bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cysteinyl‐leukotriene release test (CAST) in the diagnosis of immediate drug reactions
Authors: Lebel B. , Messaad D. , Kvedariene V. , Rongier M. , Bousquet J. , Demoly P. 
Published: March 2003

Background: The diagnosis of allergic reactions to drugs is difficult. Most skin tests are not standardized, and in vitro tests are needed to avoid provocation tests. Cross‐linking of IgE on basophils is known to cause the release of both cysteinyl leukotriene (Cys‐LT) and histamine. We aimed to evaluate the diagnostic utility (sensitivity, specificity, and efficiency) of measurement of sulfidoleukotrienes in drug allergy. Methods: We performed a prospective study in 55 patients with proven immediate adverse reactions to drugs (30 to β‐lactams, six to acetaminophen, and 19 to aspirin) and 64 drug‐exposed nonallergic controls. Positive diagnosis was established by history, skin tests, and, if needed, oral provocation tests. Cys‐LT release was determined after drug‐allergen stimulation by the cellular antigen stimulation test (CAST®) technique. Histamine release was also assessed on the same samples by enzyme immunoassay. Spontaneous and anti‐FcεRIα‐induced mediator release was also studied in all subjects. Sensitivity, specificity, and efficiency were calculated. Results: Net Cys‐LT release was over the maximal threshold given by the manufacturer in 19/55 patients and in 9/64 controls. Net histamine release was over 5% of total histamine content in 28/55 patients and 34/64 controls. The efficiency of both tests was low. Conclusions: Thus, in most cases, the in vitro Cys‐LT test has little or no diagnostic utility and is not superior to histamine release.
Fexofenadine reduces nasal congestion in perennial allergic rhinitis
Authors: Ciprandi G. , Cosentino C. , Milanese M. , Mondino C. , Canonica G. W. 
Published: March 2003

Background: Nasal congestion is the predominant symptom in perennial allergic rhinitis (PAR), and it seems to be mainly related to the late‐phase inflammatory events. The present pilot study aimed to evaluate the therapeutic effect exerted by fexofenadine in patients with PAR due to mite allergy. Methods: This study was a parallel, double‐blind, randomized, three‐arm (1:1:1), placebo‐controlled study. Thirty‐one subjects with PAR were enrolled and received double‐blind medication: fexofenadine 120 or 180 mg, or placebo, once a day for 28 days. Results: The total symptom score was reduced by fexofenadine (both dosages) at V2 (P=0.007), whereas placebo did not modify it. Nasal congestion decreased after 1 week of treatment with fexofenadine 120 (P=0.027) and 180 (P=0.01), but not with placebo (P=NS). At V3, fexofenadine (both dosages) significantly reduced nasal congestion (P=0.011 and P=0.007, respectively), by placebo did not show any significant effect. Conclusions: This pilot study represents the first evidence of the efficacy of fexofenadine in PAR, and also the control of the nasal congestion. We suggest performing larger trials to confirm these preliminary findings.
The role of patient training in the management of seasonal rhinitis and asthma: clinical implications
Authors: Gani F. , Pozzi E. , Crivellaro M. A. , Senna G. , Landi M. , Lombardi C. , Canonica G. W. , Passalacqua G. 
Published: March 2003

Background: Allergic rhinitis is an inflammatory disease often associated with bronchial asthma. Intranasal corticosteroids and oral antihistamines are the first‐choice drugs. Patient training is relevant to asthma management, but little is known about its impact on rhinitis. We evaluated the role of patient training in the treatment of allergic rhinitis and its effects on nasal and bronchial symptoms. Methods: One hundred and one patients (M/F=62/39, age range 12–62 years) with pollen‐induced rhinitis (32 with concomitant mild asthma) were enrolled. They were randomized into three groups: A (n=30) with drug therapy alone, B (n=35) with drug therapy plus training on the use of nasal spray, and C (n=36) the same as B plus a lesson on rhinitis and asthma. All patients received mometasone furoate nasal spray for 8 weeks as regular therapy, plus rescue medications on demand. Symptoms and drug consumption were evaluated during the pollen season. Results: The rate of noncompliance/dropout was highest in the untrained patients (P=0.001). No difference in nasal symptoms was seen among the three groups. On the other hand, group C had significantly fewer asthma symptoms (P=0.02) and less albuterol use (P=0.005) than group A. Moreover, the trained group globally used less rescue medication than the other groups (P=0.02). Conclusions: Detailed training of patients seems to improve compliance with treatment, reduce concomitant asthma symptoms, and reduce the use of symptomatic drugs.
Allergenic cross‐reactivity between the nematode Anisakis simplex and the dust mites Acarus siro, Lepidoglyphus destructor, Tyrophagus putrescentiae, and Dermatophagoides pteronyssinus
Authors: Johansson E. , Aponno M. , Lundberg M. , Van Hage‐Hamsten M. 
Published: March 2003

