bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of basophils by immunohistochemistry in the airways of post‐mortem cases of fatal asthma
Authors: KOSHINO T. , TESHIMA S. , FUKUSHIMA N. , TAKAISHI T. , HIRAI K. , MIYAMOTO Y. , ARAI Y. , SANO† Y. , ITO K. , MORITA Y.
Published: April 2006

There is increasing evidence for the role of basophils in the pathogenesis of bronchial asthma. To examine the presence of basophils in the airways of patients with fatal asthma by immunohistochemistry, we stained lung tissues from four post‐mortem cases who had died from severe asthmatic attacks and four controls with a monoclonal antibody raised against tryptase (AA‐1) and anti‐IgE. Mast cells and basophils were identified in the bronchioles as A A‐1‐ and anti‐IgE‐positive cells, and anti‐IgE‐posilive cells, respectively. Airway mast cells were found beneath the basemenl membrane, near blood vessels in the submucosa, and adjacent to the submucosal glands, and scattered throughout the muscle bundles. There was a significant increase of mast cells in the asthma group compared with the control group (203.5 ± 84.6/mm2, mean ± s. d. vs 37.7 ± 8.7/mm2, P < 0.05, n= 4). In contrast, basophils were observed in the airway lumen, in the bronchial epithelium and in the submucosa. The number of basophils in the bronchioles was 81.8 ± 55.5/mm2 (n= 4); however, basophils were not found at all in the airways of the control group. Although eosinophils, B lymphocytes and macro‐phages bear low affinity IgE receptors and could react with anti‐IgE, the location of these cells in the close sections did not correspond closely with basophils. The presence of basophils in lung tissues obtained from fatal asthma patients supports the view that basophils play a role in the pathogenesis of bronchial asthma.
The effectiveness of a peripatetic allergy nurse practitioner service in managing atopic allergy in general practice—a pilot study
Authors: BRYDON MARY
Published: April 2006

The effectiveness of an allergy nurse practitioner service operating within community health care was evaluated in terms of symptom improvement and reduction in allergy related general practitioner consultations and prescribed medication. A postal questionnaire survey of 53 allergy patients, identified from three general practices in the Norwich area during a pilot scheme, was carried out concurrently with a survey of the patients' case records at the surgeries. The questionnaire included questions concerning allergy status, general practitioner visits and the number of prescribed medications supplied. The main outcome measures were the number of general practitioner consultations and prescribed medications before and after the allergy nurse practitioner consultation and the patient's reported level of symptoms. The results showed that the intervention of an allergy nurse practitioner consultation produced significant reductions in the outcome measures. The number requiring a general practitioner consultation fell by 40% (from 133 to 80, P < 0.001) and the number of prescribed medications fell by 42% (from 153 to 89, P < 0.001). Twenty‐seven (69%) of the 39 patients who responded to the questionnaire reported an improvement in symptoms, whilst 26% (n= 10) remained the same and 5% (n= 2) were worse. An additional study of 23 of the +ve skin‐tested patients, over an extended period, showed greater reductions in general practitioner consultations and prescribed medication (71%, P < 0.001 and 59%, P < 0.004 respectively). In conclusion, it is apparent that the application of developed skills and expertise in allergy assessment by a nurse coupled with time can lead to improvement in symptom level in allergy patients. Such a service also has the possibility of providing savings within the National Health Service. Simply prescribing drugs without a system of self‐management and avoidance measures is unlikely to improve the care available to allergy patients.
Comparative IgE responses to extracts of five species of house dust mite, using Western blotting
Authors: HILL M. R. , NEWTON M. R. , HART B. J.
Published: April 2006

IgE responses towards extracts of Demotopkagoides pteronysssinus, D. farinae, D. microceras, Euroglyphus maynei and Gymnoglyphus longior have been evaluated with sera from a mite sensitive population and the international reference pool of sera, NIBSC 82/528, using Western blotting. Using mite body and faecal extracts 21 of 29 mite protein bands responded to by sera were common to all five species of mite. All sera were unique with respect to proteins bound and species recognized. Mite proteins bound by more than 40% of sera included the Group II and FFI main allergens and protein bands 14 (MW 40.4 kD) and 21 (MW 27.8 kD), all of which were found in every mite species studied. The Group I allergen, found in all species, was bound by 29.4% of sera. Similar response profiles between mite species suggest that human specific IgE may bind predominantly to crossreactive determinants on mite allergens.
Natural history of cows' milk allergy in children: immunological outcome over 2 years
Authors: HILL D. J. , FIRER M. A. , BALL G. , HOSKING C. S.
Published: April 2006

In this investigation 98 children (median age 24 months) with cows' milk allergy (CMA) were studied over a median period of 2 years to see whether acquisition of clinical tolerance to cows' milk was associated with the changes in levels of IgG and IgE anti‐cows' milk antibodies, and skin test reactivity to a cows' milk extract. Two groups of CMA patients were examined. The first were IgE sensitized and responded rapidly to small volumes of cows' milk with urticaria, and/or exacerbations of eczema, and/or wheeze, and/or vomiting (n= 69). The second, a late reacting group (n= 29) demonstrated coughing, diarrhoea, eczematoid rashes, and/or a combination of these which developed more than 20 hr after commencing normal volumes of cows' milk. Significant immunological changes were confined to the 69 IgE sensitized immediate‐reacting‐group of patients. Of these, there were 15 children who achieved clinical tolerance to cows' milk and they showed a significant fall in the levels of skin test reactivity to cows' milk over the study period (P <0.01). In addition, these 15 children had lower serum IgE antibodies to cows' milk proteins both at the outset and the final follow‐up compared with the 54 patients whose CMA persisted. No consistent change in the IgG antibody responses to cows' milk proteins was seen in either group of patients over the study period. The findings suggest patients with immediate type hypersensitivity to cows' milk proteins whose disease persists for more than 2 years have a more severe dysregulation of IgE synthesis to cows' milk proteins from the outset. The role of humoral immune mechanisms in the pathogenesis of late reacting CMA remains unclear.
Allergen avoidance in the homes of atopic asthmatic children: the effect of Allersearch DMS
Authors: WARNER J. A. , MARCHANT J. L. , WARNER J. O.
Published: April 2006

