loss-of-function mutations in FLG leading to near-complete absence of profilaggrin in the homozygous or compound heterozygous state. Therefore it can be hypothesized that filaggrin deficiency contributes to the observed photosensitivity and/or reduced threshold to UVB-induced erythema in patients with AD. We have performed a detailed analysis of cutaneous photoresponse in clinically normal skin to avoid the confounding effects of atopic inflammation. Our findings have excluded a large effect of FLG genotype on photosensitivity (> _1.8-fold difference in MED) at any of the wavebands tested. In addition, the results of our monochromator phototesting did not indicate a differential erythemal sensitivity within the wavelengths representing UVB, as would be predicted from the known absorption spectrum of UCA. One limitation of our study is that the healthy volunteers did not include any subjects with ichthyosis vulgaris, and therefore we have not excluded the possibility that FLG homozygous (or compound heterozygous) subjects might show greater erythemal sensitivity than wild-type subjects. However, FLG-null heterozygosity has a significant effect on filaggrin expression in vivo, 9,10 and therefore we would expect an effect to be observed in FLG heterozygotes if this was substantial. The fact that observations of UVB-induced damage in murine and in vitro models have not been supported by clinical data suggest that different mechanisms lead to cutaneous erythema in vivo than the markers of UV damage studied in vitro and in mice. For example, apoptosis is known to occur within areas of skin damaged by UVexposure, and this is associated with cutaneous erythema, but the relationship is nonlinear. Furthermore, the photoprotective effect of the FLG wild-type genotype might be attributable to a mechanical filtering of UV radiation by the stratum corneum rather than by chemical photoimmunosuppression. In conclusion, our FLG genotype-stratified analysis of responses to UV and visible radiation in clinically normal skin does not support the hypothesis that the breakdown products of filaggrin play a major role in the sensitivity of human skin to UV-induced erythema. This has relevance to the ongoing search for predictors of patient response in phototherapy for AD and for the development of personalized medicine. We thank the patients and volunteers who participated in this study and Lynn Fullerton, who provided technical support in the photobiology investigations. We are very grateful to Professors

PurposeThe purpose of this study was to evaluate the utility of specific IgE (sIgE) concentrations for the diagnosis of immediate-type egg and cow's milk (CM) allergies in Korean children and to determine the optimal cutoff levels.MethodsIn this prospective study, children ≥12 months of age with suspected egg or CM allergy were enrolled. Food allergy was diagnosed by an open oral food challenge (OFC) or through the presence of a convincing history after ingestion of egg or CM. The cutoff levels of sIgE for egg white (EW) and CM were determined by analyzing the receiver operating characteristic curves.ResultsOut of 273 children, 52 (19.0%) were confirmed to have egg allergy. CM allergy was found in 52 (23.1%) of 225 children. The EW-sIgE concentration indicating a positive predictive value (PPV) of >90% was 28.1 kU/L in children <24 months of age and 22.9 kU/L in those ≥24 months of age. For CM-sIgE, the concentration of 31.4 kU/L in children <24 months of age and 10.1 kU/L in those ≥24 months of age indicated a >90% PPV. EW-sIgE levels of 3.45 kU/L presented a negative predictive value (NPV) of 93.6% in children <24 months of age, while 1.80 kU/L in those ≥24 months of age presented a NPV of 99.2%. The CM-sIgE levels of 0.59 kU/L in children <24 months of age and 0.94 kU/L in those ≥24 months of age showed NPVs of 100% and 96.9%.ConclusionsOur results indicate that different diagnostic decision points (DDPs) of sIgE levels should be used for the diagnosis of egg or CM allergy in Korean children. The data also suggest that DDPs with high PPV and high NPV are useful for determining whether OFC is required in children with suspected egg or CM allergy.

Higher exposure to CO during infancy increased the risk of development of allergic rhinitis. The risk of current atopic dermatitis symptoms increased in children who were exposed to higher CO levels during the past 12 months.