allergy
Food allergy and atopic dermatitis in low birthweight infants during early childhood.

Hikino S, Nakayama H, Yamamoto J, Kinukawa N, Sakamoto M, Hara T.

Departments of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. hikino dr.hosp.kyushu-u.ac.jp

The prevalence rates of food allergy and atopic dermatitis in low birthweight infants were evaluated. In Fukuoka City, Japan, between July 1994 and September 1997, sufficient information including birthweight, gestational age, sex, feeding method and a history of food allergy was obtained from questionnaires at the well-baby check-ups of 21766 infants (18 mo of age) and 4378 children (3 y of age). All the children were examined by pediatricians with regard to the existence of atopic dermatitis. The prevalence rate (8.1%) of food allergy in infants with low birthweight (<2,500 g) was significantly lower than that (11.2%) in infants with normal birthweight (> or = 2,500 g) at 18 mo of age (p = 0.0002). Atopic dermatitis was also observed at a lower prevalence rate (1.2%) in infants with low birthweight than in those with normal birthweight (2.3%) at the same age (p = 0.0041). However, this significance was lost at 3 y of age. Other characteristics including male sex and breast-feeding showed independent risks for the development of food allergy and atopic dermatitis at both ages. CONCLUSION: This study found that low birthweight was significantly associated with a lower risk of both food allergy and atopic dermatitis at 18 mo of age.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11529529&dopt=Abstract allergy medicine



allergy
The significance of fragrance mix, balsam of Peru, colophony and propolis as screening tools in the detection of fragrance allergy.

Wohrl S, Hemmer W, Focke M, Gotz M, Jarisch R.

FAZ-Floridsdorf Allergy Centre, Franz-Jonas-Platz 8/6, A-1210 Vienna, Austria. science faz.at

BACKGROUND: Patch testing to fragrances is an important step in the diagnosis of fragrance allergy. OBJECTIVES: To determine the usefulness of adding propolis to the European standard series to test for fragrance allergy. PATIENTS AND METHODS: A total of 2660 consecutive patients were patch tested with a standard patch test series; 747 suspected of fragrance allergy were tested further with a special fragrance series. RESULTS: The positive results to the standard series in 2660 patients were: fragrance mix 243 (9.1%), Myroxylon Pereirae [balsam of Peru] 144 (5.4%), colophony 32 (1.2%); these fragrance mixtures are used as screening substances for fragrance allergy in the European standard series. Propolis, also known as bee's glue, was also an important allergen in this locally revised standard series (n = 35, 1.3%). Positive reactions to the aforementioned allergens were associated significantly among each other (P < 0.01, chi2-test) and did not differ between the sexes. The primary locations of dermatitis in patients with a positive test to one or more fragrance allergens (n = 162) among those suspected of fragrance allergy (n = 747) were: face 46.9%, hands 23.5%, neck 17.9%, axillae 12.3%; 92 of the 747 patients suspected of fragrance allergy had positive skin tests to the special fragrance series comprising the eight constituents of the fragrance mix (most frequent: isoeugenol 5.4%, oakmoss absolute 5.0%, eugenol 2.5%) and 14 other fragrance allergens (most frequent: clove oil 1.6%, lemon grass oil 0.8%, cedar wood oil 0.7%). The additional value of propolis as another screening substance for fragrance allergy in these patients was low. The likelihood of a reaction to one or more of the extra fragrance allergens increased with the number of reactions to fragrance screening allergens in the standard series. CONCLUSIONS: The number of positive reactions to fragrance screening allergens in a standard patch test series may be used as a rule of thumb for predicting a positive outcome of a more detailed testing to fragrances. Propolis is an important allergen in its own right but its value as a screening substance for fragrance allergy is limited.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11531790&dopt=Abstract allergy medicine



allergy
Frequency of natural rubber latex allergy in adults is increased after multiple operative procedures.

