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Biomedical subjects

K Turjanmaa

Publications and source records attributed to K Turjanmaa.

At least 55 records · Page 3Linked to original sources
PubMed1996

Combined skin prick and patch testing enhances identification of food allergy in infants with atopic dermatitis.

BACKGROUND: Early recognition of dietary allergies in infants with atopic dermatitis is essential for avoidance of unnecessary elimination diets, amelioration of the skin disease, and secondary prevention of the development of multiple food allergies. Simple and accurate methods of identifying provocative foods are urgently needed. METHODS: The usefulness of skin prick and patch tests as indicators of cow milk allergy was evaluated in 183 patients ranging in age from 2 to 36 months with double-blind, placebo-controlled (n = 118) or open (n = 65) cow milk challenges. RESULTS: The oral cow milk challenges were interpreted as positive in 54% of both challenge types. Positive challenge rapidly elicited pruritus, urticaria, and/or exanthema in 49% of cases and delayed-onset eczematous lesions in 51%. The skin prick and patch tests gave markedly discrepant results; prick tests were positive in 67% of the cases with acute-onset reactions to milk challenge, whereas patch tests tended to be negative. Patch tests were positive in 89% of those with delayed-onset reactions, although prick tests were frequently negative. CONCLUSIONS: The observations indicate that IgE and T cell-mediated responses to cow milk can be distinguished in atopic dermatitis. Parallel skin testing with combined prick and patch tests can significantly enhance the accuracy in diagnosis of specific dietary allergies in patients with atopic dermatitis.

Animals↗
PubMed1996

Significance of rubber elongation factor as a latex allergen.

IgE-mediated hypersensitivity to proteins eluting from surgical gloves and other natural rubber products is a well-recognized allergic condition with special impact to health care workers and sensitized patients. Since rubber elongation factor (REF) has been suggested to be the major latex allergen (Hev b 1) we purified REF from rubber particles using electrophoresis and electroelution and reevaluated the occurrence of IgE antibodies to purified REF. The purified protein was subjected to tryptic digestion, peptide separation and amino acid sequencing. Amino acid sequences of 9 tryptic peptides from the purified 14-kD protein gave 100% homology to REF. In immunoblotting, sera from 4 of 6 latex-allergic children with spina bifida or other congenital anomalies exhibited IgE antibodies against REF whereas only 1 serum from the 30 other latex-allergic patients had similar antibodies. In IgE ELISA 8/45 (18%) latex-allergic patients had IgE antibodies to purified REF, whereas 30 (67%) of the same patients had IgE antibodies to purified prohevein, another rubber protein, recently shown to be a major natural rubber latex allergen. The observed overall low frequency of IgE antibodies to purified REF, as measured by two specific IgE assays, indicates that REF is one but not the most significant allergen among the natural rubber latex proteins.

Adolescent↗
PubMed1996

Crossreactivity between allergens in natural rubber latex and banana studied by immunoblot inhibition.

BACKGROUND: An association between allergic reactions to natural rubber latex and to banana has been reported but the immunochemical properties of the putative cross-reacting allergens remain unknown. OBJECTIVE: To study extracts of banana and natural rubber latex and sera from latex-allergic patients for possible crossreacting allergens and IgE antibodies. METHODS: Sera from 22 latex-allergic patients and 22 control subjects with no evidence of allergy to latex or to banana were studied. All patients had positive and controls negative reactions in skin-prick testing using an eluate of latex gloves. IgE antibodies to natural rubber latex and to banana were evaluated by immunoblotting and by radioallergosorbent test (RAST) and crossreactivity between allergens in banana and natural rubber latex by immunoblot inhibition. Skin-prick testing was used to examine in vivo reactivity to banana. RESULTS: Ten of the 22 (45%) latex-allergic patients sera recognized altogether 14 allergens in banana by immunoblotting. The most frequently identified banana allergens were 23, 32, 36, 39 and 47 kDa proteins. The banana skin-prick test was positive in 14 of 18 (78%) latex-allergic patients studied and banana RAST in 12 of 14 patient sera tested. Fourteen of 21 interviewed patients reported symptoms from eating or handling bananas. In immunoblot inhibition studies a dose-dependent inhibition of IgE binding to banana extract with natural rubber latex proteins was observed in all five patient sera tested and, likewise, the binding of IgE to natural rubber latex extract was inhibited with banana proteins in four of the five patient sera. CONCLUSIONS: The present results confirm the existence of crossreacting allergens in natural rubber latex and banana and provide new information on the immunochemical nature and heterogeneity of these allergens.

