1.Predictive model of curative effect of mite subcutaneous immunotherapy in 5-18 years of age patients with allergic asthma.
Qing Ning DUAN ; De Yu ZHAO ; Min YAN ; Feng LIU ; Ming Xia CHEN ; Ling Hui YANG
Chinese Journal of Pediatrics 2022;60(4):291-296
Objective: To analyze the factors affecting the efficacy of mite subcutaneous immunotherapy (SCIT) in allergic asthma patients aged 5-18 years, and to find the best predictive model for the curative effect. Methods: The data of 688 patients aged 5-18 years with allergic asthma who completed more than 3 years of mite SCIT from December 2006 to November 2021 in the Department of Respiratory Medicine, Children's Hospital Affiliated to Nanjing Medical University were retrospectively analyzed. Male, results of skin prick test (SPT), age, daily medication score (DMS), visual analogue scale (VAS) score, and enrollment season were defined as independent variables. R language models, including Logistic regression model, random forest model and extreme gradient boosting (XGboost) model, were used to analyze the impact of these independent variables on the outcomes. The receiver operating characteristic curve was applied to compare the predictive ability of the models. Hypothesis testing of the area under curve (AUC) of the 3 models was performed using DeLong test. Results: There were 435 males and 253 females in the 688 patients. There were 349 patients aged 5-<8 years, 240 patients aged 8-<11 years, and 99 patients aged 11-18 years. SPT showed that 429 cases (62.4%) were only allergic to mite, and 259 cases (37.7%) were also allergic to other allergens. According to the efficacy after 3 years of SCIT, 351 cases (51.0%) discontinued the treatment and 337 cases (49.0%) required continued treatment. The DMS was 4 (3, 6) at initiation, 3 (2, 5) at 3 months, 3 (2, 5) at 4 months, 2 (1, 3) at 12 months, and 0 (0, 1) at 3 years of SCIT treatment. The VAS was 3.5 (2.5, 5.2) at initiation, 3.2 (2.2, 4.8) at 3 months, 2.6 (1.4, 4.1) at 4 months, 1.0 (0.6, 1.8) at 12 months, and 0.5 (0, 1.2) at 3 years of treatment. At 3, 4, and 12 months, the rate of decline in DMS was 0 (0, 20%), 16.7% (0, 33.3%), and 50.0% (31.0%, 75.0%), respectively; and the VAS decreased by 7.1% (3.2%,13.8%), 27.6% (16.7%,44.4%), and 70.2% (56.1%, 82.3%), respectively. Regarding the enrollment season, 99 cases were in spring, 230 cases in summer, 171 cases in autumn, and 188 cases in winter. The R language Logistic regression model found that DMS>3 points at 3 months (OR=-3.5, 95%CI:-4.3--2.7, P<0.01), male (OR=-1.7, 95%CI:-2.3--1.0), P<0.01), DMS decline rate>16.7% at 4 months (OR=-1.6, 95%CI:-2.3--0.8, P<0.01) and DMS decline rate>0 at 3 months (OR=-0.7, 95%CI:-1.3--0.2, P<0.05) had higher possibility of drug discontinuation; whereas, the decline rate of DMS at 12 months>50.0% (OR=0.7, 95%CI: 0.1-1.3, P<0.05), VAS at 12 months>1.0 points (OR=0.9, 95%CI: 0.3-1.6, P<0.05), and initial VAS<4.0 points (OR=1.0, 95%CI: 0.4-1.6, P<0.01) had lower possibility of drug discontinuation. Both the random forest model and the XGboost model showed that DMS>3 points at 3 months (mean decrease accuracy=30.9, importance=0.45) had the greatest impact on drug discontinuation. The AUC of the random forest model was the largest at 0.900, with an accuracy of 78.2% and a sensitivity of 84.5%. Logistic regression model had AUC of 0.891, accuracy of 80.0%, and sensitivity of 80.0%; XGboost model had AUC of 0.886, accuracy of 76.9%, and sensitivity of 84.5%. The AUC of the pairwise comparison model by DeLong test found that all three models could be used for the prediction of this data set (all P>0.05). Conclusions: The more drugs used to control the primary disease, and the more careful reduction of the control medicine after starting SCIT treatment, the more favorable it is to stop all drugs after 3 years. The random forest model is the best predictive model for the efficacy of mite SCIT in asthmatic children.
