bluuebunny/crossref_metadata_2025 huggingface dataset:
Genetic and environmental factors affecting the development of atopy through age 4 in children of atopic parents: a prospective randomized study of food allergen avoidance
Authors: Zeiger R. S. , Heller S. , Mellon M. H. , Halsey J. F. , Hamburger R. N. , Sampson H. A.
Published: June 2007

The effect of food allergen avoidance, as well as other environmental and genetic factors, on the development of atopy were determined in this follow‐up report of a prospective randomized controlled study of 288 infants of atopic parents, in which 78% were available for evaluation at age 4 years. The prophylactictreated group consisted of mothers who avoided cow milk. egg. and peanut during the last trimester of pregnancy and lactation and of infants who avoided cow milk until 1 year (casein hydrolysate supplementation prior to 1 year) and egg, peanut, and fish until after 2 years. The control group consisted of maternal/infant pairs who followed standard feeding practices. The cumulative prevalence of food allergy and food sensitization remained lower in the prophylactic treated group from 1 to 4 years of age. However, the period (current) prevalence of food allergy in both study groups was similar (about 5%) at 3 and 4 years. Such findings suggest that period prevalence may represent the more appropriate measure to assess the impact of intervention measures on the development of atopic disease at older ages. Prophylactic‐treated children evidenced lower levels of IgG beta lacloglobulin (BLG) at 4 months and I and 2 years (p < 0.0001) and lower IgG ovalbumen/ovomucoid (OVA) levels only at 2 years (p < 0.001). Both groups evidenced similar prevalences of asthma, allergic rhinitis, and positive inhalant skin tests from birth to 4 years. Children with food allergy evidenced higher 4 year cumulative prevalences of allergic rhinitis and asthma (p < 0.05). Risk factors for atopic disease by age 4 years were shown by multivariate analysis (p < 0.05) to include (1) unrestricted diet and elevated cord blood IgE with food allergy, (2) male gender and lower paternal level of education with asthma, and (3) non‐caucasian ethnicity and spring/summer birth with atopic dermatitis and allergic rhinitis. Serum IgE levels were not significantly different between groups at 3 and 4 years, despite their being a trend towards lower serum IgE levels in the prophylactic‐treated group at 4 months (p < 0.07). In the control group, formula feeding prior to 4 months was associated with higher 4 month serum IgE levels (p < 0.05). Stepwise linear regression revealed that serum IgE variability from birth to 4 years was influenced by male gender, non‐caucasian ethnicity, maternal and paternal serum IgE levels, 4 month IgG BLG levels, positive food and inhalant skin tests, and the development of atopic dermatitis, food allergy, asthma, and allergic rhinitis. These findings demonstrate the strength of genetic factors and their modulation by dietary and envi‐ronmental influences in the development of atopy and reveal that the reduction in food allergy in infancy by maternal/infant food allergen avoidance fails to affect respiratory allergy development from birth to 4 years.
Eosinophil cationic protein (ECP), eosinophil chemotactic activity (ECA), neutrophil chemotactic activity (NCA) and tryptase in serum before and during bronchial challenge in cat‐allergic children with asthma
Authors: Hedlin G. , Ahlstedt S. , Enander I. , Håkansson L. , Venge P.
Published: June 2007

In order to study ECP, ECA, NCA and tryptase levels in serum in 18 cat‐allergic children with asthma scrum samples were obtained before and during an allergen bronchial challenge. All children were on regular treatment with inhaled steroids (200‐800 μg/day) and bronchodilators. Peak expiratory flow (PEF) was recorded twice daily for at least a week before the challenge. The baseline ECP levels were significantly higher in the children who had a baseline PEF 80‐95% of pred. compared to those who had PEF >95% of pred. (mean 24. 3 μg/l and 14. 3 μg/l respectively, p <0.02). ECP in serum before the ehallenge correlated significantly to PEF in % of the expected optimal PEF obtained from the PEF curve (r= 0. 48, p <0.05). During the challenge ECA and NCA increased significantly from mean 96. 2% and 97. 9% to 122. 7% and 118. 7% (p <0.05 for both), while ECP did not change significantly, mean 20. 4 μg/l before and 17. 5 μg/l after the challenge. Tryptase levels in serum were not detectable (<0. 5 ng/ml) before or during the asthmatic attack.

We eoncludc that there are significantly raised ECP levels in serum in symptom‐free asthmatic children on long‐term treatment with topical steroids possibly indicating remaining airway inflammation. Acute asthma results in an increase of ECA and NCA while ECP levels seem to reflect the chronic rather than the acute phase of asthma in children.
Food challenge procedures: standardization of oral challenge and pulmonary measurements
Authors: Metcalfe D. D.
Published: June 2007

