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D Charpin

Publications and source records attributed to D Charpin.

At least 19 recordsLinked to original sources

[Characteristics of allergic asthma].

The frequency of extrinsic (or allergic) asthma varies with age and sex. An inborn tendency to atopy, shown by a positive Phadiatop test or by skin tests positive to air-borne allergens, is found in 50% of asthmatic patients. The arguments in favour of the allergic origin of asthma are primarily clinical: same time and place of symptoms in the typical form, frequent bouts of acute rhinitis, history of familial or personal atopy. The responsible allergen is often easily identified by questioning, and its nature can be confirmed by positive skin tests. The allergens most frequently involved are air-borne allergens, notably house dust mites furs or feathers of domesticated animals, and pollens. Compared with intrinsic asthma, extrinsic asthma has the following features: it begins at an earlier age, it is less severe, it seldom evolves towards chronic ventilatory impairment and, by definition, it implies that an allergen is responsible for the onset or worsening of the symptoms.

Adolescent

Serological response of tuberculosis patients to antigen 60 of BCG.

Two ELISA tests (IgG and IgM) for the serodiagnosis of tuberculosis, both based on antigen 60 (A60) of M. bovis BCG, were applied to 1,644 controls and patients to analyse the immune response in different forms of this infectious disease. Out of 200 healthy individuals, 148 being tuberculin--positive BCG-vaccinated adults, only 10 contacts--nurses of the pneumology department and laboratory technicians of the mycobacterial laboratory--were found positive for anti-A60 IgG. One quarter of hospitalized patients affected by non-tuberculous pneumopathies (194 in total) were found weakly positive for anti-A60 IgG. We suppose that these positive cases have suffered from inapperant infections and are in a "persistent state". Out of 344 cases of primary pulmonary tuberculosis, 88% were positive for anti-A60 IgG and 75% for the corresponding IgM. Among 97 cases of primary extra-pulmonary tuberculosis, 94% were found IgG positive and 33% IgM positive. The difference between active and inactive post-primary (chronic) tuberculosis was striking: about 100% of both pulmonary and extra-pulmonary cases (367 altogether) had high titers of anti-A60 IgG but IgM positivity was observed in only 15% of the cases, whereas in inactive and quiescent noncavitary tuberculosis (442 cases), 57% of the patients were weakly positive for anti-A60 IgG and none were positive for IgM. Kinetics of synthesis of anti-A60 IgG and IgM were analysed in primary and post-primary (chronic) active tuberculosis. The IgM tracing immune response to A60 was shorter and lower during primary tuberculosis as compared to post-primary tuberculosis. Our findings point to the high prognostic value of the A60- ELISA test for tuberculosis. Anti-A60 IgM mark initial stages of the disease or reactivation processes whereas anti-A60 IgG last longer than IgM and provide an evaluation of the intensity of the infectious process. Repeated serological tests allow monitoring of the course of the infection and the efficacy of therapy. The test is negative in healthy BCG-vaccinated persons (tuberculin-positive) and healed tuberculous infection cases. The combined use of both IgG and IgM tests helps in the correct diagnosis of "false positive" cases.

Adolescent

Prevalence of latex allergy in operating room nurses.

The twofold purpose of this study was to assess the prevalence of latex sensitivity in a large group of operating room nurses and to evaluate the relationship between questionnaire responses and skin tests. Of the total target population of 268 operating room nurses, 248 (93%) answered the questionnaire and 197 had skin prick tests to latex (1/10 wt/vol solution). Symptoms associated with glove wearing were acknowledged by 41.1% of nurses. Skin tests to latex were positive in 21 nurses (10.7%), 4.4 times more often in atopic nurses. Among nurses complaining of local symptoms, only 18.6% had positive skin tests. Itching of the hands during glove wearing correlated poorly with latex sensitivity, but correlation with local urticaria was better. Atopic nurses complaining of urticaria had latex allergy in 70% of cases. Thus latex allergy is common in nurses, especially atopic nurses. A questionnaire is unreliable in predicting latex sensitivity and must be supported by latex skin test. More data will be needed to assess the risk of anaphylactic perioperative reactions in operating room nurses.

