PURPOSE: Component-resolved diagnostics (CRD) is expected to provide additional diagnostic information in allergic patients. PROTIA™ Allergy-Q 64 Atopy®, a recently developed CRD-based multiplex specific immunoglobulin E (sIgE) assay, can quantitatively measure sIgE to major allergen components. METHODS: The sIgE detection by PROTIA™ Allergy-Q 64 Atopy® and ImmunoCAP® assays was compared using the sera of 125 Korean allergic patients. Group 1 and 2 allergens of house dust mites (HDMs; Dermatophagoides farinae (Der f) 1 and Der f 2 in PROTIA™ Allergy-Q 64 Atopy®, Dermatophagoides pteronyssinus (Der p) 1 and Der p 2 in ImmunoCAP®), Bet v 1, Fel d 1, Que a 1, ω-5 gliadin, α-lactalbumin, β-lactoglobulin, casein and α-Gal were measured by both assays. RESULTS: Comparing the results from the 2 assays, the agreement rate for all the 10 allergens was > 88% (group 1 HDM allergen, 100%; group 2 HDM allergen, 94.6%; Bet v 1, 97.4%; Fel d 1, 90.5%; Que a 1, 89.2%; α-lactalbumin, 96%; β-lactoglobulin, 88%; casein, 88%; ω-5 gliadin, 96%; α-Gal, 100%). Correlation analysis indicated that, all the 10 allergen sIgEs showed more than moderate positive correlation (Pearson correlation coefficients > 0.640). Additionally, intra-class comparison showed more than high correlation for all the 10 allergens (Spearman's rank correlation coefficients > 0.743). CONCLUSIONS: PROTIA™ Allergy-Q 64 Atopy® is reliable and comparable to the ImmunoCAP® assay for component-resolved diagnosis.
Allergens ; Caseins ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Diagnosis ; Gliadin ; Humans ; Immunoassay ; Immunoglobulin E ; Immunoglobulins ; Pyroglyphidae

PURPOSE: Pneumonia is one of the most common respiratory diseases in hospitalized children, and often recurs. It has been reported that asthma is one of the significant contributing factors to recurrent pneumonia. On the basis of similarities between asthma and recurrent pneumonia, we intended to evaluate the influence of allergy on recurrent pneumonia. METHODS: Seventy one children with recurrent pneumonia were defined as recurrent group(RG) and twenty one children with first episodes of pneumonia were defined as control group(CG). WBC, total eosinophil count, Eosinophilic Cationic Protein(ECP), serum total IgE and specific IgE for eleven common allergens using the CAP system were measured and compared. Recurrent pneumonia was defined as at least two pneumonia episodes in a year, or at least three episodes from birth to the time of our study. Children with previous allergic disorders were excluded. RESULTS: There were no statistical differences in WBC, total IgE, and ECP between the two groups. Total eosinophil count in RG was significantly higher than CG(P=0.021), significantly correlating with ECP(r=0.755, P<0.05) and total IgE(r=0.354, P<0.05). When the cut-off value was 0.35 kU/L in CAP test, positive prevalence of CAP in RG was significantly higher than CG(P=0.009). Also, the positive prevalence of house dust mites group, especially Dermatophagoides farinae(D.f.), was significantly higher in RG(P=0.019, 0.025, respectively). When the cut-off value was 0.7 kU/L in CAP test, only a positive prevalence of house dust mites group was significantly higher in RG than CG (P=0.042). The quantitative levels of specific IgE for Dermatophagoides pteronyssinus(D.p.) and D.f. were very high in RG(P=0.018, 0.028, respectively), significantly correlating with each other(r=0.639, P<0.05). CONCLUSION: Allergic sensitization, especially to house dust mites, is one important contributable factor in recurrent pneumonia in children. Further study, such as bronchial hyperresponsiveness, is needed in children who were sensitized by D.p. or D.f..
Allergens ; Asthma ; Child* ; Child, Hospitalized ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Eosinophils ; Humans ; Hypersensitivity* ; Immunoglobulin E ; Parturition ; Pneumonia* ; Prevalence ; Pyroglyphidae

