bluuebunny/crossref_metadata_2025 huggingface dataset:
The rhetoric versus the reality: a critical perspective on practice with fathers in child care and protection work
Authors: Daniel  , Taylor
Published: March 2003

Within social work training and practice there is a firm emphasis on anti‐discriminatory practice. At the same time, however, fathers are often marginalized or ignored in child protection practice. In suggesting a framework for practice we argue that it is essential to address the anomaly between the rhetoric and the reality of such practice if we are to provide a coherent child protection service. This paper addresses the limitations of current models of practice and traces the theoretical strands that influence them. It is essential that social work practitioners understand the role terms they use and the aim of engaging fathers. By beginning to unravel the differences between role and gender and unpicking the diverse (but overlapping) dimensions of fatherhood, it is contended that there is no definitive, dominant discourse regarding fatherhood in the same way as there is about motherhood. However, in conceptually recognizing these roles it is suggested that intervention can be planned in a way that explicates the specific aim of engaging men.
Imaging the future: theatre and change within the child protection system
Authors: Spratt  , Houston  , Magill
Published: March 2003

The use of social pedagogy as a paradigm for critically appraising developments within child and family social work has been largely neglected. This paper outlines the work of Augusto Boal and his adoption of social pedagogy as a method for empowering oppres‐sed social groups in Brazil. It is argued that Boal’s approach can be adapted by using action research techniques to analyse and effect change in situations where child care professionals face daily contradictions in their attempts to both protect children and support families. To demonstrate its relevance to child care practice, a description is provided of how the approach was used with two groups of social work students – one undertaking qualifying training, the other post‐qualifying training. The results of this application suggest a new theoretical framework for practice which aims to establish communicative consensus around the needs of children and a mutual appreciation of roles and responsibilities.
Challenging passive partnerships with parents and children in the core group forum: a framework for a proactive approach
Authors: Calder  , Horwath
Published: March 2003

This paper looks at two concepts central to effective child protection practice: partnerships and the core group system, which need to work together if we are to improve the worrying, ad hoc approaches to child protection work once a child’s name has been added to the child protection register. These concepts emerged at around the same point in time, but little has been written about the core group, even though it has been given the key tasks of formulating, implementing and reviewing the child protection plan, and forging effective working partnerships with other professionals, parents/carers and their children ( Calder 1991,
1995b;
Calder & Horwath 1999). Whilst the concept of partnership has received considerable media and publishing attention, no previous paper has explored partnerships with families within the core group phase. This reflects the low priority currently afforded to activity following the initial child protection conference, and arguably sets the core group up to fail, even before it has started (
Calder 1996a,
1998). The authors draw on their national research into core group practice to explore the notion of partnerships between the core group and parents, carers and children, concluding with some recommendations on how Area Child Protection Committees can create the environment in which we can move from passive to proactive partnerships within a higher profile for this stage and focus of the work. The authors draw on some suggestions from Messages from Research (
Department of Health 1995a) and from several small‐scale research studies into core group practice.
Defining the boundaries: social worker assessment of sexual abuse in a cultural context – multivariate analysis of personal and professional factors influencing social workers' labelling of intimacy behaviour
Authors: Carstens Carol A.
Published: March 2003

To explore personal and professional factors influencing social worker assessment of family intimacy behaviour in diverse cultural groups, a 27‐item questionnaire was mailed to a random, stratified sample of MSW‐level social workers. The instrument measured rank‐order responses to 10 questions about attitudes towards public exposure to sexual stimuli and rank‐order responses to questions about three vignettes depicting culturally informed family intimacy behaviour. The instrument also measured sample characteristics such as area of social work practice and per cent of caseload involving sexually abused as well as diverse clients. Completed questionnaires (n=387) were analysed for association between respondents' definition of intimacy behaviour (dependent variable), attitude towards sexual stimuli, and intervening variables thought to explain variance in the dependent measure. Labelling theory provided a basis for hypotheses testing.

When mean attitude scores were correlated with mean definition scores, Pearson'srreturned a significant low, positive association between conservative attitudes towards exposure to sexual stimuli and definitions of cross‐cultural scenarios as sexual abuse. Holding attitude scores constant, regression modelling of the sample's definition of scenarios indicated that practice area, minority status, and per cent of caseload with sexual abuse clients were significant predictors ofR2change in the dependent variable. Further analysis of data through regression tree modelling showed that a small group of conservative practitioners with ethnically diverse caseloads were more likely to label culturally influenced behaviours as deviant. Among conservative practitioners with less diverse caseloads, number of hours in sexuality training had a moderating influence on deviancy labelling. Tree modelling of the data also indicated that an ethnic minority subgroup within the sample accounted for the lowest ranking of scenarios as sexual abuse.

