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- Ermis, Özuygur, 1991, et al.
(författare)
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Sensitization patterns to cat molecular allergens in subjects with allergic sensitization to cat dander
- 2023
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Ingår i: Clinical and translational allergy. - : Wiley. - 2045-7022. ; 13:8
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Tidskriftsartikel (refereegranskat)abstract
- The use of molecular allergology has increasingly become common in the diagnosis and management of allergic diseases. However, there is still a lack of data on cat molecular allergens in adults. Therefore, we aimed to uncover the sensitization patterns to cat molecular allergens.Participants were recruited from the West Asthma Sweden Study, a population-based study enriched with asthma subjects aged 16-75years. Of 1872, 361 individuals were positive for cat dander immunoglobulin E and were further analysed for cat molecular allergens (Fel d 1/2/4/7). Sensitization patterns were classified as monosensitization, polysensitization, and concomitant sensitization, and were related to demographic and clinical measurements.Among cat-sensitized subjects, 84.2% were sensitized to secretoglobin, while 42.4% were sensitized to lipocalins. Nearly half of the subjects were monosensitized to Fel d 1. Polysensitization was observed in 20.2%, and concomitant sensitization to protein families was seen in 7.2%. Asthma prevalence, cat exposure, and rural living were associated with poly- and concomitant sensitization to protein families. Concomitant sensitization to single allergens was more common in those with asthma than in those without, while concomitant sensitization to both Fel d 1 and Fel d 4 was the most common pattern in individuals with asthma. Sensitization patterns also differed according to cat ownership and the degree of urbanization.Sensitization to molecular allergens was observed in 90.9% of cat-sensitized subjects and showed variations across participants' background characteristics and the presence of asthma. Identification of sensitization patterns to cat allergens might provide better characterization of cat-allergic subjects.
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- Ermis, Özuygur, 1991, et al.
(författare)
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Sensitization to molecular dog allergens in an adult population: Results from the West Sweden Asthma Study
- 2023
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Ingår i: Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology. - : Wiley. - 0954-7894 .- 1365-2222. ; 53:1, s. 88-104
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Tidskriftsartikel (refereegranskat)abstract
- As the prevalence of dog allergy rises, component resolved diagnosis might improve the diagnosis, understanding of the clinical outcomes, and the effectiveness of immunotherapy. Considering the paucity of data in adults, the current study characterized the patterns of sensitization to dog molecular allergens in an adult population.Data were derived from the West Sweden Asthma Study, a population-based and representative sample of adults from western Sweden. Of the 2006 subjects clinically examined, 313 participants sensitized to whole dog allergen extract were measured for specific immunoglobulin E (sIgE) levels to Can f 1, Can f 2, Can f 3, Can f 4, Can f 5, Can f 6 using ImmunoCAPTM . Poly-sensitization was defined as sensitization to ≥3 components. Overlapping sensitization was defined as having concomitant sensitization to at least two dog molecular allergen families (lipocalin, albumin, or prostatic kallikrein).Of 313, 218 (70%) subjects tested positive to at least one dog allergen component. Sensitization to Can f 1 (43%) was the most common, followed by Can f 5 (33%) among molecular allergens, while sensitization to lipocalins (56%) was the most common among component families. Polysensitization was found in 22% of all participants and was more common in participants with than in those without asthma. Subjects with asthma were less likely to be monosensitized to Can f 5 than those without asthma. Subjects with asthma had higher IgE levels of Can f 3, Can f 4 and Can f 6 than those without asthma. Overlapping sensitizations also differed between those with asthma and allergic rhinitis and those without.Increased knowledge about the sensitization patterns of dog allergen components can aid in defining their role in asthma and rhinitis. In complex clinical cases of dog allergy, a detailed analysis of dog allergen components can provide additional information on the nature of sensitization.
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- Mikkelsen, Andrea, et al.
(författare)
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Milk allergy school: nutritional therapy in group for parents of children with cow's milk allergy/intolerance in Primary Health Care
- 2005
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Ingår i: Pediatric Allergy and Immunology. - 0905-6157. ; 16, s. 86-90
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Tidskriftsartikel (refereegranskat)abstract
- Pediatric Primary Health Care Services, Göteborg, Sweden. The objective of this study was to create a method for group nutritional therapy for parents of children with cow's milk allergy/intolerance in a paediatric primary care setting to increase accessibility to nutritional therapy. A second objective was to evaluate a milk allergy school. Follow-up time after the group session was 3 yr. All parents to newly diagnosed children (n=98) with cow's milk allergy/intolerance in the Primary Health Care system in the city of Goteborg during an 11-month period were invited. The majority of the families chose to participate (n=84, 86%). The mean age of the children was 9 months (3 months to 5 yr). The number of participants obtaining nutritional treatment within a month after diagnosis has significantly increased. Seventy-four families (88%) could be re-contacted 3 yr after participation for a second evaluation. Seventy-eight per cent of the children no longer had cow's milk allergy/intolerance. Most participants expressed satisfaction with the information obtained in the meeting. The milk allergy school does not replace but complements individual counselling. The milk allergy school seems to meet the families' needs for information, has few administrative routines and is cost-efficient. This activity has become permanent, is being offered weekly and can be recommended. PMID: 15693918 [PubMed - indexed for MEDLINE]
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- Mikkelsen, Andrea, et al.
