egg-white and Asthma

The onset of asthma may be related to Th2 cytokine dominance at the time when food allergies occur several months after birth. This study investigated the effectiveness of early intervention with a Th2 cytokine inhibitor (suplatast tosilate) for prevention of asthma in infants with food allergies and atopic dermatitis. Suplatast tosilate dry syrup (6 mg/kg daily) or a histamine H(1)-blocker (ketotifen fumarate dry syrup: 0.06 mg/kg daily) was administered randomly to 53 infants with atopic dermatitis caused by food allergies. The primary endpoints were the incidence of asthma and the time to the onset of wheezing. The peripheral blood Th1/Th2 ratio, total IgE level, and eosinophil count were measured before and after treatment. After 24 months of treatment, the prevalence of asthma was significantly lower in the suplatast group (20.8%) than in the ketotifen group (65.6%, p < 0.01). Additionally, the time from the start of treatment to the initial episode of wheezing for infants who developed asthma was significantly longer in the suplatast group than the ketotifen group (p < 0.01). Furthermore, the eosinophil count was significantly decreased by suplatast treatment (p < 0.05), and there was a significant difference between the suplatast and ketotifen groups with respect to both the eosinophil count (p < 0.01) and the Th1/Th2 ratio (p < 0.05). The results of the present pilot study suggest that suplatast tosilate is useful for the primary prevention of wheezing and asthma in children.

Topics: Allergens; Animals; Anti-Allergic Agents; Arylsulfonates; Asthma; Chemoprevention; Dermatitis, Atopic; Egg White; Female; Food Hypersensitivity; Humans; Hypersensitivity, Immediate; Incidence; Infant; Ketotifen; Male; Milk; Pilot Projects; Respiratory Sounds; Sulfonium Compounds; Th1 Cells; Th2 Cells; Time Factors; Treatment Outcome

The current increase in the prevalence of food allergies appears to have several causes including better screening, improved diagnosis and changes in both the techniques used by food manufacturers and eating habits. Labial food challenge (LFC)is simple, rapid to perform and is associated with only low risks of systemic reaction. It is thus an appealing alternative to the oral food challenge (OFC) for pediatric use. We report a series of 202 LFC performed over two years in 142 children with food allergy suspected from the case history, positive skin prick tests and specific serum IgE assays: 156 LFC were positive; and 46 negative, followed by positive single-blind, placebo-controlled food challenges (SBPCFC). The foods provoking reactions were egg white (75 cases), peanut (60 cases), mustard (23 cases), cow's milk (13 cases), cod (8 cases), kiwi fruit, shrimp (4 cases each), chicken, peanut oil (3 cases each), hazel nuts (2 cases), and snails, apple, fennel, garlic, chilli peppers, pepper, and duck (1 case each). LFC positivity was mostly (89.7% of cases) manifested as a labial edema with contiguous urticaria. There were systemic reactions in 4.5% of cases: generalized urticaria, hoarseness and rapid-onset and generalized eczema. The 46 infants with negative LFC results had positive SBPCFC. The reactions were in 34 cases generalized urticaria, 10 cases asthma attacks, 2 cases early and generalized eczema, and in one case general anaphylactic shock. The sensitivity of the LFC was 77%. The LFC was easy to perform with children. Positive results indicate the presence of food allergy, but negative results require further investigations preferably double-blind, placebo-controlled food challenge (DBPCFC).

Topics: Administration, Oral; Adolescent; Anaphylaxis; Animals; Arachis; Asthma; Child; Child, Preschool; Dermatitis, Atopic; Egg White; Female; Fishes; Food; Food Hypersensitivity; Humans; Immunoglobulin E; Labial Frenum; Male; Milk; Mustard Plant; Plants, Medicinal; Skin Tests; Urticaria

Topics: Animals; Aspergillus fumigatus; Asthma; Candida albicans; Cats; Child; Child, Preschool; Cladosporium; Dermatitis, Atopic; Egg White; Female; Humans; Immunoglobulin E; Infant; Malassezia; Male

