BACKGROUND: Dogs are among the most commonly allergenic pets for children. Data on risk factors for the development of dog allergy are scarce. This study aimed to evaluate the characteristics of children with dog allergy and identify predictors of symptom development with dog exposure.
METHODS: The study included children with dog allergen sensitization demonstrated by skin prick test (SPT) between September 1, 2019, and December 1, 2022. Demographic, clinical, and laboratory data were collected from the patients\' records and interviews with parents.
RESULTS: Dog allergen sensitization was detected by SPT in 548 (5.5%) of 9,907 patients. Of these, 507 patients had complete data and were included in the analysis. The patients\' median age was 11 (IQR: 8-15) years, 55.8% were male, 97.6% exhibited polysensitization (pollen 75.1%, cat 69.6%), 83.6% had allergic rhinitis, and 46.2% had asthma. Acute dog exposure caused symptoms in 164 patients (32.3%), most commonly sneezing (n = 97) and nasal symptoms (n = 80). Predictors of acute symptoms in dog-sensitized children were male sex (OR: 0.584 [CI: 0.38-0.87]), dog exposure before 1 year of age (OR: 2.35 [CI: 1.18-4.66]), close contact with a dog owner (OR: 2.93 [CI: 1.78-4.8]), and cat allergy (OR: 2.75 [CI: 1.82-4.1]).
CONCLUSIONS: Approximately one-third of children with dog sensitization developed symptoms after exposure to the dog. Male sex, direct dog exposure before the age of one, close contact with a dog owner, and cat allergy were identified as predictors of dog allergy.

(1) Peanut allergy is associated with high risk of anaphylaxis which could be prevented by oral immunotherapy. Patients eligible for immunotherapy are selected on the basis of a food challenge, although currently the assessment of antibodies against main peanut molecules (Ara h 1, 2, 3 and 6) is thought to be another option. (2) The current study assessed the relationship between the mentioned antibodies, challenge outcomes, skin tests and some other parameters in peanut-sensitized children. It involved 74 children, divided into two groups, based on their response to a food challenge. (3) Both groups differed in results of skin tests, levels of component-specific antibodies and peanut exposure history. The antibody levels were then used to calculate thresholds for prediction of challenge results or symptom severity. While the antibody-based challenge prediction revealed statistical significance, it failed in cases of severe symptoms. Furthermore, no significant correlation was observed between antibody levels, symptom-eliciting doses and the risk of severe anaphylaxis. Although in some patients it could result from interference with IgG4, the latter would not be a universal explanation of this phenomenon. (4) Despite some limitations, antibody-based screening may be an alternative to the food challenge, although its clinical relevance still requires further studies.

BACKGROUND: Cockroach allergy contributes to morbidity among urban children with asthma. Few trials address the effect of subcutaneous immunotherapy (SCIT) with cockroach allergen among these at-risk children.
OBJECTIVE: We sought to determine whether nasal allergen challenge (NAC) responses to cockroach allergen would improve following 1 year of SCIT.
METHODS: Urban children with asthma, who were cockroach-sensitized and reactive on NAC, participated in a year-long randomized double-blind placebo-controlled SCIT trial using German cockroach extract. The primary endpoint was the change in mean Total Nasal Symptom Score (TNSS) during NAC after 12 months of SCIT. Changes in nasal transcriptomic responses during NAC, skin prick test wheal size, serum allergen-specific antibody production, and T-cell responses to cockroach allergen were assessed.
RESULTS: Changes in mean NAC TNSS did not differ between SCIT-assigned (n = 28) versus placebo-assigned (n = 29) participants (P = .63). Nasal transcriptomic responses correlated with TNSS, but a treatment effect was not observed. Cockroach serum-specific IgE decreased to a similar extent in both groups, while decreased cockroach skin prick test wheal size was greater among SCIT participants (P = .04). A 200-fold increase in cockroach serum-specific IgG4 was observed among subjects receiving SCIT (P < .001) but was unchanged in the placebo group. T-cell IL-4 responses following cockroach allergen stimulation decreased to a greater extent among SCIT versus placebo (P = .002), while no effect was observed for IL-10 or IFN-γ.
CONCLUSIONS: A year of SCIT failed to alter NAC TNSS and nasal transcriptome responses to cockroach allergen challenge despite systemic effects on allergen-specific skin tests, induction of serum-specific IgG4 serum production and down-modulation of allergen-stimulated T-cell responses.

