Clinical Characteristics and Sensitization Profile of Patients Allergic to Cow Epithelium.

INTRODUCTION: Cow epithelium allergy (CEA) has been described in workers highly exposed to cattle, such as farmers and veterinarians, being a health problem in this population since it is their main livelihood. This study aimed to characterize the main clinical manifestations and define the sensitization profile of the cow epithelium-allergic population treated in our health area. METHODS: This is a retrospective study including a total of 34 patients with a clinical diagnosis of CEA, confirmed by skin tests, bovine epithelium-specific IgE levels and allergen-specific conjunctival challenge test in some cases. They were distributed by age, sex, profession, clinical symptoms, specific IgE levels to other mammalian epithelia, pollens, mites, and foods. Immunoblotting was performed with extracts from cow dander, cow body fluids (urine and saliva), bull urine, and 17 sera from immunotherapy-untreated CEA patients. RESULTS: The mean age of the patients was 44 years, with a higher incidence in cattle farmers. Rhinoconjunctivitis occurred in 100% of cases, with 35% having monosensitization to cow epithelium. Sera from most patients detected a 20-kDa IgE-binding band in cow dander, cow saliva, cow urine, and bull urine, corresponding to the major allergen Bos d 2 (bovine lipocalin). In 70% of the patients, a 25-kDa band was detected in cow and bull urine extracts, whose identification by mass spectrometry and investigation with protein databases led to the identification of a Bos taurus lipocalin (UniProt protein ID: A0A3Q1LGU7_BOVIN). CONCLUSION: CEA should be considered in patients exposed to cattle and as a cause of occupational disease. The IgE immunodetection revealed sensitization to a protein present in cow and bull urine (odorant-binding protein) not previously described.

Hymenoptera venom allergy: characteristics, tolerance and efficacy of immunotherapy in the paediatric population

Hymenoptera venom allergy is a growing problem in Spain. This problem has a special relevance in areas where population is frequently exposed to hymenoptera stings, being paediatric patients a high risk population. Immunotherapy with hymenoptera venom is an effective and safe treatment for these patients. However, there is a lack of data on the role of this treatmenton paediatric population. For this reason, from the data base of the Allergy Unit from Hospital Xeral (Lugo, Spain) which includes 560 patients, have been analyzed the 21 paediatric patients, all of them treated with venom immunotherapy.Eighteen patients completed the treatment. The maintenance dose administered was 100 mg. Two systemic reactions (both with an Apis extract) were registered. Cutaneous test and specific IgE shown a statistical significant reduction at the end of treatment (p = .0004 and p < .0001respectively). Seven patients (33 %) suffered a spontaneous re-stung during maintenance phase or after immunotherapy was completed. In 4 patients there was no allergic reaction and the other 3 children suffered a mild local reaction.In conclusion, venom immunotherapy is a safe and effective treatment in paediatric patients with hymenoptera venom allergy, being necessary to increase the experience on this specific segment of the allergic population (AU)

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