bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of positive skin prick tests, allergic asthma, and rhinoconjunctivitis in teenagers in northern Sweden
Authors: Norrman E. , Rosenhall L. , Nyström L. , Jönsson E. , Stjernberg N.
Published: May 2007

The prevalence of positive skin prick tests (SPT) for common allergens and symptoms of allergic rhinoconjunctivitis or asthma was investigated in Umeå in northern Sweden in 1987. Skin prick tests with 10 allergens common in Sweden and a questionnaire were used to examine 1112 teenagers. All subjects with a positive skin prick test or symptoms were interviewed, and they were further investigated by a serum specific IgE test, a ventilatory lung function test, and a physical examination. At least one skin prick test was positive in 43% of the subjects. Ninety‐three percent had at least one positive skin prick test to one of the three most common allergens: cat, timothy grass, and birch. The prevalence of current allergic rhinoconjunctivitis was 17%, current allergic asthma 2.8%, and current asthma (both allergic and nonallergic) 6.8%. Multiple logistic regression analysis showed that the most important risk factors for current asthma were sex (being a girl) and atopy. Heredity of asthma or rhinoconjunctivitis and being born in the winter (October‐March) also increased the risk. In atopic subjects, having a mother who smoked and heredity of asthma increased the risk. For allergic rhinoconjunctivitis, heredity increased the risk of getting rhinoconjunctivitis.
Shortness of interval between two stings as risk factor for developing Hymenoptera venom allergy
Authors: Pucci S. , Antonicelli L. , Bilò M. B. , Garritani M. S. , Bonifazi F.
Published: May 2007

The aim of the study was to determine whether a short interval (<2 months) between two consecutive stings influences the development of Hymenoptera venom allergy. The study compared the sting‐interval distribution in 120 allergic patients who experienced a first‐time systemic reaction to a Hymenoptera sting, and in 100 healthy controls. A significant difference in sting‐interval distribution between the two groups was found (P= 0.0001). In 71 of 120 allergic patients, the sting that provoked the systemic reaction had been preceded by another, completely tolerated sting not more than 2 months before. However, in the control group only four subjects out of 100 had received two consecutive stings within less than 2 months. In conclusion, a short interval between two consecutive stings seems to be a risk factor for the onset of Hymenoptera venom allergy.
Immunoglobulin preparations for intravenous administration
Authors: Nielsen H.
Published: May 2007

Substitution therapy with human immunoglobulin preparations is well established in disorders of primary or secondary deficiencies of humoral immunity. However, modifications of the immunoglobulins are required to achieve tolerance for the preferred intravenous route of administration. Several procedures are employed by different commercial suppliers of immunoglobulins, and from the literature it appears that various important biologic functions, e.g., opsonic activity, complement fixation, and Fc‐receptor function, are subject to alterations during the preparation. The best preservation of such activity, when assessed in vitro, is obtained with polyethylene glycol precipitation or DEAE‐Sephadex fractionation, whereas enzymatic or chemical treatment can potentially reduce the biologic activity. It is recommended that immunoglobulin preparations be evaluated in vitro for intact biologic function before being given to immunodeficient patients.
Glucocorticoid‐induced attenuation of mucosal exudation of fibrinogen and bradykinins in seasonal allergic rhinitis
Authors: Svensson C. , Klementsson H. , Andersson M. , Pipkorn U. , Alkner U. , Persson C. G. A.
Published: May 2007

The mucosal plasma exudate with its proteins, enzymes, derived peptides, and matrix molecules is an important factor in inflammatory airway diseases. This study investigated whether topical glucocorticosteroid treatment influences mucosal exudation of bulk plasma (fibrinogen) and the generation of plasma‐derived mediators (bradykinins) in seasonal allergic rhinitis. Twenty‐two patients with birch‐pollen‐induced allergic rhinitis participated in a double‐blind, randomized, placebo‐controlled study during the birch pollen season in 1989. After a 2‐week run‐in period, the participants received treatment with budesonide (200 μg per nasal cavity and day) or placebo. The patients kept a diary to record their daily nasal symptoms (itching, sneezing, nasal blockage, and secretion). The amount of birch pollen in the air was determined with the aid of a Burkhard pollen trap. A nasal lavage was performed once a week, and the levels of bradykinins and fibrinogen were determined in the lavage fluid samples. The birch pollen season was very mild, resulting in only minor nasal symptoms. In spite of the low pollen exposure, treatment with budesonide reduced the lavage fluid levels of both bradykinins and fibrinogen. The present results show that topical glucocorticosteroid treatment attenuates plasma exudation and the generation of plasma‐derived mediators in seasonal allergic rhinitis. This action may not result from simple vascular antipermeability effects of the drug but may rather reflect the anti‐inflammatory efficacy of topical glucocorticoids in the airway mucosa.
Occupational asthma and rhinoconjunctivitis from inhalation of dried cow's milk caused by sensitization to α‐lactalbumin
Authors: Bernaola G. , Echechipía S. , Urrutia I. , Fernández E. , Audícana M. , Fernández de Corres L.
Published: May 2007

A chocolate candy worker was diagnosed as having occupational asthma and rhinoconjunctivitis on the basis of clinical record and methacholine challenge. Positive conjunctival and bronchial challenge tests with lactalbumin showed that this protein was the pathogenetic agent. Type I hypersensitivity mechanism is demonstrated by means of skin prick test and RAST.
Atopic asthma caused by Candida albicans acid protease: case reports
Authors: Akiyama K. , Shida T. , Yasueda H. , Mita H. , Yamamoto T. , Yamaguchi H.
Published: May 2007

