J ALLERGY CLIN IMMUNOL Abstracts AB137

VOLUME 141, NUMBER 2

Department of Pediatrics, Kochi University, Nankoku, Japan, 2National

432 Patch Testing in Patients with Atopy
Research Institute for Child Health and Development, Tokyo, Japan.
RATIONALE: Consumption of probiotics during perinatal and postnatal
Irum Noor, DO1, Marcella R. Aquino, MD, FAAAAI1, Mark A. Davis-
periods has been reported to reduce the risk of atopic dermatitis in the
Lorton, MD, FAAAAI2, and Luz S. Fonacier, MD, FAAAAI3; 1Winthrop
offspring; however, its precise mechanism remains unclear. Because
University Hospital, Allergy & Immunology, Mineola, NY, 2Division of
probiotics consumption does not affect IgE levels and is not associated
Rheumatology, Allergy, and Immunology, NYU Winthrop Hospital,
with risks of other allergic diseases, we hypothesized that probiotics
Mineola, NY, 3NYU Winthrop Hospital, Mineola, NY.
consumption may reduce skin hypersensitivity. To test this hypothesis, we
RATIONALE: Newer data demonstrates that contact sensitization is at least
investigated whether perinatal/postnatal consumption of yogurt associates
as common in atopic dermatitis (AD) patients as it is in the general population
with skin hypersensitivity to histamine.
which is contrary to previous beliefs. We sought to compare positive patch test
METHODS: This was a cross-sectional study that enrolled 256 mother–
(PPT) results in patients with atopy and AD (ATw/AD) and atopy without AD
infant (>_6-months-old) pairs. Physician-diagnosed allergic diseases and
(AT w/o AD) to our control group, those without atopy (w/oAT). We
perinatal/postnatal food consumption were assessed using self-question-
hypothesized that impaired skin barrier function which increases allergen
naires. Skin prick tests (SPTs) were performed using 1 mg/ml histamine
penetrance in atopic patients with AD increases risk of sensitization.
and bifurcated needles, and wheal sizes 15 minutes after puncture were
METHODS: An IRB-approved retrospective 7 year chart review was
measured.
performed of 114 patients patch tested with the North American Contact
RESULTS: The SPT wheal sizes in infants with eczema/atopic dermatitis
Dermatitis Group Standard (NACDG) or the Thin-Layer Rapid Use
(n551) were significantly larger than those in infants without eczema/
Epicutaneous (T.R.U.E.) test at our allergy practice. Data collected included
atopic dermatitis (n5156; 4.462.1 mm vs. 3.761.8 mm, respectively,
atopic disease type (food allergy, allergic rhinitis, asthma, & AD), location of
P50.029). Among infants without eczema/atopic dermatitis, the SPT
dermatitis, occupation, and rate of PPT to at least 1 allergen.
wheal sizes were significantly smaller in those with daily yogurt con-
RESULTS: The age range was 13 – 95 years and 83% were female.
sumption (n59) than in those without (n5146; 2.461.3 mm vs. 3.861.3
Nineteen percent (n-22) had allergic rhinitis (AR), asthma, and/or food
mm, respectively, P50.014). Perinatal consumption of yogurt by the
allergy (FA) with AD, 47% (n553) had AR, asthma, and/or FA without AD
mothers showed no associations with SPT wheal sizes in both mothers and
and 34% (n539) had no atopy. In the AT w/ AD group, 82% of patients had
infants.
a PPT. Patients in the AT w/o AD and the w/oAT had similar rates of at least
CONCLUSIONS: Daily yogurt consumption may reduce skin hypersen-
1 PPT (53% and 64% respectively; p-value 5 0.06).
sitivity to histamine and thereby reduce the risk of atopic dermatitis during
CONCLUSIONS: In our patient population, AT w/AD had a higher
infancy. The role of probiotics/yogurt consumption in the regulation of skin
likelihood of sensitization to contact allergens compared to AT w/oAD and
hypersensitivity to histamine warrants further study.
w/o AT. Larger studies in these populations are warranted for confirmation.

