bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of histamine release from basophils in whole blood by benzylpenieilloyl poly‐L‐lysine in penicillin‐sensitized patients
Authors: Koller D.Y. , Rosenkranz A. R. , Pirker C. , Götz M. , Jarisch R.
Published: May 2007

Histamine release from basophil granulocytes in whole blood by benzylpenicilloyl poly‐l‐lysine (PPL) was investigated in 7 patients with penicillin allergy. All patients presented with systemic immediate hypersensitivity reactions after i.v. administration of penicillin G. Total histamine (of 7 patients) ranged from 27.5 ng/ml to 62.1 ng/ml (mean 43.2 ng/ml). The spontaneous histamine release ranged from 0.15% to 5.1% (mean 1.8%) of the total content. Addition of PPL in various concentrations resulted in values between 0.8 and 9.6%. Although PPL is a reliable allergen for prick‐ and intradermal testing in the diagnosis of penicillin allergy ‐ demonstrating a histamine liberation in the skin ‐ the in vitro experiment using the same allergen showed no histamine release above 10%. Using a threshold of 5% out of 7 patients, 4 (57%) would show a positive histamine release. Therefore it might indicate that in penicillin allergy a threshold of 5% must be used. In addition, basophils in whole blood and skin mast cells may be activated differently.
Clinical evaluation of CAP System and RAST in the measurement of specific IgE
Authors: Pastorello E. A. , Incorvaia C. , Pravettoni V. , Marelli A. , Farioli L. , Ghezzi M.
Published: May 2007

We investigated the diagnostic value of a new in vitro test, Pharmacia CAP System (Pharmacia Diagnostics AB, Uppsala, Sweden), for the quantitative measurement of allergen‐specific IgE antibodies by comparison with RAST in 2 groups of patients, 71 atopic and 48 non‐atopic. In the last 20 years RAST has supplied a good diagnostic tool, but this test presents some problems, the main one being sensitivity. The new test has a solid phase able to bind even very small amounts of specific IgE and an anti‐IgE tracer with very low cross‐reactivity with other immunoglobulins, thus presenting more favourable conditions. From the analysis of our results, Pharmaeia CAP System gave higher sensitivity (94% compared to 88% of RAST) with no loss of specificity (96% for both tests). The reliability of these results is ensured by the proper selection of patients who were all suffering from pollinosis and were clinically diagnosed as certainly hypersensitive to a single pollen. A positive trend was found between severity of asthma and levels of specific IgE for timothy. Pharmacia CAP System appears to identify a larger number of atopic patients than RAST.
Clinical evaluation of in vitro leukocyte histamine release in allergy to muscle relaxant drugs
Authors: Mata E. , Guéant J. L. , Moneret‐Vautrin D. A. , Bermejo N. , Gérard P. , Nicolas J. P. , Laxenaire M. C.
Published: May 2007

We have evaluated the in vitro leukocyte histamine release tests for the diagnosis of allergy to muscle relaxant drugs in 40 patients (Group A) and a control group of 44 subjects with negative leukocyte histamine release (Group B). Non‐IgE dependent histamine release, expressed as a percentage of the total blood histamine, was 3.94%± 0.49 in Group B. The upper limit of positivity was estimated to be 5% (mean + 2 SD). Leukocyte histamine release tests were positive in 65 % of the patients from Group A. The concordance between LHR and QAS‐RIA was 64%. The maximal histamine release was observed at dilutions of 10−2–10−4 in 20 of the 26 positive cases. The maximal histamine release was 43.8%± 23.3. The spontaneous histamine release was as low as 1.7%± 1.1. Cross‐reactivity among the 5 different muscle relaxant drugs has been investigated and compared by intradermal testing. The muscle relaxant drugs which gave the lower skin reaction (M2) and the drug responsible for shock (M1) were selected for the study of in vitro leukocyte histamine release. Of 20 patients, 10 had, simultaneously, a positive test to Ml and a negative to M2. All of the 10 cases had negative ID tests with M2. Three of these patients subsequently underwent general anesthesia with the muscle relaxant chosen as harmless (M2) without any clinical reaction.
Twelve months, treatment with inhaled salmeterol in asthmatic patients
Authors: Lötvall J. , Lunde H. , Ullman A. , Törnqvist H. , Svedmyr N.
Published: May 2007

Salmeterol is a new β2‐receptor agonist with a prolonged duration of action after inhalation, exceeding 12 h in most patients. We have performed a 12‐month open follow‐up study on 11 patients with reversible asthma. All patients were given salmeterol inhalations (50 μg twice daily). Additional asthma treatment included inhaled corticosteroids in all patients, and oral slow‐release theophylline or β2‐receptor agonists in a minority of patients (3 and 1, respectively). Before salmeterol treatment was initiated and after 3, 6, 9 and 12 months of salmeterol treatment, a cumulative dose‐response curve to inhaled salbutamol (100, 300 and 900 μg) was performed, and FEV1 measured. We also evaluated the effect of each salbutamol dose on finger tremor, systemic blood pressure and heart rate. Blood tests, including white blood count and electrolytes, were taken at each visit. After salmeterol treatment was initiated, morning FEV1, measured before the morning asthma medication, was significantly improved (p<0.05). The responsiveness to inhaled salbutamol was not decreased during salmeterol treatment, except in one patient with asthma worsening over the study year. Baseline finger tremor measured before salbutamol dose‐response curves, was significantly lower at the 12‐month visit than before treatment was initiated (p<0.05). Effects of salbutamol on systemic blood pressure, heart rate or finger tremor was not significantly changed during salmeterol treatment. We found a successive and significant decrease in blood eosinophils (p<0.05) during the 12 months of salmeterol treatment, when the patient with asthma worsening was excluded in the analysis. Also platelet count was significantly decreased during the treatment period (p< 0.001), although within the normal range for all patients. In the present study, we found no evidence that long‐term treatment with inhaled salmeterol (50 μg twice daily) produced decreased β2‐receptor sensitivity in airways.
Distribution of serum IgE in children and adolescents aged 7 to 16 years in Copenhagen, in relation to factors of importance
Authors: Backer V. , Ulrik C. S. , Wendelboe D. , Bach‐Mortensen N. , Hansen K. K. , Laursen E. M. , Dirksen A.
Published: May 2007