The lung is one of many target organs that can be affected in an adverse reaction to a food or food additive. The question of pulmonary involve ment is often in the context of patients who have underlying asthma, a disease of the airways characterized by reversible airways narrowing. A number of unique problems must be addressed when attempting to measure pulmonary responses during adverse reactions. Prior to the study, it is necessary to determine if the subject has asthma and if so, to quantitate the severity of asthma. This can be accomplished by assessing pulmonary function, measuring airways reactivity, documenting medication requirements, recording duration of disease, and detailing complications. Procedures that may result in pulmonary reactions should be performed only where severe reactions can be optimally treated such as in the hospital or an office near a hospital. Medical personnel must have proper training in, and equipment for, resuscitation. Medications should be withheld when possible that may effect the ability to measure pulmonary responses. Specific endpoint criteria of a positive response should be set in advance of testing. Double‐blind placebo controlled food challenge is the experimental protocol of choice. Responses to specific foods or additives can be assessed both by measuring changes in pulmonary function and by repeated methacholine challenge to assess airways reactivity. With proper definition of the question, use of appropriate experimental design, exercise of caution, application of appropriate analytic methods, and the presentation of a clear and thorough report, adverse reactions to foods and additives involving pulmonary responses may be assessed with safety and scientific accuracy.
Foodborne toxicants affecting the lung
Authors: Taylor S. L. , Nordlee J. A. , Kapels L. M.
Published: June 2007

Foods contain several toxicants that can exert adverse effects on the lung. Some of these toxicants are naturally occurring substances such as the pyrrolizidine alkaloids, histamine, the sweet potato toxins, perilla ketone, paralytic shellfish toxins, the red tide toxins, and botulinum toxins. Other foodborne toxicants affecting the lungs are additives (nitrite, BHT, carrageenan), processing‐induced toxicants (the agent involved in Spanish toxic oil syndrome, the mutagens from cooked meats), or environmental contaminants (paraquat, PCBs, PCDFs). Some of these toxicants have primary effects on other organ systems. For example, paralytic shellfish toxins, the red tide toxin, and botulinum toxins are primarily neurotoxins whose effects on the lung are secondary. The pyrrolizidine alkaloids primarily affect the liver. However, some of the toxicants exert their primary effects on the lung (paraquat, the sweet potato toxins, perilla ketone). For some of the foodborne toxicants affecting the lungs, these effects are only noted in experimental animals fed high doses of the toxicant for prolonged periods of time. Examples would include BHT, nitrite, and carrageenan. These particular chemicals are likely to be safe to consume under more normal circumstances of exposure.
Pulmonary reactions to monosodium glutamate
Authors: Schwartzstein Richard M.
Published: June 2007

Since the first report of bronchoconstriction provoked by ingestion of a meal containing monosodium glutamatc (MSG) in 1981, many studies have been performed to define the role of MSG in asthma. These studies have employed a variety of methodologies, and their results have led to different conclusions. In an effort to resolve these differences I used the Paperchase computerized database system to identify all references in the medical literature (English language) to MSG and asthma between 1966 and November 1991. These citations were reviewed with particular attention to 1) prevalence of MSG‐associated asthma, 2) selection of subjects, 3) protocol design. 4) dosing of MSG, and 5) time course of the reaction. A total of 29 cases of alleged MSG provoked asthma appear in the medieal literature. In subjects not selected for a history of food reactions, the incidence of MSG‐induced bronchospasm is less than 5%. There is only one report of MSG‐induced bronchospasm in a double‐blind controlled challenge. The remainder of the cases are anecdotal reports or single‐blind challenges performed primarily in patients selected for a prior history of reactions to MSG or other food substances. There is no clear evidence to support the concept of a threshold dose for this reaction. The latency between ingestion of MSG and development of bronchospasm is reported to be between 30 min and 12 h. In vitro data suggest there is no direct effect of MSG on bronchial smooth muscle. While MSG may precipitate bronchospasm in a small group of selected patients, this association remains to be validated in double‐blind placebo controlled studies.
Responses of plasma vasoactive intestinal polypeptide to methacholine and exercise loading in children and adolescents with bronchial asthma
Authors: Ohzeki T. , Ishitani N. , Hanaki K. , Motozumi H. , Ohtahara H. , Fukushima K. , Nakai S. , Kishida M. , Kobayashi S. , Shiraki K.
Published: June 2007

Responses of plasma vasoactive intestinal polypeptide (VIP) to methacholine inhalation and to exercise loading were studied in asthmatic patients to clarity a significant role of the peptidc. The mean of basal VIP in asthmatics was not significantly different from the normals. The levels were increased after FEV (1. 0) (forced expiratory volume in a second) decreased to 80% of the baseline following methacholine inhalation and were returned to values similar to the baseline when FEV (1. 0) recovered to 100%. Thirty minutes after the exercise, mean VIP was significantly lower in patients with the lowest FEV (1. 0). These results suggest that VIPergic system contributes, at least partly, to relax constricted bronchioles in some patients with bronchial asthma.
IgE levels in cord and capillary blood at 5 days of age
Authors: Hansen D. , Hornnes P. , Poulsen L. K.
Published: June 2007

We have determined the correlation between IgE in cord blood and capillary scrum from 98 mature children at 5 days of age, Sixty‐six per cent had no family history of atopy., 29% had a single and 5% a double disposition. The study showed a good correlation, rho = 0. 75, p < 10−5, between IgE levels in cord blood and capillary blood samples drawn on the 5th day of life in children both with and without a heredity of atopic diseases. There was no correlation between the concentrations of cord blood IgE and IgA.
Multicenter study with ketotifen (Zaditen) oral drop solution in the treatment of wheezy children aged 6 months to 3 years
Authors: Varsano I. , Volovitz B. , Soferman R. , Tal A. , Schlessinger M. , Rotchild M. , Tabachnik E.
Published: June 2007

