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Biomedical subjects

G Lilja

Publications and source records attributed to G Lilja.

At least 55 records · Page 3Linked to original sources

Neonatal IgA and IgE levels among infants with paternal heredity for atopic disease.

Serum IgA and IgE levels were studied in the postnatal period in 21 infants having a paternal heredity of atopic disease. Three different sampling techniques were used, aspirated cord blood (CB), gravity-collected cord blood, and capillary collected blood at 4-5 days of age. Significant differences among the three sampling techniques were recorded for IgA (P < 0.01), but not for IgE. The IgA levels decreased from birth to 4-5 days of age in 90% (19/21 of infants (P < 0.01). The corresponding decrease in IgE levels was 20%. This postnatal difference in the frequency of decreasing/increasing IgA and IgE levels was significant (P < 0.05). An analysis of CB IgA to detect maternal contamination of CB was found to be of questionable value, since only 50% (2/4) of the cases with an elevated CB-IgA level could be considered contaminated. The results of this study further emphasize that aspiration of CB and capillary collection of blood at 4-5 days of age are the best sampling techniques to avoid contamination. The general finding that paternal heredity had no significant influence on infant IgE contrasts with the strong influence of maternal heredity. Further studies will show whether the explanation lies in genetic or transplacental factors, or in both kinds of factors.

Fetal Blood↗

Effects of maternal pethidine on infants' developing breast feeding behaviour.

The aim of this quasi-experimental study was to examine the effects of maternal pethidine during labour on the developing breast feeding behaviour in infants in the first 2 h after birth compared with infants not exposed to pethidine. Forty-four healthy infants were observed immediately after birth. They were placed skin-to-skin on their mothers' chests. The development of mouth and sucking movements as well as rooting behaviour and state of sleep/wakefulness were noted. The observer was blind as to the pain relief the mother had received during labour. Of the 44 mothers 18 had received pethidine. The main findings were that infants exposed to pethidine had delayed and depressed sucking and rooting behaviour. In addition, a smaller proportion of infants exposed to pethidine started to suckle the breast. Rooting movements which are expected to be vigorous at 30 min after birth were affected both by administration of pethidine and a longer second stage of labour. It is suggested that the differences found in sucking behaviour may be a central effect of pethidine. Depression of rooting movements in the pethidine group may be caused by exhaustion due to a longer second stage of labour and administration of pethidine. It is recommended that pethidine-exposed mother-infant couples stay together after birth long enough to enable the infant to make the choice to attach or not to attach to the nipple without the forceful helping hand of the health staff.

Adult↗

Elevation of oxytocin levels early post partum in women.

BACKGROUND: The aim of this study was to determine plasma levels of oxytocin in women immediately after delivery. METHODS: Oxytocin was measured in 18 healthy women at 15 minute intervals after normal vaginal deliveries with healthy infants. The mothers had their infants put skin-to-skin on their chests immediately after birth. The infants stayed there up to two hours post partum. RESULTS: There were significant elevations of oxytocin 15, 30 and 45 minutes after delivery (p = 0.007, 0.02 and 0.02 respectively) when compared with average pre partum levels sampled approximately 7-15 minutes before partus. This elevation of oxytocin coincided with the expulsion of placenta. In most women this first elevation was followed by repeated elevations of oxytocin. Oxytocin levels returned to pre partum levels at 60 minutes post partum. CONCLUSIONS: Oxytocin is known to play a role in maternal bonding in animals. Earlier studies indicate that there is a sensitive period for bonding the first hour after giving birth even in women. Our study demonstrates a coincidence of this putative 'sensitive period' and high levels of oxytocin.

Adult↗

Neonatal IgE levels and three different blood sampling techniques.

