bluuebunny/crossref_metadata_2025_split huggingface dataset:
A double‐blind, placebo‐controlled birch allergy vaccination study: inhibition of CD23‐mediated serum‐immunoglobulin E‐facilitated allergen presentation
Authors: Van Neerven R. J. J. , Arvidsson M. , Ipsen H. , Sparholt S. H. , Rak S. , Würtzen P.A. 
Published: March 2004

SummaryBackgroundThe clinical efficacy of specific allergy vaccination (SAV), previously called specific immunotherapy is well documented. The working mechanism of this treatment is not completely known at present. Allergen‐specific CD4+ T lymphocytes are activated at extremely low allergen concentrations in vivo possibly as a result of serum IgE‐facilitated allergen presentation (S‐FAP). Previously, we have shown that this process can be inhibited by long‐term birch SAV sera.MethodsIn the present study, we have analysed sera from birch‐allergic patients in a randomized double‐blind, placebo‐controlled clinical trial for their ability to mediate S‐FAP. Birch‐specific IgE levels were not changed after SAV. Bet v 1‐specific IgE levels, however, were significantly decreased (P<0.05) and Bet v 1‐specific IgG4 levels were strongly increased after SAV (P<0.001). None of these changes were observed in the placebo group. When the sera were tested for their ability to induce S‐FAP, a complete abrogation of this effect was noted in the sera from patients receiving active treatment (P<0.001), but not in the control group. This inhibition of S‐FAP seemed to be associated with the reduction in the ratio between Bet v 1‐specific IgE and IgG4 antibodies in serum, but a clear correlation could not be demonstrated.ConclusionIn conclusion, the present study clearly shows that SAV leads to an inhibition of the S‐FAP needed to obtain optimal T cell activation at the low allergen concentrations present in vivo. This novel mechanism may explain the increased allergen threshold levels found in allergen provocation tests and the reduction of late‐phase reactions observed after SAV.
VH gene usage in immunoglobulin E responses of seasonal rhinitis patients allergic to grass pollen is oligoclonal and antigen driven
Authors: Davies J. M. , O'Hehir R. E. 
Published: March 2004

SummaryBackground
IgE is the pivotal‐specific effector molecule of allergic reactions yet it remains unclear whether the elevated production of IgE in atopic individuals is due to superantigen activation of B cell populations, increased antibody class switching to IgE or oligoclonal allergen‐driven IgE responses.Objectives
To increase our understanding of the mechanisms driving IgE responses in allergic disease we examined immunoglobulin variable regions of IgE heavy chain transcripts from three patients with seasonal rhinitis due to grass pollen allergy.Methods
Variable domain of heavy chain‐epsilon constant domain 1 cDNAs were amplified from peripheral blood using a two‐step semi‐nested PCR, cloned and sequenced.Results
The VH gene family usage in subject A was broadly based, but there were two clusters of sequences using genes VH 3‐9 and 3‐11 with unusually low levels of somatic mutations, 0–3%. Subject B repeatedly used VH 1‐69 and subject C repeatedly used VH 1‐02, 1‐46 and 5a genes. Most clones were highly mutated being only 86–95% homologous to their germline VH gene counterparts and somatic mutations were more abundant at the complementarity determining rather than framework regions. Multiple sequence alignment revealed both repeated use of particular VH genes as well as clonal relatedness among clusters of IgE transcripts.Conclusion
In contrast to previous studies we observed no preferred VH gene common to IgE transcripts of the three subjects allergic to grass pollen. Moreover, most of the VH gene characteristics of the IgE transcripts were consistent with oligoclonal antigen‐driven IgE responses.
RNA editing of interleukin‐12 receptor β2, 2451 C‐to‐U (Ala 604 Val) conversion, associated with atopy
Authors: Kondo N. , Matsui E. , Kaneko H. , Aoki M. , Kato Z. , Fukao T. , Kasahara K. , Morimoto N. 
Published: March 2004

