Displaying publications 41 - 60 of 73 in total

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  1. Yaacob I, Elango S
    Asian Pac J Allergy Immunol, 1991 Jun;9(1):39-43.
    PMID: 1776978
    In a study of 124 adult patients with bronchial asthma, 65% of them had associated rhinitis. In the asthmatics who had associated rhinitis, both diseases usually started within two years of one another but either disease might develop first. In 21% of the patients, asthmatic attacks were preceded or precipitated by rhinitis symptoms. In the patients who had asthma alone or those associated with rhinitis, no significant difference were found in terms of age and sex distribution, age of onset, and a positive family history of asthma, rhinitis or allergic diseases. Response to skin prick test using six different types of allergens also showed no difference in the two groups of patients. Sensitivity to house dust was common among both groups of patients as well as in the normal controls suggesting a common occurrence of house dust mite in our community and making the skin prick test using this allergen unsuitable as a test for atopy in our population.
    Study site: Chest clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
    Matched MeSH terms: Skin Tests
  2. Ross I
    Br J Dis Chest, 1984 Oct;78(4):369-75.
    PMID: 6487527 DOI: 10.1016/0007-0971(84)90170-0
    Asthmatic patients constitute up to 5% of admissions to medical wards in our area. Analysis of 1099 adult asthmatic admissions over a 3-year period showed that Malays composed 31% of patients (expected 23%), Indians composed 36% (expected 31%) and Chinese only 32% (expected 46%). There was a reduced prevalence of asthma in the Chinese (P less than 0.001). Male asthmatic admissions showed a non-seasonal cyclic variation (P less than 0.01) with an increasing trend in the number of admissions (P less than 0.02). The proportion of male to female asthmatic admissions did not differ. In a sample of 50 asthmatic patients, studied in detail, the mean age of onset was 33.3 years (range 6-74) while only 14% of subjects had onset of asthma before the age of 10 years. Although the clinical features of these patients differ from those of Caucasian asthmatics, skin prick tests and other features suggest that the majority of our patients suffer from extrinsic atopic asthma.
    Study site: Hospital [unknown], Pulau Pinang, Malaysia
    Matched MeSH terms: Skin Tests
  3. 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
  4. Norhafizah S, Salina H, Goh BS
    Eur Ann Allergy Clin Immunol, 2020 05;52(3):121-130.
    PMID: 31668057 DOI: 10.23822/EurAnnACI.1764-1489.119
    Summary: Introduction.The prevalence of allergic rhinitis in children with persistent otitis media with effusion in different countries varies between 82% to 93%. Many risk factors of otitis media with effusion has been studied and proven. However, its association with allergic rhinitis remains controversial. Objective. The main objective of this study is to determine the prevalence of allergic rhinitis in children with persistent otitis media with effusion. This study is also aimed to identify the risk factors of otitis media with effusion, common allergens associated with allergic rhinitis and determine the hearing threshold of children with otitis media with effusion. Methods.A hundred and thirty children were recruited. History taking, physical examination and hearing assessment were done in the first visit. Those with allergic rhinitis underwent skin prick test and treated with intranasal corticosteroid and antihistamine. A second examination and hearing assessment were then repeated after 3 months. Results.The prevalence of allergic rhinitis in children with persistent otitis media with effusion in this study was noted to be 80.3%. Among these children, dust mites appeared to be the most common allergen (87.7%). Another risk factor appeared to be families with more than 4 members per-household (96%). It is noted that that otitis media with effusion caused a hearing loss up to 33 dB. However, there was a statistically significant improvement of the hearing threshold during second visit after commencement of allergy treatment. It was also noted that the hearing threshold in allergic rhinitis group was significantly impaired compared to the non-allergic rhinitis group. Conclusions.Allergic rhinitis and larger family household appeared to be common risk factors in children with persistent otitis media with effusion. There is significant hearing loss noted in children suffering from otitis media with effusion and allergic rhinitis. The hearing threshold improved remarkably with medical therapy. This study hence clarifies the controversy on the association between allergic rhinitis and otitis media with effusion.
    Matched MeSH terms: Skin Tests
  5. Nurul Izzah, A.R., Zailatul Hani, M.Y., Noormalin, A., Faizal, B., Shahnaz, M., Rosmilah, M.
    Medicine & Health, 2015;10(2):90-97.
    MyJurnal
    Crab meat is a valuable source of proteins and functional lipids and it is widely consumed worldwide. However, the prevalence of crab allergy has increased over the past few years. In order to understand crab allergy better, it is necessary to identify crab allergens. The aim of the present study was to compare the IgE-binding proteins of raw and cooked extracts of mud crab (Scylla serrata). Raw and cooked extracts of the mud crab were prepared. Protein profiles and IgE reactivity patterns were identified by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) followed by immunoblotting using sera from 21 skin prick test (SPT) positive patients. In SDS-PAGE, 20 protein bands (12 to 250 kDa) were observed in the raw extract while the cooked extract demonstrated fewer bands. Protein bands between 40 to 250 kDa were sensitive to heat denaturation and no longer observed in the cooked extract. In immunoblotting experiments, raw and cooked extracts demonstrated 11 and 4 IgE-binding proteins, respectively, with molecular weights of between 23 and 250 kDa. A heat-resistant 36 kDa protein, corresponding to crab tropomyosin was identified as the major allergen of both extracts. In addition, a 41 kDa heat-sensitive protein believed to be arginine kinase was shown to be a major allergen of the raw extract. Other minor allergens were also observed at various molecular weights.
    Matched MeSH terms: Skin Tests
  6. Hamizan AW, Christensen JM, Ebenzer J, Oakley G, Tattersall J, Sacks R, et al.
    Int Forum Allergy Rhinol, 2017 01;7(1):37-42.
    PMID: 27530103 DOI: 10.1002/alr.21835
    BACKGROUND: Middle turbinate edema could be a characteristic feature of aeroallergen sensitization. In this study we sought to determine the diagnostic characteristics of middle turbinate edema as a marker of inhalant allergy.

