bluuebunny/crossref_metadata_2025 huggingface dataset:
Allergy to ingested cereals in atopic children
Authors: Räsänen L. , Lehto M. , Turjanmaa K. , Savolainen J. , Reunala T.
Published: May 2007

Clinical features, hypersensitivity mechanisms, and differential diagnosis of cereal allergy or intolerance were investigated in children with atopic dermatitis (AD). On oral provocation, 18 children exhibited a positive response to wheat, three to rye, one to barley, and one to oats. Cereal‐induced symptoms were dermatologic, gastrointestinal, or oropharyngeal, and their onset after provocation was immediate (eight cases), delayed (14 cases), or both immediate and delayed (one case). A combination of type I allergy tests (prick test, RAST, and histamine‐release test) detected all immediate reactors and 9/14 delayed reactors. Of the five subjects remaining negative in these tests, three were positive in the patch or lymphocyte‐proliferation tests. Subjects with cereal allergy or intolerance frequently possessed IgE, IgA, and IgG antibodies against gliadin, but only one of these children was HLA‐DR3‐positive, and none had reticulin antibodies typical of celiac disease. Combining tests of immediate and delayed hypersensitivity can confirm allergy to cereals in a more reliable way. The coexistence of cereal allergy and celiac disease seems to be rare.
Occupational asthma caused by ethanolamines
Authors: Savonius B. , Keskinen H. , Tuppurainen M. , Kanerva L.
Published: May 2007

Amino alcohols are used in various industries, often as minor constituents of compounds to modify the properties of the compound. Generally, they are considered to be safe, but they have been known to cause local skin irritation at higher concentrations in solutions. We report on three cases of occupational asthma caused by ethanolamines: two metal workers exposed to a cutting fluid containing triethanolamine, and one cleaner exposed to a detergent containing monoethanolamine. The diagnosis was based on work‐related symptoms and on a chamber challenge with the suspected agent. Persistence of the symptoms after exposure ended was a common feature of the three cases.
Allergy to the coffee plant
Authors: Axelsson I. G. K.
Published: May 2007

Occupational respiratory allergy to green coffee beans in coffee roastery workers is well established. I now report on a 50‐year‐old female atopic patient sensitized to the coffee plant used for indoor decoration. The symptoms were rhinitis and conjunctivitis on exposure to the plant. Investigation showed a positive skin prick test, RAST, and rhinoconjunctival provocation test to coffee leaf allergen extract. However, the commercially available RAST disk for green coffee beans seems to be appropriate for diagnosing allergy to the potted coffee plant.
Determination of the size of airborne flour particles
Authors: Sandiford C. P. , Nieuwenhuijsen M. J. , Tee R. D. , Newman Taylor A. J.
Published: May 2007

Air sampling was done in a UK bakery and a flour mill with an eight‐stage cascade impactor to determine the size of airborne flour particles. The concentration of captured material was determined by a competitive inhibition radioimmunoassay. Comparison of the different sites revealed that 8.79% and 52.14% of the particles in the bakery dough‐brake and roll‐production areas had a diameter 6.0 μm, respectively, and 19.7% of the particles in the flour mill packing area were of this size. We conclude that in dusty areas up to 20% of the airborne flour particles are of a diameter likely to allow them to be deposited in the bronchial airways and alveoli.
Effects of immunotherapy with a purified standardized allergen preparation of Dermatophagoides farinae in adults with perennial allergic rhinoconjunctivitis
Authors: Löfkvist T. , Agrell B. , Dreborg S. , Svensson G.
Published: May 2007

Immunotherapy (IT) was performed for 12 months with a purified and standardized preparation of Dermatophagoides farinae. Twenty adults with rhinoconjunctivitis sensitive to house‐dust mite were given IT, and a similar group of 11 patients served as open controls. A total of 512 injections were given. Twenty‐eight episodes of allergic side‐effects occurred, 13 general and 15 local, most of them during the initial incremental dose period. No severe reactions started later than 30 min after the injection. One patient suffered anaphylactic shock. In this patient, specific antibodies fell immediately, followed by an increase within 1 week. The therapy group improved significantly in relation to the open controls in patients’ subjective evaluation of symptoms (P<0.028) and skin (P<0.0001) and conjunctival (P<0.001) sensitivity. Specific IgE increased in controls (P<0.0001) but not in IT‐treated patients during the “mite season;” that is, there was a significant difference in change during the observation period (P<0.0001). There was also a difference in change of specific IgG between the groups during the first 4–5 months and the whole year (P<0.0001), but not from 4–5 months to 12 months. In contrast to changes in antibody titers (IgG, P=0.04), changes in conjunctival (P<0.01) and especially skin sensitivity (P<0.005) correlated well with subjective improvement. This implies that the skin prick test and the conjunctival test can be recommended for follow‐up of IT. Furthermore, we recommend that changes in skin sensitivity be expressed as change in allergen concentration either inducing the same wheal response before and after IT as evaluated by parallel‐line bioassay, or inducing the same wheal response before and after IT as that induced by histamine tested at the same time. Finally, our findings support the hypothesis of a switch from IgE + to IgE ‐ during successful IT.
Allergic reactions to betalactams: studies in a group of patients allergic to penicillin and evaluation of cross‐reactivity with cephalosporin
Authors: Audicana M. , Bernaola G. , Urrutia I. , Echechipia S. , Gastaminza G. , Muñoz D. , Fernández E. , Fernández de Corres L.
Published: May 2007

