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  • 1.
    Blöndal, Viiu
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Sundbom, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Zhou, Xingwu
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Movérare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research. Thermo Fischer Sci, Uppsala, Sweden..
    Borres, Magnus P
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Inflammation, Metabolism and Child Health Research. Thermo Fischer Sci, Uppsala, Sweden..
    Högman, Marieann
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Alving, Kjell
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Inflammation, Metabolism and Child Health Research.
    Malinovschi, Andrei
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Allergic sensitisation and type-2 inflammation is associated with new-onset and persistent allergic disease2023In: Clinical and Translational Allergy, ISSN 2045-7022, E-ISSN 2045-7022, Vol. 13, no 4, article id e12240Article in journal (Refereed)
    Abstract [en]

    Background: Allergic disease is common. The aim of this study was to look at the change in asthma and rhinitis over time and to characterise factors contributing to remission and persistence of disease.

    Methods: This cohort study included 255 individuals with or without asthma and or rhinitis that participated in a population survey and a follow-up 10 years later. The participants were tested for allergic sensitisation, total IgE, multiplex allergen component analysis and type-2 inflammatory markers: exhaled nitric oxide (FENO), eosinophil cationic protein (ECP) and eosinophil-derived neurotoxin (EDN).

    Results: Of the 132 healthy individuals, 112 remained healthy, 16 developed rhinitis, 4 asthma and rhinitis over the 10 years. Out of 82 subjects with rhinitis, 26 went into remission, 53 remained unchanged and 3 developed asthma in addition to rhinitis. None of the 41 participants with asthma and rhinitis went into remission. Subjects with persistent rhinitis and asthma had higher levels of total IgE (odds ratio [OR] 95% confidence interval [CI]: 6.16 [3.05-12.5]) at baseline and after 10 years, and FENO and ECP at baseline (OR per log unit increase, 95% CI 5.21 [1.20-22.7] and 6.32 [1.52-26.4], respectively), compared with those that remained healthy. Subjects with persistent rhinitis were more likely to be sensitised to grass pollen and had higher total IgE levels than those that went into remission. Individuals with persistent asthma were more likely to be sensitised to tree pollen and furry animals than those with only persistent rhinitis (OR 95% CI: 3.50 [1.29-9.49] and 6.73 [2.00-22.6], respectively).

    Conclusion: IgE sensitisation and total IgE levels are associated with the persistence of rhinitis and asthma. Participants with persistent allergic disease had higher levels of allergen sensitisation and type 2 inflammation markers at baseline than those who remained healthy.

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  • 2. Ebisawa, Motohiro
    et al.
    Moverare, Robert
    Sato, Sakura
    Borres, Magnus P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Ito, Komei
    The predictive relationship between peanut- and Ara h 2-specific serum IgE concentrations and peanut allergy2015In: JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, ISSN 2213-2198, Vol. 3, no 1, p. 131-132.e1Article in journal (Refereed)
  • 3. Ebisawa, Motohiro
    et al.
    Movérare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Sato, Sakura
    Maruyama, Nobuyuki
    Borres, Magnus P.
    Komata, Takatsugu
    Measurement of Ara h 1-, 2-, and 3-specific IgE antibodies is useful in diagnosis of peanut allergy in Japanese children2012In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 23, no 6, p. 573-581Article in journal (Refereed)
    Abstract [en]

    Background: Food challenges are time-consuming, expensive, and not always possible to perform. Therefore, new tools to diagnose food allergy are desired. The aim was to evaluate IgE antibodies to peanut allergens in the diagnosis of peanut allergy in Japanese children using ImmunoCAP (R) and IgE immunoblotting.

    Methods: The study included 213-yr-old consecutive patients (n = 57) referred to our specialist clinic for investigation of current peanut allergy using food challenge. All children had a previous doctors diagnosis of peanut allergy and were on elimination diet. Serum samples were analyzed for IgE reactivity to peanut, recombinant (r) Ara h 1, 2, 3, 5, 8, and 9. IgE immunoblotting (n = 23) was performed using extracts from raw and roasted peanut.

    Results: Twenty-six of the children failed (allergic group), and 31 passed the peanut challenge (tolerant group). The rAra h 2 ImmunoCAP test was superior in its ability to differentiate between children in the allergic and tolerant groups with a sensitivity and specificity of 88% and 84%, respectively (cutoff, 0.35 kUA/l). The combination of rAra h 1, 2, and 3 resulted in a higher specificity (94%) when IgE to all of them was the criteria for positivity. ImmunoCAP generally showed a good agreement with immunoblotting using both raw and roasted peanut for IgE reactivity to Ara h 1, 2, and 3.

    Conclusions: Measurement of IgE antibodies to rAra h 1, 2, and 3 is useful in the diagnosis of peanut allergy and in the investigation of reactions to raw and roasted peanut.

  • 4. Englund, H.
    et al.
    Kuitunen, M.
    Moverare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Borres, M. P.
    Makela, M.
    IgE and IgG(4) antibody levels towards milk components are associated with outcome of oral immunotherapy in Finnish milk allergic children2013In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 68, no Suppl. s97, p. 327-327Article in journal (Other academic)
  • 5. Eriksson, C.
    et al.
    Lind, P.
    Nystrand, M.
    Moverare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    A new automated anti-drug antibody screening assay with high sensitivity and drug tolerance2013In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 68, no Suppl. s97, p. 142-142Article in journal (Other academic)
  • 6. Everberg, Henrik
    et al.
    Brostedt, Peter
    Öman, Hans
    Bohman, Svante
    Movérare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Affinity Purification of Egg-White Allergens for Improved Component-Resolved Diagnostics2011In: International Archives of Allergy and Immunology, ISSN 1018-2438, E-ISSN 1423-0097, Vol. 154, no 1, p. 33-41Article in journal (Refereed)
    Abstract [en]

    Background: Egg is a common cause of food-allergic reactions, especially among young children. Some egg-allergic patients do, however, tolerate heated egg products and component-resolved diagnostics (CRD) may facilitate prediction of different disease manifestations. Commercially available preparations of the egg-white allergens, ovomucoid, ovalbumin, conalbumin and lysozyme, have been reported to contain impurities which interfere with accurate CRD. Methods: Commercial preparations of the 4 egg-white allergens were characterized using allergen-specific monoclonal chimeric human/mouse IgE antibodies in experimental ImmunoCAP (R) tests. Further purification of commercial ovomucoid, ovalbumin and conalbumin preparations was performed by chromatography based on affinity to monoclonal antibodies. Purity was monitored by size exclusion chromatography, SDS-PAGE, Western blotting and experimental ImmunoCAP tests using allergen-specific chimeric IgE antibodies. IgE reactivity to the highly purified egg components was analyzed in 83 samples from egg white-sensitized individuals. Results: Preparations of commercially available ovomucoid, ovalbumin and conalbumin were found to contain other egg allergens which were removed by chromatographic purification. No impurities were detected in the commercial lysozyme preparation. Previously unknown complexes between the target allergens and contaminating allergens were detected and removed by affinity chromatography. IgE reactivity to ovalbumin was most common in the analyzed samples (87%), followed by ovomucoid (72%), conalbumin (69%) and lysozyme (58%). Conclusions: In this study we demonstrate the advantage of using monoclonal antibodies for purification, and monoclonal chimeric IgE antibodies for characterization, of egg allergens intended for CRD. Our study also established that ovalbumin, ovomucoid, conalbumin and lysozyme are all major allergens.

