bluuebunny/crossref_metadata_2025_split huggingface dataset:
Montelukast for treating seasonal allergic rhinitis: a randomized, double‐blind, placebo‐controlled trial performed in the spring
Authors: Philip G. , Malmstrom K. , Hampel F. C. , Weinstein S. F. , LaForce C. F. , Ratner P. H. , Malice M.‐P. , Reiss T. F. ,   for the Montelukast Spring Rhinitis Study Group
Published: March 2003

SummaryBackground Cysteinyl leukotrienes are important proinflammatory mediators believed to have a role in allergic rhinitis.Objective This multicentre, randomized, double‐blind, placebo‐ and active‐controlled trial evaluated the effectiveness and tolerability of montelukast, a cysteinyl leukotriene receptor antagonist, for treating patients with seasonal allergic rhinitis.Methods After a 3‐ to 5‐day, single‐blind placebo run‐in period, 1302 male and female patients (aged 15–81 years) with active allergic rhinitis symptoms were randomly assigned to receive montelukast 10 mg (n = 348), loratadine 10 mg (n = 602), or placebo (n = 352) administered once daily at bedtime for 2 weeks during the spring allergy season.Results Mean patient characteristics and symptom scores at baseline were similar for the three treatment groups. The primary end‐point, daytime nasal symptoms score (mean of nasal congestion, rhinorrhea, nasal pruritus, and sneezing scores; 0–3 scale), improved from baseline during treatment by (least squares mean, 95% confidence interval) − 0.37 (− 0.43, − 0.31), − 0.47 (− 0.52, − 0.43), and − 0.24 (− 0.29, − 0.18) in the montelukast, loratadine, and placebo groups, respectively (P ≤ 0.001 comparing each active treatment with placebo). Mean changes from baseline in all other diary‐based scores, including night‐time and eye symptom scores, were significantly greater for each active treatment than for placebo. The rhinoconjunctivitis quality of life overall score improved significantly with montelukast and with loratadine as compared with placebo. Montelukast and loratadine showed a safety profile comparable to that of placebo.Conclusion Montelukast is well tolerated and provides improvements in daytime and night‐time symptoms, as well as quality of life parameters, for patients with seasonal allergic rhinitis.
Oral tolerance induction to Dermatophagoides pteronyssinus and Blomia tropicalis in sensitized mice: occurrence of natural autoantibodies to immunoglobulin E
Authors: Sato M. N. , Oliveira C. R. , Futata E. A. , Victor J. R. , Maciel M. , Fusaro A. E. , Carvalho A. F. , Duarte A. J. S. 
Published: March 2003

SummaryBackground The dust mites Dermatophagoides pteronyssinus (Dp) and Blomia tropicalis (Bt) are important sources of indoor allergens in tropical and subtropical countries. Murine models allow the analysis of the immune response and regulation of IgE production to Dp and Bt allergens. Oral tolerance induces unresponsiveness in naive animals, but its application in sensitized animals can provide useful information to improve allergy therapy.Objective To study the profile of IgE and IgG subclasses antibody upon oral administration with Bt and Dp extract in previously sensitized mice. Further, the occurrence of autoantibodies IgG anti‐IgE in the immunization and in the oral tolerance was investigated.Methods A/Sn mice were immunized with Bt or Dp extract in alum, orally administrated with 0.25 mg of Bt or Dp extract or PBS at the 6th, 7th and 8th days after immunization and boosted twice with their respective allergens. To analyse the mice groups, specific IgE antibodies were measured by passive anaphylaxis reaction and specific IgG subclasses and anti‐IgE IgG autoantibody by ELISA assay.Results IgE levels were markedly increased in Bt‐immunized mice compared with Dp‐immunized mice. A distinct profile of the specific isotypes was verified in Bt‐immunized mice with a preferential production of IgG3 and IgA antibodies, whereas Dp‐immunized mice developed high titres of anti‐Dp IgG1, IgG2a and IgG2b antibodies. The antigen feeding inhibited IgE response in both fed‐mice groups but only Dp‐fed mice presented decreased levels of IgG antibodies. Free anti‐IgE IgG autoantibodies were detected mainly in the Dp‐immunization and they correlated with the antibody isotypes found against the allergen.Conclusions This is the first time that the murine‐type I hypersensitivity is employed to study Bt‐immunization, showing a marked IgE production, associated with IgG response, which is at least in part driven by T‐independent antigens. The oral tolerance protocol in previously sensitized animals was able to down‐modulate IgE response and points out this route as a strategy for allergy therapy.
A rapid test for detection of mite allergens in homes
Authors: Tsay A. , Williams L. , Mitchell E. B. , Chapman M. D. 
Published: March 2003