Comparison was made of IgE and IgA levels in aspirated and gravity-collected cord blood (CB) from the umbilical vein and in capillary blood samples collected on the 4-5th day of life among 21 infants with atopic heredity. The IgA levels, but not the IgE levels, were significantly (p < 0.001) lower at days 4-5 of life than at delivery. Further, there were significantly (p < 0.05) more infants with decreasing IgA levels (20/21; 95%) than IgE levels (9/15; 60% of those with detectable IgE, i.e., > or = 0.125 kU/l). These observations, together with the highly significant correlation observed between IgE in aspirated CB samples and at 4-5 days of age, suggest active IgE synthesis during the prenatal and postnatal periods. Contamination of CB with maternal blood, defined as an increased CBIgA level (> or = 14.1 micrograms/ml), was found in 3 (14%) CB samples, all of which were gravity-collected. Of 4 CB samples (gravity-collected) with elevated IgE (i.e., > or = 0.9 kU/l), 2 had suspected maternal contamination. Therefore, aspiration of CB or capillary collection at 4-5 days of age should be preferred for allergy prediction. If gravity collection is used, contamination should be investigated by determining IgA in all CB samples with IgE concentrations exceeding the cut-off point.

Adult↗

Abnormal serum IgG subclass pattern in children with Down's syndrome.

Susceptibility to infections is a well known feature of Down's syndrome. The possible relation between this predisposition and the serum concentrations of the IgG subclasses was studied in 38 children with Down's syndrome aged 1-12 years. An age matched group of 50 healthy children served as controls. The serum concentrations of IgG1 and IgG3 were significantly raised among children with Down's syndrome in all three age groups studied (that is 1-2.5, 4-8, and 9-12 years). The serum concentrations of IgG2 were normal in the first two groups but significantly reduced in the third age group. In contrast, the concentrations of IgG4 among children with Down's syndrome were significantly reduced in all three age groups. Moreover, among the children with Down's syndrome aged 4-12 years 68% (15/22) had IgG4 concentrations below 2 SDs of the geometrical mean of the controls. The results may partially explain the proneness of children with Down's syndrome to infections with encapsulated bacteria. Although the underlying cause of these abnormalities is unknown, IgG subclass determination seems relevant in the clinical evaluation of children with Down's syndrome.

Age Factors↗

Immunotherapy with cat- and dog-dander extracts. V. Effects of 3 years of treatment.

The effect of a 3-year course of cat or dog immunotherapy (IT) was evaluated in 32 patients with a history of asthma on exposure to cat or dog. Twenty-one subjects (14 children and seven adults) received cat IT and 11 subjects (six children and five adults) received dog IT. Bronchial challenges with allergen and histamine were performed once a year. Specific IgE, IgG1, and IgG4 were measured, and skin prick tests were done in connection with the challenges. Allergen sensitivity decreased significantly in both treated groups (p less than 0.001 and p less than 0.05 in the cat-allergen and dog-allergen treated groups, respectively). Bronchial hyperreactivity measured by the provocative concentration of histamine causing a 20% decrease in peak expiratory flow in the cat-allergen treated patients (p less than 0.001) but not in the dog-allergen treated patients. Skin sensitivity decreased in both groups (p less than 0.01 and p less than 0.05), whereas specific IgE increased initially but dropped to the pretreatment level during the second year. Specific IgG1 and IgG4 increased during the first and second year in the cat-allergen treated group (p less than 0.01 and p less than 0.001), whereas only IgG4 increased in the dog-allergen treated group (p less than 0.01). Five cat-allergen treated children and one of the adults who completed 3 years of therapy had mild systemic reactions. We conclude that cat IT ameliorated bronchial allergen sensitivity and bronchial hyperreactivity and resulted in an adequate antibody response. Dog IT was less efficacious but led to attenuation of bronchial allergen sensitivity.

Adult↗

Effects of maternal diet during late pregnancy and lactation on the development of IgE and egg- and milk-specific IgE and IgG antibodies in infants.

