bluuebunny/crossref_metadata_2025 huggingface dataset:
Asthma and allergy in Albania
Authors: Priftanji A.V. , Qirko E. , Layzell J.C.M. , Burr M.L. , Fifield R.
Published: March 2003

Background: The risk of allergic disease may be influenced by the degree of “westernization”. A survey was conducted to ascertain whether the prevalence of allergy was lower in Albania than elsewhere in Europe, as it has been the most isolated European country.

Methods: The subjects were residents of Tirana aged 20–44 years. A screening questionnaire was completed by 2653 subjects. A more detailed questionnaire was administered to a random sample of 564 respondents, together with skin prick tests and serum IgE assay.

Results: The prevalence of wheeze in the last year, and of wheeze without a cold, was lower in Albania than in any country that participated in the European Community Respiratory Health Survey. Nasal allergy and atopy (as indicated by serum specific IgE) were also uncommon in Albania, although serum total IgE concentrations were high.

Conclusions: The findings confirmed the hypothesis of a low prevalence of allergy in Albania. Possible reasons include the recent economic isolation of Albania, the infrequency of smoking by women, the lack of domestic pets, and the high incidence of childhood infection and parasitic infestation. The prevalence of allergy and its potential determinants should be monitored in Albania as that country acquires the characteristics of other parts of Europe.
Seminal plasma anaphylaxis: successful pregnancy after intravaginal desensitization and immunodetection of allergens
Authors: Park Jung Won. , Ko Si Hwan. , Kim Cheol Woo. , Hong Chein‐soo. , Bae Sang Wook
Published: March 2003

For seminal plasma‐allergic patients to achieve pregnancy, immunotherapy or artificial insemination is recommended. However, these modalities require complicated procedures. We recently treated a patient with human seminal plasma anaphylaxis who was successfully desensitized after intravaginal rush desensitization and became spontaneously pregnant. She had a healthy full‐term infant. With immunoblotting, we identified multiple allergens in her husband's seminal plasma, with molecular masses such as 100, 75, 65, 50, 40, 38, 33, 20, and 18 kDa, and the pattern of immunoblotting did not change after desensitization. We found not only specific antibodies to the seminal plasma of the patient's partner, but also common antibodies to both the partner's and the control specimen. Our results suggest that intravaginal desensitization might be an effective and convenient initial approach for patients who want to achieve pregnancy, and also confirm the presence of both the specific and shared common allergens in the seminal plasmas of the patient's partner and the control subject.
Adult asthmatics sensitized to cats and dogs: symptoms, severity, and bronchial hyperresponsiveness in patients with furred animals at home and patients without these animals
Authors: Plaschke P , Janson C , Balder B , Löwhagen C , Järvholm B
Published: March 2003

Background: Domestic furred animals are important sources of allergens in asthma, but few clinical studies have investigated the effects of exposure to or elimination of these allergens. The objective of this study was to investigate whether pet‐sensitized asthmatics with pets at home have worsened asthma, compared with similar asthmatics without pets.

Methods: In a cross‐sectional epidemiologic study, 129 adult asthmatics sensitized to cats or dogs were investigated by interviews, skin prick tests, specific IgE, eosinophil counts, and bronchial methacholine challenge tests. Patients with a cat or dog at home (n=39) were compared with subjects without pets (n=90).

Results: More subjects with pets had symptoms, inhaled or oral steroids, abnormal peak‐flow records, higher eosinophil counts, and a higher degree of bronchial hyperresponsiveness than subjects without pets. Asthmatics with pets more frequently ascribed their symptoms to their home environment, but fewer of them reported that their symptoms were elicited by contact with cats or dogs.

Conclusions: This study strongly indicates that living with a cat or a dog aggravates symptoms and biomarkers of airway inflammation in asthmatics sensitized to cats or dogs. The study indicates that avoidance of these allergens may be an important measure in the treatment of sensitized asthmatics.
Eosinophil chemotaxis by chemokines: a study by a simple photometric assay
Authors: Nagase H. , Morita Y. , Yamaguchi M. , Yamada H. , Yamamoto K. , Jibiki S. , Hirai K. , Ohta K. , Kawasaki H. , Yoshie O.
Published: March 2003

Background: The effects of a panel of 15 chemokines on eosinophil chemotaxis were studied by a new photometric assay which is both less tedious and less laborious than the conventional manual counting methods. Approximately 40 chemokines have been identified to date, but there is little information on the eosinophil migration‐inducing ability of chemokines other than CC chemokine receptor (CCR) 3 ligands.

Methods: Eosinophil migration was measured by the Boyden chamber technique with a 96‐well multiwell chamber and polycarbonate membrane filter. Eosinophil migration was assessed by determination of the eosinophil peroxidase (EPO) activity, and photometric measurement was performed with a microtiter plate reader.

Results: The assay was sensitive enough to detect 200 eosinophils, and the time required was within 4 h. CCR3 ligands, i.e., regulated on activation normal T‐cell expressed and secreted (RANTES), eotaxin, eotaxin‐2, and monocyte chemoattractant protein (MCP)‐3, induced significant migration, while other chemokines showed no significant migration‐inducing ability. Although the chemotaxis induction by these chemokines was efficiently inhibited by anti‐CCR3 mAb, anti‐CCR1 mAb failed to show any inhibitory effects.

