Atopic Patch Tests – Methods and Significance


Authors: J. Čelakovská 1;  K. Ettlerová 2;  K. Ettler 1;  J. Vaněčková 1
Authors‘ workplace: Klinika nemocí kožních a pohlavních FN a LF UK Hradec Králové přednosta doc. MUDr. Karel Ettler, CSc. 1;  Ambulance klinické imunologie a alergologie, Hradec Králové vedoucí MUDr. Květuše Ettlerová 2
Published in: Čes-slov Derm, 83, 2008, No. 2, p. 62-68
Category: Pharmacologyand Therapy, Clinical Trials

Overview

Atopic dermatitis is a chronic skin disease. Both immediate and delayed type of hypersensitivity plays role in its pathogenesis. The course of atopic dermatitis is complicated mostly by food allergens and aeroallergens, contact allergens, emotional, climatic and hormonal factors. Food allergy to cow milk and eggs has often been found in children under 3 years of age; however tolerance to these compounds is induced in majority (80%) of these patients after the age of three years. The food allergy in adult patients with atopic eczema has not been fully evaluated yet. Whereas immediate-type food reactions can be identified quite easily by evaluation of the specific IgE titres, the presence of the delayed hypersensitivity can be confirmed by atopy patch tests. The elaboration of atopic patch test methods and introducing such approach into the clinical practice could improve the diagnostic possibilities of food allergy and potentially replace the double blind, placebo controlled food challenge tests. The main task is the standardisation of food allergens in performing the tests.

Key words:
atopy – atopic dermatitis – food allergy – atopy patch tests


Sources

1. BEYER, K., TEUBER, SS. Food allergy diagnostics: scientific and unproven procedures. Current Opinion in Allergy and Clinical Immunology, 2005; 5: s. 261-266.

2. BINDSLEV-JENSEN, C., POULSEN, LK. Accuracy of in vivo and in vitro tests. Allergy, 1998; 53 (Suppl. 46): 72-74.

3. BREUER, K., KAPP A., WERFEL, T. The impact of food allergy in patients with atopicdermatitis. Hautarzt, 2003; 54: 2, s. 121-9.

4. BREUER, K., HERATIZADEH, A., WULF, A., BAUMANN, U., CONSTIEN, C., TETAU D., KAPP A., WERFEL, T. Late eczematous reactions to food in children with atopic dermatitis. Clin Exper Allergy, 2004; 34: 5, s. 817-824.

5. BRUIJNZEEL-KOOMEN, C., ORTOLANI, C., AAS, K., BINDSLEY-JENSEN, C., et al. EAACI Position paper Adverse reactions to food. Allergy, 1995; 50: 623-635.

6. CAFFARELLI, C., CAVAGNI, G., GIORDANO, S., et al. Relationship between oral challenges with previously uningested egg and egg-specific IgE antibodies and skin prick tests in infants with food allergy. J. Allergy Clin. Immunol., 1995; 95: 1215-1220.

7. CAPRISTO, C., ROMEI, I., BONER, AL. Environmetal prevention in atopic eczema dermatitis syndrome (AEDS) and asthma: a avoidance if indoor allergens. Allergy, 2004; 59: Suppl. 78, s. 53-6.

8. ČELAKOVSKÁ, J., ETTLER, K., ETTLEROVÁ, K., VANĚČKOVÁ, J. Atopy patch tests. Our first experience. Sborník abstrakt, 3. 11. 2005; I. Vědecká konference postgraduálního studia LF UK v Hradci Králové.

9. DARSOW, U., LAIFAOUI, J., KERSCHENLOHR, K., WOLLENBERG, A., PRZYBILLA, B., WÜTHRICH, B., BORELLI, S., GIUSTI, F., SEIDENARI, S., DRZIMALLA, K., SIMON, D., DISCH, R. The prevalence of positive reactions in the atopy patch test with aeroallergen and food allergens in subjects with atopic eczema: a European multicenter study. Allergy, 2004; 59: 12, s. 1318-1325.

10. DARSOW, U., RING, J. Airborne and dietary allergens in atopic eczema: a comprehensive review of diagnostic tests. Clin Exper Dermatol, 2000; 25: 7, s. 544-551.

11. DE BRUIN-WELLER, MF., KNOL, EF., BRUIJNZEEL-KOOMEN, C. Atopy patch testing – a diagnostic tool? Allergy, 1999; 54: 8, s. 784.