Two cases of atopic asthma caused by acid protease produced by Candida albicans are reported. Both patients had high levels of serum IgE antibodies against the acid protease and showed positive conjunctival and immediate bronchial responses when challenged with the protease. Significant histamine release was detected in both patients when their peripheral leukocytes were challenged with the protease antigen. These findings clearly showed that C. albicans acid protease is the causative allergen of atopic asthma.
* Immediate allergic reactions to amoxicillin
Authors: Vega J. M. , Blanca M. , Garcia J. J. , Carmona M. J. , Miranda A. , Perez‐Estrada M. , Fernandez S. , Acebes J. M. , Terrados S.
Published: May 2007

A large group of patients with suspected allergic reactions to (β‐lactam antibiotics was evaluated. A detailed clinical history, together with skin tests, RAST (radioallergosorbent test), and controlled challenge tests, was used to establish whether patients allergic to β‐lactam antibiotics had selective immediate allergic responses to amoxicillin (AX) or were cross‐reacting with other penicillin derivatives. Skin tests were performed with benzylpenicilloyl‐poly‐L‐lysine (BPO‐PLL), benzylpenicilloate, benzylpenicillin (PG), ampicillin (AMP), and AX. RAST for BPO‐PLL and AX‐PLL was done. When both skin test and RAST for BPO were negative, single‐blind, placebo‐controlled challenge tests were done to ensure tolerance of PG or sensitivity to AX. A total of 177 patients were diagnosed as allergic to β‐lactam antibiotics. We selected the 54 (30.5%) cases of immediate AX allergy with good tolerance of PG. Anaphylaxis was seen in 37 patients (69%), the other 17 (31%) having urticaria and/or angioedema. All the patients were skin test negative to BPO; 49 of 51 (96%) were also negative to MDM, and 44 of 46 (96%) to PG. Skin tests with AX were positive in 34 (63%) patients. RAST was positive for AX in 22 patients (41%) and to BPO in just 5 (9%). None of the sera with negative RAST for AX were positive to BPO. Challenge tests with AX were performed in 23 subjects (43%) to establish the diagnosis of immediate allergic reaction to AX, and in 15 cases (28%) both skin test and RAST for AX were negative. PG was well tolerated by all 54 patients. We describe the largest group of AX‐allergic patients who have tolerated PG reported so far. Diagnosis of these patients can be achieved only if specific AX‐related reagents are employed. Further studies are necessary to determine the exact extent of this problem and to improve the efficacy of diagnostic methods.
IgG subclass antibodies against Parietaria judaica in normal and allergic subjects
Authors: Palumbo S. , Di Felice G. , Mari A. , Bonini S. , Bruno G. , Tinghino R. , Afferni C. , Sallusto F. , Pini C.
Published: May 2007

IgG antibody response to the inhalant allergen Parietaria judaica (Pj) and IgG subclass distribution were studied in 82 normal subjects, divided into three groups according to age (0–1, 1–20, and 20–60 years) and in 32 allergic subjects aged 20–60 years. Both normal and allergic subjects showed an IgG response, and all had IgG1 antibodies specific for PjE. Serum IgG2, IgG3, and IgG4 against PjE were detectable in 36%, 46%, and 22% of normal subjects, and in 58%, 31%, and 65% of allergic subjects, respectively. A significant difference in class distribution between allergic and age‐matched normal subjects was found only for IgG4 antibodies against PjE (65% and 17%; P<0.01). The ELISA results were also analyzed quantitatively, taking into account the relative proportion of specific antibodies. Thus, in normal subjects IgG1 antibodies showed a decreasing trend as the age rose, while no differences according to the age of the subject were found for IgG2 and IgG4. When data from allergic subjects (20–60 years) and the age‐matched normal group were compared, they were different for the relative percentage of IgG2 only, showing for this a significantly lower value (P< 0.001). The present data indicate that normal and allergic subjects show differences in the IgG isotype distribution depending on their sensitivity and duration of allergen exposure.
Full automation in allergy testing: measurement of specific IgE by the ENEA System
Authors: Plebani M. , Faggian D. , Borghesan F.
Published: May 2007

We evaluated the ENEA System, a fully automated instrument for the measurement of specific IgE antibodies. The instrument dispenses sera and reagents, incubates, washes, and reads and prints results automatically. The “core” of the instrument is the reactive unit called ACE (Allergy Chamber Enzymatic), which is a new solid phase to which the allergens are linked. The system uses calibration curves specific for the major allergen families, and data are supplied qualitatively (five classes) and quantitatively. We evaluated the analytic efficiency of the system and its correlation with the in vivo test (skin prick test (SPT)) results in 60 patients with inhalant allergic diseases and in 20 controls. Results: 450 results were available within 4 h. A satisfactory within‐run (CVs between 1.58 and 6.2%) and between‐run (CVs 6.3–11.5%) precision was found. No significant earn‐over was observed. A wide linearity of the assay was demonstrated. With the concordance between the clinical history and SPT as the reference value, the clinical sensitivity of the ENEA System was 84.1 %, the specificity 82.8%, and the overall efficiency 83.4%. Finally, a good agreement with the results of another technique for the in vitro measurement of specific IgE (Pharmacia CAP System) was proven.
The effect of disodium cromoglycate (DSCG) on in vitro proliferation of CD4+, CD8+, and CD19+ cell populations derived from allergic and healthy donors
Authors: Holen E. , Elsayed S.
Published: May 2007

