Yuko Chinuki

Shimane University, Izumo, Shimane-ken, Japan

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Publications (21)39.34 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Immediate-type wheat allergy caused by a specific hydrolyzed wheat protein (HWP-IWA), Glupearl 19S (GP19S), typically develops food-dependent exercise-induced anaphylaxis (FDEIA), but is different from conventional FDEIA, or simple wheat allergy in many aspects. The skin prick test (SPT) is considered to be the most effective method for diagnosis of HWP-IWA. As SPT is a relatively qualitative method, we developed quantitative and high-throughput test method for HWP-IWA. Methods: An enzyme-linked immunosorbent assay (ELISA)-based GP19S-specific IgE assay was tested using sera from 14 HWP-IWA and five conventional wheat-dependent exercise-induced anaphylaxis (CO-WDEIA) patients, as well as five healthy subjects. Then a validation study at five different institutions was carried out using sera from 10 HWP-IWA and five CO-WDEIA patients, as well as five healthy subjects different from the previous studies. Results: The mean unit values converted from measured absorbance of ELISA were 68.3, 1.3 and 1.1 respectively. Furthermore, the validation study revealed reproducible results across all five institutions, with the standard deviation (SD) being 0.3-0.4 for the healthy group, 0.2-0.6 for the CO-WDEIA group, and 3.8-9.6 for HWP-IWA group except for one case. One case of HWP-IWA was excluded from analysis due to the high SD of 53.3 units, indicating that samples with a unit value > 100.0 will affect inter-laboratory reproducibility. Conclusions: Our findings suggest that the ELISA-based GP19S-specific IgE assay can be used to test HWP-IWA using venous blood samples, except for those with a unit value > 100.0.
    Allergology International 04/2014;
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    ABSTRACT: Sensitization to the carbohydrate galactose-α-1,3-galactose (α-Gal) has been reported in patients with beef allergy. However, the proteins responsible for this allergy have not yet been identified. This study aimed to identify beef proteins that predominantly react with serum IgE in Japanese patients with beef allergy. Sera were collected from 29 patients with beef allergy who had allergic reaction(s) such as urticaria, abdominal pain, vomiting, and anaphylactic shock after ingestion of beef and pork; the sera tested positive for IgE against beef and pork. IgE-binding proteins were detected by immunoblotting sera from the patients and identified using a combination of two-dimensional gel electrophoresis and peptide mass fingerprinting techniques. The involvement of carbohydrate in the binding of IgE to allergens was examined by periodate treatment and an inhibition assay with cetuximab by immunoblotting. Specific IgE binding to cetuximab was measured using the CAP-fluorescent enzyme immunoassay. Two IgE-binding proteins (240 kDa and 140 kDa) were detected in beef extract and identified as laminin γ-1 and the collagen α-1 (VI) chain from Bos taurus, respectively. Periodate treatment or the inhibition assay resulted in the loss of IgE binding to these proteins. Immunoblotting with anti-α-Gal antibody revealed the presence of α-Gal on the 240- and 140-kDa beef proteins. The amount of IgE bound to cetuximab was significantly correlated with that to beef in the patients with beef allergy. The carbohydrate moiety (α-Gal) on laminin γ-1 and collagen α-1 (VI) chain are possibly common IgE-reactive proteins in the Japanese patients with beef allergy.
    Allergy 11/2013; · 5.88 Impact Factor
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    ABSTRACT: Background: A large-scale study of causative allergen components of shrimp allergies has never been conducted in Japan. Subjects: A total of 31 patients with shrimp allergy who were referred to the Kakogawa Prefectural Medical Center from January 2004 to August 2011 were enrolled in the study. Shrimp allergy was diagnosed according to the clinical symptoms, and positive prick testing using black tiger shrimp. Methods: Serum-specific IgE to two preparations of shrimp allergens (shrimp: shrimp extracts used before June 2012; and new shrimp: shrimp extracts used after July 2012 for ImmunoCAP®) and tropomyosin was determined with ImmunoCAP® (CAP-FEIA, Phadia) . Western blot analysis was performed using soluble and insoluble fractions from black tiger shrimp to define the causative shrimp allergens. Results: In 31 cases of shrimp allergy, detection rate (more than class 1) of allergen-specific IgE to conventional shrimp was 58.1%, to new shrimp was 66.7%, and to tropomyosin was 29.0%. Positive rate (more than class 2) of allergen-specific IgE to conventional shrimp was 54.8%, to new shrimp was 55.0%, and to tropomyosin was 19.4%. In the 5 cases of FDEIA, detection rate of allergen-specific IgE to conventional shrimp was 20%, to new shrimp was 40%, and to tropomyosin was 0%. In the 19 cases of immediate-type allergy, detection rate of allergen-specific IgE to conventional shrimp was 68.4%, to new shrimp was 66.7%, and to tropomyosin was 36.8%. In the 7 cases of OAS, detection rate of allergen-specific IgE to shrimp was 57.1%, to new shrimp was 85.7%, and to tropomyosin was 28.5%. Western blot analysis of the 31 cases showed that several cases showed a band with a molecular weight of 35-38 kDa, which corresponds to tropomyosin. However, a 70-kDa band was detected in 30 of 31 cases. Conclusion: The 70-kDa protein may be a new major allergen component of shrimp allergy.