  • 7. Färdig, Martin
    et al.
    Lie, Anine
    Borres, Magnus P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Inflammation, Metabolism and Child Health Research.
    Ekenkrantz, Tina
    Granum, Berit
    Haugen, Guttorm
    Jonassen, Christine M
    Movérare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Rehbinder, Eva Maria
    Skjerven, Håvard O
    Cathrine, Anne
    Vettukattil, Riyas
    Lødrup Carlsen, Karin C
    Söderhäll, Cilla
    Nordlund, Björn
    Eosinophil-derived neurotoxin levels in early childhood and association with preschool asthma - A prospective observational study2023In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 53, no 11, p. 1198-1211Article in journal (Refereed)
    Abstract [en]

    Introduction: Eosinophil-derived neurotoxin (EDN) is related to childhood asthma, while normal values are lacking. We aimed to document serum EDN levels at 1 and 3 years in general and in non-atopic children, and explore if EDN levels differed by sex or were associated with preschool asthma at 3 years.

    Methods: From the PreventADALL birth cohort, we included 1233 children with EDN analysed using ImmunoCAP at 1 and/or 3 years. Non-atopic children had no history of wheeze, asthma, allergic sensitization or atopic dermatitis. Preschool asthma was defined as having ≥3 episodes of bronchial obstruction between 2 and 3 years, plus doctor diagnosed asthma and/or asthma medication use by 3 years. The upper limit of normal (ULN) of EDN was defined as the 95th percentile. With Youden Index we calculated EDN cut-off levels for risk of preschool asthma.

    Results: The overall median (ULN) EDN levels were 27.4 (121) μg/L at 1 year (n = 787), and 20.1 (87.8) μg/L at 3 years (n = 857). Non-atopic children had EDN levels of 24.0 (107) μg/L at 1 year (n = 147), and 17.3 (84.6) μg/L at 3 years (n = 173). EDN levels were higher in boys compared to girls; 32.0 (133) versus 24.5 (97.0) μg/L at 1 year, and 20.9 (96.3) versus 19.0 (72.4) μg/L at 3 years. Preschool asthma was observed in 109/892 (12.2%) children. Higher EDN levels at 1 (>26.7 μg/L) and 3 (≥20.5 μg/L) years were associated with preschool asthma; adjusted OR (95% CI) 2.20 (1.09, 4.41) and 4.68 (2.29, 9.55), respectively.

    Conclusion and Clinical Relevance: We report EDN values in early childhood, demonstrating higher levels at 1 compared to 3 years and in boys compared to girls at both ages. Higher EDN levels at both ages were associated with preschool asthma. However, EDN cut-off levels for preschool asthma were overall lower than the ULN of non-atopic children, limiting translation into clinical practice.

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  • 8. Glaumann, S.
    et al.
    Nilsson, C.
    Asarnoj, A.
    Moverare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Johansson, S. G. O.
    Borres, M. P.
    Lilja, G.
    Nopp, A.
    IgG(4) antibodies and peanut challenge outcome in children IgE-sensitized to peanut2015In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 26, no 4, p. 386-389Article in journal (Refereed)
  • 9. Ito, Komei
    et al.
    Futamura, Masaki
    Movérare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Tanaka, Akira
    Kawabe, Tsutomu
    Sakamoto, Tatsuo
    Borres, Magnus P
    The usefulness of casein-specific IgE and IgG4 antibodies in cow's milk allergic children2012In: Clinical and Molecular Allergy, E-ISSN 1476-7961, Vol. 10, no 1, p. 1-Article in journal (Refereed)
    Abstract [en]

    Background

    Cow's milk allergy is one of the most common food allergies among younger children. We investigated IgE antibodies to milk, and IgE and IgG4 antibodies to casein, α-lactalbumin and β-lactoglobulin in cow's milk allergic (CMA) and non-allergic (non-CMA) children in order to study their clinical usefulness.

    Methods

    Eighty-three children with suspected milk allergy (median age: 3.5 years, range: 0.8-15.8 years) were diagnosed as CMA (n = 61) or non-CMA (n = 22) based on an open milk challenge or convincing clinical history. Their serum concentrations of allergen-specific (s) IgE and IgG4 antibodies were measured using ImmunoCAP®. For the sIgG4 analysis, 28 atopic and 31 non-atopic control children were additionally included (all non-milk sensitized).

    Results

    The CMA group had significantly higher levels of milk-, casein- and β-lactoglobulin-sIgE antibodies as compared to the non-CMA group. The casein test showed the best discriminating performance with a clinical decision point of 6.6 kUA/L corresponding to 100% specificity. All but one of the CMA children aged > 5 years had casein-sIgE levels > 6.6 kUA/L. The non-CMA group had significantly higher sIgG4 levels against all three milk allergens compared to the CMA group. This was most pronounced for casein-sIgG4 in non-CMA children without history of previous milk allergy. These children had significantly higher casein-sIgG4 levels compared to any other group, including the non-milk sensitized control children.

    Conclusions

    High levels of casein-sIgE antibodies are strongly associated with milk allergy in children and might be associated with prolonged allergy. Elevated casein-sIgG4 levels in milk-sensitized individuals on normal diet indicate a modified Th2 response. However, the protective role of IgG4 antibodies in milk allergy is unclear.