The effect of disodium cromoglycate (DSCG) on in vitro proliferation of CD4+ and CD8+ T cells and CD19+ B cells, positively selected by immunomagnetic separation, was investigated. The cells were obtained from allergic patients with moderate serum IgE levels and mild to moderate atopic dermatitis, and healthy controls. The different cell subfractions were stimulated with mitogens or specific allergens, as well as cell supernatants from the lymphoblastoid B‐ (RPMI 8866) and T‐hybridoma (166 A2) cell lines. Proliferative responses of T‐ and B‐cell subsets stimulated with mitogens together with recombinant interleukin‐2 (rIL‐2) or accessory cells (AC) could be inhibited by DSCG. In allergic individuals, significant allergen‐specific stimulation could be observed in the CD8‐depleted peripheral blood mononuclear cell (PBMC) fractions. Isolated CD4+ T cells, without AC or IL‐2, could also be stimulated with specific allergen, but the responses were rather low. DSCG inhibited, concentration dependently, all allergen‐induced responses. Interestingly, only atopic derived CD4+ and CD8+ T cells were stimulated by soluble low‐affinity IgE receptor (FcɛRII/sCD23) and IgE binding factor (IgEBF), including IgE enhancing factor, present in culture supernatants from RPMI 8866 and 166 A2, respectively. These responses were also inhibited by DSCG. This was in contrast to the amplifying effect of DSCG on spontaneously proliferating RPMI 8866 and 166 A2 cells, cultured in fresh cRPMI 1640 medium without sCD23 and IgE enhancing factor. Our results show that DSCG delivers an inhibitory signal or signals to PBMC subpopulations expressing FcɛRII/sCD23, either upregulated by phytohemagglutinin in normal and atopic cells, or by allergens or sCD23 in atopic cells. The findings suggest that sCD23 in supernatants or in serum may reverse the general inhibitory mode of DSCG.
Allergic reactions associated with airborne fish particles in IgE‐mediated fish hypersensitive patients
Authors: Crespo J. F. , Pascual C. , Dominguez C. , Ojeda I. , Muñoz F. M. , Esteban M. M.
Published: May 2007

We evaluated the clinical characteristics found in 21 children who showed allergic reactions upon incidental inhalation offish odors or fumes, from 197 diagnosed with IgE‐mediated fish hypersensitivity. Allergic reactions to fish via ingestion began in most patients (86%) within the first 24 months of life. The vast majority (19/21) of patients showed cutaneous symptoms, either alone or, less frequently, associated with other clinical manifestations. Hake and flounder were the species offish most frequently implicated in eliciting clinical manifestations upon ingestion. After diagnosis, all these patients were placed on a strict fish‐avoidance diet. During this period of avoidance, patients reported allergic reactions (mean age 7 years) after incidental exposure to airborne fish odors or fumes. Clinical manifestations through inhalation were respiratory (mainly wheezing) in 12 patients and cutaneous (mainly urticaria) in nine patients. Nineteen of 21 patients reported three or more episodes upon exposure to fish aerosols; in most cases, these episodes occurred at home when other people were eating fish. In conclusion, incidental inhalation of fish odors or fumes could play an important role in accidental and unknown encounters with fish in children on fish‐avoidance diets for fish IgE‐mediated hypersensitivity. Such exposures could elicit clinical symptoms and could have some effect in delaying the development of tolerance.
Effect of allergen provocation on inflammatory cell profile and endothelin‐like immunoreactivity in guinea‐pig airways
Authors: Andersson S. E. , Zackrisson C. , Behrens K. , Hemsen A. , Forsberg K. , Linden M. , Lundberg J. M.
Published: May 2007

The effect of allergen challenge on the number of leucocytes and the concentration of endothelin 1‐like immunoreactivity (ET‐LI) in bronchoalveolar lavage fluid (BALE) was investigated in guinea‐pigs sensitized to Ascaris suum. The animals were twice exposed to allergen aerosol. All animals responded to the second challenge with bronchoconstriction. Twelve hours later, a significant increase in the number of eosinophilic granulocytes in BALE, compared to unsensitized and unprovoked control animals, was noted. Twenty‐four hours after provocation, there was also an elevation of ET‐LI concentration and content of neutrophils. During the first day post‐challenge, the ET‐LI values were moderately correlated to the eosinophil levels. One week after challenge, the ET‐LI level and the neutrophil count did not differ from corresponding values in control animals whereas the number of eosinophils remained elevated. Pretreatment with dexamethasone before the second allergen challenge did not consistently affect the parameters studied during the first 24 h. Bronchoconstriction induced by carbachol aerosol affected significantly neither the ET‐LI concentration nor the number of inflammatory cells in BALE. It is concluded that the allergen‐induced inflammation in the guinea‐pig airways causes an elevation in the ET‐LI concentration in BALE and that this is moderately correlated to the influx of eosinophils during the first 24 h.
The efficacy and tolerability of fluticasone propionate aqueous nasal spray in children with seasonal allergic rhinitis
Authors: Boner A. , Sette L , Martinati L. , Sharma R. K. , Richards D. H.
Published: May 2007

Fluticasone propionate aqueous nasal spray (FPANS) contains fluticasone propionate, which is a new topically active glucocorticoid with approximately twice the potency of beclomethasone dipropionate. In this European multicentre study, 143 children with seasonal allergic rhinitis were recruited: 47 received FPANS 100 jag once a day (od), 46 received FPANS 200 μg od, and 50 patients received placebo od, for 4 weeks. Treatment efficacy was assessed using diary card nasal symptom scores for sneezing, rhinorrhoea, blockage and itching, and eye watering/irritation. Patients receiving FPANS 100 μg or FPANS 200 μg demonstrated statistically significant improvements in median nasal symptom scores in all the symptoms recorded, when compared with placebo. There were no statistically significant differences between the FPANS 100 μg and FPANS 200 μg groups in improvement in nasal symptom scores. There was no effect on eye watering/irritation symptoms which could be attributed to either FPANS 100 μg or FPANS 200 μg when compared with placebo. Use of rescue antihistamine medication was significantly reduced in the FPANS 100 μg group when compared with placebo. The adverse events profile was similar in all three treatment groups, and the events reported were generally mild and related to the patients’ rhinitis.
Human seminal plasma anaphylaxis (HSPA): case report and literature review
Authors: Ebo D. G. , Stevens W. J. , Bridts C. H. , De Clerck L. S.
Published: May 2007

