Allergen-specific immunotherapy (SIT) reduces allergen specific IgE (sIgE) levels and achieves clinical and immunological tolerance by modulating innate and adaptive immunological responses. Increased temperature and CO2 concentrations caused by climate changes contribute to an increase of pollen count and allergenicity that influences clinical SIT outcomes. In this study, we investigated the changes of IgE binding components to tree and weed pollens in pollinosis patients who showed a paradoxical increase of serum sIgE level during pollen-SIT. We enrolled nine patients who showed an increasing pattern of serum sIgE level to alder, birch, ragweed and mugwort pollens by enzyme-linked immunosorbant assay. IgE immunoblot analysis confirmed the intensification or new generation of major IgE binding components that could be induced by climate change. The findings suggest that the regular monitoring of sIgE levels and symptom changes is required to improve the clinical outcomes of SIT in patients undergoing SIT for tree and weed pollens.
Adult ; Climate Change ; *Desensitization, Immunologic ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoglobulin E/*blood ; Male ; Middle Aged ; Pollen/immunology ; Rhinitis, Allergic, Seasonal/*therapy ; Skin Tests ; Young Adult

PURPOSE: Pollinosis is one of the major allergic diseases caused by airborne pollens. Alder and birch pollens are the major sensitizing tree pollens in this country. The immunoglobulin E (IgE) reactivity to each pollen allergen is known to be variable according to the region. We determined the major IgE binding components of these tree pollens in sera of adult patients with allergic rhinitis. METHODS: Allergic rhinitis patients, of whom specific IgE level to birch and/or alder pollens (>10 kU/L by ImmunoCAP) were included. The protein bands of two pollen extracts were determined by sodium dodecyl sulphate-polyacrylamide gel electrophoresis, and their IgE-binding components were identified by IgE immunoblot analysis. The binding specificity and cross-reactivity between two pollens were evaluated by IgE enzyme linked immunosorbent assay (ELISA) inhibition test. RESULTS: Six IgE binding components were found in birch pollens in which two (14 kDa and 17 kDa) were major components. Two IgE binding components were found in alder pollens in which the 17 kDa was a major component. The IgE binding component to the major allergen component of 17 kDa was observed in 90.3% of the study subjects sensitive to alder pollens and 72.7% of them sensitive to birch pollens. The ELISA inhibition tests showed significant inhibitions with additions of birch/alder pollen extracts. CONCLUSION: We identified two major IgE binding components (17 kDa and 14 kDa) from birch pollens and one component (17 kDa) from alder pollens. Significant cross reactivity was noted between these two pollens.
Adult ; Allergens ; Alnus ; Betula ; Cross Reactions ; Electrophoresis ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoblotting ; Immunoglobulin E ; Immunoglobulins ; Pollen ; Rhinitis ; Rhinitis, Allergic, Perennial ; Rhinitis, Allergic, Seasonal ; Sodium

BACKGROUND: There is no standardized tool and parameter that can accurately assess the sympathetic function before and after performing sympathectomy in patients with primary palmar hyperhidrosis. We examined the effectiveness of the sympathetic skin response (SSR) study for documenting the change of sympathetic denervation before and after performing selective thoracic sympathicotomy. MATERIAL AND METHOD: We prospectively investigated the SSR from 12 healthy subjects who were diagnosed with primary hyperhidrosis. Each SSR was recorded on the right palm or sole with electrical stimuli applied to the skin at the left wrist and foot and vice versa for the controlateral side. This test was performed before, 2 weeks and 1 year after selective thoracic sympathicotomy. The data was corrected for the onset latency and the amplitude of the SSR (n=24). RESULT: The mean age of the 12 patients was 24.6+/-0.4 years (range: 19~36) and the gender ratio was 1:0.7. The mean values of the preoperative, postoperative 2 weeks and postoperative 1 year onset latency and amplitude of the palmar side (n=24) were 1.46+/-0.24 msec and 6,043+/-2,339micronV, 1.63+/-0.42 msec and 823+/-638micronV, and 1.44+/-0.39 msec and 2,412+/-1,546micronV, respectively. The mean values of the plantar side (n=38) were 1.83+/-0.42 msec and 2,816+/-1,694micronV, 2.16+/-0.39 msec and 1,445+/-1,281micronV and 1.95+/-0.25 msec and 1,622+/-865micronV, respectively. Among the documented parameters, only the palmar amplitude (p=0.002) showed statistical significance in recording the change of the sympathetic system within the same individual for the pre and postoperative period. CONCLUSION: The SSR amplitude ratio may be a useful parameter for documenting the efficacy of sympathetic denervation after selective sympathicotomy.
Foot ; Humans ; Hyperhidrosis ; Postoperative Period ; Prospective Studies ; Skin ; Sympathectomy ; Sympathetic Nervous System ; Wrist