Results support earlier work on social worker assessment of child maltreatment as a function of agency setting. Another implication for social work is the need for practitioners to understand their attitudes towards human sexuality in relation to assessment of diverse patterns of childhood sexual socialization.
Emotional and behavioural difficulties in children with diabetes: a controlled comparison with siblings and peers
Authors: Gardner
Published: March 2003

This study describes a comparison of children with insulin dependent diabetes mellitus (IDDM) with two control groups: the sibling nearest to them in age, and peers matched for gender and age. A broad range of emotional and behavioural difficulties were assessed using the Conners' Teachers' and Parents' rating scales (CTRS 39 and CPRS 93). Individually completed children's questionnaires provided qualitative data about the children's problems. The results of the study showed markedly higher scores for the children with diabetes on the parent scales on factors such as hyperactivity, psychosomatic and restless/disorganized, in comparison to their siblings, but not their peers. These differences were not found on the Teachers' Scales. The findings are discussed in terms of parental perceptions of children with diabetes and the difficulties these children and their siblings experience in their lives. Suggestions are made for further research.
Families' experiences of caring at home for a technology‐dependent child: a review of the literature
Authors: Kirk
Published: March 2003

Recent medical advances have led to the emergence of a group of chronically ill children who are dependent upon technology for their survival. Many of these children are cared for at home by their parents. This paper presents an overview of the literature that has examined the experiences of families caring for a technology‐dependent child at home. The social, emotional and financial impact on families and their perspectives on the services supporting them at home is described. The paper concludes by identifying areas where further research is needed.
‘Health assessment’ at school entry: performance of a system based on school nurse interviews
Authors: Laing G. J. , Rossor E. B.
Published: March 2003

Objectives To describe the performance of a school entry ‘health assessment’ based on school nurse interviews.

Background Universal medical examination at school entry has largely been replaced by a ‘health assessment’ led by the school nurse, based on screening tests, a health interview, eliciting parental and professional concern and past history. As a result children with possible problems are selected for school medicals, reviewed in school or referred to a range of health professionals and other agencies.

Setting Inner city south‐east London.

Subjects Children born between 1/3/89 and 31/8/89 who were on the class lists of 21 randomly selected primary schools.

Data collection A form for each subject was distributed to the school nurse and completed as children were invited for screening, school health interviews and medical examinations.

Main outcome measures Proportion of subjects attending, patterns and proportions of reviews and referrals.

Results 426 children were eligible for inclusion and 419 (98%) forms were returned. 232 children were seen for a health interview and a further 50 were screened for vision, hearing and growth problems only. 124 had no contact with the school nurse or doctor. Following health interview or screening, 180 children were reviewed and/or discussed with other health professionals. 71 external referrals were made.

Conclusion Adequate coverage at school entry is difficult to obtain. The objectives of school entry health assessment and the relationship between selection criteria and health needs require clarification.
Disclosure of diagnosis and planning for the future in HIV‐affected families in Europe
Authors: Thorne C , Newell M‐L , Peckham C S
Published: March 2003

Information relating to disclosure of infection status in families affected by HIV and the existence of plans for the future social care of children with infected parents was collected as part of a larger survey on clinical and psychosocial service use of these families. Parents and alternative carers of HIV‐affected children in follow‐up in 10 paediatric centres from seven European countries were surveyed. A total of 182 questionnaires were returned: most (73%) were completed by parents, of whom 92% were HIV‐infected. Of the 226 children cared for by the respondents, most (62%) were HIV‐infected. Disclosure of both the child’s and the parent’s infection status was rare and found to be associated with child’s age in both cases. Infected children living with their parents were less likely to know their diagnosis than those living in alternative care. Uninfected parents and carers were significantly more likely to want professional help with disclosing to an infected child than infected parents. Infected parents also face difficult decisions regarding the issue of who will care for their children when they are unable to. Half of the infected parents had made long‐term plans for their children’s future social care. European parents were more likely to have made such plans than those from elsewhere (mainly Africa) and parents with plans had known about their HIV infection for significantly longer than those without. Increasing numbers of vertically infected children are reaching adolescence as a result of improvements in the management of paediatric HIV infection. As both disclosure and planning for the future social care of HIV‐affected children have been found to be strongly associated with child’s age, the changing epidemiology of paediatric HIV highlights the need for more information on these issues in order to support families more effectively.
Biological, social, and environmental correlates of preschool development
Authors: To T , Cadarette S M , Liu Y
Published: March 2003

Baseline data from the Canadian National Longitudinal Survey of Children and Youth (NLSCY, a population‐based study of child health, development and well‐being), were used to determine biological, social and environmental correlates of poor development among preschool children. A total weighted sample of 1233 500 (n= 6982 unweighted) children aged from birth to 3 years were studied. Developmental attainment was measured by the motor, social and development (MSD) scale. Children scoring amongst the lowest 15% for their age group were categorized as having poor developmental attainment (PDA). Correlates of PDA were determined using logistic regression.

