allergy
The "egg-egg" syndrome: occupational respiratory allergy to airborne egg proteins with consecutive ingestive egg allergy in the bakery and confectionery industry.

Leser C, Hartmann AL, Praml G, Wuthrich B.

Department of Dermatology, University Hospital, Zurich, Switzerland.

Allergies to various inhalative allergens are a serious problem in the bakery and confectionery industry. Sensitization to wheat flour and enzymes such as alpha-amylase are a frequent cause of occupational asthma. Airborne egg allergens have been reported as another cause of respiratory allergy. We examined bakery and confectionery workers with respiratory symptoms due to egg aerosols. Skin tests (SPT), scratch tests (ST), nasal provocation tests (NPT) and serological examinations (IgE) were performed. Lung function was assessed by spirometry, and continuous registration of aerosols and particulates as well as gravimetric sampling was done at the workplace. Four bakery and two confectionery workers intensively exposed to airborne egg proteins suffered from conjunctivitis and rhinitis, four also from asthma. Subsequently, three of these four workers reported symptoms after ingestion of food that contained egg. SPT with commercial egg white and egg yolk extracts were negative in four cases. Only two employees had clearly positive SPT to commercial egg allergens and reacted also to wheat flour extracts. Scratch tests with native egg proteins were positive in four employees. Specific IgE to egg white and egg yolk were positive (CAP > or = 2) in three and in four cases, respectively, whereas they were negative in two cases. Elevated levels of specific IgE to lysozyme were detected in four employees. Two workers were sensitized to lysozyme but not to other egg proteins. The clinical relevance of egg sensitization was confirmed by continuous air sampling and by correlating the onset of the respiratory symptoms which were reflected by a significant decline (> or = 30%) of the forced one second capacity (FEV1) in two workers. Sieving of egg white powder and an inadequate spray station for liquid eggs were identified as sources of excessive allergen exposure. Bakery and confectionery workers exposed to airborne egg proteins are at risk of developing occupational asthma and subsequent nutritive egg allergy. To our knowledge, these are the first cases of inhalative egg allergy and subsequent nutritive egg allergy reported in the literature, which we refer to as the "egg-egg syndrome" in analogy to the already known "bird-egg" and "egg-bird" syndromes.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11642578&dopt=Abstract allergy medicine



allergy
[The incidence of food allergy in atopic dermatitis]

[Article in Japanese]

Ogura Y, Ogura H, Zusi N.

Department of Clinical Reseach and Pediatric Allergy, Kochi National Hospital.

To clarify the incidence of food allergy in atopic dermatitis, non-selected 226 cases with atopic dermatitis visited in our hospital were evaluated by oral food challenge tests based on masked food allergy. 181 of 200 cases except 26 cases dropped out showed a positive reaction to at least one challenge test, after their skin manifestations had been relieved by environmental control and elimination diets. In conclusion, the incidence of food allergy in atopic dermatitis was 90.5%, and egg allergy, cow's milk allergy, soy bean allergy, wheat allergy, rice allergy were 83.5%, 51.5%, 33.5%, 20.0%, 2.5% respectively in 200 cases.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11554066&dopt=Abstract allergy medicine



allergy
Weekly dosing of carboplatin increases risk of allergy in children.

Yu DY, Dahl GV, Shames RS, Fisher PG.

Northwestern University Medical School, Chicago, Illinois, USA.