A group of 34 penicillin‐allergic patients was studied to determine skin test reactivity to the different penicillins involved in inducing the allergic reaction and the cross‐reactivity with side‐chain‐related and side‐chain‐unrelated cephalosporins. All the subjects selected for the study had to be skin test positive to at least one of the following determinants: benzyl‐penicilloyl‐polylysine (BPO‐PLL), minor‐determinant mixture (MDM), amoxicillin (AX), or ampicillin (AMP), or to possess in vitro IgE to the following conjugates: benzyl‐penicilloyl‐human‐serum albumin (BPO‐HSA), ampicilloyl‐human‐serum albumin (AMP‐HSA), and amoxicilloyl‐human‐serum albumin (AX‐HSA). Cephalexin (CE) and ceftazidime (CEF) were used to assess cross‐reactivity. If skin tests to any of these compounds were positive, the patient was considered to be allergic; if negative, a challenge test was performed. Sixteen patients (47%) were skin test positive to BPO and/or MDM, and nine (26%) exclusively to AX and/or AMP. In three cases (8%), the RAST was positive although the skin test was negative; one to BPO‐HSA and two to AX‐HSA and AMP‐HSA. Six patients (17%) needed to be challenged with the penicillin involved to establish the diagnosis. In five patients (14%), the skin tests were positive to CE and in none to CEF. In all the others, the skin tests were negative to both cephalosporins, and the patients tolerated the drugs when challenged. These results indicate the relevance of side‐chain‐specific minor determinants in betalactams allergy and provide support for the role of this chemical structure in the evaluation of cross‐reactivity between penicillins and cephalosporins.
Mite allergens during 18 months of intervention
Authors: Wickman M. , Nordvall S. L. , Pershagen G. , Korsgaard J. , Johansen N. , Sundell J.
Published: May 2007

Wickman M, Nordvall SL, Pershagen G, Korsgaard J, Johansen N, Sundell J. Mite allergens during 18 months of intervention.

In Stockholm, Sweden, 17 children with newly diagnosed sensitization to house‐dust mites (HDM) and 11 children with previously diagnosed HDM‐sensitization were included in a study of HDM‐allergen avoidance. Mattress dust was collected on repeated occasions during 18 months and assayed for concentration of major HDM allergens. During the first 12 months, the parents of the intervention group were instructed to intensify cleaning and airing of the child's bedroom. During the last 6 months of the study, the mattresses and pillows of seven children in the intervention group and sibling controls were encased in semipermeable polyurethane covers. The homes exhibited a high absolute indoor humidity throughout the year, and even during the winter the mean levels exceeded 7 g/kg. No mite allergen reduction was seen in the intervention group during the first year. However, among the newly diagnosed HDM‐sensitized children, there was a mean reduction of the mattress mite allergen concentration of 83% (P= 0.02), and this was most pronounced in the homes with low humidity. At the end of the mattress encasement period, an average difference of 98% (P< 0.001) was found between the vacuumed amount of mite allergen on top of the covers and that underneath.
Exquisite food allergy without eating
Authors: Bahna S. L.
Published: May 2007

The past few decades have witnessed an increasing understanding of the role of food allergy in human disease. Nevertheless, controversies still exist in several aspects of this area. One such controversy concerns the body systems that can be the target of food hypersensitivity reactions. Another is the role of noningestant exposure to food in a nonoccupational setting. Both of these aspects are vividly demonstrated in the case presented here.
Increased intestinal sugar permeability after challenge in children with cow's milk allergy or intolerance
Authors: Troncone R. , Caputo N. , Florio G. , Finelli E.
Published: May 2007

The diagnosis of cow's milk allergy or intolerance (CMAI) is based on clinical improvement on exclusion diet and relapse after challenge with milk. The aim of this work was to investigate the value of the cellobiose/mannitol (C/M) sugar permeability test, performed before and after cow's milk challenge, as a tool for the diagnosis of CMAI. Thirty‐two patients underwent milk challenge at a median age of 13 months (range 3–84 months). A dual sugar (C/M) permeability test with an iso‐osmolar solution was performed before and 24 h after challenge. Of the 10 patients who developed symptoms after challenge, nine showed increased postchallenge C/M ratio, whereas such an increase was observed in only one of the 22 nonrelapsed subjects. The postchallenge C/M ratio increase in relapsed subjects is to be attributed to both higher cellobiose and lower mannitol urinary excretion. These results suggest the use of the sugar permeability test, in addition to clinical observation, as an aid in the evaluation of provocation tests in infants with suspected CMAI.
A double‐blind group comparative study of ophthalmic sodium cromoglycate, 2% four times daily and 4% twice daily, in the treatment of seasonal allergic conjunctivitis
Authors: Leino M. , Montan P. , Njå F.
Published: May 2007

In a multicenter, double‐blind, single‐dummy, group‐comparative study, 169 patients received ophthalmic sodium cromoglycate 2% four times daily, and 170 patients received 4% ophthalmic sodium cromoglycate twice daily, together with placebo eye‐drops twice daily, for the treatment of seasonal allergic conjunctivitis (SAC) to birch pollen. The treatment period was 4 weeks during the birch pollen season. Daily pollen counts were used to identify the peak 14‐d period. Clinical examinations were made before the start of treatment, after 1 week of treatment, and at the end of the treatment period. Patients kept daily diary record cards of eye symptom severity and concomitant therapy. Symptoms were generally mild and, except for chemosis (week 4) and soreness (weeks 2 and 3), which were less in the 4% group (P0.05), no significant treatment differences were seen for symptoms or for antihistamine rescue therapy. Both treatments were considered to be very or moderately effective by more than 90% of patients, and no treatment differences occurred in either clinicians’ or patients’ opinions of efficacy. The results indicate that the use of 4% sodium cromoglycate eye‐drops twice daily is as effective and well tolerated as 2% sodium cromoglycate four times daily in the treatment of birch‐pollen conjunctivitis.
The Phadiatop® test compared with RAST, with the CAP system; proposal for a third Phadiatop outcome: “inconclusive”
Authors: Crobach M. J. J. S. , Kaptein A. A. , Kramps J. A. , Hermans J. , Ridderikhoff J. , Mulder J. D.
Published: May 2007

