{"title":"Improved IgG antibody diagnostics of hypersensitivity pneumonitis and pulmonary mycoses by means of newly evaluated serum antibody ranges and frequencies using IgG ImmunoCAP™","authors":"Joachim Sennekamp, Emilia Lehmann, Marcus Joest","doi":"10.1007/s40629-022-00208-7","DOIUrl":"10.1007/s40629-022-00208-7","url":null,"abstract":"<div><h2>Summary</h2><div><h3>Background</h3><p>The ranges of most human IgG antibodies against avian, microbial, and chemical antigens between their cut off values and their maximum values detected by IgG ImmunoCAP™ (Thermo Fisher Diagnostics, Freiburg, Germany) are not well known in pulmonary immune-mediated disorders. In addition, for many antigens it is not yet known how frequently their IgG antibodies appear in patients with these lung diseases. Therefore, we evaluated ranges and frequencies of these IgG antibodies.</p><h3>Methods</h3><p>The sera of 47,200 patients with suspected hypersensitivity pneumonitis (HP, extrinsic allergic alveolitis) or bronchopulmonary mycoses (mainly allergic bronchopulmonary aspergillosis [ABPA]), which were examined for 32 various IgG antibodies against birds, bacteria, molds, yeasts, and chemicals using the IgG ImmunoCAP™ assay, were evaluated retrospectively.</p><h3>Results</h3><p>We found a large spreading of the specific IgG ranges with maximum values from 26 mgA/l for <i>Rhizopus nigricans</i> up to 4640 mgA/l for pigeon. When the maximum values in the literature are also taken into account, the ranges of avian antibodies reach values up to 7280 mgA/l, the ranges of molds and yeasts up to 1707 mgA/l, of bacterial thermoactinomycetes up to 206 mgA/l, and of chemicals up to 139 mgA/l. The evaluated antibody ranges of the individual antigens can be used to decide whether a detected IgG antibody value is weakly, moderately or strongly positive. According to consistent evidence from numerous studies, a strongly positive antibody indicates HP or pulmonary mycosis more likely than a weakly positive antibody. It was found that the antigens of the highest maximum antibody levels—pigeon, budgerigar, parrot, <i>Aspergillus fumigatus—</i>are the causative agents of the most common immune-mediated lung diseases: bird breeder’s lung and pulmonary aspergillosis. Evaluation of the frequencies of eight major IgG antibodies of HP revealed the following rates: pigeon 28%, <i>Aspergillus fumigatus</i> 25%, budgerigar 23%, <i>Penicillium chrysogenum</i> 11%, <i>Saccharopolyspora rectivirgula</i> 7%, <i>Acremonium kiliense</i> 6%, <i>Aureobasidium pullulans</i> 5%, and <i>Thermoactinomyces vulgaris</i> 2%.</p><h3>Conclusion</h3><p>This study is the first to evaluate the ranges not only of avian and <i>Aspergillus fumigatus</i> antigens, as has been done up to now, but also of antibodies against 24 other environmental antigens. Quantification of IgG antibodies regarding their specific ranges can help to improve the serodiagnostics of immune-mediated lung diseases. In the lower ranges IgG antibodies are mainly physiological, while higher ranges correlate with the mentioned diseases as HP and ABPA/allergic bronchopulmonary mycoses (ABPM). The determined frequencies of the eight HP antibodies can be helpful in establishing HP screening tests.</p></div></div>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-022-00208-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47761545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lorenzo Salvati, Chiara Allegrini, Benedetta Piccardi, Ivano Lombardo, Lorenzo Ciambellotti, Sonia Rizzello, Vanessa Palumbo, Federico Lavorini, Gianna Camiciottoli, Paola Parronchi
{"title":"“Adrenaline junkie”: a case report of repeated use of epinephrine","authors":"Lorenzo Salvati, Chiara Allegrini, Benedetta Piccardi, Ivano Lombardo, Lorenzo Ciambellotti, Sonia Rizzello, Vanessa Palumbo, Federico Lavorini, Gianna Camiciottoli, Paola Parronchi","doi":"10.1007/s40629-022-00209-6","DOIUrl":"10.1007/s40629-022-00209-6","url":null,"abstract":"","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-022-00209-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44475936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Duygu Yazici, Ismail Ogulur, Ozan Kucukkase, Manru Li, Arturo O. Rinaldi, Yagiz Pat, Alexandra Wallimann, Sebastian Wawrocki, Zeynep Celebi Sozener, Betul Buyuktiryaki, Cansin Sackesen, Mubeccel Akdis, Yasutaka Mitamura, Cezmi A. Akdis
