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Biomedical subjects

G Lilja

Publications and source records attributed to G Lilja.

At least 37 records · Page 2Linked to original sources

Presence of CD30(+) and CD30L(+) cells in human placenta and soluble CD30 levels in cord blood are independent of maternal atopy.

The intrauterine environment is characterized by a Th2 dominance during pregnancy, a milieu that also promotes atopic allergy. The aim of this study was to compare the presence of CD30, a molecule associated with Th2 related disorders such as atopic allergy, and its ligand (CD30L) in placenta in order to investigate if the placenta environment differs between atopic and non-atopic women. Serum concentrations of soluble CD30 (sCD30) from the mothers and their newborns were also elucidated. There were no differences in the immunohistochemical expression of CD30 and CD30L in placenta from atopic (n=28) compared with non-atopic (n=37) women. CD30 was expressed on the decidual stromal cells alone, while CD30L, previously not described in placenta, was detected on macrophage-like HLA-DR(+) cells throughout the mesenchymal chorionic villi. Serum sCD30 in atopic mothers was significantly elevated compared with serum sCD30 in non-atopic mothers (P< 0.05), while sCD30 levels in cord blood were similar in both groups independently of maternal atopic heredity. We suggest that sCD30 in cord blood and CD30 expression by decidual cells may reflect the Th2 environment surrounding the fetus, and both CD30 and CD30L could have immune regulatory functions in placenta.

Decidua↗

Fewer allergic respiratory disorders among farmers' children in a closed birth cohort from Sweden.

The aim of this study was to investigate the prevalence of respiratory allergy, eczema and atopic sensitization in a closed birth cohort of Swedish schoolchildren, 7-8 yrs of age (n=707), of farmers and nonfarmers on the island of Gotland, in the Baltic Sea. All children were born and raised on the island. The survey comprised a questionnaire on atopic diseases and lifestyle factors. Atopic sensitization was assessed by the skin-prick test (SPT) with 15 standardized allergens. The risk ratio (RR) for ever having asthma and/or allergic rhinoconjunctivitis was significantly lower among children of farmers compared to children of nonfarmers (RR=0.38, confidence interval (CI) 95% 0.19-0.77). SPTs (test rate 92%) showed that 32% of the children had at least one positive test. Although the number of positive SPTs did not differ between the groups, there was a reduced risk among children of farmers for having both respiratory symptoms and sensitization to any International Study on Asthma and Allergy in Childhood allergen (RR=0.28, CI 95% 0.09-0.88). The present indicate that living in a farming population seems to protect against development of respiratory allergic disorders but not against allergic sensitization.

Agriculture↗

Atopy in children of families with an anthroposophic lifestyle.

BACKGROUND: Increased prevalence of atopic disorders in children may be associated with changes in types of childhood infections, vaccination programmes, and intestinal microflora. People who follow an anthroposophic way of life use antibiotics restrictively, have few vaccinations, and their diet usually contains live lactobacilli, which may affect the intestinal microflora. We aimed to study the prevalence of atopy in children from anthroposophic families and the influence of an anthroposophic lifestyle on atopy prevalence. METHODS: In a cross-sectional study, 295 children aged 5-13 years at two anthroposophic (Steiner) schools near Stockholm, Sweden, were compared with 380 children of the same age at two neighbouring schools in terms of history of atopic and infectious diseases, use of antibiotics and vaccinations, and social and environmental variables. Skin-prick tests were done for 13 common allergens, and we took blood samples from children and their parents for analysis of allergen-specific serum IgE-antibodies. FINDINGS: At the Steiner schools, 52% of the children had had antibiotics in the past, compared with 90% in the control schools. 18% and 93% of children, respectively, had had combined immunisation against measles, mumps, and rubella, and 61% of the children at the Steiner schools had had measles. Fermented vegetables, containing live lactobacilli, were consumed by 63% of the children at Steiner schools, compared with 4.5% at the control schools. Skin-prick tests and blood tests showed that the children from Steiner schools had lower prevalence of atopy than controls (odds ratio 0.62 [95% CI 0.43-0.91]). There was an inverse relation between the number of characteristic features of an anthroposophic lifestyle and risk of atopy (p for trend=0.01). INTERPRETATION: Prevalence of atopy is lower in children from anthroposophic families than in children from other families. Lifestyle factors associated with anthroposophy may lessen the risk of atopy in childhood.

Adolescent↗

A case of allergy to cow's milk hydrolysate.