Human seminal plasma anaphylaxis (HSPA) is rare but may be life‐threatening. The antigen or antigens involved in these reactions reside in a glycoprotein fraction of human seminal plasma (HSP). We report a woman who experienced HSPA. Literature on the subject is reviewed.
Proteinase content of mast cells of nasal mucosa; effects of natural allergen exposure and of local corticosteroid treatment
Authors: Juliusson S. , Aldenborg F. , Enerbäck L.
Published: May 2007

The distribution and density of metachromatic cells (MCC) and mast cells containing chymase plus tryptase (MCTC) or tryptase alone (MCT) were studied in the nasal mucosa by dye‐binding methods and immuno‐histochemical analysis. Biopsies were obtained from 17 subjects with birch pollen allergy before and during the peak season and from nine healthy controls. Six patients were treated with an intranasal glucocorticosteroid before and during the season in an open study. Hay fever patients, even when asymptomatic, showed signs of mast cell system activation, exhibiting an increased number of mast cells in the nasal epithelium. Basophils, lacking immunohistochemically detectable tryptase, were not a major component of the mast cell response. MCT, most conspicuous in the epithelium, were found to be the most frequent mast‐cell type in the nasal mucosa of allergic, but not of normal, subjects. Only 33% of the epithelial, but 90% of the stromal, immunopositive cells in the atopic mucosa before as well as during the season were MCC. Intraepithelial MCT thus displayed a low capacity to stain metachromatically, indicating a relative deficiency of the glycosaminoglycan (heparin) component of the granules. Intraepithelial mast cells also appeared to be markedly sensitive to steroid treatment and aldehyde fixation. The findings suggest that the lack of chymase, the characteristic feature of MCT, may reflect a functional activation of the mast cells, rather than a stable phenotypic differentiation related to anatomic site.
Methacholine induces wheal‐and‐flare reactions in human skin but does not release histamine in vivo as assessed by the skin microdialysis technique
Authors: Petersen L.J. , Skov P. S.
Published: May 2007

A number of investigations have indicated that cholinergic agonists release histamine from isolated mast cells and suggested that cholinergic stimulation releases histamine in vivo. The purpose of this study was to investigate whether the cutaneous wheal‐and‐flare reaction induced by methacholine challenge in human skin involves histamine release as measured by the skin microdialysis technique. Five hollow dialysis fibers were inserted intradermally in forearm skin in eight healthy subjects. Each fiber was perfused with Kreb's‐Ringer bicarbonate at a rate of 3 μl/min. Dialysates were collected in 2‐min fractions before skin challenge and for 20 min after intradermal injection of methacholine 10–‐3 ‐10‐1 M, the vehicle, and a positive control, codeine phosphate 0.3 mg/ml. Histamine was assayed spectrofluorometrically. Methacholine caused a statistically significant dose‐related wheal‐and‐flare reaction, the flare reaction to methacholine 10‐1 M being comparable with that seen with codeine 0.3 mg/ml. No significant histamine release was observed with methacholine, cumulative histamine release of 16 ± 8nM by methacholine 10‐1 M being similar to vehicle responses of 15 ± 9 nM. Histamine release by codeine was 2524 ± 435 nM. In conclusion, methacholine‐induced wheal‐and‐flare reactions in human skin appeared not to involve histamine release from skin mast cells.
Drug‐dependent exercise‐induced anaphylaxis
Authors: van Wijk R. Gerth , de Groot H. , Bogaard J. M.
Published: May 2007

Exercise‐induced anaphylaxis (EIA) is well known and may be food‐dependent. We describe a patient with a history of anaphylaxis during exercise after taking nafylpropion acid (Naprosyne®), a nonsteroidal anti‐inflammatory drug. An exercise‐challenge test after Naprosyne intake induced bronchoconstriction. The combination of history and challenge tests suggests that intolerance or allergy to drugs may present as EIA.
Costimulation of CD3/TcR complex with either integrin or nonintegrin ligands protects CD4+ allergen‐specific T‐cell clones from programmed cell death
Authors: Agea E. , Bistoni O. , Bini P. , Migliorati G. , Nicoletti I. , Bassotti G. , Riccardi C. , Bertotto A. , Spinozzi F.
Published: May 2007

