XXIV World Allergy Congress 2015

206 Pages·2016·4.36 MB·English

WorldAllergyOrganizationJournal2016,Volume9Suppl1
DOI10.1186/s40413-016-0096-1
MEETING ABSTRACTS Open Access
XXIV World Allergy Congress 2015
Seoul,Korea.14-17October2015
Published:14April2016
A1 purposeofthisstudywastodemonstratetheefficacyof,andsuggesta
PirfenidoneinhibitsTGF-b1-inducedextracellularmatrix regimenfor,oralsteroidinthetreatmentofCSUpatientswhowerere-
productioninnasalpolyp-derivedfibroblasts fractorytoahighdosageofantihistamines.Weconductedaretrospect-
Heung-ManLee1,Il-HoPark2,Jae-MinShin3 ive chart review of all patients diagnosed with urticaria between
1KoreaUniversityCollegeofMedicine,GuroHospital;2Collegeof Feburary1,2012,andDecember31,2014.Atotalof98patientswith
Medicine,KoreaUniversity;3KoreaUniversityGuroHospital,SouthKorea CSU wereincluded.Of these,16 patients (16.3%) wereantihistamine-
Correspondence:Jae-MinShin–KoreaUniversityGuroHospital,South resistant and prescribeda 2-weekcourse ofsteroid.Thirteen patients
Korea (81.2%) were successfully controlled with antihistamines only after
WorldAllergyOrganizationJournal2016,9(Suppl1):A1 stoppingthefirstcourse.Secondcourseofsteroidinducedremission
additionallyintwopatients(12.5%).Noadverseeventsandcomplica-
Purpose:Pirfenidonehasbeenshowntohaveanti-fibroticandanti- tionsassociatedwithoralsteroidwereobservedoverthestudyperiod.
inflammatory effects in the lungs. The purpose of this study was to This study demonstrated the excellence of a 2-week course of oral
evaluatetheinhibitoryeffectsofpirfenidoneontransforminggrowth corticosteroidinantihistamine-resistantCSUandproposestandardized
factor (TGF)-β1-induced myofibroblast differentiation and extracellu- corticosteroidtreatmentregimen.
lar matrix accumulation. We also determined the molecular mecha-
nismsofpirfenidoneinnasalpolyp-derivedfibroblasts(NPDFs).
Methods:NPDFswereisolatedfromnasalpolypsfromeightpatients A3
who had chronic rhinosinusitis with nasal polyp. Pirfenidone was Thealtereddistributionoffollicularthelpercellsmaypredicta
used to treat TGF-β1-induced NPDFs. Cytotoxicity was evaluated morepronouncedclinicalcourseofprimarysjögren’ssyndrome
using a 3-(4,5- dimethylthiazol-2yl)-2,5-diphenyl-tetrazolium bromide MargitZeher
assay. Fibroblast migration was evaluated with scratch assays. Ex- DivisionofClinicalImmunology,FacultyofMedicine,Universityof
pression levels of α-smooth muscle actin (SMA), fibronectin, and Debrecen,Hungary,Debrecen,Hungary
phosphorylated Smad2/3 were determined by western blot and/or WorldAllergyOrganizationJournal2016,9(Suppl1):A3
reverse transcription-polymerase chain reaction and immunofluor-
escent staining. Total collagen production was analyzed with the Recent studies emphasized the important role of follicular T helper
Sircolcollagenassayandcontractileactivitywasmeasuredbyacol- (T ) cells, which contribute to B-cell differentiation, as well as anti-
FH
lagengelcontractionassay. body production. The aim of our study was to investigate the pos-
Results: Pirfenidone (0 – 2 mg/ml) has no significant cytotoxic ef- sible role of T cells in the pathogenesis of primary Sjögren’s
fects in TGF-β1-induced NPDFs. Migration of NPDFs was signifi- syndrome (pSS)F.HIn the first part of the study, we focused on the
cantly inhibited by pirfenidone treatment. The expression levels of periphery by analyzing immune-competent cells and serological
α–SMA and fibronectin were significantly reduced in pirfenidone- markers.Weenrolled50pSSpatientsand16healthycontrolsinthe
treated NPDFs. Collagen contraction and production were also sig- study. Patients had elevated ratio of peripheral T cells, however,
FH
nificantly decreased by pirfenidone treatment. Finally, pirfenidone when dividing patients into two groups defined by the presence of
significantlyinhibitedphosphorylationofSmad2/3pathwayinTGF- extraglandular manifestations (EGMs), only patients with EGMs dif-
β1-inducedNPDFs. feredfromcontrolssignificantly.Moreover,T cellpercentagescor-
Conclusions:PirfenidonehasaninhibitoryeffectonTGF-β1-induced related positively with both activated T cell aFHnd Tr1 cell values, but
migration, myofibroblast differentiation (α-SMA), extracellular matrix T cellpercentagesshowednegativecorrelationwithbothIgMand
FH
accumulation,andcollagencontractionbyblockingthephosphoryl- IgG memory B cell proportions. Elevated T percentages were
FH
ation of Smad2/3 pathways in NPDFs. Thus, pirfenidone may inhibit observed in the anti-SSA/SSB positive patients. In the second part,
TGF-β1-inducedextracellularmatrixbyregulatingSmad2/3. we concentrated on the site of the inflammation, and determined
the composition of lymphocyte infiltration in labial salivary gland
A2 (LSG)biopsieswithspecialemphasisonT cells.Weselectedtissue
FH
Theefficacyofa2-weekcourseoforalsteroidinthetreatmentof blocksobtainedfrom10patientsat thetimeofdiseaseonset.LSGs
chronicspontaneousurticariarefractorytoantihistamines weregradedbasedontheorganizationallevelofperiductallympho-
Hyun-SunYoon,GyeongYulPark cytic infiltrates. T cell markers occurred predominantly in more
FH
SeoulNationalUniversityBoramaeHospital,Seoul,SouthKorea organized structures with higher focus scores. The co-expression of
Correspondence:Hyun-SunYoon–SeoulNationalUniversityBoramae CD3andBcl-6markersidentifiedT cellsclosetoBcl-6+Bcellswith
FH
Hospital,Seoul,SouthKorea the typical formation of germinal centers. Systemic features were
WorldAllergyOrganizationJournal2016,9(Suppl1):A2 developed later in the disease course only in patients with more
structuredinfiltrates.
Even though antihistamines are the mainstay in the treatment of OurresultsindicatethatthepresenceofT cellsinLSGsatthedis-
FH
chronic spontaneous urticaria (CSU), some CSU patients have not ease onset may predict a more pronounced clinical course of pSS.
respondedtoantihistamines.Manyclinicianshaveacceptedtheef- We expect that the further understanding of the regulation of T
FH
ficacy of steroids in the treatment of CSU. There is, however, little cells will providenewpotentialtherapeutic targetsinthe treatment
evidencesupportingsteroiduseinantihistamine-resistantCSU.The ofpSSpatientswithEGMs.
©2016TheAuthor(s).OpenAccessThisarticleisdistributedunderthetermsoftheCreativeCommonsAttribution4.0
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WorldAllergyOrganizationJournal2016,Volume9Suppl1 Page2of206
A4 rox-burghii. The extensive botanical and aero-biological surveys with
BetamethasonesuppressesTh2celldevelopmentinducedby clinicalevaluationofaverylargrenumberofcasesofallericbronchial
langerhanscelllikedendriticcells asthmashouldbecarriedoutinfutureinordertodrawtheexactpolen
KatsuhikoMatsui,SakiTamai,ReikoIkeda calenderofthisregion.
MeijiPharmaceuticalUniversity,Kiyose,Tokyo,Japan
Correspondence:KatsuhikoMatsui–MeijiPharmaceuticalUniversity,
Kiyose,Tokyo,Japan A6
WorldAllergyOrganizationJournal2016,9(Suppl1):A4 EvaluationferqencyofADHDinchildhoodasthma
MarziehHeidarzadehArani
Objective: It is well known that Langerhans cells (LCs) work as the ShahidBeheshtiUniversity,Tehran,Iran
primaryorchestratorsinthepolarizationofimmuneresponsestowards WorldAllergyOrganizationJournal2016,9(Suppl1):A6
Thelpertype1(Th1)orThelpertype2(Th2)immuneresponses.Inthis
study,weinvestigatedtheeffectsoftacrolimusandbetamethasoneon Introduction
Th2celldevelopmentbyLCs. Attention Deficit-Hyperactivity Disorder is one of the most common
Methods:LC-like dendriticcells(LDCs)weregeneratedfrom mouse problemsofchildrenandadolescentsandisaverycommonreason
bone marrow cells. Mice were primed with ovalbumin (OVA) forvisitingapediatricpsychologistorconsultant.Thisdisorderwhich
peptide-pulsed LDCs, which had been treated with tacrolimus or hasaprofoundeffectonthelivesofthousandsofchildrenandtheir
betamethasone, via the hind footpad. After 5 days, the cytokine re- familiesmanifestsinearlychildhoodwithsymptomsofhyperactivity,
sponse in the draining popliteal lymph nodes was investigated by inattentionandimpulsivity.Instudiesconductedinwesterncountries
enzyme-linked immunosorbent assay. The expression of LDC surface it has been pointed out that there is an association between ADHD
molecules was investigated using reverse transcriptase polymerase symptomsandasthmainasthmaticchildren,andalsotheresponseto
chainreaction. asthma treatment in children with ADHD is poor. This study is per-
Results: AdministrationofOVApeptide-pulsedLDCs,whichhadbeen formedwiththeaimtoevaluatetheprevalenceof ADHDinchildren
treatedwithbetamethasone,intothehindfootpadsofmiceinhibited referringtotheclinicofKashanBeheshtihospital.
Th2 development as represented by down-regulation of interleukin MaterialandMethod
(IL)-4productionaswellasTh1developmentasrepresentedbydown- Inthiscase-controlstudy206childrenreferredtothepediatricclinicof
regulation of interferon (IFN)-γ production. However, unlike the LDCs Kashan Beheshti hospital in the second half of 1388 were evaluated.
treated with betamethasone, those treated with tacrolimus did not SpirometeryorpeakflowmeterywasusedforthediagnosisofADHD.
inhibit Th1/Th2 cell development. The inhibition of Th1 cell and Th2 UsingtheSPSSsoftwareversion19,chi-squaretestandFisher’sexact
celldevelopmentbybetamethasonewasassociatedwithsuppression test.
ofCD40andTIM-4expression,respectively,inLDCs. Result
Conclusion: These results suggest that topical application of beta- ItwasfoundthattheprevalenceofADHDinchildrenwithasthmais
methasone to lesional skin would be beneficial for control of atopic significant higher than control group and increases the risk about
dermatitisbyactingonepidermalLCsandinhibitingthedevelopment fivefoldmore.ItwasalsofoundthathavingADHDdoesnothavea
ofTh2cells. significantcorrelationwiththeseverityofasthma.