Conclusions: The photometric assay is suitable for analyzing a large number of samples. CCR3 ligands are the most important chemokines inducing eosinophil chemotaxis; thus, CCR3 represents a possible therapeutic target for the treatment of allergic diseases.
Turbutest™ in the training of asthmatic Turbuhaler™ users
Authors: Branco Ferreira M , Santos A , Clode MH , Palma Carlos AG
Published: March 2003

Background: Correct utilization of inhalation devices is a key factor in asthma management. Objective assessment of the ability to use inhaler devices is therefore fundamental.

Methods: The objective was to assess objectively the inhalation technique of Turbuhaler™ users who reported having no difficulty in using such a device. A total of 600 asthmatic patients of our allergology outpatient department, daily users of Turbuhaler devices, were evaluated with Turbutest™. This is a simple portable apparatus which connects a Turbuhaler inhaler with an electronic device to allow semiquantitative assessment of inhalation technique, with a score ranging from 0 (worst) to 3 (best), readily visualized on the apparatus. Patients were allowed to practice with Turbutest, assisted by an allergologist, until they improved their scores. A second Turbutest assessment was performed at a 2‐month follow‐up visit.

Results: On the first assessment, one‐third of the patients had scores inadequate to allow a good inhalation, and only 20% achieved a score of 3. On the second assessment, significantly higher Turbutest scores were observed.

Conclusions: Turbutest is a valuable tool in asthmatic patients' training, allowing identification and improvement of an inadequate inhalation technique with Turbuhaler.
Measurements of ECP in serum and the impact of plasma coagulation
Authors: Björk A. , Venge P. , Peterson C. G. B.
Published: March 2003

Serum measurement of ECP (eosinophil cationic protein) is used as an indication of eosinophil activation in diseases such as asthma. The levels are dependent on sample handling, since a certain amount of ECP is released during storage. The mechanisms that induce this in vitro release are not known, but are supposed to be related to the coagulation process. The aim of this study was to investigate this further. ECP was measured in EDTA plasma and serum at 22 and 37°C from healthy individuals and patients with asthma and allergy. The serum levels of ECP increased with temperature. Recalcification of citrated plasma in the presence of granulocytes with increasing concentrations of Ca2+ showed a dissociation between the levels of ECP and the occurrence of coagulation. Further experiments indicated that plasma coagulation is not of any importance for the degranulation of eosinophils, nor did the addition of platelets or mononuclear cells affect the ECP levels. Incubations of granulocytes with fresh or frozen plasma and Ca2+suggested the existence of a freezing labile factor in plasma, necessary for the degranulation of healthy eosinophils, but not for allergic/asthmatic eosinophils. Further experiments with pure eosinophils indicated the existence of factors in serum and plasma which facilitate ECP secretion of an active, temperature‐dependent nature. We conclude that the raised ECP levels in serum, as compared to EDTA plasma, are unrelated to the coagulation process, but are due to the continuous secretion ex vivo of ECP from active eosinophils. This process is time and temperature dependent and may be facilitated by eosinophil‐activating components in the extracellular environment.
Quantitative, rather than qualitative, differences in CD69 upregulation in human blood eosinophils upon activation with selected stimuli
Authors: Nopp A. , Lundahl J. , Halldén G.
Published: March 2003

Background: The study aimed to investigate whether CD69 expression on granulocytes is subject to specific regulation by inflammatory mediators, and, if so, to identify these factors in relation to eosinophil activity markers such as the EG2 epitope and ECP release.

Methods: Peripheral blood leukocytes from healthy donors were used. The surface and intracellular distribution of CD69 was investigated with a whole‐blood cell‐membrane permeabilization technique, the FOG method, and flow cytometry. In vitro stimulation was performed with GM‐CSF, IL‐5, IL‐5 plus eotaxin, LPS, and fMLP.

Results: A preformed intracellular pool of CD69 was demonstrated in both eosinophils and neutrophils, but not in monocytes. Almost no resting eosinophils, neutrophils. or monocytes expressed CD69 on the cell surface. However, in vitro stimulation with selected stimuli increased the proportion of CD69‐positive eosinophils to various extents, with GM‐CSF being the most and fMLP the least efficient stimulus. The neutrophils did not respond under these conditions. Increased expression of the EG2 epitope and initiation of degranulation preceded CD69 upregulation.

Conclusions: Eosinophils and neutrophils from healthy donors have a preformed intracellular pool of CD69, which is mobilized on the cell surface on eosinophils, but not on neutrophils, to various extents by selected stimuli. Monocytes, however, do not have a preformed intracellular pool of CD69. Our data indicate that a kinetic order exists among the EG2 expression, the degranulation process, and CD69 upregulation. Due to a quantitative, rather then a qualitative, upregulation of CD69 by stimuli associated with both allergic and bacterial inflammation, CD69 may be a potential activity marker of clinical value.
Effect of current exposure to Der p 1 on asthma symptoms, airway inflammation, and bronchial hyperresponsiveness in mite‐allergic asthmatics
Authors: Alvarez M. J. , Olaguibel J. M. , Acero S. , García B. E. , Tabar A. I. , Urbiola E.
Published: March 2003

