Spectrum of susceptibility to air quality and weather in individual children with atopic dermatitis.

BACKGROUND: Exposure to air pollution aggravates symptoms of atopic dermatitis (AD) in children in the population studies. Variability in individual patient's response from individual susceptibility is needed to be explored. OBJECTIVE: This study aimed to investigate spectrum of individual variability in the associations between AD symptoms and air quality. METHODS: We enrolled 89 children aged 0-6 years with AD (22 890 person-days). Daily manifestation of symptoms was recorded for an average of 257 days (range 100-499). Both an individual analysis using logistic regression models and an overall analysis using a generalized estimating equation were performed. RESULTS: The odds ratios of an individual ranged 0.24-8.11 for particulate matter <10 µm in diameter (PM10 ), 0.09-101.92 for nitrogen oxide (NO2 ), 0.03-44.00 for ozone (O3 ), 0.11-58.30 for sulfur dioxide (SO2 ), 0.00-15.83 for carbon monoxide (CO), 0.00-39 446.94 for temperature, and 0.03-5.18 for relative humidity, demonstrating a wide individual variability. In the overall analysis, PM10 , NO2 , SO2 , and CO had a significantly positive association, whereas temperature and relative humidity were negatively associated with AD symptoms. Air pollution was responsible for aggravation of symptoms from 24.7% (O3 ) to 39.3% (SO2 ) of AD children. Overall, 71.9% of the AD children responded to at least one or more air pollution and weather variable. CONCLUSION: Responses of AD children to air pollution and weather variable were considerably variable among individuals. An individualized model would be useful to forecast and manage AD symptoms in patients.

Prevalence of Immediate-Type Food Allergy in Korean Schoolchildren in 2015: A Nationwide, Population-based Study.

PURPOSE: This study aimed to determine the prevalence of immediate-type food allergy (FA) among schoolchildren in Korea. METHODS: A nationwide, cross-sectional study was performed in September 2015. A stratified random sample of 50,000 participants was selected from children and adolescents aged 6-7 years (n=17,500), 9-10 years (n=17,500), 12-13 years (n=7,500), and 15-16 years (n=7,500). Parents were asked to complete a questionnaire on the detailed history of immediate-type FA. RESULTS: A total of 32,001 (64.0%) responded to the questionnaire survey, and 29,842 children (59.7%) were analyzed after adjusting for missing data. The number of the cases in each age group was 9,671 (6-7 years), 9,756 (9-10 years), 5,169 (12-13 years), and 5,246 (15-16 years). The prevalence of lifetime perceived FA was 15.82%. The prevalence of current immediate-type FA was 4.06% in total, with 3.15% in 6- to 7-year-olds, 4.51% in 9- to 10-year-olds, 4.01% in 12- to 13-year-olds, and 4.49% in 15- to 16-year-olds. Among individual food items, peanut (0.22%) was the most frequent causative food, followed by hen's egg (0.21%), cow's milk (0.18%), and buckwheat (0.13%). Among the food groups, fruits (1.41%), crustaceans (0.84%), tree nuts (0.32%), and fish (0.32%) were the most common offending foods. The prevalence of food-induced anaphylaxis was 0.97%. The most frequent causative food of anaphylaxis was peanut (0.08%), followed by cow's milk (0.07%), buckwheat (0.06%), and hen's egg (0.06%), while fruits (0.28%), crustaceans (0.18%), tree nuts (0.12%), and fish (0.09%) were the most commonly responsible food groups. CONCLUSIONS: The prevalence of current immediate-type FA and food-induced anaphylaxis in Korean schoolchildren in 2015 was 4.06% and 0.97%, respectively. Peanuts, cow's milk, hen's egg, fruits, crustaceans, and tree nuts are common allergens.

Short-term effects of weather and air pollution on atopic dermatitis symptoms in children: A panel study in Korea.

