Treatment of Allergies to Fur Animals.

Allergy to fur animals is becoming an increasingly common clinical problem in everyday medical practice. Depending on the route of exposure to the allergen, patients present with many, often non-specific symptoms. The most common illnesses among people with allergies to the above-mentioned allergens are as follows: allergic rhinitis, allergic conjunctivitis, atopic bronchial asthma, food allergy, allergic contact dermatitis, and sometimes anaphylactic shock. In recent years, there has been a change in the holistic approach to the treatment of allergy patients. The method of treatment should be tailored to a specific patient, taking into account his or her predispositions, economic possibilities, and therapeutic goals. The article describes the main methods of treating allergies, focusing primarily on allergies to fur animals. Allergy treatment always requires great care, and qualification for specific types of therapy should be preceded by a thorough and accurate diagnosis.

The Two-Sided Experimental Model of ImmunoCAP Inhibition Test as a Useful Tool for the Examination of Allergens Cross-Reactivity on the Example of α-Gal and Mammalian Meat Sensitization-A Preliminary Study.

Cross-reactivity of allergens is the cause of various, sometimes unexpected, clinical reactions. There are no standard methods to investigate cross-reactivity. We present an experimental model of a two-sided inhibition test (IT) on ImmunoCAP membranes (CAP). We constructed the described model based on the known cross-allergy syndrome to red meat developing in people bitten by ticks (α-Gal syndrome; AGS). Some individuals who are bitten by ticks develop IgE antibodies specific to the carbohydrate determinant, galactose-α-1,3-galactose (α-Gal), present in the tick's saliva. These antibodies can cross-react with α-Gal molecules expressed on mammalian meat proteins. The well-known property of anti-α-Gal IgE antibodies binding by various sources of this allergen was used by us in the proposed model of the two-sided inhibition test on ImmunoCAP membranes. We expected that anti-α-Gal IgE antibodies bind allergens from mammalian meat and blocking them abolishes this reactivity, and the two-sided inhibition test model we proposed on ImmunoCAP membranes allowed us to observe such a relationship. We conducted the experiment three times on biological material from people with different clinical manifestations of allergy to α-Gal, each time obtaining similar results. In conclusion, the model of bilateral inhibition on ImmunoCAP membranes proposed by us seems to be an attractive, simple tool for direct testing of allergic cross-reactivity.

Social and economic difficulties of patients with food intolerances.

Introduction: The basic method of treating food hypersensitivity is the elimination diet, which is difficult for the patient in many ways. Aim: To identify the main problems faced by patients with symptoms of food intolerance. Material and methods: The survey was conducted from February 2021 to December 2021. The survey was posted in Polish thematic groups on Facebook, dedicated to people with food intolerances. The survey contained 34 questions about food intolerances and the use of elimination diets. Questions about the cost of the diet and difficulties in applying the elimination diet were included. Results: There was no statistically significant relationship between the type of food intolerance and the body mass index of patients. It was found that people with lactose intolerance had a lower increase in food expenditure since the introduction of the diet than those without lactose intolerance. Almost half of the respondents did not find a difference in expenses. 21% of respondents noticed an increase of PLN 50-100/month, 19% - PLN 10-50/month, and only 6% above PLN 200/month. Circumstances where following an elimination diet is a particular challenge included intense private and professional lifestyle, prolonged stay away from home, and lack of time to prepare meals at home. Conclusions: The difficulties in maintaining an elimination diet are dependent on the patient's work and lifestyle. The cost of equivalents of intolerant products is also an important factor to consider when analysing the source of problems in maintaining the diet.

Assessment of RANTES, MIP4A, MMP7, MMP9, MMP14, TIMP 1, TIMP 2 and TIMP 3 concentration in the follicular fluid of patients undergoing in vitro fertilization/embryo transfer procedure.

