bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceptions of the quality of life for the adolescent with a chronic illness by teachers, parents and health professionals: a Delphi study
Authors: Meuleners L. B. , Binns C. W. , Lee A. H. , Lower A. 
Published: March 2003

AbstractAimsThe perceptions that teachers, parents and health professionals have on the relative importance of different aspects of quality of life (QOL) for the adolescent with a chronic illness were explored using a three‐round Delphi study.MethodsThe first round questionnaire identified the level of importance each panel attached to 16 aspects relating to QOL. Panellists were also encouraged to provide additional comments on why they felt a particular item was important. In round two, panellists were asked to prioritize the items in order of importance, whereas round three attempted to achieve consensus among each of the three panels.ResultsDifferences between and within panels in the prioritization of items in round one and round two were evident. However, consensus was achieved in round three, except for the prioritization of very important items by the panel of teachers. Items identified by all three panels as extremely important included the adolescent's attitude, family relationships and friendships with the same age group. Themes to emerge from the qualitative responses to the open‐ended questions included the perception of the chronically ill adolescent ‘not wanting to be different’ and the importance of a ‘positive attitude’. The majority of participants also perceived adolescents with a chronic illness as having worse QOL than their healthy counterparts.ConclusionsBy increasing the awareness among the different groups of the impact of chronic illness on various aspects of adolescent QOL, the overall care and support of those adolescents could be improved. Further studies should also be undertaken to explore the views of the chronically ill adolescents themselves.
GC/MS analysis of urinary excretion of 9α,11β‐PGF2 in acute and exercise‐induced asthma in children
Authors: Nagakura T. , Obata T. , Shichijo K. , Matsuda S. , Sigimoto H. , Yamashita K. , Masaki T. , Maekawa K. 
Published: March 2003

Background9α,11β‐Prostaglandin (PG) F2 is an initial metabolite of PGD2 which has a potent bronchoconstrictive activity.ObjectivesWe measured the urinary levels of 9α,11β‐PGF2 in asthmatic children to investigate its role in not only acute asthmatic attack in a time course study but also in exercise‐induced asthma (EIA).MethodsIn the acute asthma study, 30 asthmatic children were examined. Urine samples were collected on the first, third, and sixth days. Urinary levels of 9α,11β‐PGF2 were measured with gas chromatography mass spectrometry using the electron impact method. In the exercise challenge study, 14 children with EIA and 14 children without EIA were studied. Urine samples were collected before exercise challenge, and at 1 h, and 5 h after exercise challenge. Urinary levels of 9α,11β‐PGF2 were measured.ResultsElevated urinary levels of 9α,11β‐PGF2, which were observed on the first day when treatment was started in the hospital, were gradually decreased on the third day (P < 0.05), and on the sixth day (P < 0.01). A significant correlation between urinary levels of 9α,11β‐PGF2 and symptom scores (P < 0.005) was observed on the first day. In EIA, there was a significant increase in urinary levels of 9α,11β‐PGF2 at 1 h (P < 0.01) and at 5 h (P < 0.01) after exercise challenge, but not in the children without EIA.Conclusion9α,11β‐PGF2 may be involved in the pathogenesis of acute and exercise‐induced asthma in children.
Prospective, double‐blind, placebo‐controlled, multicentre study on the effect of high‐dose, intravenous immunoglobulin in children and adolescents with severe bronchial asthma
Authors: Niggemann B. , Leupold W. , Schuster A. , Schuster R. , Berg A. v. , Grübl A. , Hardt H. v. d. , Eibl M. M. , Wahn U. 
Published: March 2003

ObjectiveIn order to study the effect of high‐dose, intravenous immunoglobulin (IVIG) in severe childhood asthma, we investigated 31 children and adolescents (15 girls, 16 boys) aged 9–22 years (median age of 14 years) suffering from severe bronchial asthma.MethodsIn a prospective, double‐blind fashion, patients received either four doses of IVIG (1 g/kg body weight) or identical doses of intravenous human serum albumin. The first two doses were given on two consecutive days, followed by two further doses at 4 week intervals.ResultsThere was no statistical difference in the actively treated group when compared with the placebo group in symptom‐score, bronchial hyperreactivity or peak‐flow‐variability. There was a trend for fewer total days of upper respiratory tract infections and also symptom‐scores in the IVIG group but these did not reach statistical significance.ConclusionOur data indicate that treatment with IVIG in asthmatic children did not show a significant reduction in the incidence of upper respiratory tract infections, but the patients who did have upper respiratory infections in the IVIG‐group appear to have less protracted infections. Severity and bronchial hyperreactivity do not seem to be affected by the treatment as performed in our study.
Post‐translational modifications influence IgE reactivity to the major allergen Phl p 1 of timothy grass pollen
Authors: Petersen  , Schramm  , Schlaak  , Becker  
Published: March 2003