SummaryBackground
The production of IgE in B lymphocytes is down‐regulated by IFN‐γ. IL‐12 induces IFN‐γ production by T lymphocytes and natural killer cells by binding to its specific receptor. RNA editing is a post‐transcriptional modification.Objective
Here we show that the RNA editing of IL‐12 receptor (R) β2 is associated with atopy.Methods
Atopic patients and non‐atopic healthy controls were studied. Fragments of IL‐12R β2 cDNA and genomic DNA were amplified and sequenced. Furthermore, the function of the IL‐12R β2 chain was investigated.Results
Sequence analysis of the cDNA clones representing IL‐12R β2 mRNA transcripts revealed a C‐to‐U conversion at nucleotide 2451 (Ala 604 Val) on exon 13 in some atopic patients. Surprisingly, sequence analysis of their genomic DNA showed no 2451 C‐to‐T (Ala 604 Val) mutation. We concluded that the observed C‐to‐U mismatch in the cDNA clone is due to a post‐transcriptional modification, RNA editing. The C‐to‐U conversion was observed in 21 (20.6%) of 102 atopic patients, whereas this conversion was observed in only 4 (3.8%) of 104 non‐atopic subjects (P<0.001). IFN‐γ production by peripheral blood mononuclear cells (PBMCs) stimulated with IL‐12 in the subjects with the C‐to‐U conversion was significantly lower than that in the subjects without the C‐to‐U conversion. In atopic patients with the C‐to‐U conversion, PBMCs faintly showed the tyrosine phosphorylation of Stat4, and the IgE production by PBMCs was not suppressed by IL‐12 whereas it was suppressed by IFN‐γ.Conclusions
The RNA editing of IL‐12R β2, 2451 C‐to‐U (Ala 604 Val) conversion causes impairment of the IL‐12 signal cascade and the subsequent reduction in IFN‐γ production, resulting in the impaired down‐regulation of IgE production. This is the first report indicating that atopy is associated with RNA editing.
Interleukin‐4 increases the permeability of human endothelial cells in culture
Authors: Kotowicz K. , Callard R. E. , Klein N. J. , Jacobs M. G. 
Published: March 2004

SummaryBackground
IL‐4 plays a key role in the induction of allergic inflammation, but its role as an effector molecule is less well‐established. Although some observations suggest that IL‐4 may mediate increased vascular permeability, which is a characteristic feature of allergic inflammation, evidence for a direct effect on endothelial cell permeability is lacking.Objective
To determine the effect of human IL‐4 on the albumin permeability of cultured human endothelial cells.Methods
Human umbilical vein endothelial cells were cultured on permeable membranes and the albumin permeability of endothelial monolayers was measured with and without exposure to recombinant human IL‐4. Endothelial cells were exposed to various concentrations of IL‐4 (0.001–100 U/mL), for various durations (6–24 h), either in the presence or absence of anti‐IL‐4 antibody. Recovery of endothelial barrier function following exposure to IL‐4 was also examined.Results
IL‐4 induced a dose‐dependent, reversible increase in endothelial permeability to albumin. Low concentrations of IL‐4 (1 U/mL) induced a significant increase in endothelial permeability (P=0.004). IL‐4‐mediated endothelial leak occurred rapidly, within 6 h of exposure.Conclusions
IL‐4 has the capacity to induce vascular leak by a direct effect on cultured endothelial cells, suggesting a potential effector role for IL‐4 in the pathogenesis of vascular leak in allergic diseases.
New pregnancies and loss of allergy
Authors: Harris J. M. , White C. , Moffat S. , Mills P. , Newman Taylor A. J. , Cullinan P. 
Published: March 2004

AbstractBackground
Inverse associations between allergic disease and sibship have been consistently described and are frequently explained by purported lower rates of early infection among children from small families. Alternative explanations include the possibility that pregnancy itself determines maternal atopic status.Objective
To test the hypothesis that atopy defined by skin prick test (SPT) declines with increasing numbers of pregnancies.Methods
At enrolment to a birth cohort, mothers were skin prick tested to three common allergens. Seven years later these women underwent a second SPT and provided information on their reproductive histories. At both visits, information on allergic disease was also sought.Results
Twenty five (15%) women who were initially atopic were no longer so at the second visit; loss of hayfever symptoms was reported by 33 (29%) women. Women with higher numbers of intervening pregnancies were more likely to ‘lose’ their atopy (P=0.05) and symptoms of hayfever (P=0.02); this was not true for asthma. The findings could not be accounted for by maternal age.Conclusion
Successive pregnancies may in part determine a mother's atopic state. Since maternal atopy is a risk factor for childhood atopic disease, this process may affect the atopic state of successive children. These findings suggest an alternative explanation for the sibship effect in allergic disease.
Respiratory syncytial virus, pneumonia virus of mice, and influenza A virus differently affect respiratory allergy in mice
Authors: Barends M. , De Rond L. G. H. , Dormans J. , Van Oosten M. , Boelen A. , Neijens H. J. , Osterhaus A. D. M. E. , Kimman T. G. 
Published: March 2004