The IgE levels and food-allergen-specific IgE- and IgG-antibodies (Ab) to ovalbumin (OA), ovomucoid (OVO) and beta-lactoglobulin (BLG) were determined up to 18 months of age in 163 infants born to women who were atopic. A high (HIGH group) or a low (REDUCED group) intake of hen's egg and cow's milk by the mother during the third trimester gave no significant differences in the concentrations of IgE or in IgE-Ab (OVO, BLG) and IgG-Ab (OA, OVO, BLG). Similarly, a prolongation of the abstention diet to the early lactation period did not influence the immune response. The IgG-Ab levels to all three food allergens decreased significantly (P less than 0.001) in both study groups between birth and 2 months of age, but then increased significantly (P less than 0.001) between 6 and 18 months of age. The presence in serum of IgE-Ab to OVO (greater than or equal to 0.15 PRU/ml) was associated with significantly higher IgG-Ab levels to OVO at 6 months (P less than 0.001) and at 18 months (P less than 0.05). Infants with positive skin-prick tests (SPT) to OA and OVO showed higher IgG-Ab levels at 6 and 18 months of age than did infants with negative SPT reactions to the two egg allergens. This indicates a relation between the IgE- and IgG-Ab response and it also suggests that some individuals are 'high responders' to both types of immunoglobulin isotypes while others are 'low responders'.

Allergens↗

Serum levels of IgG subclasses in relation to IgE and atopic disease in early infancy.

The levels of IgG1, IgG2, IgG3, and IgG4 were analysed by ELISA in cord serum and in serum samples collected at 6 and 18 months of age from infants whose mothers were atopic. None of the four IgG subclasses was significantly influenced on any sampling occasion by infant atopy, gender, month of birth, maternal IgE or maternal diet during pregnancy and early lactation. However, at 18 months of age, significantly higher levels of IgG1 (P less than 0.05) and of IgG4 (P less than 0.01) were found in infants with an elevated IgE (greater than or equal to 8.0 kU/l) than in those with a lower level. A weak positive correlation (rs = 0.26; P = 0.05) between IgE and IgG4 was also observed. Despite the fact that the serum levels of IgG4 at 18 months were significantly higher (P less than 0.01) among infants with positive IgE-RAST (greater than or equal to 0.15 PRU/ml) to ovomucoid or beta-lactoglobulin, our data suggest that the the concentration of IgG4 relates more to the level of IgE than to the clinical symptoms of atopy. Determination of IgG subclasses seems to be of limited value for prediciting atopy during early infancy.

Aging↗

IgE levels in cord blood and at 4-5 days of age: relation to clinical symptoms of atopic disease up to 18 months of age.

To evaluate the variation in serum IgE levels during the neonatal period and its relation to the development of atopy, 83 infants with a heredity of atopy were studied with regard to the concentration of IgE in cord blood (CB) and capillary blood on the fourth or fifth day of life. During the neonatal period, the average IgE level remained unchanged in the whole group but there were large individual changes. Among 22 infants with CB-IgE levels greater than or equal to 0.9 kU/l the IgE concentrations in 50% decreased below this value on days 4-5. The correlation between maternal IgE and CB-IgE concentrations (rs = 0.41; P less than 0.001) was interpreted as indicating a probable contamination with maternal blood. This view was supported by the presence of an elevated IgA level and of IgE antibodies against inhalant allergens in 16% of the cord blood samples of which 69% had an IgE level exceeding 0.9 kU/l. It therefore seems preferable to collect the blood samples on the fourth or fifth day. However, in the 74 infants available for atopic classification at 18 months of age, the positive predictive value of IgE determinations was low: on days 4-5 25-38% and in CB 42%. A high CB-IgE level may merely be an indication of the mother's atopic state.

Adolescent↗

Immunotherapy with cat- and dog-dander extracts. IV. Effects of 2 years of treatment.