The aim of this study was to investigate the role of immunoglobulin E (IgE) in the late phase reaction (LPR) of murine experimental asthma. Our model consisted of an implant of DNP-conjugated, heat-coagulated hen's egg white (DNP-EWI), followed 14 days later by an intratracheal challenge with aggregated DNP-ovalbumin. Airway inflammation was analyzed 48 h after challenge and compared with a similarly immunized group of mice with highly suppressed humoral response due to anti-micro and anti-delta antibody treatment. Total number of cells in the bronchoalveolar lavage (BAL) (with predominance of eosinophils) and EPO activity in the lung homogenate were increased in the DNP-EWI-immunized group compared with immunosuppressed or nonimmunized mice. However, the cellular infiltration and EPO activity observed in the immunosuppressed group were still significantly above those obtained in the nonimmunized group, indicating that inhibition of antibody production did not completely prevent the inflammatory manifestations in BAL and lung. Airway hyperresponsiveness to methacoline was obtained in DNP-EWI-immunized mice, but the respiratory mechanical parameters returned to normal levels in the immunosuppressed group. When these mice were reconstituted with monoclonal anti-DNP antibodies, only IgE, but not IgG1, restored lung inflammation and decreased the conductance of the respiratory system, therefore, increasing hyperresponsiveness. These results indicate that antibodies are not essential for induction of LPR in the lung. However, IgE enhances pulmonary inflammation and hyperresponsiveness.

Topics: Animals; Antibody Formation; Asthma; Bronchial Hyperreactivity; Bronchoalveolar Lavage Fluid; Cell Count; Dinitrophenols; Egg White; Eosinophil Peroxidase; Eosinophils; Immunoglobulin E; Immunoglobulins; Inflammation; Male; Mice; Mice, Inbred BALB C; Ovalbumin; Peroxidases

Sensitization to aeroallergens is a major risk factor for asthma. Although patients frequently consider food ingestion as an asthma trigger, the relationship between serum food-specific IgE antibodies and childhood asthma in China remains unclear. We therefore conducted a case-control study on asthmatic children attending a university hospital-based outpatient clinic to investigate their pattern of food sensitization. Asthmatic patients underwent spirometric assessment, and peripheral blood was collected for serum-specific IgE antibodies to common food and inhalant allergens. Two hundred and thirty-one asthmatics (aged 9.3+/-4.3 years) and 79 age- and sex-matched controls were enrolled. The serum logarithmic total IgE concentrations in patients and controls were 2.49 and 1.92, respectively (p < 0.0001). Subjects with increased serum total IgE level were significantly more likely to have food sensitization than those with normal values (33% vs. 16%; p = 0.001). Twenty-nine (52%) of 56 asthmatics younger than 6 years old and seven (27%) of 26 age-matched controls hadfood-specific IgE in their sera (p = 0.035). Asthmatics with food-specific IgE also used more doses of as-needed bronchodilator weekly (p = 0.005). Nonetheless, no association was found between asthma diagnosis and sensitization to individual food allergens. Significant food sensitization, with food-specific IgE level above 95% predictive values for clinical food allergy as proposed by Sampson, was only found in two patients for peanut and three subjects for egg white. In conclusion, a significant association was found between asthma and the presence of food-specific IgE antibodies in young Chinese children. Significant sensitization to common foods is rare in this cohort.

Topics: Administration, Inhalation; Adolescent; Adrenal Cortex Hormones; Allergens; Antibody Specificity; Arachis; Asian People; Asthma; Case-Control Studies; Child; Child Welfare; Child, Preschool; Dose-Response Relationship, Immunologic; Egg White; Female; Food Hypersensitivity; Forced Expiratory Volume; Hong Kong; Humans; Immunization; Immunoglobulin E; Male; Milk Proteins; Predictive Value of Tests; Risk Factors; Severity of Illness Index

Topics: Allergens; Animals; Animals, Domestic; Asthma; Cats; Child, Preschool; Conjunctivitis, Allergic; Cross Reactions; Dermatitis, Atopic; Egg White; Food Hypersensitivity; Humans; Immunoglobulin E; Islam; Male; Meat; Radioallergosorbent Test; Skin Tests; Swine

