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Epidemiology of Mosquito Bite Allergy in the Centre of Allergy and Clinical Immunology of Monterrey, Mexico
S128 Abstracts
Epidemiology of Mosquito Bite Allergy in the Centre of Allergy and Clinical Immunology of Monterrey, Mexico A. Arias-Cruz, E. Avitia-Valenzuela, S. N. González-Díaz, G. GalindoRodríguez; Allergy and Clinical Immunology, University Hospital, Monterrey, N.L., MEXICO. RATIONALE: To know the prevalence and type of allergic reactions to mosquito bite in our population, we performed a descriptive cross sectional study. METHODS: 482 patients ranged in age from 2 to 58 years referred to our centre were evaluated. A questionnaire on mosquito bite reactions history was applied to the adult patients and the parents’ children. Additionally, skin prick test (SPT) were performed in all of these subjects with common aeroallergens of the northeastern of Mexico and whole body extract of Aedes aeigypti (a common mosquito species in Mexico). RESULTS: The mean age of the subjects was 18.5 ± 14.8 years. 257 (53.3%) were female. 307 (63.7%) were atopic with positive SPT to at least one aeroallergen. 395 (82%) had a positive history of local reactions to mosquito bites, but only 12 (2.5%) presented large local reactions (8 were younger than 10 years). The most common local reactions included erythema, itching, papules and small wheals. Only one patient (0.2%) had history of systemic reaction characterized by urticaria. SPT to mosquito was positive in 85 subjects (17.6%) and 78 of them had history of local reactions (p= 0.24), but only 3 of them were large. There were not differences in the sensitization to mosquito between atopic and no atopic subject (p> .05). CONCLUSIONS: Local reactions to mosquito bites are common and sensitization to this insect is frequent in our population. In general, the prevalence of large local reactions is relatively low, although it is greater in children. Allergic systemic reactions seem to be rare. Funding: UANL
500
SUNDAY
Circulating Specific IgE to Gliadin Can be a Useful Marker for Diagnosing Wheat-Dependent Exercise-Induced Anaphylaxis Patients Among the Wheat-Sensitized Patients J. Lee1, S. Yoon2, Y. Ye2, S. Kim2, H. Park2; 1Department of internal medicine, College of medicine, Hallym University, Chunchon, REPUBLIC OF KOREA, 2Department of Allergy and Rheumatology, Ajou University School of Medicine, Suwon, REPUBLIC OF KOREA. RATIONALE: Wheat is one of the common sensitizing food allergens to cause food-dependent exercise-induced anaphylaxis in Korea. In pediatric patients with wheat-induced anaphylaxis, circulating specific IgE was detected. Exercise could increase serum gliadin level after taking wheat flour containing foods. In this study, we evaluated serum specific IgE to gliadin for the diagnosis of wheat-dependent exercise-induced anaphylaxis (WDEIA), and their binding characteristics were evaluated. METHODS: Thirty-six adult subjects sensitized to wheat were enrolled; 26 were asymptomatic sensitizers and 6 had WDEIA. Specific IgE to wheat flour and gliadin extracts were measured by ELISA. IgE immunoblot analysis to both wheat and gliadin extracts were compared with or without simulated gastric and intestinal fluid incubation (SGF and SIF). RESULTS: Among 6 WDEIA patients, only 3 (50%) had high specific IgE to wheat, but 6 (100%) had high serum specific IgE to gliadin. However, in 26 asymptomatic subjects, 14 had high specific IgE to wheat but no one had specific IgE to gliadin. All of 6 WDEIA patients had high IgE binding signals to 50 kDa of gliadin extract on IgE immunoblot, which could be suppressed by SGF, but minimal inhibitions were noted by SIF incubation.
