Studies - House dust mite sensitivity is a factor in chronic urticaria

BACKGROUND: Chronic urticaria is one of the perplexing problems faced by clinicians. There are a few reports associating house dust mite sensitivity with chronic urticaria, based upon the patient\u2032s history as well as intradermal skin testing and in vitro analysis. AIMS: To investigate the possible association between house dust mite sensitivity and chronic urticaria. METHODS: In this case control study three groups of patients were enrolled. Group I: Chronic urticaria (73 subjects). Group II: Chronic urticaria with collateral allergic disorders (49 subjects). Group III: Normal subjects without chronic urticaria or other allergies (25 subjects). All the patients underwent skin prick testing with antigens of the house dust mite, Dermatophagoides pteronyssinus (DP) and Dermatophagoides farinae (DF), with positive and negative controls. RESULTS: Among the patients with chronic urticaria, 78/122 (64%) patients had skin sensitivity to house dust mites. Out of these, 39/73 (53%) had chronic urticaria alone and 39/49 (79%) had chronic urticaria with other associated allergies. Among the normal control subjects, 7/25(28%) reacted positively to house dust mites. CONCLUSION: This study suggests a possible association of house dust mite sensitivity with chronic urticaria

A preliminary study on the association of single nucleotide polymorphisms of interleukin 4 (IL4), IL13, IL4 receptor alpha (IL4Rα) & Toll-like receptor 4 (TLR4) genes with asthma in Indian adults

Background & objectives: Interleukin 4 (IL4) and IL13 genes are believed to be responsible for inflammation of the airways in asthmatics. These share a common receptor component called IL4Rα which is another potentially important candidate gene linked to asthma phenotypes. Another gene Toll-like receptor 4 (TLR4) might affect the incidence or progression of asthma through the expression of proinflammatory genes. Several single nucleotide polymorphisms (SNPs) in IL4, IL13, IL4Rα and TLR4 have been reported to be linked to asthma or related phenotypes in several ethnic populations using linkage studies and association studies. However, the results have not been consistent. We investigated five SNPs (C-589T and C-33T of IL4, G+2044A of IL13, A+1902G of IL4Rα, and A+896G of TLR4) in patients with adult onset asthma to evaluate their role in manifestation and severity of asthma. Methods: Adult (>18 yr of age) patients with asthma (n=100) and healthy controls (n=50) were included in the study. Genotyping was performed using sequenom MassARRAY technology. Results: The mutant alleles of the C-589T and C-33T SNPs in the promoter region of IL4 were present in 4 per cent patients with asthma but absent from the control group suggesting that the variations in IL4 may contribute to asthma occurrence. The SNPs of other genes were seen in both controls and patients. Interpretation & conclusions: The results suggest the possible association between the genetic distribution of C-589T and C-33T SNPs of IL4 with asthma in Indian adults

Association of socio-economic status with family history in adult patients with asthma

Background & Objectives: Socio-economic status is associated with increased morbidity in patients with asthma. The aim of the present study was to assess the association between socio-economic status and family history of asthma in adult asthma patients. Methods: The study included 200 adults with asthma and 400 non-asthmatic controls. Socio-economic status was determined based on income. Regression analysis was used to estimate odd ratios in relation to socio-economic class, using age, gender, family history of asthma and smoking habits. Results: The highest occurrence of having any family history of asthma was observed in the high class group (88.2%), followed by upper middle class (79.5%), lower middle class (60%) and the lowest in the low class group (34%). Having any family history of asthma was an important risk factor in both univariate and multivariate analyses in lower middle class, upper middle class and high class, but not in the low class group. Interpretation and Conclusions: The results indicated a positive association between having a family history of asthma and higher socio-economic status. Further studies on a large representative sample need to be conducted to confirm these findings

