BACKGROUND: We developed skin prick test (SPT) reagents for common inhalant allergens that reflected the real exposure in Korea. The study aim was to evaluate diagnostic usefulness and allergen potency of our inhalant SPT reagents in comparison with commercial products. METHODS: We produced eight common inhalant allergen SPT reagents using total extract (Prolagen): Dermatophagoides farinae, Dermatophagoides pteronyssinus, oak, ragweed, mugwort, Humulus japonicus pollens, as well as cat and dog allergens. We compared the newly developed reagents with three commercially available SPT reagents (Allergopharma, Hollister-Stier, Lofarma). We measured total protein concentrations, sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE), major allergen concentration, and biological allergen potencies measured by immunoglobulin E (IgE) immunoblotting and ImmunoCAP inhibition test. RESULTS: Diagnostic values of these SPT reagents were expressed as positivity rate and concordance rate of the results from ImmunoCAP allergen-specific IgE test in 94 allergic patients. In vitro analysis showed marked differences in protein concentrations, SDS-PAGE features, major allergen concentrations, and biological allergen potencies of four different SPT reagents. In vivo analysis showed that positive rates and concordance rates of Prolagen® SPT reagents were similar compared to the three commercial SPT reagents. CONCLUSION: The newly developed Prolagen® inhalant SPT reagents are not inferior to the commercially available SPT reagents in allergy diagnosis.
Allergens ; Allergy and Immunology ; Ambrosia ; Animals ; Artemisia ; Cats ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Diagnosis ; Dogs ; Electrophoresis ; Electrophoresis, Polyacrylamide Gel ; Humans ; Humulus ; Hypersensitivity ; Immunoblotting ; Immunoglobulin E ; Immunoglobulins ; In Vitro Techniques* ; Indicators and Reagents* ; Korea ; Methods* ; Pollen ; Skin* ; Sodium

OBJECTIVETo study the skin prick test (SPT) reactivity to house dust mite allergens in overweight and normal weight children with allergic asthma before and after standard subcutaneous specific immunotherapy.

METHODSTwo hundred and fifteen children with allergic asthma who had positive SPT responses to Dermatophagoides pteronyssinus (DP) and Dermatophagoides farinae (DF) were enrolled. According to the weight index, they were classified into overweight (n=63) and normal weight groups (n=152). Skin indices (SI) to DP and DF were compared between the two groups at 6 months and 1 year after standard subcutaneous specific immunotherapy.

RESULTSThe overweight group had a significantly larger histamine wheal diameter than the normal weight group after controlling the variation in testing time (P<0.05). After controlling the variation in weights, there were significant differences in the SIs to DP and DF before specific immunotherapy and at 6 months and 1 year after specific immunotherapy. At 6 months and 1 year after specific immunotherapy, the SIs to DP and DF were significantly reduced in both groups (P<0.05), and the overweight group had greater decreases in the SIs to DP and DF than the normal weight group.

CONCLUSIONSThe overweight children with allergic asthma have stronger responses to histamine than the normal weight patients. Specific immunotherapy can reduce the reactivity to dust mite allergens in children with allergic asthma. Within one year after specific immunotherapy, the overweight children with allergic asthma have a significantly greater decrease in the reactivity to dust mite allergens than the normal weight patients.

Adolescent ; Animals ; Asthma ; immunology ; therapy ; Child ; Child, Preschool ; Dermatophagoides farinae ; immunology ; Dermatophagoides pteronyssinus ; immunology ; Female ; Humans ; Immunotherapy ; Male ; Overweight ; immunology ; Pyroglyphidae ; immunology ; Skin Tests

OBJECTIVE: To study the therapeutic effects of the specific immunotherapy (SIT) on allergic rhinitis and allergic rhinitis combined bronchial asthma. METHED: All patients were classified into allergic rhinitis group (AR group) with 32 patients and allergic rhinitis combined bronchial asthma group (AR+BA group) with 32 patients. Another health control group with 32 cases was designed as well. The allergens,symptom scores and therapeutic effects of the former two-group patients were analysis, and the serums of all three-group cases were extracted to evaluate the specific Immunoglobin E(sIgE), Interleukin-4 (IL-4). The SPSS13. 0 package was applied to conduct t-test and chi-square test, and the difference of P<0. 05 was regarded as statistical significance. RESULT: The main allergens of 64 patients were dermatophagoides farinae and dermatophagoides pteronyssinus. The improvement of symptom scores before and after SIT was statistical significant with P<0. 05. Although total effective rate reached 100% , AR group was superior than AR+BA group in term of the efficacy comparison, and P<0. 05 indicated the statistical significance. The serum sIgE, IL-4 values of three groups were brought into comparison, and P<0. 05 indicated the statistical significance of the difference. CONCLUSION The SIT on the AR, AR+BA is a safe and effective treatment, but different disease responds diversely. The long-term treatment course is recommended.
Allergens ; immunology ; Animals ; Asthma ; therapy ; Dermatophagoides farinae ; immunology ; Dermatophagoides pteronyssinus ; immunology ; Humans ; Immunoglobulin E ; blood ; Immunotherapy ; Interleukin-4 ; blood ; Rhinitis, Allergic ; therapy ; Treatment Outcome

