bluuebunny/crossref_metadata_2025 huggingface dataset:
Oral allergy syndrome (OAS): symptoms of IgE‐mediated hypersensitivity to foods
Authors: AMLOT P. L. , KEMENY D. M. , ZACHARY C. , PARKES P. , LESSOF M. H.
Published: April 2006

Eighty highly atopic patients were selected for study because they had either atopic eczema (fifty cases) or atopic reactivity to foods, as judged by a positive skin‐prick test (thirty cases). In all, sixty‐five out of eighty subjects (81%) described symptoms of some kind provoked by foods, but correspondingly positive skin tests were found in only half of these, thirty‐three out of eighty (41%). The symptoms experienced by thirty‐one of the thirty‐three patients with positive skin tests were immediate in onset (within 1 hr) and were at first confined to the upper gastrointestinal tract, the most frequent symptoms being oral irritation and throat tightness. In a proportion of these patients, further symptoms such as urticaria, asthma or anaphylaxis developed following the initial oral symptoms, which suggested the term‘oral allergy syndrome’. In the absence of the oral allergy, symptoms such as asthma, urticaria, migraine or eczema starting later than 1 hr after food were seldom associated with positive skin tests. In the oral allergy syndrome, the characteristic symptoms (strong association with positive skin tests and RAST, time of onset and sites at which symptoms are expressed) suggest a causative relationship between exposure to food antigens and specific IgE‐induced release of mediators. In cases of food intolerance that lack a characteristic symptom pattern and a positive skin test or radio‐allergo‐sorbent test, it seems appropriate to consider non‐IgE‐mediated causes.
SRS‐A leukotrienes decrease the activity of human respiratory cilia
Authors: BISGAARD H , PEDERSEN M.
Published: April 2006

We have studied the effects of the slow reacting substance of anaphylaxis (SRS‐A) constituents leukotrienes (LT) C4 and D4 on the ciliary activity of human respiratory cells. The ciliary beat frequency on human nasal cells harvested by cell scraping from the inferior turbinate was measured in a blind design by a microphoto‐oscillographic technique. A total of 740 ciliated cells from seventy‐four cell scrapings were studied. Mean baseline of ciliary beat frequency was 10.2 Hz. The ciliary beat frequency exhibited a pronounced variability in the spontaneous changes between the cell scrapings, yet less so within cell samples from the cell scrapings. We, therefore, evaluated the effect of the test solutions relative to the spontaneous decrease found during simultaneous perfusion with control solution of samples from the same cell scrapings. LTC4, 3–300 nmol/l, caused a highly significantly dose‐related decrease in the ciliary beat frequency by up to approximately 20% as compared to the corresponding control solution. The effect of LTC4 was significantly inhibited by the SRS‐A receptor antagonist FPL 55712 (10μmol/l), but not by indomethacin (10 μmol/l). LTD4, 300 nmol/l, also decreased the ciliary beat frequency. LTB4, which is a leukotriene, although without the sulphidopeptide side chain of the SRS‐A leukotrienes, did not affect the ciliary beat frequency in a concentration of 100 nmol/l. This would seem to confirm the structure specificity of the elucidated effect of the SRS‐A leukotrienes. Histamine (100 μmol/l) did not affect the ciliary beat frequency. The present study demonstrates that the SRS‐A leukotrienes have a specific cilio‐depressive effect, which may contribute to mucus obstruction in the lower airways in asthma and other chronic airway diseases.
Farmer's lung—a 5‐year follow‐up of eighty‐six patients
Authors: MÖNKÄRE SINIKKA , HAAHTELA TARI
Published: April 2006

We studied the clinical course of eighty‐six patients with fanner's lung for a period of 5 years. The patients were first evaluated at an acute or sub‐acute stage of the disease and 1, 3, 6, 12 and 60 months thereafter. Special attention was paid to the development of lung function and radiological findings with reference to corticosteroid treatment and antigen contact during the follow‐up. Many of the patients were severely ill at the acute stage of the disease. Most of the recovery took place during the first month. Significant improvement of lung function happened up to 6 months, thereafter the improvement was insignificant. After 5 years, respiratory symptoms were reported by 65% and minor respiratory dysfunction (lowered diffusing capacity) was observed in about 40% of the farmers. Thirty‐two per cent of the patients showed diffuse opacities in chest X‐ray. Corticosteroid treatment had no effect on long term prognosis. There was no difference in the recovery of lung function between those who returned to work compared with those who did not. Exacerbations happened in 8% of the patients during the follow‐up. We conclude that respiratory symptoms, minor airway dysfunction and mild radiological fibrosis are common findings after 5 years of an acute or sub‐acute stage of the farmer's lung. However, in Finland two‐thirds of the patients return back to their previous occupation of farming and cattle feeding.
Possible role for rotavirus in the development of cows' milk enteropathy in infants
Authors: FIRER M. A. , HOSKING C. S. , HILL D. J.
Published: April 2006

In order to test the hypothesis that rotavirus infection leads to IgE hypersensitivity to cows’ milk, evidence of past rotavirus infection, as reflected by the presence of antibodies, was sought in two groups of children with cows’ milk allergy. The groups were defined according to the time to react to milk challenge. In group I there were fifteen children with an adverse reaction within 40 min of milk challenge. The twenty‐one children in group II had gastrointestinal reactions between 1 hr and 24 hr after milk challenge. The results showed a higher incidence of antibodies to rotavirus in group II than group I (P < 0.05). Although group I patients had significantly higher levels of total and milk‐specific IgE antibodies to cows’ milk than those in group II, both patient groups had lower levels of serum IgG, IgA and IgM than a control population. No association between the presence of rotavirus antibodies and IgE hypersensitivity to cows’ milk was found. However, an association between non‐IgE milk enteropathy and previous rotavirus antibodies was demonstrated.
Effect of eicosapentaenoic acid in asthma
Authors: KIRSCH C. M. , PAYAN D. G. , WONG M. Y. S. , DOHLMAN J. G. , BLAKE V. A. , PETRI M. A. , OFFENBERGER J. , GOETZL E. J. , GOLD W. M.
Published: April 2006