In 19 general practices, blood samples were obtained from 361 patients aged 12 years or older with chronic nasal symptoms. The Phadiatop test and a panel of RASTs to common inhalant allergens were performed on all sera with the recently introduced Pharmacia CAP system. The RAST panel was accepted as the standard. The sensitivity of the Phadiatop was 94% (95% confidence interval (CI): 89–97%), the specificity 98% (95% CI: 95–99%), the positive predictive value 97% (95% CI: 94–99%), and the negative predictive value 95% (95% CI: 91–98%). It is noteworthy that these values are very similar to those found in hospital outpatient departments. It was possible to reduce further the small percentage of false outcomes by replacing the cutoff point of the Phadiatop ratio of 1.00 by the two cutoff points 0.75 and 1.15. This resulted in three possible outcomes: a highly predictive positive outcome, a highly predictive negative outcome, and an “inconclusive” outcome. Alternatively, the cutoff point of 1.00 may be maintained while attaching the annotation “borderline” to all positive or negative Phadiatop outcomes where the Phadiatop ratio is between 0.75 and 1.15. By this simple method, physicians are alerted to the possibility of a false outcome; on the basis of the case history and other clinical findings, they can then decide whether further testing should be done.
Salmeterol compared with slow‐release terbutaline in nocturnal asthma A multicenter, randomized, double‐blind, double‐dummy, sequential clinical trial
Authors: Brambilla C. , Chastang C. , Georges D. , Bertin L. ,   French Multicenter Study Group, Desfougeres Dr Jean‐Luc
Published: May 2007

Brambilla C, Chastang C, Georges D, Bertin L. Salmeterol compared with slow‐release terbutaline in nocturnal asthma. A multicenter, randomized, double‐blind, double‐dummy, sequential clinical trial.

The aim of the multicenter, randomized, double‐blind, double‐dummy, parallel‐group clinical trial with a 2‐week treatment period was to compare the efficacy and safety of salmeterol (50 ug twice daily) with slow‐release (SR) terbutaline (5 μg orally, twice daily) in nocturnal asthma. A total of 159 asthmatic adults (FEV, 50‐90% of predicted value; sex ratio: 0.87) with at least two nocturnal awakenings during a 7‐d run‐in period was included in the study. Patients were centrally randomized with a national computer network (Minitel®). The main variable (number of awakening‐free nights during the last week of treatment) was analyzed according to a sequential method with the one‐sided triangular test. The number of awakening‐free nights (± SD) was significantly higher in the salmeterol group: 5.3 ± 2.4 vs 4.6 ± 2.3 (P= 0.006). Salmeterol was significantly more effective than SR‐terbutaline in the following factors: number of patients without any awakening during the last week of treatment (50%vs 27%, P = 0.003), mean morning PEF (351 ± 1091/min‐1vs 332 + 105 I/min‐1, P= 0.04), PEF diurnal variation 6 ± 10%vs 11 ± 12%, P= 0.01), overall assessment of efficacy by the patient and the investigator (P= 0.001 and 0.005, respectively), and daily rescue salbutamol intakes (P=0.004). In the salmeterol group, significantly fewer patients reported adverse events (16%vs 29%, P= 0.04). This study confirms that salmeterol, 50 μg twice daily, is particularly useful in controlling nocturnal symptoms of asthma: as compared with the control group, twice as many salmeterol‐treated patients were totally free of nocturnal symptoms after 2 weeks of treatment.
Avocado hypersensitivity
Authors: Blanco C. , Carrillo T. , Castillo R. , Quiralte J. , Cuevas M.
Published: May 2007

The avocado (Av) is a fruit that belongs to the Lauraceae family. We report 17 patients with immediate hypersensitivity to avocado. Clinical manifestations in relation to avocado ingestion were as follows: systemic anaphylaxis in seven patients, angioedema/urticaria in six, vomiting in two, bronchial asthma in one, and rhinoconjunctivitis in one. Skin prick test (SPT) with fresh avocado was positive in all patients with the Strong avocado variety (SAv) and in 14 patients with the Hass avocado variety (HAv). Our patient‐associated sensitizations were as follows: 10 to latex, eight to chestnut, eight to banana, four to kiwi, and four to walnut. Avocado‐sensitized patients with latex allergy were typically middle‐aged women, professionally exposed to latex, who also exhibited frequent associated sensitizations to chestnut, banana, and other fruits. Specific IgE against avocado was demonstrated in 11 of our patients, by both commercial CAP and RAST with avocado extract coupled to nitrocellulose disks. Despite its lower protein content, SAv seems to be more allergenic than HAv, both in vivo and in vitro. On incubating a pool of sera from our patients with avocado, latex, chestnut, and banana extracts, a progressive RAST inhibition was obtained, with SAv‐ and chestnut‐marked disks. This suggests the existence of common antigenic determinants among these allergens.

Blanco C, Carrillo T, Castillo R, Quiralte J, Cuevas M. Avocado hypersensitivity.
Variations in airborne pollen antigenic particles caused by meteorologic factors
Authors: Pehkonen E. , Rantio‐Lehtimäki A.
Published: May 2007

Pehkonen E, Rantio‐Lehtimäki A. Variations in airborne pollen antigenic particles caused by meteorologic factors.