(författare)
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The Food hypersensitivity famiLy ImPact (FLIP) questionnaire - development and first results
- 2013
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Ingår i: Pediatric Allergy and Immunology. - : Wiley. - 0905-6157. ; 24:6, s. 574-581
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Tidskriftsartikel (refereegranskat)abstract
- Background: Elimination of the offending food(s) is the usual treatment when a child suffers from food hypersensitivity. This treatment can impair everyday life in families with affected children. Instruments to assess these impairments generated from families attending primary care and in comparison to families with children without food hypersensitivity are scarce. The aim of this study is to develop and test a method to assess food hypersensitivity's impact on everyday life on affected families. Methods: The Food hypersensitivity famiLy ImPact (FLIP) questionnaire was developed and validated on parents of children (0.5-7 years) with cow's milk protein hypersensitivity, exclusively or in combination with other food hypersensitivity, together with the Swedish Parental Stress Questionnaire (SPSQ) and in comparison to parents with children without food hypersensitivity. Results: The validation of FLIP on 94 families indicated excellent internal consistency (Cronbach a 0.9) and good reproducibility (ICC 0.71). The FLIP showed moderate correlation with the SPSQ (r = 0.48) and proved capable of discriminating families by disease burden. Affected families experienced higher stress on their daily lives (p = 0.02) and higher impact on nutrition concerns (p < 0.0001) compared to families with children without food hypersensitivity. Conclusions: The FLIP is a reliable, valid and sensitive instrument and could be valuable both clinically and in research. The results confirm recommendations of the need for continuous and updated dietary treatment and support for the families with young children with food hypersensitivity.
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- Nwaru, Bright I, et al.
(författare)
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Furry Animal Allergen Component Sensitization and Clinical Outcomes in Adult Asthma and Rhinitis
- 2019
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Ingår i: Journal of Allergy and Clinical Immunology. - : Elsevier. - 2213-2198 .- 2213-2201. ; 7:4, s. 1230-1238.e4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sensitization to allergen components has been linked to asthma in children, but studies in adults are lacking.Objective: To study the relation of sensitization to furry animal allergen components to risk of asthma, rhinitis, and markers of asthma severity in adults.Methods: From the West Sweden Asthma Study, a random population-representative sample of adults aged 16 to 75 years, 2006 participants were clinically examined; 1872 were analyzed for serum IgE level to a mix of aeroallergens. Those with an IgE level of more than 0.35 kUA/L to cat, dog, or horse allergen components were analyzed for specific cat (Felis domesticus [Fel d 1, Fel d 2, and Fel d 4]), dog (Canis familiaris [Can f 1, Can f 2, Can f 3, and Can f 5]), and horse (Equus caballus [Equ c 1]) allergen components. We defined monosensitization, double sensitization, and polysensitization (>2 components) patterns and applied cluster analysis to derive distinct sensitization clusters.Results: Sensitization to each allergen component, lipocalins, each sensitization pattern, and each sensitization cluster (nonsensitized, Fel d 1–driven sensitized, and multisensitized clusters) was associated with substantial increased risk of asthma, rhinitis, concomitant asthma and rhinitis, and Asthma Control Test–controlled asthma. Fel d 1, Can f 1, Can f 2, Can f 3, polysensitization, and multisensitized cluster were further associated with increased fractional exhaled nitric oxide and eosinophil levels, but with lower PD20 methacoline (provocative dose of methacholine causing a 20% drop in FEV1) values. There was no association with asthma exacerbations, FEV1 predicted values, emergency visits or regular oral steroid use, and neutrophil levels.Conclusions: Sensitization to furry animal allergen components is an important predictor of asthma, rhinitis, and markers of asthma severity with increased blood eosinophils, fractional exhaled nitric oxide, and airway hyperreactivity.
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- Savolainen, Johannes, et al.
