bluuebunny/crossref_metadata_2025 huggingface dataset:
Peak expiratory flow variation and bronchial hyperresponsiveness in asthmatic children during periods of antigen avoidance and reexposure
Authors: Valletta E. A. , Comis A. , Col G. Del , Spezia E. , Boner A. L
Published: May 2007

Changes of diurnal variation of peak expiratory flow rate (%PEF variation) and their relationship with bronchial hyperresponsiveness (BHR) to methacholine (PC20) were evaluated in 12 children with mild‐to‐moderate asthma and house‐dust mite allergy, during successive periods of stay in a mite‐free environment at high altitude (1756 m) and at their home at sea level. The children remained at the high altitude from October until the end of December; then they spent a 3‐week period at home and returned to high altitude residence in January. PEF was measured daily, in the morning and in the evening, during the 3 months’ stay at high altitude and then for 10 days after the return in January. PC20 was assessed in 8/12 children, once a month from October to December, and at the return in January. Mean absolute PEF values did not change significantly throughout the study. From October to December, patients showed a significant decrease of mean %PEF variation (P= 0.04), while PC20 showed an increase (P= 0.05). After the 3 weeks at home, both %PEF variation (P= 0.03) and PC20 (P= 0.05) significantly worsened. The correlation between PC20 values and mean %PEF variation in the 2 days before and after each methacholine test was r=−0.63 (P= 0.001). Our data suggest that there is a beneficial effect of a prolonged stay in a mite‐free environment, on both PEF variability and BHR, also in asthmatic children with good pulmonary function. PEF variability and bronchial responsiveness to methacholine were significantly correlated also for small changes of the two variables.
Isolation and characterization of the 18‐kDa major apple allergen and comparison with the major birch pollen allergen (Bet v I)
Authors: Vieths S. , Janek K. , Aulepp H. , Petersen A.
Published: May 2007

The major allergen from birch pollen, Bet v I, and the cross‐reacting 18‐kDa major allergen from Golden Delicious and Granny Smith apples were isolated by micropreparative SDS‐PAGE followed by electroelution. In the case of apples, highly active, low‐temperature extracts were used. The purity of the allergens was checked by analytic SDS‐PAGE and immunoblotting with allergic patients’ sera, as well as by N‐terminal amino acid microsequencing, and the allergens were found to be very pure. The strong immunologic activity of the isolates was determined by the enzyme allergosorbent test (EAST) and EAST inhibition assays; this activity was, in the case of Bet v I, similar to that of a preparation obtained by monoclonal antibody affinity chromatography. The allergenic potency of Bet v I and of the cross‐reactive apple allergen was determined by EAST inhibition and dose‐related histamine release. With both assay systems, the allergenic reactivity of Bet v I was considerably higher than that of the major apple allergen. Fürthermore, skin prick tests with the purified allergens and with whole allergenic extracts were performed on a group of 33 patients suffering from birch‐pollen and apple hypersensitivity, and on a control group of 10 patients. The frequency of positive prick test results in the allergic patient group ranged from 73% for the major allergen from Golden Delicious apples to 97% with Bet v I and whole birch pollen extract, respectively. In contrast to our low‐temperature extracts, commercial prick test solutions of four different manufacturers were found to be unreliable for the diagnosis of apple allergy. The skin test results again indicated the strong immunologic activity of the allergen isolates and the predominance of the major allergens in context with birch‐pollen and apple hypersensitivity. Taken together, the results support the view that the 18‐kDa major allergen represents most of the allergenicity of the the apple fruit, and that all allergenic epitopes of the apple proteins are present on Bet v I.
Identification of important allergenic proteins in extracts of the granary weevil (Sitophilus granarius)
Authors: Herling C. , Svendsen U.G. , Schou C.
Published: May 2007

This paper describes the identification of important allergens from the granary weevil (Sitophilus granaries) (Sg). Sera from Danish bakers whose skin prick tests were positive to extracts of Sg were screened for IgE against Sg extracts. We found that 54% (n= 66) had elevated levels of IgE (RAST classes 1–3, by luminescent immunoassay) against whole‐body extracts of Sg. The specificity of patient IgE was investigated in an inhibition‐dot immunoblotting assay. IgE binding was inhibited in all sera but two, thus indicating that the patients’ IgE was indeed specific for the Sg extract. In crossed immunoelectrophoresis, 23 different proteins were identified. All RAST‐positive sera were investigated in crossed radioimmuno‐electrophoresis. At least 11 proteins in the Sg extract were capable of binding IgE. All individual sera reacted with at least four different proteins. The two most prominent allergens bound IgE from 88% and 100%, respectively, of the patients. These two are considered to be the most important allergens from Sg, and will be useful as markers in environmental immunochemical assays to detect allergens in samples from bakeries, grain stores, etc.
Etiologic role of unapparent exposure in cat allergy
Authors: Brasó‐Aznar J. V. , Pelaez‐Hernandez A. , Rochina‐Puchades A. , Morales‐Rubio C. , Burches‐Baixauli E.
Published: May 2007