501
J ALLERGY CLIN IMMUNOL FEBRUARY 2006
CONCLUSIONS: Circulating specific IgE to gliadin can be applied as a sensitive marker for diagnosing adult WDEIA patients. Funding: Korea augricultural R&D promotion center
502
Anaphylaxis in Children in Central Israel
B. Garty, V. Hoffer, N. Marcus, O. Schoerman, Y. Levy, Y. Finkelstein, Y. L. Danon; Schneider Children Medical Center of Israel, Petah Tikva, ISRAEL. RATIONALE: Despite being a medical emergency, little is known about the causes and clinical features of anaphylaxis in children in Israel. METHODS: We evaluated events of anaphylaxis in children admitted to our children’s hospital during a period of 12 years. RESULTS: 92 children with anaphylaxis (50 boys and 42 girls), age range 4 days to 18 years (mean 8.5 years) were admitted during the study period; 43 children had atopic disorders (mainly asthma). Anaphylaxis occurred at home in 52 children (54%) and in the medical institution in 24 children (26%). The main causes of anaphylaxis were food (39%) mainly milk and nuts, medications (22%) and hymenoptera venoms (13%). Sixteen patients had more than one episode of anaphylaxis, and except in one case, did not use self-administered epinephrine injection(EpiPen). Seven patients were admitted to intensive care unit. There were no fatalities. CONCLUSIONS: Most cases of anaphylaxis in our series were caused by food, particularly milk and nuts. The majority of our patients had only one episode of anaphylaxis, therefore its prevention seemed to be almost impossible. EpiPen was used only by one out of 16 patients who had more than one episode of anaphylaxis, showing that the education for its use might have been insufficient.
503
Purification of Insect Venom Proteins
D. R. Hoffman; Pathology and Laboratory Medicine, Brody School of Medicine, Greenville, NC. RATIONALE: Some of the chromatographic materials used in the original descriptions of purification of insect venom proteins are no longer available. METHODS: A selection of currently available chromatographic materials were evaluated for the purification of fire ant and yellowjacket venom proteins. Separations and purity were monitored by SDS-PAGE. RESULTS: High performance gel filtration materials based on silica, agarose or polyacrylamide all interacted with materials including both proteins and peptides in the venoms, preventing separation based upon size. High salt concentrations reduced, but did not eliminate these interactions. A 1.7meter column of Sephadex G50F gave the best results in acidic buffer containing 0.15M NaCl. Sephadex G75 superfine columns were extremely difficult to use with venoms. Excellent cation-exchange separations were obtained with Pharmacia Mono S and PolyLC polysulfoethyl A columns. Other silica based cation exchangers did not work as well. The use of traditional reversed phase columns caused varying degrees of denaturation. Perfusion chromatography columns Poros R from Applied Bioscience and TSK Gel SuperODS from TosoHaas gave good separations with preservation of immunoreactivity. CONCLUSIONS: Many high performance gel filtration columns are unsuitable for use with venom proteins; Sephadex remains the medium of choice. Excellent cation-exchange columns and perfusion chromatography columns are readily available. Funding: Brody School of Medicine
Epidemiology of Mosquito Bite Allergy in the Centre of Allergy and Clinical Immunology of Monterrey, Mexico A. Arias-Cruz, E. Avitia-Valenzuela, S. N. González-Díaz, G. GalindoRodríguez; Allergy and Clinical Immunology, University Hospital, Monterrey, N.L., MEXICO. RATIONALE: To know the prevalence and type of allergic reactions to mosquito bite in our population, we performed a descriptive cross sectional study. METHODS: 482 patients ranged in age from 2 to 58 years referred to our centre were evaluated. A questionnaire on mosquito bite reactions history was applied to the adult patients and the parents’ children. Additionally, skin prick test (SPT) were performed in all of these subjects with common aeroallergens of the northeastern of Mexico and whole body extract of Aedes aeigypti (a common mosquito species in Mexico). RESULTS: The mean age of the subjects was 18.5 ± 14.8 years. 257 (53.3%) were female. 307 (63.7%) were atopic with positive SPT to at least one aeroallergen. 395 (82%) had a positive history of local reactions to mosquito bites, but only 12 (2.5%) presented large local reactions (8 were younger than 10 years). The most common local reactions included erythema, itching, papules and small wheals. Only one patient (0.2%) had history of systemic reaction characterized by urticaria. SPT to mosquito was positive in 85 subjects (17.6%) and 78 of them had history of local reactions (p= 0.24), but only 3 of them were large. There were not differences in the sensitization to mosquito between atopic and no atopic subject (p> .05). CONCLUSIONS: Local reactions to mosquito bites are common and sensitization to this insect is frequent in our population. In general, the prevalence of large local reactions is relatively low, although it is greater in children. Allergic systemic reactions seem to be rare. Funding: UANL
