Investigation of the cell composition and gene expression in the delayed-type hypersensitivity tuberculin skin test

Dear Editor,The tuberculin skin test(TST)reagents have continuously improved,with the ESAT6-CFP10(EC)test having recently been introduced,but are seldom based on the direction of the delayed-type hypersensitivity(DTH)mechanism.Previous studies only partially showed the infiltration and activation of immune cells and the production of cytokines of the skin induration[1,2],and lack the detailed measurements of cell proportions and gene expression in the DTH response.Therefore,in this study,we revealed the comprehensive characteristics of DTH by single-cell RNA sequencing(scRNA-seq)in the guinea pig tuberculosis(TB)model[Experimental Animal Welfare Ethics Committee,Beijing Tuberculosis and Thoracic Tumor Research Institute(2021-064)].

Relationship between Serum Specific IgE and Allergen Skin Test in Allergic Patients of Wuhan Area

Summary: In order to study the relationship between serum specific IgE (sIgE) and allergen skin test, allergen skin tests and detections of sIgE in 220 allergic patients of Wuhan area were analyzed. The coherent rate of the two methods was beyond 70 % (P<0.01). It was concluded that the in vitro and in vivo detection methods of allergens have a high coherence and can be used as the effective ways to diagnose the allergic diseases in clinical practice.

Food intolerance and skin prick test in treated and untreated irritable bowel syndrome

AIM： To correlate the clinical features of treated and untreated patients with irritable bowel syndrome （IBS） to the results of skin prick test （SPT） for food and inhalant allergens. METHODS： We recruited 105 subjects to form three different target groups： treated group （n=44） undergoing treatment for IBS, untreated group （n =31） meeting the Rome Ⅱ criteria without treatment for IBS, control group （n = 30） with no IBS symptoms. RESULTS： SPT results were different among the three groups in which SPT was positive in 17 （38.6%） treated patients, in 5 （16.1%） untreated patients and in 1 （3.3%） control （P〈0.01）. The number of positive SPTs was greater in the IBS group than in the control group （P〈 0.001）. The number of positive food SPTs was higher in the treated IBS group than in the untreated IBS group （P= 0.03）. CONCLUSION： Positive food SPT is higher in IBS patients than in controls.

Performance and correlation of QuantiFERON-TB Gold, T-SPOT.TB and tuberculin skin test in young children with or exposed to tuberculosis

Objective:To evaluate the performance of interferon gamma release assays and tuberculin skin test in Bacillus Calmette-Guerin vaccinated young children.Methods:A cross-sectional study was conducted in healthy children younger than 5 years who were recently diagnosed with tuberculosis or had recent exposure to active tuberculosis.QuantiFERON-TB Gold,T-SPOT.TB and tuberculin skin test were performed in each patient.Results:Of the 60 children,median age 3.3 years,17 had tuberculosis and 43 had recent tuberculosis exposure.Overall,15(25.0%)children had tuberculin skin test reaction≥10 mm;8(13.3%)were positive by QuantiFERON-TB Gold In-Tube test,and 12(20.0%)by T-SPOT.TB.Nineteen(31.7%)children had at least one positive test.There was a moderate agreement between interferon gamma release assays and tuberculin skin test.Conclusions:The positive rates of interferon gamma release assays and tuberculin skin test were low in young children who were infected with tuberculosis,supporting the management strategy of not testing children younger than 5 years.

Skin Sensitive Difference of Human Body Sections under Clothing— Smirnov Test of Skin Surface Temperatures' Dynamic Changing

Skin sensitive difference of human body sections under clothing is the theoretic foundation of thermal insulation clothing design. By a new method of researching on clothing comfort perception, the skin temperature live changing procedure of human body sections affected by the same cold stimulation is inspected. Furthermore with the Smirnov test the skin temperatures dynamic changing patterns of main human body sections are obtained.

Performance and correlation of interferon gamma release assays and tuberculin skin test in HIV-infected children and adolescents with immune reconstitution

Objective:To evaluate the performance of interferon gamma release assays and tuberculin skin test in HIV-infected children and adolescents with immune reconstitution.Methods:A cross-sectional study was conducted in HIV-infected patients aged 5-18 years receiving antiretroviral treatment with CD4 T-lymphocytes>25%or>500 cells/mm3 for at least 6 months.QuantiF ERON-TB Gold,T-SPOT.TB,and tuberculin skin test were performed in each patient.Results:A total of 50 patients were enrolled with median age of 13.7 years,CD4 counts of 753(IQR:587-989)cells/mm3.Among 27 patients with tuberculosis(16)or tuberculosis exposure(11),8(29.6%)were positive to at least one test,2(7.4%)were positive QuantiFERON-TB Gold,3(11.1%)positive T-SPOT.TB,and 7(25.9%)had tuberculin skin test≥5 mm.Among 23 patients without history of tuberculosis or exposure,all had negative interferon gamma release assays,while 2(8.7%)had positive tuberculin skin test.Conclusions:All tests had low sensitivity despite immune reconstitution.