    METHODS: A cross-sectional diagnostic study was performed on patients who had undergone nasal endoscopy and allergy testing. Allergy status was determined by positive serology or epicutaneous testing. Endoscopy was reviewed by blinded assessors for middle turbinate head edema. Appearance was graded as either normal, focal, multifocal, diffuse, or polypoid edema. Receiver-operator (ROC) analysis, likelihood ratio (LR), sensitivity, specificity, and positive predictive value (PPV) were determined.

    RESULTS: One hundred eighty-seven patients representing 304 nasal cavities were assessed (42% female, age 39.74 ± 14.7 years, 57% allergic). Diffuse edema (PPV 91.7%/LR = 8) and polypoid edema (PPV 88.9%/LR = 6.2) demonstrated the strongest association with inhalant allergy. Multifocal edema was used as a cut-off to represent inhalant allergy from ROC analysis, which demonstrated 94.7% specificity and 23.4% sensitivity. The PPV for multifocal was 85.1% and LR = 4.4.

    CONCLUSION: Middle turbinate edema is a useful nasal endoscopic feature to predict presence of inhalant allergy and, although not sensitive, has excellent PPV.

    Matched MeSH terms: Skin Tests
  7. Teo, Keat Seong, Cheah, Cheong Wooi, Mak, Joon Wah
    MyJurnal
    Background: Sensitisation to house dust mite (HDM) has been regarded as a major risk factor for development of asthma. This study was carried out to investigate the profiles of HDM sensitisation among Malaysian children with asthma.
    Material and Methods: The association between HDM sensitisation and control and severity of asthma was investigated. The salivary HDM specific IgE levels were quantified in different grades of control and severity of asthma in 125 unselected asthmatic children aged 5-12 years old attending the asthma follow-up clinic in Hospital Tuanku Ja’afar Seremban. An additional 29 non-asthmatic patients were selected as control. The skin prick test to assess sensitisation to Dermatophagoides pteronyssinus (DP) and Dermatophagoides farinae (DF) was performed on all the participants. A questionnaire regarding the control and severity of asthmatic symptoms of the subject was administered. Saliva was collected by voluntary spitting and ELISA was used to quantify the IgE specific to HDM antigen.
    Results: There was a significant association between sensitisation to DP and DF and the control of asthma. The association between DP sensitisation and severity of asthma just failed to reach a significant level although there is a clear trend for this. Significant association was found between DF sensitisation and severity. The HDM specific IgE in the saliva was significantly higher in asthmatic patients compared to non-asthmatic patients. There was no significant difference between the specific IgE levels in patients with different severity status of asthma.
    Conclusion: Salivary IgE levels may not be an appropriate indicator of the patients’ asthmatic condition in this study. However, it can be concluded that there is significant association between the sensitisation of HDM and the control and severity of asthma.
    Study site: Asthma clinic, Hospital Tuanku Jaafar, Seremban, Negeri Sembilan, Malaysia
    Matched MeSH terms: Skin Tests
  8. Soegiarto G, Abdullah MS, Damayanti LA, Suseno A, Effendi C
    Asia Pac Allergy, 2019 Apr;9(2):e17.
    PMID: 31089459 DOI: 10.5415/apallergy.2019.9.e17
    Background: The prevalence of allergy among Surabaya school children is currently unknown.

