Background: The skin prick test (SPT) is used to diagnose sensitization to antigens. This study proposes a deep learning approach to infer wheal dimensions, aiming to reduce dependence on human interpretation. Methods: A dataset of SPT images (n=5844) was used to infer a convolutional neural network for wheal segmentation (ML model). Three methods for inferring wheal dimensions were evaluated: the ML model; the standard protocol (MA1); and approximation of the area as an ellipse using diameters measured by an allergist (MA2). The results were compared with assisted image segmentation (AIS), the most accurate method. Bland-Altman, distribution analyses, and correlation tests were applied to compare the methods. The study also compared the percentage deviation among these methods in determining the area of wheals with regular geometric shapes (n = 150) and with irregular shapes (n=150). Results: The Bland-Altman analysis showed that the difference between methods was not correlated with the absolute area. The ML model achieved a segmentation accuracy of 85.88% and a strong correlation with the AIS method (ρ=0.88), outperforming all other methods. Additionally, MA1 showed significant error (13.44±13.95%) for pseudopods. Conclusions: The ML protocol can potentially automate the reading of SPT, offering greater accuracy than the standard protocol.

High prevalence of allergic disorders in Indian pediatric patients demands early diagnosis of allergens so that appropriate allergen avoidance methods, pharmacotherapy or immunotherapy can be provided in time to avoid the worsening of symptoms due to triggers. In this context, identification of the most prevalent aeroallergens in a given area is critical for diagnosis and treatment of various allergic reactions especially in case of rhino-conjunctivitis and asthma. The specific diagnosis of IgE mediated allergy is usually based on the correlation between the clinical history and signs and symptoms endorsed by the diagnostic tests. Skin prick tests are the gold standard however has some limitation. In view of this, the aim of this study was to assess the significance of ImmunoCAP assay for assessing serum specific IgE levels, available in India, against skin prick test by standardized allergens, for the diagnosis of allergic sensitization. A single-center observational study was conducted at tertiary care corporate hospitals in North India from 2017-2020. Patients with self-reported allergic symptoms or whose symptoms were suspected for allergies were tested for the type of sensitization using skin prick test (SPT) after their consents followed by ImmunoCAP based quantification of serum specific IgE levels. A total of 256 (95.9%) pediatric patients were analyzed in the study and were analysed. The patients were most commonly (30% patients) sensitized to D. farinae (173 [67.6%]), D. pteronyssinus (174 [68.0%]), Acarus siro (93 [36.3%]), Lepidoglyphus destructor (96 [37.5%]), Plantago lanceolata (Engl.). The ROC curve of Bermuda grass shows that the AUC of serum-specific IgE is larger than that of SPT (1.000 / 0.881). The receiver operating characteristic (ROC) analysis of serum-specific IgE reference method resulted in the largest AUC of all the allergens taken into consideration (0.711 / 1.000) compared to those of SPT (0.589 / 1.000). These results revealed that serum-specific IgE is more reliable method over prick test for accessing the sensitivity of patient for various allergens. This study may be helpful in performing early diagnosis of allergies as well as in taking appropriate preventive measures for managing life threatening allergic reactions

Hazelnut is a widespread nut species, especially in Europe, that can be consumed raw or roasted, due to its pleasant taste and nutritional properties. Despite the renowned beneficial properties, hazelnuts contain several proteins capable of inducing food allergy in sensitized individuals such as Cor a 2 (profilin), Cor a 8 (lipid transfer protein), Cor a 9 (11S seed storage globulin, legumin-like) and Cor a 11 (7S seed storage globulin, vicilin-like). In the present paper we investigated the effectiveness of autoclave based treatments in decreasing the allergic potential of hazelnut as also assessed by submitting the treated material to in vivo skin prick test and to in vitro immunoblot analysis with sera of allergic individuals exposed to the treated food material. This preliminary analysis shows that autoclave treatment, preceded by hydration and/or followed by drying, seems to be a promising approach and appears to be effective in reducing the allergenicity of hazelnut in most patients, probably due to the denaturation of most major and minor allergenic proteins. This work will open to the opportunity to produce, in perspective, hypoallergenic hazelnut derivatives tolerated by the allergic subjects.