BACKGROUND: Carboplatin (CBDCA) has been used increasingly to treat pediatric low-grade gliomas. Allergic reactions to CBDCA have been reported in 2% to 30% of children. The reason for this high incidence of allergy is unclear. METHODS: To determine the risk factors for CBDCA allergy, an historic cohort study was conducted for all children who received the drug during a 6-year period at the Lucile Salter Packard Children's Hospital at Stanford. The patients' medical records were reviewed for data on age, tumor type, CBDCA dose schedule, total number of doses, cumulative dosage, dose per treatment, other chemotherapy administered, and allergic reaction. RESULTS: Fifty-four children (mean age 7.2 years, 35 boys) were identified. Six children (11.1%) had an allergic reaction to CBDCA. All reactors had low-grade gliomas treated with weekly CBDCA and vincristine, with a dosage per treatment <500 mg/m2. Overall, six (75%) of eight children administered weekly CBDCA, 6 (46.2%) of 13 children with brain tumors, and 6 (40%) of 15 administered CBDCA dosage <500 mg/m2 manifested allergic reactions. Patients receiving more than five doses had significant risk for CBDCA allergy (relative risk [RR] = 11.8; 95% confidence interval [CI]: 1.5-94.1). Using logistic regression with multiple variables, weekly dose schedule was the most predictive covariate for allergic reaction (P < 0.000 1), and other factors were unrelated or redundant. CONCLUSIONS: Children with low-grade gliomas receiving CBDCA weekly are at significantly increased risk for CBDCA allergy. The repetitive, weekly dosing schedule of CBDCA appears to be a key risk factor for allergic reaction in brain tumor patients. The high frequency of allergy with weekly CBDCA warrants further consideration when planning future trials.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11563768&dopt=Abstract allergy medicine



allergy
The role of allergy in manifestations of respiratory disease in adult cystic fibrosis.

Hallstrand TS, Calenoff E, Becker JW, Henderson WR Jr, Aitken ML.

Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, Washington 98195-6522, USA. tealh u.washington.edu

BACKGROUND: Variability is present in the expression of the clinical phenotype in cystic fibrosis (CF). Part of this variability may be explained by the coexistence of allergy in CF. OBJECTIVE: To determine the rate of allergy in adult CF and evaluate the association between allergy and the manifestations of upper and lower airway disease. METHODS: We performed a cross-sectional study of consecutive patients enrolled in a university hospital adult CF clinic. Allergen specific IgE was determined by radioallergosorbent and skin prick tests to common aeroallergens. We characterized features of upper and lower airway disease by clinical evaluation of rhinitis and spirometry before allergy testing. RESULTS: The study population consisted of 55 patients. Allergen specific IgE was present to at least 1 aeroallergen in 67% by skin prick testing and 80% by radioallergosorbent testing. Rhinitis occurred in 50% of the population and was associated with immediate-type hypersensitivity to aeroallergens other than molds. The frequency of rhinitis increased when there was sensitization to a greater number of aeroallergens and rarely occurred in the absence of allergic sensitization. There was no detectable difference in lung function between those with and without allergic sensitization. CONCLUSIONS: Immediate-type hypersensitivity to aeroallergens commonly occurs in adult CF. The coexistence of allergy in CF is associated with clinical features of rhinitis. Because allergic manifestations of CF warrant appropriate therapy, individuals with CF should be evaluated for coexistent allergy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14989391&dopt=Abstract allergy medicine



allergy
Allergy development and the intestinal microflora during the first year of life.

Bjorksten B, Sepp E, Julge K, Voor T, Mikelsaar M.

Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden.

BACKGROUND: The intestinal microflora is a likely source for the induction of immune deviation in infancy. OBJECTIVE: The purpose of this study was to prospectively relate the intestinal microflora to allergy development in 2 countries differing with respect to the prevalence of atopic diseases. METHODS: Newborn infants were followed prospectively through the first 2 years of life in Estonia (n = 24) and Sweden (n = 20). By that age, 9 Estonian and 9 Swedish infants had developed atopic dermatitis and/or positive skin prick test results. Stool samples were obtained at 5 to 6 days and at 1, 3, 6, and 12 months, and 13 groups of aerobic and anaerobic microorganisms were cultivated through use of standard methods. RESULTS: In comparison with healthy infants, babies who developed allergy were less often colonized with enterococci during the first month of life (72% vs 96%; P <.05) and with bifidobacteria during the first year of life (17% to 39% vs 42% to 69%; P <.05). Furthermore, allergic infants had higher counts of clostridia at 3 months (median value, 10.3 vs 7.2 log(10); P <.05). The prevalence of colonization with Staphylococcus aureus was also higher at 6 months (61% vs 23%; P <.05), whereas the counts of Bacteroides were lower at 12 months (9.9 vs 10.6 log(10); P <.05). CONCLUSION: Differences in the composition of the gut flora between infants who will and infants who will not develop allergy are demonstrable before the development of any clinical manifestations of atopy. Because the observations were made in 2 countries with different standards of living, we believe that our findings could indicate a role for the intestinal microflora in the development of and protection from allergy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11590374&dopt=Abstract allergy medicine



