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Biomedical subjects

E Tovey

Publications and source records attributed to E Tovey.

14 recordsLinked to original sources
PubMed1999

Methods and effectiveness of environmental control.

In recent years the role of allergen exposure and atopy, and the interaction between them in the clinical expression of allergic disease, has been examined in a quantitative manner in epidemiologic studies. Such analyses suggest that avoidance of exposure to domestic allergens is a critical element in integrated strategies for both the prevention and the management of asthma. The promise of primary intervention in high-risk infants, as shown in the Isle of White study, has been confirmed in a recent study in Japan, and at least 4 similar trials are in progress. Applying these principles to the management of symptoms in patients with chronic asthma has proved more difficult, and it is likely that many earlier studies were poorly designed to test the hypothesis that allergen avoidance was clinically useful. Recent studies with patients moved to high altitudes during seasonal reductions in mite exposure and randomized controlled interventions in houses have all shown improvements in clinical manifestations of asthma. These recent trials have also demonstrated something that was less certain-that massive reductions in domestic allergen exposure can be achieved and that people will adopt the significant changes to their domestic environment and lifestyles if the risks and benefits are known. In the future, it seems likely that better study designs, as well as improvements in methods to monitor exposure and clinical outcomes, will provide further support for the role of allergen avoidance in the prevention and management of asthma.

Allergens↗
PubMed1998

Association between Der p 1 concentration and peak expiratory flow rate in children with wheeze: a longitudinal analysis.

BACKGROUND: House dust mite (HDM) allergen exposure has been well documented as an environmental cause of airway hyperresponsiveness (AHR) and asthma symptoms. The relationship between asthma morbidity and exposure to low concentrations of HDM allergen suggests that there may be no safe exposure threshold to HDM allergen. OBJECTIVE: We aimed to investigate the associations between Der p 1 in bedding and lung function in 30 children with a history of wheezing in a longitudinal study. METHODS: After a cross-sectional study of school children, which included histamine challenge for AHR and skin testing for dust mite atopy, we made repeated measurements of HDM allergens in children with a history of wheeze over a 12-month period. These children also kept a daily asthma diary in which they recorded their peak expiratory flow rates (PEFRs). We used a repeated measures model to determine the association between PEFR and HDM allergen concentration. RESULTS: There was a significant association between PEFRs and HDM allergen concentration (beta-coefficient = -14.17, P = .0024) in children with HDM atopy. An association was not found in children without HDM atopy. CONCLUSIONS: These findings support the hypothesis that HDM allergens have an adverse effect on the lung function of children with wheeze and highlight the importance of maintaining low dust mite allergen levels throughout the year in the home environment of children sensitized to HDMs.

Allergens↗
PubMed1998

A species-specific monoclonal antibody to Cynodon dactylon.

BACKGROUND: It is usually difficult to differentiate between the pollens of different grass species on the basis of their appearance under a microscope, as they often appear similar. Such distinctions are important when interpreting the clinical relevance of pollens in air samples as individuals can differ in their allergic responses to different grass species. As this allergenic distinction occurs at the level of presence and differences of epitopes on the allergens associated with different species, it could be anticipated that species-specific monoclonal antibodies could provide such distinctions between pollens. METHOD: Monoclonal antibodies raised against Cynodon dactylon were screened and characterised in ELISA assays and blotting, using a range of grass pollen extracts, to identify clones which were species specific. RESULTS: The most specific monoclonal raised to C. dactylon did not react at a level of greater than 1.2% to extracts of 10 other grass pollens in a direct ELISA assay and showed no detectable cross-reactivity in a particle blotting assay. CONCLUSION: It has been possible to produce a monoclonal antibody that is functionally species specific to C. dactylon.

Animals↗
PubMed1996

House dust mite allergens. A major risk factor for childhood asthma in Australia.

If house dust mite allergen (Der p I) is an important cause of asthma, there should be a direct relationship between level of exposure to this allergen and asthma severity. To examine this, we studied six large random samples of children in different regions of New South Wales, Australia. We measured recent wheeze by questionnaire, airway hyperresponsiveness (AHR) by histamine inhalation test and sensitization to house dust mites by skin prick tests. Current asthma was defined as the presence of recent wheeze and AHR. We measured Der p I levels in the beds of approximately 80 children in each region. In regions where Der p I levels were high, more children were sensitized to house dust mites, and these children had significantly more AHR and recent wheeze. After adjusting for sensitization to other allergens, we found that the risk of house dust mite-sensitized children having current asthma doubled with every doubling of Der p I level. There was a modest correlation between AHR and Der p I exposure in individuals (r = 0.23, p < 0.03). These data suggest that house dust mite allergens are an important cause of childhood asthma and that reducing exposure to these allergens could have a large public health benefit in terms of asthma prevention.

Administration, Inhalation↗
PubMed1994

Asthma severity and morbidity in a population sample of Sydney schoolchildren: Part II--Importance of house dust mite allergens.