High birch pollen antigenic activities in outdoor air samples were found in all particle sizes studied (>7.2, 2.4–7.2, <2.4 μm and molecular size class, with an ELISA modification). Sampling was done with a low‐volume, size‐selective bioaerosol sampler (SSBAS) simulating the human respiratory tract in both volume and fractionation. Airborne birch pollen counts for comparisons were obtained from a Burkard trap. No correlations were obtained between antigen concentrations in any particle size fraction and airborne pollen counts. The meteorologic factors studied differed clearly in their effect on antigenicity, depending on the size class studied. Likewise, the effect of meteorologic factors differed among the three study periods (period I, 4 weeks before the peak pollen season; period II, during the season; and period III, 4 weeks after the season). During the peak pollen period, temperature and relative humidity were the most important meteorologic factors. Before the season, large and very small particles predominated, medium‐sized particles being totally absent. The largest size class studied (containing all intact pollen grains) clearly reacted to changes in meteorologic factors; for smaller size classes, these factors were found to be less important, a fact which may make the forecasting of antigen concentrations in the air on the basis of meteorologic data impossible.
Occupational asthma related to fresh Gypsophila paniculata
Authors: Antépara I. , Jáuregui I. , Urrutia I. , Gamboa P. M. , González G. , Barber D. , Presa Ignacio Jáuregui
Published: May 2007

Antépara I, Jáuregui I, Urrutia I, Gamboa PM, González G, Barber D. Occupational asthma related to fresh Gypsophila paniculata.
Clustering of allergenic pollen on the basis of skin responses of atopic patients by matrix analysis
Authors: Kosman E. , Eshel A. , Keynan N. , Waisel Y. , Waisel Prof. Yoav
Published: May 2007

The responses of 148 atopic patients to some 43 different extracts of allergenic pollen were tested by prick tests. The measure of dissimilarity was introduced and calculated for all pairs of allergens. The investigated allergens were clustered into groups, according to their unbiased greatest similarity, by a matrix‐structuring method. Results indicate that subgroups of allergens can be distinguished even within groups of closely related pollen allergens that were believed to be fully cross‐reactive. A few cases are demonstrated for various varieties of olives, pecans, date palms, and turf grasses and for some wild chenopods and amaranths. The usefulness of the suggested solution for allergy research and for clinical practice is discussed.
Anaphylactic reactions to sunflower seed
Authors: Axelsson I. G.K. , Ihre E. , Zetterström O.
Published: May 2007

We report on four patients sensitized to sunflower seed. Three of them developed anaphylaxis and one chronic bronchial asthma. All four patients reacted the first time sunflower seeds were ingested, and all had kept cage birds fed on sunflower seeds. Therefore, the route of sensitization was probably by inhalation of airborne sunflower seed allergens. Investigation of this type of hypersensitivity in 84 atopic patients showed that only three patients were RAST‐positive, indicating that this allergy is fairly uncommon. On the other hand, when atopic persons are exposed to cage birds, the rate of sensitization is rather high, as indicated by the fact that in this category 79% were skin prick positive and 21% were unequivocably RAST positive to sunflower seed.
Quantification of a major bovine allergen by a two‐site immunometric assay based on monoclonal antibodies
Authors: Ylönen J. , Virtanen T. , Rytkönen M. , Mäntyjärvi R.
Published: May 2007

A two‐site immunometric assay based on monoclonal antibodies (mAb) was developed for the measurement of a 20‐kDa major allergen of cow. The sensitivity of this assay was (BDA20) 1 ng/ml. It was used to measure airborne allergen concentrations in 10 Finnish cowsheds. The mean concentration of the BDA20 measured at two stationary sites was 280 ng/m3. Concentrations varied more than 10‐fold among cowsheds (54–804 ng/m3). The mean intertest coefficient of variation was 8.2%, and the mean intratest variation 4.1 %.
Fecal IgE levels in infants at 1 month of age as indicator of atopic disease
Authors: Sasai K. , Furukawa S. , Kaneko K. , Yabuta K. , Baba M.
Published: May 2007

Fecal IgE levels were investigated in 165 asymptomatic infants at 1 month of age under two nutritional regimens, breast‐feeding and formula feeding, and the possibility of predicting by fecal IgE levels the onset of atopic disease was studied in these infants. IgE levels were measured by time‐resolved fluoroimmunometric assay. IgE antibodies are detectable in fecal extracts, and we have already reported that IgE levels are increased in food‐allergy patients after administration of food allergens, and this increase in fecal IgE levels may be a specific consequence of the local immune response to food‐allergen stimulation in the gut mucosa. The presence of atopic disease and the feeding method during the nursing period were surveyed by questionnaire in 89 of these 165 infants when they were 18 months old. In an analysis of the present results, IgE values above 0.015 U/ml, the lower limit of measurement, were considered to be high. Forty‐eight (29%) of the 165 subjects showed a high fecal IgE level. Thirty‐seven (35%) of 105 formula‐fed infants had high fecal IgE levels, whereas only 11 (18%) of 60 breast‐fed infants had high levels (P<0.05). With respect to atopic family history, 30(39%) of the 77 infants with atopic family history had high fecal IgE levels, as compared with 18 (20%) of the 88 infants without atopic family history (P<0.01). When the relationship between fecal IgE levels at 1 month of age and presence of atopic disease in the first 18 months was investigated, the prevalence of atopic disease was significantly higher in subjects with high fecal IgE levels (50%) than in subjects with low fecal IgE levels (14%) (P<0.01). We conclude that cow's milk proteins or dietary antigens in breast milk consumed by infants, in addition to genetic predisposition, may stimulate IgE immune response in the developmental gut mucosa, and that fecal IgE level at 1 month of age is an important and noninvasive factor for predicting the development of atopic disease during infancy and early childhood.
Hypersensitivity reactions from inhalation of milk proteins
Authors: Vargiu A. , Vargiu G. , Locci F. , Del Giacco S. , Del Giacco G. S.
Published: May 2007