OBJECTIVE: To evaluate the efficacy and safety of the sublingual immunotherapy with dermatophagoides farinae drops on patients with allergic rhinitis. METHOD: One hundred and twelve cases were collected from adult patients with dust-mite allergic rhinitis of our hospital who could adhere to treatment and regular follow-up. These patients were randomly allocated to receive either sublingual immunotherapy (SLIT group, n = 56) or medical treatment (Control group, n = 56). To evaluate the clinical efficacy by side effects which were registered, symptom and medication scores which were assessed and rhinoconjunctivitis quality of life questionnaire (RQLQ) which was completed in the baseline and two years after treatment. RESULT: Dropouts after the 2 years' treatment were 5 of SLIT group and 4 of Control group respectively. SLIT group induced the significant reductions on both the symptom scores (7.81 ± 3.14 to 3.89 ± 2.01, P < 0.0 1) and the medication scores (2.86 ± 0.75 to 0.44 ± 0.06, P < 0.01). Meanwhile, Control group induced the reductions on both the symptom scores (8.01 ± 3.32 to 5.20 ± 2.43) and the medication scores (2.95 ± 0.80 to 1.75 ± 0.40). There were significant differences (P< 0. 01) in symptom and medication scores between the two groups after 2-year treatment. The patients in SLIT group had fewer symptoms and lower intake of medication. There were statistically significant differences in RQLQ between SLIT group [19 (15,22)] and Control group [36 (26,47)] after two years treatment (Z = -5. 21, P < 0.01). SLIT group also had significant improvement in RQLQ (Z = -6.10, P < 0.01) between before and after the treatment. There were 4 patients who showed adverse reactions in SLIT group (3 occurred in increment period, and 1 occurred in the maintenance period). The incidence of adverse reactions was 7.14%. No severe systemic side effects were registered. CONCLUSION SLIT with standardized dermatophagoides farinae drops in China is safe and effective to patients with allergic rhinitis.
Administration, Sublingual ; Adult ; Animals ; Antigens, Dermatophagoides ; immunology ; China ; Dermatophagoides farinae ; Humans ; Quality of Life ; Rhinitis, Allergic ; drug therapy ; Sublingual Immunotherapy ; Treatment Outcome

We attempted to investigate the correlation between the severity of atopic dermatitis (AD) in children and the indoor level of house dust mite (HDM) allergens. Ninety-five patients (31.1 +/- 19.5 months of age) with AD were enrolled in this study, and serum specific IgE against Dermatophagoides pteronyssinus and D. farinae was measured. The severity of AD was assessed using the visual analogue scale on the same day of house dust collection. Living rooms and mattresses where the child usually slept were vacuumed for 2 minutes and concentrations of Der f 1 were measured by enzyme-linked immunosorbent assay. The skin symptoms were more severe in patients with Der f 1 concentrations in living room > 2 microg/g dust than < or = 2 microg/g dust (P = 0.018). This difference was noted in AD patients without sensitization to HDM (P = 0.004), but not in patients with sensitization. There was no difference in symptom severity according to Der f 1 concentrations in mattresses (P = 0.062). The severity of skin symptoms is associated with indoor concentrations of HDM in children with AD, and it is likely to act as nonspecific irritants as well as allergens in AD skin lesions.
Adolescent ; Animals ; Antigens, Dermatophagoides/*analysis ; Beds/parasitology ; Child ; Child, Preschool ; Dermatitis, Atopic/*diagnosis/pathology ; Dermatophagoides farinae/immunology ; Dermatophagoides pteronyssinus/immunology ; *Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoglobulin E/blood ; Infant ; Male ; Severity of Illness Index