Background: The nematode Anisakis simplex is a common parasite on fish and other seafood. It is considered to be a food allergen and to induce IgE‐mediated reactions. Allergenic cross‐reactivity between A. simplex and other nematodes has been reported, as has cross‐reactivity with arthropods: red mosquito larvae and German cockroach. We have here studied the allergenic relationship between A. simplex and four different dust‐mite species. Methods: Serum samples collected from 69 farmers allergic to dust mites were analyzed for IgE to A. simplex by CAP FEIA. Allergenic cross‐reactivity between A. simplex and dust mites was studied in two of the sera by CAP FEIA and immunoblotting inhibition. Results: We found that 14/69 farmers had detectable levels of IgE antibodies to A. simplex. The IgE response in CAP FEIA to A. simplex was inhibited to various degrees in the two studied sera by extracts of the dust mites Acarus siro, Lepidoglyphus destructor, Tyrophagus putrescentiae, and Dermatophagoides pteronyssinus. In the reverse inhibition experiment, extract of A. simplex inhibited the response in both sera to A. siro and T. putrescentiae, but not to L. destructor. The IgE binding to D. pteronyssinus was inhibited in one of the two sera. In blotting inhibition experiments, the IgE binding to several allergens in A. simplex was inhibited by each of the four mite extracts, especially by A. siro and T. putrescentiae, which completely inhibited the IgE binding to several allergens. Conclusions: The results show allergenic cross‐reactivity between several allergens in A. simplex and four dust‐mite species. The clinical significance of this cross‐reactivity remains to be evaluated.
Nasal and exhaled nitric oxide in response to occupational latex exposure
Authors: Tan K. , Bruce C. , Birkhead A. , Thomas P. S. 
Published: March 2003

Background: Latex sensitivity is an increasing problem among health‐care workers. Allergic responses are associated with changes in nitric oxide (NO) generation and the changes secondary to latex have not been described. Methods: A total of 22 subjects comprising equal numbers of control volunteers and subjects with self‐reported latex sensitivity were recruited to undergo latex skin prick testing. Symptom scores, exhaled nitric oxide (eNO), and nasal nitric oxide (nNO) were studied 1) before and after a controlled latex challenge (n=16), and 2) at the beginning and end of the working week, during exposure to latex (n=18). Results: Latex challenge caused a significant fall in nNO levels in latex‐sensitive subjects, compared to normal control subjects (P=0.04). eNO levels also decreased in the latex‐sensitive subjects after latex challenge, but to a lesser degree. There were no significant differences between the beginning and end of the working week in terms of eNO or nNO in either group, although symptom scores showed a nonsignificant increase in latex‐sensitive subjects. Conclusions: Fall in nasal NO after latex challenge is associated with reported symptomatic latex sensitivity, and this corresponds to latex skin prick test positivity. Neither nNO nor eNO showed a clear relationship to routine workplace exposure.
IL4‐R1 (5q31–q33) and FcεRI‐βca (11q13) markers and atopy: a case/control study in a Spanish population
Authors: Torres‐Galván M. , Quiralte J. , Pestano J. J. , Ortega N. , Blanco C. , Castillo R. , Carrillo T. , Pérez‐Aciego P. , Sánchez‐García F. 
Published: March 2003

Background: Rhinoconjunctivitis and bronchial asthma are atopic diseases with a high prevalence in the Canary Islands (Spain). Given that the most prevalent allergen is the house‐dust mite Dermatophagoides pteronyssinus, early detection of genetically susceptible subjects would allow the application of preventive measures. The objective was to investigate the possible association of IL4‐R1 (chromosome 5q31–q33) and FcεRI‐βca (chromosome 11q13) markers with the atopic disease in our population. Methods: We performed a case/control study in which patients were recruited on the basis of diagnosis of rhinoconjunctivitis and/or bronchial asthma, and positive skin prick test to D. pteronyssinus. Analysis of IL4‐R1 and FcεRI‐βca microsatellites was carried out by PCR and electrophoresis in acrylamide gels. Results: We have not found evidence of association between IL4‐R1 and FcεRI‐βca markers and atopic disease in our population. In addition, these markers have shown a high percentage of homozygosis. Conclusions: IL4‐R1 and FcεRI‐βca markers have not proved to be useful genetic markers for linkage or association studies in our population.
Oilseed rape flour: another allergen causing occupational asthma among farmers
Authors: Alvarez M.J. , Estrada J.L. , Gozalo F. , Fernandez‐Rojo F. , Barber D. 
Published: March 2003