To determine the importance of unnoticed exposure to cat, we studied 20 patients with a history of respiratory allergy. All the patients had a positive prick test to cat dander extract, and none of them kept cats as pets. The prick test was carried out with a dander extract from cat at a concentration of 100 BU/ml. The specific IgE was determined by the commercially available Pharmacia CAP System. We carried out a conjunctival challenge test. The concentration of Fel d I was quantified in dust samples from the patients’ homes by a commercially available method. The patients were reassessed in order to establish a relation between exposure and symptoms, and concealed allergen sources. Sixteen patients, showed significant levels of Fel d I in their homes (mean of 3.35 μg g of dust). The conjunctival challenge test was positive in 15 patients. These patients showed an exposure mean of 0.4 μg/g of dust. The mean levels of specific serum IgE were higher in those patients with a positive challenge than in those with a negative challenge (P= 0.0145). In nine reassessed patients, a relation was established between natural exposure and the onset of the symptoms. A possible hidden allergen source was established in 11 patients. Hidden exposure to cat allergen may play a role in the symptomatology of many atopic patients, and investigation of sensitization to Fel d I should be included in the routine allergologic evaluation of all patients with asthma or perennial rhinitis.
Survey of the allergic status of patients with bronchial asthma in Turkey: a multicenter study
Authors: Kalyoncu A. F. , Çöplü L. , Selçuk Z. T. , Emri A. S. , Kolaçan B , Kocabaş A. , αkkoçlcu A. , Erkan L. , şahin A. , Bariş Y. I.
Published: May 2007

Patients diagnosed with bronchial asthma (BA) were prospectively enrolled to assess their allergen spectra and atopic status. The patients came from five major cities (Ankara. Ízmir, Samsun. ElazíǵC, and Adana) in different regions of Turkey. Atopic status, total IgE levels, and allergen speelra were determined in 1149 patients and 210 controls who were spouses of the patients sharing the same environment hut not consanguinity with the patients. Total IgF. levels were significant higher in the asthmatic patients. For both groups, total IgE. levels were higher in both alopic and male subjects. Atopy rates were 42% in asthmatics and 26.1% in controls, declining notably by age in both groups. The most common allergen in both groups was house‐dust mite (RDM), which was more frequency detected in coastal regions (Samsun. Izmir, and Adana). Allergen spectra of the patients included HDM. pollens, cockroach, pet animals, and molds in decreasing order of frequency. Phleum praiensi: and Artemisia vulgam were the most common pollens in all regions, whereas Olea europaea was the most common in Izmir. Pollen sensitivity was least frequent in hlazig. For all of the regions, pet sensitivity was less common than, and mold sensitivity was comparable to, that of Western countries. In conclusion. BA patients in Turkey displayed significant differences in their allergen spectra and total IgE levels from control subjects and BA patients in Western countries.
Cry j 2, a major allergen of Japanese cedar pollen, shows polymethylgalacturonase activity
Authors: Ohtsuki T. , Taniauchi Y. , Kohno K. , Fukuda S. , Usui M. , Kurimoto M.
Published: May 2007

We examined Cry j 2, a major allergen of Japanese cedar (Cryptomeria japonica) pollen, for polygalacturonase enzyme activity, since a nucleotide sequence of cDNA of Cry j 2 showed a significant homology with that of tomato polygalacturonase. Polygalacturonase is well known to depolymerize preferentially polygalacturonic acid (PGA) by hydrolysis. However, Cry j 2 did not act on PGA, but was found to depolymerize pectin and methylesterified PGA in a dose‐dependent manner. The substrate specificity of Cry j 2 was different from that of polygalacturonase derived from Aspergillus niger. The depolymerizing activity of Cry j 2 reached a maximum at 50%‐60% of methylesterification of PGA. In contrast, polygalacturonase showed its maximum activity to PGA, and the activity decreased as the degree of methylesterification increased. Interestingly, the pectin‐depolymerizing activity of Cry j 2 was due to a hydrolysis, but not a lyase, activity which splits the glycosidic bonds by β‐elimination, since no unsaturated uronides were found by measurement of absorbance at 235 nm in the reaction mixture. The enzyme activity was markedly inhibited by anti‐Cry j 2 antibodies. These results indicate that Cry j 2 probably has polymethylgalacturonase enzyme activity, as postulated by von Neukom in 1963, although existence of this activity has not yet been proven.
Characterization of Chenopodiales (Amaranthus retroflexus, Chenopodium album, Kochia scoparia, Salsola pestifer) pollen allergens
Authors: Wurtzen P. A. , Nelson H. S. , Løwenstein H. , Ipsen H.
Published: May 2007

Pollen extracts of the four taxonomically related weeds, Amaranthus retroflexus (Ama r), Chenopodium album (Che a), Kochia scoparia (Koc s), and Salsola pestifer (S. kali) (Sal p), were characterized by various methods including crossed immunoelectrophoresis (CIE), crossed radioimmunoelectrophoresis (CRIE), and SDS‐PAGE immunoblotting. The allergen profiles were determined by CRIE and SDS‐PAGE IgE immunoblotting. CRIE detected from one to four important allergens, while SDS showed up to four bands that bound IgE from a number of patient sera. CRIE and SDS‐PAGE immunoblotting did not recognize the same number of important allergens in the individual weeds, and the number of allergens detected by the two methods differed considerably, suggesting that IgE‐binding epitopes may be denatured during SDS‐PAGE. However, it was possible to correlate the identity of some of the important allergens detected by CRIE and SDS‐PAGE immunoblotting in all four weeds.
A 4‐week comparison of salmeterol and terbutaline in adult asthma*
Authors: Hermansson B. A. , Jenkins R. J.
Published: May 2007