The existence of a dose‐response relationship between indoor allergen exposure and sensitization has been widely described, but the effect of allergen exposure on asthma activity (symptoms, bronchial hyperresponsiveness [BHR], and inflammation) is not clear. Our aim was to determine the existence of an association among current exposure to mite allergens and symptoms, BHR, and airway inflammation assessed in blood and sputum from asthmatic patients sensitized to Dermatophagoides pteronyssinus. We selected 31 mild and recently diagnosed (12–24 months) asthma patients sensitized to D. pteronyssinus. Allergenic exposure (Der p 1, Der 2) was assessed by a commercial assay based on monoclonal antibodies (mAb), carried out on the dust samples collected from patients' beds in a standardized way. Patients completed an asthma symptom questionnaire and underwent skin tests, methacholine bronchial challenge, and sputum induction. Sputum cell profile was analyzed and eosinophil cationic protein (ECP), tryptase, albumin, and interleukin(IL)‐5 levels were quantified in sputum supernatant. Total eosinophil numbers and ECP levels were measured in blood samples. Most patients were exposed to Der p 1 levels under 2 μg/g of dust. Der p 1 exposure was higher among the subjects with positive sputum tryptase detection (P=0.020). Der p 1 levels showed a trend toward correlation with asthma symptoms (P=0.066, r=0.36) and correlated with sputum tryptase levels (P=0.032, r=0.42). No relationship between BHR, eosinophilic inflammation, and allergenic exposure was found. Our results suggest that asthma symptoms and lung mast‐cell activation are at least partially dependent on current allergen exposure. The lack of correlation between mite exposure, eosinophilic inflammation, and BHR supports the role of other factors that enhance the immunologic response initiated by allergen, increasing the activity of asthma.
Association of asthma symptoms and severity with indoor bioaerosols
Authors: Ross M. A. , Curtis L. , Scheff P. A. , Hryhorczuk D. O. , Ramakrishnan V. , Wadden R. A. , Persky V. W.
Published: March 2003

Background: In this study, repeated measurements were made of levels of mold spores, bacteria, and dust‐mite allergens over a 7‐month period in the homes of asthmatics, and relationships with measures of asthma severity were evaluated.

Methods: A sample of 57 asthmatic individuals, living in 44 homes in East Moline, Illinois, and nearby communities, participated in a panel study. The homes were visited up to nine times during the study to collect air and dust samples. Asthma severity indicators were derived from questionnaire data and from the daily health records from the panel study. Associations between indoor levels of mold spores, bacteria, and dust‐mite allergens were tested with several asthma severity indicators.

Results: There was evidence of associations between all asthma severity measures and levels of total and Gram‐negative bacteria, but mold‐spore abundance was associated only with emergency room (ER) visits for asthma. No significant associations were found with house‐dust‐mite allergen and any of the asthma severity indicators, but the levels of dust‐mite allergen were low, with median concentrations of 0.18 µg/g dust Der f 1 and 0.19 µg/g dust Der p 1.

Conclusions: Some evidence was found for associations of increased concentrations of Gram‐negative bacteria and mold spores with asthma severity, particularly with ER visits. No association was found between house‐dust‐mite allergen and asthma severity indicators; however, the mite‐allergen levels in the study homes were generally well below the proposed threshold level of 2 µg/g dust.
Effects of human lung fibroblasts on eosinophil degranulation*
Authors: Takafuji S. , Miyakuni Y. , Nakagawa T. , Shoji S. , Murata S. , Yamamoto K. , Ito K.
Published: March 2003

Background: Although eosinophils and fibroblasts are thought to contribute to the mechanisms of chronic asthmatic inflammation, the interaction between eosinophils and fibroblasts has not been thoroughly clarified. We examined eosinophil cationic protein (ECP) release from human eosinophils cultured in the presence of human lung fibroblast HFL‐1.

Methods: Eosinophils from healthy donors were cultured with or without C5a for 16 h in the presence of human fetal lung fibroblasts which had previously been incubated with or without TNF for 4 h. ECP in supernatants was measured by RIA.

Results: ECP release was potentiated only when both eosinophils and fibroblasts were activated by C5a and TNF, respectively, while it was not significantly potentiated when either eosinophils or fibroblasts were activated. Paraformaldehyde fixation of fibroblasts had some suppressive effect on ECP enhancement, and mAb against GM‐CSF partly inhibited ECP enhancement. Coculture of eosinophils and fibroblasts with stimulus treatment resulted in the enhancement of both eosinophil adhesion and ECP release. The potentiation of ECP release was partially inhibited by anti‐ICAM‐1 mAb, anti‐CD18 mAb, and anti‐CD29 mAb, which caused partial and comparable inhibition of the enhancement of eosinophil adhesion.

Conclusions: This study suggests that the activation of fibroblasts may have some role in the potentiation of ECP release from cocultured eosinophils, and that adhesion of eosinophils to fibroblasts may partly be involved in the mechanism of ECP potentiation.
Prevalence and predictors of rhinitis in Danish children and adolescents
Authors: Ulrik C. S. , Linstow M.‐L. von , Backer V.
Published: March 2003

Background: The prevalence of self‐reported symptoms of allergic rhinitis is increasing in many countries, but the reasons for this trend are not well understood. Data from a 6‐year follow‐up study of a population sample of children and adolescents (n=408), aged 7–17 years at enrolment in 1986, were analyzed to investigate the prevalence and predictors of self‐reported rhinitis.

Methods: Case history was used to assess the presence or absence of rhinitis (sneezing and running or blocked nose not associated with a cold), asthma, and eczema. Pulmonary function, skin prick test reactivity, and airway responsiveness to histamine were measured in all participants; a screening test for IgE antibodies to common allergens (Magic Lite SQ, Allergy Screen, ALK, Denmark) was performed in 237 (58%) of the participants.