Conclusion
It was found that asthma is one of the risk factors for developing
A5 ADHD,butADHDisnotrelatedtotheseverityofasthmamorbidity.
Anevaluationofvariousallergensincasesofallergicbronchial Keywords:AttentionDeficit-HyperactivityDisorder,Asthma
asthmaatlucknowandneighbouringdistrictsbyintradermal
skintest
DrsushilSuri,DranuSuri A7
SuriMedicalFoundationHospital,Lucknowdistrict,UttarPradeshState, Stevenjohnsonsyndromecausedbytyphoidfeverinachild
India AzwinLubis,AnangEndaryanto
Correspondence:DrsushilSuri–SuriMedicalFoundationHospital, 1AirlanggaUniversityTeachingHospital,Surabaya,Indonesia
Lucknowdistrict,UttarPradeshState,India Correspondence:AzwinLubis–AirlanggaUniversityTeaching
WorldAllergyOrganizationJournal2016,9(Suppl1):A5 Hospital,Surabaya,Indonesia
WorldAllergyOrganizationJournal2016,9(Suppl1):A7
TheworkofKasliwasetal.(1959)andShivpurietal.(1971)haveproved
beyonddoubtthatthereisadefinitecorrelationbetweenpollenpeaks Background:Steven-JohnsonSyndrome(SJS)inchildrencancaused
andsymptomatologyofthepatientsofrespiratotyallergy.Withthese byinfection.Thypoidisoneofbacterialetiologies.
factors in mind the present study was conducted with the aims - to Case report: A 7 years-old boy with main complaint of blistering all
clinicallyevaluatethecasesofbronchialasthma,toknowthespectrum overhisbody,feverandweakcondition.Hislipswereulcerated,ery-
ofallergensbyskintestinginthesecases(intradermalskintests)andto thematous, swollen covered with pseudomembran and hemorrhagic
findoutseasonalandclimaticvariationsinthesecases. crust.Therewerepruritichyperpigmentedplaqueswithpapilovesicular
Thepatientswerepreparedforintradermal skintestasperShivpuri eruptionsattheircenter(bulloustargetlesions)coveredalmostofhis
etal(1964).Theintradermalskintestswereperformedbymeansof wholebody.Therewerealsomaculaerythematouswithvesicleandul-
a tuberculin syringe and 26 gauge (1”length) short bevelled needle. cerationinhisexternalgenitalandscrotum.Hesufferedfromblistering
Anegativecontroltestwasdoneinthesimilarmanner with0.01ml since3daysbeforeadmission.Thelesionappearedfirstinthefaceand
ofbuffersaline(thediluentoftheantigen)andmarkedas“C’.Aposi- mouth, then spreads to the whole body. After that his mucosa of
tivecontroltestwasdonebyHistaminephosphatesolution(100micro- mouthandlipswereulceratedandhehaddifficultyinswallowing.He
gram/ml)andmarkedas“H”.InterpretationwasdoneasperShivpuri’s hadbeenonmedicaltreatmenttoadoctorbefore,butonthe4thday
criteria(Shivpuri1962,1969).The2to4reactionsweretakenas“mark- ofillnesstherewereredblotchesandvesiclesappearedonhisbody,
edlypositive”.Thisstudyshowedthattheprevalanceofallergicmani- sorethroatandoralthrush.Soheadmittedinhospitalfor3days,but
festationswerehigherinfirstdegreerelatives(50%)thanthesecond hisconditionwasgettingworseandcametoourhospital.TheOwidal
degreerelatives(8%)ofthepatients.Inthisstudythepollenantigens testresultwas1/320.TheassessmentwereSJSandsuspectedTyphoid
whichgave“significantpositivereactions”(andthereclinicalcorrelation fever. Treatment were supportive, ceftriaxone and corticosteroid. This
withthepatient’shistory)inthedescendingorderofsignificancewere patientdischargedinagoodcondition.
asCassiasiamea,Adhantoda,Morus,Parthenium,Artemesia,Argemone- Summary:ThypoidisoneofSJSbacterialetiologiesinchildren.Diagno-
maxicana, Cannabisoccidentalis, Rumex, Asphodelous, Gynandropsis, sis established after clinical examination, serological, epidemiologically-
Amaranthus, Cenchrusalbum, Ricinuscommunis, Crataeva nurvuala, prevalentandprobableinfectionsincountryarea.Antibioticisrequired
Melia,Kigelia,Prosopsis,Pennisetum,Dodonaea,Azadirechta,Putranjiva forSJScausedbyinfections.
WorldAllergyOrganizationJournal2016,Volume9Suppl1 Page3of206
A8 withfemale, unemployment but notassociatedwithlung functionin
ChronicBronchitiswithRadioContrastMediaHypersensitivity:A asthmatics.
CasewithHypothesizedGINAStep1Asthma Conclusion: The present study showed that depression was an im-
ShinichiroKoga portantriskfactoroftheprevalenceofasthmainKoreanadult.These
TokyoMetropolitanPoliceHospital,Tokyo,Japan resultswarrantfuturestudiestoexplorethemechanismsresponsible
WorldAllergyOrganizationJournal2016,9(Suppl1):A8 fortheassociationbetweendepressionandasthma.
Background:Nonimmediatereactionsinducedbyradiocontrastmedia
A10
(RCM) are an important health problem because nearly 50 % of pa- Managementofallergicdiseaseexacerbationsinpregnancy
tientswithasuspectednonimmediatereactionstoRCMareconfirmed
YasunobuTsuzuki
asallergic(GomezE,etal.CurrOpinClinImmunol2013;13:345-53).
SapporoTokushukaiHospital,Japan
Case Record: A 60-year-old female was brought to emergency
WorldAllergyOrganizationJournal2016,9(Suppl1):A10
departmentwithchiefcomplaintofhemoptysisonedayaftertran-
sient dry cough. Past medical history included current smoking in
Introduction: Allergicdiseaseexacerbations canaffectmaternaland
30 pack-per-years, acute hypersensitivity reaction with nicotinic
fetalconditionsinpregnancy.Someofallergicdiseaseexacerbations
α4β2 receptor partial agonist valenicline, epilepsy on phenytoin
may trigger pregnancy complications, life-threatening events of the
and phenobarbiturate, and pollinosis. Body temperature 98.5 F, motherandfetus.Eventually,itpredisposesboththemtotheriskof
blood oxygen saturation 95 % in room air; No crackle, stridor, nor
severedamages.Wereport4casesofmaternalallergicdiseaseexac-
wheeze was audible. Contrast chest computed tomography show
erbations (food allergy(FA) and anaphylaxis, bronchial asthma(BA),
atelectasisinleftlowerlobe,butnotaboutcarvenouslesion,pulmon-
atopic dermatitis(AD), allergic rhinitis(AR), atopic eruption of preg-
aryarteriovenousfistula,norracemosehemangioma.Bronchoscopyde- nancy(AEP)),theirmanagementisdiscussed.
tectedthrombusinleftlowerlobe;Mycobacteriumavium,intracellulare,
Casereport:Case1:a31-year-oldfemalein32weeksofgestation,with
andtuberculosiswerenegativeinbronchoalveolarlavagefluid.Specific
a medicalhistoryofBA inchildhood, AD, AR,FA, was referredby an
immunofluorescenceinM.tuberculosiswasalsoinnegative.Serumtest
otolaryngologist because of persistent moderate-to-severe asthma
was thoroughlynegativein SCC, CYFRA, ProGRP,NSE,IgG4, PR3- and symptoms, severe AR. We introduced long-acting β2-agonist plus in-
MPO-ANCA, Aspergillus, (1,3→) βD-glucan, ANA,ds-DNA-IgG, anti-RNP,
haled corticosteroids, short term oral methylprednisolone and nasal
anti-sm, and anti-GBM antibodies. Clinical diagnosis of chronic bron-
corticosteroid. Case2: a 26-year-old female in 25 weeks of gestation,
chitiswasmadewithfindingsdescribedabove.Pruritusexanthemain
with a medical history of AD, but without a history of any FA or
trunkone-and-a-halfdayaftercontrastmediaiomeprolinfusion(Dona anaphylaxis, was brought to the emergency department because of
I,etal.JInvestigAllergyClinImunol2014;24:143-53)wasdisappeared
dyspnea, generalized itchy rash, abdominal pain, and severe uterine
severaldaysafterbepotastinebesilateadministration.
contractionsafterhavingeatendinner.Shewasdiagnosedasanaphyl-
Discussions:GlobalInitiativeofAsthma(GINA)step1washypothesized
axisandthreatedabortion.Shewasimmediatelytreatedbyepineph-
becausepatientswhoweretreatedwithGINAstep1havereportedto rine i.m injection 2 times and obsterician. We disclosed buckwheat
haveover3-fold-increasedrisktodevelopacutehypersensitivityreaction
allergyasthecauseof anaphylaxis.Case3:a30-year-oldfemalein27
ascomparedwithpatientswhodidnothaveasthma(KobayashiD,etal.
weeks ofgestation,witha medicalhistoryofAD,was referred by an
Chest2012;141:1367-8).
obsterician because of her severe AD and AR. She had stopped the
Conclusions:Pharmacogeneticsand/ortranscriptomicsshouldbehelp- medication afterher pregnancy, which developedsevere AD and AR.
fultoclarifyT-cellmediatedmechanismsindevelopmentofRCMhyper-
We introduced local corticosteroids and nasal corticosteroid. Case4: a
sensitivityreaction(FernandezTD,etal.Allergy2014;69:150-8).
34-year-oldfemalein31weeksofgestation,withamedicalhistoryof
AR and AD during her childhood, came to our hospital because of
her severe itchy hives in her both arms and body. She was diag-
A9
nosed as AEP and was introduced to use local corticosteroids. All
TheassociationbetweenasthmaanddepressioninKoreanadult:
mothersandtheirconditionsimprovedimmediatelyandthebaibiesof
AnanalysisofthefifthKoreanationalhealthandnutrition
4caseswerenormallydeliveredwithoutneurologicaldeficiencyorcon-
examinationsurvey(2010-2012)
genitalmalformations.