This was a 4‐week, open‐label, parallel‐group study designed to compare the efficacy and safety of the long‐acting inhaled bronchodilator, salmeterol, with the established inhaled bronchodilator, terbutaline, in the treatment of patients with mild to moderate asthma. A total of 243 adult patients was randomized to receive treatment with either salmeterol 50 μg bd via a DiskhalerTM (Glaxo) inhaler (n=121) or terbutaline 500 μg qds via a reservoir powder inhaler device (n=122). Apart from all bronchodilator treatment which was withdrawn at the start of the run‐in period and replaced by inhaled salbutamol to be used as required for symptom relief, all concurrent medications were kept constant throughout the study. Salmeterol produced a significantly greater increase in mean morning peak expiratory flow (PEF) than terbutaline (difference in adjusted means after treatment=28 l/min; 95% CI=19–37 l/min; P<0.001). Likewise, the increase in mean evening PEF was significantly greater following treatment with salmeterol than with terbutaline (difference in adjusted means=9 l/min; 95% CI=0–17 l/min; P=0.045). Salmeterol was associated with a significant reduction in diurnal variation in PEF by comparison with terbutaline (difference in adjusted means=−18 l/min; 95% CI=−24, −12 l/min; P<0.001). Significant improvements with salmeterol by comparison with terbutaline were also observed in daytime and night‐time asthma scores, percentage of symptom‐free days and nights, use of additional inhaled bronchodilator, and percentage of days and nights when no additional inhaled bronchodilator was needed. The greater overall improvement in the control of asthma and its symptoms after treatment with salmeterol was further evident from the lower incidence of asthma‐related adverse events in patients taking salmeterol compared with those taking terbutaline (2% and 15%, respectively). While both treatments were well tolerated, more patients withdrew from the terbutaline group than from the salmeterol group (12 and 3 patients, respectively) and terbutaline was associated with a higher incidence of drug‐related adverse events (26% and 9% in the terbutaline‐ and salmeterol‐treated groups, respectively). This study demonstrated that salmeterol 50 mUg bd via a Diskhaler was significantly more effective and associated with fewer adverse events than terbutaline 500 μg qds via a reservoir powder inhaler device.
*Nonimmediate reactions to betalactams: prevalence and role of the different penicillins
Authors: Terrados S. , Blanca M. , Garcia J. , Vega J. , Torres M. J. , Carmona M. J. , Miranda A. , Moya M. , Juarez C. , Fernandez J.
Published: May 2007

In patients treated with penicillins, adverse cutaneous reactions can occur within minutes or may take several days to develop. IgE antibody‐mediated reactions are well documented, but other mechanisms may also be involved. In particular, nonimmediate reactions have not been studied extensively, and the purpose of the present work was to establish the incidence of such reactions among a large group of patients and to study the penicillins involved. A total of 380 subjects with a history of a cutaneous reaction following administration of a penicillin antibiotic was included in the study. Skin tests and specific IgE measurements (RAST) were carried out using various penicillins and penicillin‐related reagents, and patients were also challenged with various penicillins. In some patients with delayed skin test responses, skin biopsies were carried out. The tests confirmed that 74 subjects (19.4% of total investigated) had suffered a cutaneous reaction to a penicillin derivative, and 29 of these subjects (7.6%, of total or 39% of confirmed) showed evidence of having suffered a nonimmediate reaction. The latter group were identified by giving a positive delayed direct challenge, and in 65% of the cases a delayed skin test response was detected. In most cases, these responses were to amino penicillins. Skin biopsies showed a lymphomonocytic cell infiltrate. Nonimmediate reactions to penicillins are a reproducible phenomenon, suggesting that a specific mechanism is responsible. By direct challenge, 93 Q of responders were positive to amino penicillins (10.3% ampicillin, 82.7% amoxicillin), indicating a major role for these penicillins in nonimmediate reactions. The high percentage (65%) of subjects in this group who showed delayed skin test responses, taken together with the biopsy results, suggests that a lymphocyte‐mediated reaction occurred. However, the possibility that other mechanisms may also have been involved cannot be ruled out
A prospective study of cancer incidence in a cohort examined for allergy
Authors: Eriksson N. E. , Holmén A. , Högstedt B. , Mikoczy Z. , Hagmar L.
Published: May 2007

In order to assess the association between atopy and cancer risk, a cohort of 6593 skin‐prick‐tested patients was established. Among atopic subjects, no overall increased cancer risk was found, but the incidence of both breast cancer (standardized incidence ratio (SIR) 2.50, 95% CI 1.01–5.16) and malignant lymphomas (SIR 4.40, 95% CI 1.20–11.3) was significantly enhanced. Atopic subjects with asthma showed a decreased overall cancer risk (SIR 0.73, 95%, CI 0.27–1.60), as compared with the other asthmatic subjects (SIR 1.46, 95% CI 1.03–2.04). The cancer risk for subjects with rhinitis was near unity (SIR 1.11), irrespective of whether the subjects were atopic or not. An almost significant risk increase for cancer was observed among subjects with urticaria (SIR 1.70, 95% CI 0.99–2.80). Our results support neither the original hypothesis of an overall cancer protective effect of atopy, nor that of an opposite effect; rather, they strengthen the view that the association between atopic diseases and cancer is complex.
Increased frequency of bronchial hyperresponsiveness in patients with inflammatory bowel disease
Authors: Louis E. , Louis R. , Drion V. , Bonnet V. , Lamproye A. , Radermecker M. , Belaiche J.
Published: May 2007

