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PubMedDate not supplied

The allergen spectrum in Turkey and the relationships between allergens and age, sex, birth month, birthplace, blood groups and family history of atopy.

This study was performed retrospectively on 2,342 patients who were treated in the allergy department from 1985 to 1996. All patients had been skin prick tested with 40 common aeroallergens in Turkey. Allergen immunotherapy was given to 1,455 of them. Mean age of the patients was 25.9 (range 5 to 69). Fifty-five percent were males and 45.1% females. Forty percent had bronchial asthma and 60.2% had allergic rhinitis. Fifty-five percent of them had a family history of atopy. Sensitization to pollens was 59.7%, to house dust 20.5%, to molds 2%, to pollens and molds 2.9%, to pollens and house dust 11.5%, to molds and house dust 1.4%, and to pollens, molds and house dust 2%. The grass pollen sensitivity was threefold more common than that for trees, and fourfold more common than that for weed pollens. The diagnosis of bronchial asthma in the 5 to 9 age group was higher than in the other age groups (p < 0.005). The mold sensitization increased in parallel with age and it was the highest in 60 to 69 age group (p < 0.0001). There was no relationship between the allergens and sex, history of family atopy or blood group (p > 0.05) (except for house dust allergen). However, there was a relationship between month of birth (p < 0.005, p < 0.05, respectively) and birthplace (p < 0.001) with pollen and house dust allergen. House dust and molds were more common causes of bronchial asthma than pollens (p < 0.001, p < 0.01, respectively). In conclusion, the most common allergen was pollen in Turkey. In addition, atopic diseases are multifactorial, including such factors as genes and environment. Month and place of birth may influence early exposure and subsequent risk for allergy.

Adolescent↗
PubMed1998

Symptoms related to the sick building syndrome in a general population sample: associations with atopy, bronchial hyper-responsiveness and anxiety.

OBJECTIVE: The sick building syndrome (SBS) is a term mainly applied to irritative symptoms in the eyes, skin and upper airways that are experienced in certain environments. The aim of this study was to investigate the characteristics of subjects from the general population that report SBS-related symptoms. METHODS: The study comprised a randomly selected population of 418 individuals aged 20-45 years. The subjects underwent a structured interview, skin prick tests, a methacholine provocation test and answered two questionnaires respectively assessing psychiatric status and the presence of SBS symptoms. RESULTS: Eighty-seven subjects (21%) reported one or more SBS symptom weekly. Most common were general symptoms reported by 10% of the population. Female sex (odds ratio [OR] = 2.1), atopy (OR = 2.2) and anxiety (OR = 2.6) were significant independent risk factors for reporting at least one SBS-related symptom. Anxiety (OR = 3.2) and depression (OR = 4.4) were significant predictors for general symptoms, while bronchial hyper-responsiveness was a significant predictor for pharyngeal symptoms (dryness in the throat, sore throat and irritating cough) (OR = 5.4). CONCLUSIONS: Sick building symptoms are common in the general population and among women, while atopy and anxiety increase the risk of reporting such symptoms. Psychological factors are mainly related to general symptoms, while bronchial hyperresponsiveness is connected with pharyngeal symptoms.

Adult↗
PubMed1993

A follow-up study of laboratory animal exposed workers: the influence of atopy for the development of occupational asthma.

In a 5-year follow-up study of 88 animal exposed laboratory technicians, the incidence of laboratory animal allergy (LAA), lung function, and the development of allergy test reactivity were investigated. Only two individuals developed test positive LAA rhinitis during the follow-up period. Furthermore, one subject who had previously had LAA rhinitis developed LAA asthma. In the remaining subjects the results of skin prick tests against laboratory animals and environmental allergens, total serum IgE levels, and lung function were unchanged. Atopy defined as parental and childhood allergy, raised total serum IgE levels, and positive skin prick tests against nonanimal environmental allergens and nonlaboratory animals (dog and horse) were risk indicators for development of test positive LAA asthma. The low incidence of LAA during the 5-year follow-up is interpreted as a result of an early LAA development in atopic subjects.

Adult↗
PubMed1992

The effects of airway hyperresponsiveness, wheezing, and atopy on longitudinal pulmonary function in children: a 6-year follow-up study.