The MSD scale may not be discriminatory enough to identify PDA in children aged < 1 years. Among children aged between 1 and 3 years, biological factors remain important correlates of PDA, whereas the timing of social and environmental factors appears important to their effects on developmental attainment. The findings suggest a complex relationship between risk factors and developmental outcomes. Correlates of PDA vary according to the age of a child. Social and environmental factors appear to play a larger role among older children. Prospective studies are required to determine the effect of change in risk factor profiles on child development.
The care and health needs of children in residential care in the Maltese Islands1
Authors: Baron A. Muscat , Baron Y Muscat , Spencer N.J.
Published: March 2003

Objectives To survey the health needs of children in residential care in the Mediterranean Islands of Malta and Gozo.

Setting Thirteen children's Residential Homes in the Maltese Islands.

Study design Cross‐sectional interview survey.

Methods Carers at the Residential Homes were interviewed using a semistructured questionnaire between June and November 1996. Data related to all the children resident in the homes at the time of the interview were collected including socio‐demographic factors, reasons for admission to care, medical needs and medical services received.

Results In all, 309 children, aged birth–16 years—equivalent to 4.2/1000 Maltese children—were in residential care at the time of the study. Fifty‐three per cent were boys and 52% were < 8 years of age. The most common reasons for admission into residential care were single parenthood (25%), separated parents and parents unable to offer adequate care (19% each). Admission ‘medicals’ rarely included a developmental assessment or use of growth charts. Medical and developmental examinations were not carried out on a regular basis and children were medically examined only when required. Dental check‐ups were performed more regularly; 30% of the children had a dental check‐up every 6 months. Behavioural problems were common affecting 20.7% of all children, followed by chronic bronchial asthma which was present in 7.4%. Developmental delay (global or specific) was reported in 23.3% of children under the age of 4.

Conclusions Residential care is the predominant form of substitute care for disadvantaged children in Malta and Gozo. The demography of the child population in Residential Homes in these Islands is different from that in other countries, in that 52% of children in residential care are < 8 years of age compared to proportionately more adolescents in other countries. Medical supervision is minimal. A standardised medical and developmental assessment should be established as an essential part of this form of substitute care.
Can parents accurately perceive hyperactivity in their child?
Authors: Hutchinson E , Pearson D , Fitzgerald C , Bateman B , Gant C , Grundy J , Stevenson J , Warner J , Dean T , Matthews S , Arshad H , Rowlandson P
Published: March 2003

In all, 1872 children were recruited as part of a larger study concerning food additives and behaviours in preschool children. This figure represented 70% of the whole population of ‐year‐old children resident on the Isle of Wight, UK. Parents completed an assessment concerning their perceptions of their child's behaviour. The results of this assessment were compared with scores on two validated parental questionnaires, the Weiss Werry Peters (WWP) hyperactivity scale and the Emotionality, Activity and Sociability Temperament Questionnaire (EAS), which were used to assess hyperactivity. The accuracy of parents in perceiving hyperactivity in their children was found to be around 50% if the child was hyperactive, and 89% if the child was not hyperactive. The implications of these findings for services are discussed. Frequencies of potential risk groups for future Attention Deficit Hyperactivity Disorder (ADHD) and Conduct Disorder were also suggested.
Use of chopsticks in Chinese children
Authors: Wong Sheila , Chan Kingsley , Wong Virginia , Wong Wilfred
Published: March 2003

Objective There has been no study on the developmental stage of acquiring the skill of using chopsticks, which is a common eating tool of the Orientals. We aimed to obtain a developmental profile for achieving the skills of chopsticks manipulation in Chinese children and to assess the correlation between chopsticks manipulation and the level of achieving independence in ‘eating’ item in the Functional Independence Measure of children (WeeFIM). We also studied the relationship between demographic and environmental factors and the age of achieving chopstick manipulation.

Methods Direct interview with the mothers of 445 non‐disabled children who were randomly selected from the community. A chopsticks score (CS) of 1 was defined as children who could use chopsticks to finish more than half the meal, and a CS of 0 as failure to do so.

Results The mean age of achieving a CS of 1 was 4.6 years. At 6.7 years, all these children achieved this skill. There was a significant relationship between age of achieving the skills of chopsticks and the level of attaining independence in ‘WeeFIM eating’ score. (P < 0.001) However, there was no correlation of age of achieving CS of 1 with sex, social class or the presence of a domestic helper.

Conclusion Most non‐disabled Chinese children can achieve the visual motor skill of using chopsticks at 4.6 years. There was also a correlation with the age of achieving independence in the WeeFIM eating score. The skill of using chopsticks should be added as part of the tools, apart from spoons or forks, for scoring WeeFIM in Chinese children.
Parenting behaviour described by mothers in a general population sample
Authors: Thompson Margaret J. J. , Raynor Alex , Cornah Deborah , Stevenson Jim , Sonuga‐Barke Edmund J. S.
Published: March 2003

Objectives To collect mothers’ reports of the range of behaviours used by them in the management of their children’s difficult behaviour.

Design A cross‐sectional study using an interview with both semi‐structured and open‐ended question routes.

Sampling frame The population of mothers with 10‐year‐old children living in the New Forest region of Hampshire, UK.

