bluuebunny/crossref_metadata_2025 huggingface dataset:
Monitoring of serologic immune parameters in inflammatory skin diseases
Authors: Gebhardt M. , Wenzel H. C. , Hipler U. C. , Herrmann D. , Wollina U.
Published: May 2007

This paper deals with the correlation of clinical scoring and serologic markers of inflammation in atopic dermatitis and psoriasis. Serum eosinophil cationic protein (ECP), soluble inlerleukin‐2 receptor (sIL‐2R), total serum IgE, IgG and IgM anti‐IgE antibodies, and IgE immune complexes were evaluated in monitoring inflammatory skin diseases such as atopic dermatitis and psoriasis. Well‐established clinical activity scores were used as standards in recording skin improvement under treatment in a clinical setting. Serum ECP was found to be increased in both atopic dermatitis and psoriasis patients compared to normal controls; sIL‐2R and IgE immune complexes were increased only in atopies with increased serum IgE. Anti‐IgE antibodies did not show any deviation in both groups of patients. There was a significant elevation of sIL‐2R and IgE immune complexes and a nonsignificant elevation of ECP in high‐IgE atopics in comparison to those with normal serum IgE. In both groups of patients, there was a significant reduction of ECP and sIL‐2R accompanying the improving skin condition. Serum IgE and the other immune parameters failed to respond. In contrast to other studies, serum ECP failed to correspond significantly with disease activity in our study. Our results showed measurable changes of ECP and sIL‐2R for atopic dermatitis and/or psoriasis under treatment, but comparison to clinical scores remains difficult due to the different basis of the two systems. The only significant correlation was established for relative changes in sIL‐2R and psoriasis area and intensity (PASI), a correlation which might be a useful approach in psoriasis.
An approach to the understanding of the nasal early‐phase reaction induced by nasal allergen challenge
Authors: Wang D. , Smitz J. , Waterschoot S. , Clement P.
Published: May 2007

Quantitative determinations of the inflammatory mediators in nasal secretions were performed and correlated with the objective nasal symptoms within 1 h after nasal allergen challenge (NAC). Twenty‐six patients with seasonal allergic rhinitis were enrolled outside the pollen season. All measurements were performed before (as a baseline control) and at 1, 5, 10, 30, and 60 min after NAC. This study aimed to clarify the pathogenic mechanism of the early‐phase reaction (EPR) by monitoring the evolution of early‐phase mediators in nasal secretions and the presence of nasal symptoms during this period. The results showed that, after NAC, the maximal mediator concentration was already reached after 1 min for histamine (124 ng/g), 5 min for tryptase (56 μU/g), and 5‐10 min for leukotriene C4 (40 ng/g). Itching and sneezing started as early as 20‐30 s, and they were predominant symptoms within 5 min. Rhinorrhea and nasal obstruction started a few minutes after NAC and lasted until more than 1 h after NAC. There was no significant correlation between any single mediator and nasal symptoms during the sampling period. In conclusion, this study demonstrated that during the EPR the presence of nasal symptoms involves a complex mechanism, reflecting the interaction between the mediators released by inflammatory cells, and the receptors on different target organs. When evaluating symptoms during the EPR, one must consider not only the severity of these symptoms but also the time period within which these symptoms occur. For the symptoms of nasal obstruction and rhinorrhea, the early‐phase reaction often lasted more than 1 h.
Mattresses as a winter refuge for house‐dust mite populations
Authors: de Boer R. , Kuller K.
Published: May 2007

House‐dust mites are a major source of allergens. Beds are often heavily infested. It is conceivable that, during the winter period in temperate climates, the ambient indoor air is too dry for their survival, but that mites can still survive in beds where the humidity is raised when the bed is occupied. To investigate whether house‐dust mites can take advantage of daily episodes with elevated humidity to restore water balance, we exposed mites to spells of high humidity (90% relative humidity [RH]), lasting 0,1.5, 3, 6, or 12 h, once every day, while the humidity was low (10% RH) during the rest of the time. Survival was markedly promoted when only 1.5h of moist air per day was given. Three hours of moist air per day allowed the mites to reproduce. The same average humidity but at a constant level would have been lethal to the mites. Thus, average humidity can be misleading as an indicator of mite survival conditions. Measurements of relative humidity were made inside the foam core of a mattress and underneath the ticking. The rise of humidity occurring when the bed was occupied was often insufficient for the mites, because the temperature rose at the same time. At higher temperatures, mites required a higher relative humidity, abolishing the effect of the simultaneous rise in absolute humidity. Thus, it seems quite possible to regulate house‐dust mite numbers also in beds by reducing the water content of the ambient air. The rules governing changes in temperature and humidity inside a bed may be simple enough to allow assessment of house‐dust mite living conditions by measurements in the ambient air.
Anti‐inflammatory drugs do not alleviate bronchial hyperreactivity in Sjögren's syndrome
Authors: Stålenheim G. , Gudbjörnsson B.
Published: May 2007