One hundred and seven chronically wheezing infants, aged 6 months to 3 years, completed a double‐blind placebo controlled multicenter study. Alter a two‐week baseline period the patients were randomized into two groups receiving twice daily either ketotifen or placebo for a period of 12 weeks. The ketotifen dosage was 0. 5 mg for children younger than one year and 1 mg for the older. During the 12‐week treatment period the patients from the two groups demonstrated gradual improvement of the disease severity parameters, as compared with the baseline period. The amelioration was more marked in the ketotifen treated patients and during the 0‐4, and 4‐8 weeks of treatment a significant decrease was achieved in the percentage of days with a cough (p < 0.04) and in the number of wheezing episodes (p = 0.02). Moreover, a 50% reduction of the days and nights with cough and in the number of wheezing episodes occurred earlier in the ketotifen than in the placebo treated patients, i. e. after 1. 2 vs 4. 6; 4. 4 vs 8. 6 and 5. 2 vs 7. 2 weeks, respectively. It should be stressed that the ameloration of the asthmatic morbidity in the ketotifen group was achieved with a significantly reduced need for the concomitant use of bronchodilators. The principal side effects observed were weight gain and transient sedation. It is concluded that ketotifen may be effective in the amelioration of asthma associated symptomatology and acceleration in the natural tendency for improvement in chronic wheezing infants.
Are hypodense eosinophils in children activated or immature?
Authors: Moens M. M. , Mertens A. V. , De Clerck L. S. , Van Bever H. P. , Bridts C. H. , Stevens W. J.
Published: June 2007

In patients with allergic asthma and rhinitis high numbers of hypodense eosinophils (HE) have been demonstrated. In a previous study we reported that asthmatic and healthy children had more HE than their adult counterparts. We assumed that this might, in part, he due to the presence of immature eosinophils in children. To distinguish between immature and activated eosinophils, determination of eosinophil cationic protein (ECP) might be interesting as it is known that high serum levels of ECP are associated with increased activation of eosinophiis. In this study we determined (he levels of ECP in scrum in asthmatic and healthy children and adults trying to distinguish activated from immature eosinophils. We found that ECP levels were not increased in children (healthy and asthmatic) compared to adults (healthy and asthmatic). This supports the hypothesis that increased numbers of HE in childhood are, at least in part, immature eosinophils. Nevertheless, we could confirm that inflammation was present in children because soluble interleukin‐2‐receptor (slL‐2R), a marker of lymphocyte activation, was higher in asthmatic children as compared to healthy children. IL‐6, a marker of macrophage/monocyte activation, was not different in the different patient groups. We conclude that although signs of inflammation are present in childhood asthma, the increased numbers of HE in children are in part due to the presence of immature eosinophils.
Association of mononuclear cells and eosinophils with airway resistance and responsiveness in rat pulmonary inflammatory responses
Authors: Sorkness R. , Castleman W. , Clough J. , Ritter M. , McCarthy D. , Lemanske R. F.
Published: June 2007

To evaluate the association of various leukocytes with pulmonary resist ance and methacholine responsiveness, we induced pulmonary eosi‐nophil‐rich inflammation in IgE‐sensitized (ovalbumin) Sprague Dawlcy rats. Sensitized rats were challenged with either relevant (OA) or irrele vant antigen by tracheal insufflation a) with no other treatment, b) in conjunction with intravenous Sephadex beads pretrcatment, or c) with antigen coupled covalently to Sepharose heads. About 24 h after antigen challenge, respiratory system resistance (Rrs), response to aerosolized methacholine, and pulmonary histopathology were evaluated. Challenge with OA, insufflation with Sepharose, and treatment with i. v. Sephadex all independently increased inflammatory cell infiltrates, but the combi nation of OA with the other agents did not significantly enhance the inflammatory response over OA alone. Interactive stepwise regression techniques were utilized to identify correlates for Rrs and methacholine responsiveness. Mononuclear cell score was a significant predictor (p < 0.1) for Rrs, and insufflation of Sepharose had a significant inde pendent effect on Rrs (p=. 01) above that predicted by mononuclear cell infiltrates. Conversely, eosinophil score and neutrophil score were not significant predictors for Rrs, and challenges with antigen or Sephadex had no significant independent effect on Rrs beyond that predicted from mononuclear cell infiltrates. Eosinophil score was the only significant histological predictor for methacholine responsiveness (p <0.001). Chal lenges with Sephadex, antigen and Sepharose did not significantly change methacholine responsiveness independently of the changes asso ciated with eosinophil infiltrates. These findings suggest that mononucle ar cells and eosinophils contribute to increases in airway resistance and responsiveness, respectively, following the induction of pulmonary inflammation by both allergic and non‐allergic stimuli.
Chronic meningococcemia in a child with a deficiency of the sixth component of complement
Authors: Fasano M. B. , Sullivan K. , Ibsen L. , Winkelstein J. A.
Published: June 2007

Chronic meningococcemia represents an uncommon manifestation of meningococcal disease. Microbial and host factors which may predispose to this form of meningococcal disease are not understood. Although acute meningococcal disease is frequently found in patients with terminal complement deficiencies, the relationship of chronic meningococcemia to complement deficiencies is unclear. We present a case report and a review of the literature describing chronic meningococcemia in association with deficiencies of the complement system. A total of eight cases were identified, all of whom were male. Six of the eight patients were children and two of the eight had a previous history of meningococcal disease. This case report, in conjunction with the previously reported cases, suggests an association between complement deficiencies and chronic meningococcemia.
Several genetic and environmental factors influence cord blood IgE concentration
Authors: Bjerke T. , Hedegaard M. , Henriksen T. B. , Nielsen B. W. , Schiotz P. O.
Published: June 2007