Methods Mothers (n = 67), selected from the sampling frame, were interviewed about the range of parenting behaviours they used in the management of their children’s difficult behaviour.

Results Mothers reported a wide range of behaviours. Both authoritative (e.g. reasoning was mentioned by 42%) and authoritarian (e.g. the use of physical punishment was mentioned by 37%) behaviours were mentioned frequently. Although the different behaviours within these domains were intercorrelated, there was little overlap between the two domains. The use of praise for good behaviour seemed to be independent of other behaviours. There was no association between mothers’ parenting behaviours and the behaviour problems of their children.

Conclusions These data suggest that parenting takes many forms, with variations of behaviour across the ‘normal’ range being unlikely to represent a significant risk to children’s development. Public funding for parenting education should be targeted at those children who are at significant risk from extreme forms of parenting.
The role of Disability Living Allowance in the management of Attention‐Deficit/Hyperactivity Disorder
Authors: Steyn B. J. , Schneider J. , McArdle P.
Published: March 2003

Objective To explore the use of Disability Living Allowance (DLA) by families of children and adolescents with Attention‐Deficit/Hyperactivity Disorder (ADHD), and to discuss the implications for clinicians involved in their treatment.

Study design Opportunistic survey of patients attending ADHD clinic.

Setting Urban area in the north‐east of England.

Subjects A total of 32 carers of children being treated for ADHD with methylphenidate.

Intervention Semi‐structured telephone interviews about receipt and use of DLA. This involved open and closed questions and a multiple‐choice section.

Results In total, 19 out of the 32 families were receiving DLA. They chose to use it mainly to replace clothes and furniture and to provide diversions and activities for the children concerned. Some families were unaware of potential eligibility for DLA, whereas a few had chosen not to apply. Only one family's application for DLA had been unsuccessful. Carers were unanimously positive about the extra income.

Conclusions Families view DLA as an important means to replace damaged items and to fund recreational activities to contain over‐activity. Families receive little formal guidance on ways of using DLA money to support children with ADHD. Virtually no specific training in benefits awareness is provided to general practitioners and child health specialists, who are often asked to judge the child's level of impairment or incapacity. Applying for DLA may affect the therapeutic relationship for good or ill. There is a need for professionals in contact with children with ADHD to inform families of the possibility of receiving DLA and support them in applications. As diagnosis and treatment of ADHD becomes more commonplace, more families are likely to be entitled to claim DLA. This has definite implications for the social security budget.
Histamine and tryptase in nasal lavage fluid following challenge with methacholine and allergen
Authors: Jacobi  , Skov  , Kampen  , Poulsen  , Reimert  , Bindslev‐Jensen  , PRÆtorius  , Malling  , Mygind
Published: March 2003

Background

The level of histamine in nasal lavage fluid has been used as an index of mast cell/basophil activation in a number of studies. Obviously, such an index can only be valid if changes in the secretory activity of nasal glands do not affect the level of histamine in lavage fluid (i.e. hypersecretion, without a simultaneous activation of mast cells/basophils in the nasal mucosa, must not increase the level of histamine).

Objectives

To asses the effect of nasal hypersecretion on histamine levels in lavage fluid.

Methods

Nasal challenges were performed with methacholine and allergen in grass pollen‐allergic patients and non‐allergic controls. Nasal lavage fluid was collected before and repeatedly for nine hours after nasal challenge, and the level of histamine was compared with that of a specific mast cell‐derived enzyme, tryptase. In addition, the effect of methacholine on basophils was examined in vitro.

Results

Allergen challenge of allergic patients produced sneezing and a significant increase in histamine and tryptase levels, whereas challenge of non‐allergic subjects produced no such response. Interestingly, challenge with methacholine also induced a significant increase in histamine levels. This increase was seen in both allergic and non‐allergic subjects and it was not associated with any sneezing or increase in tryptase levels, indicating that mast cells were not activated. Furthermore, stimulation of basophils with methacholine did not induce any histamine release in vitro.

Conclusions

Apparently, there exists a pool of histamine in the human nose that can be transferred to lavage fluid during glandular hypersecretion. The source of this histamine is yet to be identified. As the level of histamine seems to be affected by the secretory activity of nasal glands, we question the use of this single mediator as an index of mast cell/basophil activation in nasal lavage studies.
Limited genetic control of specific IgE responses to rye grass pollen allergens in Australian twins
Authors: Sluyter  , Tovey  , Duffy  , Britton
Published: March 2003

Background

Both genetic and environmental factors are thought to contribute to specific IgE responses, however, the relative contribution of each in the responses to individual ryegrass pollen allergens is largely unknown even though some responses to allergens have been linked to certain HLA complexes.

Objective

Using a large group of monozygotic and dizygotic twins, this study was designed to investigate the IgE binding profiles of individual ryegrass pollen (Lolium perenne) components to assess the relative contribution of genetic and environmental factors in determining IgE responses to specific allergens.