Bronchial hyperreactivity (BHR) is found in Sjögren's syndrome, as in a number of other conditions such as asthma. BHR associated with asthma can be effectively treated with corticosteroids or sodium cromoglycate. We treated 19 Sjögren's syndrome patients with BHR with inhaled budesonide and inhaled cromoglycate for 6 weeks each. None of the treatments had any significant effect on symptoms of hyperreactivity or lung function. There was no effect on BHR measured as methacholine reactivity. Primary Sjögren's syndrome is a disease with inflammation not only in the salivary and lacrimal glands but also in the pulmonary alveoli and the bronchi. The main inflammatory cell is the lymphocyte, whereas, in the bronchi in asthma, the eosinophil granulocyte is the characteristic inflammatory cell. The cause of the discrepancy with regard to treatability of BHR in asthma and in Sjögren's syndrome is not known. Possibly not all BHR is caused by inflammation. There is not a perfect correlation between inflammation and hyperreactivity even in asthma. Even if the bronchial inflammation and the asthma symptoms are easy to treat with anti‐inflammatory medicines, a considerable component of BHR usually still remains, as measured with methacholine or histamine.
Oral allergy syndrome to jackfruit (Artocarpus integrifolia)
Authors: Wüthrich B. , Borga A. , Yman L.
Published: May 2007

A 30‐year‐old man from the Philippines with pollen allergy noted the appearance of oral allergy syndrome (OAS) after eating raw apple, raw peach, raw celery, and, recently, jackfruit (Artocarpus integrifolia), a tropical fruit which belongs to the Moraceae family (mulberry) and to the genus Artocarpus (breadfruit tree). Despite the patient's multiple sensitization in skin prick tests and in the Pharmacia CAP System to birch, grass, mugwort pollen, related fruits and vegetables, and jackfruit, in RAST‐inhibition studies neither rBet v 1 nor rBet v 2 (profilin), the well‐known cross‐reacting allergenic components in OAS, could inhibit the specific IgE response to jackfruit. Whether the reaction to jackfruit is specific or whether other pollen‐related, cross‐reacting allergenic components exist should be investigated further.
Angiotensin‐converting enzyme inhibitor‐induced angioedema: late onset, irregular course, and potential role of triggers
Authors: Schiller P. I. , Messmer S. Langauer , Haefeli W. E. , Schlienger R. G. , Bircher A. J.
Published: May 2007

Angioedema is a rare but potentially life‐threatening adverse effect of angiotensin‐converting enzyme inhibitors (ACEI) which usually occurs within the first weeks of therapy. We report three patients in whom ACEI‐induced angioedema began with a late onset of 12‐33 months, and who had an irregular, unpredictable course under ACEI therapy. In two patients, other drugs or trauma appeared to trigger some of the episodes. After withdrawal of the ACEI, the trigger drugs were well tolerated in provocation tests and upon re‐exposure. To avoid putting some patients unnecessarily at risk for long periods, one should consider this irregular pattern of ACEI‐induced angioedema and regularly monitor patients for this adverse effect.
The effects of topical nasal steroids on rat respiratory mucosa in vivo, with special reference to benzalkonium chloride
Authors: Berg Ø. H. , Lie K. , Steinsvåg S. K.
Published: May 2007

Fifty rats were treated with topical nasal steroids with and without the preservative benzalkonium chloride in their right nostril twice daily for 21 days, while the left nostrils were exposed to 0.9% NaCl. By cutting the noses serially in frontal sections, the structure of the mucosal lining of all parts of the nose could be investigated. Areas with squamous cell metaplasia were observed in all nostrils exposed to topical steroids containing benzalkonium chloride. Such alterations were not observed in any nasal cavities exposed to the topical nasal steroid without the preservative or to 0.9% NaCl. In conclusion, benzalkonium chloride appears to be potentially toxic to the mucosa in vivo.
Dust‐mite‐allergen concentrations in asthmatics' bedrooms in the Quad Cities (Illinois, USA) after the Mississippi River floods of 1993
Authors: Curtis L. , Ross M. , Scheff P. , Persky V. , Wadden R. , Ramakrishnan V. , Hryhorczuk D.
Published: May 2007

This study aimed to measure allergens from Dermatophagoides farinae and D. pteronyssinus and to examine possible relationships of these mite allergens with flooding and other housing factors. A total of 313 dust samples were collected from the bedrooms of 57 asthmatics in 45 homes in the Quad Cities (Illinois, USA) and analyzed by ELISA for the presence of the D. farinae and D. pteronyssinus allergens. Twenty of these homes had some flooding in the last 12 months due to the Mississippi River floods of 1993 and/or other factors. The log‐transformed least‐squares means of allergens collected were 28 ng/m2 for the D. farinae allergen and 26 ng/m2 for the D. pteronyssinus allergen. D. farinae allergen levels were significantly higher in homes located in the valley, in homes during the summer months, in homes with furred or feathered pets, in homes which had not been flooded in the last year, and in homes where rugs had been steam‐cleaned in the last 12 months. D. pteronyssinus allergen levels were significantly higher in homes located in the valley, in homes during April and July‐September, in homes with furred or feathered pets, and in homes with no dehumidifier.
Adjunct effect of loratadine in the treatment of acute sinusitis in patients with allergic rhinitis
Authors: Braun J. J. , Alabert J. P. , Michel F. B. , Quiniou M. , Rat C. , Cougnard J. , Czarlewski W. , Bousquet J.
Published: May 2007

H1‐blockers are often added to the standard treatment of acute sinusitis, but this is not supported by a controlled study. A multicentric, randomized, double‐blind, placebo‐controlled, parallel‐group study was done in 139 allergic patients (15–65 years) to assess the adjunct efficacy of loratadine in acute exacerbation of rhinosinusitis. Sinusitis was diagnosed by symptoms and confirmed by rhinoscopy and sinus radiograph. Allergy was characterized by skin tests, RAST, and history. Patients were treated with antibiotics (14 days), oral corticosteroids (10 days), and loratadine (10 mg OD) or placebo (28 days). Treatment efficacy was assessed over 28 days by symptom scores quoted daily by patients. Physicians also rated total symptom scores at entry and at day 28. At entry, both groups had similar symptoms. Placebo‐treated patients improved significantly, but patients who received loratadine had a significantly greater improvement in sneezing (P=0.003) after 14 days, and in nasal obstruction (P=0.002) after 28 days. Physicians found that patients receiving loratadine were significantly improved compared to placebo patients (P=0. 0125). Loratadine in addition to standard therapy was found to improve the control of some symptoms of sinusitis.
Protein and allergen content of various natural latex articles
Authors: Baur X. , Chen Z. , Raulf‐Heimsoth M. , Degens P.
Published: May 2007