OBJECTIVE: To compare the efficacy of sublingual immunotherapy (SLIT) with standardized house dust mite extract in mono sensitized and polysensitized children with allergic rhinitis. METHOD: One hundred and fifty-seven children who were sensitized to house dust mites and treated with SLIT for house dust mites for at least 1 year were studied. The monoallergen sensitized group included patients who were sensitized to Dermatophagoides pteronyssinus and/or Dermatophagoides farinae (n=92). The polyallergen sensitized group included patients who were simultaneously sensitized to house dust mites and other allergens (n = 65). A standardized extract of house dust mites was used for immunotherapy. Antiallergic medication and the total nasal symptom score (TNSS) were evaluated before and 1 year after SLIT. RESULT: One hundred and twenty-five children completed 1-year SLIT. The TNSS improved significantly after SLIT in both groups, with monoallergen sensitized group 11.42 +/- 1.60 vs 3.55 +/- 1.57 (t=30.03, P<0.01), and polyallergen sensitized group 11.54 +/- 1.55 vs 3.23 +/- 1.56 (t=27.76, P< 0.01). But the change in the TNSS did not differ significantly between the groups (TNSS change, 7.94 +/- 2.24 vs 8.32 +/- 2.18, P>0.05). The AMSs were decreased significantly after SLIT in both groups, with monoallergen sensitized group 1.62 +/- 0.44 vs 0.56 +/- 0.37 (t=15.01, P<0.01), and polyallergen sensitized group 1.63 +/- 0.43 vs 0.50 +/- 0.40 (t=13.49, P<0.01). But the AMSs improvement did not differ significantly between the two groups(AMSs change 1.03 +/- 0.58 vs 1.13 +/- 0.61, P>0.05). CONCLUSION In polysensitized allergic rhinitis patients, SLIT for D pteronyssinus and/or D farinae produced improvements in both nasal symptoms and rescue medication scores comparable to those in mono sensitized patients. SLIT for D pteronyssinus and/or D farinae should be considered in polysensitized allergic rhinitis patients.
Administration, Sublingual ; Adolescent ; Animals ; Antigens, Dermatophagoides ; administration & dosage ; immunology ; therapeutic use ; Asthma ; therapy ; Child ; Child, Preschool ; Dermatophagoides farinae ; immunology ; Desensitization, Immunologic ; Female ; Humans ; Immunotherapy ; Male ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; therapy

BACKGROUND: Total IgE levels in allergic patients tend to be higher than those in healthy individuals. We evaluated the usefulness of total IgE levels in predicting positive results of allergen specific IgEs in multiple allergen simultaneous tests. METHODS: A total of 133 patients with allergic symptoms were evaluated. Allergen specific IgEs were detected using 3 different kits: Allergy screen (R-biopharm, Germany), AdvanSure Allergy Screen (LG Life Science, Korea) and Polycheck allergy (Biocheck Co., Germany). Total IgE was measured by turbidoimmunometric assay (LX-2200, Eiken Chemical Co., Japan). The patients were divided into high (> or =170 IU/mL) and low (<170 IU/mL) groups of total IgE level, and the positive rates and number of positive allergen specific IgEs were evaluated in each group. Positive concordance rates among different kits were also evaluated. RESULTS: High total IgE group showed significantly higher positive rates and number of positive allergen specific IgEs in all of the 3 test kits used compared to low total IgE group. Only two of the allergens, Dermatophagoides farinae and Dermatophagoides pteronyssinus had positive concordance rates of > or =50%. Allergen specific IgEs to these two allergens showed good correlation with total IgE (correlation coefficients >0.5). CONCLUSIONS: Total IgE appears to be useful in predicting positive results in allergen specific IgE tests to common allergens. The specific IgEs to D. farinae and D. pteronyssinus showed good correlation with total IgE. However, for other allergens, significant differences were observed among different test kits, and the standardization of allergens in multiple allergen simultaneous tests is needed.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Allergens/*immunology ; Animals ; Child ; Child, Preschool ; Dermatophagoides farinae/immunology ; Dermatophagoides pteronyssinus/immunology ; Female ; Humans ; Hypersensitivity, Immediate/*diagnosis ; Immunoglobulin E/*blood ; Male ; Middle Aged ; Predictive Value of Tests ; Reagent Kits, Diagnostic ; Republic of Korea

BACKGROUNDDisequilibrium of Th1/Th2 is known as an important cause of allergic asthma with a biased Th2 type response. It has been shown that lipopolysaccharide (LPS) administration during post-sensitization modified the inflammation of asthma via upregulating the Th1 response that decrease the Th2 immunity. We would like to know if, during pre-sensitization, the elevated Th1 response is necessary for LPS exposure to modify the asthmatic response.