We examined growth of spirometric lung function in 696 children of European ancestry who were followed from ages 9 to 15 years and stratified according to their degree of responsiveness to methacholine inhalation challenge, atopic status, and respiratory symptoms. Subjects were participants in the longitudinal Multidisciplinary Health and Development Study in Dunedin, New Zealand. Forced expired volume in 1 second (FEV1), and vital capacity (VC) were measured at 9, 11, 13, and 15 years of age, concurrently with assessment of airway responsiveness determined by the concentration of methacholine causing a 20% fall in FEV1 (PC20 FEV1). Atopic status was assessed at age 13 by skin-prick testing to 11 allergens. In children demonstrating airway hyperresponsiveness, FEV1 increased with age at a slower rate, and the FEV1/VC ratio had a faster rate of decline through childhood, compared to non-responsive children. Subjects with positive skin tests to house dust mite and cat dander also had lower mean FEV1/VC ratios than the control group. Any reported wheezing was associated with slower growth of FEV1 and VC in males. We conclude that in New Zealand children with airway responsiveness and/or atopy to house dust mite or cat growth of spirometric lung function is impaired.

Adolescent↗
PubMed1994

Relationship between atopy and frequent bronchial response to exercise in school children.

The natural history of a bronchial response to exercise (BRE) was studied in a cohort of primary-school children, who were followed over a 2-year period. In 1,094 children, three free-running tests were performed in 1-year intervals. Children who responded in one of the tests were designated as "infrequent" responders (20.5%), whereas those responding at two or all three occasions were designated as "frequent" responders (7.4%). A frequent positive BRE was closely associated with atopy (defined as skin test positivity to 1 of 7 common aeroallergens) and respiratory symptom status. Compared to atopics without respiratory symptoms, an increased risk for a frequent positive BRE was seen for atopic children who were symptomatic during the whole study period [odds ratio (OR) 25.4; confidence interval (CI) 6.9-94.0], who had gained symptoms (OR, 11.0; CI, 2.8-43.2) or who had symptoms at the beginning of the study but had lost them during follow-up (OR, 4.6; CI, 1.0-20.6). A sensitization to dust mites (OR, 8.0; CI, 4.3-15.0) but not to animal dander (OR, 2.3; CI, 1.0-5.2) or pollen (OR, 0.7; CI, 0.3-1.6) was significantly related to a frequent positive BRE. Our findings support the notion that while "children grow out of asthma," they might maintain their bronchial hyperresponsiveness. Regarding specific sensitization, mite allergy seems to play the predominant role.

Allergens↗
PubMed2006

Bronchial hyperresponsiveness, atopy, and bronchoalveolar lavage eosinophils in persistent middle lobe syndrome.

Most cases of middle lobe syndrome (MLS) in children are considered to be due to asthma and may recover spontaneously; however, in persistent MLS, repeated episodes of infection often institute a vicious cycle that may lead to persistent symptoms and bronchial hyperresponsiveness (BHR). The present study was undertaken to investigate whether asthma, as an underlying diagnosis, is predictive of a favorable outcome of children with persistent MLS. We evaluated 53 children with MLS who underwent an aggressive management protocol that included fiberoptic bronchoscopy (FOB) and bronchoalveolar lavage (BAL). These patients were compared to two other groups: one consisting of children with current asthma but no evidence of MLS (N = 40) and another of non-asthmatic controls (N = 42), matched for age and sex. Prevalence of sensitization (>or=1 aeroallergen) did not differ between patients with MLS and "non-asthmatics" but was significantly lower than that of "current asthmatics." A positive response to methacholine bronchial challenge was observed with increased frequency among children with MLS when compared to "current asthmatic" and non-asthmatic children. Multivariate logistic regression analysis revealed a positive correlation between an increased number of eosinophils in the BAL fluid (BALF) and a favorable outcome, whereas no correlation was detected between sensitization or BHR and BAL cellular components. In conclusion, children with MLS have an increased prevalence of BHR, even when compared to asthmatics, but exhibit prevalence of atopy similar to that of non-asthmatics. An increased eosinophilic BALF count is predictive of symptomatic but not radiographic improvement of MLS patients after aggressive anti-asthma management.

Asthma↗
PubMed1996

Measuring atopy in a multi-centre epidemiological study.