Allersearch DMS (an alcohol based purified benzyltannate complex) is an acaricide with allergen denaturing properties. The living rooms in the homes of 16 atopic asthmatic children were thoroughly cleaned and treated with Allersearch DMS and the effect on allergen concentrations in carpet and soft‐furnishing dusts was determined. The skintest reactivity of the children to their own dust, collected before and after treatment, was compared. In 13 of the 16 homes the concentration of major house dust mite allergen Der p I was reduced in the carpet dust after treatment (P< 0.001) and in 11 homes major cat allergen Fel d I was reduced (P= 0.03). Changes in allergen concentrations in soft‐furnishing dusts were not significant. Control homes, which were cleaned but not treated, showed no significant difference in allergen concentrations. There were highly significant reductions in skin‐test reactivity to both types of dust after treatment (P<0.004, P< 0.008) suggesting an effect of the compound on allergens other than those individually monitored. The change in skin‐test response to soft‐furnishing correlated significantly (P< 0.05) with the number of individual sensitivities detected in each child. Controlled clinical trials of the effect of Altersearch DMS as part of an allergen avoidance study are now necessary.
Immediate and delayed allergy to nickel with contact urticaria, rhinitis, asthma and contact dermatitis
Authors: ESTLANDER T. , KANERVA L. , TUPASELA O. , KESKINEN H. , JOLANKI R.
Published: April 2006

A 27‐year‐old woman had for 2 years performed manual grinding of metal castings that contained nickel. She had previously had allergic contact dermatitis from nickel but started to get contact urticaria, rhinitis and asthmatic attacks at work. The symptoms disappeared at weekends and on holiday. Scratch chamber tests, open tests, specific IgE determinations (RAST), and RAST‐inhibition test indicated that she had developed an IgE‐mediated allergy to nickel; the bronchial provocation reaction with NiSO4was, however, a late one. Patch tests confirmed her allergic contact dermatitis to be caused by nickel. This is the first patient, to the best of our knowledge, reported to have developed allergic contact dermatitis, allergic contact urticaria, rhinitis and asthma from nickel.
Candida albicans and atopic dermatitis
Authors: SAVOLAINEN J. , LAMMINTAUSTA K. , KALIMO K. , VIANDER M.
Published: April 2006

The role of sensitization and exposure to Candida albicans in atopic dermatitis (AD) was studied with skin‐prick tests, yeast cultures and immunoblotting in 156 young adults with AD attending the Department of Dermatology, University of Turku, during 1983–89. Eighteen patients with allergic rhinitis without eczema and 39 non‐atopics were included as controls. Parameters associated with severe AD were simultaneous anti‐C. albicans IgE and saprophytic C. albicans growth. A statistically significant correlation between C. albicans sensitization (specific IgE antibodies) and AD symptoms was observed only in patients with saprophytic C. albicans exposure. No correlation between C. albicans‐specific IgE and AD severity was shown in patients without gastrointestinal growth. Furthermore, severe eczema was seldom seen in patients without saprophytic C. albicans growth. The most important IgE‐binding components of C. albicans in immunoblotting were 27 and 46 kD proteins and mannan, a polysaccharide. IgG and IgA antibodies to C. albicans, mainly towards C. albicans mannan, were found in practically all 70 sera studied. These results suggest a continuous exposure and induction of IgE antibodies by C. albicans in AD patients. Severe phases of AD in colonized patients are associated with IgE synthesis against C. albicans. These findings suggest a role for C. albicans in the exacerbations of AD but the clarification of this subject needs double‐blind placebo‐controlled treatment trials.
Cutaneous late‐phase response in food‐allergic children and adolescents with atopic dermatitis
Authors: CHARLESWORTH E. N. , KAGEY‐SOBOTKA A. , NORMAN P. S. , LICHTENSTEIN L. M. , SAMPSON H. A.
Published: April 2006

Food hypersensitivities contribute to disease exacerbation in a sub‐group of children with atopic dermatitis (AD). It has been shown that only selected foods are capable of causing clinical reactions when ingested, whereas other foods, to which the patient is equally sensitive by skin‐prick testing, may be tolerated. The purpose of this study was to examine the cutaneous late‐phase response (LPR) to food antigens in food‐allergic patients with AD and to determine if the skin reacted differently to ‘relevant foods’ (foods eliciting positive skin‐prick tests and positive oral challenges) than to ‘non‐relevant foods’ (foods eliciting positive skin tests but negative oral challenges). Using blister chambers adfixed to the skin, six children with AD were challenged epicutaneously with foods to which they had previously been shown to be sensitive. Histamine and PGD2 were measured hourly for 10–12 hr in parallel with quantitation of the cellular traffic. There appeared to be no difference in any of the measured parameters between relevant foods and non‐relevant foods, and the patterns of the LPR cells and mediators were similar to those previously described with aero‐allergens in patients with respiratory allergy. Histamine rose to 13.0±24 ng/ml (P < 0.005) during the first hours, declined to < 1 ng/ml by the fifth hour, and then rose a second time to 6.72 ± 3.4 ng/ml (P < 0.05) during the 12th hour. PGD2 rose to an average of 312 pg/ml (P < 0.05) during the first 3 hr followed by a decline to baseline. The cellular traffic was similar to that observed during the LPR in atopic adults without AD. Neutrophils peaked at 11.2 ± 6.8 × 104 cells but did not reach significance because of background traffic in the control chambers. Eosinophils were significantly increased (P < 0.05) and rose to 2.52 ± 1.7 × 104 cells. Mononuclear ceils (P < 0.05) and basophils (P < 0.38) were also increased but less than either neutrophils or eosinophils. These studies suggest that selectivity in gastrointestinal antigen absorption or differential antigen processing, transport and/or clearing may explain the differences in clinical reactivity to ingested food allergens.
The effect of 10, 50 and 200 μg inhaled fenoterol on exercise induced asthma
Authors: RARE K. F. , JÖRRES R. , MAGNUSSEN H.
Published: April 2006