LeeJuSuk
ShinichiroKoga–SamsungChangwonHospital,Seoul,SouthKorea Discussions: Allergic disease exacerbations may be common events
during pregnancy, that reduce the maternal QOL and can even de-
WorldAllergyOrganizationJournal2016,9(Suppl1):A9
velopthepotentialrisksofpregnancycomplications,life-threatening
events of mother and fetus, severe fetal brain damages. To prevent
Purpose:Asthmaisaoneofthemostcommonallergicdiseaseand
these situations, we should promote the appropriate therapies and
depressionisanimportantcomorbidityinasthma.However,itislittle
educations to allergic diseases, and encourage the mothers to keep
knownaboutthedifferentprevalenceofdepressioninKoreanadult
allergic medications, not only during pregnancy but prepregnant
asthmatics than normal adults. This study was performed to find
period. More investigations toward the pharmacologic management
association between asthma and depression and investigate the
inallergicdiseasesarenecessarytokeeppregnantwomenandnew-
characteristicsinKoreanadultasthmaticswithdepression.
bornshealthy.
Methods: Data were acquired from 18,066 men and women, aged
older than 19 years who participated in the Fifth Korea National
Health and Nutrition Examination Surveys (KNHANES), which was A11
conductedfrom2010to2012.Thepresenceofasthmawasbasedon Subcutaneousimmunotherapymousemodelforatopicdermatitis
self-reported physician diagnosis of asthma in the Health Interview SeoHyeongKim1,2,JungU.Shin1,JiYeonNoh1,ShanJin1,ShanJin2,
Surveys. HeminLee1,JungsooLee1,ChangOokPark1,KwangHoonLee2,Kwang
Results: The prevalence of asthma was 3.2 % and depression was HoonLee1
4.2%.Inunivariatedanalysis,adultswithasthmawereolder,single, 1DepartmentofDermatology,YonseiUniversityCollegeofMedicine;
unemployed, low educated, lower monthly family income, lower 2BrainKorea21PLUSProjectforMedicalScience,YonseiUniversity
household members, obese (p<0.05) but sex, residence area and CollegeofMedicine,SouthKorea
smokingstatuswerenotassociatedwiththepresenceofasthma.The Correspondence:SeoHyeongKim–DepartmentofDermatology,
prevalenceofhypertensionanddepressionwerehigherinasthmatics YonseiUniversityCollegeofMedicine
(p<0.05),whilediabetesmellituswasnotassociatedwithasthma.After WorldAllergyOrganizationJournal2016,9(Suppl1):A11
adjustment for age, marital status, number of household members,
monthly family income, body mass index, hypertension, we found Subcutaneousimmunotherapy(SCIT)isaclinicallyeffectivetreatmentin
unemployment, lower educated status, depression were associated atopicdermatitis.However,therewasnomousemodeltounderstand
withhigherprevalenceofasthma(p<0.01).Depressionwasassociated themechanismofhousedustmiteimmunotherapyinatopicdermatitis.
WorldAllergyOrganizationJournal2016,Volume9Suppl1 Page4of206
Theaimof this study wastoestablish amousemodelofSCIT mouse Background:Itiswellknownthatatopicdermatitis(AD)isrelatedto
model of house dust mite induced atopic dermatitis. Female NC/Nga food hypersensitivity, although its prevalence varies among several
mice were treated with Dermatophagoides farinae (D.farinae) body ex- studies.
tractointmentfor4weekstoinduceatopicdermatitislikeskinlesion. Objective:Toexaminetheprevalenceandstatusoffoodhypersensitiv-
Thenweseparatedthemiceinto2groups,controlgroupandimmuno- ityamongADpatientsinKorea.
therapy(IT)group.BothgroupswerecontinuouslytreatedwithD.farinae Methods: Thehistory of food hypersensitivitywas collected by inter-
bodyextractointmentfor4weeks,however,onlyimmunotherapy(IT) views.Wetookbloodsamplestoexaminefood-specificimmunoglobu-
groupwastreatedwith8injectionsofD.farinae(100ugsubcutaneouse) linE(IgE)levels.Basedonpatients’historiesandserumIgElevels,open
twiceaweekalongwithD.farinaebodyextractointmenttreatment.Sub- oralfoodchallenge(OFC)testingwereperformed.
sequently,clinicalseverityof skinlesion,histologicalfeatures,totalIgE, Results:49(37.7%)ofthe130childhoodADpatientsand33(25.4%)
IL-4andIL-10weremeasured.WeobservedthatAD-likeskinlesionsof of 130 adult AD patients had histories of food hypersensitivity. The
IT group were milder than control group. In histological examination, mostcommon suspicious foods in childhoodADwereegg,pork and
epidermiswasthinnerinITgroupthancontrolgroup.Theleveloftotal cow milk. In adult AD patients, the most common suspicious foods
IgEwasdecreasedinITgroupthancontrolgroupat3weeksfromthe were instant food, wheat, ramen, beef, pork, chocolate. According to
beginning of immunotherapy, while the level of IgG4 was remarkably openOFCtesting,ninechildhoodpatientsshowedpositiveresponses.
increased in IT group than control group from the beginning of im- The most common offending food were egg and milk (n=3 each),
munotherapy. Increased level of IL-10 in IT group was observed at 2 followed bypork, beef, peanut (n=1each). Inadult ADpatients, only
weeksfromthebeginningofimmunotherapythancontrolgroup.How- onepatientshowedpositiveresponsetopork.
ever,therewasnosignificantdifferenceofIL-4betweenITgroupand Conclusion: The overall prevalence of food hypersensitivity in child-
controlgroup.Inthepresentstudy,wehaveestablishedahousedust hoodADpatientswas6.9%,and0.8%inadultADpatientsasassessed
mite SCIT mouse model and demonstrated that house dust mite SCIT byopenOFCtesting.Thenumberofpatientswithactualfoodhyper-
mightimproveatopicdermatitis-likeskinlesionbydecreasingtotalIgE sensitivitywaslowerthanthenumberofpatientsreportingahistoryof
andincreasingtheIgG4andIl-10.Usingthismodel,itwillbepossibleto foodhypersensitivity.Therefore,dietaryrestrictionmustbeconducted
findnovelwaytopotentiatetheeffectsofallergenimmunotherapy. afterconfirmingfoodhypersensitivitybymedicalprofessionals.
A12
A14
Atopicdiseaseand/oratopyareriskfactorsforlocalanesthetic
Anaphylaxiscausedbyanant(Brachyponerachinensis)inJapan
allergyinpatientswithhistoryofhypersensitivityreactionsto
YoshinoriKatada1,ToshioTanaka2,AkihikoNakabayashi1,KojiNishida1,
drugs?
KenichiAoyagi1,YukiTsukamoto1,KazushiKonma1,MotooMatsuura1,
FatmaMerveTepetam
Jung-WonPark3,YoshinoriHarada4,KyoungYongJeong3,AkikoYura4,
SureyyapasaChestDiseasesandChestSurgeryTrainingHospital,Turkey
MaikoYoshimura4
WorldAllergyOrganizationJournal2016,9(Suppl1):A12
1SakaiCityMedicalCenter;2OsakaUniversity;3YonseiUniversityCollege
ofMedicine;4Osaka-MinamiMedicalCenter
Background: Thereissomeconcernamongphysiciansthatapositive
Correspondence:YoshinoriKatada–SakaiCityMedicalCenter,Japan
historyofadversereactionstodrugsand/oratopicdiseaseremainsarisk
WorldAllergyOrganizationJournal2016,9(Suppl1):A14
factorfordevelopingahypersensitivityreactiontolocalanesthetics(LA).
Objective:InthepresentstudyweaimedallergytestingtoLAisjus-
A)Background:Indexpatient
tified in patients with a positive history of hypersensitivity reactions
Ant allergy is rare comparing bee allergy. Anaphylaxis caused by
todrugsadditionallybyatopyandatopicdiseases.
BrachyponerachinensisissporadicallyreportedinFarEastnations.
Methods: The study was conducted among patients admitted to our
Weexperiencedsuchacase.
allergyclinicwhogaveareliablehistoryofurticaria/angioedema,nasoo-
Anotherwisehealthy63-year-oldwomanwhodevelopedananaphyl-
cular symptoms and bronchospasm after ingesting drugs. A standard
acticreactioninapublicopen-airbath,somefiveminutesafteranant
questionnaire regarding demographic data, history of atopic disease
stungherhip.Shefelldownthereandexperiencingdiarrhea,dyspnea
(asthma,allergicrhinitis,atopicdermatitis,urticaria)wasfilledout,total
andurticaria,andtransferredtoahospital,wheresherecoveredwith
IgEandeosinophilcountwereassesedforeachpatient.Skinpricktests
catecholaminesandantihistamines.Later,anantnamedBrachyponera
(SPT),intradermaltest(IDT)andsubcutaneusincrementalchallengetest
chinensis (Emery, 1895), which is often referred as Pachycondyla chi-
(ICT) were perfomed step by step with adrenaline free lidokain and
nensis, was caught at the same place. Specific IgE against its venom
prilokain.
proteinwas detected inher serum.This isthe firstcasewithspecific
Results: 239 patients (63men,176 women) with history of drug al-
IgEagainstantvenomprovedinvitroinJapan.
lergywereadmitted.Asthmaprevalence,atopyrate andmeantotal
B)Methods
IgElevelsarefoundhigherinthestudy.Whenwelookattheresults
We explored medline and a Japanese database seeking literature
of skin tests and provocations with LA; while positive results of SPT
writtenEnglishorJapaneseforanaphylacticcasesbyantsinJapan
werentfound,3ofIDTand4ofICTwerepositive.Oftheall4patients
andinvestigateditsnature.
thatreactedtoLA,hadrhinosinusitisandapositiveSPTreactionwith
C)Results
aeroallergens, 1 patient had also food allergy, 2 patient had asthma.
Including present case, 9 cases (age 20~63, male 5, female 4) with
Althougheosinofilcountswerenormal,2patienthadhighleveloftotal
anaphylaxis by ant siting have been reported in Japan since 1987.
IgE.