Thirty-five patients (20 children and 15 adults) with animal-dander asthma completed 2 years of immunotherapy with partly purified and standardized cat- or dog-danger extracts. The first year of the study was performed double-blind with a placebo-treated control group. These 15 patients were transferred to active treatment for a second year. All patients were followed by use of the skin prick test (SPT), allergen and histamine bronchial challenges, and tests for allergen-specific IgE, IgG1, and IgG4 levels. In the group treated with active extracts for 2 years (group A), the previously reported decrease in bronchial responsiveness to cat extract (p less than 0.001) and histamine (p less than 0.01) was even more pronounced after the second year. After 1 year of active treatment in the original placebo group (group B), a significant decrease in the bronchial responsiveness to cat extract was noted (p less than 0.001). The responsiveness to histamine was decreased only in the patients treated with cat-dander extracts (p less than 0.05). A significant decrease in the SPT (p less than 0.001) and an increase in the allergen-specific IgE (p less than 0.001) and IgG4 (p less than 0.001) was also noted in patients (group B) treated with cat-dander extracts. The side effects in the two groups (A and B) were negligible, except for some systemic side effects, especially among the children during the initial phase of immunotherapy. The symptoms were mild and responded promptly to treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Effects of maternal diet during late pregnancy and lactation on the development of atopic diseases in infants up to 18 months of age--in-vivo results.

One hundred and sixty-two women with respiratory allergy to animal danders and/or pollens were randomly allocated to a diet consisting of either a very low ingestion of hens' egg and cows' milk or a daily ingestion of one hens' egg and about 11 of cows' milk during the last 3 months of pregnancy. One hundred and sixty-three infants were followed prospectively up to 18 months of age when the cumulated incidence of atopic disease in each child was evaluated blindly. No significant differences in the distribution of atopic disease were found among the infants in relation to the maternal diet during late pregnancy. The numbers of skin-prick tests positive to ovalbumin, ovomucoid, beta-lactoglobulin and cows' milk were likewise not influenced by differences in the maternal diet during late pregnancy. Genetic factors rather than maternal diet during the perinatal period probably have a greater effect on the incidence of atopic diseases during early infancy.

Adult↗

Immune response of the atopic woman and foetus: effects of high- and low-dose food allergen intake during late pregnancy.

The influence of the mother's consumption of cows' milk and hens' egg on the immune response (IgE, IgG) in the mother and foetus was studied in 165 pregnant women with atopical respiratory disease with an allergy to pollen and/or animal dander. The women were randomly allocated to four diets ranging from a diet free from hens' egg and cows' milk to a diet containing intake of one egg and one litre of milk daily during the third trimester. No significant differences in cord blood IgE levels were noted in spite of differences in maternal diet, and no specific IgE antibodies to ovalbumin, ovomucoid and betalatoglobulin were found in the cord blood. The mother's IgG antibody concentrations to ovalbumin, ovomucoid and betalactoglobulin were influenced by her diet, but cord blood IgG antibody levels to the selected food allergens were unaffected. The data presented on the IgE and IgG antibody levels to ovalbumin, ovomucoid and betalactoglobulin in cord blood suggest that changes in maternal diet during the last trimester of pregnancy in order to prevent atopic sensitization in utero are less likely to affect the foetus than previously supposed.

Adult↗

Purified trichophytin: lymphocyte reactivity in vitro and trichophytin-induced suppression.

Three trichophytin preparations from different strains of Trichophyton mentagrophytes were produced according to the ethylene glycol method and assessed for their lymphocyte stimulation activity in vitro (LST). These trichophytin preparations showed significant variations in their effects on cord lymphocytes reactivity. The preparations also varied in their stimulation of lymphocytes from patients with dermatophytosis. Conclusions could be drawn about the immunological specificity, sensitivity and lymphocyte toxicity, which is important for the standardization of antigens. Furthermore, it was demonstrated that trichophytin-preincubated lymphocytes mediated a suppression of lymphocyte reactivity to this antigen.

Adult↗

Immunotherapy with partially purified and standardized animal dander extracts. I. Clinical results from a double-blind study on patients with animal dander asthma.

