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Allergy Advisor Digest - June 2011
Editor: Dr. Harris A. Steinman

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This is a monthly digest of interesting information that is being added to Allergy Advisor. While we add a great deal of information every month, here we highlight some of the more interesting articles.
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Co-sensitisation (but co-recognition also) to novel banana and tomato allergens.

A role for measurement of nasal IgE antibodies in diagnosis of Alternaria-induced rhinitis in children.

Resolution of IgE-mediated fish allergy.

Is food anaphylaxis a cause of antiphospholipid syndrome and thrombosis or a coincidence?

Tropomyosin IgE-positive results are a good predictor of shrimp allergy.

Api m 10, a genuine A. mellifera venom allergen, is clinically relevant but underrepresented in therapeutic extracts.

Anaphylaxis related to avocado ingestion.

Peanut sensitization in a group of allergic Egyptian children.

Exposure to flour dust and sensitization among bakery employees.

Food-dependent exercise-induced anaphylaxis-sequence of causative factors might be reversed.

Seafood allergy in children: a descriptive study.

Potential allergens of green gram (Vigna radiata L. Millsp) (mung bean) identified as members of cupin superfamily and seed albumin.

The relevance of chlorhexidine contact allergy.

Prevalence of cutaneous reactions to the pine processionary moth (Thaumetopoea pityocampa) in an adult population.

Fragrance allergens in 'specific' cosmetic products.

Late reactions to patch test preparations with reduced concentrations of p-phenylenediamine

A review on exposure, epidemiology and clinical manifestations of palladium allergy.

Role of allergen sensitization in older adults.

Molecular diagnosis of cow's milk allergy.

Microarray of allergenic component-based diagnosis in food allergy.

Proteomics in immunological reactions to drugs.

Immediate adverse reactions to biologicals

Molecular diagnosis of fruit and vegetable allergy.

Dermatologic manifestations of musicians

Food protein-induced enterocolitis syndrome by cow's milk proteins passed through breast milk.

Gene polymorphisms, breast-feeding, and development of food sensitization in early childhood.

Aspergillus fumigatus synergistically enhances mite-induced allergic airway inflammation.

Increased throat symptoms in Japanese cypress pollinosis.

Educational case series: Mechanisms of drug allergy.

The impact of age on prevalence of positive skin prick tests and specific IgE tests.

Pragmatic approach to the clinical work-up of patients with putative allergic disease to metallic orthopaedic implants before and after surgery.

Lifetime exposure to cigarette smoking and the development of adult-onset atopic dermatitis.

Hypersensitivity pneumonitis and metalworking fluids contaminated by mycobacteria.

Salicylate intoxication from teething gel in infancy.

Climate change, aeroallergens, and pediatric allergic disease.

Histamine intolerance: lack of reproducibility of single symptoms by oral provocation with histamine.

Co-sensitisation (but co-recognition also) to novel banana and tomato allergens.
An unusual case of both banana and tomato allergy is reported. A 17-year-old boy with slight rhinoconjunctivitis in springtime reported two distinct episodes of angioedema of the face, hypotension, and diarrhoea during the previous 2 months, both occurring about 30 min after the ingestion of banana and lasting for about 1 hour. The patient also reported a typical oral allergy syndrome (immediate itching of oral mucosa) following the ingestion of raw tomato. These symptoms were not related to the onset of the seasonal rhinoconjunctivitis> He tolerated all other foods. SPT showed strong skin reactivity to commercial extracts of tomato, banana and hazelnut, SPT with fresh tomato both raw and boiled at 100°C for 5 min scored intensely positive with no difference between the raw and the heat-processed food. In contrast, no skin reactivity to natural rubber latex extract and to purified date palm profilin (Pho d 2) was recorded. On immunoblot analysis IgE reactivity against proteins from 43 to 90 kDa in banana extract and against 43, 67, and 94 kDa proteins in tomato extract was found. Pre-absorption of patient's serum with banana abolished IgE reactivity to 67 and 94 kDa tomato allergens, whereas IgE reactivity against the 43-kDa-zone remained unchanged. The IgE reactivity to 67 and 94 kDa was possibly due to CCD in both tomato and banana. Therefore in vitro tests showed that both co-sensitization to and co-recognition of allergen in the two fruits were present. Interestingly, the patients showed IgE reactivity to hitherto not described, high molecular weight allergens.

Co-sensitisation (but co-recognition also) to novel banana and tomato allergens.
Asero R, Mistrello G, Amato S.
Eur Ann Allergy Clin Immunol 2010 Aug;42(4):159-162

A role for measurement of nasal IgE antibodies in diagnosis of Alternaria-induced rhinitis in children.
These findings suggest that sensitisation to Alternaria is frequently expressed by exclusive production of specific IgE in the nasal mucosa. Thus, measuring nasal IgE in children with rhinitis and negative SPT during the period of presence of Alternaria spores seems helpful to avoid a mistaken diagnosis of non-allergic rhinitis

A role for measurement of nasal IgE antibodies in diagnosis of Alternaria-induced rhinitis in children.
Fuiano N, Fusilli S, Incorvaia C.
Allergol Immunopathol (Madr) 2011 Jun 3;

Resolution of IgE-mediated fish allergy.
Long-term follow-up successful management of a patient with lasting and severe fish allergy that resolved: an 18-year-old Portuguese male with eczema since early infancy, allergic rhinitis and asthma since four years of age, had hake introduced into his diet when he was seven months old. He tolerated fish for about three months, then experienced two sudden episodes of difficulty in breathing, stridor, urticaria and vomiting, immediately after hake and mackerel ingestion (at 10 and 11 months of age, respectively). SPT using commercial extracts yielded positive results to fish (hake, cod, sardine). Fish avoidance was advised. After a fish-free diet for two years, with no allergic episodes, a hake oral food challenge was performed. After ingestion of 1 mg cooked fish, perioral urticaria and mild wheezing difficulty in breathing developed. Complete fish avoidance was again recommended. Two accidental exposures occurred, also eliciting facial urticaria and dyspnoea, the last when the child was 11 years of age - after eating cereals in a redfish contaminated bowl. At 14-yearsfish was reintroduced into the diet. Open OFC to tuna, sole, salmon, hake, and cod were sequentially performed (separated by six months mean time intervals) and were all negative. The patient has regularly eaten the tested fish thereafter, including hake. No further reactions have occurred, despite on-going fish sensitisation (hake, cod, sardine).

Resolution of IgE-mediated fish allergy.
Pite H, Prates S, Borrego LM, Matos V, Loureiro V, Leiria-Pinto P.
Allergol Immunopathol (Madr) 2011 Jun 1;

Is food anaphylaxis a cause of antiphospholipid syndrome and thrombosis or a coincidence?
This study suggests that seed lipoproteinswhich causes evere food anaphylaxis might have a potential role in the antiphospholipid syndrome and related thrombosis.

Is food anaphylaxis a cause of antiphospholipid syndrome and thrombosis or a coincidence?
Korkmaz C.
Allergol Immunopathol (Madr) 2011 Jun 13;

Tropomyosin IgE-positive results are a good predictor of shrimp allergy.
This study assessed the value of IgE antibodies in the diagnosis of shrimp allergy and studied red shrimp (Solenocera melantho) tropomyosin both as a new allergen and as a cross-reactive IgE-binding protein. Shrimp allergy was confirmed in 18 shrimp-allergic patients. Skin prick test and IgE antibodies to shrimp were positive in all shrimp-allergic patients; sIgE to rPen a 1 was detected in 98% of these patients. Of the 18 shrimp-tolerant patients, 61% had positive SPT to shrimp, 55% were IgE-positive to shrimp, and 33% showed IgE antibodies to rPen a 1. Determination of IgE to rPen a 1 yielded a positive predictive value of 0.72 and a negative predictive value of 0.91. Therefore IgE levels to rPen a 1 provided additional value to the diagnosis of shrimp allergy. Some allergens in mite extract are recognized by patients who are allergic to shrimp, though their clinical relevance remains unknown.