Introduction: Matrix metalloproteinases (MMP) degrade extracellular matrix. Some studies show that MMP9 concentration in follicular fluid (FF) may play a role in oocyte maturation and in vitro fertilization (IVF) success. The immunology of follicular fluid is still not fully understood. Aim: Assessment of RANTES, MIP4A, MMP7, MMP9, MMP14, TIMP 1, TIMP 2 and TIMP 3 concentration in the follicular fluid of patients undergoing in vitro fertilization/embryo transfer procedure. Material and methods: This case-control study included 20 randomly selected patients with a positive pregnancy (PPG) test and 20 patients with a negative pregnancy (NPG) test after IVF/ET. In FF obtained during oocyte retrieval, the concentrations of MIP4A, MMP7, MMP14, TIMP 1, TIMP 2, TIMP 3, RANTES, IL-12p40, and IL-17A were measured. Their effect on the characteristics of follicles, embryos, and the efficiency of IVF and ET were analysed. Results: There was no statistically significant relationship between a positive pregnancy test and the results of the immunoassay performed. The number of COC-1 correlates significantly and positively with RANTES (r = 0.34; p = 0.038) and IP-10 (r = 0.329; p = 0.038). MII correlates significantly and positively with RANTES (r = 0.341, p = 0.031). The number of top-quality embryos correlates significantly and positively with IL-17A (r = 0.451, p = 0.004) and TIMP 1 (r = 0.44, p = 0.005). Conclusions: The concentration of IL-17A and TIMP 1 may predict IVF/ET success. Further studies are required on the influence of the follicular fluid immunological environment on oocyte maturation and quality and, subsequently, embryo development.

Extended IgE profile of shrimp-sensitized patients based on Multiplex Examination ALEX2 - Allergy Explorer.

Introduction: The key to the correct diagnosis of shrimp allergy is a qualification to the most efficient diagnostic method and later interpretation of the result. To achieve this, it is necessary to apply a diagnostic strategy relevant to each patient's clinical situation and approach every case individually. Aim: In this study the allergen profile of shrimp-sensitized patients was analysed using ALEX2 Allergy Explorer. Material and methods: This study includes 50 adult patients with positive prick-by-prick tests with tiger shrimp bought from the local eco-market and an elevated concentration of IgE specific to the shrimp allergen extract (ImmunoCap). A total of 35 patients with negative skin prick tests with shrimp and not detectable sIgE shrimp in ImmunoCap were included in the control group. All patients had ALEX2 Allergy Explorer microarray test. Results: In the shrimp-sensitized group, 22 patients were sensitized to at least one allergen component of Penaeus monodon, 20 patients were sensitized to crab, and 20 were sensitized to lobster. Only 15 (30%) patients were sensitized to the Northern prawn (Pandalus borealis) allergen extract in ALEX2 and only 12 (24%) to Shrimp mix (Litopenaeus setiferus, Farfantepenaeus aztecus, Farfantepenaeus dourarum). Conclusions: Sensitization to shrimp tropomyosin in the research group was present only in 34% of cases. There may be other shrimp allergen components, not available in ALEX2, which are responsible for shrimp sensitization.

Experimental Research Models to Assess the Cross-Reactivity between Can f 5 and Human PSA-Two Different Perspectives.

The similarity in antigenic structures, including the degree of correspondence between the amino acid sequence and the spatial structure, is not always reflected in the actual cross-reactivity of allergens. Inhibition tests appear to be an invaluable tool for assessing potential cross-reactivity between allergens under natural conditions. In this publication, we present two experimental models of inhibition tests: solid phase (SP-IT) and liquid phase (LP-IT). As an exemplary research model, we used the cross-reactivity between human PSA and anti-Can f 5 IgE antibodies. We performed an SP-IT model using a microplate coated with human PSA. The LP-IT model was based on mixing anti-Can f 5 IgE positive serum with a material containing human PSA. Anti-Can f 5 IgE and PSA concentrations before and after inhibition were measured to evaluate inhibition effectiveness. The results of the performed experiments showed that both proposed models of inhibition tests are an effective tools for studying cross-reactive relationships between antigens. In the SP-IT, the concentration of anti-Can f 5 decreased by 21.6% and, in the LP-IT, it decreased by 34.51%. In turn, the PSA concentration in the SP-IT decreased by 11.25% and, in the LP-IT, it decreased by 15.49%. In conclusion, both the SP-IT and the LP-IT seem to be effective tools for assessing the actual cross-reactivity between different allergens.

Assessment of the post-SARS-CoV-2 vaccination response depending on the epidemiological status, demographic parameters and levels of selected cytokines in medical personnel.

