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Biomedical subjects

H Mosbech

Publications and source records attributed to H Mosbech.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Diagnosis of allergy in bee-keepers. A 1-year prospective study].

Thirty-six Danish bee-keepers were clinically investigated by means of a questionnaire before and after the bee season 1990. Their serum was assayed for IgE and IgG antibody reacting with bee venom, and skin prick tests were performed prior to the season. Thirty-six percent had previously reacted abnormally, either with a systemic reaction (SR) (25%) or a large local reaction (LLR) (11%). Retrospectively, eight of the nine bee-keepers with SR had upon re-exposure developed a normal reaction, in spite of the fact that seven of them had specific IgE and/or a positive prick test at subsequent examination. At follow up 38% of the persons who had previously had a SR reacted with a SR or a LLR on the first sting in the season. Two of eight with previous SR reacted with SR during the observation period in spite of a negative prick test and no specific IgE. Of the bee-keepers who had previously only reacted normally there were no systemic of large localised reactions during the observed period, although six showed signs of IgE-sensitization. The results confirm the problems of identifying patients where immunotherapy is superfluous in the group with previous SR and IgE sensitization.

Adolescent↗
PubMed1993

Histamine-releasing serum factors as a predictor of the outcome of insect sting reactions. Results from a multicentre study.

Cord blood cells were incubated (passively sensitized) with sera from 27 patients with previous systemic reactions to insect stings. Histamine release (HR) from these cells was measured following exposure to venom extracts at increasing concentrations. The aim was to see whether this parameter could predict more efficiently than RAST and skin test the outcome of a subsequent re-sting. Results showed that HR from passively sensitized cells tended to reflect skin sensitivity and specific IgE levels. If patients were not re-stung during the follow-up period, HR from the passively sensitized cells frequently decreased whereas an increase was seen (in 6/13) when using sera collected after re-sting. In conclusion HR from passively sensitized cord blood cells could not satisfactorily predict re-sting reactions in the serum donors.

Fetal Blood↗
PubMed1992

Comparison between two different assays for measurements of allergen-specific IgE and skin prick test in the diagnosis of insect venom allergy.

Forty-one patients stung by wasp and 29 by bee were evaluated by comparing the correlation between skin prick test (SPT), Phadebas radioallergosorbent test (P-RAST) and Magic Lite SQ Specific IgE assay (LIA). All patients had had a systemic reaction to insect sting. In the patients stung by bee we found agreement between SPT and P-RAST, and SPT and LIA. Similarly, there were no significant differences in sensitivity between P-RAST and LIA (p > 0.05). In patients stung by wasp, SPT was found to be more sensitive than P-RAST. There were no differences between SPT and LIA or between P-RAST and LIA.

Allergens↗
PubMed1992

Aeroallergen analyses and their clinical relevance. II. Sampling by high-volume airsampler with immunochemical quantification versus Burkard pollen trap sampling with morphologic quantification.

A comparison was made between the amount of airborne pollen collected by Burkard airsampler and the allergenic activity of particles trapped on glass fibre filters in an Accu-Vol high-volume airsampler. The comparison was made throughout the pollen seasons 1986 to 1989. Both airsamplers were operated 24 h a day. They were placed less than 5 m apart, and estimation of the pollen amount was made on a day-to-day basis during the pollen seasons, and on a weekly basis outside the seasons. The occurrence of the 3 clinically most important allergenic types of pollen, birch, grass, and mugwort, was analysed, and close correlations between the 2 sampling techniques were found (rs 0.5-0.8, p < 0.001). The detected range of counted pollens/m3 was: birch 0-1075, grass 0-156, and mugwort 0-44. By immunochemical analysis we found the corresponding amounts to be 0-80, 0-8, and 0-1 SQ-U/m3, respectively. Pollen counts and immunochemical estimation were compared with the symptom score recordings of allergic persons for birch season 1989 and for grass seasons 1986, 1988, and 1989. A close correlation was found for both sampling techniques for the grass seasons in 1986 and 1989 (rs 0.51-0.61, p < 0.001-0.0001), but a less significant correlation was found for the 1988 grass season, and for birch in 1989 (rs 0.24-0.34, p < 0.001-0.05).