Methods

Ryegrass pollen proteins were separated by electrophoresis and immunoblotted with sera from 191 pairs of twins where at least one sibling had a SPT > 2 mm to perennial ryegrass. Concordance levels for individual ryegrass pollen components were compared between monozygotic and dizygotic twins in a subset group where both twins had SPT > 3 mm to perennial ryegrass.

Results

Immunoblotting revealed 23 individual IgE‐binding components from ryegrass pollen. Although there was a significantly greater proportion of monozygotic twins with SPT wheals greater than 3 mm when compared with the dizygotic twins, the mean case‐wise concordance for the immunoblot components was similar for both groups of twins. The mean case‐wise concordance when at least four pairs of sera were involved was 44% for the MZ twins (n = 11 components) and 45% for the DZ twins (n = 12 components). We found no significant differences in concordance levels for any of the 23 individual components including allergens previously associated with HLA.

Conclusion

Evidence for genetic control of allergen‐specific IgE responses in a large population sample of twins to individual ryegrass allergens is limited, indicating that the IgE responses to specific ryegrass pollen allergens are determined largely by environmental factors.
Diethanolamine‐induced occupational asthma, a case report
Authors: Piipari  , Tuppurainen  , Tuomi  , MÄntylÄ  , Henriks‐Eckerman  , Keskinen  , Nordman
Published: March 2003

Background

Amino alcohols are low molecular weight chemicals used widely in industrial processes, often as minor constituents. They have been found to cause allergic contact dermatitis. Marked exposure through airways is uncommon in other than occupational settings where chemicals containing amino alcohols may be heated or vaporized, liberating free amino alcohols into the ambient air. A few cases of asthma and allergic rhinitis have been reported, but the amounts inducing the airway reactions have not been defined.

Objective

To further characterize ethanolamine‐induced asthma and define the concentration inducing the asthmatic reaction, a case of diethanolamine‐induced occupational asthma in a patient handling diethanolamine containing cutting fluid is reported.

Methods

Suspicion of work related asthma was raised by symptoms and peak expiratory flow monitorings at work and at home. Specific bronchial provocation tests with the cutting fluid containing DEA and with DEA aerosol at two different concentration below the American Conference of Governmental Industrial Hygienists threshold limit value of DEA (2.0 mg/m3) were done.

Results

DEA caused asthmatic airway obstruction at two different concentrations below the ACGIH TLV. A slight dose–response relationship was observed. Specific IgE‐antibodies against DEA could not be found.

Conclusions

DEA is able to induce occupational asthma by a sensitization mechanism, the exact pathophysiological mechanism of which is not known.
Identification of HLA‐DR and ‐DQ alleles conferring susceptibility to pollen allergy and pollen associated food allergy
Authors: Boehncke  , Loeliger  , Kuehnl  , Kalbacher  , BÖhm  , Gall
Published: March 2003

Background

Allergenic crossreactivity of pollen and foods due to the antigeneic similarity of oligopeptides is a well established clinical phenomenon.

Objective

To determine the immunopathological relevance of antigen presentation, we analysed the HLA class‐II genotype of patients with either pollen allergy or pollen associated food allergy.

Methods

One hundred and twenty patients with pollen allergy and 80 patients with pollen associated food allergy were evaluated by skin‐ prick tests, RAST, and HLA class‐II genotyping. The control population comprised 4251 healthy blood and bone marrow donors.

Results

Monovalent pollen allergy was observed in 57% (n = 68) of patients with pollinosis (57x grass pollen, 11x birch pollen), but only in 15% (n = 12) of patients with food allergy (9x grass pollen, 3x birch pollen). Hazelnut (71%), almond (65%), walnut (44%) and apple (41%) were the most common food allergens and frequently associated with birch pollen allergy. Grass pollen allergy was associated with an increased frequency of HLA‐DQB1*0301 (RR = 2.3; EF = 0.4; P = 0.0016) when compared with the control population. HLA‐DRB1*08 confered a sixfold higher risk for peanut allergy (EF = 0.3; P = 0.0013) and ‐DRB1*12 a 13‐fold higher risk for carrot allergy (EF = 0.3; P < 0.000001). The differences on allele frequencies detected among patients with food allergies diminished or turned statistically insignificant when their genotypes were directly compared to those of patients with the corresponding pollen allergies. This was found in the case of birch pollen associated hazel nut allergy for the extended haplotype HLA‐DRB1*01, ‐DQA1*0101, ‐DQB1*0501 as well as in grass pollen associated peanut allergy for HLA‐DRB1*08 (from RR = 6, P = 0.0013 to insignificant) and in birch pollen associated carrot allergy for HLA‐DRB1*12 (from RR = 13, P < 0.000001 to insignificant).

