bluuebunny/crossref_metadata_2025_split huggingface dataset:
House dust mite allergen exposure in infancy
Authors: Mahmic  , Tovey  , Molloy  , Young  
Published: March 2003

BackgroundInfancy may be a critical time for exposure to house dust mite allergens, when exposure to high levels can increase the risk of allergic sensitization and the development of asthma in later life.ObjectiveTo measure house dust mite allergen (Der p 1) concentration in the infants' environment and examine lifestyle factors which may influence mite allergen exposure.MethodsInfants aged between 4 and 12 months (n = 134) from the western region of Sydney, Australia, participated. Reservoir dust samples were collected from four sites within each home: infant's bed, second bed (adult or second child's bed), lounge floor and sheepskins (where available). Settling aeroallergen was collected for 10–14 d in Petri dishes in the infant's room. Der p 1 was measured by ELISA. A questionnaire on types of bedding, sleeping and playing patterns of the infant was completed by the parents at the time of dust collection.ResultsAll infants were exposed to at least one site with Der p 1 concentrations greater than 10 μg/g fine dust. The mean settling aeroallergen level in the infants' room was 24 ng Der p 1/m2day and this was weakly related to bed allergen levels (r = 0.21, P < 0.05). Mattress type had a weak effect on Der p 1 levels as measured in the whole bed (P = 0.07), while bed cover and bed type had no effect (P > 0.6). The mean product of time spent at a site and its allergen concentration was highest for beds in 69% of infants.ConclusionThe high level of allergen exposure in the environment of this group of infants places them at an increased risk of early sensitization and development of asthma. Any strategy to reduce asthma prevalence should address these high and avoidable levels.
Antigenicity of the proteins in soy lecithin and soy oil in soybean allergy
Authors: Awazuhara  , Kawai  , Baba  , Matsui  , Komiyama  
Published: March 2003

BackgroundSoy lecithin and soy oil are usually produced from the hexane extract of soybean. Some of the soybean proteins are included in the extract and are therefore present in small amounts in both soy lecithin and soy oil. The antigenicity of the proteins present in defatted soybean has been studied with respect to soybean allergy, but the antigenicity of those found in the extract is yet to be investigated.ObjectiveThe antigenicity of soy lecithin and soy oil proteins with regard to soybean allergy were investigated.MethodsThe proteins present in soy lecithin and soy oil were determined according to already established method and analysed by SDS‐PAGE. The IgE‐ and IgG4‐binding abilities of the soy lecithin proteins were investigated by immunoblotting with sera from 30 soybean‐sensitive patients, including seven with a positive challenge test. Immunoblotting of soy oil proteins was performed with the sera from some of these patients.ResultsIn 100 g of sample, the soy lecithin and soy oil contained 2.8 mg and 1.4–4.0 μg of proteins, respectively. The results of SDS‐PAGE demonstrated the presence of only three proteins, with molecular weights of about 58–67 kDa in soy oil, and suggested that soy lecithin also contains these proteins. The soy lecithin also contained many proteins besides these. In the soy lecithin, the detection rate of only one protein, with a molecular weight of 31 kDa, by the serum IgE of patients was significantly different compared with controls (detection rate: 40%). The proteins with molecular weights of 58–67 kDa rarely bound to serum IgE. Only one of the patients who presented a positive challenge test had IgE antibodies to soy lecithin proteins. IgG4‐binding proteins were found only rarely in soy lecithin. Neither the IgE nor the IgG4 present in the patients' sera reacted to any soy oil protein.ConclusionProteins present in soy lecithin and soy oil have little antigenicity with regard to soybean allergy.
Antihistamines in urticaria
Authors: Ring J. , Brockow K. , Ollert M. , Engst R. 
Published: March 2003