BACKGROUND: The relationship between atopic dermatitis (AD) and low vitamin D levels has been studied. Emerging evidence has implicated vitamin D as a critical regulator of immunity, playing a role in both the innate and cell-mediated immune systems. However, the effect of vitamin D on house dust mite (HDM) sensitization in patients with AD has not been established. OBJECTIVE: We investigated the association between vitamin D levels and HDM sensitization according to AD severity. METHODS: In total, 80 patients (43 men and 37 women) with AD were included. We classified AD severity using Rajka and Langeland scores. Laboratory tests included serum 25-hydroxyvitamin D3, total immunoglobulin E (IgE), and specific IgE antibody titer against Dermatophagoides farinae and D. pteronyssinus. RESULTS: There were no differences in vitamin D levels between the mild or moderate AD and severe AD groups. In the severe AD group, high HDM sensitization group had lower serum vitamin D levels compared to low HDM sensitization group with statistical significance. In addition, a significant negative correlation was found between vitamin D levels and HDM sensitization in the severe AD group. CONCLUSION: Our results demonstrate that low vitamin D levels may link to high HDM sensitization in patients with the severe AD. Further elucidation of the role of vitamin D in HDM sensitization may hold profound implications for the prevention and treatment of AD.
Calcifediol* ; Dermatitis, Atopic* ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Dust* ; Humans ; Immune System ; Immunoglobulin E ; Immunoglobulins ; Male ; Plasma* ; Pyroglyphidae* ; Vitamin D

PURPOSE: Atopy and specific immunogloguline (Ig) E to individual aeroallergen are considered a hallmark of allergic diseases, including asthma. However, the association between these parameters and lung function or bronchial hyperresponsiveness (BHR) is still controversial in previous studies. METHODS: A total of 234 atopic asthmatic children was recruited in this study. The amounts of total IgE and specific IgE were determined by employing the CAP system FEIA (Pharmacia Diagnostics, Uppsala, Sweden). Specific IgE was focused on two major inhalant allergens in Korea, Dermatophagoides pteronyssinus (Der p) and Dermatophagoides farinae (Der f). To evaluate BHR, methacholine and exercise challenge tests were performed. RESULTS: In the atopic asthmatic group, total IgE correlated negatively with methacholine PC20 and positively with a maximum percentage fall in FEV1 after exercise. Specific IgE to Der f strongly correlated with a maximum percentage fall in FEV1 after exercise in atopic asthmatics, particularly exercise-induced asthma (EIA) (r=0.176, P=0.007 and r=0.199, P=0.011, respectively) and specific IgE to Der p weakly correlated with a maximum percentage fall in FEV1 after exercise only in EIA-positive children with atopic asthma (r=0.140, P=0.073), while neither of them correlated with methacholine PC20 (P> 0.05). However FEV1, FVC, and FEF25-75% were not associated with total IgE and specific IgE to Der p or Der f regardless of positivity of EIA in atopic asthmatic children. CONCLUSION: The severity of atopy and sensitization to house dust mites are significantly correlated with BHR, especially challenged by exercise but not pulmonary function in atopic asthmatic children.
Allergens ; Asthma ; Asthma, Exercise-Induced ; Child* ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Humans ; Immunoglobulin E ; Korea ; Lung ; Methacholine Chloride ; Pyroglyphidae

