Biomedical subjects
D N Gillespie
Publications and source records attributed to D N Gillespie.
Childhood hypersensitivity pneumonitis (farmer's lung): four cases in siblings with long-term follow-up.
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Inhalant allergy to wild animals (deer and elk).
We studied 15 highly atopic persons with historic and/or skin test evidence of allergy to deer or elk. All 15 were also reactive to domestic animal danders (dog, cat, or horse). Twelve patients had elevated IgE antibody levels to deer hair/dander and six patients had elevated IgE antibody levels to elk hair/dander. Elevated IgE antibody levels to serum or urine from deer or elk were found in six persons. By using individual patient sera in RAST inhibition experiments we showed that IgE antibodies were directed to allergens common to hair/dander, urine, and serum. One individual reacted to an allergen common to both deer and cat hair/dander. We concluded that atopic individuals sensitive to domestic animals may develop IgE-mediated reactions to deer or elk allergens following recreational or professional hunting contact with these animals.
Detection of allergy to nuts by the radioallergosorbent test.
The diagnosis of food allergy is often difficult to make by conventional means. Histories are frequently ambiguous, and skin testing is of dubious reliability because of the number of false-positive and false-negative reactions. We have evaluated the radioallergosorbent test (RAST) for the in vitro measurement of the specific IgE antibodies to nuts, including Brazil nut, almond, walnut, pecan, cashew, and the legume, peanut. Serums were obtained from 18 patients with a history of nut allergy and IgE level and specific IgE antibodies were measured. Thirteen of the 18 patients had significantly elevated IgE antibody (greater than twice control) to one or more of the allergens. Prausnitz-Küstner tests on selected serums in general corroborated the results of the in vitro studies. Five patients had RAST elevations to 2 or more nuts. As a group RAST-positive patients had elevated mean serum IgE levels and more severe clinical symptoms (p less than 0.01). The specificity and cross-reactivity of IgE antibodies to different nut antigens was investigated by RAST inhibition with serums from 5 patients having high levels of IgE antibody. In 4 patients no cross-reactivity between Brazil nut and peanut was found. In contrast, several nut extracts inhibited the reaction of pecan allergen with IgE antibodies. These results indicate that specific IgE antibodies can be measured by RAST in patients with nut allergy and the cross-reactivity of nut antigens can be investigated. RAST would appear to be most useful in confirming the diagnosis of nut hypersensitivity in children or in highly allergic patients in whom skin testing poses a risk of anaphylaxis.
Differences between IgA and IgE as secretory proteins.
IgA is the prototype of a secretory immunoglobulin and usually is present in external fluids in proportions greater than in serum. Previous studies have suggested that IgE also is a secretory immunoglobulin. We measured IgE, IgA and albumin levels in nasal washings (NW), parotid fluids (PF) and serum in seventeen individuals. In secretions, all of these proteins were measured by radioimmunoassay (RIA). In serum, IgE was measured by RIA, IgA by a turbidimetric method, and albumin by radial immunodiffusion. IgA was detected in NW and PF in all individuals and IgA/total protein ratios in both of these secretions exceeded the corresponding ratios in serum (P less than 0-01). In contrast, IgE was detected only in NW from atopic subjects and IgE/total protein ratios were less than those in serum (P less than 0-02). IgE was not detected in the PF in any of the seventeen subjects. When the proportion (protein/total protein) of IgA, IgE, or albumin in NW was expressed as a percentage of the proportion in serum, IgA and IgE were increased when compared to albumin (P less than 0-01 and P less than 0-03, respectively). These results support the view that IgE is a secretory immunoglobulin in that it is present in NW in proportions greater than expected if it diffused from serum. However, IgE differs from secretory IgA in that ratios of IgE to total protein are greater in serum than in NW. This difference is discussed in terms of local production of IgE and passive diffusion into serum and nasal secretions. Finally, the observation that IgE is present in one external secretion while absent from another indicates that external secretions may be subdivided into two classes on the basis of their content of IgE.
Polyarteritis nodosa in infancy: a diagnostic enigma.
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Aeroallergens of western Montana.
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