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Hamilton RG, Holbreich M, Bronzert C, Anderson RL, Schoettler N, Ober C. Screening asthmatics for atopic status using the ALergy EXplorer (ALEX 2) macroarray. J Asthma 2024:1-8. [PMID: 38415683 DOI: 10.1080/02770903.2024.2324839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 02/25/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Screening asthma patients for atopy facilitates management. Since 2010, the core biomarker for screening asthma subjects for atopic status has been the qualitative Phadiatop. multi-aeroallergen screen. A more quantitative macroarray, the Allergy Explorer (ALEX2), shows promise as an alternative. OBJECTIVE The study's goal was to examine the pros and cons of the use of ALEX2 in the screening of asthma patients for atopic status. METHODS We evaluated the atopic (IgE-sensitization) status in asthmatic Amish and Hutterite farm children using the ImmunoCAP and ALEX2 assays in Phadiatop equivocal and positive subjects. RESULTS All 42 asthmatic children were analyzed by Phadiatop and total serum IgE. Of these, 22 had a negative Phadiatop (<0.1 kUa/L) and total IgE <100 kU/L which defined them as non-atopic and they were excluded from ALEX2 testing. Of six children with equivocal Phadiatops (0.1-0.2 kUa/L-Group 1) and three children with a negative Phadiatop but total IgE >100 kUa/L (group 3), 44% (n = 4) had detectable IgE antibody by ALEX2 to mite, tree pollen, and other allergens not detected by Phadiatop, but confirmed by allergen-specific ImmunoCAP testing. In 11 Phadiatop positive subjects (>0.2 kUa/L-group 2), all but one were positive by ALEX2. IgE antibody specific for mold and rabbit aeroallergens matched their agricultural and pet exposure history. Three children were positive for IgE antibody to allergens in the profilin, nsLTP, or PR-10 cross-reactive protein families. CONCLUSION Judicious use of ALEX2's enhanced specificity data not provided by the Phadiatop can aid in the interpretation of sensitization patterns and planning management of atopic asthmatics, but sensitization relevance must be confirmed by the patient's clinical history.
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Affiliation(s)
- Robert G Hamilton
- Johns Hopkins University School of Medicine, Johns Hopkins Asthma and Allergy Center, Baltimore, MD, USA
| | | | - Charles Bronzert
- Johns Hopkins University School of Medicine, Johns Hopkins Asthma and Allergy Center, Baltimore, MD, USA
| | - Rebecca L Anderson
- Department of Human Genetics, The University of Chicago, Chicago, IL, USA
| | | | - Carole Ober
- Department of Human Genetics, The University of Chicago, Chicago, IL, USA
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Hou L, Li Z, Bao L, Zhou Z, Li S, Zhou X, Zhang M. Prevalence and screening of specific aeroallergens in Chinese male patients with chronic obstructive pulmonary disease: A retrospective cross-sectional observational study. Clin Respir J 2021; 15:691-698. [PMID: 33687803 DOI: 10.1111/crj.13350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 08/22/2020] [Accepted: 03/04/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Sensitization to aeroallergens was linked to severe symptoms and frequent exacerbations in chronic obstructive pulmonary disease (COPD) patients. Elevated serum total immunoglobulin E (tIgE) level is a hallmark of allergic COPD patients. Phadiatop test exhibited high sensitivity for predicting specific aeroallergens (SAs) sensitization. However, the prevalence of aeroallergens, the value of Phadiatop test, alone or combined with tIgE, for predicting aeroallergens sensitization in male COPD patients have not been explored in China. OBJECTIVES To explore the prevalence and predictors of aeroallergens in the context of COPD. METHODS The predictive value of Phadiatop test for SAs sensitization in male COPD patients was analyzed via the area under receiver operating characteristic curves (AUCs). RESULTS The top five SAs in the context of COPD were d2, mx2, i6, d1, and tx5, of which the seasonal distribution showed no significant differences. Allergic group showed higher levels of blood eosinophils, total Phadiatop IgE and tIgE than the nonallergic group (all P ≤ 0.001). The AUCs of total Phadiatop IgE and tIgE for predicting the sensitization to SAs, SAs excluding mx2 (AEM) and mx2 were ((0.921 vs. 0.879, P = 0.2522), (0.967 vs. 0.807, P = 0.0003), and (0.780 vs. 0.883, P < 0.05)) (AUCPhadiatop vs AUCtIgE ), respectively. The combined application of these two parameters (model) increased the AUC of SAs, significantly higher than the single parameter used (P < 0.05 for all). CONCLUSION d2, mx2, i6, and d1 were the top four SAs sensitized in male COPD patients; Phadiatop test was valuable for predicting the sensitization to SAs when it was > 0.13 kAU/L.