Although bronchopulmonary manifestations are rare in inflammatory bowel diseases (IBD), subclinical abnormalities have been described in up to 50% of cases. The pathophysiology of these abnormalities remains unknown. However, a latent inflammation of the bronchial mucosa secondary to the inflammation of the intestinal mucosa has been suggested. This subclinical inflammation may lead to increased bronchial responsiveness. We studied the bronchial responsiveness in 38 inflammatory bowel disease (IBD) patients, using the methacholine test. Bronchial hyperresponsiveness was defined by a PC20M <16 mg/ml. Twenty‐four healthy controls were also studied. There was no significant difference in baseline FEV1 between IBD patients and controls. However, there was a significantly greater fall in FEV1 in the IBD patients at the concentrations of methacholine tested. The frequency of bronchial hyperresponsiveness was significantly higher in the IBD population (45%) than in controls (17%; P<0.03). Atopy, defined by skin test, was more common in IBD patients (42%) than in controls (21%). Even when only nonatopic subjects were considered, the frequency of bronchial hyperresponsiveness was significantly higher in IBD patients (41%) than in controls (5%; P<0.02). Thus, subclinical bronchial hyperresponsiveness is common in IBD, and may be considered a further extraintestinal manifestation.
Diagnostic value of the nasal provocation test with Dermatophagoides pteronyssinus in childhood asthma
Authors: Baki A. , Uçar B.
Published: May 2007

We aimed to determine whether the nasal provocation test (NPT) with allergen could be used as a diagnostic test in asthmatic children with or without allergic rhinitis, and whether it had any effects on pulmonary function tests and arterial oxygen saturation (SaO2) values. Therefore, 25 asthmatic outpatients sensitive to Dermatophagoides pteronyssinus (Dp), aged 6–17 years, 12 having allergic rhinitis, and 10 nonatopic children as a control group were challenged intranasally with solution containing Dp extract by administration of a total dose of 800–1000 AU to both nasal cavities. Before the test and 10 min and 20 min after the administration of the allergen intranasally, the nasal expiratory peak flow (NEPF), pulmonary function tests, and SaO2 were measured. In the NPT, a decrease of 20% or more in NEPF and occurrence of nasal symptoms were considered to be positive. NPT was positive in all the asthmatic patients with or without allergic rhinitis, while all the children in the control group had a negative test. Compared to values prior to the test, values of FEV1, (forced expiratory volume in 1 s) and SaO2 showed no statistically significant decrease, and no clinically significant asthmatic reaction was observed in any of the groups. Our study suggests that in asthmatic children with or without allergic rhinitis, the NPT with allergen is a simple, safe, and useful diagnostic test.
A double‐blind comparison of inhaled budesonide, long‐acting theophylline, and their combination in treatment of nocturnal asthma
Authors: Youngchaiyud P. , Permpikui C. , Suthamsmai T. , Wong E.
Published: May 2007

In 61 patients with nocturnal asthma, the effects of budesonide, an inhaled steroid (Pulmicort®; 200 μg twice daily), long‐acting theophylline (Theodur®; 200 mg twice daily), and their combination were compared. After a 2‐week placebo run‐in period, the patients were entered into double‐blind, crossover periods of 3 weeks. Patients were allowed to use inhaled β2‐agonists as required throughout the study. Morning and evening peak expiratory flow rate (PEFR) (percentage of predicted normal ± SEM) was significantly higher during the budesonide (morning 77 ± 1%; evening 80 ± 1%) and combination therapy (morning 79 ± 1%; evening 81 ± 1%) than the theophylline treatment (morning 74 ± 1%; evening 76 ± 1; P ≤0.01, respectively). Significantly fewer sleep disturbances and fewer nighttime inhalations of β2‐agonists were required during budesonide and combination therapy than theophylline treatment. No statistically significant differences were seen between combined therapy and budesonide alone. Budesonide, an inhaled steroid, was significantly better than the bronchodilator, theophylline, in controlling nocturnal asthma, but no additional improvement in efficacy was seen when the drugs were used in combination.
Mite allergens in relation to home conditions and sensitization of asthmatic children from three climatic regions
Authors: Munir A. K. M. , Bjorksten B. , Einarsson R. , Ekstrand‐Tobin A. , Moller C. , Warner A. , Kjellman N.‐I.M.
Published: May 2007

We investigated the levels of mite (Der p I and Der f I) allergen in dust from bedrooms, living rooms, kitchens, and bathrooms from 130 homes of asthmatic children in three climatic zones of Sweden. Bedroom dust samples included the child's mattress, carpets, floors, and other plain surfaces. Living‐room dust samples were taken from sofas and other furniture, carpets, floors, and other plain surfaces. The allergen levels were related to home characteristics, including absolute indoor humidity (AIH), relative humidity (RH), and air changes per hour (ach). Mite allergen was detected in 62% of the homes. Levels of Der p I varied between <16 ng and 50 μg/g dust, and Der f I between ≤16 ng and 73 μg/g dust. Because we have designed a composite type of dust collection in our study, the allergen levels found tend to average down the results. Mite allergen levels were higher in homes with dampness problems, in homes with a smoker, and in homes without a basement. Homes with high absolute humidity (7 g/kg) or relative humidity (45%) and poor ventilation (≤0.5 ach) contained higher levels of mite allergens than homes with lower humidity and better ventilation. However, the number of ach measurements in homes was not high, and few homes had ≤0.5 ach. Sensitization to house‐dust mites was more common in southern than in northern and central Sweden. High levels of house‐dust mite allergen in a temperate climate where mites are not ubiquitous are thus associated with dampness problems in homes and with tobacco smoking. Our data confirm and extend previous findings that high AIH and RH and poor ventilation increase the risk of mite infestation in homes. It seems to be important and necessary to control indoor humidity and ventilation levels, to avoid high mite allergen exposure in a temperate climate, because 34% of mite‐sensitized asthmatic children were exposed to levels of mite allergen >2 μg/g dust in their homes. The study also shows that mite allergen levels below the suggested threshold level (2 μg/g dust) are associated with mite sensitivity in children with perennial symptoms of asthma.
Pigeon‐serum‐induced hypersensitivity pneumonitis in the dog
Authors: Reijula1 K. E. , Bota B. , Kurup V. P. , Clifford P. S. , Choi H. , Coon R.L , Fink J. N.
Published: May 2007

