scholarly journals Galactose-alpha-1,3-galactose syndrome

2020 ◽  
Vol 2 (1) ◽  
pp. 108-110
Author(s):  
Mary Nguyen ◽  
Jordan Heath
Keyword(s):  
Immunoglobulin E ◽  
Skin Prick Testing ◽  
Skin Testing ◽  
Specific Ige ◽  
Carbohydrate Antigen ◽  
Total Serum ◽  
Intradermal Testing ◽  
Total Ige ◽  
Lone Star Tick ◽  
Mammalian Meat

The galactose-alpha-1,3-galactose (alpha-Gal) syndrome is a newly recognized and unique form of food allergy, characterized by delayed reactions to mammalian meats. This form of allergy occurs in individuals who become sensitized to alpha-Gal, a carbohydrate that is present on most mammalian tissues. Sensitization occurs after exposure to multiple arthropod bites, most commonly the lone star tick. Cases of the alpha-Gal syndrome are primarily found in the southeastern United States, which overlaps with the known geographic distribution of the lone star tick. Patients present with a history of delayed symptom onset, ∼2‐6 hours after ingestion of mammalian meat. As with other immunoglobulin E (IgE) mediated food allergic reactions, alpha-Gal reaction symptoms may include skin, respiratory, gastrointestinal, or cardiovascular systems, and severity may range from mild reactions to severe anaphylaxis. The diagnosis is based on the detection of alpha-Gal specific IgE (sIgE) as well as the total IgE value because some cases include patients with low total IgE levels but a high percentage of alpha-Gal sIgE to total serum IgE levels. Percutaneous testing with commercial meat skin-prick testing extracts is not a reliable tool for diagnosis. Prick-prick skin testing to fresh cooked meat may be considered, whereas intradermal testing to fresh meat is primarily reserved for research purposes. The mainstay of treatment involves avoidance of mammalian meat and medications that express the same carbohydrate antigen. With a small portion of patients, other meat-containing products should also be avoided if symptoms persist with mammalian meat avoidance alone. Prolonged avoidance of mammalian meat as well as avoidance of further tick bites can decrease alpha-Gal sIgE over time, and some patients are able to reintroduce mammalian meat into their diet.

scholarly journals Enterotoxin-Specific Immunoglobulin E Responses in Humans after Infection or Vaccination with Diarrhea-Causing Enteropathogens

2000 ◽  
Vol 68 (10) ◽  
pp. 6077-6081 ◽  
Author(s):  
Firdausi Qadri ◽  
Muhammad Asaduzzaman ◽  
Christine Wennerås ◽  
Golam Mohi ◽  
M. John Albert ◽  
...  
Keyword(s):  
North American ◽  
Immunoglobulin E ◽  
Specific Ige ◽  
Cholera Vaccine ◽  
Total Ige ◽  
B Subunit ◽  
The North ◽  
Specific Immunoglobulin E ◽  
Oral Cholera Vaccine ◽  
Ige Response

ABSTRACT Cholera toxin (CT)-specific antibody responses of the immunoglobulin E (IgE) isotype in the sera of adult patients suffering from infection with either Vibrio cholerae O1, V. cholerae O139, or enterotoxigenic Escherichia coli(ETEC) were analyzed and compared with those in the sera of volunteers immunized with a bivalent B subunit O1/O139 whole-cell cholera vaccine. A significant IgE response to CT was observed in 90% of the patients with V. cholerae O1 infection (18 of 20; P = <0.001) and 95% of the patients with V. cholerae O139 infection (19 of 20; P = <0.001). Similarly, the majority of the patients with ETEC diarrhea (83%; 13 of 15) showed a positive IgE response to CT. Eight of 10 North American volunteers (80%) orally challenged with V. cholerae O1 showed CT-specific IgE responses (P = 0.004). In contrast, Swedish volunteers immunized with the oral cholera vaccine showed no IgE responses to CT (P value not significant). During the study period, total IgE levels in the sera of the diarrheal patients, the North American volunteers, and the Swedish cholera vaccinees alike remained unchanged. However, the total IgE levels in the sera of patients and healthy Bangladeshi controls were on average 89-fold higher than those in the sera of the healthy Swedish volunteers and 34-fold higher than those in the sera of the North American volunteers.