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Affiliation(s)
- Lili Hou
- Department of Respiratory and Critical Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhengyu Li
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Luhong Bao
- Department of Respiratory and Critical Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiguo Zhou
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shanqun Li
- Department of Respiratory and Critical Care Medicine, Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Xin Zhou
- Department of Respiratory and Critical Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Zhang
- Department of Respiratory and Critical Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Traiyan S, Manuyakorn W, Kanchongkittiphon W, Sasisakulporn C, Jotikasthira W, Kiewngam P, Kamchaisatian W, Benjaponpitak S. Skin Prick Test Versus Phadiatop as a Tool for Diagnosis of Allergic Rhinitis in Children. Am J Rhinol Allergy 2020; 35:98-106. [PMID: 32597210 DOI: 10.1177/1945892420938300] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Skin prick test (SPT) or Phadiatop, a multi-allergen IgE screening test, was used as a tool for detecting aeroallergen sensitization. OBJECTIVE To compare SPT and Phadiatop as a tool for diagnosis allergic rhinitis (AR) using the nasal provocation test (NPT) as a comparative standard. METHODS Children aged 5-18 years with rhinitis symptoms more than 6 times in the past year were enrolled. SPT to 13 common aeroallergens, serum for Phadiatop, and NPT to Dermatophagoides pteronyssinus (Der p) were performed. NPT to mixed cockroach (CR) were performed in children who had CR sensitization and negative NPT to Der p. Children who had a disagreement between the result of SPT and Phadiatop or having negative results were evaluated for specific IgE (sIgE) to common aeroallergens. RESULTS One hundred-forty children were enrolled with the mean age of 9.8 ± 3 years, 56% were male. Of 92 children (65.7%) with positive SPT to any aeroallergens, 88 children (95.6%) were sensitized to house dust mite (HDM). NPT showed positive results in 97 children (69.3%). Of 48 children who showed negative SPT, 4 children (8.3%) had sIgE to aeroallergens but NPT was positive in 1 child. Eighty-eight children (62.9%) had positive tests for Phadiatop and 4 (4.5%) of them had negative results for NPT to Der p. Among 52 children who had negative results for Phadiatop, 4 children (7.6%) had sIgE to aeroallergens but NPT was positive in 2 children (3.8%). SPT and Phadiatop showed 94.2% agreement: with Kappa 0.876, p < 0.001. Using NPT as a comparative standard for diagnosis for AR, SPT showed a sensitivity of 89.6% and specificity of 88.3% and Phadiatop provided the sensitivity of 88.6% and specificity of 95.3%. CONCLUSIONS SPT to aeroallergen and Phadiatop have good and comparable sensitivity and specificity for the diagnosis of AR in children.
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Affiliation(s)
- Sasiwimon Traiyan
- Division of Pediatrics Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wiparat Manuyakorn
- Division of Pediatrics Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Watcharoot Kanchongkittiphon
- Division of Pediatrics Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Cherapat Sasisakulporn
- Division of Pediatrics Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wanlapa Jotikasthira
- Division of Pediatrics Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Potjanee Kiewngam
- Division of Pediatrics Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wasu Kamchaisatian
- Division of Pediatrics Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suwat Benjaponpitak
- Division of Pediatrics Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Ek WE, Ahsan M, Rask-Andersen M, Liang L, Moffatt MF, Gyllensten U, Johansson Å. Epigenome-wide DNA methylation study of IgE concentration in relation to self-reported allergies. Epigenomics 2017; 9:407-418. [PMID: 28322575 DOI: 10.2217/epi-2016-0158] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
AIM Epigenetic mechanisms are critical for normal immune development and epigenetic alterations might therefore be possible contributors to immune diseases. To investigate if DNA methylation in whole blood is associated with total and allergen-specific IgE levels. METHODS We performed an epigenome-wide association study to investigate the association between DNA methylation and IgE level, allergen-specific IgE and self-reported immune diseases and allergies in 728 individuals. RESULTS We identified and replicated 15 CpG sites associated with IgE, mapping to biologically relevant genes, including ACOT7, ILR5A, KCNH2, PRG2 and EPX. A total of 331 loci were associated with allergen-specific IgE, but none of these CpG sites were associated with self-reported allergies and immune diseases. CONCLUSION This study shows that IgE levels are associated with DNA methylation levels at numerous CpG sites, which might provide new leads for investigating the links between IgE and allergic inflammation.