SummaryBackground
Respiratory viral infections in early childhood may interact with the immune system and modify allergen sensitization and/or allergic manifestations. In mice, respiratory syncytial virus (RSV) infection during allergic provocation aggravates the allergic T helper (Th) 2 immune response, characterized by the production of IL‐4, IL‐5, and IL‐13, and inflammatory infiltrates. However, it is unclear whether the RSV‐enhanced respiratory allergic response is a result of non‐specific virus‐induced damage of the lung, or virus‐specific immune responses.Objective
In the present study we investigated whether RSV, pneumonia virus of mice (PVM) and influenza A virus similarly affect the allergic response.Methods
BALB/c mice were sensitized and challenged with ovalbumin (OVA), and inoculated with virus during the challenge period. Pulmonary inflammation, lung cytokine mRNA responses, and IgE production in serum were assessed after the last OVA‐challenge.Results
Like RSV, PVM enhanced the OVA‐induced pulmonary IL‐4, IL‐5, and IL‐13 mRNA expression, which was associated with enhanced perivascular inflammation. In addition, PVM increased the influx of eosinophils in lung tissue. In contrast, influenza virus decreased the Th2 cytokine mRNA expression in the lungs. However, like PVM, influenza virus enhanced the pulmonary eosinophilic infiltration in OVA‐allergic mice.Conclusion
The Paramyxoviruses RSV and PVM both are able to enhance the allergic Th2cytokine response and perivascular inflammation in BALB/c mice, while the Orthomyxovirus influenza A is not.
The mental health assistant practitioner: an oxymoron?
Authors: WARNE T. , McANDREW S. 
Published: March 2004

The United Kingdom is currently experiencing a recruitment and retention crisis in its nursing workforce. Mental health care is a particular problem area. Widening access to health and social care careers is a challenge for educational and health care organizations. This discussion paper examines the congruence between an educational programme aimed at developing Mental Health Assistant Practitioners’ and the organizational responses to the subsequent opportunities for practice innovation within mental health care services. Whilst the ‘learning while working’ philosophy of the educational programme has been enthusiastically embraced by many health care organizations, the change in management required for using these assistant practitioners in service innovation appears beset by organizational, cultural and professional concerns. Not least of which are the often ambiguous concepts of the role and purpose of being a mental health nurse. This paper argues that if current mental health nurses are unclear about their role it is oxymoronic to establish the mental health assistant practitioners.
Familial hypercholesterolemia (Type IIb) in a child: a case report with interesting features
Authors: Prasad P. V. S. , Chidambaram N. 
Published: March 2004

Familial hypercholesterolemia (FH) is the most commonly recognized disorder of lipoprotein metabolism in childhood. We report a case of FH in a 5‐year‐old boy with onset of jaundice since birth, and multiple planar, tuberous, palmar and intertrigenous xanthomas covering the trunk and limbs. His total cholesterol was 590 mg/dl and triglycerides were 171 mg/dl. Echocardiography revealed mild aortic stenosis as a result of premature atherosclerosis. He was diagnosed with homozygous FH, and is reported here because of the interesting clinical features.
Favre‐Racouchot disease
Authors: Patterson Wanda M. , Fox Michael D. , Schwartz Robert A. 
Published: March 2004

AbstractSolar elastosis with comedones studding the central face is often referred to as Favre‐Racouchot disease. These open and cystically dilated comedones tend to appear in the periorbital region of the face. The clinical manifestations, pathogenesis and current treatment of this disorder are reviewed.
Evaluation of nail involvement in patients with chronic cutaneous graft versus host disease: A single‐center study from Turkey
Authors: Sanli Hatice , Arat Mutlu , Oskay Tugba , Gürman Günhan 
Published: March 2004

