Allergic Rhinitis Improvement in Asthmatic Children After Using Acaricidal Bait: A Randomized, Double-Blind, Cross-Placebo Study

Objective: This study aimed to evaluate the effects of acaricidal bait use on the house dust mite (HDM) allergen concentration and occurrence of allergic rhinitis (AR) and asthma symptoms in children sensitized to HDMs.Study Design: Sixty-six children (3–12 years old) with AR and asthma sensitized to HDMs were randomly assigned to receive an acaricidal bait intervention for 8 weeks and a placebo intervention for 8 weeks separated by a 4-week washout period. The visual analog scale (VAS) score, rhinitis control assessment test (RCAT) score, rhinoconjunctivitis quality of life questionnaire (RQLQ) score, asthma control questionnaire-5 (ACQ-5) score and HDM allergen levels were monitored.Results: HDM allergen levels were significantly decreased after 8 weeks (Δder p2+f2 2.282 (3.516) μg/g vs. 0.147 (0.25) μg/g, P < 0.05) in the acaricidal bait group compared with the placebo group. The VAS, RCAT and RQLQ scores in the acaricidal bait group were also significantly improved (ΔVAS 7.5 (16) vs. 3 (18), P < 0.05; ΔRCAT−3 (5) vs. 0 (7), P < 0.05; ΔRQLQ 4.5 (8) vs. 1 (8), P < 0.05), but the ACQ-5 score did not improve (ΔACQ-5 0.2 (0.4) vs. 0 (0.65), P > 0.05).Conclusion: Acaricidal bait reduced HDM exposure and improved rhinitis symptoms. This trial is registered at www.chictr.org.cn.

Allergic acute coronary syndrome: Amoxicillin/clavulanic acid intake

Anaphylaxis rarely manifests as a vasospastic acute coronary syndrome (ACS). Kounis Syndrome (KS) is described as the coincidental occurrence of chest pain and clinical and laboratory findings of ACS. The prognosis depends on the magnitude of the initial allergic response, the patient’s sensitivity, comorbidities, the site of antibody antigen reaction, the allergen concentration, and the route of allergen entrance. We report a rare case of KS secondary to antibiotic allergy. This case may suggest that Kounis syndrome should be taught in the differential diagnosis of acute coronary syndromes. Clinicians should be aware of this adverse effect and consider it during diagnostic workup of myocardial injury.

Climate, Carbon Dioxide, and Plant-Based Aero-Allergens: A Deeper Botanical Perspective

There is global evidence of a general increase in the incidence and prevalence of respiratory diseases including allergic rhinitis and associated asthma. This increase in turn, has been related, in part, to concurrent increases in carbon dioxide (CO2) and temperature on pollen production and allergic disease generated from plant-based sources of pollen. Such links to anthropogenic climate change has suggested three significant and interrelated consequences associated with respiratory allergies or disease. First, warmer temperatures and a longer frost-free growing season can influence pollen season length and temporal exposure to airborne aeroallergens. Second, both warmer temperatures and additional CO2 can increase the amount of pollen, the seasonal intensity, from spring through fall. Thirdly, there is evidence from oak and ragweed that rising levels of CO2 could increase the allergen concentration of the pollen and symptom severity. However, while these outcomes are of obvious consequence, they do not fully encompass all of the plant derived changes that could, directly or indirectly, influence aeroallergen production, exposure, and consequences for public health. In this overview, I will delve deeper into other plant-based links to climate/CO2 that are consequential either directly or indirectly to allergic rhinitis and associated disease. Such interactions range from pollen morphology to fire occurrence, from volatile organic compounds to potential changes in pesticide usage. The goal in doing so is to provide a broader context and appreciation for the interactions between plant biology and climate that can also affect allergen production and human impact but which, to date, have received little recognition or research.