Discrepancies between the responses to skin prick test to food and respiratory antigens in two subtypes of patients with irritable bowel syndrome

AIM:To compare the response to skin prick tests (SPTs) to food antigens (FAs) and inhalant allergens (IAs) in patients with two subtypes of irritable bowel syndrome (IBS) and healthy controls. METHODS:We compared the results of SPTs for IAs and FAs in 87 volunteers divided into three groups:diarrhea predominant IBS (D-IBS) GroupⅠ(n = 19), constipation predominant IBS (C-IBS) Group Ⅱ (n = 17), and normal controls Group Ⅲ (n = 51). RESULTS:Of the 285 tests (171 for FAs and 114 for IAs) performed in GroupⅠwe obtained 45 (26.3%) positive responses for FA and 23 (20.1%) for IA. Of the 153 tests for FA in Group Ⅱ, we obtained 66 (20.1%) positive responses, and of the 102 tests for IA, we obtained 20 (19.6%) positive responses. Of the 459 tests for FA performed in Group Ⅲ, we obtained 39 (84%) positive responses, and of the 306 for IA, we obtained 52 (16.9%) positive responses. The numbers of positive responses were not significantly different between the three groups, but in the D-IBS group, the number of SPTFA responses differed significantly from those for the other two groups (P < 0.01). CONCLUSION:Despite the small number of cases studied, the higher reactivity to FAs in GroupⅠcompared to Groups Ⅱ and Ⅲ adds new information, and suggests the presence of a possible alteration in intestinal epithelial function.

Comparison and Evaluation of Several Dermatophagoides Pteronyssinus Allergen Extracts for Skin Prick Test

Objective To evaluate the significance of several Dermatophagoides pteronyssinus allergen extracts for skin prick test(SPT) in patients allergic to Dermatophagoides pteronyssinus.Methods Two hundred and nineteen patients enrolled in Peking Union Medical College Hospital underwent SPT and serum specific IgE assay to detect the Dermatophagoides pteronyssinus allergen.Three kinds of house dust mite allergen extracts were used for SPT,including the Dermatophagoides pteronyssinus extract prepared by our laboratory(group A),standardized Dermatophagoides pteronyssinus extract(group B),and mixed extracts of Dermatophagoides pteronyssinus and Dermatophagoides farinae(group C).Human serum specific IgE result was regarded as the reference standard for diagnosis of Dermatophagoides pteronyssinus allergy.The receiver operating characteristic(ROC) curve was used to evaluate the diagnostic performance of SPT with the extracts of three groups.Results SPT results showed that the median wheal diameter of group A,group B,and group C was 0.43,0.35,and 0.28 cm,respectively,with significant difference among three groups(P<0.05).The difference was significant between group A and B(P<0.01) as well as group A and C(P<0.01),but not between group B and C(P>0.05).There was no local urticaria or systemic allergic reactions following the procedure of SPT.Local reaction was observed in 5 patients and delayed reaction was in 2 patients of group A.As for group B and C,local reaction occurred in 3 cases and delayed reaction in 2 cases in each group.The area under ROC curve of SPT with extract in group A,group B,and group C was 0.765,0.801,and 0.782,respectively.Based on the detection results of serum specific IgE,the sensitivity of SPT in diagnosis of Dermato-phagoides pteronyssinus allergy with extract of group A,group B,and group C was 92.4%,87.0%,and 81.5%,and the specificity was 60.6%,73.2%,and 74.8%,respectively.Conclusion The Dermatophagoides pteronyssinus extract for SPT prepared by our laboratory offers good sensitivity and specificity comparable to commercially available allergen extracts,and it may be an appropriate candidate for clinical screening and diagnosis of Dermatophagoides pteronyssinus allergy.

Preliminary Observation and Significance of Changes on Rash of Skin Prick Test during SLIT

Objective: To observe the changes on skin wheal and erythema of skin prick test for the patients with allergic rhinitis during SLIT. Methods: Since March 2010 the 103 cases of SLIT attacked by allergic rhinitis patients, divided into four age groups, respectively measured the diameter of skin wheal and erythema before treatment, six months, one year and 2 years after SLIT. The data were analyzed by analysis of variance method;P Results: The results showed that the most changes of skin erythema diameter were statistically significant in N1, N2, N3 age group during test observation compare with the data before SLIT (p Conclusion: Although most of the skin test wheal did not change significantly during the treatment of SLIT, the erythema reaction decreased to a certain extent, indicating that the intensity of histamine release may be reduced during the treatment.