Air Pollutants↗
PubMed1992

Airway calibre as a confounder in interpreting bronchial responsiveness in asthma.

BACKGROUND: The relation between airway responsiveness to constrictor agents and forced expiratory volume in one second (FEV1) is important when interpreting change in airway responsiveness after an intervention. The aim of the study was to analyse the relation between FEV1 as a percentage of predicted values (% predicted) and airway responsiveness between and within asthmatic subjects. METHODS: Results of non-specific bronchial challenge tests were pooled from two randomised crossover studies comparing the effect of a non-sedative antihistamine with placebo in 35 patients with moderate asthma. The design of the two studies was similar: the provocative concentration of either histamine (first study) or methacholine (second study) resulting in a 20% decrease in ventilatory capacity (PC20) was repeated at two week intervals while patients were treated with the antihistamine or placebo. The dose of inhaled corticosteroid was gradually reduced during the study. Data were analysed with PC20 as the dependent variable in a general linear model so that the influence on PC20 of inhaled corticosteroid dose, antihistamine, and choice of bronchoconstricting agent could be separated from the influence of FEV1% predicted. RESULTS: The correlation coefficient between mean PC20 and mean prechallenge FEV1 for each patient was 0.45. In the general linear model two thirds (65%) of the variation in PC20 was due to variation between subjects. One third of the within subject variation in PC20 could be explained by variation in prechallenge FEV1% predicted (a change in FEV1 of 27% predicted was associated with one doubling or halving of PC20). Treatment with the antihistamine had no influence on PC20, except when histamine was used as the bronchoconstricting agent. The dose of inhaled corticosteroid had a small but significant effect. CONCLUSIONS: The variation in a patient's PC20 over time (several months) is related to changes in FEV1% predicted. Variation in FEV1% predicted explains less of the variation in bronchial responsiveness between subjects where a patient specific factor, which is probably related to the pathogenesis of bronchial asthma, seems to dominate.

Adrenal Cortex Hormones↗
PubMed1991

[Allergy to insect stings].

Components in the insect venom and probably also in their saliva may have direct toxic effects or may cause sensitization and may result in allergic reactions to subsequent stings. In Denmark, only the stings of honey bees and wasps (yellow jackets) are of clinical significance and it is important to be aware that these insects contain separate allergenic components. Clinical manifestations following stings are observed from all of the organ systems on the whole. The commonest are itching of the skin, urticaria, possibly angioedema and slight generalized symptoms with vertigo, headache and fatigue. Life-threatening reactions may also occur and one or two fatal cases are registered annually in Denmark. It may be difficult to decide whether an allergic or a toxic reaction is involved on the basis of the symptoms. Possible IgE-sensitization must therefore be assessed by means of a prick test and measurement of specific IgE. The main treatment in cases of acute systemic reactions is adrenaline which may possibly be supplemented with antihistamine and corticosteroid. In cases of massive local reactions and urticaria, antihistamines will, as a rule, prove sufficient. Hyposensitization with insect venom preparations eliminates the future risk for systemic insect sting reactions practically entirely and this must be recommended for patients with demonstrated IgE-sensitizing and generalized reactions. At present, treatment should be continued for three to five years and protection lasts for a series of years after cessation of treatment.

Humans↗
PubMed1991

[Insect stings and visits to emergency departments].

For four representative hospitals, emergency room contacts were registered during 1988, 1989 and 1990. A total of 2,935 of these contacts were due to insect stings, equivalent to approximately 9,000 p.a. in the whole of Denmark. For insect sting allergics and for others with severe reactions to insect stings it is important to realize that stings can occur during whole year and during day as well as at night. However, 59% were stung in July or in August and 46% between 3 and 9 p.m. Stings on head or hands were most common. Only 2% required admission and only 5% were controlled in out-patient clinics or by doctors outside hospitals. This means that surprisingly few patients were referred for allergy testing and possibly immunotherapy.

Adolescent↗
PubMed1991

Emergency treatment of allergic reactions to Hymenoptera stings.