  • 10. Ito, Komei
    et al.
    Sjölander, Sigrid
    Sato, Sakura
    Movérare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Tanaka, Akira
    Soderstrom, Lars
    Borres, Magnus
    Poorafshar, Maryam
    Ebisawa, Motohiro
    IgE to Gly m 5 and Gly m 6 is associated with severe allergic reactions to soybean in Japanese children2011In: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 128, no 3, p. 673-675Article in journal (Refereed)
  • 11. Kuitunen, M.
    et al.
    Englund, H.
    Remes, S.
    Moverare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Pelkonen, A.
    Borres, Magnus P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Makela, M. J.
    High IgE levels to -lactalbumin, -lactoglobulin and casein predict less successful cow's milk oral immunotherapy2015In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 70, no 8, p. 955-962Article in journal (Refereed)
    Abstract [en]

    BackgroundA new treatment option for persistent cow's milk allergy (CMA) is oral immunotherapy (OIT). Not all patients develop tolerance during therapy, and markers to identify those who will benefit from it are needed. The objective was to study the IgE and IgG(4) antibody profiles to milk and milk proteins before and after OIT in relation to clinical outcome. MethodsSeventy-six children (5-17years) with challenge-verified CMA were subjected to a 6-month OIT protocol. The treatment aimed at reaching a maintenance dose of 200ml CM (high dose=HD). Those who did not reach target were analysed as a low-dose (LD) group. Sera were characterized before and after OIT regarding serum levels of IgE and IgG(4) to milk and five milk allergen components evaluated together with clinical CMA symptoms and outcome of OIT. ResultsFifty-five (72%) patients reached the maintenance dose (HD) during therapy. High specific IgE levels towards the milk allergens -lactalbumin (P=0.048), -lactoglobulin (P=0.006) and casein (P=0.015) before OIT start were associated with lower maintenance dose reached. Patients who developed desensitization had a larger increase in IgG(4) levels to -lactalbumin (P=0.034), -lactoglobulin (P=0.010), casein (P=0.047) and lactoferrin (P=0.030) during treatment than those who failed. ConclusionsComponent-resolved diagnostics before OIT can help to identify children with lower probability of a successful OIT outcome, as high IgE levels to -lactalbumin, -lactoglobulin and casein are associated with lower maintenance dose reached. An increase in the IgG(4) concentration to milk components during treatment indicated effective desensitization.

  • 12. Lundkvist, M.
    et al.
    Engdahl, E.
    Holmen, C.
    Moverare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Olsson, T.
    Hillert, J.
    Fogdell-Hahn, A.
    Characterization of anti-natalizumab antibodies in multiple sclerosis patients2013In: Multiple Sclerosis Journal, ISSN 1352-4585, E-ISSN 1477-0970, Vol. 19, no 6, p. 757-764Article in journal (Refereed)
    Abstract [en]

    Background: A small proportion of multiple sclerosis (MS) patients treated with natalizumab develop anti-drug antibodies. Objective: The objective of this paper is to characterize the anti-natalizumab antibody response and to investigate differences between persistently and transiently antibody-positive patients. Methods: Screening for anti-natalizumab antibodies was performed using a standardized bridging ELISA. Antibody-positive samples were further analyzed for IgM and IgG1-4 antibodies using ELISA and ImmunoCAP (R). Results: Anti-natalizumab antibodies developed in 57 of 1379 (4.1%) treated patients after a median treatment duration of three months. Of the positive patients, 20 (35%) patients reverted to negative, 19 (33%) patients were confirmed persistently positive and 18 (32%) patients were unconfirmed positive. Significantly higher anti-natalizumab antibody levels were detected in persistently compared to transiently positive patients. A cutoff value predicting persistence of antibodies could be determined with a sensitivity of 0.84 and a specificity of 0.80. IgM and IgG4 antibody levels were significantly higher in persistently compared to transiently positive patients, and IgG1, IgG2 and IgG4 increased significantly over time. Conclusions: The level of total anti-natalizumab antibodies in a first positive sample can be used to predict patients at risk for persisting antibody positivity. However, neither IgM nor IgG1-4 antibodies could be used to discriminate between transiently and persistently positive patients.

  • 13. Lundkvist, Malin
    et al.
    Engdahl, Elin
    Holmen, Carolina
    Moverare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Olsson, Tomas
    Hillert, Jan
    Fogdell-Hahn, Anna
    Anti-Natalizumab Antibodies in Patients with Multiple Sclerosis2012In: Scandinavian Journal of Immunology, ISSN 0300-9475, E-ISSN 1365-3083, Vol. 76, no 2, p. 206-207Article in journal (Other academic)
  • 14.
    Maruyama, N.
    et al.
    Kyoto Univ, Grad Sch Agr, Lab Food Qual Design & Dev, Uji, Kyoto 6110011, Japan..
    Nakagawa, T.
    Aichi Childrens Hlth & Med Ctr, Dept Allergy, Obu, Aichi, Japan..
    Ito, K.
    Aichi Childrens Hlth & Med Ctr, Dept Allergy, Obu, Aichi, Japan..
    Cabanos, C.
    Kyoto Univ, Grad Sch Agr, Lab Food Qual Design & Dev, Uji, Kyoto 6110011, Japan..
    Borres, Magnus P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. Thermo Fisher Sci, Uppsala, Sweden..
    Moverare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Thermo Fisher Sci, Uppsala, Sweden..
    Tanaka, A.
    Thermo Fisher Sci, Tokyo, Japan..
    Sato, S.
    Sagamihara Natl Hosp, Clin Res Ctr Allergol & Rheumatol, Dept Allergy, Sagamihara, Kanagawa, Japan..
    Ebisawa, M.
    Sagamihara Natl Hosp, Clin Res Ctr Allergol & Rheumatol, Dept Allergy, Sagamihara, Kanagawa, Japan..
    Measurement of specific IgE antibodies to Ses i 1 improves the diagnosis of sesame allergy2016In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 46, no 1, p. 163-171Article in journal (Refereed)
    Abstract [en]

    Background The number of reported cases of allergic reactions to sesame seeds (Sesamum indicum) has increased significantly. The specific IgE tests and skin prick tests presently available for diagnosis of sesame allergy are all based on crude sesame extract and are limited by their low clinical specificity. Thus, oral food challenge (OFC) is still the gold standard in the diagnosis. Objective The aim was to identify the allergen components useful to diagnose sesame-allergic children with the goal to reduce the number of OFCs needed. Methods Ninety-two sesame-sensitized children were consecutively enrolled and diagnosed based on OFC or convincing history. Specific IgE to purified native 11S globulin (nSes i 11S), 7S globulin (nSes i 7S), 2S albumin (nSes i 2S), and two recombinant 2S albumins (rSes i 1 and rSes i 2) was measured by ELISA and/or ImmunoCAP (rSes i 1/streptavidin application). Results Based on area under curve (AUC) values from receiver operating characteristic (ROC) analysis, rSes i 1 was shown to have the best diagnostic performance of the allergen components in ELISA. The experimental rSes i 1 ImmunoCAP test had larger AUC (0.891; 95% CI, 0.826-0.955) compared to the commercially available sesame ImmunoCAP (0.697; 95% CI, 0.589-0.805). The clinical sensitivity and specificity for the rSes i 1 ImmunoCAP test at optimal cut-off (3.96 kUA/L) were 86.1% and 85.7%, respectively. Conclusion and Clinical Relevance Sensitization to Ses i 1 is strongly associated with clinical sesame allergy. Measurement of specific IgE to rSes i 1 could reduce the numbers of OFCs needed.