allergy
Food Allergy Herbal Formula-1 (FAHF-1) blocks peanut-induced anaphylaxis in a murine model.

Li XM, Zhang TF, Huang CK, Srivastava K, Teper AA, Zhang L, Schofield BH, Sampson HA.

Department of Pediatrics, Mount Sinai School of Medicine, New York, NY 10029-6574, USA.

BACKGROUND: Peanut allergy is a major cause of fatal and near-fatal anaphylactic reactions to foods. There is no curative therapy for this condition. Traditional Chinese medicines have been reported to have antiallergic properties, which might be useful for treating peanut allergy. OBJECTIVE: The purpose of this study was to investigate the effects of a Chinese herbal formula, FAHF-1, on peanut anaphylactic reactions in a mouse model of peanut allergy. METHODS: Mice were sensitized with freshly ground whole peanut in the presence of cholera toxin and boosted 1 and 3 weeks later. FAHF-1 treatment was initiated 1 week later and continued for 7 weeks. After treatment, mice were challenged with peanut, and anaphylactic symptoms, body temperatures, and plasma histamine and IgE levels were measured. T-cell proliferative responses and cytokine production were also determined. RESULTS: FAHF-1 completely blocked peanut-induced anaphylactic symptoms and markedly reduced mast cell degranulation and histamine release. Peanut-specific serum IgE levels were significantly reduced by 2 weeks of treatment at the time of challenge, and they remained lower 4 weeks after discontinuation of treatment. FAHF-1 significantly reduced peanut-induced lymphocyte proliferation as well as IL-4, IL-5, and IL-13 synthesis but not IFN-gamma synthesis. No toxic effects on liver or kidney functions were observed, nor was there any overall immune suppression. CONCLUSION: FAHF-1 protected peanut-sensitized mice from anaphylactic reactions and significantly reversed established IgE-mediated peanut allergy. This suggests that FAHF-1 might prove valuable for the treatment of peanut allergy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11590394&dopt=Abstract allergy medicine



allergy
Prevalence of evaluation for latex allergy and association with practice characteristics in United States dermatologists: results of a cross-sectional survey.

Warshaw EM, Nelson D.

Department of Dermatology and the Center for Chronic Disease Outcomes Research, Minneapolis, MN, USA.

BACKGROUND: Natural rubber latex allergy is a potentially life-threatening, immunoglobin E (IgE) mediated reaction. Despite great strides in identification of high-risk groups, methods for diagnosis remain limited in the United States and most evaluations are performed by allergists. OBJECTIVE: The objective of this study was to estimate the prevalence of evaluation for latex allergy and association with practice characteristics in United States dermatologists. METHODS: A cross-sectional survey of one third of United States Fellows of the American Academy of Dermatology. RESULTS: The survey response rate was 43%. Of responding dermatologists, 17% stated that they evaluate patients for latex allergy, most commonly with a radioallergosorbent (RAST) or use test. Only 3.6% stated that they perform prick or scratch tests for latex allergy in their office, and most of these dermatologists (86%) prepare their own latex prick test solutions. Evaluation for latex allergy was significantly associated with patch testing, photopatch testing, an interest in contact dermatitis, and number of contact dermatitis books owned, but not with number of years in practice. CONCLUSIONS: Most United States dermatologists do not evaluate patients for latex allergy, most likely because of lack of available antigens and because methods for diagnosing latex allergy are not familiar to most dermatologists. Copyright 2001 by W.B. Saunders Company

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11526518&dopt=Abstract allergy medicine