INTRODUCTION: The effects of weather and air pollution on the severity and persistence of atopic dermatitis (AD) are important issues that have not been investigated in detail. The objective of our study was to determine the short-term effects of meteorological variables and air pollution on AD symptoms in children. METHODS: We enrolled 177 AD patients with 5 years or younger from the Seoul Metropolitan Area, Korea, and followed for 17 months between August 2013 and December 2014. Symptoms records of 35,158 person-days, including itching, sleep disturbance, erythema, dry skin, oozing, and edema, were obtained. We estimated the effect of meteorological variables including daily mean temperature, relative humidity (RH), diurnal temperature range (DTR), rainfall and air pollutants including particulate matter with an aerodynamic diameter ≤10 µm (PM10), nitrogen dioxide (NO2), and tropospheric ozone (O3) on AD symptoms using a generalized linear mixed model with adjustment for related confounding factors. RESULTS: A 5°C increase in outdoor temperature and a 5% increase in outdoor RH was associated with 12.8% (95% confidence intervals (CI): 10.5, 15.2) and 3.3% (95% CI: 1.7, 4.7) decrease in AD symptoms, respectively, on the same day. An increase of rainfall by 5 mm increased AD symptoms by 7.3% (95% CI: 3.6, 11.1) for the days with <40 mm rainfall. The risk of AD symptoms increased by 284.9% (95% CI: 67.6, 784.2) according to a 5°C increase in DTR when it was >14°C. An increase in PM10, NO2, and O3 by 10 units increased the risk of AD symptoms on the same day by 3.2% (95% CI: 1.5, 4.9), 5.0% (95% CI: 1.4, 8.8), and 6.1% (95% CI: 3.2, 9.0), respectively. CONCLUSION: Exposure to meteorological variables and air pollutants are associated with AD symptoms in young children.

Exposure to phthalates and bisphenol A are associated with atopic dermatitis symptoms in children: a time-series analysis.

BACKGROUND: Despite increasing evidence on the relationship between exposure to phthalates and bisphenol A with allergies and asthma, reports on atopic dermatitis (AD) with these chemicals are few. We assessed the association between AD symptoms and the exposure to phthalates and bisphenol A and in children. METHODS: We surveyed 18 boys with AD (age 3-7 years) in a day care center in Seoul between May 2009 and April 2010. AD symptoms were recorded by using a daily symptom diary. We collected 460 series of pooled urine twice a day, in the morning and afternoon, over 230 working days and measured the concentrations of mono-2-ethyl-5-oxohexyl phthalate (5-oxo-MEHP), mono-2-ethyl-5-hydroxyhexyl phthalate (5-OH-MEHP), mono-isobutyl phthalate (MnBP) and bisphenol A glucuronide (BPAG) in the pooled urine. Logistic regression was used for statistical analysis. RESULTS: Most phthalate metabolite levels were higher in the morning than in the afternoon (p < 0.0001). There was seasonal variation in the levels of phthalates and bisphenol A metabolites. Levels of 5-OH-MEHP, MnBP, and BPAG were highest in summer (p < 0.0001). Manifestation of AD symptoms was associated with an increase in urinary levels of MnBP (adjusted odds ratio, aOR = 2.85, 95% CI: 1.12-7.26 per 1 µg/L of MnBP) and BPAG (aOR = 1.79, 95% CI: 0.91-3.52 per 1 µg/L BPAG) on the same day. The levels of MnBP and BPAG in the previous day increased AD symptoms (aOR = 2.74, 95% CI: 1.21-6.20, for 1 µg/L of MnBP and aOR = 2.01, 95% CI: 1.08-3.74 for 1 µg/L BPAG). CONCLUSION: Our results suggest that exposure to phthalates and bisphenol A is associated with aggravation of AD symptoms in children.

Effect of Proteolysis with Alkaline Protease Following High Hydrostatic Pressure Treatment on IgE Binding of Buckwheat Protein.

Buckwheat is a popular food material in many Asian countries and it contains major allergenic proteins. This study was performed to analyze the effects of hydrolysis with alkaline protease following high hydrostatic pressure (HHP) treatment on the IgE binding of buckwheat protein. Extracted buckwheat protein was treated with HHP at 600 MPa for 30 min and hydrolyzed with alkaline protease for 240 min. IgE binding was examined using an enzyme-linked immunosorbent assay (ELISA) with serum samples from 14 patients who were allergic to buckwheat. Depending on the serum samples, HHP treatment of buckwheat protein without enzymatic hydrolysis decreased the IgE binding by 8.9% to 73.2% or increased by 31% to 78%. The IgE binding of buckwheat protein hydrolyzed with alkaline protease decreased by 73.8% to 100%. The IgE binding of buckwheat protein hydrolyzed with alkaline protease following HHP treatment decreased by 83.8% to 100%. This suggested that hydrolysis with alkaline protease following HHP treatment could be applied to reduce the IgE binding of buckwheat protein.

Effect of the prenatal maternal environments and diets on cord blood interleukin-4 and interferon -gamma: A pilot study.