Thenumbersofantstingsjustbeforetheonsetofanaphylaxiswere
Conclusion: There is noincreased risk requiring performing skin and
1to3.Theintervalsbetweenantstingsandonsetofanaphylaxisin
provocationtestforLAinthepatientswithahistoryofhypersensitivity
most cases were less than 15 minutes, except 2 cases without de-
reaction todrugsalonebutadditionallybypresence ofatopy, atopic
scriptionand1case,inwhichtheonsetwastwohoursaftertheant
diseaseandmultidrugallergyhistorycanincreasetheriskofLAallergy,
sting.Symptomsincludewhealandurticaria,diarrhea,dyspnea,and
theamountofevidenceisscarce.
hypotension. As for diagnosis, the causal relationship between ant
stings and anaphylaxis was established mainly based on their tem-
A13 poralorder.Thepatientsthemselvesordoctorsinchargecaughtthe
FoodhypersensitivityinpatientswithatopicdermatitisinKorea ants on the same day or later, enabling determination of the ant
ChunWookPark,JeeHeeSon,SooIckCho,YongSeCho,YunSun species. In most cases, the ants were identified as B. chinensis. The
Byun,YoonSeokYang,BoYoungChung,HyeOneKim,HeeJinCho proofofIgEantibodyagainstantproteinwasdonebyskinpricktest
KangnamSacredHeartHospital,SouthKorea onlyin2cases.OurpresentcaseisthefirstJapanesecaseinwhichIgE
Correspondence:ChunWookPark–KangnamSacredHeartHospital, antibodyagainstB.chinensisproteinwasdirectlyproved.Epinephrine
SouthKorea wasusedin5cases,whileonlyanti-histamineandglucocorticoidwere
WorldAllergyOrganizationJournal2016,9(Suppl1):A13 usedinothercaseswithgoodprognosis.Allpatientshadpriorhistory
WorldAllergyOrganizationJournal2016,Volume9Suppl1 Page5of206
ofantstings.Mostofthemhadmorethanoneantstingbefore.The Methods: Patients with CU were assessed for a previous history of
longestintervalbetweenthelastpriorstingandthetriggerstingswere food hypersensitivity that caused symptoms of CU. Blood samples
17 months. It is notable that 2 patients including our case had prior were taken from the patients to measure food allergen-specific IgE.
stings about a year before and a month before, suggesting that the Based on history and laboratory results, open oral food challenge
second stings might have booster effects. Cross-reaction with bee (OFC)testswereperformed.
venomwasseenin2casesoutof5casesmentioned.Inonecase,IgE Results:Of350participants,46(13.1%)claimedtohaveexperienced
antibodyagainstpaperwaspwaspositivewithoutanobviousformer previous food hypersensitivity. Pork (n=16) were the main foods
stingbyit.Theothercasehadahistoryofanaphylaxisbyawaspsting. mentioned,followedbybeef(n=7),shrimp(n=6)andmackerel(n=6).
D)Conclusions We found that 73 participants (20.8%) had elevated levels of food-
Antallergyisrare.Itsnatureissimilartobeeallergy. specific IgE, with pork (n=30), wheat (n=25), and beef (n=23) being
LeeEK,JeongKY,LyuDP,LeeYW,SohnJH,LimKJ,HongCS,ParkJW. the most common. However, when the open OFC tests were con-
CharacterizationofthemajorallergensofPachycondylachinensisin ductedin102participantswithself-reportedfoodhypersensitivityor
antstinganaphylaxispatients.ClinExpAllergy.2009;39:602-7. raised levels of food-specific IgE, only four participants showed a
positivereactiontopork.
Conclusions: Although some participants claimed to have a history
A15 ofCUrelatedtofoodintake,whenanopenOFCtestwasconducted,
Anti-allergiceffectofanti-IL-33bysuppressionofimmunoglobulin few of them had positive results. We therefore conclude that food
lightchainandinduciblenitricoxidesynthase allergyisanuncommoncauseofchronicCU.
Tae-SukKyung1,YoungHyoKim1,Chang-ShinPark2,TaeYoungJang1,
Min-JeongHeo1,Ah-YeounJung1,Seung-ChanYang1
1InhaUniversity,CollegeofMedicine,SouthKorea;2InhaUniversity
Hospital A17
Correspondence:Tae-SukKyung–InhaUniversity,Collegeof Doseoptimizingstudyofadepigmentedpolymerizedallergen
Medicine,SouthKorea extractofphleumpollenbymeansofconjunctivalprovocation
WorldAllergyOrganizationJournal2016,9(Suppl1):A15 test(CPT)
OliverPfaar1,AngelikaSager2
Objective: IL-33 is involved in several steps in allergic cascade. We 1CenterforRhinologyandAllergologyWiesbaden;2LetiPharmaGmbh,
aimedtofindnovelgenes,whicharesignificantlyinducedinallergic Germany
individualsandsignificantlydown-regulatedbyanti-IL-33treatment. Correspondence:AngelikaSager–LetiPharmaGmbh,Germany
Methods: Thirty-six mice were allocated into Group A (intraperito- WorldAllergyOrganizationJournal2016,9(Suppl1):A17
neally sensitized and intranasally challenged to saline), Group B
(sensitized and challenged to ovalbumin), Group C (null treatment Background: Clinical efficacy of a depigmented polymerized Phleum
with intraperitoneal saline) and Group D (anti-IL-33 intraperitoneal pollenextracthasbeenshowninonelargephaseIIIstudieswith1000
injection).Wecheckedthenumber ofnose-scratchingbehaviorsin DPP/ml. To date dose-response studies are required to showoptimal
10 minutes, serum ovalbumin-specific IgE, titers of cytokines (IL-1, efficacyofanallergendose.Theconjunctivalprovocationtest(CPT)is
IL-4, IL-5, IL-10, IL-13) in bronchoalveolar lavage fluid. Using one anoutcomeparameteracceptedfromtheregulatoryauthorities(EMA).
wholelungtissuefromeachmouse,weperformedmicroarrayana- Method:308(ITT)patientswithconfirmedrhinitisand/orrhinocon-
lysisandreal-timePCR. junctivitisweretreatedinadouble-blindstudywith4dosesof100
Results: Group D showed significantly reduced number of nose- DPP/ml,1000DPP/ml,5000DPP/mland10.000DPP/mlallergenex-
scratchingandlowerserumovalbumin-specificIgE.Allcytokinesin tractover22weeksinGermany,Poland,SpainandCzechRepublic.
bronchoalveolarlavagefluidweresignificantlydecreasedafteranti- A1-day build-up phaseapplying0.1mland2times0.2mlextract
IL-33 treatment. In microarray analysis, Group B (Immunoglobulin wasfollowedbyamaintenanceperiodapplying0.5mlin3-4weeks
free light chain (IgFLC): 89.1 times, Nitric Oxide Synthase 2 (NOS2): intervals. Before treatment a CPT was performed with increasing
11.5times)andGroupC(IgFLC:141.6times,NOS2:11.7times)had dosesupto3HEP/mlofnativePhleumextract,aftertreatmentthe
significantlyincreasedexpressionofIgFLCandNOS2genecomparedto CPT was repeated with doses up to 30 HEP/ml. The primary end-
GroupA.Afteranti-IL-33treatment,GroupDshowedsignificantlyde- pointparameterwasthepercentageofpatientswithanincreaseof
creasedexpression(IgFLC:49.3times,NOS2:6.5times).Inreal-timePCR, allergen extract to provoke a positive CPT after Allergen Immuno-
Group B (IgFLC: 10.4 times, NOS2: 3.8 times) and Group C (IgFLC: 29 therapy (AIT). Secondary parameters were specific IgE, IgG1 and
times,NOS2:4.5times)hadsignificantlyincreasedexpressionofthese IgG4,VitaminDbaselinelevelaswellassafety.
genes.Aftertreatment,GroupDshowedsignificantlydecreasedexpres- Theprimaryendpointparameterwasinvestigatedusingahierarchic
sion(IgFLC:5.0times,NOS2:2.5times). testprocedurecomparingthehighestdoseagainstthelowest,ifsta-
Conclusion: Anti-allergic effect of anti-IL-33 could be explained by tistically significant testing the next lower dose against the lowest
suppressionofIgFLCandNOS2inamurinemodelofallergicrhinitis untilthedifferencewasnolongersignificant.
andasthma. Results:Theresponderratesinthe100DPP/mLandthe1,000DPP/
Keywords:Asthma:AnimalModels;Immunoglobulins mL groups were 72.9% and 72.3%, respectively (ITT), in the 5,000
DPP/mL (75.3%) and the 10,000 DPP/mL groups (77.4%). The re-
spective differences to the 100 DPP/mL group were -4.5% for the
A16 10,000DPP/mLgroup,-2.5%forthe5,000DPP/mLgroup,and0.6%
FoodhypersensitivityinpatientswithchronicurticariainKorea for the 1,000 DPP/mL group (ITT). No statistically significant differ-
HyeOneKim1,YongSeCho1,YunSunByun1,YoonSeokYang1,Bo ence was found. For the PP set, similar results were observed.
YoungChung1,JeeHeeSon1,ChunWookPark1,HeeJinCho2 VitaminDbaselineresultswerelowinallgroups,buthadnoinflu-
1KangnamSacredHeartHospital;2ChuncheonSacredHeartHospital ence on the results. Specific IgEs remained stable in all groups
Correspondence:HyeOneKim–KangnamSacredHeartHospital, whereasspecificIgG1andIgG4showeddose-dependentincreases.
SouthKorea Systemicreactionsoccurredin12.9%(100DPP/ml),10.8%(1000DPP/
WorldAllergyOrganizationJournal2016,9(Suppl1):A16 ml),26.4%(5000DPP/ml)and33.3%(10.000DPP/ml)ofpatients.79.4%
ofSRwereGrade1,8.7%grade2and1grade3reactionoccurredin
Background:Theetiologyofchronicurticaria(CU)remainsunknown the100DPP/mlgroup.
inmostpatients.Possiblecausesinsomecasesincludefood,butthe Conclusion: We determined increased allergen amounts to obtain
roleofhypersensitivitytofoodantigensinpatientswithCUremains a positive CPT after AIT from 1000 -10.000 DPP/ml depigmented
controversial. polymerized Phleum pollen extract. Since the CPT results did not
Objectives: The aim of this study was to evaluate the association discriminate the different doses the dose-finding study will be re-
betweenfoodhypersensitivityandCUin350Koreanparticipants. peatedwithadifferentassessmentmethod.
