<p>It has been suggested that environmental factors substantially contribute to the increased prevalence of peanut allergy in industrialized countries. Specifically, the role of disrupted barrier integrity in the gastrointestinal tract has been implicated in the development of food allergy. The use of non-steroidal anti-inflammatory drugs (NSAIDs), which increase intestinal permeability, for the treatment of pain and fever is prevalent in industrialized countries. Therefore, the first aim of this study was to determine whether treatment with indomethacin, a prototypical NSAID, would act in an adjuvant like manner to facilitate sensitization to co-administered peanut protein. Furthermore, we investigated whether indomethacin increases susceptibility to anaphylaxis following oral challenge with peanut in sensitized mice.</p> <p>First, a short model of cholera toxin-mediated sensitization to peanut was developed. Mice were given 1 mg of peanut protein and 5 μg of cholera toxin by oral gavage for 10 consecutive days. This resulted in a robust anaphylactic response and increased peanut-specific IgG1, but not IgE, two weeks following treatment. Mice exposed to peanut during a 10-day treatment with indomethacin (5 mg/kg on alternating days or 3.5 mg/kg daily) did not develop peanut-specific immunoglobulins or anaphylaxis following systemic challenge with peanut protein. Furthermore, treatment with two 5 mg/kg doses of indomethacin 24 and 1 hour before oral challenge did not facilitate anaphylaxis in peanut-sensitized mice. Therefore, we concluded that NSAID treatment is unlikely to play a role in the increased prevalence of peanut allergy, and that NSAID treatment does not increase susceptibility to peanut-induced anaphylaxis in sensitized mice.</p> <p>The second part of this study aimed to develop a short model of epicutaneous sensitization, and address the impact of epicutaneous exposure to peanut during infancy. We investigated the role of site of exposure, duration of exposure, epidermal integrity, strain and age in epicutaneous sensitization. 10 consecutive days of epicutaneous exposure to 20 μg of peanut protein through tape stripped skin induced robust anaphylaxis following i.p. challenge. Neither 7 days of exposure through tape stripped skin, nor 10 days of exposure through intact skin facilitated sensitization. The strength of sensitization was strain-dependent; peanut-specific IgG1 was increased equally in both C57BL/6, and BALB/c mice, and to a greater extent in C3H/HeJ mice. Peanut-specific IgE was increased in both BALB/c and C3H/HeJ mice three weeks following peanut exposure. Epicutaneous exposure beginning one day after birth did not facilitate the development of either peanut-specific IgE or IgG1 in BALB/c mice, or anaphylaxis following systemic challenge. Beginning exposure at 2 weeks of age resulted in peanut-specific IgE and IgG1 production, as well as a robust anaphylaxis following i.p. challenge. Therefore, the development of peanut allergy through epicutaneous exposure is age dependent, and exposure during the neonatal period results in a hyporesponsive response.</p> / Master of Science (MSc)

<p><strong>Inledning: </strong>Epikutantester används för utredning av kontaktallergier. Det görs ca 3000 tester varje år i Sverige som överförs till ett kvalitetsregister. <strong> </strong>Målet med projektet var att utveckla en webbapplikation och en underliggande databas för hantering och lagring av ett nationellt kvalitetsregister för epikutantester (The Swedish Patch Register). Databasen skall lagras på en central server lokaliserad på Universitetssjukhuset, Örebro.</p><p><strong>Metoder:</strong> Lösningen blev en applikation för webbläsare programmerad i språket C# med hjälp av Microsoft Visual Studio 2008 och ramverket ASP.NET 3.5. MySQL .NET connector tool 6.2.2 möjliggjorde anslutningen mellan ASP.NET och databasen. Databasen skapades på MySQL Server 5.1, en databasserver med öppen källkod. Driftsättning av webbapplikationen testades med IIS 7.</p><p><strong>Resultat: </strong>En webbapplikation, med en design liknande Örebro Läns Landsting webbplats och med följande funktionalitet skapades: Säker inloggning (https, SSL-certifikat), registrera testresultat, hantera användarkonton och behörigheter, skapa standardtester och lägga till nya ämnen för allergitestning, och en hjälpsida. Inmatningen av data standardiserades genom användning av kalenderkomponenten och DropDownLists med förvalda svar för testreaktioner, bedömning, relevans och ett fördefinierat standardtestsystem, för att minska antalet möjliga felkällor. Databasen inkluderar åtta tabeller och informationen har företrädesvis lagrats som heltalsvärden för att förenkla framtida statistiska beräkningar.</p><p><strong>Diskussion: </strong>I brist på licens för Microsoft SQL Server 2008 utvecklades projektet med hjälp av en lösning med öppen källkod som fungerar bra i utvecklingsmiljön. En lösning kopplad till en Microsoft SQL Server 2008 kräver en viss anpassning av källkoden.</p> / <p><strong>Introduction: </strong>Epicutaneous patch testing is used to evaluate contact allergies. Every year approximately<strong> </strong>3000 tests are performed in Sweden and the results are entered in a quality registry. The<strong> </strong>aim of the project was to develop a web application and a corresponding database for managing and storage of a national dermatologic quality registry (The Swedish Patch Test Register). The database will be located on a central server at the University hospital, Örebro.