BackgroundGrass group I consists of very potent allergenic components which are found in the pollen of all temperate grasses. Several post‐translational modifications are predicted from the cDNA data.ObjectiveThe aim of this study was to identify sequential IgE‐binding sites on the allergen Phl p 1 and to determine their influence on IgE reactivity.MethodsBased on cDNA data and microsequencing results we synthesized overlapping decapeptides covering the complete Phl p 1 molecule and tested them for immunological reactivity by means of the PEPSCAN technique. In a dot test we determined the frequency of IgE reactivities to post‐translationally modified structures (hydroxylated proline residues, carbohydrate structure, and disulphide formations).ResultsScreening by overlapping peptides demonstrated an IgE binding site on the 10 N‐terminal amino acids. Comprehensive studies showed that the two hydroxyproline residues of the native Phl p 1 allergen (at positions 5 and 8) and the N‐glycan (at position 9) can result in an increased IgE reactivity; 3.3% of the sera exclusively bound to the hydroxyproline bearing peptide, while only 0.4% bound to the proline containing peptide. With regard to glycosylation, we estimated that 20% of sera recognized protein and carbohydrate epitopes, while one serum exclusively bound to the glycan. The formation of disulphide bonds has no detectable effect on the IgE reactivity to Phl p 1.ConclusionOur results indicate that the post‐translational modifications, the carbohydrate structure and the hydroxylation of proline residues, can enhance the IgE reactivity of Phl p 1.
HLA class II DRB1, DQB1 and DPB1 genotypic associations with peanut allergy: evidence from a family‐based and case‐control study
Authors: Howell W. M. , Turner S. J. , O'B Hourihane J. , Dean T. P. , Warner J. O. 
Published: March 2003

BackgroundPeanut is one of the most common foods provoking allergic reactions and is the most frequent cause of fatal and near‐fatal food‐induced anaphylaxis. However, as yet, little is known of the genetic and immunological mechanisms which underly peanut allergy.ObjectiveBased on findings in other allergic diseases, we have investigated whether particular human leucocyte antigen (HLA) class II genetic polymorphisms contribute to the development of peanut allergy.MethodsAll individuals from 37 families each containing one or more peanut allergic individuals, plus nine unrelated patients (161 individuals in total, defined as the study group) were typed for the HLA class II DRB1, DQB1 and DPB1 loci, by PCR‐based techniques. Genotype frequencies were compared with those found in 293 unrelated controls.ResultsFour class II genotypes (DRB1*08 (13.7% vs 4.8%; Pc = 0.026), DRB1*08/12 tyr 16 (22.4% vs 8.2%; Pc = 0.021), DQB1*04 (12.2% vs 2.7%; Pc = 0.0026) and DPB1*0301 (49.1 vs 22.5%; Pc = 0.00062)) were present at a significantly higher frequency in the study group compared with controls. Three of these genotypes (DRB1*08 (18.0%; Pc = 0.027), DRB1*08/12 tyr16 (24.0%; Pc = 0.029) and DQB1*04 (16.7%; Pc = 0.0029)) were also significantly increased in peanut allergic individuals compared with controls. In addition, two genotypes (DPB1*0101 and 0201) were significantly decreased in frequency in the overall study group, but not specifically in peanut allergic individuals.ConclusionWhile other genetic factors may be important, results from this study indicate that HLA class II genetic polymorphism may play a role in determining susceptibility to peanut allergy.
Histamine release from bronchoalveolar lavage cells from asthmatic subjects after allergen challenge and relationship to the late asthmatic response
Authors: Heaney L. G. , Cross L. J. M. , Ennis M. 
Published: March 2003