Results: The point prevalence of rhinitis increased from the first to the second survey, 14% and 22%, respectively; 54 (13%) of the subjects reported rhinitis only at the second survey (new rhinitis). Confining the analysis to participants without symptoms of rhinitis at the first survey showed that self‐reported eczema (relative risk [RR] 2.3, 95% confidence interval [CI] 1.2–4.7), airway hyperresponsiveness (RR 2.5, CI 1.8–3.0), atopy to grass pollen (RR 2.6, CI 1.7–3.3), atopy to dog dander (RR 2.4, CI 1.6–3.3), and atopy to house‐dust mite (RR 2.7, CI 1.4–5.2) at the first survey predicted an increased risk of the presence of rhinitis at the second survey. A positive Allergy Screen test at enrollment was associated with an increased risk of self‐reported rhinitis at follow‐up (RR 2.4, CI 1.4–3.4).

Conclusions: This longitudinal population study of children and adolescents showed an age‐related increase in the point prevalence of self‐reported rhinitis; furthermore, sensitization to common aeroallergens, airway hyperresponsiveness, and the presence of self‐reported eczema were significantly associated with an increased risk of subsequent development of rhinitis.
Detection of allergens in plantain (Plantago lanceolata) pollen
Authors: Asero R. , Mistrello G. , Roncarolo D. , Casarini M.
Published: March 2003

Background: Allergens in Plantago lanceolata have not been characterized yet. The objective was to characterize some plantain‐pollen allergens and to investigate the cross‐reactivity between plantain and grass pollens.

Methods: Sera from four patients monosensitive to plantain pollen and from eight grass‐pollen‐allergic patients showing strong skin reactivity to plantain pollen in the skin prick test (SPT) underwent immunoblot analysis with both Plantago and grass mix extract. Moreover, immunoblot inhibition experiments were done with grass mix extract as inhibitor.

Results: All four sera from plantain‐allergic patients reacted to two distinct bands at 17 and 19 kDa, and 2/4 sera showed further reactivity to a 40‐kDa protein, which in one case represented the most prominent IgE‐binding allergen. Plantain‐monosensitive subjects did not show any reactivity to grass‐pollen extract, and preabsorption of their sera with grass‐pollen extract did not cause any loss of reactivity to plantain pollen. Sera from all eight grass‐pollen‐allergic controls reacted to a 30‐kDa protein in plantain pollen, and some sera showed cross‐reactivity to higher and lower molecular‐weight structures as well. In all cases, plantain reactivity was totally abolished by preabsorption of sera with grass‐pollen extract. A preliminary investigation by immunoblot showed that polyclonal IgG anti‐Phl p 5 (but not polyclonal Phl p 1) from rabbit reacted to a 30‐kDa protein in plantain pollen.

Conclusions: Three specific allergens (of 17, 19, and 40 kDa, respectively) have been detected in plantain pollen. Further studies on a larger number of patients will determine whether these proteins may be considered major allergens. Cross‐reactivity between grass and plantain pollen is mainly caused by a 30‐kDa protein in plantain pollen. Group 5 grass‐pollen allergen is probably responsible for most grass/plantain cross‐reactivity.
Desloratadine reduces nasal congestion in patients with intermittent allergic rhinitis
Authors: Nayak A. S. , Schenkel E.
Published: March 2003

Nasal congestion is among the most bothersome of the symptoms of intermittent allergic rhinitis (IAR). Decongestants such as pseudoephedrine are often accompanied by adverse effects and should be avoided by patients with hypertension, arrhythmia, and other medical conditions. Most of the currently available antihistamines are ineffective for nasal congestion. Oral desloratadine, a new, potent H1‐receptor antagonist, was examined for its ability to relieve nasal congestion/stuffiness in 346 patients (172 in the desloratadine group and 174 in the placebo group) with IAR. Desloratadine, administered once daily at a dose of 5 mg, demonstrated significant improvement in nasal congestion/stuffiness at all time points assessed in the study. This benefit was observed as early as the first patient evaluation on day 2 and continued throughout the 2 weeks of the study. Desloratadine is a new treatment option for patients with IAR and nasal congestion.
Plasmapheresis in the treatment of steroid‐dependent bronchial asthma
Authors: Ellingsen I. , Florvaag E. , Henrik Andreassen A. , Magnus Iversen B. , Irgens Å. , Matre R.
Published: March 2003

Background: Can plasmapheresis improve disease severity and lung function and reduce steroid doses in severe asthma patients dependent on oral corticosteroids?

Methods: A pilot study with four asthma patients was undertaken using PEF (peak expiratory flow) symptom score, number of puffs of β2‐agonist, and dose of systemic steroids as disease variables. After at least an 8‐week run‐in, the patients were randomized to a crossover treatment regimen consisting of either 10 days of plasmapheresis or placebo treatment. Each treatment was succeeded by an 8–26‐week follow‐up period.

Results: No patients achieved a significant effect of plasmapheresis treatment according to the established criteria, nor did anyone experience deterioration.