Allergic reactions to Hymenoptera stings are frequently observed all over Europe. Rarely they may induce long-standing morbidity or even be fatal. Several investigations have shown that the emergency treatment given to these patients is often inadequate. Cutaneous symptoms respond well to antihistamines and also to adrenaline. Adrenaline is the mainstay for outside hospital treatment of more severe reactions involving the respiratory tract (bronchial asthma, laryngeal oedema) and the cardiovascular system (anaphylactic shock). Inhaled adrenaline is especially useful in respiratory symptoms, while parenteral application of adrenaline is prefered for shock treatment. All patients with severe respiratory or cardiovascular reactions must be hospitalized, treated under intensive care conditions and observed for at least 24 hr. Emergency medications including adrenaline for inhalation or for self-injection must be given to all patients with a history of systemic allergic reactions to hymenoptera stings. These patients must also get instructions for safety measures to avoid further stings. They should be referred to an allergist in order to evaluate the indication for venom immunotherapy.

Anaphylaxis↗
PubMed1991

House dust mite allergens on different types of mattresses.

Beds and especially mattresses are important breeding grounds for house dust mites. We investigated whether supposed differences in the microclimate on water, spring and foam mattresses were reflected in the occurrence of house dust mite major allergens (Der fI, Der mI, and Der pI) in mattress dust. Fifty-one mattresses that had been in use for 8-25 months were sampled. Median concentration of total major allergens was 0.5 microgram/g dust (range 0-45) with little difference between the three major allergens and between the three types of mattresses. Occurrence of mattresses with concentrations above and below the proposed risk level (2 micrograms/g) was similar in the mattress groups. However, the allergen concentration was above risk level in 56%, if washable underblankets were not applied, compared with only 21% in the group with such underblankets. In conclusion, mattresses tend to accumulate allergen rather rapidly. Neither heated water mattresses, spring nor foam mattresses seem to be of any advantage for mite allergics, whereas underblankets made of synthetic fibres in a cotton or synthetic cover, commonly used in Denmark, might play a beneficial role in reducing allergen exposure.

Allergens↗
PubMed1991

Diagnosis of house dust mite allergy.

The medical history may be conclusively descriptive in house dust mite allergy in patients with asthma and rhinoconjunctivitis. Often the patients have both diseases. Sensibilization to D. pteronyssinus and D. farinae can be demonstrated by skin prick testing. If the diagnosis is still doubtful, the next step will be to perform a RAST test or a histamine release test. It is also important to investigate for mite exposure at the patient's residence, if the patient is suspected to be mite-allergic. Allergen challenge test in the shock organ should be performed, if hyposensitization is considered, or if, in a few cases, the mite diagnosis is still doubtful.

Allergens↗
PubMed1990

A long-term follow-up study of hyposensitization with immunoblotting.

The formation of specific IgE, IgG1, and IgG4 antibodies was investigated by immunoblotting during hyposensitization with timothy grass-pollen extract and 6 years later, Until the end of immunotherapy, specific IgG antibody levels increased. Also simultaneously, the number of allergenic components detected by IgG increased. However, this IgG response was similar in responding and nonresponding patients; thus, it did not correlate with the clinical outcome of the therapy. More allergenic compounds were also detected by IgE on immunoblots, but again without correlation to success of therapy. Six years after immunotherapy, the therapeutic effect was still present, although by now the observed immunoglobulin-binding patterns were similar to patterns observed in the same patients' sera collected before the initiation of hyposensitization. Thus, changes of antibody-binding patterns in immunoblot do not relate to the success or failure of immunotherapy.

Allergens↗
PubMed1990

Hyposensitization in asthmatics with mPEG-modified and unmodified house dust mite extract. III. Effect on mite-specific immunological parameters and correlation to changes in mite-sensitivity and symptoms.

