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Biomedical subjects

M H Lessof

Publications and source records attributed to M H Lessof.

At least 37 records · Page 2Linked to original sources

The generation and cellular distribution of leukotriene C4 in human eosinophils stimulated by unopsonized zymosan and glucan particles.

Human eosinophils (EOSs) stimulated under optimal conditions with 5 X 10(8) unopsonized zymosan particles at 37 degrees C for 30 minutes produced an average total immunoreactive leukotriene (LT) C4 of 1.6 ng per 10(6) EOSs, and 30% to 60% of the generated product remained cell associated. The dose-response characteristics of zymosan-induced LTC4 generation were different from those of phagocytosis, suggesting that the two events were independent. Pretreatment of EOSs with 10(-8) mol/L of formyl-methionyl-leucyl-phenylalanine for 30 minutes led to a twofold to fivefold augmentation of LTC4 generation by cells subsequently activated by unopsonized zymosan. Optimal EOS activation with 1 mumol/L of the calcium ionophore A23187 at 37 degrees C for 15 minutes produced more than 100 times greater quantities of LTC4 than with zymosan. The amount of immunoreactive LTC4 that remained cell associated after calcium ionophore A23187 stimulation reached a maximum after 5 minutes and then declined. Of the relatively small amount generated in the first minute, 71% was cell associated, but this figure declined to 9% after 15 minutes, by which time there had been a redistribution of the LTC4 to the supernatant. Inflammatory leukocytes may respond to zymosan because the cells recognize either one or both of its major polysaccharide components, glucan and mannan. Glucan, but not mannan, stimulated EOSs to generate LTC4 in a dose- and time-dependent manner. Under optimal conditions, there was no significant difference in the total quantities of LTC4 elaborated by EOSs stimulated by glucan and by unopsonized zymosan. This suggests that zymosan may induce leukotriene generation in the human EOS through a glucan recognition mechanism.

Calcimycin

IgE and IgG antibody response to purified bee-venom antigens and peptides in four patients who had adverse reactions to immunotherapy.

The immunological response to individual bee-venom allergens was studied in blood samples collected at frequent intervals from four bee-venom allergic patients who had suffered systemic allergic reactions to injections of bee venom during immunotherapy. All had high IgE antibody levels, at the upper end of the range found in bee-sting allergic patients, and all had antibodies to the minor allergens at the time of the reactions. These did not, however, provide a simple explanation for the reactions that occurred. We were able to observe two interesting phenomena--in one patient IgE antibodies to the individual venom antigens appeared to be 'switched off' sequentially. In another, IgE antibodies to hyaluronidase rose substantially after 4 years of therapy. We believe that these results provide evidence to support the view that the regulation of IgE antibodies is controlled by mechanisms that are both isotype- and antigen-specific.

Acid Phosphatase

Clinical reactions to food.

Sensational claims have been made about allergy to food and food additives, to the point where the predominant reaction in the medical profession has been one of scepticism. Nevertheless, some patients experience severe reactions caused by foods, for which they may find it difficult to obtain treatment through the National Health Service. This is a subject which needs to be reappraised.

Food Additives

Allergy testing.

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Animals

How reliable are commercial allergy tests?

The ability to diagnose allergic disease was studied in 9 fish-allergic and 9 control subjects, who provided specimens of blood and hair for testing. All fish-allergic subjects had previously been shown at Guy's Hospital to have a positive skin prick test to fish. The specimens were submitted as coded, duplicate samples to five laboratories which all offer a commercial service in carrying out diagnostic tests for allergy. All five laboratories were not only unable to diagnose fish allergy but also reported many allergies in apparently non-allergic subjects and provided inconsistent results on duplicate samples from the same subject.

Adult

Plasma esterase activity in patients with aspirin-sensitive asthma or urticaria.