Sesame seed labelling and health protection of allergic consumers

Purpose Sesame can cause food allergy and according to European legislation, its presence in food must be declared on the label. The purpose of this paper is to investigate the presence of sesame in food products carrying no mention of sesame on the ingredient label and in food products carrying the voluntary labelling statement “may contain traces of sesame”. Design/methodology/approach Packaged bakery and non-bakery food items were collected at retail. Sample size was calculated according to estimated prevalence of 2 per cent and precision of 5 per cent: in total 32 samples of packaged bakery and non-bakery food were collected for each food category. The RIDASCREEN®FAST Sesame test (R-Biopharm AG, Darmstadt, Germany) was used for the analysis: its limit of detection was fixed in the laboratory at 0.5 ppm. Findings Of the 32 food samples that did not mention sesame seed on the ingredient label, one (3.1 per cent) breadsticks sample tested positive at a concentration (326 ppm). Of the 32 food samples that carried the precautionary label statement “may contain traces of sesame”, one (3.1 per cent) breadcrumbs sample tested positive (305 ppm). Comparison between the allergen concentration and the published eliciting dose (ED5) for sesame proteins (1 mg) was performed. The calculated exposure was more than 2 the ED05 reported in the literature. Originality/value To date, few studies investigating compliance with food-allergen labelling requirements are available. This survey provides data for preliminary risk assessment for sesame allergenic consumers.

Egg and Milk Proteins as Hidden Allergens in Food: 5-Year (2010 to 2014) Results of Food Allergen Monitoring in Piedmont, Italy

ABSTRACT Cow's milk and egg allergies are two of the most common food allergies. Manufacturers of food products containing milk or eggs or their derivatives as an ingredient are required by European Union regulations to list their presence on the ingredient label. Under European Union legislation, member states are mandated to carry out food safety monitoring programs to verify compliance with food labeling requirements. Through the Regional Integrated Plan for Food Safety, the Piedmont (Italy) regional authority carries out an annual program to determine the presence of undeclared allergens in foods. In the 5-year period from 2010 to 2014, a total of 1,566 food samples were analyzed for the presence of hidden egg and milk proteins. The average positive percentage was 2.8% (3.6% egg and 2% milk proteins). Comparison between the allergen concentration and the published eliciting dose (ED) for egg proteins (0.03 mg) and for total milk proteins (0.1 mg) indicated a high risk of allergen exposure for sensitized consumers. The calculated exposure was up to 135× (for milk) the ED01 reported in the literature. Food manufacturers will need to improve their allergen control programs to reduce allergen exposure and risk.

Few Associations Found between Mold and Other Allergen Concentrations in the Home versus Skin Sensitivity from Children with Asthma after Hurricane Katrina in the Head-Off Environmental Asthma in Louisiana Study

Mold and other allergen exposures exacerbate asthma symptoms in sensitized individuals. We evaluated allergen concentrations, skin test sensitivities, and asthma morbidity for 182 children, aged 4–12 years, with moderate to severe asthma, enrolled 18 months after Katrina, from the city of New Orleans and the surrounding parishes that were impacted by the storm, into the Head-off Environmental Asthma in Louisiana (HEAL) observational study. Dust (indoor) and air (indoor and outdoor) samples were collected at baseline of 6 and 12 months. Dust samples were evaluated for dust mite, cockroach, mouse, andAlternariaby immunoassay. Air samples were evaluated for airborne mold spore concentrations. Overall, 89% of the children tested positive to ≥1 indoor allergen, with allergen-specific sensitivities ranging from 18% to 67%. Allergen concentration was associated with skin sensitivity for 1 of 10 environmental triggers analyzed (cat). Asthma symptom days did not differ with skin test sensitivity, and surprisingly, increased symptoms were observed in children whose baseline indoor airborne mold concentrations were below median levels. This association was not observed in follow-up assessments. The lack of relationship among allergen levels (including mold), sensitivities, and asthma symptoms points to the complexity of attempting to assess these associations during rapidly changing social and environmental conditions.