Cord blood samples were collected from a birth cohort of 2631 infants to elucidate the association between genetic and environmental factors and fetal production of IgE. The cord blood IgE values were treated both as a continuous and as a dichotomous variable in the statistical analyses. Multivariate analysis was used to control for confounding factors. Infants with single and biparental atopic heritage had higher IgE concentrations in cord plasma than children of parents without atopy. Multiple logistic regression analysis revealed a significant association to maternal allergic eczema or perennial rhinitis. The cord blood IgE concentration varied with month of birth with peaks in late autumn. This seasonal variation was not related to parental atopic disease. Boys had significantly higher levels of IgE and more often elevated IgE values (≥0.5 kU/1) than girls. Alcohol and caffeine consumption by the mothers during pregnancy were both significantly associated with elevated IgE concentration. There was also a relation between mothers prepregnant weight and elevated CB‐IgE levels. No significant association was observed between maternal smoking and cord plasma IgE levels. The fact that many factors presumably not related to child allergy seem to influence the regulation of fetal IgE production, could explain the questionable value of cord blood IgE in predicting allergy in childhood.
Immunogloblin E and G responses to pertussis toxin after booster immunization in relation to atopy, local reactions and aluminium content of the vaccines
Authors: Odelram H. , Granström M. , Hedenskog S. , Duchén K. , Björkstén B.
Published: June 2007

The role of aluminium for IgG and IgE responses to pertussis toxin (PT), as well as for side effects, was investigated in 49 children with known atopy status. Primary immunization had been given with an adsorbed monocomponent or an adsorbed two‐component acellular pertussis vaccine. The children were then randomized to receive a booster immunization with either aluminiumadsorbed or non‐adsorbed, whole cell, pertussis vaccine. Both vaccines induced good IgG responses with the adsorbed vaccine giving higher post‐booster levels (p < 0.05). The adsorbed vaccine was, however, associated with more local side effects (p < 0.05) and tended to induce higher PT‐IgE responses than the non‐adsorbed vaccine. Furthermore, individuals who had received the two‐component vaccine as primary immunization had higher PT‐IgE responses after the booster, compared with individuals initially receiving the monocomponent vaccine (p = 0.041). No correlation between PT‐IgE and PT‐IgG levels was seen in any of the groups. Total serum IgE levels correlated to PT IgE levels, particularly in children with atopy (r = 0.950, p < 0.001). The addition of aluminium to the pertussis vaccine, was, thus, associated with a stronger IgG antibody response, but tended also to induce a stronger IgE antibody response. The correlation between total IgE and PT‐IgE, which was most prominent in children with atopy, indicates that the role of immunization for the development of allergy merits further studies.
Antineutrophil cytoplasmic antibodies (ANCA) in idiopathic pulmonary hemosiderosis
Authors: Blanco A. , Solis P. , Gomez S. , Valbuena C. , Telleria J. J.
Published: June 2007

Four children were diagnosed with idiopathic pulmonary hemosiderosis (IPH), over a period of 4 years. Retrospectively, antineutrophil cytoplasmic antibodies (ANCA) were studied by indirect immunofluorescence (IIF) and ELISA in 18 sera from these patients, stored at ‐20°C. ANCA‐positive sera, from 1/20 to 1/1, 200 dilution, were found in 3/4 of the patients, by IIF. The patient with the highest titre of ANCA died 3 months later during an acute crisis, the other two patients need a minimal dose of steroids. In one case only, a patient who is still without treatment, had no ANCA. The antibodies anti‐myeloperoxidase and anti‐pro‐teinase‐3 were negative or at border line levels. Rheumatoid factor, anti‐nuclear (Hep‐2), anti‐endomysial, anti‐reticulin and antibasement membrane antibodies were negative in all sera. The surviving patients were followed‐up for more than 10 years with no systemic or renal disease appearences. The presence of serum ANCA may help to classify children with pulmonary haemorrhage and may have a prognostic value.
Ontogeny of IL4 production
Authors: Tang Mimi L. K. , Kemp Andrew S.
Published: June 2007

There is evidence to suggest that the production of some cytokines in childhood is different to that in adults. The production of IL4 in PHA‐stimulated PBMC cultures was examined in healthy neonates, children and adults to determine the ontogeny of IL4 production throughout childhood. In vitro IL4 production was found to be significantly reduced in neonates and children under 10 years of age as compared to adults, and to increase progressively with age. The mechanisms leading to reduced IL4 production in neonates were shown to be different to those in children, with a defect in signal transduction demonstrated for lymphocytes from neonates but not children < 10 years. The presence of an inhibitory factor in cord blood plasma was also noted. These age‐dependent variations in IL4 production and response to stimulation with PMA/Ca may reflect differences in naive and memory T cell populations.;
Systemic reactions to specific immunotherapy in children with respiratory allergy: a prospective study
Authors: Businco L. , Zannino L. , Cantani A. , Corrias A. , Fiocchi A. , Rosa M. La
Published: June 2007

