bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical symptoms and results of skin test, RAST and bronchial provocation test in thirty‐three papain workers: Evidence for strong immunogenic potency and clinically relevant ‘proteolytic effects of airborne papain’
Authors: BAUR X. , KÖNIG G. , BENCZE K. , FRUHMANN G.
Published: April 2006

Seventeen out of thirty‐three workers who have been exposed to airborne papain at their place of work regularly developed asthmatic symptoms such as shortness of breath, wheezing, coughing, sneezing, rhinorrhea and conjuctival irritation upon contact with this proteolytic enzyme. Investigations by RAST, skin test and bronchial provocation test proved IgE‐mediated hypersensitivity to papain in fourteen symptomatic workers. Ten of these were in a screening investigation involving twenty‐nine of the thirty‐three workers; i.e. the incidence of IgE‐mediated sensitization was 34.5%, of this group. Bronchial provocation of as little as 0.001–0.5 mg of papain was shown to elicit immediate or dual asthmatic reactions in all eight tested workers with RAST values > 3 u/ml. On the other hand, inhalation of 0.5 mg of papain did not cause any remarkable change in non‐exposed asthmatics. Occupation‐related blood‐stained nasal secretions and/or cutaneous flare reactions in all four heavily‐exposed papain workers, of whom three had negative skin test and RAST results, suggest a direct effect of the proteolytically active enzyme on human tissue.

There was a significant elevation (P < 0.001) of serum trypsin inhibitory capacity in papain workers which seems to depend on the degree of exposure. No significant differences between symptomatic and asymptomatic workers in α1‐antitrypsin (Pi) phenotype subtypes were found.
Immunoglobulin E antibodies to ingested cereal flour components: studies with sera from subjects with asthma and eczema
Authors: SUTTON R. , HILL D. J. , BALDO B. A. , WRIGLEY C. W.
Published: April 2006

The specificity of immunoglobulin E for different cereal grain proteins was investigated using sera from twenty paedialric patients with asthma and/or eczema. Close correlations were observed between radioallergosorbent test values for grain extracts of wheat, rye and barley, and, to a lesser extent, oats. Of the different wheat flour fractions tested, the globulins and glutenins consistently bound higher levels of IgE than the gliadins and albumins. This is in contrast both with bakers' asthma (an allergy to inhaled flour where the albumins are important allergens) and with coeliac disease (in which gliadin is the most toxic fraction). Partial digestion of the flour proteins largely removed their ability to bind IgE, An analytical technique of identifying allergens after gel isoelectric focusing demonstrated that many different flour proteins were involved.
Diagnosis of penicillin allergy
Authors: LEVACHER M. , ROUVEIX B. , BADENOCH‐JONES P.
Published: April 2006

A study was made to establish the value of the leucocyte aggregation test (LAT) in drug allergy using penicillin antigen. The antigen‐induced human peripheral blood leucocyte aggregation was measured quantitatively. The results obtained have been compared with the leucocyte migration inhibition test (LMIT) in patients with or without delayed penicillin allergy. Among forty‐four penicillin‐allergic subjects and thirty‐six control subjects, LAT was found positive in respectively 70.5 and 30.5% (P < 0.001) whereas LMIT was found positive in respectively 56.8 and 50% of the patients. These results were confirmed by multiple correspondence analysis (MCA), using a computer. Furthermore, this method, enables a more comprehensive and reliable interpretation of the tests, by the help of various quantitative and qualitative criteria.

It is concluded that LAT shows more discrimination than the LMIT in distinguishing a penicillin‐allergic population from a non‐allergic one. In addition, LAT offers great technical advantages over the LMIT for the diagnosis of drug allergy.
A comparison of the Phadebas® and Phadezym® IgE paper immunosorbent test kits
Authors: ORMONROYD P. , ROBERTSHAW D.
Published: April 2006

The Phadebas (isotype label) and Phadezym (enzyme label) paper immunosorbent test kits have been compared. Precision and ease of operation are shown to be comparable for both kits, and the advantages and disadvantages of each are similar. The enzymatic labelled kit seems to provide a suitable alternative for laboratories wishing to measure IgE but who do not have isotope‐counting facilities available.
An in vitro study of lymphocytes in patients with atopic dermatitis
Authors: VALVERDE E. , VICH J. M. , HUGUET J. , GARCÍA‐CALDERÓN J. V. , GARCÍA‐CALDERÓN P. A.
Published: April 2006

The authors studied the T‐ and B‐lymphocyte sub‐populations, the stimulation of the lymphocytes with phytohaemagglutinin and pokeweed mitogen, the non‐specific T suppressor activity and the amounts of serum IgE in a group of thirty‐four patients with atopic dermatitis. Comparison with a group of 100 healthy controls revealed a diminution in the T sub‐population, an increase in the B sub‐population, no change in the response index to stimulation with phytohaemagglutinin or pokeweed mitogen, a diminished T‐suppressor activity and an increase in the level of serum IgE.
The effect of inhaled verapamil on allergen‐induced bronchoconstriction
Authors: PATEL K. R. , AL SHAMA M. R. , KERR J. W.
Published: April 2006

In eight patients with extrinsic bronchial asthma the effect of inhaled verapamil (3 and 6 mg) was compared with saline on bronchial challenge with extracts of Dermatophagoides pteronyssinus. There was no significant difference in the baseline FEV1 before and after inhalation of saline or verapamil 2.5 mg/ml. However, verapamil at a higher concentration (5 mg/ml) caused bronchoconstriction in four patients who had to be excluded from the part of the study. Verapamil at both these concentrations failed to have an effect on the allergen‐induced bronchoconstriction. These findings suggest that verapamil given by inhalation does not prevent mediator release from the lung mast cells following specific allergen challenge.
Astemizole: a new long‐acting antihistamine in the treatment of seasonal allergic rhinitis
Authors: WILSON J. D. , HILLAS J. L.
Published: April 2006