The role of arachidonic acid metabolites in the pathogenesis of airway inflammation and clinical asthma is currently unknown. The addition of eicosapentaenoic acid (EPA) to the diet of humans has been shown to generate metabolites that are less potent than their arachidonic acid counterparts. The substitution of EPA for arachidonic acid metabolites in patients might cause a decrease in airway inflammation and an improvement in clinical asthma. We studied the effect of addition of EPA to the diet of twelve asthmatic patients. Standard clinical evaluations and pulmonary function tests were done on weeks 0, 3, 6, 10, 12 and 14. Patients ingested either low‐dose EPA (0.1 g/day) or high‐dose EPA (4.0 g/day) from weeks 6–14 (total of 8 weeks). There was no difference in clinical status or pulmonary function between groups at the start of the study. There was no change in clinical status or pulmonary function between or within groups at the end of 8 weeks of EPA ingestion.
Month of birth and grass pollen or mite sensitization in children with respiratory allergy: a significant relationship
Authors: BUSINCO LUISA , CANTANI A. , FARINELLA F. , BUSINCO ELENA
Published: April 2006

This report describes a retrospective analysis of the month of birth distribution of 2124 children with respiratory allergy in the Rome district between 1964 and 1985, in comparison with the total live births in the same district over the same period. Of the 2124 children, 1685 had positive skin tests and or RAST only to mites, and 439 only to grass pollen (P < < 0.001). A significant relationship was found between grass or mite sensitization and the month of birth. A high proportion of children born in June‐September had mite allergy (P <0.005), and even higher was that of those born in March‐May with grass sensitivity (P< < 0.005), compared with the total live birth distribution in the Rome district in the same years as the children examined. These results are consistent with the idea that allergy may be associated with a period of susceptibility to sensitization in early infancy.
Cross‐reaction between aromatic isocyanates (TDI and MDI): a specific bronchial provocation test study
Authors: INNOCENTI A. , CIRLA A. M. , PISATI G. , MARIANO A.
Published: April 2006

A study was performed on twenty‐five workers exposed to polyurethane varnishes exclusively catalysed with TDI, who developed asthma to this substance. The aim of the study was to establish, using bronchial provocation tests, whether a cross‐response to MDI exists. The results were positive but no definitive evidence has been reached because there was cross‐response in only 48% of cases. It is interesting, however, that cross‐responders did not predominate among the subjects with a late reaction to TDI (P= 0.0038), whereas cross‐responders were in the majority among the subjects with a dual reaction to TDI (P= 0.0334). It is possible that the pattern of the asthmatic reaction to BPT with TDI influences the cross‐reaction to other isocyanates.
Treatment of hay fever by Allerglobuline: a randomized double‐blind study
Authors: GIRARD J. P. , EL‐HABIB G. , GRANJARD P.
Published: April 2006

Eighty patients suffering from documented hay fever have been entered in a double‐blind randomized study with the purpose of evaluating the efficacy of Allerglobuline®, a 10% human immunoglobulin preparation of placental origin, in the treatment of hay fever. The placebo was a 10% human albumin solution. The treatment started 6 weeks before the customary onset time of the clinical symptoms. It included a course often pre‐seasonal intramuscular injections, with 1 vial (5 ml) given twice a week, and followed by a booster injection of 1 vial on 15 June and 30 June during the grass pollen season.

As the two groups of patients were similar, it was possible to demonstrate a significant symptomatic relief of rhinitis and conjunctivitis in the treated group, compared with the control group (P<0.0001), and an improvement of the respiratory symptoms. Symptomatic improvement was already apparent at the onset of the pollen season and persisted during the following weeks. An appreciable reduction in the consumption of antihistamines could also be shown (P<0.0001). Furthermore, a lesser increase in the total IgE level and in the specific cereal and grass pollen RAST could be demonstrated. This treatment can be seriously considered for the management of severe pollen allergy, particularly in those cases that show a poor response to immunotherapy.
Sensitivity to Parietaria pollen in the Southampton area as determined by skin‐prick and RAST tests
Authors: HOLGATE S. T. , JACKSON LINDA , WATSON H. K. , GANDERTON MARIANNE A.
Published: April 2006

The pollen of Parietaria species is a well‐recognized and important inhalant allergen in the Mediterranean area. Parietaria judaica (Pellitory‐of‐the‐Wall) is native to the U.K., flowering from June to September, but is not usually considered to be of any clinical importance by U.K. allergists. We skin tested 62 patients with a clinical history of summer seasonal respiratory symptoms and a control group of 11 patients with perennial respiratory symptoms only. Each was skin tested in duplicate with extracts of grass pollen, birch pollen, Parietaria pollen, Dermatophagoides pteronyssinus, Cladosporium, Alternaria, nettle pollen and negative and positive controls, and serum samples were collected for RAST assays for Parietaria and nettle. Eight of the 62 patients in the main group showed skin reactivity to Parietaria. Five of these eight had never visited the Mediterranean area and therefore it is possible that sensitization occurred in the U.K. Thirteen of the 62 patients were skin reactive to nettle but there was no correlation between skin reactivity to Parietaria and nettle. This supports a recent report that, despite their close botanical relationship, no antigenic cross‐reactivity exists between the two species. No correlation was seen between skin reactivity and serum RAST activity to Parietaria or nettle. It is not known whether exposure to Parietaria pollen contributes to the seasonal symptoms of the patients found to be skin reactive. None of the 11 patients in the control group was skin reactive to Parietaria.
IgE‐mediated allergic reactions to fruit gums and investigation of cross‐reactivity between gelatine and modified gelatine‐containing products
Authors: WAHL R. , KLEINHANS D.
Published: April 2006

