allergy
Asthma and allergy: the significance of chronic conditions for individual health behaviour.

Bolin K, Lindgren B.

Lund University, Department of Economics, Department of Community Medicine, and LUCHE (Lund University Center for Health Economics), Lund University, SE-220 07 Lund, Sweden.

BACKGROUND: In health economics, health is regarded as part of an individual's human capital. As such it depreciates over time, and investments in health are made in order to keep the stock of health capital at the desired level. Using this framework for analysis of health-related behaviour and Swedish panel data, we examined whether the presence of asthma or allergy affects perceived health and investments in health. METHODS: A set of panel data for approximately 3800 individuals interviewed repeatedly in 1980/81, 1988/89, and 1996/97 was created from the Swedish biannual survey of living conditions. Self-assessed health was chosen as the indicator of health capital and the reported number of sick days as the indicator of health investment. The presence of asthma or allergy, age, wage rate, wealth, marital status, number of children, exercise and smoking habits, gender, and geographic location of household were all chosen as explanatory variables. An ordered probit model was estimated for the health equation and a Poisson model for the investment equation. RESULTS: We found that both asthmatics and those who suffer from allergy invested more in their health than the general population. We also found that asthmatics reported significantly lower self-assessed health than the general population, while those who suffered from allergy did not differ significantly from the general population regarding their self-assessed health. CONCLUSION: The human capital approach was found suitable for studying the impact of asthma and allergy on individual health behaviour. Health policy measures, which reduce the individual's costs of investing in his or her health, would improve health levels. Because asthmatics were found less healthy than those suffering from allergy, the potential gains would be larger for patients with asthma than for patients with allergy. The issue of whether this would be a cost-effective policy or not would require a different design and, hence, could not be solved within the present study.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11929413&dopt=Abstract allergy medicine



allergy
[Allergy to house dust mites: allergy independent symptoms dominate]

[Article in German]

Herwig LM, Helbling A, Pichler WJ, Pichler CE.

Allergologisch-Immunologische Poliklinik, Klinik fur Rheumatologie, Klinische Immunologie/Allergologie, Inselspital Bern.

A sensitisation to allergens has not always a clinical relevance. Therefore, the history has an uppermost importance for defining the relevance of a sensitisation. In contrast to the history in seasonal rhino-conjunctivitis, which causes typical complains in a restricted time period patients with house dust mite allergy seem to have less defined complaints. To define the most relevant symptoms of this frequent allergy, we evaluated 35 patients with clearly defined house dust mite allergy by a questionnaire and evaluated the same questionnaire also in a control group of 18 patients without sensitisation or asthma. The symptoms described in the patient group confirm that symptoms of house dust mite allergy are frequently not related to a direct allergen exposure. Some patients complained about itchy red eyes in the morning, but the majority of symptoms occurred independent from allergen exposure. These are blocked nose as well as exercise induced asthma. These symptoms are present all year around and are not only restricted to mite exposed areas. They are probably related to the underling eosinophilic inflammation. Thus exercise induced asthma and blocked nose are symptoms, which may indicate a mite allergy, particular in younger patients.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15032137&dopt=Abstract allergy medicine



allergy
Harmful effect of immunotherapy in children with combined snail and mite allergy.

Pajno GB, La Grutta S, Barberio G, Canonica GW, Passalacqua G.

Pediatric Division II, University Hospital, Messina, Italy.

BACKGROUND: With respect to allergy, the possibility of cross-reactivity between snail and mite is well recognized, and anecdotal reports suggesting that allergen immunotherapy with mite extract can worsen snail-induced allergy exist. OBJECTIVE: We describe the effect of immunotherapy in 4 children with snail-mite allergy. METHODS: Four children (1 boy and 3 girls; 9-13 years of age) had consistent clinical histories (mild immediate respiratory symptoms after ingestion) and positive skin reactions for allergy to snail. They also had mite-induced asthma and were therefore prescribed subcutaneous specific immunotherapy and subsequently followed. RESULTS: Several months (8-25) after starting immunotherapy, all children experienced life-threatening reactions, anaphylaxis, and respiratory failure after inadvertent ingestion of snail. Skin reactivity to the fresh food increased in all patients. CONCLUSIONS: This observation confirms that in patients with combined mite-snail allergy, immunotherapy should be avoided.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11941311&dopt=Abstract allergy medicine



allergy
Evaluation of the need for routine preoperative latex allergy tests in children.

Sapan N, Nacarkucuk E, Canitez Y, Saglam H.

Division of Pediatric Allergy, Medical Faculty, Uludag University, Bursa, Turkey. nsapan uludag.edu.tr

BACKGROUND: Recently, there was a great increase in allergic reactions to latex and this brought relatively more concern to the latex allergy. In this prospective study we aimed to identify the frequency of latex allergy in preoperative patients, and tried to clarify whether it is necessary to perform latex allergy tests routinely in the preoperative period or not. METHODS: A total of 188 children, aged 1-14, who were admitted for various operations, were randomly included in this study and of them, 181 completed the study. Latex specific history was taken from all patients. Latex skin prick tests, challenge tests with latex gloves, total IgE and latex specific IgE measurements were performed. RESULTS: Of 181 children, two (1.1%) had positive latex skin prick tests. Latex challenge tests were negative in all children. Latex specific IgE was positive in 12 children (6.6%) as class II or higher, but no patient had allergic reactions in operations. History of repeated operations was a risk factor for latex sensitization. The risk was higher in the presence of both history of repeated operations and history of allergic disease. However, the risk was not higher in patients with the history of only allergic disease, compared to ones who had a history of neither repeated operations nor allergic disease. CONCLUSION: We conclude that routine preoperative latex allergy tests seem to be not necessary because of no allergic reactions during operation in spite of the sensitization of 6.6% detected by latex specific IgE. However, this should be investigated in larger studies.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11896874&dopt=Abstract allergy medicine



allergy
Vbeta18.1(+) and V(alpha)2.3(+) T-cell subsets are associated with house dust mite allergy in human subjects.