Diagnostic and Therapeutic Principles In Allergy

2018 ◽  
Author(s):  
Mitchell H. Grayson ◽  
Peter Mustillo
Keyword(s):  
Food Allergy ◽  
Immunoglobulin E ◽  
Skin Testing ◽  
Allergic Sensitization ◽  
Allergic Diseases ◽  
Specific Ige ◽  
Severe Form ◽  
Therapeutic Principles ◽  
Anticytokine Therapy ◽  
Release Assay

The incidence of allergic diseases, like asthma, allergic rhinitis, and food allergy, is increasing in Westernized countries. This chapter discusses the importance of taking a careful and focused history and physical examination, as well as the laboratory studies that can be used to demonstrate the presence of allergic sensitization. Treatment for allergic disease is discussed, with an emphasis on new biologic therapies that have been developed. Finally, the chapter explores relatively new studies on the potential for interventions to prevent food allergy.  Allergy is defined as an untoward physiologic event mediated by immune mechanisms, usually involving the interaction between an allergen and the allergic antibody, immunoglobulin E (IgE). Allergic reactions typically occur due to exposure to either airborne allergens, foods, drugs, chemicals, or Hymenoptera (such as wasps, bees and fire ants). Allergies manifest in numerous ways, including allergic asthma, allergic rhinoconjunctivitis, urticaria, eczema, and in its most severe form, anaphylaxis. This review contains 4 videos, 5 figures, 4 tables and 42 references Key Words: Delayed allergic reaction (Alpha-gal), Allergy diagnosis, Measurement of specific IgE, Allergy and asthma therapies, Anticytokine therapy (dupilumab, mepolizumab, reslizumab), AntiIgE therapy (omalizumab), Allergy skin testing, Basophil histamine release assay

Proficiency Survey-Based Evaluation of Clinical Total and Allergen-Specific IgE Assay Performance

2010 ◽  
Vol 134 (7) ◽  
pp. 975-982 ◽  
Author(s):  
Robert G. Hamilton
Keyword(s):  
Allergic Disease ◽  
Immunoglobulin E ◽  
Diagnostic Algorithm ◽  
Specific Ige ◽  
Total Serum ◽  
Design Data ◽  
Ige Antibody ◽  
Marked Variability ◽  
Specific Immunoglobulin E ◽  
History Of

Abstract Context.—The diagnostic algorithm for human allergic disease involves confirmation of sensitization by detection of allergen-specific immunoglobulin E (IgE) antibody in individuals suspected of having allergic disease because of a history of allergic symptoms after known allergen exposure. Previous studies showed wide disparity among clinically reported allergen-specific IgE levels from different serologic assays. Objective.—To validate the relative analytic performance (sensitivity, interassay reproducibility, linearity/parallelism, intermethod agreement) of clinically used total and allergen-specific IgE assays by using College of American Pathologists' Diagnostic Allergy “SE” Proficiency Survey data. Design.—Data from 2 SE survey cycles were used to assess relative analytic performance of the ImmunoCAP (Phadia), Immulite (Siemens Healthcare-Diagnostics), and HYTEC 288 (HYCOR-Agilent Technologies) total and allergen-specific IgE assays. In each cycle, 2 recalcified plasma pools from atopic donors were diluted twice with IgE-negative serum and evaluated in approximately 200 federally certified clinical laboratories for total IgE and IgE antibody to 5 allergen specificities. Statistical analysis evaluated analytic sensitivity, linearity, reproducibility, and intermethod agreement. Results.—Interlaboratory intramethod, intermethod, and interdilution agreement of all 6 clinically used total serum IgE assays were excellent, with coefficients of variation (CVs) below 15%. Interlaboratory intramethod, and interdilution agreement of 3 clinically used allergen-specific IgE assays were also excellent with CVs below 15%. However, intermethod CVs identified between-assay disagreement greater than 20% in 80% of allergen-specific IgE measurements. Allergen reagents and patients' immune response heterogeneity are suggested probable causes. Conclusions.—Clinical total and allergen-specific IgE assays display excellent analytic sensitivity, precision, reproducibility, and linearity. Marked variability in quantitative estimates of allergen-specific IgE from clinically used automated immunoassays is a concern that may be ameliorated with component allergen use.

