bluuebunny/crossref_metadata_2025 huggingface dataset:
Wheat allergy: diagnostic accuracy of skin prick and patch tests and specific IgE
Authors: Majamaa H , Moisio P , Majamaa H , Turjanmaa K , Holm K
Published: March 2003

Background: Food allergy makes an important contribution to the pathogenesis of atopic eczema in infants. However, clinical data on cereal allergy are scanty. The objective was to study the relevance of patch testing, skin prick tests, and the concentration of wheat‐specific IgE antibodies (CAP RAST) in correlation with oral wheat challenge in infants with suspected wheat allergy. In particular, we aimed to determine whether the patch test could increase the diagnostic accuracy in detecting wheat allergy.

Methods: The study material comprised 39 infants under the age of 2 years. Of these patients, 36 were suffering from atopic eczema and three had only gastrointestinal symptoms. The patients were subjected to a double‐blind, placebo‐controlled or open wheat challenge. Wheat‐specific IgE was measured by CAP RAST, and skin prick and patch tests were performed.

Results: Of the total 39 wheat challenges, 22 (56%) were positive. Of the positive reactions, five involved immediate‐type skin reactions over a period of 2 h from the commencement of the challenge. In 17 patients, delayed‐onset reactions of eczematous or gastrointestinal type appeared. Of the infants with challenge‐proven wheat allergy, 20% showed elevated IgE concentrations to wheat, 23% had a positive skin prick test, and 86% had a positive patch test for wheat. The specificities of CAP RAST, skin prick tests, and patch tests were 0.93, 1.00, and 0.35, respectively.

Conclusions: Our study demonstrated that patch testing with cereals will significantly increase the probability of early detection of cereal allergy in infants with atopic eczema and is helpful in the planning of successful elimination diets before challenge. The specificity of the patch test was lower than that of other tests. Therefore, confirmation of the diagnosis with the elimination‐challenge test is essential in patients with positive patch test results.
Risk factors associated with asthma and rhinoconjunctivitis among Swedish farmers
Authors: Kronqvist M. , Johansson E. , Johansson S.G.O. , Van Hage‐Hamsten M. , Kronqvist M. , Pershagen G.
Published: March 2003

Background: Earlier studies have shown a high prevalence of respiratory symptoms in farming communities and that storage mites constitute important allergens. We examined risk factors associated with asthma and rhinoconjunctivitis among Swedish farmers.

Methods: A population of 1015 small‐scale dairy farmers was part of an epidemiologic survey. After selection based on symptom reports in a questionnaire, 461 of the farmers attended a medical examination, which comprised SPT, RAST analyses, and lung‐function measurements. Risk factors for sensitization to different allergens, and development of asthma and rhinoconjunctivitis were assessed by multiple logistic regression.

Results: The prevalence of atopy was 26.7% among the farmers. For both asthma and rhinoconjunctivitis, sensitization to mites (OR=5.8 vs OR=3.8) and pollens (OR=10.3 vs OR=5.8) was a significant risk factor. There was a significant relationship between sensitization to mites and working time (OR=5.2). Environmental tobacco smoke and exposure to different animal species at the farm did not appear to affect the risk of allergen sensitization or respiratory symptoms. Farmers smoked less than the general population, but they more frequently had reduced FEV1.

Conclusions: Allergen sensitization, especially to mites and pollens, was significantly associated with asthma and rhinoconjunctivitis in a farming community. The results point to allergen avoidance as a major goal for the prevention of occupational respiratory diseases among the farming population.
Latex allergy: characterization of major allergens and isotypic expression
Authors: Chardin H , Mayer C , Desvaux Fx , Sénéchal H , Peltre G , Chardin H
Published: March 2003

Latex allergy is now known to be related to type I hypersensitivity. In latex products, several reports have identified at least 10 allergens. However, 56 polypeptides have been shown to react to IgE by two‐dimensional gel electrophoresis and immunoprints. All studies using immunoprints have analyzed a relatively small number of sera. The aim of the present study was to analyze the specificity and the isotypic expression of a wide sample of latex‐sensitive patients. Latex proteins were separated by SDS–PAGE in an 8–18% gel gradient, transferred onto a nitrocellulose sheet by Western blot, and revealed by serum from latex‐sensitive patients. The presence of IgE, IgA, IgG1, IgG2, IgG3, and IgG4 was analyzed for each of the 54 sera. The results showed Hev b 3 to be the most frequently recognized protein, followed by Hev b 1, Hev b 7, and molecules of 94 kDa and 6–8 kDa. The most common isotypic association was IgE‐IgG1, frequently with IgA. IgG4 was also present in a little less than half of the IgE‐positive sera. IgG3 was also expressed but frequently recognized nonallergenic molecules. IgG2 was present in only two cases. Thus, as several authors have proposed a protective role for IgG in the allergic reaction, it may be of interest to compare these results with the course of the disease.
IgG antibodies, chronic bronchitis, and pulmonary function values in farmer's lung patients and matched controls
Authors: Erkinjuntti‐Pekkanen R. , Kokkarinen J.I. , Tukiainen H.O. , Reiman M. , Terho E.O.
Published: March 2003