BackgroundMetachromatic cells obtained from asthmatic subjects demonstrate increased spontaneous and stimulated histamine release in vitro. Their ability to synthesize and store proinflammatory cytokines has focused renewed interest on their role in asthma.ObjectiveThe late asthmatic response provides a useful model of clinical asthma. The aim of the study was to examine metachromatic cell derived mediators and histamine releasability in vitro after in vivo allergen exposure in atopic subjects with and without asthma and relate them to the type of physiological response observed.MethodsBronchoalveolar lavage (BAL) cells were obtained 4 h after challenge from asthmatics exhibiting a single early response (EAR, n = 5), a dual response (LAR, n = 7), unchallenged (basal, n = 5), atopic non‐asthmatic (ANA, n = 6) and non‐atopic non‐asthmatics (normal, n = 5). BAL histamine and tryptase concentrations and in vitro histamine release (HR) after stimulation with anti‐IgE, allergen, A23187, conconavalin A and substance P were compared.ResultsMetachromatic cell numbers were lower in normal controls compared with all asthmatic groups and in LAR compared with EAR. Metachromatic cell derived mediators were higher in asthmatic compared with normal subjects. Spontaneous HR in LAR (20.5 ± 5.0%) was lower than EAR (29.5 ± 3.9%) and ANA (30.2 ± 1.4%) (P < 0.05). No differences were seen in stimulated HR between EAR and LAR. HR in ANA stimulated with anti‐IgE was greater than LAR (P < 0.05). HR in ANA stimulated with anti‐IgE was greater than LAR (P < 0.05). After stimulation with ionophore A23187 (1 μM), release was greater in LAR compared with basal (P < 0.05) and no different at 5 μM. All subject groups responded to substance P (SP) but was significantly more in the asthmatic subjects compared to normal controls (P < 0.05). Allergen challenge did not modify the response of asthmatic subjects to SP.ConclusionFunctional differences in metachromatic cell reactivity are present in atopic subjects 4 h after in vivo allergen exposure which relate to the physiological response observed after this time and suggest that there is ongoing metachromatic cell degranulation subjects who subsequently develop LAR.
Inflammatory mediators in naturally occurring rhinitis
Authors: Wilson S. J. , Lau L. , Howarth P. H. 
Published: March 2003

BackgroundThe mediators released during the allergic inflammatory reaction induce the clinical symptoms of the allergic disease and although there have been numerous studies investigating mediator release in allergen challenge models of allergic rhinitis very few have extended this approach to the study of natural disease.ObjectiveThe aim of this investigation was therefore to measure mast cell and eosinophil mediator levels and indices of vascular permeability in naturally occurring rhinitis.MethodsThree groups of subjects were studied, normal non‐rhinitics, seasonal allergic rhinitics in and out of the grass pollen season and perennial allergic rhinitics. Mediators were recovered using the technique of nasal lavage and the levels of tryptase, histamine, eosinophil cationic protein and albumin were determined. In addition, eosinophils were enumerated in nasal smears as an indices of underlying inflammation.ResultsThe levels of tryptase, eosinophil cationic protein and albumin were significantly higher in the lavage recovered from the symptomatic seasonal allergic rhinitics than when asymptomatic (P = 0.05,P = 0.003,P = 0.009, respectively). These levels of eosinophil cationic protein and albumin were also significantly higher than those of the normal non‐rhinitics (P = 0.0008,P = 0.0.003, respectively). In the perennial allergic rhinitics the levels of tryptase, eosinophil cationic protein and albumin were higher than the normal non‐rhinitics (P  < 0.0001,P = 0.0003,P = 0.0001, respectively). The levels of tryptase and histamine were higher in the perennial allergic rhinitics than the seasonal allergic rhinitics (P = 0.0003,P = 0.006, respectively). These changes in mediator levels were accompanied by a significant influx of eosinophils into the nasal mucosa of both the symptomatic seasonal rhinitics, compared with asymptomatic (P = 0.04) and normal controls (P = 0.0006) and the perennial rhinitics compared to normal controls (P = 0.03).ConclusionThese results indicate that in both naturally occurring seasonal allergic rhinitis and perennial allergic rhinitis mast cell and eosinophil activation occurs and this is accompanied by an increase in vascular permeability. These measurements in lavage fluid provide a method of monitoring the mucosal cellular events in response to therapy.
Determinants of eosinophil cationic protein in nasal lavages in children
Authors: Wojnarowski  , Studnicka  , KÜhr  , Koller  , Haschke  , Gartner  , Renz  , Frischer  
Published: March 2003