{"title":"Epithelial barrier hypothesis and the development of allergic and autoimmune diseases","authors":"Duygu Yazici, Ismail Ogulur, Ozan Kucukkase, Manru Li, Arturo O. Rinaldi, Yagiz Pat, Alexandra Wallimann, Sebastian Wawrocki, Zeynep Celebi Sozener, Betul Buyuktiryaki, Cansin Sackesen, Mubeccel Akdis, Yasutaka Mitamura, Cezmi A. Akdis","doi":"10.1007/s40629-022-00211-y","DOIUrl":"10.1007/s40629-022-00211-y","url":null,"abstract":"<div><p>The “epithelial barrier hypothesis” proposes that genetic predisposition to epithelial barrier damage, exposure to various epithelial barrier–damaging agents and chronic periepithelial inflammation are responsible for the development of allergic and autoimmune diseases. Particularly, the introduction of more than 200,000 new chemicals to our daily lives since the 1960s has played a major role in the pandemic increase of these diseases. The epithelial barrier constitutes the first line of physical, chemical, and immunological defence against external factors. A leaky epithelial barrier initiates the translocation of the microbiome from the surface of affected tissues to interepithelial and even deeper subepithelial areas. In tissues with a defective epithelial barrier, colonization of opportunistic pathogens, decreased microbiota biodiversity, local inflammation, and impaired regeneration and remodelling takes place. A dysregulated immune response against commensals and opportunistic pathogens starts. Migration of inflammatory cells to other tissues and their contribution to tissue injury and inflammation in the affected tissues are key events in the development and exacerbation of many chronic inflammatory diseases. Understanding the underlying factors that affect the integrity of epithelial barriers is essential to find preventive measures or effective treatments to restore its function. The aim of this review is to assess the origins of allergic and autoimmune diseases within the framework of the epithelial barrier hypothesis.</p></div>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-022-00211-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43585794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Blumchen MD, A. Fischl, T. Eiwegger, E. Hamelmann, L. Klimek, L. Lange, Z. Szepfalusi, C. Vogelberg, K. Beyer
{"title":"White paper peanut allergy","authors":"K. Blumchen MD, A. Fischl, T. Eiwegger, E. Hamelmann, L. Klimek, L. Lange, Z. Szepfalusi, C. Vogelberg, K. Beyer","doi":"10.1007/s40629-022-00207-8","DOIUrl":"10.1007/s40629-022-00207-8","url":null,"abstract":"<div><p>The current management of a primary IgE-mediated peanut allergy consists of the two basic pillars “exposure prophylaxis” with avoidance of the allergen and “emergency therapy” with short-term treatment of an acute allergic reaction after accidental ingestion. Accidental reactions are common despite attempted avoidance. The severity of an allergic or even anaphylactic reaction after accidental ingestion is difficult to assess prior to reaction. In addition, reaction thresholds may vary depending on the accompanying augmentation factor. Therefore, every peanut allergic patient should receive individual dietary counseling as well as instructions for the use of the emergency kit and a structured patient education program (anaphylaxis group training), if necessary. For the first time, since fall 2021 a causal treatment option with a drug for oral immunotherapy will now be available for 4‑ to 17-year-old peanut-allergic children and adolescents. The oral immunotherapy with peanut protein as defatted powder of <i>Arachis hypogaea L., semen</i> (peanuts) leads to desensitization with a good efficacy record and an acceptable safety profile. Other treatment options with different therapeutic approaches are also under development and will probably expand the range for treatment in the coming years.</p></div>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-022-00207-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41608476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mandy Cuevas, Marie-Luise Polk, Sven Becker, Tilman Huppertz, Jan Hagemann, Christoph Bergmann, Holger Wrede, Wolfgang Schlenter, Boris Haxel, Karl-Christian Bergmann, Ludger Klimek
{"title":"Rhinitis allergica in storage mite allergy","authors":"Mandy Cuevas, Marie-Luise Polk, Sven Becker, Tilman Huppertz, Jan Hagemann, Christoph Bergmann, Holger Wrede, Wolfgang Schlenter, Boris Haxel, Karl-Christian Bergmann, Ludger Klimek","doi":"10.1007/s40629-022-00205-w","DOIUrl":"10.1007/s40629-022-00205-w","url":null,"abstract":"<div><h3>Background</h3><p>Storage mites are frequently found in our daily environment. Nevertheless, storage mite allergy is often neglected in allergological diagnostics and possible allergies requiring therapy are thus overlooked.</p><h3>Methods</h3><p>Recommendations for action are made based on a literature review from March 2021 to August 2021 in PubMed, Medline, and GoogleScholar.</p><h3>Results</h3><p>This review article provides an overview of the species of storage mites, sensitization rates in different countries and occupations, and co-sensitization rates to house dust mite. Recommendations for diagnosis as well as therapy are given. The importance of provocation testing as well as causal therapy by allergen immunotherapy (AIT) is presented.