12. BURKS, AW., MAKLËRY, SB., WILLIAMS, LW., SHIRRELL, MA. Atopic dermatitis clinical relevance of food hypersensitivity reactions. J Pediatr, 1988; 113: 447-451.

13. EIGENMANN, PA., SICHERER, SH., BORKOWSI, TA., COHEN, BD., SAMPSON, HA. Prevalence of IgE-mediated food allergy among children with food atopic dermatitis. Pediatrics, 1998; 101.

14. ETTLEROVÁ, K., KOHOUT, P. Diagnostické možnosti potravinové alergie a intolerance. Alergie, 2000, 2, č.3, 190-196.

15. FOUCARD, T., MALMHEDEN-YMAN, I. A study on severe food reactions in Sweden – in soy protein an understimated cause of anaphylaxis? Allergy, 1999; 103: 262-265.

16. FOROUGHI, S., THYAGARAJAN, A., STONE, KD. Advances in pediatric asthma and atopic dermatitis. Curr Opin Pediatr, 2005; 17: 658-663.

17. HEINEMANN, C., SCHLIEMANN-WILLERS, S., KELTERER, D., METZNER, U., KLUGE, K., WIGGER-ALBERTI, ELSNER, WP. The atopy patch test-reproducibility and comparison of different evaluation methods. Allergy, 2002; 57: s. 641-645.

18. HOST, A., HALKEN, S. A prospective study of cow milk allergy in Danish infants during the first three years of life. Allergy, 1990; 45: 587-596.

19. HOST, A. Cows milk protein allergy and intolerance in infancy. Pediatr Allergy Immunol, 1994; 5: 5-36.

20. INGORDO, V., D´ANDRIA, G., D´ANDRIA, C., TORTORA, A. Results of atopy patch tests with house dust mites in adults with „intrinsic“ and „extrinsic“ atopic dermatitis. J Eur Acad Derm Venerol, 2002; 16: 5, s. 450.

21. INGORDO, V., NOGARE, R. D., COLECCHIA, B., D´ANDRIA, C. Is the Atopy Patch Test with House Dust Mites Specific for Atopic D. Dermatology, 2004; 209: s. 276-283.

22. KEKKI, OM., TURJANMAA, K., ISOLAURI, E. Differences in skin-prick and patch-test reactivity are related to the heterogeneity of atopic eczema in infants. Allergy, 1997; 52: s. 755-759.

23. KERSCHENLOHR, K., DARSOW, U., BURGDORF, WH., RING, J., WOLLENBERG, A. Lessons from atopy patch testing in atopic dermatitis. Current Allergy and Asthma Reports, 2004; 4: s. 285-289.

24. MAJAMAA, H., MOISIO, P., KAUTIAINENT, H., TURJANMAAK, K., HOLM, K. Cow´s milk allergy: diagnostic accuracy of skin prick and patch tests and specific IgE. Allergy, 1999; 54: 4, s. 346.

25. METCALFE, DD., SAMPSON, HA. Workshop on experimental methodology for clinical studies of adverse reactions to foods and food additivies. J Allergy Clin Immunol, 1990; 86: 421-442.

26. NEČAS, M. The role of atopy patch tests in the identification of triggering factors of atopic eczema. Sborník Hradec Králové Medical Postgraduate Conference, 8. – 9. 12. 2005; s. 127-130.

27. NIGGEMANN, B., BEYER, K. Diagnostic pitfalls in food allergy in children. Allergy, 2005; 60: 1, s. 104-7.

28. NIGGEMANN, B., REIBEL, S., ROEHR, CH. C., FELGER, D., ZIEGERT, M., SOMMERFELD, CH., WAHN, U. Predictors of positive food challenge outcome in non-IgE-mediated reactions to food in children with atopic dermatitis. J Allergy Clin Immunol, 2001; 108: s. 6.

29. NIGGEMANN, B., REIBEL, S., WAHN, U. The atopy patch test (APT) – a useful tool for the diagnosis of food allergy in children with atopic dermatitis. Allergy, 2000; 55: s. 281-285.

30. NIGGEMANN, B., ROLINCK-WEMINGHAUS, C., MEHL, A., BINDER, C., ZIEGERT, M., BEYER, K. Controlled oral food challenges in children – when indicated, when superfluous? Allergy, 2005; 60: 7, s. 865.

31. ORANJE, AP., DE WAARD-VAN DER SPEK, BF. Atopic dermatitis: review 2000 to January 2001. Curr Opin Pediatr, 2002; 14: s. 410-413.

