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World Allergy Organization Journal 2016, Volume 9 Suppl 1 A407 Immune-Modulatory Genomic Properties Differentiate Gut Microbiotas of Infants with and without Eczema Gaik Chin Yap4, Wen Tso Liu1, Seungdae Oh1, Pei Ying Hong2, Chiung Hui Huang3,4, Marion Aw3,4, Lynette Shek3,4, Bee Wah Lee3,4 1 University of Illinois at Urbana-Champaign, USA; 2King Abdullah University of Science and Technology, Saudi Arabia; 3National University Health System, Singapore; 4National University of Singapore, Singapore Correspondence: Gaik Chin Yap – National University Health System, Singapore World Allergy Organization Journal 2016, 9(Suppl 1):A407 Background: The gastrointestinal tract is the primary site of interaction between the host immune system and microorganisms. Studies have suggested that selective microbial targets may influence the development of the allergic diseases. But the difference in functional gene composition remains unknown. We aim to assess the structural and functional gene composition of stool microbiota of infants with eczema and their matched (for age, gender, mode of delivery, feeding) controls at the age of 1 month. Methods: Twelve children with eczema and their controls were selected from the placebo arm of a birth cohort of at-risk infants participating in a randomized double-blind trial on the protective effects of supplemental probiotics in early life on allergic outcomes. The four were caesarean delivery followed by formula feeding (eczema = 2 and healthy control = 2) and the eight were vaginal delivery followed by partial breast feeding mixed with formula feeding (eczema = 4 and healthy control = 4). Bacterial genomic DNA were extracted from fecal samples and prepared for Illumina Miseq and Hiseq sequencing. Data analysis such as sequence quality check, contigs assembly and gene annotation were carried out for the DNA sequences obtained from Miseq and Hiseq sequencing. Results: Phylogenetic analysis of metagenomic sequences revealed that four phyla dominated both microbial communities: Proteobacteria (54% and 63% for healthy and eczema communities, respectively), Firmicutes (26% and 18%), Actinobacteria (13% and 8%), Bacteroidetes (7% and 8%). Comparative metagenomic analysis showed that immune-regulatory TCAAGCTTGA motifs were significantly enriched in healthy communities, many of which were encoded by Bifidobacterium (38% of the total motifs in the healthy communities). Draft genomes of five Bifidobacterium species (B. longum, B. bifidum, B. breve, B. dentium, and B. pseudocatenulatum ) were recovered from metagenomic datasets. The B. longum BFN-1212 genome encoded more TCAAGCTTGA motifs (4.2 copies per 1 million genome sequence) than other Bifidobacterium genomes and was significantly overrepresented (P < 0.05) in the healthy communities. Conclusions: Our results report distinct immune-modulatory genomic properties of gut microbiotas in healthy infants as compared to children with eczema and provide new insights into potential roles of gut microbiotas in affecting human immune homeostasis. A408 The Effect of Medication in OSA Patients with Allergic Rhinitis Young Seok Byun1, Sung Wan Kim1, Tae Kyung Koh1, Joong-Saeng Jo1, Kun Hee Lee2, Chul Kwon1, Sung-Hwa Dong1 1 Kyung Hee Medical Center, South Korea; 2Kyung Hee University Hospital at Gangdong Correspondence: Young Seok Byun – Kyung Hee Medical Center, South Korea World Allergy Organization Journal 2016, 9(Suppl 1):A408 Objective Allergic rhinitis occurs at 10-40% in the world’s population and it cause runny nose, sneezing, itching and qualitative degraded sleep disorder which are causing the failure of social life. Allergic rhinitis can be associated with patient of obstructive sleep apnea. The aim of this study was to investigate the impact of allergic rhinitis on obstructive sleep apnea and the change of the symptoms of obstructive sleep apnea after allergic rhinitis treatment. Page 126 of 206 Method We examined patients who diagnosed with obstructive sleep apnea using polysomnography in our sleep clinic. All the patient was examined by allergy skin testing and diagnosed with allergic rhinitis. Patients were group of OSA with AR. We did Allergic rhinitis medical treatment for 2 weeks before OSA treatment. We did the survey of Visual analogue scale, Epworth Sleepiness Scale, Chalder Fatigue Scale, Daily Hassles Scale, Conner-Davidson Resilience Scale, Rhinoconjunctivitis Quality of Life Questionnaire before and after Allergic rhinitis treatment. Results OSA-AR group was 14 pateints. Age ranged from 17 to 66 years old and mean age 27. prior treatment, OSA-AR group score was less than average in VAS(sleep time, wake time), ESS, CFS, DHS, CD-RISC, RQLQ examination and TNSS, which associated with rhinitis in RQLQ, showed less than average except nasal obstruction in OSA-AR. VAS (sleep time, wake time) and RQLQ in patients who underwent 2weeks medical treatment showed statistically significant difference after treatment. (sleep time P = 0.001, wake time P = 0.000, RQLQ P=.011) The average scores of ESS, CFS, DHS, CD-RISC, RQLQ, TNSS was lower but no significant difference after treatment than before treatment. Conclusion We could find out Allergic rhinitis treatment contributes to improve subjective symptoms and QOL of patients in OSA-AR treatment patients. But considering lower number of subject, further investigation should be performed. A409 A Case of Generalized Pustular Psoriasis Mimicking Acute Generalized Exanthematous Pustulosis Myung Shin Kim1, Chansun Park2 1 Soonchunhyang University Gumi Hospital South Korea; 2Haeundae Paik Hospital, Inje University College of Medicine Correspondence: Myung Shin Kim – Soonchunhyang University Gumi Hospital, South Korea World Allergy Organization Journal 2016, 9(Suppl 1):A409 Differentiating between acute generalized exanthematous pustulosis (AGEP) and generalized pustular psoriasis (GPP) can be extremely difficult, as both present as erythematous pustular eruptions. A 60-yearold woman presented at the emergency department with generalized erythematous pustular eruption, generalized edema and fever. She had treated with drug eruption by herbal remedy in dermatologic department for 3 weeks. One week before visiting ED, she received dapsone and zaltoprofen from another hospital. Body temperature measured as 38.7 °C. Blood neutrophil was 85.3 % of total leukocytes. Based on the clinical and laboratory findings, she was diagnosed as AGEP by dapsone or NSAIDs. All the medications were discontinued. After treatment with systemic steroid for 3 days, fever and skin lesions were improving. However, new pustular lesions were developing immediately after the dose reduction of steroid and rapidly aggravated. The results of skin biopsy were compatible with GPP rather than AGEP. Acitretin was started and steroid was slowly tapered. The pustular lesion and scaling had improved. We report a patient with a pustular eruption initially diagnosed as AGEP, with the diagnosis changed to GPP. This case highlights the importance of differential diagnoses in order to treat the condition appropriately. A410 Anaphylaxis Caused By Gummy Jelly Ingestion: A Case Report Han Seok Cho, Min-Ju Kim, Min Ji Kim, Young Ok Park, Hye Yeong Lee, Hee Seong Kim, Eun Lee, Hyun-Ju Cho, Jinho Yu, Soo-Jong Hong, Keum Hee Hwang Asan Medical Center, South Korea Correspondence: Han Seok Cho – Asan Medical Center, South Korea World Allergy Organization Journal 2016, 9(Suppl 1):A410 Gelatin allergy has been well described in type 1 hypersensitivity reactions to vaccines, but only a few case reports have been published about anaphylaxis associated with food.