    Objective: To identify the prevalence of the common allergic sensitization and allergic diseases among school children and undergraduate students in suburban of Surabaya by epidemiologic data collection.

    Methods: A multistage simple random sampling was done to select 5 primary schools, 8 secondary schools (4 of junior high schools and senior high schools, respectively), and 1 university from 5 districts in Surabaya city. Out of 550 invited respondents, 499 (128 primary school, 221 secondary school, and 150 undergraduate) respondents gave their consent. A complete personal history, allergic symptoms, environmental exposure of common allergens was obtained from interview and the physical examinations were performed. Skin prick test (SPT) was done using 45 different allergen extracts. Total serum IgE and specific IgE radioallergosorbent test levels were measured for respondents with allergic manifestations.

    Results: There was an increasing SPT positivity among study respondents, from primary school, secondary school, to undergraduate students (21.90%, 28.95%, to 45.30% respectively). Cockroach (42.85%) and fungi/mold spore (42.85%) were the most common allergens in primary school children. House dust mites was the most common allergen in secondary school (63.16%) and undergraduate students (58.82%). Urticaria and rhinitis were the commonest allergic diseases manifestation. History of atopy was positive in 60.79% of the allergic respondents.

    Conclusion: The prevalence of allergic sensitization among school children and undergraduate students in Surabaya suburb areas were increased compared to previous estimates in 1998. While house dust mites are known as important allergens, surprisingly cockroach was the common allergen among the younger school children.

    Matched MeSH terms: Skin Tests
  9. 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
  10. 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
  11. Leecyous B, Bakhtiar F, Tang MM, Yadzir ZHM, Abdullah N
    Allergol Immunopathol (Madr), 2020 06 09;48(6):626-632.
    PMID: 32532468 DOI: 10.1016/j.aller.2020.01.006
    INTRODUCTION: Basophil activation test (BAT) and immunoassays are the most widely used in vitro tests to diagnose IgE-mediated allergic reactions to penicillin. However, studies to determine if one test is interdependent from another are limited.

    OBJECTIVE: The present study aimed to measure the agreement between BAT and immunoassay in diagnosis of penicillin allergy.

    METHOD: BAT was performed using penicillin G (Pen G), penicillin V (Pen V), penicilloyl-polylysine (PPL), minor determinant mix (MDM), amoxicillin (Amx) and ampicillin (Amp) in 25 patients. Immunoassay of total IgE (tIgE) and specific IgE (sIgE) antibodies to Pen G, Pen V, Amx and Amp were quantified. Skin prick test (SPT) using PPL-MDM, Amx, Amp and Clavulanic acid were also performed.

    RESULTS: Minimal agreement was observed between BAT and immunoassay (k=0.25). Of two BAT-positive patients, one patient is positive to Amx (59.27%, SI=59) and Amp (82.32%, SI=82) but sIgE-negative to all drug tested. This patient is also SPT-positive to both drugs. Another patient is BAT-positive to Pen G (10.18%, SI=40), Pen V (25.07%, SI=100) and Amp (19.52%, SI=79). In sIgE immunoassay, four patients were sIgE-positive to at least one of the drugs tested. The sIgE level of three patients was between low and moderate and they were BAT-negative. One BAT-positive patient had a high level of sIgE antibodies (3.50-17.5kU/L) along with relatively high specific to total IgE ratio ≥0.002 (0.004-0.007).

    CONCLUSIONS: The agreement between BAT and immunoassay is minimal. Performing both tests provides little increase in the sensitivity of allergy diagnosis work-up for immediate reactions to penicillin.

    Matched MeSH terms: Skin Tests/statistics & numerical data
  12. 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
  13. 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
  14. 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
  15. Choon-Kook S, Teck-Soong SL
    Asian Pac J Allergy Immunol, 1995 Jun;13(1):23-7.
    PMID: 7488340
    The specific serum IgE levels to 20 allergens were determined by enzyme immunoassay in 90 Malaysian patients with allergic rhinitis. Ninety-two percent of patients had elevated IgE to at least 1 of the allergens. The housedust mites D. pteronyssinus and D. farinae were the major allergens, elevated IgE to either allergen being present in 86% of the patients. Prick skin tests were carried out in some of the patients, housedust mites, cat fur, dog hair and shrimp were the allergens used. Close correspondence was found between IgE and prick skin tests to the mites.
    Matched MeSH terms: Skin Tests
  16. Leung R, Ho P, Lam CW, Lai CK
    J Allergy Clin Immunol, 1997 May;99(5):594-9.
    PMID: 9155823
    BACKGROUND: Allergen sensitization is associated with asthma and allergic disease in children, but such a relationship has not been confirmed in Chinese populations.

