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Biomedical subjects

M D Valentine

Publications and source records attributed to M D Valentine.

At least 55 records · Page 3Linked to original sources
PubMed1978

A controlled trial of immunotherapy in insect hypersensitivity.

Insect hypersensitivity is currently treated by immunization using whole-body extracts. We compared this regimen with immunotherapy using insect venoms or placebo in groups of 20 patients matched for history and sensitivity, as judged by venom skin test, histamine release and IgE antibody to venom. After six to 10 weeks of immunization, systemic reactions to stings occurred in seven of 12, seven of 11, and one of 18 patients treated with placebo, whole-body extract, and venom, respectively. Placebo and whole-body extract gave similar results and were significantly less effective than venom immunotherapy (P less than 0.01). The 14 patients with failure of treatment with whole-body extract and placebo were subsequently provided with venom immunotherapy; one reacted to a subsequent sting. We conclude that venom immunotherapy is clinically superior to therapy on whole-body extract or placebo.

Anaphylaxis↗
PubMed1978

Sensitization following Hymenoptera whole body extract therapy.

Treatment of an insect-sensitive patient with Hymenoptera whole body extracts (WBE) led, on five occasions, to a serum sickness--like syndrome which did not recur after therapy was stopped. The patient was found to be sensitive by skin test, histamine release, and radioallergosorbent test (RAST) to both venom and WBE as well as to venomless bee body preparations. Subsequent therapy with honeybee and yellow jacket venoms was without sequelae, and after treatment the patient did not react to a sting. In order to assess the frequency of sensitivity to irrelevant body proteins in patients treated with WBE we carried out WBE RASTs on sera from 15 such patients and compared them with those from 15 nontreated insect-allergic patients who had similar venom-specific IgE antibody levels. None of the patients allergic to insects who had not been treated with WBE had detectable IgE anti-WBE antibodies, while about 50% of those treated with WBE had developed IgE antibodies against these proteins. It appears that sensitization to nonvenom WBE proteins in terms of the development of IgE antibody is a common result of this therapy, and, rarely, repeated challenge with this complex antigenic mixture can also lead to clinical illness.

Adolescent↗
PubMed1978

Allergy to insect stings. IV. Diagnosis by radioallergosorbent test (R.A.S.T.).

Radioallergosorbent tests (RAST(s)) have been developed and assessed for the diagnosis of insect hypersensitivity by using a purified allergen from honeybee venom, phospholipase A, and crude yellow jacket venom. Sera from 193 patients positive both by history and skin test to one of these insects were compared with various groups of control sera. Eighty percent of sera from skin test-positive patients were RAST positive; positive RAST were found in 16% of sera tested from skin test-negative patients. A highly positive RAST correlates well with a positive skin test and clinical sensitivity, but serum IgE is not measurable in many patients with mast cell or basophil bound antibody. Since biologically important reactions of antigen with IgE require that the antibody be cell bound, skin testing would be preferred to RAST if one were limited to a single test for the diagnosis of insect allergy.

Animals↗
PubMed1978

Immediate (IgE-mediated) skin testing in the diagnosis of allergic disease.

Immediate (IgE-mediated) skin tests are widely used in the diagnosis of allergic diseases. Skin tests correlate well with more specialized studies (RAST, histamine release and provocation tests) in the diagnosis of allergic disease. Lack of standardization and quantitation of biologic potency of allergens make critical comparison of skin test results impossible. A survey of practicing allergists yielded widely divergent opinions concerning the effect of anti-allergic drugs on skin tests. The results of published studies indicate that only antihistamines cause significant depression of skin reactivity. Therefore, therapy for asthma may be continued while diagnostic skin testing is in progress, avoiding the possible morbidity associated with discontinuing pharmacologic therapy.

Adrenergic beta-Agonists↗
PubMed1977

Diagnosis of Hymenoptera hypersensitivity by skin testing with Hymenoptera venoms.

This double-blind study provides evidence that skin testing with dialyzed Hymenoptera venoms is a more accurate, reliable method of diagnosing hypersensitivity to the sting of honeybee, yellow jacket, yellow hornet, white-faced hornet, and wasp than is skin testing with the corresponding whole body diagnostic allergenic extract. Furthermore, the incidence of false-positives was greatly reduced by using the dialyzed Hymenoptera venom (HDV) diagnosis. In this clinical trial, most sensitive individuals had skin test reactions greater than the diluent control at concentrations of 1 mug/ml or below. Levels of venom diagnostic of 100 mug/ml appeared to produce nonspecific local irritation. Skin test with whole body diagnostic allergenic extract did not produce a consistent differentiation between sensitive and nonsensitive individuals. No untoward reactions were seen using the dialyzed Hymenoptera venom (HDV) diagnostic.

Animals↗
PubMed1976

Allergy to insect sting. III. Allergenic cross-reactivity among the vespid venoms.

Recent reports have indicated that venoms may be more beneficial than whole body extracts for the diagnosis and treatment of Hymenoptera sensitive patients. These studies were undertaken to determine the cross-reactivity among the vespid venoms. Eighteen patients who were anaphylactically sensitive to vespid venoms were studied using in vitro leukocyte histamine release. The results (venom concentration for 50% histamine release) were analyzed by linear regression analysis; there was no allergenic cross-reactivity between any of the venoms, except for a modest association between yellow hornet and white hornet venom. In spite of this result 13 of the 18 patients studied were sensitive to three or four of the venoms tested. There is no clear explanation for this observation, but it suggests the existence of multiple major allergens in the vespid venoms, some of which are cross-reactive. Since immunotherapy with inappropriate proteins may lead to the development of IgE and the possibility of clinical sensitivity and since the majority of patients were not sensitive to all venom preparations, we suggest that appropriate diagnostic studies be carried out before the institution of therapy.

Animals↗
PubMed1976

Diagnosis of allergy to stinging insects by skin testing with Hymenoptera venoms.

SKin testing was done on 30 patients with a history of anaphylactic reactions after a Hymenoptera sting and on 30 control subjects. The patients all had positive basophilhistamine release to one or more venoms on challenge with the specific venoms used for skin testing (honey bee, yellow jacket, white-faced hornet, yellow hornet, and Polistes). At 0.1 mug of venom/ml and at 1.0 mug of venom/ml, 75% and 100%, respectively, of the sensitive patients had a positive skin test. There was a significant (P less than 0.001) correlation between skin test and histamine release results. Of the 150 skin tests in control patients, only 1 was positive. Venom skin tests provide, for the first time, a simple, readily available technique to accurately diagnose allergy to stinging insects.

Clinical Trials as Topic↗
PubMed1976

Measurement of IgG-blocking antibodies: development and application of a radioimmunoassay.

A radioimmunoassay for measuring blocking antibodies has been developed. We used the ragweed antigen E system to show that the same blocking antibodies (IgG) measured by inhibition of antigen-induced leukocyte histamine release were precipitated in the binding assay (r8 = 0.96, p less than 0.001), thus validating a widely applicable technique for measuring blocking antibodies. Binding of phospholipase-A (Phos-A), the major allergen in honey bee venom, was also shown to correlate significantly with inhibition of histamine release. Hymenoptera (insect) hypersensitivity was used as a model to demonstrate application of the binding assay. Sera obtained from patients undergoing whole body extract therapy contained negligible amounts of specific blocking antibodies. Significantly higher blocking antibody titers to both whole honey bee venom and Phos-A were measured in sera drawn from patients immunized with whole venom. The use of the binding radioimmunoassay should facilitate management of allergic disease processes in which blocking antibodies are thought to be protective.

Antibodies↗