Urticaria is one of the most common and, in its chronic course, excruciating dermato‐allergic diseases. Apart from the dermatological diagnosis, the identification and evaluation of causal triggering factors is of utmost importance. Here a ‘three‐step guideline’ (according to Ring and Przybilla) has gained acceptance, ranging from a general basic examination via an intensive investigation until oral provo‐cation tests for food allergy and oral provocation tests for idiosyncrasy (OPTI) against food additives. Apart from true IgE‐mediated allergies, pseudo‐allergic reactions against food additives as well as food contents represent a major problem in chronic urticaria. Recently gastric mucosal colonization with Helicobacter pylori as the trigger of chronic urticaria has received attention. New patho‐physiological concepts describe autoantibodies that are directed either against IgE or against the high‐affinity IgE‐receptor on the surface of mast cells and basophil leucocytes. In the intradermal test with autologous serum positive wheal and flare reactions can be observed (Greaves’ test). In many patients with chronic urticaria considerable psychosomatic involvement is also observed. Histamine is one of the major mediators of most forms of urticaria although in some cases, especially physical urticaria, other mediators seem to play a role. Therefore antihistamines, and mainly H1 antihistamines, are the mainstay of antiurticaria therapy. Some studies have shown a benefit of combined H1‐ and H2‐antagonist treatment in special forms of urticaria namely urticaria factitia. Similarily pretreatment with combined H1 and H2 antagonists has been proven to reduce effectively the frequency of pseudo‐allergic reaction to some histamine‐releasing drugs used in radiology or surgery. More than 50 years after the first introduction of an antihistamine into allergy therapy, antihistamines still represent modern and exciting agents contributing to the continuous improvement of antiallergic therapy. Antihistamine therapy can be performed with either the classical or second generation antihistamines. Classical antihistamines are connected with considerable side‐effects especially sedation and anticholinergic effects. New non‐sedating antihistamines have been developed that do not cross the blood–brain barrier. The efficacy of mizolastine, a new non‐sedating H1 antagonist, has been evaluated in several placebo‐controlled and comparative clinical trials. Overall, mizolastine 10 mg/day was found to be significantly more effective than placebo and as effective as other second generation antihistamine drugs in the management of patients with chronic urticaria, with a rapid and sustained action.
Outcome of double‐blind, placebo‐controlled food challenge tests in 107 children with atopic dermatitis
Authors: NIGGEMANN  , SIELAFF  , BEYER  , BINDER  , WAHN  
Published: March 2003

Background and objectiveLittle is known about late phase clinical reactions during oral food challenges and the value of specific IgE in terms of sensitivity and specificity.MethodsWe therefore analysed retrospectively the clinical outcome of 387 oral provocations during double‐blind, placebo‐controlled food challenge tests in 107 children with atopic dermatitis.ResultsEighty‐seven (81%) children showed a positive clinical reaction to at least one challenge. The vast majority of children (94%) showed clinical symptoms to one or two allergens. One hundred and thirty‐one of 259 (51%) of verum challenges and 1/128 (0.8%) placebo challenge were assessed as positive. Oral provocations with hen's egg showed the highest percentage of positive reactions (70%). Sensitivity of specific IgE to the four allergens tested was 90%, specificity 30%. Sensitivity of the parental history as a predictive factor was 48%, specificity 72%. Ninety‐two of 131 (70%) children with positive verum provocations showed early reactions, 33 (25%) late and six (5%) combined early and late reactions. In 84/131 (64%) positive provocations one organ system was involved, while in 44 (34%) provocations two and in three (2%) challenges three organ systems were involved. Skin reactions were the most frequent clinical manifestation leading to positive reactions followed by gastro‐intestinal and respiratory symptoms. There was no correlation between titration dose and specific IgE. The subgroup of non‐sensitized children did not differ in terms of sex, age or titration dose from the total study population.ConclusionDouble‐blind, placebo‐controlled oral food challenges are helpful in distinguishing children with clinically manifested symptoms from those with food sensitization. Accurately identifying children with a clinical relevant food allergy may help to prescribe specific diets on a scientific basis, avoiding dietary limitations which may be unneccessary or even harmful.
Reference values of total serum IgE and their significance in the diagnosis of allergy among the young adult Kuwaiti population
Authors: Ezeamuzie  , Al‐Ali  , Al‐Dowaisan  , Khan  , Hijazi  , Thomson  
Published: March 2003