A 32‐year‐old female reacted with a contact urticaria syndrome after eating ‘gummy bears’ (fruit gums). The reaction began in the oral mucosa and led to treatment on an inpatient basis. RAST measurements with allergen discs produced with gelatine and gelatine‐containing products (among them ‘gummy bears’) demonstrated the presence of IgE antibodies in the serum of this patient. Proteins with molecular weights in the range of 40–120 kD were identified as the allergens in gelatine by using Western blot analysis. RAST inhibition showed cross‐reactivity between gelatine, gelatine‐containing products and the modified gelatine used in some plasma substitutes. Allergic reactions towards coloured fruit candies and ‘gummy bears’ may result from an IgE‐mediated hypersensitivity towards gelatine. The long‐known anaphylactoid reactions towards gelatine‐containing plasma substitutes may, at least in part, be of an allergic nature.
Allergenic components of Candida albicans identified by immunoblot analysis
Authors: SHEN HORNG‐DER , CHOO K. B. , TANG R. B. , LEE C. F. , YEH JAN‐YING , HAN S. H.
Published: April 2006

Allergenic components of Candida albicans fractionated by SDS–polyacrylamide gel electrophoresis (PAGE) and transferred to nitrocellulose membranes were identified using sera from 30 asthmatic patients who showed positive skin test and RAST (radio‐allergosorbent test) to C. albicans. The IgE‐binding yeast components in the complex antigen preparation were then detected by reaction with enzyme‐labelled anti‐human IgE antibodies. They were confirmed by Coomassie blue R‐250 staining of the membrane to visualize all protein bands after reaction with the enzyme substrate. The IgE‐binding patterns of the sera tested were heterogeneous, displaying a total of 16 identifiable components with molecular weights ranging from 20 to 94 kD. A 40 kD component showed the highest IgE‐binding frequency, being recognized by 23 (77%) of the 30 sera examined. The other 15 allergenic components identified were recognized by less than 25% of the sera tested. Only two of the 30 serum samples contained IgE antibodies reactive with seven to eight allergenic components. Ten of the 30 sera reacted with only one allergenic component, and the remaining serum samples recognized two to five of the 16 identified allergens. Results described in this study are applicable to allergen standardization work and provide a basis for further study on the role of C. albicans in clinical allergy.
Report on the Second International Symposium on Leukotrienes and Prostanoids in Health and Disease, Jerusalem, October 1988
Authors: Cromwell O.
Published: April 2006

Arachidonic acid metabolites of both the lipoxygenase and cyclo‐oxygenase pathways have been implicated in biological mechanisms in a variety of tissues. Their real significance in the pathophysiology of disease, particularly as mediators of inflammation and in the regulation of the immune response, is poorly understood. In this review Oliver Cromwell focuses on those topics discussed at the meeting which were of particular relevance to allergy and asthma.
Seasonal variability of exercise‐induced asthma especially outdoors. Effect of birch pollen allergy
Authors: KARJALAINEN J. , LINDQVIST A. , LAITINEN L. A.
Published: April 2006

A study was made to determine whether natural allergenic exposure modulates exercise‐induced asthma. Eighteen asthmatic men, ten non‐allergic and eight allergic to birch pollen, underwent heart rate‐monitored outdoor exercise tests during both the cold winter season and in the spring, the birch pollen season. The mean fall in FEV1 after the outdoor exercise test increased in the allergic group from 17.3% in the winter to 27.6% in the spring, while it decreased in the non‐allergic group from 31.6% to 22.4% respectively (P<0.01). Initial FEV1 and FCV values remained unchanged in both groups. The non‐specific airway responsiveness to histamine did not change significantly in birch pollen allergic or non‐allergic subjects during the spring, when compared with the winter values. We conclude that the exercise‐induced asthma is aggravated in the birch pollen allergic asthmatics during the pollen season, when compared to the non‐birch pollen allergic asthmatics, in whom the exercise‐induced bronchoconstriction is attenuated as expected, because of the warmer and more humid weather in the spring.
Occupational allergy in an entomological research center. II. Identification of IgE‐binding proteins from developmental stages of the blowfly Lucilia cuprina and other species of adult flies
Authors: BALDO B. A. , BELLAS T. E. , TOVEY E. R. , KAUFMAN G. L.
Published: April 2006

Sera from 30 workers in an entomological research institute and from five Sydney asthmatics, all with serum IgE antibodies to sheep blowfly (Lucilia cuprina) antigens, were studied with the aim of identifying individual IgE‐binding proteins in extracts of L. cuprina adult flies, larvae and eggs, and in extracts of related species of flies from the order Diptera. Using protein blotting, 21, 18 and nine different IgE‐binding components were identified in extracts of L. cuprina adult flies, larvae and eggs, respectively. A component(s)of MW 67 kD found in all three developmental stages, showed the highest frequency of IgE‐binding; reacting, for example, with 70% of the sera tested with the adult fly extract. Some components were detected in only one of the three developmental stages. Investigations of possible allergenic cross‐reactivity between L. cuprina and extracts from six other related species of flies revealed IgE‐binding bands in each of the extracts as well as in an extract of Agrotis infusa, a cutworm not belonging to the order Diptera. One strongly reacting component of MW 20 kD was detected in extracts of five different fly species as well as in the A. infusa extract. The results suggested that allergenic cross‐reactivity between some fly species exists, and may extend to taxonomically unrelated insect species.
Birth season variation in asthma and allergic rhinitis
Authors: ÅBERG N.
Published: April 2006