We describe the case of a young man with IgE‐mediated hyper sensitivity to milk, casein, and lactoglobulin, who went into respiratory crisis every time he milked his sheep.
Effects of lipoxin A4 on chemotaxis and degranulation of human eosinophils stimulated by platelet‐activating factor and N‐formyl‐L‐methionyl‐L‐leucyl‐L‐phenylalanine
Authors: Soyombo O. , Spur B. W. , Lee T. H.
Published: May 2007

Lipoxins are trihydroxytetraene metabolites derived through a double lipoxygenation of arachidonic acid. Lipoxin A4 (LXA4) was prepared by total chemical synthesis, and its capacity to modulate eosinophil migration has been evaluated. LXA4 is a weak and partial chemotactic agent; at 10−6 M, it achieved about 20% of the response of 10−6 M platelet‐activating factor (PAF). Preincubation of eosinophils with increasing doses of LXA4 (10−10−10−5 M) resulted in a concentration‐dependent inhibition of cell migration induced by 10‐6 M formyl‐methionyl‐leucyl‐phenylalanine (FMLP) and 10‐6 M PAF. The concentration of LXA4 which produced 50% inhibition (IC50) of eosinophil migration was approximately 10‐6 M. LXA4 (10‐10‐10‐6 M) did not elicit ECP release or modulate ECP release induced by 10‐6 M FMLP. LXA4 may have antiallergic properties in preventing eosinophilic migration.
Presence of C5a‐potentiating activity in the plasma of a patient with Kimura's disease
Authors: Abe M. , Tanaka K. , Kudo J. , Fukuoka Y. , Hara N.
Published: May 2007

To determine whether the response to the active complement fragment C5a in polymorphonuclear leukocytes (PMN) obtained from a patient with Kimura's disease is similar to that in normal subjects, we evaluated superoxide anion (O2‐) generation after stimulation with C5a. The patient's PMN produced more O2‐ than did those from healthy controls after stimulation with human C5a in vitro. The response returned to normal with the improvement in clinical indicators after initiation of steroid administration. We conducted the following experiments with the plasma of this patient during the active disease stage to establish the presence of a humoral factor that potentiated the C5a‐response of PMN. Incubation of PMN from normal controls having the same blood type as the patient at 37°C for 2 h with the patient's plasma at the active disease stage revealed that the cells generated abundant O2‐ after stimulation with C5a. Incubation of normal PMN with the patient's plasma during the inactive disease stage showed no potentiated response to C5a. This activity was lost after incubation at 56°C for 30 min. Coincubation of PMN with methylprednisolone up to 100 μg/ml did not suppress this activity. Although the plasma concentration of C5a at the active stage was mildly elevated (13 ng/ml), it was below the limit of detection (<10 ng/ml) at the inactive stage. These results suggest the presence of a heat‐labile, humoral factor in the patient's plasma that upregulated the response of PMN to C5a and that was not suppressed by in vitro treatment with a steroid. This factor may influence the acute inflammatory reaction in this disorder.
Multiplicity of cross‐reactive epitopes on Bet v I as detected with monoclonal antibodies and human IgE
Authors: Akkerdaas J. H. , van Ree R. , Aalbers M. , Stapel S. O. , Aalberse R. C.
Published: May 2007

Six monoclonal antibodies against Bet v I, the major cross‐reactive allergen of birch pollen (Betula verrucosa), were obtained. Four did not react with fruits, but two monoclonal antibodies (mAbs) (5H8 and 9C11) were reactive with apple and other fruits. These two cross‐reactive antibodies reacted with identical or overlapping sites, but differed in their relative degree of cross‐reactivity toward various fruits and hazelnut. Cross‐reactive human IgE antibodies reacted with a nonoverlapping epitope, as indicated by results of a two‐site radioimmunoassay (RIA) with the fruit‐reactive mAb 9C11. By isoelectric focusing (IEF) in conjunction with immunoblotting, a maximum of seven isoforms could be distinguished. Depletion of birch‐pollen extract for Bet v I with the most reactive mAb (7F7) removed approximately 95% of the IgE cross‐reactivity between birch pollen and apple extract. The remaining 5% cross‐reactive material was still capable of inhibiting the binding of IgE to apple allergen completely, and was reactive with mAbs 5H8 and 3C4. By means of IEF/immunoblot, it was shown that these mAbs recognize an isoform of Bet v I that is poorly, if at all, recognized by mAb 7F7. These results illustrate the heterogeneity of Bet v I, both with respect to the cross‐reactive sites as well as to the backbone structure. This type of heterogeneity has possible implications for the use of monoclonal antibodies in allergen standardization.
A breathing filter exchanging heat and moisture prevents asthma induced by cold air
Authors: Millqvist E , Bake B , Bengtsson U , Löwhagen O.
Published: May 2007