Adult↗
PubMed1995

Efficacy and safety of hydrolyzed cow milk and amino acid-derived formulas in infants with cow milk allergy.

OBJECTIVE: To determine the antigenicity, nutritional adequacy, and growth-promoting efficacy of protein hydrolysate or amino acid-derived formulas in infants with cow milk allergy. STUDY DESIGN: Several protein hydrolysate or amino acid-derived formulas were graded for beta-lactoglobulin content and skin reactivity in 74 atopic children with cow milk allergy proved by a double-blind, placebo-controlled challenge. A randomized, prospective follow-up study of 9 months included 22 infants with a mean age of 6 months (95% confidence interval, 4 to 7), who were fed an extensively hydrolyzed whey formula (group We), and 23 infants with a mean age of 17 (95% confidence interval, 4 to 7) months, who were given an amino acid-derived formula (group AA). RESULTS: Both formulas were clinically and biochemically tolerated. The mean concentration of essential amino acids in plasma was lower in group We but higher in group AA compared with values for breast-fed control infants (p = 0.001). There was a different trend between the groups in weight (p = 0.09) and length (p = 0.006). Growth was promoted in group AA during the follow-up; it was constant during the first months, followed by a gradual decline in rate in group We. In both groups, atopic eczema improved significantly and progressively, and a downward trend was found in serum total and milk-specific IgE concentrations, proving the efficacy of both formulas. CONCLUSIONS: Extensively hydrolyzed formulas are safe and effective for most infants; an amino acid-derived formula may be preferable for infants with multiple food allergies, especially for the maintenance of normal growth.

Amino Acids↗
PubMed1995

Cross-reacting allergens in natural rubber latex and avocado.

BACKGROUND: An association between allergy to latex and avocado has been reported but the responsible cross-reacting allergens have not been identified or characterized. METHODS: Immunoblotting, immunoblot inhibition, and RAST inhibition methods were used to study cross-reactive proteins between natural rubber latex (NRL) and avocado. Sera from 18 patients with previously verified latex allergy were used as the source of IgE antibodies, and 11 of the patients underwent skin prick testing with fresh avocado. RESULTS: Fourteen of the 18 sera (78%) had IgE antibodies that bound to a total of 17 avocado proteins with apparent molecular weights ranging from 16 to 91 kd. Ten most strongly reacting sera were used for immunoblot inhibition studies. When NRL proteins were used as soluble inhibitors, binding of IgE antibodies to solid-phase avocado proteins was inhibited in a dose-dependent manner: 100 micrograms of NRL proteins inhibited IgE binding to 15 of the 17 avocado proteins, and 10 micrograms caused inhibition to 13 protein bands. Comparably, soluble avocado proteins were able to inhibit IgE binding to solid-phase NRL. Corresponding RAST inhibitions were performed with two patient sera; in both, avocado inhibited IgE binding to NRL and in one NRL proteins inhibited IgE binding to avocado. Skin prick test responses to fresh avocado were positive in seven of the 11 patients with latex allergy who were tested. CONCLUSIONS: The large number of inhibitable proteins in immunoblot experiments and clinical observations from skin prick tests suggest considerable immunologic cross-reactivity between NRL and avocado. The observed cross-reacting protein components may be responsible for the recently reported type I hypersensitivity reactions to NRL and avocado in patients with a preexisting allergy to either allergen.

Adolescent↗
PubMed1995

Prohevein from the rubber tree (Hevea brasiliensis) is a major latex allergen.