Astemizole, a new long‐acting antihistamine, (H1 receptor antagonist), 10 mg taken once daily was found to be an effective prophylactic treatment for the symptoms of allergic rhinitis in 75% (twelve from sixteen) of subjects in a double‐blind placebo‐controlled study. The success rate with placebo was < 20% (three from sixteen). There were two treatment failures in highly atopic individuals taking the active drug. The classic side effects of antihistamines, most notably sedation, were minimal and reflected in the control group. Two subjects reported weight gain: one of these noted an increase in appetite during the 6‐week trial period. Six of seven subjects who continued to take the drug for a longer period (up to 16 weeks) experienced marked weight gain: five of them reported an increase in appetile. Reactions to allergen skin tests were significantly reduced in patients taking astemizole.
A double‐blind comparison of ketotifen and disodium cromoglycate in atopic adult asthmatics
Authors: SEARS M. R.
Published: April 2006

The therapeutic effects of inhaled disodium cromoglycate (DSCG) and orally administered ketotifen were compared in thirty atopic asthmatics aged 15‐34 years during a 22‐week double‐blind parallel group study. Ketotifen is a cycloheptathio‐phene with experimental antihistaminic, anti‐allergic and anti‐anaphylactic effects equal or superior to those of DSCG. During the first 6 weeks of treatment, mean airflow meter readings increased and bronchodilator use diminished in those receiving DSCG, but no improvement was seen in those given ketotifen. In the next 10 weeks. concomitant therapy was reduced in both groups, but this reduction was greater in the group receiving DSCG. No serious adverse effects occurred. Asthma worsened after abrupt discontinuation of DSCG but not ketotifen. Although a small number of patients may have benefited from ketotifen. its effect on asthma was not comparable with that of inhaled disodium cromoglycate.
Long‐term falls in antibodies to dust mite and pollen allergens in patients with asthma or hay fever
Authors: RAWLE F. C. , BURR M. L. , PLATTS‐MILLS T. A. E.
Published: April 2006

‘Spontaneous’ improvement in, or alteration of, allergic symptoms is a common occurrence, and the immunological basis is of interest in attempts to develop effective specific therapy. In the present study we measured levels of serum antibodies to Dermatophagoides pteronyssinus in patients diagnosed as having house‐dust‐allergic asthma up to 40 years previously. The results show a progressive fall in both IgG and IgE antibodies to antigen P1 and RAST binding lo crude D. pteronyssinus extract. By contrast changes in total serum IgE were not marked. Within each of the groups of patients diagnosed 20. 30 and 40 years previously, 70% no longer suffered severe symptoms. However, the absence of detectable IgE antibody in serum was neither a necessary nor a sufficient condition for loss of symptoms. A group of patients who had spontaneously recovered from hay fever had significantly lower IgG and IgE antibody for the major grass pollen allergen Rye I and also lower total IgE than current hay fever sufferers. In neither hay fever nor asthma was there evidence to link spontaneous improvement in symptoms with an increase in IgG antibodies.
Studies of the allergens of Olea europea pollen
Authors: BLANCA M. , BOULTON P. , BROSTOFF J. , GONZALEZ‐REGUERA I.
Published: April 2006

Allergens of Olea eurupea have been prepared by isoelectrofocusing and tested by RAST, RAST inhibition and skin tests. The major allergen was found to be an acidic protein of pI 6, consisting of two polypeptide chains of molecular weight 15000 and 17000 daltons, possibly non‐covalently associated into a dimer. Most other allergens were acidic proteins, but basic proteins were also observed with allergenic activity. The RAST inhibition studies show a considerable degree of allergic cross‐reactivity between the isoelectrofocusing fractions.
Experience with an elimination diet in children with atopic dermatitis
Authors: VAN ASPEREN P. P. , LEWIS M. , ROGERS M. , KEMP A. S. , THOMPSON S.
Published: April 2006

In order to define possible food‐provoking factors, we placed twenty‐nine children with chronic atopic dermatitis on an elimination diet. The children remained on their normal diet for 2 weeks followed by 2 weeks on the elimination diet. Foods were then re‐introduced at the rate of a new one every 2 days in an attempt to identify foods exacerbating eczema. Thirteen children (45%) completed the elimination diet and seven of these were improved on parental assessment of sleeplessness, itchiness and area of eczema. Five were improved on the dermatologist's assessment. Only two children were able to identify foods provoking their eczema. Sixteen children (55%) failed to complete the elimination diet. Eight felt it was too strict, while eight did not return for follow‐up. From our experience, dietary manipulation in older children with chronic atopic dermatitis offers only limited long‐term therapeutic gains.
Intrinsic and extrinsic asthma, a shared lymphocyte abnormality
Authors: SWINBURN C. R. , HUDSPITH B. N. , BROSTOFF J. , JOHNSON N. McI.
Published: April 2006

We have examined in vitro cell‐mediated lymphocyte responses to Concanavalin A, (Con. A), and the effects of histamine and indomethacin upon these responses, in normal subjects, and patients with extrinsic and intrinsic asthma, and chronic bronchitis. Lymphocytes from both intrinsic and extrinsic asthmatics are particularly sensitive to histamine‐induced suppression of their response to Con. A, and this increased sensitivity was reversed by indomethacin. In these respects, lymphocytes from intrinsic and extrinsic asthmatics behave in an identical fashion, but differ significantly from lymphocytes from both normal subjects and patients with fixed airways obstruction (chronic bronchitis). It is suggested that there is a common immunological mechanism in extrinsic asthma and intrinsic asthma.
Asthma and cessation of smoking
Authors: HILLERDAHL G. , RYLANDER R.
Published: April 2006

