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Las proteínas de la leche de vaca pueden causar alergia alimentaria. Los distintos mecanismos de acción involucrados y la variabilidad clínica según la etapa de la vida pediátrica en la que se manifieste ocasionan dificultades en su abordaje, con riesgo de sub- o sobrediagnóstico. En este proceso, intervienen profesionales de diversas áreas y es recomendable su interacción. Es por ello que el objetivo de este consenso ha sido reflejar el conocimiento actualizado desde la interdisciplina, generando recomendaciones para su correcto diagnóstico. Hemos trabajado con el método de Delphi para sumarle a la evidencia científica, la experiencia proveniente de neonatólogos, pediatras, especialistas en alergia, nutrición y gastroenterología. Pensamos que este enfoque interdisciplinario de trabajo va a resultar de utilidad práctica y promoverá una atención más integral de estos pacientes.
Cow's milk protein can cause food allergy. The different mechanisms of action involved, the clinical variability depending on the stage of pediatric life in which it manifests, leads to difficulties in its approach, with the risk of under- or over-diagnosis. Professionals from various areas intervene in this process and their interaction is recommended. That is why the objective of this consensus has been to reflect the updated knowledge in an interdisciplinary mode, generating recommendations for its correct diagnosis. We have worked with the Delphi method to add to the scientific evidence, the experience from neonatologists, pediatricians, experts in allergy, nutrition and gastroenterology. We think that this interdisciplinary approach will be of practical use and will promote more comprehensive care for these patients.
Тема - темы
Humans , Infant , Child, Preschool , Child , Adolescent , Milk Hypersensitivity/diagnosis , Delphi Technique , ConsensusРеферат
@#Dengue is a mosquito-transmitted infection endemic in tropical and subtropical locations of the world where nearly half of the world’s population resides. The disease may present as mild febrile illness to severe and can even be fatal if untreated. There are four genetically related but antigenically distinct dengue virus (DENV) serotypes. Immune responses to DENV infection are in general protective but under certain conditions, they can also aggravate the disease. The importance of the cellular immune responses and the antibody responses involving IgG and IgM has been well-studied. In contrast, not much has been described on the potential role of hypersensitivity reactions involving IgE in dengue. Several studies have shown elevated levels of IgE in patients with dengue fever, but its involvement in the immune response against the virus and disease is unknown. Activation of mast cells (MCs) and basophils mediated through dengue-specific IgE could result in the release of mediators affecting dengue virus infection. The present review explores the relationships between the induction of IgE in dengue virus infection, and the potential role of MCs and basophils, exploring both protective and pathogenic aspects, including antibody-dependent enhancement (ADE) of infection in dengue.
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Objective To investigate the distribution characteristics of serum sIgE antibodies against four allergenic protein components of egg white in children with egg allergy,and then clarify the clinical application value of single component-resolved diagnostics of egg allergy.Methods Serum samples from 197 children with egg allergy were collected.The levels of serum sIgE antibodies against four major allergenic protein components of egg white,including ovomucin,ovalbumin,ovotransferrin,and lysozyme,were detected by the light-excited chemiluminescence assay(LiCA),and the distribution characteristics of sIgE antibodies were analyzed.Results The positive rates of serum sIgE antibodies against ovalbumin,ovomucin,ovotransferrin,and lysozyme in 197 chlidren with egg allergy were 77.16%(152/197),70.56%(139/197),35.02%(69/197),and 18.27%(36/197),respectively.The positive rate of serum sIgE antibody against both ovomucin and ovalbumin was 30.45%.There was a weak correlation between the levels of sIgE antibodies against egg and the cumulative levels of sIgE antibodies against four allergenic protein components(r=0.266 8,P＜0.05).There were signifi-cant individual differences in the levels of serum sIgE antibodies against four allergenic protein components of egg white in the children with egg allergy.Conclusion There is individual heterogeneity in the levels of serum sIgE antibodies against four components of egg white in the children with egg allergy.The detection of sIgE antibodies against egg white components can distinguish different forms of egg allergies,which is of great value for the accurate diagnosis and precise desensitization of children's egg allergy.