Tropomyosin IgE-positive results are a good predictor of shrimp allergy.
Gamez C, Sanchez-Garcia S, Ibanez MD, Lopez R, Aguado E, Lopez E, Sastre B, Sastre J, Del P.
Allergy 2011 Jun 9;

Api m 10, a genuine A. mellifera venom allergen, is clinically relevant but underrepresented in therapeutic extracts.
The identification and characterization of all allergens is imperative for improvement of diagnosis and design of effective immunotherapeutic approaches. The aim of this study was the characterization of Api m 10, an Apis mellifera venom component with focus on the relevance of glycosylation. Api m 10 was produced as a recombinant protein. Both the aglycosylated and the glycosylated variant of Api m 10 devoid of cross-reactive carbohydrate determinants (CCD), exhibited IgE reactivity with approximately 50% of honey bee venom (HBV)-sensitized patients. Although the detection of the native protein in crude HBV suggested content comparable to other relevant allergens, three therapeutical HBV extracts lacked detectable amounts of this component. Thus, Api m 10 could become a key element for component-resolved diagnostic tests and improved immunotherapeutic approaches in hymenoptera venom allergy.

Api m 10, a genuine A. mellifera venom allergen, is clinically relevant but underrepresented in therapeutic extracts.
Blank S, Seismann H, Michel Y, McIntyre M, Cifuentes L, Braren I, Grunwald T, Darsow U, Ring J, Bredehorst R, Ollert M, Spillner E.
Allergy 2011 Jun 10;

Anaphylaxis related to avocado ingestion.
Anaphylaxis to avocado, independent of latex sensitization, has been rarely reported in the literature. This case report describes a 15 year old male who experienced anaphylaxis within half an hour after eating avocado-containing food. The patient was eating guacamole dip with chips and within a half an hour of eating the guacamole, he developed coughing, wheezing, nasal stuffiness, generalized urticaria and periorbital edema. He had been exposed to latex in the form of balloons multiple times in the past without a reaction. In addition, his diet included other foods that are often included in latex-fruit syndrome (kiwi, banana, potato). He did not experience any nausea, vomiting, diarrhea, syncope or loss of consciousness. Skin testing was positive to fresh avocado (10 mm) and commercial extract (5 mm) and borderline to the guacamole mix (3 mm). Testing to fresh and commercial chestnut was positive to fresh chestnut (10 mm) and commercial chestnut (6 mm). A latex use test (both finger and full glove) was negative. ImmunoCAP to avocado was positive at 0.9 KUA/L. It is important to consider avocado as a cause of anaphylaxis, even in patients not sensitized to latex.

Anaphylaxis related to avocado ingestion: a case and review.
Abrams EM, Becker AB, Gerstner TV.
Allergy Asthma Clin Immunol 2011 Jun 10;7(1):12

Peanut sensitization in a group of allergic Egyptian children.
The authors sought to screen for peanut sensitization in a group of atopic Egyptian childrenSeven subjects (7%) were sensitized and three out of six of them had positive oral challenge denoting allergy to peanuts. Peanut allergy does not seem to be rare in atopic children in Egypt. Skin prick and specific IgE testing are effective screening tools to determine candidates for peanut oral challenging.

Peanut sensitization in a group of allergic Egyptian children.
Hossny E, Gad G, Shehab A, El-Haddad A.
Allergy Asthma Clin Immunol 2011 May 31;7(1):11

Exposure to flour dust and sensitization among bakery employees.
The USA National Institute for Occupational Safety and Health conducted a study to determine prevalences of sensitization to bakery-associated antigens (BAAs) and work-related respiratory symptoms at a large commercial bakery. Of 186 bakery employees present during our site visit, 161 completed the questionnaire and 96 allowed their blood to be drawn. Employees in the higher-exposure group had significantly higher prevalences of work-related wheezing, runny nose, stuffy nose, and frequent sneezing than the lower-exposure group. The prevalence of IgE specific to wheat was significantly higher among employees who ever had a job in the higher-exposure group or in production at another bakery, and to flour dust and alpha-amylase at the >/= 0.10 kU/L cutoff. Therefore, despite knowledge of the risks of exposure to flour being available for centuries, U.S. employees are still at risk of sensitization and respiratory symptoms from exposure to high levels of BAA.

Exposure to flour dust and sensitization among bakery employees.
Page EH, Dowell CH, Mueller CA, Biagini RE, Heederik D.
Am J Ind Med 2010 Dec;53(12):1225-1232

Food-dependent exercise-induced anaphylaxis-sequence of causative factors might be reversed.
This study reports food-dependent exercise-induced anaphylaxis (FDEIA) where anaphylactic symptoms appeared not only after postprandial exercise, but also when the food allergen was ingested immediately after prolonged exercise.

A 27-year-old female experienced in the previous 12 years five incidents of FDEIA following ingestion of different fruits: plums, grapes, cranberries, peaches, blackberries and raspberries. In some episodes the fruits were eaten together, therefore the precise identification of culprit food was uncertain. The patient experienced two typical episodes of FDEIA. The first occurred 12 years previously after 30 minutes of intensive walking, preceded by eating blackberries. Symptoms included generalized urticaria, facial angioedema, nausea, vomiting and weakness. The second was precipitated 10 years ago by ingestion of raspberries and prolonged physical exercise started about 3 hours later. After 1 hour of dancing she developed anaphylactic symptoms which involved disseminated urticaria accompanied by facial angioedema and nausea.

The patient has experienced three unusual episodes of FDEIA:

Episode 1. Immediately after discontinuation of prolonged exercise lasting 2 hours, raspberries were ingested. About 20 minutes later she experienced generalized urticaria accompanied by angioedema localized on the face and upper limbs, vomiting and diarrhea.

Episode 2. During a hot and sunny day the patient did outdoor exercise for about 3 hours and a few minutes later ate peaches. About 10 minutes later she developed generalized urticaria, angioedema of the face, nausea and loss of consciousness requiring emergency room treatment.

Episode 3. Following a strenuous and prolonged exercise the patient ate the first meal that day - potatoes, chicken and cranberries. About 10 minutes later, disseminated urticaria localized on the neck and hands developed, which were partially reduced by 10 mg of cetirizine. Four hours later she ate white grapes and a shortly afterwards started dancing intensively. A few minutes later she developed a heavy anaphylactic reaction with the symptoms similar to those described in the episode 2.

Skin tests were positive to peach, raspberry, cranberry, nectarine, blackberry and black grape. Total serum IgE was 119 kU/L. Due to a possible lifethreatening systemic reaction, an exercise challenge after ingestion of food allergens was not performed.

Food-dependent exercise-induced anaphylaxis-sequence of causative factors might be reversed.
Wolanczyk-Medrala A, Barg W, Radlinska A, Panaszek B, Medrala W.
Ann Agric Environ Med 2010 Dec;17(2):315-317

Seafood allergy in children: a descriptive study.
Seafood allergy is now a leading cause of anaphylaxis in both the United States and Australia. This article describes the characteristics of a large cohort of children with seafood allergy using a retrospective chart review of all children presenting to an Australian tertiary allergy service with an allergic reaction to seafood between 2006 and 2009. 167 children had a history of definite clinical reaction to seafood and/or positive food challenge (103 male, 62%). 94% had evidence of co-existent atopic disease. Prawn/shrimp was the most common seafood implicated. One-fifth presented with a history of anaphylaxis to seafood. Over 50% of crustacean-allergic children could tolerate non-crustacean fish. Sensitization to other fish species was very common in fish-allergic children, with one third reporting clinical reactions to at least two species; 16% developed symptoms to fish vapours. In children with allergy to tuna and/or salmon, at least 21% were able to tolerate the fish in a tinned form.

Seafood allergy in children: a descriptive study.
Turner P, Ng I, Kemp A, Campbell D.
Ann Allergy Asthma Immunol 2011 Jun;106(6):494-501

Potential allergens of green gram (Vigna radiata L. Millsp) (mung bean) identified as members of cupin superfamily and seed albumin.
IgE-mediated reaction to green gram seedlings have been reported. This study sought to investigate the allergenic potential of green gram. BALB/c mice were sensitized with green gram proteins, and levels of specific Igs, Th2 cytokines, histamine, anaphylactic symptoms and histopathological responses were studied. Twelve naso-bronchial allergic patients with a history of sensitization to green gram were selected on the basis of positive skin prick test and elevated specific IgE levels. Green gram allergens were identified and characterized. Four proteins (molecular weights: 52, 50, 30 and 18 kDa) showed pepsin resistance and IgE-binding capability with sensitized human and mice sera. The four proteins tentatively named as Vig r2 (52 kDa), Vig r3 (50 kDa), Vig r4 (30 kDa) and Vig r5 (18 kDa) showed significant sequence similarity with known allergens of soybean, lentil, pea, lupin, etc. Vig r2 was identified as 8S globulin beta-isoform precursor, Vig r3 as 8S globulin alpha-isoform precursor and Vig r4 as seed albumin.