In a randomized, double‐blind cross‐over study we investigated the protective effect of low doses of fenoterol on the airway response to exercise during cold air breathing. In 12 mild to moderate asthmatics with exercise induced asthma (mean age: 26 [range 19‐25] years), mean FEV1 87% of predicted, exercise challenges were performed under control conditions and 30 mi n after the inhalation from a metered dose inhaler of either placebo, or 10, 50, and 200 μg fenoterol within a 4 week period. Airway response was determined by measuring specific airway resistance, sRaw. Standardization of exercise challenges was achieved by individually maintaining a constant respiratory heat exchange, with an average (range) of 1.24 (0.98‐1.61) kcal/min. Fenoterol aerosol was an effective bronchodilator at all doses administered (P<0.05), with 200 μg significantly more effective than 10 μg. Mean sRaw (s.e.m.) pre vs maximal post exercise after control conditions, placebo and 10, 50, and 200 μg fenoterol aerosol was 12.9(1.4) vs 41.8 (6.3), 13.1 (1.6) vs 41.3 (6.3), 9.6 (1.5) vs 26.6 (6.2), 7.9 (0.9) vs 16.4 (3.6) and 5.5 (0.5) vs 7.4 (0.9) cmH2O.s. The protective effect of fenoterol against exercise induced broncho‐constriction was dose‐dependent and was significantly different from placebo at 50 and 200 μg (P<0.05). From these observations we suggest that in mild to moderate asthmatics 50 μg of fenoterol is a dose which is sufficient to protect against this naturally occurring stimulus.
Monoclonal antibody immunoassay for quantitative analysis of group V allergens in grass pollen extracts
Authors: FAHLBUSCH B. , MÜLLER W.‐D. , SCHLENVOIGT G. , JÄGER L. , WAHL R. , WEBER B.
Published: April 2006

A two‐site monoclonal antibody (MoAb) ELISA has been developed for the quantification of the Phleun pratense major allergen, Phl p V. The assay is based on two MoAbs which recognize different non‐overlapping epitopes on the Phi p V molecule; one antibody (1D11) was immobilized on the solid phase and the other (3B2) was biotinylated. An affinity‐purified Phi p V preparation (purity of 95%) was used as standard. The assay has a sensitivity of 10 ng/ml of allergen and is suitable for the detection of group V allergen in aqueous grass extracts. The specificity of the assay was investigated with 14 grass pollen and five non‐grass pollen extracts. Different levels of group V allergen were delected in extracts of grasses, but not in non‐grasses. The assay gives a good correspondence with allergenic activity of extracts as determined by ELISA inhibition using serum pool of allergic patients. The results indicate that the two‐site MoAb ELISA could be very useful in the standardization of allergenic extracts from grass pollen.
Formation of phosphatidylinositol‐4‐phosphate in human peripheral blood eosinophils
Authors: KUROSAWA M. , ISHIZUKA T. , SHIMIZU Y.
Published: April 2006

To evaluate the presence of phosphatidylinositol‐4‐phosphate in peripheral blood eosinophils, venous blood was drawn from normal healthy volunteers. The eosinophils were isolated on a Percoll gradient and were incubated with [γ3P] ATP in the presence of Mg2+. After stopping the reaction, lipid extraction was performed with acidic medium and phospholipids were separated by thin‐layer chromatography on 1% (w/v) oxalic acid‐ and potassium oxalate‐impregnated silica gel plates. Considerable amounts of radioactivity were found to be incorporated into phosphatidylinositol‐4‐phosprmte on both plates. This reaction requires ATP and Mg2+, and maximal response is seen at 10 μm ATP and 20 mm Mg2+. The reaction is dependent upon the time and temperature of the assay system. No significant superoxide anion generation from the eosinophils incubated with ATP at the concentrations used in the study was observed. These results suggest the possible presence of phosphatidylinositol kinase which catalyses the formation of phosphatidylinositol‐4‐phosphate from endogenous phosphatidylinositol in human peripheral blood eosinophils.
Modifications of PC20 and maximal degree of airway narrowing to methacholine after pollen season in pollen sensitive asthmatic patients
Authors: PRIETO L. , BERTÓ J. M. , LOPEZ M. , PERIS A.
Published: April 2006

