Allergy-immunology glossary

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Wheat allergy

Food allergy is a growing health problem which emerged as the “second wave” of the allergy epidemic, lagging decades behind the ‘first wave’ of asthma, allergic rhinitis and inhalant sensitization.1 Data on challenge-diagnosed FA in some countries (e.g. China and Africa) show rising rates that became similar to those in Western countries.2 A report from US Centers for Disease Control and Prevention (CDC) indicated that among children aged 0–17 years, the prevalence of food allergies increased from 3.4% in 1997–1999 to 5.1% in 2009–2011, a 50% rise.3 About 6% of children experience food allergic reactions in the first three years of life, including approximately 2.5% with cow’s milk allergy, 1.5% with egg allergy, and 1% with peanut allergy.4 Wheat is one of the five most common foods that trigger allergic reactions in children.

IL-13 R130Q single nucleotide polymorphism in asthmatic Egyptian children

Background: Asthma and its associated phenotypes are under a substantial degree of genetic control. The common variant IL-13 gene polymorphism R130Q is reported to be associated with the risk of development of asthma in some populations. Objective: We sought to study the association of IL-13 genetic variant R130Q with bronchial asthma in Egyptian children and its relation to various clinical and laboratory phenotypes of the disease. Methods: IL13 gene polymorphism (R130Q) was detected by PCR amplification followed by sequencing using pure script total DNA in 20 asthmatic patients in acute exacerbation. The results were compared to 20 healthy age and sex matched children. Results: Asthmatic children had significantly higher frequency of distribution of R130Q genotype (50%) than controls (15%). The serum total IgE as percent of high normal for age was significantly higher in asthmatic patients as compared to controls with a mean of 208.77 ±237.06% and 14.21 ± 8.08% respectively. No significant difference was observed in the mean AEC(as a percent of high normal for age) of both groups (80.85 ± 116.4% and 82.50 ± 81.4% respectively). No significant differences were observed between patients with IL-13 polymorphism R130Q and those without such polymorphism as regards family history, relation of exacerbations to upper respiratory tract infections, history of food allergy or asthma grading. Serum total IgE was significantly higher in asthmatics with GA genotype as compared to those with GG genotype with a mean of 373.25 ± 238.11% and 44.28 ± 42.65% respectively. A similar finding was also observed among the control group with a mean of 28.03 ± 9.12% and 11.77 ± 5.00% respectively. Finally a significantly higher AEC was observed in controls with GA as compared to GG genotype with a mean of 250.00 ± 51.96% versus 52.94 ± 36.87% respectively. Conclusion: The common variant IL-13 gene polymorphism R130Q is frequently associated with pediatric asthma. This variant is more active than the wild type in inducing allergic inflammation as reflected by the higher serum total IgE and AEC. Hence, IL-13R130Q may be candidate for future gene therapy targeted at reducing the ill-effects of this polymorphism.Keywords: IL-13R130Q – bronchial asthma - pediatricsEgypt J Pediatr Allergy Immunol 2010;8(1):9-1

Allergen-specific immunotherapy in children

Egypt J Pediatr Allergy Immunol 2012;10(2):55-6

Real-Time PCR in the early detection of invasive fungal infection in immunodeficient infants and children

