Adaptive immune responses associated with allergic reactions recognize antigens from a broad spectrum of plants and animals. Herein a meta-analysis was performed on allergy-related data from the immune epitope database (IEDB) to provide a current inventory and highlight knowledge gaps and areas for future work. The analysis identified over 4,500 allergy-related epitopes derived from 270 different allergens. Overall, the distribution of the data followed expectations based on the nature of allergic responses. Namely, the majority of epitopes were defined for B cells/antibodies and IgE-mediated reactivity, and relatively fewer T-cell epitopes, mostly  CD4<sup>+</sup>/class II. Interestingly, the majority of food allergen epitopes were B-cells epitopes whereas a fairly even number of B- and T-cell epitopes were defined for airborne allergens. In addition, epitopes from nonhumans hosts were mostly T-cell epitopes. Overall, coverage of known allergens is sparse with data available for only ~17&#x0025;  of all allergens listed by the IUIS database. Thus, further research would be required to provide a more balanced representation across different allergen categories. Furthermore, inclusion of nonpeptidic epitopes in the IEDB also allows for inventory and analysis of immunological data associated with drug and contact allergen epitopes. Finally, our analysis also underscores that only a handful of epitopes have thus far been investigated for their immunotherapeutic potential.

Kerrie Vaughan

Jason Greenbaum

Yohan Kim

Randi Vita

Jo Chung

Bjoern Peters

David Broide

Richard Goodman

Howard Grey

Alessandro Sette

Towards Defining Molecular Determinants Recognized by Adaptive Immunity in Allergic Disease: An Inventory of the Available Data

Allergy is on the rise worldwide. Asthma, food allergy, dermatitis, and systemic anaphylaxis are amongst the most common allergic diseases. The association between allergy and altered behavior patterns has long been recognized. The molecular and cellular pathways in the bidirectional interactions of nervous and immune systems are now starting to be elucidated. In this paper, we outline the consequences of allergic diseases, especially food allergy and asthma, on behavior and neural activity and on the neural modulation of allergic responses.

L. Mirotti

J. Castro

F. A. Costa-Pinto

M. Russo

Neural Pathways in Allergic Inflammation

<i  >Background</i>. Asthma and obesity are common; however the impact of obesity upon asthma remains uncertain. <i  >Objectives</i>. To assess relationships between obesity and fat mass with airway inflammation, lung function, and disease control in patients with refractory asthma. <i  >Methods</i>. 151 refractory asthma patients were characterised for measures of airway inflammation, lung function, Juniper asthma control questionnaire (JACQ), body mass index (BMI), and fat mass index (FMI) derived from dual energy X-ray absorptiometry. Patients were reassessed over 12 months. <i  >Results</i>. 74&#x25; of patients had an elevated BMI. BMI and FMI correlated (<svg     style="vertical-align:-0.20474pt;width:46.912498px;" id="M1" height="11.175" version="1.1" viewBox="0 0 46.912498 11.175" width="46.912498"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,10.862)"><path id="x1D45F" d="M393 379q-9 -16 -28 -29q-15 -10 -23 -2q-19 19 -36 19q-21 0 -52 -38q-57 -72 -82 -126l-40 -197q-23 -3 -75 -18l-7 7q49 196 74 335q7 43 -2 43q-7 0 -30 -14.5t-47 -37.5l-16 23q37 42 82 73t67 31q41 0 15 -113l-11 -50h4q41 71 85 117t77 46q29 0 45 -26&#xA;q13 -21 0 -43z" /></g><g transform="matrix(.017,-0,0,-.017,11.945,10.862)"><path id="x3D" d="M535 323h-483v50h483v-50zM535 138h-483v50h483v-50z" /></g><g transform="matrix(.017,-0,0,-.017,26.649,10.862)"><path id="x30" d="M241 635q53 0 94 -28.5t63.5 -76t33.5 -102.5t11 -116q0 -58 -11 -112.5t-34 -103.5t-63.5 -78.5t-94.5 -29.5t-95 28t-64.5 75t-34.5 102.5t-11 118.5q0 58 11.5 112.5t34.5 103t64.5 78t95.5 29.5zM238 602q-32 0 -55.5 -25t-35.5 -68t-17.5 -91t-5.5 -105&#xA;q0 -76 10 -138.5t37 -107.5t69 -45q32 0 55.5 25t35.5 68.5t17.5 91.5t5.5 105t-5.5 105.5t-18 92t-36 68t-56.5 24.5z" /></g><g transform="matrix(.017,-0,0,-.017,34.808,10.862)"><path id="x2E" d="M113 -12q-24 0 -39.5 16t-15.5 42q0 24 16 40.5t40 16.5t40 -16.5t16 -40.5q0 -26 -16 -42t-41 -16z" /></g><g transform="matrix(.017,-0,0,-.017,38.684,10.862)"><path id="x39" d="M244 635q90 0 143 -72t53 -177q0 -133 -65 -229.5t-171 -139.5q-79 -32 -140 -32l-5 30q109 18 185 91t101 186l-68 -36q-29 -16 -60 -16q-79 0 -129 51.5t-50 130.5q0 80 57 146.5t149 66.5zM228 602q-52 0 -78 -45.5t-26 -98.5q0 -69 36.5 -115.5t97.5 -46.5&#xA;q53 0 90 28q4 31 4 66q0 51 -9.5 95.5t-39 80.5t-75.5 36z" /></g>