In order to devise a protective aid against bronchial obstruction induced by cold air, we have tested a breathing filter with heat and moisture exchanging properties. Nine asthma patients, who all had a history of cold‐induced asthma, took part in exercise tests on an ergometer bicycle at a temperature of approximately −10deg;C, without and with a breathing filter. Without a breathing filter, the maximum reduction in FEV1 was, on average, 36%. With the breathing filter, the maximum reduction in FEV1 was, on average, 11%. The difference was clearly significant (P < 0.001). A further five cold‐sensitive asthmatics performed similar exercise tests at −10°C on three occasions: 1) without and 2) with a breathing filter as above, and 3) with two breathing filters connected in parallel: one for inspiration and the other for expiration. Thus, no heat‐moisture exchange could take place. The fall in FEV1 after provocation without a breathing filter and with parallel breathing filters was similar but attenuated when rebreathing took place through the breathing filter. The results confirm the theory that in cold/exercise‐induced asthma, it is indeed the heat and or water loss from the airways that triggers airway narrowing, and that a heat and moisture exchanging filter has a considerable protective effect and can be of value in the treatment of asthma.
IgE autoantibodies in atopic dermatitis ‐occurrence of different antibodies against the CH3 and the CH4 epitopes of IgE
Authors: Czech W. , Stadler B. M. , Schöpf E. , Kapp A.
Published: May 2007

Levels of “free” anti‐IgE autoantibodies and IgE/anti‐IgE immune complexes were measured in the sera of patients with atopic dermatitis before and after treatment, psoriasis patients, and nonatopic controls. In this measurement, we used two monoclonal antibodies with distinct in vitro functions (LE 27, BSW 17), directed against the epsilon CH3 and CH4 domains of the IgE Fc‐fragment, in a novel immunobinding assay. In patients with atopic dermatitis, elevated levels of “free” anti‐IgE antibodies and IgE/anti‐IgE immune complexes were detected in comparison to psoriasis patients and controls. In addition, there was a positive correlation between total IgE and the amount of IgE/anti‐IgE complexes detected by LE 27 (r=0.7; P < 0.001) or BSW 17 (r= 0.64; P < 0.001) in patients with atopic dermatitis. In contrast, an inverse correlation was observed between total IgE and “free” anti‐IgE antibodies (r=−0.34; P < 0.05) in atopic dermatitis. However, serum levels of anti‐IgE autoantibodies before and after therapy in patients with atopic dermatitis did not differ, and levels of anti‐IgE antibodies did not correlate with clinical severity, as evaluated by an established clinical scoring system. Our data clearly indicate that significantly elevated amounts of anti‐IgE antibodies could be observed in patients with atopic dermatitis, which are directed against different epitopes on the IgE molecule. It is tempting to speculate that these autoantibodies exert different effects on IgE‐receptor‐bearing effector cells and may play an important role in IgE regulation.
Anaphylaxis after dental treatment with a formaldehyde‐containing tooth‐filling material
Authors: Wantke F. , Hemmer W. , Haglmüller T. , Götzu M. , Jarisch R.
Published: May 2007

A 67‐year‐old patient developed systemic reactions after application of a formaldehyde‐containing tooth filling. She had a clearly positive RAST result for formaldehyde, whereas skin prick testing and patch tests were negative. Sensitization to formaldehyde appears to have occurred 1 year previously. Induction of formaldehyde allergy may represent a major complication during dental treatment, and assessment of specific IgE should he considered in patients at risk.
IgE in stools as indicator of food sensitization
Authors: André F. , André C. , Colin L. , Cavagna S.
Published: May 2007

The fragment of the Fc segment of IgE resistant to proteolytic enzymes was determined by a radioimmunologic method in fecal extracts from several groups of patients. IgEs remained undetectable in the 95 healthy subjects studied. IgEs were detected in 16/27 carriers of intestinal parasites (60%), with a mean of 92.4 IU/g dry weight. IgEs were also detected in 236/312 food‐sensitization patients, with the sensitizing foodstuffs being identified by searching for the specific IgEs in circulation (75%), with a mean of 63.9 IU/g dry weight. The simultaneous determination of alpha‐ 1‐antitrypsin in fecal extracts arid in sera from 21 control subjects and 21 food‐sensitization carriers demonstrated that extravasation of plasma proteins into the gut lumen cannot be responsible for the presence of IgE in stools. Testing for IgE in stools therefore appears to be a simple and economical means of identifying patients without parasites who present with food sensitization.
Grass pollen immunotherapy: efficacy and safety during a 4‐year follow‐up study
Authors: Walker S. M. , Varney V. A. , Gaga M. , Jacobson M. R. , Durham S. R.
Published: May 2007

Grass pollen immunotherapy is effective, although efficacy must be balanced against side‐effects. In a double‐blind, placebo‐controlled trial of 40 adult patients with summer hay fever, immunotherapy with a depot grass pollen extract (Phleum pratense, Alutard SQ) reduced symptoms and medication requirements with an acceptable minimal level of side‐effects (31). The original placebo group, as well as the actively treated group, have now received active immunotherapy in an open fashion for a further 3 years. An important question was whether continued injection treatment was accompanied by maintained clinical improvement. By analysis of diary symptoms, rescue medication, and visual analogue scores during the pollen season, we show that efficacy was maintained throughout the 3–4‐year study period. Clinical improvement was accompanied by a sustained and marked decrease in immediate conjunctival allergen sensitivity and a further significant decrease in the size of the allergen‐induced late cutaneous response. In contrast, an initial decrease in the allergen‐induced immediate cutaneous response was not maintained at 3–4 years. Of the patients, 37/40 completed the first year, 33/40 the second year, and 32/40 the third year of treatment. Patients dropped out for reasons other than the outcome of immunotherapy. During a total of 2598 injections, five immediate systemic reactions were observed, all during the induction (not maintenance) phase, and all occurred within 10 min of injection and responded promptly to adrenaline. Grass pollen immunotherapy is effective and safe, provided it is performed on carefully selected patients by trained physicians with immediate access to resuscitative measures.
Effects of loratadine on anti‐IgE‐induced inflammation, histamine release, and leukocyte recruitment in skin of atopics
Authors: Roquet A. , Raud J. , Halldén G. , van Hage‐Hamsten M. , Hed J. , Hansson L‐O. , Zetterström O. , Grönneberg R.
Published: May 2007

