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Mold Allergens in Respiratory Allergy: From Structure to Therapy.

Teresa E TWAROCH ; Mirela CURIN ; Rudolf VALENTA ; Ines SWOBODA

Allergy, Asthma & Immunology Research.2015;7(3):205-220. doi:10.4168/aair.2015.7.3.205

Allergic reactions to fungi were described 300 years ago, but the importance of allergy to fungi has been underestimated for a long time. Allergens from fungi mainly cause respiratory and skin symptoms in sensitized patients. In this review, we will focus on fungi and fungal allergens involved in respiratory forms of allergy, such as allergic rhinitis and asthma. Fungi can act as indoor and outdoor respiratory allergen sources, and depending on climate conditions, the rates of sensitization in individuals attending allergy clinics range from 5% to 20%. Due to the poor quality of natural fungal allergen extracts, diagnosis of fungal allergy is hampered, and allergen-specific immunotherapy is rarely given. Several factors are responsible for the poor quality of natural fungal extracts, among which the influence of culture conditions on allergen contents. However, molecular cloning techniques have allowed us to isolate DNAs coding for fungal allergens and to produce a continuously growing panel of recombinant allergens for the diagnosis of fungal allergy. Moreover, technologies are now available for the preparation of recombinant and synthetic fungal allergen derivatives which can be used to develop safe vaccines for the treatment of fungal allergy.
Allergens* ; Asthma ; Climate ; Clinical Coding ; Cloning, Molecular ; Diagnosis ; DNA ; Fungi* ; Humans ; Hypersensitivity* ; Immunotherapy ; Rhinitis ; Skin ; Vaccines

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Is Your Cough Getting Better?.

You Sook CHO

Allergy, Asthma & Immunology Research.2015;7(3):203-204. doi:10.4168/aair.2015.7.3.203

No abstract available.
Cough*

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A Case of Fixed Drug Eruption Due to Doxycycline and Erythromycin Present in Food.

Won Suk LIM ; Do Hun KIM ; Sang Yun JIN ; Yun Seok CHOI ; Seung Ho LEE ; Hee Jin HUH ; Seok Lae CHAE ; Ai Young LEE

Allergy, Asthma & Immunology Research.2013;5(5):337-339. doi:10.4168/aair.2013.5.5.337

A fixed drug eruption (FDE) is not difficult to diagnose, given its clinical characteristics. However, the causative agent can be difficult to identify, particularly when the patient denies ingestion of any drugs. To the best of our knowledge, we present herein the first reported case of an FDE caused by antibiotics taken in food; doxycycline and erythromycin contained in pork and fish. A 57-year-old female experienced repeated episodes of well-demarcated erythematous patches covering her entire body. She denied taking any medications, but she thought that the lesions appeared after consuming pork and/or fish. An oral provocation test showed positive results for doxycycline and erythromycin, commonly used antibiotics in live-stock farming and in the fishing industry. Because of the antibiotics' thermostability, cooking does not guarantee the elimination of residual drugs. From the patient's history, we concluded that doxycycline and erythromycin contained in the pork and fish that she ate were the cause of the FDE.
Anti-Bacterial Agents ; Cooking ; Doxycycline ; Drug Eruptions ; Eating ; Erythromycin ; Female ; Humans

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Suppression of Heme Oxygenase-1 by Prostaglandin E2-Protein Kinase A-A-Kinase Anchoring Protein Signaling Is Central for Augmented Cyclooxygenase-2 Expression in Lipopolysaccharide-Stimulated RAW 264.7 Macrophages.

