The relationship between wheezing or asthma and serum immunoglobulin (Ig)E levels in early life is unclear. The aim of this study was to follow-up the IgE immune response in infants that did, or did not, develop recurrent wheezing during their first year of life.One-hundred and two randomised term neonates were included, in which IgE levels were quantified in cord blood samples, at 3, 6, 9 and 12 months of age. Specific IgE levels for food and inhalant allergens and the skin-prick test for inhalant allergens were also assessed at 6 and 12 months.During clinical follow-up, 32 (31%) infants presented with two or more wheezing episodes, while 70 (69%) had no wheezing. Total IgE levels were significantly higher up to 12 months in wheezing infants when compared to nonwheezing group. At 12 months, the specific IgE levels to cow9s milk, egg white and mites were higher in infants with recurrent wheezing. There was no influence of family history for atopy on IgE levels. The skin-prick tests were positive in 14% and 23% in wheezing infants at 6 and 12 months, respectively.These results indicate an early allergic sensitisation in wheezing infants, suggesting an altered immunoregulatory T-cell role in immunoglobulin E production. Eur Respir J 2002; 20: 640-645.

Twenty-five adverse reactions were diagnosed, representing 0.5 % of the study population. None of these reactions was due to an allergic cause. Most (22/25) were mild, quickly reversible psychogenic or vasovagal reactions. One case was related to defects in the anesthetic technique. In two further cases, allergic etiology was ruled out after skin and dose provocative challenge tests with the anesthetic. In conclusion, allergic reactions to LA are very rare. Most adverse reactions are psychogenic or vasovagal. Physicians and dentists should be aware of these facts in order to minimize the frequent fears and myths concerning the use of LA in the dentist's office.

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RATIONALE: Patients can be allergic to multiple substances due to IgEmediated recognition of similar epitopes on proteins from different sources. We applied cluster-detection techniques to food-allergic patient data to detect groups of cross-reactive allergens. Such groupings will be useful for patient-classification, diagnosis, treatment and discovery. METHODS: Skin prick test (SPT) results were obtained for confirmed food-allergic patients, for allergens common to Mediterranean areas. Patients/allergens with much missing data were excluded. Cluster analysis was performed using R/Cytoscape. Similarity was calculated using binary distance metrics. Patient self-reporting data was also obtained. RESULTS: Following exclusion, 525 participants and 45 agents were analysed. The allergens giving rise to the most positive SPT results were olive pollen, peach, tree-nuts/peanuts, grasses and house-dust mites. Cluster analysis found that similar allergen-sources tended to group together, including fruits, mites, nuts, dander, trees, weeds and grasses. Comparison with self-reported previous reactions showed high overlap, albeit with notable exceptions including lentils and sesame seeds. The choice of distance metric and clustering method influenced cluster-building. CONCLUSIONS: SPT analysis reveals patterns of co-reactivity between allergens. This information can aid diagnosis and suggest which allergensources to avoid. It can also guide studies of panallergens and epitope mapping. However, the choice of metric to calculate similarity is important: given the predominance of negative data, assymetric metrics are advised. Future work will investigate other geographical areas and patient IgE levels.