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Objective To investigate the distribution of serum allergens in children with respiratory allergic or infectious diseases,and then provide evidence for the prevention and treatment of children's respiratory allergic and infectious diseases.Methods The clinical data of 2 334 children aged 1 to 14 years old(median 5 years)visited Shengjing Hospital Affiliated to China Medical University from April 2019 to June 2022 were retrospectively analyzed.All the children were diagnosed with respiratory allergic or infectious diseases.The Phadia 250 automatic fluorescence enzyme immunoassay system and its supporting detection reagents were used to detect serum sIgE to allergens and statistical analysis was conducted using the GraphPad Prism 8.0 software.Results The positive rates of sIgE to allergens in children with respiratory allergic diseases(n=1 151)and respiratory infectious diseases(n=1 183)were 75.85%and 47.68%,respectively.The main allergen in the children with asthma was a mixture of dust mites(44.18%),followed by a mixture of fungi(40.64%).The main allergens in the children with allergic rhinitis were a mixture of dust mites and weed pollen,both accounting for 52.51%.The common allergen of respiratory infectious diseases was mold mixture(27.81%),followed by a mixture of dust mites(24.77%).The main allergen in children under 7 years old was a mixture of fungi(33.31%).As age increased,the positive rates of allergens in different combinations increased.The positive rates of serum sIgE to dust mite mixture,dander mixture,and weed pollen mixture in children aged≥7 years old were significantly higher than those in children aged≤3 years old and 4-6 years old(P＜0.000 1).The positive rate of serum sIgE to allergens in male patients(64.33%)was significantly higher than that in female patients(56.33%,χ2=14.29,P=0.000 2).Among various disease groups,the levels of sIgE to dust mite mixture and weed pollen mixture were distributed at levels 1-6,with the highest distribution rate at level 6 in allergic rhinitis.Each disease group was associated with one allergen or a combination of two allergens.As the number of allergen combinations increased,the positive rate of sIgE gradually de-creased.The tIgE levels in children with allergic rhinitis were significantly higher than those in children with asthma,upper respiratory tract infection,and lower respiratory tract infection(all P＜0.005).Conclusion Dust mite mixture and mold mixture are common al-lergens in children with asthma,while weed pollen mixture and dust mite mixture are common allergens in children with allergic rhini-tis.As age increases,children become more and more allergic to dust mite,mold,dander,weeds,and pollen.
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Objective To investigate the clinical significance of the detection of food-specific IgE(fsIgE)and IgG4(fsIgG4)antibod-ies in the diagnosis and treatment of children's allergic diseases.Methods A total of 641 children with allergic diseases visited Hang-zhou Women's Hospital during November 2022 and November 2023 and 100 healthy children during the same period were selected,and the levels of fsIgE and fsIgG4 in their serum samples were detected.Results The total positive rates of fsIgE and fsIgG4 in children with allergic diseases were 37.44%and 90.48%,respectively,which were significantly higher than the 11.00%and 61.00%of healthy children(P＜0.05).The main food allergens in children were milk and eggs.The intensity of fsIgE was concentrated in the 1-2 level and the positive result for a single food was more common.The intensity of fsIgG4 was concentrated in Grade 3 and the positive results for multiple foods were more common.The comparison of the detection results of sIgE and sIgG4 to the same food showed that the posi-tive rate of sIgG4 was significantly higher than that of sIgE(P＜0.05),and the consistency between them was poor(κ＜0.4).There were no significant differences in the positive rates of fsIgE and fsIgG4 between different genders(P＞0.05).The highest positive rate of fsIgE was seen in the infant group and the highest positive rate of fsIgG4 was seen in the childhood group(P＜0.05).The positive rates of sIgE to egg protein,shrimp,crab,and cashew were mainly seen in children with skin diseases(P＜0.05).The positive rates of sIgG4 to egg and milk were mainly seen in children with respiratory diseases(P＜0.05).The positive rates of sIgG4 to shrimp and wheat were mainly seen in children with skin diseases(P＜0.05).Analysis of allergen components showed that the β-lactoglobulin,α-whey protein,and casein in milk and mucin in eggs were important allergenic components.Conclusion Food allergy is an important factor leading to children's allergic diseases.The combined detection of fsIgE and fsIgG4 can provide experimental basis for clinical di-agnosis and treatment as well as personalized dietary guidance of children.