		
	
</svg>, <svg     style="vertical-align:-0.1638pt;width:58.712502px;" id="M2" height="11.375" version="1.1" viewBox="0 0 58.712502 11.375" width="58.712502"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,11.112)"><path id="x1D443" d="M619 482q0 -69 -40.5 -119t-96 -72.5t-118.5 -26.5h-44l-70 20l-31 -151q-14 -67 0.5 -83t89.5 -22l-5 -28h-287l8 28q65 7 81.5 22t29.5 83l79 398q12 56 0.5 70.5t-78.5 20.5l7 28h255q108 0 164 -43t56 -125zM524 478q0 141 -146 141q-25 0 -47 -8q-16 -6 -20.5 -13.5&#xA;t-10.5 -39.5l-43 -241q37 -13 83 -13q67 0 125.5 45t58.5 129z" /></g><g transform="matrix(.017,-0,0,-.017,15.582,11.112)"><path id="x3C" d="M512 -3l-437 233v51l437 233v-58l-378 -200v-2l378 -199v-58z" /></g><g transform="matrix(.017,-0,0,-.017,30.286,11.112)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,34.162,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,42.321,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,50.481,11.112)"><path id="x31" d="M384 0h-275v27q67 5 81.5 18.5t14.5 68.5v385q0 38 -7.5 47.5t-40.5 10.5l-48 2v24q85 15 178 52v-521q0 -55 14.5 -68.5t82.5 -18.5v-27z" /></g>

		
	
</svg>). FMI and JACQ correlated in men (<svg     style="vertical-align:-0.1638pt;width:46.912498px;" id="M3" height="11.125" version="1.1" viewBox="0 0 46.912498 11.125" width="46.912498"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,10.862)"><use xlink:href="#x1D45F"/></g><g transform="matrix(.017,-0,0,-.017,11.945,10.862)"><use xlink:href="#x3D"/></g><g transform="matrix(.017,-0,0,-.017,26.649,10.862)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,34.808,10.862)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,38.684,10.862)"><path id="x33" d="M285 378v-2q65 -13 102 -54.5t37 -97.5q0 -57 -30.5 -104.5t-74 -75t-85.5 -42t-72 -14.5q-31 0 -59.5 11t-40.5 23q-19 18 -16 36q1 16 23 33q13 10 24 0q58 -51 124 -51q55 0 88 40t33 112q0 64 -39 96.5t-88 32.5q-29 0 -64 -11l-6 29q77 25 118 57.5t41 84.5&#xA;q0 45 -26.5 69.5t-68.5 24.5q-67 0 -120 -79l-20 20l43 63q51 56 127 56h1q66 0 107 -37t41 -95q0 -42 -31 -71q-22 -23 -68 -54z" /></g>

		
	
</svg>, <svg     style="vertical-align:-0.1638pt;width:50.549999px;" id="M4" height="11.375" version="1.1" viewBox="0 0 50.549999 11.375" width="50.549999"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,11.112)"><use xlink:href="#x1D443"/></g><g transform="matrix(.017,-0,0,-.017,15.582,11.112)"><use xlink:href="#x3D"/></g><g transform="matrix(.017,-0,0,-.017,30.286,11.112)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,34.162,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,42.321,11.112)"><use xlink:href="#x31"/></g>

		
	
</svg>). After 12 months 23&#x25; lost weight. Weight change over 12 months correlated with FEV<sub  >1</sub> change (<svg     style="vertical-align:-0.1638pt;width:56.887501px;" id="M5" height="11.125" version="1.1" viewBox="0 0 56.887501 11.125" width="56.887501"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,10.862)"><use xlink:href="#x1D45F"/></g><g transform="matrix(.017,-0,0,-.017,11.945,10.862)"><use xlink:href="#x3D"/></g><g transform="matrix(.017,-0,0,-.017,26.649,10.862)"><path id="x2212" d="M535 230h-483v50h483v-50z" /></g><g transform="matrix(.017,-0,0,-.017,36.627,10.862)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,44.786,10.862)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,48.662,10.862)"><use xlink:href="#x33"/></g>

