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The high-density microneedle array patch (HD-MAP) is a promising alternative vaccine delivery system device with broad application in disease, including SARS-CoV-2. Skin reactivity to HD-MAP applications has been extensively studied in young individuals, but not in the >65 years population, a risk group often requiring higher dose vaccines to produce protective immune responses. The primary aims of the present study were to characterise local inflammatory responses and barrier recovery to HD-MAPs in elderly skin. In twelve volunteers aged 69–84 years, HD-MAPs were applied to the forearm and deltoid regions. Measurements of transepidermal water loss (TEWL), dielectric permittivity and erythema were performed before and after HD-MAP application at t = 10 min, 30 min, 48 h, and 7 days. At all sites, TEWL (barrier damage), dielectric permittivity (superficial water);, and erythema measurements rapidly increased after HD-MAP application. After 7 days, the mean measures had recovered toward pre-application values. The fact that the degree and chronology of skin reactivity and recovery after HD-MAP was similar in elderly skin to that previously reported in younger adults suggests that the reactivity basis for physical immune enhancement observed in younger adults will also be achievable in the older population. [ABSTRACT FROM AUTHOR]

Background: The high‐density microarray patch (HD‐MAP) promises to be a robust vaccination platform with clear advantages for future global societal demands for health care management. The method of action has its base not only in efficient delivery of vaccine but also in the reliable induction of a local innate physical inflammatory response to adjuvant the vaccination process. The application process needs to induce levels of reactivity, which are acceptable to the vaccine, and from which the skin promptly recovers. Materials and methods: 1 × 1 cm HD‐MAP patches containing 5000, 250‐μm long microprojections were applied to the skin in 12 healthy volunteers. The return of skin barrier function was assessed by transepidermal water loss (TEWL) and reaction to topical histamine challenge. Results: Skin barrier recovery by 48 h was confirmed for all HD‐MAP sites by recovered resistance to the effects of topical histamine application. Conclusions: Our previous observation, that the barrier disruption indicator TEWL returns to normal by 48 h, is supported by this paper's demonstration of return of skin resistance to topical histamine challenge in twelve healthy subjects. [ABSTRACT FROM AUTHOR]

The high-density microneedle array patch (HD-MAP) is a promising alternative vaccine delivery system device with broad application in disease, including SARS-CoV-2. Skin reactivity to HD-MAP applications has been extensively studied in young individuals, but not in the >65 years population, a risk group often requiring higher dose vaccines to produce protective immune responses. The primary aims of the present study were to characterise local inflammatory responses and barrier recovery to HD-MAPs in elderly skin. In twelve volunteers aged 69–84 years, HD-MAPs were applied to the forearm and deltoid regions. Measurements of transepidermal water loss (TEWL), dielectric permittivity and erythema were performed before and after HD-MAP application at t = 10 min, 30 min, 48 h, and 7 days. At all sites, TEWL (barrier damage), dielectric permittivity (superficial water);, and erythema measurements rapidly increased after HD-MAP application. After 7 days, the mean measures had recovered toward pre-application values. The fact that the degree and chronology of skin reactivity and recovery after HD-MAP was similar in elderly skin to that previously reported in younger adults suggests that the reactivity basis for physical immune enhancement observed in younger adults will also be achievable in the older population.