Proteins remaining in products made of natural rubber latex are potential sensitizers. In the present work, we quantified the releasable protein and allergen contents in 37 brands of latex gloves and 26 other latex products. Our results demonstrate the presence of widely varied protein and allergen contents in various latex articles and the lack of a correlation between the protein and allergen values. These findings may assist hospital management and medical staff to take effective preventive measures.
Neonates at risk of atopy show impaired production of interferon‐gamma after stimulation with bacterial products (LPS and SEE)
Authors: Pohl D. , Bockelmann C. , Förster K. , Rieger C. H. L. , Schauer U.
Published: May 2007

Recent studies demonstrate reduced interferon‐gamma (IFN‐γ) secretion in neonates who became atopic later in life. The underlying pathomechanism is still unknown. We therefore examined the effects of bacterial products on neonatal IFN‐γ production acting through different T‐cell‐ or antigen‐presenting‐cell (APC)‐stimulating mechanisms: cord‐blood mononuclear cells (CBMC) were incubated with lipopolysaccharide (LPS), staphylococcal enterotoxin E (SEE), or a combination of both and restimulated with PMA and ionomycin. LPS and SEE as single stimuli induced IFN‐γ production to the same extent in CBMC of neonates with high and low risk of atopy. In contrast, a combination of LPS and SEE had a multiplying effect on IFN‐γ secretion only in CBMC of neonates with low risk of atopy. Phenotype analysis revealed that only memory T cells showed impaired IFN‐γ synthesis (median 3.6% IFN‐γ‐producing cells vs 14.2% in controls; P < 0.01), whereas IFN‐γ production by naive T cells did not differ in either group. Taken together, these results point to the existence of a disturbed function of costimulatory mechanisms in neonates at high risk of atopy, provoking reduced memory T‐cell IFN‐γ production.
Bronchial hyperresponsiveness, epithelial damage, and airway eosinophilia after single and repeated allergen exposure in a rat model of anhydride‐induced asthma
Authors: Cui Z.‐H. , Sjöstrand M. , Pullerits T. , Andius P. , Skoogh B.‐E. , Lötvall J.
Published: May 2007

Bronchial hyperresponsiveness (BHR) and damage of the epithelium, as well as eosinophilia in the airway wall, induced by trimellitic anhydride (TMA) in sensitized brown Norway rats were studied. Rats were challenged once or seven times with aerosol of TMA conjugated to rat serum albumin (TMA‐RSA) 3 weeks after intradermal TMA sensitization. Airway responsiveness (‐log PC300 of acetylcholine i.v.) was measured 24 h after allergen challenge. Epithelial lesion and eosinophil infiltration in the airway walls were quantified under light microscopy, and TMA‐specific IgE and IgG in serum were evaluated with ELISA. High levels of TMA‐specific IgE and IgG were found in all rats in the sensitized groups compared to nonsensitized groups (P < 0.001). Repeated allergen challenges of 0.03% TMA‐RSA for 7 consecutive days enhanced the level of TMA‐specific IgG, compared to single challenge (P < 0.05). Single allergen challenge of 0.3% TMA‐RSA had a nonsignificant tendency to produce BHR in sensitized rats compared to nonsensitized rats (P=0.06). However, repeated allergen challenges (0.003% and 0.03% TMA‐RSA for 7 consecutive days) produced significant BHR in sensitized rats (P < 0.05). Furthermore, repeated low‐dose (0.003%) TMA‐RSA challenge produced more BHR than a 10 times higher single dose (0.03%) (P < 0.05). Slight damage of the airway epithelium was seen in sensitized and repeat‐challenged groups. However, bronchial eosinophilia was found in the sensitized and single‐challenged groups, but not in nonsensitized nonchallenged, and sensitized repeat‐challenged groups (P < 0.005). We conclude that the brown Norway rat can be sensitized with TMA, and that repeated low‐dose allergen challenges produce slight epithelial damage and BHR which is independent of ongoing eosinophilia in the airway wall.
Ingestive and inhalative allergy to the mushroom Boletus edulis
Authors: Torricelli R. , Johansson S. G. O. , Wiithrich B.
Published: May 2007

This is the first report on inhalative and ingestive allergy to the common edible mushroom Boletus edulis (Be) (English, edible boletus; German, Steinpilz, French, bolet; Italian, porcino or boleto) belonging to the class Basidiomycetes. Four cases observed in our allergy unit are presented, showing different clinical manifestations of this rare allergy: as an occupational problem or life‐threatening anaphylactic reactions after eating Be. In all cases, skin prick‐to‐prick tests with raw Be were strongly positive; in three cases, specific IgE against Be could be found. The symptoms were reproducible after an inhalation challenge test. It is noteworthy that not only can Basidiomycetes cause airborne allergy but also that edible mushrooms from this class can cause inhalative and intestinal allergy. The two patients with strong anaphylactic reactions demonstrate that Be may have great allergenic potential.
Monitoring of disease activity by measurement of inflammatory markers in atopic dermatitis in childhood
Authors: Halmerbauer G. , Frischer T. , Roller D.Y.
Published: May 2007