BackgroundThe reference total serum immunoglobulin (IgE) values and the usefulness of total IgE values in the diagnosis of allergy have not been established for the Kuwaiti population. The literature reference values may not be applicable since such values often vary among ethnic nationalities.ObjectiveThe aim of this study was to establish the reference IgE values for the young adult Kuwaiti population and to determine the usefulness of such values in the diagnosis of allergic diseases in the community.MethodsA total of 1057 randomly selected young adults were screened for atopy using the Pharmacia CAP‐PhadiatopR method. Atopy was detected in 423 individuals (40.0%). Total serum IgE was then measured in 542 randomly selected Phadiatop‐negative (non‐atopic) cases in the age range 18–50 years (mean 28.9 years) and male:female ratio of 1.3.ResultsSerum total IgE values in non‐atopics covered a very wide range (< 2–1993 kU/L) with a geometric mean (GM) value of 43.7 kU/L. The reference range, calculated as the 95% confidence interval of the log IgE (95% CI) was 3.2–602.5 kU/L. The 90% CI was 11.7–162 kU/L. The GM was significantly higher for males than females, (53.7 vs. 35.5 kU/L, P < 0.001) and for smokers than non‐smokers, (64.6 vs. 40.7 kU/L, P < 0.01), but was independent of age. Although the GM for the non‐atopics (43.7 kU/L) was significantly lower than those of the asymptomatic atopics (213.8 kU/L) and allergic asthmatics (626.6 kU/L), the 95% CI for the three groups showed considerable overlap.ConclusionsThese results show that the normal total IgE values in the young adult Kuwaiti population are generally high and that the distribution of the values is so wide that the diagnostic value of total serum IgE in this community is likely to be very limited.
High prevalence of sensitization to cat allergen among Japanese children with asthma, living without cats
Authors: ICHIKAWA  , IWASAKI  , BABA  , CHAPMAN  
Published: March 2003

BackgroundCat allergy is common among children with asthma. Many cat‐allergic patients in Japan and elsewhere do not keep cats, but nonetheless become sensitized through environmental exposure to cat allergen.ObjectiveTo assess the frequency of cat allergy and cat‐specific immunoglobulin E (IgE) and immunoglobulin G (IgG) antibody responses in young Japanese patients with asthma in relation to self‐reported cat exposure and Fel d 1 levels in dust samples.MethodsCat dander‐specific IgE antibody was measured in sera from asthma patients using the CAP system. IgE and IgG antibody to Fel d 1 was measured by antigen binding radioimmunoassay and by chimeric enzyme immunoassay. Fel d 1 levels in dust samples from a subset of patients' homes were measured by monoclonal antibody‐based enzyme immunoassay.ResultsCat‐specific IgE (CAP class≥2) was found in sera from 70% of 44 patients who kept cats and 34% of 394 patients who had never kept cats. The prevalence of sensitization increased progressively to age 6 years (40%: positive), and then increased gradually to age 16 years (approximately 60%: positive) in patients who had never kept cats. There was an excellent correlation between cat CAP values and IgE levels to Fel d 1. The absolute amount of IgE antibody to Fel d 1 ranged from 0.01 to 15.6% of total IgE. Most patients who did not keep cats were exposed to Fel d 1 levels ranging from 0.07–8 μg/g dust.ConclusionsSensitization to cat allergen is common among young asthmatic patients in Japan, even among patients who do not keep cats. Use of CAP and the chimeric enzyme‐linked immunosorbent assay allows accurate diagnosis of cat allergy and quantification of specific IgE antibody levels.
Effects of inhaled beclomethasone dipropionate on serum IgE levels and clinical symptoms in atopic asthma
Authors: Ohrui  , Funayama  , Sekizawa  , Yamaya  , Sasaki  
Published: March 2003

BackgroundA high serum immunoglobulin (Ig)E level is considered a potent predictor for the development of asthma and IgE is targeted for treatment of asthma. Although inhaled corticosteroids are well established in the treatment of asthma, the effects of inhaled corticosteroids on serum IgE levels in asthma remain uncertain.MethodsWe therefore examined asthma symptoms, concentrations of total serum IgE and specific IgE antibodies to selected allergens, blood eosinophil counts and lung functions before and 3 months after treatment with either inhaled beclomethasone dipropionate (BDP; 800 μg/day) (n = 7) or inhaled β2‐agonists alone (n = 7) in patients with atopic asthma in a randomized, double‐blind, parallel‐group controlled trial.ResultsInhaled BDP significantly improved asthma symptom scores and forced expiratory volume in 1 s, and decreased blood eosinophil counts, total serum IgE levels and specific IgE antibodies to house dust mite and cedar. Decreases in total serum IgE significantly correlated with an improvement in asthma symptom scores. In contrast, none of parameters altered in patients with atopic asthma treated with inhaled β2‐agonists alone.ConclusionsInhaled corticosteroids may improve the subsequent clinical course of atopic asthma in association with a reduction of serum IgE levels.
Peripheral blood T lymphocytes from asthmatic patients are primed for enhanced expression of interleukin (IL)‐4 and IL‐5 mRNA: associations with lung function and serum IgE
Authors: BORGER  , TEN HACKEN  , VELLENGA  , KAUFFMAN  , POSTMA  
Published: March 2003

