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Fulltext Comparison of serum specific IgE with skin prick test in the diagnosis of allergy in Malaysia

Asha'ari ZA, Suhaimi Y, Yusof RA, Rushdan I, Maraina CH

Med J Malaysia, 2011 Aug;66(3):202-6.
PMID: 22111441 MyJurnal

We compared a newer serum specific IgE (SSIgE) test with skin prick testing (SPT) in the diagnosis of allergy in Malaysia. Ninety newly diagnosed allergic patients were enrolled for both tests. Using SPT as a clinical gold standard, the sensitivity, specificity, positive, and negative predictive values (PPV, NPV) were calculated for SSIgE for each of the common allergens tested. The highest positive results for both SPT and SSIgE were for house dust mite and cat. Compared to SPT, SSIgE showed better sensitivity but poorer specificity, low PPV and good NPV in all the allergens tested. Significant positive correlation was seen between the diameter of wheal and flare of SPT and the SSIgE results.

Matched MeSH terms: Skin Tests*
In vitro and in vivo evaluation of a novel testosterone transdermal delivery system (TTDS) using palm oil base

Haron DE, Chik Z, Noordin MI, Mohamed Z

Iran J Basic Med Sci, 2015 Dec;18(12):1167-75.
PMID: 26877845

Transdermal preparations for testosterone are becoming popular because of their unique advantages such as avoidance of first-pass effect, convenience, improved bioavailability, and reduction of systemic side effects. A novel testosterone transdermal delivery system (TDDS) was developed using a palm oil base called HAMIN™ (a commercial product) and tested using in vitro and in vivo skin permeability test methods.

Matched MeSH terms: Skin Tests
Identification of major allergens of wildflower honey

Yadzir ZH, Misnan R, Abdullah N, Arip M, Murad S

Southeast Asian J. Trop. Med. Public Health, 2011 Mar;42(2):370-5.
PMID: 21710860

The aim of this study was to identify the major allergens of wildflower honey in local patients with atopic disease. SDS-PAGE revealed ten protein bands of 25 to 110 kDa, with a heavy cluster in region of 40-75 kDa. Immunoblotting demonstrated seven IgE-binding bands of 39 to 110 kDa. The 60 kDa protein had the highest frequency of IgE-binding (100%) followed by 54 kDa protein (95%), thus identified as the major allergens of wildflowerhoney. Our findings indicate that the allergen extract used for diagnosis of honey allergy contains both the 54 kDa and 60 kDa proteins.

Matched MeSH terms: Skin Tests
Identification of Ige-binding proteins of raw and cooked extracts of Loligo edulis (white squid)

Yadzir ZH, Misnan R, Abdullah N, Bakhtiar F, Arip M, Murad S

Southeast Asian J. Trop. Med. Public Health, 2010 May;41(3):653-9.
PMID: 20578555

Allergy to different classes of mollusks, including squid, which are members of the class Cephalopods has been reported. Tropomyosin, a major muscle protein, is the only well-recognized allergen in squid. The aim of this study was to characterize IgE-binding proteins of local Loligo edulis (white squid) consumed in Malaysia. Protein profiles and IgE-binding proteins were detected by sodium dodecyl sulfate-polyacrylamide gel-electrophoresis (SDS-PAGE) and immunoblotting using sera from 23 patients with positive skin prick test to raw squid extract. SDS-PAGE of the raw extract exhibited 21 protein bands (10-170 kDa) but those ranging from 19 to 29 kDa and 41 to 94 kDa were not found in the cooked extract. Immunoblotting of raw extract demonstrated 16 IgE-binding bands, ranging from 13 to 170 kDa. A heat-resistant 36 kDa protein, corresponding to squid tropomyosin, was identified as the major allergen of both extracts. In addition, a 50 kDa heat-sensitive protein was shown to be a major allergen of the raw extract. Our findings indicate that the allergen extract used for diagnosis of squid allergy should contain both the 36 kDa and 50 kDa proteins.