One hundred and twenty five cases of atopic children such as atopic dermatitis and bronchial asthma were orally provocated with rare hen egg every 20 minutes one by one upto the whole amount. In one week observation 75 cases showed any symptoms of allergy including eruption and exacerbation of atopic eczema in an immediate, late, and/or delayed responses. Frequency of positive egg white-induce IL-2 responsiveness test in patients with positive oral provocation was 90.7% (68 out of 75 cases; sensitivity). That of negative test in patients with negative provocation was 84.0% (42 out of 50 cases; specificity). In contrast, specificity of IgE RAST for egg white were 88.0% comparable to the value of antigen-specific IL-2 responsiveness (AIR) test, but the specificity was lower value (37.3%) for screening the etiological antigens as compared to that of AIR test. High frequency of positive egg white-induced IL-2 responsiveness test was observed over an immediate, late and delayed responses, while low frequency of positive IgE RAST for hen egg was observed largely in patients showing delayed but not immediate response. The results indicate that IgE RAST in this study reflects IgE-mediated immediate type hypersensitivity, whereas AIR test reflects, in addition to immediate responses, late and delayed type hypersensitivity. The combined results suggest that AIR test in hen egg allergy is a useful method in vitro for both screening and determining etiological allergens, and might be able to substitute for provocation test in vivo for which many times, labours, expenses, and patients' risks are required, and to cover IgE RAST which fails to determine etiological allergens in 62.7% of patients with positive oral provocation.

Topics: Adolescent; Asthma; Child; Child, Preschool; Dermatitis, Atopic; Egg White; Female; Food Hypersensitivity; Humans; In Vitro Techniques; Infant; Interleukin-2; Lymphocyte Activation; Lymphocytes; Male; Ovum; Radioallergosorbent Test; Recombinant Proteins

A 26-year-old man employed in a company which manufactured hen egg white derived lysozyme for use in the pharmaceutical industry was evaluated for occupational asthma. The worker began to experience immediate-onset asthmatic symptoms two months after starting to work with egg lysozyme powder. The work process involved the production of approximately 1,000 kg of purified dried lysozyme powder per week. Prick skin testing was positive to egg lysozyme (50 mg/ml) and other egg protein components, but negative to whole egg white and egg yolk reagents. Serum specific IgE to egg lysozyme was documented. Decrements in serial peak expiratory flow rates were associated with lysozyme exposure at work. A specific bronchoprovocation challenge to lysozyme powder was positive demonstrating an isolated immediate asthmatic response (48 percent decrease from baseline FEV1). This is the first reported case of lysozyme-induced asthma specifically caused by inhalational exposure to egg lysozyme.

Topics: Adult; Asthma; Egg White; Enzyme-Linked Immunosorbent Assay; Food Handling; Forced Expiratory Volume; Humans; Immunoglobulin E; Male; Muramidase; Occupational Diseases; Skin Tests

The measurement of IgE and IgG4 antibodies against egg white, milk, soybean and Dermatophagoides farinae was performed by FAST (fluorescence allergosorbent test) using 21 serum samples obtained from non-allergic children and 160 serum samples from atopic children with bronchial asthma and/or atopic dermatitis. Their antibody levels were evaluated for any association with disease severity and for clinical significance in establishing diagnosis. It was found that children with bronchial asthma showed lower levels of IgE antibodies against egg white, milk and soybean and higher levels of IgE antibodies against Dermatophagoides farinae compared with those of children with atopic dermatitis, while both groups showed higher levels of egg white and milk-specific IgG4 antibodies compared with non-allergic children. These IgE and IgG4 antibody levels revealed a tendency to correlate with disease severity in patients with atopic dermatitis, while this was not observed in patients with bronchial asthma. The contribution percentages of IgG4 antibody determination, together with IgE antibody determination, in retrieving causal allergens were 71% for egg white, 70% for milk and 48% for soybean allergy, implying their diagnostic value in establishing clinical diagnosis.

Topics: Adolescent; Allergens; Animals; Antigens, Dermatophagoides; Asthma; Child; Child, Preschool; Dermatitis, Atopic; Egg White; Female; Glycine max; Humans; Immunoglobulin G; Infant; Male; Milk; Mites

We report on a patient with asthma induced by occupational exposure to egg used to spray cakes before baking. A type I hypersensitivity to egg white was demonstrated by means of skin test, immunoassay for specific IgE, and immediate bronchial provocation test response to an egg white extract.

Topics: Adult; Asthma; Egg White; Food Hypersensitivity; Humans; Male; Occupational Diseases

We investigated B cell stimulating activity in peripheral blood mononuclear cells from allergic children with positive IgE RAST score to egg white in order to study whether interleukin-4 (IL-4) was participating in production of IgE antibody. B cell stimulating activity in peripheral blood mononuclear cells from allergic children with positive IgE RAST score to egg white stimulated with ovalbumin (OVA) was higher than that observed in allergic children with negative IgE RAST score to egg white. In allergic children with positive IgE RAST score to egg white stimulated with OVA, B cell stimulating activity in peripheral blood mononuclear cells did not correlate each other; age, IgE RIST, IgE RAST score to egg white and IgG4 antibody to egg white. These results suggest that the production of B cell stimulating activity other than IL-4 may be involved in the patients with egg allergy.