Background: Crucial to the diagnosis and effective therapy of invasive fungal infection (IFI) in the immunodeficient is the early identification of the causative agent especially in patients who lack clinical evidence of the disease. The standard methods for the detection of fungi in clinical specimens are direct microscopy and mycological culture. Microscopy often lacks a satisfactory sensitivity, whereas diagnosis by mycological culture often requires a long growth period. Studies have demonstrated the feasibility of detecting molds and yeast in a single reaction using the universal fungal primer. Objective: Evaluation of the role of real-time PCR in the early detection of fungal infection in immunodeficient patients with suspected IFI, who lack clinical evidence of the disease. Methods: This study included 30 immunodeficiency patients suspected of having IFI; 9 with primary and 21 with secondary immunodeficiency. All patients had at least one host factor, but no clinical criteria according to the EORTC-MSG definition of IFI. Twenty seven had fever and 3 had bronchopneumonia, both not responding to broad spectrum antibiotics for 96 hrs. or more. Blood samples were cultured for fungi and were analyzed with real-time PCR using universal fungal primers. For positive samples of fungal infection, aspergillus-specific primers were used for detection of aspergillus. Results: Seventeen patients (56.7%) proved to have IFI. Blood culture detected Candida in 2 patients only, while PCR detected Candida in another 9 and Aspergillus in 6, thus 15/17 patients with IFI (88%) were missed by blood culture. Blood culture for IFI diagnosis had a very low sensitivity (12%) but had a 100% specificity and positive predictive value. The results PCR did not vary with gender, degree of fever, immunodeficiency type, clinical presentation or current intake of antifungal treatment. Patients with proven IFI showed significantly increased CRP levels as compared to those without infection. Conclusion: Real-time PCR proved superior to culture in early diagnosis of IFI in patients with immunodeficiency before the appearance of the characteristic clinical and imaging signs. Reliance on blood culture alone at that stage would result in missing most of the positive cases with consequent delay in the initiation of specific treatment. Keywords: Invasive fungal infection, immunodeficiency, blood culture, real-time PCR, candida, aspergillusEgypt J Pediatr Allergy Immunol 2012;10(2):67-7

Serum transforming growth factor-beta1 in asthmatic children

Background: Transforming growth factor-beta1 is a multifunctional cytokine which has been linked to the pathogenesis of subepithelial fibrosis and airway wall remodeling in bronchial asthma. Objective: To outline the changes in serum TGF-beta1 in children with bronchial asthma in relation to severity of asthma and different treatment modalities. Methods: Twenty-three children with bronchial asthma recruited from the Pediatric Allergy and Immunology Clinic of Ain Shams University Children’s Hospital were enrolled in the study as well as 29 healthy controls. Asthmatic children were classified according to severity into two groups; the mild asthma group which included 12 children, 4 with mild intermittent and 8 with mild persistent asthma (none received steroid therapy), and the severe persistent asthma group which included 11 children (all were on steroid therapy). All patients were subjected to clinical evaluation and laboratory investigations including absolute eosinophilic count (AEC), total serum IgE% and biologically active serum TGF-beta1 by ELISA technique. All patients were studied during acute asthma exacerbations. Reevaluation during steady state asthma was carried out for 8 patients with mild persistent asthma and 9 with severe persistent asthma. Results: During acute asthma exacerbations, the mean serum TGF-beta1 was significantly elevated in mild asthma (77.04 ± 57.04 ng/ml) compared to controls (21.81 ± 22.09 ng/ml). However for severe persistent asthma , the mean serum TGF-beta1 was significantly lower (4.23 ± 0.85 ng/ml) than in controls. Comparison of paired observations of serum TGF-beta1 revealed a significant drop, during steady state, in patients with mild asthma, whereas in severe asthma, a significant rise was observed. The levels of both asthma groups during steady state were comparable to the control values. A positive correlation, of borderline significance, between serum TGF-beta1 and total serum IgE% was observed among mild asthamtics during acute exacerbations (r = 0.55). Conclusion: The behavior of serum TGF-beta1 in acute asthma exacerbations depends on asthma severity and is perhaps related to steroid inhalation therapy. The tendency towards normality of serum TGF-beta1 in steady state asthma is possibly a good prognostic sign.Keywords: TGF-beta1, bronchial asthma, children, remodelingEgypt J Pediatr Allergy Immunol 2004; 2(1): 46-5

