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Local IgE Production in Allergic (AR) and Non-Allergic Rhinitis (NAR)
Abstracts AB155
J ALLERGY CLIN IMMUNOL VOLUME 139, NUMBER 2
Local IgE Production in Allergic (AR) and NonAllergic Rhinitis (NAR)
Ahmed Hamed, BS1, Thamiris Palacios, DO1, Dilawar Khokhar, MD1, Alexander J. Schuyler, BS, BA1, John W. Steinke, PhD, FAAAAI2, Thomas A. E. Platts-Mills, MD, PhD, FAAAAI, FRS1, Monica G. Lawrence, MD3, and Larry Borish, MD, FAAAAI4; 1University of Virginia, Charlottesville, VA, 2Asthma and Allergic Diseases Center, Charlottesville, VA, 3MR4 Building, Room 5051a, Univ of Virginia Division of Asthma Allergy & Immunology, Charlottesville, VA, 4University of Virginia Health System, Charlottesville, VA. RATIONALE: Local production of IgE has been described as a pathogenic mechanism contributing to symptoms of both allergic and non-allergic rhinitis. However, whether or not this occurs has been controversial, partly due to methodological differences. We therefore assayed the presence of specific IgE relevant to exposure history in interstitial nasal secretions in subjects with rhinitis symptoms with and without positive skin tests to the Virginia aeroallergen panel. METHODS: Interstitial secretions were collected via absorptive filter paper applied to the inferior turbinates for 5 minutes. Allergen-specific IgE was assayed via immunocapÒ. To eliminate confounding influences of transudation or transcytosis, data were normalized to total IgE concentrations in the interstitial fluid and ratios compared between nasal and serum samples. RESULTS: Subjects with skin test positive (n510) and negative rhinitis (n56) were equally likely to complain of rhinorrhea, paroxysmal sneezing, nasal congestion, and posterior pharyngeal drainage. However, subjects with AR were more likely to report itchy nose, palate, eyes, or ears and epiphora. Only very low concentrations of total IgE were detected in the NAR subjects and none demonstrated specific IgE. Specific IgE was only detectable in nasal secretions of 3 AR subjects but in only 2 was the specific:total IgE ratio elevated in comparison to the serum ratio, thereby demonstrating local production. CONCLUSIONS: We could not identify any skin test negative subjects demonstrating local IgE production to aeroallergens. Furthermore, these subjects demonstrated distinct clinical findings. Local IgE production can occur in AR, although is uncommon and this was only demonstrated in 2/ 10 subjects.
497
Prevalence of Animal Allergy in Korean Veterinarians and Veterinary Researchers
Sang Min Lee, Jung Woo Shim, Hong Seok Park, Shin Myung Kang, Yu Jin Kim, Sun Young Kyung, Jeong-Woong Park, Sung Hwan Jeong, and Sang Pyo Lee; Gachon University Gil Medical Center, Incheon, Korea, The Republic of. RATIONALE: Veterinarians and veterinary researchers are exposed to variable animal allergens. However, animal allergy in this group was not sufficiently evaluated worldwide. The objective of this study is to evaluate prevalence of animal allergy in Korean veterinarians and veterinary researchers. METHODS: Thirty-three subjects who participated in 2016 annual symposium of the Korean Society of Veterinary Science were asked to answer questionnaires regarding allergic symptoms during animal exposure and underwent skin prick test (SPT) for animal allergens. Animal allergens for SPT consisted of chicken feather, cow’s milk, hen’s egg, seven animal meats, and ten mammal epithelium. We divided subjects into two groups. The one was allergic group (n514) who suffered from allergic symptoms during animal exposure, and the other was non-allergic group (n519) who did not. RESULTS: Between two groups, there were no differences in age, gender, current, past, and family history of allergic disease, current occupation and its duration, numbers and species of contact animals and contact time. Meanwhile, the sensitization to mouse, horse, rabbit, and guinea pig was significantly more frequent in allergic group than in non-allergic group. In allergic group, most common allergic disease related to animal exposure
was allergic rhinitis, followed by allergic conjunctivitis, skin allergy, and lower respiratory allergy. CONCLUSIONS: Sensitization to some allergens of animal epithelium, but not demographic or occupational factor can be associated with animal allergy in Korean veterinarians and veterinary researchers. Acknowledgement: This research was supported by National Research Foundation and Ministry of Science, ICT & Future Planning of South Korea (NRF-2015R1D1A1A02061943).