Rueff F, Kienitz A, Schopf P, Hartl WH, Andress HJ, Zaak D, Menninger M, Przybilla B.

Department of Dermatology and Allergology, Ludwig-Maximilians-University, Munich, Germany.

BACKGROUND: It has been shown that immediate-type allergy to natural rubber latex (NRL) affects predominantly health-care workers and infants with malformations requiring repeated medical procedures. Adult patients with multiple invasive procedures are not thought to be at an increased risk of NRL allergy. METHODS: A total of 325 consecutive adult inpatients (54.4+/-15.6 years; 219 men, 106 women) awaiting surgical or urologic procedures were assessed by questionnaire-based history (atopic diseases, number of previous standard operative or endoscopic procedures, intolerance to rubber products, and adverse reactions during medical care), by skin prick tests with different NRL test solutions, by measurement of NRL-specific IgE in the serum, and, if sensitization to NRL was found, by cutaneous challenge tests with NRL-containing material. Subjects were classified as sensitized to NRL if skin prick test reactions to NRL were positive or if NRL-specific IgE antibodies were found. NRL allergy was defined as NRL sensitization and immediate-type symptoms to NRL. RESULTS: Thirty-one of 325 (9.5%) subjects were found to be sensitized to NRL, 14/285 (4.9%) by skin prick testing and 23/323 (7.1%) by NRL-specific IgE antibodies in the serum. Four individuals (1.2%) were diagnosed as having clinically manifest NRL allergy, and another 27 (8.3%) were sensitized to NRL without symptoms to date. The frequency of previous invasive procedures was zero in eight patients, up to 10 in 245, 11-20 in 52, 21-30 in seven, and over 30 (up to 83) in 13 patients. No association was found between the number of invasive procedures and NRL sensitization without clinical symptoms. However, 3/4 patients with NRL allergy had undergone more than 30 interventions, and 1/4 had had 11 operations. Frequent invasive procedures (more than 10) were significantly associated with NRL allergy (P<0.001). Allergy or sensitization to NRL was associated with atopy (21/31 vs 87/294) (P<0.001). CONCLUSIONS: A remarkable percentage of unselected adult patients undergoing surgical procedures have allergy or sensitization to NRL. Repeated invasive treatment appears to be a risk factor for NRL allergy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11551255&dopt=Abstract allergy medicine



allergy
No linkage and association of atopy to chromosome 16 including the interleukin-4 receptor gene.

Haagerup A, Bjerke T, Schiotz PO, Dahl R, Binderup HG, Kruse TA.

Institute of Human Genetics, Bartholin Building, Aarhus University, DK-8000 Aarhus C, Denmark.

BACKGROUND: Several susceptibility genes for atopy have been suggested in recent years. Few have been investigated as intensively as the interleukin-4-receptor alpha (IL4Ralpha) gene on chromosome 16. The results remain in dispute. Therefore, in a robust design, we tested for association of type I allergy to the IL4R variations I50V and Q576R, and investigated chromosome 16 for atopy candidate regions in general. METHODS: We identified 100 Danish allergy sib-pair families. Five conservative phenotypes for type I allergy were defined and evaluated. The IL4R variations were genotyped in trios and evaluated by the transmission disequilibrium test (TDT). Multipoint linkage analysis and exclusion mapping were conducted with sib-pairs analyzed for 17 microsatellite markers. RESULTS: No evidence for association or linkage to the IL4R polymorphisms was found (P values: 0.12-0.90). Linkage analysis did not support linkage of any of the phenotypes to chromosome 16. Major parts of chromosome 16 were excluded as candidate regions harboring oligogenes for type I allergy. CONCLUSION: We found chromosome 16 unlikely to harbor strong candidate genes for type I allergy. The role of the IL4Ralpha gene in the inheritance of atopy was insignificant in the Danish population. The use of conservative allergy phenotypes in the search for genes predisposing to atopic disease was discussed.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11488673&dopt=Abstract allergy medicine



allergy
The relevance of specific serum IgG, IgG4 and IgE in the determination of shrimp and crab allergies in Malaysian allergic rhinitis patients.