Serum levels of soluble interleukin‐2 receptor (sIL‐2R), intercellular adhesion molecule‐1 (ICAM‐1), endothelial leukocyte adhesion molecule (ELAM‐1), and eosinophil cationic protein (ECP) were measured in 20 patients with atopic dermatitis before and after 4 days’treatment with prednisolone p.o. as well as in 16 healthy, nonatopic controls. Before steroid treatment, patients with atopic dermatitis demonstrated significantly higher serum levels of sIL‐2R, ICAM‐1, and ECP than healthy controls (P<0.001), whereas ELAM‐1 levels were not different between the groups. After 4 days of steroid treatment, clinical improvement was associated with a decrease of sIL‐2R (P<0.003), ICAM‐1 (P<0.004), and ECP serum levels (P<0.003), but ELAM‐1 levels remained unchanged. Both serum ECP and slL‐2R levels were significantly correlated with disease severity before as well as after steroid treatment. Changes of sIL‐2R concentrations were strongly related to the changes of ECP levels. In addition, changes of serum sIL‐2R and ECP levels in percentage were correlated with clinical improvement. These results indicate that the determination of sIL‐2R and ECP serum levels may be useful in monitoring disease activity in atopic dermatitis in childhood, especially in treatment trials.
The expanding role of nerve growth factor: from neurotrophic activity to immunologic diseases
Authors: Aloe L. , Bracci‐Laudiero L. , Bonini S. , Manni L. , Aloe Luigi
Published: May 2007

Numerous studies published in the last 10–15 years have shown that nerve growth factor (NGF), a polypeptide originally discovered in connection with its neurotrophic activity, also acts on cells of the immune system. NGF has been found in various immune organs including the spleen, lymph nodes, and thymus, and cells such as mast cells, eosinophils, and B and T cells. The circulating levels of NGF increase in inflammatory responses, in various autoimmune diseases, in parasitic infections, and in allergic diseases. Stress‐related events both in animal models and in man also result in an increase of NGF, suggesting that this molecule is involved in neuroendocrine functions. The rapid release of NGF is part of an alerting signal in response to either psychologically stressful or anxiogenic conditions in response to homeostatic alteration. Thus, the inflammation and stress‐induced increase in NGF might alone or in association with other biologic mediators induce the activation of immune cells during immunologic insults. A clearer understanding of the role of NGF in these events may be useful to identify the mechanisms implicated in certain neuroimmune and immune dysfunctions.
Intranasal fluticasone propionate for chronic eosinophilic rhinitis in patients with aspirin‐induced asthma
Authors: Mastalerz L. , Milewski M. , Duplaga M. , Nizankowska E. , Szczeklik A.
Published: May 2007

We performed a double‐blind, crossover, placebo‐controlled study on the effect of fluticasone propionate (FP) treatment on chronic eosinophilic rhinosinusitis in 15 patients with aspirin‐induced asthma (AIA). There were 10 women and five men aged 32–60 years; average: 45 years. After a 10‐day run‐in period, patients underwent two 4‐week treatment courses (FP vs placebo), separated by a 2‐week washout interval. Clinical activity of FP was evaluated by daily measurement of peak nasal inspiratory flow (PNIF) and a scoring system of subjective symptoms. Nasal challenges with L‐lysine aspirin, using active anterior rhinomanometry, were performed at the entry and on the last day of each treatment period. Weekly mean values of symptom scores were generally lower and PNIF measurements higher during treatment with FP than with placebo. This difference was statistically significant for most recorded parameters for the whole 4‐week FP treatment. On average, the reactions evoked by aspirin nasal challenge were significantly shorter and milder after treatment with FP than with placebo. In 8/13 patients, FP completely prevented aspirin‐precipitated nasal reaction, whereas protection after placebo was observed in only 2/12 subjects (P=0.004). We conclude that intranasal FP is an effective therapy for chronic eosinophilic rhinitis in patients with AIA.
Allergen‐avoidance measures in homes of house‐dust‐mite‐allergic asthmatic patients: effects of acaricides and mattress encasings
Authors: van der Heide S. , Kauffman H. F. , Dubois A. E. J. , de Monchy J. G. R.
Published: May 2007

This double‐blind, placebo‐controlled study investigated whether the application of an acaricide (Acarosan®) on mattresses and on textile floor coverings in living rooms and bedrooms can contribute to improvement in lung function and airway hyperresponsiveness in 40 adult asthmatic patients sensitized to house‐dust mite. In a second group of 19 patients who refused chemical intervention, the clinical effects of application of allergen‐impermeable mattress encasings were studied. In all three treatment groups, Der p 1 levels in mattress dust were statistically significantly decreased after 12 months. However, this decrease was much greater in the group who received mattress encasings (final mean level 430 ng/g) than in groups with acaricide‐ or placebo‐treated mattresses (final mean levels 1730 and 2100 ng/g, respectively). Treatment of textile floors with either Acarosan or placebo chemical caused a statistically significant decrease in the level of the house‐dust‐mite allergen Der p 1 in floor dust. In the group with mattress encasings, no significant changes of floor dust Der p 1 were found. Airway hyperresponsiveness (as measured by the PC20 histamine) improved significantly in the mattress cover group after 6 months. The Acarosan group also showed a small but statistically significant improvement after 12 months.
A comparison of three standard methods of identifying mast cells in endobronchial biopsies in normal and asthmatic subjects
Authors: Heaney L. G. , Leggett P. , Maxwell P. , Bharucha H. , Ennis M.
Published: May 2007

