13^th International Conference on Allergy and Clinical Immunology December 13-14 , 2018 Abu Dhabi, UAE

Dana Al Salah is a certified Food Allergy Coach. AllerCoach (TM), is the first International food allergy management training and certification program for coaches and consultants. Her first-hand experience in the daily effort to keep her children safe and healthy is the reason she understands the struggles families go through with having one or more people with food allergies in the house. She takes each case personally and offers support wholeheartedly to the people and families she works with.

Food allergies are on the rise and are increasing in both developed and developing countries, especially among children. A food allergy is a serious auto immune disease. Symptoms can vary from mild to severe. Globally, 220-250 million people may suffer from food allergies, which are the main and leading cause for anaphylaxis.

Challenges:

• A food allergy reaction can happen to anyone, anytime, anyplace.

• There is no cure for food allergies yet.

• Even a trace amount of allergen can be fatal.

• All food can cause an allergic reaction. More than 170 foods are documented to have caused an allergic reaction.

• Many countries have reported a lack of reliable data and the need for more studies and resources.

• The unavailability of life-saving medications such as epinephrine (in Asia, South America, Middle East, Eastern Europe and Africa) poses a critical concern.

• Food allergy has a significant social, emotional, psychological, health physical and socio-economic impact; affecting the quality of life of people suffering from food allergies (mainly children).

• Large areas in the world lack legislation on food labeling.

• Misconception of medical terms-intolerances, allergies and sensitivities. And underestimating the seriousness of food allergies.

Recommendations and solutions:

• Spread awareness and offer food allergen training wherever food is served.

• Implement food allergy and anaphylaxis plans for food.

• Improve access to adrenaline autoinjectors in countries where it is limited.

Conclusion and Significance: Food is a social activity that has become one of the last remaining social rituals for humans. The disease of food allergy results in exclusion of children from various social activities, such as school canteens, birthdays and prevents their full participation in school life and society. Parents, caregivers and people with food allergies need the help of the whole society to stay healthy, safe and included.

Vincent St Aubyn Crump is a consultant allergist at Manchester University Hospital NHS Foundation Trust and setting the only allergy service in Jamaica. He has written a number of review articles on allergy, developed Patient Education Aids and frequently participates in public and professional presentations on allergy in New Zealand and UK. He has constantly been working on expanding the database for his allergy website: www.allergyclinic.co.nz. He has published a book "Allergies New Zealand's Growing Epidemic" in 2009. The book has been described by Penny Jorgensen, CEO of Allergy New Zealand, as ‘a must have book for every New Zealander’. Dr Crump’s book offers an in-depth examination on the treatment of allergies and the ways in which allergic conditions are interrelated. It also includes case studies illustrating how allergies manifest themselves and a wealth of practical advice on how to recognize allergies and where to look for the most effective treatment options. To address the growing gap between the rising prevalence of allergies and the shortage of allergy specialists in New Zealand, the idea of AllergyDoctor was considered the most realistic solution to improving the unmet needs of allergy service in New Zealand. The core structure of AllergyDoctor is to train/up skill general practitioners in allergy. They are trained to be proficient in comprehensive allergy assessment, skin prick testing, patch testing and administering immunotherapy, safely and effectively.

Pollen Food Syndrome, in particular Oral Allergy Syndrome (OAS) has been increasing in adults. As it is often difficult to assess the risk for anaphylaxis, a number of these patients are prescribed adrenaline autoinjectors for oral allergy syndrome to peanut and tree nuts with the associated anxiety of carrying an adrenaline autoinjector. Molecular component testing has revolutionized the management of these patients. Patients with symptoms of OAS who have been prescribed an adrenaline autoinjector because of throat tightness and features of anxiety, who have PR-10 / Bet v 1 proteins only and have a safe single blind food challenge and have their adrenaline autoinjectors removed with reassurance that they are not at risk of anaphylaxis, with significant improvement in their quality of life. The talk will present patients from my practice that have had their adrenaline removed following molecular allergy testing and oral challenges, and also patients with less striking history of nut reaction, but molecular testing has identified storage protein sensitization and the risk for anaphylaxis confirmed from this and

adrenaline prescribed based on these tests.