The prevalence of asthma and allergic rhinitis was analysed in relation to birth month in two cohorts of 18‐year‐old males born in 1953 (n= 55 393) and 1963 (n= 57 150), in school children (n= 1984) and in children with defined specific allergies (n= 1080). Among the 18‐year‐olds, a marked variation with respect to birth season was only found in those born in 1963, with the highest prevalence of asthma in those born August‐January and of allergic rhinitis in those born November‐May. In the schoolchildren with allergic rhinitis the birth season pattern was found to be similar to that in the conscripts born in 1963. The influence of month of birth on the onset of allergic rhinitis was maximum about 6 years of age and was not seen before 2, and after 10 years of age. Obvious similarities in birth season patterns were found between the unselected populations and the children with defined pollen and animal dander allergies. The differences in birth season pattern between the two cohorts of 18‐year‐olds were interpreted as an effect of unidentified adjuvant factors that might have developed over a 10‐year period.
H1‐ and H2‐antagonists in allergic and pseudoallergic diseases
Authors: RING J. , BEHRENDT H.
Published: April 2006

Although known for more than 80 years, histamine still remains a fascinating substance for allergy research. Histamine antagonists have been in clinical use since 1942. The classical H1‐antagonists with sedative side‐effects have been more or less replaced by newer non‐sedating H1‐antagonists; the role of H2‐receptors in allergic diseases is still controversial. There, are however, increasing reports of beneficial effects of H2‐antagonists. mostly in combination with H1‐antagonists, in a variety of allergic and pseudoallergic conditions such as chronic urticaria, anaphylactoid reactions due to colloid volume substitutes, opioid analgesics and radiographic contrast media. The combined use of H1‐ and H2‐antagonists might not only act as specific histamine antagonism but exert a mast cell stabilizing effect, as demonstrated in animal experiments and some clinical studies. Future research will show whether the combined use of H1‐ and H2‐anlagonists will become a routine therapeutic procedure in allergy therapy.
Neuropeptides, mast cells and allergy: novel mechanisms and therapeutic possibilities
Authors: GOETZL E. J. , CHENG P. P. J. , HASSNER A. , ADELMAN D. C. , FRICK O. L. , SREEDHARAN S. P.
Published: April 2006

Diverse neuropeptides are released by neuroendocrine and immune cells at the sites of allergic and inflammatory reactions. The neuropeptides and other neuromediators affect functions of smooth muscle, microvasculature and secretory cells, and are potent stimuli of mast cell, lymphocyte and other leucocyte contributions to such reactions. The distinctive immune sources, structures and cellular receptors for neuromediators suggest the possibility of novel pathogenetic mechanisms and levels of pharmacological intervention specific for neuroregulation of immunity and hypersensitivity.
Ispaghula sensitization in workers manufacturing a bulk laxative
Authors: McCONNOCHIE KATHRYN , EDWARDS J. H. , FIFIELD R.
Published: April 2006

Exposure to ispaghula dust in a pharmaceutical factory resulted in chest tightness/ wheeze, nasal, and ocular or skin symptoms in 48 of 92 exposed workers. Whilst symptoms were not incapacitating in the majority (44) of these, one worker required antihistamines and three others experienced severe respiratory symptoms when exposed to the dust. These three were atopic, had a positive RAST and skin test to ispaghula; a combination unique to them. There was a significant relationship between work‐related symptoms and atopic status, however, smoking did not influence symptoms, total serum IgE and specific anti‐ispaghula IgE. We conclude that handling ispaghula produces an irritant effect in most exposed people, however, sensitization to the dust can occur with severe respiratory symptoms.
Mite allergy and exposure to storage mites and house dust mites in farmers
Authors: IVERSEN M. , KORSGAARD J. , HALLAS T. , DAHL R.
Published: April 2006

Sensitization to house dust mites, storage mites and other common inhalation allergens was studied in 144 farmers using SPT and RAST. The study population was selected from a random sample of 808 farmers and consisted of 47 persons who had declared themselves to suffer from asthma, 63 persons who had reported respiratory symptoms, and 34 healthy persons without respiratory symptoms. The most prevalent RAST was towards storage mites and was found in 17% of farmers who suffered from asthma and was estimated to occur in 5% of the random sample of farmers. A positive RAST to house dust mites was found in 17% of farmers who reported to suffer from asthma. Sensitization to pollens, animal dander and grain species was rare. A positive RAST to moulds was not found. There was a strong association between a positive RAST to house dust mites and a positive RAST to storage mites (odds ratio 21.0). A positive RAST to storage mites was significantly associated with living in a dwelling in the past which was recalled as damp (odds ratio 4.9). A high number of house dust mites was found in nearly all dwellings (median count 148 mites/0.1 g dust) and a high number of storage mites was found in some dwellings. This study suggests that in humid and temperate regions of Europe, allergy to storage mites in farmers is not caused exclusively by occupational exposure but damp housing conditions and indoor exposure to storage mites may also be important.
The actions of GR32191B, a thromboxane receptor antagonist, on the effects of inhaled PAF on human airways
Authors: STENTON S. C. , WARD C. , DUDDRIDGE M. , HARRIS A. , PALMER J. B. D. , HENDRICK D. J. , WALTERS E.‐H.
Published: April 2006