The distribution of total serum‐IgE and factors of importance for the level of IgE was studied in a random sample of 508 children and adolescents, aged 7–16 years, from Copenhagen. A detailed history about asthma, rhinitis, dermatitis and urticaria was obtained, and a physical examination, skin prick test with 9 common allergens, lung function test, bronchial challenge with inhaled histamine and exercise, and measurement of IgE (kU/1) were performed. The distribution of IgE among children and adolescents was found to exhibit a log normal distribution and a positive skin prick test, allergic symptoms, a family history of allergic diseases, age and smoking were found to be significantly related to an increased level of IgE. No relationship was found between increased bronchial responsiveness and IgE. The geometric mean of “normal” values of IgE (* 1 SD and *2 SD) of the Danish children and adolescents was 18 kU/1 (*4.7, * 18.2), suggesting that normal IgE values were within 330 kU/1. Measurement of IgE as the only screening for allergic disease is unreliable, as the predictive value of an elevated IgE in population samples was found to be 50%, whereas misclassification (1‐specificity) of asymptomatic subjects as allergic because of an increased IgE was low (4%). In conclusion, total IgE is highly influenced by allergen skin reactivity. Further, this study suggests that normal IgE values were within 330 kU/1, although the range was wide.
Possible consequences of elimination diets in asymptomatic immediate hypersensitivity to fish
Authors: Larramendi C. H. , Esteban M. Martín , Marcos C. Pascual , Fiandor A. , Díaz Pena J. M.
Published: May 2007

The natural history of IgE antibodies to food without related symptoms is unknown. We have followed the progress of 7 children with various atopic diseases and asymptomatic immediate hypersensitivity to fish, treated with elimination diet in spite of full alimentary tolerance. During the diet period, between 24 and 113 months, all 7 patients presented immediate symptoms upon accidental exposure to or challenge tests with fish (skin symptoms in all 7 cases, digestive in 5, respiratory in 4, and anaphylaxis in 2), which differed from those related to atopic diseases previously present. The levels offish‐specific IgE (prick test, RAST) remained unchanged or were increased. These findings suggest that during elimination diet, and perhaps due to minimal and hidden contact with the allergen, the patients’ degree of sensitization may increase, turning an asymptomatic into a symptomatic immediate hypersensitivity.
Comparison between two different assays for measurements of allergen‐specific IgE and skin prick test in the diagnosis of insect venom allergy
Authors: Eiken P. , Mosbech H. , Jacobsen L. , Larsen P. , Scharling B. , Svendsen U. G. , Søes‐Petersen U.
Published: May 2007

Forty‐one patients stung by wasp and 29 by bee were evaluated by comparing the correlation between skin prick test (SPT), Phadebas radioallergosorbent test (P‐RAST) and Magic Lite SQ Specific IgE assay (LIA). All patients had had a systemic reaction to insect sting. In the patients stung by bee we found agreement between SPT and P‐RAST, and SPT and LIA. Similarly, there were no significant differences in sensitivity between P‐RAST and LIA (p>0.05). In patients stung by wasp, SPT was found to be more sensitive than P‐RAST. There were no differences between SPT and LIA or between P‐RAST and LIA.
Egg and milk allergy in adults
Authors: Nørgaard A. , Bindslev‐Jensen C.
Published: May 2007

Nineteen adult patients representing a total of 24 medical histories of immediate adverse reactions to egg or cows’ milk underwent 1) standardized questioning about signs/symptoms occurring less than 2 h after ingestion of egg or milk, 2) skin prick test, RAST and histamine release test, and 3) titrated, oral, double‐blind, placebo‐controlled challenge (DBPCFC) with fresh egg or milk. Eleven medical histories (46%) were confirmed by DBPCFC in 10 patients (53%). All DBPCFC‐positive patients experienced gastrointestinal symptoms, and in 80% of the patients, gastrointestinal symptoms were accompanied by respiratory or skin symptoms. Threshold doses varied between 50 mg and 250 g, with 4 patients presenting objective signs following 5 g or less. DBPCFC‐positive patients reported significantly more symptoms and had a significantly higher number of positive tests than had DBPCFC‐negative patients. None of the tests were in significant concordance with DBPCFC, although RAST showed a sensitivity of 100%. Thus, DBPCFC cannot be substituted in the diagnosis of milk and egg allergy in adults. The use of titrated, fresh foods in DBPCFC proved to be a safe and well‐controlled procedure.
Aeroallergen analyses and their clinical relevance
Authors: Johnsen C. R. , Weeke E.R. , Nielsen J. , Jensen J. , Mosbech H. , Frølund L. , Madsen F. , Poulsen L. K.
Published: May 2007