    Arerugī = [Allergy] 08/2013; 62(8):960-967.
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    ABSTRACT: Background: In Japan, hydrolyzed wheat proteins (HWP) have been reported to cause wheat-dependent exercise-induced anaphylaxis (WDEIA) by transcutaneous sensitization using HWP-containing soap. Patients develop allergic reactions not only with soap use, but also with exercise after the intake of wheat protein (WP). ω5-Gliadin and HMW-glutenin were identified as major allergens in conventional WP-WDEIA patients. However, the allergens in HWP-WDEIA have yet to be elucidated. Methods: Sera were obtained from 22 patients with HWP-sensitized WDEIA. The allergenic activities of HWP and six recombinant wheat gluten proteins, including α/β-, γ-, ω1,2- and ω5-gliadin and low- and high molecular weight (HMW)-glutenins, were characterized by immunoblot analysis and histamine releasing test. IgE-binding epitopes were identified using arrays of overlapping peptides synthesized on SPOTs membrane. Results: Immunoblot analysis showed that IgE antibodies (Abs) from HWP-WDEIA bound to α/β-, γ- and ω1,2-gliadin. Recombinant γ-gliadin induced significant histamine release from basophils in eight of 11 patients with HWP-WDEIA. An IgE-binding epitope "QPQQPFPQ" was identified within the primary sequence of γ-gliadin, and the deamidated peptide containing the "PEEPFP" sequence bound with IgE Abs more strongly compared to the native epitope-peptide. The epitope-peptide inhibited IgE-binding to HWP, indicating that the specific IgE to HWP cross-reacts with γ-gliadin. Conclusions: HWP-WDEIA patients could be sensitized to HWP containing a PEEPFP sequence, and WDEIA symptoms after WP ingestion could partly be induced by γ-gliadin. These findings could be useful to help develop tools for diagnosis and desensitization therapy for HWP-WDEIA.
    Allergology International 08/2013;
  • International journal of dermatology 05/2013; · 1.18 Impact Factor
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    ABSTRACT: Background: Challenge testing with wheat plus exercise and/or aspirin is a gold standard for the diagnosis of wheat-dependent exercise-induced anaphylaxis (WDEIA); however, the test may often yield false-negative results. Our previous study suggested that an increase in serum wheat gliadin levels is required to induce allergic symptoms in patients with WDEIA. Based on this knowledge, we sought to extract the patients with false negative results in the challenge tests of WDEIA. Methods: Thirty-six patients with suspected WDEIA were enrolled. First, group categorizations -Group I, challenge tests were positive; Group II, challenge tests were negative and serum gliadin were undetectable; Group III, challenge tests were negative and serum gliadin were detectable- were given according to the results of wheat plus exercise and/or aspirin challenge testing and serum gliadin levels. Second, diagnoses were made using retests and/or dietary management in Group II and III. Results: Positive results for wheat plus exercise and/or aspirin challenge tests gave a diagnosis of definite WDEIA in 17 of 36 patients (Group I). Of the remaining 19 challenge negative patients, serum gliadin was undetectable in ten patients (Group II). Of the ten patients (Group II), three of them were diagnosed as definite WDEIA by retesting and six of them were diagnosed as probable WDEIA using a wheat elimination diet, whereas one patient was non-WDEIA. In the rest of the nine challenge negative patients, serum gliadin was detectable (Group III). No allergic episodes with a normal diet provided a diagnosis of non-WDEIA in seven of the nine patients, whereas the remaining two patients were probable WDEIA or had another food allergy because of repeated episodes. Conclusions: Our study revealed that serum gliadin monitoring during challenge testing is useful.
