bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum eosinophil cationic protein (ECP): reference values in healthy nonatopic children
Authors: Fitch P.S. , Brown V. , Schock B.C. , Ennis M. , Shields M.D. , Taylor R. 
Published: March 2003

Background: Although serum ECP concentrations have been reported in normal children, there are currently no published upper cutoff reference limits for serum ECP in normal, nonatopic, nonasthmatic children aged 1–15 years. Methods: We recruited 123 nonatopic, nonasthmatic normal children attending the Royal Belfast Hospital for Sick Children for elective surgery and measured serum ECP concentrations. The effects of age and exposure to environmental tobacco smoke (ETS) on the upper reference limits were studied by multiple regression and fractional polynomials. Results: The median serum ECP concentration was 6.5 μg/l and the 95th and 97.5th percentiles were 18.8 and 19.9 μg/l. The median and 95th percentile did not vary with age. Exposure to ETS was not associated with altered serum ECP concentrations (P=0.14). Conclusions: The 95th and 97.5th percentiles for serum ECP for normal, nonatopic, nonasthmatic children (aged 1–15 years) were 19 and 20 μg/l, respectively. Age and exposure to parental ETS did not significantly alter serum ECP concentrations or the normal upper reference limits. Our data provide cutoff upper reference limits for normal children for use of serum ECP in a clinical or research setting.
Integrin expression on neutrophils and mononuclear cells in blood and induced sputum in stable asthma
Authors: Maestrelli P. , De Fina O. , Bertin T. , Papiris S. , Saetta M. , Mapp C.E. , Ruggieri M.P. , Fabbri L.M. 
Published: March 2003

Background: We speculated that the expression of integrins in the airway lumen of asthmatic subjects might be altered compared with normal subjects during cell recruitment from circulation. Methods: To test this hypothesis, we investigated the expression of integrin α‐chains (CD11a, CD11b, and CD11c) in hypertonic saline‐induced sputum and peripheral blood leukocytes in mild to moderate stable asthmatic and control subjects. Immunoreactivity for integrin α‐chains was assessed by immunocytology on cytospin preparations of sputum and blood. Results: In comparison of the percentages of CD11a+, CD11b+ and CD11c+ mononuclear cells in sputum with their blood counterparts, no significant differences were observed in control subjects, whereas CD11a and CD11b in asthmatic subjects were less expressed on sputum cells. In both control and asthmatic subjects, sputum neutrophils tended to decrease their expression of integrin α‐chains compared with circulating neutrophils. Conclusions: We showed that the sputum of asthmatics, unlike normal subjects, is characterized by decreased expression of integrins on mononuclear cells compared with their blood counterparts. The results suggest that downregulation of integrins occurs in asthmatic airways after cell recruitment from circulation.
Interleukin‐8 inhalation directly provokes bronchoconstriction in guinea pigs
Authors: Fujimura M , Myou S , Nomura M , Mizuguchi M , Matsuda T , Harada A , Mukaida N , Matsushima K , Harada A , Nonomura A 
Published: March 2003

Background: Although it has been reported that the concentration of interleukin (IL)‐8 in nasal lavage fluid and sputum and its production in bronchial epithelium were increased in asthmatic subjects, the direct effects of IL‐8 on the airways in vivo is unclear. Methods: We examined bronchoconstriction in response to IL‐8 inhalation through an endotracheal cannula in anesthetized, artifically ventilated guinea pigs. Results: Inhalation of IL‐8 at concentrations of 1 and 10 μg/ml caused significant bronchoconstriction, as revealed by the elevation of pressure at the airway opening. Moreover, the bronchoconstriction induced by IL‐8 was significantly inhibited by the antihistamines diphenhydramine and terfenadine, suggesting the involvement of histamine release in the IL‐8‐induced bronchoconstriction. No significant leukocyte infiltration was observed in the bronchoalveolar lavage fluid or histologic findings 25 min after the first IL‐8 inhalation. Conclusions: IL‐8 provokes bronchoconstriction without leukocyte accumulation in the airways, mediated in part by histamine release, in guinea pigs.
A study on severe food reactions in Sweden – is soy protein an underestimated cause of food anaphylaxis?
Authors: Foucard T , Malmheden Yman I 
Published: March 2003