BackgroundNasal lavages are increasingly used to assess airways inflammation in children. However, there are no studies assessing how measurement error as well as biological influences contribute to the concentration of nasal inflammatory parameters in a population based survey.ObjectiveTo investigate determinants of concentration of eosinophil cationic protein (ECP) in nasal lavages we studied 147 schoolchildren (mean age 8.1 years, sd 0.6 years) by repeated nasal lavages/year over a 2 year period.MethodsStandardized questionnaires were completed by the parents each year. A skin‐prick test with seven aeroallergens (birch, cat, dog, hazel, weeds, Dermatophagoides pteronyssinus and D. farinae) was performed. One hundred and one children could perform valid lavages at least five times a year. As a measure of reproducibility the intraclass coefficient of reliability was calculated.ResultsThe intraclass coefficient of reliability was 0.27 over all observations suggesting that about a quarter of total variance is due to between‐subject variance. Taking means over each year increased reliability to 0.60. Linear regression analyses with ECP being the dependent variable demonstrated significant higher values for boys (β = 12.26; P < 0.01), children sensitized to seasonal (β = 34.27; P = 0.02) but not to perennial allergens (β = – 4.44; P = 0.57), and for children with a serous (β = 10.01; P = 0.01) or purulent rhinitis (β = 22.45; P < 0.001).ConclusionAssessment of inflammatory mediators in nasal lavages is a useful tool for epidemiological paediatric studies. However, due to the relatively high intraindividual variability of ECP concentrations multiple lavages are necessary to characterize the individual.
Cord blood‐IgE as risk factor and predictor for atopic diseases
Authors: Edenharter  , Bergmann  , Bergmann  , Wahn  , Forster  , Zepp  , Wahn  
Published: March 2003

BackgroundCord blood‐IgE as risk factor or predictor for atopic diseases in infants has been discussed in a large number of papers with contradictory results. Our aim was to evaluate cord blood‐IgE as risk factor and predictor for atopic dermatitis, recurrent wheezing and sensitization with emphasis on a clear‐cut distinction between risk factor and predictor.MethodsA cohort of 1314 newborns was recruited in six German obstetric departments and followed‐up for 5 years. Four hundred and ninty‐nine infants (38%) were considered to be at high risk with at least two atopic family members and/or a cord blood‐IgE value above the threshold of 0.9 kU/L. At follow‐up visits, parents filled in a questionnaire, the infants were clinically examined, and blood samples were taken.ResultsWith regard to early onset atopic dermatitis up to 12 months we found that the odds ratios at the cord blood‐IgE cut‐off points of 0.70 kU/L and 1.25 kU/L with values of 0.53 and 0.32, respectively, were smaller than one (i.e. protective factors) and highly statistically significant. No significant association was found between elevated cord blood‐IgE and recurrent wheezing. There was a strong positive association between elevated cord blood‐IgE levels and sensitization at 12 months, but even in this case the predictive performance was rather poor: a maximum positive predictive value of 42% was attained with a cut‐off point of 3.0 kU/L, but the sensitivity was only 10%.ConclusionWe conclude that even when elevated cord blood‐IgE levels are identified as a strong risk factor for sensitization, their poor predictive performance may make them useless as a basis for preventive measures.
Role of tachykinins in distilled water‐induced bronchoconstriction in guinea‐pigs
Authors: Fujimura  , Amemiya  , Myou  , Mizuguchi  , Ishiura  , Sasaki  , Matsuda  
Published: March 2003