SummaryBackground International guidelines recommend allergen avoidance for asthma management, but do not include making assessments of allergen exposure. Mite allergen exposure cannot be assumed, especially in geographical regions where climatic conditions vary.Objective To develop a rapid test that would enable consumers to detect mite allergen in the home.Methods A lateral flow test using gold labelled antibody for mite group 2 allergen was developed as part of a detection kit incorporating the MITEST dust sampling device. Dust samples were assayed by ELISA for group 1 and group 2 allergens and by using the rapid test. The tests were compared as indices of mite allergen exposure.Results There was a good correlation between group 1 and group 2 levels by ELISA (n = 349, r = 0.60, P < 0.001). In a multi‐centre study of 65 homes (263 dust samples) in five countries, there was a strong correlation between ELISA and the rapid test. Most samples with high scores in the test (43/48, 90%) contained > 1 µg/m2 group 2 allergen, whereas most low samples contained < 1 µg/m2 (50/64, 78%). Differences between mean group 2 levels of samples that scored low (0.28 µg/m2), medium (1.68 µg/m2) or high (3.18 µg/m2) on the test were highly significant (P 0.007 to < 0.001).Conclusions A simple rapid test has been developed that detects mite allergen in the home within 10 min. The mite screening test should educate consumers about allergen exposure and encourage compliance with allergen‐avoidance procedures. This technology has applications for the detection of other common environmental allergens.
Allergen‐induced bronchial inflammation in house dust mite‐allergic patients with or without asthma
Authors: Lopuhaä C. E. , Out T. A. , Jansen H. M. , Aalberse R. C. , Van Der Zee J. S. 
Published: March 2003

SummaryBackground It is presently unknown which factors determine the occurrence and persistence of asthma in house dust mite‐allergic individuals. The level of allergen‐specific IgE antibodies does not seem to be decisive for asthmatic symptoms. Moreover, levels of exposure to mite allergens do not seem to differ significantly between asthmatic and non‐asthmatics individuals.Aim It was hypothesized that the presence or absence of asthmatic symptoms in house dust mite‐allergic patients is associated with quantitative or qualitative differences in the cellular bronchial inflammatory response during the late phase of the allergic reaction. This hypothesis was tested in the bronchial allergen challenge model.Material and methods Whole lung challenges with house dust mite extract were performed in 52 house dust mite‐allergic subjects, of whom 26 had asthma and 26 had perennial rhinitis without asthmatic symptoms. Primary outcomes were parameters for bronchial inflammation in serial samples of induced sputum (cell differentials, eosinophil cationic protein (ECP), interleukin‐8 (IL‐8), myeloperoxydase (MPO)). In addition, lung function, non‐specific bronchial hyper‐ responsiveness and serial blood samples (eosinophils and IL‐5) were analysed.Results At baseline sputum eosinophils and ECP were similar in both groups but neutrophils and IL‐8 were higher in asthmatics. The early bronchoconstriction after allergen challenge was similar in asthma and non‐asthmatic rhinitis (median decrease in FEV1: asthma − 31.7% vs. non‐asthmatics − 29.1%, P > 0.1). The late phase bronchoconstriction was significantly greater in asthma (median decrease in FEV1: asthma − 27.6% vs. non‐asthmatics − 18.9%, P = 0.02). Induction of bronchial hyper‐responsiveness was similar in both groups. Bronchial allergen challenge elicited significant increases in sputum eosinophils and ECP, which were indistinguishable for both groups (P > 0.1 and P = 0.07, respectively). In contrast, higher numbers of neutrophils persisted in asthma 24 h after challenge and were accompanied by significant increases in IL‐8 and MPO, which were absent in non‐asthmatics (difference between groups P = 0.007 and P = 0.05, respectively).Conclusion Allergen challenge induced very similar increases in eosinophils and ECP in induced sputum in allergic asthmatics and in allergic non‐asthmatic patients. The difference in bronchial inflammation between asthma and non‐asthmatic rhinitis appeared to be more closely related to indices for neutrophilic inflammation.
Safety of inhalant allergen immunotherapy with mass units‐standardized extracts
Authors: Nettis E. , Giordano D. , Pannofino A. , Ferrannini A. , Tursi A. 
Published: March 2003