		
	
</svg>, <svg     style="vertical-align:-0.1638pt;width:50.549999px;" id="M6" height="11.375" version="1.1" viewBox="0 0 50.549999 11.375" width="50.549999"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,11.112)"><use xlink:href="#x1D443"/></g><g transform="matrix(.017,-0,0,-.017,15.582,11.112)"><use xlink:href="#x3D"/></g><g transform="matrix(.017,-0,0,-.017,30.286,11.112)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,34.162,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,42.321,11.112)"><use xlink:href="#x33"/></g>

		
	
</svg>), but not with change in JACQ or exacerbations. <i  >Conclusion</i>. Increased fat mass is common in refractory asthma and is associated with asthma symptom control in men. Loss of weight is associated with improvement in lung function in refractory asthma.

Mona Bafadhel

Amisha Singapuri

Sarah Terry

Beverley Hargadon

William Monteiro

Ruth H. Green

Peter H. Bradding

Andrew J. Wardlaw

Ian D. Pavord

Christopher E. Brightling

Body Mass and Fat Mass in Refractory Asthma: An Observational 1 Year Follow-Up Study

The complex phenotype of allergic bronchial asthma involves a variable degree of bronchoobstruction, increased mucus production, and airway remodeling. So far it is suggested that it arises from multiple interactions of infiltrating and structural cells in the context of chronic airway inflammation that is orchestrated by T helper 2 (TH2) cells. By secreting a plethora of typical mediators such as interleukin (IL) 4, IL-5, and IL-13, these cells hold a key position in asthma pathogenesis. However, therapeutic approaches targeting these TH2-type mediators failed to improve asthma symptoms and impressively showed that asthma pathogenesis cannot be reduced by TH2 cell functions. Recently, other T helper cells, that is, TH9 and TH17 cells, have been identified and these cells also contribute to asthma pathogenesis, the processes leading to formation or aggravation of asthma. Furthermore, TH25 cells, TH3 cells, and regulatory T cells have also been implicated in asthma pathogenesis. This paper aims at summarizing recent insights about these new T helper cells in asthma pathogenesis.

Christina Vock

Hans-Peter Hauber

Michael Wegmann

The Other T Helper Cells in Asthma Pathogenesis

<i>Objectives</i>. The study's objective was to examine the relation between mold/dampness exposure and mold  sensitization among residents of  Greater New Orleans following Hurricane Katrina. <i>Methods</i>. Patients were recruited from the Allergy Clinic of a major medical facility.  Any patient receiving a skin prick test for one of 24 molds between December 1, 2005 and December 31, 2008 was eligible for the study.  Exposure was assessed using standardized questionnaires. Positive mold reactivity was defined as a wheal diameter &gt;3 mm to any mold genera. <i>Results</i>. Approximately 57% of participants tested positive to any indoor allergen, 10% to any mold. Over half of respondents had significant home damage, 34% reported dampness/mold in their home, half engaged in renovation, and one-third lived in a home undergoing renovation. Despite extensive exposure, and multiple measures of exposure, we found no relationship between mold/dampness exposure and sensitivity to mold allergens. <i>Conclusions</i>. These results along with results of earlier research indicate no excess risk of adverse respiratory effects for residents living in New Orleans after the devastation of Hurricane Katrina.

Felicia A. Rabito

Sara Perry

W. Edward Davis

C. Lillian Yau

Estelle Levetin

The Relationship between Mold Exposure and Allergic Response in Post-Katrina New Orleans

<i  >Background</i>. Proximity to heavy traffic has been linked to increased asthma severity. However, it is unknown whether exposure to heavy traffic is associated with the ability to maintain asthma control. <i  >Objectives</i>. This study examines whether exposure to heavy traffic is associated with the ability to maintain asthma control in inner-city children. <i  >Methods</i>. 756 inner-city asthmatic Hispanic children were followed for one year in a pediatric asthma management program (Breathmobile). At each scheduled visit, asthma specialist tracked patients' asthma severity and managed their asthma based on the NAEPP guidelines. The patients' residential distance from the nearest freeway was calculated based on residential address at study entry. Distance to nearest freeway was used as a surrogate marker for high exposure from traffic-related air pollutants. <i  >Results</i>. Patients who lived near a freeway were significantly more likely to have asthma that was not well controlled (<svg style="vertical-align:-0.17555pt;width:48.337502px;" id="M1" height="10.9125" version="1.1" viewBox="0 0 48.337502 10.9125" width="48.337502"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,10.9125)">
		<g transform="translate(72,-63.27)">
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				<tspan style="font-size: 12.50px; " x="0" y="0">𝑃</tspan>
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				<tspan style="font-size: 12.50px; " x="32.307751" y="0">3</tspan>
			</text>

