The effect of azithromycin(AZM) administration on childhood asthma was studied. 40 children with asthma were randomized to one of two groups; AZM treatment group (10mg/kg/day AZM for three days: n=21) or no treatment group (n=19). Their symptom and treatment scores for asthma were evaluated. The diagnosis of Chlamydia pneumoniae was made by single IgM antibody titer ID≥1.00, positive culture or positive PCR. C. pneumoniae infection was confirmed in 68% of AZM treatment group and in 41% of no treatment group without significant difference.
Asthma symptom scores in AZM treatment group were improved three months after the treatment significantly. In no treatment group, symptom scores were not improved. There was no significant difference in asthma treatment scores throughout the study period in two groups. However, in treatment group, symptom scores decreased significantly not only in 12 cases with confirmed C. pneumoniae infection (one month later), but also in 7 cases without definite C. pneumoniae infection (one month and three months later).
These results conclude that azithromycin administration for children with asthma decreases symptom scores by controlling C. pneumoniae infection or other infections.

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It is uncertain what level of immunofunction is needed for safe vaccinations. There is no definite guideline regarding this issue. Therefore, we inoculated 3 partial DiGeorge syndrome patients and 2 transient hypogammaglobulinemia of infancy patients; they were vaccinated with BCG vaccine (4 times), polio vaccine (3 times), measles vaccine (3 times), rubella vaccine (3 times) and diphtheria-purified pertussis-tetanus vaccine (15 times) in order to assist making the guideline for vaccinations to immunocompromised patients. The lowest level of CD3 positive T cells before the vaccinations was 49% in the case of measles/rubella vaccine, 47% in the case of BCG/polio vaccine and 33% in the case of diphtheria-purified pertussis-tetanus vaccine. In addition, the lowest level of CD4 positive T cells before the vaccinations was 29% in the case of measles/rubella vaccine, 25% in the case of BCG/polio vaccine and 18% in the case of diphtheria-purified pertussis-tetanus vaccine. Because no severe side effects were recognized after these vaccinations, it suggests safe to vaccinate the immunocompromised patients who keep the above mentioned levels of CD3 positive T cells and CD4 positive T cells.

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We studied to clarify the adverse reactions to influenza vaccine administration and the preventive effect of ketotifen in 162 patients with allergic disorders and 47 controls. As a result, there was no significant difference in incidence of immediate adverse effects to influenza vaccine administration between the allergic group (17%) and control (20%). Late effects were observed in both two groups (11%, respectively). The incidence of immediate and late reactions linearly increased with frequency of administration of the vaccine. Administration of ketotifen decreased immediate and late adverse reactions to influenza vaccine.

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The percentage of vaccinated children in a population of 931 three-year-olds was calculated by means of a questionnaire distributed in health centers in Edogawa Ward, Tokyo. The children were divided into two groups according to the presence or absence of allergic disease, and the percentage of vaccine-inoculated subjects and the incidence of side effects were investigated in each group. Vaccination rates were not different between the allergic and non-allergic groups, but the incidence of side effects to DPT vaccine was higher in allergic children than that in the non-allergic group.
We suggested that to reduce or prevent side effects in vaccination of allergic children, improved vaccines should be developed, and then vaccination rate should be increased among the population.

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As a consequence of the general increase in allergic sensitization, the prevalence of hypersensitivity reactions to multiple foods has become a significant clinical problem in these days. It was explained that the shared homologous proteins in foods caused these cross reactions. The frequency of clinical allergy caused by cross-reacting proteins and panallergens appear to be increasing and resulted in the increases of allergic diseases and allergen sensitization.
Recently, the rate of fish, shellfish, and fish roe allergy is increasing in even Japanese children. To determine the risk of reaction to related foods, clinical evaluations such as a careful history taking, laboratory evaluation, and oral food challenges are indispensable. The evaluation of food allergens is limited by high false-positive rate of CAP-RAST^® scores and skin test results, and they are complicated by cross-reactive proteins.
In this report we evaluated specific IgE antibody against hen's egg white, fish, shellfish, and fish roe in 79 children suspected of food allergy. And we found that positive rate of CAP-RAST^® scores between egg white and fish roe, and between fish and its fish roe were not correlative (p>0.05). The IgE antibodies against fish, shell fish, and fish roe detected by CAP-RAST^® appeared to have relatively low specificity. Therefore, it was difficult to predict allergic reactions against these foods by the data of CAP-RAST^® scores. Positive results with skin test or CAP-RAST^® need to be confirmed by diet elimination and/or oral challenges except for the severe cases. Careful diagnosis is recommended for avoiding malnutrition caused by an unnecessary dietary restriction.

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