AbstractAlthough graft versus host disease (GVHD) is associated with a myriad of cutaneous signs, nail involvement is rarely mentioned in the literature. This study was conducted at the Department of Dermatology and The Bone Marrow Transplantation Unit of Hematology. All patients were examined clinically for presence of nail abnormalities. Severity of nail involvement was assessed as mild or severe. Of 28 patients diagnosed with chronic cutaneous GVHD, 14 had nail manifestations. Longitudinal ridging was the most frequently observed nail change on both the fingernails and the toenails. Severe nail changes such as ptergyium and onicoatrophy were noted in a few patients. As a result we could not find any relationship between nail changes and clinical severity but there was a relationship between nail changes and duration of disease. Nail manifestations could be responsible for considerable morbidity.
Allergic contact dermatitis to mango flesh
Authors: Weinstein Sari , Bassiri‐Tehrani Shirley , Cohen David E. 
Published: March 2004

A 22‐year‐old white female student presented to the Emergency Department with a 2‐day history of patchy pruritic erythema of the face, neck, and arms with periorbital edema. The eruption began as an isolated patch of nasal erythema, with subsequent extension to involve the entire face. Within 2 days, fine pinpoint papules were noted on the face, anterior chest, neck, and upper extremities. Periorbital edema was present without intraoral abnormalities or laryngeal changes. An erythematous, mildly lichenified plaque was noted on the ventral left wrist.The past medical history was significant for two similar, milder episodes of allergic reactions of uncertain etiology occurring within the previous 2 months. The previous eruptions resolved after treatment with oral loratodine and topical fluocinonide cream 0.05%. The patient denied any history of contact urticaria or new household or personal hygiene contactants, although she did report frequent ingestion of peeled mangoes. Her brother had a history of eczematous dermatitis.In the Emergency Department, the patient was administered intravenous diphenhydramine and a single 50 mg dose of oral prednisone. She continued treatment with a 5‐day course of prednisone, 50 mg daily, with loratodine, 20 mg daily, and diphenhydramine as needed; however, no symptomatic improvement was seen over 4 days. She was then advised to restart fluocinonide cream twice daily.Patch testing was performed to the North American Contact Dermatitis Group Standard Series utilizing methods of the International Contact Dermatitis research group with Finn chambers. Mango skin and mango flesh harvested 5 mm below the skin surface were also placed in duplicate and tested under Finn chambers. Positive (1+) reactions were noted to nickel and p‐tertbutylphenol formaldehyde resin, and bullous reactions were found to mango skin and surface flesh in duplicate (Fig. 1). Complete avoidance of mango led to resolution of the initial eruption. The clinical relevance of nickel and p‐tertbutylphenol formaldehyde resin was thought to be associated with the wrist lesion immediately below a glued portion of a wristwatch strap and metal clasp.Positive patch test reactions, in duplicate, to mango skin (left column) and mango flesh 5 mm below the skin (right column)image
Painful spitz naevus sole of foot
Authors: Ezughah Francesca I. , Orpin Sid , Colloby Peter S. 
Published: March 2004

A 21‐year‐old student of sports science presented with a 12‐month history of a painful nodule on the sole of her left foot, which severely constrained her sporting activities. She was otherwise well. On examination there was a bluish pink 7‐mm nodule on the arch of her left foot (Fig. 1). It was firm, exquisitely tender and she walked with a slight limp. The lesion was curetted and sent for histological diagnosis.Pink dermal nodule, sole of left footimageThe specimen showed a symmetrical wedge‐shaped compound melanocytic lesion reaching the margins of the biopsy. The overlying epidermis was acanthotic and hyperkeratotic. Junctional nests were present and there was clefting between them and the epidermis (Fig. 2). Near the nests were eosinophilic globules (Kamino bodies) and pigment‐laden macrophages. The lesion consisted of a mixture of large spindle and epithelioid cells with abundant eosinophilic cytoplasm and plump nuclei with prominent nucleoli. There were a few mitoses but none was atypical. Single epithelioid melanocytes were present deep within the lesion (outlier cells) and there was maturation with depth in the dermis. The histological features were those of Spitz naevus.Photomicrograph demonstrating functional nests with clefting. Pigment‐laden macrophages are shown, as are Kamino bodies (→ hematoxylin and eosin, original magnification × 20)imageThere was significant reduction in the severity of her pain after curettage but the pain subsequently recurred. In view of this and possible incomplete excision, the scar was re‐excised with a narrow margin. Histology confirmed complete excision of the residual naevus. Her symptoms have since subsided.
Erythema dyschromicum perstans: Response to dapsone therapy
Authors: Bahadir Sevgi , Çobanoglu Ümit , Çimsit Gülseren , Yayli Savas , Alpay Köksal 
Published: March 2004