We measured IgG antibody levels against eight different microbes in farmer's lung (FL) patients an average of 14 years after the first diagnosed episode of FL and in matched controls. The study population consisted of 87 FL patients and 81 control farmers, matched by age, sex, and smoking habits. Clinical studies included the measurement of IgG antibody levels againstAbsidia corym‐bifera,Aspergillusumbrosus,A. fumigatus,Humicola grisea,Saccharopolyspora rectivirgula,Penicillium brevicompactum,Rhodotorula glutinis, andThermoactinomyces vulgaris, in addition to spirometry, pulmonary diffusing capacity (DLCO), and the evaluation of chronic bronchitis. Median IgG antibody levels were two or more times higher in FL patients than control farmers againstAb. corymbifera,S. rectivirgula, andT. vulgaris(P<0.001). AgainstA. fumigatus,H. grisea, andR. glutinis, FL patients also had significantly higher antibody levels. FL patients often had positive antibody titers against several microbes, whereas control farmers usually had a positive titer against one or two microbes. A positive association between IgG antibody levels and chronic bronchitis and DLCOwas observed in FL patients, but not in control farmers. It is suggested that the high antibody levels noted in FL patients were due not only to high exposure but also to individual sensitivity to environmental microbes.
Exposure to an abundance of cat (Fel d 1) and dog (Can f 1) allergens in Swedish farming households
Authors: Parvaneh S , Kronqvist M , Johansson E , Van Hage‐Hamsten M
Published: March 2003

Background: Earlier studies have shown that farmers are to a low degree sensitized to animal allergens. We have measured the amount of cat (Fel d 1) and dog (Can f 1) in farm households and examined the relationship between exposure and sensitization to cat and dog allergens.

Methods: Dust samples from the homes of 403 farmers who had participated in an epidemiologic follow‐up study on respiratory symptoms were analyzed for allergen content by two‐site ELISA methods.

Results: Fel d 1 was detected in 99.5% of the farmers' households ranging from 0.055 to 1455 μg/g dust in mattresses (GM 13.2) and to 3775 μg/g dust in living‐room carpets (GM 17.1). Can f 1 was detected in 90.6% of the households from 0.2 to 116 μg/g dust in mattresses (GM 2.0) and to 504 μg/g dust in carpets (GM 4.3). Homes with pets present had the highest levels of the allergens (P<0.001). A total of 8.4% and 7.4% of the farmers were sensitized to cat and dog, respectively. A significant correlation was noted between exposure to the allergens and specific IgE to cat and dog, respectively (P<0.001). Sensitization to cat (OR=4.9) and dog (OR=17.8) was significantly associated with asthma.

Conclusions: In spite of the abundance of Fel d 1 and Can f 1, farmers are only to a low degree sensitized to cats and dogs.
Cytokine profiles of BAL T cells and T‐cell clones obtained from human asthmatic airways after local allergen challenge
Authors: Bodey K.J. , Semper A.E. , Redington A.E. , Madden J. , Teran L.M. , Holgate S.T. , Frew A.J.
Published: March 2003

Background: This study assessed the heterogeneity of cytokine expression in asthma before and after local allergen challenge.

Methods: BAL T cells were obtained 10 min or 24 h after local endobronchial allergen challenge in atopic asthmatic subjects. T cells were cloned by direct limiting dilution. mRNA expression was assessed by RT‐PCR, and cytokine protein production by ELISA.

Results: Unstimulated baseline BAL T cells expressed mRNA for IFN‐γ, IL‐13, and TNF‐α. A minority of samples expressed IL‐4 and IL‐5, but no IL‐3 mRNA was detected. PHA stimulation increased expression of IL‐3, IL‐4, and IL‐5 mRNA in 4/6 samples. IL‐13 and GM‐CSF mRNA were found in BAL cells after allergen challenge, but expression of IFN‐γ was reduced. Both IL‐4 and IL‐3 were strongly upregulated after PHA stimulation, while the expression of TNF‐α and IFN‐γ was reduced, compared to equivalent baseline samples. Seventeen panels of BAL T‐cell clones were derived (average cloning efficiency 1/40 T cells). Seven panels survived to 8 weeks for analysis. Clones derived 4 h after saline challenge showed strong mRNA signals for IL‐13, IL‐4, and IFN‐γ, whereas clones derived 24 h after allergen challenge expressed IL‐13, GM‐CSF, IL‐3, IL‐4, and often IL‐5 (i.e., closer to the Th2 profile). There was considerable heterogeneity in the patterns of cytokine mRNA and protein production by different clones.

Conclusions: T cells from asthmatic airways produce IL‐13, IFN‐γ, and TNF‐α, but after allergen challenge, type 2 cytokines are upregulated. mRNA and protein analysis provide complementary information on airways T‐cell cytokine profiles.

Abbreviations: BAL: bronchoalveolar lavage; FEV1: forced expiratory volume in 1 s; IFN: interferon; IL: interleukin; PBMC: peripheral blood mononuclear cells; PBS: phosphate‐buffered saline; PC: cumulative provocative concentration producing 20% fall in FEV1; PE: phycoerythrin; Per‐CP: peridin chlorophyll‐protein conjugate; PHA: phytohaemagglutinin; TNF: tumour necrosis factor.
Allergic disease in teenagers in relation to urban or rural residence at various stages of childhood
Authors: Nilsson L , Castor O , Kjellman N‐im , Löfman O , Magnusson A
Published: March 2003

Background: Higher prevalences of allergic diseases and IgE antibodies to inhalant allergens have been reported for persons living in urban areas than for persons living in rural areas.

Methods: Associations between cumulative incidences of allergic diseases in 1878 children aged 13–14 years and their place of residence (urban, semiurban, or rural) from birth were assessed by questionnaire (ISAAC), in order to find out whether there is a period of increased sensitivity to external influences during the first few years of life. Family history and exposure to pets, tobacco smoke, and damp were considered in multiple regression.