Adolescent
;
Allergens
;
Animals
;
Asthma/therapy*
;
Child
;
Child, Preschool
;
Desensitization, Immunologic/methods*
;
Female
;
Humans
;
Immunotherapy/methods*
;
Injections, Subcutaneous
;
Male
;
Mites
;
Retrospective Studies
2.Human otoacariasis in a 40-year old Filipino male: A case report.
Journal of the Philippine Medical Association 2022;100(2):53-58
A 40-year old male, Filipino, farmer, from
Bakun, Benguet, presented with a 9 months history
of itchiness of right ear. He reported that he was able
to collect 4-5 insects every time he cleans his ear.
Consult was done with an Ears, Nose and Throat
specialist and video-otoscopic examination
revealed multi pie animate foreign body (mites) at
different stages of development. The patient
underwent 5 sessions of ear flushing with warm
water at intervals of 2 weeks for 3 months. Collected
insects were referred to an entomologist and were
identified as Suadasia pontifica Oudemans,
belonging to family: Acaridae. Follow up consult
after 5 sessions of ear flushing revealed complete
removal of mite infestation of his right ear. Patient
was instructed to do ear flushing twice daily using
warm water mixed with 70% isopropyl alcohol to
eradicate any eggs left behind. No other medications
were given. Based on Philippine Journal of
Otolaryngology - Head and Neck Surgery, Health
Research and Development Information Network,
and Cochrane Database of Systematic Reviews, this
is the first reported case of human otoacariasis in
the Philippines.
Mites
;
Acari
3.A Fusion Protein of Derp2 Allergen and Flagellin Suppresses Experimental Allergic Asthma
Wenzhi TAN ; Jin Hai ZHENG ; Tra My Nu DUONG ; Young Il KOH ; Shee Eun LEE ; Joon Haeng RHEE
Allergy, Asthma & Immunology Research 2019;11(2):254-266
PURPOSE: The house dust mite (HDM) is one of the most important sources of indoor allergens and a significant cause of allergic rhinitis and allergic asthma. Our previous studies demonstrated that Vibrio vulnificus flagellin B (FlaB) plus allergen as a co-treatment mixture improved lung function and inhibited eosinophilic airway inflammation through the Toll-like receptor 5 signaling pathway in an ovalbumin (OVA)- or HDM-induced mouse asthma model. In the present study, we fused the major mite allergen Derp2 to FlaB and compared the therapeutic effects of the Derp2-FlaB fusion protein with those of a mixture of Derp2 and FlaB in a Derp2-induced mouse asthma model. METHODS: BALB/c mice sensitized with Derp2 + HDM were treated with Derp2, a Derp2 plus FlaB (Derp2 + FlaB) mixture, or the Derp2-FlaB fusion protein 3 times at 1-week intervals. Seven days after the final treatment, the mice were challenged intranasally with Derp2, and airway responses and Derp2-specific immune responses were evaluated. RESULTS: The Derp2-FlaB fusion protein was significantly more efficacious in reducing airway hyperresponsiveness, lung eosinophil infiltration, and Derp2-specific IgE than the Derp2 + FlaB mixture. CONCLUSIONS: The Derp2-FlaB fusion protein showed a strong anti-asthma immunomodulatory capacity, leading to the prevention of airway inflammatory responses in a murine disease model through the inhibition of Th2 responses. These findings suggest that the Derp2-FlaB fusion protein would be a promising vaccine candidate for HDM-mediated allergic asthma therapy.