PURPOSE: Ragweed and mugwort pollens are the major weed allergens that cause pollinosis in Korea. The IgE-binding components to these 2 pollens and their cross-reactivity have not been reported in Korea, while several reports had been made in Western countries. We investigated IgE-binding components to ragweed and mugwort pollens and their allergenic relationship in patients sensitive to the 2 pollens. METHODS: We enrolled 33 allergic rhinitis patients with typical seasonal pollinosis symptoms in autumn and elevated serum specific IgE levels to ragweed and/or mugwort pollens (>10 kU/L by ImmunoCAP). The protein bands of the 2 pollen extracts were determined using sodium dodecyl sulphate-polyacrylamide gel electrophoresis, and IgE immunoblot analysis was performed to determine the IgE-binding components of each pollen extract. Enzyme-linked immunosorbent assay (ELISA) inhibition and immunoblot inhibition tests were performed to evaluate the cross-reactivity between ragweed and mugwort pollen extracts. RESULTS: Eight IgE-binding components (9, 10, 11, 12, 27, 30, 38, and 80 kDa) were found in ragweed pollen extracts, of which 4 (38, 11, 27, and 80 kDa) were major IgE-binding components. Eight IgE-binding components (10, 14, 16, 20-24, 26-30, 42, 60-66, and 80-90 kDa) were found in mugwort pollen extracts, of which 2 components (26-30 and 20-24 kDa) were major IgE-binding components. No significant inhibitions were noted between ragweed and mugwort pollen extracts by the ELISA inhibition test. No significant changes were noted in IgE immunoblot inhibition analysis. CONCLUSION: We identified 4 major IgE-binding components (38, 11, 35, 27, and 80 kDa) in ragweed pollens and 2 major IgE-binding components (26-30 and 20-24 kDa) in mugwort pollens. No cross-reactivity was found between ragweed and mugwort pollens.
Allergens ; Ambrosia* ; Artemisia* ; Cross Reactions ; Electrophoresis ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin E* ; Korea ; Pollen* ; Rhinitis ; Rhinitis, Allergic, Seasonal ; Seasons ; Sodium

PURPOSE: In asthmatic patients, treatment with corticosteroids, in addition to conventional risk factors for osteoporosis, may lead to bone loss. Trabecular bone score (TBS) is an indirect new parameter of bone quality. This study aimed to evaluate TBS in asthmatics in comparison to propensity score-matched controls and to investigate correlations between TBS and cumulative systemic and inhaled corticosteroid doses 1 year prior to bone mineral density (BMD) measurement in patients with asthma. METHODS: In total, 627 patients with asthma and the same number of non-asthmatic controls matched for sex and age were included in this retrospective cohort study. TBS was calculated in the lumbar region, based on 2 dimensional projections of dual-energy X-ray absorptiometry. RESULTS: Patients with severe asthma exhibited lower vertebral TBS values (1.32 ± 0.1) than those with non-severe asthma (1.36 ± 0.1, P = 0.001), with non-active asthma (1.38 ± 0.1, P < 0.001), and without asthma (1.39 ± 0.1, P < 0.001). No significant differences in BMD were noted among the study groups. TBS was significantly correlated with cumulative systemic and inhaled corticosteroid doses as well as asthma duration, lung function and airway hyper-responsiveness. A generalized linear model revealed that age, severe asthma, and frequency of oral corticosteroid burst were significant predictors for TBS levels. CONCLUSIONS: TBS can be used as an early indicator of altered bone quality stemming from glucocorticoid therapy or, possibly, more severe asthma.
Absorptiometry, Photon ; Adrenal Cortex Hormones ; Asthma ; Bone Density ; Cohort Studies ; Humans ; Linear Models ; Lumbosacral Region ; Lung ; Osteoporosis ; Respiratory Hypersensitivity ; Retrospective Studies ; Risk Factors