Introduction: SARS-CoV-2 is responsible for causing the COVID-19 disease, which affected 174 million people worldwide. After vaccines were launched, the focus was on their effectiveness and the degree of their safety. Aim: The authors try to find factors that may affect the response to vaccination. Material and methods: The study was conducted in 47 adults (39 women and 8 men; age: 47.3 ±11.2). Participants were vaccinated with two doses of the Comirnaty mRNA vaccine. Each patient had a medical history taken and the concentration of specific sIgG antibodies against S1 protein and SARS-CoV-2 N protein, as well as of selected cytokines (IL-8, TGF-ß, IFN-γ) was determined before and 3 weeks after the first and second dose of the vaccine. Results: There were 18 convalescents among the respondents. A statistically significant increase in the concentration of specific sIgG S1 in subsequent determinations was observed. Higher levels of sIgG S1 were found after the first dose of the vaccine in COVID-19 convalescents. There was no statistically significant influence of age, body mass index and sex on the increase in the concentration of antibodies and the concentration of the determined cytokines. It was shown that the higher the initial TGF-ß concentration, the greater the increase in sIgG S1 after administration of the vaccine. Conclusions: Vaccination did not increase the levels of IL-8, IFN-ß and TGF-γ. A higher concentration of serum TGF-ß before vaccination correlated with the higher concentration of sIgG S1 antibodies after the first dose of the vaccine.

Function of Follicular Cytokines: Roles Played during Maturation, Development and Implantation of Embryo.

A balance within the immune system is necessary for the proper development of ovarian follicles. Numerous cytokines were detected in follicular fluid, the role of which in reproductive physiology seems crucial. They influence the development and maturation of the follicle, ovulation, and corpus luteum formation, as well as embryo implantation and maintenance of pregnancy. The analysis of follicular fluid requires its collection by puncturing of the ovary, which is usually executed in connection with various gynaecological procedures. When interpreting such test results, clinical indications for a given procedure and the method of patient preparation should be taken into account. This review revealed the results of currently available studies on the concentration of pro-inflammatory cytokines in follicular fluid in various forms of infertility. Additionally, it presented cytokines, whose concentration has a significant impact on the size of ovarian follicles, their number, the effectiveness of in vitro fertilisation, development of the embryo, and chances of correct implantation. Despite the many recent publications, the knowledge of follicular fluid immunology in the context of reproductive pathology is superficial and further research is required to extensively understand the roles of individual cytokines in reproductive pathology. In the future, this knowledge may enable patients' individual qualifications to individual methods of infertility treatment, as well as the possible adjustment of the treatment regimen to the patient's immune profile.

Tree nut allergy.

From a botanical point of view, a nut is a kind of dry, closed, unbroken, single-seeded fruit, which has a ligneous pericarp made up of several fruiting bodies surrounded by one free semen. The term "allergy to tree nuts" includes allergies to almonds, Brazil nuts, cashew nuts, hazelnuts, chestnuts, macadamia nuts, pecan nuts, pistachios and walnuts. All tree nuts belong to five orders of plants: Rosaceae, Fagales, Sapindales, Ericales and Proteales. Allergies to tree nuts usually start in childhood, but unlike other food allergies, they rarely fade away and generally persist throughout life. They are one of the main causes of serious allergic reactions ending in death in both children and adults. The epidemiology of allergy to nuts is variable and depends mainly on the geographical zone and eating habits. In northern Europe, hazelnut allergy is prevalent, whereas in the USA the most common is allergy to peanuts and, when taking tree nuts into consideration, to walnuts. The diagnosis of allergies to nuts is difficult and requires the use of the most modern research tools including molecular diagnostic techniques.

Recurrent anaphylaxis in patient allergic to eggplant - a Lipid transfer protein (LTP) syndrome.

Eggplant allergy is rare and most of the previously described reactions were mild. In this case report, we present an interesting case of a 27-year-old male who experienced symptoms of anaphylaxis (shortness of breath, and swelling of the face, lips and tongue, which was followed by hypotension, tachycardia of 140/min and a sudden loss of consciousness) several minutes after eating a dish containing backed eggplant. Previously, the patient had experienced symptoms of allergy after eating different types of food, such as salad and chicken in spices. The symptoms were enhanced by co-factors. They were heterogeneous, ranging from oral symptoms to anaphylactic shock. During the diagnostic pathway, skin prick tests (SPTs) were positive to grass and cat. Prick by prick skin tests were positive for eggplant, both cooked and fresh. In ImmunoCap ISAC, IgE specific to rPhl p 1 (1.7 ISU-E), rCan f 5 (1,2 ISU-E), Fel d 1 (9.6 ISU-E ) and LTPs - nJug r 3 (0.5 ISU-E), rPru p 3 (0.6 ISU-E), rPla a 3 (1.3 ISU-E) were found. Based on the clinical pattern of the disease and the results of component resolved diagnosis, we suspect that this complex case of anaphylaxis may be gathered with LTP syndrome.

Diagnostics of Allergy to Furry Animals-Possibilities in 2024.