Forty-one patients (21 adults and 20 children) with cat dander-or dog dander-induced asthma were selected for immunotherapy with standardized and partially purified cat- or dog-dander extracts by use of a double-blind protocol. Based on sex, age, clinical history, results of bronchial challenge, and crossed radioimmunoelectrophoresis studies, the patients were stratified in matched pairs, and the treatment alternatives were distributed randomly among the pairs. Twenty-two patients treated with allergen (15 with cat allergen and seven with dog allergen) and 17 patients receiving placebo therapy completed the first year of treatment. In the cat allergen-treated group, the bronchial sensitivity toward cat and histamine decreased (p less than 0.001 and p less than 0.05, respectively). Measured by bronchial challenge, the cat allergen-treated patients could tolerate 11 times more allergen at the end than at the start of the study, and they also demonstrated a tendency toward less pronounced symptoms after exposure to cat and dog allergens. No significant changes were observed in the dog allergen treated- or placebo-treated groups. The adverse effects in general were negligible except for some systemic side effects during rush hyposensitization, especially among the children, but these were mild and responded promptly to treatment.

Adolescent↗

Immunotherapy with cat- and dog-dander extracts. II. In vivo and in vitro immunologic effects observed in a 1-year double-blind placebo study.

The effects of immunotherapy on the skin prick test, allergen-specific IgE, and IgG in 39 patients (19 adults and 20 children), treated with partially purified cat- or dog-dander extracts or placebo for 1 year, were studied by use of a double-blind protocol. IgG levels were measured by three different assays: IgG RAST, IgG4 RAST, and Staph A IgG1, 2, and 4. The skin prick test reaction decreased continuously in the allergen-treated patients, the decrease being the first sign of an immunologic effect of the therapy. Allergen-specific IgE levels increased during the first 9 months in both children and adults. The RAST activity during the last 3 months continued to rise for the children, whereas it declined for the adults. IgG levels measured by all three methods demonstrated an increase in the allergen-treated patients and no increase in the placebo-treated patients. The children developed higher values on IgG RAST and IgG4 RAST than the adults. IgG RAST correlated negatively with IgE levels in the cat allergen-treated group. No correlation between skin prick test results, IgE levels, and IgG levels was found, nor was there any correlation between these parameters and the patients' own subjective evaluation or the allergen bronchial challenge test. In summary, the expected change in skin prick test reaction and allergen-specific IgE and IgG levels was found. The children tended to be more immunologically active than the adults.

Adolescent↗

Immunotherapy with cat- and dog-dander extracts. III. Allergen-specific immunoglobulin responses in a 1-year double-blind placebo study.

An investigation was made of the specific antibody response to individual antigens in 40 patients taking part in a double-blind placebo study of immunotherapy with cat- or dog-dander extracts. Antigen-specific IgE levels were measured by means of CRIE, and the results were expressed as scores. The patients demonstrated IgE specificities toward 1 to 5 antigens. Cat-dander antigens Nos. 4 (cat Ag 1) and 7, and dog antigens Nos. 6 and 13, produced the highest scores, but high IgE binding was also found for dog albumin. After 1 year of treatment, the IgE responses of the two treatment groups (allergen and placebo) were statistically indistinguishable from those before the start of treatment. There was a tendency toward a reduction in score for two of the dander antigens (cat Ag 1 and dog Ag No. 13), and no new IgE specificities appeared. Antigen-specific IgG levels were measured by means of CIE with patient serum incorporated in an intermediate gel, and the results were expressed as plus/minus precipitins. Only two patients had precipitating antibodies before the start of treatment (one against cat albumin and one against cat Ag 1). During the course of treatment, the production of antigen-specific IgGs was observed in 18/22 allergen- and 1/18 placebo-treated patients. For the cat allergen-treated group, the specificities were directed against cat antigens Nos. 2, 3 (cat albumin), 4 (cat Ag 1), and 7, and for the dog allergen-treated group, against dog antigens Nos. 2 (dog albumin), 13, and 20.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