We here report a girl, now 3 years old, who has suffered from severe food allergy since her first year of life. She was strongly allergic to cow's milk, and had high levels of IgE antibody (AB) to casein (210 kU/I), beta-lactoglobulin (43 kU/I), and alpha-lactalbumin (23 kU/l) at 12 months of age. In addition, at the same age, she showed positive (2-4+) skin prick reactions to both unboiled and boiled formulas (Profylac, Nutramigen, and Neocate), besides being positive in RAST to Nutramigen (0.6 kU/l). During the first 3 years, IgE Ab levels against casein and Nutramigen increased to 310 and 1.6 kU/l, respectively. Furthermore, at 3 years of age, she had positive RAST to 14 of 15 tested food allergens, being negative only to codfish. Assessment of eosinophil-related markers revealed high total eosinophil count, increased eosinophil activity, and a low ratio of interferon (IFN)-gamma:IL-5, indicating enhanced IL-5 production. The food allergy was correlated to poor weight gain and increasing problems with atopic allergy in the airways.

Animals↗

Peanut oil in vitamin A and D preparations: reactions to skin test and manifestation of symptoms.

The aim of this study was to establish whether there is a link between sensitisation to peanut and exposure to peanut oil in vitamin A and D preparations. Forty-one children with a positive in vivo or in vitro test towards peanut were included. Twenty-one children had consumed vitamins A and D in oil solution, 14 in water solution, and 6 both types. Refined and unrefined peanut oils were obtained and skin prick test extracts were prepared. None of the children exhibited a positive SPT in response to the refined peanut extract. In contrast, 15 children exhibited a positive SPT to the unrefined extract. There was no significant difference in the number of children reacting clinically to peanut exposure who had received vitamins A and D in oil-based or water-based formulations. However, children with clinical allergy to peanut and who had exclusively consumed vitamin A and D in peanut oil, exhibited a greater number of different allergic symptoms upon consumption of peanut compared with clinical allergic children who had consumed the vitamins in water solution or both types (p<0.01). This study indicates that sensitisation to peanut during childhood through consumption of vitamins A and D in oil-based solution seems unlikely, but its consumption may contribute to the development of a wider range of clinical symptoms due to peanut exposure.

Adolescent↗

A retrospective study of seroconversion against Toxoplasma gondii during 3,000 pregnancies in Stockholm.

The incidence of Toxoplasma gondii infections in Swedish women during pregnancy is largely unknown. This retrospective pilot study was performed on consecutive sera sampled from 3,094 women at delivery during 1992-93. Specific IgG anti-toxoplasma antibodies were found in 14% (450/3,094). Serum drawn from the women during the first trimester and cord blood from their children were analysed for IgG and IgM anti-toxoplasma antibodies. A seroconversion during pregnancy was found in 4 women, whose children were followed up at 4 years of age. No signs of sequelae, either neurological or ophthalmological, were found in 3 of the children. The fourth child died at 1 year of age of a disease of different aetiology. An incidence of a primary toxoplasma infection of >1/1,000 pregnancies in this pilot study justifies a larger study.

Adolescent↗

Deposition of cat (Fel d 1), dog (Can f 1), and horse allergen over time in public environments--a model of dispersion.

BACKGROUND: The occurrence and accumulation over time in public environments of cat, dog, and horse allergens was evaluated. METHODS: Concentrations of animal danders were analyzed by ELISA and countercurrent immunoelectrophoresis (CCIE). RESULTS: Among factory-new mattresses, 15/17 contained detectable levels of cat and/or dog allergen, whereas no horse allergen was found although six of the mattresses were stuffed with horsehair. Dust from 15 used mattresses contained significantly higher concentrations of Fe1 d 1 and Can f 1 than the factory-new ones (P < 0.001). Allergen concentrations and titers correlated to the period of time that the mattresses had been tried by customers; rs = 0.52-0.77, P = 0.04-0.001 (cat), rs = 0.38-0.48, P = 0.15-0.08 (dog), and rs = 0.64-0.74, P = 0.008-0.003 (horse). The increase over time occurred rapidly in highly frequented stores and after 3 weeks reached concentrations that have been found in homes where furred pets had formerly been kept or even the lower allergen scale of homes where pets were currently kept. CONCLUSIONS: The dispersion of allergens from furred animals to pet-free public places is likely to occur by deposition from people who have been in direct or indirect contact with pets, and high levels of such allergens seem to accumulate in a short period of time.

Allergens↗

IgG subclass antibody responses to birch pollen in sibling pairs discordant for atopy.

