Autologous Serum Skin Test as a Diagnostic Aid in Chronic Idiopathic Urticaria

ISRN Dermatology
Volume 2013 (2013), Article ID 291524, 4 pages
http://dx.doi.org/10.1155/2013/291524

Clinical Study

Autologous Serum Skin Test as a Diagnostic Aid in Chronic Idiopathic Urticaria

Hayder R. Al-Hamamy,¹ Ammar F. Hameed,¹ and Asaad S. Abdulhadi²

¹Department of Dermatology and Venereology, College of Medicine, University of Baghdad, Medical Collection Office, P.O. Box 61211, Baghdad 12114, Iraq
²Department of Dermatology and Venereology, Baghdad Teaching Hospital, Baghdad, Iraq

Received 26 February 2013; Accepted 27 March 2013

Academic Editors: A. Firooz, J. Y. Lee, and W. Vanscheidt

Copyright © 2013 Hayder R. Al-Hamamy et al. This is an open access article distributed under theCreative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Chronic urticaria is defined as urticaria persisting daily for more than six weeks. A significant number of patients had autoimmune basis where autologous serum skin test is widely used for detection of chronic autoimmune urticaria. Objectives. To estimate the frequency of autoimmune urticarial in Iraqi patients utilizing the autologous serum skin test and to evaluate its results with the variable clinical features of chronic idiopathic urticaria. Methods. In this prospective study, 54 patients with chronic idiopathic urticaria were investigated with autologous serum skin test where its results were examined with the different clinical parameters of chronic autoimmune urticaria. Results. Twenty two patients (40.7%) out of 54 patients with chronic idiopathic urticarial had positive autologous serum skin test. Statistical analysis of the clinical variables did not show a significant difference between patients with positive and negative autologous serum skin test except for the distribution of wheals on the face and extremities which was significantly associated with positive autologous serum skin test results (P value 0.004). Conclusion. Autologous serum skin test is a simple, office-based test for detecting chronic autoimmune urticaria patients who have no distinctive clinical features differentiating them from chronic idiopathic urticaria patients.

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Efficacy, safety and tolerability of GSK2190915, a 5-lipoxygenase activating protein inhibitor, in adults and adolescents with persistent asthma

Research

Efficacy, safety and tolerability of GSK2190915, a 5-lipoxygenase activating protein inhibitor, in adults and adolescents with persistent asthma: a randomised dose-ranging study

Richard M Follows, Neil G Snowise, Shu-Yen Ho, Claire L Ambery, Kevin Smart and Barbara A McQuade

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Respiratory Research 2013, 14:54 doi:10.1186/1465-9921-14-54

Published: 17 May 2013

Abstract (provisional)

Background

GSK2190915 is a high affinity 5-lipoxygenase-activating protein inhibitor being developed for the treatment of asthma. The objective of this study was to evaluate GSK2190915 efficacy, dose--response and safety in subjects with persistent asthma treated with short-acting beta2-agonists (SABAs) only.

Methods

Eight-week multicentre, randomised, double-blind, double-dummy, stratified (by age and smoking status), parallel-group, placebo-controlled study in subjects aged 12 years or more with a forced expiratory volume in 1 second (FEV1) of 50--85% predicted. Subjects (n = 700) were randomised to receive once-daily (QD) oral GSK2190915 (10--300 mg), twice-daily inhaled fluticasone propionate 100 mug, oral montelukast 10 mg QD or placebo. The primary endpoint was mean change from baseline (randomisation) in trough (morning pre-dose and pre-rescue bronchodilator) FEV1 at the end of the 8-week treatment period. Secondary endpoints included morning and evening peak expiratory flow, symptom-free days and nights, rescue-free days and nights, day and night-time symptom scores, day and night-time rescue medication use, withdrawals due to lack of efficacy, Asthma Control Questionnaire and Asthma Quality of Life Questionnaire scores.