Allergens
;
Animals
;
Asthma
;
Eosinophils
;
Flagellin
;
Immunoglobulin E
;
Inflammation
;
Lung
;
Mice
;
Mites
;
Ovalbumin
;
Pyroglyphidae
;
Rhinitis, Allergic
;
Therapeutic Uses
;
Toll-Like Receptor 5
;
Vibrio vulnificus
4.Evaluation of multiple allergen simultaneous (sIgE) testing compared to intradermal testing in the etiological diagnosis of atopic dermatitis in horses
Piotr WILKOŁEK ; Marcin SZCZEPANIK ; Wiesław SITKOWSKI ; Beata RODZIK ; Michał PLUTA ; Iwona TASZKUN ; Marcin GOŁYŃSKI
Journal of Veterinary Science 2019;20(6):e60-
Although intradermal testing (IDT) is commonly used in the etiological diagnosis of allergies, in vitro testing for specific IgE (sIgE) is an attractive alternative. Currently, new laboratory techniques in veterinary allergological practice, including multiple allergen simultaneous tests (MASTs), gradually supersede in vivo tests. Both, serological (sIgE) and IDTs in fourteen atopic Malopolski horses were performed. Correlation and agreement between test results were evaluated. Receiver operating characteristic analysis showed that sIgE to Acarus siro had the best diagnostic performance (Area under the ROC curve [AUC] = 0.969), followed by Dermatophagoides pteronyssinus (AUC = 0.844), Dermatophagoides farinae (AUC = 0.813) and Tyrophagus putrescentiae (AUC = 0.803). A significant positive correlation between IDT and MAST was found for A. siro (r(S) = 0.870; p = 0.00005), and D. farinae (r(S) = 0.657; p = 0.011). There was significant moderate agreement for 2 of 5 allergens, A. siro (κ = 0.569) and D. farinae (κ = 0.485) in semiquantitative assessment and significant fair to substantial agreement for 3 of 5 allergens, D. pteronyssinus (κ = 0.689), A. siro (κ = 0.569), D. farinae (κ = 0.432) in dichotomic assessment. Sensitivity ranged from 44% to 89%, depending on the allergen, while specificity was significantly higher for all allergens in MAST (60%–100%); the mean accuracy was 73% (manufacturer cut-off) and 77.4% (optimal cut-off) based on the Youden index. Compared with IDT, serological MAST showed good detection performance for 60% allergen sIgE in dichotomic assessment with substantial diagnostic capability, but careful clinical interpretation is needed for some allergens.
Allergens
;
Dermatitis, Atopic
;
Dermatophagoides farinae
;
Dermatophagoides pteronyssinus
;
Diagnosis
;
Horses
;
Hypersensitivity
;
Immunoglobulin E
;
In Vitro Techniques
;
Intradermal Tests
;
Mites
;
ROC Curve
;
Sensitivity and Specificity
5.Annual Fluctuation in Chigger Mite Populations and Orientia Tsutsugamushi Infections in Scrub Typhus Endemic Regions of South Korea
Seong Yoon KIM ; Byoungchul GILL ; Bong Gu SONG ; Hyuk CHU ; Won Il PARK ; Hee Il LEE ; E hyun SHIN ; Shin Hyeong CHO ; Jong Yul ROH
Osong Public Health and Research Perspectives 2019;10(6):351-358
OBJECTIVES: Chigger mites are vectors for scrub typhus. This study evaluated the annual fluctuations in chigger mite populations and Orientia tsutsugamushi infections in South Korea.METHODS: During 2006 and 2007, chigger mites were collected monthly from wild rodents in 4 scrub typhus endemic regions of South Korea. The chigger mites were classified based on morphological characteristics, and analyzed using nested PCR for the detection of Orientia tsutsugamushi.RESULTS: During the surveillance period, the overall trapping rate for wild rodents was 10.8%. In total, 17,457 chigger mites (representing 5 genera and 15 species) were collected, and the average chigger index (representing the number of chigger mites per rodent), was 31.7. The monthly chigger index was consistently high (> 30) in Spring (March to April) and Autumn (October to November). The mite species included Leptotrombidium pallidum (43.5%), L. orientale (18.9%), L. scutellare (18.1%), L. palpale (10.6%), and L. zetum (3.6%). L. scutellare and L. palpale populations, were relatively higher in Autumn. Monthly O. tsutsugamushi infection rates in wild rodents (average: 4.8%) and chigger mites (average: 0.7%) peaked in Spring and Autumn.CONCLUSION: The findings demonstrated a bimodal pattern of the incidence of O. tsutsugamushi infections. Higher infection rates were observed in both wild rodents and chigger mites, in Spring and Autumn. However, this did not reflect the unimodal incidence of scrub typhus in Autumn. Further studies are needed to identify factors, such as human behavior and harvesting in Autumn that may explain this discordance.