Background: Farmers are exposed to a wide variety of sensitizers. Since occupational asthma (OA) can lead to permanent disability, exposure discontinuation is the preferred treatment. When this is not possible, the identification of the causative allergen may allow an alternative therapy. Methods: We present three farmers diagnosed with OA as a consequence of handling fodder. We carried out skin tests with common and occupational allergens and with oilseed rape (OSR) extract. Total and specific serum IgE levels were measured. The patients underwent the OSR‐bronchial provocation test (OSR‐BPT). The day before and 24 h after the OSR‐BPT, the methacholine (M)‐BPT and induced sputum were performed. Eosinophil percentages and ECP levels were measured in the sputum samples. Results: OSR sensitization (skin tests and specific serum IgE) was detected in all the patients. The OSR‐BPT elicited early responses in two subjects. Methacholine sensitivity, sputum eosinophils, and sputum ECP levels increased 24 h after the OSR‐BPT in all the patients. Conclusions: We have demonstrated that inhalation of OSR flour causes bronchoconstriction, induces an eosinophilic inflammatory bronchial response, and increases bronchial hyperresponsiveness in sensitized asthmatics. OSR flour contained in animal fodder should be considered another potential cause of OA among farmers.
Pigeon allergens in indoor environments: a preliminary study
Authors: Curtis L. , Lee B.‐S. , Cai D. , Morozova I. , Fan J.‐L. , Scheff P. , Persky V. , Einoder C. , Diblee S. 
Published: March 2003

Background:  Few studies have measured pigeon allergens in non pigeon coop environments. This study was conducted to determine approximate pigeon dropping allergen concentrations in indoor environments.Methods:  Polyclonal antibody serum was prepared by injecting a rabbit three times with crude wild pigeon dropping extract in 50 mM Tris buffer with Freund's adjuvant. One hundred and fifteen dust samples were collected in a pigeon‐infested school, pigeon coops, homes and hospitals and analyzed by a direct competitive pigeon enzyme‐linked immunosorbent assay (ELISA).Results:  The highest level of pigeon allergen inhibitory activity were recorded in four samples from pigeon coop bedding samples with a median activity of 11.2% relative to pigeon droppings. The second highest level of pigeon allergens was in a pigeon‐infested high school with a median or 7.4% activity relative to pigeon droppings. At an entrance underneath pigeon roosts, one sample had a relative inhibitory activity of 62.3%. Pigeon allergen inhibitory levels were generally low in the home and hospital samples, but nevertheless 46 out of 89 of these samples were still above detection limit.Conclusions:  This study suggests that large concentrations of pigeon allergens can be found in buildings without domestic pigeons such as the pigeon‐infested high school.
Polymorphism 4G/5G in the plasminogen activator inhibitor‐1 (PAI‐1) gene is associated with IgE‐mediated allergic diseases and asthma in the Czech population
Authors: Buč D. , Izakovičová Hollá L. , Vácha J. 
Published: March 2003

Background: Plasminogen activator inhibitor type 1 (PAI‐1) is a glycoprotein that belongs to the serine protease inhibitor superfamily and has an essential role in tissue remodeling after inflammation. Recently, a single base pair deletion/insertion (4G/5G) polymorphism of the PAI‐1 gene has been associated with an increased risk of asthma in nuclear families from the UK.Methods: The present study was thus conducted to determine the association of this polymorphism with the development of IgE‐mediated asthma and other allergic diseases in the Czech population. A case‐control approach was used in our study. DNA taken from subjects with clinically manifested asthma and other allergic diseases (n = 207) and from reference ethnically age‐gender‐matched unrelated subjects (n = 186) was examined for base deletions/insertions in the PAI‐1 gene.Results: A significant association (P = 0.0035) was observed between the PAI‐1 promoter polymorphism and IgE‐mediated allergic diseases altogether. Furthermore, the 4G allele frequency was also significantly higher in the asthmatic patients than in the control group (P = 0.0148).Conclusions: Our findings support the idea that the 4G allele of the 4G/5G polymorphism in the PAI‐1 gene may be a risk factor for IgE‐mediated asthma and allergic diseases.
Up‐regulation of IL‐18 in allergic rhinitis
Authors: Verhaeghe B. , Gevaert P. , Holtappels G. , Lukat K. F. , Lange B. , Van Cauwenberge P. , Bachert C. 
Published: March 2003