Conclusions: Removing humoral factors extensively over a 10‐day period did not significantly influence the clinical condition of the four steroid‐dependent asthma patients studied. Circulating humoral factors seem to be of little importance for the maintenance of the established chronic allergic inflammation in these patients. Plasmapheresis does not seem to be a treatment option for this patient category.
Prolonged nasal eosinophilia in all_ergic patients after common cold
Authors: Van Benten I. J. , KleinJan A. , Neijens H. J. , Osterhaus A. D. M. E. , Fokkens W. J.
Published: March 2003

Background: Viral respiratory tract infections may cause both harmless common colds and severe asthma exacerbations; the differences in disease expression probably depend on the all_ergic status of the patient. To determine whether altered immunologic mechanisms underlie these differences, we investigated nasal inflammation during naturall_y acquired common cold.

Methods: In a group of 16 patients (eight all_ergic), nasal brush samples were taken, and nasal symptoms were recorded during common cold, 2 weeks later (convalescence), and at baseline (>4 weeks without nasal symptoms). Nasal brush cells were stained immunohistochemicall_y for Langerhans cells, T cells, monocytes, neutrophils, B cells, macrophages, natural killer (NK) cells, mast cells, eosinophils, eotaxin, and RANTES.

Results: Four rhinovirus, four coronavirus, three RSV, one Mycoplasma pneumoniae, and one influenza A/enterovirus double infection were confirmed. Increased numbers of T cells, monocytes, macrophages, NK cells, eosinophils, and RANTES‐ and eotaxin‐positive cells, but not neutrophils, were observed during common cold in all_ergic and nonall_ergic patients, and increased numbers of mast cells in all_ergic patients. Compared to nonall_ergic patients, in all_ergic patients eosinophil influx persisted into convalescence.

Conclusions: Prolonged nasal eosinophil influx was observed in all_ergic patients after common cold. What immunologic factors can induce prolonged eosinophil influx and whether this may increase the risk of subsequent all_ergen‐induced hypersensitivity reactions must be studied further.
Identification of carmine allergens among three carmine allergy patients
Authors: Chung K. , Baker J. R. , Baldwin J. L. , Chou A.
Published: March 2003

Background: There have been several reports of carmine allergy; however, identification of the responsible carmine allergens has not been widely documented.

Methods: Three female patients presented with a history of anaphylaxis and/or urticaria/angioedema after ingestion of carmine‐containing foods. All three patients had 4+ skin prick tests to carmine. Among them, two patients were confirmed to have carmine allergy by blinded, placebo‐controlled food challenges to carmine. SDS–PAGE of cochineal insects and carmine, immunoblotting for IgE antibody with sera from all three patients, and immunoblotting inhibition with carmine were performed.

Results: SDS–PAGE of minced cochineal insects revealed several protein bands of 23–88 kDa. Several of these bands were variably recognized by our three patients' sera, and this reactivity was inhibited by carmine. Although no protein bands could be visualized on SDS–PAGE of carmine in Coomassie brilliant blue staining, three protein bands were recognized by two of the three patients' serum.

Conclusions: These results suggest that commercial carmine retains proteinaceous material from the source insects. These insect‐derived proteins (possibly complexed with carminic acid) are responsible for IgE‐mediated carmine allergy. Patient reactivity to these proteins may vary.
Adult‐onset asthma is associated with self‐reported mold or environmental tobacco smoke exposures in the home
Authors: Thorn J. , Brisman J. , Torén K.
Published: March 2003

Background: In recent years, we have gained better knowledge about the influence of indoor environments on respiratory symptoms and asthma. The purpose of this study was to examine certain exposures in the home environment and the risk of adult‐onset asthma.

Methods: A nested case‐referent study of adult‐onset asthma was performed in a random population sample (n=15 813), aged 20–50 years. Cases for the study included subjects reporting “physician‐diagnosed” asthma (n=174). The referents (n=870) were randomly selected from the whole population sample. The case‐referent sample was investigated with a comprehensive mailed questionnaire about exposures in the home environment, asthma, respiratory symptoms, smoking habits, and atopy. Odds ratios (OR) with 95% confidence intervals (CI) were calculated while controlling for age, sex, smoking, and atopy.

Results: Increased adjusted OR for asthma were associated with exposure to molds (OR 2.2, 95% CI 1.4–3.5), environmental tobacco smoke (OR 2.4, 95% CI 1.4–4.1), and the presence of a wood stove (OR 1.7, 95% CI 1.2–2.5).

Conclusions: This population‐based case‐referent study indicates that self‐reported domestic exposures to molds or environmental tobacco smoke can be associated with adult‐onset asthma.
Three years of specific immunotherapy with house‐dust‐mite extracts in patients with rhinitis and asthma: significant improvement of allergen‐specific parameters and of nonspecific bronchial hyperreactivity
Authors: Pichler C. E. , Helbling A. , Pichler W. J.
Published: March 2003

Twenty‐seven patients with allergy to house‐dust mite and the clinical symptoms of perennial rhinitis and/or mild asthma were treated with specific immunotherapy (SIT) with standardized extracts of house‐dust mite for 3 years. The success of therapy was evaluated in yearly intervals by

1) subjective rhinitis and asthma scores

2) allergen‐specific skin and conjunctival tests

3) nonspecific bronchial hyperreactivity to methacholine

4) medication scores of rhinitis and asthma.