Sheah-Min Y, Choon-Kook S.

Institute of Biological Sciences, University of Malaya, Kuala Lumpur, Malaysia.

The significance of food specific serum IgG4 antibody in food allergy is unclear and this led us to investigate the relevance of specific IgG4, along with IgG and IgE antibodies to two common food allergens in Malaysia. Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum antibodies in 143 allergic rhinitis patients' sera, of which 47 were from patients with clinical indication of shrimp allergy, 46 with clinical indication of crab allergy and 50 without indication to either allergy. Clinical indication of allergy was based on answers to a questionnaire or results of the skin prick test. We found that the elevation of specific IgE or IgG4 is associated with shrimp and crab allergies but elevation of specific IgG is not associated with either allergy. However, the clinical utility of elevated specific IgG and IgG4 levels is pending further investigation.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11495303&dopt=Abstract allergy medicine



allergy
Chromium allergy: significance of both Cr(III) and Cr(VI).

Hansen MB, Johansen JD, Menne T.

The National Allergy Research Centre for Consumer Products, University of Copenhagen, Gentofte Hospital, Ledreborg Alle 40, 2820 Gentofte, Denmark.

Most studies investigating chromium allergy have been performed with Cr(VI). However, real exposure to chromium from leather products includes both Cr(III) and Cr(VI). We have determined and compared the minimum elicitation threshold (MET) concentration for Cr(III) and Cr(VI) in Cr(VI)-sensitive patients. In addition, reactions to combinations of Cr(III) and Cr(VI) were compared to reactions elicited by Cr(III) and Cr(VI) alone. Dilution series of Cr(III) and Cr(VI) were applied in Finn Chambers on the back of 18 patients. The patches were left for 2 days and readings were done on days 2, 3 and 7. The MET10% for Cr(III) and Cr(VI) was calculated from the dose-response curves to be 0.18 microg/cm2/48 h (6 p.p.m.) and 0.03 microg/cm2/48 h (1 p.p.m.), respectively. No significant differences in the response to combined Cr(III) and Cr(VI) solutions versus single solutions were found. Cr(III) was concluded to play an important role in chromium allergy, because Cr(III) and Cr(VI) were both capable of eliciting eczema at low concentrations. Rather than regarding chromium dermatitis as a result of Cr(VI) allergy alone, it may be more correct to consider it as a result of a combined Cr(III) and Cr(VI) allergy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14996070&dopt=Abstract allergy medicine



allergy
[Is allergy a contraindication for tonsillectomy?]

[Article in Slovak]

Jakubikova J, Nevicka E, Stanikova A, Buchelova L, Cingelova D, Danilla T, Semberova J.

Department of Pediatric Otorhinolaryngology, Faculty of Medicine, Comenius University and University Hospital for Children, Bratislava, Slovakia. jakubi nextra.sk

Many immunologists indicate that tonsillectomy (TE) performed in patients with allergy has an unfavourable impact on the development of allergy and asthma. This warning has significantly decreased the number of TE in children, and resulted in an increase in the occurrence of peritonsillar abscesses, and high incidence of obstructive breathing disturbances during sleep associated with developmental physical and mental consequences in children. The subjective of this study was to find out the influence of TE on the development of allergy in 29 children, in whom their allergy was confirmed 1-5 years after TE. The allergic disease has improved or disappeared in 24 children (82.8%), no changes were recorded in 4 children (13.8%), deterioration has occurred only in 1 child (3.4%) who developed asthma, while in common population, asthma occurs in 10% of children. The results of this study confirm that TE does not have an unfavourable impact on the development of allergy, and therefore allergy does not represent a contraindication for tonsillectomy. (Fig. 1, Ref. 22.)

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11433603&dopt=Abstract allergy medicine