The aim of this study was to assess the ability of the H1‐receptor antagonist loratadine to modify anti‐IgE‐induced cutaneous wheal‐and‐flare and late‐phase reactions (WFR and LPR), as well as histamine release and leukocyte accumulation in skin chambers. For this purpose, 10 atopics with allergic rhinitis were entered into a double‐blind crossover study in which they received either placebo or loratadine (20 mg/day orally) for 8 days separated by a 7‐day washout period. Blisters were induced on both forearms on day 7 of each treatment period, and were unroofed on day 8 and covered with plastic skin chambers. Chamber fluids were collected during 7 h after 1‐h incubation with anti‐IgE or control IgG. Intradermal challenge with histamine and anti‐IgE was performed at the same occasion. As compared to placebo treatment, loratadine inhibited the immediate WFRs to anti‐IgE by 35% (wheal) and 65% (flare), respectively (P < 0.01), and corresponding reactions to histamine challenge by 50% and 70% (P<0.001), respectively. Moreover, the initial phase (0‐2 h) of the LPR induced by anti‐IgE was attenuated by up to ∼60% (P < 0.001) during loratadine treatment. Thereafter, no inhibition of the LPR was observed. The magnitude and time course of histamine release into skin chambers was virtually the same after loratadine and placebo treatment, with a peak during 0‐1 h and a progressive decline during the following 2 h. Accumulation of α2‐macroglobulin, reflecting extravasation of large plasma proteins, also peaked during the first hour and was unaffected by loratadine during the 8‐h observation period. Moreover, loratadine did not reduce the anti‐IgE‐induced recruitment of eosinophils or other subtypes of leukocytes. Altogether, loratadine inhibited both the WFRs to histamine and anti‐IgE and the initial phase of the IgE‐mediated LPR. However, loratadine did not express anti‐inflammatory activity with respect to mast‐cell mediator release or leukocyte recruitment. The latter findings are in contrast to the action of loratadine in allergic rhinitis and conjunctivitis, suggesting that the actions of loratadine may be organ specific and that the effects of loratadine cannot always be extrapolated from one tissue to another.
First report of anaphylactic reaction after fig (Ficus carica) ingestion
Authors: Dechamp C. , Bessot J.‐C. , Pauli G. , Deviller P.
Published: May 2007

We report an anaphylactic reaction which occurred very shortly after ingestion of a fresh fig. The IgE‐dependent mechanism was demonstrated on the basis of positivity of the prick test performed with fresh fig (Ficus carica) extract. In addition, we were able to detect specific IgE to the same extract in the serum. The patient did not demonstrate sensitization to other common allergens involved in respiratory and food allergies. However, detection of specific IgE to F. benjamina indicated a sensitization to weeping fig. The CAP F. benjamina was partially inhibited by preincubation of the serum with fig extract, suggesting that these two species of Ficus share some common allergens. In this context, the assumption can be made that weeping fig was responsible for the initial sensitization in this patient.
Clinical symptoms and immunologic reactivity to bee and wasp stings in beekeepers
Authors: Annila I. T. , Karjalainen E. S. , Mörsky P. , Kuusisto P. A.
Published: May 2007

We compared the history of sting reactions with venom skin prick test (SPT) and CAP RAST reactions in beekeepers in order to assess the value of structured questions and symptom backgrounds. The study population consisted of 102 beekeepers, who were 25–75 years of age. Bee and wasp venom SPT was performed with concentrations of 10, 100, and 300 μg/ml. The CAP Phadiatop® test was used in the screening of IgE antibodies against common inhalant allergens. Eorty‐two beekeepers had never experienced large local or systemic reactions after a bee sting. Of the 31 subjects with a history of systemic reactions, 13 had experienced these during the previous year. A significant difference (P<0.01) between systemic reactors and nonreactors was found in bee venom CAP and SPT (300 μg/ml). However, due to considerable overlap, these tests are unable to discriminate between allergic and nonallergic beekeepers. Both bee venom SPT (300 μg/ml) and CAP tests were positive in 65% of systemic reactors and in 34% of nonreactors (P=0.008). Venom SPT (300 μg/ml) correlated significantly with CAP for both venoms. No correlation was observed between venom allergy and atopy. Clinically, the most practical concentration for evaluating bee and wasp venom sensitization by SPT proved to be 300 μg/ml.
Investigation of the stability of apple allergen extracts
Authors: Rudeschko O. , Fahlbusch B. , Henzgen M. , Schlenvoigt G. , Herrmann D. , Vieths S. , Jäger L.
Published: May 2007

To determine optimal conditions for allergen preservation, we investigated the influence of different stabilizing additives and of storage temperature on the allergen activity of apple protein preparations, obtained by extraction in phosphate buffer or by precipitation in diacetone alcohol and resolubilization in phosphate buffer in the presence or absence of enzyme inhibitors. For this purpose, the extracts were stored for 6 months either in frozen state at −20° C or in lyophilized state at −20° C, 4° C, or room temperature and were characterized by SDS‐PAGE, immunoblot, ELISA inhibition, and prick test. The highest stability revealed the extracts that were prepared by precipitation in the organic solvent in the presence of enzyme inhibitors, lyophilized, and stored at −20° C. For storage of extract solutions at 4° C, PBS/glycerol and cysteine/sodium citrate/glycerol were found to be the most effective stabilizing additives.
Fixed eruption caused by ciprofloxacin without cross‐sensitivity to norfloxacin
Authors: Ayllón M. Lozano , Martinez M. Gómez , Mosquera M. R. , Laguna Martinez J. J. , Martiartu M. Orta , Fernández de Miguel C.
Published: May 2007

