Assessment of egg and milk allergies among Indians by revalidating a food allergy predictive model.

Background: The recent upsurge in food allergy indicates the need for accurate medical diagnostics. The application of predictive diagnostic models can envisage the outcome of oral food challenge (OFC), reducing cost and time. A logistic regression model was developed by DunnGalvin for children predicting OFC outcome using six predictors viz: sex, age, history, specific IgE, total IgE minus specific IgE, and skin prick test. This model was later updated by Klemans, reducing the number of predictors enhancing the calibration and discrimination of outcome. Objective: Our aim was to revalidate both the models for assessment of egg and milk allergies among Indians in the age group 0-19 years and to determine regression coefficients for our study population. Methods: Revalidation was done at the allergy clinic using OFC outcomes of egg and milk allergic patients. Precise values of the predictors were set up for which calibration (predicted against observed outcome) and discrimination (area under curve [AUC] of receiver operator characteristic curve [ROC]) would be better. Results: The Klemans model with reduced number of predictors showed better accuracy, calibration and discrimination than the DunnGalvin. Best calibration for egg allergy was achieved in the Klemans model with correlation coefficient (r2) of 0.90 and accuracy of 97%. The AUC of ROC was 0.90. For milk allergy, the coefficient was 0.94 with accuracy of 98%. The AUC was 0.91. Conclusion: The present study showed that mathematical models are non-invasive and can be successfully used as appropriate alternative to OFC in Indian population after proper validation.

Association of HLA-DQ and IL13 gene variants with challenge-proven shrimp allergy in West Bengal, India.

Little is known about genetic factors and mechanisms underlying shrimp allergy. Genome-wide association studies identified HLA class-II and IL13 genes as highly plausible candidates for shrimp allergy. The present study was designed to investigate potential associations of HLA-DQ rs9275596, IL13 rs20541, and IL13 rs1800925 polymorphisms with challenge-proven shrimp allergy using the data from 532 people of West Bengal, India; selected on basis of positive skin prick test, elevated specific IgE and medical history. Risk genotypes, i.e., HLA-DQ rs9275596 CC, IL13 rs20541 AA, and IL13 rs1800925 TT, were found to be significantly associated with challenge positive shrimp allergy (P = 0.04, 0.01, and 0.03, respectively). Distribution of genotypes for HLA-DQ and IL13 polymorphisms in allergic and control subjects showed significant difference between younger (20-40 years) and older (> 40 years) age group (P = 0.006). Risk genotypes significantly associated with elevated shrimp-specific IgE. IL13 TA haplotype significantly associated with shrimp allergy and elevated specific IgE (P = 0.02). Synergistic effect of IL13 TA haplotype-HLA-DQ rs9275596 CC genotype interaction significantly elevated specific IgE (P = 0.03). The present study suggests that HLA-DQ and IL13 polymorphisms pose major risk for shrimp allergic patients in West Bengal, India and thus could be helpful for early target-specific therapeutic intervention in near future.

Assessment of Hymenoptera and Non-Hymenoptera Insect Bite and Sting Allergy Among Patients of Tropical Region of West Bengal, India.

West Bengal, India, is inhabited by abundance and variety of insects that triggers sensitization in some humans to inhalant allergens and/or insect stings/venoms. Lack of research on this topic prevented accurate diagnosis and proper follow-up treatments to patients suffering from insect-induced allergies. The aim of our study was to identify the allergy-causing insects and evaluate resulting sensitization among a study population in West Bengal, India. The skin prick test (SPT) evaluated sensitivity of 450 patients who sought treatment at the Allergy and Asthma Research Center from July 2017 to June 2018. Eight insect allergens were tested: Common Black Ant (Lasius niger, Linnaeus 1758), Fire Ant (Solenopsis invicta, Buren 1972), Honey Bee (Apis cerana indica, Fabricius 1798), Common Wasp (Vespula vulgaris, Linnaeus 1758), Mosquito (Aedes aegypti, Linnaeus in Hasselquist 1762), American Cockroach (Periplaneta americana, Linnaeus 1758), House Fly (Musca domestica, Linnaeus 1758), and Grasshopper (Gesonula punctifrons, Stal 1861). From a total of 450 patients evaluated, 370 patients had positive SPT reaction from at least one of the 8 insect allergens tested. Sensitivity to some Hymenoptera insects (common black ant, 87.62%; fire ant, 84.59%; and honey bee, 67.02%) was found in higher proportion than non-Hymenoptera group (mosquito, 66.67%; American cockroach, 33.33%; house fly, 10.41%; and grasshopper, 5.14%). There was significant difference in sensitivity among child, adolescent, and adult (P < 0.001). While female patients showed more sensitivity than males to SPT, the difference was statistically insignificant. In regards to occupation, farmers and bee keepers were most sensitive of field workers sensitive to Hymenoptera-derived allergens.

Phytochemical analysis of mite-infested tea leaves of Darjeeling Hills, India.