Egg Hypersensitivity and Measles-Mumps-Rubella Vaccine Administration

PEDIATRICS ◽  
1991 ◽  
Vol 88 (5) ◽  
pp. 913-917
Author(s):  
Suzanne A. Beck ◽  
Larry W. Williams ◽  
M. Annette Shirrell ◽  
A. Wesley Burks
Keyword(s):  
Atopic Dermatitis ◽  
Skin Prick Testing ◽  
Skin Testing ◽  
Screening Method ◽  
Negative Control ◽  
Mmr Vaccine ◽  
Double Blind ◽  
Intradermal Testing ◽  
Vaccine Administration ◽  
History Of

Because reports have described egg-sensitive individuals in whom anaphylaxis developed after measles vaccination, current recommendations include delaying administration of egg-derived vaccines until skin testing can be performed. Specifically, the 1988 Red Book recommends skin testing via scratch, prick, or puncture with 1:10 dilution of the vaccine and, if the result is negative, intradermal testing is suggested. The purpose of this study was to evaluate the likelihood of reaction to measles-mumps-rubella (MMR) vaccine in patients with documented egg sensitivity and to delineate the efficacy of skin-prick testing (SPT) to MMR as a predictor of hypersensitivity to the vaccine. Egg sensitivity was documented by initial SPT to egg and then, if possible, double-blind placebo-controlled food challenge (DBPCFC). Patients with a positive DBPCFC to egg or a history of anaphylactic egg sensitivity had a SPT with the MMR vaccine and then were given the MMR vaccine. Additionally, children with atopic dermatitis who had been previously proven egg sensitive via DBPCFCs were evaluated retrospectively for sensitivity to the MMR vaccine. Sixteen children with a history of egg sensitivity underwent SPT to egg, with a positive result 3 mm greater than the negative control found in 12 patients. Eight of these children had a positive DBPCFC to egg. The SPT to MMR vaccine was negative in all 16 children; vaccine administration followed with no resultant systemic problems. Three children had a local reaction at the site of injection. Twelve additional children with atopic dermatitis and egg sensitivity were reviewed. Each child had a positive SPT and DBPCFC to egg. Ten of these children received the MMR vaccine prior to the time that their egg sensitivity was elucidated. Two other children were vaccinated elsewhere after they were documented egg sensitive. All 12 of these children tolerated the vaccine without incident. These results further substantiate the safety of MMR administration in egg-sensitive children and support routine vaccination of children who do not exhibit systemic allergic hypersensitivity to egg. It is suggested that SPT is an adequate screening method for children with anaphylactic egg sensitivity.

Otitis Media in the Young Infant: An IgE-Mediated Disease?

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 133-137 ◽  
Author(s):  
John L. Sloyer ◽  
John H. Ploussard ◽  
Laurel J. Karr
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Skin Testing ◽  
Young Infant ◽  
Specific Ige ◽  
Serum Samples ◽  
Igg Antibody ◽  
Total Ige ◽  
Ige Antibody ◽  
The Mean

IgE antibody directed against noncapsular antigens of mechanically disrupted Streptococcus pneumoniae, serotype 3 rough, was demonstrated in middle ear effusions (MEE) and serum of infants with and without prior evidence of pneumococcal otitis media with effusion (OME). The techniques employed included radioimmunoassay (RIA), passive skin testing, Prausnitz-Küstner (P/K), and enzyme-linked immunospecific assay (ELISA). Adsorption of MEE with ultrasonically disrupted crude pneumococcal antigen (CPA-U) resulted in a reduction of total IgE counts per minute and suggested bacteria-specific IgE antibody ranging from approximately 22 to 92% of the total IgE. The biological activity of the IgE antibody was confirmed by challenging skin passively sensitized with MEE IgE and CPA-U. Areas of induration appeared 20 minutes after challenge and continued to increase in size until 90 minutes. An ELISA procedure was developed as a tool to determine the nature of the antigen(s) and to determine the class(es) of antibody other than IgE. It appeared that CPA-U possesses free amino groups and that it can withstand the rigors of autoclaving. An analysis of 45 cord bloods revealed that high levels of IgG CPA-U antibody occur in this type of sample and that no correlation exists between the IgE and IgG levels. The mean IgG: IgE ratio, optical density at 420 nm (OD 420), for cord bloods was 2.49. In contrast, serum samples from nine infants without pneumococcal otitis media and from 14 infants with pneumococcal otitis media had lower levels of IgG antibody. There was no significant relationship between IgG and IgE OD 420 in infants who never had an episode of pneumococcal otitis media and the mean IgG: IgE was 1.88, whereas the ratio for those infants with pneumococcal otitis media was 1.56. In addition, there was a significant correlation between IgG and IgE levels in this latter group. The results suggest that it may be important to monitor the levels of at least these two classes of antibody to enhance our understanding of the pathogenesis and recovery from otitis media.

scholarly journals The Study of a Possible Correlation between Serum Levels of Interleukin 17 and Clinical Severity in Patients with Allergic Rhinitis