PURPOSE: The clinical efficacy of allergen-immunotherapy is known to be dose dependent. However, optimal maintenance dosage has not yet been determined for sublingual immunotherapy (SLIT). Furthermore, since companies adopt their own units for expression of allergenicity, the allergen concentrations of individual reagents cannot be compared easily. We sought to measure and compare the allergenicities of 3 commercially available house dust mite (HDM) SLIT regents and a subcutaneous immunotherapy reagent. METHODS: We measured the HDM allergenic potency of the maintenance dosages of three SLIT reagents: Staloral(R) (300 index of reactivity [IR] /mL, recommended maintenance dosage [MD]: 120 IR), SLITone(R) (1,000 standard therapeutic unit [STU]/mL, recommended MD: 200 STU), Wolwopharma(R) (100 microg/mL, recommended MD: 20 microg), and subcutaneous immunotherapy regents of Hollister-Stier (10,000 allergy unit [AU] /mL). The allergenic potency was assessed by measuring the total protein concentrations, mite group 1 and 2 allergens using 2-site ELISA, and an inhibition test against IgE specific to Dermatophagoides farinae and Dermatophagoides pteronyssinus. RESULTS: The protein content of the Wolwopharma(R) reagent was 1.5-261.4 times higher than that of the other 2 SLIT reagents. The concentration of group 1 major allergens in Staloral(R) (132.03 microg/mL) was 33- to 44.5-fold higher than in SLITone(R) (4.00 microg/mL) and Wolwopharma(R) (2.97 microg/mL). The concentration of group 2 major allergen was also 8.9- to 10.5-fold higher in Staloral(R) (15.7 microg/mL) than in SLITone(R) (1.8 microg/mL) or Wolwopharma(R) (1.5 microg/mL). An ELISA inhibition study against HDM-specific IgE showed that the allergen potency of Staloral(R) reagent is 8.5-fold and 21-fold higher than that of SLITone(R) or Wolwopharma(R), respectively. The differences between the maintenance dosages are further exaggerated by the differences in the recommended volumes of SLIT reagents. CONCLUSIONS: The allergen potencies of commercially available HDM SLIT reagents are markedly different. Consensus regarding the optimal allergen concentration for SLIT reagents used to treat HDM respiratory allergies is needed.
Allergens ; Consensus ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Enzyme-Linked Immunosorbent Assay ; Hypersensitivity ; Immunoglobulin E ; Immunotherapy ; Indicators and Reagents* ; Mites ; Pyroglyphidae* ; Sublingual Immunotherapy*

BACKGROUND: Evidence is conflicting regarding the effectiveness of creating a low-allergen environment or reducing allergen exposure to control asthma exacerbations. OBJECTIVE: This study determined the association of house dust mite (HDM)-specific IgE levels with asthma symptom control, selected medications, family history of allergic disease, and exposure to second-hand smoke and household pets. METHODS: Serum samples from 102 doctor-diagnosed allergic asthma patients and 100 non-atopic controls were subjected to enzyme-linked immunosorbent assay using the HDM species Dermatophagoides pteronyssinus (Dp), Dermatophagoides farinae (Df), and Blomia tropicalis (Bt) allergens. Point-biserial correlation coefficient, Pearson R correlation, and logistic regression analyses were used to determine association of HDM-specific IgE levels with the abovementioned variables. RESULTS: Of the 102 cases, 38.24%, 47.06%, and 33.33% were sensitized to Bt, Df, and Dp, respectively. Sensitized patients showed greater probability [Bt (OR = 1.21), Df (OR = 1.14), and Dp (OR = 1.35)] to manifest symptoms than those who were not. Obtained p-values [Bt (p = 0.73), Df (p = 0.83), and Dp (p = 0.59)], however, proved that HDM-specific IgE levels had no significant contribution in predicting or explaining occurrence of asthma symptoms. Bt- and Df-specific IgEs showed moderately weak but significant relationship with bambuterol HCl and expectorant, respectively. Patients currently on said medications registered higher HDM-specific IgE levels than those who were not. No significant correlation between IgE levels and family history of allergic disease or with exposure to second-hand smoke was seen. Dp-specific IgE levels of patients exposed to household pets were significantly lower compared to those without exposure. CONCLUSION: This study proves that sensitization to Bt, Df, and Dp allergens is not significantly associated with asthma symptoms and control. Although cases were shown to be sensitized to HDMs, their current medications were at least effective in controlling their asthma symptoms.
Allergens ; Asthma ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Dust ; Enzyme-Linked Immunosorbent Assay ; Family Characteristics ; Humans ; Immunoglobulin E ; Logistic Models ; Pyroglyphidae ; Smoke