Results

For the primary endpoint, there was no statistically significant difference between any dose of GSK2190915 QD and placebo. However, repeated measures sensitivity analysis demonstrated nominal statistical significance for GSK2190915 30 mg QD compared with placebo (mean difference: 0.115 L [95% confidence interval: 0.00, 0.23], p = 0.044); no nominally statistically significant differences were observed with any of the other doses. For the secondary endpoints, decreases were observed in day-time symptom scores and day-time SABA use for GSK2190915 30 mg QD versus placebo. No dose--response relationship was observed for the primary and secondary endpoints across the GSK2190915 dose range studied; the 10 mg dose appeared to be sub-optimal. GSK2190915 was associated with a dose-dependent reduction in urinary leukotriene E4. The profile and incidence of adverse events were similar between treatment groups.

Conclusion

Efficacy was demonstrated for GSK2190915 30 mg compared with placebo in day-time symptom scores and day-time SABA use. No additional improvement on efficacy endpoints was gained by administration of GSK2190915 doses greater than 30 mg. GSK2190915 was well-tolerated. These results may support further studies with GSK2190915 30 mg.

Trial registration: Clinicaltrials.gov: NCT01147744.http://www.clinicaltrials.gov/ct2/show/NCT01147744?term=NCT01147744&rank=1

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

J Pediatr (Rio J). 2013;89:158-63

Respiratory function in children of asthmatic mothers

Marco A. Valadares^a, Ricardo Q. Gurgel^b, Enaldo V. Melo^c, Alzira M.D.N. Guimarães^d, Kildane M.A. Guedes^e, Neuly A.F. Rocha^f, Maria L.D. Almeida<sup>g

a</sup> MD, MSc in Health Sciences, Universidade Federal de Sergipe (UFS), São Cristóvão, SE, Brazil. Assistant Professor, Departamento de Medicina, UFS, São Cristóvão, SE, Brazil
^b MD, PhD in Child and Adolescent Health, Universidade de São Paulo (USP), São Paulo, SP, Brazil. Adjunct Professor, Departamento de Medicina, UFS, São Cristóvão, SE, Brazil
^c MD, PhD in Health Sciences, UFS, São Cristóvão, SE, Brazil. Professor, Departamento de Medicina, UFS, São Cristóvão, SE, Brazil
^d Nurse, PhD in Health Sciences, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brazil. Adjunct Professor, Departamento de Enfermagem, UFS, São Cristóvão, SE, Brazil
^e Dental Surgeon, PhD Candidate in Health Sciences, UFS, São Cristóvão, SE, Brazil
^f MD, MSc in Health Sciences, UFS, São Cristóvão, SE, Brazil
^g MD, PhD in Child and Adolescent Health, USP, São Paulo, SP, Brazil. Adjunct Professor, Departamento de Medicina, UFS, São Cristóvão, SE, Brazil 

Keywords

Asthma; Child; Spirometry

Abstract

Objective: To evaluate lung function and clinical manifestations suggestive of asthma in children of mothers with a reported medical diagnosis of asthma.

Methods: An observational cross-sectional analytical study nested in a cohort of 4,757 pregnant women. A total of 86 six-year-old children were evaluated, born to mothers with a medical diagnosis of asthma before pregnancy. Information was collected regarding clinical symptoms of atopy and respiratory diseases, as well as socioeconomic and exposure variables; the children were submitted to spirometry.

Results: Spirometric alterations were observed in 30.3% of cases, with a prevalence of asthma in those who had an obstructive pattern. 9.3% of the children had a previous medical diagnosis of asthma; however, the established diagnosis based on the presence and frequency of asthma symptoms was 18.6%. Of the 86 participating children, 37.2% had a score of five or more points in the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, which was associated with spirometry alterations (p = 0.002). After multiple logistic regression analysis, higher paternal education, higher number of bedrooms in the family's home, and mother who did not have "wheezing" episodes during pregnancy were statistically significant as protective factors for the presence of respiratory disorder detected by spirometry.