Jae Hyoung LEE ; Nam Hee JUNG ; Byoung Hoon LEE ; Sang Hoon KIM ; Jin Hyun JUN

Allergy, Asthma & Immunology Research.2013;5(5):329-336. doi:10.4168/aair.2013.5.5.329

PURPOSE: Prostaglandin (PG) E2 is an immunomodulatory lipid mediator generated mainly via the cyclooxygenase-2 (COX-2) pathway from arachidonic acid at sites of infection and inflammation. A positive feedback loop of PGE2 on COX-2 expression is critical for homeostasis during toll-like receptor (TLR)-mediated inflammatory processes. The mechanism of PGE2-regulated COX-2 expression remains poorly understood. The low-molecular-weight stress protein heme oxygenase-1 (HO-1) contributes to the anti-inflammatory, anti-oxidant and anti-apoptotic response against environmental stress. METHODS: We explored the involvement of HO-1 on PGE2 regulation of LPS-induced COX-2 expression in RAW 264.7 macrophages. RESULTS: LPS-induced COX-2 expression in RAW 264.7 macrophages was enhanced by exogenous PGE2 or cyclic AMP (cAMP) analogue and was suppressed by a COX inhibitor (indomethacin), a protein kinase A (PKA) inhibitor (KT5720), and A kinase anchoring protein (AKAP) disruptors (Ht31 and RIAD). This result suggests that the stimulatory effects of endogenous and exogenous PGE2 on COX-2 expression are mediated by a cAMP-PKA-AKAP-dependent pathway. The induction of HO-1 was observed in LPS-stimulated RAW 264.7 macrophages. This induction was suppressed by exogenous PGE2 and enhanced by blockage of the endogenous PGE2 effect by the PKA inhibitor or AKAP disruptors. In addition, HO-1 induction by the HO activator copper protoporphyrin suppressed LPS-induced COX-2 expression, which was restored by the addition of exogenous PGE2. The induction of HO-1 inhibited LPS-induced NF-kappaB p-65 nuclear expression and translocation. CONCLUSIONS: AKAP plays an important role in PGE2 regulation of COX-2 expression, and the suppression of HO-1 by PGE2-cAMP-PKA-AKAP signaling helps potentiate the LPS-induced COX-2 expression through a positive feedback loop in RAW 264.7 macrophages.
Arachidonic Acid ; Copper ; Cyclic AMP ; Cyclic AMP-Dependent Protein Kinases ; Cyclooxygenase 2 ; Dinoprostone ; Heme ; Heme Oxygenase-1 ; Homeostasis ; Inflammation ; Intracellular Signaling Peptides and Proteins ; Macrophages ; NF-kappa B ; Phosphotransferases ; Toll-Like Receptors

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Usefulness of Colored 3D Imaging of Respiratory Impedance in Asthma.

Toshihiro SHIRAI ; Kazutaka MORI ; Masashi MIKAMO ; Yuichiro SHISHIDO ; Takefumi AKITA ; Satoru MORITA ; Kazuhiro ASADA ; Masato FUJII ; Takafumi SUDA ; Kingo CHIDA

Allergy, Asthma & Immunology Research.2013;5(5):322-328. doi:10.4168/aair.2013.5.5.322

PURPOSE: Recently, the clinical application of the forced oscillation technique (FOT) has progressed with the spread of commercially available FOT devices, including the impulse oscillation system and MostGraph. We investigated the usefulness of color 3D imaging of respiratory impedance in asthma using MostGraph. METHODS: Whole-breath and within-breath respiratory system resistance (Rrs) and reactance (Xrs) were measured in 78 patients with asthma. Color 3D images were classified into three patterns: the chronic obstructive pulmonary disease (COPD)-like pattern (high values of Rrs and Xrs with a marked respiratory cycle and frequency dependence), the asthma pattern (moderately high Rrs over the entire frequency and a respiratory cycle with slight Xrs changes), and a normal-like pattern (low Rrs and Xrs with few within-breath changes). The classification was performed by three researchers, who were unaware of the clinical information, and the clinical characteristics were compared among the three groups. RESULTS: Color 3D imaging provided a COPD-like pattern in 25 patients, an asthma pattern in 39 patients, and a normal-like pattern in 14 patients. Patients with the COPD-like pattern were predominantly female with a higher body mass index, lower forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), and higher Rrs and Xrs values (whole-breath and within-breath variation). Those with the normal pattern had higher FEV1 and FVC, and a lower single-breath nitrogen washout slope. There were no differences in asthma control or exhaled nitric oxide levels among the three groups. CONCLUSIONS: These results suggest that color 3D imaging of respiratory impedance may show asthma phenotypes.
Asthma ; Body Mass Index ; Electric Impedance ; Female ; Forced Expiratory Volume ; Humans ; Nitric Oxide ; Nitrogen ; Phenotype ; Pulmonary Disease, Chronic Obstructive ; Respiratory System ; Vital Capacity

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Allergic Diseases in Preschoolers Are Associated With Psychological and Behavioural Problems.