SummaryBackground Allergen‐specific immunotherapy (SIT) is an effective treatment for patients with respiratory allergies. However, subcutaneous injection of allergens can provoke systemic side‐effects.Objective This study was carried out to determine the incidence and risk factors of systemic reactions caused by SIT treatment, using extracts of different inhalant allergens, adsorbed in aluminium hydroxide and biologically standardized with the major allergens quantified in mass units.Methods Five hundred and fifty‐five subjects with allergic rhinitis and/or asthma were evaluated on clinical history and skin prick test (SPT) reactions to common inhalant allergens. Subcutaneous SIT was administered to all patients, according to the suggested precautionary guidelines and administration schedule. Patients were treated with house dust mite, grass pollen, Parietaria judaica pollen and olive pollen extracts, each receiving one or two extracts.Results A total of 36 359 injections were administered in the 555 patients. We observed 34 episodes of serious systemic side‐effects (0.093% of all injections), in 29 patients (5.2% of all patients), and no fatalities. About 55% of patients reported mild rhinitis and asthma. The majority (59%) of the serious systemic reactions (SSR), and all the anaphylactic reactions, were immediate (i.e. occurred within 30 min after the injection). Asthmatic subjects were at higher risk of SSR than patients with rhinitis (P = 0.01). Most of the side‐effects observed occurred during the dose‐increase phase (P < 0.05). There was no association of SSR with age, gender, SPT reactivity or allergen type.Conclusion SIT performed in patients with respiratory allergies by specialized staff with the allergen extracts studied, standardized in mass units, provoked a low rate of SSR. The significant risk factors for systemic reactions were asthma and the build‐up period.
The range of minimum provoking doses in hazelnut‐allergic patients as determined by double‐blind, placebo‐controlled food challenges
Authors: Wensing M. , Penninks A. H. , Hefle S. L. , Akkerdaas J. H. , Van Ree R. , Koppelman S. J. , Bruijnzeel‐Koomen C. A. F. M. , Knulst A. C. 
Published: March 2003

SummaryBackground The risk for allergic reactions depends on the sensitivity of individuals and the quantities of offending food ingested. The sensitivity varies among allergic individuals, as does the threshold dose of a food allergen capable of inducing an allergic reaction.Objective This study aimed at determining the distribution of minimum provoking doses of hazelnut in a hazelnut‐allergic population.Methods Thirty‐one patients with a history of hazelnut‐related allergic symptoms, a positive skin prick test to hazelnut and/or an elevated specific IgE level, were included. Double‐blind, placebo‐controlled food challenges (DBPCFC) were performed with seven increasing doses of dried hazelnut (1 mg to 1 g hazelnut protein) randomly interspersed with seven placebo doses.Results Twenty‐nine patients had a positive challenge. Itching of the oral cavity and/or lips was the first symptom in all cases. Additional gastrointestinal symptoms were reported in five patients and difficulty in swallowing in one patient. Lip swelling was observed in two patients, followed by generalized urticaria in one of these. Threshold doses for eliciting subjective reactions varied from a dose of 1 mg up to 100 mg hazelnut protein (equivalent to 6.4–640 mg hazelnut meal). Extrapolation of the dose–response curve showed that 50% of our hazelnut‐allergic population will suffer from an allergic reaction after ingestion of 6 mg (95% CI, 2–11 mg) of hazelnut protein. Objective symptoms were observed in two patients after 1 and 1000 mg, respectively.Conclusion DBPCFCs demonstrated threshold doses in half of the hazelnut‐allergic patients similar to doses previously described to be hidden in consumer products. This stresses the need for careful labelling and strategies to prevent and detect contamination of food products with hazelnut residues.
Relationship between changes in interferon‐γ production by peripheral blood T cells and changes in peak expiratory flow rate in patients with chronic stable asthma
Authors: Koh Y. I. , Choi I. S. , Lee H.‐C. 
Published: March 2003