Kircher MF, Haeusler T, Nickel R, Lamb JR, Renz H, Beyer K.

Institute of Clinical Chemistry and Biochemistry, Berlin, Germany.

BACKGROUND: The recognition of allergenic peptides by T cells through their T-cell receptor (TCR) represents a crucial step in the initiation of an allergen-specific immune response. In parallel to the superantigen-driven restricted expansion of Vbeta subsets in autoimmune and infectious diseases, reports in animals and human subjects have shown a similar capacity of classical antigens. OBJECTIVE: The study was performed to analyze the V(alpha)/Vbeta expression in house dust mite (HDM) allergy. METHODS: The TCR repertoire of 15 subjects with HDM allergy, 22 atopic subjects without HDM allergy, and 19 nonatopic individuals, members of 2 extended and 4 nuclear families, was determined. By using flow cytometry, the expression of 22 Vbeta and 3 V(alpha) elements was analyzed in vivo and after in vitro allergen stimulation. RESULTS: In comparison with nonatopic and atopic individuals without HDM allergy, freshly isolated PBMCs of individuals with HDM allergy showed a significantly higher frequency of Vbeta18(+) and V(alpha)2.3(+) T cells. Although members of all 3 groups had a similar lymphocyte proliferation response after in vitro stimulation with Der p 1 or Der p 1 peptide(101-131), a significant expansion of Vbeta18(+) and V(alpha)2.3(+) T cells in vitro occurred only in individuals with HDM allergy. Moreover, the degree of expansion correlated with the levels of allergen-specific IgE antibodies. No expansion of Vbeta18(+) and V(alpha)2.3(+) was observed after mitogen stimulation with PHA, indicating allergen specificity of the response. CONCLUSION: Our results strongly suggest restricted TCR V(alpha)/Vbeta gene use in HDM allergy and might be a step toward TCR-based immunotherapy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11898001&dopt=Abstract allergy medicine



allergy
Allergic reactions to brimonidine in patients treated for glaucoma.

Blondeau P, Rousseau JA.

Department of Ophthalmology, Universite de Sherbrooke, Que. blondeau microtec.net

BACKGROUND: Allergic reactions to ophthalmic drugs have not been studied extensively in ophthalmology. We performed a study to estimate the incidence of allergy to brimonidine in patients treated for glaucoma. METHODS: We identified all patients in a private glaucoma practice who started therapy with brimonidine between Mar. 19, 1998, and Aug. 14, 1999. We recorded the patient's diagnosis, age, sex, concomitant glaucoma medication, previous allergy to glaucoma medication and allergy to brimonidine. Allergy was defined as allergic contact dermatoconjunctivitis or follicular conjunctivitis. RESULTS: Of the 140 patients identified, 36 (25.7%) had had an allergic reaction to brimonidine. Contact dermatoconjunctivitis was noted in 19 patients (52.8%) and follicular conjunctivitis in 18 (50.0%). The rate of development of those two manifestations was linear and almost parallel throughout the study period. In logistic regression analysis previous allergy to a topically given antiglaucoma medication (t = -5.13) and concurrent use of levobunolol (t = 3.46) were retained as the most probable predictor variables of allergy to brimonidine. Life-table analysis showed a fairly linear curve, with no peak in allergy rate. Allergic reactions occurred throughout the year, with a small peak in March. INTERPRETATION: We found a rate of allergy to brimonidine of 25.7%. Concomitant levobunolol use and allergy to another glaucoma medication were associated with a higher allergy rate.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11865954&dopt=Abstract allergy medicine



allergy
Prevalence of food allergies in young adults and their relationship to asthma, nasal allergies, and eczema.

Woods RK, Thien F, Raven J, Walters EH, Abramson M.

Department of Epidemiology and Preventive Medicine, Central and Eastern Clinical School, Monash University and The Alfred Hospital, Prahran, Victoria, Australia. Rosalie.Woods med.monash.edu.au

BACKGROUND: The true prevalence of food allergy in adults is generally thought to be uncommon. It is unknown whether there are any relationships between food allergy and atopic diseases. OBJECTIVE: To determine the prevalence of probable immunoglobulin (Ig)E-mediated food allergy to peanut, shrimp, cow's milk, wheat, and egg as defined by a positive skin prick test result and relevant clinical history to the same food, and to explore the relationship with atopic diseases. METHODS: Cross-sectional epidemiologic study. One thousand one hundred forty-one randomly selected young adults (aged 20 to 45 years) underwent skin prick testing to five common food allergens (cow's milk, peanut, egg white, shrimp, and wheat), completed a detailed questionnaire, including validated items on respiratory symptoms, history of asthma and other allergic conditions, as well as undergoing lung function testing. RESULTS: Just over one percent (1.3%, n = 15) had probable IgE-mediated food allergy. The prevalence of probable IgE food allergy was: <0.27% for wheat, 0.09% (95% confidence interval = 0.0 to 0.49%) each for cow's milk and egg, 0.53% (0.21 to 1.09%) for shrimp, and 0.61% (0.25 to 1.26%) for peanut. Those with probable IgE peanut and shrimp allergy were significantly more likely to have current asthma and doctor-diagnosed asthma. Wheeze and history of eczema were also associated with peanut allergy, whereas nasal allergies were associated with shrimp allergy. CONCLUSIONS: The prevalence of probable IgE-mediated food reactions is rare in young adults. Some positive associations between probable IgE-mediated food allergy and allergic diseases were found, but larger study numbers are required to confirm these results.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11868923&dopt=Abstract allergy medicine