We investigated acute bronchoconstriction and changes in airway responsiveness to methacholine following the inhalation of platelet activating factor (PAF) in an open study of 12 non‐asthmatic subjects. Ventilatory function was monitored using a flow rate at 30% of vital capacity (V̇30) and airway responsiveness was measured as PD40V̇30, i.e. the dose of metacholine causing a 40% fall in V̇30. PAF (3–422 μg) resulted in dose‐related acute bronchoconstriction in 10 of the 12 subjects. There was no association between the airway responsiveness to PAF and to methacholine. Ten subjects showed some increase in airway responsiveness to methacholine 1 or 3 days following PAF. Overall, these changes were statistically significant (P < 0·05) but were of small magnitude (geometric mean PD40V̇30 pre‐PAF=457 μg; 24 hr after PAF = 259 μg; 72 hr after PAF =258 μg) and variable: only seven subjects showing increased airway responsiveness on both day 1 and day 3 after PAF. Six subjects who appeared to show increases in airway responsiveness following PAF were re‐studied with the inhaled PAF pre‐medicated by either placebo or a specific thromboxane receptor antagonist (GR32191B) in a double‐blind fashion. GR32191B did not reduce the acute bronchoconstriction due to PAF. In this part of the study, these six subjects did not show significant increases in airway responsiveness following the placebo pre‐medicated PAF challenge and so no effect of the drug on airway responsiveness could be shown. We conclude that PAF‐induced bronchoconstriction in normal individuals is not mediated by thromboxane and that any increases in airway responsiveness following PAF are frequently poorly sustained, are poorly reproducible, and are not readily detectable.
Modulation of the immune response to ragweed allergens by peptic fragments
Authors: MICHAEL J. G. , LITWIN A. , HASSERT V. , PESCE A.
Published: April 2006

Fragments of short ragweed extract were prepared by peptic digestion and fractionated by molecular exclusion chromatography. We focused on fragmenting a ragweed fraction that was enriched for Amb a I. Digestion products in the molecular weight range of 5–15 kD (fSRW) were examined for their antigenic, immunogenic and immunosuppressive properties. fSRW was poorly immunogenic and unable to induce ragweed‐specific PCA reactions in rat skin or to bind to anti‐ragweed IgG antibodies. Intravenous administration of fSRW either prior to or after intraperitoneal immunization with a ragweed preparation resulted in a significant suppression of the immune response. T cells isolated from lymph nodes of mice immunized with ragweed were stimulated by fSRW in a lymphoproliferation assay. Moreover, T cells from mice injected with fSRW were immunosuppressive when transferred into mice immunized with intact ragweed antigens. Our data demonstrate that peptic fragments (fSRW) of ragweed lack B‐cell determinants while retaining their T‐cell immunoregulatory properties. Potentially these peptides are less likely to cause adverse reactions in allergen sensitive patients and thus offer a new approach to allergen immunotherapy.
Antigen‐dependent activation of alveolar macrophages from ovalbumin‐sensitized guinea‐pigs: relevance of the route of administration and the amount of antigen provided
Authors: BACHELET M. , LAGENTE V. , FOUQUE F. , DUMAREY C. , HAVET N. , MASLIAH J. , BEREZIAT G. , VARGAFTIG B. B.
Published: April 2006

Alveolar macrophages from guinea‐pigs sensitized by different amounts of ovalbumin, administered either by subcutaneous injection or aerosol exposure, liberate increased amounts of arachidonic acid and thromboxanc B2 when challenged in vitro with ovalbumin. This antigen‐dependent activation of macrophages was immunospecific. The comparison between different sensitization procedures showed that the aerosol exposure was the most efficient with respect to the activation of macrophages, as cells from guinea‐pigs sensitized subcutaneously were poorly activated by the antigen unless high doses were used for sensitization. The antigen‐dependent activation of macrophages was affected by acid and neutral washings, suggesting the involvement of a loosely bound antibody that could not be identified. These observations suggest that, as mast cells and basophils, alveolar macrophages from actively sensitized guinea‐pigs contribute to the allergic reaction by an antibody‐mediated mechanism.
The effect of intranasal nedocromil sodium on viral upper respiratory tract infections in human volunteers
Authors: BARROW G. I. , HIGGINS P. G. , AL‐NAKIB W. , SMITH A. P. , WENHAM R. B. M. , TYRRELL D. A. J.
Published: April 2006

Two studies involving double‐blind group comparative trials in human volunteers compared the effects of intranasal nedocromil sodium (2·6 mg active drug per nostril, q.i.d.) with placebo on clinical symptoms and performance impairment associated with the common cold. In the first study volunteers were challenged with rhinoviruses (RV9 and RV14), and in the second study with respiratory coronavirus. In both studies, active and placebo groups of volunteers were demographically similar. Infection rates in both groups were also similar. There were no withdrawals resulting from unusual symptoms related to either treatment. In the rhinovirus study (19, placebo; 20, nedocromil sodium) daily symptom scores and daily mean nasal secretion weights were significantly lower in the nedocromil sodium‐treated group. In the coronavirus study (26, placebo; 27, nedocromil sodium) there was little difference in the severity of colds between the active and placebo‐treated groups, but trends favoured nedocromil sodium. In both studies the impairment of performance in volunteers who developed a cold was significantly less in those treated with nedocromil sodium than in those treated with placebo.
Serum levels of IgG subclasses in relation to IgE and atopic disease in early infancy
Authors: LILJA G. , MAGNUSSON C. G. M. , ÖMAN H. , JOHANSSON S. G. O.
Published: April 2006