  • 15.
    Maruyama, Nobuyuki
    et al.
    Kyoto Univ, Grad Sch Agr, Lab Food Qual Design & Dev, Kyoto 6110011, Japan..
    Sato, Sakura
    Sagamihara Natl Hosp, Clin Res Ctr Allergol & Rheumatol, Sagamihara, Kanagawa, Japan..
    Yanagida, Noriyuki
    Sagamihara Natl Hosp, Dept Pediat, Sagamihara, Kanagawa, Japan..
    Cabanos, Cerrone
    Kyoto Univ, Grad Sch Agr, Lab Food Qual Design & Dev, Kyoto 6110011, Japan..
    Ito, Komei
    Aichi Childrens Hlth & Med Ctr, Dept Allergy, Obu, Japan..
    Borres, Magnus P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. Thermo Fisher Sci, Uppsala, Sweden..
    Moverare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology. Thermo Fisher Sci, Uppsala, Sweden..
    Tanaka, Akira
    Thermo Fisher Sci, Tokyo, Japan..
    Ebisawa, Motohiro
    Sagamihara Natl Hosp, Clin Res Ctr Allergol & Rheumatol, Sagamihara, Kanagawa, Japan..
    Clinical utility of recombinant allergen components in diagnosing buckwheat allergy2016In: JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, ISSN 2213-2198, Vol. 4, no 2, p. 322-+Article in journal (Refereed)
  • 16.
    Moverare, Robert
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Ahlstedt, Staffan
    Bengtsson, Ulf
    Borres, Magnus P.
    van Hage, Marianne
    Poorafshar, Maryam
    Sjolander, Sigrid
    Akerstrom, Johanna
    van Odijk, Jenny
    Evaluation of IgE Antibodies to Recombinant Peanut Allergens in Patients with Reported Reactions to Peanut2011In: International Archives of Allergy and Immunology, ISSN 1018-2438, E-ISSN 1423-0097, Vol. 156, no 3, p. 282-290Article in journal (Refereed)
    Abstract [en]

    Background: Peanut may cause severe reactions in allergic individuals. The objective was to evaluate IgE antibodies to various recombinant (r) peanut and birch pollen allergens in relation to IgE levels to whole peanut extract and severe allergic reactions to peanut. Methods: Seventy-four Swedish peanut-allergic patients (age: 14-61 years) reported previous peanut exposure and associated symptoms using a questionnaire. Their IgE reactivity to peanut, birch pollen and individual allergen components was analyzed using ImmunoCAP(R). Results: Of the 48 subjects sensitized to Ara h 1, 2 or 3, 60% had peanut-specific IgE levels >15 kU(A)/l, while 100% of the subjects without detectable IgE to these allergens had low peanut-specific IgE levels (<10 kU(A)/l). The levels of IgE to rAra h 8, rBet v 1 and birch pollen were highly correlated (r(S) = 0.94, p < 0.0001). Fifty-eight patients reported adverse reactions after accidental or deliberate peanut exposure (oral, inhalation or skin) of whom 41 had IgE to rAra h 1, 2 or 3. Symptoms of respiratory distress were associated with sensitization to Ara h 1, 2 or 3 (56 vs. 18%, p < 0.01). Two cases of anaphylaxis were reported among the individuals sensitized to Ara h 1-3. IgE to rAra h 8, rAra h 9, profilin or cross-reactive carbohydrate determinants were not associated with severe symptoms. Conclusions: The results indicate that IgE reactivity to Ara h 1, 2 and 3 is associated with severe reactions after exposure to peanut in Swedish patients.

  • 17.
    Movérare, Robert
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research. Thermo Fisher Sci, ImmunoDiagnost, Uppsala, Sweden.
    Blume, Karin
    Thermo Fisher Sci, ImmunoDiagnost, Uppsala, Sweden..
    Lind, Peter
    Thermo Fisher Sci, ImmunoDiagnost, Uppsala, Sweden..
    Crevel, Rene
    Unilever SEAC, Colworth Sci Pk, Sharnbrook, Beds, England..
    DeWitt, Asa Marknell
    Thermo Fisher Sci, ImmunoDiagnost, Uppsala, Sweden..
    Cochrane, Stella
    Unilever SEAC, Colworth Sci Pk, Sharnbrook, Beds, England..
    Measurement of human IgG subclass antibodies to allergens with new research ImmunoCAP assays2017In: Scandinavian Journal of Immunology, ISSN 0300-9475, E-ISSN 1365-3083, Vol. 86, no 4, p. 306-306Article in journal (Other academic)
  • 18.
    Movérare, Robert
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology. Thermo Fisher Sci, ImmunoDiagnost, POB 6460, SE-75137 Uppsala, Sweden..
    Blume, Karin
    Thermo Fisher Sci, ImmunoDiagnost, POB 6460, SE-75137 Uppsala, Sweden..
    Lind, Peter
    Thermo Fisher Sci, ImmunoDiagnost, POB 6460, SE-75137 Uppsala, Sweden..
    Crevel, Rene
    Unilever SEAC, Colworth Sci Pk, Sharnbrook, Beds, England..
    DeWitt, Åsa Marknell
    Thermo Fisher Sci, ImmunoDiagnost, POB 6460, SE-75137 Uppsala, Sweden..
    Cochrane, Stella
    Unilever SEAC, Colworth Sci Pk, Sharnbrook, Beds, England..
    Human Allergen-Specific IgG Subclass Antibodies Measured Using ImmunoCAP Technology2017In: International Archives of Allergy and Immunology, ISSN 1018-2438, E-ISSN 1423-0097, Vol. 172, no 1, p. 1-10Article in journal (Refereed)
    Abstract [en]

    Background: Knowledge of human IgG subclass antibody responses to various allergens has been hampered by a lack of reliable standardized assays. The aim here was to develop quantitative immunoassays for human IgG1, IgG2, and IgG3 antibodies using ImmunoCAP (R) technology and to evaluate their application. Methods: Enzyme conjugates with isotype-specific monoclonal antibodies and calibrators composed of purified myeloma paraproteins were developed for each assay and used together with other standardized assay reagents for the Phadia (R) 100 instrument. The calibrators were adjusted to the international reference preparation IRP 67/86. The assays were characterized and used together with other standard ImmunoCAP assays to measure antibodies to various allergens in preliminary studies. Results: The new assays had limits of quantitation of 1.0 (IgG1), 4.6 (IgG2), and 0.04 mg(A)/L (IgG3), and coefficients of variation of <20%. Only some minor cross -reactivity with IgG2 was observed for the specific IgG1 assay. The specific IgG2 assay showed a bias for the allotype G2m(23) and compensation factors were used to adjust the measured concentrations accordingly. Preliminary studies indicated a strong and stable IgG4 antibody response to P-lactoglobulin in healthy individuals, a high IgG1 and even higher IgG2 antibody response to house dust mite in sensitized and nonsensitized subjects, and a mixed IgG subclass response to venom allergens in allergic patients with increasing IgG4 antibody levels during venom immunotherapy. Conclusions: The new research assays are valuable tools for immunological studies, enabling the characterization of antibody profiles using a standardized approach, and facilitating data interpretation and the comparison of results across studies.