BackgroundAn inhalation of ultrasonically nebulized distilled water (UNDW) induces bronchoconstriction only in asthmatics, but the mechanism underlying the response is not fully understood. We recently showed that bronchoconstriction occurs immediately after UNDW is inhaled 20 min after an aerosolized antigen challenge in passively sensitized guinea‐pigs.ObjectiveThis study was conducted to examine the role of tachykinins in this response.MethodsPassively sensitized animals were anaesthetized and artificially ventilated, and changes in pressure at the airway opening (Pao) were measured as an overall index of airway narrowing. A tachykinin NK1 and NK2 dual receptor antagonist, FK224, and a tachykinin NK1 selective antagonist, FK888, were intravenously administered 15 min after the antigen challenge. The effects of capsaicin desensitization and a neutral endopeptidase inhibitor, phosphoramidon, were also examined.ResultsFK224 and FK888 significantly (P < 0.05 and P < 0.05, respectively) reduced the time course curve of the increase in Pao caused by UNDW inhalation in a dose‐dependent manner. The percentage increase in Pao from the preantigen challenge value at 1 min after the UNDW inhalation was 267.4 ± 17.1, 358.0 ± 33.7 and 412.4 ± 27.6% with 10 mg/kg of FK224, 1.0 mg/kg of FK224 and vehicle, respectively, (P < 0.01 between 10 mg/kg of FK224 and vehicle) and the value was 254.4 ± 48.5% with 10 mg/kg of FK888, 327.1 ± 57.6% with 1.0 mg/kg of FK888 and 418.5 ± 39.0% with vehicle, respectively (P < 0.05 between 10 mg/kg of FK888 and vehicle). The capsaicin desensitization, but not phosphoramidon, significantly reduced the UNDW‐induced increase in Pao.ConclusionThese results suggest that tachykinins, at least substance P, are involved in a part of the UNDW‐induced bronchoconstriction in our guinea‐pig model.
Comparison of skin‐prick test and specific serum IgE determination for the diagnosis of latex allergy
Authors: Blanco  , Carrillo  , Ortega  , Alvarez  , Dominguez  , Castillo  
Published: March 2003

BackgroundLatex IgE‐mediated hypersensitivity has been recognized as an international health problem. However, there is poor information on the efficiency of the diagnostic methods available.ObjectiveThe purpose of this study was to specify the efficiency of several diagnostic methods for latex allergy.MethodsWe designed a prospective study involving 50 adult patients with latex allergy, as diagnosed by a suggestive clinical history and a positive skin‐prick test (SPT) to a latex extract. One control group of 50 subjects paired for age, sex, total IgE levels and latex exposure, and another control group of 30 subjects with pollen allergy were used. A low‐ammoniated natural‐latex and several glove‐latex extracts were elaborated. SPTs with these extracts, as well as with four different commercial‐latex extracts were performed. Latex‐specific serum IgE was determined by the CAP and the AlaSTAT methods.ResultsDiagnostic sensitivity was 98% for the natural‐latex extract SPT, from 90% to 98% for the commercial‐latex extract SPT, and from 64% to 96% for the glove‐latex extract SPT. Diagnostic specificity of SPT was 100%, and no severe adverse reactions were observed during skin testing. With respect to the latex‐specific serum IgE determinations, sensitivity was 86% for the CAP system and 84% for the AlaSTAT assay, and specificity was dependent on the population considered.ConclusionSPT with natural latex extracts has shown a diagnostic efficiency close to 100%, significantly higher than that of latex‐specific serum IgE determination.
Prevalence and determinants of house dust mite allergen in East German homes
Authors: Hirsch  , Range  , Walther  , Hederer  , LÄssig  , Frey  , Leupold  
Published: March 2003

BackgroundIn 1990/91, allergic sensitization to house dust mites (HDM) and other allergens was more prevalent in children from West Germany than from East Germany.ObjectiveTo test the hypothesis that low indoor exposure to HDM allergen in East Germany has contributed to this difference.MethodsHDM allergen concentrations were determined in 634 East German dwellings shortly after the German reunification.ResultsHDM group I allergen (Der p 1 + Der f 1) levels in mattresses (median 2.16, geometric mean 2.07, maximum 278.9 μg/g dust) and carpets (median 0.41, geometric mean 0.48, maximum 96.3 μg/g dust) were within the range of levels determined in West Germany in other studies. One particular East German type of dwelling (light concrete buildings) was associated with lower mite allergen exposure, but only a minority of the population lived there. Coal heating, installed in the majority of dwellings before 1989, was associated with higher allergen exposure. Higher relative humidity (RH) was a main risk factor for higher Der p 1 exposure (odds ratio [OR] for exposure to > 0.05 μg/g dust on carpets: 1.4 [95% confidence intervall (CI) 1.2–1.8] for + 10% RH) but not for higher Der f 1 exposure. Higher temperature was associated with a lower risk for elevated Der p 1 levels (> 0.05 μg/g dust on carpets): OR 0.6 (95% CI 0.5–0.8) for + 2 °C.ConclusionMite allergen exposure is not lower in East Germany than in West Germany. The data does not support the hypothesis, that low HDM allergen exposure in East Germany is a cause for the lower prevalence of HDM sensitization in East German children.