Background and methods: Because of a fatal case of soy anaphylaxis occurring in Sweden in 1992, a study was started the following year in which all physicians were asked to report fatal and life‐threatening reactions caused by food. The results of the first 3 years of the study are reported here, including results from another ongoing study on deaths from asthma during the same period. Results: In 1993–6, 61 cases of severe reactions to food were reported, five of them fatal. Peanut, soy, and tree nuts seemed to have caused 45 of the 61 reactions, and four of them were fatal. If two cases occurring less than a year before our study started are included, we are aware of two deaths caused by peanuts and four deaths caused by soy. All four youngsters who died from soy anaphylaxis with asthma were severely allergic to peanuts but had no previously known allergy to soy. In most cases, there was a rather symptom‐free period for 30–90 min between early mild symptoms and severe and rapidly deteriorating asthma. Conclusions: Soy has probably been underestimated as a cause of food anaphylaxis. Those at risk seem to be young people with asthma and peanut allergy so severe that they notice symptoms after indirect contact.
Mustard allergy in children
Authors: Rancé F. , Dutau G. , Abbal M M. 
Published: March 2003

Background: Mustard allergy is not well known. This study aimed to assess its clinical features and other associated allergies, and to define skin prick tests (SPT), specific IgE, and dose response by oral food challenge.Methods: Our study investigated 36 children with positive mustard SPT. The diagnosis of mustard allergy was based on open or single‐blind, placebo‐controlled food challenge (SBPCFC). We compared the subjects to 22 controls.Results: The initial clinical features were atopic dermatitis (51.8%), and urticaria and/or angioedema (37%). Fifteen children were allergic (positive SBPCFC) and 21 children were nonallergic (negative SBPCFC). Symptoms after mustard ingestion started under 3 years of age in 53.3% of the subjects. There was no significant difference in the food allergies and associated inhalant allergen sensitizations between the two groups. In the allergic group, the mean wheal diameter for mustard SPT was 8.8 mm and the median concentration of mustard serum (s) IgE 14.8 kU/l. The mean cumulative reactive dose were 153 mg.Conclusions: Allergic reactions to mustard started early in life. Clinical symptoms were not severe in children. Mustard should be included in screening tests of food allergy in children.
Trends in hospital admissions for childhood asthma in Oslo, Norway, 1980–95
Authors: Jónasson G. , Lødrup Carlsen K. C. , Leegaard J. , Carlsen K.‐H. , Mowinckel P. , Halvorsen K. S. 
Published: March 2003

Background: Prevalence of asthma and quality of asthma care both influence hospital admission rates for childhood asthma. Therefore, we aimed to assess possible changes in hospital admission rate for acute asthma in Oslo, Norway, from 1980 to 1995, as well as evaluate the possible effect of changes in asthma treatment upon hospitalization for acute asthma in this period. Methods: All pediatric patient records from the two municipal hospitals in Oslo from 1980 through 1995 with the discharge diagnosis (ICD‐9) acute asthma, acute bronchitis/bronchiolitis, pneumonia, and/or atelectasis were thoroughly reviewed. Results: Of the 3538 children admitted for acute asthma, 66% were boys and 75% were younger than 4 years, and the admittance rate increased significantly among children aged 0–3 years. First admissions increased throughout the study, whereas readmissions, as well as the mean duration of hospital stay, decreased significantly. Prophylactic treatment with inhaled steroids prior to admission increased over 1980–89, but stabilized thereafter. The use of a short course of systemic steroids during admission increased markedly from 1991. Conclusions: The findings of increasing first admission rate as well as overall admission rate for acute asthma in children under 4 years of age, but decreasing readmissions as well as number of treatment days in hospital, probably reflect changes in the management of the disease, as well as an increasing prevalence of childhood asthma.
Glucocorticosteroids rapidly inhibit allergen‐induced expression of E‐selectin in vitro in a mucosal model of allergic rhinitis
Authors: Rudack C. , Bachert C. 
Published: March 2003