Impact of copeptin on diagnosis of acute coronary syndrome

AbstractBackgroundAcute coronary syndrome remains the principal cause of death, so the early diagnosis is of great importance. Cardiac troponin is the preferred biomarker for acute myocardial infarction. Cardiac chest pain immediately increased copeptin secretion. The combination of copeptin and cardiac troponin I is being suggested for early diagnosis of acute coronary syndrome.SubjectIt was done to emphasize the importance of association of copeptin, cardiac troponin I and high sensitive C reactive protein to confirm the diagnosis of acute myocardial infarction or unstable angina pectoris in patients with a cardiac chest pain.MethodThe current study enrolled 22 patients with acute myocardial infarction as group i and 33 patients with unstable angina pectoris as group ii. The third group consisted of 23 apparently healthy persons. Patients and controls were subjecting to laboratory investigations, which include the levels of copeptin, high-sensitivity cardiac troponin high sensitive C reactive protein creatine kinase MB fraction, lipid and I profile.ResultsWe found a significant increase of copeptin in group i when compared to group iii (30.01±12.92) (9.54±3.55), respectively, p value=0.000 and group ii (30.01±12.92) (11.16±4.58) respectively, p value 0.000, but a non-significant difference in group ii when compared to group iii (11.16±4.58) (9.54±3.55) respectively, p value=0.160. Also cardiac troponin I showed a significant increase in group i when compared to group ii (136.73±26.07) (11.18±3.79), p value=0.000, and group iii (136.73±26.07) (9.61±3.70) respectively, p value=0.000, but a non-significant difference between group ii (11.18±3.79), and group iii (9.61±3.70), p value=0.129. There was a positive correlation between copeptin and cardiac troponin I within group i, r=0.718, p value=0.000.ConclusionIn suspected acute coronary syndrome, determination of copeptin and cardiac troponin I provides a remarkable negative predictive value, which aids in early and safe ruling out of myocardial infarction

Protective effect of zinc against cadmium toxicity on pregnant rats and their fetuses at morphological, physiological and molecular level

Cadmium is a potent teratogen in laboratory animals, causing exencephaly when administered at early stages of development. Due to its heterogenicity with respect to molecular targets, the mechanisms behind cadmium toxicity are not well understood. In the present study, 40 pregnant rats (Sprague-Dawley) were divided into four groups (10 each); first group served as the control (G1), the second group (G2) received 61.3 mg/kg cadmium chloride daily from 7th to 16th day of gestation (organogenesis period) by oral tube. Group 3 (G3) was administrated a solution of 25 mg/kg zinc chloride orally from the 1st day to 20th day of pregnancy. Group 4 were administrated a solution of cadmium chloride (61.3 mg/kg) and zinc chloride (25 mg /kg) daily from the 7th to16th day of gestation. Maternal body weights were measured on gestational day 0, 6, 9, 12, 15 and 20. At the 20th day of gestation, blood samples were collected from the eye, using orbital sinus technique. Serum aspartate transaminase (AST) and alanine transaminase (ALT) were determined calorimetrically and serum, urea and creatinine were determined. All of the pregnant rats were sacrificed by ether anaesthesia at the 20th day of gestation and foetuses were removed from the uterus. The implantation sites, corpora lutea, living, dead and reabsorbed foetuses were counted and recorded. Liver of pregnant rats and their fetuses were used to isolate a total RNA for quantification of Msx1, Cx43, Bcl2 and Bax genes. The results show the toxic effect of Cd on the pregnant rats and their fetuses, at morphological, physiological and molecular level but, zinc has a very effective protection against cadmium-induced developmental toxicity.Keywords: Cadmium, zinc, rat, organogenesis, gene expressionAfrican Journal of Biotechnology Vol. 12(16), pp. 2110-211

High resolution computed tomography and pulmonary function tests in childhood systemic lupus erythematosus and juvenile rheumatoid arthritis