Reported mast‐cell counts in endobronchial biopsies from asthmatic subjects are conflicting, with different methodologies often being used. This study compared three standard methods of counting mast cells in endobronchial biopsies from asthmatic and normal subjects. Endobronchial biopsies were obtained from atopic asthmatic subjects (n= 17), atopic nonasthmatic subjects (n=6), and nonatopic nonasthmatic control subjects (n=5). After overnight fixation in Carnoy's fixative, mast cells were stained by the short and long toluidine blue methods and antitryptase immunohistochemistry and were counted by light microscopy. Method comparison was made according to Bland & Altman. The limits of agreement were unacceptable for each of the comparisons, suggesting that the methods are not interchangeable. Coefficients of repeatability were excellent, and not different for the individual techniques. These results suggest that some of the reported differences in mast‐cell numbers in endobronchial biopsies in asthma may be due to the staining method used, making direct comparisons between studies invalid. Agreement on a standard method is required for counting mast cells in bronchial biopsies, and we recommend the immunohistochemical method, since fixation is less critical and the resultant tissue sections facilitate clear, accurate, and rapid counts.
A 1‐year, placebo‐controlled, double‐blind house‐dust‐mite immunotherapy study in asthmatic adults
Authors: Olsen O. T. , Larsen K. R. , Jacobsen L. , Svendsen U. G.
Published: May 2007

Thirty‐one adult patients with asthma caused by house‐dust mites (HDM) were included in this placebo‐controlled, double‐blind study to evaluate the efficacy and safety of specific immunotherapy (SIT) with biologically standardized extracts of HDM. The specific diagnosis was confirmed by skin prick tests, specific IgE, and bronchial provocation tests with HDM allergens. The patients were randomized to receive active treatment with extracts of either Dermatophagoides pteronyssinus (Dpt) or D. farinae (Dfa) (Alutard® SQ, ALK, Denmark) or placebo injections. Twenty‐three patients completed the study. After 1 year of treatment, we found a clinically important and significant reduction in both asthma medicine consumption (inhaled steroids 38% and p2–agonists 46%) and symptom score (57%) in the actively treated group, but not the placebo group. These findings were confirmed by a significant decrease in skin and bronchial sensitivity to HDM in the active group. Additionally, there was a significant difference in the patients' scores for effect in favor of the actively treated group. Total IgE and specific IgE to HDM showed no significant changes before and after treatment for either group. Spirometric lung‐function measurements showed a significant increase in forced expiratory volume in 1 s (FEV1) from 85% before to 89% of predicted values after treatment for the actively treated group. Peak‐flow measurements at home showed no significant changes during the study. It is concluded that allergen SIT is an effective treatment in adult patients suffering from asthma due to HDM.
Increased allergen‐specific Th2 responses in vitro in atopic subjects receiving subclinical allergen challenge
Authors: Gabrielsson S. , Paulie S. , Roquet A. , Ihre E. , Lagging E. , Hage‐Hamsten M. van , Harfast B. , Troye‐Blomberg M.
Published: May 2007

The study aimed to determine whether inhalation of subclinical allergen doses leads to a shift in the balance between T helper (Th) 1 and Th2 cells in asthmatic patients. Elevated IgE requires allergen‐specific T cells producing cytokines such as interleukin (IL)‐4 or 1L‐13. Interferon‐gamma (IFN‐y) produced by Till cells counteracts the effects of IL‐4. In nature, allergic persons are often exposed to low levels of allergen, leading to hyperreactivity, but not to acute allergic reactions. In this study, nine allergic persons inhaled low doses of allergen or placebo in a double‐blind manner over seven consecutive weekdays. During the study, the bronchial responsiveness to histamine challenge increased, but no subject exhibited asthmatic symptoms. Blood was drawn on days 0,1, 4, and 9, and the number of IL‐4– and IFN‐γ‐producing cells was measured by enzyme‐linked immunospot (ELISPOT) assay after in vitro stimulation with a low‐dose phytohemagglutinin (PHA) mixed with the relevant allergen or with PHA alone. In three of the four subjects receiving allergen, the IL‐4/IFN‐y ratio increased during the time of the study. No increase was seen in the placebo group. No increase was seen in serum IgE levels in any of the groups. We conclude that a shift in the balance between Thl and Th2 cells can be detected in subjects exposed to subclinical allergen doses.
Occupational asthma caused by fish inhalation
Authors: Rodríguez J. , Reaño M. , Vives R. , Canto G. , Daroca P. , Crespo J. F. , Vila C. , Villarreal O. , Bensabat Z.
Published: May 2007

Occupational asthma (OA) due to fish inhalation, confirmed by specific bronchial challenge (SBC), has not been described as yet in medical literature, as far as we know. We describe two patients whose asthma was induced by occupational exposure to fish and confirmed by serial measurements of PEFR and SBC. Two fish‐processing workers reported asthma symptoms related to their workplace. They were skin tested with fish extracts and their sera assayed for IgE antibodies to various fish species. Nonspecific bronchial reactivity was assessed by methacholine challenge. The occupational relationship was confirmed by PEFR monitoring in working and off‐work periods. SBC with fish extracts was carried out to confirm the diagnosis of OA. Skin tests with raw and cooked plaice, salmon, hake, and tuna in patient 1 and anchovy, sardine, trout, salmon, Atlantic pomfret, and sole in patient 2 were positive. Specific IgE serum antibodies were found to salmon in patient 1 and to trout, anchovy, and salmon in patient 2. PEFR measurements differed significantly (P<0.001) between work and off‐work periods for both patients. A bronchial challenge with methacholine was positive in patient 1. SBC with raw hake, salmon, plaice, and tuna extracts in patient 1 and raw salmon extract in patient 2 were all positive with an immediate response. SBC with Dermatophagoides pteronyssinus extract was entirely negative in both patients. In three asthmatic, non‐fish‐allergic controls, SBC with tuna, hake, salmon, and plaice were all negative. These results suggest that fish inhalation can elicit IgE‐mediated occupational asthma.
Successful administration of cytarabine after a previous anaphylactic reaction
Authors: Blanca M. , Torres M. J. , Girón M. , Corzo J. L. , Martínez‐Valverde A.
Published: May 2007