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Affiliation(s)
- Weronica E Ek
- Department of Immunology, Genetics & Pathology, Science for Life Laboratory, Uppsala University, Box 815 75108 Uppsala, Sweden
| | - Muhammad Ahsan
- Department of Immunology, Genetics & Pathology, Science for Life Laboratory, Uppsala University, Box 815 75108 Uppsala, Sweden
| | - Mathias Rask-Andersen
- Department of Immunology, Genetics & Pathology, Science for Life Laboratory, Uppsala University, Box 815 75108 Uppsala, Sweden
| | - Liming Liang
- Department of Epidemiology & Biostatistics, Harvard School of Public Health, Boston, MA 02115, USA
| | - Miriam F Moffatt
- National Heart & Lung Institute, Imperial College London, London, SW3 6LY, UK
| | - Ulf Gyllensten
- Department of Immunology, Genetics & Pathology, Science for Life Laboratory, Uppsala University, Box 815 75108 Uppsala, Sweden
| | - Åsa Johansson
- Department of Immunology, Genetics & Pathology, Science for Life Laboratory, Uppsala University, Box 815 75108 Uppsala, Sweden
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Lee SP, Lee SY, Kim JH, Sung IK, Park HS, Shim CS, Moon HW. Correlation between Helicobacter pylori infection, IgE hypersensitivity, and allergic disease in Korean adults. Helicobacter 2015; 20:49-55. [PMID: 25257099 DOI: 10.1111/hel.12173] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The correlation between allergic disease and Helicobacter pylori infection is still controversial in endemic areas. The aim of this study was to determine whether H. pylori infection is related to allergic disease and/or immunoglobulin E (IgE) hypersensitivity in Korean adults. MATERIALS AND METHODS Consecutive Korean adults who visited our center for a routine checkup were enrolled. All subjects completed a questionnaire that was designed to ascertain their medical history pertaining to physician-diagnosed allergic disease, allergy treatments, and H. pylori eradication therapy. Blood was sampled for serum anti-H. pylori IgG antibody. IgE hypersensitivity was measured using a commercially available ImmunoCAP(®) Phadiatop (Phadia AB, Uppsala, Sweden). RESULTS Of the 3376 Korean adults who were enrolled, 62 did not answer to the questionnaires adequately and were thus excluded. The proportion of noninfected subjects (p < .001) and the prevalence of IgE-related allergic disease (p < .001) were both highest among those aged <40 years, while the prevalence of non-IgE-related allergic disease was highest among those aged ≥70 years (p < .001). Logistic regression analysis revealed that being younger than 40 years was significantly related to the absence of H. pylori infection (OR = 2.507, 95% CI = 1.621-3.878, p < .001). CONCLUSIONS The statuses of H. pylori infection, IgE hypersensitivity, and allergic diseases differ with age group, there being a higher prevalence of IgE-related allergic disease and a lower H. pylori infection rate among young adults. The hygiene hypothesis might explain these findings in young Koreans, due to the rapid development and improvements in sanitation in Korea.
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Affiliation(s)
- Sang Pyo Lee
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
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Okusaga O, Hamilton RG, Can A, Igbide A, Giegling I, Hartmann AM, Konte B, Friedl M, Reeves GM, Rujescu D, Postolache TT. Phadiatop Seropositivity in Schizophrenia Patients and Controls: A Preliminary Study. AIMS Public Health 2014; 1:43-50. [PMID: 25346942 PMCID: PMC4205967 DOI: 10.3934/publichealth.2014.2.43] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
There is a dearth of information on the association of atopy with schizophrenia. The few available studies used population-based registers to classify the atopy status of the patients but this strategy is not reliable. This study measured seropositivity with a multiallergen screen of allergen specific IgE antibodies in schizophrenia patients versus healthy controls. A subset of 66 schizophrenia patients and 34 healthy controls were randomly selected from a large comparative study of schizophrenia patients and controls. The Phadiatop multi-allergen screen was performed on sera from all the participants to assess their atopic status. Logistic regression was used to calculate the odds ratio for the association of schizophrenia with Phadiatop seropositivity as a measure of atopy. The prevalence of Phadiatop seropositivity was significantly lower (χ2 4.59, p = 0.032) and there was a reduced odds ratio for atopy in schizophrenia patients relative to controls (OR 0.40; 95% CI 0.17 to 0.94, p = 0.036). Though limited by a relatively small sample size and potentially confounded by anti-psychotic medications, this study suggests that the prevalence of atopy is lower in patients with schizophrenia. Replicating these results in larger samples could add to our growing understanding of immunological implications in mental illness.
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Affiliation(s)
- Olaoluwa Okusaga
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD USA ; Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, TX, USA
| | - Robert G Hamilton
- Johns Hopkins Dermatology, Allergy and Clinical Immunology Reference Laboratory, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Adem Can
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD USA
| | - Ajirioghene Igbide
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD USA ; St. Elizabeths Hospital, Psychiatry Residency Training Program, Washington, DC, USA
| | - Ina Giegling
- Department of Psychiatry, University of Halle-Wittenberg, Germany
| | | | - Bettina Konte
- Department of Psychiatry, University of Halle-Wittenberg, Germany
| | - Marion Friedl
- Department of Psychiatry, University of Halle-Wittenberg, Germany
| | - Gloria M Reeves
- Division of Child and Adolescent Psychiatry, University of Maryland, School of Medicine, Baltimore, Maryland, USA ; University of Maryland Child and Adolescent Mental Health Innovations Center, Baltimore, Maryland, USA
| | - Dan Rujescu
- Department of Psychiatry, University of Halle-Wittenberg, Germany
| | - Teodor T Postolache
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD USA ; University of Maryland Child and Adolescent Mental Health Innovations Center, Baltimore, Maryland, USA
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