WorldAllergyOrganizationJournal2016,Volume9Suppl1 Page6of206
A18 In THP-1 cells, Colabomycin E inhibited TNF alpha induced mRNA
Correlationofcutaneoussensitivityandcytokineresponsein expression of several proinflammatory genes including IL-1β, IL-6,
childrenwithasthma TLR8, and MyD88. The effect was evident after 4h and 8h cultures
AmitAgarwal1,MeenuSingh1,BishnupdaChatterjee2,AnilChauhan1 andinsomeofthegenespersistedfor24h.Furthermore,colabomy-
1PostgraduateInstituteofMedicalEducationandResearch,India;2West cin E downregulated TNF alpha induced IL-1β, IL-6 and chemokine
BengalTechnicalUniversity CXCL8/IL-8 release in a dose dependent manner from 0.25μM con-
Correspondence:AmitAgarwal–PostgraduateInstituteofMedical centration. The secretion of IL-18 from THP-1 cells was only slightly
EducationandResearch,India upregulated by TNF alpha and not affected by colabomycin E. Our
WorldAllergyOrganizationJournal2016,9(Suppl1):A18 datasuggestthatcolabomycinEisapotenttranscriptioninhibitorof
proinflammatorycytokinesinhumanmononuclearphagocytes.
Background:Foodallergensplayapivotalroleinthemanifestationof SupportedbyIGAMZCRgrantNT/13012-4andbyMHCZ-DRO(„Insti-
atopicdisorderslikeasthma,rhinitis,andeczemainchildren.Th17cells tuteforClinicalandExperimentalMedicine–IKEM,IN00023001“).
play a key role in the regulation of inflammatory diseases, and there
arefewstudiesbasedontheroleofTh17infoodallergicchildren. Reference
Methods:Fiftychildrenwithrespiratoryallergyandhistoryofworsen- *PetrickovaKetal.ChemBioChem15:1334-45,2014
ing symptoms by food allergy (Patient group) and 20 non-atopic
healthy children (Control group) were enrolled in the study. Food al- A20
lergywasassessedthroughSkinpricktest(SPT)withvariousfoodaller-
Intravenousimmunoglobluintreatmentinachildwithresistant
gensandtotalIgElevelswasdeterminedbysandwichELISA.Th1,Th2,
atopicdermatitis:Abriefreviewonthistherapeuticregimen
and Th17 dependent cytokines were determined by flow cytometric
HyuckHoonKwon,KyuHanKim
beadarray. SeoulNationalUniversityHospital,SouthKorea
Results:Inthestudygroup,allthe50childrenwerefoundtobeposi- Correspondence:HyuckHoonKwon–SeoulNationalUniversity
tiveforcutaneoushypersensitivityagainstvariousfoodallergens(Milk
Hospital,SouthKorea
and Orange=7, Egg=6, Banana, Fish and Groundnut=10, Mango=4,
WorldAllergyOrganizationJournal2016,9(Suppl1):A20
Wheat=9 and Rice=17). The average level of total IgE in the study
groupwas316.8±189.8IU/mL. Therewasasignificantpositivecorrel-
Atopic dermatitis (AD) is one of the most common dermatologic
ationoftotalIgEwithIL-17(r=0.796;p<0.0001),IL-13(r=0.383;p=0.01)
diseases,affectingapproximately20%ofchildrenlivinginindustri-
and IL-4 (r=0.263; p=0.043) level, and negative correlation with IFN-γ
alizedcountries.Moreover,approximately70%ofcasesofADaffect
(r=-0.5823;p<0.0001)andIL-10(r=-0.4474;p<0.001)level.Anegative children less than 5 years of age. Most cases of AD are effectively
correlationwasnotedbetweenthedurationofbreastfeedingandtotal
treatedwithtopicalsteroids,topicalcalcineurininhibitorsandinter-
IgElevel(r=-0.31,p=0.03).
mittentuseofimmunosuppressiveagents,includingoralcorticoste-
Conclusions: The study demonstrates positive correlation between
roids and cyclosporine. However, for recalcitrant AD, continuous
totalIgE,Th2cytokinesandTh17cytokines.Italsodemonstratedthat useofsystemicimmunosuppressiveagentsislimitedbyseveread-
durationofbreastfeedingissignificantlycorrelatedwithTotalIgE.
verse effects, especially for children. For this subgroup of patients,
afewstudiestestingsystemicimmunomodulatorydrugshavebeen
reported,andhigh-doseintravenousimmunoglobulin(IVIG)therapy
hasbeenalsointermittentlyreportedtobeeffectivewithoutstrong
A19
evidences. Herein we report a case of intractable atopic dermatitis
ColabomycinE,aStreptomycete-DerivedSecondaryMetabolite,
ina5-year-oldgirlwhohadasignificantclinicalimprovementafter
InhibitsProinflammatoryCytokinesinHumanMonocytes/
receiving 3 cycles of IVIG treatment (2 g/kg) without notable side
Macrophages
IljaStriz1,EvaCecrdlova1,KaterinaPetrickova2,LiborKolesar1,Alena effects.SincethefirstinfusionofIVIG,thepatient’sskinlesionsim-
Sekerkova1,VeronikaSvachova1,MiroslavPetricek2 proved steadily and the improvement persisted until the 8-month
1InstituteforClinicalandExperimentalMedicine,CzechRepublic; follow-up.TheEASIscoredecreasedremarkably,whiletheimmuno-
2InstituteofMicrobiology,AcademyofSciencesoftheCzechRepublic logic parameters did not correlate with clinical improvement. IVIG
Correspondence:IljaStriz–InstituteforClinicalandExperimental monotherapy is considered especially useful for children with se-
vere AD since its immunoregulatory function is more profound in
Medicine,CzechRepublic
the relatively immature immune system of children. The mecha-
WorldAllergyOrganizationJournal2016,9(Suppl1):A19
nisms of action of immunoglobulin may include cytolysis of target
cells through complement or antibody-dependent cell-mediated
Polyketideantibioticsincludingmacrolidesareknowntoaffectsig-
cytotoxicity, induction of apoptosis of target cells, blockade of co-
nalling pathways of transcription factors and regulate a number of
stimulatory molecules, and neutralization of pathogenic antibodies
genes involved in their potential anti-inflammatory effects but
andsolublefactorssuchascytokinesandtheirreceptors,whichul-
thesepropertiescannotbeusedinclinicalsettingsduetoariskof
timatelyleadtoameliorationoftheinflammatoryprocess.Thiscase
bacterial resistance. The aim of our study was to assess the effect
suggests that IVIG therapy can be quite effective and safe for chil-
ofcolabomycinE,anewstreptomycete-derivedsecondarymetabol-
drenwithresistantatopicdermatitis.
ite*,onthemRNAexpressionandreleaseofproinflammatorycyto-
kines and chemokines from THP-1 monocyte/macrophage cell line
andperipheralbloodmonocytes. A21
ColabomycinEwasisolatedandpurifiedfromthenaturalproducer Wheatallergyisdifficulttodiagnosethenotherfoodallergens
Streptomyces aureus SOK1/5-04 by extraction of post-fermentation SumanKumar
mediasandmyceliawithorganicsolventsandmultiplesubsequent EntandAllergyCentre(INDIA),India
liquidchromatography purification steps andcrystallization. Mono- WorldAllergyOrganizationJournal2016,9(Suppl1):A21
cytes/macrophages were cultured in RPMI1640 with 10% fetal calf
serumandthenstimulatedwithTNF-α(20ng/ml)underserumfree Background
conditions in the presence or absence of colabomycin E. The total Wheatallergyiscommoninchildrenandadults.Skinpricktestsand
mRNA was extracted from cultured monocytes/macrophages with wheat specific IgE tests has low specific value for wheat then other
RNAeasy Plus Mini Kit (Qiagen) and quantitative RT-PCR (SABios- allergens.
ciences) was used for the evaluation of 84 different gene expres- The challenge tests are to be done to confirm Wheat allergy.It has
sions in TNF alpha and colabomycin E stimulated cultures and been noticed that in patients of Wheat allergies the reactions may
compared to unstimulated cells. The concentrations of cytokines occur late .In normal food allergen challenges maximum number of
and chemokines in culture supernatants of monocytes and THP-1 reactionsarefoundwithinonehouroffoodchallengeandothersin
cellsweremeasuredbyELISAorLuminex. second hour. In wheat allergen challenge less number of reactions
WorldAllergyOrganizationJournal2016,Volume9Suppl1 Page7of206
occurinfirsthourfollowedbysomeinsecondhoursandrestoccur Background: Cases of dermatitis by injection of certain drugs have
after2hoursoftest. beenreported.Thisadversereactionofdrugspresentsvariousfeatures
Objective likeeczematoidpatch,andurticariallesion,andsoon.
To see wheather wheat challenge tests have delayed responses in Objective: Theaimofthisstudywastoassessthecauseandclinico-
patientsofwheatallergy. pathologic findings of injection-induced dermatitis, and to reveal
Methods whetherthereactionhaveanyrelationsintheage,site,concentration
DatabaseofpatientsofWheatallergyattendingENTANDALLERGY ofthedrugs,andtimeintervalfrominjectionofdrugtooccurrenceof
CENTRE(INDIA)PANCHKULA. Retrospective study of wheat allergy skinlesion.
patientsforlast3years. Methods:Thisstudyenrolled10patientswhohaderythematousskin
Observations lesionafterinjectionofcausativedrugs.Thelesionsarecomparedto
68patientsofsuspectedwheatallergywereputonWheatchallenge eachotherbasedonthesite,timeintervalfrominjectionofdrugto
tesrts. occurrenceofskinlesion,andclinicalcharacteristics.Weperforemed
28werepositive,2werestillnotconclusiveand38werenegative. intradermaltestandpatchtesttoeachpatientwithdifferentconcen-
Inwheatallergychallengetests25%patientsshowedreactionsin1st trationofcausativedrugs.
hour. Results: Themostcommoncausativedrugswerediclofenacandvita-
55%patientsreactedin2ndhourand20%reactionsoccurredafter2 minK1.Eczematoustypewasthemostfrequentclinicalfeature.Intra-
hours. dermal test showed more positive results than the patch test. Patch
Conclusion test with diclofenac (as is, 2.5%, 5%, and 10%) and vitamin K1 10%
Inwheatallergypatientsweneedtoknowthatreactionscanoccur wereallnegativein10patients.Andintradermaltestswithdiclofenac
evenafter2hoursofchallengeincomparisonwithotherreallergens asisandvitaminK1(0.1%,1%,and10%)wereperformedin8patients.
inwhichmostreactionsoccurin1sthourofchallenge. Sixpatientshadapositivereaction,consistingoferythema,induration
andvesiculationafter1and2days.