BACKGROUND: There are limited longitudinal data on the population prevalence of allergic conditions during childhood, and few studies have incorporated the reference standard oral food challenge to confirm food allergy.
OBJECTIVE: To describe the population prevalence of IgE-mediated food allergy, eczema, asthma, and rhinitis at ages 6 and 10 years in Melbourne, Australia.
METHODS: The HealthNuts study recruited 5,276 1-year-old infants in Melbourne, Australia, with repeat assessments at ages 6 and 10 years. At ages 6 and 10 years, carers completed a questionnaire on symptoms and doctor diagnosis of allergic conditions (International Study of Asthma and Allergies in Children). Children were invited to attend a clinic assessment including skin prick test, lung function tests, and oral food challenges when indicated. To minimize the impact of attrition bias, prevalence estimates among participants at ages 6 and 10 years were weighted to reflect characteristics of the whole cohort at recruitment.
RESULTS: In total, 4,455 and 4,065 families participated at ages 6 and 10 years, respectively (84% and 77% of the original cohort). Of those, 73% and 55% of participants ages 6 and 10 years, respectively, completed clinical assessments. Overall, 36.5% (95% CI, 34.8-38.2) and 38.2% (95% CI, 36.5-40.1%) of 6- and 10-year-olds had at least one current allergic disease, and around one third of those had two or more allergic diseases. Food allergy occurred in 6.4% (95% CI, 5.6-7.2) of 6-year olds and 6.3% (95% CI, 5.5-7.2) of 10-year-olds. Among infants with challenge-confirmed food allergy in infancy, 45% had persistent disease at age 10 years. The prevalence of current diagnosed asthma at ages 6 and 10 years were 12.1% (95% CI, 10.9-13.3) and 13.1% (95% CI, 11.9-14.4), respectively, current eczema decreased slightly from 15.3% (95% CI, 14.1-19.7) at age 6 years to 12.9% (95% CI, 11.7-14.2) at age 10 years, and current rhinitis increased from 15.1% (95% CI, 13.9-16.5) at age 6 years to 25.0% (95% CI, 23.4-26.7) at age 10 years.
CONCLUSIONS: Allergic diseases affect 40% of primary school-age children; one third have multiple allergic diagnoses. Challenge-confirmed food allergy prevalence remains high, and 45% of infants with food allergy have persistent disease to age 10 years.

Allergic rhinitis affects 30% of the Indian population (Dey et al. in Int Arch Allergy Immunol 178:60-65, 2019). Patients can be sensitive to single or multiple allergens. Polysensitization is more common (Bousquet et al. in Ann Epidemiol 20:797-803, 2010; Arbes et al. in J Allergy Clin Immunol 116:377-383, 2005). Sensitization to multiple allergens may have a role in the severity and the association of Asthma in such patients. A total of 798 patients with allergic rhinitis (SFAR ≥ 7) were included. Disease severity and associated symptoms were evaluated using questionnaire. Each patient underwent a Skin prick test with an allergen panel of 35 allergens each (Annesi-Maesano et al. in Allergy 57:107-114, 2002) and the results were evaluated to study the association of asthma and severity of Allergic rhinitis. Data consisting of 389 (48.7%) males and 409 (51.3%) females were assessed. A total of 82.2% of the study population of symptomatic patients were sensitized to at least one of the allergens. Seventy patients (8.78%) had associated asthma. Forty-four patients were polysensitized and fifteen were mono sensitized. Among polysensitized patients, 36 patients had sensitization to at least 6 different allergens. Dermatophagoides pteronyssinus was the most common allergen among asthma patients. This study provides a thorough knowledge of locally prevalent aeroallergens which is essential for the prompt diagnosis and treatment of allergic patients. Skin prick test can be a non-invasive vital tool in analyzing patterns of allergen exposure, the prevalence of allergen, sensitizing potential of different allergens in that specific geographic area.

Some grass species that are either common or widely spread in Thailand have not been used for pollen allergy diagnosis. In order to improve diagnostic accuracy, the aim of this pilot study was to identify the grass species responsible for pollen allergy in Thailand.
The skin sensitization of pollen extracts from six different grass species, including rice (Oryza sativa), corn (Zea mays), sorghum (Sorghum bicolor), para grass (Urochloa mutica), ruzi grass (Urochloa eminii), and green panic grass (Megathyrsus maximus), was evaluated by skin prick test (SPT). Serum\'s IgE specific to each pollen extract was analyzed by Western blot (WB). The ImmunoCAPTM test for Johnson grass was also evaluated.
Of the thirty-six volunteers who participated in this study, eighteen tested positive for at least one of the diagnostic tests, namely SPT, WB analysis, or ImmunoCAPTM. Notably, skin reactivity to para grass, corn, sorghum, and rice was more commonly observed compared to ruzi grass and green panic grass. However, in the WB analysis, individuals with pollen-specific IgE were more frequently detected in sorghum, green panic grass, corn, rice, and ruzi grass than para grass.
In this pilot investigation, our findings indicate that the pollen extracts of rice, corn, sorghum, and para grass are associated with pollen allergy in Thailand. These results contribute to the current knowledge on the identification of grass species that are associated with pollen allergy in Thailand and Southeast Asia.