Cytarabine (Cyt) is an antimetabolite used primarily in the treatment of leukemia, and both immediate and delayed hypersensitity reactions have been reported. We studied a 9‐year‐old girl with lymphoblastic leukemia, who developed three anaphylactoid reactions during Cyt treatment courses over a 1‐year period. Three years later, Cyt was required again. Although a skin test was negative to Cyt at the concentration of 4 μg/ml, we decided on placebo‐controlled administration of the drug. The Cyt was well tolerated, and urine values of N‐methylhistamine showed no important variations throughout this period compared to those during the placebo administration. Skin tests carried out 14 days after the study were positive at the concentration of 4 μg/ml. The history of different episodes of allergic reactions to Cyt, the last one being the most severe, indicated the possible participation of an immediate hypersensitivity phenomenon, but because no studies had been carried out initially, we could not establish the presence of IgE antibodies. These results indicate that good tolerance existed after the control administration procedure. The long interval, 3 years, between the allergic episode and our protocol and the appearance of a positive skin test 14 clays after the protocol indicated that the subject had lost sensitivity and become resensitized after the controlled administration procedure.
Reduction of Staphylococcus aureus in atopic skin lesions with acid electrolytic water ‐ a new therapeutic strategy for atopic dermatitis
Authors: Sasai‐Takedatsu M. , Kojima T. , Yamamoto A. , Hattori K. , Yoshijima S. , Taniuchi S. , Namura S. , Akamatsu H. , Horio T. , Kobayashi Y.
Published: May 2007

The subjects studied were 22 pediatric patients newly diagnosed with atopic dermatitis (AD); 11 were treated with acid electrolytic water (AEW), which has a strong bactericidal activity (AEW group), and the other 11 with tap water (placebo group). AEW or tap water, 1 ml/cm2 (body surface area), was sprayed on their skin lesions with a spray gun each twice a day for a week. There were no significant differences between the two groups in regard to sex, age, serum IgE, peripheral eosinophil counts, grading scores of AD, and duration of AD. The study was designed as a randomized, placebo‐controlled, double‐blind clinical trial. Colony counts of Staphylococcus aureus on skin lesions in the AEW group, both 3 min after spraying (P < 0.05) and after 1 week of skin treatment (P < 0.01), were significantly decreased as compared with colony counts before treatment, while there was no significant difference in the placebo group before and after treatment. Grading scores of AD also decreased in the AEW group (P <0.01), but not in the placebo group. Both the subjects' guardians' evaluation and a referee physician's evaluation of treatment effect were significantly higher in the AEW group than in the placebo group (P < 0.01). AEW may be potentially effective in preventing a staphylococcal chronic inflammation in AD because of its strong bactericidal activity.
Retinoic acid modulation of induced basophil differentiation
Authors: Leber B. F. , Denburg J. A.
Published: May 2007

Current models of the regulation of hematopoiesis postulate a combination of both factor‐directed cell differentiation/survival acting through intracellular signaling pathways, and factor‐independent differentiation along intrinsically set, default pathways. Recent reports have indicated that eosinophil/basophil (Eo‐Baso) differentiation may represent one default pathway. Because of the strong modulating effect of all trans‐retinoic acid (ATRA) on hematopoietic differentiation, we have investigated the role of ATRA in regulating Eo‐Baso differentiation from pluripotent progenitors. Our results indicate that ATRA inhibits Eo‐Baso maturation at early stages of lineage commitment. Because allergic responses may depend on the continued recruitment and differentiation of such inflammatory mediators, the ability to modulate this pathway may eventually prove to have a therapeutic role in allergic inflammation.
Permeation of polysucrose 15 000 across the human nasal mucosa in vivo
Authors: Andersson M. , Greiff L. , Öman H. , Svensson C. , Wollmer P. , Persson C. G. A.
Published: May 2007

Studies of the nasal permeation of small molecules (< 1000 Da) have yielded important information about the integrity of the human airway mucosa in health and disease. In this study, we used a much larger tracer molecule, polysucrose (PS) 15000 (approx. 14700 Da), to predict the mucosal permeation of inhalational allergens. PS 15000 (50 mg/ml; 15 ml), with or without a detergent type of permeation enhancer (dioctyl sodium sulfosuccinate 10 mg/ml), was maintained for 15 min in one nasal cavity of 12 healthy nonatopic subjects by employment of a nasal‐pool device. Permeation as determined by the 24‐h urine recovery of PS (micro‐ELISA analysis assay) was expressed as percentage of nasal instillate. Mean baseline permeation was 0.044% (range 0.009–0.250%). In the presence of the detergent, permeation increased to 0.600% (range 0.007–2.260%) (P<0.01). After oral intake of 750 mg of PS 15 000 (50 μg/ml; 15 ml), the 24‐h urinary recovery was 0.013% (range 0.004–0.023%). Our study thus demonstrates a measurable baseline permeation of PS 15 000, an elevated permeation rate in the presence of an epithelium‐damaging detergent molecule, and a negligible permeation by the oral route. These properties support the utility of PS 15 000 as a nasal airway permeation tracer. Its size further suggests that its permeation may reflect mucosal perviousness to many allergens.
Pollinosis due to Australian pine (Casuarina): an aerobiologic and clinical study in southern Spain
Authors: García J. J. , Trigo M. M. , Cabezudo B. , Recio M. , Vega J. M. , Barber D. , Carmona M. J. , Cervera J. A. , Toro F. J. , Miranda A.
Published: May 2007