A comparison was made between the amount of airborne pollen collected by Burkard airsampler and the allergenic activity of particles trapped on glass fibre filters in an Accu‐Vol high‐volume airsampler. The comparison was made throughout the pollen seasons 1986 to 1989. Both airsamplers were operated 24 h a day. They were placed less than 5 m apart, and estimation of the pollen amount was made on a day‐to‐day basis during the pollen seasons, and on a weekly basis outside the seasons. The occurrence of the 3 clinically most important allergenic types of pollen, birch, grass, and mugwort, was analysed, and close correlations between the 2 sampling techniques were found (rs 0.5–0.8, p< 0.001). The detected range of counted pollens/m3 was: birch 0–1075, grass 0–156, and mugwort 0–44. By immunochemical analysis we found the corresponding amounts to be 0–80, 0–8, and 0–1 SQ‐U/m3 respectively. Pollen counts and immunochemical estimation were compared with the symptom score recordings of allergic persons for birch season 1989 and for grass seasons 1986, 1988, and 1989. A close correlation was found for both sampling techniques for the grass seasons in 1986 and 1989 (rs 0.51–0.61, p< 0.001–0.0001), but a less significant correlation was found for the 1988 grass season, and for birch in 1989 (rs 0.24–0.34, p<0.001–0.05).
Polyunsaturated fatty acids in plasma, red blood cells and mononuclear cell phospholipids of patients with atopic dermatitis
Authors: Lindskou R. , Hølmer G.
Published: May 2007

Recent studies of polyunsaturated fatty acids (PUFA) in plasma and blood cell components of patients with atopic diseases have indicated disordered fat metabolism as linoleic acid (18:2n‐6) tends to be increased while the more unsaturated fatty acids, such as gamma‐linolenic acid (18:3n‐6) and arachidonic acid (20:4n‐6) are present in decreased amounts. To further clarify these abnormalities, we examined the PUFA content in phospholipids derived from plasma, red blood cells and mononuclear cells (MNC) in patients with atopic dermatitis. In plasma no significant differences were found between patients and controls. In red blood cells dihomo‐gamma‐linolenic acid (20:3n‐6) was reduced in eczema patients, as compared with controls. The most significant findings in eczema patient MNC were reduced ratios of 20:4n‐6/20:3n‐6 in total lipids and in phosphatidyl ethanolamine (PE) and of 20:4n‐6/18:2n‐6 in both total lipids, phosphatidyl choline (PC) and PE. These findings indicate a disordered fatty acid metabolism in MNC of patients with atopic dermatitis. It is possible that these changes in the fatty acid profile of MNC may account for some of the immunological abnormalities seen in these patients.
Ovalbumin aerosol challenge in actively sensitized guinea pigs: relationship between airway microvascular leakage and airflow obstruction
Authors: Hui K. P. , Lötvall J. , Rogers D. F. , Barnes P. J. , Chung F. K.
Published: May 2007

Airway inflammation is a common feature of asthma, and one of the cardinal features of inflammation is increased microvascular permeability. We investigated the characteristics of inhaled ovalbumin challenge‐induced airflow obstruction and airway microvascular leakage in vivo in mechanically ventilated guinea pigs actively sensitized to ovalbumin. A method was used to quantify both airflow obstruction and airway microvascular leakage in order to investigate the relationship between these 2 pathophysiological features in the same animal. Airway microvascular leakage was assessed by Evans blue dye extravasation into airway tissues. Actively sensitized guinea pigs developed both acute airflow obstruction (increased lung resistance and reduced dynamic lung compliance) and Evans blue dye extravasation in response to exposure to aerosolised ovalbumin. Evans blue dye extravasation was preferentially distributed in the distal airways and correlated with airflow obstruction. The results show that inhaled allergen induced both acute airflow obstruction and airway microvascular leakage.
Evaluation of antihistamine‐related daytime sleepiness
Authors: Murri L. , Massetani R. , Krause M. , Dragonetti C. , Iudice A.
Published: May 2007

The daytime sleepiness potentially associated with antihistamines was evaluated by the multiple sleep latency test (MSLT) in a study comparing terfenadine with placebo. According to a double‐blind, randomized, cross‐over design, 12 healthy men were given either 120 mg terfenadine or placebo once daily in the morning, for 3 consecutive days with a 5‐day interval. EEG‐polygraphic recordings were made each study day at 9.30 and 11.30 a.m., and 1.30, 3.30, and 5.30 p.m., and the tendency to fall asleep was measured. All mean stage‐1 sleep latencies throughout the study failed to show any significant difference between terfenadine and placebo. Accordingly, psychomotor performance assessed by visual and auditory reaction time did not change after treatment. The results of this study confirmed that terfenadine does not induce daytime sleepiness as objectively measured by MSLT.
Characterization of antigens and allergens of date palm (Pheonix dactylifera) pollen
Authors: Harfi Harb A. , Kwaasi A. A. A. , Tipirneni P. , Parhar R. S. , Graff‐Lonnevig V. , Al‐Sedairy S. T.
Published: May 2007