Background: Alveolar and airway injury represent one of the most common features of rheumatological diseases and is believed to have a significant impact on the course of these diseases. Objective: This work aimed at evaluating airway and alveolar involvement in children with systemic lupus erythematosus (SLE) and juvenile rheumatoid arthritis (JRA). Methods: Thirty four children (21 with SLE and 13 with JRA) were assessed by pulmonary function tests (PFTs) namely spirometry and carbon monoxide diffusion capacity (DLCO) in comparison to 10 healthy controls, as well as by plain roentgenography and high resolution computed tomography (HRCT) of the chest. Results: The studied patients had significantly lower mean PFT values as compared to controls. A restrictive pattern of PFTs was more common as it was detected in 62% of patients with SLE and 23% of those with JRA whereas an obstructive pattern was detected in 14% and 8% respectively. Significantly lower FEF 25-75% values were detected in symptomatic patients. Low values of DLCO (less than 80% of predicted) were recorded in 60% of the studied patients. Chest HRCT was abnormal in 68% of studied patients. In SLE, ground glass appearance and pleural irregularity were the most common findings whereas in JRA, bronchial wall thickening, mosaic appearance and air trapping were prominent. Abnormal findings were detected in 5/9 of asymptomatic patients. Conclusion: airway and alveolar abnormalities are frequently encountered in children with SLE (95%) and JRA (85%) even if they are asymptomatic. HRCT and pulmonary function tests including diffusion studies are recommended as useful tools for the diagnosis and early detection of pulmonary involvement in these patients.Keywords: JRA, SLE, HRCT, PFTs, DLCOEgypt J Pediatr Allergy Immunol 2004; 2(1): 8-1

Anti-Obesity Evaluation of Averrhoa carambola L. Leaves and Assessment of Its Polyphenols as Potential α-Glucosidase Inhibitors

Averrhoa carambola L. is reported for its anti-obese and anti-diabetic activities. The present study aimed to investigate its aqueous methanol leaf extract (CLL) in vivo anti-obese activity along with the isolation and identification of bioactive compounds and their in vitro α-glucosidase inhibition assessment. CLL improved all obesity complications and exhibited significant activity in an obese rat model. Fourteen compounds, including four flavone glycosides (1–4) and ten dihydrochalcone glycosides (5–12), were isolated and identified using spectroscopic techniques. New compounds identified in planta included (1) apigenin 6-C-(2-deoxy-β-D-galactopyranoside)-7-O-β-D-quinovopyranoside, (8) phloretin 3′-C-(2-O-(E)-cinnamoyl-3-O-β-D-fucopyranosyl-4-O-acetyl)-β-D-fucopyranosyl-6′-O-β-D fucopyranosyl-(1/2)-α-L arabinofuranoside, (11a) phloretin3′-C-(2-O-(E)-p-coumaroyl-3-O-β-D-fucosyl-4-O-acetyl)-β-D-fucosyl-6′-O-(2-O-β-D-fucosyl)-α-L-arabinofuranoside, (11b) phloretin3′-C-(2-O-(Z)-p-coumaroyl-3-O-β-D-fucosyl-4-O-acetyl)-β-D-fucosyl-6′-O-(2-O-β-D-fucosyl)-α-L-arabinofuranoside. Carambolaside M (5), carambolaside Ia (6), carambolaside J (7), carambolaside I (9), carambolaside P (10a), carambolaside O (10b), and carambolaside Q (12), which are reported for the first time from A. carambola L. leaves, whereas luteolin 6-C-α-L-rhamnopyranosyl-(1-2)-β-D-fucopyranoside (2), apigenin 6-C-β-D-galactopyranoside (3), and apigenin 6-C-α-L-rhamnopyranosyl-(1-2)-β-L-fucopyranoside (4) are isolated for the first time from Family. Oxalidaceae. In vitro α-glucosidase inhibitory activity revealed the potential efficacy of flavone glycosides, viz., 1, 2, 3, and 4 as antidiabetic agents. In contrast, dihydrochalcone glycosides (5–11) showed weak activity, except for compound 12, which showed relatively strong activity