Background: The purpose of this study was to compare the antigenicity of Bonlact^® i (BL) with that of defatted soy protein (SP) and soy protein isolate (SPI), which is the original source of BL, using sera from patients with soybean allergy.

Methods: Proteins were extracted from SP, SPI, and BL using PBS. Proteins in each sample were analyzed for antigenicity using inhibition ELISA with SP-specific IgE (sIgE), SDS-PAGE, and immunoblotting. Sere from patients with soybean allergy confirmed by an oral food challenge (OFC) (n=6, OFC⁺ Pt), and from patients who were positive for soy-sIgE without symptoms ( n = 7, sIgE⁺ Pt) were used for these assays. The cross-antigenicity of SP and BL with cow's milk (CM) proteins was also analyzed in the sera from patients with CM allergy using inhibition ELISA.

Results: SDS-PAGE showed that the proteins in BL produced a smear-like band in the low-molecular-weight region compared with that in SP and SPI. Inhibition ELISA against SP-sIgE showed that BL had a significantly lower inhibition rate than that of SP in both OFC⁺ Pt and sIgE⁺ Pt. Immunoblotting analysis showed that the bands of BL were thinner than those of SP and SPI. Additionally, SP and BL showed no cross-antigenicity with CM proteins.

Conclusion: The proteins in BL was partially digested, and its antigenicity was lower than that of SP and SPI.

Background: Sublingual immunotherapy (SLIT) has become applicable to insurance for children in Japan in 2018. However, as for the efficacy of SLIT for children, objective evaluation methods have not been sufficiently investigated.

Subjects and Methods: We investigated the efficacy of SLIT as both subjective and objective evaluation in 44 children with allergic rhinitis sensitized to house dust mite who started the treatment in the summer of 2018 in our hospital. The children and their patients wrote the allergy diary every day, and in winter/spring/summer vacations, they answered Japanese allergic rhinitis quality of life standard questionnaire and were evaluated with nasal provocation test, blood test, rhinomanometry for 3 years.

Results: 29 (66%) of the 44 children continued SLIT for 3 years. Symptom scores, QOL scores, symptom medication scores halved in a year and the effect lasted in the second and third year. Nasal provocation test and rhinomanometry showed significant improvement. Specific IgE increased transiently and then decreased. Specific IgG₄ increased annually.

Conclusion: The present study showed a decrease in scores not only for subjective assessments but also for objective evaluation methods, the house dust nasal provocation test and the nasal airway resistance.

A 69-year-old woman who had been treated with Otsu-ji-to for fourteen days developed liver dysfunction. She continued to take Otsu-ji-to and was admitted to our hospital due to respiratory failure with extensive ground-glass opacities on chest computed tomography 22 days after starting to take Otsuji-to. Although she developed severe respiratory failure, her condition was improved by discontinuation of Otsu-ji-to and high-dose corticosteroid pulse therapy. The lymphocyte stimulation test was positive for Otsu-ji-to. Finally, we diagnosed drug-induced lung injury due to Otsu-ji-to. As in this case, severe herbal medicine-induced lung injury may be developed secondary to preceding liver injury. When a patient prescribed ou-gon-containing herbal medicines such as Otsu-ji-to develops liver dysfunction, due to herbal medicines containing ou-gon such as Otsu-ji-to, it is important to evaluate lung injury and discontinue the Kampo drug.