Conclusion

We were able to identify HLA class‐II alleles associated with some allergies thus indicating that these alleles might confer susceptibility to the respective allergens. Similarities at the level of the HLA class‐II genotype parallel the empirical finding of distinct cross‐reactivity patterns thus complementing investigations of IgE specificities. Our observations provide evidence for the major importance of antigen presentation on the manifestation of distinct crossreactivity patterns.
Inhaled procaterol inhibits histamine‐induced airflow obstruction and microvascular leakage in guinea‐pig airways with allergic inflammation
Authors: Mirza  , Tokuyama  , Arakawa  , Kato  , Mochizuki  , Morikawa
Published: March 2003

Background

β2‐adrenoceptor agonists (β2‐agonists) are shown to inhibit airway microvascular leakage in experimental animals. This effect may change in animals with chronic airway inflammation.

Objective

We examined whether inhaled β2‐agonists inhibit microvascular leakage in guinea‐pig airways with chronic allergic inflammation.

Methods

Three weeks after the sensitization with ovalbumin (OA; 6 mg/mL), each guinea‐pig was challenged with inhaled OA once a day for 1 or 3 weeks. Control animals without sensitization with OA also inhaled vehicle for OA (saline) for 3 weeks. One day after the last challenge, different doses of inhaled procaterol (1, 3 or 10 μg/mL) or vehicle was given to animals for 10 min after an anaesthesia. Fifteen minutes after the end of inhalation, the animals were given i.v. Evans blue dye (EB dye; 20 mg/kg), a marker of microvascular leakage, and then i.v. histamine (3 or 30 μg/kg) or vehicle. Lung resistance, a parameter of airflow obstruction, was measured for 6 min and the lungs were removed to calculate the amount of extravasated EB dye into the airways.

Results

A significant increase in eosinophil infiltration into the airways was seen in sensitized and challenged animals compared with control animals without sensitization. Among animals receiving antigenic exposure for either 0 (control), 1 or 3 weeks, 10 μg/mL procaterol significantly inhibited 30 μg/kg histamine‐induced increase in EB dye extravasation to a similar degree (ranged from 28.7 to 69.8% inhibition) as well as that in lung resistance (more than 90% inhibition in all groups). The minimal dose of procaterol to inhibit 3 μg/kg histamine‐induced microvascular leakage was not different between non‐sensitized control animals and those sensitized and challenged for 3 weeks at all airway levels.

Conclusion

Inhaled β2‐adrenoceptor agonists may be also potent in attenuating microvascular leakage even in the airways with chronic allergic inflammation.
Inhibitory effect of NPC‐17731 on BK‐induced and antigen‐induced airway reactions in guinea‐pigs
Authors: Ikemura  , Sasaki  , Ohmori
Published: March 2003

Background

Bradykinin (BK) has been suggested to act as a mediator in the airways in inflammatory conditions, such as asthma through the activation of B2‐receptors. NPC‐17731 (D‐Arg0[Hyp3, D‐HypE(trans‐propyl)7, Oic8]BK) has potent antagonistic activity against B2‐receptors without agonistic activity.

Objective

We have evaluated the inhibitory effect of NPC‐17731 against BK in guinea‐pig airways. In addition, we have investigated the effects of NPC‐17731 on antigen‐induced airway responses.

Methods

Bronchoconstriction was assessed as an increase in lung resistance (RL) and a decrease in dynamic compliance (Cdyn). Airway plasma leakage was assessed by extravasation of intravenously injected Evans blue dye. To estimate the effect of drugs on antigen‐induced reactions, guinea‐pigs were actively sensitized by exposure to aerosol ovalbumin (OA) twice and challenged by OA inhalation. Acute bronchoconstriction was measured for 15 min. Airway vascular leakage was measured at 10 min after the challenge. Assessment of airway hyperresponsiveness against acetylcholine and bronchoalveolar lavage were conducted at 18–24 h after the antigen‐challenge.

Results

NPC‐17731 (0.3–30 μg/kg, iv) inhibited intravenously applied BK‐induced bronchoconstriction in a dose‐dependent manner. The 50% inhibitory doses (ID50) were 1.3 μg/kg for RL and 2.8 μg/kg for Cdyn. NPC‐17731 (1–10 μg/kg, iv) inhibited BK‐induced microvascular leakage in a dose‐dependent manner (ID50 = 4.2 μg/kg). In addition, 10 μg/kg of NPC‐17731 abolished the inhaled BK‐induced bronchoconstriction. In the sensitized animals, 100 μg/kg NPC‐17731 significantly reduced the airway microvascular leakage and the decrease in Cdyn induced by ovalbumin exposure (P < 0.05), but did not influence the increase in RL. NPC‐17731 (100 μg/kg) inhibited the antigen‐induced airway hyperresponsiveness and the increase in eosinophils in BAL fluids.

Conclusion

These results indicate that NPC‐17731 is a potent BK antagonist in vivo and that BK may partially contribute to the antigen‐induced airway responses in guinea‐pigs.
Mite antigen‐induced IL‐4 and IL‐13 production by basophils derived from atopic asthma patients
Authors: Shimizu  , Shichijo  , Hiramatsu  , Takeuchi  , Nagai  , Takagi
Published: March 2003

Background

There is increasing evidence for the role of basophils in the pathogenesis of atopic diseases such as bronchial asthma, atopic dermatitis and atopic rhinitis. Recently, it has been reported that basophils derived from healthy donors produce the immunoregulatory cytokines interleukin (IL)‐4 and IL‐13 after cross‐linking of cell surface IgE. In addition to well‐known inflammatory mediators, such as histamine and leukotriene C4, these cytokines produced by basophils are also considered to be associated with atopic diseases.