Potential allergens of green gram (Vigna radiata L. Millsp) identified as members of cupin superfamily and seed albumin.
Misra A, Kumar R, Mishra V, Chaudhari BP, Raisuddin S, Das M, Dwivedi PD.
Clin Exp Allergy 2011 Jun 1;

The relevance of chlorhexidine contact allergy.
Chlorhexidine-containing corticosteroid creams, skin disinfectants and oral hygiene products are principal sources of chlorhexidine contact sensitization. Exposure to chlorhexidine in cosmetics may lead to delayed improvement of eczema in sensitized patients, emphasizing the importance of identifying the potential cosmetic sources

The relevance of chlorhexidine contact allergy.
Liippo J, Kousa P, Lammintausta K.
Contact Dermatitis 2011 Apr;64(4):229-234

Prevalence of cutaneous reactions to the pine processionary moth (Thaumetopoea pityocampa) in an adult population.
Pine processionary moth (PPM)] is one of the most important lepidopteran agents causing urticant cutaneous reactions in humans in Mediterranean countries. This species is also expanding northwards, because of global warming. This study investigated the prevalence, distribution by habitat group and possible risk factors of PPM cutaneous reactions in a randomly designed survey was carried out on 1224 adults. A point prevalence, estimated after corrections, of 8.7% was obtained (12% rural areas, 9.6% for semi-urban areas, and 4.4% for urban areas). Airborne contamination was the most important cause of reactions (83.3% of 48 participants who visited the hospital and fulfilled the criteria for a convincing reaction presented with symptoms after walking on/passing by pine tree areas).

Prevalence of cutaneous reactions to the pine processionary moth (Thaumetopoea pityocampa) in an adult population.
Vega JM, Moneo I, Ortiz JC, Palla PS, Sanchis ME, Vega J, Gonzalez-Munoz M, Battisti A, Roques A.
Contact Dermatitis 2011 Apr;64(4):220-228

Fragrance allergens in 'specific' cosmetic products.
Together with preservative agents, fragrance components are the most important sensitizing culprits in cosmetic products. This study's objective was to identify the nature of the fragrance ingredients responsible for allergic contact dermatitis (ACD) from specific cosmetic products. Between 2000 and 2009, positive patch test reactions or positive usage tests with the patients' own cosmetic products, were recorded using a standardised form. Of the 806 cosmetic records, corresponding to 485 patient files, 344 concerned reactions to fragrance ingredients that according to the label were present ('Presence Confirmed' [PC n = 301]) or suspected to be present ('Presence Not Confirmed' [PNC n = 376]) in the causal cosmetic products used, which belonged to 15 different categories, toilet waters/fine perfumes being the most frequent. Geraniol in fragrance mix I (FM I) and hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) in FM II were the most frequent PC, and together with hydroxycitronellal and Evernia prunastri (oak moss) the most frequent PNC ingredients in the causal cosmetic products. Limonene was the most frequent PC confirmed fragrance allergen. The study not only underlines the usefulness of fragrance-ingredient labelling in order to identify the causal allergen(s) present in specific cosmetic products, but may also provide information on trends in the actual use of sensitizing fragrance ingredients in them.

Fragrance allergens in 'specific' cosmetic products.
Nardelli A, Drieghe J, Claes L, Boey L, Goossens A.
Contact Dermatitis 2011 Apr;64(4):212-219

Late reactions to patch test preparations with reduced concentrations of p-phenylenediamine
This study concludes that the occurrence of late reactions to PPD may be influenced by patch test concentration and duration. PPD 0.4-0.5% pet. May cause late reactions indicative of active sensitization.

Late reactions to patch test preparations with reduced concentrations of p-phenylenediamine: a multicentre investigation of the German Contact Dermatitis Research Group.
Hillen U, Dickel H, Loffler H, Pfutzner W, Mahler V, Becker D, Brasch J, Worm M, Fuchs T, John SM, Geier J.
Contact Dermatitis 2011 Apr;64(4):196-202

A review on exposure, epidemiology and clinical manifestations of palladium allergy.
Consumers are mainly exposed to palladium from jewellery and dental restorations. Palladium contact allergy is nearly always seen together with nickel allergy, as palladium and nickel tend to cross-react. This study aimed to analyse the available palladium patch test data and case reports to determine whether the prevalence of palladium mono-sensitization has increased. A total of 10 778 patients were patch tested with palladium chloride. The median prevalence of palladium allergy was 7.8% in dermatitis patients and 7.4% in dental patients. The median prevalence of palladium mono-sensitization (defined as the presence of palladium allergy and the absence of nickel allergy) was 0.2% in dermatitis patients and 0.5% in dental patients.

Metal allergen of the 21st century--a review on exposure, epidemiology and clinical manifestations of palladium allergy.
Faurschou A, Menne T, Johansen JD, Thyssen JP.
Contact Dermatitis 2011 Apr;64(4):185-195

Role of allergen sensitization in older adults.
"There is a common perception among physicians and patients that allergic diseases are not relevant in older adults. There is also recognition that innate and adaptive immune functions decline with aging. It is the function of a variety of immune cells in the form of allergic inflammation that is a hallmark of allergic diseases. In fact, there is a fairly consistent observation that measures of allergic sensitization, such as skin prick testing, specific IgE, or total IgE, decline with age. Nonetheless, the association between allergic sensitization and allergic diseases, particularly asthma and allergic rhinitis, remains robust in the older adult population. Consequently, an appropriate evaluation of allergic sensitivities is warranted and indicated in older asthma and rhinitis patients to provide optimal care for the individual and minimize any resultant morbidity and mortality"

Role of allergen sensitization in older adults.
Viswanathan RK, Mathur SK.
Curr Allergy Asthma Rep 2011 Jun 11;

Molecular diagnosis of cow's milk allergy.
"Purpose of Review: To identify and discuss studies on the molecular diagnosis of cow's milk allergy (CMA) with a view to update allergists since a general review of the methodology in 2006.

Recent Findings: Seven basic research studies reporting the use of component-resolved diagnostics in CMA were found. All studies were on children positively reacting to a formal challenge with cow's milk. Six studies used natural allergens and three used recombinant milk proteins. Microarray platforms were customized and, thus, differed across studies. Three studies assessed the association between molecular-scale patterns and different presentations of the condition, that is the association between anaphylaxis, gastrointestinal symptoms and other severe phenotypes and the pattern of protein sensitization. Two studies assessed the association between positive oral food challenge and the persistence of milk allergy over time. Protein profiling could be useful to indicate appropriate specific immunotherapy.

Summary: Accurate diagnosis of CMA is challenging and essential. The determination of the immunoglobulin E (IgE)-mediated response to sequenced and characterized allergens may be more useful in predicting the presence and severity of clinical allergy than the currently used skin or blood tests performed with whole extracts. However, as component recognition pattern heterogeneity is observed in different areas, further clinical studies are essential to correlate useful molecular diagnostics and biological markers with disease and patient profiles. Until such markers are found and validated in different age groups, oral food challenge remains the reference standard for the diagnosis of CMA"

Molecular diagnosis of cow's milk allergy.
Fiocchi A, Bouygue GR, Albarini M, Restani P.
Curr Opin Allergy Clin Immunol 2011 Jun;11(3):216-221

Microarray of allergenic component-based diagnosis in food allergy.
"Purpose of Review: The determination of specific IgE (sIgE) against allergenic components fixed in a solid support that is provided as a microarray of high capacity and allows a more precise evaluation in the food allergy diagnosis. In this review, we will analyze the results obtained to date with this technology applied to the component-based diagnosis of food allergy.

Recent Findings: Microarrays of proteins or glycoproteins allow us to know the profile of sensitization of a patient with food allergy. At present, a commercially available technique exists which allows sIgE to be detected against 103 allergenic molecules. Several laboratories worldwide have explored and optimized this technique for few allergen extracts and the results have been promising with high reliabilities and sensitivities and above all, good correlations with previous existing conventional assays.

Summary: In recent years, as a result of advances in molecular biology, together with the development of new technologies of producing high-capacity solid-phase matrices such as microarrays, the diagnosis of food allergy has improved and the basic situation of analyzing sIgE against an allergenic source has now become real the possibility of analyzing sIgE against an allergenic protein or glycoprotein. This change has not only led to a more precise diagnosis of sensitization, but can also be used to explain the different hazards of certain molecular sensitizations, crossreactivity phenomena in many cases and can even change the clinical management according to the information provided. Further studies are clearly needed to evaluate more precisely the scope of this new technique."