Anaphylaxis to Skin Prick Testing in a 29-Year-Old Woman

Introduction: Skin prick testing (SPT) is a common test to diagnose IgE sensitization and the rate of adverse reactions is very low. Case Presentation: 29-year-old woman with anaphylactic reaction to routine SPT with 11 allergens (aero and food). Discussion: Allergy profile included multiple food and inhalant allergies, polysensitization, prior episode of anaphylaxis to mushrooms, active eczema and active hay fever but not active asthma. Conclusion: Anaphylaxis to SPT, although a rare event, is unpredictable necessitating availability of appropriate personnel and adequate resuscitation facilities for all testing.

Assessment of a Case of Immediate-Type Allergy against Human Insulin in a Type 2 Diabetic Patient and Allergic Reactions to Human Insulin in Japan

We report a 64-year-old female patient with an insulin allergy. She was treated with a combination of oral antihistamines, topical hydrocortisone cream, and moisturizing agents, which resulted in the improvement of eczema and intense pruritus. To evaluate insulin allergy, intradermal skin tests were performed with several insulin agents for clinical use and 0.9% NaCl. Skin testing with semisynthetic human insulin resulted in local, immediate skin reactions such as itchy erythema and wheals. Furthermore, we analyzed our case and 25 Japanese cases of insulin allergy previously reported in the literature as far as we know. Interestingly, the number of male patients was approximately two times higher than that of female, and the insulin-specific IgE antibody test was positive in 21 patients. We should keep the possibility of human insulin allergy in mind and prepare for it when initiating human insulin therapy.

Indications, Interpretation and Clinical Consequences of Tuberculin Skin Tests in Resource Limited Settings

Objective: to evaluate the policy of TST testing in Suriname. As there is no gold standard to diagnose latent tuberculosis infection (LTBI), the tuberculin skin test (TST) is used to diagnose LTBI. However, internationally, the cut-off values of the TST are not uniform and depend on local tuberculosis (TB) epidemiology and guidelines for test initiation. In Suriname, where currently several indications exist for TSTs, cut-off values are set at 5 mm or 10 mm, depending on the age and/or medical history of the patient. LTBI classification is performed by pulmonologists primarily based on the American Thoracic Society targeted TB testing guidelines. Method: retrospective analysis of outpatient TST data between 2011 and 2019 from Suriname’s sole pulmonary medicine clinic. Result: 1373 patients were evaluated. 590 patients were from the screening group of whom 253 had a positive TST result, 46 of whom were classified as LTBI. In the contact tracing group of 649 patients, 616 had a positive TST, 352 of whom were classified as LTBI. In the medical condition group of 134 patients, 96 had a positive TST, 38 of whom were classified as LTBI. Eventually, positive TST results were found for 965 tested patients: 436 patients were classified as LTBI and 529 non-LTBI patients were not prescribed chemoprophylaxis. None of the non-LTBI TST-positive patients were diagnosed with active TB, including 174 patients with a TST result of 15 mm or greater and in need of IPT, but not prescribed by judgement of the pulmonologist or because of loss to follow-up. Conclusion: the overrepresentation of positive TST results in Suriname is attributable to stringent cut-off values, especially among patients who do not disclose TB risk factors. In our opinion the TST cut-off value for such patients in Suriname and other similar settings could be set at 15 mm. We also promote that for all patients with a TST result of 15 mm or greater, offering IPT should be considered (after excluding active TB).

Comparison between Quanti-FERON-TB Gold In-Tube test and tuberculin skin test for diagnosis of latent tuberculosis in children: A cross-section study

Objective: To compare Quanti-FERON-TB Gold In-Tube (QFT-GIT) test and tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection in children. Methods: In this cross-sectional study, 64 participants who were between 3 months and 14 years old and had close contact with smear-positive pulmonary tuberculosis were included. Both QFT-GIT test and TST were done and the results were analyzed by SPSS software and Kappa test. Results: The distribution of gender and age according to QFT-GIT and TST results were matched (P>0.05). Overall agreement between QFT-GIT and TST for diagnosis of latent tuberculosis infection in children was 75%. In addition, the contingency coefficient was 0.257, and the Kappa measure of agreement was 0.246 (P=0.034). Conclusions: Compared to TST, QFT-GIT shows no apparent advantage for diagnosis of latent tuberculosis infection in children.

