 +/- 6.1) months after the diagnosis was confirmed, and the risk factor was the long-lasting hypersensitivity to egg (OR = 6.109, 95% CI: 1.818-20.527, P < 0.05). After 4 cases and 15 cases were diagnosed as allergic rhinitis and asthma, respectively, (16.8 +/- 8.3) months after diagnoses and the risk factors were the long-lasting hypersensitivity to egg and the respiratory symptoms (OR = 3.596, 95% CI: 1.429-9.045; OR = 4.235, 95% CI: 1.152-15.563, P < 0.05).

CONCLUSIONAt least 75% of children with egg or cow's milk allergy could develop tolerance to egg or cow's milk within 3 years after diagnoses; 10.9%, 12.6% and 3.4% of children with food allergy suffered from other food allergy, asthma and allergic rhinitis. Strengthening the screening and management of children at high risk for persistent food allergy will contribute to improvement of the prognoses of food allergy.

Child, Preschool ; China ; epidemiology ; Female ; Food Hypersensitivity ; diagnosis ; epidemiology ; immunology ; Humans ; Immune Tolerance ; Infant ; Male ; Prognosis ; Retrospective Studies ; Risk Factors

In Korea, common whelk (Buccinum undatum) is a popular edible shellfish. The aim of this study was to observe the sensitization rate to common whelk and to characterize its allergens. We carried out skin prick test (SPT) in 1,700 patients with various allergic diseases. Specific IgE were detected by ELISA in the patient sera and ELISA inhibition tests were conducted. IgE-binding components were identified by means of SDS-PAGE and IgE-immunoblotting. The effects of diges-tive enzymes were evaluated in both raw and thermally treated extracts. SPT to common whelk was positive (> or =2+) in 83 (4.9%) patients studied. Twenty-four (38.7%) out of 62 SPT positive patients had high serum specific IgE to common whelk. ELISA inhibition test showed significant inhibitions by abalone as well as by common whelk. IgE-immunoblotting demonstrated three IgE-binding components (40, 71, 82 kDa), which were digested by simulated intestinal fluid and moderately digested by simulated gastric fluid, and the digestibility of allergens remained unchanged after thermal treatment. In conclusion, IgE-sensitization rate to com-mon whelk was 4.9% in allergy patients. IgE-immunoblotting demonstrated three IgE-binding components, which were degraded by digestive enzymes. Further studies are needed to evaluate the clinical significance of the sensitized patients to common whelk.
Allergens/immunology ; Animals ; Comparative Study ; Cookery ; Digestion/*physiology ; Food Handling/methods ; Food Hypersensitivity/diagnosis/*epidemiology/*immunology/metabolism ; Heat ; Humans ; Immunoglobulin E/*immunology/metabolism ; Intestines/enzymology ; Korea/epidemiology ; *Mollusca ; Research Support, Non-U.S. Gov't ; Shellfish/*adverse effects ; Skin Tests ; Stomach/enzymology

We performed this study to assess the prevalence of sensitization to aeroallergens and to analyze the difference between prevalence rates according to children's ages and residential areas. In this nationwide cross-sectional study, first grade students of 45 elementary schools and 40 middle schools were randomly selected, and skin prick tests were performed for 18 inhalant allergens between October and November 2010. Of 7,829 analyzed subjects, 3,753 (47.9%) were sensitized to at least one aeroallergen. Sensitization to Dermatophagoides farinae was found to be the most prevalent in elementary schoolchildren (32.4%), followed by Dermatophagoides pteronyssinus, Tyrophagus putrescentiae, Japanese hop, and oak. In middle schoolchildren, D. pteronyssinus yielded the highest prevalence (42.7%), followed by D. farinae, T. putrescentiae, Japanese hop, and cat. In middle schoolchildren, the sensitization rate to aeroallergens in metropolitan, urban, and rural areas was 57.2%, 54.3%, and 49.8%, respectively (P = 0.019). In this age group, the sensitization rate in low, middle, high, and very high income groups was 53.8%, 51.8%, 59.0%, and 59.6%, respectively (P = 0.002). In conclusion, the sensitization rate is 47.9% and house dust mite is the most prevalent allergen in the pediatric population in Korea. The rate is higher in metropolitan areas and the highest income group than in rural areas and low income groups.
Adolescent ; Age Factors ; Air Pollutants/*immunology ; Allergens/*immunology ; Animals ; Child ; Cross-Sectional Studies ; Demography ; Female ; Humans ; Hypersensitivity/*diagnosis/epidemiology/immunology ; Male ; Pyroglyphidae/immunology ; Republic of Korea ; Rural Population ; Sex Factors ; Skin Tests ; Socioeconomic Factors ; Urban Population

OBJECTIVETo investigate the seasonal influence on the diagnosis of food allergy in children under 3 years of age.