Background:  This paper reports a study on the concentrations of the pro‐inflammatory cytokines IL‐18 and IL‐1β in nasal secretions of allergic rhinitis patients in relation to ECP and nasal symptoms.Methods:  We measured IL‐18 and IL‐1β concentrations using ELISA, and eosinophilic cationic protein (ECP) using the CAP system, in nasal secretions of 15 seasonal allergic rhinitis (SAR) patients at six visits throughout the pollen season. Pollen exposure, nasal and ocular symptoms were monitored daily. Furthermore, we measured IL‐18, IL‐1β and ECP concentrations in nasal secretions of 19 controls and 20 symptomatic persistent allergic rhinitis (PAR) patients with house dust mite allergy.Results:  In SAR, the increase of IL‐18, IL‐1β and ECP paralleled the pollen flight with a time delay. IL‐18 and IL‐1β significantly increased during the pollen season compared to baseline, and differently from ECP, remained elevated until 4 weeks after the season. In PAR, the concentrations of IL‐18 and ECP, but not IL‐1β, were significantly higher compared to controls, with IL‐18 concentrations also being significantly higher than in SAR.Conclusion:  This is the first study to demonstrate the up‐regulation of IL‐18 in nasal secretions in allergic rhinitis. The persistence of elevated IL‐18 concentrations until after the season and the high concentrations in PAR compared to SAR suggests its role in persistent allergic inflammation.
Treatment of asthmatic patients with a cysteinyl leukotriene receptor‐1 antagonist montelukast (Singulair), decreases the eosinophil survival‐enhancing activity produced by peripheral blood mononuclear leukocytes in vitro
Authors: Becler K. , Håkansson L. , Rak S. 
Published: March 2003

Background: Montelukast (Singulair, MSD) has been shown to have a beneficial effect on the clinical symptoms of asthma. We aimed to investigate the effect of montelukast treatment on the production of eosinophil survival‐enhancing cytokines by peripheral blood mononuclear cells (PBMNC).Methods: PBMNC obtained from 15 grass‐allergic patients (7 treated with montelukast and 8 with a placebo) were cultured for 72 h. Eosinophils from allergic patients were cultured with MNC supernatants alone or with addition of neutralizing antibodies, and the proportion of living cells was assessed by flow cytometry. In another experiment PBMNC from 6 allergic patients were cultured in vitro in the presence of montelukast or vehicle. Following stimulation the production of GM‐CSF in monocytes was assessed.Results: Eosinophil survival in the MNC supernatants from the placebo‐treated patients was significantly (P < 0.05) higher than in supernatants from montelukast‐treated patients. GM‐CSF was the predominant cytokine responsible for the eosinophil survival‐enhancing activity (ESEA). In vitro production of GM‐CSF by allergen‐stimulated monocytes was significantly suppressed by addition of montelukast.Conclusion: Treatment of patients with montelukast decreased the production of MNC‐derived cytokines, particularly GM‐CSF. We suggest that cysteinyl leukotriene receptor‐1 (CysLT‐R1) antagonists may act, at least partially, by diminishing the production of GM‐CSF from PBMNCs.
Rapid method for arrayed investigation of IgE‐reactivity profiles using natural and recombinant allergens
Authors: Suck R. , Nandy A. , Weber B. , Stock M. , Fiebig H. , Cromwell O. 
Published: March 2003