Microarray of allergenic component-based diagnosis in food allergy.
Sanz ML, Blazquez AB, Garcia BE.
Curr Opin Allergy Clin Immunol 2011 Jun;11(3):204-209

Proteomics in immunological reactions to drugs.
Immunological reactions to drugs pose important clinical problems. Since early works exploring drug-protein interactions, there has been steady progress in this field. However, the mechanisms involved remain incompletely understood. The availability of proteomic techniques with high resolution and sensitivity presents a unique opportunity to tackle this subject from a broad perspective, integrating work in model systems and in patients. Chemical and metabolic characterization of immunological reactions to drugs may also help in the prevention, diagnosis and/or treatment of these processes

Proteomics in immunological reactions to drugs.
Ariza A, Montanez MI, Perez-Sala D.
Curr Opin Allergy Clin Immunol 2011 Jun 8;

Immediate adverse reactions to biologicals
The rapid expansion of the use of biologics has resulted in an increase in adverse drug reactions, some of which can be life-threatening, due to the immunogenicity of these new drugs. This review summarizes the current knowledge of the pathogenic mechanisms of biologics-induced hypersensitivity reactions and highlights the most useful diagnostic and prophylactic tools now available in the clinical management of immunogenicity associated with biologics.

Immediate adverse reactions to biologicals: from pathogenic mechanisms to prophylactic management.
Vultaggio A, Maggi E, Matucci A.
Curr Opin Allergy Clin Immunol 2011 Jun;11(3):262-268

Molecular diagnosis of fruit and vegetable allergy.
The purpose of this paper is to review and discuss studies on molecular diagnosis in fruit and vegetable allergy. Celeriac, carrot and tomato are the most prevalent allergenic vegetables, whereas fruit allergy is mainly induced by apple, peach and kiwi. Component-resolved molecular diagnosis has been recently applied in two well-defined patient groups with kiwifruit and celeriac allergy, respectively. In kiwifruit allergy Act d 1 and Act d 3 were identified as potential marker allergens for severe symptoms. For celeriac allergy, however, such markers are still missing. In both studies component-resolved molecular diagnosis approach improved in particular sensitivity compared to extract-based diagnostic test assays.

Molecular diagnosis of fruit and vegetable allergy.
Ballmer-Weber BK, Hoffmann-Sommergruber K.
Curr Opin Allergy Clin Immunol 2011 Jun;11(3):229-235

Dermatologic manifestations of musicians
A case of a professional musician with a unique allergic contact dermatitis to nickel sulfate and possibly palladium and cobalt chloride in his tuba.

Dermatologic manifestations of musicians: a case report and review of skin conditions in musicians.
Vine K, DeLeo V.
Cutis 2011 Mar;87(3):117-121

Food protein-induced enterocolitis syndrome by cow's milk proteins passed through breast milk.
Food proteininduced enterocolitis syndrome by cows milk proteins passed through breast milk after accidental maternal ingestion. An exclusively breast-fed girl, whose mothers diet had been unrestricted since the girls birth, presented at 1 month of age to the local hospital emergency department for persistent diarrhea, weight loss, and anorexia without fever. Intravenous rehydration was again required a few days later because of the return of diarrhea, anorexia, and weakness. Afterthe third episode in 2 weeks, cows milk allergy was suspected. At the age of 2 months, when she was again healthy, her parents gave her a cows milkbased standard starting formula. Approximately 3 hours after the ingestion of 50 mL, she developed repetitive vomiting, lethargy, and pallor. After recovery, nevertheless, 2 weeks later, she was again given a cows milkbased standard starting formula. Immediately after the ingestion of the first spoonful, she refused to continue the meal; 3 hours later, repetitive vomiting, lethargy, and marked pallor occurred. She again required intravenous fluid resuscitation.

Food protein-induced enterocolitis syndrome by cow's milk proteins passed through breast milk.
Monti G, Castagno E, Liguori SA, Lupica MM, Tarasco V, Viola S, Tovo PA.
J Allergy Clin Immunol 2010 Dec 10;

Gene polymorphisms, breast-feeding, and development of food sensitization in early childhood.
This study sought to evaluate the effect of breast-feeding and gene-breast-feeding interactions on food sensitization (FS) in a prospective US birth cohort. The study included 970 children who were prospectively followed since birth. Children who were ever breast-fed (n = 739), including exclusively breast-fed children, were at a 1.5 (95% CI, 1.1-2.1; P = .019) times higher risk of FS than never breast-fed children (n = 231). This association was significantly modified by rs425648 in the IL-12 receptor beta1 gene (IL12RB1; P for interaction = .0007): breast-feeding increased the risk of FS (odds ratio, 2.0; 95% CI, 1.4-3.1; P = .0005) in children carrying the GG genotype but decreased the risk (odds ratio, 0.6; 95% CI, 0.3-1.4; P = .252) in children carrying the GT/TT genotype. The data suggests that the effect of breast-feeding on FS was modified by SNPs in the IL12RB1, TLR9, and TSLP genes both individually and jointly. The findings underscore the importance of considering individual genetic variations in assessing this relationship

Gene polymorphisms, breast-feeding, and development of food sensitization in early childhood.
Hong X, Wang G, Liu X, Kumar R, Tsai HJ, Arguelles L, Hao K, Pearson C, Ortiz K, Bonzagni A, Apollon S, Fu L, Caruso D, Pongracic JA, Schleimer R, Holt PG, Bauchner H, Wang X.
J Allergy Clin Immunol 2011 Jun 18;

Aspergillus fumigatus synergistically enhances mite-induced allergic airway inflammation.
The fact that Aspergillus fumigatus (Af) causes a distinct clinical syndrome, allergic bronchopulmonary aspergillosis (ABPA), suggests unique immunological properties in allergic asthma. The present study aimed to determine how Af enhances preexisting allergic airway inflammation and colonizes the airway in asthma. In BALB/c mice, Af infection significantly enhanced Dermatophagoides farinae (Df) allergen-induced eosinophilic inflammation via enhancement of Th2-like response. Live, but not dead, Af significantly exacerbated neutrophilic inflammation. Induction of IL-13 and Muc5ac proteins by Df allergen sensitization was significantly enhanced by both live and dead Af infection, resulting in mucous hypersecretion.

Aspergillus fumigatus synergistically enhances mite-induced allergic airway inflammation.
Fukushima C, Matsuse H, Fukahori S, Tsuchida T, Kawano T, Senjyu H, Kohno S.
Med Sci Monit 2010 Jul;16(7):BR197-BR202

Increased throat symptoms in Japanese cypress pollinosis.
Seasonal allergic rhinitis caused by Japanese cypress pollen is highly associated with that by Japanese cedar pollen, due to the similar antigen of the two pollens. Clinically, patients with cypress pollinosis complain of strong throat symptoms. Weekly nasal and throat symptoms during the pollen season in patients with Japanese cedar-cypress pollinosis were measured using a visual analog scale (VAS). VAS showed that nasal symptoms appeared parallel with pollen scattering, and that they were severe in the cedar season more than in the cypress season. On the other hand, throat discomfort and cough were worse in the cypress season, even though this study took place of during a year when there was only a small amount of cypress-pollen scattering. The severity of symptoms other than rhinoconjunctivitis in cedar pollinosis depended on the total amount of pollen, however, cypress pollinosis showed severe throat symptoms in both a small and a mass scattering year. Therefore although cypress and cedar pollinosis is considered as the same disease, cypress pollinosis showed more severe symptoms other than rhinoconjunctivitis. Throat symptoms in particular are more severe in cypress pollinosis, even in the year of a small amount of scattering.

Increased throat symptoms in Japanese cypress pollinosis. [Japanese]
Ogihara H, Yuta A, Miyamoto Y, Kitano M, Takeo T, Takeuchi K.
Nippon Jibiinkoka Gakkai Kaiho 2011 Feb;114(2):78-83

Educational case series: Mechanisms of drug allergy.
Once administered, a drug can activate the immune system by various mechanisms and lead to a large range of clinical manifestations closely related to the type of immune reaction elicited. Administration of the drug can classically result in an immunoglobulin E (IgE)-type sensitization, but can also result in more complex activation of the immune system potentially resulting in severe syndromes, such as the drug-induced hypersensitivity syndrome (DIHS). Although there has been a major increase in our knowledge over the last years, the exact mechanisms of drug allergy are not well understood for most clinical manifestations. A complex interaction between individual characteristics, environmental factors, and the drug itself is usually responsible for adverse reactions to drugs. In this educational review series, the authors describe three cases of drug allergy: first, a child with a typical IgE-mediated drug allergy, second, a child with a non-immediate reaction to penicillin, and in the third patient, they discuss the drug-induced hypersensitivity syndrome, which is rare but potentially fatal. These cases are correlated to the immune mechanism potentially involved.