Results: There was a significantly higher prevalence of allergic diseases with urban residence than with rural residence during the first 2 years of life (e.g., for bronchial asthma, relative risk (RR) for the first year 2.1, 95% CI 1.2–3.7). An increased risk was still found after multiple regression (RR=1.7). Semiurban residence was associated with an intermediate cumulative incidence of allergic diseases. Maternal smoking during pregnancy was associated with asthma (RR=1.4, 95% CI 1.0–2.0).

Conclusions: The findings support a period of increased susceptibility during the first years of life. Whether rural lifestyle protects against allergy or whether urban pollutants contribute to allergy has to be elucidated.
Clinicoimmunologic studies on Phoenix sylvestris Roxb. pollen: an aeroallergen from Calcutta, India
Authors: Chakraborty P. , Chowdhury I. , Gupta‐bhattacharya S. , Chanda S. , Gupta S. , Sengupta D.N.
Published: March 2003

Background: This study highlights the allergenicity and allergenic components of the pollen of Phoenix sylvestris Roxb. (PS), or date sugar palm, which is predominantly airborne in the air of Greater Calcutta.

Methods: A 2‐year aerobiologic survey was performed by Burkard sampler. PS pollen extract was used in skin tests of allergic patients, fractionated by (NH4)2SO4 and the SephacrylS‐200 column. The allergenicity of each fraction was checked by skin test and IgE ELISA inhibition. The principal allergenic fraction, Fr.IIa, was separated in 11% SDS–PAGE, and its allergenicity was confirmed by IgE ELISA inhibition and immunoblotting.

Results: PS pollen grains were found to be prevalent in the air of the suburban zone of Calcutta from January to March with a peak in February. The pollen extract showed high (44.07%) positive skin reaction on 540 respiratory allergic patients. Among the (NH4)2SO4 cut fractions, Fr.II was the most active one, and it was resolved into four subfractions in the Sephacryl S‐200 column. Fr.IIa was the principal allergenic fraction, showing the presence of two components of 33 and 66 kDa in SDS–PAGE. In IgE immunoblotting, both of the components were found to be allergenic.

Conclusions: The PS pollen grain is an important aeroallergen from Calcutta, India. The 33‐ and 66‐kDa components are the major allergens present in the relevant pollen extract.
The role of allergen‐specific T cells in the allergic immune response: relevance to allergy vaccination
Authors: Van Neerven Rjj
Published: March 2003

Recent research has elucidated many of the immunologic mechanisms that underlie atopic allergies. In particular, it has become clear that the role of CD4+ allergen‐specific T cells is crucial for the induction of IgE and eosinophilia, factors that mediate the immediate hypersensitivity reaction and late‐phase responses, respectively. Therefore, the reactivity patterns and activation requirements of allergen‐specific T cells are important parameters for understanding and manipulating the allergic immune response. This review addresses these issues and discusses their relevance to the further development of allergy vaccines.
Allergen‐specific immunotherapy in birch‐ and grass‐pollen‐allergic rhinitis. II. Side‐effects
Authors: Winther L. , Malling H.‐J. , Mosbech H.
Published: March 2003

Background: Allergen‐specific immunotherapy (IT) involves the risk of side‐effects. Different side‐effect profiles have been reported for different allergens, and it would be of great benefit to be able more precisely to predict patient‐ and allergen‐related risk factors.

Methods: Fifty‐two patients with rhinoconjunctivitis and allergy to birch as well as grass pollen participated in a 3‐year IT study, with a baseline year followed by 2 years of treatment. During the first treatment year, the patients received double‐blinded IT with either birch (Betula verrucosa) or grass (Phleum pratense) pollen extracts adsorbed to aluminum hydroxide. The following year, the other allergen extract was added. Assessment of systemic reactions (SRs) was performed, and related to patient pretreatment parameters such as seasonal symptoms and medication requirement, skin prick test (SPT), conjunctival provocation test (CPT), nasal provocation test (NPT), total and specific IgE, basophil histamine release (HR), eosinophil count (EOS), eosinophil cationic protein (ECP), and eosinophil protein X (EPX).

Results: In total, 44 and 47 patients started IT with birch‐ and grass‐pollen extracts, respectively. All SRs occurred during the dose‐increase phase. No life‐threatening SRs were observed. There were a higher number of patients with SRs during IT with grass pollen than IT with birch pollen, 21 vs five patients (P<0.001), with SRs to 3.3% of grass‐pollen injections compared to 0.7% of birch‐pollen injections (P<0.0001). The SRs of birch‐pollen IT were mild, consisting of rhinoconjunctivitis and oral‐pharyngeal itching, whereas asthma and urticaria episodes were observed in the grass‐pollen IT. No difference was found in sensitivity to birch and grass, when measured by SPT, CPT, NPT, specific IgE, or HR, and no difference was found in age, duration of allergic symptoms, prevalence of asthma, mean seasonal birch/grass symptom score, eye‐drop use, or antihistamine or prednisolone intake between the group with and without subsequent SRs to IT. No difference was found in EOS, serum ECP, or EPX, between the group with and without subsequent SRs to IT.

Conclusions: IT with grass‐pollen extract seems to be associated with a higher number and more severe SRs than birch‐pollen IT. Neither demographic data nor diagnostic tests of allergy such as specific IgE, HR, SPT, CPT, and NPT could identify the patients with subsequent SRs.
Correlation between atopic diseases and tuberculin responses
Authors: Yılmaz M. , Bingöl G. , Altıntaş D. , Kendirli S. G.
Published: March 2003

Background:In recent decades, the prevalence of atopic diseases has risen steadily in developed countries. The reasons for this increase are not clear. It has been hypothesized that a reduction in infections and immunization programs may contribute to the increase in the prevalence of atopic diseases. We investigated the relationship between tuberculin response and atopic disease.

