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Biomedical subjects

A M Cirla

Publications and source records attributed to A M Cirla.

At least 19 recordsLinked to original sources
PubMed1996

Preseasonal intranasal immunotherapy in birch-alder allergic rhinitis. A double-blind study.

A double-blind, placebo-controlled study was carried out to test the clinical efficacy and safety of local nasal immunotherapy (LNIT) in powder form. Twenty-two patients suffering from allergic rhinitis strictly associated with early spring symptoms, with positive skin prick tests and RAST for birch-alder, all responders to a specific nasal provocation test (NPT), received randomly active or placebo treatment for 4 months. Immunotherapy consisted of administration of a set of capsules containing progressively increasing amounts of birch (Betula pendula) and speckled alder (Alnus incana) allergens in powder form with controlled granulometry. The active (birch-alder) and placebo (lactose) group completed the treatment according to a similar schedule. During the pollen season (March-April), the patients who took the active treatment reported less sneezing and rhinorrhea than the placebo group, on the basis of a symptoms score, and the differences were statistically significant; the need for drugs (terfenadine) was also significantly reduced. These findings agreed well with the results of specific NPT after the treatment; only patients in the active group had a higher threshold dose of nasal specific reactivity to birch-alder allergens than in tests before the LNIT.

Administration, Intranasal↗
PubMed1994

Cobalt-related asthma: clinical and immunological aspects.

Several clinical and experimental findings point to cobalt as the only sensitizer and causal agent of hard metal asthma. The clinical features have been clearly defined by bronchial provocation tests, with a prevalence of late phase responses. Epidemiology is still insufficient to configure prevalence and incidence rates for cobalt asthma. IgE and IgG antibodies with cobalt specificity have been demonstrated, but T-lymphocytes and eosinophils involvement seem to be important in the mechanism of an allergic inflammation in the airways. Such an immunological pathogenesis links cobalt asthma with other manifestation of hard metal disease.

Antibodies↗
PubMed1988

Cross-reaction between aromatic isocyanates (TDI and MDI): a specific bronchial provocation test study.

A study was performed on twenty-five workers exposed to polyurethane varnishes exclusively catalysed with TDI, who developed asthma to this substance. The aim of the study was to establish, using bronchial provocation tests, whether a cross-response to MDI exists. The results were positive but no definitive evidence has been reached because there was cross-response in only 48% of cases. It is interesting, however, that cross-responders did not predominate among the subjects with a late reaction to TDI (P = 0.0038), whereas cross-responders were in the majority among the subjects with a dual reaction to TDI (P = 0.0334). It is possible that the pattern of the asthmatic reaction to BPT with TDI influences the cross-reaction to other isocyanates.

Adult↗
PubMed1987

Subclinical inorganic mercury neuropathy: neurophysiological investigations in 17 occupationally exposed subjects.

17 workers in a thermometer factory exposed to mercury for periods ranging from 1 to 40 years all had high urine and blood mercury levels on undergoing electromyographic examination. All were clinically free from central and peripheral nervous symptoms. 88% had subclinical neuropathy, mainly distal and axonal. There was no correlation between severity of the neuropathy and blood and urine mercury levels or between severity of neuropathy and duration of exposure to mercury. The presence of a subclinical neuropathy in symptomless workers exposed to mercury is perhaps the most reliable index for the detection of the early toxic effects of mercury on the peripheral nerve fiber when it is probably still reversible.

Adult↗
PubMedDate not supplied

Pathology produced by isocyanates: methods of immunological investigation.

A group of 182 workers exposed to diisocyanates (varnishers, carpenters, producers of polyurethane resins and expanded plastic) were examined to study the immunogenic capacity of these substances. The skin tests, particularly the intradermal tests, revealed reactions of the immediate, accelerated and/or delayed types due to the presence of IgE and IgG, in addition to responses of the cellular type. This was confirmed by passive transfer in guinea-pigs and man and immunohaematological tests such as passive haemagglutination and lymphocyte transformation. In 4 cases it was possible to demonstrate thermoresistant, homocytotropic immunoglobulins, that were not dependent on complement and behaved like reagins (i.e. short-term anaphylactic IgG). Exposure tests were performed on 45 cases; the results are analyzed and compared with those of the skin tests. It is concluded that both these groups of tests are of value in investigating the aetiopathogenesis of the pathology of the isocyanates: the skin tests for initial screening, and then the exposure tests for resolving doubtful diagnoses. Cross-reactions were also demonstrated between toluene-diisocyanate and methylene-diisocyanate. Two phases could be considered in the pathogenesis; in the first phase, signs of inflammation appeared at the primary sites of contact with the irritant, then the ability of the diisocyanates to form a conjugate with organic proteins results in the production of a complete antigen and consequent sensitization of the exposed person. The appearance of symptoms naturally depends on subsequent exposure and the immunogenic capacity of the patient: the response is mainly of the reagin type in atopic patients and of type 3 in non-atopic patients.

Animals↗
PubMedDate not supplied

A pre-seasonal birch/hazel sublingual immunotherapy can improve the outcome of grass pollen injective treatment in bisensitized individuals. A case-referent, two-year controlled study.

BACKGROUND: The study tests the hypothesis of a reduction of priming due to tree allergy in patients sensitised to both birch/hazel and grass pollen undergoing an associated preseasonal Sublingual/Injective immunotherapy. METHODS: 36 out of 49 bisensitized candidates were pair-matched into 18 case-referent couples. During two years all patients were administered preseasonal grass-SIT and one patient in each couple received also birch/hazel-SLIT. Diary cards were fulfilled for three consecutive grass pollen seasons. Specific Nasal Provocation Test (NPT) for grass and aspecific bronchial challenge were done; sera were analyzed for specific IgE and IgG. RESULTS: During the peak of the grass pollen season both groups showed a significant improvement in total symptom-score. Conjunctivitis and cough improved significantly more in patients with associated therapies. While antihistamine score decreased significantly in both groups, antiasthmatics did only in the SLIT-SIT group. The follow-up documented a significant increase in grass- and birch-specific IgG and a decrease in grass-specific IgE. Grass-NPT threshold was clearly higher in SLIT-SIT-group (p = 0.01) and only in this group PD20 methacholine improved significantly (p < 0.05). CONCLUSIONS: Combined birch/hazel-SLIT and grass-SIT are safe and improve clinical outcomes of SIT alone in young bisensitized patients. Priming reduction is supported by specific NPT and bronchial hyperresponsiveness.

Administration, Sublingual↗