Matched MeSH terms: Skin Tests
Improved Diagnosis of the Polysensitized Allergic Rhinitis Patients Using Component Resolved Diagnosis Method

Mohamad Yadzir ZH, Bakhtiar F, Misnan R, Abdullah N, Leecyous B, Murad S

Iran J Allergy Asthma Immunol, 2016 Apr;15(2):156-60.
PMID: 27090369

Allergy diagnosis needs to be improved in polysensitized patients due to the existence of possible confounding factors in this type of patients. Component resolved diagnosis (CRD) is a new concept in the investigation of polysensitized patients. The aim of this study was to evaluate if the utilization of ImmunoCAP ISAC improve the diagnosis of the polysensitized allergic rhinitis patients. Skin prick test (SPT) to 58 crude allergen extracts and CRD (ImmunoCAP ISAC) were carried out for 5 polysensitized allergic rhinitis patients. Two patients had a shellfish allergy and avoidance of shellfish was the only way to prevent an allergic reaction. In contrast, although the remaining three patients had low risk for shellfish allergy, but they were the best candidates for immunotherapy using mite extracts. CRD and particularly ImmunoCAP ISAC have proven to be a valuable diagnostic tool in polysensitized patients. ImmunoCAP ISAC helps refine the individual patient's sensitization profile and predict the potential risk of allergic reactions and improve the selection of patients for immunotherapy.

Matched MeSH terms: Skin Tests/methods
Component-resolved diagnosis (CRD): Is it worth it? frequency and differentiation in rhinitis patients with mite reactivity

Mohamad Yadzir ZH, Misnan R, Abdullah N, Bakhtiar F, Leecyous B, Murad S

Iran J Allergy Asthma Immunol, 2014 Aug;13(4):240-6.
PMID: 24659159

Component-resolved diagnosis (CRD) using microarray technology has recently been introduced with the aim to improve diagnosis of allergy. The aim of this study was to compare performance of this allergen microarray to those of an established extract-based skin prick testing (SPT).45 patients with allergic rhinitis were studied (16 children and 29 adults). SPT to Dermatophagoides pteronyssinus, Dermatophagoides farinae and Blomia tropicalis extracts and allergen microarray ImmunoCAP ISAC were carried out for all patients. Forty out of 45 patients demonstrated positive SPT to all mite extracts tested. These 40 patients were considered to be mite-allergic based on the positive SPT results. The remaining 5 patients with negative SPT to any mite extracts were classified as non-mite allergic. Comparatively, based on the microarray results, only 34 mite-allergic patients had detectable serum IgE to at least one of the mite allergen components tested whereas 6 patients with positive SPT to mite extracts showed no detectable IgE reactivity to any of the components tested. One non-mite allergic patient had a positive test- Blo t 5. Der p 10-positive patients also reacted to other cross-reactive tropomyosin from anisakis (Ani s 3) (25%), cockroach (Bla g 7) (50%) and shrimp (Pen m 1) (75%). CRD is a reliable tool for the diagnosis of allergy to mites. Der p 10 might be a useful indicator to identify a subset of mite-allergic patient that have additional sensitization due to cross-reactivity and thus allows selection of patients for immunotherapy.

Matched MeSH terms: Skin Tests
Fulltext Identification of major and minor allergens of black tiger prawn (Penaeus monodon) and king prawn (Penaeus latisulcatus)

Sahabudin S, Misnan R, Yadzir ZH, Mohamad J, Abdullah N, Bakhtiar F, et al.