The levels of IgG1, IgG2, IgG3 and IgG4 were analysed by FLISA in cord serum and in serum samples collected at 6 and 18 months of age from infants whose mothers were atopic. None of the four IgG subclasses was significantly influenced on any sampling occasion by infant atopy, gender, month of birth, maternal IgE or maternal diet during pregnancy and early lactation. However, at 18 months of age, significantly higher levels of IgG1 (P < 0·05) and of IgG4 (P < 0·01) were found in infants with an elevated IgE ( 8·0 kU/1) than in those with a lower level. A weak positive correlation (rs= 0·26; P= 0·05) between IgE and IgG4 was also observed. Despite the fact that the serum levels of IgG4 at 18 months were significantly higher (P < 0·01) among infants with positive IgE‐RAST ( 0·15 PRU/ml) to ovomucoid or β‐lactoglobulin, our data suggest that the the concentration of IgG4 relates more to the level of IgE than to the clinical symptoms of atopy. Determination of IgG subclasses seems to be of limited value for predicting atopy during early infancy.
Platelet activating factor does not cause a reproducible increase in bronchial responsiveness in normal man
Authors: SPENCER D. A. , GREEN SALLY E. , EVANS JANE M. , PIPER PRISCTLLA J. , COSTELLO J. F.
Published: April 2006

The reproducibility of acute effects of inhaled PAF on airway calibre, circulating neutrophil count and any subsequent increase in bronchial responsiveness has been studied in six normal subjects and compared to the effects of inhaled lyso‐PAF, the inactive precursor and metabolite of PAF. PAF caused acute bronchoconstriction and a transient fall in neutrophil count on two separate occasions in five out of six subjects (minimum percentage of baseline values (mean): first PAF challenge; sGaw 69%, V̇max30 72%; neutrophil count 70%; second PAF challenge; sGaw 61 %, V̇max30 74%, neutrophil count 63%). In one subject inhaled PAF caused bronchoconstriction and a transient fall in neutrophil count once, but a second challenge resulted in no detectable changes. There was no significant increase in bronchiai responsiveness to methacholine in any subject studied on five occasions over a 2‐week period following each PAF challenge. Challenge with lyso‐PAF did not cause acute effects or any subsequent changes in bronchial responsiveness. These findings demonstrate that any effects of inhaled PAF on bronchial responsiveness in normal man are small and probably not of clinical significance. It would also be inappropriate to use this human model to study the mechanisms of bronchial hyperresponsiveness or for the preliminary assessment of potential new anti‐asthma drugs.
Changes in non‐specific nasal reactivity and eosinophil influx and activation after allergen challenge
Authors: KLEMENTSSON H. , ANDERSSON M. , BAUMGARTEN C. R. , VENGE P. , PIPKORN U.
Published: April 2006

It has been suggested that the eosinophilic granulocyte plays a crucial role in the genesis of increased reactivity of the airways. In order to characterize changes in non‐specific reactivity in the upper airways following a nasal allergen challenge further 16 subjects with strictly seasonal allergic rhinitis were studied. They were challenged with allergen outside the relevant pollen season and monitored at intervals for a period of 24 hr for nasal symptoms, changes in nasal reactivity, eosinophil influx and activation, and markers of inflammation. The same challenge sequence without an initial allergen challenge was used as a control. A symptom score technique was used to record nasal symptoms and methacholine challenges were used to monitor changes in non‐specific reactivity. A nasal lavage was made prior to each methacholine challenge to monitor the influx of cells, specifically eosinophils, and to determine changes in the levels of eosinophil cationic protein (ECP) and TAME‐esterase activity. Cells from the mucosal surface were also collected with a Rhinobrush® prior to the allergen challenge as well as at the 24‐hr follow up. The allergen challenge induced a five‐fold increase in non‐specific nasal reactivity, as measured by the methacholine challenges, at the 2‐hr follow up from 0·051 ml ± 0·012 (mean ± s.e.m.) to 0·255 ± 0·062 (P < 0·01) and a significant increase was also noted at all observation points, whereas no increases could be observed in the control setting. With a similar timing the allergen challenge also induced an increase in the proportion of eosinophils on the mucosal surface from an initial 0·8 ± 0·4% to 6·2 ± 2·1% of the cells as early as 2 hrs later (P < 0·05). A significant correlation was foundbetween the levels ofECP and eosinophils in the lavage fluid (r= 0·64, P < 0·001) and between the levels of ECP and TAME esterase (r= 0·43, P < 0·01). No correlations were, however, disclosed between the increases in non‐specific nasal reactivity and the number of eosinophils (regardless of the cell‐harvesting technique) or ECP levels at any of the observed time points. It is therefore suggested that the allergen‐induced change in non‐specific nasal reactivity is a complex phenomenon rather than just the recruitment and activation of eosinophilic granulocytes in the nasal cavity.
Ragweed IgE and IgG4 antibody in nasal secretions during immunotherapy
Authors: PENG Z. , LEE H.‐B. , PROUD D. , NACLERIO R. , ADKINSON N. F.
Published: April 2006