		</g>
	</g>
</svg>). Patients with intermittent and mild baseline severity have a two-fold increased risk of having asthma that is uncontrolled if they lived <svg style="vertical-align:-0.30096pt;width:22.987499px;" id="M2" height="11.0625" version="1.1" viewBox="0 0 22.987499 11.0625" width="22.987499"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,11.0625)">
		<g transform="translate(72,-63.15)">
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				<tspan style="font-size: 12.50px; " x="12.027886" y="0">2</tspan>
			</text>

		</g>
	</g>
</svg>&#x2009;miles from a freeway (<svg style="vertical-align:-0.17554pt;width:60.762501px;" id="M3" height="10.9125" version="1.1" viewBox="0 0 60.762501 10.9125" width="60.762501"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,10.9125)">
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			</text>

		</g>
	</g>
</svg>, <svg style="vertical-align:-0.17555pt;width:48.337502px;" id="M4" height="10.9125" version="1.1" viewBox="0 0 48.337502 10.9125" width="48.337502"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,10.9125)">
		<g transform="translate(72,-63.27)">
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				<tspan style="font-size: 12.50px; " x="32.307751" y="0">4</tspan>
			</text>

		</g>
	</g>
</svg>). <i  >Conclusion</i>. In children with asthma, residential proximity to freeways is associated with uncontrolled asthma.

Peter Huynh

Muhammad T. Salam

Tricia Morphew

Kenny Y. C. Kwong

Lyne Scott

Residential Proximity to Freeways is Associated with Uncontrolled Asthma in Inner-City Hispanic Children and Adolescents

<i>Background</i>. Allergies can substantially impact health-related quality of life (HRQL). We investigated the psychosocial impact of morning symptoms amongst Australian adults with self-reported allergic rhinitis (AR). <i>Method</i>. An online survey comprising 24 questions was conducted in August 2008. Inclusion criteria were age (20–49 years) and self-reported moderate to severe  symptoms of AR. <i>Results</i>. One thousand sixty respondents met the inclusion criteria. Amongst consumers with self-reported AR, symptoms were more severe in the morning in 597 (56%) and affected mood in 1025 (97%). Nine hundred seventy (91%) indicated that their symptoms had some impact on their day ahead and 868 (82%) reported a negative impact on relationships. Morning symptoms in particular had a substantial affect on mood for the day. HRQL impact was more pronounced in those who reported severe symptoms and in females. <i>Discussion</i>. Encouraging consumers with self-diagnosed AR to seek formal diagnosis and offering appropriate treatment strategies, such as those offering sustained effectiveness over 24-hours, may aid in negating the negative impact of morning symptoms.

Timothy J. Sharp

Celina Seeto

The Psychosocial Impact of Self-Reported Morning Allergy Symptoms: Findings from an Australian Internet-Based Survey

Type I hypersensitivity is driven by allergen specific immunoglobulin E (sIgE) and thus sIgE represents a marker for modern allergy diagnosis. Recently, a rapid assay for the detection of sIgE, termed as (Allergy Lateral Flow Assay) ALFA, has been developed. The objective of our study is the evaluation of a scanner-based system for the semiquantitative interpretation of ALFA results. Agreement to Skin Prick Test (SPT, Allergopharma), ALLERG-O-LIQ System (Dr. Fooke), and ImmunoCAP (Phadia) was investigated using 50 sera tested for specific IgE to timothy grass pollen (g6). 35/50 sera were positive by SPT, ALLERG-O-LIQ, and ImmunoCAP. Excellent agreement was observed between ALFA results and SPT, ImmunoCAP, and ALLERG-O-LIQ. Area under the curve (AUC) values were found at 1.0, and 100&#37; sensitivity and specificity was found versus all other methods. Visual- and scanner-based interpretation of the ALFA results revealed excellent agreement.