  • 19.
    Movérare, Robert
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Kosunen, T. U.
    Haahtela, T.
    Change in the pattern of IgE reactivity to timothy grass and birch pollen allergens over a 20-year period2006In: Journal of investigational allergology & clinical immunology, ISSN 1018-9068, E-ISSN 1698-0808, Vol. 16, no 5, p. 274-278Article in journal (Refereed)
    Abstract [en]

    Background: Several studies have shown that the prevalence of allergy and allergen sensitization has increased in recent years. However, the changes in the pattern of IgE reactivity to individual allergens are mostly unknown.

    Objective: The aim of this preliminary study was. to assess the change in IgE reactivity profile to individual timothy grass and/or birch pollen allergens in sera from sensitized individuals randomly collected 20 years apart.

    Methods: Serum samples from 51 sensitized individuals were obtained from 2 cross-sectional surveys performed in 1973 and 1994 using random samples from Vammala, Finland. The sera were analyzed for IgE reactivity to timothy grass and/or birch pollen extracts, recombinant (r)Phl p 1, 2, 5, 6, 7, 11, 12, native (n)Phl p 4, and rBet v 1, 2 and 4 by immunoassay (ImmunoCAP).

    Results: The median (range) concentrations of IgE antibodies to timothy grass and birch pollen were higher in 1994 than in 1973 (6.47 [0.35 to > 100] kU(A)/L vs 1.53 [0.40-25.3] kU(A)[L; P=.0035). The prevalence of IgE reactivity to some allergens was higher in 1994 than in 1973, particularly rPhl p 5 (52% vs 19%), rPhl p 6 (43% vs 12%), and rBet v 1 (100% vs 29%). There was a correlation between timothy grass pollen-specific serum IgE levels and the numbers of IgE reactivities to individual allergens (p=0.76, P <.001).

    Conclusions: The increase in specific IgE levels together with a possible increase in the prevalence of IgE reactivity to the major allergens Phl p 5 and Bet v 1 between 1973 and 1994 may have contributed to the increase in atopic conditions in Finland.

  • 20.
    Movérare, Robert
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Larsson, Håkan
    Carlsson, Raimo
    Holmquist, Ingrid
    Mugwort-Sensitized Individuals from North Europe, South Europe and North America Show Different IgE Reactivity Patterns2011In: International Archives of Allergy and Immunology, ISSN 1018-2438, E-ISSN 1423-0097, Vol. 154, no 2, p. 164-172Article in journal (Refereed)
    Abstract [en]

    Background: Sensitization to weed pollen allergens at the molecular level is not fully understood. We studied IgE reactivity to the major mugwort allergen Art v 1 in relation to allergens from other weed pollen and cross-reactive components in mugwort-sensitized subjects. Methods: Art v 1 and Amb a 1 were affinity purified and coupled to experimental ImmunoCAP (R) tests. Samples from North Europe (n = 50), South Europe (n = 19) and North America (n = 41) were analyzed for IgE against mugwort pollen, weed allergen components, pan-allergens and cross-reactive carbohydrate determinants (CCDs). Results: The prevalence of IgE reactivity (> 0.35 kU(A)/l) to Art v 1 was significantly higher in samples from North Europe than in those from North America. IgE to Amb a 1 was more common in North America than in North and South Europe, while IgE to Par j 2 was common in South Europe, less common in North America, and absent in North Europe. IgE to Art v 3 in mugwort-allergic patients was more common in North Europe than in South Europe and North America, while IgE to Sal k 1 was similar between the areas. Subjects with an Art v 1/mugwort-specific IgE ratio < 0.5 had more often IgE to Amb a 1, profilin, polcalcin and CCDs than subjects with a ratio > 0.5. Conclusions: Mugwort-sensitized subjects have different IgE reactivity profiles to weed allergens, reflecting their exposure to various pollens. Subjects with a low ratio between the IgE levels to Art v 1 and mugwort have a diverse IgE reactivity profile, indicating a role for cross-reactive allergens in their mugwort sensitization.

  • 21.
    Movérare, Robert
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research. Thermo Fisher Scientific, Uppsala, Sweden.
    Persson, Eilif
    Malinovschi, Andrei
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Reference values of serum total IgE in Uppsala: comparison over four decades2023In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 128, article id e9892Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Total immunoglobulin E (IgE) analysis is a common tool in allergy diagnosis. Suggested reference values for IgE are divergent and sometimes based on outdated assay methods. We aimed to validate the published reference values (geometric mean [GM]: 13.2 kU/L, upper limit of normal [ULN], 114 kU/L) shown in an Uppsala cohort from 1974 using Phadebas IgE PRIST, and the suggested clinical threshold of 100 kU/L (Zetterström and Johansson 1981).

    METHODS: Immunoglobulin E was measured in two Uppsala cohorts from 1997 (Blood bank) and 2011 to 2013 (the European community respiratory health survey part III [ECRHS III]) using ImmunoCAP™ Total IgE. For the reference value calculations, exclusion criteria were atopy (both cohorts), doctor's diagnosis of asthma and self-reported allergy (hay fever, rhinitis, rash) (only ECRHS III). Upper limit of normal was defined as mean + 2 standard deviations (SD) calculated using log-transformed values and back-transformation of the ULN prior to presentation. Common imputation methods for results below the assay range were evaluated.

    RESULTS: The average GM was 14.2 kU/L (Blood bank, n = 63; imputation method range: 16.9-17.4 kU/L; ECRHS III, n = 113: 10.7-11.6 kU/L) and the overall mean ULN was 118 kU/L (Blood bank: 113-130 kU/L; ECRHS III: 104-128 kU/L). The clinical sensitivity and specificity of the 100 kU/L IgE threshold were 37.8 and 94.3% for atopy, 34.9 and 89.5% for doctor's diagnosis of asthma, and 24.5 and 97.3% for any self-reported allergy (ECRHS III).

    CONCLUSION: The calculated ULN values were similar between the cohorts. We conclude that the total IgE reference values shown for Uppsala subjects from 1974 are still valid and suitable also for the ImmunoCAP Total IgE assay. The 100 kU/L threshold for total IgE had a low sensitivity but high specificity for atopy, asthma, and allergy.

