Cross-reactivity of Can f 1 with Syrian hamster and Fel d 1 in children.

Introduction and objectives: With increasing pet allergies among pediatric patients, the need for precise environmental care is increasing. We investigated the clinical, immunological, and environmental characteristics of pediatric patients sensitized to a dog to evaluate the cross-antigenicity of canine lipocalin Can f 1 with feline lipocalin Fel d 1 and Syrian hamster extract.Materials and methods: The protein fractions of the processed and commercial Syrian hamster extracts were compared using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). An enzyme-linked immunosorbent assay (ELISA) inhibition test was performed on Can f 1, Fel d 1, and processed Syrian hamster extract, and the antigen-specific immunoglobulin E (IgE)-binding capacity for each antigen was analyzed using serum samples from patients.Results: Twelve of 19 patients with a median age of 40.5 months were symptomatic when exposed to dogs. Eleven (91.7%) patients showed a positive IgE response to Can f 1. Two patients were positive for Fel d 1-specific IgE antibody, and one was positive for hamster-specific IgE antibody. SDS-PAGE confirmed the presence of different patterns of protein bands between the commercial and processed hamster extracts. There was no cross-antigenicity among Can f 1, Fel d 1, and processed Syrian hamster extract.

Variation in the Allergenicity of Scrambled, Boiled, Short-Baked and Long-Baked Egg White Proteins

Background@#Hen’s egg white (HEW) is the most common cause of food allergy in children which induces mild to fatal reactions. The consultation for a proper restriction is important in HEW allergy. We aimed to identify the changes in HEW allergenicity using diverse cooking methods commonly used in Korean dishes. @*Methods@#Crude extract of raw and 4 types of cooked HEW extracts were produced and used for sodium dodecyl-sulfate polyacrylamide gel electrophoresis (SDS-PAGE), enzyme-linked immunosorbent assay (ELISA), and ELISA inhibition assays using 45 serum samples from HEW allergic and tolerant children. Extracts were prepared; scrambled without oil for 20–30 seconds in frying pan without oil, boiled at 100°C for 15 minutes, short-baked at 180°C for 20 minutes, and long-baked at 45°C for 12 hours with a gradual increase in temperature up to 110°C for additional 12 hours, respectively. @*Results@#In SDS-PAGE, the intensity of bands of 50–54 kDa decreased by boiling and baking.All bands almost disappeared in long-baked eggs. The intensity of the ovalbumin (OVA) immunoglobulin E (IgE) bands did not change after scrambling; however, an evident decrease was observed in boiled egg white (EW). In contrast, ovomucoid (OM) IgE bands were darker and wider after scrambling and boiling. The IgE binding reactivity to all EW allergens were weakened in short-baked EW and considerably diminished in long-baked EW. In individual ELISA analysis using OVA+OM+ serum samples, the median of specific IgE optical density values was 0.435 in raw EW, 0.476 in scrambled EW, and 0.487 in boiled EW. Conversely, it was significantly decreased in short-baked (0.406) and long-baked EW (0.012). Significant inhibition was observed by four inhibitors such as raw, scrambled, boiled and short-baked HEW, but there was no significant inhibition by long-baked HEW (IC50 > 100 mg/mL). @*Conclusion@#We identified minimally reduced allergenicity in scrambled EW and extensively decreased allergenicity in long-baked EW comparing to boiled and short-baked EW as well as raw EW. By applying the results of this study, we would be able to provide safer dietary guidence with higher quality to egg allergic children.

Additional diagnostic value of component resolved diagnosis in children with kiwifruit allergy

Purpose@#In food allergy, significant component antigens can be assessed by using the microarray. The purpose of this study was to evaluate the diagnostic value of component resolved diagnosis (CRD) in young children with kiwifruit allergy. @*Methods@#Through a retrospective review of medical records, we evaluated the clinical characteristics of 12 children who underwent measurement of serum immunoglobulin E concentrations to kiwifruit (kiwi-sigE) and were diagnosed as kiwifruit allergy. We applied ImmunoCAP ISAC-CRD 112 using the residual sera of patients at the initial visit. @*Results@#The median age of kiwifruit allergic children was 33.5 months (range, 13 to 84 months), and the proportion of systemic reactions, including 2 anaphylaxis cases, was 66.7%. Four had localized reactions on the lips. A total of 11 (91.7%) were sensitized to Act d 1; among them, 8 were mono-sensitized to Act d 1 and 3 were sensitized to ≥ 2 kiwifruit components. There was no significant difference in CRD results between those with systemic reactions and those with local reactions. @*Conclusion@#Act d 1 is the major allergenic component in Korean young children with clinical kiwifruit allergy. The additional diagnostic value of the CRD in diagnosing and predicting the severity of kiwifruit allergy is expected to be low in young children.