Adult

Prevalence of allergy to hymenoptera stings in different samples of the general population.

To get figures of prevalence of systemic reactions (SRs) to hymenoptera sting in adults between the ages of 18 to 65 years, we performed three different surveys using the same questionnaire from 1984 to 1988. The first one was a door-to-door survey in Southeast France, which included 8271 adults and used a questionnaire. The second one, which included 2067 adults, was performed in a health care center and comprised the same questionnaire and venom skin tests in subjects reporting a history of SRs. The third survey was a national poll performed through a home-based national computer network. The percentage of SRs ranged from 0.66% in the second survey including skin tests to 3.3% in the poll survey. The higher prevalence figure in this latter survey may be related to a false-positive history. There was no urban-rural difference in prevalence of SR.

Adolescent

Allergy to latex.

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Allergens

Fel d I allergen: skin and or saliva?

To determine the relative importance of saliva and sebaceous glands as sources of Fel d I allergen, we compared Fel d I levels at the base and tip of the hair in areas presenting more or less sebaceous glands and areas licked more or less frequently. The amount of Fel d I was significantly higher at the base than the tip of the hair. Further, it was strongly correlated with the density of sebaceous glands. This study demonstrated that the most abundant source of Fel d I allergen is cat skin.

Allergens

[Spatial and temporal variations of the quantities of pollen from Cupressaceae-Taxaceae collected in Marseilles].

Marseille has two sites (Centre and North) where airborne pollens are collected and counted. The most numerous pollens are from Cupressaceae Taxaceae. We compared the quantities collected with both pollen traps during February, March and April 1988 and 1989. Most of pollinization takes place in March. In Marseille's Centre, there were three times more trapped pollen during 1989 than in 1988. In 1989, there was 40% more pollen on northern site as compared with the other one. As indicated in 1989 with both sites, it suggests a circadian periodicity of Cupressaceae Taxaceae pollen: their highest count is usually between 9 and 11 hours a.m.

Air

[Evaluation of asthma: clinical or functional scores?].

This article is a review of the clinical and functional scores used for the assessment of the severity of asthma. Dyspnea is a key feature of asthma but its severity is difficult to interpret. Subjects with continuous airway obstruction may tend to be poor sensors of their dyspnea. The addition of other symptoms such as cough, wheezing, etc. to the dyspnea score can also be criticized. An international consensus conference recently proposed a clinical and functional scale to assess the severity of asthma. A combination of clinical, drug and functional information can best express the severity of asthma. Data originating from the authors work suggest that the correlations between clinical and drug scores on the one hand and peak expiratory flow rate values on the other hand are weak. It is the authors' final impression that the severity of asthma should be judged in a global way by considering various parameters.

Adrenal Cortex Hormones

Fel d I allergen distribution in cat fur and skin.

Immunohistochemical procedures were performed to ascertain Fel d I antigen (Ag) distribution in cat fur and skin biopsy specimens and to analyze Fel d I allergen concentrations in fur. One hundred strands of fur and 24 skin biopsy specimens (6 by 4 by 3 mm) from shaved areas were collected from 11 different cats. Freshly depilated hairs were immunostained by free-floating monoclonal anti-Fel d I, avidin-biotin-peroxidase complex, and either processed for scanning electron microscopic examination or mounted on glass slides for computer-assisted densitometric analysis (SAMBA system). Skin biopsy specimens were promptly frozen and sectioned just before the immunohistochemical processing. Densitometric analysis of fur demonstrated that immunoprecipitate concentrations were tenfold higher at the root than at the tip. However, this finding may be explained by decrease of the thickness of the hair cortex that varied in similar proportions. The Ag accumulated on the strand surface but may focally penetrate into the medulla through the scale-like cortical interstices. In skin biopsy specimens, Fel d I Ag was found in epithelial squamous cells, within the epidermis and hair follicles, on the surface of the epidermis and hair follicles, and in sebaceous gland cells. These data suggest that Fel d I Ag is produced by sebaceous cells and, to a lesser extent, by basal squamous epithelial cells and that it is stored mainly on the surface of the epidermis and fur.

