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Biomedical subjects

J Merrett

Publications and source records attributed to J Merrett.

11 recordsLinked to original sources

Infant feeding and allergy: 12-month prospective study of 500 babies born into allergic families.

This investigation studied 487 babies for symptoms of allergic disease during their first year of life. Because of their positive family histories all the babies are at high risk of becoming allergic. The babies were randomly divided such that cows' milk was deliberately withheld from one group; infants in this group were fed with a soya substitute where required. No benefit resulted from withholding cows' milk, indeed symptoms were more usually associated with this group. Breast feeding, even for a short period, was clearly associated with a lower incidence of wheeze, prolonged colds, diarrhoea, and vomiting. It seemed that the duration of breast feeding was less important than whether or not the child had been breast-fed at all. Wheezing was both more common among boys than girls (P less than .05) and if the mother was a smoker. Other environmental features related to wheezing were social class, month of birth, lack of breast feeding, exposure to dampness, mould and coal fires, but not to domestic pets nor to the numbers of mites found in bedding and carpets. Mite exposure was, however, associated with prolonged colds. Eczema was the only allergic symptom not positively associated with any environmental factor; moreover, it was neither associated with a lack of breast feeding nor with inclusion of cows' milk in the diet. Eczema was associated with the incidence of positive skin prick tests and IgE antibodies to egg white. IgE and IgG4 antibodies were estimated at birth (mothers' and cord bloods) and 3 and 12 months later.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Phadiatop--a novel IgE antibody screening test.

The Phadiatop test, which is based on a multi-allergen allergosorbent, proved to be a test that is simple to perform in the laboratory and produces reliable results. When compared with the more conventional RAST atopy screening test for grass, mite and IgE antibodies it produced similar results, except in those rare instances of patients who were RAST-positive only for moulds where the Phadiatop test was decidedly superior. The Phadiatop test disc contains only inhalant allergens and so it could not be used for screening infants and very young children whose IgE response, if any, is probably limited to foods.

Evaluation Studies as Topic

Epithelial or dandruff allergen for the diagnosis of dog allergy by RAST?

When used for screening by the RAST technique, dog epithelium provided too few positive results (29.2%) compared with dog dandruff (58.8%), cat epithelium (53.6%) and horse dandruff (52.2%). However, dog dandruff can provide an unexpectedly high incidence of positive RAST results (45.2%) in sera from patients with an allergic history to cat or horse, but not to dog. Dog dandruff allergens were found to cross-react with some cat or horse serum proteins in about 25% of such patients. We conclude that dog dandruff is preferable to epithelium for screening by the RAST technique, but if emotional issues involving a family pet arise then confirmation by a trial separation is likely to be more convincing than a provocation test with a possibly non-specific allergenic extract.

Allergens

Methods of quantifying circulating IgE.

Four radioimmunoassay techniques, two conventional and two sandwich, have been used to measure circulating IgE levels in 100 sera. The test sera had IgE levels ranging from 1.0 to 20,000 u/ml, and each was measured at five dilutions, ranging from three-fold to 400-fold. The same IgE standards were used throughout, and the optimal range for each assay was determined by assessing data for quality control sera and the WHO standard 69/204. To be of general use in the United Kingdom an IgE test must measure accurately levels as low as 20-30 u IgE/ml. The Phadebas RIST method failed to meet this criterion, and of the remaining tests the double antibody method had the most useful operating range and produced the most reliable results. However, the double antibody method is not available commercially and so, for the majority of laboratories, the Phadebas PRIST technique should be the method chosen.

Animals

Computer analysis of allergic histories taken by questionnaire.

We report the development of a detailed allergy questionnaire designed so that the answers can be typed into a mini-computer. Computer programmes have been written to file and to retrieve these answers, and to print a summary which is then 'weighed', so as to produce a clinical atopy score which is then further broken down into indoor and outdoor scores. In a pilot survey of ninety patients, their clinical atopy scores and immunoglobulin E (IgE) profiles have been compared, and additional computer programmes have been written which will (a) assess if a more detailed IgE investigations is warranted, and (b) suggest which allergens, if any, are likely to be responsible for the patients' symptoms.

Adult

RAST atopy screen.

A single in vitro screening test for atopic allergy is described. It uses the radioallergosorbent test (RAST) principle, and has been applied to screening sera from U.K. patients with possible atopic symptoms. When compared with the Phadebas RAST, the test sensitivity was 97% and the specificity 100%, and these results suggest that it is useful in any preliminary allergy investigation.

Animals

IgE, parasites and asthma in Tanzanian children.

Two rural Tanzanian primary schools were surveyed to test the hypothesis that parasitic infestation prevents the development of asthma. 242 pupils were interviewed to determine the prevalence of pupils with recurrent episodes of wheezing. The nineteen pupils so discovered had more exercise-induced bronchial lability than equivalently exercised controls. More girls (12.8%) than boys (3.3%) had asthma. In one school, 77% of the controls had faecal parasites, mainly Ascaris spp., and in the other school 55% of the controls had Schistosoma haematobium in their urine. Parasites were found in similar proportions in the asthmatics. The mean serum IgE for the whole population was 3174 u/ml with no demonstrable difference between the asthmatics and controls. There was no difference in immediate cutaneous hypersensitivity to twenty-two allergens between the asthmatics and controls. These findings suggest that parasitic infestation does not prevent the development of asthma.

Adolescent

Measurement of specific IgE antibodies in nasal secretion--evidence for local production.

Serum levels of total and specific immunoglobulin E (IgE) have been determined by radioimmunoassays in sixty-nine allergic subjects. The forty-one subjects with mild symptoms were the most difficult to diagnose, since nine had IgE levels less than 50 U/ml and nineteen had no detectable specific IgE antibodies. Samples of nasal secretions were collected from these nineteen subjects and five were found to have specific IgE antibodies, and in a further eight increased amounts of total IgE. The possibility of locally produced IgE antibodies should therefore be considered when using in vitro tests to diagnose mild or recently acquired allergies, especially when serum IgE levels are less than 50 U/ml.

Humans

Allergy and parasites: the measurement of total and specific IgE levels in urban and rural communities in Rhodesia.

Eighty adult asthmatics living in an African city had a significantly higher serum IgE level (799 u/ml) than the control group (350 u/ml). A high proportion (78.7%) of the asthmatics had demonstrable circulating mite-specific IgE antibodies. The rural population of a filariasis endemic region was investigated and although no allergic subjects were identified, the group had a significantly higher IgE level (1613 u/ml) than the asthmatics and also showed a relatively high incidence of grass pollen-specific IgE antibodies (35%). The discrepancy between clinical history and laboratory results supports the mast cell saturation hypothesis and suggests: (a) an explanation for the susceptibility to allergy of African and Asian immigrants to Great Britain, and (b) a practical approach for preventing allergic reactions in vivo.

Adolescent

Identification of allergen-specific IgE antibodies in the sera of African asthmatics.

Of eighty African asthmatics, sixty-three had significant levels of specific IgE against the house dust mite dermatophagoides pteronyssinus. By contrast, grass-specific IgE was found in six patients and mould-specific IgE in none. Sixty-three patients also had symptoms predominantly during the rainy season. Positive skin tests against D. pteronyssinus correlated well with the presence of mite-specific IgE, as did the size of these skin test weals with the amount of specific IgE. For grass pollen and moulds there was no such relationship. There was no correlation between a history of sensitivity to house dust and either skin tests or specific IgE against D. pteronyssinus. The results support previous findings that it is allergy to house dust mite and not to grass pollens or moulds which is important in producing the seasonal symptoms in our patients.

Adult