32. PAULS, JD., CROSS, D. Food-dependent exercise – induced anaphylaxis to corn. J Allergy Clin Immunol, 1998; 101: s. 853-855.

33. RANCÉ, F. What is the optimal occlusion time for the atopy patch test in the diagnosis of food allergies in children with atopic dermatitis? Pediatr Allergy Immunol, 2004; 15: s. 93-96.

34. RING, J., KUNZ, B., BIEBER, T.: The „atopy patch test“ with aeroallergens in atopic eczema. J Allergy Clin Immunol,1989; 82, s. 195.

35. ROEHR, CC., EDENHARTER, G., REIMANN, S., EHLERS, I., WORM, M., ZUBERBIER, T., NIGGEMANN, A. Food allergy and non-allergic food hypersensitivity in children and adolescents. Clin Exper Allergy, 2004; 34: 10, s. 1534.

36. ROEHR, CHC., REIBEL, S., ZIEGERT, M., SOMMERFELD, CH., WAHN, U., NIGGEMANN, B. Atopy patch tests, together with determination of specific IgE levels, reduce the need for oral food challenges in children with atopic dermatitis. J Allergy Clin Immunol, 2001; 107: 548-553.

37. ROGER, A., PENA, M., BOTEY, J., ESEVERRI, JL., MARIN, A. The prick test and specific IgE (RAST and MAST-CLA) compared with the oral challenge test with milk, eggs and nuts. J Invest Allergol Clin Immunol, 1994; 4: 178-181.

38. SAMPSON, HA. Eczema and food hypersensitivity. In Food Allergy: adverse reactions to foods and food additives. Medcalfe DD, Sampson HA, Simon RA, ed. Blackwell Science, USA, 1997: 193-209.

39. SAMPSON, HA. Epidemiology of food allergy. Pediatr Allergy Immunol, 1997; 7 Suppl. 9: 42-50.

40. SAMPSON, HA. Update on food allergy. J Allergy Clin Immunol, 2004; 113: 5.

41. SAMPSON, HA., HO, DG. Clinical aspects of allergic disease. Relationship between food-specific IgE concentrations and the risk of positive food challenges in children and adolescents. J Allergy Clin Immunol, 1997; 100 (4): 444-451.

42. SAMPSON, HA., McCASKLILL, C. M. Food hypersensitivity and atopic dermatitis: evaluation of 113 patients. J Pediatr, 1985; 107: 669-675.

43. SAMPSON, HA., MENDELSON, L., ROSEN, JP. Fatal and near fatal anaphylactic reactions to food in children and adolescents. New Engl J Med, 1992; 327:380-384.

44. SAMPSON, HA., SICHERER, SH. Eczema and food hypersensitivity. Immunol Allergy Clin N Am, 1999; 19: 495-518.

45. SCHÄFER, T., HEINRICH, J., BÖHLER, E., KLEMM, E., MERKL, J., RUHDORFER, S., WEIGL, L., WESSNER, A., WICHMANN, HE., RING, J. Allergien bei Erwachsenen. Gesundheitswesen, 2005; 67: 1, 5187-5192.

46. ŠPIČÁK, V., PANZNER, P. Alergologie. Galén 2004, Praha, 1. vyd., ISBN 80-7262-265-X.

47. TURJANMAA, K. The role of atopy patch tests in the diagnosis of allergy in atopic dermatitis. Cur Opin Allergy Clin Immunol, 2005; 5: s. 425-428..

48. Vědecký výbor pro potraviny. Potravinová přecitlivělost: alergie a intolerance.VVP: ALERG, 2003; 3: deklas URL:http://www.chpr.szu.cz/vedvybor/vvp.htm

49. Vědecký výbor pro potraviny. Vliv zpracování potraviny na alergenicitu. VVP: ALERG, 2004; 1: deklas URL:http://www.chpr.szu.cz/vedvybor/vvp.htm

50. WEISSENBACHER, S., BACON, T., TAGRETT, D., BEHRENDT, H., RING, J., DARSOW, U. Atopy patch test – reproducibility and elicitation of itch in different application sites. Acta Derm Venereol, 2005; 85: s. 147-151.

51. WERFEL, T., KAPP, A. Environmental and other major provocation faktors in atopic dermatitis. Allergy, 1998; 53: s. 731-739.

52. WISTOKAT-WÜLFING, SCHMIED, DARSOW, RING, KAPP&WERFEL. Atopy patch test reactions are associated with T lymphocyte – mediated allergen – specific immune responses in atopic dermatitis. Clin Exper Allergy, 1999; 29: 4, s. 513.

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