Skin prick tests are used as a measure of atopy in epidemiological studies, but results may be influenced by the fieldworker performing the test. In a multi-centre epidemiological study the method of reporting the results should consider the need for comparability of findings from different centres. Data on over 1000 subjects from three English centres of the European Community Respiratory Health Survey were analysed to determine whether allergen wheal should be adjusted for histamine wheal, and what cutoff diameter gave the most comparable results. No consistent relation between allergen wheal diameter and histamine wheal diameter was found for any fieldworker or allergen. A cutoff of > 0 mm for a positive result gave a more consistent relation with the corresponding specific IgE value between fieldworkers than either a cutoff of > or = 3 mm or the use of the mean wheal diameter. While this result is not immediately generalisable to studies using different skin prick test reagents, the method of analysis to determine the appropriate criterion of reporting can be used in other epidemiological studies.

Adult↗
PubMed1999

Bronchial hyperresponsiveness in farmers: relation to respiratory symptoms, lung function, and atopy.

There is only limited information on the factors associated with nonspecific bronchial hyperresponsiveness (BHR) in farmers. Our purpose was to examine the relationship between BHR and respiratory symptoms, atopy, and abnormalities of lung function in a sample of French farmers. Farmers scheduled for a preventive medicine check-up in northeastern France were examined. Occupational exposure, respiratory symptoms, and work-related symptoms were assessed by questionnaire, sensitization to 34 common and agricultural allergens by skin prick tests, and BHR by the single-dose (1,200 microg) acetylcholine (ACh) challenge test. Data were obtained from 741 farmers (95% of those invited). Seventy-seven subjects (10.3%) had BHR defined as a fall in forced expiratory volume in 1 s (FEV1) >/= 10% after the inhalation of ACh or, for those with a poor lung function, an increase in FEV1 > 10% and > 200 ml after the inhalation of 200 microg of salbutamol. The proportion of asthmalike symptoms, especially wheeze during work, positive skin tests to acarian (storage mites) and cereal dust allergens, and low levels of lung function was significantly greater among reactors than among nonreactors. Stepwise logistic regression analysis showed a significant and independent association between BHR and wheezing during work (OR = 4.99; 95% CI = 2.29-10.89; p = 0.0001) and baseline FEV1 (OR = 1.49; 95% CI = 1.05-2.20; p = 0.026). In conclusion, hyperreactive farmers had significantly more asthmalike symptoms, positive skin tests, and abnormal lung function than normoreactive farmers. Work-related wheeze and low baseline FEV1 were significantly and independently associated with BHR.

Agriculture↗
PubMed2001

Prospective cohort studies using hydrolysed formulas for allergy prevention in atopy-prone newborns: a systematic review.

UNLABELLED: The aim of this study is to give a systematic overview on publications having investigated the allergy preventive effect of extensively and/or partially hydrolysed infant formulas. Publications were searched by several strategies. Inclusion criteria were: prospective cohort study, randomisation, family history of atopy of the subjects, follow-up for at least the 1st year of life. Studies were described systematically as to methods, study participants, interventions and co-interventions, and study outcomes. The methodological quality was judged according to an instrument assessing the reduction of bias (score between 0 and 7 points). Data of studies having examined partial hydrolysates are presented as odds ratios. Of 16 studies found, 10 fulfilled the inclusion criteria. Study designs showed considerable differences as to methods, intervention and co-intervention procedures and definition of outcomes. Methodological quality varied between 0 and 6 points. The comparison of exclusively test- and control formula-fed groups showed a uniform tendency towards allergy protection in studies with partial hydrolysates. Study results on the effect of extensive hydrolysates were not comparable because of major differences in study designs. CONCLUSION: More well-designed studies with an adequate statistical power are needed to compare the allergy preventive effect of partially and extensively hydrolysed formulas with a standard infant formula.

Cohort Studies↗
PubMed2005

[Atopy patch testing with aeroallergens and food].

The atopy patch test (APT), a patch test employing allergens known to elicit IgE-mediated reactions which is assessed by evaluating eczematous skin lesions after 24 h to 72 h, was developed as a diagnostic tool for characterizing patients with aeroallergen-triggered atopic eczema (AE, atopic dermatitis). Positive APT reactions are associated with allergen-specific T-cell responses. The specificity of APT is higher than the specificity of skin prick tests or RAST. More studies for the standardization of APT methods are necessary, especially with regard to food APT.

Adult↗
PubMed1997

[Allergy and atopic eczema: on the value of the "atopy patch test"].