Pigeon serum (PS) is one of the most common causes of hypersensitivity pneumonitis (HP). PS‐induced HP was examined in a dog model. The dogs (n=6) were immunized by i. m. injections of PS, followed by insufflation with aerosolized PS, while all control dogs (n=3) received saline only. All animals insufflated with PS developed tachypnea 2–4 h after PS inhalation. After PS insufflation, a significant decrease in arterial oxygen tension (PaO2) was detected in sensitized dogs. No change in PaO2 was detected in sensitized dogs after saline or in the controls after PS insufflation. In intradermal skin tests with PS antigen, a positive skin reaction was found in 3/6 dogs in 30 min, and in 5/6 dogs in 6 and 48 h after the PS injections. Sensitized dogs showed a significant increase in PS‐specific IgG in serum and lavage fluid (LF). In LF of sensitized dogs, an increase in the percentage of lymphocytes, eosinophils, and neutrophils was detected. Sensitized dogs developed chronic interstitial inflammation with lymphocytes, macrophages, plasma cells, and eosinophils in lungs. Granulomas with lymphocytes, histiocytes, and giant cells were detected in both the interstitium and the bronchiolar wall in the lungs of sensitized dogs. PaO2 was lowest in dogs showing the most severe interstitial inflammation in the lungs. The results indicate that dogs can be successfully used in immunologic and physiologic studies of PS‐induced HP.
Allergic reaction after eating α‐amylase (Asp o 2)‐containing bread A case report
Authors: Baur X. , Czuppon A. B.
Published: May 2007

A 29‐year‐old female bakery shop assistant was occupationally sensitized to flour allergens and Aspergillusα‐amylase (Asp o 2). The latter represents a strongly allergenic component of routinely used baking additives. The patient had repeatedly responded to the consumption of white bread with rhinitis, conjunctivitis, and, occasionally, wheal and flare reactions. She underwent allergologic investigations including oral challenge tests with commercially available bread loaves. Elevated specific IgE antibodies against bread extracts, Asp o 2, and flour allergens were detectable in her serum. The provocation test with bread resulted in a running nose together with a strong increase in nasal resistance. All symptoms subsided about 3 h after the challenge. None of the above symptoms could be observed when bread free of Aspergillusα‐amylase was administered. This outcome provides evidence of a clinically relevant persistent allergenicity to Asp o 2 in bread.
Antiallergic actions of high topical doses of terbutaline in human nasal airways
Authors: Svensson C. , Greiff L. , Andersson M. , Alkner U. , Grönneberg R. , Persson C. G. A.
Published: May 2007

It is debatable whether β2‐receptor agonists produce antiallergic effects in human airways. This question has been addressed in the present study by examination of both mast‐cell indices and the physiologic response to allergen challenge in human nasal airways. Twelve asymptomatic patients with seasonal allergic rhinitis were investigated outside the pollen season. Intranasal allergen provocation was carried out with diluent and three increasing doses of allergen. Topical terbutaline sulfate (1.0 mg) was given 5 min prior to each allergen challenge and nasal lavage was carried out 10 min after each challenge. The study design was double‐blind, placebo‐controlled, crossover, and randomized. The allergen challenge‐induced mast‐cell activation and the ensuing physiologic response of the airway tissue were investigated by measuring a mast‐cell‐derived mediator (tryptase) and plasma proteins (albumin and α2 macroglobulin), respectively, in the lavage fluids. Allergen provocation produced dose‐dependent increments of nasal symptoms and lavage fluid levels of tryptase, albumin and α2‐macroglobulin. Both nasal symptoms (p≤0.05) and lavage fluid levels of tryptase (p≤0.05), albumin (p≤0.05), and α2‐macroglobulin (p≤0.01) were reduced by pretreatment with topical terbutaline sulfate. We conclude that high doses of topical terbutaline may produce significant antiallergic effects in human airways by equally reducing both tryptase release and plasma exudation in the acute allergic reaction in human airways. Further studies are now warranted to determine whether microvascular antipermeability effects of (β2‐receptor stimulation contribute to the present observations.
Exercise‐induced bronchospasm (EIB) in relation to seasonal and perennial specific IgE in young adults
Authors: Brutsche M. , Britschgi D. , Dayer E. , Tschopp J. M.
Published: May 2007

We investigated the relationship between exercise‐induced bronchospasm (EIB) and specific IgEs for seasonal (S‐IgE) and perennial (P‐IgE) allergens. The study, outside the main pollen season, was conducted on 289 20–year‐old soldiers, who completed a self‐administered questionnaire. A total of 289 subjects had S‐lgE and P‐IgE measured. The population was divided into subjects with (n‐ 166) and without (n = 123) history of atopic diseases (HAD). Twenty‐three of 289 subjects (8%) had asthma, 70 289 (24%) allergic rhinitis, and 92/289 (32%) atopic siblings. Measured EIB was found in 17/289 subjects (6%). They had significantly higher levels of S‐IgE and P‐IgE than those without measured EIB (respectively, P ≤0.01 and p ≤0.05). The odds ratios of having EIB were significantly increased in the entire population in relationship with an increase in both S‐IgE and P‐IgE (chi‐square test for trend 9.4 and 12.7, P ≤0.002 and 0.001. respectively). Interestingly, this highly significant relationship remained true when considering only the no HAD group (chi‐square test = 7.4 and 8.8. P ≤0.006 and 0.003, respectively). Outside the pollen season. EIB was highly related to the level of both specific seasonal and perennial IgEs in the total population and in the subjects without HAD. This suggests that even in young adults who have been asymptomatic throughout their life EIB appears to be closely linked to seasonal or perennial allergic diathesis as measured by specific IgEs.
Cross‐reactivity of IgE‐binding components between boiled Atlantic shrimp and German cockroach
Authors: Crespo J. F. , Pascual C. , Helm R. , Sanchez‐Pastor S. , Ojeda I. , Romualdo L. , Martin‐Esteban M. , Ojeda J. A.
Published: May 2007