Antigenic and allergenic components of date palm (Phoenix dactylifera) pollen were investigated to observe their effects on the skin test reactivity, lymphocyte blastogenesis and cytokine production in atopic and healthy individuals. Date pollen extracts were fractionated using SDS‐PAGE and Sephacryl S‐200 gel filtration. Western blotting of SDS‐PAGE separated components with antiserum raised against whole pollen extract in rabbits revealed at least 22 immunoreactive bands ranging in molecular weight between 12 and 94 kD. The immunogenicity of the pollen extract was further confirmed by strong positive reactions in ELISA and Ouchterlony's double diffusion tests. Immunoblot analyses revealed IgG and IgE reactive components (14‐94 kD for IgG and 12‐90 kD for IgE) in the skin test‐positive patients’ sera against whole pollen extract. Fifteen of 60 atopies reacted positively to either whole or some fractions of date pollen extract when skin tested. In response to whole or components of date pollen extract atopic patients showed differential peripheral blood lymphocyte (PBE) proliferative response and cytokine (IL‐2, IL‐4) production when compared with PBE of normal subjects. Our findings strongly suggest that date palm pollen should be considered a reaginic component and should be included in the battery of allergens for determining the allergic status of atopic patients, particularly in those parts of the world where the date palm is grown commercially.
Effect of an allergy prevention programme on incidence of atopic symptoms in infancy
Authors: Halken S. , Høst A. , Hansen L.G. , Østerballe O.
Published: May 2007

A total of 105 “high‐risk” infants born in 1988 were studied prospectively from birth to 18 months of age. The infants were recommended breastfeeding and/or hypoallergenic formula (Nutramigen or Profylac) combined with avoidance of solid foods during the first 6 months of life. All mothers had unrestricted diet. Avoidance of daily exposure to tobacco smoke, furred pets and dust‐collecting materials in the bedroom were advised. This prevention group was compared with a control group consisting of 54 identically defined “high‐risk” infants born in 1985 in the same area. All infants had either severe single atopic predisposition combined with cord blood IgE ≥ 0.5 KU/1 or biparental atopic predisposition. The control group had unrestricted diet and was not advised about environmental factors. Apart from the prevention programme and year of birth the prevention group and the control group were comparable. The parents were highly motivated and compliance was good. The rate of participation was 97%, and 85% followed the dietary measures strictly. The cumulative prevalence of atopic symptoms was significantly lower at 18 months in the prevention group (32%), as compared with the control group (74%) (p<0.01), due to reduced prevalence of recurrent wheezing (13%, versus 37%; p<0.01), atopic dermatitis (14% versus 31%; p<0.01), vomiting/diarrhoea (5% versus 20%; p<0.01) and infantile colic (9% versus 24 %; p<0.01). The cumulative prevalence of food allergy was significantly lower in the prevention group (6% versus 17%; p<0.05). In both high‐risk groups daily exposure to tobacco smoke increased the risk of recurrent wheezing significantly (p<0.01). The main difference between the prevention group and the control group was the diet. Thus, feeding with breastmilk and/or hypoallergenic formula combined with avoidance of solid foods until the age of 6 months appeared to reduce the cumulative prevalence of atopic symptoms during the first 18 months of life.
Biomolecular regulation of the IgE immune response
Authors: Poulsen L. K. , Baron L. , Heinig J.H. , Skov P. Stahl , Bendtzen K.
Published: May 2007

Several cell types, including mast cells, basophils, macrophages/monocytes, lymphocytes, platelets and eosinophils, may bind or contain IgE. To investigate the source of cell‐associated IgE and its relation to spontaneous IgE synthesis, peripheral blood mononuclear cells from allergic and non‐allergic donors were examined. Using a combination of different cell fractionation techniques and varying methods for extraction of cell‐associated IgE, data were obtained indicating that monocytes constitute a major source of cell‐associated IgE in human blood. The amount of cell‐associated IgE in peripheral blood mononuclear cells from allergic and non‐allergic donors varied more than 100‐fold but correlated closely to the level of serum IgE (r = 0.84, p < 0.001, n= 38). Spontaneous and mitogen‐induced in vitro syntheses of IgA, IgE and IgG were compared for allergic and non‐allergic donors. Only one donor with very high serum IgE demonstrated spontaneous or mitogen‐induced in vitro IgE synthesis despite synthesis of IgA and IgG.
Anaphylactic shock by rupture of hydatid hepatic cyst
Authors: de San Pedro B. Saenz , Cazaña J. L. , Cobo J. , Serrano C. L. , Quiralte J. , Contreras J. , Martinez F.
Published: May 2007

Total and specific serum IgE antibodies were estimated in a 68‐year‐old woman with anaphylactic shock due to spontaneous rupture of hydatid cyst of the liver. After she had recovered, an abdominal ultrasonography showed a cyst, 10×15 cm, in the right hepatic lobe. The cyst was surgically removed. Antihydatid IgE in the acute phase and periodically after surgical intervention, determined by Phadezym RAST, Pharmacia, and Pharmacia CAP system (a new solid‐phase immunoassay, fully automated, for the titration of specific IgE with greater sensitivity in the detection of low IgE antibody levels), showed decreasing antihydatid IgE antibodies on day 10 after surgical intervention and may thus serve to monitor the evolution of hydatid disease.
Occupational pharyngitis associated with allergic patch test reactions from acrylics
Authors: Kanerva L. , Estlander T. , Jolanki R. , Pekkarinen E.
Published: May 2007

A female dentist specialized in orthodontics repeatedly developed symptoms of pharyngitis at work. A chamber provocation test indicated that her symptoms were caused by acrylics. Prick tests with acrylics were negative, while patch tests were strongly positive although the patient had no skin symptoms. The relationship between the symptoms and the patch test results is discussed. It is suggested that type IV allergic reactions may be involved in symptoms of the upper respiratory tract.
A case of fallow deer allergy
Authors: Huwyler T. , Wüthrich B.
Published: May 2007

We report the case of a 25‐year‐oId housewife, a native of Mexico City, with rhinitis and asthma induced by exposure to fallow deer in an animal park close to her home. In the literature, we could find only one previous case.

