Effectiveness and safety of oral lactococci-based vaccine encoding triple common allergens to prevent airway allergy in mice

Allergic airway disease is the most common chronic airway inflammatory disorder in developed countries. House dust mite, cockroach, and mold are the leading allergens in most tropical and subtropical countries, including Taiwan. As allergen avoidance is difficult for patients allergic to these perennial indoor allergens, allergen-specific immunotherapy (ASIT) is the only available allergen-specific and disease-modifying treatment. However, for patients sensitized to multiple allergens, ASIT using each corresponding allergen is cumbersome. In the present study, we developed a recombinant L. lactis vaccine against the three most common indoor aeroallergens and investigated its effectiveness for preventing respiratory allergy and safety in mice. Three recombinant clones of Der p 2 (mite), Per a 2 (roach), and Cla c 14 (mold) were constructed individually in pNZ8149 vector and then electroporated into host strain L.lactis NZ3900. BALB/c mice were fed with the triple vaccine 5 times per week for 4 weeks prior to sensitization. The effectiveness and safety profile were then determined. Oral administration of the triple vaccine significantly alleviated allergen-induced airway hyper-responsiveness in the vaccinated mice. The allergen-specific IgG2a was upregulated. IL-4 and IL-13 mRNA expressions as well as inflammatory cell infiltration in the lungs decreased significantly in the vaccinated groups. No body weight loss or abnormal findings in the liver and kidneys were found in any of the groups of mice. This is the first report to describe a triple-aeroallergen vaccine using a food-grade lactococcal expression system. We developed a convenient oral delivery system and intend to extend this research to develop a vaccination that can be self-administered at home by patients.

Differential Correlations among Allergy Tests According to Indoor Allergens in Allergic Rhinitis

Objectives: Several allergy tests are used for the diagnosis of allergic rhinitis; however, few studies have reported a direct comparison of the skin prick test (SPT), multiple allergen simultaneous test (MAST), and ImmunoCAP according to specific allergens. This study aimed to evaluate the correlations between each test and allergic rhinitis symptoms and to evaluate the correlations of the MAST and ImmunoCAP with the SPT for representative indoor allergens in Korea. Methods: Electronic medical charts were retrospectively reviewed, and 698 patients with allergic rhinitis who had performed SPT, MAST, and ImmunoCAP were enrolled. Correlations between each allergy test for 4 representative indoor allergens and the symptoms of allergic rhinitis were analyzed. Agreements of the MAST and ImmunoCAP with the SPT were compared according to each allergen. Results: The SPT showed higher correlations with allergic rhinitis symptoms for 4 indoor allergens ( Dermatophagoides pteronyssinus, Dermatophagoides farinae, cat, and dog allergens) than the MAST or ImmunoCAP. In comparison between the MAST and SPT, the least correlation was observed for the dog allergen, whereas between the ImmunoCAP and SPT, the least correlation was observed for the cat allergen. The correlation between the ImmunoCAP and SPT was higher than that between the MAST and SPT for the dog allergen, whereas no significant differences were noted for other allergens. Conclusions: Overall, the SPT showed a higher correlation with allergic rhinitis symptoms than the MAST or ImmunoCAP for 4 indoor allergens. ImmunoCAP showed similar reactivity to MAST; however, it showed better positivity with dog allergen in patients who were reactive to the allergen in the SPT. Care should be taken while evaluating dog allergen sensitization using the MAST.

Detection of Serum Allergen-Specific IgE in Atopic Dogs Tested in Northern Italy: Preliminary Study

Canine atopic dermatitis (CAD) is a pruritic allergic skin disease associated with IgE-mediated hypersensitivity. IgE is detected using Serum Allergen-Specific IgE test (SAT) in order to identify allergens. The present study aims to identify the environmental allergens in atopic dogs living in Northern Italy using SAT. The screening SAT (sSAT), using a monoclonal antibody cocktail-based ELISA to identify indoor and outdoor allergens, was performed. In all positive samples, an anti-IgE monoclonal antibody ELISA test was performed to extend panel of allergens. Out of 117 selected dogs, 69 were included in the study; 71% were positive and 29% were negative to sSAT. Among the 49 positive sSAT, 53% were positive for both indoor and outdoor, 38.8% only for indoor, and 8.2% only for outdoor allergens. This is the first study on the frequency of allergens involved in CAD in Italy using SAT. IgE hypersensitivity in atopic dogs of Northern Italy is usually associated with indoor allergens, primarily house dust mites. Among the outdoor allergens, an important role was played by Rumex acetosa. Polysensitization also commonly occurs. Therefore, since the numerous factors affect the IgE positivity in CAD, specific panels for geographical areas should be considered and re-evaluated at time intervals.

RISK FACTORS FOR INNER CITY ASTHMA PATIENTS

Asthma patients in inner cities have the highest prevalence of asthma and the highest death rates in America. The purpose of this study was to evaluate sensitization and exposure to common indoor allergens seen for asthma treatment at Grady Memorial Hospital, Atlanta, Ga. Eighty asthma patients were enrolled in the emergency department and 64 in hospital clinics in this study. Neither sensitization nor visibility In this population, cat allergens are prevalent. The findings show that black asthma patients are exposed to high levels of mite and cockroach allergens in downtown Atlanta and that a high percentage of patients with asthma are sensitized to these allergens; a significant risk factor for asthma in this population is the combination of sensitization and exposure. Keywords: asthma; mechanical ventilation, status asthmaticus , Pathophysiology epidemiology mechanisms.

