Biomedical subjects

C Bindslev-Jensen

Publications and source records attributed to C Bindslev-Jensen.

13 recordsLinked to original sources

PubMed1992

Egg and milk allergy in adults: comparison between fresh foods and commercial allergen extracts in skin prick test and histamine release from basophils.

The ability of skin prick test (SPT) and histamine release from basophils (HR) to diagnose clinical type I allergy to egg and milk was investigated as compared with double-blind, placebo-controlled food challenge (DBPCFC) in 17 adults suspected of type I egg and/or milk allergy. In both SPT and HR, commercial allergen extracts commonly used for SPT were compared with fresh, standardized foods. With commercial extracts the overall sensitivities of SPT and HR were 0.75 and 0.56 respectively, and none of the tests showed concordance with DBPCFC. With fresh, standardized foods the overall sensitivities of SPT and HR were 1.00 and 0.89 respectively, and both tests now showed a significant concordance with DBPCFC (P < 0.05). Specificity was only slightly improved in SPT, and unchanged in HR. Thus, the use of fresh, standardized foods significantly improved the outcome of both tests, as regards to sensitivity and concordance with DBPCFC. The diagnostic ability of SPT and HR appear to be strongly influenced by the allergen quality.

Adult↗

PubMed1992

Egg and milk allergy in adults. Diagnosis and characterization.

Nineteen adult patients representing a total of 24 medical histories of immediate adverse reactions to egg or cows' milk underwent 1) standardized questioning about signs/symptoms occurring less than 2 h after ingestion of egg or milk, 2) skin prick test, RAST and histamine release test, and 3) titrated, oral, double-blind, placebo-controlled challenge (DBPCFC) with fresh egg or milk. Eleven medical histories (46%) were confirmed by DBPCFC in 10 patients (53%). All DBPCFC-positive patients experienced gastrointestinal symptoms, and in 80% of the patients, gastrointestinal symptoms were accompanied by respiratory or skin symptoms. Threshold doses varied between 50 mg and 250 g, with 4 patients presenting objective signs following 5 g or less. DBPCFC-positive patients reported significantly more symptoms and had a significantly higher number of positive tests than had DBPCFC-negative patients. None of the tests were in significant concordance with DBPCFC, although RAST showed a sensitivity of 100%. Thus, DBPCFC cannot be substituted in the diagnosis of milk and egg allergy in adults. The use of titrated, fresh foods in DBPCFC proved to be a safe and well-controlled procedure.

Adolescent↗

PubMed1992

Codfish allergy in adults. Identification and diagnosis.

Ten adult patients with a medical history of immediate allergic reactions following ingestion of minute amounts of codfish were examined together with 27 control subjects (8 nonatopics, 7 pollen allergics, and 12 suffering from atopic dermatitis) all regularly ingesting codfish without experiencing reactions. All 37 subjects were evaluated by skin prick test, RAST, and histamine release test in order to determine the value of these commonly used diagnostic tests. The results were compared to titrated, oral, double-blind, placebo-controlled food challenges (DBPCFCs) with fresh codfish undertaken in the 10 patients, whereas all control subjects were classified as challenge-negative according to their questionnaires. Totally, 7 of 10 medical histories were confirmed by DBPCFC, and in these most of the reported symptoms proved reproducible. Oropharyngeal itching and swelling occurred as the first symptom, always preceding the onset of any accompanying symptom. For identification of DBPCFC-positive subjects, skin prick test and RAST proved to be the most sensitive tests (7/7), and all tests showed specificities of 90-97%. The skin prick test still seems reliable but does not, however, exclude the need for DBPCFC.

Adult↗

PubMed1992

Histamine release in immediate-type hypersensitivity reactions in intact human skin measured by microdialysis. A preliminary study.

The purpose of this study was to evaluate the application of a microdialysis technique for measurement of interstitial histamine levels in intact human skin. Three allergic subjects were investigated. Single dialysis fibers were glued to nylon tubings and inserted in forearm skin by means of a fine cannula. Dialysis fibers were inserted in triplicate and perfused with isotonic saline at a rate of 3 microliters/min. After a period of 2 h a 60-microliters base-line period was established. Then the patients were skin prick tested (SPT) with allergen in duplicate and a single saline control. Dialysate was collected in consecutive 30 microliters fractions. Histamine concentration in the dialysate was analyzed with a glass fiber fluorescence assay. Median base-line histamine level was 4 (range 4-7) ng/ml. Following allergen SPT, dialysate histamine concentration increased to 81 ng/ml (74-128), with maximum values 10-20 min after SPT. Intraindividual coefficient of variation on peak histamine levels was 18.9%. No histamine increase was seen following saline SPT. We consider microdialysis to be a valuable method for assessment of allergic mechanisms in intact human skin.

Adult↗

PubMed1991

Cytokine-induced histamine release from basophils of AIDS patients. Interaction between cytokines and specific IgE antibodies.

Basophil leukocytes obtained from AIDS patients, allergic patients and healthy controls were stimulated in vitro with interleukin 4, lymphotoxin, tumour necrosis factor alpha and interferon gamma to examine the histamine releasing effect. The cytokines caused histamine release from the basophils of approximately half the AIDS patients and from 8-17% of the allergic patients. No response was obtained in the control group. Removal of cell surface immunoglobulins abolished the response to cytokines, indicating an Ig-dependent mechanism. Passive sensitization with cell-derived Ig, with Ig deprived of IgE, or with IgG, indicated that cell-bound IgE was responsible for the cytokine-induced histamine release in AIDS patients. This response may be mediated by cytokine-selective IgE antibodies.

Acquired Immunodeficiency Syndrome↗

PubMed1991

Oral allergy syndrome: the effect of astemizole.

The effect of treatment with astemizole (Hismanal) on symptoms elicited by ingestion of hazelnuts in birch pollen-allergic patients (the oral allergy syndrome) was investigated. Thirty patients with a well-documented allergy to silver birch, experiencing symptoms when ingesting hazelnuts, were included in the study. All had a positive skin prick test (SPT) to birch, whereas 29 and 27, respectively, showed a positive RAST and basophil histamine release test (HR) to birch. In contrast, only 15 patients had a positive SPT to hazelnut, 13 had a positive RAST, whereas 24 had a positive HR. After two oral provocations with hazelnuts the patients were randomized to receive either 10 mg of astemizole or placebo daily for 2 weeks in a double blind protocol followed by two oral provocations. Treatment with astemizole significantly reduced the symptoms compared with placebo (P = 0.004); however, without completely abolishing the symptoms.

Astemizole↗

PubMed1990

[Acrivastine--a new antihistaminic].

Explore the source record for details and available documents.

Clinical Trials as Topic↗

PubMed1989

[Diagnostic reliability of the CLA test and RAST in IgE-mediated allergy compared with anamnesis and the prick test].

The principle and mode of conduction of a non-isotope method, the DHS-CLA-allergy test, for in vitro diagnosis of allergic disease is described. The method has been tested and found easy to carry out without special laboratory facilities. Thirty-nine patients all of whom were suspected of allergy were tested for nine typical allergens with the prick test, Al-RAST (ALK) and the DHS-CLA-allergy test. Definite allergy was defined on the basis of definite history of allergy and the positive prick test and, from this, the nosological sensitivity was calculated. No history of allergy and negative prick test results were defined as no allergy, and the nosological specificity was calculated from this. The nosological sensitivity for all nine allergens: Al-RAST: 46.8%, DHS-CLA: 85.5%. Nosological specificity for all nine allergens: Al-RAST: 85.7%, DHS-CLA: 80.3%. The results for the individual allergens are apparent from the text.

Humans↗

PubMed1989