We examined the effect of cessation of exposure to pollen on non‐specific airway responsiveness in 10 grass and/or parietaria pollen sensitive asthmatics. Three methacholine inhalation challenges were performed, the first during pollen season (seasonal period), the second 2 months after the end of season (short lime after seasonal period), and the third 5 months after the end of season (long time after seasonal period). The dose response curves to methacholine were characterized by the PC20 (provocative concentration of methacholine required to produce a 20% fall in FEV|) and maximal response plateau, if possible. A maximal response plateau on the dose‐response curve was considered to he present if three or more data points for FEV1 fell within a 5% response range. The challenge was stopped when FFV1 dropped more than 50% or the highest concentration of methacholine (200 mg/ml) was reached. The geometric mean (range) methacholine PC20 increased from 1.08 (0.18–37.22) in the seasonal period to 4.67 (0.71–200) mg/ml during the long time after seasonal period (P< 0.01). On the other hand, in six subjects in whom it was possible to obtain a plateau on at least one challenge, the level of the maximal response decreased from (mean ± s.e.m.) 44.1 ± 4.9 in the seasonal period to 30 ± 4.4 during the long lime after seasonal period (P < 0.05). These results suggest that in pollen sensitive asthmatic patients, the cessation of exposure to pollen is associated with a reduction of non‐specific bronchial responsiveness (PC20 and maximal degree of airway narrowing to methacholine).
Rapid Hymenoptera venom immunotherapy: comparative safety of three protocols
Authors: BIRNBAUM J. , CHARPIN D. , VERVLOET D.
Published: April 2006

We compared 284 sting‐allergic patients treated with either a 4 day (group 1), 6 hr (group 2) or 210 min (group 3) rapid venom immunotherapy (RVIT) protocol using honey bee (HB) or yellow jacket (YJ) venom at cumulative doses of 527.6 μg, 226.6 μg and 101.1 μg respectively. The 4 day protocol involved four times as many injections as the 210 min protocol and twice as many as the 6 hr protocol. Desensitization was conducted in a hospital providing full emergency resuscitation facilities. In group 1, 1 × 100 μg boosters were given on days 7,10,15 and 45 and, in groups 2 and 3, 2 × 50 μg boosters were given on day 15 and 1 × 100 μg on day 45. The patients in the three groups were comparable with regard to clinical characteristics and immunological reactivity determined by skin tests. All patients had large local reactions. Systemic reactions (SR) occurred in 28.2% of patients in group 1, 28.6% in group 2 and 6.9% in group 3. The mean total cumulative venom dose (s.e.m.) for occurrence of SR was 123.75 (± 24.2) in group 1,183.27 (± 28.5) in group 2, and 36.43 (±9.3) in group 3. HB led to more systemic reactions than YJ venom. The rate of SR decreased when the cumulative venom dose was reduced during RVIT. The median dose was 137.6 μg in group 1, 226.6 μg in group 2, and 21.1 μg in group 3. No systemic reactions were observed after the booster injections. The results of this study suggest that short RVIT protocols with low cumulative doses carry a lesser risk of SR.
Nodules, eosinophilia, rheumatism, dermatitis and swelling (NERDS): a novel eosinophilic disorder
Authors: BUTTERFIELD J. H. , LEIFERMAN K. M. , GLEICH G. J.
Published: April 2006

This study presents the clinical and laboratory findings of a novel syndrome associated with eosinophilia. Two young women presented with marked eosinophilia, and large, non‐tender compressible articular nodules arising from the tenosynovium of extensor tendons, dermatitis, episodic swelling of the hands and/or feet and pain in adjacent muscles and joints. Tissue specimens were examined by routine haematoxylin and eosin staining, immunofluorescent staining for eosinophil granule major basic protein (MBP) and rhodamine‐avidin or tryptase staining for mast cells. Plasma levels of MBP and eosinophii‐derived neurotoxin (EDN) were quantilated by immunoassay. The first patient presented in 1967 at the age of 20 and had, in addition to nodules and eosinophilia, dermographism, recurrent episcleritis and axillary urticaria. Biopsy of a nodule showed lenosynovitis with necrotizing granulomas, non‐specific vasculitis, eosinophils and eosinophil degranulation as shown by extracellular deposition of eosinophil granule MBP. Her symptoms responded to low‐dose, alternate‐day predni‐sone and have remained quiescent over the past 15 yr. The second patient presented in 1990 at the age of 28 with generalized pruritic dermatitis for 15 yr, eosinophilia for 2 yr. subcutaneous nodules and non‐limiting pain in several joints. Biopsy of a nodule showed chronic mild tenosynovitis, numerous eosinophils and extracellular deposition of M BP. She remains untreated. Serum IgE values and plasma levels of M BP and EDN were elevated in both patients; mast cells were numerous in their synovial tissue. Based on their clinical courses, these patients reveal the existence of a distinctive, relatively benign eosinophilic disorder with good long‐term prognosis.
Mast cells and mediators in the nasal mucosa after allergen challenge. Effects of four weeks' treatment with topical glucocorticoid
Authors: JULIUSSON S. , HOLMBERG K. , KARLSSON G. , ENERBÄCK L. , PIPKORN U.
Published: April 2006

The study focuses on the relationship between the tissue density of mast cells, the tissue hislamine levels and the levels of markers of mast cell activation after an allergen challenge of the nasal mucosa of allergic patients. The effect of 4 weeks' treatment with a topical glucocorticoid, fluticasone propionate, was studied in a double‐blind, placebo‐controlled study of 25 hay fever patients. Nasal biopsies were obtained before and after the treatment period for the evaluation of mast cell density and tissue histamine levels. Nasal challenges were performed at 2‐week intervals for 8 weeks using a standardized nasal lavage model. TAME‐esterase was analysed in the returned lavage fluid from all the challenges (weeks 0–8), while the levels of histamine and tryptase were analysed in lavage fluids from challenges performed before and after the treatment period (weeks 0 and 4). The symptoms of nasal allergy were assessed after each challenge. Treatment with fluticasone proprionate did not influence mast cell density, the tissue histamine concentration, the lavage histamine levels or the TAME‐esterase activity, while a reduction in nasal symptoms and tryptase in nasal lavagc fluid was revealed. Our present study again emphasizes the fact that the mast cell is an important trigger cell in the immediate nasal allergic response. The study also demonstrates the usefulness of the measurements of tryptase as an indicator of both mast cell activation and the efficacy of topical steroid treatment.
CD23 expression on B‐lymphocytes and its modulation by cytokines in allergic patients
Authors: COROMINAS M. , MESTRE M. , BAS J. , VERDAGUER J. , VALLS A. , ROMEU A. , BUENDIA E.
Published: April 2006