Rehab Bagadood is a Lecturer in Immunology at Umm al-Qura University, Saudi Arabia. She has completed her Bachelor’s degree in Laboratory Medicine from Umm al-Qura University, Saudi Arabia in 2010. She later moved to University of Leicester where she earned MSc degree in Infection and Immunity in 2014. She is

currently pursuing PhD at University of Leicester, UK.

Introduction & Aim: Asthma is a chronic inflammatory disease of the lungs affecting millions of people worldwide. Obesity, on the other hand is considered as a low-grade systemic inflammation that affects large number of individuals. It is important to note that obesity has a significant impact on asthmatic patients as obese patients are mostly suffering from severe symptoms, frequent exacerbation, poor quality of life and poor response to anti-inflammatory therapies including corticosteroids, although the underlying mechanisms are still unknown. We here investigated whether obesity affects pro-asthmatic changes in the lung and immune cells in a murine model of allergic asthma.

Methodology: Splenocytes were isolated from ovalbumin (or saline as control) sensitized and challenged C57BL/6 mice that were fed with either Low (LFD) or High-Fat (HFD) diets. These splenocytes were treated with (1 mg/ml ovalbumin) in the presence of dexamethasone and production of different cytokines was measured using ELISA. Inflammatory cytokines levels were also assessed in bronchoalveolar lavage fluids. To score the degree of inflammation and mucus secretion in the airways, mice lung sections were stained with Haematoxylin & Eosin (H&E) and Periodic Acid-Schiff (PAS) stains respectively.

Results: Production of TNFα and IL-6 levels by cultured splenocytes was greater in HFD-fed ovalbumin-challenged mice (148.5±13.4 and 597.9±136.5 pg/ml; P<0.0001 and P=0.01 respectively) when compared to that in cells from LFD-fed group. Interestingly, dexamethasone failed to inhibit the production of IL-6 by splenocytes from ovalbumin-challenge HFD-fed mice compared to LFD mice. Ovalbumin-challenged obese mice exhibit significant IL-6 secretion into BALF (P<0.05). H&E and PAS stains showed high levels of inflammatory cell infiltration and mucus secretion in the airways of ovalbumin-challenged mice. More importantly, HFD significantly increased lung inflammation in various compartments including peri-vascular, peri-bronchial and parenchyma areas in ovalbumin-challenged mice.

Conclusion & Significance: HFD exacerbate allergen responses in vivo and dexamethasone sensitivity in vitro in culturedsplenocytes. Obesity induced by HFD augments allergen-induced airway inflammation possibly as a consequence of increased infiltration of immune cells in the lungs and release of pro-inflammatory cytokines.

Fuad Alrowaishdi is the consultant in Allergy and Immunology (Adult-Pediatrics) field of medicine. He is also the consultant Pediatric Pulmonology and Bronchoscopy. He is fellow member of American Academy of Asthma Allergy and Immunology. He serves as member of several organizations like European Academy of allergy and Clinical Immunology, European Respiratory Society, French Allergy Pulmonology Society and World Allergy Organization.

The rate of allergic diseases in children is increasing every year and more than 17 million people in Europe suffer from food allergy. The Impact of food allergy on Quality of Life is:

• Reduced general health perception, emotional impact and limitation of family activities

• Frequent accidental adverse reactions with pronounced effect in severe cases

• Risk of nutritional deficiencies

The only currently approved treatments are avoidance and administration of emergency medications on accidental exposure of allergenic food. The knowledge of the intensive treatment in the case of a reaction after exposure to the specific food is crucial. In the last years allergen immunotherapy for food allergy has been developed in reference centers with promising results, although the rate of adverse events places this technique in a balance between the achievement of desensitization/tolerance and the threat of adverse events. The aim of the lecture is to determine the technique performance, to know the different schedules and products used for egg, milk and peanuts immunotherapy and to also deduce use of unmodified and modified foods. The

other things to gain from the lecture are:

• To know the Biomarkers of desensitization/tolerance in food allergy

• To know the advantages and pitfalls of immunotherapy for food allergy

• To know the way to minimize the adverse events in the clinical practice along with increase of efficacy & safety of immunotherapy

• To know the concepts of desensitization/tolerance/sustained unresponsiveness

• To know the European Academy of Allergy and Clinical Immunology recommendations from the recent publications in the field

Azhken Bakhtiyar has been researching lymphoid formations within the university for a long time. His ability to approach the problem from the alternative side helps to study the problems and search for their causes on a completely different level. Early age is not an obstacle to research. At the moment, he is conducting a study of patients in dynamics, taking into account clinical aspects. If the study can change the understanding of this pathology, given its relationship with all systems of homeostasis.

In this case, the process of development of the Barrett's esophagus and the development of adenocarcinoma as a complication of this disease with involvement of lymphoid tissue with the formation of follicles of different types was studied. Barrett's esophagus is a precursor of adenocarcinoma of the esophagus, a disease with a growing burden in the Western world. The incidence of BE increased dramatically during the late 20th century and increased morbidity of these disease. Prevalence is between 0.5 and 2.0%. There are risk factors for BE including obesity and tobacco smoking but gastro-esophageal reflux disease is the strongest risk factor. Adenocarcinoma of the esophagus is the most common form of esophageal cancer. However, the

data from United Kingdom and the Netherlands show that the incidence of BE increased even after monitoring the increase in endoscopy indices. These estimates indicate an increase in the incidence of BE in approximately 65% between 1997 and 2002 and 159% between 1993 and 2005. It is disturbing that the greatest proportionate increase in the diagnosis of BE was in people younger than 60 years which is consistent with other works from Europe. N.I. Kolycheva, R.R. Bektayeva studied at ultramicroscopic level. When studying the work on the lymphoid formations of the esophagus, we can cite, concerning the lymphoid component of the esophagus. At present, the source of lymphocyte infiltration into its proper mucous plate, types of lymphoid formations, has not been studied. To study the lymphoid noncapsular formations of the mucous membrane of Barrett's esophagus, biopsy specimens of Barrett's esophagus were taken. Early only the epithelium of the esophagus was studied, but there was no evidence of a propria of the mucous membrane and lymphoid tissue.

Anwar Sayed has developed his interest in the field of immunology during his undergraduate studies. He has pursued his MSc in Immunology and is undertaking a PhD in Immunology at Imperial College London where he has developed his skills using cellular techniques such as tissue culture, state-of-the-art flow cytometry, widefield and confocal imaging. Besides his own research, he enjoys collaborating with national and international teams applying his immunological experience in different fields such as oncology and experimental hematology.

Immune Thrombocytopenia (ITP) is an autoimmune disorder characterized by isolated low platelet count. It was thought to be primarily due to autoantibody against platelets. However, the absence of detectable autoantibodies in over 30% of patients and their unresponsiveness to B-cell-targeting therapy suggested an active role for T cells. Studies have confirmed the proinflammatory nature of ITP characterized as Th1/Th17 profile. However, little is known about the involvement of CD8+ Cytotoxic T cells (CTL) in ITP pathophysiology and whether they are regulated by regulatory T cells (Treg). Immunosuppressive therapy has been the mainstay treatment in ITP. More recently, Thrombopoietin Receptor Agonists (TPORA); Romiplostim