BACKGROUND AND OBJECTIVE: Ingestion and inhalation of buckwheat flour can induce IgE-mediated bronchoconstriction and anaphylaxis in sensitized individuals, especially in childhood. The aim of this study was to determine the sensitization rate of buckwheat allergen, measure the level of specific IgE to buckwheat, and identify IgE-binding components in adult patients with various allergic diseases. METHODS: 1,738 allergy patients and 40 healthy controls were enrolled. Skin prick tests were performed using homemade buckwheat extract. The specific IgE level to homemade buckwheat allergen was measured by ELISA, and results were compared to those of the CAP system. ELISA inhibition tests were done to evaluate allergenic relationships with major food allergens and IgE binding components were identified using IgE immunoblot analysis. RESULTS: Among 1,738 patients tested, 60 patients (3.5%) showed more than a 2+ response on skin prick tests to buckwheat. The prevalence of serum specific IgE to buckwheat ranged from 24% in patients with a 2+ response to buckwheat skin prick test, to 50% in patients with a 4+ response. The mean absorbance value increased with skin reactivity although it was not statistically significant. However, CAP results were significantly correlated with skin reactivity (p<0.05). A significant correlation was noted between (the) results by homemade ELISA and CAP. IgE immunoblot demonstrated 20 IgE binding components ranging from 20 to 114 kDa, and 10 components were bound to IgE in more than 50% of the patients tested. CONCLUSION: Natural buckwheat allergens should be considered as one of the causative food allergens in exposed adults. Specific IgE results by homemade ELISA were comparable with those of CAP system. Twenty IgE binding components and 10 major allergens were noted within natural buckwheat allergen. Further studies will be needed to evaluate the allergenic relationships with other food allergens.
Adult* ; Allergens ; Anaphylaxis ; Bronchoconstriction ; Eating ; Enzyme-Linked Immunosorbent Assay* ; Fagopyrum* ; Flour ; Humans ; Hypersensitivity* ; Immunoglobulin E* ; Inhalation ; Prevalence ; Skin

PURPOSE: Allergic rhinitis (AR) is a common and increasing disease in which Dermatophagoides (D.) farinae is one of the most common causative allergens. The aims of this study were to confirm the presence of locally produced antibodies to D. farinae in nasal secretions between nasal provocation test (NPT)-positive and -negative groups of AR patients, to evaluate their relationships with the levels of inflammatory mediators, and to determine adaptive and innate immune responses in nasal mucosa. METHODS: Sixty AR patients sensitive to house dust mites confirmed by skin prick test or serum specific IgE to D. farinae underwent NPT for D. farinae. Nasal packs were placed in both nasal cavities of the patients for 5 minutes to obtain nasal secretions after NPT. The levels of total IgE, specific IgE to D. farinae, eosinophil cationic protein (ECP), and tryptase in nasal secretions were detected by using ImmunoCAP. The levels of specific IgE, IgA, and secretory IgA antibodies to D. farinae in nasal secretions were measured by using ELISA. The levels of IL-8, VEGF, IL-25, and IL-33 were also measured by using ELISA. RESULTS: High levels of total IgE, specific IgE, specific IgA, and secretory IgA to D. farinae, as well as inflammatory mediators, such as ECP, IL-8, VEGF and tryptase, were detected in nasal secretions, although the differences were not statistically significant between the NPT-positive and NPT-negative groups. Levels of all immunoglobulins measured in this study significantly correlated with ECP, IL-8, and VEGF (P<0.05), but not with tryptase (P>0.05). IL-33 and IL-25 were also detected, and IL-25 level significantly correlated with IL-8 (r=0.625, P<0.001). CONCLUSIONS: These findings confirmed the presence of locally produced specific antibodies, including D. farinae-specific IgE and IgA, in nasal secretions collected from D. farinae-sensitive AR patients in both the NPT-positive and NPT-negative groups, and close correlations were noted between antibodies and nasal inflammatory mediators, including such as ECP, IL-8 and VEGF, indicating that locally produced antibodies may be involved in the nasal inflammation of AR.
Allergens ; Antibodies* ; Enzyme-Linked Immunosorbent Assay ; Eosinophil Cationic Protein ; Humans ; Immunity, Innate ; Immunoglobulin A ; Immunoglobulin A, Secretory ; Immunoglobulin E ; Immunoglobulins ; Inflammation ; Interleukin-8 ; Nasal Cavity ; Nasal Mucosa ; Nasal Provocation Tests ; Pyroglyphidae ; Rhinitis* ; Skin ; Tryptases ; Vascular Endothelial Growth Factor A