The aim of this study was to assess the expression of CD23 on peripheral blood B‐cells. and its in vitro modulation by recombinant human interferon‐γ (IFN‐γ) in phytohaem‐agglutinin‐ (PHA) or recombinant human interleukin‐4 (IL‐4)‐stimulaled cultures in atopic patients with Dermatophagoides pteromyssinus hyprrsensitivity and in healthy non‐atopic subjects. Atopic patients with asthma not receiving allergen‐specific immunotherapy (n= 21) were studied and further compared with a group of atopic subjects with asthma under allergen‐specific immunotherapy (n = 21). They were age‐(± 5 yr) and sex‐matched. The results were also compared with those obtained in the non‐atopic group (n= 11).CD23 expression on B‐lymphocytes and its modulation were analysed by flow cytometry using conjugated monoclonal antibodies with a double immunofluorescence method. Atopic patients had an increase in the percentage of B‐cells expressing CD23 in peripheral blood. Phytohaemagglutinin and IL‐4 induced a rise in the percentage of CD23‐positive B‐cells in both atopic groups and non‐atopic subjects. Phytohaemagglutinin provoked an increase in the intensity of CD23 expression on B‐cells from stimulated cultures in all groups, while IL‐4 only produced a significant increase in atopic patients. The presence of IFN‐γ decreased the CD23 expression on B‐cells in PH A‐stimulated culture of atopic patients, whereas it caused an increase in CD23 expression in the non‐atopic group. Furthermore, the presence of IFN‐γ in IL‐4‐stimulatcd cultures induced a decrease in CD23 expression on B‐cells in all cases. These results indicate a difference between atopic and non‐alopic donors in their responses to IL‐4 and IFN‐γ. On the other hand, allergen‐specific immunotherapy did not induce any shift in the expression and modulation of this receptor.
Toxicity and immediate allergenicity of latex gloves
Authors: CORMIO L. , TURJANMAA K. , TALJA M. , ANDERSSON L. C. , RUUTU M.
Published: April 2006

Surgical latex gloves and a natural rubber latex (NRL) catheter were evaluated for biocompatibilily by cell culture methods and Type I allergic reactions in operating room personnel using latex gloves. The prevalence of relevant immediate allergy to NRL was 5.2% when using eluates made from different latex gloves as allergens and the skin‐prick test methodology. The reliability of a questionnaire in detecting the sensitized persons was limited. Weak positive skin test reactions to surgical latex glove eluates were found to be unreliable as compared with challenging with the corresponding glove. Latex gloves exhibited more toxicity in cell culture than non latex gloves but, inversely, the toxic catheter gave weak positive skin‐prick test reaction in oniy one sensitized person, confirming that the allergenicity and toxicity of natural rubber products do not refer to the same properties of the products. Catheters exhibiting toxicity in cell culture have earlier been found to cause significant clinical symptoms in operated patients, but in the case of surgical gloves this relationship is not clear. One glove brand with a low content of known sensitizing rubber chemicals caused clear toxicity in cell culture but was well tolerated by the hospital personnel.
Standardization of pollen allergens of Parthenium hysterophoms and selection of an in‐house reference extract
Authors: SRIRAMARAO P. , SCHRODER H. , RAO B. S. SUBBA , PRAKASH O. , RAOH P. V. SUBBA
Published: April 2006

A standardized in‐house reference extract from the pollen of Parthenium hysterophoms, which is responsible for the high incidence of allergic rhinitis in India, was generated and examined by skin test, radio‐allergosorbent test inhibition and isoelectric focusing. Parthenium reference allergen discs and positive reference serum were also generated. These reference reagents could not only be used for the quantitation of Panhenium‐specific IgE in the sera of rhinitis patients but also for the evaluation of allergenic activity (relative potency and lot‐to‐lot variation) of different batches of Parthenium pollen.
Cough variant asthma is associated with a higher wheezing threshold than classic asthma
Authors: KOH Y. Y. , CHAE S. A. , MIN K. U.
Published: April 2006

Cough variant asthma is an occult form of asthma in which the only sign or symptom is chronic cough. It is a common problem amongst all ages that frequently goes unrecognized, leading to under diagnosis and under treatment. To characterize the pathophysiological abnormalities in these patients, we performed bronchial provocation tests with methacholine using the stepwise doubling concentration technique, and measured the concentration of methacholine and the severity of airway obstruction when wheezing was first detected. Airway hyper responsiveness, defined as PC20 in the cough variant asthma group was not significantly different from that of classic asthma. There was a good correlation between the PCW (the concentration of methacholine causing wheezing) and the PC20 with the PCW values higher than PC20 values in both groups. However, in the cough variant asthma group, the PCW: PC20 ratio was greater than that of the classic asthma group. Furthermore, the mean % fall in FEV1 at which wheezing was first detected in the former group was significantly larger than that of the latter group. The results indicated that the mechanism for the manifestation of cough without wheeze in the cough variant asthma may be a higher wheezing threshold, i.e. wheezing becomes audible at the greater degree of airway obstruction than classic asthma. They suggested that patients with cough variant asthma may represent a subset of asthmatic subjects whose airways are less able to produce a wheeze.
Comparison of skin‐prick test assay and reverse enzyme immunoassay competition (REINA‐C) for biological activity of allergens
Authors: CASANOVAS M. , MARAÑÓN F. , BEL I.
Published: April 2006