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Objective To investigate the distribution characteristics of inhalant and ingestive allergens in patients with allergic rhinitis(AR)in Lishui area,and then provide evidences for the clinical diagnosis,treatment and prevention of AR.Methods The detection data of serum sIgE antibodies to allergens from 1 610 patients with suspected AR visited the Department of Otolaryngology of Lishui Central Hospital during January 2020 and December 2022 were collected,and the distribution characteristics of various allergen spectra in AR patients were further analyzed.Results A total of 1 020 patients were diagnosed with AR and the positive rate of serum sIgE an-tibodies to allergens was 63.35%.The positive rate(66.59%)in male AR patients was significantly higher than that in females(59.48%,P＜0.01).The main allergen among AR patients in Lishui area was house dust mite.The top five inhalant allergens were house dust mite(77.94%),mixed mold(10.20%),cat dander(9.22%),tree pollen(5.88%),and dog dander(3.43%).The top five ingestive allergens were milk(23.33%),crab(7.75%),cashew nut(6.67%),shrimp(4.41%),and egg protein(3.33%).The positive rates of serum sIgE antibodies to milk,crab,and shrimp in males were significantly higher than that in females(P＜0.05).There were significant differences in the positive rates of serum sIgE antibodies to house dust mite,mulberry tree,cockroach,tree pol-len,and grass pollen among different age groups(P＜0.05).The positive rates of serum sIgE antibodies to egg protein,milk,crab,and amaranth were significantly different(P＜0.05).There were seasonal differences in the positive rates of serum sIgE antibodies to house dust mite,mulberry,mixed mold,tree pollen,and grass pollen(P＜0.05).Conclusion The allergens of AR patients in Lishui area are diverse and complex,and are affected by factors such as gender,age and season.
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Objective To analyze the clinical characteristics of mycoplasma pneumoniae pneumonia(MPP)in children with atopic constitution and exploring the predictors of disease conditions.Methods A total of 250 children diagnosed with MPP in the Department of Pediatric Respiratory Medicine,Xinhua Hospital,Shanghai Jiaotong University School of Medicine from September 2019 to September 2022 were selected and divided into atopic group(n=149)and non-atopic group(n=101)according to whether they were atopic,to explore the clinical characteristics of MPP in children with atopic constitution and the risk factors of severe mycoplasma pneumoniae pneu-monia(SMPP).The efficacy of the combined test of lactate dehydrogenase(LDH),immunoglobulin E(IgE)and serum amyloid A(SAA)in predicting the development of SMPP in MPP children with atopic constitution was evaluated by the receiver operating character-istic(ROC)curve.Results Children in the atopic group had more pronounced symptoms of cough,wheezing,nasal congestion,croup,combined pleural effusion with severe pneumonia and the proportion requiring hormone therapy than those in the non-atopic group,and the differences were statistically significant(P＜0.05).Logistic regression analysis showed that serum IgE,SAA and LDH levels were in-dependent risk factors for the development of SMPP in MPP children with atopic constitution(P＜0.05);ROC curve analysis showed that the combined test of IgE,LDH and SAA could be used to predict the development of SMPP in MPP children with atopic constitution,with an area under the curve(AUC)of 0.881,sensitivity of 81.0％,and specificity of 85.0％.Conclusion MPP children with atopic con-stitution are more likely to develop SMPP and require hormone therapy.The combined detection of serum IgE,SAA and LDH can effec-tively predict the occurrence of SMPP in MPP children with atopic constitution.
