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920 Natural History of Egg Allergy and Prognostic Factors of the
Development of Tolerance for Egg Allergy in Children with
Atopic Dermatitis (AD)
J. Kim, Y. Chung, J. Kwon, K. Ahn, S. Lee; Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, REPUBLIC OF
RATIONALE: We studied to understand the natural course of egg allergy,
to analyze the association between tolerance and prognostic factors
including serum total IgE, specific IgE, sex, duration of breastfeeding,
age of introduction to solid foods, age at development of AD, initial
severity of AD, family history, maternal dietary restriction during
breastfeeding, feeding of hydrolyzed formula, and delayed sensitization
to house dust mite (HDM).
METHODS: We evaluated clinical characteristics and prognostic factors
in 116 subjects, who were diagnosed as having egg allergy and AD before
12 months of age. Egg allergy was confirmed by specific IgE >2KU
/L or
convincing history. In order to check the development of tolerance for the
food, open challenge tests were carried out at home or in the hospital during
follow-up period.
RESULTS: Sixty-seven children developed tolerance to egg, and the
median survival age was 60 months. The tolerance was related to total IgE
(P50.003), egg white specific IgE (P50.009), duration of breastfeeding
(P50.013), initial severity of AD (P50.021), and delayed IgE positivity
to HDM (P50.007). The cutoff point of the specific IgE level at initial
evaluation for outgrowing the allergy until the age of 3 year was 23.25
CONCLUSIONS: Half of the children younger than 12 months of age
with egg allergy and AD tolerate the food at 60 months of age. The specific
IgE antibody level at initial evaluation can be used as an indicator of
tolerance for egg allergy.
921 Sodium Nitrate Suppressed The Mitogen Induced T and B
Lymphocytes Stimulation In Mice
A. K. Daoud, N. M. Abu Harfeil, E. H. Sarsour; Jordan University
Science and Technology, Irbid, JORDAN.
RATIONALE: Since Sodium Nitrate is a widely used chemical in food
and drug industries as a preservative and has some therapeutic uses and is a
known carcinogen, we wanted to examine the effects of subtoxic levels of
this substance on the Immune System in mice.
METHODS: 72 Female Balb/c mice and equal controls were fed either 0,
125, 250 or 500 mg/L of Sodium Nitrate in drinking water for 3 weeks. The
following tests were done repeatedly at the end of exposure, 1 and 3 weeks
after it. Routine hematologic tests were done and Concanavalin A and
Lipopolysaccharide mitogens Lymphocytes’ Proliferation were done in
vitro for splenocytes. Nitro-Blue Tetrazolium test was done to peritoneal
macrophages stimulated by PMA. Serum IgG and IgM Antibodies were
tested by ELISA and as a response against SRBC’s inoculation were done.
Statistical analysis was applied to results.
RESULTS: Sodium Nitrate caused a statistically significant dose depen-
dent suppression of the mitogen induced proliferation to both ConcA and
LPS and the in vitro IgG and IgM synthesis after exposure to antigens but a
significant increase in the phagocytes activity by NBT tests. There was no
statistically significant change in routine hematological studies or serum
immunoglobulins’ levels.
CONCLUSIONS: Sodium Nitrate had multiple actions on the functions
of the Immune cells. It suppresses the Mitogen Induced proliferation of
both T and B lymphocytes and their ability to mount antibody responses,
but is stimulant to Macrophages Respiratory burst.
922 Investigations of the Potential Allergenicity of Ramon Seed
J. A. Nordlee, R. E. Goodman, S. L. Taylor; University of Nebraska,
Lincoln, NE.
RATIONALE: Ramon seed (RS), Brosimum alicastrum, also known as
ramon nut or Maya nut, comes from a large rainforest tree, order
Rosales (almonds, peaches). Though novel in the U.S., RS has been
consumed in certain parts of Latin America for decades. Though distantly
related to any known allergenic tree nut, the potential allergenicity of RS
was investigated by targeted serum screening with sera from almond- and
walnut-allergic individuals, the two most commonly allergenictree nuts in
North America.
METHODS: Extracts of unroasted and roasted RS were analyzed by
radio-allergosorbent testing (RAST) inhibition and IgE immunoblotting
with autoradiography using pooled sera of almond and walnut-allergic
individuals. Inhibition of IgE binding in the immunoblots was conducted
by preincubation of the sera pools with wheat extract.
RESULTS: Weak, but not inconsequential inhibition was observed only
with unroasted RS powder extract by RAST-inhibition using almond-
allergic sera. In immunoblotting, a single 20kD band from unroasted RS
extract bound IgE from the almond-allergic sera but was inhibited with
wheat extract.
CONCLUSIONS: Roasted RS powder is unlikely to present any risk to
almond- or walnut-allergic individuals. Although weak, IgE binding was
observed with the unroasted RS powder. However, binding is likely due to
non-specific, clinically irrelevant interactions such as cross-reactive car-
bohydrate epitopes since it was inhibited with wheat extract. Interpretation
of targeted serum screening is often complicated by non-specific IgE
Funding: Food Allergy Research & Resource Program
923 A 6-year Experience with Influenza Vaccination in Egg
Allergic Patients
S. L. Hotte, C. Lejtenyi, M. Primeau; Montreal Children’s Hospital,
Montreal, PQ, CANADA.
RATIONALE: Most egg allergic children (EAC) are denied the influenza
vaccine because of fear of allergic reaction despite no recent studies
reporting serious allergic reaction. We wanted to report our experience
with influenza vaccination in EAC.
METHODS: Retrospective chart review of EAC who received influenza
vaccine at the Montreal Children Hospital between 2000 and 2006.
RESULTS: One hundred fifteen EAC received 173 doses (not including
booster doses) of influenza vaccine either FluviralÒor VaxigripÒ. Reason
for vaccination was asthma in 64%. Twelve percent of doses were preceded
by intradermal skin test (dilution 1:10 or 1:100) of which 29% were
positive. Fifty percent of doses were given as a single dose of which 69%
were given to patients that had tolerated the vaccine before. Forty-five
percent of doses were given in 2 steps (10% and 90% of the dose given 30
minutes apart) and 5% in 3 or more steps. Ninety-three percent of
vaccination caused no reaction including all doses that were preceded by
positive intradermal skin test. Six doses caused minor immediate local
reactions. Three doses caused one facial urticarial plaque shortly after
vaccination that resolved quickly. Three doses caused symptoms likely
related to the act of vaccination (anxiety/vasovagal reactions). An
additionnal 67 booster doses were given and none led to reaction.
CONCLUSIONS: None of EAC who received the influenza vaccine
developed serious allergic reaction with nearly half receiving it as a single
dose. Prospective studies are needed to assess safety of administering a
single dose of this vaccine in that population.
Abstracts S239
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