</p><h3>Conclusion</h3><p>The position paper gives recommendations for the diagnosis and therapy of allergic rhinitis in case of storage mite allergy. AIT is recommended in symptomatic allergy and proven storage mite allergy. Reliable detection by provocation testing is advised in this persistent allergy. The therapy should be carried out independently of the treatment of a possible house dust mite allergy.</p></div>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-022-00205-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44330978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anaphylaxis to food additives","authors":"Regina Treudler, Jan Christoph Simon","doi":"10.1007/s40629-022-00203-y","DOIUrl":"10.1007/s40629-022-00203-y","url":null,"abstract":"<div><p>A variety of additives found in foodstuffs have been associated with triggering of a number of clinical pictures. Hypersensitivity reactions of allergic and non-allergic etiology have been widely described, but are reported to be rare overall. This review presents a selection of food additives for which anaphylactic reactions have been described. These include colorants (e.g., tartrazine, carmine, patent blue), preservatives (e.g., sulfites, sodium benzoate), and thickeners/gelling agents (e.g., carboxymethylcellulose, guar, gum arabic). Possible diagnostic procedures (skin test, specific IgE, cellular antigen stimulation test, oral provocation) are presented. For those affected, avoidance of consumption is facilitated by the mandatory declaration (class name, E‑number/designation) required in the European Union. Only sulfur dioxide and sulfites have to be highlighted as food allergens, depending on the concentration. Due to the limited diagnostic procedures available, it cannot be excluded that the frequency of hypersensitivity to food additives is underestimated.</p></div>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-022-00203-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44466610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Chronic spontaneous urticaria following ChAdOx1-S COVID-19 vaccination","authors":"Dan Suan, Adrian Y. S. Lee","doi":"10.1007/s40629-022-00204-x","DOIUrl":"10.1007/s40629-022-00204-x","url":null,"abstract":"","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-022-00204-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43732571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"It’s all in the mix: allergy to fenugreek in a boy with known sumac nut sensitization","authors":"Marc-Alexander Oestreich, Oliver Fuchs MD, PhD","doi":"10.1007/s40629-022-00202-z","DOIUrl":"10.1007/s40629-022-00202-z","url":null,"abstract":"","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-022-00202-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45800052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carole Guillet MD, Oliver Yves Martin PhD, Cordula Meincke MD, Lukas Joerg MD, Peter Schmid-Grendelmeier MD
{"title":"Part I: Insect stings and bites—Beyond the realm of bee and wasp allergies","authors":"Carole Guillet MD, Oliver Yves Martin PhD, Cordula Meincke MD, Lukas Joerg MD, Peter Schmid-Grendelmeier MD","doi":"10.1007/s40629-022-00199-5","DOIUrl":"10.1007/s40629-022-00199-5","url":null,"abstract":"<div><h2>Summary</h2><div><h3>Background</h3><p>Insects are a very diverse group of animals and valuable members of any ecosystem. Allergies to bees and wasps (order: Hymenoptera) are well known in Europe. Allergies, toxicities, and the spread of diseases by other insects are also possible but quite frequently are not diagnosed.</p><h3>Sources</h3><p>A MEDLINE search on allergy caused by stinging and biting insects apart from bees and wasps was conducted. All relevant articles were evaluated, and a selection of relevant publications and cases from our outpatient units are used to illustrate our arguments.</p><h3>Content and implications</h3><p>Allergies to insects following bites and stings are common. Ant stings, mainly from imported fire ants, frequently lead to severe anaphylaxis, and their venom can elicit systemic toxic effects. Stings and bites of various other ant species can also lead to severe allergic reactions. Mosquito stings and horsefly or other Diptera stings may elicit severe local and IgE-mediated systemic reactions. True bugs (Hemiptera) are hematophagous insects and can also cause severe allergic reactions, in addition to being feared for transmitting diseases.</p></div></div>","PeriodicalId":37457,"journal":{"name":"Allergo Journal International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40629-022-00199-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48555513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}