House dust mite sensitivity is a factor in chronic urticaria

BACKGROUND: Chronic urticaria is one of the perplexing problems faced by clinicians. There are a few reports associating house dust mite sensitivity with chronic urticaria, based upon the patient′s history as well as intradermal skin testing and in vitro analysis. AIMS: To investigate the possible association between house dust mite sensitivity and chronic urticaria. METHODS: In this case control study three groups of patients were enrolled. Group I: Chronic urticaria (73 subjects). Group II: Chronic urticaria with collateral allergic disorders (49 subjects). Group III: Normal subjects without chronic urticaria or other allergies (25 subjects). All the patients underwent skin prick testing with antigens of the house dust mite, Dermatophagoides pteronyssinus (DP) and Dermatophagoides farinae (DF), with positive and negative controls. RESULTS: Among the patients with chronic urticaria, 78/122 (64%) patients had skin sensitivity to house dust mites. Out of these, 39/73 (53%) had chronic urticaria alone and 39/49 (79%) had chronic urticaria with other associated allergies. Among the normal control subjects, 7/25(28%) reacted positively to house dust mites. CONCLUSION: This study suggests a possible association of house dust mite sensitivity with chronic urticaria

Allergic Disease Prevalence in School Children in Bengaluru, India: A Cross-Sectional Survey.

India is a Low-Middle Income Country (LMIC) with a population of ~1.3bn. It is the second most populous country comprising 20% of the global population. Whilst India has not faced an 'allergy epidemic' as in High Income Countries (HICs), there is some evidence that the burden of allergic diseases has gradually risen1, and is greatly magnified by the absolute numbers and is compounded by the unmet demand for allergy services2,3. Data regarding epidemiology, risk factors and natural course of allergic diseases in India are relatively sparse. By virtue of considerable diversity in culture, breast feeding, infections including parasitic, diet, environmental conditions such as weather, aero-allergens, and unacceptably high levels of particulate matter ≤2.5µm (PM ), India offers an invaluable platform to study immune-mediated diseases

Cluster analysis identifies distinct clinical phenotypes with poor treatment responsiveness in asthma.

Background: Treatment responsiveness, an important consideration in asthma management is different from asthma severity Objectives: Identify clinical phenotypes based on treatment responsiveness. Methodology: Retrospective study of 113 asthmatics on guideline based (GINA) treatment, minimum 6-month follow-up. Demographic characteristics, age at disease onset, disease duration, smoking and indoor air pollution, BMI, serial lung functions and allergen sensitization were collected. Treatment responsiveness was defined based on improvement in FEV1. R version 3.4.3 was used to perform statistical analysis. Ward’s minimum-variance hierarchical clustering method was performed using an agglomerative (bottom-up) approach and a dendrogram generated. To compare differences between clusters, analysis of variance using Kruskal-Wallis test (continuous variables) and chi-square test (categorical variables) was used. Results: Cluster analysis identified 4 different clusters. Cluster 1, largest cluster (N=40), is characterized by childhood onset of disease, normal weight, equal gender distribution and very high treatment responsiveness. Cluster 2, (N=16), adults (Mean age 41.7 years), more males, disease onset in adolescence, obese and poorly treatment responsive. Cluster 3 (N= 20), elderly (Mean age 61.2 years), more males, late onset of disease (Mean 51.9 years), obese and poorly treatment responsive. Cluster 4 (N=24), adults (mean age 38.5 years), predominantly female (75%), obese, onset of disease in adulthood (mean 31. 8 years) and highly treatment responsive. Conclusion: Cluster analysis identified 2 distinct clinical phenotypes who were poorly treatment responsive

Serum levels of interleukin-13 and interferon-gamma from adult patients with asthma in Mysore