BackgroundThe TH2‐like cytokines interleukin (IL)‐4 and IL‐5 play a pivotal role in airway wall inflammation in asthma and these cytokines are increased in peripheral blood and bronchoalveolar lavage fluid from asthmatic patients. It is unclear why specifically TH2‐like cytokines are increased in asthmatic patients. A possible explanation may be an impaired adenylyl cyclase activity, which has been observed in peripheral blood mononuclear cells of asthmatics.ObjectiveTo assess interferon (IFN)‐γ, IL‐4 and IL‐5 mRNA expressions and their control by prostaglandin E2 (PGE2), which activates adenylyl cyclases, of peripheral T lymphocytes from patients with moderately severe asthma and healthy controls.MethodsPeripheral blood T lymphocytes from asthmatics and healthy controls were isolated and stimulated with antibodies against CD3 plus CD28 in the absence and presence of increasing concentrations of PGE2. IFN‐γ, IL‐4 and IL‐5 mRNA levels were detected by reverse transcription‐polymerase chain reaction.ResultsIn contrast to IFN‐γ mRNA, IL‐4 (P = 0.03, n = 8) and IL‐5 (P < 0.05, n = 5) mRNAs in the asthma group were significantly higher than in controls (n = 4). In addition, IL‐5 showed a significant inverse correlation with forced expiratory volume (FEV1) (P < 0.04, n = 5), whereas IL‐4 positively correlated with PC20adenosine‐monophosphate (AMP) (P < 0.02, n = 8). Accumulation of mRNA for IFN‐γ, IL‐4 and IL‐5 mRNA were significantly diminished by 10−5 m PGE2 in both asthmatics and controls. In contrast, 10−6 m PGE2 significantly down‐regulated IFN‐γ and IL‐4 mRNAs (P < 0.05 for both IFN‐γ and IL‐4, n = 4) in the control group, whereas this was not observed for IL‐4 mRNA in the asthma group (n = 7).ConclusionsActivated peripheral blood T lymphocytes from asthma patients display higher levels of IL‐4 and IL‐5 mRNA in vitro, which may be due to a diminished activity of adenylyl cyclase. A new observation is that higher IL‐4 mRNA levels are associated with less severe AMP responsiveness, which might be due to a negative feedback loop of IL‐4 production by mast cells.
Relationship between allergic status and specificity of IgG antibody to inhaled allergens: the grass pollen model
Authors: MICHILS  , VERVIER  , CHOUFANI  , GOSSART  , DUCHATEAU  
Published: March 2003

BackgroundWe have previously reported that IgG antibodies from healthy individuals and patients suffering from non‐seasonal mite allergy bind to different sets of epitopes on Der p 1, allowing almost complete discrimination of the populations.ObjectivesTo confirm this observation in a seasonal allergy model where a clear relationship between allergic symptoms and exposure to the offending agent is established. To investigate whether the pattern of modified specificity is related to the differences in IgG subclass hierarchy usually exhibited by nonallergic and allergic populations.MethodsThe capacity of individual sera from patients allergic to grass pollen and healthy individuals, including grass pollen‐sensitized subjects, to prevent the binding of pooled IgG, IgG1, and IgG4 fractions from grass pollen‐allergic patients and healthy individuals to solid‐phase bound grass pollen antigen was evaluated in enzyme‐linked immunosorbent assay (ELISA) using streptavidin‐biotin technology. Specificity controls were performed using sera from patients allergic to cat dander and house dust mite.ResultsThe capacity of sera to prevent the antigen binding of allergic IgG averaged 84 ± 5% for allergic sera and 53 ± 6% for healthy sera (P < 0.001 by one‐way
anova). Conversely, using the antigen‐binding capacity of healthy control IgG as reference, percentage inhibitions averaged 46 ± 9% in grass pollen‐allergic subjects compared with 80 ± 4%, 82 ± 2% in healthy individuals, and mite‐ and cat‐allergic patients, respectively, resulting in two well‐separated populations (P < 0.0001 by one‐way
anova). Similar results were found regardless of whether pooled IgG1 or IgG4 were used.ConclusionTogether with previous data, our results define a new type of humoral signature in the immune response to inhaled allergens. Allergic and healthy status differ not only in the presence or absence of specific IgE antibody but also in the preferential expression of distinct IgG specificities that are better correlated with clinical manifestations and are unrelated to subclass distribution.
Peptidase activities in serum and bronchoalveolar lavage fluid from allergic asthmatics — comparison with healthy non‐smokers and smokers and effects of inhaled glucocorticoids
Authors: VAN DER VELDEN  , NABER  , VAN HAL  , OVERBEEK  , HOOGSTEDEN  , VERSNEL  
Published: March 2003