One hundred and twenty‐five patients with asthma were questioned on the character of their symptoms in connection with cessation of tobacco smoking. Eighteen out of fifty‐nine patients who stopped smoking, reported worsening of their symptoms. The pathogenesis behind this effect may be the effect of tobacco smoke on the immune system particularly macrophages and T cells.
Platelet‐activating factor: a possible mediator of the dual response to allergen?
Authors: BASRAN G. S. , PAGE C. P. , PAUL W. , MORLEY J
Published: April 2006

Certain allergic asthmatic patients exhibit a dual response in the lung following bronchial challenge with the appropriate allergen, Often this is paralleled by a cutaneous dual response when the antigen is injected intradermally. The mechanisms underlying such phenomena are not established, but some evidence suggests that the late response is a consequence of the early response. Since platelet activation has been observed following antigen challenge in asthmatic subjects, we have studied the ability of platelet activating factor (PAF‐acether. AGEPC) to induce cutaneous inflammatory responses in man. In a time course study over 24 hr, PAF‐acether produced a biphasic response: an immediate weal and flare reaction, which resolved within 1‐2 hr and was followed some 3‐6 hr later by a delayed reaction in which erythema associated with hyperaigesia was evident. These observations suggest that PAF‐acether should be considered in the context of allergic asthma as a possible mediator of the dual response to allergen.
A controlled trial of hyposensitization with adsorbed tyrosine Dermatophagoides pteronyssinus antigen in childhood asthma: in vivo aspects
Authors: PRICE J. F. , WARNER J. O. , HEY E. N. , TURNER M. W. , SOOTHILL J. F.
Published: April 2006

Continuing study for a second year and further analysis of a double‐blind placebo controlled trial, already briefly reported, of injections of tyrosine‐adsorbed, glutaraldehyde‐modified Dermatophagoides pteronyssinus antigen in fifty‐one children with perennial asthma and positive bronchial challenge to the antigen, confirms that the patients receiving the treatment reduced their symptomatic medication more than controls, without deterioration of symptoms. Some became symptom‐free, when off all treatment.

A double‐blind placebo controlled trial of continuing treatment for a second year gave evidence of deterioration when the treatment was stopped.

Within the treatment group, the improvement was associated with loss of late (6 hr) reaction to bronchial provocation with the antigen, but was not associated with change of immediate (20 min) reaction in lungs or skin. Those who improved in the placebo group did not lose their late reaction.

There was a trend for similar benefit from active treatment in the control group, during the second year, though less than in the original active group, and only one lost his late reaction.

Only one of the six children with very severe early onset asthma improved.

Local reactions to either active or placebo (tyrosine) were seen in half the patients; these were mild and did not influence the treatment. Systemic symptoms occurred shortly after four active injections and after two placebo injections; only one patient stopped the treatment.
Epithelial damage in nasal polyps
Authors: WLADISLAVOSKY‐WASERMAN P. , KERN E. B. , HOLLEY K. E. , EISENBREY A. B. , GLEICH G. J.
Published: April 2006

Bronchial epithelial damage occurs regularly in bronchial asthma, but it is not known whether such damage occurs in the mucosa of nasal polyps. We obtained nasal polyp tissues from thirty patients and we examined these tissues for evidence of epithelial damage. Immediately after resection, polyp tissue was fixed in Karnovsky's fixative, embedded in methacrylate and stained with Giemsa pH 6‐5. Normal nasal tissue from eight patients undergoing nasal septal reconstruction was similarly processed. As a disease control, we examined tissue from eight patients with nasal polyps associated with cystic fibrosis. Tissues were viewed by microscopy and epithelial damage was expressed as the percent of surface involved. Twenty‐eight of the thirty patients with idiopathic nasal polps (93%) showed complete loss of nasal mucosa in varying degrees (range 3‐81% of surface; mean, 29%). All patients showed evidence of some epithelial damage, either complete loss or marked desquamation (range 9‐99% of surface; mean 54%). In contrast, six of eight biopsies from patients undergoing septal reconstruction and five of eight nasal polyps from patients with cystic fibrosis showed little or no evidence of epithelial damage. The results indicate that nasal polyps regularly show evidence of epithelial damage similar to that seen in bronchial asthma, and this abnormality may partly explain the rhinorrhea which is prominently associated with nasal polyps.
Breast milk cell supernatants from atopic donors stimulate cord blood IgE secretion in vitro
Authors: ALLARDYCE R. A. , WILSON ANDREA
Published: April 2006

Breast milk cell culture supernatants from atopic mothers (nineteen) were compared by ELISA with normal breast‐feeding controls (twenty‐one) for regulation of cord blood lymphocyte IgA and IgE secretion in vitro. A minority of atopic (five out of nineteen) and normal (three out of twenty‐one) cell supernatants stimulated cord blood lymphocyte IgA release to the same extent. The others were inactive. Stimulation was not related to breast milk cells donor atopic history or cord blood lymphocyte atopic heredity.