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Objective:To construct a mouse asthma model induced by mugwort pollen and to explore endotyping,providing methods for subsequent precision treatment.Methods:BALB/c mice were intraperitoneally injected with mugwort pollen extract(MPE)to sensitize,following MPE intranasal challenge to construct MPE allergic asthma murine model.Mice were randomly divided into PBS sensitization and PBS challenge(P-P),MPE sensitization and PBS challenge(M-P),MPE sensitization and MPE challenge model(M-M)groups.24 h after final challenge,mice were performed to examine airway responsiveness;bronchoalveolar lavage fluid(BALF)was harvested for cell counting and statistical classification of inflammatory cells through flow cytometry analysis.Pulmonary slides were collected for pathological examination,including HE,PAS,Masson and α-SMA immunohistochemical staining.ELISA was used to detect levels of IFN-γ,IL-4,IL-5,IL-13,IL-17A in lung tissue and serum,as well as serum total IgE and MPE-specific IgE,IgG1,IgG2a levels.Results:Pathological examination showed higher airway reactivity,more inflammatory cells infiltration around airway,obvious goblet metaplasia,thickening of airway smooth muscles and dramatical fibrin deposition around airway in model group.Total cell numbers of BALF were increased from<1×105 cells/ml in P-P group to>5×105 cells/ml in model group,in which eosinophils were predominant cellular type,levels of IL-4,IL-13,IL-17A in lung and IL-5,IL-13 levels in serum were significantly increased,as well as significant increasing levels of total IgE and MPE-specific IgE,IgG1,IgG2a.Conclusion:MPE-sensitized and challenged mice induces typical eosinophilic asthma featured with elevated eosinophils,as well as secretion of inflammatory factors of type 2 and type 17,IgE,IgG1 and IgG2a subtypes soars to high levels.
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ObjectiveThe heightened expression of local immunoglobulins is a significant pathological characteristic of chronic rhinosinusitis with nasal polyps （CRSwNP）， particularly in the Asian population. This study is centered on exploring the association between MZB1 and the localized aggregation of immunoglobulins in Asian individuals with CRSwNP. MethodsNasal polyp tissues obtained from 40 CRSwNP patients and inferior turbinates from 6 healthy controls underwent examination for both mRNA and protein levels. The assessments were conducted using polymerase chain reaction， luminex， and immunohistochemical staining. Statistical analyses， including one-way Anova （ANOVA）， independent samples t-test， and Pearson's correlation analysis， were employed for comprehensive data evaluation. ResultsThe mRNA expression levels of MZB1（P < 0.01） and HSP90B1 （P < 0.01） were significantly higher in type 2 CRSwNP patients compared with those in healthy controls. Immunohistochemical staining revealed a significant increase in MZB1 protein expression in type 2 CRSwNP. MZB1 demonstrated correlation with the expression of immunoglobulin E in nasal polyp tissues （P < 0.01， r = 0.52）. Additionally，MZB1correlated with the expression ofIL-5（P < 0.05， r = 0.4） and IL-13 （P < 0.05， r = 0.44） in nasal polyp tissues. Furthermore，MZB1showed correlation with the number of eosinophils in nasal polyp tissues （P < 0.05， r = 0.72）. ConclusionThe expression of MZB1 is notably elevated in Asian CRSwNP， particularly in type 2 CRSwNP， when compared with controls.MZB1expression correlates significantly with high IgE expression and disease severity in nasal polyp tissues.
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Abstract The aim of this study was to determine the allergenic activity of components present in crude extracts of Pterobothrium crassicolle plerocerci (CPE) and blastocysts (CBE) obtained from Micropogonias furnieri in a murine model. Two groups of seven animals each received 50 µg of CPE or CBE on days 1, 35 and 120. Serum samples were tested by ELISA and Immunoblotting. Specific IgG and IgE levels were detected by ELISA, showing specific humoral responses for the primary immunization for both immunoglobulins and continuously growing titers for IgE. Positive Passive Cutaneous Anaphylaxis tests in rats sensitized with anti-CBE sera and tested by CBE, showed biologically, the allergenic activity of the extracts. The CPE and CBE showed some different recognition regions but both experimental groups recognized all regions of the extracts when tested for cross reactions, showing that CPE and CBE could share antigenic recognition sites.