(Romi) and Eltrombopag (EPAG) have been increasingly used to stimulate megakaryocytopoiesis to produce more platelets. TPO-RAs are reported to induce complete remission in up to 30% of cases with limited understanding of their impact on the immune system. Here we describe changes in T cell subsets, particularly CTL and Tregs in patients with ITP: How these

changes are affected by disease activity and how TPO-RA may induce remission through modulating the immune system. Multi-color flow cytometric panels were designed to characterize peripheral blood T cell subsets phenotypically as well as functionally through intracellular cytokine expression. Forty (40) patients with ITP were studied and compared with 26 age and gender matched Healthy Controls (HC). Terminally-differentiated effector CTLs were significantly higher in patients compared to HC. This effector population is polyfunctional, expressing high levels of proinflammatory cytokines compared to HC. Although Treg functionality was preserved in these patients, they corresponded to disease activity and in relation to CTLs. Romi and EPAG demonstrate differential T-cell changes which also impacted the disease activity. While Th1/Th2-cell ratio is

considered as driving ITP, these results highlight the role of cytokine-secreting CTLs in the disease pathogenesis, as well as suggesting an immunomodulatory mechanism of these TPO-RAs.

Sana Waris is currently pursuing PhD at Department of Biochemistry, Jawaharlal Nehru Medical College, Aligarh Muslim University, India. Her area of expertise is protein immunology. For four years she has been working on biophysical characterization of acetaldehyde modified IgG molecule and trying to induce antibodies in rabbits which can further be used as a diagnostic biomarker in oral cancer.

Statement of Problem: Acetaldehyde associated with the consumption of alcoholic beverages is classified by the International Agency for Research on Cancer (IARC) as a Group 1 human carcinogen. It has potential to interact with different biomolecules such as protein and nucleic acids in various tissues causing structural and functional modifications that may lead to severe

complications progressing to cancer. The objective of this study is to analyze any structural and immunological changes in human IgG modified with varying concentrations of acetaldehyde and its possible involvement in carcinogenesis.

Materials and Methods: Native and acetaldehyde modified IgG (AA-IgG) was subjected to various physicochemical techniques such as UV, Fluorescence, CD and FT-IR spectrometry, Gel electrophoresis, MALDI-MS, scanning and transmission electron microscopy. Protein oxidation and total thiol groups were also estimated. Binding characteristics and specificity of cancer antibodies towards native and modified IgG were screened by Enzyme-Linked Immunosorbent Assay (ELISA). Formation of immune complexes was visualized by band shift assay. Various oxidative stress and inflammatory biomarkers were further assessed to see their role in etiopathogenesis of oral cancer.

Findings: Acetaldehyde-modified IgG exhibited 51.6% hyperchromicity in UV-absorbance studies. CD and FT-IR studies showed loss in β-structure of the protein. MALDI-MS studies revealed an increase in the mass of modified IgG. Morphological changes incurred upon modification were evident by the appearance of fibrillar structure by scanning electron microscopy.

Crosslinking of Lys-Lys residues were confirmed by transmission electron microscopy. It was observed that preferential binding of cancer antibodies to AA-IgG in comparison to native IgG. Band shift assay further substantiated the enhanced recognition of AA-IgG by cancer antibodies.

Conclusion & Significance: The findings indicate structural perturbation in secondary and tertiary structure of IgG molecule that may result in induction of neo-epitopes in IgG molecule.

The systemic manifestations induced by food hypersensitivity responses are due to the ability of localized exposure to foods in the gastrointestinal tract to result in symptoms in distal target organs. Cow’s milk protein, for example, may induce hives (urticaria), atopic dermatitis, isolated gastrointestinal symptoms or severe generalized anaphylaxis in different individuals or in the same person at different times. These diverse manifestations are the result of complex interactions among the causal food protein, gut, immune system and target organs. The dynamic state of these interactions is demonstrated by

the development of food tolerance in most subjects and by the ability to experience the development of new allergies in some subjects. This presentation explores the variety of clinical manifestations of food hypersensitivity disorders in the context of the question: What determines the local or systemic expression of food allergy in a given individual at a particular time? Evidence is provided for both systemic and local immune activation. The role of food-protein chemistry, absorption and processing of ingested allergen, immune responses (type, degree, and specificity) and target organ hyper reactivity are considered as determinants in the expression of food allergic disorders.