In contrast, 70% of atopic milk cell supernatants stimulated cord blood lymphocyte cultures to form IgE (x± s.d. = 2070 ± 2240 pg/culture) while stimulatory supernatants (24%) from normal donors resulted in less lymphocyte IgE release (x ± s.d. = 680 ± 490 pg/culture) (P< 0.001). These differences did not correlate with breast milk cell supernatant IgE concentrations, cord blood donor serum IgE levels or atopic heredity.
Rapid enzyme‐linked immunosorbent assay (ELISA) for the detection of IgG antibodies against
Authors: KHAN Z. V. , RICHARDSON M. D. , WARNOCK D. W.
Published: April 2006

A rapid ELISA was developed for the detection of specific IgG against Micropolyspora faeni and Thermoactinomyces vulgaris and compared with counterimmunoelectrophoresis (CIE) in twenty‐seven patients with suspected farmer's lung disease (FLD). Seventeen patients had precipitins to M. faeni or T. vulgaris or both, and ten had no precipitins. The optimum conditions for each step in the ELISA were determined: pre‐equilibration of reagents at 370C and vigorous agitation during incubation enabled the total test time required for the procedure to he reduced to 4 hr. A serum dilution of 10‐fold produced good differentiation between CIE‐positive and ‐negative sera. Little correlation was seen between CIE and ELISA for either M. faeni or T. vulgaris antigens in tests with sera from patients with precipitins: high readings were often recorded in ELISA where no precipitins had been detected with the same antigen. Positive‐ negative discrimination of unknown sera in ELISA was achieved through the inclusion of CIE‐positive and ‐negative reference sera in each test run. Thirteen CIE‐positive sera were classed as positive in ELISA with the M. faeni antigen while eight of thirteen CIE‐positive sera were positive in ELISA with the T. vulgaris antigen. For both antigens, four CIE‐negative sera were recorded as positive in ELISA.
Immediate hypersensitivity, IgE and asthma
Authors: CARSWELL F. , HUGHES A. O. , MERRETT T. G. , MERRETT J. , HARLAND P. S. E. G. , MEAKINS R. H.
Published: April 2006

Twenty‐one asthmatic and twenty‐two non‐asthmatic children and nine asthmatic adults from two different rural areas of Tanzania, and eight asthmatic children from Dar‐es‐Salaam were surveyed by questionnaires, skin testing and the measurement of serum IgE. Asthma was significantly commoner in female rural children (four males, fifteen females). The rural asthmatic children apparently had less skin reactivity (in seven of nine tests) and lower specific (in two of four tests) and total serum IgE than age‐, sex‐ and village‐matched controls. This pattern of asthma in rural children in the tropics represents a different type of asthma from that found in temperate zones. In contrast, the adult rural asthmatics and the urban children seemed to have the pattern of increased skin reactivity and serum IgE found in asthmatic patients from temperate climates.
Antibodies to hen and duck antigens in poultry workers
Authors: ANDERSEN P. , SCHØNHEYDER H.
Published: April 2006

Serum antibodies to avian and Aspergillus antigens were detected by enzyme‐linked immunosorbent assays (ELISA) in forty‐two workers from a poultry abattoir and in twenty healthy blood donors. The levels of IgG and IgA antibodies to hen and duck serum were significantly higher in poultry workers than in blood donors (P<0.01). In workers employed for less than 1 year the antibody levels were lower than in those who had been employed for a longer period of time (P<0.05). The IgA antibody level to a high molecular weight Aspergillus antigen was higher in poultry workers than blood donors (P<0‐05), whereas the level of other Aspergillus antibodies were similar in the two groups. The level of IgG antibodies to hen antigen was higher in non‐smokers than in smokers (P<0‐02). A correlation between the antibody levels to hen and duck antigens and to pigeon antigen was found (P<0.05). indicating cross‐reactivity between these antibodies. No cases of allergic alveolitis were found, and no correlation between antibody levels and respiratory symptoms could be demonstrated.
Abdominal migraine and food sensitivity in children
Authors: BENTLEY D. , KATCHBURIAN ADRIANA , BROSTOFF J.
Published: April 2006

As part of a larger investigation into the subject of chronic abdominal pain in children we have conducted a preliminary survey on twelve children with ages ranging between 5 and 15 years. They all presented with a history of recurrent abdominal pain for a minimum of 3 months (Apley, 1975), but some had been symptomatic for more than 8 years. All had experienced nausea and/or vomiting combined with a family history of classical migraine. In addition, pallor (Liebman, 1978) was a feature in eleven of the patients during a migrainous attack. On this basis, a clinical diagnosis of abdominal migrain was established (see Table 1).
A controlled trial of oral hyposensitization in pollen asthma and rhinitis in children
Authors: COOPER P. J. , DARBYSHIRE JANET , NUNN A. J. , WARNER J. O.
Published: April 2006

This study describes the effect of an orally administered grass‐pollen vaccine, taken pre‐seasonally, on the clinical symptoms of fifty‐four children with hay fever, asthma or both, during the 1982 grass‐pollen season.

Oral mixed grass‐pollen vaccine and a matched placebo were randomly allocated to form two matched groups. Although small differences were observed in favour of the active group for both hay fever and asthma, no significant advantage was demonstrated over placebo in terms of symptom scores or additional medication required.
Clinical symptoms and IgE responses to common food proteins in atopic and healthy children
Authors: HATTEVIG G. , KJELLMAN B. , JOHANSSON S. G. O. , BJÖRKSTÉN B.
Published: April 2006