An optimal stimulation of CD4+ cells in an immune response requires not only signals transduced via the TcR/CD3 complex, but also costimulatory signals delivered as a consequence of interactions between T‐cell surface‐associated costimulatory receptors and their counterparts on antigen‐presenting cells ‘APC). The intercellular adhesion molecule‐1 ‘ICAM‐1, CD54) efficiently costimulates proliferation of resting, but not antigen‐specific, T cells. In contrast, CD28 and CD2 support interleukin ‘IL)‐2 synthesis and proliferation of antigen‐specific T cells more efficiently than those of resting T cells. The molecular basis for this differential costimulation of T cells is poorly understood. Cypress‐specific T‐cell clones ‘TCC) were generated from four allergic subjects during in vivo seasonal exposure to the allergen. Purified cypress extract was produced directly from fresh collected pollen and incubated with the patients' mononuclear cells. Repeated allergen stimulation was performed in T‐cell cultures supplemented with purified extract and autologous APC. The limiting‐dilution technique was then adopted to generate allergen‐specific TCC, which were also characterized by their cytokine secretion pattern as ThO ‘IL‐4 plus interferon‐gamma) or Th2 ‘IL‐4). Costimulation‐induced proliferation or apoptosis was measured by propidium iodide cytofluorometric assay. By cross‐linking cypress‐specific CD4+ and CD8+ T‐cell clones with either anti‐CD3 or anti‐CD2, anti‐CD28, and anti‐CD54 monoclonal antibodies, we demonstrated that CD4+ clones ‘with ThO‐ or Th2‐type cytokine production pattern) undergo programmed cell death only after anti‐CD3 stimulation, whereas costimulation with either anti‐CD54 or anti‐CD28 protects target cells from apoptosis. The costimulation‐induced protection from apoptotic death was associated with a significant rise in IL‐4 secretion in both Th0 and Th2‐type clones. In contrast, cypress‐specific Th0 CD8+ clones were more susceptible to stimulation‐induced apoptosis via either anti‐CD3 or anti‐CD2, alone or in combination with anti‐CD54 or anti‐CD28, thus displaying only slight but nonsignificant modifications in the pattern of IL‐4 secretion. The death‐promoting costimulatory effects were not observed with highly purified normal resting CD4+ or CD8+ lymphocytes. Taken together, these results suggest that TcR engagement by an allergen in the context of functionally active APC induces activation‐dependent cell death of some, perhaps less specific, cells, and this may be an important homeostatic mechanism through which functional expansion of allergen‐specific T cells is regulated during an ongoing immune response.
The use of anti‐H1drugs in mild asthma
Authors: Meltzer Eli O.
Published: May 2007

Meltzer EO. The use of anti‐H1drugs in mild asthma.
Distribution of total serum IgE and specific IgE to common aeroallergens by sex and age, and their relationship to each other in a random sample of the Dutch general population aged 20–70 years*
Authors: Kerkhof M. , Droste J. H. J. , de Monchy J. G. R. , Schouten J. P. , Rijcken B.
Published: May 2007

To describe the distribution of serum total IgE and specific IgE. to common aeroallergens by sex and age and to study their relationship to each other, we measured serum total IgE and specific IgE (CAP) to house‐dust mite, timothy grass, cat, birch, and Cladosporium in a random sample of 2496 subjects, aged 20–70 years from the Dutch general population. We found that total IgE was higher in men, independently of smoking, and that total IgE had no relationship with age after adjustment for specific IgE and smoking in linear regression analysis. At least one positive specific IgE test was found in 32% in both sexes. Men had higher prevalences of specific IgE to house‐dust mite and lower prevalences of specific IgE to birch than women. The proportion with positive specific IgE decreased with age. The mean total IgE increased with the number of positive specific IgE tests. Thus, total IgE is higher in men and has no relationship with age if specific IgE is taken into account. The prevalences of specific IgE to aeroallergens are high and decrease with increasing age. We suggest that sex differences in total IgE should be considered when using total IgE.
Effects of rapamycin, cyclosporin A, and dexamethasone on interleukin 5‐induced eosinophil degranulation and prolonged survival
Authors: Meng Q. , Ying S. , Corrigan C. J. , Wakelin M. , Assoufi B. , Moqbel R. , Kay A. B.
Published: May 2007

Interleukin‐5 (IL‐5) enhances eosinophil degranulation and prolongs eosinophil survival. Rapamycin, cyclosporin A, and dexamethasone have been shown to influence either cytokine transcription, cytokine‐mediated signalling, or degranulation by granulocytes. The study aimed to determine whether these agents inhibited IL‐5‐enhanced eosinophil survival or degranulation. Peripheral blood eosinophils were isolated from atopic subjects. The effects of serial dilutions (10−6‐10−9 M) of these drugs or vehicle control on 1) the viability of eosinophils cultured (1–5 days) in the presence and absence of recombinant human IL‐5, as measured by propidium iodide staining and flow cytometry, and 2) degranulation of eosinophils preincubated (45 min) with rhIL‐5 or medium control, as measured by eosinophil cationic protein (ECP) release after stimulation with serum‐coated Sephadex beads, were assessed. Dexamethasone and rapamycin produced significant, concentration‐dependent inhibition of IL‐5‐enhanced eosinophil survival at pharmacologic concentrations, whereas cyclosporin A did not. Prior incubation of eosinophils with IL‐5, as compared with medium control, significantly enhanced ECP release by eosinophils on subsequent exposure to serum‐coated Sephadex beads. Cyclosporin A and rapamycin significantly inhibited IL‐5‐enhanced ECP release in a concentration‐dependent fashion, whereas dexamethasone did not. All three drugs had no significant effect on eosinophil survival and degranulation in the absence of IL‐5. Our results suggest that immunosuppressive drugs may inhibit IL‐5‐mediated mechanisms in eosinophils which result in enhanced survival and release of granule contents. These findings may be relevant to the further development of therapeutic strategies in allergic diseases.
Serum tryptase levels in adverse drug reactions
Authors: Ordoqui E. , Zubeldia J. M. , Aranzábal A. , Rubio M. , Herrero T. , Tornero P. , Rodríguez V. M. , Prieto A. , Baeza M. L.
Published: May 2007