Merin Kuruvilla is an Assistant Professor of Allergy and Immunology at Emory University in Atlanta, GA. Her research interests include drug allergy and biologic therapies. She is also collaborating with translational researchers to elucidate disease mechanisms behind nasal polyps and provide insight into future therapies. She acts as Clinical Mentor for young investigators involved in clinical research. She is also interested in antimicrobial stewardship in the context of medication allergies and is actively contributing to the antimicrobial stewardship program at Emory.

Background: Ten percent (10%) of hospitalized patients report Penicillin Allergy (PA); however, studies indicate that ~98% patients are not truly allergic. Unconfirmed PA labels pose substantial public health risks and PA evaluation is recommended as part of effective antibiotic stewardship. While the most widely accepted protocol is Skin Testing (ST) followed by oral

amoxicillin challenge, time constraints and other limited resources may be a barrier to ST application. An accumulating body of evidence supports the safety and efficacy of using direct oral amoxicillin challenges in low-risk individuals with a history of PA.

Objectives: To evaluate the safety of direct oral graded challenges to amoxicillin.

Methodology: This is a retrospective review of adult patients treated at the outpatient allergy clinic at Emory University. For PA, we currently recommend direct oral amoxicillin challenge in patients with history of benign rash, benign somatic symptoms or unknown history associated with last penicillin exposure >12 months ago. If the index reaction occurred within the past 12 months, or with a history of anaphylaxis, we perform ST first and proceed to oral challenge only if the ST is negative. We do not evaluate PA further if there is a history of a penicillin-associated blistering rash, hemolytic anemia or organ involvement. Any delayed reactions after the oral challenge are reported by the patient.

Results: We describe outcomes of direct oral challenges in patients with PA labels. No acute positive reactions or delayed reactions were noted for the course of the study period. While subjective reactions were reported, these did not constitute a clinically significant challenge reaction.

Conclusion: Direct oral challenge without preceding ST is safe and sufficient to rule out PA in low risk patients. While a history of anaphylaxis or severe drug reactions warrants extreme caution, a simpler and more streamlined protocol might do for lower risk patients.

Objective: To assess adherence to asthma medications among pediatric population in Saudi Arabia, correlate poor adherence with the level of asthma control and investigate the factors that may influence the patient's adherence.

Methods: This cross-sectional study includes 319 pediatric participants. They are recruited from two pediatric Asthma Clinics at King Abdullah Medical City, KAMC and Maternity and Children Hospital, MCH in Makkah by using a valid Arabic translation of the 8-item Morisky Medication Adherence Scale (MMAS-8).

Results: Our study group consisted of total 319 patients, male 45.1% and female 54.9% with a mean age of 6.34±7.35 years, the adherence rate among children by MMAS-8 identified in 35.1% were low adherence rate, while medium adherence were 64.9%. The adherence rate significantly increased with the parent's educational level among mothers (P-Value≤0.001) while the

fathers is (P-Value=0.004). Moreover, the prevalence of parents concern about asthmatic medication side effects of long-term usage is 56.7% while 43.3% of parents are not.

Conclusion: The studies in Saudi Arabia showed high prevalence of asthma among children and a high rate of poor asthma control, yet no studies was conducted to assess the rate of pediatric adherence to asthma medication also the burden of the problem of non-adherence among asthmatic children in terms of medical complications, educational problems and healthcare cost, although the lack of studies in Saudi Arabia in particular and Middle East in general. Routine screening for bronchial asthma risk factors among children, promotes the education about risk factors of bronchial asthma as well as the morbidity

of poor adherence and the benefits of strict adherence to asthma medication, may improve the adherence rates to asthma medication as well as the severity of asthma.

