Biomedical subjects
Publications and source records attributed to J Charpin.
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Although studies of families, inbred populations and twins have established that asthma has a hereditary basis, little evidence has shown that intrinsic asthma has an increased familial occurrence. To document this issue, we compared the prevalence of asthma in families of intrinsic asthmatics, extrinsic asthmatics and non-asthmatics. The intrinsic asthma group included those with negative skin tests to common aero-allergens (n = 117). The extrinsic asthma group included those with one or more positive skin tests (n = 164). The non-asthmatic group (n = 224) was recruited at a check-up center. The siblings of each subject completed a standardized questionnaire on history of asthma. The results showed that asthma was more prevalent (P less than 0.001) in siblings of intrinsic asthmatics (8.9%) than in siblings of the non-asthmatic group (2.4%). The prevalence of asthma in siblings of intrinsic and extrinsic asthmatics was similar. In conclusion, both intrinsic and extrinsic asthma have an increased family occurrence.
In a double-blind randomized study 60 patients with either irritative cough due to seasonal respiratory disorders or chronic cough of any etiology were treated with either butamirate citrate linctus (Sinecod, Zyma) or with clobutinol syrup (Silomat, Boehringer, Ingelheim) for a period of 5 days at a dose regimen of 3 tablespoons daily. Efficacy was assessed based on the reduction of the severity as well as frequency of the cough and on the global opinion of the physician. Both groups showed highly significant improvements for the severity and frequency parameters (p less than 0.001), thus demonstrating the effectiveness of both treatments. No significant differences between groups were detected globally for the whole collective. For cough due to carcinomas (n = 14), however, a significantly better effect of butamirate on the frequency of cough (p = 0.026) was found which originated other significant differences in the global scores (p = 0.013) and in the physician's opinion (p = 0.026). Seven patients in both groups complained about side effects (mainly nausea and drowsiness).
This investigation was undertaken to assess the effectiveness of an enzyme-linked immunosorbent assay (ELISA) using A60 antigen in ascertaining diagnosis in hospitalized patients suspected to have pulmonary tuberculosis (TB) but with negative sputum stains. Cultures were performed to confirm active or inactive disease. IgG and IgM antibody activity was determined by adding a 1:100 dilution of serum to plates coated with A60 antigen. After addition of peroxidase-conjugated antihuman IgG or IgM and color development, optical density (OD) was determined. A total of 83 patients was studied, taking into account their current disease status and prior history. Using as a cutoff value the mean value +/- 2 SD measured in the negative culture, no TB history group, that is, OD = 0.50 for IgG measurements and 0.43 for IgM measurements, the sensitivity, specificity, and positive predictive value of IgG measurements were equal to 48, 71, and 50%, respectively. Using IgM measurements, these parameters were equal to 76, 98, and 95%, respectively. Combining the results of IgG and IgM measurements, sensitivity, specificity, and positive predictive value were equal to 68, 100, and 100%, respectively. Thus, the ELISA described here can greatly facilitate the diagnosis of TB in patients with negative smears.
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In this double-blind, multicentre study the antihistamine acrivastine was compared with terfenadine for the treatment of seasonal allergic rhinitis. The study was divided into three periods which together lasted 56 days. Patients (n = 83) were randomly assigned treatment with either 8 mg acrivastine three times daily or 60 mg terfenadine twice daily. Both agents were equally efficacious in reducing the severity of sneezing, itchy nose, blocked nose, running nose, itchy eyes, watery eyes and itchy throat as recorded daily by patients, and as rated by both the patients and their physicians at the end of each treatment period. Acrivastine and terfenadine were equally well tolerated with no serious side-effects. Both effectively controlled the symptoms of seasonal allergic rhinitis in otherwise healthy individuals.
Anaphylaxis to muscle relaxants appears to be a very useful model to study the IgE-dependent mechanisms of mediator release in humans. The serum IgE binding sites of the drugs appeared to be the ammonium ion determinants. In patients allergic to suxamethonium, one of the most frequently used muscle relaxants for general anesthesia, significant histamine release could be obtained in each case with simple diammonium salts. The length of the chain linking the ammonium groups appears to play an important role. In fact, when the length was less than or equal to 4 A, no significant histamine release could be obtained, whereas the optimal length for histamine release appeared to be greater than or equal to 6 A. Furthermore, muscle relaxants with a rigid backbone between the ammonium determinants (such as pancuronium) are less active than flexible molecules (such as suxamethonium) in initiating mediator release. This study suggests that small divalent molecules can induce anaphylactic shock in sensitized patients and that the length and the flexibility of the chain bearing the haptenic determinants appear to be important factors in the elicitation of mediator release.
