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To further investigate the possibility of a cause and effect relationship between exposure to house-dust mite (HDM) allergens and respiratory disease associated with dust mite sensitivity, we compared schoolchildren living in the Alps, where exposure to HDM is low, with those living at sea level, where it is high. The study included 933 schoolchildren from the fourth and fifth grades. The protocol included the standardized 1978 American Thoracic Society (ATS) questionnaire for children, skin testing using common aero-allergens and controls, and antigenic measurements of dust samples from mattresses (Group I antigen). The prevalence of asthma with positive skin test to HDM and the overall prevalence of positive skin test to HDM were significantly lower in mountain schoolchildren. The mean geometric HDM antigenic level in mattresses was much lower in the Alps (0.36 micrograms/g dust) than at sea level (15.8 micrograms/g dust). In contrast, the prevalence of hay fever and positive skin test to grass pollens as well as the overall prevalence of positive skin tests to grass pollens were significantly higher in the Alps. These data illustrate a striking relationship between exposure to environmental allergens and atopic sensitization.

To elucidate whether systemic reactions (SR) to drugs should be included in the atopic status in epidemiological studies, we compared the distribution of atopy in subjects with or without a history of SR to drugs. The studied population comprised 2067 adults, 20 to 60 years old, visiting a health care center for a check-up examination. The protocol included a questionnaire related to history of SR to drugs and a Phadiatop test which evaluates on a blood sample the presence of specific IgE against common aeroallergens. Overall, 14.7% of the study group, including 66% women, reported reliable histories of SR to drugs. The cumulative prevalence of asthma, hay fever and childhood dermatitis was higher in the SR group. By contrast, the percentage of positive Phadiatop tests was similar in subjects with or without a history of SR. Thus atopy, defined by an objective criterion, i.e. the presence of specific IgE against common aero-allergens, is not associated with the occurrence of SR to drugs. Such a history should not be included as part of the atopic status.

As reliance of responses to epidemiological questionnaires on atopic symptoms is doubtful, we studied the predictive value of these questions relative to atopy, defined by the presence of serum specific IgE, taking into account some extraneous variables such as age and sex. The study population included 2067 adults, 20-60 years old. The protocol consisted of a standardized questionnaire and an evaluation of serum specific IgE using the Phadiatop (Pharmacia Diagnostics, Uppsala, Sweden) test. The predictive value of each symptom suggestive of atopy was quite low, but was much dependent on age and sex. Women more often than men reported atopic symptoms in the absence of atopy. Similarly, the predictive value of each symptom decreased with age. Thus atopic symptoms do not have the same value as predictors of atopy. These findings have both clinical and epidemiological important implications.

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BackgroundThe reliability and reproducibility of experimental procedures is a cornerstone of scientific practice. There is a pressing technological need for the better representation of biomedical protocols to enable other agents (human or machine) to better reproduce results. A framework that ensures that all information required for the replication of experimental protocols is essential to achieve reproducibility.MethodsWe have developed the ontology EXACT2 (EXperimental ACTions) that is designed to capture the full semantics of biomedical protocols required for their reproducibility.To construct EXACT2 we manually inspected hundreds of published and commercial biomedical protocols from several areas of biomedicine. After establishing a clear pattern for extracting the required information we utilized text-mining tools to translate the protocols into a machine amenable format. We have verified the utility of EXACT2 through the successful processing of previously 'unseen' (not used for the construction of EXACT2) protocols.ResultsThe paper reports on a fundamentally new version EXACT2 that supports the semantically-defined representation of biomedical protocols. The ability of EXACT2 to capture the semantics of biomedical procedures was verified through a text mining use case. In this EXACT2 is used as a reference model for text mining tools to identify terms pertinent to experimental actions, and their properties, in biomedical protocols expressed in natural language. An EXACT2-based framework for the translation of biomedical protocols to a machine amenable format is proposed.ConclusionsThe EXACT2 ontology is sufficient to record, in a machine processable form, the essential information about biomedical protocols. EXACT2 defines explicit semantics of experimental actions, and can be used by various computer applications. It can serve as a reference model for for the translation of biomedical protocols in natural language into a semantically-defined format.

To better understand the clinical consequences of exposure to house dust mites (HDM), we investigated the relationship between treatment requirements to control symptoms in mite-allergic asthmatic patients and HDM-allergenic levels in their mattresses. This study included 49 asthmatic subjects recruited from an outpatient clinic. The protocol consisted of a questionnaire about the number of asthma attacks and treatment requirements in the last 3 months. Patients provided a sample of house dust collected from their mattresses by a standardized vacuum cleaning procedure. Mean antigen P1 equivalent defined as the sum of major allergens Der pI and Der fI (Ag P1 Eq) level was 1.34 micrograms/g dust in patients who had no treatment, 5.4 micrograms/g dust in patients who took puffs of beta 2-agonists only when required and 17.8 micrograms/g dust in patients who required daily long-term treatment. Similar relationships were demonstrated between mean Ag P1 Eq levels and the number of asthma attacks. These data support the clinical role of allergenic exposure in HDM-allergic asthmatics.

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