BACKGROUND: There is general agreement that proteins eluting from different natural rubber latex products can cause immediate type hypersensitivity reactions in latex-allergic patients. However, there is as yet no consensus as to what are the most important allergens in natural rubber latex. OBJECTIVE: We wanted to purify and characterize at the primary structure level three natural latex proteins, suggested to represent significant allergens. METHODS: Proteins were purified from ultracentrifuged bottom fraction of natural rubber latex using high performance liquid chromatography gel filtration and reversed phase chromatography. Purified proteins were subjected to tryptic cleavage, peptide separation and amino acid sequencing. Immunoblotting was used to demonstrate IgE antibodies to the purified proteins in sera from latex-allergic patients. RESULTS: A 20 kDa protein was identified by amino acid sequencing as prohevein, a major protein in the rubber tree Hevea brasiliensis, and a 30 kDa natural rubber latex protein as hevamine, another essential rubber tree protein. A third, previously undescribed natural rubber latex protein, showed high homology to several plant endo-1,3-beta-glucosidases. In immunoblotting, the purified prohevein bound IgE antibodies from 24/29 (83%) sera of latex-allergic patients including positive results in 4/6 latex-allergic children with spina bifida or other congenital anomalies. The purified prohevein elicited positive skin-prick test reactions in all six latex-allergic patients showing IgE to prohevein. The purified 36 kDa protein bound IgE from 6/29 (21%) latex-allergic sera, and the purified hevamine from only 1/29 patient sera. CONCLUSION: The observed high frequency of IgE antibodies to prohevein suggests that this protein is a major natural rubber latex allergen.

Adolescent↗
PubMed1995

Purification and partial amino acid sequencing of a 27-kD natural rubber allergen recognized by latex-allergic children with spina bifida.

We purified from natural rubber latex (NRL) by means of high-performance liquid chromatography a 27-kD protein, recognized characteristically by IgE in sera from latex-allergic children with spina bifida or other congenital anomalies and histories of multiple surgeries. N-terminal sequence analysis of the purified 27-kD protein was unsuccessful suggesting that its N-terminus is blocked. To obtain internal sequence information from the protein it was digested with trypsin and the purified tryptic peptides were subjected to sequence analysis. Thirteen of the 14 sequenced peptides revealed no significant homology to any of the published protein sequences indicating that the 27-kD protein is previously undescribed at the primary structure level. However, one of the 14 sequenced peptides showed significant homology to the rubber elongation factor, a 14.6-kD NRL protein. For the time being, the 27-kD NRL protein is the first molecularly characterized NRL allergen associated with defined clinical manifestations of latex allergy.

Adolescent↗
PubMed1994

IgE immune response to rubber proteins in adult patients with latex allergy.

In the present immunoblot study we examined IgE immune responses to natural rubber latex proteins in sera from 27 adult patients with latex allergy. We demonstrated at least 30 proteins in the rubber tree sap, of which 19 bound IgE antibodies in a heterogeneous manner in patient sera. Twenty-two of the 27 patient sera (81%) showed positive immunoblot test results. IgE antibodies in the patient sera bound most frequently to a 20 kd allergen, which was recognized by 17 of the 22 (77%) patient sera with positive immunoblot test results. These results suggest that a 20 kd rubber protein could be a major allergen in adult patients with latex allergy. Immunoblotting with a representative set of allergens as antigen would offer a sensitive, confirmatory in vitro test to demonstrate hypersensitivity to latex.

Adult↗
PubMed1994

Allergy to ingested cereals in atopic children.

Clinical features, hypersensitivity mechanisms, and differential diagnosis of cereal allergy or intolerance were investigated in children with atopic dermatitis (AD). On oral provocation, 18 children exhibited a positive response to wheat, three to rye, one to barley, and one to oats. Cereal-induced symptoms were dermatologic, gastrointestinal, or oropharyngeal, and their onset after provocation was immediate (eight cases), delayed (14 cases), or both immediate and delayed (one case). A combination of type I allergy tests (prick test, RAST, and histamine-release test) detected all immediate reactors and 9/14 delayed reactors. Of the five subjects remaining negative in these tests, three were positive in the patch or lymphocyte-proliferation tests. Subjects with cereal allergy or intolerance frequently possessed IgE, IgA, and IgG antibodies against gliadin, but only one of these children was HLA-DR3-positive, and none had reticulin antibodies typical of celiac disease. Combining tests of immediate and delayed hypersensitivity can confirm allergy to cereals in a more reliable way. The coexistence of cereal allergy and celiac disease seems to be rare.