BACKGROUND AND OBJECTIVE: TThe environment of a pregnant woman can affect not only fetal growth and development, but also diseases in childhood. Neonatal cord blood cytokines are commonly used to evaluate the immune development of neonates. The purpose of this study was to evaluate the effects of the environment and diet during pregnancy on IL-4 and IFN-γ in neonatal cord blood. METHOD: A total of 111 pregnant women participated in this study from April to November 2010. Allergy history, sensitization assessed by the skin prick test, dietary intake and indoor environment were evaluated. IL-4 and IFN-γ levels were measured in the complete cord blood of neonates using real-time PCR. RESULTS: There were 54 pregnant women with allergic disease. Both IL-4 and IFN-γ levels in neonatal cord blood were higher in samples from allergic mothers than in non-allergic mothers (p<0.05). The indoor environment and nutrient intake were not different between allergic and non-allergic mothers, except regarding carpet use. When the cytokine levels were divided into quartiles, lower folate and vitamin B6 intake was associated with the highest levels of IL-4 in neonatal cord blood (p<0.05), and higher folate and vitamin B6 intake was associated with highest levels of IFN-γ in neonatal cord blood. CONCLUSIONS: In this study, a strong association between IL-4 and IFN-γ levels in cord blood and the intake of folate and vitamin B6 was found, which indicates that food intake during pregnancy might have a strong influence on IL-4 and IFN-γ levels in cord blood, to a greater extent than environmental factors.

Comparison of diverse estimation methods for personal exposure to air pollutants and associations with allergic symptoms: The Allergy & Gene-Environment Link (ANGEL) study.

We estimated the exposure to ambient air pollutants and analyzed the associations with allergic diseases. We enrolled 177 children with atopic dermatitis (AD) and 70 asthmatic adults living in Seoul Metropolitan Area, Korea, and followed for 17months between August 2013 and December 2014. Parents or patients recorded symptom scores on a daily basis. Exposure to particulate matter with a diameter <10µm (PM10) and nitrogen dioxide (NO2) was estimated in four different ways in each individual, using the AQ1 (measurements from the nearest air quality monitoring station to residential houses), AQ2 (measurements modified from AQ1 with the indoor level of air pollutants and time activity of each individual), AQ1-DI, and AQ2-DI (measurements modified from AQ1 and AQ2, respectively, with daily inhalation intakes of air pollutants). A generalized linear mixed model (GLMM) was used to analyze the associations between exposure metrics and clinical symptoms after adjusting for ambient temperature and humidity, age, season, gender, and time trend. The exposure metrics for PM10 and NO2 showed different distributions. Symptoms of AD and asthma were positively associated with exposure to PM10, but not NO2, in all exposure metrics. The effect size of PM10 exposure on asthma symptoms was slightly greater in metrics with inhalation capacity (AQ-DIs) than in those without (AQs). This pattern was not observed in AD. Exposure to PM10 is associated with symptom aggravation in childhood AD and adult asthma. Different exposure estimates may be used to evaluate the impact of air pollution on different allergic diseases.

Effect of acid treatment on allergenicity of peanut and egg.

BACKGROUND: Many food experts have studied various treatments or processing techniques in order to develop hypoallergenic foods. In a previous study, acid treatment dramatically mitigated the allergenicity of peanut, especially Ara h 2. RESULTS: Gel electrophoresis showed that most protein bands of acid-treated peanut were not detected, but protein bands of egg white became weaker and broader by acid treatment. In immunoblotting using a rabbit antibody, the antigenicity against ovalbumin or ovomucoid in acid-treated egg white was decreased but the antigenicity against Ara h 1 or Ara h 2 in peanut treated with pH 2 acetic acid was completely undetected. The allergenicity of ovalbumin and peanut fell significantly to 1/1022 and 1/5380, respectively, when measured as IC50 in the sample treated with pH 2.0 acetic acid. CONCLUSION: This study showed that acid treatment was more effective in peanut and barely effective in ovomucoid. This may contribute to the development of hypoallergenic food and clinical management of food allergy. © 2016 Society of Chemical Industry.

What Characteristics Confer Proteins the Ability to Induce Allergic Responses? IgE Epitope Mapping and Comparison of the Structure of Soybean 2S Albumins and Ara h 2.