AbstractErythema dyschromicum perstans (EDP) is a rare disorder characterized by asymptomatic, slowly progressive, ash‐gray macular pigmentation of the skin, which usually occurs from age 5 years through adult life. Most cases reported to date are of Latin American and Indian patients. Rare cases has been reported from Turkey. No treatment of choice is presently available. Various therapies have been tried, including sun protection, chemical peels, antibiotics, corticosteroids, vitamins, isoniazid, griseofulvin, and chloroquine, without any benefit. Some authors have suggested the therapeutic efficacy of clofazimine and dapsone on EDP. We report a case of EDP that responded remarkably well to treatment with dapsone.
Dermatology in Nigeria: evolution, establishment and current status
Authors: George Adekunle O. , Daramola Olaniyi O. M. 
Published: March 2004

AbstractThe history of dermatology in Nigeria can be summarized by listing the “first events and people” who played major roles. The first dermatologist to work in Nigeria was George HV Clarke in the mid 1950s. He was based in Lagos. Organized training/teaching and research in dermatology was first established at the University of Ibadan in the western region of Nigeria, in collaboration with the Institute of Dermatology, London. The first set of dermatologists from the Institute on secondment who established dermatology as a discipline at the University of Ibadan were Roger RM Harman as lecturer and GC Wells as the Visitor/supervising consultant in 1962. The first indigenous dermatologist was Anezi Okoro. The first female dermatologist was Yetunde M Olumide. The first (and still the only) Department of Dermatology was at the Obafemi Awolowo University in Ile‐ife in the western region of Nigeria, started by a German trained dermatologist: F. Soyinka, the junior brother of Nigeria's first (and only) Nobel Laureate. The first leprologist in Nigeria was George Stanley Browne, a medical missionary. He worked briefly as an associate lecturer (1963–65) under Professor Alexander Brown at the University of Ibadan. Most of the events in Nigeria's dermatology history as well as the greatest concentration of dermatologists in the country have been around the south‐western part of the country: Lagos, Ibadan, and Ile‐ife. The military coup and the political events that occurred thereafter had a great negative impact on the development/growth of dermatology in Nigeria. The documentation by Ryan as of 1990 indicates that many African countries still do not have a single trained dermatologist.1
Disseminated granuloma faciale
Authors: Zargari Omid 
Published: March 2004

A 40‐year‐old man presented in January 2001 with multiple purple plaques and nodules, which had been present on the back for approximately 3 years. The lesions had gradually extended over the face, trunk and proximal extremities. He had no symptoms except occasional mild pruritus. The patient was in good health and was on no medications. Physical examination revealed multiple violaceous to brown, indurated, 5–50‐mm, round to oval plaques on the face, arms, shoulders, and back (Fig. 1), as well as a solitary lesion on the right thigh. Surface telangiectases were noted, especially on the shoulder lesions. There was no scaling or ulceration. Routine laboratory tests were unremarkable.Multiple reddish‐brown plaques on the backimageIn April 1999, another medical center performed a biopsy of what they thought was sarcoidosis. The results were reported as “possible angiolymphoid hyperplasia with eosinophilia.” With the possibility of granuoma faciale (GF) in mind, another skin biopsy was obtained from a facial lesion. This revealed a diffuse, relatively dense infiltrate of neutrophils, eosinophils and mononuclear inflammatory cells in dermis with an obvious Grenz zone (Fig. 2). Pilar units were intact, and endothelial cell swelling was present (Fig. 3). Retrospective evaluation of the initial biopsy, taken from the back, revealed the same changes, and helped confirm the diagnosis of GF.A diffuse, relatively dense mixed infiltrate, separated from a normal epidermis by a Grenz zone (hematoxylin and eosin, × 40)imagePolymorphous infiltrate containing eosinophils, neutrophils, and lymphocytes surrounding dilated dermal vessels with swollen endothelial cells (hematoxylin and eosin, × 400)imageThe patient was treated with liquid nitrogen for 20 s followed immediately by intralesional triamcinolone acetonide (5 mg/ml). This treatment was repeated every 4 weeks for three courses, resulting in partial resolution of the lesions.