We report the case of a female patient who presented fixed exanthema following administration of ciprofloxacin. To our knowledge, only one case of fixed exanthema in response to this agent has appeared in the literature, and it was associated with cross‐sensitivity to norfloxacin.
Neonatal IgA and IgE levels among infants with paternal heredity for atopic disease
Authors: Lilja G. , Magnusson C. G. M. , Kusoffsky E. , Johansson S. G. O. , Öman H.
Published: May 2007

Serum IgA and IgE levels were studied in the postnatal period in 21 infants having a paternal heredity of atopic disease. Three different sampling techniques were used, aspirated cord blood (CB), gravity‐collected cord blood, and capillary collected blood at 4–5 days of age. Significant differences among the three sampling techniques were recorded for IgA (P<0.01), but not for IgE. The IgA levels decreased from birth to 4–5 days of age in 90% (19/21) of the infants (P<0.01). The corresponding decrease in IgE levels was 20%. This postnatal difference in the frequency of decreasing/increasing IgA and IgE levels was significant (P<0.05). An analysis of CB IgA to detect maternal contamination of CB was found to be of questionable value, since only 50% (2/4) of the cases with an elevated CB‐IgA level could be considered contaminated. The results of this study further emphasize that aspiration of CB and capillary collection of blood at 4–5 days of age are the best sampling techniques to avoid contamination. The general finding that paternal heredity had no significant influence on infant IgE contrasts with the strong influence of maternal heredity. Further studies will show whether the explanation lies in genetic or transplacental factors, or in both kinds of factors.
Comparison of IgE and IgG antibody responses of atopic individuals with sensitization to tree and grass pollens
Authors: Olsen E. , Fallang A. , Mohapatra S. S.
Published: May 2007

Sera of atopic individuals with predominant sensitization to either tree pollen (TAs) or tree and grass pollens (TGAs) as well as of nonatopic subjects (NAs) were analyzed for IgE, IgG, and IgG4 antibodies specific for grass pollen allergens. Of 600 atopic individuals with serum IgE antibodies specific for birch pollen allergens, 54% also had serum IgE antibodies specific for grass pollen. The mean titers of IgG antibodies specific for grass pollen proteins were about 10 times higher in the sera of TGAs than those in the TAs and NAs. SDS‐PAGE immunoblotting analysis of grass pollen proteins using sera of TGAs, TAs, and NAs with respect to the binding of these proteins with IgE and IgG antibodies in these sera exhibited a similar pattern of variation. Quantitation by enzyme immunoassay of the antibody binding to a recombinant grass pollen allergen, rKBG8.3, further demonstrated that elevated IgG antibody levels in TGAs are mainly due to a broader range of specificities, and not to high specific binding to the individual protein. Statistically significant correlation was found between IgE and IgG4 antibodies specific for the Kentucky bluegrass (KBG) extract, but not for the isolated recombinant allergen. These results indicate that the grass pollens elicit a complex array of antibody specificities in both atopics and nonatopics, and that the profile of antibodies specific to the pollen extract and pure allergens differs, suggesting that single grass allergens may be inadequate for replacing grass pollen extracts for immunotherapy.
Cross‐sensitivity among oxicams in piroxicam‐caused fixed drug eruption: two case reports
Authors: Ordoqui E. , De Barrio M. , Rodríguez V. M. , Herrero T. , Gil P. J. , Baeza M. L.
Published: May 2007

Fixed drug eruption (FDE) caused by oxicams is very rare. There are few reports of FDE induced by piroxicam, and this explains why cross‐sensitivity among oxicams (piroxicam, tenoxicam, and droxicam) has been studied in only one patient. The patch test on residual lesions has lately been used by some authors in FDE diagnosis with variable results. We describe two cases of piroxicam‐caused FDE and demonstrate cross‐sensitivity among piroxicam, tenoxicam, and droxicam in both of them. One patient had residual lesions and the patch test was useful for diagnosis and cross‐sensitization studies. The second patient had no residual lesions, and the patch test was negative on normal but previously affected skin; therefore, the study was performed by single‐blind controlled oral challenge.
Causative allergens of allergic rhinitis in Japan with special reference to silkworm moth allergen
Authors: Suzuki M. , Itoh H. , Sugiyama K. , Takagi I. , Nishimura J. , Kato K. , Mamiya S. , Baba S. , Ohya Y. , Itoh H. , Yokota A. , Itoh M. , Ohta N.
Published: May 2007

To determine the importance of silkworm moth allergens, we tested 267 patients with allergic rhinitis with CAP‐RAST®, a new assay system for detecting specific IgE in sera. We used the following allergen sources: house‐dust mite, Candida, Altemaria, cat dander, orchard grass, ragweed, mugwort, Japanese hops, Japanese cedar, Japanese cypress, cotton, silk, larval chironomid midge, adult chironomid midge, and silkworm moth. As expected, the highest positive rate of reaction, as determined by CAP‐RAST, was 73.8% for Japanese cedar, followed by 53.2% for mite and 50.6% for Japanese cypress. Although the positive rate for silkworm moth was not as high as for cedar pollen, one‐third of patients had specific IgE against silkworm moth. The positive rate of reaction to silkworm moth was much higher than that to chironomid. It was interesting to note that the patients reported had not been documented as having frequent contact with silkworm moth allergen. Correlations between silkworm moth and silk, and silkworm moth and chironomid midge were found to be significant (P <0.001). Silkworm moth allergen showed the third highest reaction rate in patients with severe symptoms. These results suggest that silkworm moth allergen should be considered to be important in patients with allergic rhinitis in Japan.