Allergens

Reliability of respiratory symptoms to diagnose atopy.

As reliance of responses to epidemiological questionnaires on atopic symptoms is doubtful, we studied the predictive value of these questions relative to atopy, defined by the presence of serum specific IgE, taking into account some extraneous variables such as age and sex. The study population included 2067 adults, 20-60 years old. The protocol consisted of a standardized questionnaire and an evaluation of serum specific IgE using the Phadiatop (Pharmacia Diagnostics, Uppsala, Sweden) test. The predictive value of each symptom suggestive of atopy was quite low, but was much dependent on age and sex. Women more often than men reported atopic symptoms in the absence of atopy. Similarly, the predictive value of each symptom decreased with age. Thus atopic symptoms do not have the same value as predictors of atopy. These findings have both clinical and epidemiological important implications.

Adult

Is intrinsic asthma a hereditary disease?

Although studies of families, inbred populations and twins have established that asthma has a hereditary basis, little evidence has shown that intrinsic asthma has an increased familial occurrence. To document this issue, we compared the prevalence of asthma in families of intrinsic asthmatics, extrinsic asthmatics and non-asthmatics. The intrinsic asthma group included those with negative skin tests to common aero-allergens (n = 117). The extrinsic asthma group included those with one or more positive skin tests (n = 164). The non-asthmatic group (n = 224) was recruited at a check-up center. The siblings of each subject completed a standardized questionnaire on history of asthma. The results showed that asthma was more prevalent (P less than 0.001) in siblings of intrinsic asthmatics (8.9%) than in siblings of the non-asthmatic group (2.4%). The prevalence of asthma in siblings of intrinsic and extrinsic asthmatics was similar. In conclusion, both intrinsic and extrinsic asthma have an increased family occurrence.

Adult

Medication requirements and house dust mite exposure in mite-sensitive asthmatics.

To better understand the clinical consequences of exposure to house dust mites (HDM), we investigated the relationship between treatment requirements to control symptoms in mite-allergic asthmatic patients and HDM-allergenic levels in their mattresses. This study included 49 asthmatic subjects recruited from an outpatient clinic. The protocol consisted of a questionnaire about the number of asthma attacks and treatment requirements in the last 3 months. Patients provided a sample of house dust collected from their mattresses by a standardized vacuum cleaning procedure. Mean antigen P1 equivalent defined as the sum of major allergens Der pI and Der fI (Ag P1 Eq) level was 1.34 micrograms/g dust in patients who had no treatment, 5.4 micrograms/g dust in patients who took puffs of beta 2-agonists only when required and 17.8 micrograms/g dust in patients who required daily long-term treatment. Similar relationships were demonstrated between mean Ag P1 Eq levels and the number of asthma attacks. These data support the clinical role of allergenic exposure in HDM-allergic asthmatics.

Adolescent

Altitude and allergy to house-dust mites. A paradigm of the influence of environmental exposure on allergic sensitization.

To further investigate the possibility of a cause and effect relationship between exposure to house-dust mite (HDM) allergens and respiratory disease associated with dust mite sensitivity, we compared schoolchildren living in the Alps, where exposure to HDM is low, with those living at sea level, where it is high. The study included 933 schoolchildren from the fourth and fifth grades. The protocol included the standardized 1978 American Thoracic Society (ATS) questionnaire for children, skin testing using common aero-allergens and controls, and antigenic measurements of dust samples from mattresses (Group I antigen). The prevalence of asthma with positive skin test to HDM and the overall prevalence of positive skin test to HDM were significantly lower in mountain schoolchildren. The mean geometric HDM antigenic level in mattresses was much lower in the Alps (0.36 micrograms/g dust) than at sea level (15.8 micrograms/g dust). In contrast, the prevalence of hay fever and positive skin test to grass pollens as well as the overall prevalence of positive skin tests to grass pollens were significantly higher in the Alps. These data illustrate a striking relationship between exposure to environmental allergens and atopic sensitization.

Altitude