Effectiveness of Virtual Reality for Pediatric Pain and Anxiety Management during Skin Prick Testing

This study investigated the effectiveness of virtual reality (VR) distraction, compared to comic book distraction and no distraction, in reducing pain and anxiety during a medical procedure in a pediatric population: the skin prick test. Although this test has many advantages and is considered to be minimally invasive, it causes anxiety and painful discomfort in children. Ninety-two children aged 7 to 17 years consulting for an allergic test received VR distraction, comic book distraction, or no distraction. Outcome measures included pain score, level of anxiety, and VR measures. The results showed that there were no significant differences between the three groups regarding sex, age, and preprocedural anxiety level. In the distraction groups (VR and comic book), children reported significantly lower pain and procedural anxiety scores than children with no distraction;VR distraction had a more significant effect than comic book distraction. A decrease in anxiety before and during the skin prick test is significantly more significant in VR distraction. This study suggested the effectiveness and feasibility of VR to reduce pain and anxiety during the pediatric skin prick test.

Pharmacodynamics of frigid zone plant Taxus cuspidata S.et Z.against skin melanin deposition,oxidation,inflammation and allergy

Background:Taxus cuspidata S.et Z.is a precious species of frigid zone plant belonging to the Taxaceae family,which possesses anticancer,anti-inflammatory,hypoglycemic,and antibacterial pharmacological properties.While taxane extracted from Taxus chinensis has been reported to elicit antioxidant activities,whether Taxus cuspidata S.et Z.has skin-protective actions against injuries remained unknown.This study aims to explore the pharmacological effects of three Taxus extracts on skin melanin deposition,oxidation,inflammation,and allergy so as to provide new ideas for the prevention and treatment of various diseases related to skin damage.Methods:Skin melanin deposition was evaluated by measuring melanin content in the skin of guinea pigs by alkali lysis method.Antioxidant capacity was evaluated by measuring superoxide dismutase(SOD)concentration and glutathione(GSH)content in skin tissue homogenates of Kunming mice by SOD assay kit and micro reduced GSH assay kit.The quantitative real-time polymerase chain reaction(qRT-PCR)and western blotting were used to examine the levels of both SOD and recombinant glutathione peroxidase 4(GPX4).Skin inflammation was evaluated by xylene-induced ear swelling test and egg-white-induced paw swelling test in mice.In a mouse model of skin allergy induced by 4-aminopyridine(4-AP),allergy was determined by licking body counts and histamine concentrations in tissue homogenates using enzyme-linked immunosorbent assay(ELISA)kits.Two proinflammatory factors tumor necrosis factor(TNF)-αand interleukin(IL)-1βwere measured by qRT-PCR.Hematoxylin and eosin(HE)staining was conducted to assess the degree of skin lesion.Results:All three Taxus extracts including Taxus chinensis essential oil,Taxus chinensis extract and Taxus chinensis extract compound reduced the melanin deposits in the back skin relative to the non-treated control animals,of which Taxus chinensis essential oil produced the greatest effect.In contrast,the three Taxus extracts elevated SOD and GSH levels in the skin tissues,and the highest increase was seen with Taxus chinensis essential oil.Three Taxus extracts,especially Taxus chinensis essential oil,effectively reduce the rate of ear and paw swelling.All three Taxus extracts reduced the number of body licks,the levels of TNF-αand IL-1β,and the histamine content in tissue homogenates of mice and alleviated skin damage.Consistently,Taxus chinensis essential oil yielded the greatest magnitude of decreases.Conclusion:While all three Taxus extracts possessed the anti-skin melanin deposition,oxidation,and allergy properties,Taxus chinensis essential oil produced the superior effects.

Novel approach for the automated detection of allergy test using spectral imaging

This paper proposes a novel approach for the automatic detection of allergy test (allergy lesion). A hyperspectral microscope system was used to image the test samples which were diagnosed by dermatologist. It was found that allergy of different levels, and healthy skin cells show absorption spectra, which are sufficiently characteristic and yet reproducible enough to allow for differentiation when using a spectroscopic system. Principal components analysis was used to extract relevant features that could be used for classification from these spectra. Preliminary results indicate that the different types of allergy cells can be reliably distinguished by these features. We conclude that hyperspectral microscopic analysis is a promising approach for improving and automating the diagnosis of allergy test as well as another skin lesions.

