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PREVALENCE AND PATTERNS OF FOOD ALLERGY AMONG SCHOOL CHILDREN OF EASTERN NORTH CAROLINA
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Abstracts: Poster Sessions / Ann Allergy Asthma Immunol 121 (2018) S22−S62
with CAP aged 19 to 38 years received treatment with rectal electrostimulation every other day for 10 sessions lasting 15 minutes each. Patients in Group 1 (n=42) additionally received oral Sertraline with an initial dose of 50 mg gradually increased to 200 mg for 1 month. Patients in Group 2 (n=39) received basic treatment only. Results: Both Groups 1 and Groups 2 after treatment had significant (p Conclusions: Greatest effectiveness occurred with rectal electrostimulation and anti-depressant treatment of CAP, including increases in anti- inflammatory cytokines, suggesting a link between depression and cytokine responses in CP/CPPS patients.
lymphopenia and 2 children with SCID phenotypes. In the children with abnormal screening and a diagnosis of CHH, the absolute CD4 lymphocyte counts on initial immunophenotyping ranged from 76 − 757 cells/mm3 (median = 552 cells/mm3). The two CHH patients with SCID received bone marrow transplants. Conclusions: CHH is a rare genetic disorder associated with widely varying levels of T-cell lymphopenia ranging from clinically insignificant to SCID. The T-cell lymphopenia may cause an abnormal result on the NBS TREC analysis, allowing for early diagnosis of a significant immunodeficiency and institution of life-saving therapies. Food Allergy
P262 ASSESSMENT OF SELECT SERUM CYTOKINES TNF-A AND IL-22 IN ORAL LICHEN PLANUS PATIENTS A. Kurchenko1, G. Drannik1, R. Rehuretska1, L. DuBuske*,2, 1. Kiev, Ukraine; 2. Gardner, MA Introduction: Lichen planus (LP) is a chronic inflammatory autoimmune disease that affects oral mucous membranes and skin. Tumor necrosis factor-a (TNF-a) and Interleukin 22 (IL-22) in blood may impact disease progression in oral lichen planus. Methods: 97 patients aged 18 to 60 years were studied including 35 with erosive oral lichen planus, 32 with non-erosive oral lichen planus and 30 healthy control subjects of similar age. The levels of serum cytokines TNF-a, IL-22, were determined by enzyme-linked immunosorbent assay (“Immunotech”; France). Results: During relapse of erosive oral lichen planus there is change in select cytokines compared with control group levels including IL22 (36.2§4.1 pg/ml) being 9 - fold increased versus healthy controls (4.2§0.4 pg/ml) and TNF-a being 4.3- fold increased (0.3§1.6 pg/ml versus 1.3§1.2 pg/ml). In erosive chronic OLP there is an increase in IL-22 by 4.5 − fold (18.4§2.2 pg/ml), and an increase of TNF-a by 1.8fold (0.6§0.4 pg/ml) compared to healthy controls (4.2§0.4 pg/ml and 0.3§1.6 pg/ml, respectively). In chronic non-erosive oral lichen planus IL-22 was reduced 2.1- fold and TNF-a reduced 0.8- fold in comparison to OLP relapse (p<0.05). Conclusions: Acute relapse and chronic stages of lichen planus of the oral mucosa are characterized by immunological changes detectable in peripheral blood serum including increases in TNF-a and IL-22, characteristic of development of a recurrent inflammatory immune response and chronic persistent erosive disease.