(författare)
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Structured intervention plan including component-resolved diagnostics helps reducing the burden of food allergy among school-aged children
- 2019
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Ingår i: Pediatric Allergy and Immunology. - : WILEY. - 0905-6157 .- 1399-3038. ; 30:1, s. 99-106
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Tidskriftsartikel (refereegranskat)abstract
- Background Food allergies can substantially burden patients and families by negatively affecting finances, social relationships, and personal perceptions of health. This study was performed under the Finnish Allergy Programme aimed at reducing avoidance diets to foods in schoolchildren by 50%. The main goal of this study was to investigate how many children could be freed from diet restrictions in a Finnish school district through a diagnostic algorithm including component-resolved diagnostics and food challenge. The secondary aim was to provide a crude estimate of the burden of the elimination food diets in the region, and the savings associated with the proposed intervention. Methods A total of 205 children on a food avoidance diet according to the school register because of food allergy were invited into the study. One hundred and fifty-seven children were interviewed, tested for IgE to extracts and allergen components and food challenged in respective order. Results After two years, 12 children still had an avoidance diet and three of them were treated successfully with sOTI; the rest suspended their avoidance diet (n = 134) or dropped out of the study (n = 11). The cost of the elimination diets was estimated in 172 700euro per year at start and 13 200euro per year at the end of the study; total savings were 128 400euro yearly. Conclusions The results demonstrate a 65% reduction of avoidance diets to foods in school-aged children, exceeding the 50% aim of the Finnish Allergy Programme. Therefore, it is possible to actively reduce the number of food allergy diagnoses that remain unmonitored in the society through a tailored diagnostic work-up.
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- Suzuki, Shintaro, et al.
(författare)
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Characterization of sensitization to furry animal allergen components in an adult population.
- 2019
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Ingår i: Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology. - : Wiley. - 1365-2222 .- 0954-7894. ; 49:4, s. 495-505
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Tidskriftsartikel (refereegranskat)abstract
- There are paucity of data on sensitization to furry animal allergen components in adults. Furry animals are major sensitizers and contributors to asthma burden in northern Europe and North America.To characterize sensitization patterns to furry animal allergen components in Swedish adults.Based on the West Sweden Asthma Study, a random population (n=1103) and an asthma sample (n=769) were tested for allergen sensitization using Phadiatop® . Those with IgE≥0.35kUA /L were tested for cat (Fel d 1, 2, and 4), dog (Can f 1, 2, 3, and 5), and horse (Equ c 1) allergen component sensitization. We defined allergen component poly-sensitization patterns, identified data-driven sensitization clusters, described component sensitization overlaps, and assessed determinants of sensitization patterns.The prevalence of allergen component sensitization ranged from 0.8% for Fel d 2 and Can f 3 to 8.9% for Fel d 1. The most common dog component was Can f 5 (3.6%); 2.1% were sensitized to Equ c 1. Those sensitized to Fel d 2 and Fel d 4 were commonly sensitized to Fel d 1. The most common dog component overlap was between Can f 1/Can f 2 and Can f 5. Mono-sensitization was 5.6%, double sensitization 1.5% and poly-sensitization 2.1%. Sensitization was always higher in the asthma than in the random sample. Three sensitization clusters were derived, namely non-sensitized (90% in random vs 66% in asthma sample); Fel d 1-driven sensitized (7% vs 19%); and multi-sensitized (3% vs 15%). Key determinants of sensitization were gender, age, raised on a farm, family history of allergy or asthma, smoking, and occupational exposure to dust or fumes.Fel d 1 and Can f 5 are the most common cat and dog components sensitization in this adult Swedish population. Mono-sensitization is more common than poly-sensitization. This detailed characterization highlights the current distribution of furry animal allergen components in Swedish adults, and their impact on clinical outcomes of asthma will be further explored.
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- Thorpe, Michael, et al.
(författare)
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History and Utility of Specific IgE Cutoff Levels : What is the Relevance for Allergy Diagnosis?
- 2023
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Ingår i: Journal of Allergy and Clinical Immunology. - : Elsevier. - 2213-2198 .- 2213-2201. ; 11:10, s. 3021-3029
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Tidskriftsartikel (refereegranskat)abstract
- Allergy is defined clinically, by symptoms on allergen exposure. A patient is considered sensitized when allergen-specific IgE (sIgE) antibody can be detected in serum or plasma or a skin test result is positive, even if no clinical reaction has been experienced. Sensitization should be regarded as a requisite and risk factor for allergy but is not synonymous with an allergy diagnosis. To provide a correct allergy diagnosis, test results regarding allergen-sIgE must always be considered in view of the patient's case history and clinical observations. Correct assessment of a patient's sensitization to specific allergens relies on the use of accurate and quantitative methods for detection of sIgE antibodies. The evolution of sIgE immunoassays toward higher analytical performance and the use of different cutoff levels in the interpretation of test results sometimes cause confusion. Earlier versions of sIgE assays offered a limit of quantitation of 0.35 kilounits of sIgE per liter (kUA/L), which also became an established cutoff level for a positive test result in the clinical use of the assays. Current sIgE assays are capable of reliably measuring sIgE levels as low as 0.1 kUA/L and can thereby demonstrate sensitization in cases in which previous assays could not. When the outcome of sIgE test results is evaluated, it is critically important to distinguish between the analytical data as such and their clinical interpretation. Even though sIgE may be present in the absence of symptoms of allergy, available information suggests that sIgE concentrations between 0.1 kUA/L and 0.35 kUA/L may be clinically relevant in some individuals, not least among children, although this should be further evaluated for various allergies. Moreover, it is becoming widely adopted that nondichotomous interpretation of sIgE levels may offer a diagnostic benefit compared with using a predefined cutoff level.
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