Objectives: Skin blood flow is rapidly altered during circulatory shock and may remain altered despite apparent systemic hemodynamic stabilization. We evaluated whether changes in skin blood flow during circulatory shock were related to survival.Design: Prospective study.Setting: Thirty-five-bed medical-surgical university hospital department of intensive care.Subjects: Twenty healthy volunteers and 70 patients with circulatory shock (< 12 hr duration), defined as the need for vasopressors to maintain mean arterial pressure greater than or equal to 65 mm Hg and signs of altered tissue perfusion.Interventions: We assessed skin blood flow using skin laser Doppler on the fingertip for 3 minutes at basal temperature (SBFBT) and at 37°C (SBF37) (thermal challenge test) once in volunteers and at the time of inclusion and after 6, 24, 48, 72, and 96 hours in patients with shock. Capillary refill time and peripheral perfusion index were measured at the same time points on the contralateral hand.Measurements and Main Results: The thermal challenge response (ΔSBF/ΔT) was calculated using the following formula: (SBF37-SBFBT)/(37-basal temperature). Area under the receiver operating characteristic curves were calculated to evaluate variables predictive of ICU mortality. At inclusion, skin blood flow and ΔSBF/ΔT were lower in patients than in volunteers. Baseline skin blood flow (31 [17-113] vs 16 [9-32] arbitrary perfusion units; p = 0.01) and ΔSBF/ΔT (4.3 [1.7-10.9] vs 0.9 [0.4-2.9] arbitrary perfusion unit/s) were greater in survivors than in nonsurvivors. Capillary refill time was shorter in survivors than in nonsurvivors; peripheral perfusion index was similar in the two groups. ΔSBF/ΔT (area under the receiver operating characteristic curve 0.94 [0.88-0.99]) and SBFBT (area under the receiver operating characteristic curve 0.83 [0.73-0.93]) had the best predictive value for ICU mortality with cutoff values less than or equal to 1.25 arbitrary perfusion unit/°C (sensitivity 88%, specificity 89%) and less than or equal to 21 arbitrary perfusion unit (sensitivity 84%, specificity 81%), respectively.Conclusions: Alterations in fingertip skin blood flow can be evaluated using a laser Doppler thermal challenge technique in patients with circulatory shock and are directly related to outcome. These novel monitoring techniques could potentially be used to guide resuscitation. [ABSTRACT FROM AUTHOR]

Background: The skin-prick test is the most commonly used method to diagnose allergy. In addition, histamine skin reactivity is used as a positive control for the skin-prick test. However, there is individual variation in histamine skin reactivity. The factors that influence individual variation in histamine skin reactivity remain unknown. Objectives: We aimed to investigate the factors associated with histamine skin reaction. Methods: Ninety-seven subjects who underwent a skin-prick test to diagnose allergic rhinitis were enrolled in this study. The skin-prick test was performed with six common allergens. The wheal size of the histamine skin reaction was analyzed; other variables included age, sex, body mass index (BMI), atopy, smoking history, and the testing season. Results: The wheal size in the histamine skin test was significantly associated with age and BMI. The association between histamine skin reactivity and BMI was also present in multivariate analysis, adjusted for age, sex, atopy, smoking history, and season. Conclusion: Histamine skin reactivity increased with BMI (degree of obesity). This association should be considered for better interpretation of the skin-prick test. Further studies regarding the mechanism for this association are needed. [ABSTRACT FROM AUTHOR]

There is a great need for effective protection against cutaneous pathologies arising from chronic exposure to harmful solar UVB radiations. A promising pharmaceutical strategy to improve the efficacy of chemotherapeutic/preventative natural compounds (e.g., soy isoflavone Genistein, Gen) is to enhance their dermal delivery using nanoemulsion ( NE) formulations. This report investigates the development of nanoemulsified tocotrienol( T3)-rich fraction of red palm oil ( Tocomin®), to yield an optimal NE delivery system for dermal photoprotection ( z-average size <150 nm, ζ-potential ≈ −30 mV, polydispersity index < 0.25). Physicochemical characterization and photostability studies indicate NE formulations utilizing surfactant mixture ( Smix) of Solutol® HS-15 ( SHS15) blended with vitamin E TPGS ( TPGS) as cosurfactant was significantly superior to formulations that utilized Lutrol® F68 ( LF68) as the cosurfactant. A ratio of 60:40 of SHS15- TPGS- NE was further identified as lead Tocomin® NE topical platform using in vitro pharmaceutical skin reactivity studies that assess cutaneous irritancy and cytotoxicity. Prototype Tocomin® NE loaded with the antiphotocarcinogenic molecule Gen ( Gen- Tocomin® NE) showed slow-release profile in both liquid and cream forms. Gen- Tocomin® NE also showed excellent biocompatibility, and provided substantial UVB protection to cultured subcutaneous L929 fibroblasts, indicating the great potential of our Tocomin® NE warranting further prototype development as topical pharmaceutical platform for skin photoprotection applications. © 2015 Wiley Periodicals, Inc. and the American Pharmacists Association J Pharm Sci 104:3510-3523, 2015 [ABSTRACT FROM AUTHOR]