498
Comparison of Exhaled Nitric Oxide in Varying Disease States of Allergic Rhinitis in the Pediatric Population
Pattara Tanticharoenwiwat, MD1, Siwaporn Sapsaprung1, Prapasri Kulalert1, Dhave Setabutr2, and Orapan Poachanukoon1; 1Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathum-thani, Thailand, 2Division of Pediatric Otolaryngology, Cohen’s Children Hospital, Hofstra University School of Medicine, New Hyde Park, NY. RATIONALE: Exhaled nitric oxide (eNO) has been proposed as noninvasive marker of airway inflammation. This study aimed to determine whether measurement of eNO could be useful for evaluating children with allergic rhinitis. METHODS: We measured eNO in children aged 5 to 15 years with allergic rhinitis (n5 40) and healthy control subjects (n540). We then compared this measurement with clinical symptoms according to the ARIA (Allergic Rhinitis and its Impact on Asthma) classification. RESULTS: Mean eNO in children with allergic rhinitis (AR) (12.64 614.67 ppb) was significantly higher than in the healthy control (7.00 6 6.33 ppb) (p-value 5 0.046). In the persistent allergic rhinitis group (17.11 6 18.40 ppb), eNO level was significantly higher than individuals in the intermittent allergic rhinitis group (8.59 68.88 ppb, p-value 5 0.024) and healthy control group (7.00 6 6.33 ppb, p-value50.008). Among the children with allergic rhinitis, eNo was not significantly different in terms of gender, age, weight and passive smoking exposure. CONCLUSIONS: Exhaled nitric oxide may be elevated in children with allergic rhinitis that do not have concomitant asthma. This suggests exhaled nitric oxide may show utility as both a diagnostic tool and surveillance measure in patients with allergic rhinitis. Physicians should see whether children have allergic rhinitis when they use exhaled nitric oxide as monitoring tools of treatment in asthma.
SUNDAY
496
J ALLERGY CLIN IMMUNOL VOLUME 139, NUMBER 2
Local IgE Production in Allergic (AR) and NonAllergic Rhinitis (NAR)
Ahmed Hamed, BS1, Thamiris Palacios, DO1, Dilawar Khokhar, MD1, Alexander J. Schuyler, BS, BA1, John W. Steinke, PhD, FAAAAI2, Thomas A. E. Platts-Mills, MD, PhD, FAAAAI, FRS1, Monica G. Lawrence, MD3, and Larry Borish, MD, FAAAAI4; 1University of Virginia, Charlottesville, VA, 2Asthma and Allergic Diseases Center, Charlottesville, VA, 3MR4 Building, Room 5051a, Univ of Virginia Division of Asthma Allergy & Immunology, Charlottesville, VA, 4University of Virginia Health System, Charlottesville, VA. RATIONALE: Local production of IgE has been described as a pathogenic mechanism contributing to symptoms of both allergic and non-allergic rhinitis. However, whether or not this occurs has been controversial, partly due to methodological differences. We therefore assayed the presence of specific IgE relevant to exposure history in interstitial nasal secretions in subjects with rhinitis symptoms with and without positive skin tests to the Virginia aeroallergen panel. METHODS: Interstitial secretions were collected via absorptive filter paper applied to the inferior turbinates for 5 minutes. Allergen-specific IgE was assayed via immunocapÒ. To eliminate confounding influences of transudation or transcytosis, data were normalized to total IgE concentrations in the interstitial fluid and ratios compared between nasal and serum samples. RESULTS: Subjects with skin test positive (n510) and negative rhinitis (n56) were equally likely to complain of rhinorrhea, paroxysmal sneezing, nasal congestion, and posterior pharyngeal drainage. However, subjects with AR were more likely to report itchy nose, palate, eyes, or ears and epiphora. Only very low concentrations of total IgE were detected in the NAR subjects and none demonstrated specific IgE. Specific IgE was only detectable in nasal secretions of 3 AR subjects but in only 2 was the specific:total IgE ratio elevated in comparison to the serum ratio, thereby demonstrating local production. CONCLUSIONS: We could not identify any skin test negative subjects demonstrating local IgE production to aeroallergens. Furthermore, these subjects demonstrated distinct clinical findings. Local IgE production can occur in AR, although is uncommon and this was only demonstrated in 2/ 10 subjects.
