Allergo Journal International最新文献

As a widespread disease, contact dermatitis affects all age groups with a high prevalence and incidence. In addition to a reduction in the quality of life, it causes considerable health and socioeconomic costs. Essentially, five subtypes can be distinguished, namely irritant contact dermatitis, phototoxic contact dermatitis, allergic contact dermatitis with its two special forms of hematogenous and aerogenous contact dermatitis, photoallergic contact dermatitis, and protein contact dermatitis. The diagnosis is based on a detailed history and clinical skin findings as well as the exposure-related performance of allergological in vivo and in vitro tests. Once the contact substance—irritant or allergen—has been identified, the key to therapeutic success lies in its strict avoidance. Symptomatic therapy of contact dermatitis should always be individualized and based on the stage of eczema. Topical glucocorticoids are considered first-line therapy for both irritant and allergic contact dermatitis. The always accompanying basic therapy with skin care products plays a central role for sustainable therapeutic success. Systemic therapy is considered when topical therapy is ineffective or not feasible. In this context, the short-term use of systemic glucocorticoids should be limited to extensive or clinically severe acute contact dermatitis and exacerbations of chronic contact dermatitis. The efficacy of the use of newer biologics and Janus kinase inhibitors in contact dermatitis is currently being evaluated in several clinical trials.

Purpose

Aeroallergens are airborne particles capable of triggering rhinitis and respiratory complications in sensitive individuals. Tree pollen is a major source of aeroallergens and can potentially induce allergic responses in a variety of ways. Thus, studying the allergenicity of urban green spaces is crucial to public health quality. Conocarpus trees have been vastly imported in recent years in Iran for reforestation projects and now have a wide distribution in southern parts of Iran, especially in Khuzestan province. Yet, these plants have not been studied adequately for their allergenic potential. This work aims to evaluate the IgE-mediated skin reactivity to Conocarpus pollen extract in patients suffering from asthma and allergic rhinitis living in southwest Iran.

Methods

Ninety consecutive patients diagnosed with asthma and allergic rhinitis were selected. Mild cases initially and moderate to severe cases after a period of treatment and follow-up underwent skin prick test (SPT) for Conocarpus pollen extract and several other aeroallergens.

Results

A skin prick test was performed for all 90 patients presenting asthma and allergic rhinitis symptoms and treated and followed in an outpatient setting. 17% had weakly positive test results for Conocarpus pollen extract. The maximum mean wheal diameter was 4 mm. For comparison, about 48% of the patient were sensitized to Russian thistle, with a maximum mean wheal size of 12 mm. Sensitization to grasses, some other trees, and indoor allergens were also measured.

Conclusion

Conocarpus trees have a low potential for inducing allergic responses in the studied population. There is no evidence that they have any role in triggering the thunderstorm asthma episodes.

Indications for epicutaneous patch testing include the detection or exclusion of allergic contact dermatitis of the skin, transitional mucosa or oral mucosa, suspected delayed-type immune reactions to ingredients of implants, and certain drug reactions (maculopapular exanthema, symmetrical drug-related intertriginous and flexural exanthema [SDRIFE], acute generalized exanthematous pustulosis [AGEP], and fixed drug eruption). When available, allergen preparations that have been pharmaceutically tested and that are approved or marketable as medicinal products should be used. Existing diagnostic gaps can be closed by testing the patient’s own materials in a suitable preparation. Interferences of ultraviolet (UV) light exposure or drugs with patch test reactions have to be considered. In addition to the reading after 48 h and 72 h, a further reading between day 7 (168 h) and day 10 (240 h) is useful, since about 15% of the positive test reactions remain undetected without this late reading. All positive patch test reactions considered allergic must be evaluated with regard to their clinical relevance based on existing exposures.

Background

A perennial house dust mite-associated allergic rhinitis has a major impact on the quality of life of patients and is associated with a high socioeconomic burden. The most common symptoms of allergic rhinitis include a runny nose and nasal congestion, sneezing, itching of nose, mouth and/or throat, and/or ocular symptoms. Affected patients often develop allergic bronchial asthma. Therapy options for allergic rhinitis include allergen avoidance, symptomatic treatment, and allergen immunotherapy. Allergen immunotherapy is the only disease-modifying treatment that can permanently alleviate the symptoms of allergic rhinitis. In July 2021, a new sublingual mite tablet was approved in Germany.

Methods

This review summarizes clinical studies on the 300 IR (index of reactivity) mite tablet in adolescents and adults with house dust mite-associated allergic rhinitis and presents the results.

Results

In the phase II and phase III studies considered here, different dosages of the mite tablet were investigated. The 300 IR mite tablet showed the best benefit–risk profile and has been approved in Europe, Japan, South Korea, Australia, and New Zealand for the treatment of house dust mite-associated allergic rhinitis.

Conclusion

Allergen immunotherapy with the 300 IR mite tablet is an effective treatment that relieves allergic symptoms, reduces the need for symptomatic medication, and improves the quality of life in both adults and adolescents with house dust mite-associated allergic rhinitis. At the same time, treatment with the 300 IR mite tablet is well tolerated. Mild to moderate reactions at the application site subside after a few days.

Background

Many plant food allergens have been implicated in cross-reactivities and may cause repetitive pan-allergenic exposures, which increase the severity of patients’ allergic symptoms. Identification of allergenic protein levels in food allows for more precise dietary advice. This study aimed to determine LTP, profilin, and PR-10 in the 15 most popular fruits in Taiwan.

Methods

cDNA encoding profilin (Sola l 1), nonspecific lipid transfer protein (nsLTP, Sola l 3), and pathogenesis-related protein (PR-10, Sola l 4) were cloned into the pQE30, expressed in Escherichia coli, and purified. Extracts of the most popular fruits, including apple, banana, carrot, celery, dragon fruit, hami melon, jujube, kiwi, mango, melon, orange, papaya, peach, persimmon, and tomato, in Taiwan were prepared in PBS. The allergenic protein levels in these extracts were determined by immuno-dot blotting using rabbit anti-rSola l 1, 3, and 4 polyclonal antibodies.

Results

Among all 15 fruit extracts tested, peach and mango contained the highest levels of profilin, nsLTP, and PR-10. Papaya, melon, and tomato contained low but detectable levels of the three pan-allergens.

Conclusion

Our data suggest that peach and mango contain the highest levels of important pan-allergens among the 15 common fruits tested, which agrees with epidemiological data.

House dust mites are a major source of allergens in house dust and, thus, the main trigger of perennial allergic respiratory diseases [1,2,3,4,5]. Scientific research on the life cycle, diet, and reproductive behavior of dust mites and on the biology of mite allergens has uncovered mechanisms leading to the development of respiratory allergies and suggests measures that can minimize exposure to dust mite allergens. Here, we discuss the evidence linking house dust mite exposure and respiratory allergies and present the efficacy of avoidance measures and their scientific evidence.