Adolescent↗
PubMed1994

Allergy to natural rubber latex: a growing problem.

Immediate, IgE-mediated allergy to natural rubber latex has recently been found to be responsible for contact and generalized urticaria, protein contact dermatitis, rhinitis, asthma and even fatal anaphylactic reactions. The proteins present in latex from the rubber tree (Hevea brasiliensis) can still persist in rubber end-products where they are capable of sensitizing exposed users. Atopic people and those with hand eczema are prone to become sensitized by natural rubber latex, which often causes occupational problems in connection with the use of protective gloves. But people blowing up balloons and those using condoms are also at risk if their symptoms are misinterpreted. Severe adverse reactions caused by rubber products in medicare cannot be prevented if the diagnosis has not been made before operations and medical examinations. So the most important task today is to develop reliable and safe methods for diagnosing natural rubber latex allergy and to manufacture rubber products with fewer allergens.

Gloves, Protective↗
PubMed1994

Update on occupational natural rubber latex allergy.

Health care workers are a known risk group for occupational immediate type allergy to latex gloves, but users of household and other protective gloves have been less extensively studied. This article shows that non-health care workers form an even larger group with natural rubber latex allergy, which often is work related. Hand eczema and atopy are the most frequent risk factors for sensitization, therefore, dermatologists should be especially aware of the diagnostic methods and prevention.

Dermatitis, Allergic Contact↗
PubMed1994

Allergen and protein content of latex gloves.

BACKGROUND: Proteins eluting from surgical gloves and other medical rubber products elicit immediate local and systemic hypersensitivity reactions in latex-allergic subjects but detailed knowledge about the amount and allergenic potential of these proteins is scanty. OBJECTIVE: To protect latex-allergic people and to diminish the risk of sensitization, adequate methods are needed to measure and monitor the allergen content of surgical latex gloves. METHODS: Extracts of six surgical and one household latex glove brand were studied. Bradford and Lowry methods were used for total protein measurements. Sera from 17 latex-allergic patients were used as a source of latex IgE antibodies. Allergen content of extracts was studied in vitro by immunoblot, crossed radioimmunoelectrophoresis and immunospot methods, and in vivo by skin prick testing in 35 latex-allergic patients. RESULTS: The total protein concentration of the glove extracts varied from 3 to 337 micrograms/g glove. The Bradford method gave lower values than the Lowry method. Immunoblotting showed allergenic rubber proteins in four of the seven glove brands. Ten proteins in two surgical and six proteins in one household glove brand bound latex IgE antibodies in a heterogeneous manner. The results from crossed radioimmunoelectrophoresis and immunospot assays were mostly in line with immunoblotting findings. Extracts from five of the seven glove brands elicited positive prick tests; in all five also the presence of allergens could be shown by in vitro tests. Prick test reactivity and total protein concentration were not directly correlated. CONCLUSIONS: In vitro assays showed considerable variation in the total protein and allergen contents of different latex glove brands. The amount of protein eluting from the gloves did not always correlate with their allergenicity in skin prick tests indicating that total protein measurement is not a sufficient method to monitor the allergenic properties of latex gloves.

Allergens↗
PubMed1994

Latex allergy: frequent occurrence of IgE antibodies to a cluster of 11 latex proteins in patients with spina bifida and histories of anaphylaxis.

Proteins and allergens in natural rubber latex were characterized by a two-dimensional immunoblot method with serum samples from 17 patients with latex allergy of whom 10 had spina bifida and 7 were health care workers. We demonstrated in rubber tree sap approximately 240 polypeptides of which 57 bound immunoglobulin E (IgE) in patient serum samples. Forty-six of the 57 allergens were identified by patients with spina bifida, 19 of 57 allergens by health care workers, and 8 of 57 allergens by both patient groups. IgE antibodies from all 5 patients with spina bifida with histories of anaphylaxis bound three allergens with molecular weights of 27 kd and isoelectric points ranging from pH 4.6 to pH 4.8. Four of these 5 patients also identified a complex of eight other allergens with molecular weights ranging from 13 kd to 27 kd and isoelectric points from pH 4.4 to pH 5.6. This cluster of 11 allergens was identified by none of the 7 health care workers and by only 1 of 5 patients with spina bifida without demonstrable anaphylaxis. These preliminary findings indicate that patients with spina bifida in whom latex hypersensitivity has developed exhibit a strong anti-latex IgE immune response, which seems to differ markedly from the immune response of health care workers with latex allergy. The characteristic anti-latex IgE profile in patients with spina bifida and with a history of an anaphylactic reaction may be valuable in the evaluation of pathogenetic processes in latex allergy.

