[Unusual case of hypersensitivity to Ambrosia].
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Biomedical subjects
Publications and source records attributed to B Romanski.
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Cockroach allergy was investigated in 10 patients with the endoscopic diagnosis of peptic ulcers and chronic gastritis, all with positive skin reactions to Blatella germanica extract. In all the cases examined, the total serum IgE level was raised, specific serum IgE detectable and both the increased number of eosinophils and IgE-bearing cells found in biopsy specimens of gastric and/or duodenal tissues. The direct provocation test of the gastric mucosa, done under fiberoscopic control, was positive in all patients, in which the immediate oedematous and haemorrhagic reaction was observed after allergen challenge. Seven patients reacted also a few minutes later with abdominal pains and/or nasal and conjunctival manifestations. The provocation with the same cockroach extracts was negative in 4 control patients with peptic ulcers but without symptoms of allergy. In the authors' opinion, cockroach antigens, like other food and inhalant allergens, may be partly responsible for the chronic inflammatory processes as well as ulcerations of gastroduodenal tissues in predisposed persons.
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A study on the presence of specific precipitins against tobacco antigens was done in a population of 361 healthy cigrette smokers and in a group of 60 healthy non-smokers. The tests were made by the gel diffusion technique of Ouchterlony using tobacco extract prepared by the Coca method. A positive precipitation reaction was observed in 11.8 per cent of the smokers' sera examined but never in the non-smokers group. The reaction occurred in subjects of both sexes and was neither dependent upon how long they had smoked nor on the number of cigarettes smoked daily. In the authors' opinion, the formation of precipitins against tobacco antigens may be the result of a sensitivity reaction. It is therefore possible that in predisposed individuals immune complexes of precipitins and tobacco antigens may be formed. They could be responsible for some cardiovascular disorders occuring in smokers. In order to confirm such a hypothesis, a study was carried out recently by the authors on a large group of patients suffering from coronary disease.
Polymorphonuclear leucocytes (PMNL) isolated from the defibrinated blood of 44 healthy volunteers (20 no smoking subjects and 22 smokers) were examined for the presence of tobacco antigens using specific rabbit antiserum conjugated with FITC. In 11 persons from the smokers group PMNL were examined by the direct immunofluorescence technique, using appropriate antisera, as well as for the presence of IgG, IgM and C3. It was stated that the number of PMNL with fluorescent tobacco antigens rose significantly after exposure to tobacco smoke. The above cells were detected both in non-smokers and smokers venous blood, while their percentage was more important in the latter. IgG, IgM and C3 were found in PMNL of all 11 examined smoking subjects. In the authors opinion, tobacco antigens are phagocytized after penetration into the organism, either alone or in the shape of immune complexes formed with specific serum antibodies. The possibility of vascular injuries caused by the above complexes as well as the question of a presumed affinity of tobacco and solanaceae antigens are discussed.
The effects of heparin, aspirin, promethazine and prednisone on late skin reactions, provoked by tobacco extracts were studied in four groups of 17 patients with coronary artery disease. In all patients, intracutaneous tests were made with four different tobacco preparations, both on the first day of their hospitalisation and after 14 days of therapy. It was found that strongly positive late skin reactions with tobacco extracts were decreased or suppressed in patients taking heparin and in patients taking prednisone, but not in those who were treated with promethazine or with aspirin. This seems to confirm the hypothesis that these reactions are really provoked by a local type III allergy to tobacco antigens.