433 Differential Treatment effects of Budesonide on

Eosinophilic Esophagitis (EoE) versus Healthy
435 Elevated serum TSLP, IL-33, 6Ckine and MCP-3
levels in school children or older patients with
eosinophilic gastroenteritis
Fibroblasts
Ichiro Nomura, MD, PhD1, Hideaki Morita, MD, PhD1, Akio
Lance Y. Hsieh; University of California, San Diego, San Diego, CA.
Matsuda, PhD.1, Miori Sato, MD2, Motoko Mitsui2, Yumiko
RATIONALE: Topical esophageal corticosteroid therapy reduces eosino-
Miyaji, MD, PhD2, Shinichiro Inagaki, MD, PhD2, Tatsuki Fukuie, MD,

SUNDAY
philic inflammation in esophageal epithelium in EoE. TCS can also diminish
PhD2, Masami Narita, MD, PhD2, Yukihiro Ohya, MD, PhD2, Hirohisa
subepithelial fibrosis pediatric EoE subjects who respond to therapy. However,
Saito, MD, PhD, FAAAAI1, and Kenji Matsumoto, MD, PhD1; 1National
whether topical steroids direct alter esophageal fibroblast function and whether
Research Institute for Child Health and Development, Tokyo, Japan, 2Na-
there are differential effects on normal versus EoE fibroblasts is unclear.
tional Center for Child Health and Development, Tokyo, Japan.
METHODS: Esophageal fibroblasts from 3 children with active EoE (2
RATIONALE: Eosinophilic gastroenteritis (EGE) is characterized by
non-responders to budesonide, 1 on proton pump inhibitor monotherapy)
abnormal accumulation of eosinophils in the GI mucosa. Non-IgE-
and 2 healthy donors were isolated and cultured from the esophagus. EoE
mediated immune responses are reportedly involved in the pathogenesis
and normal fibroblasts were matched for culture conditions and passage
of infantile EGE, but the pathogenesis of EGE remains largely unknown.
and treated concurrently. Fibroblasts were treated with TGFb1 (1ng/ml) in
One of the major difficulties in diagnosing and treating EGE is the lack of
the presence or absence of budesonide (0.01uM) and qPCR was performed
reliable serum biomarkers. We recently reported that serum TSLP, IL-33,
to analyze gene expression of fibrotic genes.
6Ckine and MCP-3 levels were elevated in infantile EGE (Shoda et al.,
RESULTS: Both EoE and normal fibroblasts had significant increases in
JACI 2016). In the present study, we examined the serum cytokine/
remodeling gene expression with TGFb1 treatment (collagen, fibronectin, PLN,
chemokine profiles of school age and adult patients with EGE.
PAI-1, and aSMA p<0.01 for all). Both EoE and normal fibroblasts had
METHODS: We used a Milliplex assay system to determine the
significant decreases in TGFb1-induced collagen and PLN (p<0.01) in the
comprehensive cytokine/chemokine profiles in sera from 9 patients with
presence of budesonide but only normal fibroblasts had a significant reduction in
moderate to severe EGE, 14 patients with ulcerative colitis (UC) and 31
TGFb1 induced aSMA (p<0.001). Compared with normal fibroblasts, EoE
patients with immediate-type food allergy (FA).
fibroblasts had significantly less down regulation of TGFb1-induced fibronectin,
RESULTS: The EGE patients were 3 males and 6 females, with a median
aSMA, PLN, and PAI-1 expression in the presence of budesonide (p<0.01 for all).
age of 12 years (5;35 y). Major symptoms and signs of EGE were
CONCLUSIONS: Budesonide was less effective at inhibiting fibrotic
abdominal pain (100%), vomiting (33%), diarrhea (56%), ascites (22%)
genes expression in EoE as opposed to normal fibroblasts. This may reflect
and hypoproteinemia (33%). Among 66 chemokines/cytokines tested,
intrinsic differences in esophageal fibroblasts from diseased versus normal
TSLP (P5.035), IL-33 (P<.000), 6CKine (P5.003) and MCP3 (P5.008)
subjects and may have therapeutic implications in EoE.
levels were elevated in EGE when compared with UC and FA. Those
elevated levels decreased after resolution of the symptoms. Serum
434 Daily Yogurt Consumption In Infancy Is Associated
With Reduced Skin Hypersensitivity proinflammatory cytokine levels were not elevated.
CONCLUSIONS: Serum TSLP, IL33, 6CKine, MCP3 levels are likely to
Miwa Shinohara, MD, PhD1, and Kenji Matsumoto, MD, PhD2; be good biomarkers for diagnosing and treating school children and older
1
Department of Pediatrics, Ehime University Hospital, Toon, Japan; patients with EGE. EGE in school children and older patients may have a
similar pathogenesis with infantile EGE.

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