Objective

Our first objective was to determine whether or not mite‐sensitive atopic asthmatic basophils produce IL‐4 and IL‐13 in response to mite antigens. Our second objective was to investigate the relationship between antigen‐specific or nonspecific IgE in the serum and the production of these cytokines in order to determine the association of basophil‐derived cytokines with the pathogenesis of atopic asthma. Our final objective was to study how production of these cytokines could be regulated by some anti‐asthma drugs.

Methods

Basophils were purified from peripheral venous blood of 67 atopic asthma patients with elevated RAST for the house dust mite. Cells were stimulated with mite antigens for 6 hours and then IL‐4 and IL‐13 levels in the supernatants were measured by enzyme‐linked immunosorbent assay (ELISA).

Results

Mite‐sensitive asthmatic basophils produced IL‐4 and IL‐13 when stimulated with mite antigens. Mite‐induced IL‐4 production peaked at 6 hours after the stimulation, whereas IL‐13 production continued up to 24 hours. The higher the concentration of mite‐specific IgE but not total IgE released in the serum, the more IL‐4 and IL‐13 were produced by basophils in response to mite antigens. The production of these cytokines was significantly suppressed by the anti‐asthma drugs theophylline (IL‐4, p < 0.001, n = 6; IL‐13, p < 0.001, n = 10) and dexamethasone (IL‐4, p < 0.001, n = 15; IL‐13, p < 0.001, n = 10).

Conclusion

Mite‐antigen‐induced IL‐4 and IL‐13 production by basophils derived from mite‐sensitive asthma patients was associated with the concentration of mite‐specific IgE and may play an important role in the pathogenesis of atopic asthma. The inhibitory effect of dexamethasone and theophylline on allergic inflammation may be due to the inhibition of IL‐4 and IL‐13 production not only by T cells but also by basophils.
CD11b and L‐selectin expression on eosinophils and neutrophils in blood and induced sputum of patients with asthma compared with normal subjects
Authors: IN 'T Veen  , Grootendorst  , Bel  , Smits  , Van Der Keur  , Sterk  , Hiemstra
Published: March 2003

Background

Patients with asthma show altered surface expression of the adhesion molecules CD11b and L‐selectin on airway granulocytes compared with blood granulocytes.

Objective

To investigate whether this modulation is related to disease activity or due to transendothelial migration, we compared the CD11b and L‐selectin expression on blood and induced sputum eosinophils and neutrophils between patients with asthma and normal subjects.

Methods

Eleven normal subjects (21–43 years), nine patients (21–34 years) with mild atopic asthma and 10 patients (20–47 years) with moderate to severe atopic asthma on regular treatment with inhaled steroids underwent sputum induction by inhalation of nebulized hypertonic saline (4.5%). CD11b and L‐selectin expression on granulocytes from blood and DTT‐homogenized sputum were analysed by flow cytometry. Eosinophils could be discriminated from neutrophils by using depolarized light scatter. Disease activity was assessed by baseline FEV1 and airway responsiveness to histamine (PC20).

Results

Sputum eosinophils showed higher expression of CD11b (P < 0.001) and lower expression of L‐selectin (P < 0.001) compared with peripheral blood eosinophils. CD11b and L‐selectin expression on eosinophils from blood or sputum did not differ between the three groups. Similar results were obtained for neutrophils. The PC20 in the patients with moderate‐to‐severe asthma was related to CD11b expression on blood (R = − 0.92, P = 0.001) and sputum eosinophils (R = 0.75, P = 0.02).

Conclusions

Flow cytometry of induced sputum granulocytes from asthmatic as well as normal subjects is feasible. We conclude that the modulated expression of CD11b and L‐selectin on airway granulocytes is not specific for asthmatic airway inflammation, but is probably the result of tissue migration per sé. This implies that CD11b and L‐selectin expression on granulocytes in induced sputum cannot be used as marker of disease activity.
Identification and partial characterization of multiple major allergens in peanut proteins
Authors: DE Jong  , Van Zijverden  , Spanhaak  , Koppelman  , Pellegrom  , Penninks
Published: March 2003

Background

Peanuts are a major cause of food allergies both in children as in adults which can induce an anaphylactic shock. The identification and characterization of peanut allergens could lead to more insight into the mechanism and contribute to the improvement of diagnostic tests and treatment for peanut allergy.

Objective

In the present study, the peanut protein‐specific immunoglobulin concentrations as well as their recognition of the various peanut proteins or protein subunits was determined in the plasma of peanut‐allergic (PA) and non‐allergic (NA) individuals. Moreover, two peanut allergens were characterized in more detail to confirm them as the earlier described Ara h1 and Ara h2.