BackgroundNeuropeptides may be involved in the pathogenesis of asthma by evoking neurogenic inflammation. Since the effects of neuropeptides are limited by peptidases, reduced activity of peptidases may contribute to the inflammatory process.ObjectiveWe hypothesized that soluble peptidase activities are decreased in asthmatics and that inhaled glucocorticoids exert part of their anti‐inflammatory action by increasing soluble peptidase activities.MethodsSerum and bronchoalveolar lavage (BAL) fluid was obtained from non‐smoking and smoking volunteers and from allergic asthmatics both before and after treatment for 12 weeks with placebo or inhaled fluticasone propionate. Activities of neutral endopeptidase (NEP), aminopeptidase N (APN) and dipeptidyl peptidase IV (DPP IV) were determined using colourometric assays.ResultsReduced DPP IV activity in serum and reduced NEP activity in BAL fluid were found in healthy smokers compared with non‐smokers. In contrast, no differences in peptidase activities in serum or BAL fluid were observed between allergic asthmatics and healthy non‐smokers. Fluticasone propionate treatment did not affect peptidase activities in the asthmatic patients.ConclusionsWe conclude that reduced peptidase activities in serum or BAL fluid can be found in healthy smokers, but not in allergic asthmatics, and that inhaled glucocorticoids do not affect peptidase activities in BAL fluid or serum of asthmatics. Our results do not support the hypothesized dysfunction of peptidases in the asthmatic airways.
Usefulness of early serial measurement of specific and total immunoglobulin E in the diagnosis of gastro‐allergic anisakiasis
Authors: Daschner  , Alonso‐Gómez  , Caballero  , Suarez‐De‐Parga  , López‐Serrano  
Published: March 2003

BackgroundSensitization to Anisakis simplex (A. simplex) has been documented to produce severe allergic reactions following ingestion of mainly raw or under‐cooked parasitized fish. False positive skin prick tests (SPT) or specific IgE against this nematode and cross‐reactivity restricts diagnosis. Gastric anisakiasis and gastro‐allergic anisakiasis occur if fish is parasitized by live A. simplexObjectiveTo investigate if serial serological analysis could be useful in the diagnosis of acute parasitation by this nematode.MethodsWe included 41 patients who experienced an allergic reaction and/or abdominal symptoms after ingestion of raw or undercooked fish and displayed specific IgE against A. simplex. Total and specific IgE were determined two times: in the 24‐h period after onset of clinical symptoms and after 1 month. SPTs were performed against A. simplex and implicated fish. A fibre optic gastroscopy was performed in 22 patients.ResultsMedian total IgE was 80.0 (Interquartile range [IQR] 41.5–186.5) kU/L in the first evaluation and 247.0 (IQR 96.5–649.5) kU/L after 1 month. Median specific IgE against A. simplex was 11.4 (IQR 7.1–33.5) kU/L in the first 24 h and 36.8 (IQR 19.5–79.5) kU/L after 1 month. A rise of total IgE was observed in 35 of 41 patients (P < 0.00001) and a rise in specific IgE against A. simplex in 37 of 41 patients (P < 0.00001). Mean percentage increment was 392% (215–571%; 95% confidence interval [CI]) for total IgE and 339% (177–502%; 95% CI) for specific IgE. In nine of 22 gastroscopic examinations at least one larva, identified as A. simplex, could be detected by our microbiology service. In this group (n = 9) a rise of total and specific IgE was detected in eight patients (89%) (P = 0.02).ConclusionsWe consider a rise of total and specific IgE in the first month after an allergic reaction as a useful tool in the diagnosis of gastro‐allergic anisakiasis (together with patient's history), even if the parasite cannot be seen with fibre optic gastroscopy. The important rise of total and specific IgE against A. simplex can be considered as a reaction induced by the live parasitizing larva in the context of a polyclonal immunological stimulation.