Resumo O objetivo deste estudo foi determinar a atividade alergênica de componentes presentes em extratos crus de plerocercos (CPE) e de blastocistos de Pterobothrium crassicolle (CBE), obtidos de Micropogonias furnieri, em modelo murino. Dois grupos de sete animais receberam cada um 50 µg de CPE ou CBE nos dias 1, 35 e 120. As amostras de soro foram testadas por ELISA e Imunoblot. Os níveis específicos de IgG e IgE foram detectados por ELISA, mostrando respostas humorais específicas para a imunização primária para ambas as imunoglobulinas e títulos crescentes de IgE. Testes positivos de Anafilaxia Cutânea Passiva em ratos sensibilizados com soros anti-CBE e testados por CBE, demonstraram biologicamente, a atividade alergênica dos extratos. O CPE e o CBE evidenciaram algumas regiões de reconhecimento diferentes, mas ambos os grupos experimentais reconheceram todas as regiões dos extratos, quando testados para reações cruzadas, mostrando que o CPE e o CBE poderiam compartilhar locais de reconhecimento antigênico.
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Introduction: Monitoring changes in the levels of immune markers is of great significance in evaluating the effectiveness of treatment in patients with allergic rhinitis. Objectives: Determine the change in the concentration of immune markers after treatment in patients with allergic rhinitis caused by cotton dust. Methods: A descriptive, single-group, comparative before and after intervention study on 52 patients with allergic rhinitis caused by cotton dust. Comparison of immunological markers results before and after 36 months of treatment. Results: Total IgE concentration after treatment decreased, the median decreased from 1227.756 U/mL to 676.805 UI/mL. Serum levels of IgG, IgG4, and IgG1 in patients after treatment increased compared to before (p< 0.001). The cytokines also changed in the direction of no longer responding toward allergy. Median IL-17 decreased from 1.752 mg/dL to 0.417 mg/dL. Conclusion: In patients with allergic rhinitis after specific sublingual desensitization treatment, IgE levels and cytokines such as IL-6 and IL-17 are significantly reduced and IgG, IgG4 and IgG1 levels are increased after treatment.
Introducción: El monitoreo de los cambios en los niveles de marcadores inmunes es de gran importancia para evaluar la efectividad del tratamiento en pacientes con rinitis alérgica. Objetivos: Determinar el cambio en la concentración de marcadores inmunes después del tratamiento, en pacientes con rinitis alérgica causada por polvo de algodón. Métodos: Estudio descriptivo, monogrupo, comparativo antes y después de la intervención, en 52 pacientes con rinitis alérgica por polvo de algodón. Se compararon resultados de marcadores inmunológicos antes y después de 36 meses de tratamiento. Resultados: La concentración de IgE total después del tratamiento disminuyó, la mediana disminuyó de 1227,756 U/mL a 676,805 UI/mL. Los niveles séricos de IgG, IgG4 e IgG1 en pacientes, después del tratamiento, aumentaron (p< 0,001). Las citocinas también cambiaron en dirección a ausencia de respuesta a la alergia. La mediana de IL-17 disminuyó de 1,752 mg/dL a 0,417 mg/dL. Conclusión: En pacientes con rinitis alérgica, después del tratamiento específico de desensibilización sublingual, los niveles de IgE y citocinas como IL-6 e IL-17 se reducen significativamente y los niveles de IgG, IgG4 e IgG1 aumentan.
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Hyper-IgE syndrome (HIES) comprises a group of rare primary immunodeficiencies, which are characterized by extremely high serum IgE levels, eczema, recurrent skin and pulmonary infections.Signal transduction and activator of transcription 3( STAT3)-HIES is the most common type, which is caused by dominant-negative mutations in STAT3.STAT3-HIES confers broad innate and acquired immune defects, defects in skeletal, connective tissue, and vascular functions, causing a clinical phenotype including eczema, staphylococcal and fungal skin and pulmonary infections, scoliosis and minimal trauma fractures, vascular tortuosity and aneurysm.In this article, the advance in diverse clinical manifestations and management strategies of STAT3-HIES was summarized.