The role of allergic reactions in eliciting and maintaining atopic eczema (AE) is still controversial. In a subgroup of patients with atopic eczema, exacerbations of itching and eczematous skin lesions have been described after contract with aeroallergens. To investigate this observation, an epicutaneous patch test with IgE-inducing allergens (atopy patch test, APT) has been proposed, which results in eczematous skin reactions in 30-70% of AE patients. Usage of allergen concentrations exceeding 5000 PNU/g in petrolatum allows testing on clinically uninvolved skin without potentially irritating epidermal tape stripping. The clinical relevance of positive APT reactions is suggested by comparison of APT with skin prick test, specific IgE, patient's history and eczema pattern. Patients with an eczema pattern with preferred localization of skin lesions in air-exposed areas, a predictive history and raised specific IgE (depending on allergen) were shown to have the highest rate of positive APT. Future controlled studies with allergen avoidance and reexposition may focus on this patient group.

Allergens↗
PubMedDate not supplied

Relationship among pulmonary function, bronchial hyperresponsiveness, and atopy in children with clinically stable asthma.

Pulmonary function testing plays a key role in the diagnosis and management of asthma in children. However, the literature does not clearly show whether children with clinically stable asthma have significantly reduced lung function when compared with normal children. We compared the lung function of 242 clinically stable asthmatic children who were initially diagnosed with mild intermittent or mild persistent asthma with the lung function of 100 nonasthmatic controls. The lung function was assessed using FEV1, FEV1/FVC, FEF25-75 and PEF. In addition, we measured bronchial hyperresponsiveness (BHR) using the provocation concentration of methacholine needed to produce a 20% fall in FEV1. All measures of pulmonary function were significantly decreased in the children with asthma. Pulmonary function was not influenced by atopy, serum IgE, or total eosinophil count (TEC). However, the likelihood ratio for trends revealed a significant association between our pulmonary parameters and the degree of BHR. Children with mild-to-severe BHR had greatly decreased lung function compared with those with normal BHR, the control group. In addition, a direct correlation was found between PC20 and our pulmonary parameters in asthmatic children. However, only atopic children with asthma had a significant correlation between PC20 and TEC. We found children with clinically stable asthma to have pulmonary obstruction, which associated strongly with their degree of BHR.

Adolescent↗
PubMed2002

The risk factors of occupational hypersensitivity in apprentice bakers -- the predictive value of atopy markers.

OBJECTIVES: The aim of the study was to assess the predictive value of known risk factors of asthma, such as atopy, exposure to pet allergens at home, and tobacco smoking, in predicting the occurrence of occupational respiratory allergy due to high-molecular-weight allergens. METHODS: A questionnaire study, skin-prick tests (SPTs) for common and occupational allergens, and evaluation of total and - in selected cases - specific IgE, were performed in 357 apprentice bakers before and after a year of vocational training. RESULTS: Mean age of examined subjects was 17.2+/-0.5 years. The prevalence of newly developed symptoms was 7% for rhinitis, 3.1% for chest symptoms, and 3.6% for skin symptoms. The frequency of at least one positive SPT result changed from 17.9% to 24.4% after the 1st year of vocational training, including SPTs for common allergens - from 16.8% to 22.7%, and for occupational allergens - from 2% to 8%. The proportion of subjects with elevated total IgE level increased from 38.7% to 44.3%. Generally, after a year of vocational training 9.2% of examined subjects presented hypersensitivity to occupational allergens. Logistic regression analysis revealed that positive results of SPTs for common allergens (odds ratio (OR) =4.4; 95% confidence intervals (CI) 1.9, 10.27) and elevated IgE level (OR=3.6; 95%CI 1.55, 8.57) were significant risk factors of hypersensitivity to occupational allergens. CONCLUSIONS: In apprentice bakers hypersensitivity to occupational allergens develops even during vocational training. SPTs for common allergens, performed before apprentices started their vocational training, would enable the identification of subjects at the highest risk of sensitisation to occupational allergens.

Adolescent↗
PubMed1997

Tendency toward atopy in Kawasaki disease.