SIT induced a significant improvement of all parameters already after 1 year, with further improvement in the follow‐up measurements at 2 and 3 years. We found a constant improvement of the rhinitis and asthma symptom scores, a reduced reactivity in the skin prick and conjunctival provocation tests, and a constantly increasing reduction of bronchial hyperreactivity to methacholine. Concomitantly, the use of medication (topical corticosteroids, β2‐mimetics, and antihistamines) was reduced. Our data support the concept that SIT with standardized extracts of house‐dust mite results in an improvement of allergen‐specific parameters in patients with perennial rhinitis and intermittent asthma. This beneficial effect of SIT on allergen‐specific immune parameters seems to induce also a diminution of nonspecific bronchial hyperreactivity and enables reduction of symptomatic treatment.
Effects of xiao‐qing‐long‐tang (XQLT) on bronchoconstriction and airway eosinophil infiltration in ovalbumin‐sensitized guinea pigs: in vivo and in vitro studies
Authors: Kao S‐T. , Lin C‐S. , Hsieh C‐C. , Hsieh W‐T. , Lin J‐G.
Published: March 2003

Background: Xiao‐qing‐long‐tang (XQLT sho‐seiru‐to), a traditional Chinese medicine, has been used to treat patients with bronchial asthma in Oriental countries for several centuries. However, the therapeutic mechanisms of this Chinese medicine remain a matter of considerable debate. Therefore, a series of experiments using ovalbumin‐sensitized guinea pigs was performed to elucidate the possible antiasthmatic effect of XQLT.

Methods: The effect of XQLT on ovalbumin‐induced airway inflammation in a guinea pig model of allergic asthma was examined, and early and late asthmatic responses were measured in terms of airway resistance and extent of eosinophil infiltration. Furthermore, the bronchorelaxing effect of XQLT was measured in isolated guinea pig trachea.

Results: XQLT significantly inhibited the antigen‐induced immediate asthmatic response (IAR) and late asthmatic response (LAR) in actively sensitized guinea pigs. Cumulative administration of XQLT caused concentration‐dependent relaxation of the carbachol‐precontracted guinea pig trachea. The bronchorelaxing effect of XQLT was reversed by ICI‐118551, a selective β2‐adrenoceptor antagonist. Furthermore, examination of bronchoalveolar lavage fluid (BALF) revealed that XQLT significantly suppressed the increase in eosinophils (24 h after antigen challenge) in the airway. In addition, XQLT significantly attenuated the increase in eosinophils at 1, 6, 24, 48, and 72 h after antigen challenge when it was administered once daily from the day of sensitization to the day of challenge. Histopathologic examination results showed that XQLT suppressed eosinophil infiltration into lung tissue.

Conclusions: These results demonstrate that the antiasthmatic effects of XQLT appear to be partly mediated by stimulation of β2‐adrenoceptors, leading to bronchorelaxation, and that XQLT inhibits the infiltration of eosinophils into the airway. Thus, XQLT may be useful for the prevention or treatment of asthma.
Monoclonal antibodies against the major allergen of Plantago lanceolata pollen, Pla l 1: affinity chromatography purification of the allergen and development of an ELISA method for Pla l 1 measurement
Authors: Calabozo B. , Duffort O. , Carpizo J. A. , Barber D. , Polo F.
Published: March 2003

Background: Plantago lanceolata (English plantain) pollen is a relevant cause of pollinosis in temperate regions. The major allergen of this pollen, Pla l 1, is recognized by the specific IgE from more than 80% of plantain‐sensitive patients. It displays significant sequence homology with the major olive‐pollen allergen Ole e 1. The objective was to develop a monoclonal antibody‐based ELISA to quantify Pla l 1, and to assess the correlation of Pla l 1 content with the biologic activity of plantain pollen extracts. We also aimed to establish the specificity of the monoclonal antibodies against the potentially cross‐reactive allergen Ole e 1, and to investigate the presence of Pla l 1‐like proteins in psyllium and melon that have been reported to cross‐react with P. lanceolata pollen.

Methods: After fusion of myeloma cells with spleen cells from a BALB/c mouse, two Pla l 1‐specific monoclonal antibodies secreting hybridomas were selected, and the antibodies characterized. One of them (2A10) was used as the capture antibody in an ELISA for Pla l 1 quantitation. An anti‐P. lanceolata rabbit serum was used as the second antibody. Pla l 1 was purified by immunoaffinity chromatography and used as the standard in the assay.

Results: The ELISA developed was highly reproducible and sensitive, with a detection limit of 0.1 ng/ml, and a practical working range of 0.4–12 ng/ml. The specificity was demonstrated against a large battery of allergens, including Ole e 1. The concentration of Pla l 1 was measured in 19 extracts of P. lanceolata pollen, and a good correlation was observed between the Pla l 1 content and the allergenic activity of the extracts. Pla l 1 was not detected in psyllium or melon extracts.

Conclusions: The results prove the usefulness of the Pla l 1‐ELISA for the standardization of extracts of P. lanceolata pollen intended for clinical use.
Analysis of allergens in rat fur and saliva
Authors: Gordon S. , Tee R. D. , Stuart M. C. , Newman Taylor A. J.
Published: March 2003

Background: The fur is an important source of allergens in many mammal species, but this source has not been extensively studied in rats. Rat room dust contains high‐molecular‐weight allergens that have been found to cross‐react with fur and its presumed salivary contaminants. The role of rat fur and saliva as a source of respiratory allergens merits further investigation. The objective was to describe the allergens present in the fur and saliva of male rats.

Methods: Allergen extracts were prepared from the saliva and fur of the pelts from adult male rats. Immunoblotting was used to describe the allergens present in rat fur and saliva with serum from 76 and 25 individuals, respectively.