Clinical and Laboratory Findings of Barley Allergy in Korean Children: a Single Hospital Based Retrospective Study

BACKGROUND@#Barley is a grain that is consumed in various forms in Asia. Studies on barley allergy are limited to a few case reports about hypersensitivity reactions to beer, but there is no barley allergy study in children. This study aimed to identify the phenotype and immunologic findings in Korean children with barley allergy.@*METHODS@#Forty-two participants with a history of ingesting barley who underwent serum specific immunoglobulin E to barley (barley-sIgE) assay at the Department of Pediatrics in Ajou Medical Center were enrolled through a retrospective analysis of medical records from March 2008 to February 2018. The demographic characteristics, symptoms, and immunologic parameters of the patients were assessed.@*RESULTS@#Twenty subjects presented with clinical barley allergy (B-allergic group), and 22 were atopic controls without allergic reactions after the ingestion of barley (B-tolerant group). The median ages of the B-allergic and B-tolerant groups were 1 and 3 years, respectively. In the B-allergic group, the cutaneous system (90.0%) was most frequently affected, followed by the respiratory system (40.0%). Anaphylaxis was observed in 35.0% of the B-allergic group. The median level of barley-sIgE was 13.90 kU(A)/L (range, 0.14–101.00 kU(A)/L) in the B-allergic group, and this value was significantly higher (P < 0.001) than that of the B-tolerant group (0.30 kU(A)/L; range, 0.01–24.40 kU(A)/L), with an optimal cutoff level of 1.24 kU(A)/L (sensitivity, 85.0%; specificity, 86.4%). A positive correlation was found between the serum levels of barley-sIgE and wheat-sIgE in the B-allergic group with clinical wheat allergy.@*CONCLUSION@#Barley is an important allergen for children in Korea. This study showed the clinical characteristics of barley allergy and suggested optimal cut-off levels of barley-sIgE for clinical barley allergy. Clinically, cross-reactivity or co-sensitization is often observed between barley and wheat.

Clinical and Laboratory Findings of Barley Allergy in Korean Children: a Single Hospital Based Retrospective Study

Clinical and Laboratory Findings of Barley Allergy in Korean Children: a Single Hospital Based Retrospective Study

BACKGROUND@#Barley is a grain that is consumed in various forms in Asia. Studies on barley allergy are limited to a few case reports about hypersensitivity reactions to beer, but there is no barley allergy study in children. This study aimed to identify the phenotype and immunologic findings in Korean children with barley allergy.@*METHODS@#Forty-two participants with a history of ingesting barley who underwent serum specific immunoglobulin E to barley (barley-sIgE) assay at the Department of Pediatrics in Ajou Medical Center were enrolled through a retrospective analysis of medical records from March 2008 to February 2018. The demographic characteristics, symptoms, and immunologic parameters of the patients were assessed.@*RESULTS@#Twenty subjects presented with clinical barley allergy (B-allergic group), and 22 were atopic controls without allergic reactions after the ingestion of barley (B-tolerant group). The median ages of the B-allergic and B-tolerant groups were 1 and 3 years, respectively. In the B-allergic group, the cutaneous system (90.0%) was most frequently affected, followed by the respiratory system (40.0%). Anaphylaxis was observed in 35.0% of the B-allergic group. The median level of barley-sIgE was 13.90 kU(A)/L (range, 0.14–101.00 kU(A)/L) in the B-allergic group, and this value was significantly higher (P < 0.001) than that of the B-tolerant group (0.30 kU(A)/L; range, 0.01–24.40 kU(A)/L), with an optimal cutoff level of 1.24 kU(A)/L (sensitivity, 85.0%; specificity, 86.4%). A positive correlation was found between the serum levels of barley-sIgE and wheat-sIgE in the B-allergic group with clinical wheat allergy.@*CONCLUSION@#Barley is an important allergen for children in Korea. This study showed the clinical characteristics of barley allergy and suggested optimal cut-off levels of barley-sIgE for clinical barley allergy. Clinically, cross-reactivity or co-sensitization is often observed between barley and wheat.