METHODThe data of epidemiological studies about food allergy of children under 3 years of age attending routine well-baby checks at the Department of Primary Child Care, Children's Hospital of Chongqing Medical University in the winter and summer, 2009, including questionnaires, results of skin prick test (SPT), food elimination and oral food challenge (OFC) were analyzed. All the data were analyzed by SPSS 17.0.

RESULTThe age and sex distribution, and both the rates of the drop-out in two studies were similar. Ninety infants were positive for SPT, 40 infants were positive for OFC, and 31 infants dropped out in winter; while 65 infants were positive for SPT, 25 positive for OFC, and 31 dropped out in summer. The percentage of positive SPT in the children performed in winter was higher than that in summer (14.9%, 90/603 vs 10.7%, 65/607) (P = 0.028). Skin prick test accuracy was similar when the studies were performed in winter and in summer [sensitivity 0.85 and 0.84, positive predictive value (PPV) 0.54 and 0.47, negative predictive value (NPV) 0.99 and 0.99]. The prevalence of food allergy in the children studied in winter was higher than that in summer (7.0% vs 4.3%), but the difference was not significant. After correcting the prevalence for dropout children, the prevalence of food allergy (FA) investigated in winter was significantly higher than that in summer (9.3% vs 5.9%). The results of circular distribution analysis showed the date of birth corresponding to estimated value of peak point of SPT in winter were not consistent with it in summer, so was OFC. Either the results of skin prick test or oral food challenge in two studies were not correlated with the seasons of birth.

CONCLUSIONOur data showed that the rates of positive SPT and the prevalence of food allergy were correlated with the seasons, but the seasons of birth did not influence the results of skin prick test or oral food challenge in children, while the real age of children were related to them.

Age Factors ; Child, Preschool ; China ; epidemiology ; Female ; Food Hypersensitivity ; diagnosis ; epidemiology ; immunology ; Humans ; Infant ; Infant, Newborn ; Male ; Predictive Value of Tests ; Prevalence ; Seasons ; Sensitivity and Specificity ; Severity of Illness Index ; Skin Tests ; methods ; Surveys and Questionnaires

Animals ; China ; epidemiology ; Clinical Trials as Topic ; Evidence-Based Medicine ; Humans ; Infant ; Infant, Newborn ; Milk Hypersensitivity ; diagnosis ; epidemiology ; therapy ; Milk Proteins ; adverse effects ; immunology ; Practice Guidelines as Topic ; standards ; Skin Tests ; methods

Exposure to cephalosporins could cause occupational allergic diseases in health care workers (HCWs). We evaluated the prevalence of serum specific IgE and IgG antibodies to cephalosporin-human serum albumin (HSA) conjugate and to identify potential genetic risk factors associated with sensitization to cephalosporins in exposed HCWs. The study population consisted of 153 HCWs who had been exposed to antibiotics in a single university hospital and 86 unexposed healthy controls. A questionnaire survey of work-related symptoms (WRS) was administered. A skin-prick test (SPT) was performed, and serum-specific IgE and IgG antibodies to 3 commonly prescribed cephalosporins were measured by ELISA. Four single-nucleotide polymorphisms of the candidate genes related to IgE sensitization were genotyped. The prevalence of WRS to cephalosporins was 2.6%. The prevalence rates of serum-specific IgE and IgG antibodies to cephalosporins were 20.3% and 14.7%, respectively. The FcepsilonR1beta-109T > C polymorphism was significantly associated with IgE sensitization to cephalosporins in HCWs (P = 0.036, OR = 3.553; CI, 1.324-9.532). The in vitro functional assay demonstrated that the T allele of FcepsilonR1beta-109T had greater promoter activity than did the C allele (P < 0.001). The FcepsilonR1beta-109T > C polymorphism may be a potential genetic risk factor for increased IgE sensitization to cephalosporins.
Adult ; Alleles ; Anti-Bacterial Agents/analysis/*immunology ; Cephalosporins/analysis/*immunology ; Enzyme-Linked Immunosorbent Assay ; Female ; Genetic Predisposition to Disease ; Health Personnel ; Humans ; Hypersensitivity/*diagnosis/epidemiology ; Immunoglobulin E/blood ; Immunoglobulin G/blood ; Male ; Occupational Diseases/*chemically induced/epidemiology ; Occupational Exposure ; Odds Ratio ; Questionnaires ; Receptors, IgE/genetics ; Skin Tests ; Young Adult