Results: There was considerable variation between the individuals in the binding of IgE to the separated fur and saliva allergens. Immunoblot analysis identified 23 allergens in rat fur. “Major” allergens were found at the “origin”, and at 55, 51, 19, and 17 kDa, and “intermediate” allergens at 74, 67 (probably albumin), and 21.5 (diffuse) kDa. Seventeen salivary allergens were described with “major” allergens at 21.5, 19.5, 19, 18, and 17.5 kDa. Many subjects had IgE to the 67 kDa (56%) and 43 kDa (64%) allergens but the density of staining was weak.

Conclusions: Rat fur and saliva are the sources of many allergens. Fur contained five “major” allergens and was a complex source of allergens of relatively high molecular weight (>22 kDa). The most important salivary allergens have molecular weights of less than 22 kDa. Fur is the most probable source of the high‐molecular‐weight allergens found in rat room dust.
Allergy symptoms and IgE immune response to rose: an occupational and an environmental disease
Authors: Demir A. U. , Karakaya Gül , Kalyoncu A. F.
Published: March 2003

Background: Turkey is one of the four major producers of rose. Cultivation of rose is the main economic activity of many villagers in the Lakes region. Rose allergy has not been reported before. We investigated the prevalence of allergy symptoms and specific‐IgE immune response due to rose in villagers who had been cultivating rose in Güneykent village in the Lakes region.

Methods: A screening questionnaire including respiratory and allergic symptoms was administered to 290 villagers. The investigation team visited and studied 75 randomly selected villagers with an interviewer‐administered questionnaire, pulmonary function testing, skin prick testing and serum total IgE. Specific IgE against Rosa rugosa was measured in 41 villagers.

Results: Villagers reported asthma/allergy symptoms outside the rose season (17.6%), during the rose season (6.2%), and both during the rose season and outside the rose season (whole the year) (17.6%). Atopy and specific IgE against Rosa rugosa were detected in 12 (19%), and 8 (19.5%) of the villagers tested. Villagers who had symptoms whole the year reported wheeze more frequently than those who reported symptoms only outside the rose season (41.2% vs 11.1%).

Conclusions: IgE‐mediated allergy could occur due to rose and/or its pollen. Symptoms mainly affect the upper airways. Further studies in the rose handlers, florists and workers of the rose industry would help elucidate the occurrence of rose allergy.
House‐dust mites and mattresses
Authors: Schei M. A. , Hessen J. O. , Lund E.
Published: March 2003

Background: Despite considerable efforts to develop anti dust mite strategies, surprisingly few studies have evaluated the allergen content in different types of mattresses in everyday use. This study investigated the presence of mite feces (an indicator of mite allergens) in foam and spring mattresses.

Methods: The homes of 152 schoolchildren in Northern Norway were investigated. Dust samples were collected in a standardized way from 24 foam mattresses without covers, 68 foam mattresses with covers, and 24 spring mattresses, and the presence of mite feces detected by a guanine colorimetric paper test (Acarex).

Results: We found mite feces in 15 (40.5%) of the dust samples from the foam mattresses without covers and 18 (26.3%) of the foam mattresses with covers. Only three (12.5%) of the spring mattresses contained detectable amounts of feces. Signs of dampness, age of mattress, cleaning of mattress, frequency of vacuuming the bedroom, mechanical ventilation, bedroom temperature and bedroom relative humidity were associated with the presence of mite feces. After adjustment for relevant confounders, the risk of finding mite feces was four times higher in foam compared to spring mattresses (odds ratio 4.0, 95% confidence interval (CI) 1.1–15.1), and eight times higher for the foam mattresses without cover (OR 8.1, 95% CI 1.8–36.9).

Conclusion: A simple replacement of foam mattresses with spring mattresses may reduce the exposure to house‐dust‐mite allergens.
The atopy patch test – reproducibility and comparison of different evaluation methods
Authors: Heinemann C. , Schliemann‐Willers S. , Kelterer D. , Metzner U. , Kluge K. , Wigger‐Alberti W. , Elsner P.
Published: March 2003

Background: There is still a lack of standardization of the atopy patch test (APT) in test procedures and evaluation methods. Our aim was to examine the reproducibility of APT results and to compare visual evaluation to chromametry and laser Doppler imaging.

Methods: Fifty‐two volunteers with atopic eczema/dermatitis syndrome (AEDS) were included. The APT was performed on tape‐stripped and unstripped test fields on their backs using cat dander, house dust mite and grass pollen allergens from two different suppliers. Responders were re‐tested 4–12 weeks later with the same allergens on their forearms.

Results: Using Allergopharma allergens, 14 (26.9%) volunteers showed one or more positive reactions. The reproducibility rate was 56.3%. The Erlangen atopy score in APT‐positive and negative volunteers was 19 ± 6 vs 15 ± 6. The test agreement in volunteers tested with both allergens, from Allergopharma and Stallerge`nes, was poor. Correlation of the results between the three evaluation methods was significant (P ≤ 0.001).