BACKGROUND: Specific serum IgE determination is widely used in the diagnosis of IgE-mediated allergic diseases. House dust mite allergens are known to show good sensitivity on in vitro tests. We report the results of specific IgE against house dust allergen by Pharmacia CAP system FEIA and compared them with those of in vivo test. OBJECTIVE: The aim of this study is to find out the clinical application of Pharmacia CAP system FEIA in atopic dermatitis. METHODS: In 46 atopic dermatitis patients, skin prick test and Pharmacia CAP system FEIA were performed for Dermatophagoides pteronyssinus and Dermatophagoides farinae allergens. For all patients, atopy and family histories were taken. RESULTS: The positive results were more frequent in adult patients(over 16 years old, 73.3%) than in child patients(below 15 years old, 38.7%) in skin prick test for both Dermatophagoides pteronyssinus and Dermatophagoides farinae allergens. When skin prick tests were used as a reference standard, the sensitivity of Pharmacia CAP system FEIA was 89.5% for Dermatophagoides pteronyssinus and 90.0% for Dermatophagoides farinae, and the specificity of Pharmacia CAP system FEIA was 77.8% for Dermatophagoides pteronyssinus and 80.8% for Dermatophagoides farinae. Correlations were found between Pharmacia CAP system FEIA results and serum total IgE (r=0.574 for Dermatophagoides pteronyssinus and r=0.534 for Dermatophagoides farinae). CONCLUSION: Our results suggest that Pharmacia CAP system FEIA offers high sensitivity and can be an effective method of screening for allergies to Dermatophagoides pteronyssinus and Dermatophagoides farinae in atopic dermatitis.
Adolescent ; Adult ; Allergens ; Antigens, Dermatophagoides ; Child ; Dermatitis, Atopic* ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Diagnosis ; Dust* ; Humans ; Hypersensitivity ; Immunoglobulin E ; Mass Screening ; Pyroglyphidae* ; Sensitivity and Specificity ; Skin

PURPOSE: Population studies have reported that sensitization to inhalant allergens is rare in young children; however, most subjects in those studies had little or no symptoms or signs highly suggestive of allergic diseases. The aim of the present study was to assess the prevalence of sensitization to inhalant allergens in young children with symptoms and/or signs of allergic disease. METHODS: We analyzed the results of all specific IgE tests performed at our hospital laboratory in children younger than 6 years presenting with symptoms and/or signs highly suggestive of allergic diseases between 2008 and 2013. Specific IgE tests for Dermatophagoides pteronyssinus, Dermatophagoides farinae, Alternaria alternata, German cockroach, cat dander, egg white or egg yolk, milk, peanut, and soybean were performed on 295 children; a specific IgE concentration > or =0.35 or > or =0.2 IU/mL was considered positive. We also compared allergen sensitization rates using the two cutoff values. RESULTS: One hundred eighty-one children (61.4%) were positive to at least 1 allergen tested and 53 children (18.9%) were positive to at least 1 inhalant allergen when a specific IgE concentration > or =0.35 IU/mL was considered positive. The children were more likely to have asthma or allergic rhinitis when they were sensitized to any inhalant allergen, particularly house dust mites. The prevalence of sensitization to inhalant allergens increased with age (P<0.001). There was no significant difference in the prevalence of polysensitization among different age groups, but sensitization to both inhalant and food allergens significantly increased with age. CONCLUSION: Our results suggest that specific IgE tests to common inhalant allergens, particularly the house dust mites, may be considered when performing blood screening tests for young children presenting with symptoms and/or signs of allergic diseases.
Allergens* ; Alternaria ; Animals ; Asthma ; Blattellidae ; Cats ; Child* ; Dander ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Egg White ; Egg Yolk ; Humans ; Immunoglobulin E ; Laboratories, Hospital ; Mass Screening ; Milk ; Prevalence ; Pyroglyphidae ; Rhinitis ; Soybeans