The patient presented a polyvalent IgE sensitization in prick skin tests and RAST to several animals’ dander and epithelia, but RAST inhibition experiments showed a cross‐reactivity only between fallow deer and horse allergen extracts.
Bronchodilating effect of ipratropium bromide inhalation powder and aerosol in children and adolescents with stable bronchial asthma
Authors: Ulrik C. S. , Backer V. , Bach‐Mortensen N.
Published: May 2007

Ulrik CS, Backer V, Bach‐Mortensen N. Bronchodilating effect of ipratropium bromide inhalation powder and aerosol in children and adolescents with stable bronchial asthma.

The purpose of this study was to compare the bronchodilating effect of ipratropium bromide (IB) administered by a conventional Ingelheim powder device system (IPI) and by a metered dose inhaler (MDI) in children and adolescents with stable bronchial asthma. Seventy patients, aged 7 to 16 years, with stable bronchial asthma from our outpatient clinic were tested for bronchial responsiveness to inhaled IB. Fifteen (21%) of the 70 subjects were found to have a substantial bronchial response to inhalation of 40 γg IB, i.e. at least 15% increase in FEV1 30 min after inhalation; the remaining 55 subjects had <15% increase in FEV1. No relationship between severity of asthma, age or sex and bronchial responsiveness to inhaled IB was found. Among the 15 subjects who had substantial bronchial response to IB, the increase in FEV1 after inhalation of fenoterol tended to be greater than the response to inhaled IB, although this did not reach statistical significance. Responders, i.e. subjects who had at least 15% increase in FEV1 after inhalation of IB, took part in a double‐blind, cross‐over study of the bronchodilating effect of 40 γg IB delivered by IPI and MDI. We found no significant differences in the bronchodilating effect during a 6‐h follow‐up. Maximum bronchodilating effect of IB was reached after 30 min and the maximum response lasted for 90 min. No side or adverse effects were observed following inhalation of IB. We conclude that before starting treatment with ipratropium bromide for bronchial asthma in children and adolescents, the patients should be tested for bronchial responsiveness to inhaled IB to find out whether they are responders or nonresponders; and further that, among responders, inhalation of powder is as effective as inhalation from a dosis‐aerosol.
Enhanced production of platelet activating factor by peripheral granulocytes from children with asthma
Authors: Schauer U. , Koch B. , Michl U. , Jäger R. , Rieger C. H. L.
Published: May 2007

Schauer U, Koch B, Michl U, Jäger R, Rieger CHL. Enhanced production of platelet activating factor by peripheral granulocytes from children with asthma.

Granulocytes from 23 asthmatic children aged 4–15 years and 32 age‐matched healthy children were studied. Cells were purified by Dextran sedimentation and Percoll gradient centrifugation from heparinized blood. After in vitro stimulation by ionophore A23187 the amount of newly synthesized PAF and LTC4 was assessed by radio receptor assay or radioimmunoassay respectively. Eight patients had symptoms of asthma within the last 3 weeks before examination. Granulocytes from the symptomatic patients showed a significantly higher PAF generation (median 125 ng/106 cells, range 7–189 ng/106 cells) when compared to asymptomatic patients (p < 0.001. median 14 ng/106cells, range 6–33 ng/106 cells) or controls (p < 0.001, median 11 ng/106 cells, range 3–26 ng/106 cells). In contrast, LTC4 generation was increased in both patient groups. The results suggest a regulatory role of PAF in the exacerbation of asthma.
Effect of inhaled formoterol versus terbutaline on respiratory function in moderate bronchial asthma
Authors: Hedenström H. , Wegener T. , Boman G. , Wåhlander L. , Melander B.
Published: May 2007

Hedenström H, Wegener T, Boman G, Wåhlander L, Melander B. Effect of inhaled formoterol versus terbutaline on respiratory function in moderate bronchial asthma.

In a double‐blind cross‐over study comparing the duration of action of 12 μg and 24 μg formoterol, 500 μg terbutaline and placebo, lung function tests were performed in 12 never‐smokers with non‐allergic bronchial asthma. All the patients were hyperreactive to methacholine, had normal serum IgE level, and negative skin or RAST results. The lung function tests were carried out over an 11‐h period and included measurements of lung volumes, airway resistance, dynamic spirometry, nitrogen single breath wash‐out test and single breath diffusion capacity for CO. The airway resistance and maximal forced expiratory flow tests indicated a pronounced bronchodilator effect without adverse effects of 12 μg and 24 μg formoterol on both large and peripheral airways. Improved intrapulmonary gas distribution measured by the nitrogen wash‐out test and more even distribution of the lung volumes indicating more homogeneous ventilation was seen for approx. 3h after terbutaline and approx. 11 h after 24 μg formoterol. Measurement of the CO diffusion capacity indicates more effective gas diffusion and a better ventilation‐perfusion ratio for at least 11 h, especially after inhalation of 24 μg formoterol.
High‐dose inhaled steroids in the management of asthma A comparison of the effects of budesonide and beclomethasone dipropionate on pulmonary function, symptoms, bronchial responsiveness and the adrenal function
Authors: Svendsen U.G. , Frølund L. , Heinig J. H. , Madsen F. , Nielsen N. H. , Weeke B.
Published: May 2007

Svendsen UG, Frølund L, Heinig JH, Madsen F, Nielsen NH, Weeke B. High‐dose inhaled steroids in the management of asthma. A comparison of the effects of budesonide and beclomethasone dipropionate on pulmonary function, symptoms, bronchial responsiveness and the adrenal function.