Serum protein analysis for noninvasive quantification of airway inflammation in asthma is a promising research tool in the field of lung diseases. Cytokines are believed to have major role in inflammatory process of the airways of the lung. There is an imbalance between T-helper (Th)-2 cells, which secrete interleukin (IL)-4 and interleukin (IL)-13, and Th1 cells, which secrete interferon (IFN)-gamma in asthma. To test the hypothesis that serum IL-13 and IL-4 levels may be elevated whereas IFN-gamma would be decreased in this cohort of patients, a property that could make them possible candidate biomarkers in determining asthma occurrence and severity, we measured concentrations of IL-4, IL-13 and IFN-gamma in serum samples of 88 subjects (44 normal, 12 with mild asthma, 16 with moderate asthma, and 16 with severe asthma). Serum Levels of IL-4, IL-13, and IFN-gamma were determined by an enzyme-linked immune-sorbent assay (ELISA). Median serum level of IFN-gamma in asthmatic patients was 8.0pg/ml, while it was 11.4pg/ml in healthy controls. However, the difference was not significant. Among the different age groups in whom IFN-gamma was assessed, the highest median value in both cases and controls was observed in the age group of 31–40years. The median serum level of IL-13 was 40.0pg/ml in asthmatic patients and 58.25pg/ml in healthy controls. The difference was not significant. On subgroup analysis, no significant difference of IFN-gamma and IL-13 between asthma of different severities was observed. The study also revealed nonsignificant difference of serum cytokines with the duration of asthma, number of allergens, and severity of sensitization. Normal serum levels of IFN-gamma and IL-13 in asthmatic patients suggest their neutral role in the inflammatory process; however, more studies are required to establish the effect of these cytokines in adulthood asthma in different ethnic populations

Serum levels of IL-10, IL-17F and IL-33 in patients with asthma: a case–control study

AbstractObjectives: The development of inflammation in asthma involves an intricate network of cytokines that recruit and activate numerous immune cells. This study was aimed to compare serum levels of IL-10, IL-17F, and IL-33 in asthmatic patients and non-asthmatic controls and correlate cytokine levels to asthma severity and various clinical, spirometric, and laboratory variables. Methods: Using ELISA, serum levels of IL-10, IL-17F, and IL-33 were evaluated in 44 asthmatics (14 mild persistent, 15 moderate persistent, and 15 severe persistent) and 44 controls. Results: This is one of the first reports showing a significant difference in serum levels of asthma-associated cytokines, anti-inflammatory IL-10, and pro-inflammatory IL-17F and IL-33, in the same subset of asthmatic patients. Our results showed diminished level of IL-10 and elevated levels of IL-17F and IL-33 in asthmatics than in controls (p < 0.001). Assessment of cytokine levels between subjects of different gender, age group, and BMI showed non-significant differences. Correlation analysis of cytokine levels to clinical variables showed that IL-17F is associated negatively to FVC % predicted (forced vital capacity) and FEV1% predicted (forced expiratory volume in one second) and positively to number of allergens sensitized and FEV1 reversibility. A strong negative correlation was found between IL-10 and IL-33 levels (p = 0.001). Conclusions: Negative correlation between IL-10 and IL-33 levels may reflect a converse relationship between anti-inflammatory and pro-inflammatory cytokines in an individually balanced pattern. The association between IL-17F level and asthmatic phenotypes such as reduced FVC and FEV1, higher degree of sensitization, and post-bronchodilator reversibility needs further assessments

Serum levels of IL-10, IL-17F, and IL-33 in asthmatic patients of south India

Background: Asthma is an inflammatory disorder of the airways in which the development of inflammation involves an intricate network of cytokines. Objectives: This study was aimed to compare serum levels of IL-10, IL-17F and IL-33 in asthmatic patients and non-asthmatic controls and correlate with asthma severity and various demographic, clinical, spirometric and laboratory variables. Methods: Asthmatics were diagnosed and classified as mild, moderate and severe persistent asthma according to GINA guidelines. Age and gender-matched healthy controls were selected from the general population. Using ELISA (enzyme linked immunosorbent assay) method, serum levels of IL-10, IL-17F, and IL-33 were evaluated in 44 asthmatics and 44 non-asthmatic controls. Results: This is one of the first reports showing a significant difference in serum levels of three important cytokines associated with asthma, anti-inflammatory IL-10 and pro-inflammatory IL-17F and IL-33 in the same subset of asthmatic patients. Our results showed diminished level of IL-10 and elevated levels of IL-17F and IL-33 in asthmatics than in controls (p &#60; 0.001). No correlation was observed with most of the demographic, clinical and laboratory variables for the levels of all the three cytokines. IL-17F was associated negatively to FVC% predicted (Forced Vital Capacity) and positively to number of allergens sensitized and FEV1 (Forced Expiratory Volume in one second) reversibility. Conclusion: The association between IL-17F and asthmatic phenotypes such as asthmatics with reduced FVC, higher degree of sensitization and post bronchodilator reversibility needs further evaluation