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Monogenic inherited skin diseases are a group of clinically rare diseases that include nearly 1000 phenotypically distinct disorders. Through the concerted efforts of researchers in dermatological sciences and related disciplines worldwide, many advances have been made in the etiology and pathogenesis of these diseases in the last 30 years. However, it is important to note that the treatment of the majority of monogenic inherited skin diseases remains a challenge for clinicians. Dupilumab is a fully human monoclonal IgG4 antibody that specifically binds to the α subunit of the IL-4 receptor, thereby inhibiting the IL-4 and IL-13 signaling pathway. It was first approved for the treatment of moderate-to-severe atopic dermatitis (AD) and has been used worldwide. In recent years, the drug has been successfully used to treat some monogenic inherited skin diseases with AD-like clinical manifestations, such as hyper-IgE syndrome and Netherton syndrome, with good efficacy. The drug was later tried for the treatment of other monogenic inherited skin diseases, such as Hailey-Hailey syndrome and epidermolysis bullosa pruriginosa, where it was also proven to be effective. In this paper, we review literature reports related to dupilumab for the treatment of monogenic inherited skin diseases in recent years, focusing on its efficacy, safety and possible therapeutic mechanisms. We aim to provide a possible scientific basis for the future application of this drug in the field of rare monogenic inherited skin diseases.
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Lolium multiflorum grass is the major pollen allergen source in the southern region of Brazil, but most of its allergens remain poorly characterized. The aim of this study was to investigate antibody reactivity to L. multiflorum crude and carboxymethyl-ligand extracts in allergic patients and healthy individuals. Ion exchange carboxymethyl (CM) chromatography (CM-Sepharose) was used to isolate proteins (S2) from L. multiflorum crude extract (S1), which were assessed by SDS-PAGE. S1- and S2-specific IgE and IgG4 levels were measured by ELISA using sera from 55 atopic and 16 non-atopic subjects. Reactive polypeptide bands in S1 and S2 were detected by immunoblotting, and the most prominent bands in S2 were analyzed by mass spectrometry (MS-MS). Similar IgE and IgG4 levels were observed to both S1 (IgE median absorbance: 1.22; IgG4 median absorbance: 0.68) and S2 (IgE median absorbance: 1.26; IgG4 median absorbance: 0.85) in atopic subjects. S1 and S2 had positive correlations for IgE and IgG4 (IgE: r=0.9567; IgG4: r=0.9229; P<0.0001) levels. Homology between S1 and S2 was confirmed by IgE (84%) and IgG4 (83%) inhibition. Immunoblotting revealed that the 29-32 kDa band was recognized by 100% of atopic subjects in both S1 and S2. MS-MS analysis identified similarity profile to groups 1 and 5 grass allergens. This study revealed that carboxymethyl-ligand fraction played an important role for pollen allergy diagnosis by containing clinically relevant allergens and constituted a promising candidate for allergen-specific immunotherapy.
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Cow′s milk protein allergy (CMPA) is one of the most common presentations of food allergy seen in early childhood.It is an abnormal immune response caused by cow′s milk protein.CMPA can be clinically subdivided into either immediate-onset IgE mediated or delayed onset non-IgE mediated, or both.At present, concerns regarding the early and timely diagnosis of CMPA have been high-lighted over the years and there are many expert consensus on CMPA in China, but these consensus did not distinguish IgE mediated or non-IgE mediated CMPA.In view of the obvious clinical differences between the two type of CMPA and non-IgE mediated CMPA is more common in infancy, experts focus on pediatric gastroenterology, allergy/immunology, dermatology, nutrition and child healthcare convened by the Allergy Prevention and Control Professional Committee of Chinese Preventive Medicine Association present this guideline to help practitioners in primary care settings to early recognize and make suitable management of non-IgE mediated CMPA in China.The guideline incorporates the cutting-edge international guidance and the actual situation of Chinese children describing in detail the types, clinical features, diagnosis and nutritional intervention of non-IgE mediated CMPA.There are 42 recommendations in 7 categories in total referring to the common questions related to non-IgE mediated CMPA.