Fuad Alrowaishdi is the consultant in Allergy and Immunology (Adult-Pediatrics) field of medicine. He is also the consultant Pediatric Pulmonology and Bronchoscopy. He is fellow member of American Academy of Asthma Allergy and Immunology. He serves as member of several organizations like European Academy of Allergy and Clinical Immunology, European Respiratory Society, French Allergy Pulmonology Society and World Allergy Organization.

This lecture intended for doctors involved in allergy of anesthesia consultations (eg anaesthetists, allergists, dermatologists, pediatricians and pulmonologists). The goal is to comply with the recommendations for clinical practice, update knowledge and practices in the prevention of anesthesia allergic risk.

The main themes addressed during the topic:

• The epidemiology of these reactions

• The anesthetic agents involved

• People at risk

• The clinical presentation of these reactions, their consequences

• Diagnostic methods: skin tests, biological tests

• The organization of an allergy of anesthesia consultation

• Preventive measures

The reality of allergic risk in anesthesia is confirmed by the publications in English and French of more cases of anaphylactoid reactions during the last 15 years, about 60% are IgE-dependent immunological origin .the anaphylactoid reaction represents 9 to 19% of the complications of anesthesia .The mortality is 5 to 7% .The incidence of the anaphylactic reaction was evaluated in

France, in 1996, at 1 / general and loco-regional anesthesia, all responsible substances combined. The incidence of anaphylaxis in the patients was 1/6 500 anesthesia with curare .The curare represents 62% of them, the latex 16.5%, the hypnotics 7.4%, the antibiotics 4.7%, the substitutes of the plasma 3.6%, the opioids 1.9%. Allergy to local anesthetics appears exceptional (0.7%).

No anaphylactic reactions have been published with halogenated anesthetics.The curares most involved were: rocuronium, suxamethonium, atracurium and vecuronium .The clinical manifestations are more serious in an immunological reaction than in a pharmacological reaction. The clinical signs are not always complete. In 17 to 30% of the cases of anaphylactic reactions to the curares, there was no preliminary contact with molecules. The situation is often aggravated by the existence of an underlying cardiac pathology or by the use of certain drugs such as beta-blockers. The treatment of allergic reactions during anesthesia should not be designed in a rigid pattern.

Naren Pandey is an allergist from Kolkata, West Bengal, India. He is the general secretary of Indian Primary Respiratory Care & Allergy Foundation. He serves as an international affiliate member at American College of Allergy Asthma & Clinical Immunology, life member at Indian Academy of Allergy and also member of European Academy of Allergy & Clinical Immunology; He is also the fellow of royal society of tropical medicine & hygiene and an associate member of International Primary Respiratory Care Group.

Introduction: Sub Lingual Immunotherapy (SLIT) Rush immunotherapy was tried on some patients to evolve some faster and affordable immunotherapy modality to make the patient achieve the maintenance plateau within a very short time. Conventional method of immunotherapy is administered with long durations, rush immunotherapy is super-fast methodology in attaining the maintenance/boosting module, which requires hospitalization and other precautionary methods and multiple allergen vaccines to be administered within short span of time. But in this method, it was found that within 15-20 days the relief of the immunotherapy was reached. Nasal ointment reduces allergic rhinitis symptoms.

Material & Method: 186 patients out of which 48 with urticaria allergy and 138 with allergic rhinitis & bronchial asthma were selected. The therapy consists of administration of four vials of mixed allergen extracts of Pollens HDM and insects, 1st vial: 1:25.00, 2nd vial 1:2.5, 3rd vial 1:25, and 4th vial 1:10 dil. The 1st & the 2nd concentrations were administered in daily 6

hourly schedules in a graphically rising manner. The patients had been given pre-medication. Blood examination and IgG & IgE level estimation were done before & after 8 weeks. The Allergen extracts were procured from All Cure Pharma Pvt.Ltd, Bahadurgarh,Harayana, of Allergens of Herbal base . All the patients gave informed written consent for inclusion.