Methods

The presence of Ig‐binding sites in peanut proteins was studied by immunoblotting assays whereas the concentrations of peanut‐specific Ig was determined by ELISA.

Results

Peanut proteins were found to contain multiple binding sites for immunoglobulins. Of these proteins, six were recognized by peanut‐specific IgE present in more than 50% of the plasma samples of the PA group. Their molecular weights were ≈44, 40, 33, 21, 20 and 18 kDa. The last three protein bands were recognized by peanut‐specific IgE present in more than 70% of the PA plasma samples and were thought to contain Ara h2. This allergen as well as another protein that was thought to be Ara h1, which was not recognized by the majority of the patients' IgE‐containing plasma samples, were isolated and the N terminal amino acid sequence was determined. Peanut protein‐specific IgA, IgM, IgG and IgG‐subclasses showed a more diverse recognition pattern of peanut protein in the PA group compared to the NA group. No differences were found in the plasma concentrations of peanut protein‐specific immunoglobulins of the various classes between the PA and NA group.

Conclusions

From the present study, we conclude that peanuts contain multiple allergens, of which six can be described as major allergens, Ara h2 included. In our population Ara h1 is not a major allergen. The recognition of peanut proteins by immunoglobulins is more diverse in PA individuals compared with NA individuals which, however, is not substantiated in the concentrations of peanut‐specific immunoglobulins in plasma, other than IgE.
Anti‐betalactoglobulin IgG antibodies bind to a specific profile of epitopes when patients are allergic to cow's milk proteins
Authors: Duchateau  , Michils  , Lambert  , Gossart  , Casimir
Published: March 2003

Background

We demonstrated recently that mite‐allergic patients differed from healthy controls in the specificity of their IgG antibodies towards mite antigens.

Objective

The present study investigates whether these discriminatory IgG responses could be associated with the expression and the evolution of clinical manifestations in allergy to cow's milk proteins.

Methods

Antibody specificity was evaluated by comparing IgG‐binding to native bovine beta‐lactoglobulin (nBLG) and its products of pepsin hydrolysis (dBLG) using a solid‐phase enzyme‐linked immunosorbent assay (ELISA). Antibody specificity was further investigated in competitive ELISA using streptavidin‐biotin technology with purified IgG fractions from selected subjects and specific mouse monoclonals raised against BLG.

Results

IgG antibodies from CM‐intolerant or allergic sera (n = 222) showed a higher degree of binding to nBLG than to dBLG, while control sera showed similar levels to both nBLG and dBLG (n = 99 children/65 adults). Sera from symptomatic patients, wether or not they contained IgE antibodies, demonstrated group‐segregating capacities to compete with pooled purified IgG from each clinical class, and with selected murine anti‐nBLG monoclonal antibodies for binding to n‐ and dBLG. Furthermore, this inhibitory capacity shifted dramatically in a small subset (n = 14) of children as they developed CM‐tolerance.

Conclusion

The IgG responses to BLG of CM‐intolerant or allergic patients are very different from those of healthy controls, being characterized not only by increased titres but also similar patterns of modified specificity, including a marked preference for conformational epitopes.

Cross‐competition experiments confirmed that the restricted specificity was clinically associated, appearing as an immunological signature, which allowed almost complete discrimination between patient groups. This phenomenon is a particularly promising diagnostic feature in this category of young patients where conventional tests usually only document the status of sensitization.
Home dampness and respiratory health status in European children
Authors: Andriessen  , Brunekreef  , Roemer
Published: March 2003

Background

Living in a damp home has been associated with impaired respiratory health in previous studies, but objective data on lung function variability and atopy have been lacking from most studies.

Objectives

Data collected in the winter of 1993–1994 in the framework of the PEACE study (Pollution Effects on Asthmatic Children in Europe) were used to study the association between home dampness and Peak Flow (PEF) variability, frequency of respiratory symptoms and relief medication use during the period of observation.

Methods

Children were selected with a screening questionnaire on the basis of positive answers to questions on symptoms of asthma and chronic cough. Children were instructed to perform PEF measurements with Miniwright PEF meters twice daily over a period of 2 months. Parents kept diaries on respiratory symptoms and medication use of their children. Data on demographic and housing characteristics were derived from a parent‐administered questionnaire. As indicators for home dampness reported moisture stains and moulds were used. Children were tested for atopy with skin‐prick tests. Data from 1614 children from 13 centres in 10 different countries were available for analysis. Linear regression models and prevalence rate ratios were used to investigate the association between home dampness and PEF variability and the period prevalence of cough, phlegm, lower and upper respiratory symptoms and bronchodilator use.

Results

In atopic children, PEF variability was positively related to self‐reported moulds but not to moisture stains. The period prevalence of cough and upper respiratory symptoms was significantly higher in children living in houses with reported moulds, compared with ‘dry’ homes.

Conclusions

These results show that self‐reported moulds in homes are associated with objective as well as subjective markers of airway lability in European children with chronic respiratory symptoms.