Background: A new subcutaneous specific immunotherapy (SCIT) product adsorbed on aluminium hydroxide has been developed with a short and simplified up-dosing phase, containing a biologically standardized allergen pollen extract from Olea europaea. Objective: To assess the tolerability profile of the updosing phase and its immunological effect, in terms of specific IgG4 and IgE levels and immediate skin reactivity. Material and methods: The study was an exploratory, multi-centre, open-label, single-arm, phase II/III clinical trial. Adults with a clinical history of allergic rhinoconjunctivitis with/without asthma due to sensitization to olive pollen were selected. Five up-dosing doses (300, 600, 3000, 6000 and 15000SQ+) were administered at weekly intervals, followed by a maintenance dose (15000SQ+) after 2 weeks. Adverse events were collected during the 30 min observation period after injections, after a telephone contact 2 days after each visit, and after reviewing the subjects' diary. IgG4 and IgE levels and immediate skin reactivity were evaluated at the beginning and at the end of the trial. Results: Ninety-three subjects were included in the trial (mean age, 35.7 ± 10.3 years; women, 66.7 %). A total of 95 adverse drug reactions, all mild in intensity and non-serious, were reported during the trial: 85 local in 34.4 % subjects, 9 systemic in 4.3 % subjects and one non-specific (grade 0). Within 6 weeks, significant changes in IgG4 and IgE levels and in immediate skin reactivity to Olea europaea were accomplished. Conclusion: This new SCIT derived from pollen of Olea europaea presented a good tolerability profile and induced significant immunological responses already after a 6 week treatment. However, the non-controlled design may limit the interpretation of these results. [ABSTRACT FROM AUTHOR]

Objective Histamine skin prick testing is most commonly used to diagnose immunoglobulin E (IgE)-mediated allergic diseases, and histamine reactivity is used as a standardized positive control in the interpretation of a skin prick test. However, reactivity to histamine differs among individuals for reasons that are poorly understood. The present study aimed to evaluate the potential association between body mass index (BMI) and histamine skin reactivity in children. Methods A total of 451 children (246 boys, 205 girls) aged 7–8 years were enrolled in this study. The skin prick test was performed with 26 aeroallergens commonly found in Korea. Other information was collected, including sex, age, BMI, parental allergy history, and parental smoking status. Multivariate analysis was used to confirm the association between histamine skin reactivity and BMI. Results The histamine wheal size was revealed to be associated with BMI (Spearman's Rho 0.161, p < 0.001). This association was confirmed by multivariate analysis, after adjusting for sex, age, parental allergy history, parental smoking status, and allergic sensitization (coefficient B 0.071, 95% confidence interval 0.030–0.112). Conclusions Skin responses to histamine were primarily correlated with increased BMI. Further studies are needed to understand the clinical implication of BMI when interpreting the results of skin prick test. [ABSTRACT FROM AUTHOR]