Ara h 2, a peanut 2S albumin, is associated with severe allergic reactions, but a homologous protein, soybean 2S albumin, is not recognized as an important allergen. Structural difference between these proteins might explain this clinical discrepancy. Therefore, we mapped sequential epitopes and compared the structure of Ara h 2, Soy Al 1, and Soy Al 3 (Gly m 8) to confirm whether structural differences account for the discrepancy in clinical responses to these two proteins. Commercially synthesized peptides covering the full length of Ara h 2 and two soybean 2S albumins were analyzed by peptide microarray. Sera from 10 patients with peanut and soybean allergies and seven non-atopic controls were examined. The majority of epitopes in Ara h 2 identified by microarray are consistent with those identified previously. Several regions in the 2S albumins are weakly recognized by individual sera from different patients. A comparison of allergenic epitopes on peanut and soybean proteins suggests that loop-helix type secondary structures and some amino acids with a large side chain including lone electron pair, such as arginine, glutamine, and tyrosine, makes the peptides highly recognizable by the immune system. By utilizing the peptide microarray assay, we mapped IgE epitopes of Ara h 2 and two soybean 2S albumins. The use of peptide microarray mapping and analysis of the epitope characteristics may provide critical information to access the allergenicity of food proteins.

Association of carbon monoxide levels with allergic diseases in children.

BACKGROUND: Air pollution is regarded as a potential reason for the development or aggravation of allergic diseases. OBJECTIVE: To investigate the relationship between exposure to outdoor air pollution during the first year of life and the development of allergic diseases, and to determine the association between outdoor air pollution near the residence and recent symptoms of allergic diseases in children. METHODS: A nationwide cross-sectional survey was conducted in 6- to 7-year-old children. Among them, subjects who had been born (n = 1828) or lived (n = 1894) within 2 km of the nearest air quality monitoring sites were selected. The prevalence of allergic diseases was assessed by using questionnaires. Each subject was examined by pediatricians to determine the presence of eczema. Publicly available data were used regarding the daily ambient concentrations of sulfur dioxide, nitrogen dioxide, ozone, carbon monoxide (CO), and particulate matter. RESULTS: For a 100 ppb increase in the mean daily CO level during the first year of life, the adjusted odds ratio for lifetime allergic rhinitis was 1.10 (95% confidence interval, 1.03-1.19). For a 1 ppm increase in the annual average CO level during the past 12 months, the adjusted odds ratio for the presence of atopic dermatitis on the day of the survey was 8.11 (95% confidence interval, 1.06-62.12). However, the other air pollutants showed no statistical significance. CONCLUSIONS: Higher exposure to CO during infancy increased the risk of development of allergic rhinitis. The risk of current atopic dermatitis symptoms increased in children who were exposed to higher CO levels during the past 12 months.

Diagnostic Value of Specific IgE to Peanut and Ara h 2 in Korean Children with Peanut Allergy.

PURPOSE: The purpose of this study was to establish the diagnostic decision point (DDP) of peanut specific IgE (sIgE) for predicting the outcome of oral food challenge (OFC). We also evaluated the usefulness of sIgE to peanut components (Ara h 1, 2, 3, 8, and 9) in diagnosing peanut allergy. METHODS: Korean children aged over 12 months with a suspected peanut allergy were enrolled. Diagnosis of peanut allergy was confirmed by an open OFC or through the convincing history of anaphylaxis. Cutoff levels of sIgE to peanut and peanut components were determined by analyzing receiver operating characteristic curves. RESULTS: Forty-eight children (22 boys and 26 girls) with a suspected peanut allergy were enrolled. The previously established DDP for peanut-sIgE antibodies (14 kU/L) showed a sensitivity of 22.7%, specificity of 100%, positive predictive value (PPV) of 100%, and negative predictive value of 60.4% in our study population. The median levels of peanut-sIgE (5.4 kU/L vs 1.1 kU/L, P<0.001) and Ara h 2-sIgE (0.8 kU/L vs 0 kU/L, P<0.001) were significantly higher in the peanut allergy group than in the peanut tolerance group. The peanut-sIgE concentration indicating a PPV of 100% was 10.3 kU/L. The Ara h 2-sIgE level of 4.0 kU/L had a PPV of 100%. CONCLUSIONS: Our results showed that the cutoff levels for peanut (10.3 kU/L) and Ara h 2 (4.0 kU/L) established in this study is useful for the diagnosis of peanut allergy in Korean children.

Reactivity change of IgE to buckwheat protein treated with high-pressure and enzymatic hydrolysis.