Educational case series: Mechanisms of drug allergy.
Caubet JC, Pichler WJ, Eigenmann PA.
Pediatr Allergy Immunol 2011 Jun 6;

The impact of age on prevalence of positive skin prick tests and specific IgE tests.
Aging is associated with modifications of the immune system, defined as immunosenescence. This could contribute to a reduced prevalence of allergic disease in the elderly population. This article is a review of the available literature assessing the impact of age on atopy. In the majority of papers, the authors found a lower prevalence of atopy in the most advanced ages, both in healthy subjects and in individuals affected by allergic respiratory diseases. No large, longitudinal studies performed in the general population have been conducted to further explore this observation. From a clinical perspective, allergic reactions in older adults can have the same or even worse manifestations compared to young people. Therefore the evaluation of the atopic condition also in the geriatric patient is recommended.

The impact of age on prevalence of positive skin prick tests and specific IgE tests.
Scichilone N, Callari A, Augugliaro G, Marchese M, Togias A, Bellia V.
Respir Med 2011 May;105(5):651-658

Pragmatic approach to the clinical work-up of patients with putative allergic disease to metallic orthopaedic implants before and after surgery.
"Allergic complications following insertion of metallic orthopaedic implants include allergic dermatitis reactions but also extracutaneous complications. As metal-allergic patients and/or surgeons may ask dermatologists and allergologists for advice prior to planned orthopaedic implant surgery, and as surgeons may refer patients with complications following total joint arthroplasty for diagnostic work-up, there is a continuous need for updated guidelines. This review presents published evidence for patch testing prior to surgery and proposes tentative diagnostic criteria which clinicians can rely on in the work-up of patients with putative allergic complications following surgery. Few studies have investigated whether subjects with metal contact allergy have increased risk of developing complications following orthopaedic implant insertion. Metal allergy might in a minority increase the risk of complications caused by a delayed-type hypersensitivity reaction. At present, we do not know how to identify the subgroups of metal contact allergic patients with a potentially increased risk of complications following insertion of a metal implant. We recommend that clinicians should refrain from routine patch testing prior to surgery unless the patient has already had implant surgery with complications suspected to be allergic or has a history of clinical metal intolerance of sufficient magnitude to be of concern to the patient or a health provider. The clinical work-up of a patient suspected of having an allergic reaction to a metal implant should include patch testing and possibly in vitro testing. We propose diagnostic criteria for allergic dermatitis reactions as well as noneczematous complications caused by metal implants."

Pragmatic approach to the clinical work-up of patients with putative allergic disease to metallic orthopaedic implants before and after surgery.
Thyssen JP, Menne T, Schalock PC, Taylor JS, Maibach HI.
Br J Dermatol 2011 Mar;164(3):473-478

Lifetime exposure to cigarette smoking and the development of adult-onset atopic dermatitis.
Early and/or current exposure to cigarette smoking may contribute cumulatively to the development of adult-onset atopic dermatitis. Exposure to environmental tobacco smoke in childhood is associated with the development of adult-onset AD. Adults should be discouraged from smoking to prevent adult-onset atopic dermatitis in themselves and their family members.

Lifetime exposure to cigarette smoking and the development of adult-onset atopic dermatitis.
Lee CH, Chuang HY, Hong CH, Huang SK, Chang YC, Ko YC, Yu HS.
Br J Dermatol 2011 Mar;164(3):483-489

Hypersensitivity pneumonitis and metalworking fluids contaminated by mycobacteria.
"Metalworking fluids (MWF) are responsible for hypersensitivity pneumonitis (HP). The aim of the present study was to identify the antigen (Ag) responsible for MWF-associated HP, and to optimise serological diagnosis by definition of a threshold allowing discrimination between HP patients and asymptomatic exposed workers. 13 patients, who were workers at a car engine manufacturing plant, were suspected of MWF-associated HP. Microbial analysis of 83 used MWFs was carried out. Sera from 13 MWF-associated HP patients, 12 asymptomatic exposed workers and 18 healthy unexposed controls were tested to determine their immunological responses to three Ags, including Mycobacterium immunogenum. M. immunogenum was identified in 40% of used fluids by culture and confirmed by DNA sequencing. The threshold for differentiating MWF-associated HP patients from asymptomatic exposed workers was five arcs of precipitation (sensitivity 77% and specificity 92%), as determined by electrosyneresis (ES). Using ELISA methods with protein extract from M. immunogenum, a threshold leading to 92% sensitivity and 100% specificity was established. The detection of specific antibodies against M. immunogenum Ag at high levels in case sera suggests that M. immunogenum-contaminated MWF is responsible for MWF-associated HP. To discriminate MWF-associated HP patients from asymptomatic exposed workers, we suggest a five-arc threshold for ES and a 1.6-AU threshold for ELISA methods."

Hypersensitivity pneumonitis and metalworking fluids contaminated by mycobacteria.
Tillie-Leblond I, Grenouillet F, Reboux G, Roussel S, Chouraki B, Lorthois C, Dalphin JC, Wallaert B, Millon L.
Eur Respir J 2011 Mar;37(3):640-647

Salicylate intoxication from teething gel in infancy.
Salicylate intoxication from teething gel in infancy.

Patient 1

A 7-month-old boy presented with a 24-hour history of restlessness, tachypnoea, poor feeding and vomiting. An abdominal ultrasound was thought to show possible intussusception. He appeared lethargic, with minimal motor and verbal response, although this improved when a low blood sugar level was corrected. Test results showed a well compensated metabolic acidosis. The unexplained anion-gap metabolic acidosis persisted. Metabolic investigations showed a mild transaminitis (serum aspartate aminotransferase (AST), 568 U/L and alanine aminotransferase [ALT], 946 U/L (RR for both, <45U/L]) and hyperammonaemia (plasma ammonia, 183umol/L. A working diagnosis was of an organic acidaemia or urea cycle defect with decompensation, caused by intercurrent illness was made. Over the following 8 hours, with these measures in place, the transaminitis and hyperammonaemia improved marginally, but the infant's conscious state deteriorated and he required endotracheal intubation. Urine spectroscopy result showed salicylate metabolites, and blood testing showed a quantitated salicylate level of 1.44 mmol/L (therapeutic range, 1.1-2.2 mmol/L). Detailed examination of the contents of the family's home medicine cupboard revealed Bonjela teething gel (Reckitt Benckiser [8.7% choline salicylate]), which the family admitted to using on the infant's gums frequently over the preceding 2 months. Based on an average application of two to three tubes of Bonjela (1Sg per tube) per week over 2 months, it was estimated that he received about 60mg/kg/day of choline salicylate.

Patient 2

A 13-month-old girl was seen for failure to thrive. When the infant was aged 9 months, her weight started to fall away from the third centile. She was said to have a good appetite and normal stools. Clinically she was a happy, active, non-dysmorphic girl. Initial investigations of her failure to thrive were normal. The exception was an arterial blood gas test result, which showed a mixed metabolic acidosis and respiratory alkalosis and mild hyperchloraemia. Urine spectroscopy surprisingly showed a high concentration of salicylate metabolites. On further questioning, the parents admitted to giving the child Bonjela gel for teething frequently over several months and, on occasion, to using up to a whole tube of Bonjela at night to settle her to sleep. Bonjela use was stopped, results of a repeat urine spectroscopy were clear, and subsequent levels of blood gases normal. The patient made a good recovery and her normal growth pattern resumed.

Salicylate intoxication from teething gel in infancy.
Williams GD, Kirk EP, Wilson CJ, Meadows CA, Chan BS.
MJA 2011;194(3):146-148

Climate change, aeroallergens, and pediatric allergic disease.
"The degree to which aeroallergens are contributing to the global increase in pediatric allergic disease is incompletely understood. We review the evidence that links climate change to changes in aeroallergens such as pollen and outdoor mold concentrations and, subsequently, aeroallergen association with pediatric allergic disease. We specifically explore the evidence on both the exacerbation and the development of allergic disease in children related to outdoor pollen and mold concentrations. Pediatric allergic diseases include atopic dermatitis or eczema, allergic rhinitis or hay fever, and some types of asthma in children, typically defined as < 18 years of age. We discuss how the timing of aeroallergen exposure both in utero and in childhood could be associated with allergies. We conclude that the magnitude and type of health impacts due to climate change will depend on improved understanding of the relationship between climatic variables, multiple allergen factors, and allergic disease. Improved public-health strategies such as adequate humidity control, optimum air filtration and ventilation, and improved anticipatory public-health messaging will be critical to adaptation."