2017 ◽  
Vol 8 (3) ◽  
pp. ar.2017.8.0207
Author(s):  
Mai Aly Gharib Aly ◽  
Mohamed Tawfik El Tabbakh ◽  
Waheed Fawzy Heissam ◽  
Said Hamed Abbadi
Keyword(s):  
Allergic Rhinitis ◽  
Immunoglobulin E ◽  
Skin Testing ◽  
Allergic Diseases ◽  
Serum Levels ◽  
Clinical Severity ◽  
Total Serum ◽  
Interleukin 17 ◽  
Serum Ige ◽  
Cluster Immunotherapy

Introduction Allergic rhinitis (AR) is one of the most common allergic diseases, which affects ~20% of the world's population. T-helper (Th) type 2 cells produce interleukin (IL) 4 and IL-13, and mediate allergic responses, and these cytokines have been extensively studied as key players in the atopic airway diseases. However, the involvement of Th17 cells and IL-17 in AR has not been clearly examined. Aim To reevaluate AR clinical severity with serum IL-17, whether IL-17 affects the disease alone or in contribution with the atopic predisposition. Patients and Methods During an 18-month period, 39 individuals were divided into three groups: A, (13 control), B (13 with mild-to-moderate AR), and C (13 with severe AR). Both group B and group C patients (26) were subjected to clinical examination and allergy skin testing, and to measurement of both total serum immunoglobulin E (IgE) and IL-17 levels. Eleven patients with AR then were exposed to 6 months of cluster immunotherapy, whereas the rest of the patients were not exposed. Results Revealed a significant elevation of serum IL-17 levels with an associated increase in serum IgE in the patients with AR compared with controls and revealed that the serum levels of both total serum IgE and IL-17 decreased significantly after cluster immunotherapy. Conclusion These preliminary results added new data about the use of injective immunotherapy as well as reported on the use of sublingual immunotherapy.

scholarly journals Use of a Synthetic Peptide Epitope of Asp f 1, a Major Allergen or Antigen of Aspergillus fumigatus, for Improved Immunodiagnosis of Allergic Bronchopulmonary Aspergillosis

2004 ◽  
Vol 11 (3) ◽  
pp. 552-558 ◽  
Author(s):  
Taruna Madan ◽  
Priyanka Priyadarsiny ◽  
Mudit Vaid ◽  
Neel Kamal ◽  
Ashok Shah ◽  
...  
Keyword(s):  
Aspergillus Fumigatus ◽  
Synthetic Peptide ◽  
Immunoglobulin E ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Major Allergen ◽  
Specific Ige ◽  
Diagnostic Efficiency ◽  
Intradermal Testing ◽  
Peptide Epitope ◽  
Asp F 1

ABSTRACT Allergic bronchopulmonary aspergillosis (ABPA) is an immunologically complex allergic disorder caused by the fungal pathogen Aspergillus fumigatus. Elevated levels of total immunoglobulin E (IgE), specific IgE, and IgG antibodies in sera are important immunodiagnostic criteria for ABPA. International reference standards or standardized immunodiagnostic assays are not available due to a lack of well-defined diagnostic antigens. The present study was carried out to identify and evaluate the immunodiagnostic relevance of synthetic epitopic peptides of Asp f 1, a major allergen, antigen, or cytotoxin of A. fumigatus. Five overlapping peptides were synthesized from the N terminus of Asp f 1, one of the potential immunodominant regions predicted by algorithmic programs. The 11-amino-acid synthetic peptide (P1) significantly inhibited both IgG binding (89.10% ± 4.45%) and IgE binding (77.32% ± 3.38%) of the standardized diagnostic antigen (SDA) (a well-defined pool of diagnostically relevant allergens and antigens of A. fumigatus). With a panel of sera of ABPA patients, allergic patients with skin test negativity to A. fumigatus, and healthy individuals, P1 showed a higher diagnostic efficiency than SDA (specific IgG, 100%; specific IgE, 98.3%). The diagnostic efficiency of P1 could be attributed to the presence of homologous epitopes in various immunodominant allergens or antigens of A. fumigatus. The ability of P1 to induce histamine release from sensitized mast cells and a Th2 type of cytokine profile in peripheral blood mononuclear cells of ABPA patients suggests its potential for use in intradermal testing. P1 could be further explored for development of a standardized, specific, and sensitive immunodiagnostic test for aspergillosis.

scholarly journals Prevalence of specific immunoglobulin E and G against Aspergillus fumigatus in patients with asthma