Globus Pallidus
;
Humans
;
Incidence
;
Korea
;
Mites
;
Orientia tsutsugamushi
;
Polymerase Chain Reaction
;
Rodentia
;
Scrub Typhus
;
Trombiculidae
7.Overwintering status and species identification of gall mite in major wolfberry production areas.
Sai LIU ; Meng-Ke YANG ; Jian-Ling LI ; Kun GUO ; Hai-Li QIAO ; Rong XU ; Chang-Qing XU ; Jun CHEN
China Journal of Chinese Materia Medica 2019;44(11):2208-2212
To identify the wolfberry gall mite species and their overwintering situation in different wolfberry production areas and to provide a scientific basis for their prevention and control. We investigate the phoresy overwintering situation of gall mite, and identify the species of gall mite. Our results showed that the phoretic gall mite was Aceria pallida in all the production areas. The phoresy of gall mite was a common occurrence in different production areas, and the phoresy probability was above 75%. The phoretic behavior of wolfberry gall mite occurred commonly in the other production areas. The control of this mite in different production areas should pay attention to their phoretic behavior.
Animals
;
Lycium
;
parasitology
;
Mites
;
classification
;
growth & development
;
Seasons
8.The International Study of the Allergic Rhinitis Survey: outcomes from 4 geographical regions
Desiderio PASSALI ; Cemal CINGI ; Paola STAFFA ; Francesco PASSALI ; Nuray Bayar MULUK ; Maria Luisa BELLUSSI
Asia Pacific Allergy 2018;8(1):e7-
BACKGROUND: Allergic rhinitis (AR) is a global health problem and is characterised by one or more symptoms, including sneezing, itching, nasal congestion and rhinorrhea. OBJECTIVE: We investigated the features of AR and the physician's approach to the management of AR patients in four geographical regions. METHODS: In this cross-sectional study, a questionnaire survey concerning AR was completed by Honorary and Corresponding Members of the Italian Society of Rhinology from different countries among 4 world geographical regions—Asia, Europe, the Americas, and Africa. RESULTS: The prevalence of AR was reported to be 15%–25%. Children and adolescents, as well as young adults, were the age groups more affected by AR with comorbidities of asthma, sinusitis, conjunctivitis, and nasal polyposis. Nasal symptoms of AR were more intense in the spring (51.92%) and autumn (28.85%). The most common aero-allergens were pollen and mites (67.31%), animal dander and pollutants (23.08%), and fungal allergens (21.15%). Allergen-specific immunotherapy was prescribed for both perennial and seasonal allergens (32.69%) via sublingual swallow (46.15%) and subcutaneous (32.69%) routes. For the AR patients, the most prescribed drugs were intranasal corticosteroids (86.54%) and oral H₁-antihistamines (82.69%). CONCLUSION: A network of experts can improve our knowledge concerning AR epidemiology, and together with guidelines, could assist practitioners and otolaryngologists in standardising the diagnosis and treatment of AR.
Adolescent
;
Adrenal Cortex Hormones
;
Africa
;
Allergens
;
Americas
;
Animals
;
Asthma
;
Child
;
Comorbidity
;
Conjunctivitis
;
Cross-Sectional Studies
;
Dander
;
Diagnosis
;
Epidemiology
;
Estrogens, Conjugated (USP)
;
Europe
;
Global Health
;
Humans
;
Immunotherapy
;
Mites
;
Pollen
;
Prevalence
;
Pruritus
;
Rhinitis, Allergic
;
Seasons
;
Sinusitis
;
Sneezing
;
Sublingual Immunotherapy
;
Young Adult
9.Skin prick test reactivity to aeroallergens in adult allergy clinic in Thailand: a 12-year retrospective study
Supa ONCHAM ; Umaporn UDOMSUBPAYAKUL ; Wannada LAISUAN
Asia Pacific Allergy 2018;8(2):e17-
BACKGROUND: The global prevalence of allergic rhinitis, asthma, and atopic dermatitis has risen significantly over the last 2 decades. Allergic sensitization to aeroallergen is a major risk factor in developing the allergic disease. The prevalence of aeroallergen sensitization varies in different regions and countries. OBJECTIVE: To determine the prevalence of common aeroallergen sensitization and the atopic status among adult patients. METHODS: A cross-sectional, retrospective study. The data were collected from medical records and database of the result of skin prick test of patients who had the allergic symptoms or chronic urticaria in adult allergy clinic, Ramathibodi hospital from January 2004 to December 2015. RESULTS: A total of 1,516 of patients (female, 1,118 [73.7%]) were enrolled. The mean ages of participants were 41.34 (standard deviation, ±16.5) years. Fifty-eight percent (58%) of patients were diagnosed with allergic rhinitis, 19.7%, 3.2%, and 9.2% with asthma, atopic dermatitis, and chronic urticaria respectively. In the chronic urticaria group, 57.4% underwent the positive skin prick test to common aeroallergens. Mites were responsible for the most common inhaled allergen sensitization in this study as 50.1% of Dermatophagoides pteronyssinus, 32% of Dermatophagoides farinae, and 31.5% of house dust. Cockroach was the second most common aeroallergen sensitization as 32.3% followed by grass pollen, Bermuda (21.1%) and timothy (13.6%). The animal dander, cat and dog, occupied 12.9 and 10% respectively. CONCLUSION: Mites were the most common cause of aeroallergen sensitization in all patients followed by cockroach, grass pollen, and animal dander. However, Bermuda sensitization has increased significantly in the last 6 years.