Background: The availability of increasing numbers of purified natural and recombinant allergens offer the possibility for component‐resolved characterization of IgE binding. To make use of this potential, fast and simple methods with high capacity have to be developed.Methods: A laboratory multiscreen device was used in an innovative two‐dimensional approach. In the first step, natural and recombinant allergens were immobilized onto the membrane using the sample chambers as application mask and, after blocking and rotating the membrane through 90°, the same device was used to apply and incubate sera of allergic patients. Enzyme‐linked immunoassay (ELISA) quantification of specific IgE was performed for purposes of comparison.Results: Proteins were most efficiently bound onto nitrocellulose in 20 mM sodium hydroxide (NaOH). Up to 45 proteins or extracts could be investigated with a maximum of 45 sera in a single application, resulting in a resolution of 2025 spots on one membrane with a size comparable to a standard Western blot. A high correlation for IgE‐binding between natural and recombinant allergens was observed. Development of the membrane resulted in very evenly distributed square patterns. The results corresponded with the conventional ELISA measurements of specific IgE.Conclusions: The innovative usage of a standard incubation device for both application of proteins as well as screening of sera provides a simple high throughput method for the characterization of IgE binding to allergens. The results are important for component resolved diagnosis of allergy by means of fast monitoring of IgE‐ and IgG‐reactivity spectra. Recombinant allergens may be used as targets for these purposes.
Nasal provocation test (NPT) with aspirin: a sensitive and safe method to diagnose aspirin‐induced asthma (AIA)
Authors: Alonso‐Llamazares A. , Martinez‐Cócera C. , Domínguez‐Ortega J. , Robledo‐Echarren T. , Cimarra‐Alvarez M. , Mesa del Castillo M. 
Published: March 2003

Background: We have aimed to determine the sensitivity and specificity of a simpler technique with less risk than oral provocation to diagnose aspirin‐induced asthma (AIA).Methods: We studied a group of 20 AIA patients compared to a control group with 40 aspirin‐tolerant patients (confirmed by oral provocation test): 10 asthmatic patients and 30 healthy subjects. A nasal provocation test (NPT) with lysine acetylsalicylic acid (L‐ASA) was carried out. Nasal and pulmonary functions were monitored with anterior active rhinomanometry (AAR) and spirometry. An L‐ASA solution (900 mg/ml L‐ASA, equivalent to 500 mg/ml acetylsalicylic acid) was diluted with saline solution. We administered four increasing doses: 5, 25, 50 and 100 mg/ml acetylsalicylic acid (ASA) with saline solution control. Nasal and pulmonary functions were monitored with rhinomanometry and spirometry. The patients were controlled for nasal inspiratory peak flow and expiratory peak flow.Results: The results showed high sensitivity and specificity: 80% and 92.5%, respectively, with an 84.2% positive predictive value and an 89.2% negative predictive value. The patients had no bronchial or systemic symptoms, and no decreases over 20% were recorded in the FEV1.Conclusion: NPT has a high sensitivity and specificity in the diagnosis of AIA. An oral provocation should be performed to confirm the result whenever the clinical situation of the patient permits it.
In vitro kinetics of allergen‐ and microbe‐induced IL‐4 and IFN‐γ mRNA expression in PBMC of pollen‐allergic patients
Authors: Laaksonen K. , Waris M. , Mäkelä M.J. , Terho E. O. , Savolainen J. 
Published: March 2003

Background: According to a hypothesis allergens induce Th2 responses in allergic patients, and microbes induce Th1 responses. We studied the kinetics of in vitro allergen‐, tuberculin (PPD)‐ and tetanus toxin (TT)‐induced IFN‐γ and IL‐4 mRNA expression in peripheral blood mononuclear cell (PBMC) cultures of pollen‐allergic patients and healthy controls.Methods: PBMC of 10 birch or timothy pollen‐allergic patients and of 13 healthy controls were stimulated in vitro with allergen (birch or timothy), PPD or TT. Pellets and supernatants were collected at 24, 48, 72 and 96 h after stimulation. IFN‐γ and IL‐4 production was measured by enzyme linked immunosorbent assay and mRNA expression using RT‐PCR and time‐resolved fluorometry.Results: Allergen induced IFN‐γ production and mRNA expression in PBMC more in allergic patients than in healthy controls. Also allergen induced IL‐4 mRNA expression more in allergic patients than in healthy controls. PPD induced IFN‐γ mRNA expression both in allergic patients and healthy controls, whereas IFN‐γ production was induced only in healthy controls and IL‐4 was not induced at all. TT induced IFN‐γ mRNA expression in both groups, IFN‐γ production in allergic patients, and IL‐4 mRNA expression in both allergic patients and healthy controls.Conclusions: In vitro stimulation with allergen induced both IFN‐γ and IL‐4 mRNA expression of PBMC in allergic patients. These observations challenge the clearcut division of microbe‐specific Th1 and allergen‐specific Th2 responses in peripheral blood.