Depression is an important comorbidity of asthma. However, little information is available about depression and its potential impact on asthma control in Korean adult asthma patients. We aimed to estimate the prevalence and risk factors for depression in Korean adults with persistent asthma. The 127 non-elderly (20-64 yr) and 75 elderly (> or =65 yr) patients with asthma were recruited. Demographic and clinical data were extracted, and the patients completed the Asthma Specific Quality of Life (AQOL) questionnaire and asthma control test (ACT). Depression status was defined using the Korean version of the Patient Health Questionnaire-9 (PHQ-9). Depression was more prevalent in non-elderly (18.9%) than in elderly patients with asthma (13.3%). Patients with depression were significantly younger, had lower economic status, shorter disease duration, poorer asthma control, and worse AQOL scores (P<0.05). Within the non-elderly group, younger age and shorter disease duration were significantly associated with depression (P<0.05). Within the elderly group, a higher body mass index and current smoking status were significantly associated with depression (P<0.05). The PHQ-9 score was significantly correlated with worse ACT and AQOL scores in both groups. In conclusion, depression is strongly associated with poor asthma control and quality of life in Korean adult asthma patients. Our results provide important clues that used to target modifiable factors which contribute to development of depression in asthma patients.
Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Asthma/diagnosis/*epidemiology/*psychology ; Causality ; Comorbidity ; Depression/diagnosis/*epidemiology/*psychology ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Quality of Life/*psychology ; Republic of Korea/epidemiology ; Risk Factors ; Sex Distribution ; Young Adult

Various foods can induce anaphylaxis. However, mushrooms-induced anaphylaxis has not been reported in Korea. We report a patient with past anaphylactic episode caused by mushroom ingestion, confirmed by the skin test and specific IgE antibody to mushrooms. A 17-year-old girl with asthma was referred to our department due to itchy throat, dyspnea, and urticaria within 10 minutes after ingestion of a soup containing Oyster mushrooms. She presented an itching throat after ingestion of cooked mushrooms 3 years before the visit. She had an elevated serum IgE level (205 kU/L) and was sensitized to house dust mites. Skin prick tests with mushroom extracts showed a strong positive on Oyster and King Oyster mushrooms as well as Pyogo mushroom. The specific IgE antibody to each mushroom measured by enzyme-linked immunosorbent assay showed significant positive results to Oyster and Pyogo mushroom extracts, but was negative on King Oyster mushroom. We educated her to avoid eating Oyster and Pyogo mushrooms for preventing recurrence, whereas we couldn't perform oral challenge tests.
Adolescent ; Agaricales* ; Anaphylaxis* ; Asthma ; Dyspnea ; Eating* ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoglobulin E ; Korea ; Ostreidae ; Pharynx ; Pleurotus ; Pruritus ; Pyroglyphidae ; Recurrence ; Skin ; Skin Tests ; Urticaria

PURPOSE: The prevalence of pollinosis is increasing, and it is expected to increase further with climate change. Mugwort and ragweed pollens are well known as prevalent allergenic weed pollens in Korea. However, the clinical significance of dandelion pollen as an inhalant allergen has not yet been studied. The purpose of this study was to evaluate the clinical significance and cross-allergenicity between dandelion and major weed pollens. METHODS: Ninety-seven patients with allergic rhinitis and asthma or with allergic rhinitis alone who were sensitized to dandelion pollens on skin prick tests (allergen/histamine ratio>3) were enrolled between December, 2012 and November, 2013. Serum specific IgE levels to dandelion pollen extracts were measured by using enzyme-linked immunosorbent assay (ELISA). ELISA inhibition tests were performed to evaluate cross allergenecity with other weed pollens. RESULTS: When the positive cutoff value for serum specific IgE was set at the mean+/-3 standard deviation of absorbance values, 52 patients (53.6%) had a high serum specific IgE antibody level. ELISA inhibition tests showed significant inhibitions with serial addition of dandelion pollen extracts, and 5 different inhibition patterns were noted with addition of 4 weed pollen extracts: significant inhibitions with pollens of mugwort, ragweed, chenopodium and Hop J (25%, 13 of 52), inhibitions with pollens of mugwort, ragweed and chenopodium (17.3%, 9 of 52), inhibitions with 2 pollens of mugwort and ragweed (32.6%, 17 of 52), inhibitions with mugwort pollen (21.1%, 11 of 52), and inhibitions with dandelion pollen alone (4%, 2 of 52). CONCLUSION: These findings suggest that dandelion pollen may be a causative inhalant allergen to induce pollinosis in the autumn season. Cross-allergenicity with other weed pollens showed individual differences; most patients had cross-reactivity with mugwort, ragweed, and chenopodium pollens, while some with Hop J pollen. Few patients were sensitized to dandelion pollen alone.
Ambrosia ; Artemisia ; Asthma ; Chenopodium ; Climate Change ; Enzyme-Linked Immunosorbent Assay ; Humans ; Humulus ; Immunoglobulin E ; Individuality ; Korea ; Pollen* ; Prevalence ; Rhinitis ; Rhinitis, Allergic, Seasonal ; Seasons ; Skin ; Taraxacum*