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  • 1
    In: European Journal of Clinical Medicine, European Open Science Publishing, Vol. 3, No. 2 ( 2022-03-01), p. 1-7
    Abstract: Background: The Non-Celiac Gluten Sensitivity (NCGS) is a category inside the Gluten-Related Disorders (GRD) that groups the patients with unidentified mechanisms responsible for their symptoms. Objective: To evaluate the opportunity of an ex vivo challenge immunoassay, the Leukocyte Adherence Inhibition Test (LAIT), to discriminate non—IgE-mediated gluten-specific immunoreactivity in patients with NCGS. Methods: Ex vivo challenge tests performed with gluten latex extract, monitored by LAIT, were assayed in an asymptomatic control group of 30 individuals and a group of 52 patients with GRD not related to any identifiable immune mechanism (NCGS). Results: The mean Leukocyte Adherence Inhibition (LAI) of the control group was 10.9%. The mean LAI of the NCGS patients’ group was 54.9%. The non-parametric Wilcoxon-Mann-Whitney U test comparing the control group with the NCGS patient’s group showed significance with a p-value 〈 0.00001. Conclusion: The LAIT is an ex vivo challenge test able to discriminate gluten-sensitive and gluten-tolerant individuals, suggesting the participation of an immune Non—IgE-mediated hypersensitivity reaction in patients with the clinical diagnosis of NCGS.
    Type of Medium: Online Resource
    ISSN: 2736-5476
    Language: Unknown
    Publisher: European Open Science Publishing
    Publication Date: 2022
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  • 2
    In: European Journal of Clinical Medicine, European Open Science Publishing, Vol. 3, No. 1 ( 2022-01-07), p. 11-17
    Abstract: Background: Due to the lack of standardized laboratory procedures able to demonstrate specific non—IgE-mediated immune responses against latex allergens, these conditions are diagnosed mostly by clinical criteria based on empiric exclusion prescriptions monitored by in vivo challenge tests. Objective: To evaluate the opportunity of an ex vivo challenge immunoassay, the Leukocyte Adherence Inhibition (LAI) Test (LAIT), to discriminate non—IgE-mediated latex-specific immunoreactivity. Methods: Ex vivo challenge tests performed with Hevea Brasiliense’s latex extract, monitored by LAIT, were assayed in an asymptomatic control group and a group of patients with diverse respiratory and cutaneous non—IgE-mediated allergic conditions, clinically diagnosed by a certified allergologist. Results: The mean LAI of the control group was 8.3%. The mean LAI of the complete patients’ group was 41.1%. The non-parametric Wilcoxon-Mann-Whitney U (WMWU) test comparing the control group with the whole patient’s group showed significance with a p-value 〈 0.00001. The WMWU test comparing the control group with each other patient’s group showed significance with a p-value 〈 α = 0.05 for all comparisons. The WMWU test comparing the patients’ groups between each other did not show any significant p-value. Conclusion: Several patients from the diverse non—IgE-mediated allergic phenotypes presented variable immunoreactivity against the latex extract, as demonstrated by the LAIT, which proved to be an easy, quick, and inexpensive ex vivo immunoassay with the potential to predict individual immunoreactivity against Hevea brasiliensis latex allergens in real-world patients with non—IgE-mediated allergies.
    Type of Medium: Online Resource
    ISSN: 2736-5476
    Language: Unknown
    Publisher: European Open Science Publishing
    Publication Date: 2022
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  • 3
    In: European Journal of Clinical Medicine, European Open Science Publishing, Vol. 2, No. 6 ( 2021-11-16), p. 1-9
    Abstract: Background: The diagnosis of non-IgE mediated food allergies may be a complex puzzle when there is no start point to establish an elimination diet to allow a clear clinical field to initiate diagnostic Oral Food Challenges tests. Objective: To evaluate the opportunity of the tube titration of precipitins to select food allergens to proceed with elimination diets to assist the diagnosis and management of adult patients with Food Allergy manifested as Intrinsic Atopic Dermatitis (IAD). Methods: The tube titration of specific precipitins against anamnesis-chosen food allergens were performed in 64 IAD patients and their titers were associated with an Improvement Verbal Scale Rate (IVSR) of the patient’s perception of the benefits of the Precipitins-based Elimination Diet (PED) performed with these specific food allergens, as well correlated with their positive or negative perception of the impairment of symptoms after the reintroduction of the Symptom-Related Food Allergen (SRFA). Results: In most cases, the PED contributed to a significant clinical improvement that allowed the patients to evaluate the individual effect of the reintroduction of each food allergen on their diets. There was a significant positive correlation coefficient between the titers of the food-specific titration of precipitins and the percentage of positive SRFA (Pearson r = 0.91; p-value = 0.0004). Conclusion: The semiquantitative titration of specific precipitins against food allergens is a promising triage test to select food allergens to proceed with elimination diets to support the diagnosis and management of non-IgE mediated Food Allergy in patients with Intrinsic Atopic Dermatitis.