Malays J Med Sci, 2011 Jul;18(3):27-32.
PMID: 22135598 MyJurnal

BACKGROUND: Prawns and shrimp are a frequent cause of seafood allergy mediated by IgE antibodies. Penaeus monodon and Penaeus latisulcatus, commonly known as black tiger prawn and king prawn, respectively, are among the most frequently consumed prawns in Malaysia. The aim of this study was to identify the IgE-binding proteins of these 2 prawn species.
METHODS: Raw and boiled prawn extracts were prepared and then resolved by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). IgE-immunoblotting was then performed using sera from patients with positive skin prick tests to the raw prawn extracts.
RESULTS: SDS-PAGE analysis of the raw extracts of both prawn species revealed 23 protein bands; the boiled extracts yielded fewer protein bands. The bands in the range of 40 to 100 kDa were sensitive to heat and therefore were not found in the boiled extracts. Immunoblot of raw extracts of black tiger prawns and king prawns yielded 14 and 11 IgE-binding proteins, respectively, with molecular weights of between 15 and 200 kDa. Proteins at 36, 42, and 49 kDa were detected as the major allergens in both species of prawns. A protein of 75 kDa was also identified as a major allergen in black tiger prawns. Other potential allergens were also observed at various molecular masses.
CONCLUSION: Proteins of 36, 42, and 49 kDa were identified as the major allergens of both species of prawns. The 36 and 42 kDa proteins are hypothesised to be tropomyosin and arginine kinase, respectively. A high molecular weight protein of 75 kDa was found to be an additional major allergen in black tiger prawns.
KEYWORDS: Penaeus; allergens; allergy and clinical immunology; hypersensitivity; immunoblotting; tropomyosin

Matched MeSH terms: Skin Tests
Sick building syndrome (SBS) among office workers in a Malaysian university--Associations with atopy, fractional exhaled nitric oxide (FeNO) and the office environment

Lim FL, Hashim Z, Md Said S, Than LT, Hashim JH, Norbäck D

Sci Total Environ, 2015 Dec 1;536:353-61.
PMID: 26225741 DOI: 10.1016/j.scitotenv.2015.06.137

There are few studies on sick building syndrome (SBS) including clinical measurements for atopy and fractional exhaled nitric oxide (FeNO). Our aim was to study associations between SBS symptoms, selected personal factors, office characteristics and indoor office exposures among office workers from a university in Malaysia. Health data were collected by a questionnaire (n=695), skin prick test (SPT) (n=463) and FeNO test (n=460). Office settled dust was vacuumed and analyzed for endotoxin, (1,3)-β-glucan and house dust mites (HDM) allergens group 1 namely Dermatophagoides pteronyssinus (Der p 1) and Dermatophagoides farinae (Der f 1). Office indoor temperature, relative air humidity (RH), carbon monoxide (CO) and carbon dioxide (CO2) were measured by a direct reading instrument. Associations were studied by two-levels multiple logistic regression with mutual adjustment and stratified analysis. The prevalence of weekly dermal, mucosal and general symptoms was 11.9%, 16.0% and 23.0% respectively. A combination of SPT positivity (allergy to HDM or cat) and high FeNO level (≥25 ppb) was associated with dermal (p=0.002), mucosal (p<0.001) and general symptoms (p=0.05). Der f1 level in dust was associated with dermal (p<0.001), mucosal (p<0.001) and general (p=0.02) symptoms. Among those with allergy to D. farinae, associations were found between Der f 1 levels in dust and dermal (p=0.003), mucosal (p=0.001) and general symptoms (p=0.007). Office-related symptoms were associated with Der f 1 levels in dust (p=0.02), low relative air humidity (p=0.04) and high office temperature (p=0.05). In conclusion, a combination of allergy to cat or HDM and high FeNO is a risk factor for SBS symptoms. Der f 1 allergen in dust can be a risk factor for SBS in the office environment, particularly among those sensitized to Der f 1 allergen.