The appearance of symptoms suggestive of allergy through the first 4 years of life was studied prospectively in eighty‐six healthy newborn babies. Blood samples were obtained at birth, at 3,8,25 and 48 months of age and analyzed for levels of total serum IgE and for IgE antibodies to some common foods. The occurrence of IgE antibodies was related to atopic manifestations and to a detailed history of infant feeding and family history of allergy. All infants with elevated cord blood IgE (more than 1.3 kU/1) developed manifestations of atopy. Specific IgE antibodies against egg, cow's milk and soy were demonstrated at 3, 8, 25 and 48 months in nine, twenty‐three, six and two children respectively. Egg was a more potent sensitizing agent than cow's milk, IgE antibodies to egg being present in thirty‐one samples, to cow's milk in eleven and to soy in five samples. Nine infants developed IgE antibodies to eggs or cow's milk before the introduction of these nutrients into the food. The IgE antibody levels were generally low in healthy non‐atopic children and did, with one exception, not reach RAST class 1. In contrast, the levels of IgE antibodies to egg or cow's milk were higher in eleven blood samples from atopic children. We conclude that transient low IgE antibody responses to food proteins appear relatively often even in healthy infants. High concentrations of IgE antibodies however are almost exclusively seen in infants with atopic disease. Sensitization may appear early in infancy sometimes even before the offending food has been introduced into the diet.
Comparison of the stability of a mite and a pollen extract stored in normal conditions of use
Authors: BOUSQUET JEAN , DJOUKADAR FATMÉ , HEWITT BRIAN , GUERIN BERNARD , MICHEL FRANÇOIS‐BERNARD
Published: April 2006

Pollen extracts are stable in solutions containing 50% glycerol. The stability of Dermatophagoides pteronyssinus (Dp) extracts have not been determined. Two lyophilised extracts (Dp and cocksfoot pollen) were reconstituted in 50% glycerol and stored for up to 6 months at +4°C. Every day the extracts were placed at room temperature for 1 hr to mimic the natural use of allergen extracts by allergists. Every 2 months the extracts initially prepared were compared to freshly reconstituted extracts by means of prick skin tests in fifteen allergic patients. It was observed that cocksfoot pollen extract is stable but there appears a slight but significant (P > 0.05) decay in activity when the extract stored for up to 6 months was compared with a freshly prepared extract. On the other hand there is a significant (P > 0.01) decay in activity of the Dp extract after 2 months of storage. Dermatophagoides pteronyssinus and cocksfoot pollen extracts behave differently when stored. These findings have particular importance in the diagnosis and treatment of allergic disorders.
Detection of antigen‐specific IgE‐plaque‐forming cells from peripheral‐blood lymphocytes of ragweed‐ and grass‐allergic patients
Authors: PERELMUTTER L. , POTVIN L. , HÉBERT J.
Published: April 2006

The reverse haemolytic plaque assay was developed to measure antigen (AgE or rye grass I)‐specific IgE‐plaque‐forming cells from the peripheral‐blood lymphocytes of ragweed‐ and grass‐allergic patients. The anti‐IgE‐developing antisera was shown to be isotype‐specific, and the response of the assay was inhibited by 52% by the addition of 10 pg of antigen. In addition, the assay was shown to have a reproducibility (s.d.) of 15%. The blood lymphocytes from all fifteen atopic (grass and ragweed) patients were shown to form antigen‐specific IgE‐plaque‐forming cells during the pollen season (mean value 115 cells) and up to 6 months after the season (mean value 56 cells). Cycloheximide appears to block the formation of the plaque‐forming cells. This method appears to be sensitive and reproducible enough to study in vitro IgE antibody synthesis of peripheral‐blood lymphocytes from atopies.
In vitro IgE‐secreting cells in man I. Mitogen‐independent and ‐dependent subpopulations
Authors: MATSUMOTO T. , YAMAGUCHI K. , SHIMAMURA M. , HARADA Y.
Published: April 2006

In vitro IgE secretion by atopic and normal peripheral‐blood lymphocytes was examined in culture with pokeweed mitogen or Staphylococcus aureus strain Cowan‐I (StaCw) or without mitogen. IgE secreted in culture supernatants was measured with double antibody radioimmunoassay. Enumeration of IgE‐secreting cells was made by a protein‐A plaque assay. IgE was detected in increasing quantities in supernatants of cultured lymphocytes without mitogen up to the 12th day. IgE‐plaque‐forming cells were formed by the lymphocytes in large numbers on days 4–7 in cultures with mitogen. These results suggest that not only mitogen‐independent but also mitogen‐dependent subpopulations may exist in the IgE‐secreting cells.
Treatment of nocturnal asthma in children with a single dose of sustained‐release theophylline taken after supper
Authors: PEDERSEN S.
Published: April 2006

In a placebo‐controlled, double‐blind cross‐over study of 2 × 3 weeks’duration, twenty‐four children with stable asthma who were wheezing during the night, were treated with a single dose of sustained‐release theophylline (SRT) taken after supper

The mean serum theophylline levels 4 and 12 hr after dosing were 7.7 and 11.2mg/l, respectively. Few side‐effects were seen. The mean morning peak expiratory flow (PEF) was significantly higher during SRT treatment (244 ± 11 l/min) than during placebo treatment (207 ± 12 l/min) (P> 0.001). The mean difference between morning and evening PEF was reduced from 20.7 to 8.6% by treatment with SRT (P>0.001). Theophylline significantly reduced the severity of attacks of bronchoconstriction during the night as judged by PEF measurement and use of extra bronchodilator treatment per attack. The response to inhaled terbutaline was increased during SRT treatment compared with that in the placebo period, however pre‐treatment PEF did differ significantly between the two periods. The number of acute asthma attacks during the night, the number of symptom‐free nights and the use of extra bronchodilators during the night were all significantly improved by SRT treatment (P> 0.001). Seventeen children correctly identified the SRT period whilst six children showed no preference for either period. A single dose of SRT taken after supper is an effective treatment for nocturnal asthma in children.
Atopic asthma: T lymphocyte subpopulations
Authors: SCHUYLER MARK , GERBLICH ADI , URDA GREGORY
Published: April 2006

Atopy is associated with diminished cell‐mediated immunity and increased amounts of IgE, both of which may be caused by imbalances of T lymphocyte subsets.