Topics: Adolescent; Asthma; B-Lymphocytes; Child; Child, Preschool; Dermatitis, Atopic; Egg White; Female; Humans; Hypersensitivity; Infant; Leukocytes, Mononuclear; Lymphocyte Activation; Male; Radioallergosorbent Test

A long follow-up study revealed that convalescent stage children still have the potency to have an immediate type hypersensitivity reaction on exposure to mite antigen, with a high titer of mite specific IgE in their sera, but they are free from asthmatic attacks because of the reduction in the amount of mite antigen in the body, as shown by the reduction in the amount of mite specific IgG. We also made a prospective study to see whether early elimination of the allergen has any beneficial effect on the cessation of the development of allergic diathesis thereafter. Our study suggested that early elimination of food allergen in infancy not only improved clinical manifestations but also had a protective effect on the progression of the allergic march so far as production of reaginic antibodies was concerned: production of total IgE and mite specific IgE was kept to a minimum.

Topics: Adolescent; Adult; Allergens; Animals; Asthma; Child; Child, Preschool; Egg White; Food Hypersensitivity; Humans; Immunoglobulin E; Immunoglobulin G; Infant; Mites

Topics: Adolescent; Adult; Age Factors; Animals; Antibody Specificity; Asthma; Child; Child, Preschool; Egg White; Female; Food Hypersensitivity; Glycine max; Humans; Immunoglobulin E; Immunoglobulin G; Infant; Male; Milk; Radioallergosorbent Test

Topics: Adolescent; Adult; Asthma; Egg White; Food Hypersensitivity; Humans; Middle Aged; Ovalbumin

Various clinical features of eighty-four atopic patients, with clinical hypersensitivity to egg and positive RAST to egg white, were studied. Some of the clinical data were compared with data from a control group of atopic patients without egg allergy. Atopic diseases and certain food allergies in the families of the egg-allergic patients and atopic controls were also studied. This was done in order to investigate the extent to which differences between the egg allergy group and the atopic control group were reflected in their respective families.

Topics: Adolescent; Animals; Asthma; Breast Feeding; Cattle; Child; Child, Preschool; Dermatitis, Atopic; Egg White; Fish Products; Food Hypersensitivity; Humans; Hypersensitivity, Immediate; Immunoglobulin E; Infant; Milk; Radioallergosorbent Test; Skin Tests; Urticaria

Eighty-two children with food sensitivity were followed-up for 2-5 years. Most children showed a decreasing sensitivity and the clinical course of food allergy seemed to reflect the course of the humoral immune responses to the offending foods. The occurrence of IgE- and IgG-antibodies paralleled in most cases. However, an early, high IgG/IgE food antibody ratio seemed to be a good prognostic sign, indicating a possible blocking capacity of IgG-antibodies.

Topics: Adolescent; Animals; Asthma; Cattle; Child; Child, Preschool; Conjunctivitis; Eczema; Egg White; Fishes; Follow-Up Studies; Food Hypersensitivity; Humans; Immune Tolerance; Immunoglobulin E; Immunoglobulin G; Immunoglobulins; Lactoglobulins; Milk; Ovomucin; Rhinitis

Three hundred and twenty-two children under one year of age with respiratory allergy and negative inhalant skin tests were placed on a six-week hypoallergenic diet consisting of Meat Base Formula, beef, carrots, broccoli and apricots. Two hundred and ninety-two or 91% showed significant improvement of respiratory symptom scores during the trial. On subsequent oral food challenge symptoms were reproduced in only 51% of the children. Milk greater than egg greater than chocolate greater than soy greater than legumes greater than cereals were most commonly involved. Skin tests with food allergens rarely correlated with challenge results. One hundred and seventeen or 40% later developed inhalant respiratory allergy. Only 6% of the children studied five years or longer showed any evidence of food sensitivity. The data suggest (1) infants with respiratory allergy will respond to hypoallergenic diet, (2) symptoms may or may not reappear on food challenge, (3) food allergy tends to be "outgrown" and (4) many "grow into" inhalant respiratory allergy.