Methods:A total of 538 (73.0%) atopic and 198 (27.0%) nonatopic children vaccinated with BCG were included in the study. All the children included in the study had neither been given BCG nor tuberculin skin‐tested in the previous 6 months, nor did they have a condition known to cause anergy. All the children were given five tuberculin units PPD, and PPD indurations were recorded after 48 h.

Results:The PPD induration size was 6.8±5.6 mm (mean±SD) in atopic children and 7.4±5.9 mm in nonatopic children. The difference between the two groups was not significant (P>0.05). The PPD induration sizes of children with asthma, rhinitis, and atopic dermatitis were found to be similar. The children with atopic dermatitis had lower PPD induration size, but this was not statistically significant (P>0.05). The rates of negative (<5 mm skin induration) and intermediate (5–9 mm) responses were 32.6% and 30.5% in atopic children and 30.2% and 32.4% in nonatopic children, respectively. Positive tuberculin responses (PPD≥10 mm) were recorded in 36.9% of atopic children and 37.4% of nonatopic children. Total serum IgE levels of atopic and nonatopic children were 623.35 and 46.78 IU/ml, respectively. There was no correlation between serum total IgE level and PPD induration size (r=−0.0012,P=0.737).

Conclusions:We did not find any relationship between tuberculin response and atopy status later in life in BCG‐immunized subjects. We need further studies to clarify the effect of BCG on the development of atopy.
Asthma in adults: comparison of adult‐onset asthma with childhood‐onset asthma relapsing in adulthood
Authors: Ségala C. , Priol G. , Soussan D. , Liard R. , Neukirch F. , Touron D. , Lepage T.
Published: March 2003

The prevalence of asthma in children and young adults is rising. Although the general features of asthma are similar in children and adults, there are several differences. Studies of the differences between childhood‐ and adult‐onset asthma may provide new insight into the phenotypic heterogeneity of asthma. The aim of this cross‐sectional study was to compare the characteristics of asthmatic adults who reported having (n=84) or not having (n=235) asthma in childhood. The participating patients were recruited by chest specialists throughout France and were examined from March to November 1995. The specialists completed a standardized questionnaire, and carried out a clinical examination and spirometric tests. Male sex; greater severity, particularly lower spirometry values related to small airways; greater severity and earlier onset of allergy; and maternal history of atopic dermatitis and perennial rhinitis were found to be associated with reported childhood asthma. This study exhibits highly internally consistent results and indicates that subjects who did have childhood asthma and relapse in adulthood appeared to have a potentially more severe form of asthma.
Selective upregulation of a functional β7 integrin on differentiating eosinophils
Authors: Lundahl J. , Sehmi R. , Hayes L. , Howie K. , Denburg J. A.
Published: March 2003

Background: The sequence of adhesion‐molecule expression during eosinophil differentiation remains unclear.

Methods: We analyzed the surface expression of α4, β1, and β7 integrins and compared it to established myeloid developmental markers, using the eosinophilic cell line HL‐60 clone 15, as well as cord and peripheral blood differentiation assays.

Results: Cells induced to eosinophil differentiation by treatment with butyric acid, IL‐5, and GM‐CSF showed a significant upregulation of β7 integrin expression coincident with a marked upregulation of CD35 and attenuation of CD33 and β1 integrin expression. In addition, adhesion of induced HL‐60 clone 15 cells to fibronectin was attenuated by a β7 integrin antibody.

Conclusions: Our data show that protein synthesis‐dependent upregulation of the functional β7 integrin occurs under conditions when α4 and β1 integrins are fully expressed, indicating a sequential appearance of specific adhesion molecules on differentiating eosinophil progenitors.
The effect of platelet‐activating factor (PAF) on nasal airway resistance in healthy subjects is not mediated by nitric oxide
Authors: Maniscalco M. , Sofia M. , Faraone S. , Carratù L.
Published: March 2003

Background: The nose is an important source of nitric oxide (NO) in man, but the relevance of NO production to the response to inflammatory mediators is not clear.

Methods: In this study, we evaluated the effect of NO inhibition on nasal airway resistance (NAR) at baseline, after an acute challenge with platelet‐activating factor (PAF), a potent proinflammatory factor, and after an acute challenge with bradykinin (BK), both of which are mediators of allergic rhinitis in man. Eight healthy subjects were enrolled in the study. Nasal NO production was measured by the chemiluminescence method, and NAR was measured by active anterior rhinomanometry.

Results: Basal nasal NO concentration was 500.6±115.6 ppb; it significantly decreased after topical administration of the NO‐synthase inhibitor L‐NAME, and the NO‐synthase substrate
l‐arginine caused a recovery in NO production. The administration of L‐NAME did not cause any change in basal NAR. In a double‐blind fashion, we performed nasal challenge with PAF and BK after topical pretreatment with either placebo or L‐NAME. After placebo pretreatment, both PAF and BK caused a significant increase in NAR (respectively, from 0.29±0.11 Pa s cm−3 to 0.75±0.21 Pa s cm−3, and from 0.36±0.18 Pa s cm−3 to 0.71±0.25 Pa s cm−3; P<0.001, n=8). Pretreatment with L‐NAME did not prevent the PAF‐induced increase in NAR (from 0.31±0.10 Pa s cm−3 to 0.71±0.27 Pa s cm−3), whereas it prevented the BK‐induced increase in NAR (from 0.33±0.15 Pa s cm−3 to 0.43±0.16 Pa s cm−3).