IgE‐antibody reactivity to boiled Atlantic shrimp (Pandalus borealis) and German cockroach (Blattella germanica) of sera from 89 patients, sensitive to one or the other, was investigated with an enzymatic immunoassay for specific IgE detection (CAP‐FEIA System, Pharmacia, Sweden). IgE serum levels to both antishrimp and anticockroach allergens were found to be positive in 76 of the 89 (85.4%) tested sera. A positive anticockroach IgE was very rare in the absence of detectable antishrimp IgE (five of 89 sera). Linear regression analysis on antishrimp and anti‐German cockroach IgE levels‐log plot revealed correlation coefficient (r) of 0.73. Inhibition experiments showed that boiled Atlantic shrimp extract inhibited CAP with German cockroach, and vice versa. Immunoblotting showed the strongest IgE binding for both allergenic extracts between 30 and 43 kDa. By blot inhibition, the binding capacity of German cockroach was totally‐abolished by Atlantic shrimp extract, while German cockroach extract only partially IgE binding to Atlantic shrimp. Cross‐reactivity exists between shrimp, an important food allergen, and German cockroach, which has an increasing role in allergic asthma. It could be important to determine the clinical significance of cross‐allergy to both allergens, in which exposures occur in different ways.
IgE‐mediated basophil releasability is influenced by intrinsic factors and by IgE on the cell surface
Authors: Mita H. , Yasueda H. , Ishii T. , Akiyama K.
Published: May 2007

Experiments were done to clarify the mechanisms associated with releasability of histamine. First, washed leukocytes from 23 asthmatic patients sensitive to mite allergen were challenged with Der p 1, a major allergen isolated from Dermatophagoides pteronyssinus, or anti‐IgE. A significant correlation was observed between the ratio of Der p 1‐specific IgE liter to total IgE level (S/T) in the patient's plasma and either the reactivity (maximal percentage of histamine release; rs= 0.514, P= 0.016, n= 23) or the sensitivity (the minimum allergen concentration required to achieve 25% histamine release; rs= ‐0.790, P= 0.0002) to Der p 1. Additionally, the reactivity to Der p 1 was significantly correlated with that to anti‐IgE (rs= 0.690, P= 0.0012), indicating that an intrinsic cellular property may be one of the contributing factors in immunologic histamine release. In a second series of experiments, sinus mast cells were passively sensitized with immunoglobulins prepared from the patient's plasma. A statistically significant correlation was found between either the reactivity or the sensitivity to Der p 1 and S/T, thus indicating that S/T is an indicator of the releasability of histamine. When basophils or mast cells were passively sensitized with mouse IgE and subsequently stimulated with antimouse IgE, the reactivity to antihuman IgE was significantly correlated with that to antimouse IgE (rs= 0.966, P= 0.0023, n= 11). These observations suggest that an intrinsic cellular property regulates reactivity in immunologic histamine release. Taken together, our results suggest that an intrinsic cellular property, as well as specific IgE antibody levels on the cell surface, is an important factor in determining histamine release in response to IgE‐dependent activation.
The effect of cetirizine on sulfidoleukotriene production by blood leukocytes in children with allergic rhinitis
Authors: Kalayci Ö. , Saraclar Y. , Adalioglu G. , Sekerel B. , Tuncer A.
Published: May 2007

Twelve children with allergic rhinitis due to monosensitivity toDermatophagoides pteronyssinus(Dp) took part in a placebo‐controlled, double‐blind, crossover study to evaluate the effect of cetirizine, a second‐generation, nonsedating H1‐blocker‐type antihistamine, on sulfidoleukotriene releasability by blood leukocytes and to determine its correlation with clinical findings and nasal challenge scores. Sulfidoleukotriene release by blood leukocytes was determined by the cellular allergen stimulation test (CAST), which measures leukotriene (LT)C4, LTD4, and LTE4, all in one assay. Compared to placebo, cetirizine significantly (P≤0.05) decreased daily symptom scores of nasal discharge, nasal itching, and sneezing, as well as the number of sneezings after nasal challenge with the antigen, without alleviating nasal obstruction (P≥0.05). It also suppressed both early (P≤0.05) and late skin reactions to intradermal tests. Although cetirizine did not influencein vitrosulfidoleukotriene production by blood leukocytes with buffer or anti‐IgE (P≥0.05), it substantially reduced the release of these mediators upon challenge with Dp antigen. Furthermore, there was a high correlation between the number of sneezes after challenge and the amount of sulfidoleukotriene released in nine patients (r=0.78;P≤0.01). It is concluded that the amount of sulfidoleukotrienes produced by blood leukocytesin vitromay reflect the nasal hyperreactivity of the patient, and that cetirizine, which is highly effective in the treatment of allergic rhinitis, owes part of its effect to inhibition of sulfidoleukotriene releasability by blood leukocytes in children.
Selective recruitment of eosinophils by substance P after repeated allergen exposure in allergic rhinitis
Authors: Fajac I. , Braunstein G. , Lckovic M.‐R. , Lacronique J. , Frossard N.
Published: May 2007