The efficacy of budesonide (800 μg b.d.) and beclomethasone dipropionate (750 μg b.d.) in controlling the symptoms of asthma, pulmonary function, bronchial responsiveness to histamine, and adrenal function, was assessed in a double‐blind, double‐dummy cross‐over study of 36 adult chronic asthmatic patients. The patients, the majority of whom were assessed to be affected to a severe degree, were insufficiently controlled in their current regimen of inhaled steroids and/or inhaled and oral bronchodilators. A 2 weeks baseline period preceded 6 weeks of treatment with each of the study drugs. Both treatment groups showed improvements from baseline in clinical assessment of lung function carried out after the first 6 weeks of treatment. No significant differences were seen throughout the entire 12 weeks study, when comparing the effects of the treatments on FEV1 FVC, PEF or the histamine PC20. Asthma severity, symptom score and inhaled bronchodilator use showed the same results after both treatments. It is concluded that inhalations of budesonide and beclomethasone dipropionate in high doses are equally potent in the treatment of severe asthma. There is no significant influence on the adrenal function and no significant side effects during a period equal to that of the present study.
Involvement of arachidonate cyclooxygenase products in bronchial hyperresponsiveness induced by subthreshold concentration of aerosolized thromboxane A2 analogue (STA2) in guinea pigs
Authors: Saito M. , Fujimura M. , Sakamoto S. , Miyake Y. , Shintani H. , Yasui M. , Matsuda T.
Published: May 2007

Saito M, Fujimura M, Sakamoto S, Miyake Y, Shintani H, Yasui M, Matsuda T. Involvement of arachidonate cyclooxygenase products in bronchial hyperresponsiveness induced by subthreshold concentration of aerosolized thromboxane A2 analogue (STA2) in guinea pigs.

Effects of a thromboxane synthetase inhibitor (OKY‐046) and a cyclooxygenase inhibitor (indomethacin) on bronchial hyperresponsiveness induced by subthreshold concentration of aerosolized thromboxane A2 analogue (STA2) were investigated in anesthetized, artificially ventilated guinea pigs in order to examine the role of the cyclooxygenase pathway in bronchial hyperresponsiveness. Pretreatment with aerosolized OKY‐046 significantly inhibited the bronchial hyperresponsiveness to histamine, but pretreatment with intravenous indomethacin showed a tendency to potentiate bronchial hyperresponsiveness. These results suggest that subthreshold concentration of thromboxane A2 contributes to bronchial hyperresponsiveness through activating the cyclooxygenase pathway including thromboxane A2 synthesis, and that the released cyclooxygenase products have an inhibitory effect on the bronchial hyperresponsiveness in guinea pigs.
Allergens from rye pollen (Secale cereale)
Authors: Montero M. T. , Alonso E. , Sainz T.
Published: May 2007

We have studied the proteins and allergens released by rye pollen in the course of a 19‐h pollen incubation process. Nearly 40% of the total extracted proteins were collected during the first 5 min, and most of them had a molecular weight <28 kDa. Between 5 and 30 min, 15% of the proteins from total extract were released, showing in the SDS‐PAGE analysis an increase in which components moved close to 30 kDa standard. From 30 min to 19 h several extracts were collected. Electrophoretical profile of components from these extracts reveals that bands moving below 28 kDa were practically absent and those of 28 and 23 kDa became very intense. At the end of the process there was a rise of 67 kDa proteins. Dot‐immunobinding and immunoblotting techniques reveal that allergens leave the rye pollen, for the most part, after 5 min incubation and are proteins with 28 kDa, 33 kDa, 48 kDa and 67 kDa molecular weights.
Comparison of CLA with BPT, SPT, and RAST in children with asthma
Authors: Nielsen J. P. , Østergaard P. Aa. , Harris R. I. , Gammelby P.
Published: May 2007

Bronchial provocation tests (BPT) with allergen extracts were performed in 82 children with asthma, and the results were compared with the chemiluminescent assay (CLA), the radio‐allergo‐sorbent‐test (RAST) and skin prick test (SPT). It was found that CLA matched BPT with a concordance of 87% (77–93%), RAST with a concordance of 74% (64–83%) and SPT with 80% (70–88%). Most often, CLA and RAST gave similar results, although their classes did not match precisely.
Yellow jacket allergy
Authors: Jeep S. , Reiprich G. , Kunkel G.
Published: May 2007

The aim of the present study was to compare yellow jacket venom extracts from two different companies and to compare skin prick test (SPT) with intradermal test (IDT). IDT and SPT with yellow jacket venom (ALK and Pharmacia Reless®) were performed on 54 yellow jacket allergic patients and 44 symptom‐free volunteers. Venom was diluted to 300, 100, 10 and 1 μ/ml for SPT and 100, 10−1, 10−2, 10−3 and 10−4μ/ml for IDT, according to the manufacturers’instructions. Skin tests were performed on both forearms. Both extracts showed approximately the same relationship between sensitivity and specificity, but the Pharmacia Reless yellow jacket venom extract showed a 5–10 fold higher biological activity in both SPT and IDT. Thus yellow jacket venoms of ALK and Pharmacia Reless are not comparable in allergen activity at the same venom concentrations. Using extracts from the same company, SPT and IDT were comparable with regard to sensitivity and specificity at an allergen concentration 1000 times higher for SPT than for IDT.
Genetic and environmental factors in the changing incidence of allergy
Authors: Bonini S. , Magrini L. , Rotiroti G. , Ronchetti M. P. , Onorati P.
Published: May 2007