An aerobiologic and clinical survey was conducted in Málaga, southern Spain, in order to determine fluctuations of Australian pine (Casuarina) pollen in the atmosphere of the city, and the prevalence of sensitivity in a nonatopic population. The aerobiologic survey, using a Burkard spore trap, was conducted from January 1991 to December 1994, and sensitization was ascertained by the skin prick test. The pollen season is relatively short and the pollen dispersion period occurs during October and November, mainly during the last 3 weeks of October. Diurnal patterns showed that the highest concentrations of pollen occur between 12 a.m. and 2 p.m., the most influential variables in its dispersion being temperature, sunshine, and rainfall. The prevalence of sensitization to Casuarina pollen was determined by skin prick test (SPT) in a nonatopic population of 210 patients with a previous history of autumn rhinitis, asthma, or rhinitis asthma. Six subjects showed a positive reaction to the pollen extracts, and the presence of specific IgE was demonstrated by the conventional radioallergosorbent test (RAST 2) in five of these patients with positive SPT.
Insect‐venom allergy in Greek adults
Authors: Grigoreas Ch. , Galatas I. D. , Kiamouris Ch. , Papaioannou D.
Published: May 2007

Relatively few studies have investigated the prevalence of insect‐sting allergy and the results of diagnostic procedures in unselected populations. The prevalence of insect‐sting reactions and of venom sensitization in Greece is unknown. We report the results from a stratified random sample of 480 subjects (404 men, 76 women), aged 20–60 years. They all belonged to the ground personnel of the Hellenic Air Force. A detailed history particularly focused on the reactions to Hymenoptera stings was taken in all subjects. Intradermal skin tests (concentration: 1 μg/ml) with three venoms (honeybee, paper wasp, common wasp) were performed. The prevalence of venom sensitization (one or more positive skin tests) was 32.7%. Sensitization appears to be more common (2.69 times) in those living in rural areas than in those living in the capital (Athens). The prevalence of systemic reactions was 3.1% (86.7% of them had positive skin tests). Large local reactions were reported by 4.6% of the subjects (77.3% of them had positive skin tests). Asymptomatic sensitization (positive skin tests to venoms) was observed in 28.7% of subjects with no history of an allergic sting reaction. We concluded that the prevalence of Hymenoptera allergy and venom sensitization in Greece is rather high compared to that of other countries.
Immunotherapy with an alum‐adsorbed Parietaria‐pollen allergoid: a 2‐year, double‐blind, placebo‐controlled study
Authors: Tari M. G. , Mancino M. , Ghezzi E. , Frank E. , Cromwell O.
Published: May 2007

A double‐blind, placeo‐controlled study was performed in order to confirm the safety, suitability, and efficacy of an alum‐adsorbed Parietaria judaica‐pollen allergoid, Allergovit®, for allergen‐specific immunotherapy. Parietaria pollen is an important cause of pollinosis, particularly in the Mediterranean zone, where it may be encountered for up to 8–9 months of the year. It is an aggressive allergen, and the doses tolerated during immunotherapy are less than those achieved with grass pollen. This factor increases the desirability of using therapeutic preparations with minimal IgE‐binding activity, such as allergoids, in order to reduce the risk of side‐effects and enable patients to tolerate a higher dose of allergen, thereby increasing the chances of successful specific immunotherapy. Forty patients with rhinitis and/or asthma were allocated at random to active‐ or placebo‐treatment groups at the beginning of the study. All patients received the active preparation during the second year of the study. Immunotherapy was well tolerated by all patients and the incidence of side‐effects was low. Treatment resulted in significant reductions in specific cutaneous reactivity and increases in nasal tolerance. A progressive improvement in nasal inspiratory peak flow in association with the immunotherapy indicated a reduction in nasal inflammation. These objective assessments of efficacy endorsed the results from the patients’ diary cards, which indicated significant improvements in symptoms and reductions in the use of medication. The immunologic activity of the therapeutic preparation was demonstrated by the induction of a significant specific‐IgG antibody response, with increases in IgG4 during the second year of treatment. We conclude that the safety and efficacy of immunotherapy with the Parietaria allergoid make it suitable for consideration in the treatment of patients with Parietaria‐pollen‐induced rhinitis or asthma.
Physical urticaria: classification and diagnostic guidelines
Authors: Kontou‐Fili K. , Borici‐Mazi R. , Kapp A. , Matjevic L. J. , Mitchel F. B.
Published: May 2007

Kontou‐Fili K, Borici‐Mazi R, Kapp A, Matjevic LJ, Mitchel FB. Physical urticaria: classification and diagnostic guidelines. An EAACI position paper.
Leukotriene EM4 plasma levels in adult asthmatic patients with variable disease severity
Authors: Chavis C. , van Vyve T. , Chanez P. , Farce M. , Bousquet J. , Michel F. B. , Godard P.
Published: May 2007

Chavis C, van Vyve T, Chanez P, Farce M, Bousquet J, Michel FB, Godard P. Leukotriene E4 plasma levels in adult asthmatic patients with variable disease severity.