We have developed sensitive amplified immunoassays for measurement of IgE and IgG4 ragweed (RW) antibodies in unconcentrated nasal washes. IgE to Amb a I (formerly antigen E) can be assayed to <0·1 ng/ml using IgE capture by anti‐IgE on microtitre plates and an alkaline phosphatase‐conjugated Amb a I with an amplification substrate technique. IgG4 to whole RW extract was assayed to <0·01 ng/ml by amplification ELISA using monoclonal anti‐IgG4. Nasal washes (NW) (10 ml) and serum were obtained in December from 22 RW‐sensitive patients before and after 1 and 2 yr of RW immunotherapy (IT), and assayed for Amb a I IgE or RW IgE and R W IgG4 antibodies. Amb a I IgE could be measured in the NW of 15/22 pre IT, 19/22 at 1 yr IT, but only 3/10 at 2yr IT (compared with pre‐IT, P 0·05). Mean Amb a I IgE in NW was 0·66, 0·36 and 0·21 ng/ml at pre, 1 yr and 2 yr IT (P‐values > 0·05). Mean serum RW IgE, was 76, 55 and 27 ng/ml at pre, 1 yr and 2 yr IT (P‐values > 0·05). Amb a I IgE in nasal washes was correlated with RW IgE in serum (r=0·56, P <0·001, n=44). RW IgG4 was detectable in NW of 15/22pre‐IT, 18/22 at 1 yr IT and 9/10 at 2 yr IT (P‐ values > 0·05). Mean serum RW IgG4 in NW did not change with IT (0·12, 0·16 and 0·20 ng/ml at pre, 1 yr and 2 yr IT, P‐values > 0·05). whereas serum RW IgG4 rose substantially from a mean 23 ng/ml pre IT to 197ng/ml at 1 yr IT and 1324 ng/ml at 2 yr IT (P‐values < 0·0001). Nevertheless, RW IgG4 in NW and serum was significantly correlated (r= 0·59, P 0·001, n= 44). We conclude that using sensitive immunoassays IgE and IgG4 RW antibodies can be measured in unconcentrated NW of about two‐thirds of ragweed‐sensitive patients. Both isotypes in NW have strong correlation with corresponding serum antibodies, but the significant rise of serum RW IgG4 after IT is not reflected in NW of asymptomatic subjects out of season. Whether allergic inflammation can increase IgG4 in NW remains to be determined.
Plasma exudation as a first line respiratory mucosal defence
Authors: PERSSON C. G. A. , ERJEFÄLT I. , ALKNER U. , BAUMGARTEN C. , GREIFF L. , GUSTAFSSON B. , LUTS A. , PIPKORN U. , SUNDLER F. , SVENSSON C. , WOLLMER P.
Published: April 2006

A great variety of provocations of the airway mucosa produce extravasation of plasma from the abundant subepithelial microvessels. A plasma exudate has important actions through its volume, its specific and unspecific binding proteins, its enzyme systems, and its potent peptides (of kinin. complement, coagulation, fibrinolysis and other systems). If allowed to operate on the surface of an intact mucosa the plasma exudale would have important roles in normal airway defence. Recent observations in guinea‐pig tracheo‐bronchial airways and in human nasal airways suggest that the mucosal exudation of plasma into the airway lumen is a non‐injurious fully reversible process. Threshold exudative responses thus resulted in the appearance of an ‘unfiltered’ plasma exudate not only in the lamina propria but also on the surface of an undisrupted mucosa. Even after extensive luminal entry of exudate the epithelial lining was intact, as judged by light, fluorescence and electron microscopy. Hence, the epithelial barrier was reversibly permeable when approached from beneath by the plasma exudate. This was a distinct increase in outward permeability, because even during the exudation of plasma the mucosa remained a barrier to luminal solutes. It is possible that the exudate itself, by a slight compressive action on the basolateral aspect of epithelial cells, creates intercellular pathways for its entry into the lumen. Contrary to current beliefs, we propose that plasma exudation should be considered a first line respiratory defence mechanism operating together with other systems of the mucosal surface.
Unexplained CD4‐positive T‐cell deficiency in non‐HIV patients presenting as a Pneumocystis carinii pneumonia
Authors: GAUTIER V. , CHANEZ P. , VENDRELL J. P. , PUJOL J. L. , LACOSTE J. Y. , DE FAUCAL H. , GODARD P. , MICHEL F. B.
Published: April 2006

Three cases of Pneumocystis carinii pneumonia occurring in adults with unexplained T‐cell defects are reported. No HIV markers were found during the follow up, and neither was any immunosuppressive disease. The authors emphasize the possibility that Pneumocystis pneumonia may occur and may be treated successfully in previously healthy subjects.
Liposomes as carriers for allergy immunotherapy
Authors: AUDERA C. , RAMÍREZ J. , SOLER E. , CARREIRA J.
Published: April 2006

With the aim of obtaining an efficient but safer vaccine for allergy immunotherapy, the possibility of using liposomes as adjuvants has been considered given their proven low toxicity, adjuvant properties and ability to maintain the encapsulated substance in their interior for sonic time in vivo. Different methods of encapsulating allergenic extracts into neutral, positively, and negatively charged DPPC: cholesterol liposomes have been investigated and the immune response provoked by these in mice was studied and compared to the immune response to free allergen or other adjuvants such as aluminium hydroxide. The results obtained show that allergen encapsulated in all three types of liposomes elicit an increase in specific IgG levels higher than that provoked by free allergen, however, both encapsulation efficiency and specific FgG litre were higher when positively charged (DPPC.‐cholesterol steurylamine) liposomes were used. Specific IgF. levels to allergen in positive and neutral liposomes was lower than to allergen in negative liposomes or adsorbed to A1(OH)3 No differences were found in the behaviour of liposomes prepared by different methods (the results were obtained from pooled sera from different groups of mice so there is no statistical data). These results confirm the immunoadjuvanl effect of liposomes for allergy immunotherapy. Further studies to determine their lack of toxicity, pharmacokinetic studies and human clinical studies are necessary to confirm their adequacy for human use and advantage over current immunotherapy methods.
Adrenocortical suppression following treatment with beclomethasone and budesonide
Authors: PRAHL P.
Published: April 2006