Conclusions: The frequency of spirometry alterations in children of asthmatic mothers was high; the restrictive pattern was more often observed that the obstructive. There was a higher incidence of obstructive test results in those who presented clinical symptoms of asthma, with a higher frequency of clinical diagnosis of asthma than that found in the literature.

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• > Early Edition
• > Konrad J. Karczewski

Systematic functional regulatory assessment of disease-associated variants

1. Konrad J. Karczewskia,b,1, 
2. Joel T. Dudleya,c,1,2, 
3. Kimberly R. Kukurbab, 
4. Rong Chenc, 
5. Atul J. Buttec,
6. Stephen B. Montgomeryb,d, and 
7. Michael Snyderb,3

Author Affiliations

1. Edited by Joseph R. Ecker, Salk Institute, La Jolla, CA, and approved April 24, 2013 (received for review November 3, 2012)

Abstract

Genome-wide association studies have discovered many genetic loci associated with disease traits, but the functional molecular basis of these associations is often unresolved. Genome-wide regulatory and gene expression profiles measured across individuals and diseases reflect downstream effects of genetic variation and may allow for functional assessment of disease-associated loci. Here, we present a unique approach for systematic integration of genetic disease associations, transcription factor binding among individuals, and gene expression data to assess the functional consequences of variants associated with hundreds of human diseases. In an analysis of genome-wide binding profiles of NFκB, we find that disease-associated SNPs are enriched in NFκB binding regions overall, and specifically for inflammatory-mediated diseases, such as asthma, rheumatoid arthritis, and coronary artery disease. Using genome-wide variation in transcription factor-binding data, we find that NFκB binding is often correlated with disease-associated variants in a genotype-specific and allele-specific manner. Furthermore, we show that this binding variation is often related to expression of nearby genes, which are also found to have altered expression in independent profiling of the variant-associated disease condition. Thus, using this integrative approach, we provide a unique means to assign putative function to many disease-associated SNPs.

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Use of Animal Models to Investigate Major Allergens Associated with Food Allergy

Journal of Allergy
Volume 2013 (2013), Article ID 635695, 10 pages
http://dx.doi.org/10.1155/2013/635695

Review Article

Use of Animal Models to Investigate Major Allergens Associated with Food Allergy

Jenna L. Van Gramberg,¹ Michael J. de Veer,¹ Robyn E. O'Hehir,² Els N. T. Meeusen,¹ and Robert J. Bischof¹

¹Biotechnology Research Laboratories, Department of Physiology, Monash University, Clayton, VIC 3800, Australia
²Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Monash University, Prahran, VIC 3181, Australia

Received 6 February 2013; Accepted 24 March 2013

Academic Editor: K. Blaser

Copyright © 2013 Jenna L. Van Gramberg et al. This is an open access article distributed under theCreative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Food allergy is an emerging epidemic that affects all age groups, with the highest prevalence rates being reported amongst Western countries such as the United States (US), United Kingdom (UK), and Australia. The development of animal models to test various food allergies has been beneficial in allowing more rapid and extensive investigations into the mechanisms involved in the allergic pathway, such as predicting possible triggers as well as the testing of novel treatments for food allergy. Traditionally, small animal models have been used to characterise immunological pathways, providing the foundation for the development of numerous allergy models. Larger animals also merit consideration as models for food allergy as they are thought to more closely reflect the human allergic state due to their physiology and outbred nature. This paper will discuss the use of animal models for the investigation of the major food allergens; cow's milk, hen's egg, and peanut/other tree nuts, highlight the distinguishing features of each of these models, and provide an overview of how the results from these trials have improved our understanding of these specific allergens and food allergy in general.

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Editorial

You have free access to this content

The crux with a reliable in vitro and in vivo diagnosis of allergy

1. R. Crameri

Article first published online: 27 APR 2013

DOI: 10.1111/all.12177

© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Issue

Allergy

Volume 68, Issue 6, pages 693–694, June 2013

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Underdiagnosis of anaphylaxis in the emergency department: misdiagnosed or miscoded?