Climate change, aeroallergens, and pediatric allergic disease.
Sheffield PE, Weinberger KR, Kinney PL.
Mt Sinai J Med 2011 Jan;78(1):78-84

Histamine intolerance: lack of reproducibility of single symptoms by oral provocation with histamine.
Histamine intolerance represents a range of symptoms involving various effector organs following ingestion of histamine-rich food. This study evaluated histamine-associated symptoms and analysed whether oral administration of the histamine-degrading enzyme diamine oxidase (DAO) caused a reduction of symptoms. Four Austrian centres participated. Patients were given open oral provocation with 75 mg of liquid histamine. Patients who developed symptoms were tested in a randomised double blind crossover provocation protocol using histamine-containing and histamine-free tea in combination with DAO capsules or placebo. Thirty nine patients reacted to the open histamine provocation and were enrolled in the blinded part. Here, both the main and secondary symptoms were not reproducible. Subjects reacted sometimes unexpectedly and randomly. The intake of DAO demonstrated a statistically significant reduction of histamine-associated symptoms compared to placebo (P = 0.014). Therefore oral provocation with 75 mg of liquid histamine failed to reproduce histamine-associated single symptoms in many patients suggesting that histamine-intolerant subjects reacted with different organs on different occasions. As a consequence, reproducibility of single symptoms alone may not be appropriate to diagnose histamine-intolerance whereas a global symptom score could be more appropriate. That the intake of DAO capsules led to a statistically significant reduction of total symptom scores may indirectly suggest the same.

Histamine intolerance: lack of reproducibility of single symptoms by oral provocation with histamine: a randomised, double-blind, placebo-controlled cross-over study. [German]
Komericki P, Klein G, Reider N, Hawranek T, Strimitzer T, Lang R, Kranzelbinder B, Aberer W.
Wien Klin Wochenschr 2011 Jan;123(1-2):15-20

Allergen-, Food allergy-, Intolerance-related articles

Co-sensitisation (but co-recognition also) to novel banana and tomato allergens.
Asero R, Mistrello G, Amato S. Eur Ann Allergy Clin Immunol 2010 Aug;42(4):159-162

Cow's milk dependent exercise-induced urticaria after oral tolerance induction in an adolescent.
Couto M, Gaspar A, Santa-Marta C, Morais-Almeida M. Allergol Immunopathol (Madr) 2011 Jun 20;

Macrolide allergy: Which tests are really useful?
Chia FL, Thong BY. Allergol Immunopathol (Madr) 2011 Jun 6;

A role for measurement of nasal IgE antibodies in diagnosis of Alternaria-induced rhinitis in children.
Fuiano N, Fusilli S, Incorvaia C. Allergol Immunopathol (Madr) 2011 Jun 3;

Resolution of IgE-mediated fish allergy.
Pite H, Prates S, Borrego LM, Matos V, Loureiro V, Leiria-Pinto P. Allergol Immunopathol (Madr) 2011 Jun 1;

Is food anaphylaxis a cause of antiphospholipid syndrome and thrombosis or a coincidence?
Korkmaz C. Allergol Immunopathol (Madr) 2011 Jun 13;

Severe dermatitis caused by diltiazem.
Miralles JC, Carbonell A, Sanchez-Guerrero I, Pastor F, Escudero A, Brufau C, Lopez-Andreu F. Allergol Immunopathol (Madr) 2011 Jun 4;

Hypersensitivity to Fludrocortisone Acetate in a Recipient of Bone Marrow Transplantation.
Kato J, Mori T, Kamo M, Tanikawa A, Iketani O, Okamoto S. Allergol Int 2011 Jun 25;

Tropomyosin IgE-positive results are a good predictor of shrimp allergy.
Gamez C, Sanchez-Garcia S, Ibanez MD, Lopez R, Aguado E, Lopez E, Sastre B, Sastre J, Del P. Allergy 2011 Jun 9;

Molecular cloning and characterization of Fag t 2: a 16-kDa major allergen from Tartary buckwheat seeds.
Chen P, Guo YF, Yan Q, Li YH. Allergy 2011 Jun 4;

Reply: IgG4 antibodies against rodents in laboratory animal workers do not protect against allergic sensitization.
Jones M, Jeal H. Allergy 2011 Jun 7;

Corticosteroid cross-reactivity: clinical and molecular modelling tools.
Baeck M, Chemelle JA, Goossens A, Nicolas JF, Terreux R. Allergy 2011 Jun 14;

Api m 10, a genuine A. mellifera venom allergen, is clinically relevant but underrepresented in therapeutic extracts.
Blank S, Seismann H, Michel Y, McIntyre M, Cifuentes L, Braren I, Grunwald T, Darsow U, Ring J, Bredehorst R, Ollert M, Spillner E. Allergy 2011 Jun 10;

Drug-induced lichenoid reaction after kyphoplasty.
Weinborn M, Waton J, Roch D, Schmutz JL, Barbaud A. Allergy 2011 Jun 7;

Anaphylaxis related to avocado ingestion: a case and review.
Abrams EM, Becker AB, Gerstner TV. Allergy Asthma Clin Immunol 2011 Jun 10;7(1):12

Peanut sensitization in a group of allergic Egyptian children.
Hossny E, Gad G, Shehab A, El-Haddad A. Allergy Asthma Clin Immunol 2011 May 31;7(1):11

Occupational asthma in the aluminum smelters of Australia and New Zealand: 1991-2006.
Donoghue AM, Frisch N, Ison M, Walpole G, Capil R, Curl C, Di CR, Hanna B, Robson R, Viljoen D. Am J Ind Med 2011 Mar;54(3):224-231

Exposure to flour dust and sensitization among bakery employees.
Page EH, Dowell CH, Mueller CA, Biagini RE, Heederik D. Am J Ind Med 2010 Dec;53(12):1225-1232

Work-relatedness of selected chronic medical conditions and workers' compensation utilization: National health interview survey occupational health supplement data.
Luckhaupt SE, Calvert GM. Am J Ind Med 2010 Dec;53(12):1252-1263

Complications of allergic fungal sinusitis.
Bozeman S, deShazo R, Stringer S, Wright L. Am J Med 2011 Apr;124(4):359-368

Con: respiratory risks associated with chlorinated swimming pools: a complex pattern of exposure and effects.
Bernard A, Voisin C, Sardella A. Am J Respir Crit Care Med 2011 Mar 1;183(5):570-572

Pro: swimming in chlorinated pools and risk of asthma: we can now carry on sending our children to swimming pools!.
Piacentini GL, Baraldi E. Am J Respir Crit Care Med 2011 Mar 1;183(5):569-570

Segmental allergen challenge alters multimeric structure and function of surfactant protein D in humans.
tochina-Vasserman EN, Winkler C, Abramova H, Schaumann F, Krug N, Gow AJ, Beers MF, Hohlfeld JM. Am J Respir Crit Care Med 2011 Apr 1;183(7):856-864

Selective nasal allergen provocation induces substance P-mediated bronchial hyperresponsiveness.
Hens G, Raap U, Vanoirbeek J, Meyts I, Callebaut I, Verbinnen B, Vanaudenaerde BM, Cadot P, Nemery B, Bullens DM, Ceuppens JL, Hellings PW. Am J Respir Cell Mol Biol 2011 Apr;44(4):517-523

Food-dependent exercise-induced anaphylaxis-sequence of causative factors might be reversed.
Wolanczyk-Medrala A, Barg W, Radlinska A, Panaszek B, Medrala W. Ann Agric Environ Med 2010 Dec;17(2):315-317

On the cover-hop hornbeam.
Weber RW. Ann Allergy Asthma Immunol 2011 Jun;106(6):A6

Seafood allergy in children: a descriptive study.
Turner P, Ng I, Kemp A, Campbell D. Ann Allergy Asthma Immunol 2011 Jun;106(6):494-501

Identification of mold on seasonal indoor coniferous trees.
Kurlandsky LE, Przepiora J, Riddell SW, Kiska DL. Ann Allergy Asthma Immunol 2011 Jun;106(6):543-544

Fixed drug eruption on the penis due to oxcarbazepine.
Schuster C, Kranke B, Aberer W, Komericki P. Arch Dermatol 2011 Mar;147(3):362-364