Conclusions: Topical administration of the NO‐synthase inhibitor L‐NAME at doses sufficient to decrease NO nasal production does not prevent the PAF‐induced increase in NAR, indicating that NO generation in vivo is not involved in the nasal response to PAF.
Allergic rhinitis: not purely a histamine‐related disease
Authors: Howarth P. H.
Published: March 2003

Allergic rhinitis is an inflammatory disorder of the nasal mucosa typified by the symptoms of nasal itch, sneeze, anterior nasal secretions, and nasal blockage. These symptoms arise from the interaction between mediators and neural, vascular, and glandular structures within the nose. Nasal itch, sneezes, and rhinorrhoea are predominantly neural in origin, while nasal obstruction is predominantly vascular. Nasal biopsy studies show accumulation of eosinophils within the lamina propria and epithelium and an increase in tissue and cell surface basophils in both seasonal and perennial allergic rhinitis. These cells are in an activated state. Within the epithelium, increased numbers of mast cells, T cells and Langerhans' cells, which induce T‐cell activation, are found. The accumulation of these cells can be linked to chemokine and cytokine generation by the epithelial cells themselves. Thus, the tissue cell recruitment is orchestrated by activated mast cells, T cells, and epithelial cells, with the recruited tissue eosinophils also contributing to their persistence at this site through autocrine mechanisms. Mast cells generate an array of mediators including histamine, tryptase, leukotrienes, and prostaglandins. Histamine is also generated by basophils. Eosinophils and basophils contribute to the leukotriene synthesis within the tissue. Histamine nasal insufflation induces nasal itch, sneeze, and rhinorrhoea as well as nasal blockage, thereby reproducing all the symptoms of allergic rhinitis. These effects are primarily mediated by H1‐receptors, and H1‐receptor antagonists are a prominent treatment. Antagonism of histamine at these receptors reduces symptoms by about 40–50%, with the greatest effect on the neurally mediated responses. Thus, histamine is a major mediator of allergic rhinitis, but not the sole contributor. Nasal insufflation with leukotrienes, prostaglandins, or kinins is associated with the development of nasal blockage. These mediators act primarily on the nasal vasculature and, in this respect, leukotrienes are potent mediators. Leukotrienes also induce plasma protein exudation, which contributes to the anterior nasal secretions. Studies with combination products have suggested that modifying the effects of both leukotrienes and histamine has complementary effects in relieving nasal symptoms, indicating that both these mediators are relevant to disease expression.
Immune response to Anisakis simplex and other ascarid nematodes
Authors: Kennedy M. W.
Published: March 2003

Anisakis simplex is a nematode parasite belonging to the Ascaroidea group, which includes several species of medical importance, and the immune response to A. simplex is discussed with reference to some of these. The strong Th2 reaction usually provoked by nematodes seems to occur only in the context of infection, and exposure to nonviable antigens fails to do so. This would imply either that allergic reactions to A. simplex require prior infection, or that a classical atopic response is responsible, and the cause possibly varies among patients. The antibody response to secreted and exposed surface antigens of A. simplex is strong, and should be explored as potentially a better antigen source for serodiagnosis than somatic materials, and it might also be useful in addressing the question of the role of infection in predisposing to allergic reactions. As in toxocariasis, both secreted and shed surface antigens of A. simplex could provide a focus for inflammatory lesions in tissue‐invasive larvae. Humans respond heterogeneously to A. simplex allergens, and experience with other nematodes would indicate that this is due to genetic control of the immune repertoire by the major histocompatibility complex, a fact which, in turn, might have clinical implications. A. simplex is known to produce allergens similar to the ABA‐1 of Ascaris, which represents a structurally novel class of fatty acid and vitamin A‐binding protein. This and other recently described nematode proteins are known to be highly stable to thermal denaturation and can recover their structures, biochemical activities, and allergenicity upon cooling.
Allergy to Diplotaxis erucoides pollen: occupational sensitization and cross‐reactivity with other common pollens
Authors: García‐Ortega P. , Bartolomé B. , Enrique E. , Gaig P. , Richart C.
Published: March 2003

Background: Diplotaxis erucoides is a common weed of the Brassicaceae family widespread in southern and central Europe.

Methods: A total of 410 consecutive patients referred for allergy study of rhinoconjunctivitis and/or asthma were skin tested with D. erucoides pollen, 14 proving positive. A purified D. erucoides pollen extract was prepared to perform quantitative skin tests, provocation tests, immunoblotting, and EIA inhibition in the 14 sensitized patients.

Results: Three patients, directly involved in viniculture, had rhinoconjunctivitis related to D. erucoides pollen. No D. erucoides‐related symptoms were observed in most patients, who were also sensitized to Artemisia pollen. RAST was positive in 12/14 patients and nasal provocation tests in 9/12. The molecular masses of the most prevalent IgE‐binding proteins ranged from 26 to 27.5 and from 31 to 34 kDa. D. erucoides pollen inhibited the IgE‐binding of other sensitizing pollens in the three viniculture workers, whereas both Artemisia and D. erucoides pollen produced similar heterologous inhibition in the pooled serum of the remaining, nonclinically affected, D. erucoides‐sensitized patients.