Underdiagnosis of anaphylaxis in the emergency department: misdiagnosed or miscoded? Hilal Hocagil, Evvah Karakilic, Cuneyt Hocagil, Huleyde Senlikci, Fatih Buyukcam Department of Emergency Medicine, Dr Lutfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey Objectives. To distinguish allergic reactions and anaphylaxis, and to highlight the importance of anaphylaxis. Design. Case series. Setting. Adult emergency department of the medical faculty of Hacettepe University, Ankara, Turkey. Patients. Adults admitted to the emergency department between 1 May 2005 and 30 April 2010 with allergic diseases considered to be anaphylaxis or anaphylactic reactions. Main outcome measures. Patient age, gender, possible cause(s) of allergy, organ involvement, treatment, and physical examination findings. Results. Although recorded physical examination findings of patients were consistent with anaphylaxis, 88 patients were not diagnosed as having this condition. All patients in this study group were evaluated in the emergency department facility and did not consult or were not referred to any other department or specialist. In all, 79 (90%) of them were discharged in the first 12 hours, 5 (6%) after 12 to 24 hours, and 4 (5%) after 24 hours. None of these patients died. Conclusion. Emergency physicians should be better able to recognise the clinical features of anaphylaxis, so as to treat the episode promptly and appropriately. Delay in diagnoses could lead to incomplete treatment and even be fatal. Hong Kong Med J 2013;19:Epub 2013 May 20   |  DOI: 10.12809/hkmj133895 Key words: Anaphylaxis; Diagnosis; Emergency service, hospital

• Allergy and Asthma Proceedings
• ISSN: 1088-5412, Online ISSN: 1539-6304
• DOI: http://dx.doi.org/10.2500/aap.2013.34.3657
• Volume 34, Issue 3, pages 227-232
• Copyright © 2013, OceanSide Publications, Inc., U.S.A.

Relationship between treatment with antacid medication and the prevalence of food allergy in children

Karen DeMuth, M.D., M.P.H.1; Arlene Stecenko, M.D.1; Kevin Sullivan, Ph.D., M.P.H.2; Anne Fitzpatrick, Ph.D.1

From the ¹Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, and ²Emory University, Rollins School of Public Health, Atlanta, Georgia

Address correspondence and reprint requests to Karen DeMuth, M.D., M.P.H., Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive, Atlanta, GA 30322 E-mail address: kdemuth@emory.edu

ABSTRACT

Food allergy affects 8% of preschool children, but factors responsible for food allergy in children are poorly understood. Use of antacid medication may be a contributing factor. The purpose of this study was to determine if parent-reported antacid medication use was associated with higher prevalence of food allergy in atopic children. In this cross-sectional study, parents of children with atopic diseases completed a questionnaire relating to a history of treatment with antacid medication and food allergy. Charts were independently reviewed for food-specific IgE and/or skin-prick test results. Food allergy was defined as a reaction to a food consistent with the anaphylaxis consensus statement and either an elevated food-specific IgE or a positive food skin-prick test. One hundred four questionnaires were completed. Mean age of the participating children was 7.0 ± 4.3 years (range, 5 months to 18 years of age). Forty-seven (45%) individuals were reported to have taken an antacid medication in the past. History of taking antacid medication was associated with an increased prevalence (57%  versus 32% ) and higher prevalence of food allergy of having food allergy (aPR, 1.7 [1.1–2.5]). Mean peanut food-specific IgE was higher in those with a history of taking antacid medication (11.0 ± 5.0 versus 2.0 ± 5.5.; p = 0.01). History of treatment with antacid medication is associated with an increased prevalence of having food allergy.

Keywords

• Allergy, 
• anaphylaxis, 
• antacid medication, 
• children, 
• cross-sectional study design, 
• food allergy, 
• gastroesophageal reflux, 
• GER disease, 
• questionnaire

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