A22 Conclusions: In these results, most common causative agents were
Theeffectsofspirulina(Arthrospiraplatensis)dietarysupplement found as diclofenac and vitamin K1. And, it seems that intradermal
asanadjuncttherapyforchildrenaged7to14yearsoldwith testismoreusefulinthediagnosisofinjection-induceddermatitis.
asthma:Arandomized-doubleblindplacebocontrolledclinical
trial A24
LouVerLeighArciagaManzon1,PilarAgnesGonzalezAndaya2 IgEreactivityofrecombinantallergenpacc3oftheAsianneedle
1UniversityofSantoTomasHospital,Philippines;2UniversityofSanto antpachycondylachinensis
TomasFacultyofMedicine,Philippines KyoungYongJeong1,Myung-HeeYi1,MinaSon1,DongpyoLyu2,Jae-Hyun
Correspondence:LouVerLeighArciagaManzon–UniversityofSanto Lee1,Tai-SoonYong1,Chein-SooHong3,Jung-WonPark1
TomasHospital,Philippines 1YonseiUniversityCollegeofMedicine;2SangjiUniversity;3Divisionof
WorldAllergyOrganizationJournal2016,9(Suppl1):A22 AllergyandImmunology,DepartmentofInternalMedicine,Yonsei
UniversityCollegeofMedicine
A) Background: The anti-inflammatory effect of Spirulina has been Correspondence:KyoungYongJeong–YonseiUniversityCollegeof
demonstrated to inhibit histamine release from mast cell-mediated Medicine,SouthKorea
allergic reactions. Studies have documented the anti-inflammatory WorldAllergyOrganizationJournal2016,9(Suppl1):A24
andimmunomodulatorypropertiesofsupplementationasanadjunct
therapyforasthma. Background:StingsfromtheAsianneedleantareanimportantcause
B) Methods: This is a randomized, double-blind, placebo-controlled ofanaphylaxisinEastAsia.A23-kDaproteinhomologoustoantigen5
study wherein children 7 to 14 years old diagnosed with mild to isthemajorallergenproducedbytheseants.Inthisstudy,weaimed
moderatepersistentasthmawererandomlyassignedtoreceiveeither toproducearecombinant23-kDaallergen.
Spirulina (1,000 mg to 2,000 mg daily) or placebo for three months. Methods: Recombinant 23-kDa allergen from the Asian needle ant
AsthmaControlTest(ACT)andCompositeAsthmaSeverityIndex(CASI) was expressed in Pichia pastoris and purified by ammonium sulfate
wereusedforpatientreport-basedmeasures.Forcedexpiratoryvolume precipitationandNi-affinitychromatography.IgEreactivitywasdem-
at 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC and peak onstratedbyELISAandimmunoblotting.
expiratoryflowrate(PEFR)weredeterminedthroughspirometry.Post- Results:Therecombinantproteinwasrecognizedin5of6serumsam-
supplementationassessmentforthreemonthswasdone. ples(83.3%)frompatientswithdemonstratedanaphylaxistoants.IgE
C) Results: Atotalof39patients(Spirulina=20,placebo=19)were reactivitytoa23-kDaallergenfromvenomsacextractwasspecifically
enrolledinthistrial.Duringthesupplementationphase,boththeSpiru- inhibitedbytherecombinantprotein.
linaandplacebogroupsshowedsignificantimprovementinACTscores Conclusion: A recombinant 23-kDa allergen from the Asian needle
(Spirulina,P<0.0001;placebo,P=0.19)comparedtobaseline.There antwassuccessfullyproducedinthemethylotrophicyeastP.pastoris.
was no significant change in CASI scores in both groups. However, This protein could be useful for the development of component-
during post-supplementation phase, the Spirulina group showed resolveddiagnostics.
significantlysustainedimprovementonboththeACT(P<0.0001)and
CASI scores (P < 0.0001)comparedtoplacebo. TheFEV1(P = 0.014),
A25
FVC(P = 0.008),andPEFR(P = 0.0001)ofthe Spirulinagroupsignifi-
CharacterizationofspecificIgEantibodyrelatedtoantigen5of
cantly improved by the end of supplementation. Overall, significant
echinococcusgranulosus
intergroupdifferences revealed only in FEV1(P = 0.0002) and PEFR
MohammadrezaSiavashi
(P< 0.0001).
PasteurInstituteofIran,Iran
D) Conclusion: Daily supplementation with Spirulina significantly
WorldAllergyOrganizationJournal2016,9(Suppl1):A25
improvedasthmacontrol,FEV1andPEFRcomparedtoplacebo.
Background:Anaphylacticreactions,suchasurticaria,edema,respira-
A23 tory symptoms and anaphylactic shock often complicate the course
Thestudyaboutcauseandclinicopathologicalfindingsofinjection ofcysticechinococcosis(CE).
induceddermatitis Methods:ToinvestigatetheroleoftheIgEimmunoreactiveantigen
Bark-LynnLew,YoungjunOh,DongwooSuh,Woo-YoungSim 5(Ag 5) in the sero-positive patients with CE, we determined N-
KyungHeeUniversityHospitalatGang-Dong,SouthKorea terminalof57kDasubunitofAg5responsibleforIgEandC-terminal
Correspondence:Bark-LynnLew–KyungHeeUniversityHospitalat ofthisactiveantigenrelatedtoinductionofIgGspecifically.
Gang-Dong,SouthKorea Results:ImmunoblottinganalysisshowedthatspecificIgEto57kDa
WorldAllergyOrganizationJournal2016,9(Suppl1):A23 subunitrelatedtointer-chaindisulphidebandoftwo22kDaand38
WorldAllergyOrganizationJournal2016,Volume9Suppl1 Page8of206
kDacomponentsofAg5andconformationalepitopeonthesesubunits. allergic, local allergic and non-allergic rhinitis by evaluate different
Inaddition,sincethe57kDacomponentarisefromtheremovalofthe levelsinRANTES,IL-5,andTNF-αbetweenthenasalpolypsandserum
C-termainal portion of 22kDa subunit of Ag 5, thus IgE specifically fromthem.
recognizedN-terminalof22kDasubunitwhichremainboundedtothe Methods:Werecruitedtotal38adolescentswithallergicrhinitis(AR)
other component, whereas IgG reacted with C-terminal of 38 kDa (n=15, mean age: 17.4±4.2 yrs old), local allergic rhinitis (LAR) (n=9,
componentofAg5. mean age: 15.9±5.5 yrs old), and non-allergic rhinitis (NAR) (n=14,
Conclusion: Recognition of the specific binding site on the 57kDa mean age: 15.6±2.9 yrs old) undergoing polypectomy. Atopic status
subunitofAg5canleadtounderstandingtheregulatingmechanism wasdefinedaspresentingasufficientlyhightotalIgEserumconcentra-
ofIgE/IgGproductioninsomeimmunecircumstancesthatIgEtends tion(IgE>200IU/mL)andapositiveskinpricktestorserumallergen
tobedominated,whereasinotherIgGispredominated. test such as MAST (Green cross MS, Seoul, Korea) or ImmunoCAP
system(Pharmacia,Uppsala,Sweden).Immunoassayswereperformed
using polyp tissue homogenates and sera to quantify the levels of
A26
Developmentofbinaryforecastmodelofasthmaexacerbation: RANTES, TNF-α, and IL-5, and withsera toassesstotal IgE, eosinophil
cationicprotein(ECP)producedbythem.
asthmaindex
HeySukYun1,Ha-NaKang2,Jae-WonOh3,YoungJinChoi1 Results:RANTESlevelswerehigherinLARthaninNAR,buttherewas
1HanyangUniversityMedicalCenter;2HanyangUniversitySeoulHospital; no significant difference between AR and NAR. IL-5 and TNF-α levels
3HanyangUniversityKuriHospital werehigherinARandLARthaninNARbutIFN-γlevelsdidnotdiffer.
Correspondence:HeySukYun–HanyangUniversityMedicalCenter, There was significantly correlated between concentration of RANTES
SouthKorea between polyp tissue homogenates and serum (R2 =0.51, P<0.05,
WorldAllergyOrganizationJournal2016,9(Suppl1):A26 n=38).IL-5,TNF-α,andIFN-γalsodemonstratedpositivecorrelationbe-
tween concentration of that between polyp tissue homogenates and
Background: Asthma is one of the most common chronic diseases serum,however,therewerenotsignificant.
worldwide, and a growing public health concern. It is characterized Conclusions:RANTESlevelswerehigherinpolyptissuehomogenates
bychronicbronchialinflammationandamulti-factorialetiologythat fromLARthaninthosefromNAR.Therefore,RANTESprobablyinvolves
includesgenetic,immunologicalandenvironmentalfactors.Ourgoal inthepathogenesisofLAR.IL-5andTNF-αlevelswerehigherinpolyp
was to develop a patient-customizable asthma forecasting system tissuehomogenatesandserafromARandLARthaninthosefromNAR.
that takes into account meteorological factors, air pollution, and SoIL-5andTNF-αprobablyplayimportantroleinthepathogenesisof
pollen and viral respiratory infections, which are the most common ARandLAR.
environmentalfactorsknowntoexacerbateasthma.
Methods: We analyzed the health insurance records of patients who A28
visitedtheemergencydepartmentsinSeoulduetoanasthmaattack Tgfβ1levelisassociatedwithVDRgenepolymorphisminchildren
and who were treated with salbutamol. Our potential predictors of withallergydiseases
asthma symptoms included meteorological factors (temperature, hu- TatianaSentsova1,IlyaVorozhko1,OlgaChernyak1,VeraRevyakina1,Anna
midity, air pressure, and amount of sunshine), air pollution factors Timopheeva1,AndreyDonnikov2
(ozone and Asian yellow dust), environmental factors (pollen) and 1InstituteofNutrition;2DNA-Technology,JSC
health-relatedfactors(seasonalinfluenzaviralinfection).Patientswere Correspondence:TatianaSentsova–InstituteofNutrition,Russia
assigned to five age groups and separated according to gender and WorldAllergyOrganizationJournal2016,9(Suppl1):A28
season(5×2×4groups),whichresultedinatotalof40groups.Three
models(amultipleregressionmodel,alogisticregressionmodel,anda Background:vitaminDreceptor(VDR)isintracellularylocatedonthe
decision tree) were tested for their ability to predict exacerbated cellsoftheimmunesystemandisinvolvedintheimmuneresponse.
asthmasymptoms(referredtoas“attention”symptoms).Thesuitability The development of allergic inflammation is controlled by different
ofthefinalmodelwasassessedusingpredictabilityskillscores. genes,includingthegeneVDR.