Matched MeSH terms: Skin Tests
Fulltext Asthma, Airway Symptoms and Rhinitis in Office Workers in Malaysia: Associations with House Dust Mite (HDM) Allergy, Cat Allergy and Levels of House Dust Mite Allergens in Office Dust

Lim FL, Hashim Z, Than LT, Md Said S, Hisham Hashim J, Norbäck D

PLoS One, 2015;10(4):e0124905.
PMID: 25923543 DOI: 10.1371/journal.pone.0124905

A prevalence study was conducted among office workers in Malaysia (N= 695). The aim of this study was to examine associations between asthma, airway symptoms, rhinitis and house dust mites (HDM) and cat allergy and HDM levels in office dust. Medical data was collected by a questionnaire. Skin prick tests were performed for HDM allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae) and cat allergen Felis domesticus. Indoor temperature and relative air humidity (RH) were measured in the offices and vacuumed dust samples were analyzed for HDM allergens. The prevalence of D. pteronyssinus, D. farinae and cat allergy were 50.3%, 49.0% and 25.5% respectively. Totally 9.6% had doctor-diagnosed asthma, 15.5% had current wheeze and 53.0% had current rhinitis. The Der p 1 (from D. pteronyssinus) and Der f 1 (from D. farinae) allergens levels in dust were 556 ng/g and 658 ng/g respectively. Statistical analysis was conducted by multilevel logistic regression, adjusting for age, gender, current smoking, HDM or cat allergy, home dampness and recent indoor painting at home. Office workers with HDM allergy had more wheeze (p= 0.035), any airway symptoms (p= 0.032), doctor-diagnosed asthma (p= 0.005), current asthma (p= 0.007), current rhinitis (p= 0.021) and rhinoconjuctivitis (p< 0.001). Cat allergy was associated with wheeze (p= 0.021), wheeze when not having a cold (p= 0.033), any airway symptoms (p= 0.034), doctor-diagnosed asthma (p= 0.010), current asthma (p= 0.020) and nasal allergy medication (p= 0.042). Der f 1 level in dust was associated with daytime breathlessness (p= 0.033) especially among those with HDM allergy. Der f 1 levels were correlated with indoor temperature (p< 0.001) and inversely correlated with RH (p< 0.001). In conclusion, HDM and cat allergies were common and independently associated with asthma, airway symptoms and rhinitis. Der f 1 allergen can be a risk factor for daytime breathlessness.

Matched MeSH terms: Skin Tests
The association of allergy and chronic suppurative otitis media: A study in a tropical country

Mohd Khairi MD, Shahrjerdi B, Ramiza RR, Normastura R

Med J Malaysia, 2019 Jun;74(3):205-208.
PMID: 31256174

OBJECTIVE: Chronic suppurative otitis media (CSOM) usually begins as a spontaneous perforation of tympanic membrane due to an acute infection of the middle ear. This study was aimed to evaluate the association between allergy and CSOM.
METHODS: A case-control study was carried out among patients with CSOM (cases) and controls were those with no ear pathology. The presence of CSOM was made through a medical history and otoscopic examination. Allergen testing was done by the skin prick test.
RESULTS: In all 124 subjects were recruited in this study with equal number of the cases and controls. The commonest positive reaction in the skin prick test in both groups was to house dust mites. Among CSOM cases, half (50%) of them had an allergy to Blomia tropicalis and 48.4% to Dermatophagoides while in the control group, 27.4% to Dermatophagoides and 25.8% to B. tropicalis. There were significant associations between CSOM and allergy to B. tropicalis (p=0.005), Dermatophagoides (p=0.016) and Felis domesticus (p=0.040). The prevalence of allergy at 95% confidence interval (95%CI) in CSOM and control groups were demonstrated as 59.7% (95%CI: 47.5, 71.9) and 30.6 % (95%CI: 19.1, 42.1) respectively. There was a significant association between allergy and CSOM (p=0.001).
CONCLUSION: Indoor allergens are the most prevalent in our environment and therefore good control may difficult to achieve. The hypersensitivity states of the subject are likely to have a role in the pathogenesis of CSOM especially in the tropical countries where allergy occurs perennially.