    Allergology International 04/2013;
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    ABSTRACT: Food-dependent exercise-induced anaphylaxis (FDEIA) is a special form of IgE-mediated food allergy and exhibits allergic symptoms in combination of causative food-intake and triggers such as exercise. As the causative foods and the condition of triggers vary among patients, diagnosis of FDEIA is not always easy. Serum food-specific IgE tests, which are widely used in the diagnosis of FDEIA, have rather low sensitivity, because the tests mostly utilize crude extracts of foods. Concept of using defined allergen molecules has been proposed as the term "component-resolved diagnostics" for diagnosis of IgE-mediated allergy. Use of purified allergens such as recombinant omega-5 gliadin turned out to highly improve its sensitivity and specificity of the tests in the diagnosis of wheat-dependent exercise-induced anaphylaxis (WDEIA). Recently, CD203c expression-based basophil activation test (BAT) is reported to be useful in identifying adult patients with WDEIA and predicting causative allergens in WDEIA, when combined with appropriate allergens. Detection of serum allergen levels possibly gives useful information whether food challenge tests have been performed with sufficient strength.
    Journal of dermatological science 04/2013; · 3.71 Impact Factor
  • Nishi Nihon Hifuka 01/2013; 75(6):496-498.
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    ABSTRACT: Background Wheat protein derivatives are used in a variety of products worldwide. Gluten is commercially used 'as is' or with modifications such as hydrolysis, which is carried out to overcome its insolubility. Several cases of contact urticaria following exposure to hydrolysed wheat protein (HWP) in cosmetics or of anaphylaxis caused by deamidated gluten in food or non-food products have been described. Objectives To evaluate the types of HWP that have higher allergenicity for percutaneous sensitization. Methods We enrolled 7 patients with wheat-dependent exercise-induced anaphylaxis who had been sensitized to HWP primarily through the percutaneous and/or the rhinoconjunctival route by using facial soap containing HWP. Reaction to wheat proteins was confirmed by IgE immunoblotting and basophil CD203c expression with six HWP variants. Results The IgE of all the patients reacted to HWPs composed of large polypeptide aggregates. High molecular weight (MW) HWPs were also found to induce significant enhancement of basophil CD203c expression. Conclusions HWPs composed of large polypeptide aggregates possibly induce sensitization to a greater degree than lower-MW HWPs. Basophil surface CD203c expression is useful for evaluating the allergenicity of HWPs.
    Contact Dermatitis 12/2012; · 2.93 Impact Factor
  • Yuko Chinuki, Eishin Morita
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    ABSTRACT: Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a specific form of wheat allergy typically induced by exercise after ingestion of wheat products. Wheat ω-5 gliadin is a major allergen associated with conventional WDEIA, and detection of serum immunoglobulin E (IgE) specific to recombinant ω-5 gliadin is a reliable method for its diagnosis. Recently, an increased incidence of a new subtype of WDEIA, which is likely to be sensitized via a percutaneous and/or rhinoconjunctival route to hydrolyzed wheat protein (HWP), has been observed. All of the patients with this new subtype had used the same brand of soap, which contained HWP. Approximately half of these patients developed contact allergy several months later and subsequently developed WDEIA. In each of these patients, contact allergy with soap exposure preceded food ingestion-induced reactions. Other patients directly developed generalized symptoms upon ingestion of wheat products. The predominant observed symptom of the new WDEIA subtype was angioedema of the eyelids; a number of patients developed anaphylaxis. This new subtype of WDEIA has little serum ω-5 gliadin-specific serum IgE.
    Allergology International 10/2012;
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    ABSTRACT: Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a special form of food allergy typically induced by exercise after ingestion of wheat products. We identified wheat omega-5 gliadin and high molecular weight-glutenin subunit (HMW-glutenin) as major allergens for WDEIA and clarified that simultaneous detection of serum IgE binding to synthetic epitope peptides of these allergens identifies more than 90% of WDEIA patients. However, the short synthetic peptides are not suitable for CAP-fluorescent enzyme-immunoassay (CAP-FEIA), which is widely utilized for detecting allergen-specific IgE. In this study, we constructed a CAP-FEIA with recombinant HMW-glutenin, and evaluated its usefulness in identifying the patients with WDEIA. Recombinant HMW-glutenin was expressed as histidine-tag protein in E. coli and purified by histidine-tag affinity column. Wheat, gluten, recombinant omega-5 gliadin, epitope peptide of HMW-glutenin, native and recombinant HMW-glutenin specific IgE in the sera from 48 patients with WDEIA, 16 patients with atopic dermatitis (AD) who had no immediate allergic reaction after wheat ingestion and 12 healthy controls were determined by using CAP-FEIA method. In 16 AD patients without wheat allergy 12 of them (75%) had positive results for native HMW-glutenin test in contrast to epitope peptide of HMW-glutenin (12.5%) and recombinant HMW-glutenin test (12.5%). These results indicate the native HMW-glutenin test has low specificity. Sensitivity and specificity of the IgE test with recombinant HMW-glutenin were 16.7% and 92.9%. These are well compatible with results obtained by using epitope peptide of HMW-glutenin. However, sensitivity and specificity reached to 93.8% and 92.9%, when the test was combined to the test with recombinant omega-5 gliadin. We demonstrated that recombinant HMW-glutenin is best for CAP-FEIA system in point of stability and specificity and confirmed that detection of specific IgE against recombinant HMW-glutenin is useful for diagnosis of WDEIA when combined with the CAP-FEIA (recombinant omega-5 gliadin) test.