An in vitro technique for measuring the relative potency of allergenic extracts has been developed and compared with the dose‐response skin‐prick test, The in vitro technique is a modification of an EL1SA based on the method of antigen capture using polystyrene microtitre wells as solid phase (REINA‐compelition) and is also based on a doseresponse. Both methods have been applied to allergen extracts of Dermatophagoides pteronyssinus. Phleum pratense, Secale cereale, Lolium perenne, Plantigo lanceolata, Artemisia vulgaris, Salsola kali and Parietaria judaica. For each allergen, the slope of the regression log‐log dose response lines displayed by skin‐prick test and REINA‐C does not show a statistically significant difference, being parallel (P < 0.001), and indicating that the allergen ligand binding kinetics are identical in both methods.
Effect of 443c81, an inhaled μ‐opioid receptor agonist in asthma
Authors: PAVORD I. , HALL I. , WAHEDNA I. , COOPER S. , TATTERSFIELD A.
Published: April 2006

Stimulation of exposed C‐fibre afferent nerve endings by inflammatory mediators may contribute to airway inflammation and bronchoconstriction in asthma through the release of neuropathies from collateral nerve endings. The polar opioid peptide 443c81 is a μ‐optoid receptor agonist which inhibits C‐libre activation and non‐echolinergie neurally mediated bronchoconstriction in animal models. We have compared the effect of 443c81 (5 ml of 1 4 mg ml solution nebulited) four times daily for 7 days with placebo on asthma control in a double‐blind parallel group study of 40 subjects with mild asthma. Twenty subjects (12 male, mean FEV, 83 Predicted) received placebo and 20 (15 male, mean FEV, 91%, predieted) 443e81 after a 1 week run‐in Efficacy was assessed by comparing changes from baseline values in FEV1 provocative dose of histamine causing a 20%, fall in FEV1(PD20), symptom scores, bronchodilator use and home peak flow readings 443c81 had no acute effect on FEV1 and the mean changes in FEV1 after 1 week of treatment were not significantly different placebo 0.9. 443c81 3.8%. One hour after the first dose of 443c81 PD20 mecreased from a geometric mean of 0.88 to 1.48 μmol (mean change 0.76 doubling doses: 95% CI 0.23. 1.29) but this did not differ significantly from the change with placebo (mean difference between 443c81 and placebo 0.63 doubling doses. 95%. CI −0.2. 1.5: P− 0.095). After 1 week's treatmentPD20 was similar to baseline values with 443c81 (0.78 μmol) and placebo (baseline 0.71. post‐treatment 0.93 μmol) Symptom scores including cough scores.) bronehodilator use and peak flow recordings did not change significantly during or following treatment with 443c81 compared with placebo. There were no important adverse events. The lack of effect of 443c81 in our study would not support a role for activation of C‐fibres in asthma.
Identification of monocyte chemotactic factors in supernatants of ovalbumin‐stimulated lymphocytes from patients with atopic dermatitis who are sensitive to hen's egg
Authors: FUKUTOMI O. , KONDO N. , AGATA H. , SHINODA S. , KUWABARA N. , SHINBARA M. , INOUE R. , ORII T.
Published: April 2006

Monocyte chemotactic activities in supernatants of ovalbumin (OA)‐stimulated peripheral blood mononuclear cell (PBMC) cultures were studied in patients with atopic dermatitis (AD) who were sensitive to hen's egg. The monocyte chemotactic activities in hen's egg‐sensitive AD patients were significantly higher than those of non‐atopic healthy controls and patients with immediate allergic symptoms. However, the monocyte chemotactic activities were not detected in bovine serum albumin‐Stimulated PBMC culture supernatants in patients with AD who were sensitive to hen's egg. but not to cow's milk. Furthermore, there was significant correlation between the monocyte chemotactic activities and proliferative responses of PBMCs to OA in hen's egg‐sensitive AD patients, whereas there was no significant correlation between the monocyte chemotactic activities and radioallergosorbent test values. These results suggest that PBMCs stimulated with food antigens produce monocyte chemotactic factors which relate to the pathogenesis of AD in food‐sensitive AD patients and that the pathogdenesis of AD may be related to cell‐mediated immune responses.
Safety and efficacy of a 12‐week maintenance interval in patients treated with Hymenoptera venom immunotherapy
Authors: KOCHUYT A.‐M. , STEVENS E. A. M.
Published: April 2006

It is currently recommended to administer a maintenance dose of 100 μg of venom at 4–6 week intervals for Hymenoptera venom immunotherapy (VIT), Because the optimal duration of therapy is not known, we decided to progressively prolong the interval between maintenance injections instead of accepting the risk of anaphylactic reactions when VIT is discontinued after a predetermined period. We report here on the results of a first phase of this interval extension programme, covering the gradual increase of the interval from 1‐12 weeks over 19 months in 178 patients. A 12‐week interval maintenance VIT could be achieved in 117/128 (91%) of yellow jacket venom (YJV) and in 35/50(70%) of honeybee venom (HBV) allergic patients. At the lime of the interview these 152 patients had been treated with 12‐weekly 100 μg venom injections for an average period of 2 years without any untoward reaction to VIT. During this period of 48 YJV allergy sufferers experienced 77 field re‐stings without systemic reaction (SR), and 17 HBV allergic subjects were restung at least 213 times in total, with one patient developing a very large local reaction and one a mild systemic reaction. In 26 of the 17S patients the interval of 12 weeks was not reached for various reasons, with a higher failure rate among the HBV allergic patients. Most Hymenoptera venom allergic patients can thus be safely and effectively treated with 12‐weekly injections of 100 μg venom.
Stimulation of partial development of human mast cells by supernatant fluid from mouse fibroblast cultures
Authors: DVORAK A. M. , MITSUI H. , ISHIZAKA T.
Published: April 2006