Immunoglobulin E-binding Proteins of Cooked Walnuts in Korean Children

PURPOSE: The immunological characteristics of young Korean children with walnut (WN) allergy and the influence of different cooking methods on WN proteins have not been evaluated to date. This study aimed to evaluate the major WN allergens identified among Korean children, together with changes in WN antigenicity caused by common cooking methods. METHODS: We enrolled children under the age of 13 years with WN serum-specific immunoglobulin (Ig) E concentrations. The protein fractions of dry-fried and boiled WN extracts were compared with those of raw WNs using sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), 2-dimentional gel electrophoresis (2DE) and a proteomic analysis using electrospray ionization (liquid chromatography-mass spectrometry [LC-MS]). An immunoblotting analysis was conducted to examine IgE reactivity toward raw WNs using serum samples from 6 children with a clinical WN allergy. To determine the processed WN proteins with IgE-binding capacity, a 2D-immunoblotting analysis was performed using the pooled sera of 20 WN-sensitized children. RESULTS: Protein bands from raw WNs were identified at 9, 16, 28, 52, 58, and 64 kDa via SDS-PAGE. The 9- and 16-kDa protein bands were enhanced by boiling, whereas the 52- and 64-kDa bands were considerably diminished. On LC-MS analysis, of the 66 IgE-binding proteins present in raw WNs, 57 were found in dry-fried WNs, but only 4 in boiled WNs. The sera of 5 out of 6 participants reacted with the 52-kDa protein bands and those of 4 out of 6 participants reacted with the 16- and 28-kDa protein bands, respectively. Meanwhile, a 2D-immunoblotting result confirmed the presence of different binding patterns among children who consumed cooked WNs. CONCLUSIONS: The protein profile of boiled WNs is substantially different from that of raw WNs. However, 4 proteins including prolamins remained stable after dry-frying or boiling. Further studies are needed to evaluate the clinical relevance of these findings.

Clinical characteristics and diagnostic value of specific immunoglobulin E antibodies in children with kiwi fruit allergy

PURPOSE: Kiwi fruit allergy in children has scarcely been reported. This study focused on the clinical characteristics of kiwi fruit allergy and value of kiwi specific Immunoglobulin E (IgE) antibodies in Korean children. METHODS: The study was based on a data analysis of 18 patients, who were diagnosed with clinical kiwi fruit allergy at Ajou University Hospital from June 2005 to June 2012. Clinical details were collected by medical history and telephone survey. Sera from all children were analyzed for kiwi specific IgE (ImmunoCAP) and patients with negative result were further evaluated by an enzyme linked immunosorbentassay test (ELISA) using our own made kiwi fruit extracts. RESULTS: The subjects were 10 male and 8 female with a median aged 25 months. Twelve out of 18 (66.7%) were diagnosed with angioedema or urticaria, 4 (22.2%) were diagnosed with oral allergy syndrome, 1 was presented with dyspnea, and 1 was diagnosed with anaphylaxis. Oral route of exposure (88.9%) was most common and majority of patients (88.9%) experienced clinical symptoms at the first exposure to kiwi fruit. Six out of 12 patients with urticaria showed negative result in specific IgE by ImmunoCAP, but specific IgE were detected in 2 of 6 by ELISA with our own made kiwi extract. CONCLUSION: Systemic reactions to kiwi fruit were common in Korean children, and the symptoms were frequently developed at the first time of exposure. Additional diagnostic methods would be needed for evaluation of IgE sensitization in kiwi allergic patients with negative result by ImmunoCAP.

Sensitization patterns of cow's milk and major components in young children with atopic dermatitis

BACKGROUND: Cow's milk (CM) is one of the most common food allergens in children with atopic dermatitis (AD), and the component-specific immunoglobulin E (component-IgE) measurement has recently become available. OBJECTIVE: This study aimed to investigate the sensitization patterns to CM and 3 major components and their clinical values in young Korean children with AD. METHODS: Cow's milk-specific IgE (CM-IgE), α-lactalbumin-specific IgE (ALA-IgE), β-lactoglobulin-specific IgE (BLG-IgE), and casein-specific IgE (Cas-IgE) levels from the sera of patients with AD were measured using the UniCAP™ system (Thermo Fisher Scientific, Sweden) and collected from January 2004 to December 2010. Patients ≥ 4 years of age were excluded from the analysis. RESULTS: A total of 950 patients diagnosed with AD were ultimately enrolled in the study. Among them, 471 (49.6%) patients were sensitized to CM (CM-IgE[+], > 0.35 kU/L). Sensitization to casein (n = 349, 74.1%) was most common, followed by ALA (n = 283, 60.1%), and BLG (n = 245, 52.5%). Meanwhile, 95 patients had at least 2 follow-up tests. Eighty (84.2%) of these patients tested positive to CM, and the casein sensitization rate was the highest (n = 65, 81.3%). In addition, 479 (50.4%) patients were not sensitized to CM (CM-IgE[-], ≤ 0.35 kU/L) but 35 (7.3%) patients were sensitized to at least one component. Among them, a telephone survey was accessible in 21 cases. A total of 8 (38.1%) patients still suffered from adverse reactions after consuming milk and/or dairy foods. CONCLUSION: Casein was the most commonly and persistently sensitized component in CM-IgE(+) children with AD. Measuring CM component IgE antibodies, especially Cas-IgE, is helpful for evaluating problematic allergens in young children with AD.