Background: Transendothelial migration of cells to sites of inflammation is a hallmark of the allergic reaction. The adhesion cascade involves the initial expression of the adhesion molecule E‐selectin on endothelial cells. The aim of the study was to determine the efficacy of a 30‐min preincubation of the glucocorticosteroids (GCS) fluticasone, prednisolone, and fluocortin butyl on allergen‐ and interleukin (IL)‐1β‐induced E‐selectin expression in allergic rhinitis. Methods: Freshly taken nasal inferior turbinate mucosa of 19 subjects with allergic rhinitis was cut into small cubes and preincubated for 30 min with prednisolone (n=6), fluticasone (n=5), and fluocortin butyl (n=3) in different concentrations, followed by allergen exposure at a concentration of 1000 BU/ml for 1 and 2 h. Additionally, fluticasone‐preincubated tissues were exposed to recombinant human rhIL‐1β (n=5) at a concentration of 2 pg/ml. The expression of E‐selectin was assessed by immunohistochemistry (APAAP technique) and computerized image evaluation. Results: In this model, E‐selectin expression was significantly upregulated by allergen and rhIL‐1β within 1 and 2 h. After 30‐min preincubation with prednisolone and fluocortin butyl at drug concentrations of 10−8 mol/l, we found a significant (≥50%) reduction of the E‐selectin expression after 1 and 2 h. Allergen‐induced E‐selectin expression was nearly abolished at concentrations of 10−5 (prednisolone) and 10−4 mol/l (fluocortin butyl). Fluticasone significantly inhibited E‐selectin expression by ≥50% at concentrations of 10−14 and 10−12 mol/l after 1 and 2 h, and abolished E‐selectin induction at concentrations of 10−12 and 10−10 mol/l, respectively. Exposure of mucosal cubes to rhIL‐1β (n=5) also induced rapid upregulation of E‐selectin expression, an effect which could be only partially suppressed by fluticasone preincubation at concentrations of 10−10 mol/l. Conclusions: Allergen‐induced E‐selectin expression is significantly and rapidly inhibited by GCS preincubation, fluticasone being more potent than prednisolone and fluocortin butyl. We suggest that this rapid effect is mainly indirect, possibly by inhibition of allergen‐induced cytokine release.
House‐dust‐mite sublingual‐swallow immunotherapy (SLIT) in perennial rhinitis: a double‐blind, placebo‐controlled study
Authors: Guez S. , Vatrinet C. , Fadel R. , André C. 
Published: March 2003

Background: The safety and efficacy of sublingual‐swallow immunotherapy (SLIT) in rhinitis caused by house‐dust mite were evaluated in a double‐blind, placebo‐controlled study including 75 patients for 24 months. Methods: Patients received either placebo or SLIT with a standardized Dermatophagoides pteronyssinus (D.pt.) –D. farinae (D.f.) 50/50 extract. The mean cumulative dose was 90 000 IR, equivalent to 2.2 mg of Der p 1 and 1.7 mg of Der f I. Symptom and medication scores were assessed throughout the study. Exposure to house‐dust mite, skin sensitivity, and serum specific IgE and IgG4 were assessed before starting treatment and after 12 and 24 months. Results: Seventy‐two patients (36 active–36 placebo) were eligible for intent‐to‐treat analysis. Thirty‐six patients dropped out of the study. The number of patients who dropped out due to lack of efficacy was eight out of 37 (21.6%) in the active treatment group compared to 15 out of 38 (39.5%) in the placebo group (chi‐square=2.81, P=0.09). Total symptom and medication scores decreased significantly after 12 and 24 months (P<0.05) of treatment in both groups, but no significant difference was observed between the active and placebo groups. After 24 months, the number of patients with high levels of indoor allergenic load decreased significantly in both groups compared to baseline data (P=0.01). Specific IgE (D.pt. and D.f.) increased significantly in the active treatment group after 12 and 24 months, while no change was observed in the placebo group. Specific IgG4 levels were not significantly modified in either group. Two patients in each group reported mild adverse effects. No severe adverse effects were reported. Conclusions: We conclude that SLIT in rhinitis caused by house‐dust mite was safe, but there was a lack of consistent clinical benefit compared to placebo, probably due to the impact of the allergen avoidance measures that lowered the allergen burden.
Relationships between natural T cells, atopy, IgE levels, and IL‐4 production
Authors: Magnan A. , Mély L. , Prato S. , Vervloet D. , Romagné F. , Camilla C. , Necker A. , Casano B. , Montero‐Jullian F. , Malissen B. , Bongrand P. , Fert V. 
Published: March 2003

