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.

Allergic phenotypes in adult patients with atopic dermatitis, determined with the ISAC test (ImmunoCAP ISAC).

INTRODUCTION: Atopic dermatitis (AD) is a chronic inflammatory dermatosis, often with a concomitant allergy. The ImmunoCAP ISAC (Immuno Solid-Phase Allergen Chip) test is a novel method to determine the allergenic phenotype in a given patient. AIM: In this study, we used the ImmunoCAP ISAC test to analyze allergic phenotypes in adult patients with AD. MATERIAL AND METHODS: The study included 19 adult patients with AD. The severity of AD was assessed using SCORAD index. Serum concentrations of total IgE were determined by means fluoro-enzyme immunoassay (FEIA). The levels of asIgE were measured with the ImmunoCAP ISAC kits. RESULTS: Positive results of the ISAC test were documented in 84.2% of the study subjects. All patients synthesized asIgE against species-specific respiratory allergens; major components of animal allergens (57.87%), tree pollen allergens (47.3%), grass pollen allergens (42.1%), dust mite allergens (26.3%) and major allergen of mugwort (26.3%). 47.3% of the subjects were sensitive to cross-reactive allergenic components, most often proteins of the lipocalin family (57.8%), followed by PR-10 (26.3%), PR-14 (21%) and PR-5 proteins (21%). asIgE against species-specific allergens were found in 10.5% of the study subjects. No statistically significant relationships were observed between the severity or duration of AD and the prevalence and levels of asIgE against the allergens included in the ISAC panel. However, duration of AD correlated significantly with the serum concentration of total IgE. CONCLUSIONS: The ISAC test is suitable for determination of the allergenic phenotype in a given patient, and as such has an unquestioned diagnostic and therapeutic value.

Expression of IL-17A concentration and effector functions of peripheral blood neutrophils in food allergy hypersensitivity patients.

Lymphocytes Th17 and other types of immune system cells produce IL17. By induction of cytokines and chemokines, the IL17 cytokine is involved in mechanisms of allergic reaction with participation of neutrophil granulocytes. It affects activation, recruitment, and migration of neutrophils to the tissues, regulating inflammatory reaction intensity. Excited neutrophils secrete inter alia elastase and reactive oxygen species (ROS)--significant mediators of inflammation process responsible for tissues damage.The aim of the study was to evaluate the concentrations of serum interleukin 17A, serum neutrophil elastase, and ROS production by neutrophils in patients with food allergy.The study included 30 patients with food allergy diagnosed based on interview, clinical symptoms, positive SPT, placebo controlled double-blind oral provocation trial, and the presence of asIgE in blood serum against selected food allergens using fluoro-immuno-enzymatic method FEIA UNICap 100. The control group consisted of 10 healthy volunteers. The concentrations of IL17A were determined in all patients using ELISA method with eBioscience kits, and elastase using BenderMed Systems kits. Chemiluminescence of non-stimulated neutrophils was evaluated using luminol-dependent kinetic method for 40 min on Luminoskan (Labsystems luminometer).The results of serum IL-17A concentrations and the values of chemiluminescence obtained by non-activated neutrophils, as well as elastase concentrations, were higher in patients with food allergic hypersensitivity compared to healthy volunteers.This study demonstrates a significance of IL-17A and activated neutrophil granulocytes in the course of diseases with food allergic hypersensitivity.

[Food hypersensitivity in patients with pollen allergy].

Clinical observations indicate the frequently reported food hypersensitivity among patients, sensitive to airborne allergens. Symptoms of food hypersensitivity in this group of patients are often exacerbated during the pollen season. These reactions may be the results of cross-reactions between pollen and food allergens or food and pollen allergy coexisting. The aim of the study was to determine the incidence of food hypersensitivity in patients allergic to airborne allergens, the type of clinical manifestations and a kind of food frequently causing the symptoms. Retrospective analyses of case records of 55 randomly selected patients with airborne allergy aged from 18 to 72 yrs (mean 55 yrs), including 28 women ranging in age from 18 years to 62 yrs (mean 36 yrs) and 27 men aged from 18 to 72 yrs (mean 34 yrs) were carried out. All patients underwent skin prick tests with the following allergens: grass, rye, birch, alder, hazel, mugwort, plantain, Dermatophagoides farinae, Dermatophagoides pteronyssinus, skin dog, cat dander, Alternaria alternata, Cladosporium herbarum. We assessed the type of clinical manifestations of pollen allergy and evaluated the type of clinical manifestations of food hypersensitivity and the type of foods that caused it. In the examined 55 patients, 15 individuals reported food hypersensitivity (27.2%), the most frequently after consumption of apples, carrots, cherry, peach, hazelnut, walnut, celery and nectarines. Clinical manifestation of food hypersensitivity was mainly oral allergy syndrome (OAS). Hypersensitivity to food above all was reported by patients with allergic rhinitis, sensitive to grass and tree pollen. Due to the high prevalence of food hypersensitivity in patients allergic to airborne allergens, it seems advisable to consider avoiding eating some foods, such as apple, carrots, cherries, peach, particularly frequently cross-reacting with grass and trees allergens. This dietary restriction can prevent about 30% of patients with inhalant allergy against onset of oral allergy.