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  • 22. Nozawa, Asako
    et al.
    Okamoto, Yoshihisa
    Moverare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Borres, Magnus P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Kurihara, Kazuyunki
    Monitoring Ara h 1, 2 and 3-sIgE and sIgG4 antibodies in peanut allergic children receiving oral rush immunotherapy2014In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 25, no 4, p. 323-328Article in journal (Refereed)
    Abstract [en]

    Background: The aim was to study the clinical efficacy and safety of rush oral immunotherapy (OIT) for severe peanut-allergic children and to measure the antibody responses. Methods: Eighteen Japanese children were enrolled after a positive double-blind, placebo-controlled food challenge (DBPCFC). The patients ingested peanuts up to 3-5 times a day every 30 min, increasing the dose by 20% every time. The goal dose was 3.5-7 g. IgE, IgG, and IgG4 antibody levels to peanut, and peanut allergen components were measured during up to 3 yr of maintenance treatment. Results: Two children dropped out due to side effects. Sixteen patients (14 boys and two girls, median: 9 yr range: 5-14 yr) achieved the goal dose after a median of 11 days (range: 4-19 days). Their median threshold dose at DBPCFC was 0.20 g (range: 0.015-1.0 g). All were sensitized to Ara h 2. Fourteen of them had a history of previous anaphylaxis. In total, 173 adverse events were observed during the treatment (27% of the total ingestions) of which 74 needed medications. The median IgE, IgG, and IgG4 antibody levels to peanut increased during rush OIT. The IgG4 levels were high during the whole maintenance phase. IgE and IgG4 antibodies to Ara h 2 dominated the serological response during the treatment. Conclusions: The present rush OIT protocol for children with severe peanut allergy was effective and relatively safe. A sustained Ara h 2-specific IgG4 antibody response characterized the treatment.

  • 23.
    Rydell, Niclas
    et al.
    Thermo Fisher Sci, SE-75137 Uppsala, Sweden..
    Ekoff, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Gastroenterology/Hepatology. Thermo Fisher Sci, SE-75137 Uppsala, Sweden..
    Hellström, Per M.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Gastroenterology/Hepatology.
    Movérare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research. Thermo Fisher Sci, SE-75137 Uppsala, Sweden..
    Measurement of Serum IgG Anti-Integrin alpha v beta 6 Autoantibodies Is a Promising Tool in the Diagnosis of Ulcerative Colitis2022In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 11, no 7, article id 1881Article in journal (Refereed)
    Abstract [en]

    IgG anti-integrin alpha v beta 6 autoantibodies (IgG anti-alpha v beta 6) have been described as highly sensitive and specific markers of ulcerative colitis (UC) in the sera of Japanese inflammatory bowel disease (IBD) patients. We aimed to evaluate the diagnostic performance of IgG anti-alpha v beta 6 as a biomarker in Swedish patients with IBD or irritable bowel syndrome (IBS). The study included adult UC (n = 59), Crohn's disease (CD, n = 38), and IBS patients (n = 100). Partial Mayo score and Harvey-Bradshaw index were used to assess disease severity for UC and CD, respectively. Serum levels of IgG anti-alpha v beta 6, reported as absorbance units (AU), were measured using an in-house ELISA where the 95th percentile of 76 healthy controls defined positivity. Faecal calprotectin (fCP) was measured using a commercial assay. The majority of the IBD patients were on medical treatment, and many were in remission (UC: 40.7%; CD: 47.4%). Seventy-one percent of the UC patients, 74.2% of CD patients, and 23.1% of the IBS patients had fCP test results >50 mg/kg. The UC group had significantly higher IgG anti-alpha v beta 6 levels (median: 1.76 AU) than the CD and IBS groups (0.34 and 0.31 AU, both p < 0.0001). The diagnostic sensitivity of IgG anti-alpha v beta 6 in UC was 76.3%, and the specificities were 79.0% (vs. CD) and 96.0% (vs. IBS). The IgG anti-alpha v beta 6 levels related to disease severity of the UC patients (p < 0.01-0.05). Our study shows that IgG anti-alpha v beta 6 is associated with UC in Swedish IBD patients and that the levels of the autoantibodies reflect disease severity. IgG anti-alpha v beta 6 could be an attractive complement to fCP in the diagnostic work up of IBD patients.

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  • 24.
    Rydell, Niclas
    et al.
    Thermo Fisher Sci, Uppsala, Sweden..
    Nagao, Mizuho
    Natl Hosp Org Mie Natl Hosp, Allergy Ctr, Tsu, Mie, Japan..
    Movérare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research. Thermo Fisher Sci, Uppsala, Sweden..
    Ekoff, Helena
    Thermo Fisher Sci, Uppsala, Sweden..
    Sjölander, Anders
    Thermo Fisher Sci, Uppsala, Sweden..
    Borres, Magnus P
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Inflammation, Metabolism and Child Health Research. Thermo Fisher Sci, Uppsala, Sweden..
    Fujisawa, Takao
    Natl Hosp Org Mie Natl Hosp, Allergy Ctr, Tsu, Mie, Japan..
    Serum Eosinophilic Cationic Protein Is a Reliable Biomarker for Childhood Asthma2022In: International Archives of Allergy and Immunology, ISSN 1018-2438, E-ISSN 1423-0097, Vol. 183, no 7, p. 744-752Article in journal (Refereed)
    Abstract [en]

    Background: Eosinophilic cationic protein (ECP) is associated with airway inflammation and asthma. However, the clinical value of measuring ECP in childhood asthma is not fully known. We aimed to study the diagnostic performance of serum ECP and other common asthma biomarkers, individually and in combinations. Methods: In a cross-sectional study, 5-16-year-old children with current asthma (CA) (n = 37), transient asthma (TA) (n = 43), (previous history of wheezing/asthma), and healthy children (HC) (n = 86) were investigated for ECP, blood eosinophil count (B-Eos), fractional exhaled nitric oxide (FeNO), and lung function, i.e., spirometry (forced expiratory volume during the first second [FEV1]/forced vital capacity [FVC] ratio). Results: Both ECP and B-Eos were higher in CA compared to TA (p < 0.01) and HC (p < 0.0001). ECP and B-Eos were also higher in TA compared to HC (p < 0.05 and p < 0.001, respectively). FeNO was higher in CA (p < 0.0001) and TA (p < 0.01) compared to HC but similar between the asthma groups. The FEV1/FVC ratio was lower in CA compared to TA and HC (both p < 0.01) but similar between TA and HC. The best diagnostic performance regarding CA was found for ECP and B-Eos with receiver operating characteristics area under curve (AUC) of 0.801 and 0.810, respectively. The optimal cutoff for ECP (29 mu g/L) yielded a sensitivity and specificity of 70.3% and 81.4%. The corresponding AUCs for FeNO and FEV1/FVC were 0.732 and 0.670, respectively. ECP and B-Eos showed the highest AUCs (0.669 and 0.673) for differentiation between CA and TA. Combining ECP with FeNO and FEV1/FVC increased the odds ratio (OR) for having CA from OR 3.97-10.3 for the single biomarkers to OR 20.2 (95% confidence interval: 5.76-68.6). Conclusion: Our results show that serum ECP is a reliable biomarker in the diagnosis of childhood asthma, with additional value in combination with FeNO and FEV1/FVC, and that ECP can be an alternative to B-Eos.