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The diagnosis of food allergy in children is one hotspot attracting people′s attention in recent years.The incidence of it shows an increasing trend which exposes problems in the understanding of children′s food allergy in China, especially in the misdiagnosis and missed diagnosis.To further standardize the diagnosis and treatment of food allergy in children, based on the current domestic, foreign guidelines and relevant research evidence, the guideline recommends 16 clinical hot-button issues in the 4 aspects of diagnosis, treatment, prognosis, and prevention.Finally, a diagnosis flowchart has been formulated.The guideline aims to improve the standard diagnosis and treatment of food allergies in children in China.
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The hyper IgE syndrome (HIES) is a rare primary immunodeficiency disorder characterized by atopic dermatitis, recurrent skin and lung infections along with elevated IgE levels.The JOB syndrome due to heterozygous loss-of-function mutations in the signal transduction and transcription activator-3(STAT3) gene is the prototype of HIES.However, several other immunodeficiency disorders with the phenotype of HIES have been identified over the past decade.This study aims to review these disorders and their molecular mechanisms, aiming to improve the understanding of this rare disease.
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Objective:To investigate the effects of different production processes on sensitization responses to human diploid cell rabies vaccines.Methods:This study randomly collected 360 serum samples in clinical trials of four rabies vaccines with different production processes. Total IgE levels at different time points were detected by ELISA. SPSS19.0 software was used for statistical analysis.Results:Total IgE test results showed that the seropositive rate was 20% (6/30) for all four vaccines. The lowest mean value of total IgE was 9 IU/ml and the highest was 210 IU/ml. Repeated measures analysis of variance showed that there was no significant difference in total IgE levels at different sampling time points ( P=0.284), and the total IgE level in people injected with multistep concentrated human diploid cell rabies vaccine was significantly below that in people immunized with Vero cell rabies vaccine ( P=0.024). Conclusions:Increasing the immune dosage of human rabies vaccine could not result in a rise in total IgE. Human diploid cell rabies vaccines had good safety as the production process could remove most of allergenic impurities.
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Objective To explore the clinical efficacy and safety of the omalizumab treatment in children with high level IgE allergic asthma. Methods The clinical data of 2 children with allergic asthma treated with omalizumab in the Departemnt of Respiratory Medicine of Shanghai Children’s Hospital from August 2020 to May 2021 were retrospectively analyzed, and they had regular follow-up after end of treatment. The dosage and course of treatment, therapeutic effect and adverse drug reactions of omalizumab were analyzed. Results After receiving omalizumab treatment, asthma symptoms were well controlled, the dosage of inhaled corticosteroids during asthma treatment were reduced and nasal symptoms were relieved. 20 subcutaneous injections were received by 2 children, and no adverse reactions were found. After the treatment, regular pharmaceutical follow-up showed that the children were in good health. Conclusion Omalizumab is suitable for high level IgE allergic asthma and can improve asthma control symptoms with good long-term safety. However, the appropriate dosage and course of treatment still need further experience accumulation.
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Non-IgE-mediated food allergy most often presents with gastrointestinal symptoms such as diarrhoea, mucus stools, bloody stools, reflux and vomiting a few hours to days after exposure to the allergenic food.The pathogenesis may be related to the activation of intestinal T lymphocytes to secrete pro-inflammatory cytokines such as TNF-α and IL-4 by food allergens, leading to migration of neutrophils and eosinophils into the intestinal lumen, causing an intestinal inflammatory response and increased intestinal permeability.There is no rapid and specific diagnostic method.The diagnosis is mainly based on clinical manifestations combined with food avoidance and oral food challenge.In recent years, fecal biomarkers have been widely used as specific indicators for determining intestinal inflammation as an aid to diagnosis and condition assessment of intestinal infections and inflammatory bowel diseases, but their application in gastrointestinal allergic diseases is rarely reported.In this paper, we will focus on the significance of fecal calprotectin, fecal eosinophil-derived neurotoxin in non-IgE-mediated food allergy.