Analysis of the involvement of cytokines in allergy and breast cancer association.

AIM OF THE STUDY: The existence of a correlation between allergy disorders and cancer diseases has been confirmed by several epidemiological studies. Although the molecular mechanism involved in this phenomenon remains unknown, there are data indicating that certain cytokines, engaged in allergic processes, have antineoplastic activities. The aim of the present study was to explore the association between advanced breast cancer and allergic state on the molecular level. MATERIAL AND METHODS: We determined and compared the mRNA and protein expression of interleukin-1ß (IL-1ß), IL-4, IL-6, and interferon-γ (IFN-γ), cytokines known for antitumor properties, in the blood of advanced breast cancer patients and individuals with allergic diseases related to type 2 response. In addition, we performed an in vitro assay of reactivity of peripheral blood mononuclear cells after exogenous antigen stimulation. As a preliminary to molecular analysis we conducted a questionnaire study concerning the incidence of allergy among breast cancer patients and healthy subjects without malignancy. RESULTS: The results of the survey study revealed a negative relation between breast cancer and allergy prevalence. Subsequent molecular analysis, however, did not show statistically significant differences in cytokines mRNA and protein expression levels between allergic patients and those with malignancy. The in vitro reactivity test also did not reveal marked differences between IL-1ß, IL-4 and IL-6 production after PBMC triggering with exogenous antigen. CONCLUSIONS: We concluded that the studied cytokines (IL-1ß, IL-4, IL-6, and IFN-γ) are not engaged in breast cancer-allergy negative relation.

The role and therapeutic effectiveness of Plantago ovata seed husk (psyllium husk) in the prevention and non-pharmacological treatment of gastrointestinal diseases. Part 1. Clinical use of psyllium husk in the treatment of irritable bowel syndrome, ulcerative colitis, and colorectal cancer.

Plantago ovata is a common medicinal plant widely cultivated in tropical regions of the world. The outer seed coat of P. ovata, obtained by cleaning the seeds, contains soluble and insoluble fibre in a ratio of 7:3, making products containing P. ovata husk an ideal source of health-beneficial fibre. The results of clinical trials demonstrate the therapeutic efficacy of psyllium husk for various gastrointestinal disorders. It has also been documented that psyllium ingestion exhibits antioxidant, immunomodulatory, antiproliferative, anticancer, and antiviral effects. Such pleiotropic effects of P. ovata husk are related to the presence in its composition of arabinoxylan, which forms a gel in an aqueous environment, as well as bioactive compounds and their metabolites. This article presents the evidence available in the literature on the therapeutic potential and possible mechanisms of action of psyllium in the treatment of irritable bowel syndrome and ulcerative colitis, and prevention of colorectal cancer.

Role of E-selectin and platelet endothelial cell adhesion molecule 1 in gastritis in food allergy patients.

INTRODUCTION: The prevalence of food allergies and other allergic reactions is increasing worldwide, particularly in highly-urbanized populations. Cell adhesion molecules are expressed in response to various pro-inflammatory cytokines. The expression of intercellular adhesion molecule 1 - ICAM-1 (CD54), ICAM-1 (CD106), P-selectin (CD62P), and E-selectin (CD62E) on vascular endothelial cells is induced by such pro-inflammatory cytokines as tumor necrosis factor α (TNF-α) and interleukin-1 (IL-1). AIM: To analyze concentrations of E-selectin and platelet endothelial cell adhesion molecule-1 (PECAM-1) in patients with an allergic type of food sensitivity co-existing with gastritis and to compare them to the values determined in individuals with dyspeptic symptoms not associated with allergic disorders. MATERIAL AND METHODS: The study included 80 patients, among them 50 individuals with food sensitivity confirmed based on compulsory standards, and 30 subjects with dyspeptic symptoms not accompanied by allergic conditions. Venous blood samples were taken from each patient and concentrations of E-selectin and PECAM-1 were determined by means of ELISA. RESULTS: Mean concentrations of sE-selectin and sPECAM-1 in patients with food allergy amounted to 54.0 ±21.6 ng/ml and 132.8 ±31.4 ng/ml, respectively. In individuals without food allergy, mean concentrations of sE-selectin and sPECAM-1 were 57.7 ±17.9 ng/ml and 139.6 ±31.1 ng/ml, respectively. Patients with food allergy and individuals with dyspeptic symptoms not associated with food allergy did not differ significantly in terms of sE-selectin concentrations (Mann-Whitney U-test, p = 0.453028). Similarly, no significant intergroup differences were observed with regard to sPECAM-1 concentrations (Mann-Whitney U-test, p = 0.231054). CONCLUSIONS: Adhesion molecules play an important role in the development of inflammation. This study did not find significant differences in the concentrations of such molecules as sE-selectin and sPECAM-1 between patients with food allergy and gastritis, and subjects in whom gastritis was not accompanied by atopic disorders. A positive correlation between the concentrations of sPECAM-1 and E-selectin was observed in food allergy patients. Consequently, it can be concluded that these molecules participate in the pathogenesis of the inflammatory process independently of the etiopathogenesis of gastritis.

