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Basophil Activation Test Based on CD203c Expression in the Diagnosis of Fish Allergy
다카오후지사와 대한천식알레르기학회 2020 Allergy, Asthma & Immunology Research Vol.12 No.4
Purpose: The basophil activation test (BAT) has been reported to be useful for the diagnosis of various food allergies, such as allergy to peanut, but not to fish. This study aimed to evaluate the diagnostic performance of the BAT for fish allergy. Methods: We performed a retrospective review of patients with fish allergy who underwent the BAT using a panel of fish extracts (15 kinds) to examine the differential reactivity to several species of fish. The BAT score for each extract was expressed as the ratio of CD203chigh% with the extract to that with anti-IgE antibody. Clinical reactivity to each fish was confirmed by positive oral food challenge or a typical history of fish-induced immediate allergy symptoms. Receiver-operating-characteristic (ROC) analysis was performed to evaluate the diagnostic performance. Results: Fifty-one patients with fish allergy were analyzed. Using extracts of 15 species of fish, the BAT was performed a total of 184 times on the patients. Clinical allergy to each species of fish was confirmed in 90 (48.9%) of those tests. ROC analysis yielded high areas under the curve for the BAT scores for the 5 most common fish species (0.72–0.88). The diagnostic accuracy ranged from 0.74 to 0.86. Using a tentative cutoff value of 0.3 deduced from the ROC analyses of the 5 fish species, the accuracy for other fish allergic reactions was generally high (0.6–1.0), except the fish tested in a small number of patients. Conclusions: The BAT score based on CD203c expression may be useful for fish allergy diagnosis, especially since a large variety of fish can be tested by the BAT using fish extracts prepared by a simple method.
Montelukast Reduces Serum Levels of Eosinophil-Derived Neurotoxin in Preschool Asthma
김창근,Zak Callaway,박진성,Hisashi Nishimori,Tikatoshi Ogino,Mizuho Nagao,다카오후지사와 대한천식알레르기학회 2018 Allergy, Asthma & Immunology Research Vol.10 No.6
Purpose: Several markers for eosinophilic inflammation have been proposed to predictresponse to asthma treatment. However, definitive criteria for treatment decisions have notyet been established. We investigate a potentially useful relatively non-invasive biomarker,eosinophil-derived neurotoxin (EDN), to predict favorable responses to budesonide ormontelukast, common treatment for children with asthma. Methods: Young children (1 to 6 years old) were enrolled in this randomized, parallel,2-group, open-label trial. Criteria for eligibility included: 1) being symptomatic during therun-in period; and 2) having a serum EDN (sEDN) level ≥ 53 ng/mL, with positive specificimmunoglobulin E to house dust mite. Eligible patients were randomly placed into 2 groups:the BIS group received budesonide inhalation suspension (BIS) 0.5 mg once daily; the MONTgroup received montelukast 4 mg once daily. Ineligible patients were invited to receivemontelukast 4 mg once daily (OBS group). Treatment period was 12 weeks. Results: Asthma control days increased significantly in the BIS and MONT groups (P < 0.000)over the 12-week study period. There was no significant change in sEDN in the BIS group butthere was a significant decrease in the MONT group (P < 0.000). Patients in the OBS groupwith high EDN levels (> 53 ng/mL) showed a significant decrease due to MONT treatment(P = 0.023). Rescue medication usage significantly decreased in the BIS and MONT groups(P < 0.000). Conclusions: EDN is a useful relatively non-invasive biomarker for predicting responses tomontelukast and budesonide treatment of preschool children with beta2-agonist responsiverecurrent wheeze and multiple-trigger wheeze (Trial registry at UMIN Clinical Trials Registry,UMIN000008335).