SummaryBackground Cytokines production by T helper lymphocytes (Th cells), which orchestrate the interplay of the different cells involved in airway inflammation of asthma, may be reflected in peripheral blood. Some studies have suggested that the Th cell cytokines by peripheral blood T cells correlate with asthma severity.Objective To investigate the relationship between changes in IFN‐γ production by peripheral blood T cells and changes in lung function in chronic stable asthmatics.Methods Sixteen patients with chronic stable moderate asthma aged 35–65 years (nine women) were recruited. Morning and evening peak expiratory flow rates (PEFR) monitoring and blood sampling for peripheral blood T cell culture, total IgE and blood eosinophils were performed at baseline and week 12. Levels of IFN‐γ, IL‐4 and IL‐5 in culture supernatants of peripheral blood T cell were determined by using enzyme‐linked immunosorbent assay (ELISA) kits.Results Patients with increased IFN‐γ changes from baseline showed significantly increased changes in morning (P = 0.02) and evening (P < 0.05) PEFR compared with those with decreased IFN‐γ changes. The changes in IFN‐γ production and IFN‐γ: IL‐4 ratio significantly correlated with the changes in morning PEFR (Rs = 0.59, P < 0.02; Rs = 0.63, P < 0.01, respectively) and tended to correlate with the changes in evening PEFR (Rs = 0.45, P = 0.08; Rs = 0.5, P = 0.05, respectively). The changes in IL‐4 and IL‐5 did not correlate with the changes in IgE and blood eosinophils, respectively.Conclusions These findings suggest that IFN‐γ may be associated with the alteration of lung function in asthmatics and play a role in the pathophysiology of chronic stable asthma.
Atopy and serum eosinophil cationic protein in 110 white children with vernal keratoconjunctivitis: differences between tarsal and limbal forms
Authors: Pucci N. , Novembre E. , Lombardi E. , Cianferoni A. , Bernardini R. , Massai C. , Caputo R. , Campa L. , Vierucci A. 
Published: March 2003

AbstractBackground A predominance of Th2 response has been suggested in vernal keratoconjunctivitis (VKC), and a high prevalence of IgE‐sensitized (IgE‐S) patients has been reported (positive skin prick test or serum‐specific‐IgE). Palpebral and bulbar VKC are considered to be expressions of the same disease and only occasional racial and histopathological differences are described between the two forms. Tear levels of eosinophil cationic proteins have been correlated with the severity of ocular symptoms; however, there is no published study that demonstrates the presence of serum markers of disease activity.Objective This study was performed to evaluate the prevalence of IgE‐sensitization in palpebral, bulbar and mixed VKC and to determine possible useful markers of disease activity in peripheral circulation.Methods A total of 110 white VKC patients (mean age 8.3 years, range 3.2–18 years) were evaluated for ocular score in the active phase of the disease. Skin prick tests and serum‐specific IgE for common allergens, serum‐total IgE, peripheral blood eosinophil counts (PBECs) and serum eosinophil cationic protein (s‐ECP) were determined. Fifteen age‐matched non‐IgE‐S control children underwent the same determinations.Results s‐ECP, PBECs and s‐total IgE were significantly higher in IgE‐S than in non‐IgE‐S VKC patients and in non‐IgE‐S VKC patients than in controls. A lower prevalence of IgE‐S patients was found in bulbar vs. tarsal (P = 0. 050) or mixed forms (P = 0.002). The score of giant papillae was strongly correlated with s‐ECP levels (P < 0.001) and with PBECs (P = 0.001).Conclusions Our data suggest that an overall eosinophilic response is present in VKC independently of IgE‐sensitization; bulbar forms, unlike tarsal and mixed forms, were associated with a low prevalence of IgE‐sensitization. Serum ECP was a useful marker of disease activity in tarsal and mixed forms.
Microarrayed recombinant allergens for diagnosis of allergy
Authors: Harwanegg C. , Laffer S. , Hiller R. , Mueller M. W. , Kraft D. , Spitzauer S. , Valenta R. 
Published: March 2003