The aim of this multi‐centre prospective study was to evaluate the prevalence of systemic reactions to specific immunotherapy in children with allergic asthma and or rhinitis. One thousand and fifty‐six children (653 boys and 403 girls), median age 8.5 years, were enrolled in this three‐year prospective study. All the children were treated with injections of the following allergenic extracts: 689 of house dust mite, 291 of grass, 109 of Parietaria, 13 of Alternaria, 6 of Artemisia and 11 of Olea. Among 1056 treated children, 41 (3, 7%) had systemic reactions: 40 children (3.7%) experienced mild symptoms such as asthma and/or urticaria, and only one shock (0.08%). A total of 47, 247 injections were administered, and the rate of systemic reactions, according to the number of total injections was only 0.08%. According to the allergenic extract, systemic reactions occurred in 29/689 children (4.2%) treated with house dust mites extract (0.09% of the injections), in 9/291 children (3.1%) treated with grass extract (0.07% of the injections) and in 3/109 children (2.8%) treated with Parietaria extract (0.06% of the injections). The prevalence of systemic reactions was significantly higher (p< 0.0001) in the children treated with house dust mite extract in comparison with those treated with pollen extracts. All the systemic reactions appeared within 30 minutes following the administration of the extract and occurred in 37/41 cases (90.2%) with the same dose, previously tolerated. Most reactions were mild, and were readily controlled by immediate emergency treatment. There was no need for hospitalization. The low prevalence of systemic reactions (0.08% of the total injections and 3.7% of the total treated, indicates that specific immunotherapy with inhalant allergens is safe in children with respiratory allergic diseases.;
Changes in the concentration and distribution of immunoglobulin‐producing cells in SIDS palatine tonsils
Authors: Stoltenberg L. , Vege Å. , Saugstad O. D. , Rognum T. O.
Published: June 2007

Seventeen sudden infant death syndrome (SIDS) cases and 9 controls, were examined immunohistochemically with regard to the presence of IgA‐, IgM‐, IgD, and IgG, as well as for thesubtypes IgG1, IgG2‐, IgG3‐, and IgG4‐immunocytes. Differences in compartmentalization were also investigated. Differences were demonstrated between SIDS and controls in total number of IgG cells per 0.1 mm2 tissue area (median: 18.3, range: 12.3‐30.2 versus median: 6.3, range: 2.0‐14.6) (p<0.01), and for IgA immunocytes (median: 3.9, range: 2.4‐5.0 versus median: 1.5, range: 1.1‐3.7) (p<0.05), while no differences were demonstrated for IgM cells (median: 1.8, range: 1.2‐3.3 versus median: 1.8, range: 0.7‐5.6) or IgD cells (median: 1.9, range: 0.8‐2.9 versus median: 1.6, range: 0.7‐2.4). Differences were demonstrated between SIDS and control IgG plasma cells in all the four palatine tonsillar compartments; germinal centre (p<0.01), mantle zone (p<0.05), interfollicular area (p<0.01) and reticular epithelium (p<0.01). Furthermore, the number of IgA cells was higher in SIDS vs. controls in both the germinal centre (median: 1.4, range: 0.6‐2.1 versus median: 0.6, range: 0.3‐1.3) (p<0.05) and in the interfollicular area (median: 2.2, range: 1.1‐3.1 versus median: 0.5, range: 0.4‐2.0) (p<0.01). For IgM immunocytes, differences were demonstrated in the germinal centre (median: 1.0, range: 0.4‐1.6 versus median: 0.4, range: 0.3‐1.3) (p<0.01) as well as in the germinal centre (median: 0.6, range: 0.5‐0.8 versus median: 0.4, range: 0.3‐0.7) (p<0.01) and in the interfollicular area (median: 1.2, range: 0.8‐1.6 versus median: 0.5, range: 0.5‐0.7) (p<0.01) in the IgD immunocyte group. The total number of IgG1‐ and IgG3‐immunocytes were increased in SIDS (median 15.6, range: 5.3‐58.9 versus median: 2.5, range: 1.5‐8.4) (p<0.01) and (median: 3.6, range: 0.4‐8.6 versus median: 1.1, range: 0.4‐1.3) (p<0.01) respectively. Furthermore, significantly increased numbers of these two subclasses, were seen in all the four compartments in the SIDS cases. The palatine tonsillar immune system is stimulated in SIDS. Furthermore, the changes being predominantly in the germinal centres and interfollicular areas, are indicating a recent stimulation, and the IgG‐subgroup response pattern makes a viral protein antigen the most likely stimulant.;
T‐cell “priming” against environmental allergens in human neonates: sequential deletion of food antigen reactivity during infancy with concomitant expansion of responses to ubiquitous inhalant allergens
Authors: Holt P. G. , O'Keeffe P. , Holt B.J. , Upham J.W. , Baron‐Hay M.J. , Suphioglu C. , Knox B. , Stewart G.A. , Thomas W.R. , Sly P. D.
Published: June 2007