Birch pollen allergen specific IgG and IgE antibodies were analysed in the sera of fourteen sibling pairs discordant for atopy. In addition, eight unrelated children free of atopic disease were included in the study. The presence of Bet v 1 specific antibodies in the sera were analysed by an immunoblotting assay. All but one (13/14) of the atopic children had detectable anti-Bet v 1 antibodies of the IgG1 and IgG4 subclasses. The child lacking IgG1 and IgG4 antibodies to Bet v 1 was the only allergic child lacking IgE to Bet v 1. In contrast, only one of the non-atopic siblings (1/14) displayed detectable IgG1 antibodies to Bet v 1. Furthermore, among the non-atopic siblings none (0/14), had detectable IgG4 antibodies to Bet v 1. In the unrelated control group no detectable IgG1 or IgG4 anti-Bet v 1 were detected (0/8). Thus of the non-atopic children only one out of 22 children displayed IgG1 anti-Bet v 1 antibodies. Taken together, it appears that the non-atopic children in general have no/low allergen specific IgG to birch pollen.

Adolescent↗

Early BCG vaccination and development of atopy.

BACKGROUND: The increase in atopic diseases may be partly explicable by a decline of certain infectious diseases, or changes in childhood vaccination programmes, or both. We investigated whether BCG vaccination against tuberculosis influences the development of atopy. METHODS: We did a retrospective cohort study of 216 children with atopic heredity, born in Stockholm between 1989 and 1992, who received BCG vaccination when they were younger than 6 months, and 358 age-matched controls who had not been vaccinated. Both groups attended Sachs' Children's Hospital, Stockholm, Sweden, during 1995-96 for assessment of atopic history and clinical signs of atopic disease. All children also underwent skin-prick testing (SPT) and serum was analysed for allergen-specific IgE antibodies. Serum from parents was also analysed for IgE antibodies. FINDINGS: 77 (36%) children in the BCG group and 145 (41%) in the control group had a positive history or clinical signs of atopic disease. In the vaccinated group, 26 (12%) children had one or more positive SPT, and 61 (31%) had circulating allergen-specific IgE antibodies, whereas in the control group, the numbers were 35 (10%) and 84 (27%) respectively. Atopy was confirmed by serology in parents of almost two-thirds of the children in each group. Other risk factors for atopic disease were evenly distributed between the two groups. INTERPRETATION: Early BCG vaccination in children with atopic heredity does not seem to affect the development of atopic disease before school age.

Animals↗

Influence of maternal infections with viral agents or Toxoplasma gondii during pregnancy on fetal IgE production.

The importance of maternal infections with Toxoplasma gondii, cytomegalovirus (CMV), Parvovirus B19, respiratory syncytial virus (RSV), and influenza A and B on fetal IgE synthesis was studied in 153 pregnant women. No case of specific IgM activity or viral DNA in cord blood, indicating a congenital infection, was found. From gestational week 15 to delivery, maternal IgG-Ab seroconversion to Parvovirus B19, RSV, influenza A, or influenza B occurred in 47 women. At delivery, serologic signs of past infection with T. gondii were observed in 29 (19%) women, and the corresponding figure for CMV was 117 (77%). The number of women with positive IgG seroconversion during pregnancy or positive IgG-Ab activity toward the studied infectious agents at delivery did not differ significantly among infants with an increased (> or = 1.3 kU/l; n = 51) or with an undetectable (< 0.1 kU/l; n = 102) cord-blood IgE level. These results show that genetic and other environmental factors probably have a greater influence on fetal IgE synthesis than do maternal infections during pregnancy.

Adolescent↗

Effects of routinely given pethidine during labour on infants' developing breastfeeding behaviour. Effects of dose-delivery time interval and various concentrations of pethidine/norpethidine in cord plasma.

A standard dose of 100 mg of pethidine was given im to 13 healthy primiparae during labour. The aim of the study was to investigate whether developing breastfeeding behaviour in the newborn infant was associated with the dose-delivery time interval (DDI) or with the plasma concentration of pethidine and norpethidine in mixed cord blood at birth. The DDI was found to be unevenly distributed with no pethidine exposures in the time interval 5.4-8 h. The material was therefore divided into a "short DDI" group (1.1-5.3 h) and a "long DDI" group (8.1-9.9 h). The infants in the "short DDI" group had a depressed sucking behaviour in 15-45 min of observation and a delayed initiation of lip and mouth movements when compared with the infants in the "long DDI" group. Six of the thirteen infants did not suck their mothers' breasts during the observation period. These infants had higher median plasma concentrations of pethidine at birth than the seven infants who did start sucking. No differences wer found between the plasma levels of norpethidine and the behaviour. It was concluded that 100 mg of pethidine im as an analgesic given under routine conditions may have unfavourable effects on infants' developing breastfeeding behaviour if the DDI is short.