Twenty-one patients, who had previously experienced an anaphylactic reaction to suxamethonium during general anaesthesia, were selected for this study. Initially, skin tests with muscle relaxants were carried out in the twenty-one patients, detection of specific anti-choline IgE in nineteen, and leucocyte histamine release in seventeen. These three tests were then repeated between 1 year and 4 years after the initial evaluation. In the majority of patients, sensitization to the muscle relaxants persisted for more than 1 year after the anaphylactic reaction. Only three patients out of twenty-one (4%) had negative skin tests when retested 1-4 years later. A reduction in leucocyte histamine release was noticed in one of the seventeen retested patients (6%). Modifications of anti-choline IgE were observed in five of nineteen patients (26%). The persistence of sensitization to suxamethonium may result from repeated stimulation by occasional contacts with quaternary ammonium compounds. This study demonstrates the reliability of skin tests, leucocyte histamine release and detection of anti-choline IgE to diagnose allergic reactions to suxamethonium, even when they are performed a long time after the initial anaphylactic reaction.
A study was carried out on 36 patients who had presented with an anaphylactic reaction when they had been received anaesthetic induction agents including suxamethonium. After having been examined, they were assessed with various immunoallergic tests (skin tests, LHL, a search for specific anticholine IgE antibodies). They were compared with a group of 120 control patients with the same age, sex and professional characteristics. This study confirmed the part played by specific IgE antibodies in accidents involving suxamethonium. The specificity of the tests that could be used for the diagnosis was excellent. However, as far as sensitivity of the tests went, skin tests and LHL were more sensitive than the search for specific IgE antibodies. There was no statistical relationship between the limit for skin reactions and the degree of histamine release of the level of anticholine IgE antibody.
IgE antibodies cross-reacting with choline and suxamethonium were found in the sera of 15 of 22 patients with life-threatening sensitivity to suxamethonium, one of the most commonly used muscle relaxants. Furthermore, choline that is one of the metabolites of acetylcholine and a monovalent part of the suxamethonium molecule could act as a hapten inhibitor in vitro and in vivo, blocking specifically the basophil histamine release induced by suxamethonium and the positive skin tests to the drug in allergic patients. These results confirm the IgE dependency of allergic reactions to suxamethonium and suggest a possible way of preventing such reactions with choline.
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Plane-tree pollen grains were incubated in vitro with alveolar macrophages from inbred Rats, and the possibility of phagocytosis was investigated. No phagocytosis was observed even after 48 hrs incubation. But alveolar cells were bound to pollen grains generally at the apertures. This binding did not require the Fc receptor on the macrophage membrane.
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Eleven patients who suffered a reaction to the administration of muscle relaxants during induction of general anesthesia were explored using skin tests, leukocyte histamine release, lymphocyte transformation test, and the Prausnitz-Küstner test (P-K). Fifteen normal subjects served as controls. Patients who suffered a reaction showed considerable cutaneous hypersensitivity to muscle relaxants. Leukocyte histamine release was positive in three cases and the P-K test was positive in one case. These findings suggest possible specific serum IgE antibodies to muscle relaxants. However, reliable discrimination between immunological and idiosyncratic pharmacological mechanism is difficult to obtain.
Phytohemagglutinin (PHA) was capable of inducing non-cytotoxic histamine release from human leucocytes. In the presence of deuterium oxide (D2O), PHA caused significantly greater histamine release. Dibutyryl cyclic AMP (d-cAMP) could enhance the histamine release in the presence of D2O although it was an inhibitor of the release if used alone. However, a beta agonist, isoproterenol, which increases intracellular level of cAMP was inhibitory with or without D2O. These data ask the question about dual effect of cAMP and suggest the possibility of different polls of cAMP in the target cells.
A single deep inspiration (DI) is commonly followed by transient airflow obstruction in asthmatic patients. In some patients, however, DI results in a sustained response which suggests that more than one mechanism may be responsible. We have studied the characteristics of the response to repeated DI, and their modificatiion by various pharmacological agents, by measuring specific airway resistance (sRaw) in ten subjects who showed reproducible and consistent increases in sRaw after DI. Two types of reaction were observed: type A (n = 8) had an immediate maximum and usually short persistence; type B (n = 2) had a delayed maximum with a progressive increase. In type A reactions repetition of DI showed different patterns of response--either a reproducible reaction to each DI or a plateau effect. In type B reactions the response spontaneously increased with repeated DI. Type A responses to DI were inhibited completely by a beta-adrenergic stimulant (BAS), largely by an anticholinergic drug (AC, ipratropium bromide), but in no case by disodium cromoglycate (DSCG). Type B responses were inhibited completely by BAS, largely by DSCG, and partially by AC. These findings suggest that the response to DI is due to bronchoconstriction, which in type A reactions is of reflex origin, vagally mediated, and is due in part or wholly to mediator-release in type B reactions.
"Paragerm" is commonly used in hospitals where its bactericide action is well known. Preliminary tests have been carried out in the laboratory in order to study the antifungal power of this product. Variation of the different concentrations in the culture medium, variation of the time of contact between "Paragerm" and the fungus and both the mechanical and chemical effects of the product have shown that, among the species selected, certain were more sensitive and others more resistant to this solution and that, in our experimentation, "Paragerm" had a fungistatic effect.
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