Impact of omega-5 gliadin on wheat-dependent exercise-induced anaphylaxis in mice.
Tanaka M, Nagano T, Yano H, Matsuda T, Ikeda TM, Haruma K, Kato Y. Biosci Biotechnol Biochem 2011;75(2):313-317

Food allergies in children. Don't forget allergy in eczema.
Durham LE. BMJ 2011;342d2294

CD4 allergen tetramers.
Thomas WR. Clin Exp Allergy 2011 Jun;41(6):769-772

Allergen inhalation challenge in smoking compared with non-smoking asthmatic subjects.
Meghji Z, Dua B, Watson RM, Gauvreau GM, O'Byrne PM. Clin Exp Allergy 2011 Jun 1;

Potential allergens of green gram (Vigna radiata L. Millsp) identified as members of cupin superfamily and seed albumin.
Misra A, Kumar R, Mishra V, Chaudhari BP, Raisuddin S, Das M, Dwivedi PD. Clin Exp Allergy 2011 Jun 1;

Photodermatitis caused by oral ketoprofen: two case reports.
Caterina F, Nicoletta C, Antonio VG, Gianni A. Contact Dermatitis 2011 Mar;64(3):181-183

Occupational erythema multiforme-like contact reaction to iodoacetonitrile in a chemistry student.
Foti C, Soleo L, Romita P, Vestita M, Antonella B, Antelmi A. Contact Dermatitis 2011 Mar;64(3):180-181

Anaphylactic reactions following Kenacort-A(R) injection: carboxymethylcellulose is involved once again.
Al HA, van MM, Vermes A. Contact Dermatitis 2011 Mar;64(3):179-180

The increase in p-phenylenediamine allergy in Denmark is not explained by an increase in contact allergy to para group chemicals.
Thyssen JP, Menne T, Johansen JD. Contact Dermatitis 2011 Mar;64(3):176-179

Age-related sensitization to p-phenylenediamine.
Almeida PJ, Borrego L, Liminana JM. Contact Dermatitis 2011 Mar;64(3):172-174

Is matrix metalloproteinase-9 a culprit involved in dermatitis? Increased expression of gelatinolytic activity in allergic contact dermatitis.
Kobayashi T. Contact Dermatitis 2011 Mar;64(3):171-172

Contact dermatitis and secondary systemic allergy to dimethindene maleate.
Leroy A, Baeck M, Tennstedt D. Contact Dermatitis 2011 Mar;64(3):170-171

Allergic contact dermatitis caused by glycyrrhetinic acid and castor oil.
Sasseville D, Desjardins M, Almutawa F. Contact Dermatitis 2011 Mar;64(3):168-169

Occupational allergic contact dermatitis caused by morphine.
Sasseville D, Blouin MM, Beauchamp C. Contact Dermatitis 2011 Mar;64(3):166-168

Allergic contact dermatitis caused by tetrahydroxypropyl ethylenediamine in cosmetic products.
Goossens A, Baret I, Swevers A. Contact Dermatitis 2011 Mar;64(3):161-164

Occupational allergic contact dermatitis caused by rhodium solutions.
Goossens A, Cattaert N, Nemery B, Boey L, De GE. Contact Dermatitis 2011 Mar;64(3):158-161

Nickel deposited on the skin-visualization by DMG test.
Julander A, Skare L, Vahter M, Liden C. Contact Dermatitis 2011 Mar;64(3):151-157

Nickel allergy is still frequent in young German females - probably because of insufficient protection from nickel-releasing objects.
Schnuch A, Wolter J, Geier J, Uter W. Contact Dermatitis 2011 Mar;64(3):142-150

No association between metal allergy and cardiac in-stent restenosis in patients with dermatitis-results from a linkage study.
Thyssen JP, Engkilde K, Menne T, Johansen JD, Hansen PR, Gislason GH. Contact Dermatitis 2011 Mar;64(3):138-141

The EU Nickel Directive revisited--future steps towards better protection against nickel allergy.
Thyssen JP, Uter W, McFadden J, Menne T, Spiewak R, Vigan M, Gimenez-Arnau A, Liden C. Contact Dermatitis 2011 Mar;64(3):121-125

The relevance of chlorhexidine contact allergy.
Liippo J, Kousa P, Lammintausta K. Contact Dermatitis 2011 Apr;64(4):229-234

Nickel sensitization in orthodontically treated and non-treated female adolescents.
Johansson K, Kerosuo H, Lammintausta K. Contact Dermatitis 2011 Mar;64(3):132-137

Fluctuations in the prevalence of nickel and cobalt allergy in eczema patients patch tested after implementation of the nickel regulation in Denmark.
Caroe C, Andersen KE, Mortz CG. Contact Dermatitis 2011 Mar;64(3):126-131

Allergic contact dermatitis caused by an ethinylestradiol-norelgestromin transdermal therapeutic system.
Alfaya T, Mur GP, Iglesias AM, Ventura P. Contact Dermatitis 2011 Apr;64(4):242-244

Allergy to oxidized linalool in the UK.
Buckley DA. Contact Dermatitis 2011 Apr;64(4):240-241

Cobalt release from inexpensive earrings from Thailand and China.
Hamann C, Hamann D, Hamann KK, Thyssen JP. Contact Dermatitis 2011 Apr;64(4):238-240

Allergic contact dermatitis caused by Salvia officinalis extract.
Mayer E, Gescheidt-Shoshany H, Weltfriend S. Contact Dermatitis 2011 Apr;64(4):237-238

Prevalence of cutaneous reactions to the pine processionary moth (Thaumetopoea pityocampa) in an adult population.
Vega JM, Moneo I, Ortiz JC, Palla PS, Sanchis ME, Vega J, Gonzalez-Munoz M, Battisti A, Roques A. Contact Dermatitis 2011 Apr;64(4):220-228

Fragrance allergens in 'specific' cosmetic products.
Nardelli A, Drieghe J, Claes L, Boey L, Goossens A. Contact Dermatitis 2011 Apr;64(4):212-219

Is cocamidopropyl betaine a contact allergen? Analysis of network data and short review of the literature.
Schnuch A, Lessmann H, Geier J, Uter W. Contact Dermatitis 2011 Apr;64(4):203-211

Late reactions to patch test preparations with reduced concentrations of p-phenylenediamine: a multicentre investigation of the German Contact Dermatitis Research Group.
Hillen U, Dickel H, Loffler H, Pfutzner W, Mahler V, Becker D, Brasch J, Worm M, Fuchs T, John SM, Geier J. Contact Dermatitis 2011 Apr;64(4):196-202

Metal allergen of the 21st century--a review on exposure, epidemiology and clinical manifestations of palladium allergy.
Faurschou A, Menne T, Johansen JD, Thyssen JP. Contact Dermatitis 2011 Apr;64(4):185-195

Allergic contact dermatitis caused by benzophenone-4 in a printer.
Caruana DM, McPherson T, Cooper S. Contact Dermatitis 2011 Mar;64(3):183-184

Role of allergen sensitization in older adults.
Viswanathan RK, Mathur SK. Curr Allergy Asthma Rep 2011 Jun 11;

Molecular diagnosis of cow's milk allergy.
Fiocchi A, Bouygue GR, Albarini M, Restani P. Curr Opin Allergy Clin Immunol 2011 Jun;11(3):216-221

Food allergies and asthma.
Wang J, Liu AH. Curr Opin Allergy Clin Immunol 2011 Jun;11(3):249-254

Molecular diagnosis of egg allergy.
Caubet JC, Kondo Y, Urisu A, Nowak-Wegrzyn A. Curr Opin Allergy Clin Immunol 2011 Jun;11(3):210-215

Food-induced anaphylaxis.
Jarvinen KM. Curr Opin Allergy Clin Immunol 2011 Jun;11(3):255-261

Cow's milk allergy as a global challenge.
Sackesen C, Assa'ad A, Baena-Cagnani C, Ebisawa M, Fiocchi A, Heine RG, Von BA, Kalayci O. Curr Opin Allergy Clin Immunol 2011 Jun;11(3):243-248

Microarray of allergenic component-based diagnosis in food allergy.
Sanz ML, Blazquez AB, Garcia BE. Curr Opin Allergy Clin Immunol 2011 Jun;11(3):204-209

Insect anaphylaxis: addressing clinical challenges.
Tracy JM, Lewis EJ, Demain JG. Curr Opin Allergy Clin Immunol 2011 Jun 8;