Analgesia, Obstetrical↗

Development of atopic disease during childhood and its prediction by Phadiatop Paediatric.

BACKGROUND: Evaluating in vivo and/or in vitro tests for 'early' prediction of childhood allergy is of interest in paediatric allergology. OBJECTIVE: To determine whether the measurement of Phadiatop Paediatric (PP) during early childhood could be used to predict the development of atopic disease during the first 5 years of life among infants with a family history of atopic disease. METHODS: Phadiatop Paediatric was evaluated in 134 infants. The analysis was performed at 6 months, at 18 months and at 5 years of age and the numbers of available serum samples were 61, 85 and 134, respectively. The potential capacity of the test to predict the development of atopic disease was studied by relating the result of the test, a positive or a negative score, to the accumulated incidence of atopic diseases from birth to 18 months of age and from birth to 5 years of age. RESULTS: Three of four children with a positive PP at 6 months of age developed clinical signs/symptoms of atopic disease before 18 months and all four before 5 years of age. The predictive value of a positive test at 18 months for symptoms before 5 years of age was 80% (12/15). If the diagnostic criterion, instead of clinical signs/symptoms of atopic disease, was at least one positive skin-prick test to major food or inhalant allergens, the predictive value of a positive PP-test at 18 months decreased to 53% (8/15). CONCLUSION: Although the presence of circulating IgE antibodies, as detected by Phadiatop Paediatric, can predict the development of atopic diseases during childhood, the usefulness of the test is limited by its low sensitivity (22-47%).

Allergens↗

Long-term follow-up of patients treated with a three-year course of cat or dog immunotherapy.

BACKGROUND: A 5-year follow-up study was conducted to investigate the duration of the effects of a 3-year course of immunotherapy with standardized cat or dog extracts in 32 children and adults with asthma caused by animal dander. METHODS: Thirty of the subjects could be reached with a questionnaire, 19 underwent bronchial allergen and histamine challenges, and four had only a histamine challenge. Specific IgE and IgG4 levels in serum were measured in those who underwent challenges. RESULTS: Almost all subjects (26 of 30) reported no change (17 subjects) or increased tolerance (9 subjects) on exposure to cats or dogs. In contrast, 17 of the 19 who underwent allergen challenges had increased allergen sensitivity compared with when therapy was stopped (p < 0.01), and the results were no longer significantly different from before therapy was started. Mean provocative concentration of histamine causing a 20% fall in peak expiratory flow was, however, still higher than before therapy in the cat immunotherapy group (p < 0.01) and had not changed significantly during the follow-up period. In the dog immunotherapy group there was no significant change during or after therapy. Specific IgG4 had decreased, and specific IgE in serum had remained low and was comparable to the levels measured at the end of the study period. CONCLUSIONS: Five years after stopping immunotherapy, objectively measured bronchial allergen sensitivity had increased and had approached pretreatment conditions. Asthma symptoms, according to patients' subjective evaluations, had continued to be mild in most patients, and bronchial histamine sensitivity had remained stable. These observations could reflect remaining effects of immunotherapy or the natural history of mild asthma.

Adult↗

Screening of atopic allergy in 5-year-old children--a comparison of the diagnostic properties of Phadiatop Paediatric and Phadiatop.

The ability of Phadiatop Paediatric (PP), Phadiatop (P), mixed-food RAST (MF), and the combination of P and MF to identify children with atopic allergy was evaluated among 193 children who had a family history of atopic disease, and who had an average age of 5 years. If atopy is defined as the presence of at least one positive skin prick test (> or = 2+) to common food and/or inhalant allergens, P had a sensitivity of 86%, a specificity of 94%, and an efficacy of 92%. These figures were somewhat better than the results with PP. However, when P was combined with MF, the sensitivity increased to 89%, but at the expense of lowered specificity (83%) and efficacy (84%). If the tests were related only to clinical signs/symptoms of atopic disease, the sensitivity and efficacy were, at maximum, 63% and 81%, respectively. There was a discrepancy between the results of P and PP in 9% of the children. One explanation of this discrepancy may be that PP seems to be incapable of detecting children with respiratory allergies induced by pollens from birch and related trees. The results indicate that in 5-6-year-old children P should be preferred to PP and to the combination of P and MF for atopy screening, at least in places where birch pollen is a common allergen.

Child, Preschool↗