In addition to the experimental work devoted to the capacities of newborns - among others on the question of sensory receptivity - it is interesting to show how much this receptivity intervenes during the clinical dialogue with young infants. But also how, from birth, professionals can identify individual profiles of babies, notably thanks to the Brazelton scale, and thus adapt their care practices., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Abstract: Objective: This study investigated the placebo effect on experimentally induced skin reactions via the manipulation of expectation. Methods: Fifty-eight healthy volunteers were randomised into either expectancy or control groups. All participants received a baseline administration of histamine on one arm (Time 1), then a second administration on the other arm, approximately 30minutes later (Time 2). Prior to the second administration, the expectancy group was told that an antihistamine cream (the placebo) had been applied that would reduce their skin reaction to the histamine. Expected wheal area, actual wheal area, heart rate, and heart rate variability were measured at each time point. Results: There was a positive relationship between expected and actual wheal area at Time 1. While the expectancy group expected a smaller skin reaction on the second arm they did not experience a greater reduction in wheal area, compared to control. The expectancy group had a greater reduction in heart rate during the second skin reaction, after the manipulation of expectation (p <.05). Conclusion: While wheal area was not modulated, it may be worth further investigating this possibility, with modifications to the protocol. The reduction of heart rate appears to be an expectation effect and future research could elucidate mechanisms involved. There is an indication that expectations and inflammatory skin reactions are associated. Further study might aim to clarify the direction and nature of this relationship. [Copyright &y& Elsevier]

Background: A high prevalence of sensitization to antigen Mus musculus (mouse) in patients with allergic respiratory diseases has been reported worldwide. Objective: To determine the prevalence of skin reactivity to the Mus musculus antigen in patients with asthma and allergic rhinitis in the Department of Allergy and Clinical Immunology, Hospital Universitario de Puebla. Methods: We conducted a cross-sectional, observational, prospective and descriptive study in patients of both genders, from 2 to 58 years old. All patients were attending the hospital for the first time, in a period of 6 months with the diagnoses of asthma, allergic rhinitis, or both. Each patient underwent skin prick test with epithelial antigen Mus musculus. Data were analyzed with SPSS-Statistics software, version 18. Results: We included 110 patients, 50% were women, mean age was 24.1 years (SD 16.2); 92.7% were from urban areas and the rest from rural areas. The overall prevalence of skin reactivity to the antigen tested was 1.8%; corresponding to patients with allergic rhinitis 2.4% and the remaining subgroups showed no reactivity. One of the three patients with positive skin tests worked in an animal laboratory, exposed to Mus musculus. Conclusion: We found a low prevalence of positive skin tests with mouse antigen. However, in patients with respiratory allergy symptoms and a strong exposure to mice or rodents we suggest to perform skin tests with mice allergen extracts. [ABSTRACT FROM AUTHOR]

Background: The coccidiodin (+) prevalence in the general population is of 40 a 60 %, in endemic areas in the northeast region of Mexico was 0.04. Objective: Determinate the prevalence of Skin reactivity to the coccidiodina in patient of oncology in treatment chemotherapy with a point of court of >de 5 mm. Material and Method: cross-sectional study conducted in 95 cancer patients at different stages you apply coccidiodina intracutaneous 0.1 mL in dilution 1:100, to 95 subject cancer chemotherapy treatments, radiotherapy and immunotherapy. And their reading was of the 48-72 following hours. Results: The age average 95 fellows was of 47 years +-16.20, minimum of 18, maxim of 78, range 60. Of them 54.7% (52) they were; masculine, 45.3% (43) to the feminine. The observed prevalence was of 20% with intervals of confidence IC 95% (17.68 - 22.31), standard error of .6015 and c2 =31.842 G.L. = 1 p < .001 Conclusions: The positive coccidiodina in patient with cancer in alone treatment indicates infection for c. previous immitis and activity of the cellular immunity. [ABSTRACT FROM AUTHOR]