UNLABELLED: To evaluate the possible trend towards developing allergic disease in children who had suffered from Kawasaki disease (KD), we evaluated data related to allergy that were collected by parental questionnaire on 1,165 children who had suffered from KD. Comparisons were made with 5,825 sex- and age-matched control children. The incidence of household pets and of cigarette smoking in the family were significantly lower in the children with a history of KD than in those of control children. A family history of allergy was significantly more common in the children with a history of KD (71%) versus the controls (56%) (P < 0.001). The incidence of atopic dermatitis and of allergic rhinitis was significantly higher (by approximately 1.7 times) in the KD children versus the control group (P < 0.01), even in subgroups with no family history of allergy. CONCLUSION: We suggest that a genetic predisposition to atopy may be associated with a susceptibility to KD. Patients with KD tended to develop atopic dermatitis and allergic rhinitis.

Case-Control Studies↗
PubMed2006

Quantitative linkage genome scan for atopy in a large collection of Caucasian families.

Quantitative phenotypes correlated with a complex disorder offer increased power to detect linkage in comparison to affected-unaffected classifications. Asthma is a complex disorder characterized by periods of bronchial obstruction and increased bronchial hyper reactivity. In childhood and early adulthood, asthma is frequently associated also with quantitative measures of atopy. Genome wide quantitative multipoint linkage analysis was conducted for serum IgE levels and percentage of positive skin prick test (SPT(per)) using three large groups of families originally ascertained for asthma. In this report, 438 and 429 asthma families were informative for linkage using IgE and SPT(per) which represents 690 independent families. Suggestive linkage (LOD > or = 2) was found on chromosomes 1, 3, and 8q with maximum LODs of 2.34 (IgE), 2.03 (SPT(per)), and 2.25 (IgE) near markers D1S1653, D3S2322-D3S1764, and D8S2324, respectively. The results from chromosomes 1 and 3 replicate previous reports of linkage. We also replicate linkage to 5q with peak LODs of 1.96 (SPT(per)) and 1.77 (IgE) at or near marker D5S1480. Our results provide further evidence implicating chromosomes 1, 3, and 5q. The current report represents one of the biggest genome scans so far reported for asthma related phenotypes. This study also demonstrates the utility of increased sample sizes and quantitative phenotypes in linkage analysis of complex disorders.

Adolescent↗
PubMed2005

Skin localization of cow's milk proteins delivered by a new ready-to-use atopy patch test.

PURPOSE: Atopy patch tests (APTs) allow the detection of delayed allergies at the skin level. The localization of beta-lactoglobulin delivered into the skin by an innovative ready-to-use APT (E-patch was investigated and the efficacy and safety of this device were assessed. METHODS: The E-patch containing beta-lactoglobulin was placed for 24 h in contact with hairless rat skin mounted in a Franz diffusion cell. Transdermal passage was monitored by measurement of beta-lactoglobulin A-[methyl-(14)C] or by two-site enzyme immunoassay. An iterative skin stripping allowed measurement of the beta-lactoglobulin penetrating the first external skin layers. RESULTS: After 24 h, 92% of beta-lactoglobulin remained on the skin. The iterative skin strippings showed a 135-fold higher concentration of beta-lactoglobulin in the stratum corneum than that found in the epidermis-dermis. Analysis of the solution in the receiver compartment by radioactivity assays or immunoassays indicates that intact protein did not cross the skin. CONCLUSIONS: The E-patch system allows native beta-lactoglobulin to concentrate in the stratum corneum, in the vicinity of immunological cells, but does not lead to its systemic delivery. Therefore, it is suggested that this delivery system creates ideal conditions for promoting a positive topical response with reduced risk of systemic anaphylactic reactions caused by the native form of the beta-lactoglobulin A.

Animals↗
PubMed2003

Diesel fumes and the rising prevalence of atopy: an urban legend?

Recently, the incidence of allergic diseases has increased in most industrialized countries of the world. Persistent exposure to particulate air pollution from motor vehicles has been implicated as one of the factors that is responsible for the observed increased prevalence of atopy. Epidemiologic studies conducted in different parts of the world have demonstrated an important association between ambient levels of motor vehicle traffic emissions and increased symptoms of asthma and rhinitis. Additionally, recent human and animal laboratory-based studies have shown that particulate toxic pollutants, and in particular diesel exhaust particles (DEP), can enhance allergic inflammation and induce the development of allergic immune responses. In this article, our current understanding of the mechanisms by which pollutants such as DEPs enhance the underlying allergic inflammatory response is reviewed, and the evidence that supports the causative link between particulate air pollution from motor vehicles and increasing allergic diseases is discussed.

Allergens↗