Cysteinyl leukotrienes ‘C‐LTs’ are local inflammatory mediators involved in bronchial asthma. Seventeen asthmatic patients ‘FEV1 ranging from 41 to 99.8% of predicted values’ and 11 healthy subjects were studied. The clinical severity of asthma was assessed by the Aas score. Plasma C‐LTs were measured by enzyme immunoassay ‘EIA’ after sample purification by solid‐phase extraction ‘SPE’, to investigate whether differences may exist between asthmatic and control subjects and whether leukotriene E4‘LTE4’ levels were related to the severity of disease. LT measurements showed that 87.6±1.2% was recovered as LTE4 and 9.4±1.3% as LTC4. In asthmatic subjects, LTE4 plasma levels were found to be significantly higher than those in the control group ‘1.073±0.133 and 0.53±0.19 ng/ml of plasma, respectively; P < 0.002’. Moreover, there was a significant correlation between LTE4 plasma levels and the Aas clinical score ‘P < 0.005’. These data suggest that plasma LTE4 levels might be used to assess the severity of asthma.
Allergy to antibiotics: T‐cell recognition of amoxicillin is HLA‐DR restricted and does not require antigen processing
Authors: Horton H. , Weston S. D. , Hewitt C. R. A.
Published: May 2007

Allergic immune responses are initiated and maintained by T cells that recognize peptidic fragments of allergens in the context of major histocompatibility complex (MHC) class II molecules. An anomaly of this model exists in the T‐cell response to haptens. Haptens are nonpeptide antigens that alone are too small to provoke an immune response. Nevertheless. T‐cell responses to haptenic allergens clearly occur and are critically involved in allergic immune responses to drugs such as penicillin. Although the mechanisms that generate T‐cell epitopes from protein antigens are well understood, haptens create T‐cell epitopes by alternative mechanisms. These may include binding of haptens directly to preformed MHC‐peptide complexes on the cell surface, or indirect association with MHC molecules after conjugation with self cell surface or serum proteins that are then processed and presented as haptenated peptide antigens. Which of these unorthodox mechanisms of epitope generation is dominant in allergy to penicillin is unknown. This study aims to determine the nature of the epitopes recognized by amoxicillin‐specific T cells from allergic donors, and to clarify whether T‐cell responses to penicillin antibiotics are MHC restricted and require haptenated self proteins to be processed before recognition. Human T‐cell lines specific for amoxicillin were raised and used in assays with processing‐disabled and MHC‐class Il‐typed antigenpresenting cells to determine the MHC restriction and processing requirements of T cells recognizing amoxicillin. Fixation of antigenpresenting cells with paraformaldehyde. before or after pulsing with amoxicillin. established that T cells can recognize amoxicillin‐containing epitopes with a similar ezfficiency irrespective of whether the antigenic conjugate has been internalized and processed. These results suggest that amoxicillin can bind directly to preformed MHC‐peptide complexes and need not necessarily involve the processing of haptenated self carrier proteins before recognition of the conjugate by amoxicillinpecific T cells.
Deposition of cat (Fel d 1), dog (Can f 1), and horse allergen over time in public environments – a model of dispersion
Authors: Egmar A.‐C. , Almqvist C. , Emenius G. , Lilja G. , Wickman M.
Published: May 2007

Background The occurrence and accumulation over time in public environments of cat, dog, and horse allergens was evaluated. Methods Concentrations of animal danders were analyzed by ELISA and countercurrent immunoelectrophoresis (CCIE).

Results Among factory‐new mattresses, 15/17 contained detectable levels of cat and/or dog allergen, whereas no horse allergen was found although six of the mattresses were stuffed with horsehair. Dust from 15 used mattresses contained significantly higher concentrations of Fel d 1 and Can f 1 than the factory‐new ones (P<0.001). Allergen concentrations and titers correlated to the period of time that the mattresses had been tried by customers; rs=0.52‐0.77, P=0.04‐0.001 (cat), rs=0.38‐0.48, P=0.15‐0.08 (dog), and rs=0.64‐0.74, P=0.008‐0.003 (horse). The increase over time occurred rapidly in highly frequented stores and after 3 weeks reached concentrations that have been found in homes where furred pets had formerly been kept or even the lower allergen scale of homes where pets were currently kept. Conclusions The dispersion of allergens from furred animals to pet‐free public places is likely to occur by deposition from people who have been in direct or indirect contact with pets, and high levels of such allergens seem to accumulate in a short period of time.
Month of birth and childhood atopic diseases in the tropics
Authors: Chew F. T. , Goh D. Y T. , Teo J. , Quak S. H. , Lee B. W.
Published: May 2007

Relatiotiship between the month of hirth and prevalence of diagnosed asthma, asthma‐like symptoms (wheezing, nocturnal cough, and exerctse wheezing), rhinitis, and eczema was investigated in four cohorts each ol primary schoolchildren and secondary school (high school) adolescents in Singapore by questionnaire survey. Significantly increased prevalence rates of diagnosed asthtna and asthma‐like symptoms were observed in certain hirth months of the year for two adolescent cohorts, while significant association between birth month and presence of symptoms of rhinitis was found in a cohort of 6‐7‐year‐olds. However, when demographic factors were taken into consideration by multivariate analysis, only the association between asthtna. asthma‐like symptoms, and birth month remained significant in one of the adolescent cohorts. There was, therefore, only a weak association between the month of birth and atopic disease in our schoolchildren. The overall seasonal trends, however, did show two mam seasons (March‐May and September‐November) associated with higher prevalence of these diseases.