BACKGROUND: Buckwheat is a popular food material in eastern Asian countries that can cause allergenic response. This study was conducted to evaluate the effects of hydrolysis with papain and high-pressure (HP) treatment of buckwheat protein (BWP) on reactivity of immunoglobulin E (IgE) and its secondary structure. RESULTS: Reactivity of IgE was examined by enzyme-linked immunosorbent assay (ELISA) with serum samples from 16 patients allergic to buckwheat. Reactivity of IgE to hydrolysate of BWP with papain showed a maximum decrease of 79.8%. After HP treatment at 600 MPa for 1 min, reactivity of IgE to BWP decreased by up to 55.1%. When extracted, BWP was hydrolyzed with papain overnight following HP treatment at 600 MPa which the reactivity of IgE decreased significantly by up to 87.1%. Significant changes in secondary structure of BWP were observed by circular dichroism (CD) analysis after hydrolysis with papain following HP treatment. CONCLUSION: Reduction of reactivity of IgE showed a correlation with changes in secondary structure of BWP, which may cause changes in conformational epitopes. This suggests the possibility of decreasing the reactivity of IgE to BWP using combined physical and enzymatic treatments.

Arthroscopic Resection of a Tenosynovial Giant Cell Tumor in the Wrist: A Case Report.

The treatment for giant cell tumors of the tendon sheath is surgical therapy, but surgical recurrence rates were reported to be as high as 50% in some cases. Therefore, complete radical excision of the lesion is the treatment of choice. If the tumor originates from the joint, it is important to perform capsulotomy. Here, the authors report the first case of successful treatment of a localized intra-articular giant cell tumor in the wrist by arthroscopic resection.A 28-year-old right-handed woman visited the clinic because of left wrist ulnar-side pain, which had been aggravated during the previous 15 days. Vague ulnar-side wrist pain had begun 2 years ago. When the authors examined the patient, the wrist showed mild swelling on the volo-ulnar aspect and the distal radioulnar joint, as well as volar joint line tenderness. She showed a positive result on the ulnocarpal stress test and displayed limited range of motion. Magnetic resonance imaging revealed an intra-articular mass with synovitis in the ulnocarpal joint. Wrist arthroscopy was performed using standard portals under regional anesthesia. The arthroscopic findings revealed a large, well-encapsulated, yellow lobulated soft-tissue mass that was attached to the volar side of the ulnocarpal ligament and connected to the extra-articular side. The mass was completely excised piece by piece with a grasping forceps. Histopathologic examination revealed that the lesion was an intra-articular localized form of a tenosynovial giant cell tumor.At 24-month follow-up, the patient was completely asymptomatic and had full range of motion in her left wrist, and no recurrence was found in magnetic resonance imaging follow-up evaluations.The authors suggest that the arthroscopic excision of intra-articular giant cell tumors, as in this case, may be an alternative method to open excisions, with many advantages.

Erratum: Nutrient intakes of infants with atopic dermatitis and relationship with feeding type.

[This corrects the article on p. 57 in vol. 9, PMID: 25671069.].

Indoor air pollution aggravates symptoms of atopic dermatitis in children.

Most of researches on the impact of indoor air pollutants on atopic dermatitis (AD) have been based upon animal models, in vitro experiments and case-control studies. However, human data to elucidate the role of indoor air pollution on worsening symptoms of pre-existing AD from a longitudinal study are scarce. The objective of this prospective study was to evaluate the effect of indoor air pollution on AD symptoms in children. We surveyed 30 children with AD in a day-care centre, which moved to a new building during the study. These children stayed there for 8 hours a day Monday through Friday, and their daily symptom scores were recorded. Indoor and outdoor air pollutant levels were continuously measured 24 hours a day for 12 months (Period 1 to 4). Data were analyzed using a generalized linear mixed model. Compared to the period before moving (Period 1), concentrations of indoor air pollutants mostly increased after moving (Period 2) and decreased by natural ventilation and bake-out (Periods 3 and 4). The rate of positive AD symptom increased from 32.8% (Period 1) up to 43.8% (Period 2) and 50.5% (Period 3), then decreased to 35.4% in Period 4 (P < 0.0001). When the delayed effects of indoor air pollutants on AD symptoms 2 days later were evaluated, AD symptoms significantly increased by 12.7% (95% CI: -0.01 to 27.1) as toluene levels increased by 1 ppb (P = 0.05). In conclusion, indoor air pollutants increase the risk of AD aggravation in children and toluene in the indoor environment might act as an aggravating factor.

Diagnostic Decision Points of Specific IgE Concentrations in Korean Children With Egg and Cow's Milk Allergies.