We evaluated the usefulness of individual tryptase levels and variations after adverse drug reactions in 64 patients. Our aim was to find a tool for the diagnosis of drug allergy. Thirty‐seven subjects were confirmed to have drug allergy, 12 had nonsteroidal anti‐inflammatory drug (NSAID) reactions, five had negative controlled drug challenges (NAAR), and 10 had symptoms after placebo intake (PLA). Serum tryptase levels greatly increased after anaphylactic shocks (2242%) and anaphylaxis (710.5%). Patients with allergic urticaria and those with idiosyncratic responses to acetylsalicylic acid (ASA) exhibited a small increase in serum tryptase (49.5% and 38.2%, respectively). In the other two groups (NAAR and PLA), no variation in this serum protease was observed. The time of appearance of the serum tryptase peak differed considerably among patients with similar clinical reactions (from 30 min to 6 h) and was independent of the latent period, severity of symptoms, or the amount of tryptase released. We conclude that serum tryptase determinations are helpful in the diagnosis of anaphylactic shock and anaphylaxis, but serial measurements may be needed to confirm mast‐cell participation in milder reactions.
Allergenic properties of kiwi‐fruit extract: cross‐reactivity between kiwi‐fruit and birch‐pollen allergens
Authors: Voitenko V. , Poulsen L. K. , Nielsen L. , Norgaard A. , Bindslev‐Jensen C. , Skov P. Stahl
Published: May 2007

Our investigation aimed to produce and characterize a kiwi extract and to use this extract to investigate a possible cross‐reactivity with birch pollen. Kiwi was extracted in two buffers: phosphate‐buffered saline (PBS) and borate‐buffered saline (BBS). Extraction in BBS produced a double amount of protein, and a more stabile extract. Tandem crossed‐immunoelectrophoresis showed that the BBS and PBS extracts had several common, but also a few individual, proteins. The mixture of both extracts was assumed to represent the most complete allergen extract. The allergenic properties of the kiwi extract were investigated by immunoblotting (IB), RAST, and histamine‐release (HR) test in 15 birch‐pollen‐allergic patients (eight of them with clinical kiwi allergy) and one with clinical monoallergy to kiwi. All eight birch‐pollen‐allergic patients with kiwi allergy and the kiwi‐monoallergic patient were positive in kiwi IB binding most frequently to proteins of 10‐12 and 20‐25 kDa. With our extract, RAST was positive in four kiwi‐allergic and one non‐kiwi‐allergic patient, whereas the HR test was positive in five kiwi‐allergic patients and negative in all non‐kiwi‐allergic patients. RAST and IB inhibition demonstrated cross‐reactivity between birch‐pollen and kiwi allergens due to a 10‐12 kDa protein. In conclusion, a kiwi extract with allergenic properties was produced, and, by the methods used, cross‐reactivity was demonstrated between birch‐pollen and kiwi allergens.
Suppression of the immune system by oral glucocorticoid therapy in bronchial asthma
Authors: Oehling A. G. , Akdis C. A. , Schapowal A. , Blaser K. , Schmitz M. , Simon H.‐U.
Published: May 2007

The effect of systemic glucocorticoid therapy on immune parameters was studied in patients with bronchial asthma. Patients were divided into two groups: 1) those receiving oral glucocorticoid; 2) control patients who did not receive systemic glucocorticoid treatment. The glucocorticoid dose varied between 5 and 70 mg per day. Patients had been taking oral therapy for at least 1 year. Glucocorticoid treatment was associated with an increased frequency of respiratory tract infections. Therefore, we need to define immune parameters which may predict an increased risk of infections. In this study, we analyzed several surface markers on lymphocytes and monocytes by flow cytometry. A significant reduction of the ratio of peripheral blood CD4+ to CD8+ T cells was associated with the administration of oral glucocorticoids. Furthermore, the expression of the HLA‐DR molecule on monocytes was reduced in patients with systemic glucocorticoid therapy compared to control patients. Moreover, the capacity to elaborate cytokines by peripheral blood mononuclear cells upon stimulation was greatly reduced after exposure to glucocorticoids in vivo and in vitro. In addition, the humoral immune response was affected, because reduced IgG, IgM, and IgA levels were observed in patients receiving oral glucocorticoids. These results indicate that systemic glucocorticoid treatment in patients with bronchial asthma is associated with cellular and humoral immunosuppression which results in an increased risk of bacterial and viral infections.
Clinical responses to ingested fungal α‐amylase and hemicellulase in persons sensitized to Aspergillus fumigatus?
Authors: Cullinan P. , Cook A. , Jones M. , Cannon J. , Fitzgerald B. , Newman Taylor A. J.
Published: May 2007

α‐Amylase and hemicellulase, derived from culture of Aspergillus species, are commonly added to flour as improvers during baking. Two cases of women occupationally sensitized to α‐amylase who developed allergic symptoms after eating baked bread have been reported. With a randomized, controlled study design, we have investigated whether similar responses occur in those sensitized to Aspergillus species. Seventeen subjects with positive skin prick tests to Aspergillus fumigatus were studied. Symptomatic and physiologic responses after ingestion of bread baked with α‐amylase and hemicellulase were compared, in a crossover fashion, with those after ingestion of bread baked without enzymes. No increase in respiratory or other symptoms, lung function, or nonspecific bronchial hyperreactivity was reported after ingestion of the enzyme‐containing bread. We conclude that important clinical reactions to α‐amylase and hemicellulase in baked bread do not frequently occur in those sensitized to Aspergillus species.
Recombinant mite allergens
Authors: Chapman M. D. , Smith A. M. , Vailes L. D. , Arruda L. K.
Published: May 2007