P300 PREVALENCE AND PATTERNS OF FOOD ALLERGY AMONG SCHOOL CHILDREN OF EASTERN NORTH CAROLINA O. Taha*, A. Hamed, R. Ismail, Greenville, NC Introduction: Food allergy is a growing problem among children in U.S. schools. A significant proportion of them suffer from severe allergic reactions, which can be life threatening. Methods: We analyzed the most recent food allergy data (through July 2017) of 23674 students from Pre-K to 12th graders in 43 schools (23 elementary, 13 middle, 7 high schools) in Eastern North Carolina. We obtained this data from the school health program in Greenville, NC. We looked at the prevalence of physician diagnosed food allergy and its patterns amongst those students. Results: Number of students with physician diagnosed food allergy: 1506/23674 (6.36%). Peanut: 24.18%, Tree nut: 15.69%, Shellfish 10.65%, Egg 6.79%, Milk 6.38%, Fish 5.62%, Wheat 3.04%, Soy 2.57%, Other 25.05%. Number of students with multiple food allergies: 160/1506 (10.62%). Number of students with a history of severe reaction: 184/1506 (12.2%). Number of students who carry epinephrine: 233/1506 (15.5%). Number of students with Food Allergy Action Plan: 149/1506 (9.89%). Conclusions: The prevalence of food allergy was 6.36% in our cohort. Peanut, tree nut and shellfish were the most common triggering foods. Students with a history of severe food reactions make up 12.2% of those affected. The percentages of students who carry epinephrine and have food allergy action plans are very low, at less than 16% and 10% respectively. This reflects the need of more health education and community awareness to effectively plan for, recognize, and respond to an allergic reaction. Patterns of Food Allergy Among School Children of Eastern North Carolina
P263 ABNORMAL TREC RESULTS ON THE OHIO NEWBORN SCREEN IN CHILDREN WITH CARTILAGE-HAIR HYPOPLASIA D. Tapke*,1, B. Prince1, R. Hage1, R. Scherzer2, 1. Columbus, OH; 2. Blacklick, OH Introduction: While newborn screening (NBS) using T-cell receptor excision circle (TREC) analysis was introduced primarily to screen for severe combined immunodeficiency (SCID), it also identifies T-cell lymphopenia or low naive T-cell numbers due to other etiologies. Cartilage-hair hypoplasia (CHH) is an autosomal recessive disorder caused by mutations in the RMRP gene that result in short limbed skeletal dysplasia and a range of immunologic deficits involving both cellular and humoral immune function. The immune defect can range from minor abnormalities to a SCID phenotype. Methods: We analyzed the NBS TREC results performed in Ohio between July 2013 and July 2018. We reviewed the results of the immunologic workup in patients with abnormal TREC results who were later confirmed to have CHH. Results: A total of 693,706 unique infants had NBS performed between July 2013 and July 2018, with 192 (0.027%) having abnormal TREC results. Eight infants with abnormal TREC results were diagnosed with CHH. This included 6 cases of non-SCID T-cell
Abstracts: Poster Sessions / Ann Allergy Asthma Immunol 121 (2018) S22−S62
with CAP aged 19 to 38 years received treatment with rectal electrostimulation every other day for 10 sessions lasting 15 minutes each. Patients in Group 1 (n=42) additionally received oral Sertraline with an initial dose of 50 mg gradually increased to 200 mg for 1 month. Patients in Group 2 (n=39) received basic treatment only. Results: Both Groups 1 and Groups 2 after treatment had significant (p Conclusions: Greatest effectiveness occurred with rectal electrostimulation and anti-depressant treatment of CAP, including increases in anti- inflammatory cytokines, suggesting a link between depression and cytokine responses in CP/CPPS patients.
lymphopenia and 2 children with SCID phenotypes. In the children with abnormal screening and a diagnosis of CHH, the absolute CD4 lymphocyte counts on initial immunophenotyping ranged from 76 − 757 cells/mm3 (median = 552 cells/mm3). The two CHH patients with SCID received bone marrow transplants. Conclusions: CHH is a rare genetic disorder associated with widely varying levels of T-cell lymphopenia ranging from clinically insignificant to SCID. The T-cell lymphopenia may cause an abnormal result on the NBS TREC analysis, allowing for early diagnosis of a significant immunodeficiency and institution of life-saving therapies. Food Allergy
P262 ASSESSMENT OF SELECT SERUM CYTOKINES TNF-A AND IL-22 IN ORAL LICHEN PLANUS PATIENTS A. Kurchenko1, G. Drannik1, R. Rehuretska1, L. DuBuske*,2, 1. Kiev, Ukraine; 2. Gardner, MA Introduction: Lichen planus (LP) is a chronic inflammatory autoimmune disease that affects oral mucous membranes and skin. Tumor necrosis factor-a (TNF-a) and Interleukin 22 (IL-22) in blood may impact disease progression in oral lichen planus. Methods: 97 patients aged 18 to 60 years were studied including 35 with erosive oral lichen planus, 32 with non-erosive oral lichen planus and 30 healthy control subjects of similar age. The levels of serum cytokines TNF-a, IL-22, were determined by enzyme-linked immunosorbent assay (“Immunotech”; France). Results: During relapse of erosive oral lichen planus there is change in select cytokines compared with control group levels including IL22 (36.2§4.1 pg/ml) being 9 - fold increased versus healthy controls (4.2§0.4 pg/ml) and TNF-a being 4.3- fold increased (0.3§1.6 pg/ml versus 1.3§1.2 pg/ml). In erosive chronic OLP there is an increase in IL-22 by 4.5 − fold (18.4§2.2 pg/ml), and an increase of TNF-a by 1.8fold (0.6§0.4 pg/ml) compared to healthy controls (4.2§0.4 pg/ml and 0.3§1.6 pg/ml, respectively). In chronic non-erosive oral lichen planus IL-22 was reduced 2.1- fold and TNF-a reduced 0.8- fold in comparison to OLP relapse (p<0.05). Conclusions: Acute relapse and chronic stages of lichen planus of the oral mucosa are characterized by immunological changes detectable in peripheral blood serum including increases in TNF-a and IL-22, characteristic of development of a recurrent inflammatory immune response and chronic persistent erosive disease.