PURPOSE: The purpose of this study was to evaluate the utility of specific IgE (sIgE) concentrations for the diagnosis of immediate-type egg and cow's milk (CM) allergies in Korean children and to determine the optimal cutoff levels. METHODS: In this prospective study, children ≥12 months of age with suspected egg or CM allergy were enrolled. Food allergy was diagnosed by an open oral food challenge (OFC) or through the presence of a convincing history after ingestion of egg or CM. The cutoff levels of sIgE for egg white (EW) and CM were determined by analyzing the receiver operating characteristic curves. RESULTS: Out of 273 children, 52 (19.0%) were confirmed to have egg allergy. CM allergy was found in 52 (23.1%) of 225 children. The EW-sIgE concentration indicating a positive predictive value (PPV) of >90% was 28.1 kU/L in children <24 months of age and 22.9 kU/L in those ≥24 months of age. For CM-sIgE, the concentration of 31.4 kU/L in children <24 months of age and 10.1 kU/L in those ≥24 months of age indicated a >90% PPV. EW-sIgE levels of 3.45 kU/L presented a negative predictive value (NPV) of 93.6% in children <24 months of age, while 1.80 kU/L in those ≥24 months of age presented a NPV of 99.2%. The CM-sIgE levels of 0.59 kU/L in children <24 months of age and 0.94 kU/L in those ≥24 months of age showed NPVs of 100% and 96.9%. CONCLUSIONS: Our results indicate that different diagnostic decision points (DDPs) of sIgE levels should be used for the diagnosis of egg or CM allergy in Korean children. The data also suggest that DDPs with high PPV and high NPV are useful for determining whether OFC is required in children with suspected egg or CM allergy.

Nutrient intakes of infants with atopic dermatitis and relationship with feeding type.

BACKGROUND/OBJECTIVES: The prevalence of atopic dermatitis in infants is increasing worldwide. However, the nutrient intake status of infants with atopic dermatitis has not been studied properly. This study was conducted to compare the nutrient intake status of infants in the weaning period with atopic dermatitis by feeding type. MATERIALS/METHODS: Feeding types, nutrient intake status and growth status of 98 infants with atopic dermatitis from age 6 to 12 months were investigated. Feeding types were surveyed using questionnaires, and daily intakes were recorded by mothers using the 24-hour recall method. Growth and iron status were also measured. RESULTS: The result showed that breastfed infants consumed less energy and 13 nutrients compared to formula-fed or mixed-fed infants (p < 0.001). The breastfed group showed a significantly lower intake rate to the Dietary Reference Intakes for Koreans than the other two groups (p < 0.001). In addition, they consumed less than 75% of the recommended intakes in all nutrients, except for protein and vitamin A, and in particular, iron intake was very low, showing just 18.7% of the recommended intake. There was no significant difference in growth by feeding type, but breastfed infants showed a significantly higher rate of iron deficiency anemia (p < 0.001). CONCLUSIONS: Continuous management programs should be prepared for breastfed infants with atopic dermatitis, who are in a period when rapid growth takes place and proper nutrient intake is essential.

Significance of 40-, 45-, and 48-kDa Proteins in the Moderate-to-Severe Clinical Symptoms of Buckwheat Allergy.

PURPOSE: This study was aimed to investigate the relationship between the allergen components and moderate-to-severe allergic reactions in patients with buckwheat allergy. METHODS: Fifteen patients with a history of buckwheat ingestion and a buckwheat specific IgE level≥0.35 kU/L were enrolled. They were divided into 2 groups according to clinical severity scores, with 0-1 being asymptomatic-to-mild and 2-4 being moderate-to-severe symptoms. Immunoblotting was performed to investigate IgE reactivity toward buckwheat allergens and to measure intensity of each component by using a reflective densitometer. RESULTS: The proportions of positive band to the 16 kDa (62.5% vs 0%, P=0.026) and 40-50 kDa (87.5% vs 28.6%, P=0.041) buckwheat allergens in the grade 2-4 group were higher than those in grade 0-1 group. The level of buckwheat specific IgE of grade 2-4 group was higher than that of grade 0-1 group (41.3 kU/L vs 5.5 kU/L, P=0.037). The median optical densities (ODs) of IgE antibody binding to 40-50 kDa protein were higher in the grade 2-4 group, compared with those in the grade 0-1 group (130% OD vs 60.8% OD, P=0.037). CONCLUSIONS: The 40-50 kDa protein is implicated as an important allergen to predict moderate-to-severe clinical symptoms in Korean children with buckwheat allergy.

Erratum: Effects of enzymatic hydrolysis of buckwheat protein on antigenicity and allergenicity.

[This corrects the article on p. 278 in vol. 8, PMID: 24944772.].