Eosinophilic esophagitis. What diet? How to treat it? The point of view of a gastroenterologist working in a department of allergology.

Eosinophilic esophagitis (EoE) belongs to a broad group of allergic gastrointestinal diseases. More narrowly, it is classified as an eosinophilic gastrointestinal disease and is its most common representative. Until recently, this disease was extremely rare, but the last 3 decades have seen a rapid increase in its prevalence to such an extent that in some recent studies it has been named the most common esophageal disease after reflux disease. EoE is an interdisciplinary disorder on the borderline between gastrointestinal and allergologic diseases, requiring cooperation of these two branches of medicine in diagnostics and treatment. Despite the development of medical science it remains a poorly known disease, difficult to diagnose and even more difficult to treat. Recent years have seen the emergence of new studies and guidelines, both American and European, that have radically changed our approach to the diagnosis and treatment of EoE.

Selected allergic diseases of the gastrointestinal tract.

Clinical symptoms of food allergy may affect not only the digestive tract, but also the respiratory system, skin, or cardiovascular system. They may manifest themselves as gastrointestinal problems, asthma attacks, hives, or anaphylactic shock. Allergic reactions of the gastrointestinal tract may be IgE-independent (oral anaphylaxis syndrome, acute gastrointestinal reactions), mixed (eosinophilic gastrointestinal disorders), or IgE-independent (food-induced enterocolitis, proctitis, or enteropathy). The most serious conditions in which allergic background plays or can play an important role are: oral anaphylaxis syndrome, aphthous stomatitis, reflux disease, acute and chronic allergic reactions of gastric mucosa, irritable bowel syndrome, and eosinophilic gastrointestinal disorders.

[Severe hyponatremia in patient with tumor of mediastinum]. / Ciezka hiponatremia u chorej z rozpoznanym guzem sródpiersia.

Hyponatremia is the most common electrolyte derangement occurring in hospitalized patients. The study presents a case of severe hyponatremia (range 93.2 mEq/l) in 67-year-old women presented weakness and neurological abnormalities. Laboratory tests showed additional electrolyte abnormalities such as hypokaliemia, hypomphosphatemia and hypomagnesemia. The cause of syndrome of inadequate antidiuretic hormone secretion (SIADH) in reported patient was lung carcinoma.

[Assessment of postvaccinal response in children past pertussis]. / Ocena odpowiedzi poszczepiennej u dzieci, które przebyly krztusiec.

In the nineties, despite high percentage of vaccination of children, from 86% to 99% dependently on the region, there came to the increase of whooping cough cases. Until then infants and children to the age of 5 years suffered from this disease, whereas in the last decade the number of cases increased mainly among children over 5 years of age, who were subjected to full cycle of vaccination against whooping cough. Searching for the causes of such epidemiologic situation the following suggestions have been given: change of the bacteria antigenicity, the phenomenon of postvaccinal immunity extinction, immune system mechanisms disorders and groundless excuse from vaccination. The study estimates parameters of postvaccinal response to immunization with selected vaccines in children post whooping cough.

Comparison of serum prohepcidin and iron metabolism parameters in obese and non-obese elderly individuals.

INTRODUCTION: Current knowledge indicates that there is a close connection between being overweight, obesity and iron metabolism disorders,but the underlying mechanism is unclear. Hepcidin could be a major contributor to poor iron status observed in the obese population. MATERIAL AND METHODS: The study was performed in 58 obese elderly individuals (F/M 34/24) aged 65-91 (78.92 ± 8.32) years. The controlgroup consisted of 15 non-obese elderly volunteers, age- and sex-matched. Based on the WHO definition, 36 (62%) obese individualswere diagnosed with normo- or microcytic anaemia. The following parameters were determined: prohepcidin, haemoglobin, serum iron,erythropoietin, ferritin and C-reactive protein (CRP). RESULTS: Prohepcidin concentrations were significantly increased in obese elderly individuals without anaemia compared to obese andanaemic (p < 0.01) as well as non-obese volunteers (p < 0.01). In obese individuals with anaemia there was a decrease in serum iron,concomitant with increased levels of erythropoietin and CRP compared to two other groups. Ferritin concentration was increased inobese people (with and without anaemia) compared to the non-obese group. Serum prohepcidin levels were positively correlated withfat mass percentage in obese individuals without and with anaemia (r = 0.32; p = 0.02). CONCLUSION: Results of this preliminary study suggest that body fat content does have an impact on prohepcidin concentration, andthereby on iron homeostasis.