We compared the composition of highly purified peripheral‐blood T cells of fifteen atopic asthmatics with ten non‐atopic control subjects. Each subject was examined on five separate occasions. Indirect immunofluorescence using monoclonal antibodies was used to define T cell subsets. We examined the proportion of T cells with T3 (most T cells), T4 (helper/inducer), T8 (suppressor/cytotoxic), M1 (natural killer), and Ia (activated T cells) surface antigens. Blood was obtained at the same time of day to eliminate the effects of circadian rhythm. Subjects were taking no medications.

We found no difference between the groups of the percentage of T cells with T4, T8, M1, and Ia antigens, nor the ratio of T4+ (helper) to T8+ (suppressor) cells. T3 percent was slightly (94.3 vs 92.5%) higher in the atopic group. We conclude that atopic asthma is not associated with imbalances of peripheral‐blood T cell subsets.
Intragastral provocation under endoscopic control (IPEC) in food allergy: mast cell and histamine changes in gastric mucosa
Authors: REIMANN H.‐J. , RING J. , ULTSCH B. , WENDT P.
Published: April 2006

In fourteen patients with food allergy, intragastral provocation under endoscopical control (IPEC) was performed. In all patients positive immediate‐type reactions of the gastric mucosa were observed consisting of oedema, erythema and petechial bleeding. Microscopically, mast cell degranulation was observed and measured by mast cell counts using the o‐phthaldialdehyde technique. Concomitantly, tissue histamine content in gastric mucosa decreased significantly after allergen provocation, while there was no change in normal volunteers. Plasma histamine concentration increased in most patients; the increases were most evident in four patients showing mild systemic reactions (urticaria and bronchospasm). The technique described might prove to be useful in establishing the diagnosis in doubtful cases of food allergy.
Skin test and RAST responses to wheat and common allergens and respiratory disease in bakers
Authors: PRICHARD M. G. , RYAN G. , WALSH B. J. , MUSK A. W.
Published: April 2006

Interrelationships between skin and humoral tests for immediate hypersensitivity to wheat and indicators of respiratory disease were examined in 176 male bakers. Skin tests were assessed by measuring the diameter of the weal resulting from prick innoculation of allergen extract and circulating allergen‐specific IgE by radioallergosorbent test (RAST). Fifteen per cent of subjects showed positive skin‐prick test responses to wheat extracts. These subjects demonstrated an increased prevalence of respiratory symptoms and of measurable bronchial responsiveness to methacholine. Thirty per cent of subjects had positive skin test responses to common allergens but negative responses to whole wheat. Compared to subjects with no positive skin test responses they had an increased prevalence of bronchial responsiveness to methacholine but a similar prevalence of respiratory symptoms.

There was a significant association between skin test responses to whole wheat and skin test responses to common allergens suggesting that bakers with pre‐existing sensitivity to common allergens are at increased risk of developing wheat flour sensitization.

There was no significant difference between skin‐prick test and RAST responses to wheat, water‐soluble wheat protein and common allergens. Both tests showed similar relationships with indices of respiratory disease. The associations between skin test and RAST responses to wheat extracts and indices of respiratory disease was stronger for the water‐soluble wheat proteins than for other wheat grain extracts.

These results suggest that immediate hypersensitivity to wheat flour is important in the development of non‐specific bronchial hyperreactivity in bakers and that the water‐soluble fractions of wheat flour are the most important allergenic components. It agrees with in vitro results showing that water‐soluble wheat proteins bind IgE in sensitive bakers more closely than other grain extracts.
Reduction of house dust mite allergen levels in the home: use of the acaricide, pirimiphos methyl
Authors: MITCHELL E. B. , WILKINS S. , DEIGHTON McCALLUM , PLATTS‐MILLS T. A. E.
Published: April 2006

House dust mite sensitivity is very common in patients with bronchial asthma, yet dust mite avoidance frequently receives little attention in clinical management. It is likely that any reduction in allergen levels associated with routine cleaning is insufficient to allow clinical improvement. In the present study the acaricide pirimiphos methyl is shown to reduce the levels of Dermatophagoides pteronyssinus, antigen P1 in homes. Following a single application the level of antigen P1 in dust from carpets was reduced by up to 73% and by more than 50% in soft furnishings. Serial sampling showed a reduction for 6 weeks under conditions where carpets and chairs treated with solvent showed a progressive rise in allergen level. Furthermore the survival of mites in cultures or infested carpet segments was markedly inhibited, with antigen PI accumulation reduced by >90%. These results suggest major reductions in house dust mite allergen levels in the home can be achieved.
Histamine secretion from human skin slices induced by anti‐IgE and artificial secretagogues and the effects of sodium cromoglycate and salbutamol
Authors: CLEGG L. S. , CHURCH M. K. , HOLGATE S. T.
Published: April 2006

Human cutaneous mast cells show functional differences from their counterparts in other tissues. Following passive sensitization with 1% atopic serum for 30 min at 37° C human skin slices released histamine after challenge with anti‐human IgE in a concentration dependent manner. Maximum release of 14 ± 2%, was achieved with a 1/10 dilution of anti‐IgE. Passive sensitization with 10% atopic serum increased the secretory response to anti‐IgE but histamine release was only concentration related over the entire 1/1000 to 1/10 dilution range in half of the specimens studied, the remainder showing high dose tolerance to anti‐IgE, Negligible histamine release occurred with anti‐IgE challenge of slices which had not been passively sensitized.