Plasma aspirin esterase activity and cholinesterase activity were reduced in patients with aspirin sensitive asthma and aspirin sensitive urticaria compared to asthmatic and dermatological controls. Phenylacetate (non specific) esterase activities, were however unaltered in these patients. The reason for the lower activity is uncertain but it does not appear to be due to genetically determined lower cholinesterase or due to the avoidance of aspirin by sensitive patients. A low aspirin esterase activity may be a contributory factor in precipitating these aspirin sensitive reactions.

Aspirin

Oral allergy syndrome (OAS): symptoms of IgE-mediated hypersensitivity to foods.

Eighty highly atopic patients were selected for study because they had either atopic eczema (fifty cases) or atopic reactivity to foods, as judged by a positive skin-prick test (thirty cases). In all, sixty-five out of eighty subjects (81%) described symptoms of some kind provoked by foods, but correspondingly positive skin tests were found in only half of these, thirty-three out of eighty (41%). The symptoms experienced by thirty-one of the thirty-three patients with positive skin tests were immediate in onset (within 1 hr) and were at first confined to the upper gastrointestinal tract, the most frequent symptoms being oral irritation and throat tightness. In a proportion of these patients, further symptoms such as urticaria, asthma or anaphylaxis developed following the initial oral symptoms, which suggested the term 'oral allergy syndrome'. In the absence of the oral allergy, symptoms such as asthma, urticaria, migraine or eczema starting later than 1 hr after food were seldom associated with positive skin tests. In the oral allergy syndrome, the characteristic symptoms (strong association with positive skin tests and RAST, time of onset and sites at which symptoms are expressed) suggest a causative relationship between exposure to food antigens and specific IgE-induced release of mediators. In cases of food intolerance that lack a characteristic symptom pattern and a positive skin test or radio-allergo-sorbent test, it seems appropriate to consider non-IgE-mediated causes.

Adolescent

The relationship between total serum IgE and castor-bean-specific IgE antibodies in castor-bean-sensitive patients from Marseilles.

The relationship between serum IgE and castor bean (Ricinus communis)-specific IgE was studied in a group of dockworkers and other residents of Marseilles who were diagnosed as having castor bean allergy. The diagnosis was made because they had asthma or other allergic symptoms together with a positive skin test to castor bean. Total serum IgE was found to be higher in castor-bean-allergic patients (mean = 174 IU/ml) than in a control group of local blood donors (mean = 66 IU/ml). IgE levels were not as high as those found in the sera of a previously identified group of castor-bean-allergic dockworkers from Port Sudan (mean = 902 IU/ml). Castor-bean-specific IgE was demonstrated in the serum of 91% of the allergic group and there was some correlation with total IgE (r = 0.53, p less than 0.01). The proportion of IgE antibody specific for castor bean was determined in 20 castor-bean-sensitive patients using the radioallergosorbent test and was found to vary between 9 and 64% (mean = 38% or 265 ng/ml). No castor-bean-specific IgE antibody was detected in the control group.

Ricinus communis

Plasma level of histamine in aspirin-sensitive urticaria.

Twelve patients with a history of aspirin-induced urticaria and/or angioedema were studied before and after the provocation of symptoms with aspirin. The resting plasma histamine levels in these patients (0.95 +/- 0.25 ng/mL) were significantly higher than in 30 control subjects (0.21 +/- 0.02 ng/mL) (P less than .0005) and nine patients with non-aspirin-sensitive urticaria (0.27 +/- 0.06 ng/mL) (P less than .01). The plasma histamine levels fell significantly at the time of adverse reactions to aspirin (P less than .01). The high resting histamine levels, like the high venous prostaglandin F2 alpha levels that we have previously reported in the same group of patients and the high plasma histamine levels we have found in aspirin-sensitive asthmatics suggest an abnormality of mediator release in aspirin-sensitive patients.

Adult

Immune response to bee venom. II. Quantitation of the absolute amounts of IgE and IgG antibodies by saturation analysis.