R. Lucassen

J. Schulte-Pelkum

C. Csuvarszki

J. Kleine-Tebbe

M. Fooke

M. Mahler

Evaluation of a Novel Rapid Test System for the Detection of Allergic Sensitization to Timothy Grass Pollen against Established Laboratory Methods and Skin Prick Test

The aim of this study was to verify FeNO usefulness, as a marker of bronchial inflammation, in the assessment of therapeutic management of childhood asthma. We performed a prospective 1-year randomized clinical trial evaluating two groups of 32 children with allergic asthma: &#x201c;GINA group&#x201d;, in which therapy was assessed only by GINA guidelines  and &#x201c;FeNO group&#x201d;, who followed a therapeutic program assessed also on FeNO measurements. Asthma Severity score (ASs), Asthma Exacerbation Frequency (AEf), and Asthma Therapy score (ATs) were evaluated at the start of the study (T1), 6 months (T2), and 1 year after (T3). <i  >ASs</i> and <i  >AEf</i> significantly decreased only in the FeNO group at times T2 and T3 (<i  >p[T1-T2] = </i>0.0001, and <i  >p[T1-T3] = </i>0.01; <i  >p[T1-T2] = </i>0.0001; and <i  >p[T1-T3] &#x3c; </i>0.0001, resp.). After six months of follow-up, we found  a significant increase of patients under inhaled corticosteroid  and/or antileukotrienes in the GINA group compared to the FeNO group (<svg style="vertical-align:-0.17555pt;width:48.337502px;" id="M1" height="10.9125" version="1.1" viewBox="0 0 48.337502 10.9125" width="48.337502"  xmlns="http://www.w3.org/2000/svg">
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	</g>
</svg>). Our data show that FeNO measurements, might be a very useful additional parameter for management of asthma, which is able to avoid unnecessary inhaled corticosteroid and antileukotrienes therapies, however, mantaining a treatment sufficient  to obtain  a meaningful improvement of asthma.

Marcello Verini

Nicola Pietro Consilvio

Sabrina Di Pillo

Anna Cingolani

Cynzia Spagnuolo

Daniele Rapino

Alessandra Scaparrotta

Francesco Chiarelli

FeNO as a Marker of Airways Inflammation: The Possible Implications in Childhood Asthma Management

Hen&#x27;s egg white has been reported as a causative agent of allergic reactions, with ovalbumin, conalbumin, ovomucoid, and lysozyme being the major allergens. However, little is known about the effects of processing with heat and high pressure on the allergenicity of egg white proteins as ingredients in meat. For this purpose, the allergenic characteristics of such treated preparations were studied. The IgE-binding capacity was analyzed by EAST inhibition in raw and processed meat preparations using sera from patients with hen&#x27;s egg specific IgE. Increasing heat treatment as well as the application of high pressure decreased IgE binding, which is a measure of allergenic potential. The combined application of heat (<svg     style="vertical-align:-0.1638pt;width:21.475px;" id="M1" height="13.1375" version="1.1" viewBox="0 0 21.475 13.1375" width="21.475"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,12.875)"><path id="x37" d="M447 623l8 -12l-283 -613l-74 -10l-7 11q174 283 297 551h-216q-48 0 -62.5 -12t-33.5 -63h-29q10 60 18 148h382z" /></g><g transform="matrix(.017,-0,0,-.017,8.222,12.875)"><path id="x30" d="M241 635q53 0 94 -28.5t63.5 -76t33.5 -102.5t11 -116q0 -58 -11 -112.5t-34 -103.5t-63.5 -78.5t-94.5 -29.5t-95 28t-64.5 75t-34.5 102.5t-11 118.5q0 58 11.5 112.5t34.5 103t64.5 78t95.5 29.5zM238 602q-32 0 -55.5 -25t-35.5 -68t-17.5 -91t-5.5 -105&#xA;q0 -76 10 -138.5t37 -107.5t69 -45q32 0 55.5 25t35.5 68.5t17.5 91.5t5.5 105t-5.5 105.5t-18 92t-36 68t-56.5 24.5z" /></g>

			<g transform="matrix(.012,-0,0,-.012,16.375,4.712)"><path id="x2218" d="M326 255q0 -56 -41 -96t-99 -40t-99 40t-41 96t41 96t99 40t99 -40t41 -96zM274 255q0 38 -25.5 65t-62.5 27t-62.5 -27t-25.5 -65t25.5 -65t62.5 -27t62.5 27t25.5 65z" /></g>

		
	
</svg>C) and high pressure had synergistic effects in reducing the allergenic potential nearly twice as the sum of the single treatments conducted separately.

Sabine Hildebrandt

Larsen Schütte

Stefan Stoyanov

Günther Hammer

Hans Steinhart

Angelika Paschke

In Vitro Determination of the Allergenic Potential of Egg White in Processed Meat

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Journal of Allergy