  • 25.
    Sato, Sakura
    et al.
    Natl Hosp Org, Sagamihara Natl Hosp, Dept Allergy, Clin Res Ctr Allergy & Rheumatol, Sagamihara, Kanagawa, Japan;Juntendo Univ, Grad Sch Med, Course Allergy & Clin Immunol, Tokyo, Japan.
    Movérare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research. Thermo Fisher Sci, Uppsala, Sweden.
    Ohya, Yukihiro
    Natl Ctr Child Hlth & Dev, Dept Allergy, Tokyo, Japan.
    Ito, Komei
    Aichi Childrens Hlth & Med Ctr, Dept Allergy, Obu, Japan.
    Nagao, Mizuho
    Natl Hosp Org, Mie Natl Hosp, Inst Clin Res, Tsu, Mie, Japan.
    Borres, Magnus P
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research. Thermo Fisher Sci, Uppsala, Sweden.
    Ebisawa, Motohiro
    Natl Hosp Org, Sagamihara Natl Hosp, Dept Allergy, Clin Res Ctr Allergy & Rheumatol, Sagamihara, Kanagawa, Japan;Juntendo Univ, Grad Sch Med, Course Allergy & Clin Immunol, Tokyo, Japan.
    Ana o 3-specific IgE is a predictive marker for cashew oral food challenge failure2019In: Journal of Allergy and Clinical Immunology: In Practice, ISSN 2213-2198, E-ISSN 2213-2201, Vol. 7, no 8, p. 2909-2911.e4Article in journal (Other academic)
  • 26. Sato, Sakura
    et al.
    Yamamoto, Mikita
    Yanagida, Noriyuki
    Ito, Komei
    Ohya, Yukihiro
    Imai, Takanori
    Nagao, Mizuho
    Borres, Magnus P
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Thermo Fisher Sci.
    Movérare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research. Thermo Fisher Sci.
    Ebisawa, Motohiro
    Jug r 1 sensitization is important in walnut-allergic children and youth.2017In: Journal of Allergy and Clinical Immunology: In Practice, ISSN 2213-2198, E-ISSN 2213-2201, Vol. 5, no 6, p. 1784-1786.e1Article in journal (Other academic)
  • 27.
    Thorpe, Michael
    et al.
    Uppsala University, Disciplinary Domain of Science and Technology, Biology, Department of Cell and Molecular Biology. Thermo Fisher Sci, Uppsala, Sweden..
    Movérare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research. Thermo Fisher Sci, Uppsala, Sweden..
    Fischer, Christian
    Thermo Fisher Sci, Uppsala, Sweden..
    Lidholm, Jonas
    Thermo Fisher Sci, Uppsala, Sweden..
    Rudengren, Magnus
    Thermo Fisher Sci, Uppsala, Sweden..
    Borres, Magnus P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Inflammation, Metabolism and Child Health Research. Thermo Fisher Sci, Uppsala, Sweden..
    History and Utility of Specific IgE Cutoff Levels: What is the Relevance for Allergy Diagnosis?2023In: Journal of Allergy and Clinical Immunology: In Practice, ISSN 2213-2198, E-ISSN 2213-2201, Vol. 11, no 10, p. 3021-3029Article in journal (Refereed)
    Abstract [en]

    Allergy is defined clinically, by symptoms on allergen exposure. A patient is considered sensitized when allergen-specific IgE (sIgE) antibody can be detected in serum or plasma or a skin test result is positive, even if no clinical reaction has been experienced. Sensitization should be regarded as a requisite and risk factor for allergy but is not synonymous with an allergy diagnosis. To provide a correct allergy diagnosis, test results regarding allergen-sIgE must always be considered in view of the patient's case history and clinical observations. Correct assessment of a patient's sensitization to specific allergens relies on the use of accurate and quantitative methods for detection of sIgE antibodies. The evolution of sIgE immunoassays toward higher analytical performance and the use of different cutoff levels in the interpretation of test results sometimes cause confusion. Earlier versions of sIgE assays offered a limit of quantitation of 0.35 kilounits of sIgE per liter (kUA/L), which also became an established cutoff level for a positive test result in the clinical use of the assays. Current sIgE assays are capable of reliably measuring sIgE levels as low as 0.1 kUA/L and can thereby demonstrate sensitization in cases in which previous assays could not. When the outcome of sIgE test results is evaluated, it is critically important to distinguish between the analytical data as such and their clinical interpretation. Even though sIgE may be present in the absence of symptoms of allergy, available information suggests that sIgE concentrations between 0.1 kUA/L and 0.35 kUA/L may be clinically relevant in some individuals, not least among children, although this should be further evaluated for various allergies. Moreover, it is becoming widely adopted that nondichotomous interpretation of sIgE levels may offer a diagnostic benefit compared with using a predefined cutoff level.

  • 28. Vitte, Joana
    et al.
    Sjölander, Anders
    Rydell, Niclas
    Molin, Magnus
    Pejler, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Biochemistry and Microbiology.
    Hallgren, Jenny
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Biochemistry and Microbiology.
    Movérare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research. Thermo Fisher Scientific, Uppsala, Sweden.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Malinovschi, Andrei
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Cell Biology, Integrative Physiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Tryptase reference values in a Swedish middle-aged general population and association with diabetes mellitus2022In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, p. 1-4Article in journal (Refereed)
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  • 29.
    Vultaggio, A.
    et al.
    Careggi Univ Hosp, Dept Biomed, Immunoallergol Unit, Florence, Italy.
    Nencini, F.
    Univ Florence, Ctr Res Transfer & High Educ DENOTHE, Florence, Italy;Univ Florence, Dept Expt & Clin Med, Florence, Italy.
    Carraresi, A.
    Careggi Univ Hosp, Dept Biomed, Immunoallergol Unit, Florence, Italy.
    Pratesi, S.
    Univ Florence, Ctr Res Transfer & High Educ DENOTHE, Florence, Italy;Univ Florence, Dept Expt & Clin Med, Florence, Italy.
    Movérare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research. Thermo Fisher Sci, ImmunoDiagnost, Uppsala, Sweden.
    Eriksson, C.
    Thermo Fisher Sci, ImmunoDiagnost, Uppsala, Sweden.
    Venemalm, L.
    Thermo Fisher Sci, ImmunoDiagnost, Uppsala, Sweden.
    Maggi, E.
    Univ Florence, Ctr Res Transfer & High Educ DENOTHE, Florence, Italy;Univ Florence, Dept Expt & Clin Med, Florence, Italy.
    Matucci, A.
    Careggi Univ Hosp, Dept Biomed, Immunoallergol Unit, Florence, Italy.
    IgG4 anti-infliximab in treated patients: Clinical impact and temporal evolution2018In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 73, no 11, p. 2172-2181Article in journal (Refereed)
    Abstract [en]

    Background: Infliximab (IFX) carries potential risk of immunogenicity with the production of anti-drug antibodies (ADA). ADA may belong to different isotypes and are usually measured by ELISA bridging assay. This test is not designed to detect IgG4 antibodies. The aim was to measure IgG4 anti-IFX antibodies in a cohort of IFX-treated patients and to evaluate their relationship with ADA and their clinical impact.