The rising popularity of undercooked or raw seafood containing larvae of the Anisakis parasite has led to issues of public health concern due to allergic manifestations. We conducted an observational study on the use of an innovative Anisakis allergy diagnostic algorithm in a convenience sample of 53 allergic outpatients recruited in Western Sicily, between April 2021 and March 2022. We included individuals with an anamnesis suggestive of IgE sensitization to Anisakis reporting clinical manifestation in the last month due to allergic reactions after eating fresh fish, or in subjects at high exposure risk with sea products while abstaining from fish ingestion, excluding those with documented fish sensitization. Outpatients were tested via Skin Prick Test, IgE-specific dosage and Basophil Activation Test (BAT). Twenty-six outpatients were diagnosed with Anisakis, while 27 with Chronic Urticaria (CU). We found a seven-fold excess risk for Anisakis (p4) positivity in the Anisakis allergic outpatients, as compared to the CU ones. BAT showed the best diagnostic accuracy (92.45%) and specificity (100%), while specific IgE to Ascaris (p1) documented the best sensitivity (92.31%) but a very low specificity (37.04%). In conclusion, our findings may represent a potentially useful contribution to the future development of updated clinical guidelines.

Allergic Rhinitis is one of the most common allergic disease and characterized by sneezing, rhinorrhea, nasal congestion and nasopharyngeal itching. The initial management includes pharmacological treatment and the patients who are refractory to pharmacological treatment are then reffered for immunotherapy. SLIT has been widely used for treatment of allergic rhinitis and has proven its clinical efficacy. The objective of the present study was to assess the clinical effects, safety and tolerability of sublingual immunotherapy (SLIT) among the patients suffering from allergic rhinitis. The study was conducted from Aug 2018 to April 2021 and 40 patients with convincing history, positive skin prick test to one or more allergen extracts were recruited. SLIT was conducted with antigens (mix), namely dust mites, tree pollens, grass pollens and weed pollens in patients of allergic rhinitis for 1 year. There was significant improvement in quality of life and symptoms severity(Nasal and Non-Nasal) from base line to end of 1 year. SLIT lowers the total IgE, absolute eosinophilic count and medication requirement. Sublingual Immunotherapy for specific allergens decreases clinical symptoms in patients with allergic rhinitis and sensitivity to multiple allergen.

OBJECTIVE: Only limited Indian data is available regarding the food allergy pattern among allergic rhinitis patients in Indian population. This study aims to assess the pattern of food allergen sensitivity amongst allergic rhinitis patients in central India.
METHODS: A total of 218 subjects with allergic rhinitis were enrolled in the study (from May 2018 to August 2022). Skin prick test was done in all subjects with proper technique and precautions by using 125 common food allergens and 75 aero allergens. The test readings were noted after 20 minutes by comparing the wheals so formed with the negative control of Saline and positive control of Histamine. Any reaction with a wheal diameter of 3mm or greater was considered as positive.
RESULTS: While test results of both food and inhalant allergens were issued to individual patients, this study was restricted to detection and analysis of pattern of food allergens. Our study observed male preponderance with predominantly a third decade affliction. The most common food allergen in the study population was beetle nut (29.3%) followed by chilli powder and spinach (28.8% each).
CONCLUSIONS: Along with aeroallergens, food allergens are also important provocateurs of allergic rhinitis. Diagnosing the offending food allergens and its avoidance reduces patient morbidity, need for pharmaceutical agents and subsequently drug dependence and its side effects. Offering subjects a replacement diet with food items of similar taste and nutritive character helps in sustainable avoidance therapy.

This study aims to evaluate the sensitization distribution of aeroallergens in patients with allergic conjunctivitis (AC) living in a temperate subhumid region and to describe the prevalence in a Mexican cohort. A total of 761 patient records were revisited, including the results of the skin prick test (SPT) for 45 aeroallergens. We found 292 patients with AC and a positive SPT in a 5-year period. The most frequent aeroallergens include dust mites (69.2% for Dermatophagoides pteronyssinus and 47.6% for Dermatophagoides farinae), trees (36% for cypress and 22.6% for ash), animals (33.9% for dogs and 26.7% for cats), and grasses (21.2% for Paspalum notalum and 19.9% for Poa pratensis). Among the studied population, a prevalence of 38.4% for the disease was calculated. House dust mites were responsible for most sensitizations found in the studied population. There is a high prevalence of AC in the selected cohort during the period studied.