500
SUNDAY
Circulating Specific IgE to Gliadin Can be a Useful Marker for Diagnosing Wheat-Dependent Exercise-Induced Anaphylaxis Patients Among the Wheat-Sensitized Patients J. Lee1, S. Yoon2, Y. Ye2, S. Kim2, H. Park2; 1Department of internal medicine, College of medicine, Hallym University, Chunchon, REPUBLIC OF KOREA, 2Department of Allergy and Rheumatology, Ajou University School of Medicine, Suwon, REPUBLIC OF KOREA. RATIONALE: Wheat is one of the common sensitizing food allergens to cause food-dependent exercise-induced anaphylaxis in Korea. In pediatric patients with wheat-induced anaphylaxis, circulating specific IgE was detected. Exercise could increase serum gliadin level after taking wheat flour containing foods. In this study, we evaluated serum specific IgE to gliadin for the diagnosis of wheat-dependent exercise-induced anaphylaxis (WDEIA), and their binding characteristics were evaluated. METHODS: Thirty-six adult subjects sensitized to wheat were enrolled; 26 were asymptomatic sensitizers and 6 had WDEIA. Specific IgE to wheat flour and gliadin extracts were measured by ELISA. IgE immunoblot analysis to both wheat and gliadin extracts were compared with or without simulated gastric and intestinal fluid incubation (SGF and SIF). RESULTS: Among 6 WDEIA patients, only 3 (50%) had high specific IgE to wheat, but 6 (100%) had high serum specific IgE to gliadin. However, in 26 asymptomatic subjects, 14 had high specific IgE to wheat but no one had specific IgE to gliadin. All of 6 WDEIA patients had high IgE binding signals to 50 kDa of gliadin extract on IgE immunoblot, which could be suppressed by SGF, but minimal inhibitions were noted by SIF incubation.
501
J ALLERGY CLIN IMMUNOL FEBRUARY 2006
CONCLUSIONS: Circulating specific IgE to gliadin can be applied as a sensitive marker for diagnosing adult WDEIA patients. Funding: Korea augricultural R&D promotion center
502
Anaphylaxis in Children in Central Israel
B. Garty, V. Hoffer, N. Marcus, O. Schoerman, Y. Levy, Y. Finkelstein, Y. L. Danon; Schneider Children Medical Center of Israel, Petah Tikva, ISRAEL. RATIONALE: Despite being a medical emergency, little is known about the causes and clinical features of anaphylaxis in children in Israel. METHODS: We evaluated events of anaphylaxis in children admitted to our children’s hospital during a period of 12 years. RESULTS: 92 children with anaphylaxis (50 boys and 42 girls), age range 4 days to 18 years (mean 8.5 years) were admitted during the study period; 43 children had atopic disorders (mainly asthma). Anaphylaxis occurred at home in 52 children (54%) and in the medical institution in 24 children (26%). The main causes of anaphylaxis were food (39%) mainly milk and nuts, medications (22%) and hymenoptera venoms (13%). Sixteen patients had more than one episode of anaphylaxis, and except in one case, did not use self-administered epinephrine injection(EpiPen). Seven patients were admitted to intensive care unit. There were no fatalities. CONCLUSIONS: Most cases of anaphylaxis in our series were caused by food, particularly milk and nuts. The majority of our patients had only one episode of anaphylaxis, therefore its prevention seemed to be almost impossible. EpiPen was used only by one out of 16 patients who had more than one episode of anaphylaxis, showing that the education for its use might have been insufficient.
503
Purification of Insect Venom Proteins
D. R. Hoffman; Pathology and Laboratory Medicine, Brody School of Medicine, Greenville, NC. RATIONALE: Some of the chromatographic materials used in the original descriptions of purification of insect venom proteins are no longer available. METHODS: A selection of currently available chromatographic materials were evaluated for the purification of fire ant and yellowjacket venom proteins. Separations and purity were monitored by SDS-PAGE. RESULTS: High performance gel filtration materials based on silica, agarose or polyacrylamide all interacted with materials including both proteins and peptides in the venoms, preventing separation based upon size. High salt concentrations reduced, but did not eliminate these interactions. A 1.7meter column of Sephadex G50F gave the best results in acidic buffer containing 0.15M NaCl. Sephadex G75 superfine columns were extremely difficult to use with venoms. Excellent cation-exchange separations were obtained with Pharmacia Mono S and PolyLC polysulfoethyl A columns. Other silica based cation exchangers did not work as well. The use of traditional reversed phase columns caused varying degrees of denaturation. Perfusion chromatography columns Poros R from Applied Bioscience and TSK Gel SuperODS from TosoHaas gave good separations with preservation of immunoreactivity. CONCLUSIONS: Many high performance gel filtration columns are unsuitable for use with venom proteins; Sephadex remains the medium of choice. Excellent cation-exchange columns and perfusion chromatography columns are readily available. Funding: Brody School of Medicine