Matched MeSH terms: Skin Tests
A study of pollen prevalence in relation to pollen allergy in Malaysian asthmatics

Sam CK, Kesavan-Padmaja, Liam CK, Soon SC, Lim AL, Ong EK

Asian Pac J Allergy Immunol, 1998 Mar;16(1):1-4.
PMID: 9681122

In this paper we report results of skin prick tests (SPT) using pollen extracts on 200 patients with clinical symptoms of asthma, and results of a parallel study in which pollen was collected and classified over a period of 18 months. The patients were outpatients from the University Hospital in Kuala Lumpur, Malaysia, while the pollen grains were collected with a spore trap placed in the campus of the University of Malaya, approximately one kilometer from the University Hospital. Pollen extracts of 3 grasses (Bahia, Bermuda, rough pigweed) and 2 flowering trees, Acacia and Melaleuca, were used in the SPT. Of the 29.5% asthmatics with positive SPT reactions, 21.5% were to one or more of the grass pollens, 21.5% to Acacia and 7.5% to Melaleuca pollen. Acacia and Bermuda grass extracts were the most allergenic, which agreed with results of the pollen collection which showed grass and Acacia pollen grains to be the two most commonly found pollens.

Study site: University Malaya Medical Centre (UMMC)

Matched MeSH terms: Skin Tests
THE ISOLATION OF HISTOPLASMA CAPSULATUM FROM A PATIENT IN A CHEST HOSPITAL

PONNAMPALAM JT

Med J Malaysia, 1964 Mar;18:201-4.
PMID: 14157186
Matched MeSH terms: Skin Tests*
Histoplasmosis in Malaya

Ponnampalam JT

Br J Dis Chest, 1964 Apr;58:49-55.
PMID: 14152216

A survey of 227 patients from 5-60 years of age revealed the presence of positive histoplasmin skin tests in 10.5 per cent. and positive complement-fixation tests in 19-8 per cent. Sputum from 13 of the 37 patients who had a positive complement-fixation test were cultured for H. capsulatum but with negative results. Exposure to infection by the fungus is equally distributed among the different race and age groups. A careful and constant watch should be kept for histoplasmosis in all chest hospitals as a certain number of cases may be present. It tends to elude diagnosis unless specially sought as it resembles the clinical picture of tuberculosis or other granulomatous disease. It presents a field for further investigation and research in Malaya.

Matched MeSH terms: Skin Tests*
Low prevalence of latex sensitivity in South African spina bifida children in Cape Town

Johar A, Lim DL, Arif SA, Hawarden D, Toit GD, Weinberg EG, et al.

Pediatr Allergy Immunol, 2005 Mar;16(2):165-70.
PMID: 15787875

Spina bifida children have a high prevalence of latex allergy in studies reported from Europe and the USA. This study investigated the prevalence of latex allergy in a cohort of 24 spina bifida children at the Red Cross Children's Hospital from Cape Town, South Africa. The children were investigated using a detailed questionnaire, skin prick tests (ALK-Abello), ImmunoCap RASTs, Western blotting and ELISA, using the purified latex proteins Hev b1 and Hev b3 and whole latex preparation. A low overall prevalence of latex sensitization of 16.7% was found in the children. Children who were sensitive reacted to water insoluble to Hev b1 and Hev b3 proteins. The low prevalence of latex sensitization in the South African children may not be entirely explained by stringent latex avoidance. The children were from a low socioeconomic social status and 'hygiene' and other factors should be considered.

Matched MeSH terms: Skin Tests
Dermatophagoides pteronyssinus and house dust allergy in west Malaysia

Thomas V, Bock Hay Am Tan, Rajapaksa AC

Ann Allergy, 1978 Feb;40(2):114-6.
PMID: 629426

Three groups of people with different clinical histories and manifestations to house dust were skin tested with Dermatophagoides pteronyssinus extracts. The results showed close correlation between positive skin tests and clinical sensitivity to dust. The correlation was not, however, perfect and, although D. pteronyssinus is a major factor in house dust allergy, it does not appear to be the sole antigen involved.