Hyoung Yoon CHANG ; Ju Hee SEO ; Hyung Young KIM ; Ji Won KWON ; Byoung Ju KIM ; Hyo Bin KIM ; So Yeon LEE ; Gwang Cheon JANG ; Dae Jin SONG ; Woo Kyung KIM ; Jung Yeon SHIM ; Ha Jung KIM ; Jung Won PARK ; Sang Heon CHO ; Joo Shil LEE ; Yee Jin SHIN ; Soo Jong HONG

Allergy, Asthma & Immunology Research.2013;5(5):315-321. doi:10.4168/aair.2013.5.5.315

PURPOSE: The aim of the present study was to investigate the relationship between three major allergic diseases, asthma, allergic rhinitis (AR), and atopic dermatitis (AD), and psychological and behavioural problems in preschoolers based on a community survey. METHODS: A cross-sectional survey was conducted using a modified International Study of Asthma and Allergies in Childhood questionnaire to determine the prevalence of symptoms and diagnosed allergic diseases, and a Korean version of the Child Behaviour Checklist to assess internalizing, externalizing, and sleep problems among 780 preschoolers. Five-hundred and seventy-five preschoolers with valid data were included in this study. RESULTS: The prevalence of lifetime diagnosis and treatment in the past 12 months was 8.7% and 4.4% for asthma, 24.4% and 19.2% for AR, and 35.1% and 16.6% for AD, respectively. Scores for internalizing and sleep problems were significantly higher in those diagnosed with AR. Preschoolers who had been treated for AD in the past 12 months had higher attention problem and attention-deficit/hyperactivity disorder scores. Sleep problems were more severe in moderate to severe AD compared to control and mild AD groups, categorised according to SCOring index of AD. The severity of sleep problems correlated positively with the percentage of eosinophils in peripheral blood. CONCLUSIONS: Psychological and behavioural problems differed among the three major allergic diseases, weaker association for asthma and stronger association for AR and AD. The results of this study may lead to the identification of potential underlying shared mechanisms common to allergic diseases and psychological and behavioural problems.
Asthma ; Checklist ; Child ; Child, Preschool ; Cross-Sectional Studies ; Dermatitis, Atopic ; Eosinophils ; Humans ; Hypersensitivity ; Prevalence ; Psychometrics ; Rhinitis ; Rhinitis, Allergic, Perennial ; Surveys and Questionnaires

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The Allergenic Potency of Japanese Hop Pollen Is Increasing With Environmental Changes in Korea.

Hyun Jung JIN ; Gil Soon CHOI ; Yoo Seob SHIN ; Joo Hee KIM ; Jeong Eun KIM ; Young Min YE ; Hae Sim PARK

Allergy, Asthma & Immunology Research.2013;5(5):309-314. doi:10.4168/aair.2013.5.5.309

PURPOSE: The sensitization rate to Japanese Hop (Hop J) in respiratory allergy patients has increased in recent years in Korea. We evaluated changes in the allergenic potency of Hop J pollen collected in 1998 and 2009. METHODS: Thirty-five patients with allergic rhinitis and/or asthma were enrolled. Group I included 21 subjects sensitized to Hop J at an initial visit and group II included 14 subjects who developed a new sensitization. Hop J pollens were collected in 1998 and 2009 (98 and 09 extracts) and both urban and suburban environments (urban and suburban extracts). Serum specific IgE levels to Hop J pollen extracts were compared using an enzyme-linked immunosorbent assay (ELISA). IgE binding components were compared by IgE immunoblot analysis. RESULTS: Serum specific IgE levels to the 09 and urban extracts in both groups increased significantly compared to those of the 98 and suburban extracts. IgE immunoblot demonstrated that the major 10 kDa allergen was intensified in group I, while it was newly generated in group II with additional components ranging from 12-95 kDa. When the 98 and 09 extracts were compared, intensification of the major allergen of 09 extract had occurred in both groups. The IgE binding components of the urban extract was stronger than those of suburban one. CONCLUSIONS: The allergenic potency of Hop J pollen may be increased with environmental changes.
Allergens ; Asian Continental Ancestry Group ; Asthma ; Enzyme-Linked Immunosorbent Assay ; Humans ; Humulus ; Hypersensitivity ; Immunoglobulin E ; Korea ; Pollen ; Rhinitis ; Rhinitis, Allergic, Perennial