The histamine releasing ability of A23187 in human skin slices was similar to that observed in lung and adenoidal mast cells being concentration dependent over the range 0‐1 3 μM with a maximum release of 25 ±3%. In contrast to human lung and adenoidal mast cells, poly‐L‐lysine and compound 48/80 induced histamine release from skin slices. Poly‐L‐lysine induced a concentration‐dependent release of histamine over the range 0‐01‐10 mUM with a maximum of 27 ± 3%. The response to compound 48/80 was variable, releasing in some but not all specimens. Histamine release caused by anti‐IgE. A23187 and poly‐L‐lysine was shown to be dependent upon extracellular calcium while release stimulated by compound 48/80 was calcium independent. The chemotactic peptide, formyl‐methionyl‐leucyl‐phenylalanine, over the range 0.01 10 μM failed to release histamine from skin slices. Sodium cromoglycate (100 1000 μM) failed to inhibit histamine release and the β‐adrenoceptor stimulant salbutamol (1‐10 μM) showed only weak activity at the lowest of three different concentrations of anti‐IgE used for challenge.
Insect sting anaphylaxis in patients without detectable serum venom‐specific IgE
Authors: CLAYTON W. F. , GEORGITIS J. W. , REISMAN R. E.
Published: April 2006

Following insect sting anaphylaxis, twenty‐five patients of over 500 evaluated, did not have detectable serum venom‐specific IgE. Twenty‐two were evaluated within 1 year of the reaction, fifteen within 6 months. Anaphylaxis occurred in six patients after their first sting exposure. The clinical features of the sting reaction were typical of the reaction occurring in insect‐allergic patients with serum venom‐specific IgE. Eleven of the twenty‐five patients had negative venom skin tests. These observations suggest that a non‐IgE mechanism may be responsible for a minority of insect sting reactions.
Twice or four times daily beclomethasone dipropionate in mild stable asthma?
Authors: BOYD G. , ABDALLAH S. , CLARK R.
Published: April 2006

A double‐blind cross‐over study lasting 16 weeks was conducted to establish if a twice daily regimen of beclomethasone dipropionate (BDP) was as effective in controlling asthma as a four times daily regimen. The patient's need for inhaled steroids (100 meg BDP qds) was confirmed prior to entering the study by deterioration of peak expiratory flow rates and/or increased bronchodilator usage during a single‐blind placebo period of 6 weeks. Thirty six asthmatics were eligible to enter the study and completed both treatment periods. Daily record cards of symptom scores, four times daily peak expiratory flow rate measurements and inhaled bronchodilator usage were recorded throughout the study.

There was no significant difference between the mean PEFR measurements taken four times each day and the variability in PEFR, between the two treatment groups. Symptom scores for cough, wheeze, breathlessness and overall disability also showed no significant difference. Symptomatic inhaler usage for the two groups was similar. Lung function measurements of FEV1, FVC and VC were almost identical; FEV1 being 2.1 1 on twice daily regimen and 2.2 1 on four times daily regimen. A slight variation was observed in PEFR taken at the end of each treatment period at the clinic visits, being 3611/min on twice daily and 3801/min on four times daily drug dosage. In stable asthmatics, the control of asthma measured both symptomatically and by daily lung function was independent of dosing schedule, but twice daily treatment may well lead to better compliance.
Clinical and immunological characteristics of pre‐school asthma
Authors: LOFTUS B. G. , PRICE J. F.
Published: April 2006

Ninety‐two children, sixty‐two boys and thirty girls, aged 18 months to 6 years with frequent asthma were studied. Nine were born prematurely and two were ventilated in the neonatal period; two had been admitted to hospital with acute bronchiolitis. Most had an early onset of symptoms, forty‐two developing asthma in infancy. Although overall growth was normal, 63% had some chest deformity. Half had past or present eczema and just over half had chronic rhinitis. Upper respiratory infection appeared to be an important precipitant of attacks in all, and 88% had exercise‐induced asthma. The majority were atopic, 74% had elevated serum IgE levels, skin‐prick tests were positive in 61 of 77 tested and half had eosinophilia. However, allergic factors were clearly identified as causing asthma attacks in only 24%. Immunoglobulin deficiencies were found in thirteen and defective yeast opsonization in eighteen; these children showed no other obvious differences from the remainder. Eighty‐two children were followed up and after 1 year fifty‐one were receiving inhaled steroids. Measurement of serum immunoglobulin, eosinophil count and skin‐prick testing had little influence on management.
Inhalant allergy following occupational exposure to blowflies
Authors: KAUFMAN G. L. , BALDO B. A. , TOVEY E. R. , BELLAS T. E. , GANDEVIA B. H.
Published: April 2006

An allergic reaction, provoked by exposure to the blowfly Lucilia cuprina and shown to be IgE‐mediated, occurred in a subject employed in an entomological research laboratory. The subject's serum, and sera from three other asthmatic patients with IgE antibodies to blowfly extracts, also reacted with extracts from the screw‐worm fly (Chrysomya bezziana). Results suggested that antigens from the two species share immunological cross‐reactivity. Cross‐reactions also exist between the different developmental stages of both species. Allergic reactions to inhaled insect allergens may not be uncommon in the Australian community.
Serum antibodies against native, processed and digested cow's milk proteins in children with cow's milk protein intolerance
Authors: FÄLLSTRÖM S. P. , AHLSTEDT S. , CARLSSON B. , LÖNNERDAL B. , HANSON L. Å.
Published: April 2006

Children with or without cow's milk protein intolerance were investigated for serum antibodies to native cow's milk proteins, processed cow's milk proteins and native‐ and pepsin‐digested β‐lactoglobulin. Antibodies of IgG and IgA isotypes were determined with ELISA and those of IgE isotype with RAST.