INTRODUCTION: Darjeeling tea of India is one of the most famous beverages globally. However, a large amount of tea crop is damaged every year by the attack of mites. OBJECTIVES: The study aimed to determine the changes in different pigments and biochemical components of tea leaves due to mite infestation. MATERIALS AND METHODS: We used UV-visible and Fourier-transform infrared (FTIR) spectroscopy simultaneously to understand the damages in pigment contents of the leaves of tea (Camellia sinensis (L.) Kuntze) due to attack of phytophagus mite, Oligonychus coffeae Nietner. Furthermore, chemical analysis of infested tea leaves was also performed to compare the nutrients of the plants, namely total phenol, protein and soluble sugar. RESULTS: The UV-visible study reveals severe reduction of the pigments such as chlorophyll (Chl), carotenoids and xanthophylls in the tea leaf due to mite infestation. The findings of the FTIR study, also shows variation in different physiochemical components in the leaf Chl. The sugar and protein content of the infested leaves have been reduced compared to uninfested ones. Results in the case of tea leaves plucked during first (March) and third (November) flushes show similar trends. CONCLUSION: The increase in phenolic and alcoholic components and decrease in Chl contents may affect the quality of Darjeeling tea. The extent of damages done by the pests measured here could aid the pest management in tea gardens.

Association of the STAT6 rs3024974 (C/T) Polymorphism with IgE-Mediated Food Sensitization among West Bengal Population in India.

INTRODUCTION: Genetic polymorphisms associated with IgE-mediated food sensitization have been a robust area of research for decades. A genome-wide search for susceptible loci regulating the IgE response (atopy) identified the candidate gene STAT6, which is important in the context of food allergic manifestations. OBJECTIVE: The present study was designed to investigate the sensitization of West Bengal population against some common allergenic food items and to study the role of the STAT6 gene polymorphism in elevating food-specific IgE levels among sensitized individuals. METHODS: Skin prick test was performed for 6 food items among 501 patients (126 children, 85 adolescents, and 290 adults)from West Bengal, India. Among them, 165 patients were selected for measurement of total IgE and food-specific IgE levels along with 165 controls. Finally, the STAT6 (rs3024974 (C/T) polymorphism was genotyped in 139 cases and control subjects. RESULTS: Shrimp was identified as a dominant food allergen in adolescents and adults, whereas milk sensitization was highest in children. Food-sensitized patients with onset during childhood had significantly higher total IgE levels compared to patients with onset during adulthood (p < 0.00001). The frequency of the rs3024974 CC genotype in both cases and control subjects (55.40 and 46.76%, respectively) was higher than that of CT or TT. Patients with childhood onset bearing the CC genotype had significantly higher specific IgE levels in comparison to those with adult onset (p = 0.001). CONCLUSION: Food sensitization has a genetic background and the rs3024974 polymorphism is associated with susceptibility and reaction severity in food-sensitized patients in West Bengal population in India.

Investigation of house dust mite induced allergy using logistic regression in West Bengal, India.

BACKGROUND: The diagnosis of house dust mite (HDM) allergy based on Skin prick test (SPT) is not accurate, especially in lower risk cases. Our aim is to develop and validate a predictive model to diagnose the HDM allergic symptoms (urticaria, allergic rhinitis, asthma). METHODS: A forward-step logistic regression model was developed using a data set of 537 patients of West Bengal, India consisting of clinical variables (SPT based on 6 allergens of house dust and house dust mites, total IgE) and demographic characteristics (age, sex, house conditions). The output probability was estimated from the allergic symptoms shown by the patients. We finally prospectively validated a data set of 600 patients. RESULTS: The gradual inclusion of the variables increased the correlation between observed and predicted probabilities (correlation coefficient (r2) = 0.97). The model development using group-1 showed an accuracy rate of 99%, sensitivity and specificity of 99.7% and 88.6% respectively and the area under the receiver operating characteristics (ROC) curve (AUC) of 99%. The corresponding numbers for the validation of our model with group-2 were 87%, 95.6% and 66% and 86% respectively. The model predicted the probability of symptoms better than SPTs in combination (accuracy rate 0.76-0.80), especially in lower risk cases (probability< 0.8) that are highly difficult to diagnose. CONCLUSION: This is perhaps the first attempt to model the outcome of HDM allergy in terms of symptoms, which could open up an alternative but highly efficient way for accurate diagnosis of HDM allergy enhancing the efficiency of immunotherapy.

Experimental Determination of η/s for Finite Nuclear Matter.

We present, for the first time, simultaneous determination of shear viscosity (η) and entropy density (s) and thus, η/s for equilibrated nuclear systems from A∼30 to A∼208 at different temperatures. At finite temperature, η is estimated by utilizing the γ decay of the isovector giant dipole resonance populated via fusion evaporation reaction, while s is evaluated from the nuclear level density parameter (a) and nuclear temperature (T), determined precisely by the simultaneous measurements of the evaporated neutron energy spectra and the compound nuclear angular momenta. The transport parameter η and the thermodynamic parameter s both increase with temperature, resulting in a mild decrease of η/s with temperature. The extracted η/s is also found to be independent of the neutron-proton asymmetry at a given temperature. Interestingly, the measured η/s values are comparable to that of the high-temperature quark-gluon plasma, pointing towards the fact that strong fluidity may be the universal feature of the strong interaction of many-body quantum systems.