    Type of Medium: Online Resource
    ISSN: 2736-5476
    Language: Unknown
    Publisher: European Open Science Publishing
    Publication Date: 2021
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  • 4
    In: European Journal of Clinical Medicine, European Open Science Publishing, Vol. 2, No. 6 ( 2021-12-13), p. 45-50
    Abstract: Background: Due to the lack of standardized laboratory procedures able to demonstrate specific immune responses against the culprit allergens, the non—IgE-mediated allergy syndromes are a group of conditions diagnosed mostly by clinical examination and exclusion criteria. Objective: To evaluate the opportunity of the Leukocyte Adherence Inhibition Test (LAIT) to discriminate specific immunoreactivity against Dermatophagoides pteronyssinus (Dp) in a group of patients with non–IgE-mediated chronic allergic conditions. Methods: Ex vivo challenge tests performed with Dp were monitored by LAIT in patients presenting diverse non–IgE-mediated allergic conditions: intrinsic Atopic Dermatitis (iAD), intrinsic Allergic Rhinitis (iAR), intrinsic Ocular Allergy (iOA), intrinsic Chronic Pharyngitis (iCP), and intrinsic Asthma (iAS). Results: The mean LAI of the control group was 7%; the mean LAI of the iAR group was 34%; the mean LAI of the iCP group was 44%; the mean LAI of the iAS group was 45%; the mean LAI of the iOA group was 47%; the mean LAI of the iAD group was 55%. The non-parametric Wilcoxon-Mann-Whitney U test comparing the control group with each other group showed significance with p-value 〈 α = 0.05 for all groups. Conclusion: The Leukocyte Adherence Inhibition Test is an easy, quick, and inexpensive ex vivo immunoassay with the potential to predict individual immunoreactivity against HDM allergens in real-world patients with non–IgE-mediated allergies.
    Type of Medium: Online Resource
    ISSN: 2736-5476
    Language: Unknown
    Publisher: European Open Science Publishing
    Publication Date: 2021
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  • 5
    In: European Journal of Clinical Medicine, European Open Science Publishing, Vol. 3, No. 2 ( 2022-04-13), p. 38-43
    Abstract: Background:  The non—IgE-mediated food allergy syndromes are a group of conditions diagnosed mostly by clinical criteria and Oral Food Challenge tests (OFC). Objective:  To evaluate the feasibility of the Leukocyte Adherence Inhibition Test (LAIT) to discriminate antigen-specific immunoreactivity in a group of patients with non—IgE-mediated cow’s milk allergy diagnosed by OFC and clinical criteria. Methods:  Ex vivo challenge tests performed with cow’s milk proteins extracts were monitored by LAIT in two groups: A) the active group consisting of 38 patients presenting non—IgE-mediated gastrointestinal lactose-free cow’s milk hypersensitivity; B) the control group consisting of 29 cow’s milk tolerant individuals Results:  The mean Leukocyte Adherence Inhibition (LAI) of the control group was 5.48%, and the mean LAI of the active group was 54.18%.  The non-parametric Wilcoxon-Mann-Whitney U test showed p 〈 α = 0.05. Conclusion:  The Leukocyte Adherence Inhibition Test is an ex vivo immunoassay able to predict individual non—IgE-mediated immunoreactivity against cow’s milk allergens and to act as a triage test to select food allergens to be prescribed in exclusion diets to perform OFC in patients with suspected non—IgE-mediated food allergies.