The study was carried out to compare the adrenocortical suppression caused by inhaled beclomethasone dipropionate (BDP) with the suppression caused by budesonide (Bu). The study was of an open cross‐over design. Sixteen children with asthma were treated with high‐dose inhaled BDP and Bu via a 750 ml spacer (Nebuhaler), Each drug was used for periods of 6 weeks. The 24‐hr urinary cortisol excretion was unchanged in 11 subjects. A reproducible suppression of the urinary cortisol excretion was shown in three subjects following BDP and in two subjects following treatment with Bu. The results of the study indicate the occurrence of interpersonal variations of the sensitivity to the adrenocortical suppressive effect of BDP and Bu.
Double‐blind cross‐over trial of oral sodium cromoglycate in patients with irritable bowel syndrome due to food intolerance
Authors: LUNARDI C. , BAMBARA L. M. , BIASI D. , CORTINA P. , PEROLI P. , NICOLIS F. , FAVARI F. , PACOR M. L.
Published: April 2006

Twenty patients with irritable bowel syndrome due to food intolerance were randomized to either oral sodium cromoglycate or placebo in a double‐blind cross‐over trial. The study consisted of treatment with either sodium cromoglycate or placebo for 8 weeks, followed by the cross‐over treatment for 8 further weeks. Patients were allowed to eat the offending foods during the study. Eighteen patients completed the study. Analysis of patients' diary card scores showed a statistically significant difference in favour of sodium cromoglycate. There was a long carry‐over effect in the active‐placebo order group. Therefore oral sodium cromoglycate seems to be a useful treatment in patients with irritable bowel syndrome and proven food intolerance.
Allergy from cellulase and xylanase enzymes
Authors: TARVAINEN K. , KANERVA L. , TUPASELA O. , GRENQUIST‐NORDEN B. , JOLANKI R. , ESTLANDER T. , KESKINEN H.
Published: April 2006

Modern biotechnical methods have enabled production of many new types of potentially allergenic proteins. Enzymes have long been known to be respiratory allergens, but relatively few cases of skin allergy have been reported. Here we describe four patients who developed occupational allergic respiratory symptoms, three with bronchial asthma and one with allergic rhinitis, caused by cellulase and/or xylanase enzymes. Each patient also had urticarial symptoms after skin contact with these enzymes. In addition, one of the patients had allergic contact dermatitis from cellulase, and one from xylanase. Allergic contact dermatitis was verified by positive patch tests with the enzymes, and the immediate allergy was revealed by skin prick tests, specific IgE determinations (RAST) and RAST‐inhibition tests. All patients had positive RASTs to both cellulase and xylanase. In the RAST inhibition test 20 μ1 of cellulase brought about a 94% inhibition, indicating the specificity of the RAST. Xylanase (20 μl, 5% w/v) gave an 92% inhibition of cellulase RAST, indicating cross‐reactivity between cellulase and xylanase. Three patients have been able to continue at their previous places of work, but at different worksites. One of the patients requires continuous medication for asthma and had to change her job because of persistent symptoms.
Emergency treatment of allergic reactions to Hymenoptera stings
Authors: MÜLLER U. , MOSBECH H. , BLAAUW P. , DREBORG S. , MALLING H. J. , PRZYBILLA B. , URBANEK R. , PASTORELLO E. , BLANCA M. , BOUSQUET J. , JARISCH R. , YOULTEN L.
Published: April 2006

Allergic reactions to Hymenoptera stings are frequently observed all over Europe. Rarely they may induce long‐standing morbidity or even be fatal. Several investigations have shown that the emergency treatment given to these patients is often inadequate. Cutaneous symptoms respond well to antihistamines and also to adrenaline. Adrenaline is the mainstay for outside hospital treatment of more severe reactions involving the respiratory tract (bronchial asthma, laryngeal oedema) and the cardiovascular system (anaphylactic shock). Inhaled adrenaline is especially useful in respiratory symptoms, while parenteral application of adrenaline is prefered for shock treatment. All patients with severe respiratory or cardiovascular reactions must be hospitalized, treated under intensive care conditions and observed for at least 24 hr. Emergency medications including adrenaline for inhalation or for self‐injection must be given to all patients with a history of systemic allergic reactions to hymenoptera stings. These patients must also get instructions for safety measures to avoid further stings. They should be referred to an allergist in order to evaluate the indication for venom immunotherapy.
Effect of azelastine and ketotifen on the bronchial and skin responses to platelet‐activating factor in humans
Authors: LAI C. K. W. , OLLIER S. , LAU C. K. , HOLGATE S. T.
Published: April 2006

In a randomized, double‐blind placebo‐controlled study we investigated the effect of single oral doses of 8 mg azelastine and 2 mg ketotifen on the immediate response to platelet‐activating factor (PAF) inhalation and to increasing doses of PAF injected intradermally. Bronchial provocation with 100 μg of PAF resulted in marked bronchoconstrictor responses, but neither azelastine nor ketotifen had any significant effect on these responses. Intradermal injection of PAF (100, 200 and 400 ng) resulted in a dose‐related weal and flare response. Azelastine and ketotifen both caused significant reductions in this response (P < 0.002‐ P < 0.01). There was no significant difference between the effect of the two drugs.