2019 ◽  
Author(s):  
Newsha Hedayati ◽  
Vida Mortezaee ◽  
Seyed Alireza Mahdaviani ◽  
Maryam Sadat Mirenayat ◽  
Maryam Hassanzad ◽  
...  
Keyword(s):  
Aspergillus Fumigatus ◽  
Severe Asthma ◽  
Immunoglobulin E ◽  
Clinical Symptoms ◽  
Specific Ige ◽  
Total Ige ◽  
Asthmatic Patients ◽  
Specific Immunoglobulin E ◽  
Specific Immunoglobulin ◽  
The Mean

Background and Purpose: Aspergillus fumigatus as a ubiquitous fungus can be found in the respiratory tract of the asthmatic and healthy people. The inhalation of Aspergillus spores leads to an immune response in individuals with asthma and results in the aggravation of the clinical symptoms. The present study aimed to investigate the prevalence of specific immunoglobulin E and G (IgE and IgG) against A.fumigatus in asthmatic patients.Materials and Methods: This study was conducted on 200 consecutive patients with moderate to severe asthma referring to Masih Daneshvari hospital Tehran, Iran, from January 2016 to February 2018. Skin prick test (SPT) was performed in all subjects with Aspergillus allergens. Moreover, all patients underwent specific IgE testing for Aspergillus using Hycor method. Enzyme immune assay was applied to measure total IgE and Aspergillus-specific IgG.Results: According to the results, the mean age of the patients was 45.8 years (age range: 18-78 years). The mean levels of total IgE and Aspergillus specific IgE in asthmatic patients were obtained as 316.3 (range: 6-1300 IU/ml) and 1.5 (range: 0.1-61.3 IU/ml), respectively. Out of 200 patients, 27 (13.5%), 65 (32.5%), 22 (11.0%), and 86 (43.0%) cases had positive Aspergillus SPT, total IgE of > 417 IU/ml, Aspergillus-specific IgE, and IgG, respectively. The level of these variables in patients with severe asthma were 16 (16.5%), 36 (37.1%), 15 (15.5%), and 46 (47.4%), respectively.Conclusion: As the findings indicated, reactivity to Aspergillus is a remarkable phenomenon in asthmatic patients. It is also emphasised that the climatic condition may affect the positive rate of hypersensitivity to Aspergillus.

scholarly journals Total IgE Distribution in Food Allergy Suspected Patients in Republic of Macedonia (2001-2011)

2015 ◽  
Vol 3 (2) ◽  
pp. 202-208
Author(s):  
Slavica Hristomanova Mitkovska ◽  
Dejan Trajkov ◽  
Aleksandar Petlichkovski ◽  
Olivija Efinska-Mladenovska ◽  
Mirko Spiroski
Keyword(s):  
Food Allergy ◽  
Human Genetics ◽  
Specific Ige ◽  
Average Concentration ◽  
Total Serum ◽  
Age Group ◽  
Total Ige ◽  
Serum Ige ◽  
Number Of Patients

BACKGROUND: IgE may be considered the hallmark of allergic disorders. It is easily detected in serum and can be measured as total IgE and as allergen-specific IgE. In fact, the serum IgE assay is used to diagnose an allergy.AIM: The aim of this study is to evaluate, investigate and present the distribution of total serum IgE levels, determined with UniCap system, in food-allergy suspected patients in a Republic of Macedonia.MATERIAL AND METHODS: In this study we analyzed retrospectively 8898 consecutive patients that were admitted for allergy testing at the Institute of Immunobiology and Human Genetics during the ten year period between 01.01.2001 and 01.01.2011. Total IgE levels in patient sera were detected with the in vitro system UniCAP100 (Pharmacia, Uppsala, Sweden).RESULTS: When we analyzed the number of patients according to the total IgE groups, we noted that most of the patients have normal levels of total IgE in serum. However, we also discovered a group of patients with elevated levels of total IgE that are greater than 200 kU/L. The average concentration of total serum IgE is higher in women in the age group 6 (6-7 years), followed by a steep decrease in the age group 9 (9-10 years), and after that the average concentrations of total IgE were mostly constant with the exception of a partial increase in the age group 21 (65-69 years). For men, the average serum concentrations of total IgE were highest in the age group of 6 (6-7 years), which was significantly higher than the average concentrations of total IgE in all other age groups.CONCLUSION: The large number of enrolled patients, a particular strength of this study, revealed that average concentrations of total IgE in men are higher than in women and that total IgE did not decrease with age. On the contrary, increased total IgE levels were found in patients aged 65 and 69 of both genders. We continue our work with analyses of the specific IgE antibodies values toward food and the correlation with total IgE values.

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