Background: Th2 cells govern allergic disorders. Mechanisms leading to the Th2 commitment are dominated by the requirement of IL‐4. A potential source of this triggering IL‐4 could be the CD4+ subset of a small population of T cells, natural T (NT) cells. Indeed, this subset is involved in IgE responses in mice and produces promptly high amounts of IL‐4 in both mice and man. Methods: NT cells were identified in peripheral blood by flow cytometry with antibodies against Vα24 and Vβ11, recognizing the T‐cell receptor specific for NT cells. Simultaneous staining with anti‐CD3, anti‐CD4, or anti‐CD8 antibodies was performed. The frequency of NT cells in man was studied according to the presence of atopy defined by the positivity of skin tests, according to total IgE levels in serum, and according to IL‐4 concentration of whole‐blood culture supernatants determined by a flow cytometer microsphere‐based assay. Results: Seventy subjects were included, of whom 30 were atopic. The number of CD4+ NT cells was higher in atopics than in nonatopics (P=0.009). This number was correlated to the total IgE levels (r=0.34, P=0.03). In addition, the number of CD4+ NT cells, but also of CD8+ NT cells, was correlated to the levels of IL‐4 (r=0.71, P=0.01, and r=0.6, P=0.03, respectively). Conclusions: These results show that the number of NT cells, particularly the CD4+ subset, is related to atopy, IL‐4 production, and IgE levels. Therefore, this population of T cells is likely to play a role in the Th2 commitment initiating atopic diseases.
IgE‐binding activity to enzyme‐digested ovomucoid distinguishes between patients with contact urticaria to egg with and without overt symptoms on ingestion
Authors: Yamada K. , Urisu A. , Koyama H. , Tokuda R. , Wada E. , Kondo Y. , Ando H. , Morita Y. , Torii S. 
Published: March 2003

Background: We occasionally see egg‐allergic children who develop contact urticaria to hen's egg despite the absence of the overt symptoms on ingestion. The mechanisms remain to be elucidated. Methods: Twenty‐one subjects with positive reactions to 20‐min patch tests for egg‐white antigens were divided into subgroups with positive (n=10) and negative (n=11) results to oral challenge tests by the same antigens. We measured IgE antibody for egg white and its components, and IgE‐binding activities to digestive enzyme‐treated ovomucoid by RAST inhibition. Results: There were no significant differences in IgE antibody titers to egg white (positive vs negative: 30.3%vs 15.3%, P=0.130), ovomucoid (21.5%vs 10.2%, P=0.078), ovotransferrin (9.9%vs 3.7%, P=0.105), and lysozyme (3.4%vs 2.9%, P=0.944), except ovalbumin (16.8%vs 5.6%, P=0.024), between the positive and negative subjects in the provocation tests. In contrast, the concentration (1.93 μg/ml) of pepsin‐treated ovomucoid needed for 50% RAST inhibition in the challenge‐positive subjects was significantly (P=0.0003) lower than that(114.9 μg/ml) of negative subjects. Similar but less significant differences were obtained when ovomucoid fragments treated with chymotrypsin (0.91 μg/ml vs 6.86 μg/ml, P=0.014) and trypsin (0.75 μg/ml vs 4.67 μg/ml, P=0.041) were used as inhibitors. Conclusions: We suggest that IgE antibodies from subjects showing contact urticaria despite the absence of reactions to the ingestion of egg white recognize the epitope(s) unstable to digestive enzymes.
Antigliadin IgE – indicator of wheat allergy in atopic dermatitis
Authors: Varjonen E. , Vainio E. , Kalimo K. 
Published: March 2003