Summary. Fibroblasts have been implicated as culture‐competent cells for the mast cell lineage in several species. In man, fibroblast monolayers sustain the ultrastructural phenotype and function of isolated human lung mast cells and permit the differentiation and full maturation of human mast cells from their agranular precursors in cord blood cells. We examined whether development and maturation of the mast cell lineage in man can be achieved by a supply of the soluble products present in fibroblast culture supernatants. Suspension cultures of cord blood cells were supplemented with culture supernatants derived from two different murine fibroblast lines; controls were not supplemented. The cultures were sampled for light and electron microscopy at 6, 7 and 8 weeks. Human mast cells developed in quantity when cultures were supplemented with the supernatants from BALB/c 3T3 fibroblasts, in reduced numbers when supplemented with Swiss Albino 3T3 fibroblast supernatants, and not at all in culture media alone. By ultrastructural criteria, the newly developed mast cells did not achieve full maturity; they did continue to synthesize new granules and to undergo intragranular maturational events. Small numbers of mature basophils persisted in suspension cultures, and many were undergoing piecemeal degranulation. Other cell lineages noted included eosinophils, neutrophils, macrophages and endothelial cells. We conclude that a factor(s) of fibroblast origin permits the differentiation and partial maturation of human mast cells from their agranular precursors in cord blood, but that fibroblasts must be physically present for complete maturation of these lineages to occur.
Dissociation of airway responsiveness and bronchoalveolar lavage (BAL) cell composition in sensitized guinea–pigs after daily inhalation of ovalbumin
Authors: HEUER H. O. , WENZ B. , JENNEWEIN H. M. , URICH K.
Published: April 2006

Summary. The association between inflammatory cell influx, cell activation status and change of airway responsiveness to acelylcholine (ACh) after daily inhalation of ovalbumin (OA) in sensitized guinea–pigs was investigated. Starting 3 weeks after sensitization (OA at 50mg/kg s.c. + i.p.) guinea–pigs were exposed daily to 2% OA (10min: undercover of 0.5Smg/kg mepyramine i.p. 15min before OA) for 2 weeks. Concentration–response curves (CRCs) for inhaled ACh were performed 24 h after the last OA–challenge and 24 h after another single OA–inhalation 1 week later. CRCs for inhaled ACh were neither affected 24 h after the last OA challenge (daily for two weeks) nor 24 h after another OA–inhalation one week later. In contrast, bronchoalveolar lavage (BAL) from repeatedly OA– sensitized/–challenged guinea–pigs immediately after the last CRC showed a significant increase of total cell count by about tenfold and increases in eosinophils by about 20–fold, neutrophils by 30–fold, macrophages by about fivefold and lymphocytes by about tenfold (P < 0.05. multiple Wilcoxon–test). In contrast, markers of cell activation (EPO, MPO) were significantly decreased (P < 0.05). Methylprednisolone almost completely prevented these changes in increased cell numbers and decreased cell activation (vs OA contr., P < 0.05). The lack of increased airway hyperresponsiveness despite a massive inflammatory cell influx suggests other factors controlling airway responsiveness than inflammation.
High anti‐IgE levels at birth are associated with a reduced allergy prevalence in infants at risk: a prospective study
Authors: VASSELLA C. C. , ODELRAM H. , KJELLMAN N.‐I. M. , BORRES M. P. , VANTO T. , BJÖRKSTEN B.
Published: April 2006

Development of atopic disease was prospectively studied in 148 children from birth to the age of 18 months and related to serum levels of IgG anti‐IgE antibody. Children with a dual heredity of allergy, but remaining healthy, had significantly higher IgG anti‐IgE levels at birth than children with a similar predisposition to allergy, who became allergic. Children with increased allergy risk, defined by elevated IgE levels at birth (>= 0.53 kU/l) and with probable allergy symptoms had also significantly higher IgG anti‐IgE levels at birth than children of the same risk group, developing definite allergy. Independent of allergy risk, there was a significantly lower prevalence of atopic disease in children with cord serum levels of IgG anti‐IgE above 350AU.1 than in children with lower levels. Additionally, we showed that the allergy predictive capacity of IgE levels in cord serum was slightly improved in specificity, sensitivity and efficiency by including not only the family history of allergy, but also cord serum levels of IgG anti‐IgE. Our results thus raise the possibility that high levels of IgG anti‐IgE protect children of increased allergy risk from early development of atopic disease and reduce the severity of symptoms.
Immediate hypersensitivity to bakery, brewery and wine products in yeast‐sensitive atopic dermatitis patients
Authors: KORTEKANGAS‐SAVOLAINEN O. , SAVOLAINEN J. , LANTTO R. , KALIMO K.
Published: April 2006