    Methods: Anti-drug antibodies were detected using a bridging ELISA in the serum of 222 treated patients with different clinical outcomes to IFX. The same samples were analyzed for IgG4 anti-IFX antibodies using an experimental ImmunoCAP assay with reduced serum IgG4 background levels. A longitudinal evaluation was performed in a subgroup of 38 patients to define the temporal evolution of IgG4 anti-IFX.

    Results: IgG4 anti-IFX was found in 26.6% of patients. Eighty of 222 patients were ADA+ (36%) and the majority (57/80, 71.3%) had IgG4 anti-IFX. Two IgG4-positive but ADA-negative patients were identified. IgG4 anti-IFX levels correlated with the serum levels of ADA. IgG4 anti-IFX was more common in both reactive and nonresponder patients than in tolerant/responder patients. Patients who had experienced IgE-mediated reactions displayed significantly higher IgG4 anti-IFX than IgE-negative reactive patients. The majority of patients tested positive for IgG4 anti-IFX after the first seven infusions.

    Conclusions: IgG4 anti-IFX is common in treated patients and a large part of ADA producing patients produce IgG4 antibodies. The IgG4 anti-IFX response does not prevent hypersensitivity reactions to IFX and correlates with the IgE anti-IFX response.

  • 30.
    Waern, Ida
    et al.
    Swedish Univ Agr Sci, Dept Anat Physiol & Biochem, Ulls vag 26,Box 7011, S-75007 Uppsala, Sweden..
    Molin, Magnus
    Thermo Fisher Sci, Uppsala, Sweden..
    Movérare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research. Thermo Fisher Sci, Uppsala, Sweden..
    Lidholm, Jonas
    Thermo Fisher Sci, Uppsala, Sweden..
    Malinovschi, Andrei
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Borres, Magnus P
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Inflammation, Metabolism and Child Health Research. Thermo Fisher Sci, Uppsala, Sweden..
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Shrimp- and mite sensitization in a Swedish study: Influence on allergic disorders and lung function2022In: Clinical and Translational Allergy, ISSN 2045-7022, E-ISSN 2045-7022, Vol. 12, no 10, article id e12198Article in journal (Other academic)
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  • 31. Wedbäck, Anna
    et al.
    Enbom, Håkan
    Eriksson, Nils E.
    Moverare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Malcus, Inga
    Seasonal non-allergic rhinitis (SNAR)--a new disease entity?: A clinical and immunological comparison between SNAR, seasonal allergic rhinitis and persistent non-allergic rhinitis2005In: Rhinology, ISSN 0300-0729, E-ISSN 1996-8604, Vol. 43, no 2, p. 86-92Article in journal (Refereed)
    Abstract [en]

    We have earlier described a group of patients suffering from rhino-conjunctivitis during the early pollen season, but with negative allergological investigation. The present study aimed to evaluate this syndrome called Seasonal Non-Allergic Rhinitis (SNAR). Seventeen patients with SNAR were compared with 20 patients with seasonal allergic rhinitis (SAR) and 13 patients with persistent non-allergic rhinitis (PNAR). They were analyzed with skin prick tests (SPT) and nasal provocation tests (NPT) with pollen extracts, and for IgE antibodies in serum and inflammation mediators in nasal lavage. Daily symptoms and medicine consumption were recorded. Late reactions after SPT occurred in two SNAR, eight SAR and two PNAR patients. Weak immediate and late reactions after NPT were induced in 3/15 and 7/15 SNAR patients, respectively, and in 1/13 and 5/13 PNAR patients. All SAR patients had immediate and 9/18 had late reactions. The total IgE levels were lower in SNAR compared to SAR. In the SNAR group 1/15 was positive in Phadiatop. Increased tryptase levels after NPT were only observed in SAR. The SNAR patients had high daily symptom scores already before birch pollen season. Sneezing was more common in SNAR and SAR than in PNAR; eye-symptoms more prominent in SAR than in SNAR or PNAR. SNAR seems to be different from SAR and PNAR regarding immunological mechanism and symptom period. We conclude that the cause of SNAR is unknown

  • 32.
    Zaigham, Suneela
    et al.
    Lund Univ, Dept Clin Sci, Malmö, Sweden..
    Zhou, Xingwu
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Molin, Magnus
    Thermo Fisher Sci, Uppsala, Sweden..
    Sjölander, Anders
    Thermo Fisher Sci, Uppsala, Sweden..
    Movérare, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research. Thermo Fisher Sci, Uppsala, Sweden.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Malinovschi, Andrei
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Importance of type and degree of IgE sensitisation for defining fractional exhaled nitric oxide reference values2021In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 188, article id 106621Article in journal (Refereed)
    Abstract [en]

    Background

    Fractional exhaled nitric oxide (FENO) is a marker of type 2 airway inflammation used in clinical practice in asthma. However, reference values are needed to broaden the clinical use of FENO and this is within the scope of a newly started Global Lung Function Initiative task force. We aim to study FENO levels with special emphasis on the upper limit of normal (ULN) in relation to the type and degree of IgE sensitisation.

    Methods

    FENO was measured in 1855 non-smoking, respiratory healthy subjects from the Swedish CArdioPulmonary bioImage Study (SCAPIS). Atopic subjects (n = 424), defined as being IgE-sensitised to aeroallergens (ImmunoCAP Phadiatop™, ≥0.35 PAU/l) were compared to non-atopic subjects (<0.35 PAU/l, n = 1431). Atopic subjects were further characterised according to their grade of IgE sensitisation (IgE antibody tertiles: (T1<1.16, T2 1.16–3.72 and T3 >3.72 PAU/l) and sensitisation to perennial (cat or mite) or seasonal (birch) allergens.

    Results

    Subjects IgE-sensitised to cat or mite had higher FENO compared to non-atopic subjects (FENO (ppb): median 20.0 vs. 15.0, and ULN 50.4 vs. 33.0, p < 0.001). This was seen to a lesser extent for subjects IgE-sensitised to birch only (median 18.0 vs. 15.0, and ULN 38.0 vs. 33.0, p = 0.048). Atopic subjects with a high degree of IgE sensitisation (Phadiatop: >3.72 PAU/l) had the highest FENO compared to non-atopic subjects (median 20.0 vs. 15.0, and ULN 56.0 vs. 33.0, p < 0.001).

    Conclusions

    The type and degree of IgE sensitisation should be considered in generating FENO reference values.

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