Adult
;
Allergens
;
Animals
;
Asthma
;
Bermuda
;
Cats
;
Cockroaches
;
Dander
;
Dermatitis, Atopic
;
Dermatophagoides farinae
;
Dermatophagoides pteronyssinus
;
Dogs
;
Dust
;
Humans
;
Hypersensitivity
;
Medical Records
;
Mites
;
Poaceae
;
Pollen
;
Prevalence
;
Retrospective Studies
;
Rhinitis
;
Rhinitis, Allergic
;
Risk Factors
;
Skin Tests
;
Skin
;
Thailand
;
Urticaria
10.Evaluation of skin prick test to screen dust mite sensitization in chronic respiratory diseases in Southern Vietnam
Ha Thi CHU ; Isabelle GODIN ; Nguyễn Thanh PHƯƠNG ; Lan Huu NGUYEN ; Tran Thi Mong HIEP ; Ngo Minh XUAN ; Francis CORAZZA ; Olivier MICHEL
Asia Pacific Allergy 2018;8(4):e39-
BACKGROUND: In the view of the epidemic growth of sensitization to indoor allergens in Southern Vietnam, there is a requirement to screen large population. OBJECTIVE: To evaluate skin prick tests (SPTs) as predictors of positive specific IgE (sIgE) to dust allergens, among patients with chronic respiratory diseases (CRDs). METHODS: The sensitization to Blomia tropicalis (Blo t), Dermatophagoides pteronissinus (Der p), and Blattella germanica allergens (Bla g) were evaluated among 610 CRD, both SPT (≥4 mm) and sIgE by immuno-CAP (≥0.7 kUA/L). RESULTS: Based on sIgE, 45%, 32%, and 33% of patients with CRD were sensitized to Blo t, Der p, and Bla g, respectively, compared to 19%, 18%, and 13% by SPT. The association between SPT and sIgE was statistically significant, though the Kappa factor was fair (i.e., 0.39 to 0.23). While the specificity of SPT to detect sensitization (compared to sIgE) was >90% among the whole population, the sensitivity was only 34%, 41%, and 24% for Bo t, Der p, and Bla g, suggesting that SPT was not enough sensitive to screen the indoor allergen sensitization. Though, among the < 10 pack-year (PY) smokers, the sensitivity was 43% for Blo t, 52% for Der p, and 61% for Blo t and/or Der p, compared to 27%, 30%, and 35% among the ≥10 PY smokers. The sensitivity/specificity was not associated with the diagnosis of asthma compared to chronic obstructive pulmonary disease. CONCLUSION: In the present circumstance, SPT to dust mites allergens can be used to detect a sensitization among CRD population in Southern Vietnam.
Allergens
;
Asthma
;
Diagnosis
;
Dust
;
Humans
;
Immunoglobulin E
;
Mites
;
Pulmonary Disease, Chronic Obstructive
;
Pyroglyphidae
;
Sensitivity and Specificity
;
Skin Tests
;
Skin
;
Vietnam


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