    OBJECTIVES: The objective of this study was to evaluate the effects of allergen sensitization and family history of atopy on asthma and allergic disease in Chinese schoolchildren from three southeast Asian populations.

    METHODS: Written questionnaires on respiratory and allergic symptoms were completed by parents of children of secondary-school age (age range 12 to 18 years) in Hong Kong (n = 1062), Kota Kinabalu in eastern Malaysia (n = 409), and San Bu in southern China (n = 737). A subsample of school-children underwent skin prick testing to common inhalant allergens (Hong Kong 471 children, Kota Kinabalu 321, San Bu 647).

    RESULTS: The prevalence of asthma and allergic disease in schoolchildren was highest in Hong Kong, intermediate in Kota Kinabalu, and lowest in San Bu. However, the overall rate of atopic sensitization was similar in the three populations (49% to 63%). House dust mite and cockroach were the two most common allergens causing sensitization and these gave rise to more than 95% of the positive skin test results in all three populations. By regression analysis, mite allergy was associated with rhinitis and asthma in all three populations, and a family history of asthma, rhinitis, or eczema was strongly associated with respective symptoms in the subjects. After adjusting for age, sex, atopic status, and family history of allergic disease, the place of residence remained a significant independent factor for asthma (odds ratio [OR] = 1.0 for Hong Kong, 0.57 for Kota Kinabalu, 0.15 for San Bu, p < 0.001), rhinitis (OR = 1.0 for Hong Kong, 0.59 for Kota Kinabalu, 0.15 for San Bu, p < 0.001), or eczema (OR = 1.0 for Hong Kong, 0.35 for Kota Kinabalu, 1.01 for San Bu, p < 0.001).

    CONCLUSION: Sensitization to indoor allergens was a significant risk factor for asthma and allergic disease, and familial clustering of disease was common in the region. However, the marked difference in disease prevalence in the three southeast Asian populations of Chinese schoolchildren cannot be explained by atopic sensitization and family history alone, and the place of residence was an independent risk factor for asthma and allergies, which suggests an important environmental role in disease pathogenesis.

    Matched MeSH terms: Skin Tests
  17. Randhawa HS
    Mycopathol Mycol Appl, 1970;41(1):75-89.
    PMID: 4938836
    Matched MeSH terms: Skin Tests
  18. Hamilton RG, Adkinson NF
    J Allergy Clin Immunol, 1998 Sep;102(3):482-90.
    PMID: 9768592
    BACKGROUND: No characterized diagnostic natural rubber latex skin testing material is licensed for use in the United States.

    OBJECTIVE: We have conducted a multicenter clinical skin testing study to document the safety and diagnostic sensitivity and specificity of a candidate Hevea brasiliensis nonammoniated latex (NAL) extract. These data are intended to support the licensing of this reagent for the diagnosis of latex allergy in high-risk populations.

    METHODS: Three hundred twenty-four subjects (304 adults and 20 children) were classified by their clinical history as having latex allergy (LA group, 124 adults and 10 children) or having no latex allergy (NLA group, 180 adults and 10 children). All subjects provided blood samples and then received sequential puncture skin tests (PSTs) at 1, 100, or 1000 microg/mL protein with a bifurcated needle and NAL (Greer Laboratories) from Malaysian Hevea brasiliensis (clone 600) sap. A 2-stage glove provocation test was used to clarify latex allergy status of individuals with positive history/negative PST result and negative history/positive PST result mismatches.

    RESULTS: Twenty-four subjects (15%) originally designated as having LA on the basis of their initial clinical history were reclassified to the NLA group on the basis of a negative glove provocation test result. Of the 134 subjects with LA, 54 (40%) were highly sensitive to latex, with a positive PST result at 1 microg/mL NAL. The Greer NAL reagent produced a positive PST rate (sensitivity) of 95% and 99% in subjects with LA at 100 microg/mL and 1 mg/mL, respectively. The negative PST rate (specificity) in 190 subjects with a negative history with the NAL extract at 100 microg/mL and 1 mg/mL, was 100% and 96%, respectively. Immediately after the PST, mild systemic reactions (mainly pruritus) were recorded in 16.1 % of the adults in the LA group and 4.4% of the adults in the NLA group. No reactions required treatment with epinephrine. Only mild delayed reactions were observed in 9.6% (LA group) and 2.8% (NLA group) of subjects 24 to 48 hours after PST. Mean wheal and erythema diameters measured in the 10 children in the LA group with spina bifida at 100 microg/mL and 1 mg/mL were similar to those observed in the adults in the LA group, suggesting that children are not at increased risk for systemic reactions compared with adults.