Diagnosing allergies is not always easy. Sometimes the symptoms reported by the patient do not match the results of diagnostic tests. Diagnostics of IgE-dependent allergy, including allergy to furry animals, can be based on two basic strategies, "BOTTOM-UP" and "TOP-DOWN", and almost all available allergy tests can be used ranging from skin tests, through specific IgE, to molecular panels and challenge tests. Currently, most information regarding the diagnosis and incidence of allergies to furry animals focuses almost exclusively on the two most common pets-dogs and cats. This is certainly due to the fact that allergy to cats and/or dogs is a common phenomenon, has a huge impact on quality of life, and is a challenge for doctors of many specialties. However, the growing number of owners of other pet species means that diagnostic methods must keep up with the changing needs of patients. Further research in these groups will certainly provide new facts and facilitate clinical decision-making when working with allergic patients.

The use of inhibition assay in Api g 7 suspected allergy in a female patient with anaphylaxis: A case report.

The symptoms of celery allergy are mainly presented as oral allergy symptom, but there are several case reports of patients who experienced anaphylaxis. Defensin (Api g 7), as a novel allergen in celery root, was described in 2022 r. The female patient had a history of several episodes of dyspnea and cough, associated with ingestion of spice mixes containing dried celery. Up to the point of hospitalization, there were no objective tests, either sIgE or skin prick tests, that would confirm celery sensitization. During hospitalization, patient had a positive double-blind placebo-controlled food challenge with cooked celery. The patient was sensitized to mugwort defensin Art v 1. An inhibition assay with celery allergen extract was performed to prove cross-sensitization between Art v 1 and celery allergen responsible for symptoms in the patient. In conclusion, Api g 7 is an important celery allergen that can be responsible for severe reactions. Its cross-reactivity with Art v 1 is characteristic. Negative diagnostic tests with celery do not exclude Api g 7 sensitization.

Should Emollients Be Recommended for the Prevention of Atopic Dermatitis?-New Evidence and Current State of Knowledge.

INTRODUCTION: Atopic dermatitis (AD) is a chronic, pruritic skin disease with complex pathogenesis, which affects about 43 million children aged 1-4 years. One of the most known methods of alleviating symptoms of AD is emollient treatment, which varies depending on formulation and additional active ingredients. There is some evidence that emollients could be used in AD prevention in high-risk children. MATERIALS AND METHODS: A search of the literature from Cochrane Library, PubMed and Medline was conducted between August and September 2023 with the following keywords: "atopic dermatitis", "emollients", and "prevention". Only randomised clinical trials published in the last 5 years were included into the meta-analysis. RESULTS: Considering the inclusion criteria only 11 randomized clinical trials were taken into account, and six of them proved lack of effect of emollients in the prevention of atopic dermatitis among neonates from AD risk groups. CONCLUSIONS: Emollient treatment has a good safety profile and most of the ingredients used in formulations are nonirritant for sensitive newborn and infant skin. There is some evidence of the positive effects of emollient treatment in prevention of AD in predisposed populations. The relatively high cost of emollient treatment (vs regular infant skin-care routine) would support the necessity for further evaluation of their effectiveness in nonpredisposed populations.

Blood type ABO and the cytokine profile of follicular fluid in women undergoing IVF/ET.

OBJECTIVES: ABO blood type was hypothesised to be related to a number of infertility processes. There is still an open debate on ABO blood group's incompatibility and infertility. It was associated with ovarian reserve in women with subfertility. There is still not enough information on the influence of blood type and the immunology of follicular fluid (FF). MATERIAL AND METHODS: 78 patients were selected, who underwent in vitro fertilization (IVF) between April 2021 and January 2022. FF samples from each individual patient were taken on the day of ovarian puncture and stored at -80°C until immunological assessment. Concentration of chosen interleukins - IL-1α, IL-2, IL-4, IL-5, IL-6, IL-8 IL-10, IL-15, IL-1ß, IL-18, IFN, LIF, TNFα, GCSF and PIBF-1 were measured using commercially available ELISA kits. RESULTS: All assessed cytokines were present in the FF of exanimated patients. The concentration was compared to the blood type ABO of all women undergoing in vitro fertilization. No statistical relevance was found between blood type ABO and the concentration of GCSF, PIBF1, LIF, IL-15, IL-5, IL-8, IL-1 alfa, IL-1 beta, INF gamma, IL-2HS, IL-4HS, IL-6HS, IL-10HS in the FF obtained during ovarian puncture (p > 0,05). There was no statistically significant correlation between blood type ABO and the quality of embryo, and the positive pregnancy test in patients undergoing IVF/ET. CONCLUSIONS: The blood type ABO does not influence the wide cytokine profile of FF obtained during ovarian puncture in women with infertility of different origin, as well as embryo quality and pregnancy rate.