Background: Cereal grains are recognized as the cause of adverse reactions in some patients exposed to grain or flour by either inhalation or ingestion. Cereal‐related diseases, such as celiac disease and baker's asthma, have been well studied and the causative cereal proteins have been characterized. Although cereals form an essential part of daily nutrition, the allergenic proteins causing symptoms on ingestion in atopic dermatitis (AD) have remained obscure. In this study, we have investigated the allergenic fraction of wheat in AD. Methods: Skin prick tests (SPT) with a NaCl wheat suspension and the ethanol‐soluble wheat gliadin were performed on 18 wheat‐challenge‐positive or ‐negative children with AD, six adult AD patients with suspected cereal allergy, and one adult with wheat‐dependent exercise‐induced urticaria/anaphylaxis. Serum total IgE and specific IgE‐antibody levels to wheat and gluten were measured with the radioallergosorbent test (RAST) simultaneously. In addition serum samples of all 25 patients were analyzed by IgE immunoblotting with the ethanol‐soluble wheat‐protein extract. Results: Thirteen of the AD children were wheat‐challenge‐positive, 11/12 of them appeared to be positive with gliadin SPT, and all had an elevated gluten RAST value. Those challenge‐negative were negative with both gliadin SPT and gluten RAST. Positive wheat SPT and RAST alone were not associated with positive challenges. Four of the adult patients responded to a cereal‐free diet, although only two of them appeared to be positive with gliadin SPT and gluten RAST. A broad and intensive staining of gliadin peptides in IgE‐immunoblotting studies was seen in challenge‐positive children with positive gliadin SPT and/or gluten RAST. Besides staining of peptides in the main gliadin area of 30–46 kDa, a characteristic finding was the staining of small, <14‐kDa proteins with sera of challenge‐ and gliadin‐SPT‐positive patients. Conclusions: We found that wheat‐allergic AD patients have IgE antibodies against gliadin that can be detected by both SPT and the sensitive immunoblotting method. This suggests that gliadin peptides are important allergens, and ingestion of wheat causes symptoms of AD. A broad and intensive IgE staining was seen of gliadin peptides against both the previously characterized peptides in the main gliadin area and small, previously uncharacterized peptides of less than 14 kDa. The gliadin SPT and gluten RAST are good screening methods. Further characterization of the IgE‐stained gliadin proteins is needed.
The atopy patch test (APT) – a useful tool for the diagnosis of food allergy in children with atopic dermatitis
Authors: Niggemann B. , Reibel S. , Wahn U. 
Published: March 2003

Background: While immediate‐type clinical reactions to food can quite easily be identified by history or measurement of specific IgE in combination with positive oral food challenges, the evaluation of food allergy in the absence of immediate clinical reactions still presents diagnostic difficulties – particularly in children with atopic dermatitis. The objective of this study was to evaluate the diagnostic value of the atopy patch test (APT) with regard to late‐phase reactions observed in double‐blind, placebo‐controlled food challenges with cow's milk, hen's egg, wheat, and soybean. Methods: We investigated 75 children (median age 2.1 years) with suspected food allergy by double‐blind, placebo‐controlled food challenges, specific IgE in serum, skin prick test, and APT. Of the subjects, 69/75 suffered from atopic dermatitis. Results: Of 209 oral challenges, 133 were performed with allergen and 76 with placebo. We assessed 77/133 allergen and 2/76 placebo challenges as positive. In 66 of 77 (86%) positive oral challenges, specific IgE in serum to the corresponding allergen was positive; in 64/77 (83%) the skin prick test, and in 42/77 (55%) the APT was positive. While immediate‐type reactions were associated with positive skin prick test and proof of specific IgE in serum, late‐phase clinical reactions were associated with a positive APT (sensitivity 76%, specificity 95%). Conclusions: The APT seems to be a valuable additional tool in the diagnostic work‐up of food allergy in children with atopic dermatitis – especially with regard to late‐phase clinical reactions. The APT may help to prevent unnecessary restrictive diets which may be the consequence of misjudging late reactions by clinical assessment alone.
Reduction of side‐effects from ultrarush immunotherapy with honeybee venom by pretreatment with fexofenadine:a double‐blind, placebo‐controlled trial
Authors: Reimers A. , Hari Y. , Müller U. 
Published: March 2003

Background:Immunotherapy with Hymenoptera venoms is highly effective but causes allergic side‐effects frequently, especially when honeybee venom is used. Therefore, our objective was to investigate the effect of pretreatment with the antihistamine fexofenadine on the incidence of allergic side‐effects during ultrarush immunotherapy with bee venom.Methods:In a double‐blind, placebo‐controlled trial, 57 patients with a history of systemic allergic reactions to honeybee stings and positive diagnostic tests (skin tests, serum specific IgE to honeybee venom) were investigated. Bee venom immunotherapy was started with an ultrarush protocol and patients were randomized to pretreatment with either fexofenadine 180 mg or placebo on days 1, 8, 22, and 50 of the protocol. Local and systemic allergic side‐effects were registered.Results:Fifty‐four patients completed the study, 28 on fexofenadine and 26 on placebo pretreatment. On day 1, large local reactions were significantly reduced in both extension and duration by fexofenadine pretreatment (P<0.025). Systemic allergic side‐effects on the whole were not reduced. However, the symptoms pruritus, urticaria, and angioedema occurred less frequently with fexofenadine (P<0.05).Conclusions:Pretreatment with fexofenadine during venom immunotherapy reduces local allergic reactions and generalized symptoms of the urticaria and angioedema type.