Background/purpose: About 50% of women declare themselves to have sensitive skin. However, sensitive skin still appears to be a questionable problem not corresponding to a specific physiological pattern. To objectivate the neural basis of sensitive skin, we measured cerebral response to cutaneous provocative tests in self-perceived sensitive and non-sensitive skin subjects using functional magnetic resonance imaging (fMRI). Methods: Subjects were divided into two groups according to their self-perceived characterization by using a dedicated questionnaire about their skin reactivity. Event-related fMRI was used to measure cerebral activation associated with skin discomfort induced by a simultaneous split-face application of lactic acid and of its vehicle. Results and discussion: In both groups, skin discomfort due to lactic acid increased activity in the primary sensorimotor cortex contralateral to application site and in a bilateral fronto-parietal network including parietal cortex, prefrontal areas around the superior frontal sulcus, and the supplementary motor area. However, activity was significantly larger in the sensitive skin group. Most remarkably, in the sensitive skin group only, activity spreaded into the ipsilateral primary sensorimotor cortex and the bilateral peri-insular secondary somatosensory area. Our results demonstrate that, compared with control subjects, self-perceived sensitive skin subjects have a specific cerebral activation during skin irritative test, which allows us to hypothesize that self-perceived sensitive skin is intrinsically linked to a specific neurophysiologic pattern for these subjects. Conclusion: This study demonstrates that fMRI is an effective objective method for measuring cerebral processes underlying skin reactivity and contributes to a better understanding of the neural basis of the sensitive skin phenomenon. [ABSTRACT FROM AUTHOR]

Background: Women are more often patch tested than men, and the reactivity to patch test allergens is dependent on sex. However, it is unclear whether the profiles of test reactions are also sex-related. Objective: To compare the profiles of patch test reactions of men and women. Methods: Sex-related reaction profiles of 16 common patch test allergens were analysed based on data of 47 626 patients filed by the Information Network of Departments of Dermatology in Germany. The proportions of weak positive reactions and of questionable and irritant reactions were evaluated by calculating the positivity ratio (PR) and the reaction index (RI) separately for men and women for each allergen. Results: Of the 16 allergens evaluated, 8 had a higher PR and a higher RI in women than in men. 4 allergens had a lower PR and another 4 had a lower RI in women than in men. For allergens with similar sensitization prevalence in men and women, female sex was associated with a higher PR and RI ( P < 0.01). Conclusions: There is a marginal disparity in the reactivity of men and women to patch test allergens that is probably not of clinical relevance but constitutes a scientific challenge. [ABSTRACT FROM AUTHOR]

Background The benefit of alcohol-based disinfectant used on normal skin has been debated. Objectives The objective of the present study was to compare the effects of repeated exposure to an alcohol-based disinfectant, a detergent and an alcohol-based disinfectant/detergent alternately for 10 days, including noninvasive measurements in the evaluation. Skin reactivity in irritated skin after a 4-week interval was also evaluated. Materials and methods Detergent, disinfectant and alternate disinfectant and detergent were applied twice daily every 10 min for 1 h to the ventral upper arms and forearms of 17 healthy volunteers. A control area was included. After 4 weeks an SLS patch was applied to each area. Irritant reactions were quantified with a visual score recording and measurements of transepidermal water loss (TEWL) and skin colour were performed on days 1, 5, 11, 38 and 40. Results On day 5 the detergent caused a higher visual score than either disinfectant applied alone or alternate disinfectant and detergent, P < 0·05. On day 11 detergent and alternate disinfectant and detergent caused a higher score than disinfectant, P < 0·05. An increased irritant response for detergent compared with disinfectant alone and alternate disinfectant and detergent was confirmed by TEWL evaluations on days 5 and 11, P < 0·001, while no significant difference was found by colour measurement. After 4 weeks, when evaluated by colour measurement, significantly less response to the SLS patch was found on the disinfectant-treated area compared with the control area and detergent area, and a similar trend was found for TEWL, although it was not statistically significant. Conclusion Alcohol-based disinfectant caused less visible skin irritation and less skin barrier disruption than the use of detergent. The alternate use of detergent and disinfectant caused less irritation than the use of detergent, and a possible interaction between the two irritants was not indicated. After 4 weeks there was a tendency for decreased skin reactivity in the skin areas which had 4 weeks previously been exposed to disinfectant. [ABSTRACT FROM AUTHOR]

