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        Agreement Between Predictive, Allergen-Specific IgE Values Assessed by ImmunoCAP and IMMULITE 2000 3gAllergy™ Assay Systems for Milk and Wheat Allergies

        Al Hawi Yasmeen,Nagao Mizuho,Furuya Kanae,Sato Yasunori,Ito Setsuko,Hori Hiroki,Hirayama Masahiro,Fujisawa Takao 대한천식알레르기학회 2021 Allergy, Asthma & Immunology Research Vol.13 No.1

        Purpose: ImmunoCAP® (ImmunoCAP) and IMMULITE® 2000 3gAllergy™ (3gAllergy) systems are major quantitative allergen-specific immunoglobulin E (sIgE) assay methods. Due to the heterogeneous nature of allergenic extracts and differences in the assay format, quantitation of allergen-sIgEs is not expected to correlate well between different methods. However, we have recently reported good agreement between the methods in the diagnosis of egg allergy. This study aimed to determine and correlate the predictive values of sIgE by the two systems in the diagnosis of milk and wheat allergies. Methods: Children who had undergone oral food challenge (OFC) for the diagnosis of milk and wheat allergies were enrolled. The OFCs were performed to diagnose either true allergy in the 1-year-old group (A) or tolerance in the 2- to 6-year-old group (B). Milk, casein and β-lactoglobulin, and wheat and ω-5 gliadin sIgE values were measured using the 2 systems. The predictive accuracy of each sIgE for the OFC outcome was assessed using receiver operating characteristic (ROC) curves. The probability of a positive OFC outcome was estimated by logistic regression analysis. Results: A total of 395 patients were recruited from 7 primary care clinics and 19 hospitals in Japan. Milk and wheat OFCs were performed for 87 and 102 group A patients, and 124 and 82 group B patients, respectively. ROC analysis yielded similar areas under the curve for the 2 assays (0.7–0.9). The log-transformed sIgE data showed a strong linear correlation with the estimated probabilities (R > 0.9). Conclusions: The 2 systems may be interchangeable for diagnosis of milk and wheat allergies in young children.

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        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).

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