Conclusions: D. erucoides pollen may be an important prevalent aeroallergen, particularly in rural areas. It may act as an occupational allergen in vineyard workers, in whom it seems to be the primary sensitizing agent, playing a secondary cross‐reactive role in other sensitized patients.
Repeated latex aeroallergen challenges employing a hooded exposure chamber: safety and reproducibility
Authors: Kurtz K. M. , Hamilton R. G. , Schaefer J. A. , Primeau M. N. , Adkinson Jr N. F.
Published: March 2003

Background: Bronchial, nasal, and conjunctival challenges are useful for clarifying discordant clinical history (Hx) and skin and/or serologic tests and in assessing semiquantitative changes in biologic sensitivity over time. The objective of this study was to determine the safety and reproducibility of repeated latex‐allergen challenges with a hooded exposure chamber (HEC).

Methods: The HEC system comprises a powered forced‐air respirator with a fitted face shield and hood that uses glove‐derived latex‐allergen associated cornstarch particles (LAC) to expose simultaneously the conjunctiva, nose, and lungs. Serial control and incremental LAC challenges are conducted until an endpoint based on upper and/or lower respiratory tract symptoms and peak expiratory flow rates is reached. Six latex‐allergic (Hx and puncture skin test [PST]‐ and 5/6 radioallergosorbent test [RAST]‐positive) subjects were challenged on three separate occasions at least 2 weeks apart. Serial latex PST midpoints and serum anti‐latex IgE by RAST were monitored at each visit and at a fourth follow‐up visit.

Results: All subjects responded to LAC, but not to air or control cornstarch administered as controls. All responses were confined to mild symptoms of allergic rhinoconjunctivitis and/or asthma that either resolved spontaneously or were reversed with inhaled albuterol. No subject experienced a systemic or delayed reaction. There were no significant changes in the endpoint LAC doses over the three challenge visits (P>0.2). The mean coefficient of variation for log2 endpoints within‐subjects was 17.3±17.2% (SD). The serum latex‐specific IgE was not significantly boosted by the three challenges (P>0.2). The concentration of latex extract necessary to produce an 8‐mm wheal by PST was not significantly changed during the study (P>0.1), indicating that latex sensitivity was not affected by the repeated LAC exposures.

Conclusions: The results of this study indicate that repeated HEC latex‐allergen challenges are both reproducible and safe, and do not increase latex sensitivity.
Asthma in relation to personality traits, life satisfaction, and stress: a prospective study among 11 000 adults
Authors: Huovinen E. , Kaprio J. , Koskenvuo M.
Published: March 2003

Background: While patients' personality has been thought to affect all_ergic diseases, the association of asthma and psychological factors is still debated. Stress is believed to predispose to asthma, but no clear evidence of causality has been found. We have studied the role of psychological factors in prevalent as well as in incident asthma cases among the adult population.

Methods: A total of 11540 adults initiall_y aged 18–45 years responded to three questionnaires in 1975, 1981, and 1990, respectively. The association of psychological factors (including extroversion and neuroticism scales, subjective stress, and life satisfaction) and prevalent asthma was studied, as well as the predisposing effect of these factors on the risk of adult onset asthma. Logistic regression was used for risk calculations.

Results: Low life satisfaction was associated with asthma prevalence (age‐ and sex‐adjusted OR=2.27: 1.04–4.93 for prevalent asthma among those with low life satisfaction compared to those with high life satisfaction), as was neuroticism (age and sex‐adjusted OR=1.78:1.12–2.84 for those with a high neuroticism score compared to those with a low score). A high extroversion score was significantly associated with the risk of adult onset asthma among women (age‐adjusted OR=2.72: 1.44–5.12 for new asthma among those with high score compared to those with a low extroversion score).

Conclusions: No specific personality type is associated with adult onset asthma, but there is a significant sex difference in the effect of psychological factors in asthma risk. A high extroversion score is a strong predictor of incident asthma among women. Prevalent asthma decreases life satisfaction and is associated with a high neuroticism score.
Eosinophil cationic protein as a possible marker of active human Toxocara infection
Authors: Magnaval J‐F. , Berry A. , Fabre R. , Morassin B.
Published: March 2003

Background: Human toxocariasis is a common, worldwide helminthozoonosis that may elicit syndromes including various allergy symptoms. The diagnosis relies upon specific serology. However, this parasitosis is often self‐limiting, and many subjects have residual antibodies, thus making differential diagnosis quite difficult when blood eosinophilia, a commonly accepted criterion of active helminthiasis due to tissue‐dwelling parasites, is lacking.

Methods and results: We present a patient with chronic irritant cough displaying negative allergologic screening, normal blood eosinophilia, but positive toxocariasis immunodiagnosis. Therefore, this case presented the fortuitous association of an unexplained allergic picture with residual anti‐Toxocara antibodies. In an attempt to distinguish between active and past toxocaral infection, the subject's level of eosinophil cationic protein (ECP) was assessed and then compared to those of four control groups, namely, healthy volunteers, subjects presenting anti‐Toxocara residual antibodies, patients with various helminthiases, and patients with active toxocaral disease. Since the patient's ECP level was found to be sharply elevated, we hypothesized that viable Toxocara larvae were still present in the tissues, and the patient was given anthelmintic therapy. At the control checkup, the cough had waned and the ECP level had decreased to below the mean value observed in both healthy subjects and in subjects with past toxocaral infections.

Conclusions: These data suggest, first, that patients presenting unexplained allergic syndromes should be checked for helminthiases, even if blood eosinophilia is lacking, and, second, in such subjects displaying positive toxocariasis immunodiagnosis, ECP assessment would be a useful marker to distinguish between active and past toxocaral disease.
Inadvertent BSA‐induced elution of IgE in the BSA‐RAST
Authors: Kleine Budde I. , De Heer P. G. , Stapel S. O. , Zee J. S. van der , Aalberse R. C.
Published: March 2003

Background: Bovine serum albumin (BSA) is widely used to block nonspecific binding in immunochemical assays. Whereas a previous study had indicated that soluble allergen present during the incubation with anti‐IgE in the RAST did not affect bound IgE, we reinvestigated this in the current study, using IgE elution from BSA by soluble BSA as a test system.