    Clinical & Experimental Allergy 08/2012; 42(8):1293-8. · 4.79 Impact Factor
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    The Journal of allergy and clinical immunology 03/2012; 129(5):1404-6. · 12.05 Impact Factor
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    ABSTRACT: Wheat is one of the most common causes of food allergies. The exact prevalence of wheat allergy has not been well delineated in Japanese adults. We enrolled 935 adults in a cohort study established by Shimane University in order to examine the determinants of lifestyle-related diseases. A screening was conducted by a questionnaire-based examination and a detection of serum omega-5 gliadin-specific IgE. Subjects who tested positive in the questionnaire-based examination and/or the serum omega-5 gliadin-specific IgE test were further examined by detailed interviews and skin prick tests. A total of 22 subjects were picked up by the screening process, and 17 of these were further examined by secondary testing. Only two subjects were conclusively identified as having wheat allergy. The prevalence of wheat allergy in Japanese adults was found to be 0.21% by using a combination of questionnaire-based examination, skin prick test and serum omega-5 gliadin-specific IgE test.
    Allergology International 03/2012; 61(1):101-5.
  • Nishi Nihon Hifuka 01/2012; 74(3):293-300.
  • The Journal of Dermatology 12/2011; 39(8):724-6. · 2.35 Impact Factor
  • Contact Dermatitis 07/2011; 65(1):55-7. · 2.93 Impact Factor
  • The Journal of Dermatology 04/2011; 39(2):197-9. · 2.35 Impact Factor
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    ABSTRACT: To overcome the problem of maldistribution of dermatologists in rural areas, live interactive teleconsultation systems are being used in some countries. However, these systems are not in common use because few evaluations on their efficiency and economic viability were reported. We constructed an easy-to-use asymmetric digital subscriber line (ADSL)-based live interactive teleconsultation system and conducted 150 trial sessions between two rural hospitals and Shimane University Hospital. The clinical usefulness and economic advantages of this system were evaluated using data obtained from the trials. The system efficiently captured images at a resolution sufficient for specialized consultations: follicular openings were visible in the images obtained from a distance of 2 m. This system is more advantageous than a conventional clinic if the following condition is fulfilled: y ≤ 6.00 x-3.86 [x, time required for one-way travel (h); y, time required for consultation (h)]. Our two lines in trial fulfilled this condition. Asymmetric digital subscriber line-based live interactive teleconsultation technology is beneficial in many rural hospitals that do not have a dermatologist.
    International journal of dermatology 11/2010; 49(11):1272-5. · 1.18 Impact Factor
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    Acta Dermato-Venereologica 11/2010; 91(2):197-8.
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    ABSTRACT: Anaphylaxis after eating sea urchin roe has been reported. However, its major allergens have not yet been identified. The aim of this study was to identify the major allergens of sea urchin roe. Proteins of sea urchin roe were separated by sodium dodecyl sulphate-polyacrylamide gel electrophoresis and two-dimensional electrophoresis (2-DE). An immunoglobulin (Ig)E-binding protein was detected by immunoblotting using the patient's serum. An allergen isolated from 2DE-gel was identified by peptide mass fingerprinting using matrix-assisted laser desorption/ionization-time of flight-mass spectrometry. Immunoblot analysis of sea urchin extracts showed that a 160-kDa protein at pI 6-7 was recognized by the patient's IgE. Peptide mass fingerprint analysis revealed that the protein was the major yolk protein (152 kDa, pI 6.9) of sea urchins. The results show that a major allergen of sea urchin roe is the major yolk protein.
    Acta Dermato-Venereologica 05/2010; 90(3):235-8.