Anaphylaxis to radiographic contrast media.
Brockow K, Ring J. Curr Opin Allergy Clin Immunol 2011 Jun 8;

Proteomics in immunological reactions to drugs.
Ariza A, Montanez MI, Perez-Sala D. Curr Opin Allergy Clin Immunol 2011 Jun 8;

Role of dendritic cells in drug allergy.
Blazquez AB, Cuesta J, Mayorga C. Curr Opin Allergy Clin Immunol 2011 Jun 8;

Hypersensitivity reactions to quinolones.
Blanca-Lopez N, Andreu I, Torres Jaen MJ. Curr Opin Allergy Clin Immunol 2011 Jun 8;

Drug provocation tests in hypersensitivity drug reactions.
Rerkpattanapipat T, Chiriac AM, Demoly P. Curr Opin Allergy Clin Immunol 2011 Jun 8;

Quality of life in food allergy.
Lieberman JA, Sicherer SH. Curr Opin Allergy Clin Immunol 2011 Jun;11(3):236-242

Molecular diagnosis of peanut and legume allergy.
Nicolaou N, Custovic A. Curr Opin Allergy Clin Immunol 2011 Jun;11(3):222-228

Immediate adverse reactions to biologicals: from pathogenic mechanisms to prophylactic management.
Vultaggio A, Maggi E, Matucci A. Curr Opin Allergy Clin Immunol 2011 Jun;11(3):262-268

Dermatologic manifestations of musicians: a case report and review of skin conditions in musicians.
Vine K, DeLeo V. Cutis 2011 Mar;87(3):117-121

Another 'suspect': homeopathic agent associated with acute interstitial nephritis. [German]
Mekle G. Dtsch Med Wochenschr 2011 Mar;136(12):601-602

Personal exposures to traffic-related air pollution and acute respiratory health among Bronx schoolchildren with asthma.
Spira-Cohen A, Chen LC, Kendall M, Lall R, Thurston GD. Environ Health Perspect 2011 Apr;119(4):559-565

Cockroach induces inflammatory responses through protease-dependent pathways.
Wada K, Matsuwaki Y, Moriyama H, Kita H. Int Arch Allergy Immunol 2011;155 Suppl 1135-141

Oral food challenges in children with a diagnosis of food allergy.
Fleischer DM, Bock SA, Spears GC, Wilson CG, Miyazawa NK, Gleason MC, Gyorkos EA, Murphy JR, Atkins D, Leung DY. J Pediatr 2011 Apr;158(4):578-583

Hypersensitivity to systemic corticosteroids in aspirin-sensitive patients with asthma.
Szczeklik A. J Allergy Clin Immunol 2011 Jun 21;

Effect of a partially hydrolyzed whey infant formula at weaning on risk of allergic disease in high-risk children: A randomized controlled trial.
Lowe AJ, Hosking CS, Bennett CM, Allen KJ, Axelrad C, Carlin JB, Abramson MJ, Dharmage SC, Hill DJ. J Allergy Clin Immunol 2011 Jun 20;

Food protein-induced enterocolitis syndrome by cow's milk proteins passed through breast milk.
Monti G, Castagno E, Liguori SA, Lupica MM, Tarasco V, Viola S, Tovo PA. J Allergy Clin Immunol 2010 Dec 10;

Both the variability and level of mouse allergen exposure influence the phenotype of the immune response in workers at a mouse facility.
Peng RD, Paigen B, Eggleston PA, Hagberg KA, Krevans M, Curtin-Brosnan J, Benson C, Shreffler WG, Matsui EC. J Allergy Clin Immunol 2011 Jun 20;

Gene polymorphisms, breast-feeding, and development of food sensitization in early childhood.
Hong X, Wang G, Liu X, Kumar R, Tsai HJ, Arguelles L, Hao K, Pearson C, Ortiz K, Bonzagni A, Apollon S, Fu L, Caruso D, Pongracic JA, Schleimer R, Holt PG, Bauchner H, Wang X. J Allergy Clin Immunol 2011 Jun 18;

Redundant ability of phagocytes to kill Aspergillus species.
Roesler J, Rosen-Wolff A. J Allergy Clin Immunol 2011 Jun 18;

Possession of epinephrine auto-injectors by Canadians with food allergies.
Soller L, Fragapane J, Ben-Shoshan M, Harrington DW, Alizadehfar R, Joseph L, St PY, Godefroy SB, La VS, Elliott SJ, Clarke AE. J Allergy Clin Immunol 2011 Jun 17;

Aspergillus fumigatus synergistically enhances mite-induced allergic airway inflammation.
Fukushima C, Matsuse H, Fukahori S, Tsuchida T, Kawano T, Senjyu H, Kohno S. Med Sci Monit 2010 Jul;16(7):BR197-BR202

Anaphylaxis from passive transfer of peanut allergen in a blood product.
Jacobs JF, Baumert JL, Brons PP, Joosten I, Koppelman SJ, van Pampus EC. N Engl J Med 2011 May 19;364(20):1981-1982

Increased throat symptoms in Japanese cypress pollinosis. [Japanese]
Ogihara H, Yuta A, Miyamoto Y, Kitano M, Takeo T, Takeuchi K. Nippon Jibiinkoka Gakkai Kaiho 2011 Feb;114(2):78-83

Occupational allergic rhinoconjunctivitis and bronchial asthma induced by Plukenetia volubilis seeds.
Bueso A, Rodriguez-Perez R, Rodriguez M, Dionicio J, Perez-Pimiento A, Caballero ML. Occup Environ Med 2010 Nov;67(11):797-798

Occupational asthma due to 5-aminosalicylic acid.
Sastre J, Garcia del PM, Aguado E, Fernandez-Nieto M. Occup Environ Med 2010 Nov;67(11):798-799

Is potroom asthma due more to sulphur dioxide than fluoride? An inception cohort study in the Australian aluminium industry.
Abramson MJ, Benke GP, Cui J, de Klerk NH, Del MA, Dennekamp M, Fritschi L, Musk AW, Sim MR. Occup Environ Med 2010 Oct;67(10):679-685

Educational case series: Mechanisms of drug allergy.
Caubet JC, Pichler WJ, Eigenmann PA. Pediatr Allergy Immunol 2011 Jun 6;

The impact of age on prevalence of positive skin prick tests and specific IgE tests.
Scichilone N, Callari A, Augugliaro G, Marchese M, Togias A, Bellia V. Respir Med 2011 May;105(5):651-658

Allergy-inducing nickel concentration is lowered by lipopolysaccharide at both the sensitization and elicitation steps in a murine model.
Kinbara M, Sato N, Kuroishi T, Takano-Yamamoto T, Sugawara S, Endo Y. Br J Dermatol 2011 Feb;164(2):356-362

Pragmatic approach to the clinical work-up of patients with putative allergic disease to metallic orthopaedic implants before and after surgery.
Thyssen JP, Menne T, Schalock PC, Taylor JS, Maibach HI. Br J Dermatol 2011 Mar;164(3):473-478

Contact allergy to formaldehyde.
De Groot AC. Br J Dermatol 2011 Mar;164(3):463

Lifetime exposure to cigarette smoking and the development of adult-onset atopic dermatitis.
Lee CH, Chuang HY, Hong CH, Huang SK, Chang YC, Ko YC, Yu HS. Br J Dermatol 2011 Mar;164(3):483-489

Hypersensitivity pneumonitis and metalworking fluids contaminated by mycobacteria.
Tillie-Leblond I, Grenouillet F, Reboux G, Roussel S, Chouraki B, Lorthois C, Dalphin JC, Wallaert B, Millon L. Eur Respir J 2011 Mar;37(3):640-647

Titanium and gold nanoparticles in asthma: the bad and the ugly.
Lanone S, Boczkowski J. Eur Respir J 2011 Feb;37(2):225-227

Salicylate intoxication from teething gel in infancy.
Williams GD, Kirk EP, Wilson CJ, Meadows CA, Chan BS. MJA 2011;194(3):146-148

Climate change, aeroallergens, and pediatric allergic disease.
Sheffield PE, Weinberger KR, Kinney PL. Mt Sinai J Med 2011 Jan;78(1):78-84

Histamine intolerance: lack of reproducibility of single symptoms by oral provocation with histamine: a randomised, double-blind, placebo-controlled cross-over study. [German]
Komericki P, Klein G, Reider N, Hawranek T, Strimitzer T, Lang R, Kranzelbinder B, Aberer W. Wien Klin Wochenschr 2011 Jan;123(1-2):15-20

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