Roberta Alesina

Variations in serum levels of interleukin (IL)-1β, IL-2, IL-6, and tumor necrosis factor-α during specific immunotherapy

Background Cytokine production by T helper cells is essential for the induction and maintenance of allergic inflammation in the bronchial mucosa. According to recent views, specific immunotherapy (SIT) favors the differentiation of T lymphocytes into cells of the Th1 rather than those of the Th2 subset. Objective To determine whether or not SIT induces a decrease in the inflammatory reaction by studying eventual variations in the serum levels of IL-1β, IL-2, IL-6, and TNF-α in allergic subjects during SIT. Methods Serum levels of IL-1β, IL-2, IL-6, and TNF-α were determined before and after 3, 6, and 9 months of SIT by an immunoradiometric assay (IRMA) in 11 adults with perennial allergic asthma and/or rhinitis caused by house dust mites and in 6 nonatopic healthy volunteers. Results Median serum IL-1β and TNF-α levels of the patients were significantly higher at baseline than those of the controls and decreased during SIT to values similar to or lower ( P r ) of the serum levels of IL-1β, IL-6, and TNF-α versus duration of SIT were negative, while that of IL-2 was positive. Conclusions Decreases in median serum IL-1β and TNF-α levels during SIT, together with the increases in serum IL-2 and IL-6, compared with those of the controls furnish evidence supporting a reduction in the inflammatory response in the course of SIT.

Serum IgE discriminates allergy from sensitisation better than skin testing

Protection of human and animal subjects. The authors declare that the procedures followed were in accordance with the regulations of the responsible Clinical Research Ethics Committee and in accordance with those of the World Medical Association and the Helsinki Declaration. 2. Juniper EF, Thompson AK, Ferrie PJ, Roberts JN. Validation of a standardised version of the Rhinoconjunctivitis Quality of Life Questionnaire. J Allergy Clin Immuno. 1999;104:364--9. 3. Juniper EF, Buist AS, Cox FM, Ferrie PJ, King DR. Validation of a standardised version of the Asthma Quality of Life Questionnaire. Chest. 1999;115:1265--70. 4. Dokic D, Schnitker J, Narkus A, Cromwell O, Frank E. Clinical effects of specific immunotherapy: a two-year double-blind, placebo-controlled study with a one year follow-up. Prilozi. 2005;26:113--29. 5. Zielen S, Kardos P, Madonini E. Steroid-sparing effects with allergen-specific immunotherapy in children with asthma: a randomized controlled trial. J Allergy Clin Immunol. 2010;126:942--9. 6. Soler R, De la Hoz B, Badia X, Mercadal J, Lozano R, Benavides A, et al. Validación de la versión española del cuestionario de

Component-Resolved Diagnosis for Phleum Allergy: The Role of Recombinants

Background. Conventional diagnostic tests (such as radioallergosorbent test [RAST] and skin prick test [SPT]) use native raw pollen allergen extracts to establish allergy. However, recombinant allergens may offer important advantages compared with their natural counterparts. Objective. This study evaluated serum immunoglobulin E (IgE) in patients with grass-induced allergic rhinitis (AR) or AR with asthma (ARA), comparing assays with natural or recombinant grass allergens. Methods. Sixty patients (33 AR, 27 ARA) positive with SPT and serum IgE for Phleum pratense were enrolled in the study. Serum IgE specific for conventional and recombinant Phleum pratense: rPhl p 1, rPhl p 2, nPhl p 4, rPhl 5b, rPhl p 6, rPhl p 7, rPhl p 11, rPhl p 12, were measured by the IFMA procedure (ImmunoCAP, Phadia, Uppsala, Sweden). Data were expressed as the median (md) and percentiles. Recombinant allergen results were expressed also as the percentage of positive concentrations. The Wilcoxon test was used to compare samples. Because diagnosis is a binary variable (AR/ARA), logistic regression analysis was performed to identify possible correlates. Results. IgE concentrations assessed with recombinant allergens were significantly higher in ARA patients (p = .05) than in AR patients. A value >5.8 kU/L is the optimal cut-off to discriminate AR and ARA patients. Model specificity was 76%, sensitivity 78%, and efficiency 77%. Conclusion. This study shows that IgEs for natural and recombinant grass pollen allergens are significantly higher in patients with AR and asthma. Moreover, using recombinant allergens it is possible to define a prediction model for diagnosis with 77% efficiency. Therefore, this study may suggest that there are advantages of using recombinant or purified, native allergens over crude extracts.

Prediction of allergy by total serum IgE measurements in infancy: A 10-year follow-up

Asthma, allergic rhinitis and atopic dermatitis are multifactorial disorders influenced by various familial and environmental factors. Cord blood IgE levels may be predictive for subsequent allergy onset. Serum IgE assessment has been rarely investigated. This study is aimed at evaluating serum IgE levels during the first year of life and relating to subsequent allergies. Total serum IgE levels were assessed in 102 newborns in the first days of life (2–3) and then again at 3, 5, 6, 11 and 12 months of age. After ten years, paediatricians and general practitioners caring for these children were tracked through the Local Healthcare Agency (LHA) database and asked about possible allergy of their patients, including transient ones. F Serum IgE increased in allergic infants at 1 year of life. The predictive model was significant. In conclusion, this study demonstrates that serum IgE may be predictive of subsequent allergy onset, preferably if assessed at 1 year of age.

Increased Serum Inflammatory Markers as Predictors of Airway Obstruction

Recruitment and activation of both neutrophils and eosinophils seem to be a characteristic of chronic bronchitis. The purpose of this study was to evaluate whether eosinophil cationic protein and/or myeloperoxidase (ECP/MPO) serum levels differ between patients with chronic obstructive and nonobstructive bronchitis during an exacerbation-free period and if they represent clinical gravity indicators of disease. To identify a correlation between ECP/MPO values in serum and bronco-obstruction, a statistical analysis by logistic regression was used. Study results show that there is a relationship between increased serum levels of ECP and log MPO and an increased risk for forced expiratory volume in 1 second (FEV1) pathologic values associated with obstructive chronic bronchitis, with an ECP odds ratio = 1.04 and logMPO = 4.45.