Conclusions: The low reproducibility rate of APT results and the poor inter‐test‐agreement using allergens from different suppliers show that much work remains to make the APT a reliable tool in identifying relevant aeroallergens that lead to flare ups of AEDS. Compared to chromametry and laser Doppler imaging, visual scoring was superior in differentiation between irritative and allergic reactions.
Inhibition of mediator and cytokine release from dispersed nasal polyp cells by mizolastine
Authors: Carayol N. , Crampette L. , Mainprice B. , Ben‐Soussen Paul , Verrecchia M. , Bousquet J. , Lebel B.
Published: March 2003

Background Mizolastine is a potent and selective H1‐receptor antagonist with antiallergic properties; in in‐vitro animal models, mizolastine was shown to inhibit 5‐lipoxygenase activity and to decrease the release of leukotrienes (LT) and tumor necrosis factor‐α (TNF‐α). This study investigated the effects of three concentrations of mizolastine (0.1, 1.0, 10 µM) on the release of LT (LTB4 and LTC4/D4) and prostaglandin D2 (PGD2) after stimulation by anti‐IgE, and on the spontaneous release of cytokines (TNF‐α and granulocyte/macrophage‐colony‐stimulating factor [GM‐CSF]), from dispersed cells obtained from surgically resected nasal polyps of patients with nasal polyposis.

Methods Cells from nasal polyps were obtained using enzymatic dispersion. For experiments involving the measurement of LT and PGD2, the cells were preincubated with mizolastine or its dissolution vehicle for 20 min prior to challenge with 10 µg/ml ε‐chain specific anti‐IgE for 45 min at 37°C; for the cytokine release, cells were incubated with mizolastine or its dissolution vehicle for 24 h. LT and PGD2 were measured by enzyme immunoassay (EIA) and cytokines by enzyme‐linked immunosorbent assay (ELISA) using commercially available kits.

Results Mizolastine inhibited significantly and in a dose‐dependent manner the release of LTB4 and TNF‐α at all concentrations, LTC4/D4 at 10 µM, and GM‐CSF from 1 µM; no effect was observed on the release of PGD2.

Conclusion Mizolastine inhibits the release of LT, TNF‐α and GM‐CSF in this in vitro model, which mimics closely the inflammatory cells of allergic rhinitis.
Phthalic anhydride allergy: development and characterization of optimized hapten–carrier conjugates for improved diagnosis
Authors: Pakarinen M. , Koivuluhta M. , Kalkkinen N. , Keskinen H. , Nordman H. , Estlander T. , Tupasela O. , Jolanki R. , Lauerma A. I. , Pfäffli P. , Alenius H.
Published: March 2003

Background: At present the diagnosis of IgE‐mediated hypersensitivity to phthalic anhydride (PA) is based on conjugates that are not characterized or standardized. The aim of this study was to develop optimized and molecularly characterized PA conjugates that can be used to improve the diagnosis of PA‐allergy.

Methods: The PA conjugates were synthesized and the number of haptens bound on a carrier protein was estimated by matrix‐assisted laser desorption/ionization time of light (MALDI‐TOF) mass spectrometry. The ability of conjugates to bind IgE and IgG antibodies was measured by enzyme‐linked immunosorbent assay (ELISA). Reactivity of the conjugates in vivo was evaluated by skin prick testing.

Results: The most active IgE‐binding conjugates had a PA : HSA molar ratio of 80 : 1. In the optimal conjugates the average numbers of PA haptens per carrier molecule of human serum albumin (HSA) were 14–16. In ELISA, all 13 patients and none of the 20 controls had IgE antibodies to optimized PA conjugate. The sensitivity and specificity of the ELISA was comparable to commercial CAP RAST. PA conjugates elicited positive test results in skin prick testing showing that conjugates are immunologically active also in vivo.

Conclusions: These results indicate that optimized and molecularly characterized PA–HSA conjugates can be used both in vitro and in vivo assays to improve the diagnosis of PA allergy.
Nasal mucosal histamine reactivity among young students and teachers, having no or prolonged exposure to a deteriorated indoor climate
Authors: Rudblad S. , Andersson K. , Bodin L. , Stridh G. , Juto J. E.
Published: March 2003

Background: In a study performed in the spring of 1995, we found a significantly greater nasal mucosal histamine reactivity among teachers, who had worked for several years in a recently renovated moisture‐damaged school, than in those in a control school. In the present study we investigated the students who begun their high‐school studies at both schools in the autumn of 1995 and compared them with the teachers as regards mucosal reactivity, atopy and symptoms.

Methods: Twenty‐eight teachers in the target school, 18 teachers in the control school and 45 students from each school underwent a nasal histamine provocation test and a skin‐prick test. They also answered a standardized questionnaire.

Results: The teachers in both schools had more marked nasal mucosal histamine reactivity at the lowest provocation concentrations than the students. The histamine provocation curve of the target school teachers had consistently higher values than that of the students (P = 0.0001), but its slope and shape were similar (P = 0.15), while the slope of the provocation curve of the control school teachers was flatter. However, there was only a borderline significance in this respect compared to the students (P = 0.07). Teachers with a dry and crusty appearance of the nasal mucosa on anterior rhinoscopy reacted more strongly to histamine provocation than those without this finding (P = 0.0004). There was a significantly higher frequency of skin‐prick test positivity (SPT+) among the students (P = 0.03). There were no significant differences in nasal mucosal histamine reactivity between atopic and non‐atopic subjects out of pollen season.

Conclusions: Teachers had a significantly greater mucosal histamine reactivity than the students, whereas the latter had a significantly higher frequency of atopy. These results are compatible with an age‐related pattern of mucosal reactivity. A crusty appearance of the nasal mucosa seems to predispose to an increase in histamine reactivity. There were no significant differences according to histamine reactivity between atopic and non‐atopic subjects.