Results & Conclusion: Some of the patients showed local skin reactions and few with lightheadedness /vasovagal type of symptoms which subsided without drugs and no systemic reaction was noted in addition 3rd generation anti histamines were added in the initial phase for 3 weeks. There was substantial decrease in IgE & increased IgG level, significant & marked

satisfactory relief was observed in the patients symptomatology, thus the procedure was graded as a very fast & affordable & SAFE with Mixed allergen extracts of Pollens HDM and insect’s immunotherapy.

Nuha Nuwayri Salti worked as a professor at the Department of Human Morphology at the American University of Beirut, Beirut, Lebanon. Currently she serves as research associate at the Chronic Care Centre, Hazmiyeh, Lebanon.

White blood cells (WBC) are the major cells that defend the body against aggression from the environment. Their function is to recognize and differentiate self from foreign tissues and agents. Most cases with immune deficiency are due to defective leucocyte function. This may be either intrinsic to the cells such as a very low production of WBC surface receptors to chemoattractants, or extrinsic to these cells such as abnormal production of chemo-attractants by the injured tissues. These and similar defects may be inborn or acquired. In addition, poor performance of WBC may be secondary to paralysis, or early destruction, of these cells by foreign material (inert or live) that may invade and hinder their proper function and/or shorten

their life span. In circulation, WBC exists in low numbers. From the marginating pool, all types of WBC leave the blood and lymphatic vessels to infiltrate organs policing their cells. The most important exception to this surveillance is the brain which has its own defense cell type (microglia). To obtain WBC pure and in high numbers we collect them on slides using “Skin

Window” (SW), which yields both groups, granulocytes and agranulocytes, each on a separate slide. On the slides these cells can be subjected to a large variety of manipulations.

Objective: This study reports a review of patients records for over thirty years. They were referred to our laboratory for confirmation and determination of the cause of suspected immune deficiency. We carried out advanced studies testing their immune cells morphology and function. Skin Window was the test most frequently used. It is practical, inexpensive and easy to apply. Very often SW revealed the diagnosis and the patients once treated were normal again. In this presentation we recommend its use especially that not only it is simple to perform, but also at a low cost and can be applied in field studies

distant from any laboratory.

Methods: Skin Window consists of collecting each of the granulocytes and agranulocytes on sterile slides or cover slips that overlay an abraded small area within the epidermis. The leucocytes migrate to the injured surface where they adhere to the slide/cover slip. Harvested, live and in action, the leukocytes are tested for the suspected defect in the patient. Using any of several histologic techniques, including immunochemical, and fluorescent dies, each of the different cell types are studied. Since live, the cells can be set up in cultures, especially when suspected to carry live organisms.

Results: In the majority of these patients, SW revealed the problem and the patient when accordingly treated, recovered totally. In a very small minority of patients the problem could only be resolved using molecular studies. The remaining (0.3%) were not diagnosed in our laboratory.

Conclusion: SW is a very simple technique to collect live pure leucocytes in high enough numbers to facilitate studying and testing their morphology and function. SW testing in most of our patients lead to specific diagnosis which when treated resulted in the patients regaining normal functioning of the immune system.

Zoe Williams is a parent of 2 children with different food allergies and intolerances. Her youngest daughter, now aged 4 and a half, was clinically diagnosed with 6 food allergies as a baby. She is an advocate for parents of children with food allergies and food allergy sufferers. She is a food allergy blogger at www.myallergykitchen.com where she shares allergy-friendly recipes, tips and advice to help others. She is in contact with other parents of children with food allergies and food allergy sufferers on a daily basis through her blog and social media accounts.