Forty-six adult asthmatics allergic to D. pteronyssinus (Dp) participated in a 2-year study. Thirty-one underwent hyposensitization (HS-group). Fifteen were treated with Dp-extract (Dp-group), and 16 with a similar extract modified by monomethoxypolyethylene glycol with reduced allergenicity (mPEG-Dp-group). Fifteen patients served as controls. Dp-specific antibodies and histamine release from blood basophils were determined and compared with Dp-sensitivity in lungs and skin. In addition, IgG and IgE against the major allergen Der p I were followed in a subgroup. Dp-specific IgG, IgG1, and IgG4 increased significantly in both HS-treated groups after 1 and 2 years (median: 2.5- to 11.6-fold). IgG4 was not induced if maintenance dose during the first year was less than 20,000 BU. Median skin sensitivity decreased 4.4- to 8.2-fold after 1 year and 7.4- to 21.4-fold after 2 years. Der p I specific IgG response was unrelated to the occurrence or change in IgE with the same specificity. The mPEG-Dp-extract tended to have less effect on skin sensitivity and immunological parameters, differences reaching statistical significance for skin sensitivity only. In the HS-group, the decrease in bronchial sensitivity was significantly correlated to a decrease in IgE (r = 0.36), IgG1/IgG4 (r = 0.49), Dp-specific histamine release (r = 0.58), and to an increase in Dp-specific IgG4 (r = -0.36) and IgG4/IgE (r = -0.48). In patients improving clinically, Dp-specific IgG4/IgE increased, and median Dp-specific IgE was reduced to 80% compared with an increase to 150-160% seen in the unchanged or deteriorated group (P less than 0.05). Findings indicate an improvement of effect, if the allergen dose is sufficient to reduce specific IgE and/or induce an IgG and especially IgG4 response.

Adult↗
PubMed1990

Hyposensitization in asthmatics with mPEG-modified and unmodified house dust mite extract. IV. Occurrence and prediction of side effects.

A double-blind study on hyposensitization (HS) with two extracts prepared from the house dust mite Dermatophagoides pteronyssinus (Dp) was performed on a group of asthmatics with bronchial sensitivity to Dp. In 18 patients, aluminium-hydroxide was added to the Dp-extract to give a depot effect (Dp-group). Nineteen patients were treated with a similar extract in which allergenicity had been reduced by coupling to monomethoxypolyethylene glycol (mPEG-Dp-group). This extract had previously been shown to have less effect on clinical symptoms and skin sensitivity compared to the Dp-extract. In the Dp- and mPEG-Dp-groups, 778 and 675 injections were administered. Fifteen and 12 patients in the Dp- and mPEG-Dp-groups had systemic reactions (P greater than 0.05). The frequency of injections giving systemic reactions was reduced in the mPEG-Dp-group: 5.1% compared to 9.0% in the Dp-group (P less than 0.01). In the mPEG-Dp-group, reactions were mild to moderate, mainly late-occurring asthma and urticaria, whereas two episodes of anaphylaxis and four of severe asthma occurred in the Dp-group. The reduction in side effects seems promising, but a further dose increase in the mPEG-Dp-group would be necessary to compare the side effects of doses with equal therapeutic effectiveness. High frequency of late local reactions made dose increase impossible with the present slightly modified extract. The systemic side effects occurred more frequently in patients highly skin test-sensitive to Dp prior to treatment. All patients skin test-positive to less than or equal to 100 BU had systemic reactions. Systemic side effects could not be predicted from the size of previous local reactions.

Animals↗
PubMed1990

Who will benefit from hyposensitization? Predictive parameters in house dust mite allergic asthmatics.

The aim of this study was to assess the ability of various data collected before treatment to predict the therapeutic benefits of hyposensitization. Thirty-one asthmatics were hyposensitized with extract from the house dust mite Dermatophagoides pteronyssinus (Dp) for 2 years, 15 comparable patients served as controls. The treatment extract was either modified by coupling to monomethoxypolyethylene glycol (mPEG) or administered in a diluent containing Al(OH)3. Improvement would be either a greater than or equal to 10-fold increase in bronchial tolerance to Dp or an overall clinical effect judged from questionnaires plus diary cards. Patients improving in bronchial Dp-sensitivity after 1 year had been more sensitive to DP pre-treatment in bronchi and in basophils, and had a lower FEV1 compared with the patients not improving (P less than 0.05). Occurrence of late-phase bronchospasm to pre-treatment Dp-challenge increased the chance of clinical improvement approximately 3-fold (P less than 0.05). A certain mite exposure seems to be a condition of an improvement in symptoms/medication. In patients improving, the median allergen concentration on mattresses was equivalent to 1,000 mites/g compared with less than 250 mites/g in patients showing no clinical improvement (P = 0.1). Information on Dp-specific IgE, IgG, IgG subclasses, Dp-sensitivity in skin, nose and eyes, age, and duration of symptoms did not permit any prediction of therapeutic effect.

Animals↗