Application of native prick test in diagnosis of bed bug allergy.

The aim of the study was case report of the patient with systemic reaction after a bed bug (Cimex lectularius) bite. A 23-year-old female, previously healthy, reports systemic reaction, including rash on her corpus and limbs, itching, nausea, conciseness disorder, forcing her to call the ambulance. The interview revealed that the bed bug occurs in the patient's apartment. A prick-by-prick test with bed bug excretion was made. The skin test with native allergen was strongly positive (histamine 5 mm/5 mm, prick-by-prick 12 mm/8 mm). The prick-by-prick test was useful in objective confirmation of the source of symptoms.

Anaphylaxis after accidental ingestion of kiwi fruit.

Numerous cases of anaphylaxis after ingestion of kiwi fruit, after the skin tests and during oral immunotherapy were described. The article describes the case of severe anaphylactic reaction that occurred in a 55-year-old patient after accidental ingestion of kiwi. Allergy to kiwi fruit was confirmed by a native test with fresh kiwi fruit. After the test, the patient experienced generalized organ response in the form of headache, general weakness and rashes on the neck and breast, and dyspnea. The patient had significantly elevated levels of total IgE and IgE specific to kiwi fruit.

Eosinophilic gastroenteritis - a manifestation of an allergic disease in the gastrointestinal tract? Part 2. Treatment.

Treatment of eosinophilic gastroenteritis (EGE) is mainly empirical and is based on the assessment of symptom severity and the experience of clinicians. Patients with mild disease can be treated symptomatically, while patients with more severe symptoms or malabsorption symptoms require more aggressive therapy. So far, several therapeutic options have been proposed, including the following: dietary treatment, glucocorticosteroids, inhibitors of leukotriene receptors, mast cell stabilizers, immunomodulating drugs, and biological drugs. Unfortunately, there is still a lack of well-designed, prospective. and randomized clinical trials involving large groups of patients with EGE and assessing the effectiveness of individual treatments. More research is needed to compare the efficacy and safety profiles of the various treatments available, and to select the prognostic factors of relapse, which in turn will be extremely important in making decisions about the initial treatment phase and maintenance therapy.

Eosinophilic gastroenteritis - a manifestation of an allergic disease in the gastrointestinal tract? Part 1. Epidemiology and diagnosis.

Eosinophilic gastroenteritis (EGE) is a relatively rare disease, but it should be considered whenever a patient presents with unexplained gastrointestinal symptoms that cannot be explained by parasitic infection or other gastrointestinal diseases characterized by eosinophilic infiltration. A high coexistence of EGE and allergic diseases has been documented. Diagnosis of EGE is based primarily on clinical, endoscopic, and histopathological findings. Glucocorticosteroids and other immunomodulatory drugs are the mainstay of treatment, but currently the greatest hope lies in biological drugs, which are undergoing intensive research. This disease is troublesome for the patient and significantly reduces the quality of life.

Clinical Use of the ImmunoCAP Inhibition Test in the Diagnosis of Meat Allergy Caused by a Tick Bite in an Adult Male with No Previous Atopic History.

(1) Background: alpha-gal syndrome (AGS) is a serious, potentially life-threatening allergic reaction. This is a type of food allergy to red meat and other mammalian products (e.g., gelatin). In Poland, this problem seems to be rare or, more likely, very underdiagnosed. The diagnosis of AGS is difficult. It seems that the knowledge about this syndrome is insufficient. There are no effective diagnostic tools able to clearly diagnose this cross-reactive allergy. This paper presents the clinical application of a non-standard method in the diagnosis of a cross-reactive allergy using the example of AGS. (2) Methods: standard tests for in vitro allergy diagnostics and the non-standard ImmunoCAP inhibition test(IT) were carried out for serum collected from a patient with a red meat allergy. (3) Results: the serum concentration of anti-α-Gal IgE was very high (302 kUA/L), and IgE antibodies toanti-mammalian-meat allergens were found. The level of IgE antibodies to mammalian meat allergens decreased after blocking on α-GAL-CAP. The concentration of anti-α-Gal IgE decreased after blocking on CAPs coated with various mammalian meat allergens. Blocking with allergens of poultry meat did not affect the concentration of anti-α-Gal IgE. (4) Conclusions: the ImmunoCAP ITseems to be a useful tool in the diagnosis of cross-reactive allergies. Based on their clinical history and test results, the patient was diagnosed with AGS caused by a primary sensitization to α-Gal after a tick bite. This is the second case of AGS described in Poland and the first in Pomerania.