SummaryWe suggest that the coapplication of recombinant allergens and microarray technology can lead to the development of new forms of multi‐allergen tests which allow the determining and monitoring of complex sensitization profiles of allergic patients in single assays. The allergen extracts which have so far been used for diagnosis only allowed the determining of whether an allergic patient is sensitized against a particular allergen source, but the disease‐eliciting allergens could not be identified. Through the application of recombinant DNA technology a rapidly growing panel of recombinant allergen molecules has become available which meanwhile comprises the epitope spectrum of most of the important allergen sources. We demonstrate that microarray technology can be used to establish multi‐allergen tests consisting of microarrayed recombinant allergen molecules. Microarrayed recombinant allergens can be used to determine and monitor the profile of disease‐eliciting allergens using single tests that require minute amounts of serum from allergic patients. The wealth of diagnostic information gained through microarray‐based allergy testing will likely improve diagnosis, prevention and treatment of allergy.
Clinical effects of air filters in homes of asthmatic adults sensitized and exposed to pet allergens
Authors: Francis H. , Fletcher G. , Anthony C. , Pickering C. , Oldham L. , Hadley E. , Custovic A. , Niven R. 
Published: March 2003

SummaryBackground Despite medical advice, many pet‐allergic asthma sufferers refuse to remove the pet to which they are sensitized from their home.Objective We aimed to assess the clinical effects of air cleaners in the homes of adult asthma patients sensitized and exposed to cats and/or dogs.Methods We performed a randomized, parallel‐group study of 30 asthmatic adults sensitized to and sharing a home with cats or dogs. The effects of placing air cleaners in the living room and bedroom for 12 months and using high efficiency particulate air filter vacuum cleaners (active group) were compared with using these vacuum cleaners alone (control group). Measures of airway responsiveness, treatment requirement, lung function, peak flow, reservoir and airborne allergen were recorded before, during and after the interventions. A beneficial clinical response was assessed in terms of a ‘combined asthma outcome’. This was defined as a two or more doubling dose improvement in bronchial hyper‐reactivity to histamine and/or a reduction in treatment requirement of at least one step change on the British Thoracic Society guidelines for asthma treatment.Results A beneficial clinical response was observed in 10/15 subjects in the active group compared with 3/15 in the control group after 12 months intervention (P = 0.01). No significant differences between the active and control groups were detected for changes in measures of lung function, reservoir pet allergen and airborne pet allergen during the study.Conclusion Whilst the study design has not allowed complete exclusion of a placebo effect, we believe that this pragmatic study of adult asthmatic patients sensitized and exposed to pets resulted in a small, but significant improvement in combined asthma outcome.
Th1/Th2 profile in peripheral blood in atopic cough and atopic asthma
Authors: Shirai T. , Suzuki K. , Inui N. , Suda T. , Chida K. , Nakamura H. 
Published: March 2003

SummaryBackground Eosinophilic tracheobronchitis with cough hypersensitivity, abbreviated as atopic cough, is an important cause of chronic cough. The reason for the absence of airway hyper‐responsiveness is unknown, differing from asthma, a Th2 cytokine‐mediated disorder.Objective To compare the type 1 helper T cell (Th1)/Th2 balance in the peripheral blood from subjects with atopic cough and atopic asthma, we assessed the intracellular cytokine production at the single‐cell level.Methods Thirty‐six subjects (10 patients with atopic cough, 18 with atopic asthma, and eight control subjects) were included. Intracellular IL‐4 and IFN‐γ were detected in CD4+ T cells by flow cytometry.Results A significantly lower ratio of IFN‐γ‐/IL‐4‐producing CD4+ T cells after phorbol 12‐myristate acetate/ionomycin stimulation was found in patients with atopic cough and atopic asthma compared with normal subjects. In comparison between atopic patients, the ratio of IFN‐γ‐/IL‐4‐producing cells was significantly higher in atopic cough than in atopic asthma. However, the proportion of IL‐4‐producing CD4+ T cells was significantly higher in patients with atopic asthma than in normal control subjects and no significant difference was detected between patients with atopic cough and normal subjects. No significant difference in the proportion of IFN‐γ‐producing cells was found between the subjects. Overall, the total IgE levels were positively correlated to the IL‐4‐producing cells and inversely correlated to the ratio of IFN‐γ‐/IL‐4‐producing cells.Conclusion These results show the lower degree of Th2 cytokine predominance in atopic cough compared with atopic asthma and suggest the relation between the Th1/Th2 balance and atopic status.