Methods: Sepharose‐coupled BSA (0.08, 0.4, 2, or 10 µg BSA/test) was incubated overnight with serum and washed. The Sepharose was then incubated with different concentrations of soluble BSA (0, 12, 60, 300, or 1500 µg/test), washed again, and incubated with radioactive anti‐IgE. The effect on IgE binding was investigated for various incubation periods (t=0, 1, 2, 4, and 20 h).

Results: Incubation in buffer without BSA did not change IgE binding. Soluble BSA eluted IgE antibodies from immobilized BSA by up to 85%. If the BSA density on the solid phase was ≥2 µg/test, the elution efficiency was dependent on the levels of both immobilized BSA and soluble BSA. At lower densities, the dissociation was dependent only on the concentration of soluble BSA. The time needed to obtain 50% IgE elution (t½) was less if the density of immobilized BSA decreased. Below the critical density (0.8 µg BSA/mg solid phase), t½ was independent of the coating density (45 min). Probably all IgE antibodies are monovalently bound below this density.

Conclusions: Dissociation of IgE from immobilized protein in the presence of soluble protein should be taken into account, particularly when IgE to mammalian serum albumin is involved (milk, meat, or animal dander).
Cell and cytokine profiles in nasal secretions from patients with nasal polyposis: effects of topical steroids and surgical treatment
Authors: Bolard F. , Gosset P. , Lamblin C. , Bergoin C. , Tonnel A. B. , Wallaert B.
Published: March 2003

Background: Nasal polyposis (NP), a chronic inflammatory disease of the paranasal sinus mucosa, is frequently associated with asthma. Previous reports showed that surgical treatment for nasal polyps may influence asthma evolution. We hypothesized that sinus surgery may alter the cytokine network in nasal secretions.

Methods: We evaluated the characteristics (cells and mediators) of nasal lavages in nine patients with untreated NP (group A), 17 patients treated with topical steroids (group B), 21 patients treated by nasal surgery – endonasal ethmoidectomy – associated with topical steroids (group C), and 12 healthy subjects (controls).

Results: Percentages of both eosinophils and neutrophils were higher in NP patients than in controls. Percentages of eosinophils and interleukin‐5 (IL‐5) level were higher in group A than in group C and controls. There was a positive correlation between IL‐5 and eosinophils. In marked contrast, IL‐8, IL‐10, and IL‐1β levels were significantly higher in group C than in groups A and B and controls; TNF‐α concentration was significantly lower in group C than in groups A and B and controls; and there was a negative correlation between IL‐10 and TNF‐α. The percentage of eosinophils was higher in asthmatic patients with NP than in nonasthmatic patients. In addition, in group C, asthmatic patients also had a significantly higher level of IL‐10 than nonasthmatic patients.

Conclusions: Our study demonstrates that percentages of eosinophils and neutrophils, and IL‐5 level were increased in nasal secretions from untreated patients with NP. Topical steroid treatment is associated with a decrease of inflammatory cells and mediators. In marked contrast, nasal surgery is associated with marked changes, in cytokine profile in nasal secretions, that are clearly different from those of controls and topical steroid‐treated NP patients.
“Bystander” amplification of PBMC cytokine responses to seasonal allergen in polysensitized atopic children
Authors: Rudin A. , Macaubas C. , Wee C. , Holt B. J. , Slya P. D. , Holt P. G.
Published: March 2003

Background: Atopic children show increased expression and production of the Th2‐associated cytokines IL‐4, IL‐5, IL‐13, and IL‐9 from PBMCs after stimulation with allergen, but it has previously not been clearly determined whether the Th2‐cytokine production is restricted to the inhalant allergen the child is sensitized to, and whether perennial or seasonal allergens induce different cytokine responses. Our purpose was to determine whether in vitro Th2 cytokine production is specific to the sensitizing allergen, and to compare the cytokine responses to a perennial and a seasonal allergen in monosensitized and polysensitized children.

Methods: Using semiquantitative RT‐PCR, we analyzed the expression of the cytokines IL‐4, IL‐5, IL‐13, IL‐9, IL‐10, and IFN‐γ after stimulation of PBMCs with house‐dust‐mite (HDM) or ryegrass allergen. The cells were sampled from groups of 6‐year‐old children sensitized to either HDM (n=20) or ryegrass (n=24), or to both allergens (n=20), as well as from a nonatopic group (n=20).

Results: After stimulation with HDM allergen, PBMCs from children sensitized only to HDM expressed increased mRNA levels of the Th2 cytokines, but not of IL‐10 and IFN‐γ, whereas ryegrass stimulation did not result in increased cytokine expression. PBMCs from children sensitized to HDM and ryegrass expressed increased Th2 cytokines after stimulation with either of the two allergens. In contrast, PBMCs from children sensitized only to ryegrass did not express increased levels after stimulation with either of the allergens.