P300 PREVALENCE AND PATTERNS OF FOOD ALLERGY AMONG SCHOOL CHILDREN OF EASTERN NORTH CAROLINA O. Taha*, A. Hamed, R. Ismail, Greenville, NC Introduction: Food allergy is a growing problem among children in U.S. schools. A significant proportion of them suffer from severe allergic reactions, which can be life threatening. Methods: We analyzed the most recent food allergy data (through July 2017) of 23674 students from Pre-K to 12th graders in 43 schools (23 elementary, 13 middle, 7 high schools) in Eastern North Carolina. We obtained this data from the school health program in Greenville, NC. We looked at the prevalence of physician diagnosed food allergy and its patterns amongst those students. Results: Number of students with physician diagnosed food allergy: 1506/23674 (6.36%). Peanut: 24.18%, Tree nut: 15.69%, Shellfish 10.65%, Egg 6.79%, Milk 6.38%, Fish 5.62%, Wheat 3.04%, Soy 2.57%, Other 25.05%. Number of students with multiple food allergies: 160/1506 (10.62%). Number of students with a history of severe reaction: 184/1506 (12.2%). Number of students who carry epinephrine: 233/1506 (15.5%). Number of students with Food Allergy Action Plan: 149/1506 (9.89%). Conclusions: The prevalence of food allergy was 6.36% in our cohort. Peanut, tree nut and shellfish were the most common triggering foods. Students with a history of severe food reactions make up 12.2% of those affected. The percentages of students who carry epinephrine and have food allergy action plans are very low, at less than 16% and 10% respectively. This reflects the need of more health education and community awareness to effectively plan for, recognize, and respond to an allergic reaction. Patterns of Food Allergy Among School Children of Eastern North Carolina
P263 ABNORMAL TREC RESULTS ON THE OHIO NEWBORN SCREEN IN CHILDREN WITH CARTILAGE-HAIR HYPOPLASIA D. Tapke*,1, B. Prince1, R. Hage1, R. Scherzer2, 1. Columbus, OH; 2. Blacklick, OH Introduction: While newborn screening (NBS) using T-cell receptor excision circle (TREC) analysis was introduced primarily to screen for severe combined immunodeficiency (SCID), it also identifies T-cell lymphopenia or low naive T-cell numbers due to other etiologies. Cartilage-hair hypoplasia (CHH) is an autosomal recessive disorder caused by mutations in the RMRP gene that result in short limbed skeletal dysplasia and a range of immunologic deficits involving both cellular and humoral immune function. The immune defect can range from minor abnormalities to a SCID phenotype. Methods: We analyzed the NBS TREC results performed in Ohio between July 2013 and July 2018. We reviewed the results of the immunologic workup in patients with abnormal TREC results who were later confirmed to have CHH. Results: A total of 693,706 unique infants had NBS performed between July 2013 and July 2018, with 192 (0.027%) having abnormal TREC results. Eight infants with abnormal TREC results were diagnosed with CHH. This included 6 cases of non-SCID T-cell