Ultrafiltered (> 1000 Da) samples of beer, aged red wine, young white wine, sparkling wine and extracts of fresh wheat bread and dried rye bread were analysed by skin‐prick test (SPT), radioallergosorbent test (RAST) inhibition, sodium dodecylsulphate‐polyacrylamide gel electrophoresis (SDS‐PAGE) and immunoblotting to find out if they contain Saccharomyces cerevisiae(S. cerevisiae, baker's yeast) allergens. Serum pool consisting of S. cerevisiae positive sera was used in the assays. The results were compared with freeze‐dried reference. V. cerevisiae and cereal antigens. The beer, bread, red wine and sparkling wine extracts elicited immediate reactions. However, no evident correlation with suspected symptoms was observed. White wine extract caused reactions in four out of six atopic dermatitis (AD) patients with symptoms, and in five out of seven symptom‐free AD patients and in two of the 24 controls. In SDS‐PAGE, protein bands were found in wheat and rye bread extracts and beer. In IgE immunoblotting, however, no staining was seen with the S. cerevisiae positive sera suggesting that they were of cereal origin. In white wine and champagne extracts a nonspecific staining was seen in the region 20kDa representing, e.g. lectin‐like activity. No bakers yeast antigen could be detected in brewery and bakery products with IgE‐immunoblotting even in the excessively concentrated extracts. The IgE mediated allergy to baker's yeast alone should thus not lead to denial of bakery, brewery and wine products.
Effect of grain exposure and smoking on the longitudinal changes in immediate skin reactivity
Authors: LIN F. J. , KENNEDY S. M. , CHAN‐YEUNG M.
Published: April 2006

The study was carried out to investigate the effect of occupational exposure and smoking on the longitudinal changes of immediate skin reactivity over 3 years in working populations. A total of 480 grain elevator workers and 707 transit and ferry (control) workers were included because they had allergy skin tests on both surveys. Skin‐prick texts using three common allergens and a negative and histamine controls were administered during both surveys. The reaction was considered positive if the mean weal size was 3 mm or greater than that of the negative control. Conversion was defined as a change from the non‐atopic state in the initial survey to the atopic state in the follow‐up survey. Reversion was defined as a change from the atopic state in the initial survey to the non‐atopic state in the follow‐up survey. The findings showed that grain workers had two times risk of conversion than control workers. Recent smokers, who changed their habit from non‐smoker/ex‐smoker to smoker in the follow‐up survey, were at a three times risk of conversion than non‐smokers. The reversion of skin‐test reactivity was not associated with age, smoking habits, or working exposure. When investigating studies of longitudinal changes in immediate skin reactivity, the effects of age, changes in smoking habit and occupational exposure should be considered.
House dust mite allergen avoidance: a randomized controlled trial of surface chemical treatment and encasement of bedding
Authors: MARKS G. B. , TOVEY E. R. , GREEN W. , SHEARER M. , SALOME C. M. , WOOLCOCK A. J.
Published: April 2006

To test the effectiveness of a house dust mite (HDM) allergen avoidance strategy we conducted a randomized controlled trial in 35 atopic subjects with asthma, aged 13 to 60 living in Sydney — a high HDM allergen environment. After a 3 month run‐in period, subjects were randomized to active allergen avoidance treatment (n= 17) or placebo (n= 18) groups and followed for 6 months. The active treatment involved placing impermeable covers over the mattress, pillows and duvet and spraying the remaining bedding, as well as the carpets and furniture, with a tannic acid/acaricidal spray. Subjects kept a daily record of symptoms and peak expiratory flow rates and had 3 monthly assessments of lung function and airway hyperresponsiveness (AHR). Dust samples were collected from the bed, the bedroom floor and the living room floor at 3 monthly intervals and 2 weeks after the treatment. Mean HDM allergen levels at baseline at these sites were, in the active group, 15.5, 9.6 and 10.2μ/g Der p I/g of fine dust, and, in the placebo group 25.7, 11.8 and 6.3μg/g. Two weeks after the allergen avoidance treatment the HDM allergen level in the beds was reduced to 29% of baseline (95% CI 16.50%, P= 0.038 compared with placebo), but was not significantly different at 3 or 6 months. There was also no significant effect of the allergen avoidance treatment on symptom scores, peak flow variability, lung function or AHR (P > 0.1). We conclude that, in a high HDM allergen environment, simple chemical treatment and encasement of bedding is not sufficient to cause a sustained, beneficial reduction in allergen levels. Effective allergen avoidance requires an active strategy to remove allergen reservoirs and control accumulating allergen within the house.
An increased frequency of IgE‐producing B cell precursors contributes to the elevated levels of plasma IgE in atopic subjects
Authors: KASAIAN M. T. , MEYER C. H. , NAULT A. K. , BOND J. F.
Published: April 2006

Background: The production of specific IgE, which underlies the allergic response, may be a normal correlate of the immune response to a certain class of antigen (allergens), or could represent a unique response driven by regulatory signals that are absent in non‐allergic individuals. If atopic subjects do possess a regulatory environment favoring IgE production, they may display not only allergen‐specific IgE, but also higher levels of total IgE and higher frequencies of IgE‐producing B lymphocytes.

Objective: To address the contribution of antibody‐producing cell number to the circulating IgE titre in atopic vs non‐atopic subjects.

Methods: Frequency determination by limiting dilution of EBV transformants and Poisson distribution analysis. Titres of total and allergen‐specific IgM, IgG, and IgE by specific ELISA.

Results: In contrast to findings reported by others, the atopic subjects had a significantly higher frequency of IgE‐producing B cells than non‐atopies (0.79% of total Ig‐producing cells, as compared with 0.17% for the control group; P < 0.01), suggesting that one factor contributing to the high plasma IgE titres in atopic subjects is the high frequency of B lymphocytes with the potential to produce IgE. Although only the atopic subjects produced allergen‐specific IgE, the frequency of specific IgE‐producing B cells was undetectable in both groups.

Conclusion: Atopic subjects have higher frequencies of IgE‐producing B cell precursors than non‐atopies. A correlation exists between IgE‐producing B cell frequency and levels of circulating IgE.