The study below comprises prospective analysis of patterns of allergen‐specific T‐cell reactivity in a cohort of 23 children bled at'regular intervals from 6–10 weeks to 2 years of age, together with cross sectional studies on panels of cord and adult blood samples. The results indicate reciprocal patterns of responses to dietary and inhalant allergens, the former being frequent in infancy but rare in adults, whereas the latter are preserved and expand between infancy and adulthood. These findings are consistent with a recently proposed model for the development of immunity to environmental allergens which involves allergen‐driven T‐cell “selection” during early life leading to deletion of food allergen‐specific T‐cells via the induction of specific anergy, with concomitant selection and ultimately expansion of mutually exclusive TH‐1‐like or TH‐2‐like reactivity to inhalant allergens via Immune Deviation mechanisms.
Effect of intravenous gammaglobulin (IVIG) on the platelet count in patients with Wiskott‐Aldrich syndrome
Authors: Mathew P. , Conley M. E.
Published: June 2007

The ability of IVIG to increase platelet counts in patients with idiopathic thrombocytopenic purpura suggests its potential usefulness in other disease states characterized by low platelet counts. This possibility was evaluated in nine patients with the Wiskott‐Aldrich syndrome (WAS) who received IVIG, at a dose of 400 mg/kg every 4 weeks. The mean platelet count prior to institution of IVIG was 32,000/cumm (range 2,400 to 98,000). Following administration of IVIG, the platelet count ranged between 5,000 and 85,000/cumm. There were no immediate increases in platelet counts after IVIG infusion in any patient who had serial platelet counts. During treatment, patients were not given any routine platelet transfusions for low platelet counts. However, while on IVIG, two patients showed a good response to platelet transfusion prior to surgical procedures. In conclusion, chronic IVIG therapy does not appear to affect platelet counts in patients with the Wiskott‐Aldrich syndrome.
Selective expansion of T cells expressing Vβ2 in peanut allergy
Authors: Dorion B. J. , Leung D. Y. M.
Published: June 2007

Peanuts are the most common cause of fatal and near‐fatal food‐induced anaphylaxis. The immune basis for susceptibility to peanut allergy is poorly understood. The current study examined the possibility that patients with peanut allergy, as compared to normals, use different T cell receptor variable beta regions (Vβ) in the recognition of peanuts. The results demonstrate that stimulation of T cells from patients with peanut allergy results in the selective expansion of Vβ2+ T cells.
Antiperinuclear factor in the diagnosis of juvenile rheumatoid arthritis
Authors: El‐Gamal Y , Hossny E. , Mabrouk R. , El‐Gamasey T.
Published: June 2007

The antiperinuclear factor (APF) was estimated by immunofluorescent microscopy in the sera of 32 children and adolescents with juvenile rheumatoid arthritis (JRA) in comparison to a group of 16 children and adolescents with other rheumatologic disorders and a group of 20 age‐matched healthy subjects. The APF was detected in 17 children with JRA (53%), in only one patient in the group of other rheumatologic disorders (6%), and in 2 healthy children (10%). Accordingly, APF had a sensitivity of 53%, a specificity of 92%, and a diagnostic efficiency of 74% in our series. APF was found to have a higher diagnostic gain in rheumatoid factor (RF) seronegative cases than did the RF in APF negative cases, meaning a higher sensitivity of APF as compared to the RF. The APF seropositivity was neither altered by the use of corticosteroids nor influenced by the age, gender, duration of illness, or number of joints affected. Three out of 5 patients with JRA had the APF detected in their synovial fluid; they were running rather a severe course of illness. The use of the APF could be an aid in the diagnosis of JRA.
House dust mite exposure in asthmatic and healthy children: the difference is carpeting
Authors: Meijer G. G. , van der Heide S. , Postma D. S. , de Reus D. M. , Koeter G. H. , van Aalderen W. M. C.
Published: June 2007

Aim ‐ To determine whether house dust mite (HDM) exposure in living rooms and bedrooms is higher in asthmatic children than in those of age and sex matched healthy children, living in the same area. Methods ‐ Types of floor‐coverings were recorded and dust samples were collected by vacuum cleaning the total area of living rooms and bedrooms; Der p I and Der p II per gram fine dust concentrations were assessed. Twenty‐five asthmatic children (RAST HDM >= class 3, age 6–12 years) and 25 healthy children participated in the study. Results ‐ The frequency of cleaning and prevalence of smooth floor‐coverings in bedrooms of asthmatic children were significantly higher. There were no differences in living rooms in this respect. The amount of fine dust/m2 floor space was significantly lower in bedrooms of asthmatic children. Concentrations of HDM were low and no differences in Der p I and Der p II concentrations were observed between the two groups (asthmatic children: Der p I living room: 1.1 (0.04 ‐ 59.4 μg/ g), bedroom: 0.5 (below detection ‐ 19.3 μg/g); nonasthmatic children: Der p I living room: 1.4 (below detection ‐ 27.5 μg/g), bedroom: 0.9 (below detection ‐ 68.8 ug/g. Smooth floor coverings contained significantly less fine dust, Der p I, and Der p II than carpeted floors. Conclusions ‐ Low HDM concentrations are a general finding in Dutch dwellings in the present generation of children.