Several studies have indicated that the incidence and prevalence of allergic diseases are increasing. Such data should not be regarded as mere statistical curiosities, but should be analysed to provide information on the factors contributing to allergy and its changing epidemiology. Extensive evidence has been accumulated that allergic diseases are polyfactorial. Data reported in the literature and particularly twin studies have also suggested polyfactorial control of individual allergy variables, such as total serum levels IgE and IgG4, specificity of antibody response, mediator release from inflammatory cells and target organ response. Markers of genetic susceptibility may identify individuals at risk for allergy, while identification of the environmental factors influencing the phenotypic expression of allergy can be useful in evaluating the cost‐benefit ratio of taking preventive measures in such individuals.
The effects of patterns in climate and pollen abundance on allergy
Authors: Emberlin J.
Published: May 2007

Recent climatic trends in Europe have been examined in the context of longer term variations and vegetation zonation. The most recent computer models of future climatic changes resulting from increasing carbon dioxide emissions are discussed in relation to the possible impacts that the predicted climatic shifts may have on the distribution and abundance of the main allergenic pollen types. The probable repercussions of these changes on the patterns and incidences of seasonal allergic rhinitis are considered. This study focuses on pollen from Betula, the Poaceae, Ambrosia, Parietaria and Olea, but also examines the implications of climatic change for other aeroallergens, including those from various crops such as Brassica species (oil‐seed rape) and Helianthemum (sunflowers). In the case of natural distributions, the response of the plants to climatic changes are viewed in relation to the potential migration rates of the species. For agricultural crops, shifts in the location of productive areas involve agricultural economics both at the national and European community levels. In addition to broad regional impacts, this study examines the influence of increasing ultraviolet radiation on pollen production over various areas of Europe, and considers the effect of changing airflow trajectories on the long‐range transport of pollen with pollution from central and northern Europe into Scandinavia.
Psychology of the allergic patient
Authors: Michel F‐B.
Published: May 2007

Biological hypersensitivity is the fundamental feature of atopy, and patients suffering from this syndrome are characterized by their ability to produce high levels of IgE in response to low amounts of antigen. This hypersensitivity results in a range of acute and chronic diseases, such as asthma, rhinitis, allergic conjunctivitis and atopic dermatitis. In addition to their biological effects, these diseases may have psychological consequences in terms of stress, anxiety or depression. However, atopic patients, far from displaying a typical depressive psychological profile, are characterized by their increased emotional sensitivity. Atopic individuals alert us to the presence of allergens but perhaps they also indicate something about our way of life. Are the symptoms displayed by allergic patients, their wheezing, sneezing or itching skin, more than a simple biological response?
The cellular basis for allergic rhinitis
Authors: Howarth P. H.
Published: May 2007

In both seasonal and perennial rhinitis there is epithelial mast cell accumulation and tissue infiltration by eosinophils. Activation of these cells can be observed by electron microscopy and by elevated levels of tryptase and eosinophil cationic protein in nasal lavage fluid. Furthermore, seasonal increases in the antigen presenting cell (Langerhans’cell) are also evident. Investigations into the mechanisms involved in cell accumulation and activation reveals upregulation of leucocyte endothelial adhesion molecules and an increase in interleukin‐4 (IL‐4) in naturally occurring rhinitis, while mRNA for IL‐4, IL‐5 and granulocyte macrophage colony stimulating factor activity and lavage tumour necrosis factor‐alpha (TNFα) levels are increased following local allergen challenge. These cytokines may be derived from a variety of sources, including mast cells, eosinophils and T‐lymphocytes, and contribute to the underlying inflammatory process in rhinitis.
The anti‐inflammatory profile of fluticasone propionate
Authors: Johnson M.
Published: May 2007

Fluticasone propionate is a new corticosteroid based on the androstane nucleus. It is more lipophilic than beclomethasone dipropionate (BDP) and budesonide, and binds more avidly to human lung tissue. It has an absolute affinity (KD) of 0.5 nM for the glucocorticoid receptor and a relative receptor aflinity 1.5‐ and 3.0‐times greater than that of beclomethasone‐17‐monopropionate (17‐BMP) and budesonide, respectively. The rate of association with the receptor is faster and the rate of dissociation slower than with standard corticosteroids. As a result, the half‐life of the corticosteroid‐receptor complex is >10 h. Fluticasone propionate is also highly selective for the glucocorticoid receptor, with little or no activity at other steroid receptors. Pretreatment with fluticasone propionate signiflcantly inhibits the increase in mast cell numbers in the nasal mucosa of rats chronically exposed to toluene di‐isocyanate (TDI), and suppresses TDI‐induced mast cell degranulation. It is more potent in vitro than dexamethasone, BDP and budesonide in inhibiting anti‐CD3‐induced human T‐lymphocyte proliferation, in attenuating tumour necrosis factor‐α‐induced endothelial cell adhesion molecule expression, and in increasing secretory leucocyte protease inhibitor levels in airway epithelial cells. It is also more potent and longer‐acting than other corticosteroids in inhibiting oedema formation, interleukin‐5 (IL‐5)‐induced blood eosinophilia, and IL‐5‐ or platelet activating factor‐stimulated eosinophil accumulation in the lung. Fluticasone propionate therefore has increased intrinsic glucocorticoid potency and high topical anti‐inflammatory activity.
Nasal cytological changes following pharmacological intervention
Authors: Meltzer E.O.
Published: May 2007