Adolescent↗
PubMed1993

Immunoglobulin E reactivity to latex antigens in the sera of patients from Finland and the United States.

BACKGROUND: Patients with latex sensitivity and latex antigens from the United States and Finland, two countries where allergic reactions to latex have been widely reported, were evaluated to determine the spectrum of immune responses. METHODS: Sera from 27 patients from Finland and 18 from the United States with latex allergy and control sera from nonsensitive individuals were studied for latex-specific IgE antibodies. Four antigen preparations were used: two extracted from gloves and one each extracted from rubber tree sap from Malaysia and India. All 45 patients had skin prick test results that were positive to latex antigens, and all sera were evaluated by enzyme-linked immunosorbent assay (ELISA) with the various antigens. RESULTS: There were considerable differences in the reactivity of patient sera with the different antigens. Only 50% of the sera from patients with latex allergy from Finland demonstrated significant levels of IgE to latex as determined by enzyme-linked immunosorbent assay. These patients showed more reactivity with rubber tree sap antigens than with glove antigens. However, 72% of the patients from the United States demonstrated antibodies to latex, and no marked differences were noted between the antigen extracts. CONCLUSIONS: The results indicate that reagents such as rubber tree sap, which contain multiple clinically significant antigenic components, should be included in evaluation of latex allergy and that differences in patient populations may result in serologic variances.

Adult↗
PubMed1993

Toxicity and immediate allergenicity of latex gloves.

Surgical latex gloves and a natural rubber latex (NRL) catheter were evaluated for biocompatibility by cell culture methods and Type I allergic reactions in operating room personnel using latex gloves. The prevalence of relevant immediate allergy to NRL was 5.2% when using eluates made from different latex gloves as allergens and the skin-prick test methodology. The reliability of a questionnaire in detecting the sensitized persons was limited. Weak positive skin test reactions to surgical latex glove eluates were found to be unreliable as compared with challenging with the corresponding glove. Latex gloves exhibited more toxicity in cell culture than non latex gloves, but, inversely, the toxic catheter gave weak positive skin-prick test reaction in only one sensitized person, confirming that the allergenicity and toxicity of natural rubber products do not refer to the same properties of the products. Catheters exhibiting toxicity in cell culture have earlier been found to cause significant clinical symptoms in operated patients, but in the case of surgical gloves this relationship is not clear. One glove brand with a low content of known sensitizing rubber chemicals caused clear toxicity in cell culture but was well tolerated by the hospital personnel.

Allergens↗
PubMed1993

IgE reactivity to 14-kD and 27-kD natural rubber proteins in latex-allergic children with spina bifida and other congenital anomalies.

We examined by immunoblotting sera from 39 latex-allergic patients, 19 from USA and 20 from Finland, including 15 children with spina bifida and 5 children with other congenital anomalies, for IgE antibodies to natural rubber latex (latex) antigens. IgE antibodies in 10 of the 12 (83%) US spina bifida patients and in 2 of the 3 Finnish spina bifida patients recognized a previously undescribed 27-kD antigen which, together with a 14- and a 20-kD peptide, appeared to be a major latex allergen. Two patients with other congenital anomalies, one from the US and one from Finland, also demonstrated anti-27-kD bands. IgE antibodies to the 27-kD antigen were not detected in other latex-allergic patients from the US or Finland although most of them showed IgE binding to 14- and/or 20-kD latex antigens. All 21 controls, including 3 spina bifida patients with no evidence of latex allergy, gave negative immunoblot results. This observation suggests that patients with spina bifida or other congenital anomalies who have been subject to multiple operations and other invasive therapeutic procedures may have been exposed to different antigenic source materials than other latex-allergic patients.

Adolescent↗