BACKGROUND: Despite an increasing prevalence of childhood asthma, few studies have quantified the strength of associations between asthma and its aetiological factors. AIMS: To quantify the risk factors associated with childhood asthma and to investigate the characteristics of children most at risk. METHODS: We studied a population sample of 1339 schoolchildren aged eight-11 years living in Sydney, NSW. Questionnaires were used to measure respiratory illness, histamine inhalation test to measure airway hyperresponsiveness (AHR), skin prick tests to measure atopy and ELISA assay to measure house dust mite allergen (Der p I) levels. 'Current asthma' was defined as the presence of wheeze in the previous year and AHR. RESULTS: The mean Der p I level in 72 homes was 22.5 micrograms/gm dust which is high compared to suggested thresholds of 2 microgram/gm for sensitisation and 10 micrograms/gm for exacerbation of symptoms. Sensitisation to house dust mites was the most important risk factor for current asthma (odds ratio 7.0, 95% CI 9.4, 22.2). Sensitisation to ryegrass was of minor importance (odds ratio 2.0, 95% CI 1.4, 3.1). The presence of AHR was strongly related to the degree of sensitisation to house dust mite allergen and children with skin wheals greater than 4 mm had frequent morbidity caused by asthma. CONCLUSIONS: To reduce the high prevalence of childhood asthma in NSW, it is imperative that we design interventions which recognise that house dust mite allergens are a dominant risk factor and that children with large skin wheal reactions to this allergen are most at risk for severe illness including disturbed sleep, days missed from school and urgent medical attention.

Airway Resistance↗
PubMed1993

Carpet cleaning.

Explore the source record for details and available documents.

Allergens↗
PubMed1993

Importance of house dust mite and Alternaria allergens in childhood asthma: an epidemiological study in two climatic regions of Australia.

The relation of house dust mite allergen levels to asthma and allergy was examined in two population samples of children aged 8-11 years in northern New South Wales. We studied 805 children in Lismore (a hot, humid, coastal region) and 770 in Moree/Narrabri (a hot, dry inland region). Respiratory symptoms were measured by questionnaire, bronchial hyperresponsiveness (BHR) by histamine inhalation test, and allergy by skin-prick tests. Current asthma was defined as the presence of both wheeze in last 12 months and BHR. Der p I levels were measured in dust from the bed and floors in the homes of 57 randomly selected children in the coastal region and of 74 inland children. Der p I levels were significantly higher by the coast (83.0 vs 11.2 microg/g, P < 0.001). House dust mite sensitivity was of similar prevalence in both regions (28.6 vs 26.4%, n.s.) but Alternaria sensitivity was higher inland (4.0 vs 15.2% P<0.001). Bronchial responsiveness was more severe in coastal children sensitized to house dust mites and in inland children who were sensitized to Alternaria. The adjusted odds ratios for current asthma in children sensitized to house dust mites were 21.3 (95% CI 10.5, 43.2) by the coast and 2.7 (95% CI 1.3, 5.4) inland, and in children sensitized to Alternaria were 3.4 (95% CI 1.3, 9.1) in the coastal region and 5.6 (95% CI 3.1, 10.1 inland. These studies suggest that high house dust mite allergen levels in a humid, subtropical region act to significantly increase bronchial responsiveness in sensitized children, and that Alternaria allergens have a similar but less potent action in a dry, rural region.

Allergens↗
PubMed1992

The role of water temperature and laundry procedures in reducing house dust mite populations and allergen content of bedding.

The effects of various laundry procedures on house dust mites and their allergens have been established. All mites were killed by water temperatures 55 degrees C or greater. Killing at lower temperatures was not enhanced by any of the pure detergents or laundry products tested. A cold cycle of laundry washing with or without laundry powder did not remove most live mites from bedding, however, the allergen concentration (Der p I/gm fine dust) was reduced by more than 90%. Dry cleaning did not reduce the allergen concentration of the dust, although most, if not all, mites were killed.

Allergens↗
PubMed1979

Mite allergen content in commercial extracts and in bed dust determined by radioallergosorbent tests.

Radioallergosorbent (RAST) direct binding and inhibition type assays were used to quantitate the mite (Dermatophagoides pteronyssinus) allergen content of four commercial mite extracts and a laboratory prepared extract from freeze-dried mites. The content of mite allergen in extracts prepared from twenty samples of dust vacuumed from bedding was measured by RAST inhibition assay. The four commercial mite extracts designated A, B, C and D, and the laboratory extract, designated L, contained 52, 265, 108, 1.5 and 581 arbitrary units of allergen/ml for the direct binding assay and 128, 111, 217, approximately 1 and 1083 arbitrary, but different, units of allergen/ml for the inhibition assay respectively. Qualitative differences between at least two extracts were suggested by the different slopes obtained when allergen binding of anti IgE was plotted against the volume of extract used in the direct binding assay. Differences in slope between the two extracts were also apparent when they were used in the inhibition assay. The quantities of mite allergen/gm of bed dust expressed in arbitrary units for the inhibition assay were 24 to 457 (mean 129) units. These quantities are similar to and sometimes greater than the quantity in 1 ml of mite extract and so confirm bed dust as a potent source of mite allergen. There was no significant correlation between the weight of dust, the numbers of dead and live mites and the allergen content of dust.

Allergens↗
PubMed1976

Airflometer: new toy or worthwhile advance?

The Airflometer provides a useful index of expiratory flow rate and as such it is a worthwhile advance. It can provide an accurate index of FEV1 provided it is individually calibrated. Perhaps the only limitation is the lack of response of the instrument at low flow rates, for example, with an FEV1 of less than one litre. It is remarkably inexpensive.

Adult↗