Topics: Animals; Asthma; Cacao; Cattle; Egg White; Follow-Up Studies; Food Hypersensitivity; Glycine max; Humans; Infant; Milk; Rhinitis

Prick tests to milk and egg white were compared to clinical histories of sensitivity to these foods. Seventeen RAST-positive versus 17 RAST-negative controls were used. All 34 children and young adults were selected because they had atopic respiratory and/or dermal manifestations. Atopic eczema manifestations were present in 11 of the RAST-postive subjects and in two of the controls. Of these, nine had past history of egg white intolerance. Egg white challenge was associated with dermal reactions as follows: eczema in two, urticaria in two and angioedema in two. Positive clinical histories compared favorably (p less than 0.001) with prick tests for egg white but poorly (p greater than 0.05) for milk. Similarly, positive clinical histories compared significantly (p less than 0.001) with RAST for egg white but poorly (p greater than 0.05) for milk.

Topics: Adolescent; Adult; Allergens; Animals; Asthma; Cattle; Child; Eczema; Egg White; Female; Humans; Hypersensitivity; Immunoglobulin E; Male; Medical History Taking; Milk; Radioallergosorbent Test; Rhinitis, Allergic, Seasonal; Skin Tests; Time Factors

The diagnostic reliability in food allergy of skin prick tests (SPT) and the radio-allergosorbent test (RAST) was investigated in paediatric patients with respiratory and skin allergies. SPT and RAST were found to be reliable for the diagnosis of allergy to codfish, peas, nuts, peanuts and egg white. Positive SPT and RAST to cereals were common, but were most often without clinical significance or were correlated with respiratory allergy to the inhalation of flour dust. SPT and RAST were only partly reliable with regard to allergy to cow's milk, and were mostly reliable when used together and showing corresponding results. Experimental allergosorbents for RAST with soy beans and white beans were not reliable. The study shows the need to improve the diagnostic materials and to establish the diagnostic reliability of the material and tests used for each food item in question.

Topics: Adolescent; Animals; Arachis; Asthma; Child; Child, Preschool; Eczema; Edible Grain; Egg White; Fabaceae; Food Hypersensitivity; Humans; Infant; Milk; Nuts; Plants, Medicinal; Radioallergosorbent Test; Skin Tests

Eighty-eight asthmatic children aged six to 16 years received monovalent influenza A/New Jersey/76 virus vaccines. Forty-one of these children were given skin tests for allergy to eggs and vaccines, and 57 were given pulmonary function tests before and after immunization. Only four children reacted to the vaccines in the skin tests, with three of these children reacting to only one of four test preparations. Only two of the four children showed a correlation between reactivity to vaccine and allergy to egg antigens. No significant changes in pulmonary function were demonstrated.

Topics: Adolescent; Asthma; Child; Egg White; Forced Expiratory Volume; Humans; Hypersensitivity; Influenza A virus; Influenza Vaccines; Maximal Midexpiratory Flow Rate; New Jersey; Ovalbumin; Respiratory Function Tests; Skin Tests

Topics: Adolescent; Asthma; Child; Child, Preschool; Dermatitis, Atopic; Egg White; Female; Food Hypersensitivity; Humans; Immunoglobulin E; Infant; Male; Radioimmunoassay; Skin Tests

Topics: Allergens; Animals; Antibodies; Asthma; Cats; Child; Child, Preschool; Dogs; Dust; Eczema; Egg White; Female; Fishes; Follow-Up Studies; Horses; Humans; Immunoglobulin E; Infant; Male; Milk; Pollen; Radioimmunoassay; Rhinitis, Allergic, Seasonal; Skin Tests; Urticaria

Topics: Animals; Antibodies; Antibody Formation; Antigens; Asthma; Egg White; gamma-Globulins; Genes; Histocompatibility; Hypersensitivity; Immunization; Immunogenetics; Immunoglobulin E; Immunoglobulin G; Mice; Models, Biological; Penicillin G; Rhinitis, Allergic, Seasonal

Topics: Agar; Allergens; Asthma; Chromatography; Chymotrypsin; Dermatitis, Atopic; Egg White; Electrophoresis; Gels; Glycoproteins; Hexosamines; Hexoses; Humans; Immune Sera; Immunochemistry; Immunoelectrophoresis; Muramidase; Neuraminic Acids; Ovalbumin; Proteins; Rhinitis, Allergic, Seasonal; Skin Tests; Starch; Trypsin; Trypsin Inhibitors

Topics: Asthma; Egg White; Humans; Respiratory Function Tests