Children who exhibited slowly appearing untoward reactions to cow's milk feeding had significantly higher titres of IgG antibodies against both native and digested β‐lactoglobulin than children with an immediate type of reaction or no intolerance. The IgG antibodies to pepsin‐digested β‐lactoglobulin were efficiently inhibited by native β‐lactoglobulin even at low concentrations, which suggests that there were no antibodies specific for the degraded proteins. The children with slow reactions to cow's milk also tended to have higher antibody levels of the IgG and IgA isotypes to both native and processed cow's milk. Antibodies to this mix of antigens discriminated less well, however, than the antibodies to isolated β‐lactoglobulin between the groups of children with slowly appearing reactions, with immediate reactions and the controls. Seven out of nine children with an immediate type of reaction to cow's milk protein had IgE antibodies against cow's milk protein determined with the RAST, while this type of antibodies could not be demonstrated in any child in the two other groups. Using processed or digested protein as antigen did not increase the sensitivity of the antibody determinations.
Study of IgG sub‐class antibodies in patients with milk intolerance
Authors: SHAKIB F. , BROWN H. MORROW , PHELPS A. , REDHEAD R.
Published: April 2006

An ELISA was applied to measure IgG sub‐class antibodies to cow's milk betalactoglobulin (BLG), alpha‐lactalbumin (ALA) and alpha‐casein (AC) and to hen's egg ovalbumin (OA) in the sera of nineteen adult patients with milk intolerance causing either asthma, eczema or both. Results were compared with those of forty blood donors and twenty adult patients with either asthma or eczema due to inhalant allergy. Apart from one blood donor, high titres of IgG sub‐class antibodies to all three milk proteins were found only in the milk intolerance group. The most frequently detected antibody was AC‐specific IgG4; being high (i.e. > 9·98 μg/ml) in eight milk intolerance cases: six with eczema, one with asthma and one with both. A variable proportion of these eight patients also had high levels of IgG1, IgG2 and IgG3 antibodies to AC and IgG1, IgG2, IgG3 and IgG4 antibodies to BLG and ALA. In contrast, IgG antibody to the egg protein, OA, was remarkably restricted to IgG4 and was present in high titres in 68·4% of milk intolerant patients, 60% of inhalant allergy patients and 30% of blood donors. However, the greater incidence of high titres of IgG4 antibody to OA, compared to AC, was due to the superior coating efficiency of OA resulting in a more sensitive assay. We conclude that some adult cases of milk intolerance, particularly those with eczema, can be diagnosed by detecting raised serum levels of IgG sub‐class antibodies to milk proteins.
Significance of IgG antibodies against environmental microbial antigens in a farming population
Authors: KATILA MARJA‐L. , OJANEN TARJA H. , MÄNTYJÄRVI R. A.
Published: April 2006

A group of dairy farmers studied 6 years earlier in a field survey was re‐surveyed for respiratory symptoms, occupational capability and the presence of antibodies against environmental micro‐organisms. Specific IgG antibodies to Micropolyspora faeni, Thermoactinomyces vulgaris, Aspergillus umbrosus and Aspergillus fumigatus were measured by ELISA from the serum samples obtained in the two surveys. Antibody titres remained constant in 70% of both farmers and controls, but where changes took place, the titres against the actinomycete antigens tended to rise, whereas both increases and decreases were detected equally against the Aspergillus antigens. The titre of specific antibody to any of the four micro‐organisms, when measured from a single serum specimen, seemed to be of little diagnostic value. Observed changes however, were more diagnostic, in that a fall in titre, especially against the Aspergillus antigens, was closely associated with a definite decrease in exposure, such as after retirement. Increased titres occurred in farmers with continued exposure, and those against the actinomycetes were associated with the appearance of symptoms in previously symptom‐free individuals. In a case of farmer's lung which developed in this population during the follow‐up period, significant increases were detectable against T. vulgaris and M. faeni.
Low dose sublingual therapy in patients with allergic rhinitis due to house dust mite
Authors: SCADDING GLENIS K. , BROSTOFF J.
Published: April 2006

In a double‐blind placebo‐controlled cross‐over trial, low dose sublingual therapy with house dust mite was effective in relieving symptoms in 72% of the group of patients with perennial rhinitis due to house dust mite (P < 0·03). Following active treatment, there was a significant increase in morning peak nasal inspiratory flow rate (P < 0·01) in those who improved (thirteen out of eighteen) and resistance to nasal provocation with house dust mite also increased, in some cases up to 1000‐fold (P < 0·05). Oral therapy is safe and avoids the side effects of desensitizing injections which can be serious. The potential for oral desensitization is great and further studies on this form of treatment are needed.
Stimulation of IgE sensitized human alveolar macrophages by anti‐IgE is unaffected by sodium cromoglycate
Authors: FULLER R. W. , MACDERMOT L.
Published: April 2006

Abstract. Sodium cromoglycate is an effective prophylactic in the treatment of asthma. However, its mechanism of action is still uncertain. The release of thromboxane B2 and N‐acetyl‐β‐D‐glucosaminidase activity was measured from human alveolar macrophages sensitized with human myeloma IgE. Cells were challenged with rabbit affinity purified anti‐IgE (no activity against IgG) in the absence or presence of sodium cromoglycate (10‐4‐10‐8M). There was no change in the release of either thromboxane B2 or N‐acetyl‐β‐D‐glucosaminidase in the presence of sodium cromoglycate at these concentrations.