We observed a higher cleaning frequency, and more smooth floor coverings in bedrooms of asthmatic children than of healthy children, yet HDM concentrations were not significantly different. The latter can be explained by the observation that only 40% of the asthmatic children had smooth floor coverings in their bedrooms. Smooth floor coverings contain less fine dust and lower concentrations of Der p I and Der p II than carpeted floors.
(n‐6)‐Fatty acids in plasma lipids of children with atopic bronchial asthma
Authors: Leichsenring M. , Kochsiek U. , Paul K.
Published: June 2007

It has been suggested that atopy is associated with an impairment in the δ6‐desaturation of (n‐6)‐polyunsaturated fatty acids and subsequently low levels of eicosanoid precursors. To evaluate this hypothesis we analyzed the fatty acid composition of plasma phospholipids and plasma cholesterolest‐ers in a well‐defined group of children with atopic bronchial asthma (n = 17) and age‐matched healthy controls (n = 10). Atopic children showed significantly higher levels of linoleic acid and lower proportions of arachidonic acid in plasma lipids. No differences were observed with respect to γ‐lino‐lenic acid (GLA) and dihomo‐γ‐linolenic acid (DHLA). It is concluded that there is no biochemical evidence for a δ6‐desaturation defect in atopic children and therefore no justification for the supplementation of GLA and DHLA; e.g. by the use of evening primrose oil preparations.
Enhanced production of IL4 but not of IFNλ and IL10 by peripheral blood mononuclear cells from atopic children in response to CD2 plus CD28 stimulation
Authors: Holter W. , Emminger W. , Majdic O. , Knapp W.
Published: June 2007

Peripheral blood mononuclear cells from 16 children with atopic disease (range of IgE levels: 33 ‐ 2892 kU/l) and 12 age matched controls were stimulated either with mAbs specific for CD3, CD2, CD3 plus CD28, CD2 plus CD28, with Tetanus Toxoid, SEA, or PHA plus PMA and their cell proliferation was determined. In addition, their cytokine production (IL2, IL4, ILIO, IFNλ) following selected stimuli was measured. We found that the cells from atopies proliferated significantly better in response to CD2 stimulation than control cells, with no difference in response to CD3 or SEA stimulation. Furthermore, cells from atopies produced significantly higher amounts of IL4 than cells from controls, a difference most pronounced following CD2 plus CD28 stimulation. No differential production was found for IL 10 and IFNλ. We conclude that in atopic children with moderately elevated IgE a hyperreactivity of the CD2 pathway of stimulation and a clear elevation of IL4 but not of IL 10 or IENλ production can be demonstrated.
Histamine releasing cells of the newborn
Authors: Damsgaard T. E. , Nielsen B. W. , Henriques U. , Hansen B. , Merlin T. , Schiøtz P. O.
Published: June 2007

The cellular branch of the immune defence in the newborn has been shown to differ from adults in a number of ways. This report presents new data on the functions of the histamine‐sccreting cells of the newborn. Mast cells of the newborn were obtained from the human umbilical cord by enzymatic dispersion. The granules of the mast cells of the umbilical cord were found to contain both chymase and tryptase by immunohistochemical staining, and the presence of cell bound IgE on the mast cell surface was demon‐strated by staining sections of umbilical cord with peeroxidase conjugated anti IgE. The enzymatic dispersion yielded 12, 660 mast cells per gram um‐bilical cord (median), range 2, 500—60, 300 (n=48). The mast cells were found to constitute 3. 1 % of the total nucleated cells in the dispersate (median), range 1. 5—3. 8%. The histamine release from these cells was measured using a glass microfibre‐based method. Both the umbilical cord mast cells and the cord blood basophils released histamine stimulated with anti‐IgE. concanavalin A and the calcium ionophore A23187. In contrast to mast cells from adult tissue, the phorbol ester TPA was found to be an efficient secret agogue in both mast cells and basophils from the newborn. After maximal stimulation with anti‐IgE and phorbol ester the quantity of histamine released per millilitre of blood was significantly higher in cord blood than in adult blood. The spontaneous histamine release from cord blood basophils was also significantly higher than from adult blood basophils. The mast cells found in the umbilical cord matrix and the cord blood basophils represent a readily available source of metabolically active histamine releasing cells for exploration of the role of histamine‐secreting cells in newborn im‐mune defence.
Evaluation of efficacy of traditional Chinese medicines in the treatment of childhood bronchial asthma: clinical trial, immunological tests and animal study
Authors: Hsieh K‐H.
Published: June 2007

Traditional Chinese medicines (TCM) have been used to treat bronchial asthma for several centuries and a certain degree of clinical benefit has been observed; however, scientific substantiation is lacking. A multicenter, double‐blind and placebo‐controlled study was therefore conducted to evaluate the clinical efficacy in terms of symptom score, medication score, morning and evening PEFRs, and changes of immunoregulatory function, such as distribution of lymphocyte subsets and in vivo and in vitro production of lymphokines (IFN‐γ and IL‐4) and inflammatory mediators (histamine, PGE2 and LTC4). Furthermore, the protective effect of TCM on the late asthmatic reaction (LAR) was evaluated by using asthmatic guinea pigs. Three hundred and three asthmatic children were classified by Chinese doctors, according to a standardized questionnaire designed on the basis of basic logic of Chinese medicine, into three groups of specific constitution (group A, B and C). Group A consisted of 32 herb A‐treated patients and 34 placebo‐treated; group B, 74 herb B‐treated and 64 placebo‐treated; and group C, 55 herb C‐treated and 44 placebo‐treated. The study period was six months. The results were: 1) Both treatment group and placebo group showed an improvement in all clinical parameters, thus demonstrating a placebo effect. However, the improvement was usually greater in the former than the latter, although only the difference in PEFR was significant; 2) Herb A could increase total T cell and decrease B cell; 3) Herb A and B enhanced production of PGE2 but not LTC4, IFN‐γ and IL‐4; 4) There was a general tendency for in vivo and in vitro production of histamine to decrease at the end of study in both treatment group and placebo group; however, the decrease was significantly greater in the former than the latter; 5) In asthmatic guinea pigs, 10‐day's pretreatment with Chinese herbs could reverse the decrease of sGaw, suppress eosinophilia in bronchoalveolar lavage fluid (BALF), prevent the eosinophil infiltration of airways, increase PGE2 production and decrease LTC4 production in serum and BALF. Thus, traditional Chinese medicines did show a certain degree of clinical efficacy. The decreased production of histamine and LTC4, increased production of PGE2 that were found in both asthmatic children and asthmatic guinea pigs, and prevention of occurrence of LAR by suppressing eosinophil infiltration of airways and preserving airway conductance that were observed in asthmatic guinea pigs after allergen challenge might be used to account partly for the effectiveness.
Domestic fungal viable propagules and sensitization in children with IgE mediated allergic diseases
Authors: Dill I. , Niggemann B.
Published: June 2007