Food allergies in babies are underdiagnosed. The purpose of this video presentation is to describe my experience of seeking help as a parent of a baby with food allergies. My daughter had 6 food allergies, some of which were present from birth and some which were not evident until she started on solid foods. She was exclusively breastfed until 6 months and we identified that she had cow’s milk protein allergy at just 4 weeks old with the help of a breastfeeding peer supporter. It took until 14 months of age to get a formal diagnosis of all of her allergies. During this time, we saw several GPs and a pediatrician. None of them recognized the signs of food allergies in babies, despite the fact that she already had an existing food allergy. As a result, I had to undertake an exclusion diet without medical support in order to resolve her symptoms. It was only after doing this that she was referred to a pediatrician and dietician for proper diagnosis and support. This was a very stressful time for the whole family. We were caring for our sick baby whilst also looking after our older daughter. We had very little sleep as our baby frequently suffered with stomach pains in the night. This had an impact on our mental health. It was very demoralizing to ask for help from medical professionals and be turned away. We did not know why our baby was suffering. We had to focus

our efforts on managing her symptoms. If her allergies had been identified sooner, we could have eliminated her suffering immediately. Front line health professionals do not always recognize the signs of food allergies in babies. This makes it difficult for parents to access care and support.

Vasyl Y Velykyi is the Junior Researcher from Ukraine. He had made first steps in scientific from second year of study in Tars Shevchenko National University of

Ukraine. The global world problem as breast cancer had been interested him. Especially his attention concentrated on problem of diagnostic mechanisms on the early stages of disease and preventing measures for safety women health.

The risk of the development of breast cancer is a significant issue in modern medicine practice, especially in diagnostics and determination of the treatment strategy. More than 1.3 million patients suffer from cancer diseases, for instance, more than 508,000 women in the world have lost their lives due to breast cancer in 2011. The majority of issues regarding breast cancer treatment would be resolved using new immunological methods of diagnostics and immunotherapy. This study combined immunology and glycobiology to reveal new data that could be used for the construction of the novel test-system for the indication of the immune response upon the breast cancer progression. The purpose of this study was isolation, purification and characterization of lectins from albumen gland and mucus of H. pomatia, investigation their potential for the creation of an anticancer vaccine or a test system for monitoring or prognostication of the efficacy of the anticancer chemo and/or immunotherapy. For the isolation of the lectins from albumen gland homogenate and mucus we used salting out. ELISA was used for the detection of cross-reactivity of antibodies from serum of rats with transplanted Walker carcinosarcoma and also we used serum of patients with breast cancer of I-IV stages for the detection of antitumor antibodies with cross-reactivity with lectin. Western-blot with serum antibodies, which showed high cross-reactivity was used for the identification of the protein fraction which had demonstrated high cross-reactivity by ELISA results. The cross-reactive protein fraction was purified by chromatography and characterized by using MALDI-TOF. Lectins represent a huge group of proteins and glycoproteins which are able to selectively bind to glycans and glycan's determinants on biopolymers. Almost all groups of organisms contain lectins in different organs and tissues that represent a high potential for cancer diagnostics and for proper anticancer therapy construction. Malignization is known to promote the high level of cancer cells’ proteins glycosilation. This increases the amount of untypical glycans on the surface of tumor cells which facilitates intercellular interaction, migration and adhesion. Different types of lectins are used as markers for screening different tumor processes for development of new therapies for oncological pathologies treatment and for the construction of anticancer vaccines. For example, agglutinin (lectin) of Helix pomatia is used for the prediction of breast cancer metastasis. It was shown experimentally that high index of binding of lectins to the tumor cell glycocalix is associated with a high risk of metastasis and the unfavorable prognosis. We isolated and characterized protein from albumen gland and mucus of Helix pomatia which showed cross-reactivity with serum antibodies of experimental animals with transplanted Walker carcinosarcoma and also observed cross-reactivity of antibodies of patients with breast cancer of I-IV stages. The titer of antibodies from serum of experimental animals and patients, which showed cross-reactivity with isolated proteins, correlated with tumor stages and the reaction for antitumor therapy. Proteins of H.pomatia could be used for the development of perspective test system for monitoring or prognostication of the efficacy of anticancer chemoand/or immunotherapy.