Conclusions: The expression of Th2 cytokines after in vitro stimulation of PBMCs from atopic children is specific to the sensitizing allergen, indicating that atopic status per se does not affect the type of T‐cell response. In addition, T cells specific to seasonal allergens circulate in the blood out of season only if the child is concomitantly sensitized to a perennial allergen.
Quantification of major peanut allergens Ara h 1 and Ara h 2 in the peanut varieties Runner, Spanish, Virginia, and Valencia, bred in different parts of the world
Authors: Koppelman S. J. , Vlooswijk R. A. A. , Knippels L. M. J. , Hessing M. , Knol E. F. , Van Reijsen F. C. , Bruijnzeel‐Koomen C. A. F. M.
Published: March 2003

Background: The serology of peanut allergy seems to be different in various parts of the world. We analyzed the composition of 13 samples of three varieties of peanut in order to compare their allergenic nature.

Methods: Peanut cultivars that are commonly processed in the West were analyzed for protein content, protein composition, and Ara h 1 and Ara h 2 content by biochemical methods. IgE‐binding properties were analyzed by ELISA using serum from patients with documented peanut allergy.

Results: Total protein contents were comparable for all tested samples (24–29%), and proteins were extractable to the same extent. SDS–PAGE patterns differed slightly, but all major bands were visible in all samples (molecular masses of approximately 14–100 kDa under reducing conditions). Ara h 1 and Ara h 2 were quantified by SDS–PAGE densitometry and were expressed as percentage of the total protein content. Ara h 1 was in the range 12–16%, whereas Ara h 2 was 5.9–9.3%. In view of the analytic uncertainty of this determination, the content of both Ara h 1 and Ara h 2 was not significantly different between the tested samples. In an IgE‐binding inhibition ELISA, the affinities of the peanut proteins for peanut‐specific IgE were measured. Minor differences were observed between the tested samples, with the most potent IgE‐binding sample having a two times higher ability to bind IgE than the weakest IgE‐binding sample.

Conclusions: The results suggest that peanuts of different varieties, and from different parts of the world contain similar proteins, including Ara h 1 and Ara h 2. Consequently, the IgE‐binding properties are similar to a great extent. This indicates that differences in the serology of peanut allergy may not originate from differences in the allergen composition of the peanut.
The effect of vaccination with DNA encoding murine T‐cell epitopes on the Der p 1 and 2 induced immunoglobulin E synthesis
Authors: Kwon S. S. , Kim N. , Yoo T. J.
Published: March 2003

Background: Immunization with naked plasmid DNA leads to strong and persistent cell‐mediated and humoral immune response to plasmid encoded antigen. Vaccination of DNA encoded whole allergen has been tried, but little information is currently available on the efficacy of DNA encoding T‐cell epitopes in allergic disease. The purpose of this study was to determine whether the vaccination of naked plasmid DNA encoding only T‐cell epitopes suppresses the allergic reaction as effectively as naked DNA encoding whole segments of allergen.

Methods: We immunized mice with a mixed naked plasmid DNA encoding the five classes of murine T‐cell epitopes on Der p 1 and Der p 2 three times at weekly intervals via an intramuscular injection of BALB/c mice. Control mice were injected with the pcDNA 3.1 blank vector. After 3 weeks, the mice were actively sensitized twice and allowed to inhale the Der p extracts intranasally six times at weekly intervals.

Results: The vaccinated mice showed a significant attenuated induction of Der p‐specific immunoglobulin E synthesis compared to controls. In terms of the Der p‐specific IgG2a antibody response, the vaccinated mice showed more prominent responses than the control mice group. In addition, analysis of the cytokine profile after Der p stimulation of the lymph‐node cells revealed that the level of the mRNA expression of the interferon‐γ gene was higher in the vaccinated mice than in the controls. Histologic studies showed a much reduced infiltration of inflammatory cells in lung tissue of the gene‐vaccinated mice in comparison with the controls.

Conclusions: These results suggest that vaccination with DNA encoding T‐cell epitopes effectively inhibits allergen‐induced IgE synthesis and reduces cell infiltration in lung tissue. Thus, gene therapy using T‐cell epitope‐encoding DNA presents an ideal way of combating allergic disease in the future.
Molecular analysis of T‐cell clonality with concomitant specific T‐cell proliferation in vitro in nickel‐allergic individuals
Authors: Summer B. , Sander C. A. , Przybilla B. , Thomas P.
Published: March 2003

Background: The peripheral blood mononuclear cells (PBMC) of individuals with nickel contact allergy are reported to proliferate to a varying degree upon nickel stimulation in vitro. Different phenotypes of the T cells involved are described. With regard to preferential use of the T‐cell receptor (TCR), analysis of the several families of the TCR‐γ gene allows rearrangement evaluation of all T cells regardless of predominant surface expression of TCR α/β.

Methods: The PBMC of 10 nickel‐allergic and five nonallergic individuals were cultured for 4 days in the presence of either medium, PHA, NiSO4, or tetanus toxoid (TT). Proliferation was measured by radioactive thymidine uptake and expressed as stimulation index (SI). T‐cell clonality was assessed by analysis of the TCR‐γ chain gene, including the use of PCR with a primer combination covering the four main groups (Vγ1‐8, Vγ9, Vγ10, and Vγ11) of the variable region of the TCR‐β chain gene.

Results: In the allergic individuals, proliferation to NiSO4 was significantly (P<0.05) higher than in nonallergics (mean SI: 18.05/17.87 vs 0.67/2.27). In unstimulated and PHA‐stimulated cultures, there was a random TCR spectrum in both groups. In contrast, in nickel‐allergic individuals or individuals with recent TT‐booster, oligoclonality could be observed in the correspondingly stimulated cultures.

Conclusions: In addition to proliferation assay, analysis of T‐cell clonality may be a further means to characterize clinical hypersensitivity reactions on the basis of antigen‐dependent oligoclonal T‐cell expansion, as in the case of tissue‐infiltrating lymphocytes.