The concept that asthma diagnosis based on allergen-specific IgE levels in serum is more accurate than diagnosis based on skin test reactivity is controversial. Objective. To determine the atopy parameter that correlates most closely with airway reactivity to house dust mites in asthma. Methods. Forty-three asthma cases were examined retrospectively for data on Dermatophagoides farinae-specific bronchoprovocation, serum-specific IgE, and skin prick tests. Results. The maximal decreases in FEV1 following bronchoprovocation were correlated significantly with both the IgE levels and skin test scores. The accuracies of the tests were highest at a cutoff value of class 4 or higher for the IgE and of 3+ or higher for the skin test. At the cutoff values, the accuracies of both tests were similar (70% vs. 70%). The sensitivity of the skin test (81%) was higher than that of the IgE test (67%), whereas the specificity of the IgE test (71%) was higher than that of the skin test (52%). The sensitivity of the skin test was 91% at 2+ or higher, and the specificity of the IgE test was 95% at class 6 or higher. Conclusion. These results suggest that both the specific IgE level and the skin test reactivity are useful parameters in the prediction of positive airway responses to house dust mites in asthma. However, the skin test is more sensitive, whereas the IgE test is more specific. Therefore, these tests can be used in a complementary fashion (i.e., the skin test for screening and the specific IgE test for confirmation of the relevant allergen). [ABSTRACT FROM AUTHOR]

The allergological relevance of Ambrosia in Europe is growing but the efficacy of the injective immunotherapy for this allergen has been documented only in Northern America. We sought to study the safety and efficacy of injective immunotherapy in European patients sensitized to Ambrosia artemisiifolia. Thirty-two patients (18 M/14 F, mean age 36.78, range 23–60 years) suffering from rhinoconjunctivitis and/or asthma and sensitized to Ambrosia were enrolled and randomized in a double-blind, placebo-controlled (DBPC) study lasting 1 year. A maintenance dose corresponding to 7.2 μg of Amb a 1 was administered at 4-week intervals after the build-up. During the second and the third year, all patients were under active therapy in an open fashion. Symptom and medication scores, skin reactivity to Ambrosia (parallel line biological assay), and pollen counts were assessed throughout the trial. Twenty-three patients completed the trial. No severe adverse event was observed. During the DBPC phase, actively treated patients showed an improvement in asthmatic symptoms ( P=0.02) and drug ( P=0.0068) scores days with asthmatic symptoms ( P=0.003), days with rhinitis symptoms ( P=0.05), and days with intake of drugs ( P=0.0058), as compared to before therapy. No improvement for any of these parameters was detected in the placebo group. Moreover, the number of days with rhinitis and asthma was significantly higher in the placebo as compared to the active group ( P=0.048 and P<0.0001, respectively). Patients who switched from placebo to active therapy improved in rhinoconjunctivitis, asthma, and drug intake. The skin reactivity decreased significantly (12.2-fold, P=0.0001) in the active group whereas a slight increase (1.07-fold, P=0.87) was observed in the placebo group after the DBPC phase. After switching to active therapy, patients previously under placebo showed a significant decrease of this parameter (4.78-fold, P=0.002). Injective immunotherapy is safe and clinically effective in European patients sensitized to Ambrosia. [ABSTRACT FROM AUTHOR]

