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Biomedical subjects

R E Reisman

Publications and source records attributed to R E Reisman.

At least 19 recordsLinked to original sources
PubMed1992

Venom immunotherapy: 10 years of experience with administration of single venoms and 50 micrograms maintenance doses.

For the past 10 years, we have administered venom immunotherapy with single venoms, whenever it is possible, and maintenance doses of 50 micrograms. The choice of venoms was based on clinical history, skin test reactions, and a knowledge of venom cross-reactivity. There have been 258 re-stings in 108 patients with only three systemic reactions (2.7% per patient; 1.2% per sting). Two of these re-stings reactions were very mild, hives and facial edema, in patients who had had initial severe anaphylaxis. Five other patients had transient ill-defined symptoms, not considered allergic after re-stings. The patients covered a wide age range. Twenty-seven patients, nine under age 16 years, had initial dermal reactions only, and 44 patients had severe anaphylaxis. Most patients had multiple positive skin tests. Seventy-five patients received single venoms (yellow jacket, 58; honeybee, 15; hornet, 2), and 30 patients received two venoms. Re-stings occurred from 1 month to 8 years, (mean, 2 years) after starting treatment. Results indicate that this approach with 50 micrograms top doses and single venom immunotherapy may be sufficient in most patients with an associated decrease in the cost as well as possible increased morbidity associated with the use of multiple venom antigens.

Adolescent↗
PubMed1992

Stinging insect allergy.

Insect sting anaphylaxis is a relatively common problem estimated to affect at least 0.4% of the population and is responsible for at least 40 deaths per year in the United States. The allergic reactions are mediated by IgE antibodies directed at constituents in honeybee, yellow jacket, hornet, and wasp venoms. In addition, increasing numbers of reactions occur from fire ant stings, non-winged Hymenoptera present in the Southeastern United States. The anaphylactic symptoms are typical of those occurring from any cause. Most reactions in children are mild, frequently involving dermal manifestations (hives, edema) only. The more severe reactions, such as shock and loss of consciousness, can occur at any age but are relatively more common in adults. Following sting anaphylaxis, approximately 50% of unselected patients will continue to have allergic reactions to subsequent stings. The natural history of the disease process is influenced by the severity of the anaphylactic symptoms. Children with dermal reactions only have a benign course and are unlikely to have recurrent reactions. Patients with more severe reactions are at risk for repeat anaphylaxis. Patients with a history of insect sting anaphylaxis and positive venom skin tests should have epinephrine available and are candidates for subsequent venom immunotherapy, which provides almost 100% protection against subsequent re-sting reactions. Recommendations for the duration of immunotherapy are evolving. Venom therapy can be stopped if skin test reactions become negative. For most patients, 3 years of therapy appears adequate, despite persistence of positive venom skin tests.

Animals↗
PubMed1992

Natural history of insect sting allergy: relationship of severity of symptoms of initial sting anaphylaxis to re-sting reactions.

To examine the postulate that the nature of the symptoms of initial insect sting anaphylaxis is related to the risk and severity of subsequent sting reactions, the results of field re-stings were analyzed in 220 patients who had had venom anaphylaxis and did not receive venom immunotherapy. The incidence of a reaction after the first re-sting was 56% in the total group, was more frequent in adults (74%) than in children (40%), and was unrelated to the time interval since the initial sting reaction. When re-sting reactions did occur, the nature of the symptoms was similar to the symptoms of the initial sting reaction. Reactions to repeated re-stings tended to be similar. Overall, more severe reactions to re-stings occurred eventually in 24 patients. These observations confirm the frequent self-limiting course of insect sting allergy, especially in children, and the repetitive nature of specific anaphylactic symptoms, and the observations thus suggest that patients with mild to moderate anaphylactic symptoms probably do not require venom immunotherapy.

Adolescent↗
PubMed1979

Immunologic and biochemical evaluation of the potency of whole insect body extracts.

Recent studies have indicated that currently available whole body extracts have little potency and are ineffective for diagnosis and treatment of stinging insect allergy. Pure venom is a potent effective allergen but is difficult to obtain in sufficient quantities from all Hymenoptera species. In these studies, an attempt was made to prepare a potent whole body extract. Whole bee body extracts were prepared with different extraction periods and at cold and room temperatures. Potency was examined biochemically by measurements of phospholipase A (PLA) activity and immunologically by PLA and bee venom radioallergosorbent test (RAST) inhibition experiments and gel diffusion studies with the use of rabbit antisera. All extracts prepared in the laboratory had some potency, indicating that it is possible to make a whole body extract containing small quantities of PLA or bee venom. However, the potency of these extracts was minimal as compared with bee venom. Three commercial extracts were almost devoid of detectable immunologic activity. While further attempts may be made to prepare a potent whole body insect extract, these results suggest that it is necessary to obtain venom in relatively pure form for the diagnosis and treatment of stinging insect allergy.

Animals↗
PubMed1979

Sensitization to nonvenom contaminants in a venom preparation.