Several recent clinical trials reported that intralymphatic immunotherapy (ILIT) for some allergens, such as cat dander and pollen, induce tolerance more rapidly than conventional subcutaneous or sublingual immunotherapy, have a comparable duration of effect after only 3 injections, and do not provoke serious local or systemic reactions. However, the efficacy and safety of ILIT are using Dermatophagoides farinae (Df), Dermatophagoides pteronyssinus (Dp), and dog, which are indoor allergens that are commonly found globally, need to be evaluated. Furthermore, use of multiple allergens in ILIT should be investigated. We assessed the clinical efficacy and adverse effects of ILIT using aqueous Df, Dp, dog, and cat allergens or mixtures thereof in patients with allergic rhinitis. A total of 11 subjects with AR sensitized to Df, Dp, cat, and/or dog allergens received 3 intralymphatic inguinal injections of sensitized allergen extract (HollisterStier, New Orleans, LA, USA). Clinical parameters were assessed before ILIT, and 4 months and 1 year after the first injection. Rhinitis symptoms were alleviated and quality of life was improved 4 months after ILIT (P=0.012 and P=0.007, respectively), and these improvements lasted for 1 year after ILIT (P=0.047 and P=0.009, respectively). However, we observed 2 cases of anaphylaxis, one case of a moderate-to-severe systemic hypersensitivity reaction and the other case of a severe local reaction at the injection site after ILIT. In conclusion, ILIT can rapidly improve allergy symptoms and quality of life, and this effect lasts for 1 year. In hypersensitized patients, however, ILIT can provoke severe systemic and/or local hypersensitivity reactions when performed using aqueous allergen extracts.
Allergens ; Anaphylaxis ; Animals ; Cats ; Dander ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Dogs* ; Dust* ; Humans ; Hypersensitivity* ; Immunotherapy* ; Pilot Projects* ; Pollen ; Pyroglyphidae* ; Quality of Life ; Rhinitis ; Rhinitis, Allergic ; Sublingual Immunotherapy ; Treatment Outcome

PURPOSE: This study investigated the differences in the profile of IgE-binding components between Dermatophagoides pteronyssinus (Dp) and Dermatophagoides farina (Df) in respiratory allergic patients sensitized to Dp/Df. METHODS: Eighteen patients with respiratory allergic diseases having higher levels of serum specific IgE to Df compared to those to Dp (>twice) were enrolled. IgE-immunoblot analysis using Dp and Df extracts were used to compare the IgE binding components. Study subjects were classified into 2 groups according to the results of IgE-immunoblot analysis: 6 subjects having IgE-binding components to group 1 and 2 allergens (group B) and 12 subjects not having them (group A). RESULTS: Group A subjects were older (47.92±8.51 vs. 35.50±11.10, P=0.039) and males were dominant (75% vs. 0% P=0.009). IgE-immunoblot analysis demonstrated that all the group B subjects had IgE bindings to 2 major components, 14 and 25 kDa, while group A subjects had IgE bindings to high-molecular weight components ranging from 60-98 kDa. The enzyme-linked immunosorbent assay inhibition test showed a significant inhibition with additions of Df, not with Dp in group B subjects. Serum specific IgE levels to Dp and Df were significantly higher in group B than in group A, while its ratio (Df to Dp) was significantly higher in group A. No differences were noted in clinical parameters, total IgE, or eosinophil cationic protein levels. CONCLUSION: Heterogeneity of IgE binding patterns to Dp and Df extracts was noted according to the ratio of serum specific IgE (Df/Dp).
Adult* ; Allergens ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Dust* ; Enzyme-Linked Immunosorbent Assay ; Eosinophil Cationic Protein ; Humans ; Immunoglobulin E ; Male ; Population Characteristics ; Pyroglyphidae*