Results:Logisticregressionandthedecisiontreeprovidedthebest Aim:investigateTGFβ1levelsinchildrenwithfoodallergyanddiffer-
forecasts. Using the estimated binary values for “continuous man- entvariantsofVDRgenepolymorphism.
agement” versus “attention” symptoms, the optimal threshold was Materials and methods: We examined 130 infants with allergic dis-
selected. easesagedfrom1to12months,whowereontheartificialfeeding.
Conclusions:Ourbinaryforecastingmodelmayimprovethepredic- Measurement of TGFβ1 levels was performed by immunoenzyme
tionofasthmaexacerbationinaclinicalsetting. method.RT-PCRwithmeltingcurveanalysiswasusedforTaqI,BsmI
and FokI VDR single nucleotide polymorphisms (SNP) detection. For
statisticalanalysisKruskal-Wallisandpost-hoctestswereused.
A27
Results:The frequency of allele A, homozygous A/A and hetero-
Differentlevelsinrantes,IL-5andTNF-ábetweenthenasalpolyps
zygous G/A genotypes in VDR gene site BsmI were significantly
ofadolescentswithallergic,localallergicandnon-allergicrhinitis
Jae-WonOh1,YoungJinChoi1,Ha-NaKang2 increased in children with allergic diseases compare population
1HanyangUniversityKuriHospital;2HanyangUniversitySeoulHospital (OR = 1,81, p = 0.04; OR = 2,03, p = 0,05 and OR = 1,8, P =
Correspondence:Ha-NaKang–HanyangUniversitySeoulHospital, 0,05 respectively). Significantly decreased serum TGFβ1 levels in
carriers of variants A/G and G/G comparably variant A/A carriers
SouthKorea
in FokI site (Me(q1;q3): A/A - 1134(897;1705) vs A/G –
WorldAllergyOrganizationJournal2016,9(Suppl1):A27
610(511;919) vs G/G – 838(734;901) pg/mL, p=0.0216 ) were re-
vealed. Statistically significant differences in serum TGFβ1 levels
Background:Nasalpolypsaretheresultofchronicinflammationofthe
for TaqI and BsmI sites in VDR gene were not detected.
upper airways that develops in the ethmoidal and middle turbinate
Conclusion: FokI site VDR gene polymorphism may indirectly influ-
area.Theyarecharacterizedbythepresenceofanumberofinflamma-
enceonTGFβ1synthesisinallergydiseasesdevelopment.
torycellsresultingfrominfiltrationofeosinophils,Th2cells,mastcells,
and macrophages. Nasal mucosal immune-reactivity may occur in
varyingdegreesaccompanyingpolypsinallergicandnon-allergicrhin- A29
itis.RANTESislocallyproducedwithinthenasalmicroenvironmentof Dynamicsofimmunologicalbiomarkersinchildrenwithfood
polypsandmayberesponsiblefortheeosinophilrecruitment.Tumor allergyfedgoatmilkformula
necrosis factor–alpha (TNF-α) along with Th2 cytokines such as TatianaSentsova,IlyaVorozhko,OlgaChernyak,VeraRevyakina,Anna
interleukin-5(IL-5)maystimulatenasalpolypfibroblaststoproducein- Timopheeva
flammatory mediators. We evaluated the differences in levels of InstituteofNutrition
RANTES,IL-5,andTNF-αinnasalpolypsfromadolescentswithallergic Correspondence:TatianaSentsova–InstituteofNutrition,Russia
andnon-allergicrhinitis.Ourgoalwastofigureoutthepathogenesisof WorldAllergyOrganizationJournal2016,9(Suppl1):A29
WorldAllergyOrganizationJournal2016,Volume9Suppl1 Page9of206
Background: Immunology evaluation of different diet therapy types A31
in children with food allergy currently required. Goat milk formula Associationsofnaturalhistoryandenvironmentalfactorswith
areoftenusedindiettherapyofchildrenwithfoodallergy. asthmaamongchildreninruralandurbanareasofGuangdong,
Aim: Investigate dynamics of immunological biomarkers in children China
withfoodallergywichusedgoatmilkformulasupplementation. JingLi1,MulinFeng2,MarjutRoponen3,BiancaSchaub4,GaryWK
Materials and methods: We examined 66 infants with food allergy Wong5,ZhaoweiYang6
aged from 1 to 12 months, who were on the artificial feeding using 1StateKeyLaboratoryofRespiratoryDisease,theFirstAffiliatedHospital
goatmilkformula.ThedynamicsofimmunoregulatorysubstancesIL-2,- ofGuangzhouMedicalCollege;2GuangzhouInstituteofRespiratory
4,-5,-10,-13,TGF-β1andallergen-specificIgEandIgGantibodiestocow Disease,theFirstAffiliatedHospitalofGuangzhouMedicalCollege;
milk protein, α-lactalbumin, β-lactglobulin, casein, soy and goat milk 3UniversityofEasternFinland;4UniversityChildren’sHospitalMunich;
weremeasuredbyimmunoenzimemethod.Observationdurationwas 5PrinceofWalesHospital;6TheFirstAffiliatedHospital,Guangzhou
28-30days. MedicalUniversity,China
Results: Dynamics of immunological biomarkers characterized de- Correspondence:ZhaoweiYang–TheFirstAffiliatedHospital,Guangzhou
creased levels of allergen-specific IgG antibodies to the cow milk MedicalUniversity,China
proteinanditsfractions,reducedlevelsofallergen-specificIgEanti- WorldAllergyOrganizationJournal2016,9(Suppl1):A31
bodiestothecowmilkproteinandα-lactalbumin,andreductionof
IL-4,-5, levels.Thesechangeswerecorrelatedwithclinicalfoodal- Background: Asthma is influenced by natural and environmental
lergysymptomsreduction. factors,butassociationswerestillinconsistent.
Conclusion:Assessmentofofallergen-specificIgGantibodiestothe Objective:Weaimedtoexploreassociationsbetweennaturalhistory
cow milk protein and its fractions, allergen-specific IgE antibodies andenvironmentalfactorsandasthmainurbanandruralchildrenin
to the cow milk protein and α-lactalbumin, IL-4 and IL-5 can be China.
usedforimmunologyevaluationoftheeffectivenessgoatmilkfor- Methods:Aquestionnairesurveywasperformedin7164childrenfrom
mulasupplementation. urban Guangzhou and 6087 from rural Conghua. Subsamples of 854
children(419fromGuangzhou,435fromConghua)wererecruitedfor
case-controlstudyincludingdetailquestionnairefornaturalandfamily
history,environmentalexposureandeatingbehaviors,histamineairway
A30
provocation, allergen skin prick test, and serum antibody analysis.
Associationbetweenobesity,abdominalobesityandadiposity
Housedustsamplesfrom76Guangzhouand80Conghuafamilieswere
andtheprevalenceofatopicdermatitisinyoungKoreanadults:
obtainedtoanalyzelevelsofendotoxin,housedustmiteandcockroach
Thekoreanationalhealthandnutritionexaminationsurvey,
allergens.
2008–2010
Results:Theprevalenceofdoctor-diagnosed-asthmawaslowerinchil-
JiHyunLee1,YoungMinPark1,SangSooChoi1,KyungDoHan2,Han
dren from Conghua (3.4%) than Guangzhou (6.9%, p<0.001) in the
MiJung1,YoungHoonYoun1,JunYoungLee1,YongGyuPark2,
screening survey. A lower percentage for confirmed asthma (3.0% vs
Seung-HwanLee1
28.9%) and sensitization (13.3% vs 50.6%) was found in rural than
1SeoulSt.Mary’sHospital,SouthKorea;2CollegeofMedicine,theCatholic
urban subjects (p<0.001) in the nested case-control study. Parental
UniversityofKorea
allergy (3.30 [2.08-5.24]), antibiotic usage (3.29 [1.93-5.60]), high fre-
Correspondence:JiHyunLee–SeoulSt.Mary’sHospital,SouthKorea
quency of milk consumption (2.31 [1.45-3.68]) and increased level of
WorldAllergyOrganizationJournal2016,9(Suppl1):A30
house dust Der f 1 (1.71 [1.34-2.19]) were positively associated with
confirmed asthma (p<0.001). Breastfeeding (0.62 [0.39-0.97]), raising
Background: Whether obesity is a risk factor for atopic dermatitis
dogs (0.50 [0.26-0.94]) and level of house dust endotoxin (0.69 [0.50-
(AD) remains unclear. The aim of this study was to investigate the
0.95])werenegativelyassociatedwithconfirmedasthma(p<0.05).
associationbetweenobesityandADinKoreanyoungadults.
Conclusions:Parentalallergy,earlyantibioticadministration,highfre-
Methods: We included nationally representative data of 5,202
quencyofmilkintakeandlevelofDerf1exposuremightberiskfac-
Koreanadultsaged19–40years,obtainedfromthecross-sectional
tors for asthma, while breastfeeding, dog ownership and endotoxin
Korea National Health and Nutrition Examination Survey 2008–
exposurewereprotective.
2010.