An individual is described who appeared to be sensitive to nonvenom contaminants in a venom preparation. His IgE antibodies, measured by the immediate direct skin test and the radioallergosorbent test (RAST), reacted with a yellow jacket venom preparation obtained by "washing" of venom sacs. With yellow jacket venom obtained by electriral stimulation, there was a skin test reaction of equivocal significance and no serum antibodies were detected by the RAST. Moderate reactions were also found with yellow jacket body extracts. In contrast, sera obtained from patients with yellow jacket sting anaphylaxis showed strong reactions with the electrically stimulated venom preparation and only a few reacted with the body extract. In additional studies, the patient's serum reacted with yellow jacket extracts devoid of venom and a variety of hornet and wasp extracts. Analyses of the two yellow jacket venoms by gel diffusion using rabbit antisera showed the presence of body proteins in the venom obtained by venom sac "washing." Subsequent history revealed the presence of insect nests in the roof of the patient's bedroom, perhaps the source of inhalant exposure and sensitivity. This case history demonstrates the need for venom extracts that do not contain potentially sensitizing extraneous material.

Adolescent↗
PubMed1978

A solid-phase radioimmunoassay for detection of human antibodies. I. Measurement of IgG antibody to bee venom antigens.

A solid-phase radioimmunoassay (SPRA) has been developed to measure IgG antibodies to bee venom (BV) and phospholipiase A2 (PLA) in human sera. The principle of the test is similar to that of the radioallergosorbent test (RAST) measuring IgE antibody. Cyanogen-bromide-activated paper discs coupled with BV or PLA followed by supplementary coupling with human serum albumin were incubated with standard or test sera, washed, and incubated with 125I-labeled anti IgG. The serum levels of the IgG antibody have been temporarily expressed in arbitrary units. the reaction between the antigen and antibody was specific and the results were reproducible. Sera from 19 beekeepers, 42 beesting-sensitive patients and 20 blood donors (controls) were assayed by the SPRA. IgG antibodies to BV and PLA could not be detected (less than 4 U/ml) in all control sera, in 25 of the 42 patients and in one beekeeper. The IgG antibodies in 17 patients ranged between 5 to 58 U/ml (mean 7.6 U/ml), and in the 18 beekeepers ranged between 8 to 160 U/ml (mean 59 U/ml).

Animals↗
PubMed1978

Plasma prostaglandin concentrations in allergic bronchial asthma.

Prostaglandin (PG) E plasma levels, measured by radioimmunoassay using anti-PGB1 antibody, were higher in asthmatic patients than in normal subjects. PGF levels measured with anti-PGF2alpha antibody, were not significantly different between normals and asthmatics. Plasma PGE/F ratios were elevated in the asthmatic patients. The results fail to support the hypothesis of decreased PGE or increased PGF production as an etiological factor in asthma.

Adolescent↗
PubMed1977

Prostaglandin E in the secretions of allergic rhinitis.

Prostaglandin (PG) was extracted from nasal secretions of individuals with hay fever and from nasal washings of normal subjects. The extract was chromatographed in a silicic acid column and the purified PGE fraction was converted to PGB by alkaline dehydration. The PGB was then measured by a competitive radioimmunoassay with tritiated PGB1 and anti-PGB1 antibody, employing the double antibody technique. PGE was detected in the secretions of 6 of 12 hay fever patients and in the pooled normal nasal washings.

Adolescent↗
PubMed1977

Unusual reactions following insect stings. Clinical features and immunologic analysis.

Fifteen patients were studied who had unusual reactions following insect stings. These included serum sickness, neurologic disease, renal disease, and delayed hypersensitivity-type reactions. The clinical features are briefly outlined. Measurements were made of serum venom-specific IgE and IgG antibodies. These antibodies were present in some patients and in these instances suggested an immunologic pathogenesis for the reactions. Alternative etiologies for the unusual reactions are also discussed.

Acute Kidney Injury↗
PubMed1977

Clinical application of measurements of serum level of bee venom-specific IgE and IgG.

Bee venom--specific IgE and IgG antibodies were measured in the serum of beekeeepers, bee-allergic persons, and normal persons infrequently stung without adverse effects. Beekeepers, who are stung frequently and relatively "immune" to bee stings, are characterized by high serum levels of IgG- and low serum levels of IgE-specific antibodies. Bee-allergic individuals have high titers of bee venom--specific IgG. Following a bee sting, allergic individuals develop a rising titer of IgE antibodies, accompanied occasionally by a rise in IgG antibodies. Therapy with whole bee body extracts fail to effect IgE or IgG antibody titers. During the course of venom immunotherapy IgG-specific antibodies are stimulated and IgE-specific antibodies continue to decline. These observations suggest that: (1) bee sting allergy is a function of bee venom--specific IgE; (2) bee sting immunity is a function of bee venom--specific IgG; and (3) bee venom is an appropriate therapeutic antigen.

Antibodies↗
PubMed1977

Treatment of ragweed hay fever with intranasally administered disodium cromoglycate.

In a double-blind study the therapeutic effect of a 4% disodium cromoglycate (DSCG) nasal solution was evaluated in thirty-nine patients with acute symptoms of ragweed hay fever. Patients were randomly assigned to the DSCG or placebo group as they presented with allergic rhinitis. Overall, the DSCG was not more effective than placebo in controlling the symptoms of rhinitis or in decreasing the need for concomitant antihistamines or corticosteroids. Among patients with the highest pretreatment serum ragweed-specific IgE (RW IgE) levels, drug-treated patients had some reduction in symptoms as compared to their placebo controls during the peak of the ragweed pollen season. DSCG treatment did not influence the usual seasonal rise in RW IgE. Side effects from both the active and placebo aerosols were frequent but mild. We conclude that DSCG nasal solution used for the treatment of seasonal ragweed allergic rhinitis is relatively ineffective.

Administration, Intranasal↗