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Seasonal Variation in Skin Sensitivity to Aeroallergens.

Inseon S CHOI ; Seung Sin LEE ; Eun MYEONG ; Jeong Won LEE ; Woo Jin KIM ; Joon JIN

Allergy, Asthma & Immunology Research.2013;5(5):301-308. doi:10.4168/aair.2013.5.5.301

PURPOSE: We previously demonstrated seasonal variation in sensitization to aeroallergens in a small group of patients with exercise-induced asthma. This study was performed to confirm the relationship in a much larger population. METHODS: The charts of 1,891 patients who received allergy skin prick tests were reviewed retrospectively. The test results from subjects aged < or =60 years were compared between the groups classified according to the season when the patients received the tests (spring: March-May, summer: June-August, fall: September-November, winter: December-February). The data from 25 respiratory allergy patients who received the tests two or more times and showed a positive response at least once were analyzed longitudinally. RESULTS: The most prevalent among 29 tested aeroallergens were house dust mites (HDMs) Dermatophagoides pteronyssinus and D. farinae. The skin sensitization rates to D. pteronyssinus (23.2% vs. 32.1%, P=0.004) and D. farinae (22.2% vs. 30.2%, P=0.009) were significantly lower in the summer and higher in the fall (38.3% vs. 26.6% and 35.6% vs. 25.3%; P=0.001 respectively) than those in other seasons in patients with a respiratory allergy (n=1,102). The sensitization rates to weed pollens in the fall (13.9% vs. 8.3%, P=0.006) and to Aspergillus fumigatus in the winter (2.9% vs. 0.7%, P=0.005) were significantly higher. In patients with non-respiratory allergy such as urticaria/anaphylaxis (n=340), the D. farinae sensitization rate was significantly lower in the summer also but higher in the spring. The trend of the HDM sensitization rate being lower in the summer and higher in the fall was observed in the longitudinal study. CONCLUSIONS: Skin sensitivity to aeroallergens such as HDMs, pollens, and molds demonstrates seasonal variation in respiratory allergy patients. Non-respiratory allergy patients also showed seasonal variation in sensitivity to aeroallergens, which might be related to the "priming" effect of allergens.
Aged ; Allergens ; Aspergillus fumigatus ; Asthma, Exercise-Induced ; Dermatophagoides pteronyssinus ; Fungi ; Humans ; Hypersensitivity ; Pollen ; Pyroglyphidae ; Retrospective Studies ; Seasons ; Skin

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Association Between Pet Ownership and the Sensitization to Pet Allergens in Adults With Various Allergic Diseases.

Yong Bum PARK ; Eun Kyung MO ; Jae Young LEE ; Joo Hee KIM ; Cheol Hong KIM ; In Gyu HYUN ; Jeong Hee CHOI

Allergy, Asthma & Immunology Research.2013;5(5):295-300. doi:10.4168/aair.2013.5.5.295