Results: AD prevalence exhibited a U-shape trend in relation to
body mass index (BMI), waist circumference (WC), and total body
fat(BF)percentage,especiallyinyoungadultwomen.Womenwith A32
BMI≥25kg/m2,WC≥80cm,andhighestquartile(Q4)oftotalBF TheeffectofCO2-enrichedatmospherestoproducingofallergenic
percentagehadthehighestprevalenceofAD.Theoddsratio(OR) pollenbyragweed
for participants with both BMI ≥ 25 kg/m2 and WC ≥ 80 cm was YoungJinChoi1,Ha-NaKang2,Jae-WonOh3
3.29 (95% confidence interval [CI] 1.71–3.55); therefore, having 1HanyangUniversityMedicalCenter,SouthKorea;2HanyangUniversity
both general and abdominal obesity was considered prominent SeoulHospital;3HanyangUniversityKuriHospital
risk factors for AD in young women. After adjustment for con- Correspondence:YoungJinChoi–HanyangUniversityMedicalCenter,
founding factors, including age, smoking, alcohol drinking, exer- SouthKorea
cise,andvitaminDlevels,highBMI(≥30kg/m2)(OR=4.241,95% WorldAllergyOrganizationJournal2016,9(Suppl1):A32
CI:1.60–11.24),highWC(≥80cm)(OR=2.062,95%CI:1.08–3.94),
andhighBFpercentage(Q4)(OR=2.073,95%CI:1.22–3.52)were Background:Theprevalenceofallergicdiseaseshasincreasedresult
shown to be significantly associated with AD in young adult fromexposuretoenvironmentalpollutants.Aeroallergenexposureis
women. associated with allergic rhinitis and asthma. Pollens have long been
Conclusions: In this large-scale nation-wide study in Korean adults, knowntobeasignificantcauseofallergicdisease.Polleninheavily
obesity was positively related with the presence of AD in women. pollutedzonescanexpressalargeramountofproteinsdescribedas
Our findings suggest that weight management might help to pre- being allergenic. In the presence of high CO2 concentrations and
ventAD. temperatures,plantsincreasetheirpollenoutput.
WorldAllergyOrganizationJournal2016,Volume9Suppl1 Page10of206
Method:Ragweedestablishment:1)Chamberstudy:Tenplantsofrag- sIgEgraduallydecreased,andthelevelstosIgG4increased,namelythe
weedwereestablishedinopen-topchamberatdifferentconcentration sIgE/sIgG4 ratio reduced gradually, and the biggest declined of sIgE/
ofCO2(380-400,500-520,600-620,1000-1100ppm).2)Fieldstudy:Be- sIgG4ratiowasDerp1.thefastestdegreetoSITreactionwasthelow
ginninginMarch2012and2014,arural(Pocheon,Kyunggi-do,annual agechildrenwithallergies.
mean CO2: 230ppm) and urban (Kangnam, Seoul, annual mean CO2:
440ppm)locationswereestablished.Seedsofcommonragweed(Am-
brosiaartemisiifolia)andgiantragweed(A.trifida)wereobtainedfrom A34
DaejinUniversityfromacommonseedlotofragweed.Atfinalharvest, EffectofAsiandusteventsonasthmaaccordingtothe
entire plants were collected. To determine qualitative changes in socioeconomicstatususingclaimdatainKOREA
pollen, harvested pollen grains were suspended in 95% ethanol. The Yoon-SungPark
crudesolublepollenproteinpreparationswerestoredat-20°.Protein InhaUniversityHospital,SouthKorea
content of the extracts was quantified. Concentration of Allergens WorldAllergyOrganizationJournal2016,9(Suppl1):A34
(commonragweed(Amba1)andgiantragweed(Ambt5)wasquanti-
fiedthroughuseofdoublesandwichELISA. Objective:ThepurposeofthisstudyistoevaluatetheeffectsofAsian
Results:1)chamberstudy:1)chamberstudy:ConcentrationofAmb dusteventsonasthmabysocioeconomicstatususingclaimdata.
a 1 was increased with increased CO2 Conc. (380-400, 500-520, Methods: Case crossover design was used. This study is based on
600-620, 1000-1100ppm: 18.4±5.0, 30.8±13.1, 42.5±11.2, 50.1±21.2 the national health insurance claim (ICD : J45, J46), air pollutants
ng/mL), Concentration of Amb t 5 was increased with increased [PM10(μg/m3), CO(ppb), SO2(ppb), NO2(ppb), O3(ppb)] and climate
CO2 Conc. (380-400, 500-520, 600-620, 1000-1100ppm: 22.1±6.8, [temperature(°C), humidity(%), visibility(km), wind speed(m/s), air
36.3±11.6, 48.3±19.5, 64.6±21.3 ng/mL), 2) Field study: There were pressure(hPa)] data from 2007 to 2013 in Seoul and Incheon, Korea.
notsignificantlydifferentbetweenPocheon(CO2230ppm:16.0±2.0ng/ The socioeconomic status was classified into health insurance group
mL)andSeoul(CO2440ppm:20.3±8.6ng/mL)inConc.ofAmba1,also andmedicalaidgroup.Thedailymaximumvalueofairpollutantsand
Pocheon(CO2230ppm:24.5±6.9ng/mL)andSeoul(CO2440ppm:28.3 daily average climate were calculated. The daily numbers of asthma
±6.2ng/mL)inConc.ofAmbt5,thoughConc.ofAmba1andAmbt5 casesonthe‘Event’dayswerecomparedwith‘Control’days.Toselect
wereincreasedatSeoulthanthoseatPocheon. event days, 2 criteria wereapplied: 1) exclude weekends 2) excluded
Conclusion: Increased CO2 significantly influence allergenicity and reoccurred Asian dust events on the 14 days before and after the
pollenconcentrationofcommonragweedthroughthechamberand Asian dustevent. It wasobservedfor7 days after theevents days.
fieldstudy.Theelementaryexamplegivenheredemonstratesstrong Control days is defined as the 7 days before and after the event
probable links between rising CO2 levels and increased allergic dis- days.Logpoissonregressionwasusedtoestimatetheratioofaver-
eases. We suggest that urbanization might provide a alternative to agedasthmacasesusingage,gender,regionandclimatebetween
currentexperimentalmethodsevaluatingplantresponsestoclimate eventandcontroldays.
change. Results: 7 event days wereselected. On the eventdays, the average
Keywords: Allergens: Plant; Aeroallergens; Allergens: Environmental numbersof asthmacases weremuchmorethanthecontroldayson
Control thegender,age,regionandsocioeconomicstatus.However,therewas
no significant difference statistically. Humidity of the event days was
lower(p=0.0950)butwindspeed(p=0.0203)andPM (p=0.0376)were
10
A33 higherthancontroldays.Theestimatedratioofaveragedasthmacases
Applicationevaluationofhousedustmiteandcomponents oneventdayswas0.96(95%C.I.:0.95-0.98).Accordingtothesocioeco-
specific-IgEandIgG4inspecificimmunotherapywithallergic nomicstatus,theratioofasthmapatientsduring7daysfrom‘day+0’
diseases to‘day+6’wereasfollows:0.96(0.95-0.97)ontheday+0,1.27(1.26-
BaoqingSun,PeiyanZheng 1.29)ontheday+1,1.11(1.09-1.13)ontheday+2,1.25(1.23-1.26)
FirstAffiliatedHospitalGuangzhouMedicalUniversity ontheday+3,1.13(1.12-1.15)ontheday+4,1.06(1.04-1.07)onthe
Correspondence:BaoqingSun–FirstAffiliatedHospitalGuangzhou day +5 and 0.83 (0.81 - 0.84) on the day +6 in the health insurance
MedicalUniversity,China group.Also,inmedicalaidsgroup,theestimatedratiooftheeachday
WorldAllergyOrganizationJournal2016,9(Suppl1):A33 were1.00(0.94-1.07),1.14(1.06-1.22),1.15(1.06-1.25),1.18(1.11-
1.25),1.08(1.01-1.15),1.02(0.94-1.10)and0.78(0.74-0.83).
Objective:ToobservethedynamicchangeofspecificIgE(sIgE)and Conclusion:Asiandusteventscanworsenasthmaanditseffectson
specificIgG4(sIgG4)tohousedustmiteincludingDermatophagoides asthmaappeardifferentlybythesocioeconomicstatus.Timelagana-
pteronyssinus (Der p) and its main components Der p1 and Der p2 lysisis neededin studyingasthma effect on Asiandust event using
after specific immunotherapy (SIT), and to evaluate the effect of its claimdata.
applicationinclinicalmonitoringofdesensitization.
Methods: This study observed the immune indexes of 51 children
patients including the serum sIgE and sIgG4 to five periods of pre A35
SIT(Pre)and after SIT (half of year (0.5Y),1 year,2 year(2Y) and 3 TSLPdownregulateshumanâ-defensin2throughSTAT3-dependent
year(3Y)). 20 patientsbyconventionaldrug treatmentwerecollected pathwayinkeratinocytes
ascontrolgroup. SangWookSon
Results: After half of year of SIT, the levels of serum sIgE to Der p, KoreaUniversity,SouthKorea
Derp1andDerp2increasedcontinuously,however,bythenbegan WorldAllergyOrganizationJournal2016,9(Suppl1):A35
to decline, after three years treatment, the levels of sIgE to Der p1
and Der p2 were reduced step by step, particularly, sIgE to Der p1 TSLP downregulates human β-defensin 2 through STAT3-dependent
were significantly lower than Pre treatment. The levels of sIgG4 to pathwayinkeratinocytes.
Der p, Der p1 and Der p2 increased significantly along with the DepartmentofDermatology,KoreaUniversityCollegeofMedicine.
process of SIT. The increasing range of Der p sIgG4 reached to the Atopicdermatitis(AD)isachronicandpruriticinflammatoryskindis-
maximum,followedbyDerp1andthenDerp2.ThesIgE/sIgG4ratio ease associated with a defective skin barrier and a dysregulation of
ofthreeallergensweredecreasedafterSIT,andthebiggestdropped Th2immuneresponse.MostpatientswithADshowreducedexpres-
degreewasthesIgE/sIgG4ratiotoDerp1.Thelowagegroupofchil- sionofantimicrobialpeptides(AMPs),whichmayplaysanimportant
dren(5to8y)responsetoimmunehigherandfasterthanthehigh role in host defense against bacteria, fungi, and viruses infection.
agegroupofchildren(9-16y)afterSIT,andthelevelsofcomponents Thymicstromallymphopoietin(TSLP)hasapathogeneticroleinthe
sIgG4toDerp1andDerp2elevatedfasterthansIgG4toDerp. initiationandmaintenanceofallergicinflammatorydiseasesincluding
Conclusions:Intheearlystageoftreatment,thelevelsofDerp,Derp1 AD.ThefunctionofTSLPwasrevealedinpreviousstudies.However,it
andDerp2tosIgEandsIgG4inserumbythebodyinastateofim- remainsunknownthattheregulatorymechanismofHBD-2expression
munestimulatingweresignificantlyincreased.AstheSIT,thelevelsof byTSLPinprimaryhumankeratinocytes.