    Type of Medium: Online Resource
    ISSN: 2736-5476
    Language: Unknown
    Publisher: European Open Science Publishing
    Publication Date: 2022
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  • 6
    In: European Journal of Clinical Medicine, European Open Science Publishing, Vol. 4, No. 2 ( 2023-03-12), p. 1-7
    Abstract: Background: The ancient concept of “intrinsic” and “extrinsic” asthma has evolved in line with growing scientific knowledge and the use of new clinical diagnostic tools. Objective: The present study aims to evaluate the non-IgE-mediated immunoreactivity against common allergens, in asthmatic patients without evidence of IgE-mediated hypersensitivity against these allergens. Methods: A group of 127 “intrinsic” asthmatic outpatients, were submitted to ex vivo Leukocyte Adherence Inhibition Tests (LAIT) with extracts of Dermatophagoides pteronyssinus, Hevea brasiliensis latex, dog dander, cat dander, cow’s milk proteins, beekeeping pollen and a mixture of fungal extracts. Results: Cascade graphs were assembled according to the distribution of the LAIT results among the range of results of Leukocyte Adherence Inhibition (LAI) inside each group. A column graph was plotted with the mean LAI results for each antigen. The non-parametric Wilcoxon-Mann-Whitney U-test performed between the results of each test was significant only between the results of the LAIT performed with the dog extract and the mixed fungal extract (U = 1,179.5; the z-score was -2.64109; the p-value was 0.0083).  All other Wilcoxon-Mann-Whitney U-test calculations between LAIT performed with the other allergens were not significant at p 〈 0.01. Conclusion: The evidence of non-IgE-mediated immunoreactivity in allergic patients has been reported in the medical literature since the beginning of the 19th century and has been increasing since then. This descriptive article presents the contribution of the LAIT as a tool to quantify the overall non-IgE-mediated cellular/humoral immunoreactivity against common allergens in patients formerly classified inside the “intrinsic” asthma endotype.
    Type of Medium: Online Resource
    ISSN: 2736-5476
    Language: Unknown
    Publisher: European Open Science Publishing
    Publication Date: 2023
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  • 7
    In: European Journal of Clinical Medicine, European Open Science Publishing, Vol. 4, No. 2 ( 2023-03-12), p. 25-30
    Abstract: Background: The presence of anti-Saccharomyces cerevisiae antibodies (ASCA) has been reported in the serum of patients with several immune-inflammatory diseases. Objective: To evaluate the presence of ASCA in patients with non-IgE-mediated hypersensitivity. Methods: A group of 222 patients with non-IgE-mediated hypersensitivity was divided into three groups according to dermatologic, gastrointestinal, and respiratory symptoms. Group D was composed of 163 patients with dermatologic symptoms diagnosed as intrinsic atopic dermatitis and/or non-IgE-mediated urticaria. Group G was composed of 23 patients diagnosed with non-IgE-mediated gastrointestinal food allergies. Group R was composed of 36 patients with respiratory symptoms diagnosed as non-IgE-mediated rhinitis and/or non-IgE-mediated asthma. Results: The Wilcoxon-Mann-Whitney U test comparing the precipitin’s titers of group G and group D showed a non-significant p-value of 0.83366. The Wilcoxon-Mann-Whitney U test comparing the precipitin’s titers of group R and group G showed a significant p-value of 0.00034. The Wilcoxon-Mann-Whitney U test comparing the precipitin’s titers of group R and group D showed a significant p-value 〈 0.0001. Conclusion: The patients with respiratory symptoms diagnosed as non-IgE-mediated rhinitis and/or asthma presented significantly less humoral immunoreactivity against S. cerevisiae than patients with non-IgE-mediated food allergy and patients with intrinsic atopic dermatitis and/or non-IgE-mediated urticaria. The elevation of ASCA titers may be an unspecific marker of intestinal hyperpermeability, and possibly may participate in Gell and Coomb’s types II and/or type III hypersensitivity reactions responsible for the patient’s dermatologic and gastrointestinal symptoms.
    Type of Medium: Online Resource
    ISSN: 2736-5476
    Language: Unknown
    Publisher: European Open Science Publishing
    Publication Date: 2023
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