We have investigated the nasal response to substance P after pollen exposure in seasonal allergic rhinitic patients. Seven patients with strictly seasonal allergic rhinitis were studied during the pollen season, 24 h after nasal challenge with pollen. They received increasing doses of nebulized substance P (0 to 80 nmol) in each nostril. Responses were assessed by measurement of nasal airway resistance by posterior rhinomanometry and quantification of albumin, histamine, and inflammatory cells in the nasal lavage fluid. Nasal airway resistance increased in a dose‐dependent manner after substance P challenge. Protein and albumin in nasal lavage fluids increased after administration of substance P: from 2.6 ± 0.3 to 6.8 ± 1.1 mg for protein (P≤0.01) and from 0.2 ± 0.1 to 3.1 ± 0.6 mg for albumin (P≤0.02). Expressed as a percentage of total protein, albumin increased from 10.5 ± 3.6% to 39.9 ± 3.5% (P≤0.02), suggesting occurrence of plasma leakage. No histamine release was observed after challenge with substance P. Total cell counts significantly increased from 11.4 ± 2.4 to 41.8 ± 17.3 × 103 cells/ml after substance P (P≤0.05). Eosinophils were already numerous before substance P challenge (2.1 ± 0.7 × 103 cells/ml), and the number of eosinophils markedly increased in all patients after substance P (for the whole group, 25.8 ± 13.3 cells/ml, P≤0.05). In contrast, the number of neutrophils only slightly increased in five patients, and changes did not reach significance for the group as a whole. Our results show that substance P induces nasal obstruction and albumin extrusion in allergic rhinitic patients after repeated pollen exposure. These vascular phenomena are associated with recruitment of eosinophils. Since substance P is known to be released after nasal allergen challenge, our data suggest a role for substance P in the chronic eosinophilic inflammation of the nasal mucosa observed in symptomatic allergic rhinitis.
Primary systemic allergy to human insulin: recurrence of generalized urticaria after successful desensitization
Authors: Chng H. H. , Leong K. P. , Loh K.C.
Published: May 2007

Primary systemic allergy to human insulin is rare. We report a case of recurrent immediate local reactions followed eventually by generalized urticaria to recombinant human insulin (Humulin) in an insulin‐dependent diabetic. Skin test to Humulin R was positive, and the patient was successfully desensitized using a modified rapid desensitization protocol. Two weeks later, he had another episode of generalized urticaria after Humulin R injection. His treatment was resumed at a lower dose, and within a week he was able to tolerate his usual regimen of insulin. To our knowledge, this is the first report of a recurrence of systemic reaction after successful desensitization.
Cinnamon bark oil, a potent fungitoxicant against fungi causing respiratory tract mycoses
Authors: Singh H. B. , Srivastava M. , Singh A. B. , Srivastava A. K.
Published: May 2007

Cinnamic aldehyde has been identified as the active fungitoxic constituent of cinnamon (Cinnamomum zeylanicum) bark oil. The fungitoxic properties of the vapours of the oil/active constituent against fungi involved in respiratory tract mycoses, i.e., Aspergillus niger, A. fumigatus, A. nidulans, A. flavus, Candida albicans, C. tropicalls, C. pseudotropicalis, and Histoplasma capsulatum, were determined in vitro as minimum inhibitory concentration (MIC), minimum lethal concentration (MLC), inoculum density sustained, and exposure duration for fungicidal action at MIC and higher doses, as well as effect of incubation temperatures on fungitoxicity. It is concluded that these inhalable vapours appear to approach the ideal chemotherapy for respiratory tract mycoses.
Allergen cross‐reactivity between Pityrosporum orbiculare and Candida albicans
Authors: Huang X. , Johansson S. G. O. , Zargari A. , Nordvall S.L
Published: May 2007

Pityrosporum orbiculare and Candida albicans extracts were separated bySDS‐PAGE, and IgE binding was detected by immunoblotting with 21 patient sera that were RAST positive to both yeasts. Cross‐wise inhibition was performed of IgE binding of a serum pool containing IgE antibodies to both yeasts. The pool was mixed with serial dilutions of P. orbiculare or C. albicans extracts, and incubated with strips containing separated allergen. IgE binding was quantified by densitometric scanning and percent inhibition was calculated as well as the respective ratios between required extract concentration for 50% inhibition in heterologous compared to homologous inhibition for each component ‘inhibition ratio). Ten componentsof P. orbiculare were detected by more than 60% of the sera. IgE binding toC. albicans was weak, and only to four bands was IgE binding detected by more than 30% of the sera. The most important C. albicans allergen was a 48‐kDa band, to which IgE of half of the patient sera bound. There was little inhibition of IgE binding to P. orbiculare with C. albicans. Thus, all but three components exhibited an inhibition ratio higher than 100.The inhibition ratio of the 48‐kDa C. albicans compound was 50, thus indicating some degree of cross‐reactivity. Significant cross‐reactivity was shown by C. albicans compounds of 18, 24, 26, 34, and 38 kDa, the inhibition ratios of which were less than 10. There was some degree of cross‐reactivity between apparent protein allergens of the two yeasts, but IgE antibodies to C. albicans donot merely reflect sensitization to P. orbiculare.
Effect of terfenadine and budesonide on nasal symptoms, olfaction, and nasal airway patency following allergen challenge
Authors: Hilberg O.
Published: May 2007