In order to study the possible relationship between domestic fungal exposure and sensitization to fungi, the homes of 20 children with allergic diseases (mainly bronchial asthma) were inspected for visible fungal growth and airborne viable fungal propagules were sampled. Inclusion criterion was sensitization to at least one of the tested fungi as shown by proof of specific IgE in serum. Twelve of 19 homes (63%) revealed a considerable amounl of viable fungal propagules and/or visible fungal growth. Penicilli‐um, Cladosporium, Aspergillus, Mycelia sterilia and yeasts were most prevalent. There was no clear‐cut relationship to serologically proven sensitization.
Serum eosinophil cationic protein and interleukin‐5 in children with bronchial asthma and acute bronchiolitis
Authors: Øymar Knut , Elsayed Said , Bjerknes Robert
Published: June 2007

The aim of our study was to evaluate the clinical applicability of serum eosinophil cationic protein (ECP), interleukin‐5 (IL‐5) and total eosinophil counts in childhood asthma and bronchiolitis. These parameters were measured in 44 children aged 12‐84 months with moderate and mild asthma during symptomatic and asymptomatic phases of disease. Fifteen of the patients were included at the time of admission to hospital due to an acute asthmatic attack, and ten of these were also examined one month after discharge. None of the patients were treated with glucocorticoids or cromoglycate at any time during the study. Serum ECP was significantly increased in the children with acute asthma compared to children with stable moderate asthma, stable mild asthma, as well as to controls. There was no difference between the groups with stable asthma or between stable asthma and controls, and there was large overlap between all groups of asthmatics and controls. Detectable levels of circulating IL‐5 were demonstrated in eight of 15 children with acute asthma, with significantly higher levels in atopic children, whereas all samples from children with stable asthma and controls were negative. The results suggest that even though serum ECP and IL‐5 increases during acute asthmatic attacks, these parameters cannot alone be used to discriminate between different groups of young children with stable asthma, nor between asthmatics and healthy controls. In addition, the same parameters of eosinophil inflammation were examined in serum samples from 25 children aged 1‐17 months undergoing their first episode of acute bronchiolitis. Children with acute respiratory syncytial virus (RS V) bronchiolitis had significantly higher levels of serum ECP than those with RSV negative disease, whereas the total eosinophil counts were significantly decreased in all patients with acute bronchiolitis. Serum IL‐5 was only detected in two children with acute bronchiolitis. The results suggest that the inflammation in RSV bronchiolitis differs from that induced by other viruses.
Association between pronounced IgA response in RSV bronchiolitis and development of allergic sensitization
Authors: Strannegård Ö. , Cello J. , Bjarnason R. , Sigurbergsson F. , Sigurs N.
Published: June 2007

Forty‐five children who had heen hospitalized with bronchiolitis caused by respiratory syncytial virus (RSV) at a mean age of 4 months, and 90 matched control children, were tested for occurrence of RSV antibodies at one year of age. Of the children who had suffered from bronchiolitis. forty had demonstrable IgG antibodies, whereas the remaining five only had IgA antibodies against RSV. In the control group. 42% were RSV seropositive. The anti‐RSV IgA antibody titres tended to be higher in patients with bronchiolitis ihan in controls and a larger proportion of the seropositive children in the former than in the latter group had demonstrable IgG antibodies. These fmdings suggest that RSV infections causing bronchiolitis are more often associated with a strong antibody response than are mild cases of the infection.

Follow‐up of the children at 3 years of age showed that allergic sensitization and development of asthma had occurred much more frequently in children with past RSV bronchiolitis than in controls. Children with past RSV bronchiolitis who later developed allergic sensitization had elevated RSV IgA antibody titres at one year of age more frequently than children with past RSV‐bronchiolitis. who were not sensitized (p=0.015). No significant differences regarding IgG antibody titres were observed. Since IgA, similarly a. s IgE. antibody formation is strongly Th2 cell dependent, the results are compatible with other fmdings suggesting that RSV has an unusual propensity to activate the Th2 cell system. This may contribute to the pathological picture of bronchiolitis in small children and at the same lime render the infected child predisposed for later development of allergic sensitization. RSV bronchiolitis may thus be an important risk factor for later development of atopic disease although it cannot be excluded that the bronchiolitis simply serves as a marker that predicts later development of atopy.