497
Prevalence of Animal Allergy in Korean Veterinarians and Veterinary Researchers
Sang Min Lee, Jung Woo Shim, Hong Seok Park, Shin Myung Kang, Yu Jin Kim, Sun Young Kyung, Jeong-Woong Park, Sung Hwan Jeong, and Sang Pyo Lee; Gachon University Gil Medical Center, Incheon, Korea, The Republic of. RATIONALE: Veterinarians and veterinary researchers are exposed to variable animal allergens. However, animal allergy in this group was not sufficiently evaluated worldwide. The objective of this study is to evaluate prevalence of animal allergy in Korean veterinarians and veterinary researchers. METHODS: Thirty-three subjects who participated in 2016 annual symposium of the Korean Society of Veterinary Science were asked to answer questionnaires regarding allergic symptoms during animal exposure and underwent skin prick test (SPT) for animal allergens. Animal allergens for SPT consisted of chicken feather, cow’s milk, hen’s egg, seven animal meats, and ten mammal epithelium. We divided subjects into two groups. The one was allergic group (n514) who suffered from allergic symptoms during animal exposure, and the other was non-allergic group (n519) who did not. RESULTS: Between two groups, there were no differences in age, gender, current, past, and family history of allergic disease, current occupation and its duration, numbers and species of contact animals and contact time. Meanwhile, the sensitization to mouse, horse, rabbit, and guinea pig was significantly more frequent in allergic group than in non-allergic group. In allergic group, most common allergic disease related to animal exposure
was allergic rhinitis, followed by allergic conjunctivitis, skin allergy, and lower respiratory allergy. CONCLUSIONS: Sensitization to some allergens of animal epithelium, but not demographic or occupational factor can be associated with animal allergy in Korean veterinarians and veterinary researchers. Acknowledgement: This research was supported by National Research Foundation and Ministry of Science, ICT & Future Planning of South Korea (NRF-2015R1D1A1A02061943).
498
Comparison of Exhaled Nitric Oxide in Varying Disease States of Allergic Rhinitis in the Pediatric Population
Pattara Tanticharoenwiwat, MD1, Siwaporn Sapsaprung1, Prapasri Kulalert1, Dhave Setabutr2, and Orapan Poachanukoon1; 1Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathum-thani, Thailand, 2Division of Pediatric Otolaryngology, Cohen’s Children Hospital, Hofstra University School of Medicine, New Hyde Park, NY. RATIONALE: Exhaled nitric oxide (eNO) has been proposed as noninvasive marker of airway inflammation. This study aimed to determine whether measurement of eNO could be useful for evaluating children with allergic rhinitis. METHODS: We measured eNO in children aged 5 to 15 years with allergic rhinitis (n5 40) and healthy control subjects (n540). We then compared this measurement with clinical symptoms according to the ARIA (Allergic Rhinitis and its Impact on Asthma) classification. RESULTS: Mean eNO in children with allergic rhinitis (AR) (12.64 614.67 ppb) was significantly higher than in the healthy control (7.00 6 6.33 ppb) (p-value 5 0.046). In the persistent allergic rhinitis group (17.11 6 18.40 ppb), eNO level was significantly higher than individuals in the intermittent allergic rhinitis group (8.59 68.88 ppb, p-value 5 0.024) and healthy control group (7.00 6 6.33 ppb, p-value50.008). Among the children with allergic rhinitis, eNo was not significantly different in terms of gender, age, weight and passive smoking exposure. CONCLUSIONS: Exhaled nitric oxide may be elevated in children with allergic rhinitis that do not have concomitant asthma. This suggests exhaled nitric oxide may show utility as both a diagnostic tool and surveillance measure in patients with allergic rhinitis. Physicians should see whether children have allergic rhinitis when they use exhaled nitric oxide as monitoring tools of treatment in asthma.
SUNDAY
496