Symptoms of allergic rhinitis are associated with increased numbers of inflammatory cells in the nasal mucosa. The effects of fluticasone propionate on the nasal mucosal cells of patients with symptomatic allergic rhinitis were evaluated in seven multicentre, double‐blind, parallel‐group, placebo‐controlled, randomised studies. In three seasonal allergic rhinitis studies, significantly more patients receiving fluticasone propionate had a decrease in nasal eosinophils following treatment compared with patients receiving placebo. Similarly, more patients receiving fluticasone propionate had a decrease in nasal basophilic cells, but differences from placebo were not significant in all studies. Nearly identical results were observed in two 24‐week perennial allergic rhinitis studies: significantly more patients receiving fluticasone propionate or beclomethasone dipropionate had a decrease in nasal eosinophils compared with patients receiving placebo. Furthermore, a higher percentage of patients receiving corticosteroids also had a decrease in the number of basophilic cells. In two separate seasonal allergic rhinitis studies, significantly more patients receiving fluticasone propionate had a decrease in nasal eosinophils compared with patients receiving terfenadine or astemizole, respectively. The decrease in nasal basophilic cells was also significantly greater with fluticasone propionate compared with astemizole. Inhibition of mediator release from eosinophilic and basophilic cells has also been demonstrated in patients receiving fluticasone propionate compared with patients receiving antihistamines. The results of these studies suggest that the therapeutic benefits of fluticasone propionate aqueous nasal spray in the treatment of seasonal and perennial allergic rhinitis may be related to its ability to reduce nasal mucosal inflammatory cells and to inhibit local mediator activity.
The Pathophysiology of Ocular Allergy: Current Thinking
Authors: Foster C Stephen
Published: May 2007

Seasonal allergic conjunctivitis is the only ocular disease to involve solely Type‐1 hypersensitivity, the other main forms of ocular allergy ‐ perennial allergic conjunctivitis, vernal and atopic keratoconjunctivitis and giant papillary conjunctivitis ‐ each having a more complex immunological basis and a chronic inflammatory component. Involvement of secondary inflammatory cells, particularly eosinophils, in addition to the mast cells resident in the conjunctival substantia propria, can lead to more serious corneal damage with vision‐threatening potential. Thoughtful management of allergic conjunctivitis is needed in order to control the ocular inflammation without incurring steroid‐induced side‐effects, and patient education is also an important factor in maintaining optimal allergen avoidance, especially in the more severe and chronic cases. Laboratory models can be helpful in assessing the potential of new drugs, and SWR mice (topically sensitised and challenged with short ragweed) show clinical signs of allergic conjunctivitis, together with mast cell and eosinophil involvement, remarkably similar to the human pathophysiology. The antiinflammatory activity of both steroids and nedocromil sodium observed in this animal model supports therapeutic evidence of the usefulness of second‐generation mast cell stabilising drugs in the treatment of ocular allergy.
Therapeutic Considerations: Symptoms, Cells and Mediators
Authors: Lightman Susan
Published: May 2007

Immuno‐histopathological studies of conjunctival tissue biopsied from patients with non‐sight‐threatening allergic conjunctivitis or with sight‐threatening allergic keratoconjunctivitis should lead to more effective management of these eye conditions, based on the specific cellular involvement. The major difference between these two categories of eye disease was the occurrence of T‐lymphocytes, which were absent in the former but prominent in the sight‐threatening disorders. Seasonal and perennial allergic conjunctivitis both showed a heavy mast cell increase, due to infiltration of mucosal type mast cells, and allergen challenge studies linked mast cell histamine release to the early phase reaction occurring within 20 minutes. A second histamine peak at six hours after challenge might implicate basophils (or refractory mast cells) and was accompanied by a rise in eosinophil cationic protein. In sight‐threatening, chronic allergic keratoconjunctivitis the responses were clearly directed by T‐cells, themselves the primary effector cell in atopic keratoconjunctivitis, whereas vernal keratoconjunctivitis displayed a T‐cell driven eosinophilia, with increased expression of the adhesion molecules involved in tissue invasion by these cells. Appropriate therapies for each different category of conjunctivitis should be based on the specific immunopathology, and directed at the activated cell types that are primarily responsible for the disease process.
Clinical Experience with Tilavist: An Overview of Efficacy and Safety
Authors: Kjellman N‐I Max , Stevens Michael T
Published: May 2007

A programme of clinical studies was carried out to determine the basic efficacy and safety of 2% nedocromil sodium eye drops (Tilavist) in treating allergic conjunctivitis, in 2,905 patients from 3–76 years of age. Results of all the double‐masked placebo comparative studies completed to date ‐ five in vernal keratoconjunctivitis (VKC), five in perennial (PAC) and 16 in seasonal allergic conjunctivitis (SAC) ‐ have been assessed in a statistical overview analysis. Nedocromil sodium, administered four times daily to 153 patients with VKC, was significantly more effective than placebo (155 patients) and in the clinicians' opinion gave good control in 76% of cases, compared with 46% for placebo (p < 0.001). Patients with chronic symptoms of PAC also responded better to nedocromil sodium given four times daily (n = 146) rather than twice daily (n = 86), and significantly more patients (p < 0.001) were effectively controlled by four times daily treatment with nedocromil sodium (72%) than with placebo (47%; n= 156). Twice‐daily dosage with nedocromil sodium (n = 677) was adequate for SAC, however, and the treatment was statistically better than placebo (p < 0.01‐p < 0.001) whether dosed twice or four times daily. Speed of action was assessed in seven SAC studies in which 79% of all patients (n = 295) using nedocromil sodium had experienced relief of symptoms when questioned, half of them within 15 minutes and 74% during the first hour after dosing. Test treatments were well‐accepted by both adults and children, and there were no major adverse events. Minor irritations reported more frequently with nedocromil sodium than placebo were stinging or burning of the eyes on application of the drops and a distinctive taste, noted by 5% of the active treatment group (n = 1,552).