</p><p><strong>Methods:</strong> The solution required programming of an application for web browsers in the language C# with the help of Microsoft Visual Studio 2008 and the web framework ASP.NET 3.5. The .NET connector tool 6.2.2 enabled the connection between ASP.NET and the database created on the open source database server MySQL Server 5.1. Web server hosting was tested with IIS 7.</p><p><strong>Results: </strong>A web application in a design equivalent to the Örebro Läns Landsting web site and with the following functionalities was created: Secure Login (https, SSL-certificate), recording of test results, managing of user accounts and eligibility, creating test series and adding new substances for allergic skin testing respectively, and a help page. The input of data was standardised by means of the calendar component and DropDownLists with pre-selected answers for test reactions, evaluation, relevance of test results and a predefined standard test system in order to reduce possible handling errors. The database includes eight tables and information is preferably stored as integer values to facilitate future statistical calculation.'</p><p><strong>Discussion: </strong>Due to a lack of license for Microsoft SQL server 2008, the project was accomplished by means of an open source solution, and has full functionality in the corresponding environment. A solution in a Microsoft SQL server 2008 environment requires certain adapting of the source code.</p>

Inledning: Epikutantester används för utredning av kontaktallergier. Det görs ca 3000 tester varje år i Sverige som överförs till ett kvalitetsregister.  Målet med projektet var att utveckla en webbapplikation och en underliggande databas för hantering och lagring av ett nationellt kvalitetsregister för epikutantester (The Swedish Patch Register). Databasen skall lagras på en central server lokaliserad på Universitetssjukhuset, Örebro. Metoder: Lösningen blev en applikation för webbläsare programmerad i språket C# med hjälp av Microsoft Visual Studio 2008 och ramverket ASP.NET 3.5. MySQL .NET connector tool 6.2.2 möjliggjorde anslutningen mellan ASP.NET och databasen. Databasen skapades på MySQL Server 5.1, en databasserver med öppen källkod. Driftsättning av webbapplikationen testades med IIS 7. Resultat: En webbapplikation, med en design liknande Örebro Läns Landsting webbplats och med följande funktionalitet skapades: Säker inloggning (https, SSL-certifikat), registrera testresultat, hantera användarkonton och behörigheter, skapa standardtester och lägga till nya ämnen för allergitestning, och en hjälpsida. Inmatningen av data standardiserades genom användning av kalenderkomponenten och DropDownLists med förvalda svar för testreaktioner, bedömning, relevans och ett fördefinierat standardtestsystem, för att minska antalet möjliga felkällor. Databasen inkluderar åtta tabeller och informationen har företrädesvis lagrats som heltalsvärden för att förenkla framtida statistiska beräkningar. Diskussion: I brist på licens för Microsoft SQL Server 2008 utvecklades projektet med hjälp av en lösning med öppen källkod som fungerar bra i utvecklingsmiljön. En lösning kopplad till en Microsoft SQL Server 2008 kräver en viss anpassning av källkoden. / Introduction: Epicutaneous patch testing is used to evaluate contact allergies. Every year approximately 3000 tests are performed in Sweden and the results are entered in a quality registry. The aim of the project was to develop a web application and a corresponding database for managing and storage of a national dermatologic quality registry (The Swedish Patch Test Register). The database will be located on a central server at the University hospital, Örebro. Methods: The solution required programming of an application for web browsers in the language C# with the help of Microsoft Visual Studio 2008 and the web framework ASP.NET 3.5. The .NET connector tool 6.2.2 enabled the connection between ASP.NET and the database created on the open source database server MySQL Server 5.1. Web server hosting was tested with IIS 7. Results: A web application in a design equivalent to the Örebro Läns Landsting web site and with the following functionalities was created: Secure Login (https, SSL-certificate), recording of test results, managing of user accounts and eligibility, creating test series and adding new substances for allergic skin testing respectively, and a help page. The input of data was standardised by means of the calendar component and DropDownLists with pre-selected answers for test reactions, evaluation, relevance of test results and a predefined standard test system in order to reduce possible handling errors. The database includes eight tables and information is preferably stored as integer values to facilitate future statistical calculation.' Discussion: Due to a lack of license for Microsoft SQL server 2008, the project was accomplished by means of an open source solution, and has full functionality in the corresponding environment. A solution in a Microsoft SQL server 2008 environment requires certain adapting of the source code.