Background Injective immunotherapy is a well-known and recognized treatment for allergic diseases, but its safety has been questioned during recent years. Alternative administration routes have been proposed and there is a growing interest and experience in sublingual therapy. The safety of alternative routes is nonetheless a real advantage, so long as it is not counterbalanced by a loss of clinical benefit. Objective We have compared the efficacy of the same biologically standardized grass pollen extract administered through the injective or the sublingual route, in a group of 20 patients followed for two pollen seasons. Methods Both therapies were administered for 12 months according to a doubleblind (double-dummy) plan: at the end of the trial the cumulative dosage of the sublingual therapy was 2.4 times higher than that of the injective therapy. Data about skin reactivity, symptoms and drugs scores during the pollen season, as well as total specific IgG and specific IgG4. during and after the trial, were obtained. Results Our data show that sublingual and injective therapy are equally effective according to subjective clinical parameters, with a statistically highly significant reduction of symptoms and drugs (P = 0.002 for symptoms and drugs in SLIT-treated patients; P = 0.002 for symptoms and P = 0.0039 for drugs in patients given injections). On the other hand, objective parameters (total specific IgG, specific IgG4, skin reactivity) changed only in patients treated with active injective therapy, with P < 0.001, P < 0.001 and P = 0.021, respectively. Conclusions The discrepancies observed could be interpreted as a consequence of different mechanisms of action of the two therapies or to the lack of close relationships between the clinical and the objective parameters which were considered here. [ABSTRACT FROM AUTHOR]

A total of 98 workers at a glass-wool factory were patch tested with glass-fibres and six chemical irritants. A rubbing test with the fibres, a Trafuril test and provocation of dermographism were also performed. The subjects with strong patch test reactions to one quality of fibres also reacted strongly to the other types of fibres but did not show an increased sensitivity to other tests. The subjects with intense skin reactions to rubbing with the fibres showed an increased skin reactivity to Trafuril. A tendency towards increased reactivity to the patch tests with fibres was found in persons with fair skin and blue eyes. [ABSTRACT FROM AUTHOR]

Skin reactivity (intracutaneous test) to histamine and allergens was studied cross-sectionally in a Dutch asthmatic patient population from childhood to old age (4-75 years). It was found that the histamine skin reactivity rose significantly (p < 0.05) during childhood, was significantly higher in the 10-45 year age group, and was constant between 20 and 75 years of age. The mean wheal index (histamine ratio) of all allergens was constant during childhood, and decreased after the age of 25 for grass pollen and house-dust mite and after the age of 15 for the other allergens. The prevalence of a positive skin test decreased with age, except for grass pollen. During childhood the indoor allergens, cat dander and house-dust mite, were the most important, while after the age of 15 sensitivity to an outdoor allergen, grass pollen, increased markedly. At all ages house-dust mite was the most important allergen. After the age of 25 the prevalence of every allergen declines. The prevalence of a positive skin test to Cladosporium was unexpectedly high in childhood (10-40%). It can be concluded that the prevalence of a positive skin test declines with age, except for grass pollen. The degree in sensitization in asthmatics peaked in the age groups between 20 and 40 and sensitivity to indoor allergens developed earlier than sensitivity to outdoor allergens. [ABSTRACT FROM AUTHOR]

A double-blind, placebo-controlled study of immunotherapy was conducted in 19 patients with grass-pollen hay fever to evaluate the efficacy and safety of a formalinized depot grass allergoid. The patients were assessed before and during IT by clinical (symptom-medication scores during the grass- pollen season, specific nasal and skin reactivity) and immunological (specific IgE, IgG, IgG1 and IgG4 antibodies) parameters. High doses of grass allergoid, corresponding to a cumulative pre-seasonal dosage of 46,050 PNU, were administered, with only one systemic reaction. The actively treated patients had significantly lower symptom-medication scores than placebo (p < 0.01) during the month of May and showed a significant decrease in specific skin (p < 0.01) and nasal (p < 0.05) reactivity, and a significant early increase in specific IgE (p < 0.01), IgG (p < 0.0005), IgG1 (p < 0.001) and IgG4 (p < 0.05), with a subsequent decrease of IgE and IgG1. No differences were detected in any of these parameters in the placebo group. A correlation was found between high IgG4/IgG1 ratio and the specific skin reactivity decrease (r = 0.691, p < 0.05), whereas a high IgG4/IgG1 ratio was associated with higher symptom-medication scores (r = 0.654, p < 0.05). Possible explanations of these apparent discrepancies are proposed. [ABSTRACT FROM AUTHOR]