PURPOSE: As pet ownership increases, sensitization to animal allergens due to domestic exposure is a concern. Sensitization to animal allergens may occur from indirect exposure, as well as direct ownership of animals. However, there have been conflicting results regarding the association between pet ownership and sensitization to animal allergens in adults. METHODS: In total, 401 patients with various allergic diseases were enrolled in this study. We performed skin prick tests with 55 common inhalant and food allergens, including dog, cat, and rabbit allergens. A mean wheal diameter of 3 mm or greater was considered a positive reaction. The exposure modality to each animal allergen was investigated using a questionnaire and included present ownership, past ownership, occupational exposure, occasional exposure, contact with pet owner, and no contact. Present ownership, past ownership, occupational, and occasional exposure were regarded as direct exposure. RESULTS: The sensitization rate for animal allergens was 20.4% for dog, 15.0% for cat, and 9.0% for rabbit. Direct exposure to dogs (72.0%) was significantly higher than that of other animals (18.4% for cats and 16.7% for rabbits), whereas 'no contact' with cats (78.3%) and rabbits (83.3%) was significantly higher than with dogs (26.8%; P<0.0001). Independent risk factors for sensitization to animal allergens were sensitization to Dermatophagoides pteronyssinus (OR=2.4, P=0.052), Dermatophagoides farinae (OR=5.1, P<0.001), cat (OR=4.4, P<0.0001), and direct exposure to dogs (OR=1.5, P=0.029) for dog, and sensitization to dog (OR=4.4, P<0.0001) and rabbit (OR=2.6, P=0.036) for cats. Finally, for rabbits, the independent risk factor was sensitization to Alternaria (OR=6.0, P<0.002). CONCLUSIONS: These results suggest that direct exposure to dogs contributes to the sensitization to dog allergens in patients with allergic diseases, whereas indirect exposure to cats and rabbits may induce sensitization to each animal's allergen.
Adult ; Allergens ; Alternaria ; Animals ; Cats ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Dogs ; Humans ; Occupational Exposure ; Ownership ; Pets ; Rabbits ; Risk Factors ; Skin ; Surveys and Questionnaires

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The Effect of Vitamin D Status on Pediatric Asthma at a University Hospital, Thailand.

Wijittra KROBTRAKULCHAI ; Jittima PRAIKANAHOK ; Nualanong VISITSUNTHORN ; Pakit VICHYANOND ; Kotchamol MANONUKUL ; Busadee PRATUMVINIT ; Orathai JIRAPONGSANANURUK

Allergy, Asthma & Immunology Research.2013;5(5):289-294. doi:10.4168/aair.2013.5.5.289

PURPOSE: In the USA and Europe, hypovitaminosis D is associated with increased asthma severity, emergency department (ED) visit, and impaired pulmonary function in asthmatic patients. However, in tropical countries, data on the effect of vitamin D status on asthma is limited. This study evaluates the relationship between vitamin D status and the level of asthma control as well as other asthmatic parameters. METHODS: Asthmatic children were evaluated for serum 25-hydroxyvitamin D, pulmonary function tests, a skin prick test, and the level of asthma control. RESULTS: A total of 125 asthmatic children were recruited (boys, 66.4%). Their mean age+/-SD was 10.8+/-3.0 years. Vitamin D statuses were: deficiency (<20 ng/mL) in 19.2% of the patients, insufficiency (20-30 ng/mL) in 44.8%, and sufficiency (>30 ng/mL) in 36%. The vitamin D levels were 25.9+/-9.4 ng/mL in uncontrolled patients, 29.2+/-8.6 ng/mL in partly controlled patients, and 27.9+/-8.0 ng/mL in controlled patients (P>0.05). There were no significant differences in pulmonary function, asthma exacerbation, inhaled-corticosteroid (ICS) dose, anti-inflammatory drugs, or ED visit or hospitalization between different vitamin D statuses. Vitamin D deficiency patients were older and had a delayed onset of asthma than insufficiency or sufficiency patients. There was no significant correlation between serum vitamin D and pulmonary function/doses of ICS. CONCLUSIONS: High prevalences of vitamin D deficiency and insufficiency were found in asthmatic children in Thailand; however, there was no significant relationship between vitamin D status and the level of asthma control or other asthma parameters.
Asthma ; Child ; Emergencies ; Europe ; Hospitalization ; Humans ; Prevalence ; Respiratory Function Tests ; Skin ; Thailand ; Vitamin D ; Vitamin D Deficiency ; Vitamins

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