The introduction of molecular cloning techniques has led to advances in allergen identification and sequencing, production of recombinant allergens, identification of B‐cell and T‐cell epitopes, and tertiary structural analysis of allergen molecules. Over 10 groups of mite allergens have been cloned from Dermatophagoides spp., as well as several homologous allergens from Euroglyphus maynei, Lepidoglyphus destructor, and Blomia tropicalis. The availability of these allergens has made it feasible to consider their use for both diagnostic and therapeutic purposes. Several recombinant Dermatophagoides allergens show comparable reactivity on skin testing and in serologic assays to natural allergens, and cocktails of the recombinant proteins could be used as diagnostic reagents. New technologies have been developed for detection of allergen‐specific IgE and for environmental allergen detection using rapid diagnostic tests. Novel approaches to immunotherapy are also being investigated, including T‐cell‐peptide‐based vaccines, allergen variants which lack IgE reactivity, and naked DNA vaccines. The application of allergen biotechnology should lead to improvements in the management of mite‐allergic patients with asthma and represents a logical step toward reducing asthma mortality and morbidity.
Efficacy of mequitazine in comparison with placebo assessed by ocular challenge with allergen in allergic conjunctivitis
Authors: Persi L. , Dupin O. , Arnaud B. , Trinquand C. , Michel F.‐B. , Bousquet J.
Published: May 2007

Pharmacologic intervention in the management of allergic conjunctivitis was evaluated with different topical ocular agents in man. Their effect can be precisely assessed with the conjunctival provocation test (CPT). A potent specific H1‐receptor antagonist, 0.05% mequitazine eye‐drops, was tested in a double‐blind, randomized, placebo‐controlled study using CPT with grass pollen allergens. Twenty healthy subjects allergic to grass pollen were included outside the pollen season after a positive CPT screening. They received one drop of 0.05% mequitazine in one eye and the vehicle in the contralateral eye in a random order, four times daily for 5 days. CPT was performed 15 min after the last instillation, and the threshold dose inducing a positive reaction was determined. Results were given by Abelson's composite score including redness, chemosis, tearing, and itching. Topical 0.05% mequitazine significantly reduced the composite score compared to placebo. The allergen threshold concentration which induced the positive conjunctival reaction was higher in mequitazine pretreated eyes. No side effect was reported. These data clearly suggest that mequitazine has potential to treat allergic conjunctivitis.
Cockroach allergen in house dust
Authors: van Wijnen J. H. , Verhoeff A. P. , Mulder‐Folkerts D. K. F. , Brachel H. J. H. , Schou C.
Published: May 2007

The cockroach allergen (Bla g 1) content was determined in the floor dust of 46 homes with recent cockroach extermination in Amsterdam, The Netherlands. IgE antibodies to Blattella germanica, house‐dust mite, cat dander, dog dander, and a mixture of molds were determined in venous blood samples of 46 children (4‐12 years) and one of their biologic parents (24‐54 years). Specific IgE to cockroach was also determined in a sample of the general population studied in a previous case‐control study, one group (n=20) with and three groups (n=76) without history of cockroach infestation of the home. Cockroach allergen was detected in floor dust from 44% of the homes, with levels up to 3899 ng Bla g 1/g. Seven of the 46 adults and only one of the 46 children studied had positive RAST to cockroach. Geometric mean cockroach allergen concentrations in living room and master bedroom of sensitized adults were similar to those of nonsensitized adults. In the groups of children without a history of cockroach infestation of the home, positive RAST against cockroach was observed in 16% of the children with respiratory symptoms, in 4% of the children without respiratory symptoms, and in 48% of the children with two or more positive RAST to other allergens. Of the 18 children with positive RAST against cockroach, only one had a history of cockroach infestation of the home and 16 (89%) had also positive RAST against house‐dust mite.
Exposure chamber for allergen challenge. A placebo‐controlled, double‐blind trial in house‐dust‐mite asthma
Authors: Rønborg S. M. , Mosbech H. , Poulsen L. K.
Published: May 2007

Exposure chambers have proven to be valuable tools in the study of reactions to aeroallergens, and in monitoring the efficacy of antiallergic therapy. In the present study, 15 house‐dust‐mite‐allergic asthmatics and five nonallergic volunteers were challenged in a recently developed exposure chamber. The trial was performed double‐blinded with house‐dust‐mite allergen or placebo. Patients with allergy to house‐dust mite (Dermatophagoides pteronyssinus) (Der p) were included by positive skin prick test, allergen‐specific IgE, and conventional bronchial allergen challenge, with nebulizer and mouthpiece. In the exposure chamber, a total allergen dose corresponding to 1200 ng Der p 1 was applied. All participants kept diaries, recording peak expiratory flow rates, symptoms, and medication in periods of at least 2 weeks before and after each challenge. Twelve of the 15 asthmatics reacted with asthmatic symptoms with a median change in FEV1 of −16.4% when exposed to the allergen, but not to placebo, in the exposure chamber. Three patients had only minor symptoms during both chamber exposures and experienced no impairment of pulmonary function. Late‐phase reactions were less frequent (one vs three) after the exposure chamber challenges, as compared to the traditional challenges. None of the healthy subjects reacted to the challenges. In conclusion, our exposure chamber was able to elicit symptoms in allergic subjects, and this ability was obtained with only minor amounts of house‐dust‐mite allergen. The described method could prove to be a more physiologically relevant model to monitor individual responses to aeroallergens.
Influence of maternal infections with viral agents or Toxoplasma gondii during pregnancy on fetal IgE production
Authors: Lilja G. , Forsgren M. , Johansson S. G. O. , Kusoffsky E. , Oman H.
Published: May 2007