    CONCLUSIONS: A suggestive clinical history is necessary but not sufficient for a definitive diagnosis of IgE-dependent latex allergy. These data support the safety and diagnostic efficacy of the Greer NAL, skin test reagent at 100 micro/mL and 1 mg/mL for confirmatory PSTs.

    Matched MeSH terms: Skin Tests
  19. Kuo IC, Cheong N, Trakultivakorn M, Lee BW, Chua KY
    J Allergy Clin Immunol, 2003 Mar;111(3):603-9.
    PMID: 12642844
    BACKGROUND: Dual sensitization by Blomia tropicalis and Dermatophagoides pteronyssinus mites is common in tropical and subtropical countries. The human IgE cross-reactivity between clinical important group 5 allergens, Blo t 5 and Der p 5, remains controversial.

    OBJECTIVE: This study was undertaken to assess the levels of the IgE cross-reactivity between Blo t 5 and Der p 5 by using sera from a large cohort of asthmatic children in subtropical and tropical countries.

    METHODS: Purified recombinant Blo t 5 and Der p 5 were produced in Pichia pastoris and tested against sera from 195 asthmatic children. The IgE cross-reactivity was examined by direct, inhibitory and competitive human IgE enzyme-linked immunosorbent assay as well as skin prick tests.

    RESULTS: The Blo t 5 IgE responses were 91.8% (134 of 146) and 73.5% (36 of 49) for Taiwanese and Malaysian sera, respectively. The Blo t 5 specific IgE titers were significantly higher than those of Der p 5 (P Skin prick tests performed on asthmatic children in Thailand also showed differential IgE response to Blo t 5 and Der p 5.

    CONCLUSION: By using a large panel of asthmatic sera and a combination of in vitro and in vivo assays, the major allergen of B tropicalis in tropical and subtropical regions, Blo t 5, exhibits low levels of IgE cross-reactivity with homologous Der p 5. These findings suggest that highly specific clinical reagents are necessary for precise diagnosis and immunotherapeutic treatment of sensitization to group 5 mite allergens.

    Matched MeSH terms: Skin Tests
  20. Hamizan AW, Rimmer J, Alvarado R, Sewell WA, Tatersall J, Barham HP, et al.
    Am J Rhinol Allergy, 2019 Mar;33(2):178-183.
    PMID: 30656948 DOI: 10.1177/1945892418825224
    BACKGROUND: Specific immunoglobulin E (sIgE) within the nasal airway is likely to be the most ideal marker of allergic status, but little is known of the normative values in asymptomatic patients and those with rhinitis.

    OBJECTIVE: The aim of this study was to assess the diagnostic characteristics of inferior turbinate tissue biopsy sIgE in asymptomatic and rhinitic patients.

    METHODS: A diagnostic cross-sectional study was undertaken, involving patients who underwent inferior turbinate surgery with or without other surgical interventions. Inferior turbinate tissue biopsy was performed during surgery and was assessed for allergen sIgE (dust mite, grass [temperate or subtropical], and animal epithelium) using an automated immunoassay. Tissue sIgE was assessed among asymptomatic patients and those with nasal symptoms. Data were presented as median (interquartile range). A receiver operating curve was used to predict the diagnostic utility of turbinate tissue sIgE in determining allergic rhinitis.

    RESULTS: A total of 160 patients (41.89 ± 14.65 years, 36.9% females) were included. The median tissue sIgE concentration among the asymptomatic nonatopic group of patients was 0.09 (0.08-0.10) kUA/L and tissue sIgE > 0.10 kUA/L was determined as a positive threshold. Inferior turbinate tissue sIgE was shown to be a predictive test for allergic rhinitis (area under curve: 0.87, 95% confidence interval: 0.84-0.90) with 90% sensitivity and 89% negative predictive value.

    CONCLUSION: Inferior turbinate tissue biopsy sIgE is a sensitive tool to predict allergic rhinitis. The threshold value of 0.1 kUA/L corresponded well with the asymptomatic nonatopic group of patients. This method detects sIgE in the nasal mucosa and may be a useful test for allergic rhinitis in future research.

    Matched MeSH terms: Skin Tests
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