METHODSDuring pre- or post-sensitization, 40 microg LPS were intraperitoneal injected (i.p.) to asthmatic mice sensitized and challenged by Dermatophagoides farinae (D. farinea). Inflammation was assessed by examining bronchoalveolar lavage fluid (BALF) for the number and identity of cells and by cytokine titers measured by ELISA. Semi-quantified RT-PCR was used to evaluate the level of Toll-like receptor 4 (TLR4) mRNA in dendritic cells (DCs) from bone marrow (BMDCs).

RESULTSThese investigations demonstrated that LPS exposure during pre-sensitization inhibited the Th2 cytokine and inflammatory infiltration, the same as with LPS exposure during post-sensitization in allergic asthma mice. Contrary to post-sensitization LPS exposure, the Th1 cytokines were not upregulated by pre-sensitization with LPS. Finally, the study failed to show any significant difference between TLR4 mRNA expressed in BMDCs with the two times of LPS exposure.

CONCLUSIONSOur data suggest that elevated Th1 immunity is not required for the modification of the Th2 response induced by LPS exposure during pre-sensitization in asthmatic mice and that pre-sensitization differs from post-sensitization. Immune modulation with treatment is independent of TLR4 expression in BMDCs. This study implicates a potential way to protect from allergic disease and an inflammatory response.

Animals ; Asthma ; chemically induced ; immunology ; Bronchoalveolar Lavage Fluid ; immunology ; Cytokines ; immunology ; metabolism ; Dendritic Cells ; immunology ; Dermatophagoides farinae ; immunology ; Female ; Lipopolysaccharides ; immunology ; Mice ; Mice, Inbred BALB C ; Reverse Transcriptase Polymerase Chain Reaction ; Th1 Cells ; immunology ; Th2 Cells ; immunology ; Toll-Like Receptor 4 ; genetics

OBJECTIVETo report the results of skin prick test in 908 children with asthma in order to provide references for treatment of asthma.

METHODSSkin prick test was performed using ALK-Abell's inhaled prick reagents and the German Merck company's food prick reagents. Histamine was used for positive control, and normal saline, for negative control.

RESULTSSkin prick test showed positive in 703 cases (77.4%). The positive rates of inhaled and food allergens were 76.9% and 37.1%, respectively. Dermatophagoides culinae and house dust mite were two common inhaled allergens (72.4% and 74.7% respectively). Shrimp was the most common food allergen (22.9%), followed by tuna (7.3%) and mussels (6.7%). The strongest response of skin prick test was usually caused by dermatophagoides culinae (64.0%) and house dust mite (66.4%), followed by mould 1 (7.1%). The positive rate of inhaled and food allergens increased with increasing age (p<0.05).

CONCLUSIONSThe positive rate of skin prick test in the 908 children with asthma was higher. These results of this study may be useful in an epidemiological survey and specific immunotherapy of asthma.

Adolescent ; Age Factors ; Allergens ; immunology ; Animals ; Asthma ; immunology ; therapy ; Child ; Child, Preschool ; Dermatophagoides farinae ; immunology ; Humans ; Infant ; Skin Tests

OBJECTIVETo investigate the distribution of allergens in children with allergic disease in Changsha.

METHODSTotal IgE and specific IgE against some allergens were examined by the AllergyScreen system in the sera of 437 children from Changsha with allergic disease.

RESULTSThe positive rates of total IgE and special IgE were 68.9% and 69.1% respectively. Dermatophagoides farina, beef, mutton, milk and fur of cats and dogs were found as common allergens. The IgE positive rate against dermatophagoides farina was the highest in children with allergic rhinitis (86.0%), followed by in those with atopic dermatitis (41.2%), eczema (27.6%) and urticaria (20.0%). Serum IgE was positive against the fur of cats and dogs in 23.5% of children with atopic dermatitis and in 18.1% of children with eczema. The IgE positive rate was lower in children with urticaria and allergic rhinitis (10.0% and 8.7% respectively). IgE positive rates against milk, beef and mutton were high in the above four allergic diseases (range: 14.0%-24.0%), but no significant differences were observed for the IgE positive rate among the four allergic diseases. The IgE positive rate to inhalant allergens in children at ages of less than 3 years was markedly higher than that in children at ages of more than 3 years (p<0.01).

CONCLUSIONSAllergic diseases are mainly mediated by allergens. Allergens, especially dermatophagoides farina, fur of cats and dogs, beef, mutton and milk, play an important role in childhood allergic diseases in Changsha.

Adolescent ; Age Factors ; Animals ; Child ; Child, Preschool ; Dermatophagoides farinae ; immunology ; Female ; Humans ; Hypersensitivity ; etiology ; immunology ; Immunoglobulin E ; blood ; Infant ; Male