The importance of maternal infections with Toxoplasma gondii, cytomegalovirus (CMV), Parvovirus B19, respiratory syncytial virus (RSV), and influenza A and B on fetal IgE synthesis was studied in 153 pregnant women. No case of specific IgM activity or viral DNA in cord blood, indicating a congenital infection, was found. From gestational week 15 to delivery, maternal IgG‐Ab seroconversion to Parvovirus B19, RSV, influenza A, or influenza B occurred in 47 women. At delivery, serologic signs of past infection with T. gondii were observed in 29 (19%) women, and the corresponding figure for CMV was 117 (77%). The number of women with positive IgG seroconversion during pregnancy or positive IgG‐Ab activity toward the studied infectious agents at delivery did not differ significantly among infants with an increased (≥1.3 kU/1; n=51) or with an undetectable (<0.1 kU/l; n=102) cord‐blood IgE level. These results show that genetic and other environmental factors probably have a greater influence on fetal IgE synthesis than do maternal infections during pregnancy.
Aerobiologic particle sampling by a new personal collector (Partrap FA52) in comparison to the Hirst (Burkard) sampler
Authors: Fiorina A. , Scordamaglia A. , Mincarini M. , Fregonese L. , Canonica G. W.
Published: May 2007

A new personal portable sampler of biologic particles (Partrap FA52, Coppa, Biella, Italy) was used for pollen sampling in comparison with Hirst's (Burkard) fixed device. The acrobiologic samplings were carried out simultaneously outdoors with the two devices coupled on the same axis, during the daytime of 10 dry, nonconsecutive spring days. The total amount and the percentages of the pollens most often trapped by the two collectors were compared by Student's t‐test for paired samples. The Partrap FA52 showed a highly significant efficacy, quite comparable to that of the Burkard device, in pollen trapping for both the total number (P < 0.0001) and the percentages of Parietaria (P < 0.0001), pine (P < 0.002), and grass (P < 0.0001) pollens. Therefore, Partrap FA52 proved to be highly effective in obtaining quantitative and qualitative aerobiologic samples in comparison with the commonly used fixed samplers.
Correlations between skin prick tests using commercial extracts and fresh foods, specific IgE, and food challenges
Authors: Rancé F. , Juchet A. , Brémont F. , Dutau G.
Published: May 2007

The skin prick test is the most widely used test for detecting IgE‐mediated food hypersensitivity. Our study aimed to define firstly the correlations between results obtained with prick tests using commercial extracts and fresh foods, and secondly the correlations between these results and those obtained with labial and/or oral challenge. We compared the wheal diameters read at 15 min with commercial extracts and fresh foods, for four foods, in 430 children with suspected food allergy. For cow's milk, wheal diameters were larger with commercial extracts, but the difference was not significant. Conversely, wheal diameters were significantly larger with fresh foods for the other food allergens. Skin prick tests were positive in 40% of cases with commercial extracts and in 81.3% with fresh foods. The overall concordance between a positive prick test and positive challenge was 58.8% with commercial extracts and 91.7% with fresh foods. These results indicate that fresh foods may be more effective for detecting the sensitivity to food allergens. Fresh foods should be used for primary testing for egg, peanut, and cow's milk sensitivity.
Effects of air pollution and other environmental factors on birch pollen allergens
Authors: Helander M. L. , Savolainen J. , Ahlholm J.
Published: May 2007

To determine the effects of anthropogenic pollution on water‐soluble proteins and specifically allergens in birch (Betula pendulaandB. pubescens) pollen, we analyzed extracts of pollen from the pollution gradient around a factory complex (emitting sulfur oxides and heavy metals) by sodium dodecyl sulfate (SDS) ‐ polyacrylamide gel electrophoresis (PAGE) and IgE immunoblotting. In addition, tree density‐associated shading of the tree habitat, and quantity and quality of proteins and allergens in pollen of the two birch species were studied. The two studied birch species gave identical allergen profiles even though their protein profiles differed. Distance from the factory did not affect the amount of birch pollen major allergen. Bet v 1 (17 kDa), or of two other strong allergens (23 and 36 kDa). Trees growing in shaded places had significantly stronger responses to Bet v 1 and to the 23‐kDa allergen than trees growing in open or half‐open environments. Thus, we propose that combined heavy metal and sulfur dioxide pollution does not have an important effect on birch pollen allergens. Instead, other factors, e.g., shading and soil properties of the tree habitat, as well as the genetic background of the tree, may have a stronger influence on the quantity and relative composition of allergens.
Latex allergy from glove powder ‐ an unintended risk with the switch from talc to cornstarch?
Authors: Lundberg M. , Wrangsjö K. , Johansson S.G.O.
Published: May 2007

The present study aimed to investigate to what extent glove powders of different origins and brands bind and release latex allergens. One mineral talc and five cornstarch powders were used. The allergenic material was sap of Hevea brasiliensis. The powders were incubated together with the natural rubber latex sap, and four series of experiments were performed. The talc showed the highest tendency to bind isotope‐labeled proteins. When incubated with a latex allergen solution, it reduced free allergen from 100 to 2 units/ml compared to a reduction to 70–98 units/ml for the cornstarch powders. In contrast to the nonstable binding of allergen to cornstarch, the binding to talc was irreversible. The allergen bound to talc was allergenically intact and, when incubated with serum, reduced the concentration of free IgE antibody to latex to 10% of the initial level. Mineral talc had a high capacity to bind latex allergens firmly. In contrast, cornstarch captured the latex allergen, but the binding seemed less pronounced and was unstable. The replacement of talc by cornstarch as glove‐donning powder has coincided with the rapid increase in latex allergy. Mineral talc is heavy and only transiently airborne. Could this difference between talc and cornstarch in latex‐allergen‐binding pattern and the tendency of the latter to be airborne play an important role in the bioavailability of latex allergen and thus in the epidemic of latex sensitization?