Matched MeSH terms: Skin Tests
Filariasis due to Brugia malayi in West Malaysia. II. Skin test aspects

Dondero TJ, Ramachandran CP

Southeast Asian J. Trop. Med. Public Health, 1972 Mar;3(1):25-30.
PMID: 5028861
Matched MeSH terms: Skin Tests*
Nasopharyngeal carcinoma and nasal allergy: any correlation?

Prepageran N, Lingham OR, Krishnan G, Jalaludin MA, Raman R

Ear Nose Throat J, 2003 Jun;82(6):438-40.
PMID: 12861869

Although it has been observed that nasal allergy is rarely seen in patients who have nasopharyngeal carcinoma, to our knowledge, no actual study of such a lack of association has been previously reported. To fill this void, we conducted a pilot study to investigate any such inverse relationship. We conducted skin-prick allergen tests on 22 patients with newly diagnosed but not-yet-treated nasopharyngeal carcinoma. Combining these test results with findings on the history and clinical examination, we concluded that only one of the 22 cancer patients (4.5%) had allergic rhinitis. Our study also confirmed the validity of using findings on the history, clinical examination, and skin-prick testing as a reliable means of diagnosing allergic rhinitis.

Matched MeSH terms: Skin Tests
Occurrence of histoplasmosis in Asia

Randhawa HS

Mycopathol Mycol Appl, 1970;41(1):75-89.
PMID: 4938836
Matched MeSH terms: Skin Tests
Fulltext The Kveim test in lepromatous and tuberculoid leprosy

Pearson JMH, Pettit JHS, Siltzbach LE, Ridley DS, Hart PD, Rees RJ

Int. J. Lepr. Other Mycobact. Dis., 1969;37(4):372-81.
PMID: 5394258

Kveim tests using a validated material have been undertaken in Malaysia on 39 patients (32 Chinese; 4 Malay and 3 Aboriginal) with lepromatous or tuberculoid leprosy. All the patients had been treated for leprosy, most for two or more years. The tests were read microscopically. Of the 21 lepromatous patients one gave a weak positive and two an equivocal Kveim test whereas four of the nine tuberculoid patients gave equivocal or weak Kveim positivity. Only the tuberculoid form elicits a higher proportion of granulomas than might be expected in a comparable normal population. Of nine patients (8 lepromatous; 1 tuberculoid ) who failed to sensitize well to tuberculin
following two BCG vaccinations, two gave equivocal Kveim tests similar in appearance to those in the other groups.

Matched MeSH terms: Skin Tests*
Fulltext Atopic sensitization of children with rhinitis in Malaysia

Gendeh BS, Mujahid SH, Murad S, Rizal M

Med J Malaysia, 2004 Oct;59(4):522-9.
PMID: 15779586 MyJurnal

Atopy is defined as the genetic propensity to develop immunoglobulin E antibodies in response to exposure to allergens and assessed by skin prick test (SPT) responses to common allergens, which may contribute to the development of the clinical disorders (phenotype). Although it is generally agreed that atopy is an important risk factor for allergic diseases such as asthma, rhinitis, and eczema, the extent to which atopy accounts for these diseases is controversial. One hundred forty one children (up to 12 years) were skin prick tested to evaluate 16 foods common to the Malaysian diet and 4 common aeroallergens. Eighty-five percent of patients had positive SPT reactivity. The most commonly implicated aeroallergen and food allergen was house dust mite (HDM) and Prawn. Seventy percent had positive SPT reactivity results to HDM and 24.8% to prawns. Fifty five percent were positive to more than one allergen and 17.7% positive to single aeroallergen. The prevalence of atopy in children with history of eczema was 90%. The incidence of HDM and food allergy especially crabs and prawns, is significantly greater in Malaysian Children with rhinitis symptoms.

Matched MeSH terms: Skin Tests

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