The study investigated the effect of the oral H1‐blocker terfenadine on allergen challenge in subjects with nasal allergy in comparison with the topical steroid, budesonide. A randomized, placebo‐controlled, double‐blind, crossover study with 3 experimental days was performed outside the pollen season. Seventeen nonsmokers with hay fever ‘symptoms, positive skin prick test, and RAST against timothy) were treated for 14 days before each experimental day, where the response to nasal challenge with four different concentrations of timothy was measured every 15 min for 6 h. The nasal cavity dimensions were measured by acoustic rhianometry and the olfactory function as the threshold for the sense of smell of butanol. Nasal symptoms were determined by questionnaires. Both terfenadine and budesonide dry powder had an effect on the hay fever symptoms during nasal pollen challenge. Terfenadine was more efficient than budesonide against histamine‐mediated symptoms such as sneezing and itching. Budesonide increased nasal airway dimensions better than terfenadine ‘P < 0.01). A marked effect of budesonide was seen 1‐2 h after challenge, suggesting an effect on ‘early late phase’ reaction in the nose. In 7/17 subjects, a significant ‘P < 0.05) improvement of olfactory function after budesonide treatment was seen. In conclusion, topical steroid ‘budesonide) is superior to antihistamine ‘terfenadine) in treatment of nasal congestion in hay fever, especially for the postchallenge reaction, and may, in some cases, relieve the decreased sense of smell during pollen challenge.
T cell receptor‐Vβ repertoire in allergen‐specific sensitization and increased airway responsiveness
Authors: Renz H.
Published: May 2007

An animal model system was developed to study the mechanisms resulting in allergic sensitization. Local allergen exposure via the airways and the lung stimulated an allergen‐specific immunoglobulin E (IgE) response that was paralleled by the development of increased airway responsiveness (AR). It was found that CD4+ T cells of local draining lymph nodes played an important role in the regulation of these events. Stimulation of allergen‐specific T cells requires interaction between major histocompatibility complex (MHC) class II molecules (expressed on antigen‐presenting cells), peptide (presented on MHC) and the T cell receptor. Allergen sensitization stimulated T cells that expressed a restricted T cell receptor Vβ (TCR‐Vp) elements. Each allergen stimulated different Vβ elements, and sensitization to the same allergen resulted in a different pattern of TCR‐Vβ stimulation in different lymphoid tissues. Some of these T cells had pro‐allergenic effects, whereas others were able to inhibit the development of the allergic response, including the development of increased AR. These data indicate that the local T cell response regulates the type of immune response that evolves following local allergen sensitization.
Modulation of intercellular adhesion molecule 1 (ICAM‐1) expression on the human mast‐cell line (HMC)‐1 by inflammatory mediators
Authors: Wedi B. , Elsner J. , Czech W. , Butterfield J. H. , Kapp A.
Published: May 2007

The effect of inflammatory mediators on the expression of several surface adhesion molecules on the human mast‐cell line (HMC)‐1 was studied. By flow cytometry, it could be shown that among several surface adhesion molecules (ICAM‐UCDS4, VLA‐4/CD49d, Mac‐UCD11b, LFA‐1/CD11a, LFA‐2/CD2, LFA‐3/CDS8, VCAM‐1), only the constitutively expressed immunoglobulin family member intercellular adhesion molecule‐1 (ICAM‐1) is modulated by proinflammatory cytokines on HMC‐1 mast cells. Stimulation with tumor necrosis factor‐a (TNF‐α) and interferon‐γ (IFN‐γ) resulted, in addition to interleukin‐(lL‐)4, in selective upregulation of ICAM‐1 expression. Costimulation of either IL‐4 or IFN‐γ with TNF‐α further increased the ICAM‐1 expression as compared to the stimuli alone. In contrast, stem‐cell factor (SCF), granulocyte/macrophage colonystimulating factor (GM‐CSF), IL‐10, IL‐8, monocyte chemotactic and activating factor (MCAF), and the complement split product C5a failed to modulate the expression of any adhesion molecule examined. The levels of cytoplasmic free calcium in HMC‐1 mast cells were not altered by cross‐linking surface ICAM‐1, suggesting linkage of other intracellular signaling pathways. This cytokine‐induced upregulation of ICAM‐1 expression might reveal a putative regulatory mechanism of mast‐cell interaction with effector cells bearing the counterparts of ICAM‐1 (CD54), the molecules Mac‐1 (CD11b/CD18) and leukosialin (CD43), and the principal ligand LFA‐1 (CD11a/CD18).
Genes, environments, and sex: factors of importance in atopic diseases in 7—9–year‐old Swedish twins
Authors: Lichtenstein P. , Svartengren M.
Published: May 2007

Various atopic manifestations among adults have been shown to be influenced mainly by genetic factors. With the increase in prevalence of atopic diseases in recent years, especially among children, a great deal of attention has been given to environmental causes. In a study of 1480 Swedish twin pairs, 7—9 years old, we examined the importance of genetic and environmental factors in asthma, hay fever, eczema, and urticaria. Structural equation model fitting showed 33–76% of the variation in liability to the diseases to be due to genetic effects. Shared environmental effects were also important for hay fever and urticaria in both sexes and for eczema among girls. The clustering of atopic disease in families was almost entirely due to a common set of genes, but each disease manifestation also seemed to have specific genes of importance. Investigation of unlike‐sex twins showed that boys had a higher cumulative incidence of asthma and hay fever than girls, whereas girls had a higher incidence of eczema. Thus, it may be concluded that although genetic factors are of major importance in atopic manifestation in children, both environmental and sex‐related factors play a role.