Multi-Test Ⅱ点刺器在儿童过敏原皮肤点刺试验中的应用评价

目的初步评价Multi-TestⅡ点刺器在儿童过敏原皮肤点刺试验(SPT)中的适用性。方法选取2017年3～9月就诊的87例过敏性疾病患儿为研究对象,均进行6种吸入性过敏原的SPT和血清特异性IgE(sIgE)测定。分别应用单点刺针及Multi-TestⅡ点刺器于患儿左、右前臂进行SPT的测定,应用荧光酶联免疫法进行血清s IgE浓度的测定。用视觉模拟评分(VAS)标尺评估患儿接受SPT的疼痛程度。比较3种方法 6种过敏原的阳性检出率分布差异及Multi-TestⅡ点刺器的灵敏度和特异度。结果 Multi-TestⅡ法、单点刺针法、荧光酶联免疫法3种方法检出6种过敏原的阳性率比较差异无统计学意义(P>0.05)。与单点刺针法比较,Multi-TestⅡ法灵敏度为72.7%,特异度为78.2%;与荧光酶联免疫法比较,Multi-TestⅡ法灵敏度为73.4%、特异度为77.5%。Multi-TestⅡ法较单点刺针法疼痛程度低,差异有统计学意义(P<0.05)。结论 Multi-TestⅡ法灵敏度及特异度较高且易被患儿接受,但测定结果需同时与患儿的临床病史相结合,必要时结合血清特异性IgE测定结果。

Study of LDBPs Shaft Skin Friction for Piles in Cohesiove Soils

The methodology of predicting pile shaft skin ultimate friction has been studied in a systematic way. In the light of that, the analysis of the pile shaft resistance for bored and cast in situ piles in cohesive soils was carried out thoroughly in the basis of field performance data of 10 fully instrumented large diameter bored piles (LDBPs) used as the bridge foundation. The undrained strength index μ in term of cohesive soils was brought forward in allusion to the cohesive soils in the consistence plastic state, and can effectively combine the friction angle and the cohesion of cohesive soils in undrained condition. And that the classical ' α method' was modified much in effect to predict the pile shaft skin friction of LDBPs in cohesive soils. Furthermore, the approach of standard penetration test (SPT) N value used to estimate the pile shaft skin ultimate friction was analyzed, and the calculating formulae were established for LDBPs in clay and silt clay respectively.

体外构建的皮肤模型Inspectskin Ⅰ修复裸鼠全层皮肤缺损

【目的】探讨胚胎来源表皮干细胞构建的人工皮肤模型InspectskinⅠ修复全层皮肤缺损的作用,为构建含皮肤附属结构的检验用皮肤奠定基础。【方法】将人羊膜和BMP-4定向诱导小鼠胚胎细胞分化为表皮干细胞,采用筏式培养在体外与PHBV和成纤维细胞共培养构建组织工程皮肤,经短暂培养后移植于裸鼠皮肤缺损创面,对移植物进行形态学和免疫组织化学观察。【结果】移植物可封闭皮肤缺损,在其表面可形成复层表皮样结构,真皮部分可见大小不等的由单层或复层上皮样细胞构成的管状和泡状结构、汗腺样结构和毛囊样结构。免疫组化和免疫双标结果表明新生表皮的基底层分别呈CK19和CK10阳性,腺管样结构分别呈CEA和CK18阳性。【结论】体外重建的人工皮肤能修复裸鼠全层皮肤缺损,胚胎来源表皮干细胞具有分化为复层扁平上皮、汗腺样结构和毛囊样结构的潜能。

Food allergy in gastroenterologic diseases:Review of literature

Food allergy is a common and increasing problem worldwide. The newly-found knowledge might provide novel experimental strategies, especially for laboratory diagnosis. Approximately 20% of the population alters their diet for a perceived adverse reaction to food, but the application of double-blind placebo-controlled oral food challenge, the ＂gold standard＂ for diagnosis of food allergy, shows that questionnaire-based studies overestimate the prevalence of food allergies. The clinical disorders determined by adverse reactions to food can be dassified on the basis of immunologic or nonimmunologic mechanisms and the organ system or systems affected. Diagnosis of food allergy is based on clinical history, skin prick tests, and laboratory tests to detect serum-food specific IgE, elimination diets and challenges. The primary therapy for food allergy is to avoid the responsible food. Antihistamines might partially relieve oral allergy syndrome and IgE-mediated skin symptoms, but they do not block systemic reactions. Systemic corticosteroids are generally effective in treating chronic IgE-mediated disorders. Epinephrine is the mainstay of treatment for anaphylaxis. Experimental therapies for IgE-mediated food allergy have been evaluated, such as humanized IgG anti-IgE antibodies and allergen specific immunotherapy.