Molecular Allergen Profiling of Dual Mite Sensitization in Severe Allergic Rhinitis

Background: Mites are the most prevalent source of indoor allergens. The present study used a component-resolved diagnosis (CRD) approach to investigate the mite-specific IgE sensitization profile for Dermatophagoides pteronyssinus and Blomia tropicalis. We also assessed the performance of a commercially available CRD approach in patients with severe allergic rhinitis. Methods: We selected 63 consecutive patients with dual sensitization to D pteronyssinus and B tropicalis and persistent severe rhinitis according to the ARIA guidelines. We performed skin prick tests with standardized extracts and determined specific serum IgE to both mites, along with serum specific IgE to Der p 1, Der p 2, Der p 23, Der p 10, and Blo t 5. Results: Fifty-eight and 59 patients had positive sIgE to the whole extracts of D pteronyssinus and B tropicalis, respectively. While 91.67% of patients were sensitized to specific IgE to Der p 1, Der p 2, and/or Der p 23, specific IgE to Blo t 5 (≥0.3 ISU-E) was not detected in most of the serum samples (55%). Conclusions: Although the combination panel of the commercially available major allergens Der p 1, Der p 2, and Der p 23 identified more than 90% of the D pteronyssinus–allergic patients, Blo t 5 performed somewhat poorly in those sensitized to B tropicalis. Improvements in CRD and further research concerning the prevalence and clinical relevance of serodominant allergens are needed to achieve a genuine molecular diagnosis, as well as patient-centered mite allergy–specific immunotherapy.

A descriptive study of allergen-specific IgE serological tests for canine atopic dermatitis in Thailand

Background This study describes the usefulness of allergen-specific Immunoglobulin E (IgE) serology (ASIS) for identifying allergens in dogs with atopic dermatitis. ASIS tests were conducted in 23 dogs diagnosed with atopic dermatitis for indoor allergens (yeast and mites), outdoor allergens (grass pollen, weed pollen, and tree pollen), and fleas. The relationship among positive ASIS tests were determined using Pearson’s correlation coefficient (r). Results Of the atopic dogs, 26.09%, 4.35%, and 47.83% had positive ASIS tests for only indoor allergens, only outdoor allergens, and both indoor and outdoor allergens, respectively. The prevalence of positive ASIS tests was highest for mites (69.57%) and did not differ between indoor and outdoor allergens by age, breed, or sex. The prevalence of positive ASIS tests for indoor allergens during the rainy season (84.21%) was significantly higher than during winter (25.00%, P-value = 0.030). The correlation coefficient of the ASIS results among the outdoor allergens indicated a strong correlation between grass and tree pollen (r = 0.840, P-value < 0.01), grass and weed pollen (r = 0.812, P-value < 0.01), and tree and weed pollen (r = 0.714, P-value < 0.01). The correlation coefficient of the ASIS results of D. farinae indicated a strong correlation with A. siro (r = 0.951, P-value < 0.01) and a moderate correlation with B. tropicalis (r = 0.656, P-value < 0.01) and T. putrescentie (r = 0.672, P-value < 0.01). Conclusions ASIS tests are useful in screening for multiple allergens in dogs with atopic dermatitis. Dust mites are an important source of indoor allergens and may be responsible for a higher titer of IgE antibodies against indoor allergens during the rainy season.

Occupants’ Health and Their Living Conditions of Remote Indigenous Communities in New Zealand

The New Zealand Ministry of Health reported that respiratory disease affects 700,000 people, annually costs New Zealand NZ$7.05 billion, and is the third-highest cause of death. The hospitalisation rate for asthma of Māori communities is 2.0 higher than that of other ethnic groups, and hospitalisation rates for deprived homes are 2.3 times higher than those of the least deprived homes. Based on physical data and evidence, which were drawn from a mixed methodology that includes field studies of the indoor microclimate, dust-mite allergens, mould growth, and occupants’ Respiratory Health Survey of a number of sample houses of Māori communities in Minginui, Te Whaiti, Murupara, and Rotorua of New Zealand, the study identifies unhealthy indoor thermal conditions, thresholds or ranges of indoor micro-climate related to different levels of dust-mite allergen and mould growth, the most common type of indoor mould, and correlations between dust-mite and mould and correlations. The study not only identified that the poor health of occupants is closely related to their inadequate living conditions, but also identifies the threshold of indoor micro-climates to maintain indoor allergens at the acceptable level, which can be used as a guideline to maintain or improve indoor health conditions for future housing development or retrofitted old housing.

Innovative Management Methods for Patients Allergic to Cats

The prevalence of allergies to domestic animals increases due to the increase in the number of pets worldwide, followed by serious medical and social problems. Domestic cat (Felis domesticus) is one of the most common pets and one of the most frequent (after dust mite) source of indoor allergens and risk factor for bronchial asthma and allergic rhinitis. This review collects relevant information on the issues of hypersensitivity to cat allergens (the term «cat allergy» will be used later). The authors consider issues of diagnosis, treatment and prevention of this condition. Special attention is given to the management of patients with cat allergies and particularly usage of special nutrition for cats that can reduce the level of the main cat allergen Fel d 1 in the environment. Whereas, this leads to decrease of allergic diseases symptoms severity.