We have measured in allergic and non-allergic beekeepers IgE and IgG antibodies to the bee venom allergens, phospholipase A2 (PLA2) and hyaluronidase (HYAL), by the radioallergosorbent test (RAST) and a 125I-radiolabelled antigen-binding assay. The absolute amount of IgG antibody in a reference serum was determined by saturation analysis using 125I-radiolabelled PLA2 and HYAL. Using monoclonal anti-IgE coated microtitre plates, the absolute amount of IgE antibody to the same antigen was also determined by saturation analysis. Regardless of the IgE response to the different allergens, IgG antibody concentrations to PLA2 were invariably higher than those to HYAL. In addition, the ratio of IgG to IgE antibody was higher for PLA2 (220:1) than for HYAL (10:1). Higher levels of IgG antibody to both allergens (especially HYAL) were found in those who had had prolonged exposure to bee stings. These data suggest that the level of IgG antibody produced is related to the dose administered, while the amount of IgE antibody may be regulated by other factors.

Antibody Specificity

Histamine release from peripheral blood leucocytes in egg-allergic patients.

Twelve egg-allergic patients were selected on the basis of a clinical history of egg allergy and a positive skin-prick test (SPT) to whole egg. A study was then carried out on the ability of the patients' washed leucocytes to release histamine in the presence of whole egg, ovomucoid, ovalbumin and ovotransferrin. Histamine release (HR) from washed leucocytes was demonstrated in ten out of twelve patients, but only four out of ten released over 40% of their total histamine. Spontaneous HR ranged from 2.1-14.5% with a mean of 7.5%. There was good agreement between positive and negative HR, skin test and radioallergosorbent test (RAST) results. Concordance between the HR and skin test was found in 83%, HR and RAST in 71% and skin test and RAST in 78% of patients. However there was poor quantitative agreement between these three tests. When skin-prick tests and HR thresholds were compared, ovomucoid elicited the greatest skin test sensitivity in five out of six patients, whereas five of the same six were more sensitive to ovalbumin when judged by HR.

Adolescent

Sub-class of IgG in allergic disease. I. IgG sub-class antibodies in immediate and non-immediate food allergy.

Previous studies have suggested that, apart from IgE-mediated reactions, some of the symptoms of food allergy may be caused by IgG antibodies to food proteins. This study was carried out to see if there were any distinctive features of the IgG sub-class antibody response to dietary antigens which occurs in food allergic patients. IgG sub-class antibodies were measured using a quantitative enzyme-linked immuno-sorbent assay (ELISA) to wheat gliadin, ovalbumin and bovine casein in twenty patients who had coeliac disease and in twenty-eight egg allergic patients. These were compared with twenty-one atopic dermatitis patients who did not have food allergy and twenty-six healthy control subjects. Coeliac disease patients tended to have raised IgG antibody levels (especially IgG1) to all three antigens but these overlapped considerably with that seen in egg allergic and atopic dermatitis patients. Coeliacs who avoided gluten had anti-gliadin antibody levels which did not differ from those seen in healthy subjects but nevertheless had raised anti-ovalbumin and casein-specific antibodies. The IgG antibody was largely restricted to IgG1 and IgG4 sub-class although the relative amount of each varied with the antigen. Although gliadin-specific antibodies were mainly IgG1, ovalbumin-specific antibodies were mainly IgG4. The increased antibody levels to all three antigens in coeliacs were caused by a raised IgG1 response, IgG4 antibodies were usually normal. Egg allergic patients also had raised IgG1 but not IgG4 antibodies to ovalbumin. These data show that the response to different dietary antigens can vary with the antigen. The fact that IgG1 and not IgG4 antibodies were raised to all three antigens in patients with coeliac disease suggests that they are a secondary consequence of the disease, perhaps reflecting increased transport of antigens across a damaged gut mucosa rather than a specific immunopathological reaction. However, the observation that antibodies to gliadin, and not ovalbumin or casein, fell following gluten avoidance shows that the response to gliadin, at least, is dependent upon continued exposure to antigen.

Adult

Food intolerance.

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Aldehyde Dehydrogenase